CPT 28800 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 28800 |
National average reimbursement for CPT 28800 by major payers:
$757.22
$742.75
$739.73
$910.88
| 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 28800 | ||||||
United | 28800 | $850.00 | 1043290653 - SUNCOAST SURGERY CENTER, LLC | 650913259 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28800 | $1850.00 | 1568060655 - WESTERN PA SURGERY CENTER, BEAVER COUNTY BRANCH, LLC | 824214966 - (PA) WESTERN PA SURGERY CENTER BEAVER | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28800 | $2799.00 | 1003332883 - DESERT VISTA SURGICAL CENTER LLC | 821195281 - (AZ) DESERT VISTA SURGICAL CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28800 | $2100.00 | 1285936641 - RIVERS EDGE AESTHETIC SURGERY, LLC | 271645468 - (SD) RIVERS EDGE AESTHETIC SURGERY LLC | SD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28800 | $1050.00 | 1285630160 - NOVAMED EYE SURGERY CENTER OF NORTH COUNTY, LLC, WOODCREST SURGERY CENTER | 364111316 - (MO) NOVAMED EYE SURGERY CENTER OF NORTH COUNTY LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28800 | $2380.00 | 1457976383 - VHC-I | 851094630 - (AZ) VHCI | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28800 | $1273.00 | 1124559679 - MIDATLANTIC ENDOSCOPY LLC, MID-ATLANTIC GASTROINTESTINAL CENTER III | 814079161 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28800 | $2781.00 | 1902895675 - CAROMONT HEALTH SERVICES, INC., CAROMONT SPECIALTY SURGERY | 561455630 - (NC) CAROMONT HEALTH SERVICES INC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28800 | $1187.00 | 1851312771 - COLUMBUS ENDOSCOPY CENTER, INC | 640926861 - (MS) COLUMBUS ENDOSCOPY CENTER INC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28800 | $2186.00 | 1043819873 - LONE TREE SURGERY CENTER, LLC | 851321160 - (CO) LONE TREE SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28800 | $1600.00 | 1346581105 - MD LASER SURGERY CENTER, LLC | 462169227 - (MD) MD LASER SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28800 | $2080.00 | 1154724326 - BINZ SURGERY CENTER, LLC | 352484734 - (TX) BINZ SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28800 | $1100.00 | 1972711471 - NOVI SURGERY CENTER LLC, NOVI SURGERY CENTER | 201600650 - (MI) NOVI SURGERY CENTER, LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28800 | $1312.00 | 1659625101 - ENDOSCOPY CENTER OF GRAND JUNCTION LLC | 461251610 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28800 | $4600.00 | 1487371431 - BAYLOR SCOTT & WHITE SURGICARE WAXAHACHIE LLC | 920758698 | TX | 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 28800 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28800 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 28800 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; |
| 28735-CPT | High | Arthrodesis, Midtarsal Or Tarsometatarsal, Multiple Or Transverse; With Osteotomy As For Flatfoot Correction |
| 28800-CPT | Moderate | Amputation,Ft;Midtarsal (Chopart) |
| 28805-CPT | Moderate | Amputation Foot Transmetatarsal |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28800. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28800 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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