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See a sample rate comparisonCPT 28261 Fee Schedule
Medicare rates as of October 2026
CPT 28261 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 | LTLeft side of body RTRight side of body |
| Hospital Outpatient Group (APC) | APC 5112 - Level 2 Musculoskeletal Procedures |
| Surgery Center Payment (ASC) | A2 - Paid separately, from the OPPS relative weight |
| Common Revenue Codes | 0360 |
| Medicare Fee Schedule | $1,123.61 national non-facility rate (2026)View Medicare rates for 28261 |
| Medicaid Fee Schedule | $877.39 median of the 8 states in the free previewView Medicaid rates for 28261 |
National average reimbursement for CPT 28261 by major payers:
$1,338.63
BCBS / Anthem
$1,440.41
UnitedHealthcare
$1,514.49
Aetna
$1,427.57
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 28261.
CPT 28261
5 of 25 sample ratesHigher to lower in this preview
Greater New Haven Asc, LLC
Greater New Haven Asc LLC
$4,617.00Published ratePhysicians Surgery Center Of Tempe, LLC, Physicians Surgery Center Of Tempe
Physicians Surgery Center Of Tempe LLC
$2,307.00Published rateWichita Urology Surgery Center,LLC
Wichita Urology Surgery Centerllc
$1,377.00Published rateUnion Pines Surgery Center,LLC
Union Pines Surgery Center, LLC
$1,072.50Published rateLargo Endoscopy Center Lp, Tampa Bay Regional Surgery Center
Largo Endoscopy Center Lp
$735.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 28261 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 28261. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 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 |
| 28264-CPT | 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 28261. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28261 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 28261 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 28261 to APC 5112 (Level 2 Musculoskeletal Procedures). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 28261 in an ambulatory surgery center?
CMS lists CPT 28261 with ASC payment indicator A2: Paid separately, from the OPPS relative weight.
Which revenue codes are billed with CPT 28261?
Hospital price transparency files list CPT 28261 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.