CPT 28302 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 | • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 28302 |
National average reimbursement for CPT 28302 by major payers:
$945.64
$962.25
$977.95
$1,200.20
| 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 28302 | ||||||
United | 28302 | $1059.00 | 1255309951 - BAYFRONT SAME DAY SURGERY CENTER, LLC. | 845074208 - (FL) OHI WEST INC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28302 | $867.00 | 1821064031 - PIEDMONT DAY SURGERY CENTER INC | 541514162 | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28302 | $2388.00 | 1790252864 - TREASURE COAST ASC, LLC, TREASURE COAST CENTER FOR SURGERY | 384092821 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28302 | $551.00 | 1215926993 - NORTH RIVER SURGICAL CENTER, LLC, NORTH RIVER SURGICAL CENTER, INC. | 201788603 | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28302 | $2388.00 | 1659793040 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28302 | $1548.00 | 1174588206 - CHARLESTON SURGERY CENTER LIMITED PARTNERSHIP | 581709761 - (SC) CHARLESTON SURGERY CENTER LIMITED PARTNERSHIP | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28302 | $4500.00 | 1720085384 - ELMHURST OUTPATIENT SURGERY CENTER LLC | 364150045 - (IL) ELMHURST OUTPATIENT SURGERY CENTER, LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28302 | $5729.00 | 1730146861 - CONROE SURGERY CENTER 2, LLC | 760697645 - (TX) CONROE SURGERY CENTER 2 LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28302 | $1645.00 | 1699286922 - HUMBLE VASCULAR SURGICAL CENTER LLC | 820905971 - (TX) HUMBLE VASCULAR SURGICAL CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28302 | $2388.00 | 1558753095 - PACIFIC ENDOSCOPY CENTER LLC | 203905706 - (HI) PACIFIC ENDOSCOPY CENTER, LLC | HI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28302 | $2206.00 | 1265534556 - SOUTH FLORIDA AMBULATORY SURGICAL CENTER LLC | 651093026 - (FL) SOUTH FLORIDA AMBULATORY SURGI | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28302 | $5402.00 | 1457948630 - METHODIST AMBULATORY SURGERY CENTER OF LANDMARK, LLC | 842492174 - (TX) METHODIST AMBULATORY SURGERY CENTER OF LANDMARK LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28302 | $679.00 | 1275507527 - ENDOSCOPY CENTER OF NORTHWEST CONNECTICUT | 61609993 - (CT) ENDOSCOPY CENTER OF NORTHWEST CT | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28302 | $1672.00 | 1861029712 - EAST ATLANTA EYE SURGERY CENTER, LLC | 834671737 - (GA) EAST ATLANTA EYE SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28302 | $806.00 | 1528039567 - PREMIER PROFESSIONAL SURGERY CENTER PC, PARKEYE SURGI CENTER | 381894684 - (MI) PARK EYE & SURGI CENTER | MI | 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 28302 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28302 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 28302 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 |
|---|---|---|
| 28264-CPT | High | Capsulotomy Midtarsal Heyman Type |
| 28292-CPT | Moderate | Correction Hallux Valgus (Bunionectomy) With Sesamoidectomy When Performed; With Resection Of Proximal Phalanx Base When Performed Any Method.(Desc Revised 1/1/2017) |
| 28302-CPT | Moderate | Osteotomy Talus |
| 28305-CPT | Moderate | Osteotomy Midtarsal W Autograft |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28302. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28302 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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