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See a sample rate comparisonCPT 28238 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.
Revision Of Foot Tendon, Reconstruction Advancement Posterior Tibial Tendon With Excision Of Accessory Tarsal Navicular Bone Eg Kidner Type Procedure
| 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 LT - Left side of body RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 28238 |
| Medicaid Fee Schedule | View Medicaid rates for 28238 |
National average reimbursement for CPT 28238 by major payers:
$842.83
$889.82
$923.28
$823.03
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CPT 28238
5 of 25 sample ratesHigher to lower in this preview
Methodist Healthcare System Of San Antonio, Ltd., L.L.P., Methodist Hospital
$8,932.00Published rateEnti Surgery Center LLC
$4,580.00Published rateWest Bloomfield Surgery Center, LLC, Lakes Surgery Center
West Bloomfield Surgery Center LLC
$3,023.00Published rateOak & Main Surgicenter LLC
Oak Main Surgicenter LLC
$1,143.00Published rateGold Coast Surgery Center, Center For Specialized Surgery Of Santa Barbara
Gold Coast Surgery Center
$576.00Published rate
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See a sample payer proposalCPT 28238 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28238 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 28238 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 |
|---|---|---|
| 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 |
| 28264-CPT | High | Capsulotomy Midtarsal Heyman Type |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28238. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28238 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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