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See a sample rate comparisonCPT 28295 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Cor Hlx Vlgs Prx Mtar Osteot, Correction Hallux Valgus With Bunionectomy With Sesamoidectomy When Performed With Proximal Metatarsal Osteotomy Any Method
| 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 | High |
| Medicare Fee Schedule | View Medicare rates for 28295 |
| Medicaid Fee Schedule | View Medicaid rates for 28295 |
National average reimbursement for CPT 28295 by major payers:
$1,245.51
$1,333.94
$1,390.24
$998.28
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CPT 28295
5 of 25 sample ratesHigher to lower in this preview
Surgery Affiliate Of El Paso, LLC, Foundation Surgery Affiliate Of El Paso, LLC
Surgery Affiliate Of El Paso LLC
$12,233.00Published rateStone Oak Surgicenter, LLC
$4,122.00Published rateLake Endoscopy Center, LLC
Lake Endoscopy Center LLC
$3,347.00Published rateNew Orleans La Uptown West Bank Endoscopy Asc LLC, Mga Gastrointestinal Diagnostic And Terapeutic Center
$1,546.00Published rateEyecare Surgery Center, LLC
Eyecare Surgery Center LLC
$793.00Published rate
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See a sample payer proposalCPT 28295 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28295 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 28295 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 |
|---|---|---|
| 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 |
| 28295-CPT | High | Cor Hlx Vlgs Prx Mtar Osteot, Correction Hallux Valgus With Bunionectomy With Sesamoidectomy When Performed With Proximal Metatarsal Osteotomy Any Method |
| 28296-CPT | High | Correction Hallux Valgus (Bun, Correction Hallux Valgus (Bunion) With Or Withoutsesamoidectomy With Metatarsal Osteotomy (Eg Mitchell Chevron Or Concentric Type Procedures) |
| 28297-CPT | High | Correction Hallux Valgus (Bun, Correction Hallux Valgus (Bunionectomy) With Sesamoidectomy When Performed With First Metatarsaland Medial Cuneiform Joint Arthrodesis Any Metho D |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28295. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28295 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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