CPT 28675 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 | • 24 - Ambulatory Surgical Center • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • T1 - Left foot, second digit • T6 - Right foot, second digit |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 28675 |
National average reimbursement for CPT 28675 by major payers:
$721.29
$742.28
$776.96
$931.63
| 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 28675 | ||||||
United | 28675 | $2307.00 | 1366982845 - JACKSONVILLE ENDOSCOPY CENTERS LLC, JACKSONVILLE CENTER FOR ENDOSCOPY | 384016302 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28675 | $2865.00 | 1528016656 - VANTAGE SURGICAL ASSOCIATES, LLC, VANTAGE SURGERY CENTER | 450516750 - (NJ) VANTAGE SURGERY CENTER | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28675 | $2007.00 | 1275158495 - BCC CHANDLER LLC | 851284830 - (AZ) BCC CHANDLER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28675 | $900.00 | 1043204688 - INDIANA AMBULATORY SURGICAL ASSOCIATES, INC | 232923182 - (PA) INDIANA AMBULATORY SURGICAL ASSOCIATES INC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28675 | $1750.00 | 1386795540 - THE SURGERY CENTER AT LONE TREE, LLC | 260139211 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28675 | $1547.00 | 1902960206 - SINUS SURGERY CENTER IDAHO PA | 205282962 - (ID) SINUS SURGERY CENTER IDAHO PA | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28675 | $900.00 | 1669181822 - ALLIANCE SURGERY CENTER AT CUMMING | 881953675 - (GA) ALLIANCE SURGERY CENTER AT CUMMING | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28675 | $1014.86 | 1639124126 - ANNE TINTINALLI | 350593390 - DEACONESS HOSPITAL INC | MI | Emergency Medicine Physician (207P00000X) |
United | 28675 | $1377.00 | 1912965963 - PASTEUR PLAZA SURGERY CENTER LP, PASTEUR PLAZA SURGERY CENTER | 631275972 - (TX) PASTEUR PLAZA SURGERY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28675 | $1014.86 | 1245298066 - SATYAM TATINENI | 350593390 - DEACONESS HOSPITAL INC | IN | Interventional Cardiology Physician (207RI0011X) |
United | 28675 | $1712.00 | 1588328918 - HARLEM ROAD AMBULATORY SURGERY CENTER LLC | 833648797 - (NY) HARLEM ROAD AMBULATORY SURGERY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28675 | $554.00 | 1285736207 - PODIATRY GROUP OF ANNAPOLIS AMBULATORY SURGICAL CENTER, PODIATRY GROUP OF ANNAPOLIS AMBULATORY SURGICAL CENTER LLC | 522197193 - (MD) PODIATRY GROUP OF ANNAPOLIS AMBULATORY SURGICAL CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28675 | $3553.00 | 1821242488 - SPECIALTY SURGICAL CENTER OF NORTH BRUNSWICK, LLC | 208770654 - (NJ) SPECIALTY SURGICAL CENTER OF N | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28675 | $1548.00 | 1174588206 - CHARLESTON SURGERY CENTER LIMITED PARTNERSHIP | 581709761 - (SC) CHARLESTON SURGERY CENTER LIMITED PARTNERSHIP | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28675 | $2353.00 | 1760491385 - ENDOSCOPY CENTER OF NORTHERN OHIO, LLC | 341966846 - (OH) ENDOSCOPY CENTER OF NORTHERN OHIO LLC | 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 28675 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28675 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 28675 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 |
| 28755-CPT | Moderate | Arthrodesis, Great Toe; Interphalangeal Joint |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28675. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28675 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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