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CPT code 28052: Joint biopsy, metatarsophalangeal joint2026 Medicare rate & RVUs in Puerto Rico

Report this service when a surgeon opens a metatarsophalangeal joint to obtain synovial tissue for diagnostic evaluation.

CMS RVU26DEffective Oct 1, 2026One payment locality51 Medicare services in 2024

In Puerto Rico, Medicare pays $383.54 for 28052 in the office and $243.40 when it’s performed in a hospital or facility.

$383.54Office (non-facility)
$243.40Hospital or facility
+0.6%vs the national office rate ($381.10)

Check a contract rate as a % of Medicare · 28052 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 28052 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 28052 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 28052 covers

A foot and ankle surgeon, orthopedic surgeon, or podiatric surgeon opens a metatarsophalangeal joint and takes a sample of its synovial lining. The tissue may be sent for evaluation when the cause of joint inflammation or another abnormal process remains uncertain. This is an open joint procedure, not simply a needle sample or inspection of the joint. The code is specific to the metatarsophalangeal joint; the operative report should identify the joint and document the tissue sampled.

Report the service for the joint actually biopsied, supported by the operative note and specimen documentation. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral reporting with modifier 50, CMS pays at 150%. Medicare does not pay an assistant at surgery for this code. 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 Puerto Rico compares for 28052

Across 109 of 109 payment localities, the office rate for 28052 runs from $342.00 in Arkansas to $495.05 in San Benito County, CA. Puerto Rico pays $383.54. The RVUs are the same everywhere; the geographic indexes change the dollars.

28052 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$383.54
  2. Los Angeles, CA · California$426.00+$42.46
  3. Washington, DC area · District of Columbia$431.78+$48.24
  4. Miami, FL · Florida$408.70+$25.16
  5. Chicago, IL · Illinois$398.35+$14.81
  6. Manhattan, NY · New York$434.84+$51.30
  7. Alaska · Alaska$457.40+$73.86

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

Every other payment area

28052 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$346.39$225.10
ArkansasArkansas$342.00$222.93
ArizonaArizona$372.07$237.75
Bakersfield, CACalifornia$401.81$249.89
Chico, CACalifornia$400.69$248.77
El Centro, CACalifornia$400.75$248.83
Fresno, CACalifornia$400.69$248.77
Hanford, CACalifornia$400.69$248.77

28052 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.

$342.00

$457.40

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

View every state and territory as a table
28052 office rate range by state
State / territoryOffice rate rangeLocalities
AK$457.401
AL$346.391
AR$342.001
AZ$372.071
CA$400.69–$495.0529
CO$395.311
CT$404.461
DC$431.781
DE$377.741
FL$376.55–$408.703
GA$357.74–$387.652
GU$408.671
HI$408.671
IA$353.901
ID$355.971
IL$367.05–$398.354
IN$357.781
KS$352.541
KY$353.791
LA$353.34–$368.702
MA$393.42–$431.252
MD$384.31–$431.783
ME$357.71–$374.662
MI$361.98–$380.822
MN$379.751
MO$348.07–$369.743
MS$345.091
MT$381.081
NC$361.001
ND$374.161
NE$355.571
NH$389.371
NJ$409.35–$428.182
NM$363.771
NV$379.391
NY$365.77–$444.415
OH$360.571
OK$353.121
OR$376.68–$406.552
PA$361.02–$395.462
PR$383.541
RI$390.181
SC$361.331
SD$373.341
TN$354.111
TX$358.93–$393.798
UT$365.681
VA$373.64–$431.782
VI$383.541
VT$372.961
WA$392.60–$439.412
WI$363.051
WV$355.081
WY$378.061

See 28052 in every payment locality

How the 28052 rate is calculated

Each of 28052’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 · 28052

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.96

3.96 RVUs× 1.000 GPCI

Practice expense7.10

7.10 RVUs× 1.000 GPCI

Malpractice0.35

0.35 RVUs× 1.000 GPCI

Adjusted RVUs

11.4100

Conversion factor

$33.4009

Medicare rate

$381.10

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

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,105

Code
28052
Physician work
3.96
Practice expense
7.10
Malpractice
0.35

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 28052 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work3.96× 1.0003.9600
Practice expense7.10× 1.0117.1781
Malpractice0.35× 0.9850.3448
Total RVUs11.4828
Conversion factor× 33.4009

Office rate, Puerto Rico$383.54

Office: (3.96 × 1 + 7.1 × 1.011 + 0.35 × 0.985) × $33.4009 = $383.54

Facility: (3.96 × 1 + 2.95 × 1.011 + 0.35 × 0.985) × $33.4009 = $243.40

Open 28052 in the RVU calculator

Payment rules and modifiers for 28052

28052 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 28052

Joint biopsy, 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)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
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 · 28052

Joint biopsy, 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 50 · payment effect

With and without the modifier

28052 without 50 · national office

$381.10

Joint biopsy, metatarsophalangeal joint

28052-50 · Bilateral: 150%

$571.65

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

Codes related to 28052

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

Codes related to 28052
CodeHow it relatesOffice range, Puerto Rico
Same family
28050Joint biopsy, foot joint liningBiopsy service for a different foot-joint site.$409.74
28054Joint biopsy, toe joint liningBiopsy of an interphalangeal toe joint rather than a metatarsophalangeal joint.$360.13
Used instead
28070Foot synovectomy, tarsometatarsal jointRemoval of joint lining is a therapeutic synovectomy rather than diagnostic tissue sampling.$521.71
28072Joint synovectomy, foot metatarsophalangeal jointMetatarsophalangeal joint lining removal, rather than biopsy alone.$505.71

How 28052 has changed in Puerto Rico

28052 · Office / nonfacility

$383.54

Effective 2026-10-01

The base rate is $6.86 higher than on 2025-10-01, moving from $376.68 to $383.54 (1.8%).

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

    $376.68changed to$383.54

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 4.06 changed to 3.96
    • Practice expense RVU 7.24 changed to 7.10
    • Malpractice RVU 0.30 changed to 0.35
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $390.64changed to$376.68

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 7.31 changed to 7.24
    • Malpractice RVU 0.32 changed to 0.30

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $384.27changed to$390.64

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $392.84changed to$384.27

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 7.18 changed to 7.31
    • Malpractice RVU 0.30 changed to 0.32
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $391.06changed to$392.84

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $400.48changed to$391.06

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 7.13 changed to 7.18
    • Malpractice RVU 0.33 changed to 0.30
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $463.84changed to$400.48

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 8.71 changed to 7.13
    • Malpractice RVU 0.46 changed to 0.33

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $465.95changed to$463.84

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 8.32 changed to 8.71
    • Malpractice RVU 0.47 changed to 0.46
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $463.22changed to$465.95

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 8.28 changed to 8.32
    • Malpractice RVU 0.46 changed to 0.47
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $471.75changed to$463.22

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 8.49 changed to 8.28
    • Malpractice RVU 0.50 changed to 0.46

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $410.75changed to$471.75

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 8.29 changed to 8.49
    • Malpractice RVU 0.45 changed to 0.50
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $362.48changed to$410.75

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 8.41 changed to 8.29
    • Malpractice RVU 0.46 changed to 0.45
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $360.07changed to$362.48

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 8.33 changed to 8.41
    • Malpractice RVU 0.30 changed to 0.46

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $358.28changed to$360.07

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $349.56changed to$358.28

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 8.05 changed to 8.33
    • Malpractice RVU 0.47 changed to 0.30
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $348.97changed to$349.56

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 8.96 changed to 8.05
    • Malpractice RVU 0.49 changed to 0.47
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $348.97

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$383.54$243.40RVU26D
2026-07-01$383.54$243.40RVU26C
2026-04-01$383.54$243.40RVU26B
2026-01-01$383.54$243.40RVU26A
2025-10-01$376.68$252.58RVU25D
2025-07-01$376.68$252.58RVU25C
2025-04-01$376.68$252.58RVU25B
2025-01-01$376.68$252.58RVU25A
2024-10-01$390.64$258.57RVU24D
2024-07-01$390.64$258.57RVU24C
2024-04-01$390.64$258.57RVU24B
2024-03-09$390.64$258.57RVU24AR
2024-01-01$384.27$254.35RVU24A
2023-10-01$392.84$257.58RVU23D
2023-07-01$391.06$256.86RVU23C
2023-04-01$391.06$256.86RVU23B
2023-01-01$391.06$256.86RVU23A
2022-10-01$400.48$259.90RVU22D
2022-07-01$400.48$259.90RVU22C
2022-04-01$400.48$259.90RVU22B
2022-01-01$400.48$259.90RVU22A
2021-10-01$463.84$290.09RVU21D
2021-07-01$463.84$290.09RVU21C
2021-04-01$463.84$290.09RVU21B
2021-01-01$463.84$290.09RVU21A
2020-10-01$465.95$296.06RVU20D
2020-07-01$465.95$296.06RVU20C
2020-04-01$465.95$296.06RVU20B
2020-01-01$465.95$296.06RVU20A
2019-10-01$463.22$294.47RVU19D
2019-07-01$463.22$294.47RVU19C
2019-04-01$463.22$294.47RVU19B
2019-01-01$463.22$294.47RVU19A
2018-10-01$471.75$299.56RVU18D
2018-07-01$471.75$299.56RVU18C
2018-04-01$471.75$299.56RVU18B
2018-01-01$471.75$299.56RVU18AR1
2017-10-01$410.75$268.21RVU17D
2017-07-01$410.75$268.21RVU17C
2017-04-01$410.75$268.21RVU17B
2017-01-01$410.75$268.21RVU17A
2016-10-01$362.48$243.59RVU16D
2016-07-01$362.48$243.59RVU16C
2016-04-01$362.48$243.59RVU16B
2016-01-01$362.48$243.59RVU16A
2015-10-01$360.07$241.26RVU15D
2015-07-01$360.07$241.26RVU15C
2015-04-01$358.28$240.06RVU15B
2015-01-01$358.28$240.06RVU15A
2014-10-01$349.56$237.76RVU14D
2014-07-01$349.56$237.76RVU14C
2014-04-01$349.56$237.76RVU14B
2014-01-01$349.56$237.76RVU14A
2013-10-01$348.97$232.25RVU13D
2013-07-01$348.97$232.25RVU13C
2013-04-01$348.97$232.25RVU13B
2013-01-01$348.97$232.25RVU13AR

Price 28052 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

28052 billing questions

How is this code distinguished from 28050?

This code is for biopsy of a metatarsophalangeal joint lining. Code 28050 is for a different foot-joint site, so the operative report must identify the joint entered.

How is this code distinguished from 28054?

Use this code for a metatarsophalangeal joint biopsy and 28054 for an interphalangeal toe-joint biopsy. The documented joint site determines the choice.

Can the biopsy be reported separately from the joint procedure?

The joint exposure and synovial sampling are represented by this service; do not separately report another biopsy procedure for the same tissue collection.

What documentation supports reporting this code?

Document the metatarsophalangeal joint entered, the open approach, the synovial tissue obtained, and the reason for diagnostic sampling.

How does Medicare handle bilateral reporting and other procedures in the session?

CMS pays bilateral reporting with modifier 50 at 150%. For multiple procedures in one session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction.

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 28052PPRRVU2026_Oct_nonQPP.csv, line 3,105 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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