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See a sample rate comparisonCPT 28286 Fee Schedule
Medicare rates as of October 2026
CPT 28286 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
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 | 24Ambulatory Surgical Center 22On Campus Outpatient Hospital |
| Common Modifiers | T9Right foot, fifth digit T4Left foot, fifth digit |
| Hospital Outpatient Group (APC) | APC 5113 - Level 3 Musculoskeletal Procedures |
| Surgery Center Payment (ASC) | A2 - Paid separately, from the OPPS relative weight |
| Common Revenue Codes | 0360 |
| Medicare Fee Schedule | $430.20 national non-facility rate (2026)View Medicare rates for 28286 |
| Medicaid Fee Schedule | $338.125 median of the 8 states in the free previewView Medicaid rates for 28286 |
National average reimbursement for CPT 28286 by major payers:
$548.87
BCBS / Anthem
$591.53
UnitedHealthcare
$585.81
Aetna
$509.36
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 28286.
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 table lists codes related to 28286. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 28285-CPT | Correct Hammertoe (Eg Interphalang Fusion Partial Or Total Ph, Correction Hammertoe (Eg Interphalangeal Fusion Partial Or Total Ph |
| 28286-CPT | 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 | Ostectomy Partial Exostectomy Or Condylectomy Metatarsal Head, Ostectomy Partial Exostectomy Or Condylectomy Metatarsal Head Each |
| 28289-CPT | 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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Frequently Asked Questions
What APC is CPT 28286 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 28286 to APC 5113 (Level 3 Musculoskeletal Procedures). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 28286 in an ambulatory surgery center?
CMS lists CPT 28286 with ASC payment indicator A2: Paid separately, from the OPPS relative weight.
Which revenue codes are billed with CPT 28286?
Hospital price transparency files list CPT 28286 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.