CPT 28510 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | • 23 - Emergency Room • 11 - Office • 20 - Urgent Care Facility |
| Common Modifiers | • None • 54 - Surgical Care Only • T4 - Left foot, fifth digit |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 28510 |
National average reimbursement for CPT 28510 by major payers:
$167.99
$160.42
$171.23
$206.91
| 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 28510 | ||||||
United | 28510 | $145.00 | 1003855594 - OHIO EYE ASSOCIATES, INC., OHIO EYE ASSOCIATES EYE SURGERY & LASER CENTER | 341171920 - (OH) OHIO EYE ASSOCIATES, INC. | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28510 | $1500.00 | 1730180084 - BROOKLYN EYE SURGERY CENTER LLC | 113064342 - (NY) BROOKLYN EYE SURGERY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28510 | $150.00 | 1083114995 - SURGERY CENTER OF LAWRENCEVILLE | 823510956 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28510 | $198.00 | 1669483137 - PHYSICIANS AMBULATORY SURGERY CENTER INC | 593216499 - (FL) PHYSICIANS AMBULATORY SURGERY CENTER, INC. | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28510 | $566.00 | 1528210770 - SOUTH COUNTY OUTPATIENT ENDOSCOPY SERVICES, LP, SCOPES ENDOSCOPY CENTER | 263374547 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28510 | $104.00 | 1154412757 - SURGICENTER LTD, BLOOMBERG EYE CENTER | 311585329 - (OH) SURGICENTER LTD | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28510 | $175.00 | 1285083477 - GEORGIA INTERVENTIONAL PAIN | 810948119 - (GA) GEORGIA INTERVENTIONAL PAIN | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28510 | $6623.00 | 1356124309 - SAINT LUKE'S NORTH SURGERY CENTER, LLC | 920591506 - (MO) SAINT LUKES NORTH SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28510 | $112.00 | 1891763157 - HOUMAS OUTPATIENT SURGERY CENTER | 721005613 - (LA) HOUMA OUTPATIENT SURGERY CENTER | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28510 | $115.00 | 1558323956 - MELBOURNE SURGERY CENTER LP | 582101921 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28510 | $566.00 | 1487716650 - CARONDELET ST. MARY'S NORTHWEST, LLC, CARONDELET FOOTHILLS SURGERY CENTER | 201086556 - (AZ) CAMP LOWELL SURGERY CENTER | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28510 | $140.00 | 1588797807 - SPOKANE DIGESTIVE DISEASE CENTER, P.S., SOUTH ASC | 911013238 - (WA) SPOKANE DIGESTIVE DISEASE CENTER P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28510 | $1471.00 | 1386165504 - THE EMORY CLINIC INC, EMORY AMBULATORY SURGERY CENTER AT SPIVEY STATION | 582030692 - EMORY UNIVERSITY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28510 | $383.00 | 1770598591 - BOISE CENTER FOR FOOT SURGERY PLLC, MILLENNIUM SURGERY CENTER | 820477586 - (ID) BOISE CENTER FOR FOOT SURGERY PLLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28510 | $1187.00 | 1538292990 - TEXAS HEALTH HARRIS METHODIST HOSPITAL FORT WORTH | 752678857 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL SOUTHWEST FORT WORTH | TX | 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 28510 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28510 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 28510 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 |
|---|---|---|
| 28490-CPT | Low | Treatment Of Closed Fracture Great Toe, Phalanx Or Phalanges; Without Manipulation |
| 28495-CPT | Moderate | Treatment Of Closed Fracture Great Toe, Phalanx Or Phalanges; With Manipulation |
| 28496-CPT | Moderate | Treatment Of Closed Fracture Great Toe, Phalanx Or Phalanges; With Manipulation And Percutaneous Pinning |
| 28510-CPT | Low | Treatment Of Closed Fracture, Phalanx Or Phalanges, Other Than Great Toe; Without Manipulation, Each |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28510. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28510 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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