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See a sample rate comparisonCPT 28052 Fee Schedule
Last Verified: September 2026
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.
Biopsy Of Joint In Foot, Surgery To Explore A Foot Joint. The Procedure Includes Removing A Tissue Sample For Testing (Biopsy).
| 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 |
| Medicare Fee Schedule | View Medicare rates for 28052 |
| Medicaid Fee Schedule | View Medicaid rates for 28052 |
National average reimbursement for CPT 28052 by major payers:
$476.66
$574.30
$560.99
$675.46
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CPT 28052
5 of 25 sample ratesHigher to lower in this preview
East Mequon Surgery Center LLC
$7,169.00Published rateVillages Endoscopy & Surgical Center LLC
$2,388.00Published rateSouthtowns Surgery Center LLC
$1,712.00Published rateAlta-Rose Surgery Center LLC
$1,060.00Published rateWarren Anderson
Deaconess Hospital Inc
$362.80Published rate
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See a sample payer proposalCPT 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.
| Code | Complexity | Description |
|---|---|---|
| 28020-CPT | Moderate | Arthrotomy Including Explorat, Arthrotomy Including Exploration Drainage Or Removal Ofloose Or Foreign Body Intertarsal Or Tarsometatarsal Joint Arthrotomy Including Exploration Drainage Or Removal Of |
| 28050-CPT | Moderate | Biopsy Of Joint In Foot, Surgery To Explore A Foot Joint. The Procedure Includes Removing A Tissue Sample For Testing (Biopsy). |
| 28052-CPT | Moderate | Biopsy Of Joint In Foot, Surgery To Explore A Foot Joint. The Procedure Includes Removing A Tissue Sample For Testing (Biopsy). |
| 28054-CPT | Moderate | Remove Toe Tissue Sample, Surgery To Explore A Toe Joint. The Procedure Removes A Sample Of Tissue For Testing (Biopsy). |
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.
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