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

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 Iowa, Medicare pays $518.02 for 28020 in the office and $323.35 when it’s performed in a hospital or facility.

$518.02Office (non-facility)
$323.35Hospital or facility
−8.1%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 Iowa
  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 Iowa 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. Iowa pays $518.02. The RVUs are the same everywhere; the geographic indexes change the dollars.

28020 in Iowa vs other payment areas
  1. Iowa · this page$518.02
  2. Los Angeles, CA · California$631.04+$113.02
  3. Washington, DC area · District of Columbia$641.85+$123.83
  4. Miami, FL · Florida$614.84+$96.82
  5. Chicago, IL · Illinois$597.12+$79.10
  6. Manhattan, NY · New York$648.63+$130.61
  7. Alaska · Alaska$661.37+$143.35

Other areas in Iowa first, then benchmark localities. Bars start at $0.

Every other payment area

28020 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$507.07$320.90
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

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 Iowa 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

53

Locality
Iowa
Physician work
1.000
Practice expense
0.915
Malpractice
0.397
Office calculation for 28020 in Iowa
ComponentRVULocality factorAdjusted
Physician work5.02× 1.0005.0200
Practice expense11.16× 0.91510.2114
Malpractice0.70× 0.3970.2779
Total RVUs15.5093
Conversion factor× 33.4009

Office rate, Iowa$518.02

Office: (5.02 × 1 + 11.16 × 0.915 + 0.7 × 0.397) × $33.4009 = $518.02

Facility: (5.02 × 1 + 4.79 × 0.915 + 0.7 × 0.397) × $33.4009 = $323.35

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, Iowa
Same family
28022Joint exploration, metatarsophalangeal jointSibling arthrotomy code for a metatarsophalangeal joint.$459.17
28024Toe joint exploration, interphalangeal jointSibling arthrotomy code for a toe interphalangeal joint.$437.10
Used instead
28050Joint biopsy, foot joint liningJoint arthrotomy with biopsy for an intertarsal or tarsometatarsal joint.$378.30
28052Joint biopsy, metatarsophalangeal jointJoint arthrotomy with biopsy for a metatarsophalangeal joint.$353.90
28070Foot synovectomy, tarsometatarsal jointRemoval of synovium from a tarsal joint rather than general joint exploration.$478.97

How 28020 has changed in Iowa

28020 · Office / nonfacility

$518.02

Effective 2026-10-01

The base rate is $41.19 higher than on 2025-10-01, moving from $476.83 to $518.02 (8.6%).

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

    $476.83changed to$518.02

    • 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
    • Practice expense GPCI 0.913 changed to 0.915
    • Malpractice GPCI 0.457 changed to 0.397

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $499.82changed to$476.83

    • 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

    $491.66changed to$499.82

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $509.55changed to$491.66

    • 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
    • Practice expense GPCI 0.910 changed to 0.913
    • Malpractice GPCI 0.441 changed to 0.457

  5. January 1, 2023

    RVU23A

    $517.59changed to$509.55

    • 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
    • Practice expense GPCI 0.907 changed to 0.910
    • Malpractice GPCI 0.425 changed to 0.441

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $521.44changed to$517.59

    • 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

    $513.49changed to$521.44

    • 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
    • Malpractice GPCI 0.424 changed to 0.425

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $515.35changed to$513.49

    • 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
    • Malpractice GPCI 0.423 changed to 0.424

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $516.57changed to$515.35

    • 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

    $511.63changed to$516.57

    • 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
    • Practice expense GPCI 0.902 changed to 0.907
    • Malpractice GPCI 0.458 changed to 0.423

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $510.29changed to$511.63

    • 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
    • Practice expense GPCI 0.896 changed to 0.902
    • Malpractice GPCI 0.493 changed to 0.458

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $516.38changed to$510.29

    • 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

    $513.81changed to$516.38

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $504.69changed to$513.81

    • 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
    • Practice expense GPCI 0.892 changed to 0.896
    • Malpractice GPCI 0.475 changed to 0.493

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $507.62changed to$504.69

    • 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
    • Practice expense GPCI 0.887 changed to 0.892
    • Malpractice GPCI 0.456 changed to 0.475

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $507.62

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$518.02$323.35RVU26D
2026-07-01$518.02$323.35RVU26C
2026-04-01$518.02$323.35RVU26B
2026-01-01$518.02$323.35RVU26A
2025-10-01$476.83$330.94RVU25D
2025-07-01$476.83$330.94RVU25C
2025-04-01$476.83$330.94RVU25B
2025-01-01$476.83$330.94RVU25A
2024-10-01$499.82$341.48RVU24D
2024-07-01$499.82$341.48RVU24C
2024-04-01$499.82$341.48RVU24B
2024-03-09$499.82$341.48RVU24AR
2024-01-01$491.66$335.91RVU24A
2023-10-01$509.55$345.18RVU23D
2023-07-01$509.55$345.18RVU23C
2023-04-01$509.55$345.18RVU23B
2023-01-01$509.55$345.18RVU23A
2022-10-01$517.59$347.47RVU22D
2022-07-01$517.59$347.47RVU22C
2022-04-01$517.59$347.47RVU22B
2022-01-01$517.59$347.47RVU22A
2021-10-01$521.44$345.16RVU21D
2021-07-01$521.44$345.16RVU21C
2021-04-01$521.44$345.16RVU21B
2021-01-01$521.44$345.16RVU21A
2020-10-01$513.49$345.25RVU20D
2020-07-01$513.49$345.25RVU20C
2020-04-01$513.49$345.25RVU20B
2020-01-01$513.49$345.25RVU20A
2019-10-01$515.35$346.03RVU19D
2019-07-01$515.35$346.03RVU19C
2019-04-01$515.35$346.03RVU19B
2019-01-01$515.35$346.03RVU19A
2018-10-01$516.57$346.45RVU18D
2018-07-01$516.57$346.45RVU18C
2018-04-01$516.57$346.45RVU18B
2018-01-01$516.57$346.45RVU18AR1
2017-10-01$511.63$344.59RVU17D
2017-07-01$511.63$344.59RVU17C
2017-04-01$511.63$344.59RVU17B
2017-01-01$511.63$344.59RVU17A
2016-10-01$510.29$343.79RVU16D
2016-07-01$510.29$343.79RVU16C
2016-04-01$510.29$343.79RVU16B
2016-01-01$510.29$343.79RVU16A
2015-10-01$516.38$346.70RVU15D
2015-07-01$516.38$346.70RVU15C
2015-04-01$513.81$344.98RVU15B
2015-01-01$513.81$344.98RVU15A
2014-10-01$504.69$341.73RVU14D
2014-07-01$504.69$341.73RVU14C
2014-04-01$504.69$341.73RVU14B
2014-01-01$504.69$341.73RVU14A
2013-10-01$507.62$335.90RVU13D
2013-07-01$507.62$335.90RVU13C
2013-04-01$507.62$335.90RVU13B
2013-01-01$507.62$335.90RVU13AR

Price 28020 for an earlier date of service

Where the Iowa rate applies

Iowa is a Medicare payment area, not a city. Our Census mapping connects it to 1026 cities and communities in Iowa. Some span more than one payment area; confirm with the service ZIP.

  • Ackley
  • Ackworth
  • Adair
  • Adel
  • Afton
  • Agency
  • Ainsworth
  • Akron

Browse all communities in Iowa

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 IowaGPCI2026.csv, line 53 (RVU26D)

Open CMS sourceHow we calculate rates

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