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See a sample rate comparisonCPT 28090 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.
Excision Of Lesion Tendon Te, Excision Of Lesion Tendon Tendon Sheath Or Capsule(Including Synovectomy) (Eg Cyst Or Ganglion)Foot Excision Of Lesion Tendon Tendon Sheath Or Capsule
| 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 28090 |
| Medicaid Fee Schedule | View Medicaid rates for 28090 |
National average reimbursement for CPT 28090 by major payers:
$583.98
$612.98
$641.67
$523.20
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CPT 28090
5 of 25 sample ratesHigher to lower in this preview
Fairfax Surgical Center, L.P.
Fairfax Surgical Center Lp
$5,379.00Published rateThe Regents Of The University Of California, Ucla Dept Of Medicine
$2,044.00Published rateEndoscopy Center Of Knoxville Lp, The Endoscopy Center West
Endoscopy Center Of Knoxville Lp
$1,259.00Published rateSanta Monica Surgical Partners LLC, Surgery Center Of The Pacific
Santa Monica Surgical Partners LLC
$935.00Published ratePremier Surgery Center Of Santa Maria LLC
Premier Surgery Center Of Santa Maria, Inc.
$544.00Published rate
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See a sample payer proposalCPT 28090 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28090 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 28090 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 |
| 28090-CPT | Moderate | Excision Of Lesion Tendon Te, Excision Of Lesion Tendon Tendon Sheath Or Capsule(Including Synovectomy) (Eg Cyst Or Ganglion)Foot Excision Of Lesion Tendon Tendon Sheath Or Capsule |
| 28092-CPT | Moderate | Excision Of Lesion Tendon Te, Excision Of Lesion Tendon Tendon Sheath Or Capsule(Including Synovectomy) (Eg Cyst Or Ganglion)Toe(S) Each Excision Of Lesion Tendon Tendon Sheath Or Capsule |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28090. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28090 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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