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See a sample rate comparisonCPT 28103 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 Noncancerous Growth, Surgery To Remove A Pocket Of Fluid (Cyst) Or A Noncancerous Growth (Tumor) From One Or More Bones Of The Ankle Or Heel. The Area Is Repaired With A Bone Graft.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 28103 |
| Medicaid Fee Schedule | View Medicaid rates for 28103 |
National average reimbursement for CPT 28103 by major payers:
$552.92
$554.74
$546.62
$662.23
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CPT 28103
5 of 25 sample ratesHigher to lower in this preview
Aurora Surgery Centers, LLC, Aurora Pleasant Prairie Ambulatory Surgery Center
Aurora Surgery Centers LLC
$12,899.00Published rateLafayette Surgery Center Limited Partnership
$5,159.00Published rateThe Eye Surgicenter Of New Jersey, LLC
$2,700.00Published rateMidsouth Interventional Pain Institute, LLC
Midsouth Interventional Pain Institute LLC
$2,000.00Published rateRebecca Hopper
Deaconess Hospital Inc
$709.11Published rate
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See a sample payer proposalCPT 28103 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28103 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 28103 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 |
|---|---|---|
| 28100-CPT | Moderate | Remove Noncancerous Growth, Surgery To Remove A Pocket Of Fluid (Cyst) Or A Noncancerous Growth (Tumor) From One Or More Bones Of The Ankle Or Heel. |
| 28102-CPT | Moderate | Remove Noncancerous Growth, Surgery To Remove A Pocket Of Fluid (Cyst) Or A Noncancerous Growth (Tumor) From One Or More Bones Of The Ankle Or Heel. The Area Is Repaired With A Bone Graft. |
| 28103-CPT | Moderate | Remove Noncancerous Growth, Surgery To Remove A Pocket Of Fluid (Cyst) Or A Noncancerous Growth (Tumor) From One Or More Bones Of The Ankle Or Heel. The Area Is Repaired With A Bone Graft. |
| 28106-CPT | Moderate | Excision Or Curettage Of Bone, Excision Or Curettage Of Bone Cyst Or Benign Tumor Tarsalor Metatarsal Bones Except Talus Or Calcaneus With Iliac Or Other Autograft (Includes Obtaining Graft) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28103. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28103 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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