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See a sample rate comparisonCPT 28116 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.
Ostectomy,Excis Of Tarsal Coalition
| 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 LT - Left side of body RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 28116 |
| Medicaid Fee Schedule | View Medicaid rates for 28116 |
National average reimbursement for CPT 28116 by major payers:
$967.33
$994.90
$1,066.64
$951.16
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CPT 28116
5 of 25 sample ratesHigher to lower in this preview
Grove City Medical Center
$8,999.88Published rateChannel Islands Surgicenter Lp
$2,335.00Published rateDella Evans
Deaconess Hospital Inc
$1,365.02Published rateSurgery Center At The Reserve, P.A., Inc.
Surgery Center At The Reserve PA Inc
$1,020.00Published rateEyecare Surgery Center, LLC
Eyecare Surgery Center LLC
$613.00Published rate
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See a sample payer proposalCPT 28116 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28116 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 28116 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 |
| 28116-CPT | Moderate | Ostectomy,Excis Of Tarsal Coalition |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28116. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28116 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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