CPT 28052 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | • 24 - Ambulatory Surgical Center • 21 - Inpatient Hospital |
| Common Modifiers | • None • RT - Right side of body • 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
National average reimbursement for CPT 28052 by major payers:

$476.66

$574.30

$560.99

$675.46
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 28052 | ||||||
United | 28052 | $1200.00 | 1821010638 - CATARACT AND LASER CENTER LLC | 522066053 - (DE) CATARACT AND LASER CENTER LLC | DE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28052 | $1490.00 | 1164007068 - SW HEALTH LP | 853293126 - (TX) SW HEALTH LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28052 | $975.00 | 1417142084 - MID- AMERICA SURGERY CENTER, LLC | 204494200 - (MO) MID AMERICA SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28052 | $3150.00 | 1811995913 - DALLAS SURGICAL PARTNERS, LLC, BAYLOR SCOTT & WHITE SURGICARE | 752813815 - (TX) DALLAS SURGICAL PARTNERS LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28052 | $1906.00 | 1588711162 - SEATTLE HAND SURGERY GROUP PC, SEATTLE HAND SURGERY UNIT, INC | 911652268 - (WA) SEATTLE HAND SURGERY GROUP, P.C. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28052 | $789.64 | 1821155532 - LARRY CRICK | 350593390 - DEACONESS HOSPITAL INC | KY | Pediatrics Physician (208000000X) |
United | 28052 | $4058.00 | 1710207998 - PROVIDENCE SURGERY CENTERS LLC, CREEKSIDE SURGICAL CENTER | 203567411 - (AK) PROVIDENCE SURGERY CENTERS LLC DBA CREEKSIDE SURGERY CENTER | AK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28052 | $5379.00 | 1659335438 - RESTON SURGERY CENTER, LP | 113654617 - (VA) RESTON SURGERY CENTER LP | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28052 | $591.00 | 1770753998 - SKIN CANCER TREATMENT CENTER, L.L.C. | 262051034 - (MD) SKIN CANCER TREATMENT CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28052 | $2275.00 | 1124438684 - VANCOUVER DENTAL SURGERY CENTER | 910851599 - THE VANCOUVER CLINIC, INC., PS | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28052 | $2564.00 | 1336437482 - HEALTHONE RIDGE VIEW ENDOSCOPY CENTER, LLC, RIDGE VIEW ENDOSCOPY CENTER | 800688043 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28052 | $998.00 | 1336366442 - CASTLE HILLS OUTPATIENT CENTER, INC., SURGICAL ARTS CENTER | 742931255 - (TX) CASTLE HILLS OUTPATIENT CENTER INC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28052 | $2859.00 | 1821429978 - EL MIRADOR SURGERY CENTER LLC, EL MIRADOR SURGERY CENTER | 300798280 - (CA) EL MIRADOR SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28052 | $789.64 | 1972277929 - STJEPAN SURBEK | 350593390 - DEACONESS HOSPITAL INC | IL | Student in an Organized Health Care Education/Training Program (390200000X) |
United | 28052 | $1712.00 | 1518323435 - SOUTHTOWNS SURGERY CENTER LLC | 464742028 - (NY) SOUTHTOWNS SURGERY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 28052 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28052 code is part of the Surgery services used for Surgical Procedures on the Musculoskeletal System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 28052 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28052. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28052 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 28052) and we'll show you how you compare in 15 minutes or less.
