CPT 28737 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 • LT - Left side of body • RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 28737 |
National average reimbursement for CPT 28737 by major payers:
$882.76
$825.67
$710.37
$1,059.63
| 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 28737 | ||||||
United | 28737 | $3251.00 | 1578917035 - HABANA AMBULATORY SURGERY CENTER LLC | 475162374 - (FL) HABANA AMBULATORY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28737 | $938.00 | 1689646937 - OCALA ENDOSCOPY ASC LP, ENDOSCOPY CENTER OF OCALA | 621650750 - (FL) OCALA ENDOSCOPY ASC LP | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28737 | $6492.00 | 1275292229 - SCOTTSDALE ENDOSCOPY ASC LLC | 873952617 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28737 | $4000.00 | 1710552278 - CHILDREN'S DENTAL SURGERY CENTER OF JACKSON LLC, CHILDREN'S DENTAL SURGERY OF JACKSON | 852790585 - (NJ) CHILDRENS DENTAL SURGERY CENTER OF JACKSON LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28737 | $3240.00 | 1174502561 - YANKTON MEDICAL CLINIC PC | 460363830 - (SD) YANKTON MEDICAL CLINIC, P.C. | SD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28737 | $3106.00 | 1447661145 - ADVANCED OUTPATIENT SURGERY OF OKLAHOMA, LLC | 371751472 - (OK) ADVANCED OUTPATIENT SURGERY OF | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28737 | $5716.60 | 1649748708 - ANKENY MEDICAL PARK SURGERY CENTER LC | 831281114 - (IA) ANKENY MEDICAL PARK SURGERY CENTER LC | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28737 | $3487.00 | 1053508077 - JOURNEY LITE OF CINCINNATI, LLC | 208861350 - (OH) JOURNEYLITE OF CINCINNATI, LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28737 | $2190.00 | 1689633588 - SOUTH JERSEY ENDOSCOPY LLC, DIMARINO-KROOP-PRIETO GI ASSOC | 200478348 - (NJ) SOUTH JERSEY ENDOSCOPY LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28737 | $9182.00 | 1598769481 - MEMORIAL HERMANN SURGERY CENTER PRESTON ROAD, LTD., DOCTORS UNITED SURGERY CENTER | 752832459 - (TX) MEMORIAL HERMANN SURGERY CENTER PRESTON ROAD LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28737 | $4301.00 | 1417114117 - HOSP OF THE UNIV OF PA SPU | 231352685 - TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28737 | $6588.00 | 1154387710 - WARNER PARK SURGERY CENTER LLC, CENTER FOR ADVANCED SURGERY | 752824260 - (AZ) WARNER PARK SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28737 | $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 | 28737 | $3350.00 | 1265859573 - MODESTO SPECIALTY SURGERY CENTER, PC | 454954897 - (CA) MODESTO SPECIALTY SURGERY CENTER PC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28737 | $3033.00 | 1053575852 - EYNON SURGERY CENTER, LLC | 262791252 | PA | 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 28737 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28737 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 28737 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 |
| 28725-CPT | High | Subtalar Arthrodesis (Includes Grice Type Procedure) |
| 28730-CPT | High | Arthrodesis, Midtarsal Or Tarsometatarsal, Multiple Or Transverse; |
| 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 28737. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28737 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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