CPT 28119 Fee Schedule
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.
| 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 |
National average reimbursement for CPT 28119 by major payers:
$655.96
$689.34
$709.59
$863.16
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 28119 | ||||||
United | 28119 | $2564.00 | 1922160357 - ARAPAHOE ENDOSCOPY CENTER PARTNERSHIP PLLP | 472388780 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28119 | $1100.00 | 1588062400 - EAR NOSE AND THROAT SURGERY CENTER LLC | 464525209 - (NV) EAR NOSE AND THROAT SURGERY CENTER LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28119 | $1185.00 | 1013513308 - JOHN KENYON AMERICAN EYE INSTITUTE LLC, EYE SURGERY CENTER OF ELIZABETHTOWN | 351907389 - JOHN-KENYON AMERICAN EYE INSTITUTE | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28119 | $1702.00 | 1053688036 - SUNSET SURGICAL CENTRE LLC | 270224735 - (OR) SUNSET SURGICAL CENTRE LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28119 | $852.00 | 1841459211 - AASC, LLC, ATLANTA AESTHETIC SURGERY CENTER | 352491038 - (GA) SURGERY CENTER OF ATLANTA | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28119 | $950.00 | 1205978780 - MOUNTAIN HOME SURGERY CENTER | 454157268 | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28119 | $1056.00 | 1548249675 - ENDOSCOPY CENTER OF SANTA FE LP, THE ENDOSCOPY CENTER OF SANTA FE | 621548645 - (NM) ENDOSCOPY CENTER OF SANTA FE LP | NM | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28119 | $1375.00 | 1174503080 - THE SURGICAL CENTER FOR EXCELLENCE, LLLP | 743107832 - (FL) SURGICAL CENTER FOR EXCELLENCE, LLLP | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28119 | $1300.00 | 1578088787 - VACCO LLC | 821221738 - (OH) VACCO LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28119 | $2044.00 | 1538608138 - THE REGENTS OF THE UNIVERSITY OF CALIFORNIA, UCLA DEPT OF MEDICINE | 954373071 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28119 | $5841.00 | 1053391870 - NORTHWEST SURGERY CENTER, LTD, NORTHWEST SURGERY CENTER RED OAK | 760452319 - (TX) NORTHWEST SURGERY CENTER LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28119 | $1050.00 | 1225488216 - MADISON AVENUE SURGERY CENTER LLC | 475541001 - (ID) MADISON AVENUE SURGERY CENTER LLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28119 | $1862.00 | 1295883973 - SUMMIT VENTURES OF SANTA BARBARA, LP, SUMMIT SURGERY CENTER | 770529514 - (CA) SUMMIT VENTURES OF SANTA BARBARA, LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28119 | $1233.00 | 1710082680 - MBC AMBULATORY SURGERY CENTER, LP, MANN CATARACT SURGERY CENTER | 752841034 - (TX) MBC AMBULATORY SURGERY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28119 | $1734.00 | 1780218115 - SURGERY CENTER OF FORT WAYNE | 825163478 - (IN) SURGERY CENTER OF FORT WAYNE LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 28119 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28119 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 28119 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 |
|---|---|---|
| 28060-CPT | Moderate | Fasciectomy Plantar Partial |
| 28114-CPT | High | Ostectomy, Complete Excision; All Metatarsal Heads, With Partial Proximal Phalangectomy, Excluding First Metatarsal (Eg, Clayton Type Procedure) |
| 28118-CPT | Moderate | Ostectomy Calcaneus Partial |
| 28119-CPT | Moderate | Ostect,Calcan;Spur,W/Wo Pl.Fasc.Rel |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28119. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28119 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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