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See a sample rate comparisonCPT 28086 Fee Schedule
Last Verified: October 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.
Remove Covering Of Foot Tendon, Surgery To Remove Sheath (Covering) Of Tendon Located In Foot. The Procedure Is Done To Relieve Pain And Increase Joint Mobility.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 28086 |
| Medicaid Fee Schedule | View Medicaid rates for 28086 |
National average reimbursement for CPT 28086 by major payers:
$638.77
$717.83
$741.00
$605.71
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CPT 28086
5 of 25 sample ratesHigher to lower in this preview
East Mequon Surgery Center LLC
$7,081.00Published rateCarnegie Hill Endoscopy LLC
$2,003.00Published rateGeorgia Surgical Center On Peachtree, LLC
Georgia Surgical Center On Peachtree LLC
$1,376.00Published rateGpddc, LLC
$1,020.00Published rateJoshua Johnson
Deaconess Hospital Inc
$443.79Published rate
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See a sample payer proposalCPT 28086 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28086 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 28086 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 |
| 28022-CPT | Moderate | Arthrotomy Including Explorat, Arthrotomy Including Exploration Drainage Or Removal Ofloose Or Foreign Body Metatarsophalangealjoint Arthrotomy Including Exploration Drainag E Or Removal Of |
| 28086-CPT | Moderate | Remove Covering Of Foot Tendon, Surgery To Remove Sheath (Covering) Of Tendon Located In Foot. The Procedure Is Done To Relieve Pain And Increase Joint Mobility. |
| 28088-CPT | Moderate | Remove Covering Of Foot Tendon, Surgery To Remove Sheath (Covering) Of Tendon Located In Foot. The Procedure Is Done To Relieve Pain And Increase Joint Mobility. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28086. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28086 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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