CPT 28200 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 |
| Medicare Fee Schedule | View Medicare rates for 28200 |
National average reimbursement for CPT 28200 by major payers:

$605.15

$640.82

$683.23

$806.26
| 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 28200 | ||||||
United | 28200 | $576.00 | 1497201867 - ABILENE CENTER FOR ORTHOPEDIC AND MULTISPECIALTY SURGERY, L.L.C. | 813619502 - (TX) ABILENE CENTER FOR ORTHOPEDIC AND MULTISPECIALTY SURGERY LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28200 | $576.00 | 1902284045 - MURRIETA SPECIALTY SURGERY CENTER PC A PROFESSIONAL CORPORATION | 463493543 - (CA) MURRIETA SPECIALTY SURGERY CENTER PC A PROFESSIONAL CORPORATION | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28200 | $1211.00 | 1780021188 - ENDOSCOPY CENTER OF NIAGARA, LLC | 453630889 - (NY) ENDOSCOPY CENTER OF NIAGARA LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28200 | $3246.00 | 1073569562 - GRAMERCY SURGERY CENTER, INC | 204336660 - (NY) GRAMERCY SURGERY CENTER, INC. | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28200 | $598.00 | 1750312435 - CENTRAL ARIZONA ENDOSCOPY LLC | 203643513 - (AZ) CENTRAL ARIZONA ENDOSCOPY LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28200 | $2609.00 | 1528104080 - SURGICAL CENTER AT CEDAR KNOLLS LLC | 202158771 - (NJ) SURGICAL CENTER AT CEDAR KNOLLS | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28200 | $2621.00 | 1255373601 - CHESTERFIELD AMBULATORY SURGERY CENTER LP, CHESTERFIELD SURGERY CENTER | 203834076 - (MO) CHESTERFIELD AMBULATORY SURGERY CENTER LP | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28200 | $1700.00 | 1720495708 - TRI-CITY ORTHOPAEDIC CLINIC P S C, THE SURGERY CENTER AT TCO (KENNEWICK) | 911866685 - (WA) TRI-CITY ORTHOPAEDIC CLINIC, PSC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28200 | $911.00 | 1609522028 - LIVONIA SURGERY CENTER LLC | 261322609 - (MI) LIVONIA OUTPATIENT SURGERY CENTER LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28200 | $4141.00 | 1235752643 - TEXAS HEALTH SURGERY CENTER SOUTHWEST FORT WORTH, LLC | 843814490 - (TX) TEXAS HEALTH SURGERY CENTER SOUTHWEST FORT WORTH LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28200 | $1117.00 | 1053058255 - INDIANA VASCULAR SURGERY CENTER LLC | 871608290 - (IN) INDIANA VASCULAR SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28200 | $1600.00 | 1750567442 - IRELAND GROVE CENTER FOR SURGERY LLC. | 202687982 - (IL) IRELAND GROVE CENTER FOR SURGERY, LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28200 | $3742.00 | 1568427151 - PLANO AMBULATORY SURGERY ASSOCIATES, LP | 621560420 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28200 | $2388.00 | 1497165179 - SURGERY CENTER OF SCOTTSDALE, LLC, MOUNTAIN VIEW SURGERY CENTER OF PHOENIX | 731553441 - (AZ) SURGERY CENTER OF SCOTTSDALE LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28200 | $1834.00 | 1861497380 - NORTHEAST NEBRASKA SURGERY CENTER LLC, FAITH REGIONAL SURGERY CENTER | 470819088 - (NE) NORTHEAST NEBRASKA SURGERY CENTER LLC | NE | 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 28200 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28200 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 28200 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28200. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28200 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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