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See a sample rate comparisonCPT 28291 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.
Hallux Rigidus Correction With Cheilectomy Debridement, Hallux Rigidus Correction With Cheilectomy Debridement And Capsular Release Of The First Metatarsophalangeal Joint; With Implant
| 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 |
| Medicare Fee Schedule | View Medicare rates for 28291 |
| Medicaid Fee Schedule | View Medicaid rates for 28291 |
National average reimbursement for CPT 28291 by major payers:
$900.57
$1,005.87
$966.02
$820.75
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CPT 28291
5 of 25 sample ratesHigher to lower in this preview
Franciscan Orthopedic Surgery Center LLC
$11,797.00Published rateSurgery Center Of Scottsdale, LLC
Surgery Center Of Scottsdale LLC
$6,588.00Published rateFlorham Park Endoscopy Asc LLC, Florham Park Endoscopy Center
Florham Park Endoscopy Center, LLC
$5,484.00Published rateGulf Coast Outpatient Surgery Center, LLC
$1,885.00Published rateSouth Carolina Endoscopy Center
S.C. Endoscopy Center LLC
$800.00Published rate
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See a sample payer proposalCPT 28291 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28291 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 28291 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 |
|---|---|---|
| 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 | Hallux Rigidus Correction With Cheilectomy Debridement, Hallux Rigidus Correction With Cheilectomy Debridement And Capsular Release Of The First Metatarsophalangeal Joint; With Implant |
| 28292-CPT | Moderate | Cor Hlx Vlgs Rsc Prx Phlx Bs, Correction Hallux Valgus With Bunionectomy With Sesamoidectomy When Performed With Resection Of Proximal Phalanx Base When Performed Any Method |
| 28309-CPT | High | Osteotomy With Or Without Len, Osteotomy With Or Without Lengthening Shorteningorangular Correction Metatarsal Multiple (Eg S Wanson Type Cavus Foot Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28291. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28291 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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