CPT 28899 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 | • 11 - Office • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 28899 |
National average reimbursement for CPT 28899 by major payers:
$1,103.32
$470.89
$2,640.74
$1,181.72
| 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 28899 | ||||||
United | 28899 | $115.00 | 1851312771 - COLUMBUS ENDOSCOPY CENTER, INC | 640926861 - (MS) COLUMBUS ENDOSCOPY CENTER INC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28899 | $410.00 | 1972578771 - SUN CITY AZ ENDOSCOPY ASC LLC, SUN CITY ENDOSCOPY CENTER | 201519369 - (AZ) SUN CITY AZ ENDOSCOPY ASC LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28899 | $350.00 | 1376228361 - SPRINGFIELD REGIONAL OUTPATIENT SURGERY CENTER LLC | 923802390 - (OH) SPRINGFIELD REGIONAL OUTPATIENT SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28899 | $200.00 | 1255676920 - NORTHPOINTE SURGICAL CENTER, LLC | 461487986 - (UT) NORTHPOINTE SURGICAL CENTER LLC | UT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28899 | $103.00 | 1003816307 - SAGAMORE SURGICAL SERVICES, INC. | 351850819 - (IN) SAGAMORE SURGICAL SERVICES, INC. | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28899 | $71.00 | 1649219536 - USC, LLC, UNASOURCE SURGERY CENTER | 352175811 - (MI) USC, LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28899 | $200.00 | 1487096061 - ARETE SURGICAL CENTER, LLC | 455436298 - (CO) ARETE SURGICAL CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28899 | $150.00 | 1265404669 - NORTH RIVER SURGERY CENTER, LLC | 710799771 - (AR) NORTH RIVER SURGERY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28899 | $112.00 | 1275184293 - JOHNS HOPKINS SURGERY CENTERS SERIES, BEL AIR SURGERY CENTER | 208707724 - (MD) JOHNS HOPKINS SURGERY CENTER SERIES | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28899 | $135.00 | 1184690570 - PAIN CARE SURGERY, PC | 371379699 - (IL) PAIN CARE SURGERY PC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28899 | $67.00 | 1962031807 - CVP SURGERY CENTER IVY POINTE, LLC | 311473421 - CINCINNATI EYE INSTITUTE | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28899 | $163.00 | 1841952397 - SOUTHWESTERN OKLAHOMA SURGICAL ASSOCIATES, LLC | 853643949 - (OK) SOUTHWESTERN OKLAHOMA SURGICAL ASSOCIATES LLC | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28899 | $424.00 | 1629130521 - MIDWEST SURGERY CENTER, LLC, MIDWEST SURGERY CENTER- WOODBURY | 411537436 - (MN) MIDWEST SURGERY CENTER | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28899 | $555.00 | 1861740508 - ADVANCED SURGERY CENTER OF SARASOTA, LLC | 454909647 - (FL) ADVANCED SURGERY CENTER OF SARASOTA LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28899 | $683.00 | 1194770974 - HAMILTON ENDOSCOPY AND SURGERY CENTER, LLC | 223837967 - (NJ) HAMILTON ENDOSCOPY & SURGERY CENTER, LLC | NJ | 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 28899 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28899 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 28899 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 |
|---|---|---|
| 28675-CPT | Moderate | Open Treatment Of Interphalangeal Joint Dislocation, Includes Internal Fixation, When Performed |
| 28725-CPT | High | Subtalar Arthrodesis (Includes Grice Type Procedure) |
| 28750-CPT | High | Arthrodesis, Great Toe; Metatarsophalangeal Joint |
| 28899-CPT | High | Major Procedure Orthopedic Other |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28899. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28899 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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