CPT 28585 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-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 | • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 28585 |
National average reimbursement for CPT 28585 by major payers:
$1,158.72
$1,138.92
$1,203.37
$1,453.40
| 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 28585 | ||||||
United | 28585 | $1845.00 | 1558785683 - SOUTHERN SPORTS SURGICAL, LLC., INDIAN LAKE SURGERY CENTER | 463690503 - (TN) SOUTHERN SPORTS SURGICAL LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28585 | $475.00 | 1962869446 - FAYETTEVILLE GASTROENTEROLOGY ENDOSCOPY CENTER, LLC | 473997859 - (NC) FAYETTEVILLE GASTROENTEROLOGY ENDOSCOPY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28585 | $713.69 | 1902382757 - MARY GUTHRIE | 350593390 - DEACONESS HOSPITAL INC | IN | Nurse Practitioner (363L00000X) |
United | 28585 | $2044.00 | 1508304692 - THE REGENTS OF THE UNIVERSITY OF CALIFORNIA, UCLA DEPT OF MEDICINE | 954373071 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28585 | $1553.31 | 1841570140 - PRASONGCHAI SATTAYAPRASERT | 350593390 - DEACONESS HOSPITAL INC | IN | Clinical Cardiac Electrophysiology Physician (207RC0001X) |
United | 28585 | $1113.00 | 1962455428 - VALLEY EYE INSTITUTE ASC LLC, CVP SURGERY CENTER | 200080762 - (OH) VALLEY EYE INSTITUTE ASC LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28585 | $1272.00 | 1629166624 - AMBULATORY SURGICAL CENTER OF SOUTHERN NEVADA LLC | 861081788 - (NV) AMBULATORY SURGICAL CENTER OF SOUTHERN NEVADA LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28585 | $818.00 | 1497347934 - INTEGRIS DDSI ENDOSCOPY CENTERS LLC | 854253589 | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28585 | $1076.00 | 1841733326 - AU SURGERY CENTER, LLC | 814545748 - (GA) AU SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28585 | $1155.00 | 1134182546 - JACKSONVILLE SURGERY CENTER, LTD | 621600402 - (FL) JACKSONVILLE SURGERY CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28585 | $1400.00 | 1467979443 - MVH ENDOSCOPY LLC, PCS ENDOSCOPY SUITE | 822606374 - (ID) MVH ENDOSCOPY LLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28585 | $2000.00 | 1124247846 - ADVANCED SURGICAL ARTS CENTER LLC | 550815800 - (NJ) ADVANCED SURGICAL ARTS CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28585 | $1489.00 | 1245288257 - SURGICAL CENTER OF GREENSBORO, LLC | 631251243 - (NC) SURGICAL CENTER OF GREENSBORO LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28585 | $1838.00 | 1093595696 - NEW LEXINGTON CLINIC PSC, DERMATOLOGY ASSOCIATES OF KENTUCKY PSC | 611262927 - (KY) NEW LEXINGTON CLINIC, P.S.C. | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28585 | $490.00 | 1215400320 - SURGERY CENTER AT GATEWAY LLC | 823763830 - (MI) SURGERY CENTER AT GATEWAY LLC | MI | 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 28585 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28585 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 28585 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 28585. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28585 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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