CPT 28735 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 |
| Medicare Fee Schedule | View Medicare rates for 28735 |
National average reimbursement for CPT 28735 by major payers:
$1,004.82
$1,060.86
$1,090.17
$1,326.15
| 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 28735 | ||||||
United | 28735 | $1900.00 | 1063417285 - LARGO ENDOSCOPY CENTER LP, TAMPA BAY REGIONAL SURGERY CENTER | 731631684 - (FL) LARGO ENDOSCOPY CENTER LP | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28735 | $2811.00 | 1437320017 - OREGON EYE SURGERY CENTER, INC. | 930973443 - (OR) OREGON EYE SURGERY CENTER INC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28735 | $1382.18 | 1982810990 - JOSEPH JENKINS | 350593390 - DEACONESS HOSPITAL INC | IN | Emergency Medicine Physician (207P00000X) |
United | 28735 | $4162.00 | 1760931349 - SF NASSAU ASC LLC | 300870382 - (NY) SF NASSAU ASC LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28735 | $840.00 | 1508054818 - CUMMINS WOMENS HEALTHCARE LLC, ELIZABETH CUMMINS MD | 522110421 - (OH) CUMMINS WOMENS HEALTHCARE, LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28735 | $658.00 | 1689608697 - ADVANCED COLON CARE INC, SHORELINE COLONOSCOPY SUITES | 61562707 - (CT) ADVANCED COLON CARE INC | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28735 | $3945.00 | 1033105960 - SURGERY CENTER OF OAK RIDGE, LLC, ADVANCED FAMILY SURGERY CENTER | 621801416 - (TN) ADVANCED FAMILY SURGERY CENTER | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28735 | $3200.00 | 1952852873 - PACIFIC NORTHWEST UROLOGY SPECIALISTS, PLLC, PACIFIC NORTHWEST UROLOGY SURGERY CENTER | 473036836 - (WA) PACIFIC NORTHWEST UROLOGY SPECIALIST, PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28735 | $967.00 | 1922054410 - BRUNSWICK ENDOSCOPY CENTER, LLC | 582301413 - (GA) BRUNSWICK ENDOSCOPY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28735 | $1400.00 | 1134499684 - CHILDRENS SURGERY CENTER OF MALVERN, LLC | 452608984 - (PA) CHILDRENS SURGERY CENTER OF MALVERN LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28735 | $3878.00 | 1235155730 - MONTPELIER SURGERY CENTER | 770548811 - (CA) MONTPELIER SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28735 | $4189.00 | 1871052712 - KURESMART PAIN MANAGEMENT SURGERY CENTER-COLUMBIA LLC, CLEARWAY SURGERY CENTER OF COLUMBIA | 834028893 - (MD) KURESMART PAIN MANAGEMENT SURGERY CENTERCOLUMBIA LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28735 | $893.00 | 1154412757 - SURGICENTER LTD, BLOOMBERG EYE CENTER | 311585329 - (OH) SURGICENTER LTD | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28735 | $1943.00 | 1346878303 - HOT SPRINGS AMBULATORY SURGERY CENTER, LLC | 832533389 - (AR) HOT SPRINGS AMBULATORY SURGERY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28735 | $3945.00 | 1619933264 - SALEM SURGERY CENTER, LLC | 742462470 - (OR) SALEM SURGERY CENTER LLC | OR | 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 28735 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28735 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 28735 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 |
| 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 |
| 28737-CPT | Moderate | Arthrodesis, With Tendon Lengthening And Advancement, Midtarsal, Tarsal Navicular-Cuneiform (Eg, Miller Type Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28735. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28735 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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