CPT 28890 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 | • 11 - Office • 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 28890 |
National average reimbursement for CPT 28890 by major payers:
$397.99
$438.65
$432.23
$553.53
| 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 28890 | ||||||
United | 28890 | $2200.00 | 1588071575 - FOULK ROAD SURGERY CENTER | 510385184 - (DE) WILMINGTON AMBULATORY SURGICAL CENTER LLC | DE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28890 | $1269.00 | 1801822739 - SYLVAN SURGERY CENTER, INC. | 200500901 - (CA) SYLVAN SURGERY CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28890 | $1786.00 | 1386677326 - INLAND EYE SPECIALISTS A MEDICAL CORP, INLAND EYE SPECIALISTS | 330585144 - (CA) INLAND EYE SPECIALISTS, A MEDICAL CORPORATION | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28890 | $1300.00 | 1306214705 - GSI ASC, LLC | 474883816 - (OK) GSI ASC LLC | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28890 | $3500.00 | 1326142878 - LEBANON ENDOSCOPY CENTER LLC, LEBANON ENDOSCOPY CENTER | 205449574 - (TN) LEBANON ENDOSCOPY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28890 | $1818.00 | 1144200163 - ABILENE ASC LP, ABILENE ENDOSCOPY CENTER | 621562008 - (TX) ABILENE ASC LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28890 | $1410.00 | 1558305086 - SOUTHWESTERN EYE CENTER LTD, SOUTHWESTERN EYE CENTER | 860423068 - SOUTHWESTERN EYE CENTER, LTD. | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28890 | $1700.00 | 1023542339 - BATON ROUGE VASCULAR ACCESS ASC LLC | 814685509 - (LA) BATON ROUGE VASCULAR ACCESS ASC LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28890 | $4468.75 | 1831254788 - GROVE CITY MEDICAL CENTER | 251340370 - GROVE CITY MEDICAL CENTER | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28890 | $621.00 | 1023507183 - SOUTH PERRY ENDOSCOPY PLLC | 462792041 - (WA) SOUTH PERRY ENDOSCOPY PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28890 | $1200.00 | 1396454963 - ST LUKES SURGICAL CENTER INC, ST. LUKE'S SURGICAL AT WESLEY CHAPEL | 592407224 - (FL) ST LUKES SURGICAL CENTER INC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28890 | $1805.00 | 1578914891 - DH PHYSICIANS AMBULATORY SERVICES | 812885619 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28890 | $1633.00 | 1104220466 - ELITE SURGERY CENTER LLC | 320411327 - (PA) ELITE SURGERY CENTER, LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28890 | $3454.00 | 1073816690 - PENN STATE HERSHEY ENDOSCOPY CENTER LLC | 274000022 - (PA) PENN STATE HERSHEY ENDOSCOPY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28890 | $1763.00 | 1093757379 - ASC DEVELOPMENT COMPANY, LLC | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | 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 28890 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28890 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 28890 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 |
| 28715-CPT | High | Fusion Of Three Major Bones Of The Hindfoot |
| 28800-CPT | Moderate | Amputation,Ft;Midtarsal (Chopart) |
| 28890-CPT | Moderate | Extracorporeal Shock Wave High Energy Performed By A Physician Or Other Qualified Health Care Pro-Fessional Requiring Anesthesia Other Than Local Including Ultrasound Guidance Involving The Plantar Fascia (Revised 1/1/2013) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28890. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28890 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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