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See a sample rate comparisonHealthcare 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.
| 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 LT - Left side of body RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 28112 |
| Medicaid Fee Schedule | View Medicaid rates for 28112 |
National average reimbursement for CPT 28112 by major payers:

$587.68

$642.50

$652.83

$535.34
Choose a payer to see a sample of rates for CPT 28112.
Peak One Surgery Center LLC
Pharos Enterprises Of Wisconsin LLC
Zeo Surgical Center LLC
Oak Park Surgery Center
Deaconess Hospital Inc
Choose your state and specialty to build a report from payer-published rates.
Rate Benchmarking
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonPayer Contract Negotiation
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 28112 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28112 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 28112 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 |
|---|---|---|
| 28110-CPT | Moderate | Ostectomy Partial Xcision Fifth Metatarsal Head (Bunionette), Ostectomy Partial Excision Fifth Metatarsal Head (Bunionette) (Separ |
| 28111-CPT | Moderate | Ostectmy,Complete Exc;1st Meta.Head |
| 28112-CPT | Moderate | Ostectomy Comple Xcision; Other Metatarsal Head (Second Third, Ostectomy Complete Excision; Other Metatarsal Head (Second Third Or |
| 28113-CPT | Moderate | Ostectomy,Complet Exc;5th Meta.Head |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28112. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28112 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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