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See a sample rate comparisonCPT 28304 Fee Schedule
Medicare rates as of October 2026
CPT 28304 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Osteotomy, Midtarsal Bones, Not Calcaneu
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22On Campus Outpatient Hospital 24Ambulatory Surgical Center |
| Common Modifiers | LTLeft side of body RTRight side of body |
| Hospital Outpatient Group (APC) | APC 5114 - Level 4 Musculoskeletal Procedures |
| Surgery Center Payment (ASC) | A2 - Paid separately, from the OPPS relative weight |
| Common Revenue Codes | 03600960 |
| Medicare Fee Schedule | $871.76 national non-facility rate (2026)View Medicare rates for 28304 |
| Medicaid Fee Schedule | $675.955 median of the 8 states in the free previewView Medicaid rates for 28304 |
National average reimbursement for CPT 28304 by major payers:
$1,048.82
BCBS / Anthem
$1,073.98
UnitedHealthcare
$1,154.33
Aetna
$1,011.47
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 28304.
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 table lists codes related to 28304. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 28261-CPT | Release Mid-Foot Restriction, Surgery To Release Mid-Foot Contracture By Cutting The Capsule That Encases The Foot Joint. |
| 28262-CPT | Revision Of Foot And Ankle, Capsulotomy Midfoot Extensive Including Posterior Talotibial Capsulotomy And Tendon S Lengthening Eg Resistant Clubfoot Deformity |
| 28299-CPT | Cor Hlx Vlgs Double Osteot, Correction Hallux Valgus With Bunionectomy With Sesamoidectomy When Performed With Double Osteotomy Any Method |
| 28304-CPT | 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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Frequently Asked Questions
What APC is CPT 28304 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 28304 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 28304 in an ambulatory surgery center?
CMS lists CPT 28304 with ASC payment indicator A2: Paid separately, from the OPPS relative weight.
Which revenue codes are billed with CPT 28304?
Hospital price transparency files list CPT 28304 under these revenue codes: 0360 and 0960. A revenue code names the hospital department or charge category for the line; it does not change what the service is.