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CPT code 28070: Foot synovectomy, tarsometatarsal joint2026 Medicare rate & RVUs in Puerto Rico

Removal of diseased synovial lining from a tarsometatarsal joint, typically for persistent proliferative synovitis requiring surgical treatment.

CMS RVU26DEffective Oct 1, 2026One payment locality288 Medicare services in 2024

In Puerto Rico, Medicare pays $521.71 for 28070 in the office and $329.23 when it’s performed in a hospital or facility.

$521.71Office (non-facility)
$329.23Hospital or facility
+0.6%vs the national office rate ($518.38)

Check a contract rate as a % of Medicare · 28070 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 28070 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 28070 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 28070 covers

The surgeon removes abnormal synovial tissue from a tarsometatarsal joint, where the metatarsal bases meet the midfoot bones. This may be performed for persistent synovitis with inflamed or proliferative joint lining, including inflammatory disease affecting the midfoot. A foot and ankle or orthopedic surgeon typically performs the operation in an operating room.

Report 28070 when the operative work removes synovium from a tarsometatarsal joint; a limited diagnostic tissue sample is not the same service. The operative note should identify the joint and document the synovial tissue removed. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When other procedures subject to multiple-procedure reduction are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate. Medicare does not pay for an assistant at surgery, co-surgeons, or team surgery for this code.

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 28070

Across 109 of 109 payment localities, the office rate for 28070 runs from $462.81 in Arkansas to $673.59 in San Benito County, CA. Puerto Rico pays $521.71. The RVUs are the same everywhere; the geographic indexes change the dollars.

28070 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$521.71
  2. Los Angeles, CA · California$579.13+$57.42
  3. Washington, DC area · District of Columbia$588.25+$66.54
  4. Miami, FL · Florida$560.97+$39.26
  5. Chicago, IL · Illinois$545.87+$24.16
  6. Manhattan, NY · New York$593.71+$72.00
  7. Alaska · Alaska$616.54+$94.83

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

Every other payment area

28070 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$469.04$302.45
ArkansasArkansas$462.81$299.27
ArizonaArizona$505.45$320.97
Bakersfield, CACalifornia$545.73$337.07
Chico, CACalifornia$544.00$335.34
El Centro, CACalifornia$544.10$335.43
Fresno, CACalifornia$544.00$335.34
Hanford, CACalifornia$544.00$335.34

28070 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.

$462.81

$616.54

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

View every state and territory as a table
28070 office rate range by state
State / territoryOffice rate rangeLocalities
AK$616.541
AL$469.041
AR$462.811
AZ$505.451
CA$544.00–$673.5929
CO$537.301
CT$551.101
DC$588.251
DE$513.371
FL$513.50–$560.973
GA$486.54–$527.982
GU$555.391
HI$555.391
IA$478.971
ID$482.061
IL$500.51–$545.874
IN$484.601
KS$477.391
KY$480.281
LA$479.79–$501.582
MA$534.67–$587.052
MD$522.47–$588.253
ME$484.89–$508.402
MI$492.24–$519.942
MN$514.511
MO$472.53–$502.643
MS$467.731
MT$518.341
NC$489.491
ND$507.071
NE$481.231
NH$529.481
NJ$557.29–$583.022
NM$494.931
NV$515.531
NY$496.29–$607.745
OH$489.941
OK$478.971
OR$511.41–$552.722
PA$490.38–$538.602
PR$521.711
RI$530.411
SC$490.551
SD$505.741
TN$479.661
TX$487.45–$535.628
UT$496.721
VA$507.20–$588.252
VI$521.711
VT$505.691
WA$533.47–$598.042
WI$491.401
WV$483.531
WY$513.431

See 28070 in every payment locality

How the 28070 rate is calculated

Each of 28070’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 · 28070

RVUs × geographic indexes × conversion factor

Office or facility?

Work5.11

5.11 RVUs× 1.000 GPCI

Practice expense9.84

9.84 RVUs× 1.000 GPCI

Malpractice0.57

0.57 RVUs× 1.000 GPCI

Adjusted RVUs

15.5200

Conversion factor

$33.4009

Medicare rate

$518.38

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

3,110

Code
28070
Physician work
5.11
Practice expense
9.84
Malpractice
0.57

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 28070 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work5.11× 1.0005.1100
Practice expense9.84× 1.0119.9482
Malpractice0.57× 0.9850.5614
Total RVUs15.6197
Conversion factor× 33.4009

Office rate, Puerto Rico$521.71

Office: (5.11 × 1 + 9.84 × 1.011 + 0.57 × 0.985) × $33.4009 = $521.71

Facility: (5.11 × 1 + 4.14 × 1.011 + 0.57 × 0.985) × $33.4009 = $329.23

Open 28070 in the RVU calculator

Payment rules and modifiers for 28070

28070 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 28070

Foot synovectomy, tarsometatarsal 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 · 28070

Foot synovectomy, tarsometatarsal 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

28070 without 51 · national office

$518.38

Foot synovectomy, tarsometatarsal joint

28070-51 · Second procedure: 50%

$259.19

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 28070

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

Codes related to 28070
CodeHow it relatesOffice range, Puerto Rico
Same family
28072Joint synovectomy, foot metatarsophalangeal jointSynovectomy of a metatarsophalangeal joint rather than a tarsometatarsal joint.$505.71
Used instead
28050Joint biopsy, foot joint liningA joint-lining biopsy is diagnostic sampling, not removal of synovium by synovectomy.$409.74
28052Joint biopsy, metatarsophalangeal jointUse for the applicable joint-lining biopsy service when tissue sampling, rather than synovectomy, is performed.$383.54

How 28070 has changed in Puerto Rico

28070 · Office / nonfacility

$521.71

Effective 2026-10-01

The base rate is $25.00 higher than on 2025-10-01, moving from $496.71 to $521.71 (5.0%).

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

    $496.71changed to$521.71

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 5.24 changed to 5.11
    • Practice expense RVU 9.48 changed to 9.84
    • Malpractice RVU 0.58 changed to 0.57
    • 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

    $508.85changed to$496.71

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 9.45 changed to 9.48
    • Malpractice RVU 0.54 changed to 0.58

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $500.54changed to$508.85

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $513.58changed to$500.54

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 9.30 changed to 9.45
    • Malpractice RVU 0.55 changed to 0.54
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $511.36changed to$513.58

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

  6. January 1, 2023

    RVU23A

    $530.06changed to$511.36

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 9.41 changed to 9.30
    • Malpractice RVU 0.60 changed to 0.55
    • 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

    $547.46changed to$530.06

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 9.77 changed to 9.41
    • Malpractice RVU 0.61 changed to 0.60

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $553.19changed to$547.46

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 9.42 changed to 9.77
    • Malpractice RVU 0.60 changed to 0.61
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $559.74changed to$553.19

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 9.63 changed to 9.42
    • 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

    $564.90changed to$559.74

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 9.75 changed to 9.63
    • Malpractice RVU 0.64 changed to 0.60

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $498.80changed to$564.90

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 9.65 changed to 9.75
    • Malpractice RVU 0.62 changed to 0.64
    • 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

    $434.97changed to$498.80

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 9.55 changed to 9.65
    • Malpractice RVU 0.60 changed to 0.62
    • 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

    $433.35changed to$434.97

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 9.42 changed to 9.55
    • Malpractice RVU 0.61 changed to 0.60

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $431.20changed to$433.35

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $427.21changed to$431.20

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 9.45 changed to 9.42
    • Malpractice RVU 0.54 changed to 0.61
    • 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

    $423.85changed to$427.21

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 10.44 changed to 9.45
    • Malpractice RVU 0.56 changed to 0.54
    • 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: $423.85

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$521.71$329.23RVU26D
2026-07-01$521.71$329.23RVU26C
2026-04-01$521.71$329.23RVU26B
2026-01-01$521.71$329.23RVU26A
2025-10-01$496.71$342.64RVU25D
2025-07-01$496.71$342.64RVU25C
2025-04-01$496.71$342.64RVU25B
2025-01-01$496.71$342.64RVU25A
2024-10-01$508.85$346.27RVU24D
2024-07-01$508.85$346.27RVU24C
2024-04-01$508.85$346.27RVU24B
2024-03-09$508.85$346.27RVU24AR
2024-01-01$500.54$340.62RVU24A
2023-10-01$513.58$347.91RVU23D
2023-07-01$511.36$347.00RVU23C
2023-04-01$511.36$347.00RVU23B
2023-01-01$511.36$347.00RVU23A
2022-10-01$530.06$354.95RVU22D
2022-07-01$530.06$354.95RVU22C
2022-04-01$530.06$354.95RVU22B
2022-01-01$530.06$354.95RVU22A
2021-10-01$547.46$360.69RVU21D
2021-07-01$547.46$360.69RVU21C
2021-04-01$547.46$360.69RVU21B
2021-01-01$547.46$360.69RVU21A
2020-10-01$553.19$368.75RVU20D
2020-07-01$553.19$368.75RVU20C
2020-04-01$553.19$368.75RVU20B
2020-01-01$553.19$368.75RVU20A
2019-10-01$559.74$371.75RVU19D
2019-07-01$559.74$371.75RVU19C
2019-04-01$559.74$371.75RVU19B
2019-01-01$559.74$371.75RVU19A
2018-10-01$564.90$374.94RVU18D
2018-07-01$564.90$374.94RVU18C
2018-04-01$564.90$374.94RVU18B
2018-01-01$564.90$374.94RVU18AR1
2017-10-01$498.80$339.36RVU17D
2017-07-01$498.80$339.36RVU17C
2017-04-01$498.80$339.36RVU17B
2017-01-01$498.80$339.36RVU17A
2016-10-01$434.97$304.97RVU16D
2016-07-01$434.97$304.97RVU16C
2016-04-01$434.97$304.97RVU16B
2016-01-01$434.97$304.97RVU16A
2015-10-01$433.35$303.90RVU15D
2015-07-01$433.35$303.90RVU15C
2015-04-01$431.20$302.39RVU15B
2015-01-01$431.20$302.39RVU15A
2014-10-01$427.21$301.28RVU14D
2014-07-01$427.21$301.28RVU14C
2014-04-01$427.21$301.28RVU14B
2014-01-01$427.21$301.28RVU14A
2013-10-01$423.85$293.29RVU13D
2013-07-01$423.85$293.29RVU13C
2013-04-01$423.85$293.29RVU13B
2013-01-01$423.85$293.29RVU13AR

Price 28070 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

28070 billing questions

How is 28070 distinguished from 28072?

28070 is for synovectomy of a tarsometatarsal joint. 28072 applies to a metatarsophalangeal joint, so use the joint documented in the operative report.

Can 28070 be reported for a synovial biopsy?

Use 28070 when the surgeon removes synovial tissue as a synovectomy. A procedure limited to obtaining tissue for diagnosis is a biopsy service instead.

Should modifier 50 be appended for bilateral procedures?

No. CMS identifies bilateral adjustment as inappropriate for this code's descriptor or anatomy.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

How are other procedures in the same session paid?

Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%. Medicare does not pay an assistant at surgery, co-surgeons, or team surgery for 28070.

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 28070PPRRVU2026_Oct_nonQPP.csv, line 3,110 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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