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See a sample rate comparisonCPT 28455 Fee Schedule
Last Verified: October 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.
Treatment Of Tarsal Bone Fract, Treatment Of Tarsal Bone Fracture (Except Talus Andcalcaneus) With Manipulation Each Treatment Oftarsal Bone Fracture (Except Talus And
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 11 - Office 21 - Inpatient Hospital |
| Common Modifiers | None LT - Left side of body RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 28455 |
| Medicaid Fee Schedule | View Medicaid rates for 28455 |
National average reimbursement for CPT 28455 by major payers:
$367.36
$381.89
$392.99
$460.49
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CPT 28455
5 of 25 sample ratesHigher to lower in this preview
Greater Dayton Surgery Center LLC
Greater Dayton Surgery Center
$4,097.00Published rateMaple Lawn Surgery Center
Maple Lawn Surgery Center, LLC
$574.00Published rateRma Of Philadelphia Surgical Center LLC
$350.00Published rateRaider Surgical Center LLC
$150.00Published rateEyecare Surgery Center, LLC
Eyecare Surgery Center LLC
$55.00Published rate
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See a sample payer proposalCPT 28455 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28455 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 28455 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 |
|---|---|---|
| 28450-CPT | Moderate | Treatment Of Tarsal Bone Fract, Treatment Of Tarsal Bone Fracture (Except Talus Andcalcaneus) Without Manipulation Each Treatmentof Tarsal Bone Fracture (Except Talus And |
| 28455-CPT | Moderate | Treatment Of Tarsal Bone Fract, Treatment Of Tarsal Bone Fracture (Except Talus Andcalcaneus) With Manipulation Each Treatment Oftarsal Bone Fracture (Except Talus And |
| 28456-CPT | Moderate | Percutaneous Skeletal Fixation, Percutaneous Skeletal Fixation Of Tarsal Bone Fracture(Except Talus And Calcaneus) With Manipulation Each Percutaneous Skeletal Fixation Of Tarsal Bone Fracture |
| 28465-CPT | Moderate | Surgical Repair Of Broken Foot, Surgery To Repair A Broken Bone In The Foot (Tarsal Or Metatarsal). Pins Wires Or Screws May Be Used To Secure The Bone. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28455. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28455 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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