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See a sample rate comparisonCPT 28360 Fee Schedule
Last Verified: October 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.
Reconstruction, Cleft Foot
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 28360 |
| Medicaid Fee Schedule | View Medicaid rates for 28360 |
National average reimbursement for CPT 28360 by major payers:
$1,514.13
$1,420.68
$1,472.18
$1,744.74
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CPT 28360
5 of 25 sample ratesHigher to lower in this preview
Alle-Kiski Medical Center
Highmark Health
$18,877.48Published rateThe Polyclinic, The Polyclinic Plastic Surgery Center
The Polyclinic, PLLC
$5,547.00Published rateSalem Endoscopy Center, LLC
Salem Endoscopy Center LLC
$3,602.00Published rateDulaney Eye Institute, LLC
Dulaney Eye Institute LLC
$2,266.00Published rateCandescent Eye Surgicenter LLC
$891.00Published rate
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See a sample payer proposalCPT 28360 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28360 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 28360 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 |
|---|---|---|
| 28340-CPT | Moderate | Reconstruc Toe,Macrodactyly;Soft Tissue |
| 28344-CPT | Moderate | Corrective Foot Surgery, Surgery To Remove Extra Toe And Reconstruct The Foot. |
| 28360-CPT | High | Reconstruction, Cleft Foot |
| 28420-CPT | High | Surgery To Repair Broken Heel, Surgery To Repair A Broken Heel Bone (Calcaneus). Pins Wires Screws Or Plates May Be Used To Hold The Bone Together. A Bone Graft From Another Part Of The Body May Be Used. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28360. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28360 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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