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See a sample rate comparisonCPT 28113 Fee Schedule
Last Verified: September 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.
Ostectomy,Complet Exc;5th Meta.Head
| 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 28113 |
| Medicaid Fee Schedule | View Medicaid rates for 28113 |
National average reimbursement for CPT 28113 by major payers:
$769.23
$765.40
$781.12
$708.20
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CPT 28113
5 of 25 sample ratesHigher to lower in this preview
Texas Health Presbyterian Hospital Dallas
$4,781.00Published rateTorrance Ca Multispecialty Asc LLC, Surgery Center Of South Bay
Torrance Ca Multispecialty Asc LLC
$1,887.00Published rateShore Health System, Inc., Shore Health System Surgery Center
Shore Health System Inc
$1,450.00Published rateMir Ikramullah
Deaconess Hospital Inc
$1,056.04Published rateArrowhead Endoscopy And Pain Management Center LLC, Arrowhead Endoscopy Center.
Arrowhead Endoscopy And Pain Man
$610.00Published rate
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See a sample payer proposalCPT 28113 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28113 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 28113 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 28113. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28113 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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