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See a sample rate comparisonCPT 28234 Fee Schedule
Last Verified: September 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.
Tenotomy Open Extensor Foot/Toe
| 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 | 59 - Distinct Procedural Service None RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 28234 |
| Medicaid Fee Schedule | View Medicaid rates for 28234 |
National average reimbursement for CPT 28234 by major payers:
$508.60
$532.78
$550.66
$455.66
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CPT 28234
5 of 25 sample ratesHigher to lower in this preview
Hospital For Special Surgery West Side Ambulatory Surgery Center, LLC, Hss West Side Asc, LLC
$4,300.00Published rateQuincy Physicians & Surgeons Clinic, PLLC, Quincy Medical Group Surgery Center
Quincy Physicians & Surgeons Clinic S.C. D/B/A Quincy Medical Group
$2,600.00Published rateNaperville Fertility Center, Inc.
$1,201.00Published rateThibodaux Surgery Center, LLC, Bayou Region Surgical Center
Thibodaux Surgery Center, LLC Dba Bayou Region Surgical Center
$895.00Published rateNsc Management Company, Inc., Endeavor Surgical Center
Northridge Surgery And Pain Management Center, Inc.
$496.00Published rate
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See a sample payer proposalCPT 28234 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28234 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 28234 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 Tndon Flexor; Foot Sngle Or Multi Tndon(S) (Sep, Tenotomy Open Tendon Flexor; Foot Single Or Multiple Tendon(S) (Sep |
| 28232-CPT | Moderate | Tenotomy Open Tndon Flexor; Toe Sngle Tndon (Sepa Proc), Tenotomy Open Tendon Flexor; Toe Single Tendon (Separate Procedure) |
| 28234-CPT | Moderate | Tenotomy Open Extensor Foot/Toe |
| 28238-CPT | Moderate | Revision Of Foot Tendon, 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 28234. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28234 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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