CPT code 28113: Metatarsal excision, third, fourth, or fifth metatarsal2026 Medicare rate & RVUs in Illinois
Reports complete removal of a third, fourth, or fifth metatarsal head, such as for a symptomatic bony prominence or pressure-related forefoot problem.
Medicare pays $564.01–$613.69 for 28113 in the office in Illinois, from Rest of Illinois to Chicago, IL. 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.
Your location
On this page 9 sections
What 28113 covers
This service removes the head of a third, fourth, or fifth metatarsal. Foot and ankle surgeons and podiatrists may perform it for a painful prominence, deformity, or pressure problem such as a recurrent ulcer beneath the affected metatarsal head. The operative report should identify the bone and side, describe the extent of bone removed, and explain the clinical indication. A procedure that reshapes the bone without removing the head is a different service.
Report this code when the documented work is complete excision of one of these metatarsal heads, rather than partial removal of the fifth metatarsal head or excision of a different metatarsal. It has 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% reduction. For bilateral surgery, modifier 50 is paid at 150%. Assistant-at-surgery payment requires documentation of medical necessity; 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.
Where 28113 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
4 payment localities
$564.01 to $613.69
| Payment locality | Office | Facility |
|---|---|---|
| Chicago, IL | $613.69 | $434.77 |
| East St. Louis, IL | $575.60 | $411.82 |
| Rest of Illinois | $564.01 | $401.47 |
| Suburban Chicago, IL | $611.25 | $428.41 |
How the 28113 rate is calculated
Each of 28113’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 · 28113
RVUs × geographic indexes × conversion factor
Work5.96
5.96 RVUs× 1.000 GPCI
Practice expense10.94
10.94 RVUs× 1.000 GPCI
Malpractice0.60
0.60 RVUs× 1.000 GPCI
Adjusted RVUs
17.5000
Conversion factor
$33.4009
Medicare rate
$584.52
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 28113
28113 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28113
Metatarsal excision, third, fourth, or fifth metatarsal
| 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) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| 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 · 28113
Metatarsal excision, third, fourth, or fifth metatarsal
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
28113 without 50 · national office
$584.52
Metatarsal excision, third, fourth, or fifth metatarsal
28113-50 · Bilateral: 150%
$876.78
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).
28113 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 28110Metatarsal resectionPartial fifth-head excision
- Use 28110 for partial excision of the fifth metatarsal head. This code describes complete excision of a third, fourth, or fifth metatarsal head.
- 28112Metatarsal head resectionSecond metatarsal head
- Code 28112 applies to complete excision of the second metatarsal head; this code is for the third, fourth, or fifth.
- 28114Metatarsal head excisionSecond through fourth metatarsal
- Code 28114 describes metatarsal head resection on an each-head basis. Select the code that matches the documented procedure and its specific coding instructions.
- 28140Metatarsal excisionComplete bone removal
- Code 28140 removes a metatarsal, not just its head. This code is limited to complete excision of a third, fourth, or fifth metatarsal head.
28113 billing questions
How does this differ from code 28110?
This code is for complete excision of a third, fourth, or fifth metatarsal head. Code 28110 describes partial excision of the fifth metatarsal head.
What documentation supports reporting this code?
Document the affected side and metatarsal, the reason for surgery, and that the metatarsal head was completely excised. The operative report should distinguish this work from a partial resection or an osteotomy.
Are related postoperative visits included?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral surgery reported?
Use modifier 50 for a bilateral procedure; CMS pays it at 150%.
Can an assistant surgeon or co-surgeon be paid?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard 50% multiple-procedure 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
Fee sheets
Put 28113 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Build my fee sheet