CPT code 28022: Joint exploration, metatarsophalangeal joint2026 Medicare rate & RVUs in North Dakota

Reports open exploration of a metatarsophalangeal joint when the surgeon examines the joint, drains it, or removes a loose or foreign body.

CMS RVU26DEffective Oct 1, 2026One payment locality525 Medicare services in 2024

In North Dakota, Medicare pays $486.76 for 28022 in the office and $303.06 when it’s performed in a hospital or facility.

$486.76Office (non-facility)
$303.06Hospital or facility
−2.2%vs the national office rate ($497.67)

Check a contract rate as a % of Medicare · 28022 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 28022 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Dakota
  2. What 28022 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 28022 covers

This code covers open access to a metatarsophalangeal (MTP) joint for exploration, drainage, or removal of a loose or foreign body. It may be used for an MTP joint at the base of a toe when operative evaluation or one of these treatments is performed. Orthopedic foot and ankle surgeons and podiatric surgeons typically perform the procedure in an operating room or another surgical setting.

Report the code for the MTP joint work documented in the operative note; include the specific joint, the reason for opening it, and the findings and actions taken. Exploration, drainage, and removal of a loose or foreign body are part of this service, rather than separate services for the same joint work. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate; assistant-at-surgery payment is restricted, and co-surgeons and team surgery are 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 North Dakota compares for 28022

Across 109 of 109 payment localities, the office rate for 28022 runs from $443.27 in Arkansas to $648.99 in San Benito County, CA. North Dakota pays $486.76. The RVUs are the same everywhere; the geographic indexes change the dollars.

28022 in North Dakota vs other payment areas
  1. North Dakota · this page$486.76
  2. Los Angeles, CA · California$556.97+$70.21
  3. Washington, DC area · District of Columbia$565.64+$78.88
  4. Miami, FL · Florida$538.99+$52.23
  5. Chicago, IL · Illinois$524.17+$37.41
  6. Manhattan, NY · New York$570.73+$83.97
  7. Alaska · Alaska$588.72+$101.96

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

Every other payment area

28022 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$449.37$288.63
ArkansasArkansas$443.27$285.47
ArizonaArizona$485.03$307.02
Bakersfield, CACalifornia$524.44$323.10
Chico, CACalifornia$522.79$321.45
El Centro, CACalifornia$522.88$321.54
Fresno, CACalifornia$522.79$321.45
Hanford, CACalifornia$522.79$321.45

28022 rates by state

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

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.

$443.27

$588.72

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

View every state and territory as a table
28022 office rate range by state
State / territoryOffice rate rangeLocalities
AK$588.721
AL$449.371
AR$443.271
AZ$485.031
CA$522.79–$648.9929
CO$516.181
CT$529.511
DC$565.641
DE$492.731
FL$492.72–$538.993
GA$466.35–$507.002
GU$534.141
HI$534.141
IA$459.171
ID$462.181
IL$479.95–$524.174
IN$464.681
KS$457.591
KY$460.301
LA$459.80–$481.142
MA$513.55–$564.672
MD$501.61–$565.643
ME$464.92–$487.992
MI$471.97–$498.982
MN$494.101
MO$452.67–$482.223
MS$448.031
MT$497.641
NC$469.421
ND$486.761
NE$461.401
NH$508.611
NJ$535.41–$560.422
NM$474.591
NV$494.931
NY$476.08–$584.425
OH$469.751
OK$459.051
OR$490.93–$531.292
PA$470.21–$517.272
PR$500.951
RI$509.311
SC$470.401
SD$485.481
TN$459.811
TX$467.33–$514.618
UT$476.441
VA$486.79–$565.642
VI$500.951
VT$485.371
WA$512.42–$575.392
WI$471.411
WV$463.321
WY$492.901

See 28022 in every payment locality

How the 28022 rate is calculated

Each of 28022’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 · 28022

RVUs × geographic indexes × conversion factor

Office or facility?

Work4.69

4.69 RVUs× 1.000 GPCI

Practice expense9.66

9.66 RVUs× 1.000 GPCI

Malpractice0.55

0.55 RVUs× 1.000 GPCI

Adjusted RVUs

14.9000

Conversion factor

$33.4009

Medicare rate

$497.67

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

The exact North Dakota inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,095

Code
28022
Physician work
4.69
Practice expense
9.66
Malpractice
0.55

GPCI2026.csv

84

Locality
North Dakota
Physician work
1.000
Practice expense
1.000
Malpractice
0.406
Office calculation for 28022 in North Dakota
ComponentRVULocality factorAdjusted
Physician work4.69× 1.0004.6900
Practice expense9.66× 1.0009.6600
Malpractice0.55× 0.4060.2233
Total RVUs14.5733
Conversion factor× 33.4009

Office rate, North Dakota$486.76

Office: (4.69 × 1 + 9.66 × 1 + 0.55 × 0.406) × $33.4009 = $486.76

Facility: (4.69 × 1 + 4.16 × 1 + 0.55 × 0.406) × $33.4009 = $303.06

Open 28022 in the RVU calculator

Payment rules and modifiers for 28022

28022 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 28022

Joint exploration, metatarsophalangeal joint

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)0Not permitted.
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 · 28022

Joint exploration, metatarsophalangeal joint

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

28022 without 51 · national office

$497.67

Joint exploration, metatarsophalangeal joint

28022-51 · Second procedure: 50%

$248.84

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

How 28022 has changed in North Dakota

28022 · Office / nonfacility

$486.76

Effective 2026-10-01

The base rate is $23.60 higher than on 2025-10-01, moving from $463.16 to $486.76 (5.1%).

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

    $463.16changed to$486.76

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 4.81 changed to 4.69
    • Practice expense RVU 9.24 changed to 9.66
    • Malpractice RVU 0.52 changed to 0.55
    • Malpractice GPCI 0.517 changed to 0.406

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $478.31changed to$463.16

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 9.28 changed to 9.24
    • Malpractice RVU 0.54 changed to 0.52

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $470.51changed to$478.31

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $481.58changed to$470.51

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 9.15 changed to 9.28
    • Malpractice RVU 0.53 changed to 0.54
    • Malpractice GPCI 0.474 changed to 0.517
  5. January 1, 2023

    RVU23A

    $487.85changed to$481.58

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 9.05 changed to 9.15
    • Malpractice RVU 0.55 changed to 0.53
    • Malpractice GPCI 0.431 changed to 0.474

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $495.97changed to$487.85

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 9.18 changed to 9.05
    • Malpractice RVU 0.52 changed to 0.55

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $497.75changed to$495.97

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 8.73 changed to 9.18
    • Malpractice GPCI 0.485 changed to 0.431

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $498.39changed to$497.75

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 8.76 changed to 8.73
    • Malpractice RVU 0.48 changed to 0.52
    • Malpractice GPCI 0.540 changed to 0.485

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $495.88changed to$498.39

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 8.70 changed to 8.76
    • Malpractice RVU 0.49 changed to 0.48

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $494.83changed to$495.88

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 8.71 changed to 8.70
    • Malpractice GPCI 0.547 changed to 0.540

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $496.50changed to$494.83

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 8.78 changed to 8.71
    • Malpractice RVU 0.50 changed to 0.49
    • Malpractice GPCI 0.554 changed to 0.547

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $500.13changed to$496.50

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 8.82 changed to 8.78
    • Malpractice RVU 0.52 changed to 0.50

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $497.64changed to$500.13

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $493.35changed to$497.64

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 8.71 changed to 8.82
    • Malpractice RVU 0.47 changed to 0.52
    • Malpractice GPCI 0.536 changed to 0.554

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $500.25changed to$493.35

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 9.64 changed to 8.71
    • Malpractice RVU 0.49 changed to 0.47
    • Malpractice GPCI 0.517 changed to 0.536

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $500.25

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$486.76$303.06RVU26D
2026-07-01$486.76$303.06RVU26C
2026-04-01$486.76$303.06RVU26B
2026-01-01$486.76$303.06RVU26A
2025-10-01$463.16$315.66RVU25D
2025-07-01$463.16$315.66RVU25C
2025-04-01$463.16$315.66RVU25B
2025-01-01$463.16$315.66RVU25A
2024-10-01$478.31$321.86RVU24D
2024-07-01$478.31$321.86RVU24C
2024-04-01$478.31$321.86RVU24B
2024-03-09$478.31$321.86RVU24AR
2024-01-01$470.51$316.61RVU24A
2023-10-01$481.58$321.29RVU23D
2023-07-01$481.58$321.29RVU23C
2023-04-01$481.58$321.29RVU23B
2023-01-01$481.58$321.29RVU23A
2022-10-01$487.85$321.74RVU22D
2022-07-01$487.85$321.74RVU22C
2022-04-01$487.85$321.74RVU22B
2022-01-01$487.85$321.74RVU22A
2021-10-01$495.97$321.86RVU21D
2021-07-01$495.97$321.86RVU21C
2021-04-01$495.97$321.86RVU21B
2021-01-01$495.97$321.86RVU21A
2020-10-01$497.75$328.13RVU20D
2020-07-01$497.75$328.13RVU20C
2020-04-01$497.75$328.13RVU20B
2020-01-01$497.75$328.13RVU20A
2019-10-01$498.39$327.93RVU19D
2019-07-01$498.39$327.93RVU19C
2019-04-01$498.39$327.93RVU19B
2019-01-01$498.39$327.93RVU19A
2018-10-01$495.88$326.32RVU18D
2018-07-01$495.88$326.32RVU18C
2018-04-01$495.88$326.32RVU18B
2018-01-01$495.88$326.32RVU18AR1
2017-10-01$494.83$326.16RVU17D
2017-07-01$494.83$326.16RVU17C
2017-04-01$494.83$326.16RVU17B
2017-01-01$494.83$326.16RVU17A
2016-10-01$496.50$327.14RVU16D
2016-07-01$496.50$327.14RVU16C
2016-04-01$496.50$327.14RVU16B
2016-01-01$496.50$327.14RVU16A
2015-10-01$500.13$328.36RVU15D
2015-07-01$500.13$328.36RVU15C
2015-04-01$497.64$326.73RVU15B
2015-01-01$497.64$326.73RVU15A
2014-10-01$493.35$325.70RVU14D
2014-07-01$493.35$325.70RVU14C
2014-04-01$493.35$325.70RVU14B
2014-01-01$493.35$325.70RVU14A
2013-10-01$500.25$322.31RVU13D
2013-07-01$500.25$322.31RVU13C
2013-04-01$500.25$322.31RVU13B
2013-01-01$500.25$322.31RVU13AR

Price 28022 for an earlier date of service

Where the North Dakota rate applies

North Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 406 cities and communities in North Dakota. Some span more than one payment area; confirm with the service ZIP.

  • Abercrombie
  • Adams
  • Alamo
  • Alexander
  • Alice
  • Almont
  • Alsen
  • Ambrose

Browse all communities in North Dakota

28022 billing questions

How does this differ from 28020?

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

How does this differ from 28024?

28024 applies to an interphalangeal joint in a toe. Use 28022 for an MTP joint at the base of a toe.

Can exploration, drainage, or loose-body removal be billed separately?

Those actions are included in the arthrotomy service for the MTP joint. The operative note should identify which work was performed.

What documentation supports reporting 28022?

Document the MTP joint opened, the clinical reason for the procedure, and the findings and work performed, such as exploration, drainage, or removal of a loose or foreign body.

Can modifier 50 be used for bilateral MTP joint work?

CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate. The code is also subject to the 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 28022PPRRVU2026_Oct_nonQPP.csv, line 3,095 (RVU26D)
Geographic factors for North DakotaGPCI2026.csv, line 84 (RVU26D)

Open CMS sourceHow we calculate rates

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