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See a sample rate comparisonCPT 28104 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 Foot.
| 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 28104 |
| Medicaid Fee Schedule | View Medicaid rates for 28104 |
National average reimbursement for CPT 28104 by major payers:
$651.61
$688.76
$720.86
$598.63
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CPT 28104
5 of 25 sample ratesHigher to lower in this preview
Franciscan Orthopedic Surgery Center LLC
$5,389.00Published rateSouthern New Mexico Surgery Center, LLC
Southern New Mexico Surgery Center
$2,808.00Published rateMinimally Invasive Surgicenter LLC
Minimally Invasive Surgicenter L
$2,206.00Published rateCalifornia Eye Clinic
$1,061.00Published rateMusculoskeletal Ambulatory Surgery Center Inc, The Surgery Center At Pointe West
Musculoskeletal Ambulatory Surgery Center
$750.00Published rate
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See a sample payer proposalCPT 28104 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28104 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 28104 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 |
|---|---|---|
| 28104-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 Foot. |
| 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) |
| 28107-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 Foot. The Area Is Repaired With A Bone Graft. |
| 28108-CPT | Moderate | Xcision/Curettag Of Bone Cyst Or Bnign Tumor Phalanges Of Foot, Excision Or Curettage Of Bone Cyst Or Benign Tumor Phalanges Of Foot |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28104. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28104 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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