How can I find out the cost of a medical procedure?

For specific cost estimates for medical procedures based on CPT codes and your location, you can use tools like Payerprice. They offer a fee schedule lookup tool that allows users to search with CPT codes and specific locations, helping you understand potential costs before receiving a service.

What is a CPT code and how is it used?

CPT stands for Current Procedural Terminology. CPT codes are standardized numerical codes used by healthcare providers to describe medical, surgical, and diagnostic services to payers for reimbursement. They are essential for accurate billing and allow for a universal language to describe medical procedures.

Why do healthcare costs vary so much?

Healthcare costs can vary significantly due to several factors, including the type of facility (e.g., hospital vs. outpatient clinic), geographic location, the specific insurance plan, the provider's negotiated rates with insurers, and the complexity of the service. Different providers may also have different pricing strategies.

How can I compare prices for healthcare services?

To compare prices for specific healthcare services, especially if you have a CPT code and location in mind, you can utilize online tools. Payerprice offers a fee schedule lookup tool designed for this purpose, allowing you to search and compare costs based on CPT codes and specific locations. This can help you make informed decisions.

What should I do if I receive an unexpected medical bill?

If you receive an unexpected medical bill, first review it carefully for accuracy and compare it against any Explanation of Benefits (EOB) from your insurer. If you have questions about the pricing or feel it's incorrect, contact the provider's billing department. For independent research on fair pricing for specific services using CPT codes and your location, you can check resources like Payerprice's lookup tool.

CPT 28285 Fee Schedule

Q: What factors affect fee schedules?

Factors that affect fee schedules include 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), and provider type (hospital providers may have different rates than private practice).

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.

Correct Hammertoe (Eg Interphalang Fusion Partial Or Total Ph, Correction Hammertoe (Eg Interphalangeal Fusion Partial Or Total Ph

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 59 - Distinct Procedural Service T6 - Right foot, second digit
Complexity Level	Moderate
Medicare Fee Schedule	View Medicare rates for 28285
Medicaid Fee Schedule	View Medicaid rates for 28285

National average reimbursement for CPT 28285 by major payers:

$674.98

$682.47

$721.99

$630.74

Compare published rates across providers.

Choose a payer to see a sample of rates for CPT 28285.

CPT 28285

5 of 25 sample ratesHigher to lower in this preview

Hcn Ep Horizon City, LLC, The Hospitals Of Providence Northeast Campus
Hcn Ep Horizon City LLC
TXGeneral Acute Care HospitalNPI 1861994808Tax ID 81-3935393
$8,159.00Published rate
Ankeny Medical Park Surgery Center Lc
IAAmbulatory Surgical Clinic/CenterNPI 1649748708Tax ID 83-1281114
$3,144.43Published rate
Ram Saha
Mcv Associated Physicians
TXGeneral Acute Care HospitalNPI 1730556259Tax ID 54-1581185
$1,334.01Published rate
Los Robles Surgicenter, LLC, Los Robles Surgicenter
Los Robles Surgicenter LLC
CAAmbulatory Surgical Clinic/CenterNPI 1336294859Tax ID 77-0216847
$800.00Published rate
Bone & Joint Clinic Of Baton Rouge, Inc A Professional Medical Corp
Bone & Joint Clinic Of B.R., Inc.
LAOrthopaedic Surgery PhysicianNPI 1306835079Tax ID 72-1111762
$502.55Published rate

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Summit Women's CareDenver, Colorado

September 2, 2026

Contracting Manager
UnitedHealthcare
Commercial PPO

Re: Request for fee schedule renegotiation

We request a formal review of our Commercial PPO fee schedule. The comparison below summarizes our current rate alongside published rates for comparable Denver-area practices.

Market evidence · CPT 59485

Current rate: $152.40
Market median: $147.00
Market position: 61st percentile

The comparison includes 1,284 published rates from 96 provider groups, scoped to OB/GYN providers in a professional, office-based setting.

We would welcome a discussion of our fee schedule and the supporting July 2026 market analysis. Please let us know a suitable time to review the comparison together.

Sincerely,
Summit Women's Care

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CPT 28285 vs. Other Surgical Procedures on the Musculoskeletal System Codes

The CPT 28285 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 28285 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
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
28286-CPT	Moderate	Correct Cock-Up Fifth Toe W/ Plstic Skin Closur (Eg Ruiz-Mor, Correction Cock-Up Fifth Toe With Plastic Skin Closure (Eg Ruiz-Mor

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28285. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 28285 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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CPT 28285 Fee Schedule

Hcn Ep Horizon City, LLC, The Hospitals Of Providence Northeast Campus

Ankeny Medical Park Surgery Center Lc

Ram Saha

Los Robles Surgicenter, LLC, Los Robles Surgicenter

Bone & Joint Clinic Of Baton Rouge, Inc A Professional Medical Corp