CPT 28445 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 28445 |
National average reimbursement for CPT 28445 by major payers:
$1,357.30
$1,425.02
$1,474.43
$1,763.47
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 28445 | ||||||
United | 28445 | $847.76 | 1568935344 - JAMES GILSTRAP | 350593390 - DEACONESS HOSPITAL INC | MO | Certified Registered Nurse Anesthetist (367500000X) |
United | 28445 | $3680.00 | 1043271604 - NORTH FULLERTON SURGERY CENTER, LLC | 223849885 - (NJ) NORTH FULLERTON SURGERY CENTER, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28445 | $4818.00 | 1093245458 - GREAT LAKES SURGICAL SUITES, LLC, GREAT LAKES SURGICAL SUITES | 821350843 - (IN) GREAT LAKES SURGICAL SUITES, LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28445 | $6492.00 | 1053453134 - ADVANCED SURGICAL CONCEPTS LLC | 331035210 - (LA) ADVANCED SURGICAL CONCEPTS LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28445 | $920.00 | 1710979109 - SHEEPSHEAD BAY SURGERY CENTER, INC., SHEEPSHEAD BAY SURGERY CENTER | 61530394 - (NY) SHEEPSHEAD BAY SURGERY CENTER | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28445 | $2911.00 | 1477594422 - SURGERY CENTER OF AVENTURA LTD | 113765789 - (FL) SURGERY CENTER OF AVENTURA LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28445 | $2550.00 | 1962661884 - ACD-SA, LTD., SENDERO IMAGING AND TREATMENT CENTER | 742822681 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28445 | $7888.00 | 1659793040 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28445 | $1428.00 | 1518955897 - BONITA COMMUNITY HEALTH CENTER INC, BONITA SPRINGS HEALTH CENTER | 593544102 - (FL) BONITA COMMUNITY HEALTH CENTER | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28445 | $8818.00 | 1396700407 - ARLINGTON SURGERY CENTER, LLC, ARLINGTON SURGERY CENTER ASSOCIATES, LP | 752055800 - (TX) ARLINGTON SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28445 | $5000.00 | 1558313544 - MINNESOTA VALLEY SURGERY CENTER LLC | 203371241 - (MN) MINNESOTA VALLEY SURGERY CENTER LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28445 | $6380.00 | 1386119253 - CHRISTUS AMBULATORY SURGERY CENTER AT OLYMPIA HILLS LLC, CHRISTUS SURGERY CENTER OLYMPIA HILLS | 384092858 - (TX) CHRISTUS AMBULATORY SURGERY CENTER AT OLYMPIA HILLS LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28445 | $3563.00 | 1497706626 - CHICAGO PROSTATE CANCER SURGERY CENTER, LLC, DUPAGE MEDICAL GROUP SURGERY CENTER, WESTMONT | 204403852 - (IL) CHICAGO PROSTATE CANCER SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28445 | $847.76 | 1912247297 - PAUL BRINTON | 350593390 - DEACONESS HOSPITAL INC | ID | Certified Registered Nurse Anesthetist (367500000X) |
United | 28445 | $1644.00 | 1396828323 - EYE CARE SURGERY CENTER OF MEMPHIS, LLC | 470920340 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 28445 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28445 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 28445 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 |
|---|---|---|
| 28430-CPT | Moderate | Closed Treatment Of Talus Fracture; Without Manipulation |
| 28435-CPT | Moderate | Closed Treatment Of Broken Ankle Joint Bone With Manipulation |
| 28436-CPT | Moderate | Insertion Of Hardware To Broken Ankle Joint With Manipulation, Accessed Through The Skin |
| 28445-CPT | High | Open Treatment Of Closed Or Open Talus Fracture, With Or Without Internal Skeletal Fixation |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28445. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28445 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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