CPT 28760 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 | • 24 - Ambulatory Surgical Center • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • T5 - Right foot, great toe • TA - Left foot, great toe |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 28760 |
National average reimbursement for CPT 28760 by major payers:
$935.78
$1,027.80
$1,054.39
$1,273.40
| 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 28760 | ||||||
United | 28760 | $2289.00 | 1578567954 - E. RONALD SALVITTI, M.D., INC., SOUTHWESTERN PA EYE SURGERY CENTER | 251787703 - (PA) E. RONALD SALVITTI, M.D., INC. | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28760 | $3474.00 | 1023266145 - ASC DEVELOPMENT COMPANY, LLC | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28760 | $6492.00 | 1326435926 - SELECT PHYSICIANS SURGERY CENTERS | 383935220 - (FL) SELECT PHYSICIANS SURGERY CENTER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28760 | $6186.00 | 1689666596 - MENOMONEE FALLS AMBULATORY SURGERY CENTER, LLC | 391745697 - (WI) MENOMONEE FALLS AMBULATORY SURGERY CENTER | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28760 | $2373.00 | 1730410697 - SURGICAL SPECIALISTS AT PRINCETON LLC | 270749140 - (NJ) SURGICAL SPECIALISTS AT PRINCE | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28760 | $2200.00 | 1083624225 - UNIVERSITY OF MARYLAND SURGCIAL ASSOC PA, UNIVERSITY OF MARYLAND UROLOGICAL SURGERY CENTER | 521557551 - (MD) UNIVERSITY OF MARYLAND SURGICAL ASSOCIATES P A | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28760 | $8207.00 | 1952364499 - DENTON REGIONAL AMBULATORY SURGERY CENTER, L.P., MEDICAL CITY SURGERY CENTER/DENTON | 200270605 - (TX) DENTON REGIONAL AMBULATORY SURGERY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28760 | $1063.00 | 1104894369 - VALLEY OUTPATIENT SURGICAL CENTER INC | 860585124 - (AZ) VALLEY OUTPATIENT SURGICAL CENTER INC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28760 | $5927.00 | 1255353389 - SOMERSET AMBULATORY SURGICAL CENTER, LLC | 371743209 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28760 | $1959.00 | 1063419513 - ENDOSCOPY CENTER OF WESTERN NEW YORK LLC | 364427974 - (NY) ENDOSCOPY CENTER OF WESTERN NEW YORK LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28760 | $2665.00 | 1952360059 - MAINE EYE CARE ASSOCIATES, MAINE EYE CARE SURGERY CENTER | 10316462 - (ME) EYE CARE OF MAINE, P.A. F/K/A MAINE EYE CARE, P.A. | ME | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28760 | $6065.00 | 1306135298 - DMG PAIN MANAGEMENT SURGERY CENTER, LLC | 271322187 - (IL) DMG PAIN MANAGEMENT SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28760 | $5000.00 | 1417304171 - COLLIN COUNTY ASC, LP, MEDFINITY HEALTH SURGERY CENTER - PLANO | 475615966 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28760 | $1190.00 | 1073764106 - FLORIDA EYE CLINIC AMBULATORY SURGICAL CENTER, INC. | 592303141 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28760 | $2229.00 | 1194291401 - AFFILIATED PHYSICIANS & SURGEONS, LTD | 860495569 - (AZ) AFFILIATED PHYSICIANS SURGEONS LTD | AZ | 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 28760 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28760 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 28760 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 |
|---|---|---|
| 28730-CPT | High | Arthrodesis, Midtarsal Or Tarsometatarsal, Multiple Or Transverse; |
| 28755-CPT | Moderate | Arthrodesis, Great Toe; Interphalangeal Joint |
| 28760-CPT | Moderate | Arthrodesis, With Extensor Hallucis Longus Transfer To First Metatarsal Neck, Great Toe, Interphalangeal Joint (Eg, Jones Type Procedure) |
| 28810-CPT | Moderate | Amputation,Metatarsal,W/Toe,Single |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28760. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28760 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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