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CPT 28340 Fee Schedule

Last Verified: December 2025

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.

Reconstruc Toe,Macrodactyly;Soft Tissue
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Musculoskeletal System

Common Place of Service

22 - On Campus Outpatient Hospital

19 - Off Campus Outpatient Hospital

Common Modifiers

None

LT - Left side of body

T6 - Right foot, second digit

Complexity LevelModerate

National average reimbursement for CPT 28340 by major payers:

bcbs

$718.82

uhc

$774.10

aetna

$771.81

cigna

$951.35

Preview provider-level rates for...
For billing codeCPT 28340
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 28340

United
28340$670.001295793974 - SANTA LUCIA SURGICAL CENTER LLC201918525 - (FL) SANTA LUCIA SURGICAL CENTER LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
28340$2717.001205929080 - OAK TREE SURGERY CENTER, LLC223524889 - (NJ) OAK TREE SURGERY CENTER, LL, LLCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
28340$1453.001609815075 - ORTHOATLANTA SURGERY CENTER OF FAYETTEVILLE, LLC202961633 - (GA) ORTHOATLANTA SURGERY CENTER OF FAYETTEVILLE LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
28340$1043.331033792825 - MOHAMED ABD EL MAKSOUD350593390 - DEACONESS HOSPITAL INCIAHospitalist Physician (208M00000X)
United
28340$2859.001245711803 - SURGCENTER CLEARWATER, LLC, SURGCENTER DUNEDIN823682684 - (FL) SURGCENTER CLEARWATER LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
28340$4074.001508169921 - SAINT LUKES-GI DIAGNOSTICS LLC274142549 - (MO) SAINT LUKESGI DIAGNOSTICS LLCMOAmbulatory Surgical Clinic/Center (261QA1903X)
United
28340$2307.001184714214 - GAINESVILLE ENDOSCOPY CENTER, LLC10750801 - (GA) GAINESVILLE ENDOSCOPY CENTER LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
28340$3150.001902218456 - TEXAS ENDOSCOPY CENTERS, LLC, TEXAS ENDOSCOPY AT INDEPENDENCE MEDICAL VILLAGE470985876TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
28340$2206.001598996894 - SURGICAL ELITE OF AVONDALE, LLC270471437 - (AZ) SURGICAL ELITE OF AVONDALE LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
28340$839.001962743310 - WF ENDOSCOPY CENTER LLC611578919NCAmbulatory Surgical Clinic/Center (261QA1903X)
United
28340$1027.001104214261 - WEST CENTRAL SURGICAL CENTER-BAYSIDE472619181 - (OH) WEST CENTRAL SURGICAL CENTERBAYSIDEOHAmbulatory Surgical Clinic/Center (261QA1903X)
United
28340$1375.001790862183 - CATARACT AND LASER CENTER OF THE NORTH SHORE, LLC43388939 - (MA) CATARACT AND LASER CENTER OF THE NORTH SHORE LLCMAAmbulatory Surgical Clinic/Center (261QA1903X)
United
28340$2353.001326114869 - EL PASO CENTER FOR GASTROINTESTINAL ENDOSCOPY, LLC201482218 - (TX) EL PASO CENTER FOR GASTROINTESTINAL ENDOSCOPY LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
28340$2680.001033351119 - SSM ST CLARE SURGICAL CENTER LLC, SSM ST CLARE SURGICAL CENTER261439695 - (MO) SSM ST CLARE SURGICAL CENTER LLCMOAmbulatory Surgical Clinic/Center (261QA1903X)
United
28340$1399.001689863771 - CAROLINA SURGERY CENTER LLC, THE SURGERY CENTER AT EDGEWATER200707167 - (SC) CAROLINA SURGERY CENTER LLCSCAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 28340 vs. Other Surgical Procedures on the Musculoskeletal System Codes

The CPT 28340 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 28340 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.

CodeComplexityDescription
28340-CPTModerateReconstruc Toe,Macrodactyly;Soft Tissue
28341-CPTModerateRepair Toe Macrodactyly Bone Resect
28344-CPTModerateRemoval Of Extra Toes With Reconstruction
28345-CPTModerateRepair Toe Syndactyly

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28340. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 28340 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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