Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 28515 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.
Closed Treatment Of Fracture, Closed Treatment Of Fracture Phalanx Or Phalanges Otherthan Great Toe With Manipulation Each Closed Treatment Of Fracture Phalanx Or Phalanges Other
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 11 - Office 23 - Emergency Room |
| Common Modifiers | None 54 - Surgical Care Only T4 - Left foot, fifth digit |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 28515 |
| Medicaid Fee Schedule | View Medicaid rates for 28515 |
National average reimbursement for CPT 28515 by major payers:
$224.86
$212.17
$226.16
$266.33
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 28515.
CPT 28515
5 of 25 sample ratesHigher to lower in this preview
Saint Luke'S Surgicenter
Saint Lukes Surgicenter
$5,213.00Published rateVictoria Ambulatory Surgery Center, Lp, The Surgery Center
Victoria Ambulatory Surgery Center Lp
$566.00Published rateNoc Surgery Center LLC, Loc Surgery Center
Noc Surgery Center LLC
$289.00Published rateStacey Kuder
Deaconess Hospital Inc
$132.69Published rateSt Lukes Surgical Center Inc, St. Luke'S Surgical At Wesley Chapel
St Lukes Surgical Center Inc
$60.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 28515 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28515 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 28515 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 |
|---|---|---|
| 28510-CPT | Low | Closed Treatment Of Fracture, Closed Treatment Of Fracture Phalanx Or Phalanges Otherthan Great Toe Without Manipulation Each Closed Treatment Of Fracture Phalanx Or Phalange S Other |
| 28515-CPT | Moderate | Closed Treatment Of Fracture, Closed Treatment Of Fracture Phalanx Or Phalanges Otherthan Great Toe With Manipulation Each Closed Treatment Of Fracture Phalanx Or Phalanges Other |
| 28525-CPT | Moderate | Open Treatment Of Fracture Ph, Open Treatment Of Fracture Phalanx Or Phalanges Other Than Great Toe Includes Internal Fixation When Performed Each |
| 28530-CPT | Low | Closed Treatment Of Sesamoid F, Closed Treatment Of Sesamoid Fractureclosed Treatm Ent Of Sesamoid Fracture |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28515. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28515 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 28515) and we'll show you how you compare in 15 minutes or less.