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See a sample rate comparisonCPT 28630 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 Metatarso, Closed Treatment Of Metatarsophalangeal Joint Dislocation Without Anesthesia Closed Treatment Ofmetatarsophalangeal Joint Dislocation
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 23 - Emergency Room 11 - Office |
| Common Modifiers | None 54 - Surgical Care Only T5 - Right foot, great toe |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 28630 |
| Medicaid Fee Schedule | View Medicaid rates for 28630 |
National average reimbursement for CPT 28630 by major payers:
$201.60
$203.84
$209.44
$249.83
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CPT 28630
5 of 25 sample ratesHigher to lower in this preview
The Emory Clinic Inc., Emory Aesthetic Center
Emory University
$1,394.00Published rateSurgcenter Of Deer Valley, LLC
Surgcenter Of Deer Valley LLC
$574.00Published rateMercy Health Boardman Surgery
Bsmh Ambulatory Ventures II LLC
$368.00Published ratePrecision Surgery Center, LLC.
Precision Surgery Center LLC
$160.00Published rateEyes Of York Surgical Center LLC
$55.00Published rate
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See a sample payer proposalCPT 28630 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28630 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 28630 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 |
|---|---|---|
| 28630-CPT | Moderate | Closed Treatment Of Metatarso, Closed Treatment Of Metatarsophalangeal Joint Dislocation Without Anesthesia Closed Treatment Ofmetatarsophalangeal Joint Dislocation |
| 28635-CPT | Moderate | Closed Treatment Of Metatarso, Closed Treatment Of Metatarsophalangeal Joint Dislocation Requiring Anesthesia Closed Treatment Of Metatarsophalangeal Joint Dislocation |
| 28636-CPT | Moderate | Percutaneous Skeletal Fixation, Percutaneous Skeletal Fixation Of Metatarsophalangeal Joint Dislocation With Manipulation Percutaneous Skeletal Fixation Of Metatarsophalangeal Joint |
| 28645-CPT | Moderate | Open Treatmn Of Metatarsophalangeal Joint Lengthen Inclu Inte, Open Treatment Of Metatarsophalangeal Joint Dislocation Includes Inte |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28630. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28630 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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