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See a sample rate comparisonCPT 28262 Fee Schedule
Medicare rates as of October 2026
CPT 28262 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Revision Of Foot And Ankle, Capsulotomy Midfoot Extensive Including Posterior Talotibial Capsulotomy And Tendon S Lengthening Eg Resistant Clubfoot Deformity
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22On Campus Outpatient Hospital 21Inpatient Hospital |
| Common Modifiers | LTLeft side of body RTRight side of body |
| Hospital Outpatient Group (APC) | APC 5114 - Level 4 Musculoskeletal Procedures |
| Surgery Center Payment (ASC) | J8 - Device-intensive procedure, paid at an adjusted rate |
| Common Revenue Codes | 0360 |
| Medicare Fee Schedule | $1,480.33 national non-facility rate (2026)View Medicare rates for 28262 |
| Medicaid Fee Schedule | $1,145.53 median of the 8 states in the free previewView Medicaid rates for 28262 |
National average reimbursement for CPT 28262 by major payers:
$1,808.28
BCBS / Anthem
$1,862.48
UnitedHealthcare
$1,953.31
Aetna
$1,857.49
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 28262.
CPT 28262
5 of 25 sample ratesHigher to lower in this preview
Hhc Hartford Surgery Center, LLC
$4,617.00Published rateEye Mds Of Puget Sound PLLC, Narrows Eye Surgery Center
Eye M.D.S Of Puget Sound, PLLC
$1,450.00Published rateMadhu K. Kris M.D., Merced Ambulatory Endoscopy Center
Madhu K Kris Md
$1,072.50Published rateLapeer County Surgery Center LLC
Lapeer County Surgery Center L
$960.00Published rateSally K Balin Ambulatory Surgical Center Inc
Sally K Balin Ambulatory Surgical Center Inc.
$380.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 28262 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 28262. 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 28262. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28262 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 28262 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 28262 to APC 5114 (Level 4 Musculoskeletal Procedures). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 28262 in an ambulatory surgery center?
CMS lists CPT 28262 with ASC payment indicator J8: Device-intensive procedure, paid at an adjusted rate.
Which revenue codes are billed with CPT 28262?
Hospital price transparency files list CPT 28262 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.