CPT 28730 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 | 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital |
| Common Modifiers | None LT - Left side of body RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 28730 |
| Medicaid Fee Schedule | View Medicaid rates for 28730 |
National average reimbursement for CPT 28730 by major payers:
$1,032.83
$1,026.98
$1,066.31
$1,227.84
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 28730 | $4170.00 | 1215134564 - EMMAUS SURGICAL CENTER, LLC | 208939316 - (NJ) EMMAUS SURGICAL CENTER, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28730 | $624.00 | 1083670970 - GLENWOOD SURGICAL CENTER L P | 330595220 - (CA) GLENWOOD SURGICAL CENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28730 | $624.00 | 1114168309 - MEMORIAL CARE SURGICAL CENTER AT ORANGE COAST, LLC | 261394069 - (CA) MEMORIAL CARE SURGICAL CENTER AT ORANGE COAST LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28730 | $1163.00 | 1710047188 - ARROWHEAD ENDOSCOPY AND PAIN MANAGEMENT CENTER LLC, ARROWHEAD ENDOSCOPY CENTER. | 205706445 - (AZ) ARROWHEAD ENDOSCOPY AND PAIN MAN | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28730 | $1937.00 | 1073601332 - LISA RENFRO SURGERY CENTER LLC | 43612312 - (MD) LISA RENFRO SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28730 | $5797.00 | 1467796730 - WINDSOR MILL SURGERY CENTER, LLC | 461412275 - (MD) WINDSOR MILL SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28730 | $624.00 | 1700887155 - TEXAS MIDWEST SURGERY CENTER, LLC | 752800127 - (TX) TEXAS MIDWEST SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28730 | $595.65 | 1114946852 - CHRISTOPHER STEWART | 350593390 - DEACONESS HOSPITAL INC | IN | Certified Registered Nurse Anesthetist (367500000X) |
United | 28730 | $3704.00 | 1952368482 - SAN DIEGO ENDOSCOPY CENTER | 770322251 - (CA) SAN DIEGO ENDOSCOPY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28730 | $624.00 | 1275532889 - COAST SURGERY CENTER L P, COAST SURGERY CENTER OF SOUTH BAY | 450463066 - (CA) COAST SURGERY CENTER L P | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28730 | $2911.00 | 1134182660 - CORAL SPRINGS SURGI-CENTER LTD | 650538147 - (FL) CORAL SPRINGS SURGICENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28730 | $624.00 | 1235112814 - MT PLEASANT SURGICAL CENTER, LLC, MT PLEASANT SURGICAL CENTER | 752691365 - (TX) MT PLEASANT SURGICAL CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28730 | $5500.00 | 1356124309 - SAINT LUKE'S NORTH SURGERY CENTER, LLC | 920591506 - (MO) SAINT LUKES NORTH SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28730 | $9000.00 | 1346292372 - SURGERY CENTER PARTNERS. LLC, TIMBERLAKE SURGERY CENTER | 421580803 - (MO) SURGERY CENTER PARTNERS LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28730 | $3843.00 | 1992759930 - IDAHO SURGICENTER INC, IDAHO SURGICENTER SOUTH | 200049792 - (ID) IDAHO SURGICENTER INC | ID | 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 28730 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28730 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 28730 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 | Fuse Bones Of Ankle Joint, Surgery To Fuse Multiple Joints In And Around The Ankle. |
| 28715-CPT | High | Fuse Bones In The Foot, Surgery To Fuse More Than One Joint In Foot. The Procedure Eliminates Motion Between The Bones. |
| 28730-CPT | High | Arthrodesi Midtarsal Or Tarsometatarsal Multi Or Transvers;, Arthrodesis Midtarsal Or Tarsometatarsal Multiple Or Transverse; |
| 28735-CPT | High | Arthrodesis Midtarsal Or Tars, Arthrodesis Midtarsal Or Tarsometatarsal Multiple Ortransverse With Osteotomy (Eg 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 28730. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28730 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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