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See a sample rate comparisonCPT 28530 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 Sesamoid F, Closed Treatment Of Sesamoid Fractureclosed Treatm Ent Of Sesamoid Fracture
| 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 | Low |
| Medicare Fee Schedule | View Medicare rates for 28530 |
| Medicaid Fee Schedule | View Medicaid rates for 28530 |
National average reimbursement for CPT 28530 by major payers:
$158.15
$152.96
$156.34
$192.24
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CPT 28530
5 of 25 sample ratesHigher to lower in this preview
Beltway Surgery Centers, L.L.C.
$4,613.00Published rateManatee Surgicare Ltd
$557.00Published rateArizona Surgical Specialists Center, LLC
Arizona Surgical Specialists Center LLC
$314.00Published rateDallas Surgi Center, Inc.
Dallas Surgi Center Inc
$112.00Published rateDigestive Health Specialists, PA
Digestive Health Specialists, P.A.
$35.00Published rate
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See a sample payer proposalCPT 28530 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28530 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 28530 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 |
| 28530-CPT | Low | Closed Treatment Of Sesamoid F, Closed Treatment Of Sesamoid Fractureclosed Treatm Ent Of Sesamoid Fracture |
| 28531-CPT | Moderate | Open Treatment Of Sesamoid Fra, Open Treatment Of Sesamoid Fracture With Or Withoutinternal Fixation Open Treatment Of Sesamoid Fracture With Or Without |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28530. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28530 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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