CPT 28545 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 28545 |
National average reimbursement for CPT 28545 by major payers:
$391.75
$378.14
$405.85
$505.97
| 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 28545 | ||||||
United | 28545 | $1391.00 | 1306957485 - FAIRFAX COLON & RECTAL SURGERY CENTER, LLC | 510571797 | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28545 | $2307.00 | 1205949245 - MEMORIAL SURGERY CENTER, LLC | 201167151 - (OK) MEMORIAL SURGERY CENTER LLC | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28545 | $1260.00 | 1649921065 - JOINT REPLACEMENT CENTER OF LOUISIANA | 874022126 - (LA) JOINT REPLACEMENT CENTER OF LOUS | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28545 | $1530.00 | 1114057023 - CROSSROADS SURGERY CENTER INC | 205799348 - (MN) CROSSROADS SURGERY CENTER INC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28545 | $900.00 | 1952737207 - CPMSC CANTON, LLC | 463595981 - (GA) CPMSC CANTON LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28545 | $2689.00 | 1700888658 - WESTON OUTPATIENT SURGICAL CENTER LTD, WESTON OUTPATIENT SURGICAL CENTER | 650930629 - (FL) WESTON OUTPATIENT SURGICAL CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28545 | $1505.00 | 1538432844 - BARNET DULANEY PERKINS EYE CENTER, PC, AMERICAN VISION PARTNERS | 562589722 - BARNET DULANEY PERKINS EYE CENTER PLLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28545 | $760.00 | 1114912102 - BOISE ENDOSCOPY CENTER, LLC | 820506078 - (ID) BOISE ENDOSCOPY CENTER LLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28545 | $610.00 | 1386615912 - PUGET SOUND GASTROENTEROLOGY, PLLC, FREMONT ENDOSCOPY CENTER | 911123468 - (WA) PUGET SOUND GASTROENTEROLOGY, P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28545 | $239.78 | 1790205862 - SHEA SOUDERS | 350593390 - DEACONESS HOSPITAL INC | IN | Certified Registered Nurse Anesthetist (367500000X) |
United | 28545 | $1075.00 | 1730463753 - PEACHTREE ORTHOPAEDIC SURGERY CENTER AT PERIMETER | 201285759 - (GA) PEACHTREE ORTHOPAEDIC SURGERY CENTER AT PERIMETER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28545 | $1200.00 | 1477803724 - VALENCIA SPECIALTY SURGERY PC | 460979296 - (CA) VALENCIA SPECIALTY SURGERY PC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28545 | $529.00 | 1922237213 - ENDOSCOPY CENTER OF TOMS RIVER, LLC | 300568338 - (NJ) ENDOSCOPY CENTER OF TOMS RIVER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28545 | $1283.00 | 1861743601 - FLUSHING ENDOSCOPY CENTER, LLC | 274675522 - (NY) FLUSHING ENDOSCOPY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28545 | $1120.00 | 1982788220 - CASCADE REGIONAL EYE CENTER INC PS, THE HARMAN EYE CLINIC ASC | 911719913 - SIGHT PARTNERS, LLC | WA | 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 28545 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28545 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 28545 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 |
|---|---|---|
| 28540-CPT | Moderate | Closed Treatment Of Tarsal Bone Dislocation, Other Than Talotarsal; Without Anesthesia |
| 28545-CPT | Moderate | Closed Treatment Of Tarsal Bone Dislocation, Other Than Talotarsal; Requiring Anesthesia |
| 28546-CPT | Moderate | Percutaneous Skeletal Fixation Of Tarsal Bone Dislocation, Other Than Talotarsal, With Manipulation |
| 28555-CPT | High | Open Treatment Of Closed Or Open Tarsal Bone Dislocation, With Or Without Internal Or External Skeletal Fixation |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28545. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28545 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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