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See a sample rate comparisonCPT 28475 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 A Broken Foot, Treatment Of A Broken Bone In The Foot. The Bone May Be Manually Moved Into Its Proper Position. The Foot Is Put Into A Cast Splint Or Brace.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 11 - Office 23 - Emergency Room |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 28475 |
| Medicaid Fee Schedule | View Medicaid rates for 28475 |
National average reimbursement for CPT 28475 by major payers:
$344.76
$345.99
$349.58
$426.96
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CPT 28475
5 of 25 sample ratesHigher to lower in this preview
Surgery Center, LLC
The Surgery Center, LLC
$1,665.00Published rateSurgery Center Of Scottsdale, LLC, Mountain View Surgery Center Of Scottsdale
Surgery Center Of Scottsdale LLC
$555.00Published rateSurgcenter Chandler, LLC, Surgcenter Gilbert
Surgcenter Chandler LLC
$394.00Published rateMacon Outpatient Surgery, LLC
$175.00Published rateWguasc, LLC
Wguasc LLC
$64.00Published rate
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See a sample payer proposalCPT 28475 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28475 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 28475 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 |
|---|---|---|
| 28470-CPT | Moderate | Treatment Of A Broken Foot, Treatment Of A Broken Bone In The Foot. The Bone May Be Manually Moved Into Its Proper Position. The Foot Is Put Into A Cast Splint Or Brace. |
| 28475-CPT | Moderate | Treatment Of A Broken Foot, Treatment Of A Broken Bone In The Foot. The Bone May Be Manually Moved Into Its Proper Position. The Foot Is Put Into A Cast Splint Or Brace. |
| 28476-CPT | Moderate | Percutaneous Skeletal Fixation, Percutaneous Skeletal Fixation Of Metatarsal Fracture With Manipulation Each Percutaneous Skeletal Fixation Of Metatarsal Fracture With |
| 28485-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 28475. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28475 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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