CPT 28289 Fee Schedule
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.
| 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 • RT - Right side of body • LT - Left side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 28289 by major payers:
$872.52
$949.87
$982.00
$1,163.35
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 28289 | ||||||
United | 28289 | $967.00 | 1295700086 - WESTERN WASHINGTON ENDOSCOPY CENTERS, LLC | 200289310 - (WA) WESTERN WASHINGTON ENDOSCOPY CENTERS LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28289 | $1887.00 | 1811438997 - RATTNER VASCULAR MEDICAL CENTER ASC LLC | 815157265 - (CA) RATTNER VASCULAR MEDICAL CENTER ASC LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28289 | $1100.00 | 1669031886 - SURGICAL CLINIC SOLUTIONS, LLC | 823722886 - (AL) SURGICAL CLINIC SOLUTIONS | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28289 | $1471.00 | 1871538140 - INLAND EYE SPECIALISTS A MEDICAL CORP, INLAND EYE SPECIALISTS | 330585144 - (CA) INLAND EYE SPECIALISTS, A MEDICAL CORPORATION | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28289 | $1727.00 | 1144499633 - FOOTHILL SURGERY CENTER LP | 510453471 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28289 | $1138.00 | 1467429233 - WILLOW SPRINGS SURGERY CENTER, LTD, FOREST MED-SURG CENTER | 364391641 - (IL) WILLOW SPRINGS SURGERY CENTER LTD | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28289 | $895.00 | 1801949631 - THIBODAUX SURGERY CENTER, LLC, BAYOU REGION SURGICAL CENTER | 320165642 - (LA) THIBODAUX SURGERY CENTER, LLC DBA BAYOU REGION SURGICAL CENTER | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28289 | $3676.00 | 1508978990 - WOODBRIDGE CENTER LLC, ENDOSCOPY AND SURGERY CENTER AT WOODBRIDGE HILLS | 30553583 - (MI) WOODBRIDGE CENTER LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28289 | $2150.00 | 1255397808 - JOLIET SURGERY CENTER LIMITED PARTNERSHIP, AMSURG SURGERY CENTER | 742544709 - (IL) JOLIET SURGERY CENTER LIMITED PARTNERSHIP | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28289 | $1350.00 | 1376607309 - EMERALD SURGICAL CENTER LLC | 820485376 - (ID) EMERALD SURGICAL CENTER, L.L.C. | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28289 | $2046.00 | 1427144336 - PORTLAND CLINIC, THE PORTLAND CLINIC SURGICAL CENTER | 930400952 - (OR) THE PORTLAND CLINIC LLP | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28289 | $959.00 | 1598804486 - SHREVEPORT SURGERY CENTER PTRSHP | 721126552 - (LA) SHREVEPORT SURGERY CENTER OF CADDO PARISH, INC. | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28289 | $7482.00 | 1346792165 - HSS ASC OF MANHATTAN LLC, HSS ASC OF MANHATTAN | 471353602 | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28289 | $1968.00 | 1992238661 - OPTIMUM SURGICAL CENTER, LLC, NASCENT PARADISE VALLEY SURGICAL CENTER | 814730990 - (AZ) OPTIMUM SURGICAL CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28289 | $2307.00 | 1184714214 - GAINESVILLE ENDOSCOPY CENTER, LLC | 10750801 - (GA) GAINESVILLE ENDOSCOPY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 28289 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28289 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 28289 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 |
|---|---|---|
| 28286-CPT | Moderate | Hammertoe Operation;Cock-Up 5th Toe-Plas |
| 28288-CPT | Moderate | Ostectomy, Partial, Exostectomy Or Condylectomy, Single, Metatarsal Head, First Through Fifth, Each Metatarsal Head, |
| 28289-CPT | Moderate | Hallux Rigidus Correction With Cheilectomy Debridement And Capsular Release Of The First Metatarsophalangeal Joint; Without Implant. (Desc Revised 1/1/2017) |
| 28291-CPT | Moderate | Once Per Dos Hallux Rigidus Correction With Cheilectomy, Debridement & Capsular Release Of First Metatarsophalangeal Joint; With Implant |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28289. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28289 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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