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CPT 28052 Fee Schedule

Last Verified: December 2025

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.

Arthrot Metatarsophalan W Synov Bx
Key FactDetail
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 LevelModerate

National average reimbursement for CPT 28052 by major payers:

bcbs

$476.66

uhc

$574.30

aetna

$560.99

cigna

$675.46

Preview provider-level rates for...
For billing codeCPT 28052
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 28052

United
28052$1200.001821010638 - CATARACT AND LASER CENTER LLC522066053 - (DE) CATARACT AND LASER CENTER LLCDEAmbulatory Surgical Clinic/Center (261QA1903X)
United
28052$1490.001164007068 - SW HEALTH LP853293126 - (TX) SW HEALTH LPTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
28052$975.001417142084 - MID- AMERICA SURGERY CENTER, LLC204494200 - (MO) MID AMERICA SURGERY CENTER LLCMOAmbulatory Surgical Clinic/Center (261QA1903X)
United
28052$3150.001811995913 - DALLAS SURGICAL PARTNERS, LLC, BAYLOR SCOTT & WHITE SURGICARE752813815 - (TX) DALLAS SURGICAL PARTNERS LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
28052$1906.001588711162 - SEATTLE HAND SURGERY GROUP PC, SEATTLE HAND SURGERY UNIT, INC911652268 - (WA) SEATTLE HAND SURGERY GROUP, P.C.WAAmbulatory Surgical Clinic/Center (261QA1903X)
United
28052$789.641821155532 - LARRY CRICK350593390 - DEACONESS HOSPITAL INCKYPediatrics Physician (208000000X)
United
28052$4058.001710207998 - PROVIDENCE SURGERY CENTERS LLC, CREEKSIDE SURGICAL CENTER203567411 - (AK) PROVIDENCE SURGERY CENTERS LLC DBA CREEKSIDE SURGERY CENTERAKAmbulatory Surgical Clinic/Center (261QA1903X)
United
28052$5379.001659335438 - RESTON SURGERY CENTER, LP113654617 - (VA) RESTON SURGERY CENTER LPVAAmbulatory Surgical Clinic/Center (261QA1903X)
United
28052$591.001770753998 - SKIN CANCER TREATMENT CENTER, L.L.C.262051034 - (MD) SKIN CANCER TREATMENT CENTER LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
28052$2275.001124438684 - VANCOUVER DENTAL SURGERY CENTER910851599 - THE VANCOUVER CLINIC, INC., PSWAAmbulatory Surgical Clinic/Center (261QA1903X)
United
28052$2564.001336437482 - HEALTHONE RIDGE VIEW ENDOSCOPY CENTER, LLC, RIDGE VIEW ENDOSCOPY CENTER800688043COAmbulatory Surgical Clinic/Center (261QA1903X)
United
28052$998.001336366442 - CASTLE HILLS OUTPATIENT CENTER, INC., SURGICAL ARTS CENTER742931255 - (TX) CASTLE HILLS OUTPATIENT CENTER INCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
28052$2859.001821429978 - EL MIRADOR SURGERY CENTER LLC, EL MIRADOR SURGERY CENTER300798280 - (CA) EL MIRADOR SURGERY CENTER LLCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
28052$789.641972277929 - STJEPAN SURBEK350593390 - DEACONESS HOSPITAL INCILStudent in an Organized Health Care Education/Training Program (390200000X)
United
28052$1712.001518323435 - SOUTHTOWNS SURGERY CENTER LLC464742028 - (NY) SOUTHTOWNS SURGERY CENTER LLCNYAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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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.

CodeComplexityDescription
28020-CPTModerateArthrotomy,Explor/Drain/Remov F.B;Intert
28022-CPTModerateArthrotomy Metatarsophalangeal
28050-CPTModerateArthrotomy-Synovial Bx;Intertarsal/Tarso
28052-CPTModerateArthrot Metatarsophalan W Synov Bx

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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