CPT 28630 at Cascade Medical Center

Musculoskeletal

Cascade Medical Center, Leavenworth

This name is the CMS category the code belongs to (CMS's Restructured BETOS Classification System), shared with similar codes. The official CPT description belongs to the American Medical Association and isn't shown.

What Cascade Medical Center publishes for this code: as an outpatient

Cascade Medical Center’s prices for CPT 28630, as an outpatient
Who pays	Hospital’s fee (lowest – highest)	Doctor’s fee the hospital lists
Commercial insuranceInsurer rates	$213 – $2552 plans	$213 – $387
Medicare AdvantageInsurer rates	$227 – $3397 plans	$126 – $517
Medicaid managed careInsurer rates	$226 – $3394 plans	$344 – $517
Medicaid (state program)Insurer rates	$2171 plan	$330
Medicare (traditional)Insurer rates	$2351 plan	$126
Other government programInsurer rates	$160 – $3622 plans	$160 – $551
UnknownInsurer rates	$213 – $3656 plans	$213 – $556
Cash pricePaying yourself, without insurance	$325	$494
List priceBefore any discount; few people pay it	$406	$618

Lowest and highest amounts Cascade Medical Center lists for this code as an outpatient, including lines it lists for both settings or without saying which. This is one line of a bill; most care brings several.

Bills to expect

The hospital’s fee is the price above. Doctors usually send their own bills. Their amounts here are what original Medicare allows in the rest of Washington for 2026, and a private-plan estimate of 118% to 179% of that (the range found across studies of what insurers pay doctors). Those are estimates, not quotes.

Bills to expect for CPT 28630 at Cascade Medical Center
Bill	What it’s for	Original Medicare allows	Private plan estimate
Hospital's feeThe hospital	The operating or procedure room, nursing, supplies and recovery	—	The price above
Surgeon or doctor doing itThe doctor's practice	The procedure, and routine follow-up visits for 10 days	$112	$132 – $200
AnesthesiaAn anesthesia group (only sometimes)	Anesthesia or deep sedation, if you need itOnly if an anesthesia team is part of your care. Its amount depends on how long it takes.	—	—

Original Medicare amounts are only for people on original Medicare. Your share depends on your plan’s deductible, copay and coinsurance.

Compare CPT 28630 at every Washington hospital, with Medicare’s reference amounts.