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CPT 28092 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.

Exc Lesion Soft Tissue Toes
Key FactDetail
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

T5 - Right foot, great toe

T6 - Right foot, second digit

Complexity LevelModerate

National average reimbursement for CPT 28092 by major payers:

bcbs

$527.39

uhc

$555.52

aetna

$562.08

cigna

$692.53

Preview provider-level rates for...
For billing codeCPT 28092
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 28092

United
28092$935.001699780247 - CENTER FOR ORTHOPEDIC SURGERY, LLC203140907 - (CA) CENTER FOR ORTHOPEDIC SURGERY LLCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
28092$761.961821288499 - DURGA VEDATI350593390 - DEACONESS HOSPITAL INCTXFamily Medicine Physician (207Q00000X)
United
28092$926.001336138635 - EYE SURGICAL SPECIALISTS OF NEW JERSEY, SURGERY CENTER OF CENTRAL NEW JERSEY223411416 - (NJ) EYE SURGICAL SPECIALISTS OF NEW JERSEYNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
28092$1207.001235768490 - HENRY'S FORK SURGERY CENTER PLLC850508190 - (ID) HENRYS FORK SURGERY CENTER PLLCIDAmbulatory Surgical Clinic/Center (261QA1903X)
United
28092$2263.001477242154 - PLYMOUTH ORTHOPEDIC SURGERY CENTER LLC, PLYMOUTH ORTHOPEDIC SURGERY CENTER883632673 - (MN) PLYMOUTH ORTHOPEDIC SURGERY CENTER LLCMNAmbulatory Surgical Clinic/Center (261QA1903X)
United
28092$2100.001760923445 - DIALYSIS ACCESS CENTER A MEDICAL CORPORATION522384032CAAmbulatory Surgical Clinic/Center (261QA1903X)
United
28092$931.001740264811 - EYES OF YORK SURGICAL CENTER LLC200930310 - (PA) EYES OF YORK SURGICAL CENTER LLCPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
28092$650.001881875227 - SKIN & MOHS SURGERY CENTER, LLC431823843 - SKIN MOHS SURGERY CENTER LLCMOAmbulatory Surgical Clinic/Center (261QA1903X)
United
28092$544.001225245723 - FRESNO ENDOSCOPY CENTER770462622 - (CA) FRESNO ENDOSCOPY CENTERCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
28092$4181.001871033878 - REDMOND AMBULATORY SURGERY CENTER, LLC813558711 - (WA) REDMOND AMBULATORY SURGERY CENTER LLCWAAmbulatory Surgical Clinic/Center (261QA1903X)
United
28092$2119.001124084843 - ST CLOUD OUTPATIENT SURGERY LTD752201400MNAmbulatory Surgical Clinic/Center (261QA1903X)
United
28092$390.001023134640 - LOCUST GROVE ENDO CENTER205860757 - (GA) LOCUST GROVE ENDO CENTERGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
28092$2025.001912900143 - E STREET ENDOSCOPY LLC, WEST COAST ENDOSCOPY593705426 - (FL) E STREET ENDOSCOPYFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
28092$350.081063082394 - MATTHEW ANDERSON350593390 - DEACONESS HOSPITAL INCPACertified Registered Nurse Anesthetist (367500000X)
United
28092$951.001790167740 - TIDALHEALTH SURGERY CENTER, LLC474184623MDAmbulatory 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 28092 vs. Other Surgical Procedures on the Musculoskeletal System Codes

The CPT 28092 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 28092 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
28090-CPTModerateExcis Lesion-Tendon/Fibrous Sheath/Capsu
28092-CPTModerateExc Lesion Soft Tissue Toes

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28092. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 28092 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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