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CPT code 28020: Foot joint arthrotomy, intertarsal or tarsometatarsal2026 Medicare rate & RVUs in Washington, DC area

Report this open joint procedure for exploration, drainage, or removal of material from an intertarsal or tarsometatarsal joint.

CMS RVU26DEffective Oct 1, 2026One payment locality276 Medicare services in 2024

In Washington, DC area, Medicare pays $641.85 for 28020 in the office and $391.22 when it’s performed in a hospital or facility.

$641.85Office (non-facility)
$391.22Hospital or facility
+13.8%vs the national office rate ($563.81)

Check a contract rate as a % of Medicare · 28020 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 28020 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 28020 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 28020 covers

This code describes an open incision into an intertarsal or tarsometatarsal joint to inspect the joint, drain it, or remove a loose body or foreign material. A foot and ankle orthopedic surgeon or podiatric surgeon typically performs the procedure in an operating room, for example when addressing a suspected joint loose body or an infection requiring drainage. The joint location distinguishes this service from arthrotomy codes for the metatarsophalangeal or toe interphalangeal joints.

Report the code when the operative record identifies the joint entered and documents the arthrotomy and work performed. Exploration, drainage, or removal through that same joint opening is included in this service. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment is restricted; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Washington, DC area compares for 28020

Across 109 of 109 payment localities, the office rate for 28020 runs from $499.91 in Arkansas to $736.16 in San Benito County, CA. Washington, DC area pays $641.85. The RVUs are the same everywhere; the geographic indexes change the dollars.

28020 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$641.85
  2. Los Angeles, CA · California$631.04−$10.81
  3. Miami, FL · Florida$614.84−$27.01
  4. Chicago, IL · Illinois$597.12−$44.73
  5. Manhattan, NY · New York$648.63+$6.78
  6. Alaska · Alaska$661.37+$19.52
  7. Alabama · Alabama$507.07−$134.78

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

28020 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$499.91$317.15
ArizonaArizona$548.89$342.72
Bakersfield, CACalifornia$593.64$360.45
Chico, CACalifornia$591.59$358.40
El Centro, CACalifornia$591.71$358.52
Fresno, CACalifornia$591.59$358.40
Hanford, CACalifornia$591.59$358.40
Madera, CACalifornia$591.59$358.40

28020 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$499.91

$663.88

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
28020 office rate range by state
State / territoryOffice rate rangeLocalities
AK$661.371
AL$507.071
AR$499.911
AZ$548.891
CA$591.59–$736.1629
CO$584.561
CT$600.771
DC$641.851
DE$557.811
FL$559.17–$614.843
GA$528.04–$574.972
GU$605.031
HI$605.031
IA$518.021
ID$521.671
IL$544.54–$597.124
IN$524.581
KS$516.431
KY$520.441
LA$519.96–$544.992
MA$581.50–$640.422
MD$568.04–$641.853
ME$525.15–$551.822
MI$534.39–$566.802
MN$558.161
MO$511.76–$545.963
MS$505.891
MT$563.761
NC$530.391
ND$549.921
NE$520.561
NH$576.171
NJ$607.08–$635.602
NM$537.571
NV$560.281
NY$538.23–$665.035
OH$531.561
OK$518.711
OR$555.37–$601.882
PA$531.96–$586.622
PR$567.561
RI$576.771
SC$531.971
SD$548.281
TN$519.061
TX$528.60–$583.108
UT$539.061
VA$550.60–$641.852
VI$567.561
VT$548.531
WA$580.15–$652.532
WI$531.971
WV$525.051
WY$557.731

See 28020 in every payment locality

How the 28020 rate is calculated

Each of 28020’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 28020

RVUs × geographic indexes × conversion factor

Office or facility?

Work5.02

5.02 RVUs× 1.000 GPCI

Practice expense11.16

11.16 RVUs× 1.000 GPCI

Malpractice0.70

0.70 RVUs× 1.000 GPCI

Adjusted RVUs

16.8800

Conversion factor

$33.4009

Medicare rate

$563.81

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,094

Code
28020
Physician work
5.02
Practice expense
11.16
Malpractice
0.70

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 28020 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work5.02× 1.0545.2911
Practice expense11.16× 1.17813.1465
Malpractice0.70× 1.1130.7791
Total RVUs19.2167
Conversion factor× 33.4009

Office rate, Washington, DC area$641.85

Office: (5.02 × 1.054 + 11.16 × 1.178 + 0.7 × 1.113) × $33.4009 = $641.85

Facility: (5.02 × 1.054 + 4.79 × 1.178 + 0.7 × 1.113) × $33.4009 = $391.22

Open 28020 in the RVU calculator

Payment rules and modifiers for 28020

28020 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 28020

Foot joint arthrotomy, intertarsal or tarsometatarsal

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 28020

Foot joint arthrotomy, intertarsal or tarsometatarsal

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

28020 without 51 · national office

$563.81

Foot joint arthrotomy, intertarsal or tarsometatarsal

28020-51 · Second procedure: 50%

$281.91

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Codes related to 28020

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 28020
CodeHow it relatesOffice range, Washington, DC area
Same family
28022Joint exploration, metatarsophalangeal jointSibling arthrotomy code for a metatarsophalangeal joint.$565.64
28024Toe joint exploration, interphalangeal jointSibling arthrotomy code for a toe interphalangeal joint.$538.21
Used instead
28050Joint biopsy, foot joint liningJoint arthrotomy with biopsy for an intertarsal or tarsometatarsal joint.$461.10
28052Joint biopsy, metatarsophalangeal jointJoint arthrotomy with biopsy for a metatarsophalangeal joint.$431.78
28070Foot synovectomy, tarsometatarsal jointRemoval of synovium from a tarsal joint rather than general joint exploration.$588.25

How 28020 has changed in Washington, DC area

28020 · Office / nonfacility

$641.85

Effective 2026-10-01

The base rate is $47.96 higher than on 2025-10-01, moving from $593.89 to $641.85 (8.1%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $593.89changed to$641.85

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 5.15 changed to 5.02
    • Practice expense RVU 10.16 changed to 11.16
    • Malpractice RVU 0.69 changed to 0.70
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $622.69changed to$593.89

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 10.47 changed to 10.16
    • Malpractice RVU 0.67 changed to 0.69

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $612.52changed to$622.69

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $646.27changed to$612.52

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 10.53 changed to 10.47
    • Malpractice RVU 0.69 changed to 0.67
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $668.37changed to$646.27

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 10.47 changed to 10.53
    • Malpractice RVU 0.73 changed to 0.69
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $672.56changed to$668.37

    • Conversion factor 34.8931 changed to 34.6062
    • Malpractice RVU 0.70 changed to 0.73

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $652.34changed to$672.56

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 9.71 changed to 10.47
    • Malpractice RVU 0.64 changed to 0.70
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $648.66changed to$652.34

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 9.78 changed to 9.71
    • Malpractice RVU 0.66 changed to 0.64
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $650.58changed to$648.66

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 9.83 changed to 9.78
    • Malpractice RVU 0.67 changed to 0.66

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $646.36changed to$650.58

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 9.75 changed to 9.83
    • Malpractice RVU 0.68 changed to 0.67
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $646.88changed to$646.36

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 9.79 changed to 9.75
    • Malpractice RVU 0.67 changed to 0.68
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $655.82changed to$646.88

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 9.90 changed to 9.79
    • Malpractice RVU 0.71 changed to 0.67

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $652.56changed to$655.82

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $638.15changed to$652.56

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 9.68 changed to 9.90
    • Malpractice RVU 0.64 changed to 0.71
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $644.47changed to$638.15

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 10.67 changed to 9.68
    • Malpractice RVU 0.67 changed to 0.64
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $644.47

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$641.85$391.22RVU26D
2026-07-01$641.85$391.22RVU26C
2026-04-01$641.85$391.22RVU26B
2026-01-01$641.85$391.22RVU26A
2025-10-01$593.89$403.42RVU25D
2025-07-01$593.89$403.42RVU25C
2025-04-01$593.89$403.42RVU25B
2025-01-01$593.89$403.42RVU25A
2024-10-01$622.69$415.96RVU24D
2024-07-01$622.69$415.96RVU24C
2024-04-01$622.69$415.96RVU24B
2024-03-09$622.69$415.96RVU24AR
2024-01-01$612.52$409.17RVU24A
2023-10-01$646.27$427.00RVU23D
2023-07-01$646.27$427.00RVU23C
2023-04-01$646.27$427.00RVU23B
2023-01-01$646.27$427.00RVU23A
2022-10-01$668.37$436.54RVU22D
2022-07-01$668.37$436.54RVU22C
2022-04-01$668.37$436.54RVU22B
2022-01-01$668.37$436.54RVU22A
2021-10-01$672.56$432.34RVU21D
2021-07-01$672.56$432.34RVU21C
2021-04-01$672.56$432.34RVU21B
2021-01-01$672.56$432.34RVU21A
2020-10-01$652.34$425.84RVU20D
2020-07-01$652.34$425.84RVU20C
2020-04-01$652.34$425.84RVU20B
2020-01-01$652.34$425.84RVU20A
2019-10-01$648.66$423.71RVU19D
2019-07-01$648.66$423.71RVU19C
2019-04-01$648.66$423.71RVU19B
2019-01-01$648.66$423.71RVU19A
2018-10-01$650.58$424.57RVU18D
2018-07-01$650.58$424.57RVU18C
2018-04-01$650.58$424.57RVU18B
2018-01-01$650.58$424.57RVU18AR1
2017-10-01$646.36$423.21RVU17D
2017-07-01$646.36$423.21RVU17C
2017-04-01$646.36$423.21RVU17B
2017-01-01$646.36$423.21RVU17A
2016-10-01$646.88$422.97RVU16D
2016-07-01$646.88$422.97RVU16C
2016-04-01$646.88$422.97RVU16B
2016-01-01$646.88$422.97RVU16A
2015-10-01$655.82$427.63RVU15D
2015-07-01$655.82$427.63RVU15C
2015-04-01$652.56$425.50RVU15B
2015-01-01$652.56$425.50RVU15A
2014-10-01$638.15$418.55RVU14D
2014-07-01$638.15$418.55RVU14C
2014-04-01$638.15$418.55RVU14B
2014-01-01$638.15$418.55RVU14A
2013-10-01$644.47$412.55RVU13D
2013-07-01$644.47$412.55RVU13C
2013-04-01$644.47$412.55RVU13B
2013-01-01$644.47$412.55RVU13AR

Price 28020 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

28020 billing questions

How do I distinguish this from 28022?

Use 28020 for an intertarsal or tarsometatarsal joint. Code 28022 is for a metatarsophalangeal joint.

When is 28024 the better choice?

Use 28024 when the arthrotomy is at a toe interphalangeal joint, rather than an intertarsal or tarsometatarsal joint.

Can exploration, drainage, and loose-body removal be reported separately?

Those actions are included when performed through the arthrotomy represented by this code. Document the joint entered and the work performed.

What documentation supports code selection?

The operative report should identify the specific intertarsal or tarsometatarsal joint and describe the arthrotomy and its purpose, such as exploration, drainage, or removal.

Can modifier 50 be used for bilateral procedures?

No. CMS identifies bilateral adjustment as inapplicable and modifier 50 as inappropriate for this code.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full; other procedures in the session are subject to the standard multiple-procedure reduction. The code also has a 90-day global period.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 28020PPRRVU2026_Oct_nonQPP.csv, line 3,094 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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