CPT 28715 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 • LT - Left side of body • RT - Right side of body |
| Complexity Level | High |
National average reimbursement for CPT 28715 by major payers:
$1,214.83
$1,283.76
$1,348.32
$1,600.65
| 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 28715 | ||||||
United | 28715 | $4842.00 | 1770958522 - UCHEALTH AMBULATORY SURGERY CENTERS, LONGS PEAK SURGERY CENTER, LLC | 383984888 - (CO) UCHEALTH AMBULATORY SURGERY CENTERS | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28715 | $6588.00 | 1760486369 - MOUNTAIN EMPIRE SURGERY CENTER LP | 621772667 - (TN) MOUNTAIN EMPIRE SURGERY CENTER LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28715 | $1691.00 | 1326047937 - WEST SHORE ENDOSCOPY CENTER LLC | 251885828 - (PA) WEST SHORE ENDOSCOPY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28715 | $949.00 | 1518998764 - TENNESSEE PAIN SURGERY CENTER, LLC | 621790133 - (TN) TENNESSEE PAIN SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28715 | $1655.00 | 1487765897 - BAY MICROSURGICAL UNIT | 570799855 - (SC) BAY MICROSURGICAL UNIT | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28715 | $1083.00 | 1598275703 - LIBERTY ENDOSCOPY CENTER | 821414044 - (OH) LIBERTY ENDOSCOPY CENTER, LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28715 | $6365.00 | 1942472931 - SURGCENTER OF GLEN BURNIE, SURGCENTER OF GLEN BURNIE, LLC | 261572774 - (MD) SURGCENTER OF GLEN BURNIE, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28715 | $6365.00 | 1962788059 - SURGCENTER OF SILVER SPRING, LLC | 452950933 - (MD) SURGCENTER OF SILVER SPRING LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28715 | $7888.00 | 1619637543 - GAB ENDOSCOPY CENTER LLC | 372021101 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28715 | $4162.00 | 1023169380 - JCMG SURGERY CENTER, INC. | 431809950 - (MO) JCMG SURGERY CENTER INC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28715 | $6365.00 | 1174802045 - LEONARDTOWN SURGERY CENTER LLC | 452019132 - (MD) LEONARDTOWN SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28715 | $4656.00 | 1679108914 - PRECISION SC, LLC, PRECISIONCARE SURGERY CENTER | 832882696 - (NY) PRECISION SC LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28715 | $6365.00 | 1063947422 - SILVER CROSS AMBULATORY SURGERY CENTER, LLC, SILVER CROSS SURGERY CENTER | 371852055 - (IL) SILVER CROSS AMBULATORY SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28715 | $1520.77 | 1184897472 - LAKE COUNTRY ENDOSCOPY CENTER, LLC | 261572986 - (WI) LAKE COUNTRY ENDOSCOPY CENTER LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28715 | $4000.00 | 1053835983 - GROUP SURGICAL PARTNERS INTEGRATED LLC, LEGENT OUTPATIENT SURGERY - FRISCO | 821249116 - (TX) GROUP SURGICAL PARTNERS INTEGRATED LLC | 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 28715 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28715 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 28715 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 |
|---|---|---|
| 28705-CPT | High | Fusion Of All Bones Of The Ankle And Hindfoot |
| 28715-CPT | High | Fusion Of Three Major Bones Of The Hindfoot |
| 28730-CPT | High | Arthrodesis, Midtarsal Or Tarsometatarsal, Multiple Or Transverse; |
| 28735-CPT | High | Arthrodesis, Midtarsal Or Tarsometatarsal, Multiple Or Transverse; With Osteotomy As For Flatfoot Correction |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28715. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28715 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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