CPT 28570 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 |
| Common Modifiers | • None • RT - Right side of body • 54 - Surgical Care Only • LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 28570 |
National average reimbursement for CPT 28570 by major payers:
$313.28
$277.57
$294.71
$375.78
| 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 28570 | ||||||
United | 28570 | $250.00 | 1922028265 - ATLANTIC GASTRO SURGICENTER, LLC, T/A ACCESS | 223645443 - (NJ) ATLANTIC GASTRO SURGICENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28570 | $87.00 | 1225107014 - COMMONWEALTH EYE CLINIC INC | 611140257 - (KY) COMMONWEALTH EYE CLINIC INC | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28570 | $506.00 | 1295060069 - TIMONIUM SURGERY CENTER, LLC | 270399689 - (MD) TIMONIUM SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28570 | $114.00 | 1457490872 - HSC SURGICAL ASSOCIATES, FAIRFIELD ENDOSCOPY CENTER | 311386408 - (OH) HSC SURGICAL ASSOCIATES OF CINCINNATI, LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28570 | $180.00 | 1558372029 - HOLIDAY SURGERY CENTER LIMITED PARTNERSHIP L L P | 593591411 - (FL) HOLIDAY SURGERY CENTER LIMITED PARTNERSHIP L L P | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28570 | $224.00 | 1962920751 - WEST END SURGICAL, LLC, OREGON SURGICAL INSTITUTE | 812758812 - (OR) WEST END SURGICAL LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28570 | $555.00 | 1689664906 - PEDIATRIC SURGERY CENTERS, LLC | 201711553 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28570 | $566.00 | 1083624670 - PRESCOTT OUTPATIENT SURGICAL CENTER LLC | 860548048 - (AZ) PRESCOTT OUTPATIENT SURGICAL CENTER, LP | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28570 | $150.00 | 1992248512 - LUBBOCK VASCULAR ACCESS CENTER | 352344583 - (TX) LUBBOCK INTERVENTIONAL NEPHROLOGY ASSOCIATES PA | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28570 | $906.00 | 1922160357 - ARAPAHOE ENDOSCOPY CENTER PARTNERSHIP PLLP | 472388780 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28570 | $737.00 | 1629703236 - NORTH CYPRESS SURGICENTER, LLC, NORTH CYPRESS SURGERY CENTER | 851383722 - (TX) NORTH CYPRESS SURGICENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28570 | $574.00 | 1568967131 - CENTRAL MAINE EYE SURGERY CENTER LLC | 824811437 - (ME) CENTRAL MAINE EYE SURGERY CENTER LLC | ME | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28570 | $574.00 | 1861071250 - ADVENTHEALTH SURGERY CENTER MILLS PARK LLC, ADVENTHEALTH SURGERY CENTER MILLS PARK | 832780608 - (FL) ADVENTHEALTH SURGERY CENTER MILLS PARK LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28570 | $106.00 | 1851317614 - KENDALL POINTE SURGERY CENTER LLC | 364236445 - (IL) KENDALL POINTE SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28570 | $250.00 | 1083689749 - GAINESVILLE FL ORTHOPAEDIC ASC LLC, ORTHOPAEDIC SURGERY CENTER | 200603370 - (FL) THE GAINESVILLE FL ORTHOPAEDIC A | FL | 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 28570 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28570 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 28570 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 |
|---|---|---|
| 28570-CPT | Moderate | Treatment Of Closed Talotarsal Joint Dislocation; Without Anesthesia |
| 28575-CPT | Moderate | Treatment Of Closed Talotarsal Joint Dislocation; Requiring Anesthesia |
| 28576-CPT | Moderate | Insertion Of Hardware To Foot Joint Dislocation With Manipulation, Accessed Through The Skin Of The |
| 28585-CPT | High | Open Treatment Of Closed Or Open Talotarsal Joint Dislocation, With Or Without Internal Or External Skeletal Fixa |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28570. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28570 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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