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See a sample rate comparisonCPT 28291 Fee Schedule
Medicare rates as of October 2026
CPT 28291 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
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 | 24Ambulatory Surgical Center 22On Campus Outpatient Hospital |
| Common Modifiers | RTRight side of body LTLeft side of body |
| Hospital Outpatient Group (APC) | APC 5114 - Level 4 Musculoskeletal Procedures |
| Surgery Center Payment (ASC) | J8 - Device-intensive procedure, paid at an adjusted rate |
| Common Revenue Codes | 03600975Sign up to view all 4 |
| Medicare Fee Schedule | $670.36 national non-facility rate (2026)View Medicare rates for 28291 |
| Medicaid Fee Schedule | $540.175 median of the 8 states in the free previewView Medicaid rates for 28291 |
National average reimbursement for CPT 28291 by major payers:
$900.57
BCBS / Anthem
$1,005.87
UnitedHealthcare
$966.02
Aetna
$820.75
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 28291.
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 table lists codes related to 28291. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 28289-CPT | Hallux Rigidus Correction With Cheilectomy Debridement And Capsular Release Of The First Metatarsophalangeal Joint; Without Implant. (Desc Revised 1/1/2017) |
| 28291-CPT | Hallux Rigidus Correction With Cheilectomy Debridement, Hallux Rigidus Correction With Cheilectomy Debridement And Capsular Release Of The First Metatarsophalangeal Joint; With Implant |
| 28292-CPT | 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 | 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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Frequently Asked Questions
What APC is CPT 28291 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 28291 to APC 5114 (Level 4 Musculoskeletal Procedures). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 28291 in an ambulatory surgery center?
CMS lists CPT 28291 with ASC payment indicator J8: Device-intensive procedure, paid at an adjusted rate.
Which revenue codes are billed with CPT 28291?
Hospital price transparency files list CPT 28291 under these revenue codes: 0360, 0975, 0960 and 0490. A revenue code names the hospital department or charge category for the line; it does not change what the service is.