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See a sample rate comparisonCPT 28415 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.
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.
| 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 28415 |
| Medicaid Fee Schedule | View Medicaid rates for 28415 |
National average reimbursement for CPT 28415 by major payers:
$1,602.30
$1,528.75
$1,592.12
$1,854.10
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CPT 28415
5 of 25 sample ratesHigher to lower in this preview
Spalding Triangle Surgery Center, LLC, Spalding Triangle Surgery Center
Spalding Triangle Surgery Center LLC
$9,978.00Published rateSurgery Center At River Road, LLC, Aesthetic Surgery At Hacienda Del Sol
Surgery Center At River Road, LLC
$5,846.00Published rateHarbin Clinic, LLC, Harbin Clinic Gi Lab Cartersville
The Harbin Clinic, L.L.C.
$3,118.00Published rateTampa Bay Eye Surgery Center, LLC
Tampa Bay Eye Surgery Center LLC
$1,428.00Published rateLong Island Center For Digestive Health LLC
Long Island Center For Digestive Health, LLC
$668.00Published rate
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See a sample payer proposalCPT 28415 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28415 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 28415 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 |
|---|---|---|
| 28400-CPT | Moderate | Closed Treatment Of Calcaneal, Closed Treatment Of Calcaneal Fracture Without Manipulationclosed Treatment Of Calcaneal Fracture Without Manipulation |
| 28405-CPT | Moderate | Closed Treatment Of Calcaneal, Closed Treatment Of Calcaneal Fracture With Manipulationclosed Treatment Of Calcaneal Fracture With Manipulation |
| 28406-CPT | Moderate | Percutaneous Skeletal Fixation, Percutaneous Skeletal Fixation Of Calcaneal Fracture Withmanipulation Percutaneous Skeletal Fixation Of Calcaneal Fracture With |
| 28415-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 28415. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28415 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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