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See a sample rate comparisonCPT 28313 Fee Schedule
Last Verified: October 2026
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.
Reconstruction Angular Deform, Reconstruction Angular Deformity Of Toe Soft Tissueprocedures Only (Eg Overlapping Second Toe Fifth Toe Curly Toes)
| 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 59 - Distinct Procedural Service T6 - Right foot, second digit |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 28313 |
| Medicaid Fee Schedule | View Medicaid rates for 28313 |
National average reimbursement for CPT 28313 by major payers:
$657.25
$686.04
$723.78
$611.28
Compare published rates across providers.
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CPT 28313
5 of 25 sample ratesHigher to lower in this preview
Methodist Medical Center Asc Lp, Methodist Ambulatory Surgery Center Medical Center
Methodist Medical Center Asc Lp
$5,402.00Published rateSouth Denver Musculoskeletal Surgical Partners, LLC, South Denver Surgery Center
South Denver Musculoskeletal Surgical Partners LLC
$2,859.00Published rateDermatology Associates Of Kentucky, Psc
New Lexington Clinic, P.S.C.
$1,838.00Published rateJoe Choufani
Deaconess Hospital Inc
$927.73Published rateMeagan Bowling
Deaconess Hospital Inc
$426.26Published rate
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See a sample payer proposalCPT 28313 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28313 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 28313 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 |
|---|---|---|
| 28226-CPT | Moderate | Tenolysis Extensor Foot Multiple |
| 28285-CPT | Moderate | Correct Hammertoe (Eg Interphalang Fusion Partial Or Total Ph, Correction Hammertoe (Eg Interphalangeal Fusion Partial Or Total Ph |
| 28312-CPT | Moderate | Osteotomy Shorten Angular Or Rotational Correct; Other Phalang, Osteotomy Shortening Angular Or Rotational Correction; Other Phalang |
| 28313-CPT | Moderate | Reconstruction Angular Deform, Reconstruction Angular Deformity Of Toe Soft Tissueprocedures Only (Eg Overlapping Second Toe Fifth Toe Curly Toes) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28313. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28313 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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