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See a sample rate comparisonCPT 28820 Fee Schedule
Last Verified: October 2026
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.
Amputation Toe Metatarsophalangeal
| 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 T6 - Right foot, second digit T1 - Left foot, second digit |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 28820 |
| Medicaid Fee Schedule | View Medicaid rates for 28820 |
National average reimbursement for CPT 28820 by major payers:
$461.82
$711.93
$569.65
$446.14
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CPT 28820
5 of 25 sample ratesHigher to lower in this preview
Burlington County Endoscopy Center LLC
$2,865.00Published rateAtlanticare Surgery Center LLC
$1,857.00Published rateLakewood Eye Physicians And Surgeons Inc A Medical Group
Lakewood Eye Physicians & Surgeons, Inc.
$1,101.00Published rateMidwest Eye Consultants Ohio, Inc, Cataract & Laser Institute #351
Midwest Eye Consultants Ohio Inc
$950.00Published rateBox Hill Surgery Center LLC
$609.00Published rate
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See a sample payer proposalCPT 28820 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28820 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 28820 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 | Percutaneous Skeletal Fixation, Percutaneous Skeletal Fixation Of Interphalangeal Jointdislocation With Manipulation Percutaneous Skeletal Fixation Of Interphalangeal Joint |
| 28750-CPT | High | Fuse Bones Of The Big Toe, Surgery To Fuse A Joint In The Big Toe. The Procedure Eliminates Motion Between The Bones. |
| 28820-CPT | Moderate | Amputation Toe Metatarsophalangeal |
| 28825-CPT | Moderate | Amputation,Toe;Interphalangeal Jnt |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28820. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28820 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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