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See a sample rate comparisonCPT 28304 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.
Osteotomy, Midtarsal Bones, Not Calcaneu
| 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 LT - Left side of body RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 28304 |
| Medicaid Fee Schedule | View Medicaid rates for 28304 |
National average reimbursement for CPT 28304 by major payers:
$1,048.82
$1,073.98
$1,154.33
$1,011.47
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CPT 28304
5 of 25 sample ratesHigher to lower in this preview
Summit Ambulatory Surgical Center, LLC
$7,888.00Published rateUchealth Ambulatory Surgery Centers, Longs Peak Surgery Center, LLC
Uchealth Ambulatory Surgery Centers
$4,842.00Published rateHerndon Surgery Center, Inc.
Fresno Ca Multi Asc
$3,200.00Published rateDoctors Hospital Surgery Center, L.P.
Doctors Hospital Surgery Center Lp
$1,563.00Published rateAmbulatory Surgery Center Of Tucson, Inc.
Ambulatory Surgery Center Of Tucson Inc
$1,024.00Published rate
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See a sample payer proposalCPT 28304 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28304 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 28304 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 |
|---|---|---|
| 28261-CPT | High | Release Mid-Foot Restriction, Surgery To Release Mid-Foot Contracture By Cutting The Capsule That Encases The Foot Joint. |
| 28262-CPT | High | Revision Of Foot And Ankle, Capsulotomy Midfoot Extensive Including Posterior Talotibial Capsulotomy And Tendon S Lengthening Eg Resistant Clubfoot Deformity |
| 28299-CPT | High | Cor Hlx Vlgs Double Osteot, Correction Hallux Valgus With Bunionectomy With Sesamoidectomy When Performed With Double Osteotomy Any Method |
| 28304-CPT | High | Osteotomy, Midtarsal Bones, Not Calcaneu |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28304. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28304 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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