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See a sample rate comparisonCPT 28345 Fee Schedule
Last Verified: September 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.
Repair Toe Syndactyly
| 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 28345 |
| Medicaid Fee Schedule | View Medicaid rates for 28345 |
National average reimbursement for CPT 28345 by major payers:
$662.99
$702.04
$719.14
$626.99
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CPT 28345
5 of 25 sample ratesHigher to lower in this preview
Aurora Gi Asc LLC, Wisconsin Digestive Health Center
Aurora Gi Asc LLC
$7,081.00Published rateSurgery Center Of Peoria, LLC, Surgery Center Of Peoria
Surgery Center Of Peoria LLC
$2,388.00Published rateSnapfinger Vascular Access Center Asc LLC
$1,647.00Published rateOrlando Surgicare Ltd
$1,127.00Published rateAlexis Sosh
Deaconess Hospital Inc
$432.69Published rate
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See a sample payer proposalCPT 28345 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28345 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 28345 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28345. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28345 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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