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See a sample rate comparisonCPT 28260 Fee Schedule
Medicare rates as of October 2026
CPT 28260 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Release Mid-Foot Restriction, Surgery To Release Mid-Foot Contracture By Cutting The Capsule That Encases The Foot Joint.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22On Campus Outpatient Hospital 24Ambulatory Surgical Center |
| Common Modifiers | RTRight side of body LTLeft side of body |
| Hospital Outpatient Group (APC) | APC 5113 - Level 3 Musculoskeletal Procedures |
| Surgery Center Payment (ASC) | A2 - Paid separately, from the OPPS relative weight |
| Common Revenue Codes | 0360 |
| Medicare Fee Schedule | $758.20 national non-facility rate (2026)View Medicare rates for 28260 |
| Medicaid Fee Schedule | $588.295 median of the 8 states in the free previewView Medicaid rates for 28260 |
National average reimbursement for CPT 28260 by major payers:
$898.96
BCBS / Anthem
$917.68
UnitedHealthcare
$958.33
Aetna
$893.28
Cigna
Compare published rates across providers.
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CPT 28260
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Endoscopy Center North Freeway LLC, Memorial Hermann Endoscopy Center North Loop
$5,048.00Published rateWellington Endoscopy Center LLC
$2,206.00Published rateQueens Boulevard Asc LLC
$1,283.00Published rateEnt Facial Surgery Center LLC
$1,072.50Published rateUcsd Ambulatory Surgery Center, LLC, University Ambulatory Surgery Center
$624.00Published rate
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See a sample payer proposalCPT 28260 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 28260. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 28250-CPT | Split Tissue On Sole Of Foot, Surgery To Divide Fascia (Strong Connective Tissue That Surrounds Muscle Bone And Organs) On Bottom Of Foot. |
| 28260-CPT | Release Mid-Foot Restriction, Surgery To Release Mid-Foot Contracture By Cutting The Capsule That Encases The Foot Joint. |
| 28261-CPT | Release Mid-Foot Restriction, Surgery To Release Mid-Foot Contracture By Cutting The Capsule That Encases The Foot Joint. |
| 28262-CPT | Revision Of Foot And Ankle, Capsulotomy Midfoot Extensive Including Posterior Talotibial Capsulotomy And Tendon S Lengthening Eg Resistant Clubfoot Deformity |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28260. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28260 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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Frequently Asked Questions
What APC is CPT 28260 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 28260 to APC 5113 (Level 3 Musculoskeletal Procedures). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 28260 in an ambulatory surgery center?
CMS lists CPT 28260 with ASC payment indicator A2: Paid separately, from the OPPS relative weight.
Which revenue codes are billed with CPT 28260?
Hospital price transparency files list CPT 28260 under these revenue codes: 0360. A revenue code names the hospital department or charge category for the line; it does not change what the service is.