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See a sample rate comparisonCPT 28286 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.
Correct Cock-Up Fifth Toe W/ Plstic Skin Closur (Eg Ruiz-Mor, Correction Cock-Up Fifth Toe With Plastic Skin Closure (Eg Ruiz-Mor
| 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 T9 - Right foot, fifth digit T4 - Left foot, fifth digit |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 28286 |
| Medicaid Fee Schedule | View Medicaid rates for 28286 |
National average reimbursement for CPT 28286 by major payers:
$548.87
$591.53
$585.81
$509.36
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CPT 28286
5 of 25 sample ratesHigher to lower in this preview
Iu Health East Washington Ambulatory Surgery Center, LLC, East Washington Surgery Center
$8,705.00Published rateBronson Ambulatory Surgery Center, LLC, Bronson Orthopedic Surgery Center
Bronson Ambulatory Surgery Center LLC
$2,316.00Published rateNorth Crescent Surgery Center, L.L.C.
North Crescent Surgery Center LLC
$1,325.00Published rateWeir Asc, LLC, Southwest Eye Surgery Center
Weir Asc LLC
$1,011.00Published rateBeverly Hills Regional Surgery Center Lp
$544.00Published rate
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See a sample payer proposalCPT 28286 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28286 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 28286 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 |
|---|---|---|
| 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 |
| 28288-CPT | Moderate | Ostectomy Partial Exostectomy Or Condylectomy Metatarsal Head, Ostectomy Partial Exostectomy Or Condylectomy Metatarsal Head Each |
| 28289-CPT | Moderate | Hallux Rigidus Correction With Cheilectomy Debridement And Capsular Release Of The First Metatarsophalangeal Joint; Without Implant. (Desc Revised 1/1/2017) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28286. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28286 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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