CPT 28665 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 | • 11 - Office • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • T6 - Right foot, second digit |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 28665 |
National average reimbursement for CPT 28665 by major payers:
$200.90
$204.52
$204.97
$257.51
| 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 28665 | ||||||
United | 28665 | $344.00 | 1417985102 - SOUTHWESTERN EYE CENTER LTD, SOUTHWESTERN EYE CENTER | 860423068 - SOUTHWESTERN EYE CENTER, LTD. | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28665 | $1301.00 | 1508871211 - TEXAS DIGESTIVE DISEASE CENTER, LTD | 273578014 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28665 | $81.00 | 1174679054 - CROSSROADS SURGERY CENTER, LLC | 562622609 - (TN) CROSSROADS SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28665 | $92.00 | 1548296296 - ENT SURGERY CENTER OF AUGUSTA, LLC | 20577882 - (GA) ENT SURGERY CENTER OF AUGUSTA LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28665 | $122.00 | 1699711556 - ESCNC LLC, EYE SURGERY CENTER OF NORTHERN CALIFORNIA | 462800751 - (CA) ESCNC LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28665 | $80.00 | 1124296173 - TREASURE COAST SURGICAL CENTER INC | 260770428 - (FL) TREASURE COAST SURGICAL CENTER, INC. | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28665 | $646.00 | 1407591902 - AUSTIN GI SURGICENTER, LLC, AUSTIN ENDOSCOPY CENTER | 301073754 - (TX) AUSTIN GI SURGICENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28665 | $94.00 | 1073570552 - PHYSICIANS SURGICAL CENTER LLC, PHYSICIANS SURGICAL CENTER, AN AFFILIATE OF HEALTHSOUTH | 731452371 - (OK) PHYSICIANS SURGICAL CENETER, L.L.C. | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28665 | $78.00 | 1154449643 - AUGUSTA EYE SURGERY, LLC | 205644814 - (GA) AUGUSTA EYE SURGERY LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28665 | $271.00 | 1073816690 - PENN STATE HERSHEY ENDOSCOPY CENTER LLC | 274000022 - (PA) PENN STATE HERSHEY ENDOSCOPY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28665 | $250.00 | 1841255718 - PAOLI SURGERY CENTER LLC | 621547618 - (PA) PAOLI SURGERY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28665 | $139.00 | 1295738375 - OREGON SURGICENTER LLC | 431980819 - (OR) OREGON SURGICENTER, LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28665 | $788.00 | 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 | 28665 | $703.00 | 1861825986 - VADNAIS HEIGHTS SURGERY CENTER LLC, VADNAIS HEIGHTS SURGERY CENTER | 371866891 | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28665 | $306.00 | 1083659866 - ORTHOPAEDIC SURGERY CENTER OF SAN ANTONIO LP, FOUNDATION SURGERY AFFILIATE OF SAN ANTONIO LP | 742976746 - (TX) ORTHOPAEDIC SURGERY CENTER OF SAN ANTONIO LP | TX | 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 28665 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28665 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 28665 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 |
|---|---|---|
| 28530-CPT | Low | Closed Treatment Of Broken Small Bone In Tendon Attached To Great Toe |
| 28600-CPT | Moderate | Closed Treatment Of Tarsometatarsal Joint Dislocation; Without Anesthesia |
| 28630-CPT | Moderate | *Treatment Of Closed Metatarsophalangeal Joint Dislocation; Without Anesthesia |
| 28665-CPT | Moderate | Treatment Of Closed Interphalangeal Joint Dislocation; Requiring Anesthesia |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28665. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28665 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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