CPT 28666 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 | • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 51 - Multiple procedures |
| Complexity Level | Moderate |
National average reimbursement for CPT 28666 by major payers:
$248.61
$261.83
$253.95
$315.56
| 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 28666 | ||||||
United | 28666 | $2196.00 | 1043684129 - UNIVERSITY OF MARYLAND MEDICINE ASC, LLC, UNIVERSITY OF MARYLAND SURGERY CENTER | 472525050 - (MD) UNIVERSITY OF MARYLAND MEDICINE ASC LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28666 | $2353.00 | 1295479780 - ADVENTHEALTH SURGERY CENTER DAVENPORT LLC | 881811228 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28666 | $2025.00 | 1073571766 - BOCA RATON OUTPATIENT SURGERY & LASER CENTER LTD | 650241934 - (FL) BOCA RATON OUTPATIENT SURGERY LASER CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28666 | $1562.00 | 1174590434 - HARMONY SURGERY CENTER, LLC, HARMONY AMBULATORY SURGERY CENTER, LLC | 841479751 - (CO) HARMONY SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28666 | $2499.00 | 1962431197 - SHAWNEE MISSION SURGERY CENTER LLC, ADVENTHEALTH SURGERY CENTER SHAWNEE MISSION | 481243914 - (KS) SHAWNEE MISSION SURGERY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28666 | $1044.00 | 1427787142 - CAPITAL SURGERY CENTER LLC | 861660213 - (LA) CAPITAL SURGERY CENTER LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28666 | $1403.00 | 1336154152 - A CENTER FOR FOOT AND ANKLE SURGERY PA, THE CENTER FOR SPECIAL SURGERY OF HAWTHORNE | 223284458 - (NJ) A CENTER FOR FOOT AND ANKLE SU | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28666 | $1637.00 | 1750481453 - LONGVIEW SURGICAL CENTER LLC, PACIFIC SURGICAL CENTER | 161678767 - (WA) LONGVIEW SURGICAL CENTER, LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28666 | $2527.00 | 1730571118 - MEDSTAR MEDICAL GROUP | 462691028 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28666 | $1050.00 | 1316499452 - COLONIE ASC LLC, SPECIALTY EYE SURGERY & LASER CENTER OF THE CAPITAL REGION | 811964670 - (NY) COLONIE ASC LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28666 | $2353.00 | 1881013142 - ADVANCED SURGERY CENTER OF TAMPA, LLC | 463891843 - (FL) ADVANCED SURGERY CENTER OF TAMPA, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28666 | $2595.00 | 1184752305 - SEASHORE SURGICAL INSTITUTE, LLC | 223660141 - (NJ) SEASHORE SURGICAL INSTITUTE | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28666 | $850.00 | 1174670723 - GASTROINTESTINAL INSTITUTE, LLC. | 201622626 - (IL) GASTROINTESTINAL INSTITUTE LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28666 | $1256.00 | 1437115094 - SURGERY CENTER OF LANCASTER, LP | 201824455 - (PA) SURGERY CENTER OF LANCASTER, LP. | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28666 | $950.00 | 1497206890 - MIDWEST EYE CONSULTANTS OHIO, INC., CATARACT & LASER INSTITUTE ASC - MAUMEE #352 | 300888250 - (OH) MIDWEST EYE CONSULTANTS OHIO INC | OH | 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 28666 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28666 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 28666 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 |
|---|---|---|
| 28666-CPT | Moderate | Insertion Of Hardware To Toe Joint Dislocation With Manipulation, Accessed Through The Skin |
| 28675-CPT | Moderate | Open Treatment Of Interphalangeal Joint Dislocation, Includes Internal Fixation, When Performed |
| 28750-CPT | High | Arthrodesis, Great Toe; Metatarsophalangeal Joint |
| 28810-CPT | Moderate | Amputation,Metatarsal,W/Toe,Single |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28666. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28666 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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