CPT 28750 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 • RT - Right side of body • T5 - Right foot, great toe |
| Complexity Level | High |
National average reimbursement for CPT 28750 by major payers:
$1,008.72
$1,074.16
$1,122.16
$1,310.39
| 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 28750 | ||||||
United | 28750 | $1292.00 | 1295002806 - HERITAGE ONE DAY SURGERY LLC | 453788494 - (NY) HERITAGE ONE DAY SURGERY LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28750 | $9334.00 | 1104341353 - BANNER PEORIA SURGERY CENTER LLC | 901182685 - (AZ) BANNER PEORIA SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28750 | $624.00 | 1982674065 - HEMET HEALTHCARE SURGICENTER, INC. | 330526203 - (CA) HEMET HEALTHCARE SURGICENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28750 | $935.00 | 1659807717 - TAMPA SURGICAL CENTER LLC | 820715188 - (CA) TAMPA SURGICAL CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28750 | $3122.00 | 1134157225 - OCEAN SPRINGS SURGICAL AND ENDOSCOPY CENTER LLC, OCEAN SPRINGS SURGICAL AND ENDOSCOPY CENTER | 640922411 - (MS) OCEAN SPRINGS SURGICAL & ENDOSCOPY CENTER | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28750 | $6365.00 | 1851950281 - YUMA ADVANCED SURGICAL SUITES LLC | 833076801 - (AZ) YUMA ADVANCED SURGICAL SUITES, LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28750 | $2207.00 | 1194803320 - ORANGE COUNTY OPHTHALMOLOGY MEDICAL GROUP, ORANGE COUNTY EYE SURGICAL CENTER | 953520142 - (CA) ROBERT H. COLLIER, MD, INC. ET AL, PTR. ORANGE COUNTY OPHTHALMOLOGY ME | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28750 | $999.00 | 1619114824 - EAST COLUMBUS SURGERY CENTER LLC | 311641652 - (OH) EAST COLUMBUS SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28750 | $935.00 | 1710177795 - ASPEN SURGERY CENTER, LLC, ASPEN SURGERY CENTER | 205090169 - (CA) ASPEN SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28750 | $987.00 | 1811914625 - PUGET SOUND GASTROENTEROLOGY, PLLC, EDMONDS ENDOSCOPY CENTER | 911123468 - (WA) PUGET SOUND GASTROENTEROLOGY, P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28750 | $3177.00 | 1306438007 - COMPREHENSIVE SURGICAL CARE OF GILBERT, LLC | 852825570 - (AZ) COMPREHENSIVE SURGICAL CARE OF GILBERT LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28750 | $1073.00 | 1437129723 - AFFINITY OUTPATIENT SERVICES | 582189333 - (GA) AFFINITY HEALTH GROUP, L.L.C. | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28750 | $935.00 | 1366044596 - PEGASUS SURGERY CENTER LLC, PEGASUS SURGERY CENTER, LLC | 301211930 - (CA) PEGASUS SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28750 | $2005.93 | 1033190129 - MAE PHYSICIANS SURGERY CENTER, LLC | 640914895 - (MS) MAE PHYSICIAN'S SURGERY CENTER, LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28750 | $3836.00 | 1336790237 - AURORA ENDOSCOPY SURGICENTER, LLC | 825396997 - (CO) AURORA ENDOSCOPY SURGICENTER LLC | CO | 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 28750 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28750 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 28750 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 |
| 28740-CPT | High | Arthrodesis, Midtarsal Or Tarsometatarsal, Single Joint |
| 28750-CPT | High | Arthrodesis, Great Toe; Metatarsophalangeal Joint |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28750. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28750 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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