HCPCS S0028 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 | • Temporary National Codes (Non-Medicare) • Non-Medicare Drug Codes |
| Common Place of Service | • None • 11 - Office |
| Complexity Level | Low |
National average reimbursement for HCPCS S0028 by major payers:

$0.91

$0.96

$1.09

$1.31
| 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 HCPCS S0028 | ||||||
United | S0028 | $0.90 | 1679912729 - ROCCO RICHARDS | 133956599 - BOSTON CHILDREN'S HEALTH PHYSICIANS, LLP | TX | Infectious Disease Physician (207RI0200X) |
United | S0028 | $0.89 | 1639179690 - EDUARDO DEJESUS-PERDOMO | 822754294 - COMPLETE CARE PARTNERS LLC | TX | Internal Medicine Physician (207R00000X) |
United | S0028 | $0.89 | 1275532640 - BABAR ZUBERI | 752616977 - CHRISTUS TRINITY CLINIC | TX | Internal Medicine Physician (207R00000X) |
United | S0028 | $0.90 | 1336767284 - TEXAS REGENERATIVE AND INTEGRATIVE CENTERS OF HEALTH PLLC | 842609856 - TEXAS REGENERATIVE AND INTEGRATIVE CENTERS OF HEALTH PLLC | TX | Multi-Specialty Group (193200000X) |
United | S0028 | $0.89 | 1013070754 - NOMITA KIM | 462456505 - PRIVIA MEDICAL GROUP | TX | Family Medicine Physician (207Q00000X) |
United | S0028 | $0.89 | 1902909815 - RICHARD MCCALLUM | 752668018 | TX | Gastroenterology Physician (207RG0100X) |
United | S0028 | $0.89 | 1720184187 - ABSAR ALI | 680574650 - KIDNEY AND HYPERTENSION CONSULTANTS, PLLC | TX | Internal Medicine Physician (207R00000X) |
United | S0028 | $0.90 | 1740613231 - COVENANT SURGERY ASSOCIATES | 463401227 - COVENANT SURGERY ASSOCIATES | TX | Multi-Specialty Group (193200000X) |
United | S0028 | $0.90 | 1194933739 - ANU SURY | 752613493 - TEXAS HEALTH PHYSICIANS GROUP | TX | Family Medicine Physician (207Q00000X) |
United | S0028 | $0.90 | 1154339380 - ANTHONY ASISTIDO | 881012516 - INPATIENT CONSULTANTS OF CORPUS CHRISTI PLLC | TX | Internal Medicine Physician (207R00000X) |
United | S0028 | $0.89 | 1790743524 - AMARILLO MEDICAL SPECIALISTS,LLP | 752562354 - AMARILLO MEDICAL SPECIALISTS, LLP | TX | Multi-Specialty Group (193200000X) |
United | S0028 | $0.89 | 1356479901 - MANN EYE CENTER PA | 470914928 - MANN EYE CENTER, PA | TX | Multi-Specialty Group (193200000X) |
United | S0028 | $0.54 | 1447403399 - FIRM FOUNDATIONS HEALTHCARE CLINIC PC | 263528361 - FIRM FOUNDATIONS HEALTH CARE CLINIC, PC | TX | Single Specialty Group (193400000X) |
United | S0028 | $0.90 | 1386622827 - MARK GABBIE | 760422435 - C H WILKINSON PHYSICIAN NETWORK | TX | Family Medicine Physician (207Q00000X) |
United | S0028 | $0.89 | 1124339528 - KEVIN MCMAHON | 300951072 - NEUROHOSPITALIST OF MCALLEN PLLC | TX | Neurology Physician (2084N0400X) |
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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HCPCS S0028 vs. Other Non-Medicare Drug Codes Codes
The HCPCS S0028 code is part of the Temporary National Codes (Non-Medicare) services used for Non-Medicare Drug Codes. 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 HCPCS S0028 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 |
|---|---|---|
| S0023-HCPCS | Low | Injection, cimetidine hydrochloride, 300 mg |
| S0028-HCPCS | Low | Injection, famotidine, 20 mg |
| S0032-HCPCS | Low | Injection, nafcillin sodium, 2 grams |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS S0028. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the S0028 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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