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CPT code 28113: Metatarsal excision, third, fourth, or fifth metatarsal2026 Medicare rate & RVUs in North Carolina

Reports complete removal of a third, fourth, or fifth metatarsal head, such as for a symptomatic bony prominence or pressure-related forefoot problem.

CMS RVU26DEffective Oct 1, 2026One payment locality3K Medicare services in 2024

In North Carolina, Medicare pays $552.80 for 28113 in the office and $386.70 when it’s performed in a hospital or facility.

$552.80Office (non-facility)
$386.70Hospital or facility
−5.4%vs the national office rate ($584.52)

Check a contract rate as a % of Medicare · 28113 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 28113 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Carolina
  2. What 28113 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 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.

How North Carolina compares for 28113

Across 109 of 109 payment localities, the office rate for 28113 runs from $523.27 in Arkansas to $758.62 in San Benito County, CA. North Carolina pays $552.80. The RVUs are the same everywhere; the geographic indexes change the dollars.

28113 in North Carolina vs other payment areas
  1. North Carolina · this page$552.80
  2. Los Angeles, CA · California$652.81+$100.01
  3. Washington, DC area · District of Columbia$662.57+$109.77
  4. Miami, FL · Florida$630.14+$77.34
  5. Chicago, IL · Illinois$613.69+$60.89
  6. Manhattan, NY · New York$668.20+$115.40
  7. Alaska · Alaska$698.80+$146.00

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

Every other payment area

28113 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$530.14$374.37
ArkansasArkansas$523.27$370.35
ArizonaArizona$570.30$397.79
Bakersfield, CACalifornia$615.54$420.42
Chico, CACalifornia$613.68$418.56
El Centro, CACalifornia$613.78$418.66
Fresno, CACalifornia$613.68$418.56
Hanford, CACalifornia$613.68$418.56

28113 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.

$523.27

$698.80

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

View every state and territory as a table
28113 office rate range by state
State / territoryOffice rate rangeLocalities
AK$698.801
AL$530.141
AR$523.271
AZ$570.301
CA$613.68–$758.6229
CO$605.901
CT$620.841
DC$662.571
DE$579.101
FL$578.52–$630.143
GA$548.90–$594.992
GU$626.141
HI$626.141
IA$541.371
ID$544.721
IL$564.01–$613.694
IN$547.541
KS$539.501
KY$542.251
LA$541.65–$565.682
MA$603.00–$661.362
MD$589.25–$662.573
ME$547.71–$573.832
MI$555.31–$585.472
MN$581.001
MO$533.57–$567.023
MS$528.491
MT$584.481
NC$552.801
ND$572.611
NE$543.911
NH$596.991
NJ$628.04–$656.882
NM$558.221
NV$581.531
NY$560.29–$683.495
OH$552.891
OK$540.951
OR$577.10–$623.132
PA$553.45–$606.952
PR$588.231
RI$598.191
SC$553.741
SD$571.211
TN$541.991
TX$550.21–$603.828
UT$560.551
VA$572.41–$662.572
VI$588.231
VT$570.961
WA$601.68–$673.752
WI$555.301
WV$545.291
WY$579.311

See 28113 in every payment locality

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

Office or facility?

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.

The exact North Carolina inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,127

Code
28113
Physician work
5.96
Practice expense
10.94
Malpractice
0.60

GPCI2026.csv

83

Locality
North Carolina
Physician work
1.000
Practice expense
0.933
Malpractice
0.639
Office calculation for 28113 in North Carolina
ComponentRVULocality factorAdjusted
Physician work5.96× 1.0005.9600
Practice expense10.94× 0.93310.2070
Malpractice0.60× 0.6390.3834
Total RVUs16.5504
Conversion factor× 33.4009

Office rate, North Carolina$552.80

Office: (5.96 × 1 + 10.94 × 0.933 + 0.6 × 0.639) × $33.4009 = $552.80

Facility: (5.96 × 1 + 5.61 × 0.933 + 0.6 × 0.639) × $33.4009 = $386.70

Open 28113 in the RVU calculator

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

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)0Not paid without supporting documentation.
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 · 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.

  • 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

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).

When to use modifier 50

Codes related to 28113

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

Codes related to 28113
CodeHow it relatesOffice range, North Carolina
Same family
28110Metatarsal resection, partial fifth-head excisionPartial excision of the fifth metatarsal head rather than complete head excision.$440.65
28111Metatarsal excision, first metatarsal headComplete excision of the first metatarsal head.$447.10
28112Metatarsal head resection, second metatarsal headComplete excision of the second metatarsal head.$454.96
28114Metatarsal head excision, second through fourth metatarsalMetatarsal head resection reported for each head removed.$1,048.25
Used instead
28140Metatarsal excision, complete bone removalRemoval of a metatarsal rather than excision limited to its head.$531.00
28308Metatarsal osteotomy, other than first metatarsalMetatarsal osteotomy when the treatment reshapes or repositions bone rather than excising its head.$551.56

How 28113 has changed in North Carolina

28113 · Office / nonfacility

$552.80

Effective 2026-10-01

The base rate is $16.97 higher than on 2025-10-01, moving from $535.83 to $552.80 (3.2%).

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

    $535.83changed to$552.80

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 6.11 changed to 5.96
    • Practice expense RVU 10.86 changed to 10.94
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.665 changed to 0.639

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $551.20changed to$535.83

    • Conversion factor 33.2875 changed to 32.3465
    • Malpractice RVU 0.59 changed to 0.60

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $542.20changed to$551.20

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $558.01changed to$542.20

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 10.70 changed to 10.86
    • Practice expense GPCI 0.927 changed to 0.926
    • Malpractice GPCI 0.742 changed to 0.665

  5. January 1, 2023

    RVU23A

    $566.90changed to$558.01

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 10.53 changed to 10.70
    • Malpractice RVU 0.61 changed to 0.59
    • Practice expense GPCI 0.928 changed to 0.927
    • Malpractice GPCI 0.819 changed to 0.742

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $576.46changed to$566.90

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 10.68 changed to 10.53

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $580.25changed to$576.46

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 10.23 changed to 10.68
    • Malpractice RVU 0.60 changed to 0.61
    • Practice expense GPCI 0.930 changed to 0.928
    • Malpractice GPCI 0.757 changed to 0.819

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $581.58changed to$580.25

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 10.36 changed to 10.23
    • Malpractice RVU 0.55 changed to 0.60
    • Practice expense GPCI 0.931 changed to 0.930
    • Malpractice GPCI 0.695 changed to 0.757

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $582.20changed to$581.58

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 10.39 changed to 10.36
    • Malpractice RVU 0.56 changed to 0.55

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $581.74changed to$582.20

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 10.40 changed to 10.39
    • Malpractice RVU 0.57 changed to 0.56
    • Malpractice GPCI 0.732 changed to 0.695

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $580.40changed to$581.74

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 10.39 changed to 10.40
    • Practice expense GPCI 0.930 changed to 0.931
    • Malpractice GPCI 0.768 changed to 0.732

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $585.94changed to$580.40

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 10.46 changed to 10.39
    • Malpractice RVU 0.61 changed to 0.57

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $583.03changed to$585.94

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $576.39changed to$583.03

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 10.27 changed to 10.46
    • Malpractice RVU 0.60 changed to 0.61
    • Practice expense GPCI 0.929 changed to 0.930
    • Malpractice GPCI 0.732 changed to 0.768

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $579.80changed to$576.39

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 11.32 changed to 10.27
    • Malpractice RVU 0.63 changed to 0.60
    • Practice expense GPCI 0.927 changed to 0.929
    • Malpractice GPCI 0.695 changed to 0.732

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $579.80

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$552.80$386.70RVU26D
2026-07-01$552.80$386.70RVU26C
2026-04-01$552.80$386.70RVU26B
2026-01-01$552.80$386.70RVU26A
2025-10-01$535.83$401.64RVU25D
2025-07-01$535.83$401.64RVU25C
2025-04-01$535.83$401.64RVU25B
2025-01-01$535.83$401.64RVU25A
2024-10-01$551.20$408.48RVU24D
2024-07-01$551.20$408.48RVU24C
2024-04-01$551.20$408.48RVU24B
2024-03-09$551.20$408.48RVU24AR
2024-01-01$542.20$401.81RVU24A
2023-10-01$558.01$410.68RVU23D
2023-07-01$558.01$410.68RVU23C
2023-04-01$558.01$410.68RVU23B
2023-01-01$558.01$410.68RVU23A
2022-10-01$566.90$413.71RVU22D
2022-07-01$566.90$413.71RVU22C
2022-04-01$566.90$413.71RVU22B
2022-01-01$566.90$413.71RVU22A
2021-10-01$576.46$414.23RVU21D
2021-07-01$576.46$414.23RVU21C
2021-04-01$576.46$414.23RVU21B
2021-01-01$576.46$414.23RVU21A
2020-10-01$580.25$420.49RVU20D
2020-07-01$580.25$420.49RVU20C
2020-04-01$580.25$420.49RVU20B
2020-01-01$580.25$420.49RVU20A
2019-10-01$581.58$419.86RVU19D
2019-07-01$581.58$419.86RVU19C
2019-04-01$581.58$419.86RVU19B
2019-01-01$581.58$419.86RVU19A
2018-10-01$582.20$419.31RVU18D
2018-07-01$582.20$419.31RVU18C
2018-04-01$582.20$419.31RVU18B
2018-01-01$582.20$419.31RVU18AR1
2017-10-01$581.74$420.03RVU17D
2017-07-01$581.74$420.03RVU17C
2017-04-01$581.74$420.03RVU17B
2017-01-01$581.74$420.03RVU17A
2016-10-01$580.40$419.24RVU16D
2016-07-01$580.40$419.24RVU16C
2016-04-01$580.40$419.24RVU16B
2016-01-01$580.40$419.24RVU16A
2015-10-01$585.94$422.86RVU15D
2015-07-01$585.94$422.86RVU15C
2015-04-01$583.03$420.76RVU15B
2015-01-01$583.03$420.76RVU15A
2014-10-01$576.39$417.65RVU14D
2014-07-01$576.39$417.65RVU14C
2014-04-01$576.39$417.65RVU14B
2014-01-01$576.39$417.65RVU14A
2013-10-01$579.80$412.64RVU13D
2013-07-01$579.80$412.64RVU13C
2013-04-01$579.80$412.64RVU13B
2013-01-01$579.80$412.64RVU13AR

Price 28113 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Advance
  • Ahoskie
  • Alamance
  • Albemarle
  • Alexis
  • Alliance
  • Altamahaw

Browse all communities in North Carolina

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
RVUs for 28113PPRRVU2026_Oct_nonQPP.csv, line 3,127 (RVU26D)
Geographic factors for North CarolinaGPCI2026.csv, line 83 (RVU26D)

Open CMS sourceHow we calculate rates

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