How much does Medicare pay for CPT 28299?

Medicare allowed an average of $1890.67 per service and paid $1498.28 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $7242.22, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 28299?

Correction of bunion with 2 areas of realignment. It was billed 1,339 times to 1,230 Medicare beneficiaries by 67 providers in 2024.

Does 28299 pay differently in an office than a hospital?

Yes. The allowed amount averaged $830.27 in an office setting and $1934.37 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 28299 most?

Ambulatory Surgical Center, with 522 services from 25 clinicians. Next are Podiatry, Orthopedic Surgery, Physician Assistant.

CPT 28299

Correction of bunion with 2 areas of realignment

$1890.67Medicare-allowed amount per service, averaged across 1,339 services

Providers submitted

$7242.22

Asking price, not received

Medicare allowed

$1890.67

The fee schedule figure

Medicare paid

$1498.28

Balance is patient coinsurance

Providers submitted an average of $7242.22 for this code and Medicare allowed $1890.67 — 3.8× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $1498.28 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $830.27
Hospital / facility: $1934.37

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 53 services were billed in an office setting and 1,286 in a facility.

Services: 1,339
Beneficiaries: 1,230
Providers billing it: 67
Total allowed: $2,531,607

What Medicare pays for CPT 28299

Across 1,339 services billed by 67 providers to 1,230 beneficiaries, Medicare allowed an average of $1890.67 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 28299

Specialty	Services	Beneficiaries	Avg allowed	Providers
Ambulatory Surgical Center	522	469	$4038.83	25
Podiatry	420	382	$593.85	21
Orthopedic Surgery	301	286	$553.43	15
Physician Assistant	65	62	$74.32	4
Nurse Practitioner	31	31	$80.82	2

28299 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Wisconsin	164	$1482.42	$1193.98	3
South Carolina	129	$1554.43	$1350.32	7
Minnesota	108	$2146.04	$1666.73	5
Arizona	106	$2029.33	$1656.15	3
Florida	105	$772.74	$595.68	6
California	83	$1805.15	$1165.52	6
Colorado	81	$4211.01	$3350.86	1
Illinois	62	$1245.32	$1051.56	5
Tennessee	60	$1777.97	$1731.57	3
Texas	53	$1209.15	$978.46	4
Virginia	50	$1313.62	$1081.91	3
Massachusetts	48	$2533.41	$1865.01	2
Mississippi	46	$1846.52	$1706.68	2
Delaware	35	$1753.57	$1371.67	3
Georgia	34	$2801.83	$2459.99	3
North Carolina	32	$3912.32	$3297.01	2
Alabama	31	$2009.55	$1890.22	2
New Jersey	29	$1121.34	$774.10	1
Ohio	26	$1846.70	$1511.63	2
Arkansas	19	$399.83	$376.24	1
Pennsylvania	15	$4089.38	$3276.51	1
Maryland	12	$4133.84	$3254.25	1
Kansas	11	$511.54	$440.83	1

Related codes

28285Correction of toe joint deformity$553.86
28232Incision to lengthen toe tendon$235.84
28270Incision of joint capsule of foot and toe$344.55
28272Incision of toe joint capsule$247.81
28234Incision to release foot tendon$200.33

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.