CPT 28232 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 | • 11 - Office • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • 59 - Distinct Procedural Service • T8 - Right foot, fourth digit |
| Complexity Level | Moderate |
National average reimbursement for CPT 28232 by major payers:
$483.70
$505.53
$522.43
$633.94
| 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 28232 | ||||||
United | 28232 | $6651.00 | 1629032446 - AMBULATORY SURGERY CENTER GROUP LTD | 592073099 - (FL) AMBULATORY SURGERY CENTER GROUP LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28232 | $985.00 | 1033734785 - CARDIOVASCULAR INSTITUTE OF THE SOUTH ASC, LLC | 850871914 - (LA) CARDIOVASCULAR INSTITUTE OF THE SOUTH ASC LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28232 | $1669.00 | 1508986621 - ASHLAND SURGERY CENTER | 830346584 - (OR) ASHLAND SURGERY CENTER INC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28232 | $1836.00 | 1346508520 - FIRST GI ENDOSCOPY AND SURGERY CENTER LLC | 270870899 - (NJ) FIRST GI ENDOSCOPY AND SURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28232 | $2200.00 | 1952071920 - LAKEVIEW SURGERY CENTER, LLC | 872359088 - (FL) LAKEVIEW SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28232 | $500.00 | 1427052026 - SUMMIT ENDOSCOPY CENTER | 582508201 - (GA) SUMMIT ENDOSCOPY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28232 | $1258.00 | 1174938344 - SPECIALTY SURGERY CENTER, LLC | 455554765 - (MS) SPECIALTY SURGERY CENTER LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28232 | $1628.00 | 1114996774 - REDBIRD SQUARE ENDOSCOPY CENTER LLC, DIGESTIVE HEALTH CENTER AT REDBIRD SQUARE | 752816071 - (TX) REDBIRD SQUARE ENDOSCOPY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28232 | $2307.00 | 1811515034 - SALMON SURGERY CENTER LLC | 844895716 - (WA) SALMON SURGERY CENTER LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28232 | $1285.00 | 1518070879 - EHLERS EYE SURGERY LLC | 270079770 - (WA) EHLERS EYE SURGERY LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28232 | $2388.00 | 1912434697 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28232 | $587.00 | 1659683662 - PREMIER ENDOSCOPY CENTER, LLC | 272932575 - (AZ) PREMIER ENDOSCOPY CENTER, P.L.L.C. | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28232 | $318.76 | 1497476717 - SAMANTHA BYERS | 350593390 - DEACONESS HOSPITAL INC | IN | Certified Registered Nurse Anesthetist (367500000X) |
United | 28232 | $839.00 | 1497084982 - WAKE ENDOSCOPY CENTER, LLC | 611578919 | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28232 | $2859.00 | 1659772648 - SURGICAL SPECIALTY CENTER OF MID ATLANTIC, LLC | 465727021 - (MD) SURGICAL SPECIALTY CENTER OF MID-ATLANTIC, LLC | MD | 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 28232 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28232 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 28232 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 |
|---|---|---|
| 28230-CPT | Moderate | Tenotomy Open Flexor Foot |
| 28232-CPT | Moderate | Tenotomy Open Flexor Toe |
| 28234-CPT | Moderate | Tenotomy Open Extensor Foot/Toe |
| 28238-CPT | Moderate | Reconstruction (Advancement), Posterior Tibial Tendon With Excision Of Accessory Tarsal Navicular Bone (Eg, Kidner Type Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28232. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28232 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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