CPT code 28111: Metatarsal excision, first metatarsal head2026 Medicare rate & RVUs in Guam
Reports surgical removal of a limited portion of the first metatarsal head, such as a painful bony prominence, without removing the entire bone.
Medicare pays $504.53 for 28111 in the office in Guam (Hawaii, Guam, HI). Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 28111 covers
The surgeon removes a limited portion of the head of the first metatarsal, the long bone behind the great toe. This may address a painful prominence or localized bone problem. The procedure is performed by a foot and ankle surgeon or other qualified surgeon, commonly in an operating room or ambulatory surgery center. The operative report should identify the first metatarsal and describe the portion removed and the reason for excision.
Select this code when the work is a partial resection of the first metatarsal head, rather than a resection of another metatarsal or removal of the whole bone. 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 is paid in full and the others are subject to the standard multiple-procedure reduction. For bilateral surgery, modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; co-surgeons are paid only with 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.
28111 in Hawaii, Guam, HI
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam, HI | $504.53 | $310.47 |
How the 28111 rate is calculated
Each of 28111’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 · 28111
RVUs × geographic indexes × conversion factor
Work5.02
5.02 RVUs× 1.000 GPCI
Practice expense8.59
8.59 RVUs× 1.000 GPCI
Malpractice0.55
0.55 RVUs× 1.000 GPCI
Adjusted RVUs
14.1600
Conversion factor
$33.4009
Medicare rate
$472.96
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 28111
28111 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28111
Metatarsal excision, first metatarsal head
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 28111
Metatarsal excision, first metatarsal head
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
28111 without 50 · national office
$472.96
Metatarsal excision, first metatarsal head
28111-50 · Bilateral: 150%
$709.44
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).
28111 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 28110Metatarsal resectionPartial fifth-head excision
- 28110 addresses partial resection of the fifth metatarsal head; this code is for the first metatarsal head.
- 28140Metatarsal excisionComplete bone removal
- 28140 describes removal of a metatarsal, while this code is limited to partial resection of the first metatarsal head.
- 28296Bunion correctionDistal first metatarsal osteotomy
- Choose 28296 when hallux valgus is corrected with a distal metatarsal osteotomy. This code describes partial excision of the first metatarsal head.
28111 billing questions
How is this code distinguished from 28110?
This code is for partial resection of the first metatarsal head. Code 28110 applies to the fifth metatarsal head.
When is 28112 more appropriate?
Use 28112 when the partial resection involves the second metatarsal head, rather than the first.
Does the global period include routine postoperative care?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral surgery reported?
For bilateral procedures, report modifier 50; CMS pays the bilateral procedure at 150%.
What documentation supports reporting this code?
The operative report should establish that the surgeon removed part of the first metatarsal head and document the indication and extent of the resection.
Can an assistant or co-surgeon be paid?
Assistant-at-surgery payment is restricted for this code. Co-surgeons are paid only when supporting documentation is provided.
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
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