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See a sample rate comparisonCPT 28272 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.
Capsulotomy; Interphalang Joint Ea Joint (Sepa Proc), Capsulotomy; Interphalangeal Joint Each Joint (Separate Procedure)
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 11 - Office 24 - Ambulatory Surgical Center |
| Common Modifiers | None 59 - Distinct Procedural Service T6 - Right foot, second digit |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 28272 |
| Medicaid Fee Schedule | View Medicaid rates for 28272 |
National average reimbursement for CPT 28272 by major payers:
$497.68
$513.05
$513.34
$624.32
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CPT 28272
5 of 25 sample ratesHigher to lower in this preview
Fairfax Surgical Center, L.P.
Fairfax Surgical Center Lp
$5,379.00Published rateCentral Maine Eye Surgery Center LLC
$2,388.00Published rateAuburn Surgery Center Inc.
Auburn Surgery Center Inc
$1,600.00Published rateAmerican Access Care Of Baltimore Asc LLC
$1,200.00Published rateSullivan Surgicenter,LLC
Sullivan Surgicenter LLC
$750.00Published rate
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See a sample payer proposalCPT 28272 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28272 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 28272 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 |
|---|---|---|
| 28270-CPT | Moderate | Capsulotomy; Metatarsophalangeal Joint W//W/O Tenorrhaphy E, Capsulotomy; Metatarsophalangeal Joint With Or Without Tenorrhaphy E |
| 28272-CPT | Moderate | Capsulotomy; Interphalang Joint Ea Joint (Sepa Proc), Capsulotomy; Interphalangeal Joint Each Joint (Separate Procedure) |
| 28280-CPT | Moderate | Webbing Operation For Soft Corn Kelikia |
| 28285-CPT | Moderate | Correct Hammertoe (Eg Interphalang Fusion Partial Or Total Ph, Correction Hammertoe (Eg Interphalangeal Fusion Partial Or Total Ph |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28272. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28272 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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