CPT 28124 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 • 59 - Distinct Procedural Service • T5 - Right foot, great toe |
| Complexity Level | Moderate |
National average reimbursement for CPT 28124 by major payers:
$570.92
$628.81
$654.37
$785.67
| 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 28124 | ||||||
United | 28124 | $4316.00 | 1538245717 - LUBBOCK COUNTY HOSPITAL DISTRICT, UNIVERSITY MEDICAL CENTER | 751301362 - LUBBOCK COUNTY HOSPITAL DISTRICT | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28124 | $1209.00 | 1871729111 - RIVERVIEW AMBULATORY SURGICAL CENTER, LLC | 900456643 - (PA) RIVERVIEW AMBULATORY SURGICAL CE | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28124 | $395.13 | 1497799100 - SHERRI WALLING | 350593390 - DEACONESS HOSPITAL INC | IN | Nurse Practitioner (363L00000X) |
United | 28124 | $1986.00 | 1295988731 - BAPTIST EASTPOINT SURGERY CENTER, LLC | 610444707 - BAPTIST HEALTHCARE SYSTEM INC | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28124 | $2529.00 | 1447203161 - AMBULATORY SURGICAL CENTER OF STEVENS POINT LLC | 202043506 - (WI) AMBULATORY SURGICAL CENTER OF | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28124 | $1575.00 | 1689605826 - LAUREL SURGERY & ENDOSCOPY CENTER, LLC | 412044822 - (MS) LAUREL SURGERY AND ENDOSCOPY CENTER, LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28124 | $2388.00 | 1598996894 - SURGICAL ELITE OF AVONDALE, LLC | 270471437 - (AZ) SURGICAL ELITE OF AVONDALE LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28124 | $986.00 | 1174530752 - LAKE MARY SURGERY CENTER LLC | 134215228 - (FL) LAKE MARY SURGERY CENTER | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28124 | $3150.00 | 1184689010 - PARK CITIES SURGERY CENTER, LLC, PARK CITIES SURGERY CENTER | 562357079 - (TX) PARK CITIES SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28124 | $3500.00 | 1245798826 - SURGCENTER OF GREATER DALLAS, LLC., SURGCENTER OF GREATER DALLAS | 831498677 - (TX) SURGCENTER OF GREATER DALLAS LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28124 | $3348.22 | 1609343052 - ADVANCED MEDICAL IMAGING SURGERY CENTER, LLC | 831444320 - (NE) ADVANCED MEDICAL IMAGING SURGERY CENTER LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28124 | $721.00 | 1356646715 - ZACHARY ASC PARTNERS, LLC, ZACHARY ASC PARTNERS, LLC | 273854435 - (LA) ZACHARY ASC PARTNERS LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28124 | $1706.00 | 1124324181 - MANHATTAN ENDOSCOPY CENTER LLC, MANHATTAN ENDO | 271510596 - (NY) MANHATTAN ENDOSCOPY CENTER | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28124 | $4405.00 | 1619971082 - KU MEDWEST AMBULATORY SURGERY CENTER, LLC | 20664568 - (KS) KU MEDWEST AMBULATORY SURGERY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28124 | $915.00 | 1841578978 - PHYSICIANS' SURGERY CENTER OF NEVADA LLC | 273741243 - (NV) PHYSICIANS SURGERY CENTER OF NEVADA LLC | NV | 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 28124 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28124 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 28124 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 |
|---|---|---|
| 28020-CPT | Moderate | Arthrotomy,Explor/Drain/Remov F.B;Intert |
| 28092-CPT | Moderate | Exc Lesion Soft Tissue Toes |
| 28114-CPT | High | Ostectomy, Complete Excision; All Metatarsal Heads, With Partial Proximal Phalangectomy, Excluding First Metatarsal (Eg, Clayton Type Procedure) |
| 28124-CPT | Moderate | Partial Excision (Craterization, Saucerization, Sequestrectomy, Or Diaphysectomy) Bone (Eg, Osteomyelitis Or Bossing); Phalanx Of Toe |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28124. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28124 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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