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

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 Vermont, Medicare pays $570.96 for 28113 in the office and $394.72 when it’s performed in a hospital or facility.

$570.96Office (non-facility)
$394.72Hospital or facility
−2.3%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 Vermont
  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 Vermont 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. Vermont pays $570.96. The RVUs are the same everywhere; the geographic indexes change the dollars.

28113 in Vermont vs other payment areas
  1. Vermont · this page$570.96
  2. Los Angeles, CA · California$652.81+$81.85
  3. Washington, DC area · District of Columbia$662.57+$91.61
  4. Miami, FL · Florida$630.14+$59.18
  5. Chicago, IL · Illinois$613.69+$42.73
  6. Manhattan, NY · New York$668.20+$97.24
  7. Alaska · Alaska$698.80+$127.84

Other areas in Vermont 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.

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 Vermont 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

105

Locality
Vermont
Physician work
1.000
Practice expense
0.990
Malpractice
0.506
Office calculation for 28113 in Vermont
ComponentRVULocality factorAdjusted
Physician work5.96× 1.0005.9600
Practice expense10.94× 0.99010.8306
Malpractice0.60× 0.5060.3036
Total RVUs17.0942
Conversion factor× 33.4009

Office rate, Vermont$570.96

Office: (5.96 × 1 + 10.94 × 0.99 + 0.6 × 0.506) × $33.4009 = $570.96

Facility: (5.96 × 1 + 5.61 × 0.99 + 0.6 × 0.506) × $33.4009 = $394.72

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

How 28113 has changed in Vermont

28113 · Office / nonfacility

$570.96

Effective 2026-10-01

The base rate is $14.45 higher than on 2025-10-01, moving from $556.51 to $570.96 (2.6%).

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

    $556.51changed to$570.96

    • 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 0.993 changed to 0.990
    • Malpractice GPCI 0.518 changed to 0.506

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $572.53changed to$556.51

    • 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

    $563.19changed to$572.53

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $579.41changed to$563.19

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 10.70 changed to 10.86
    • Practice expense GPCI 0.997 changed to 0.993
    • Malpractice GPCI 0.543 changed to 0.518
  5. January 1, 2023

    RVU23A

    $588.22changed to$579.41

    • 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 1.001 changed to 0.997
    • Malpractice GPCI 0.569 changed to 0.543

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $598.34changed to$588.22

    • 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

    $605.26changed to$598.34

    • 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 1.008 changed to 1.001
    • Malpractice GPCI 0.582 changed to 0.569

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $610.96changed to$605.26

    • 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 1.015 changed to 1.008
    • Malpractice GPCI 0.595 changed to 0.582

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $611.60changed to$610.96

    • 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

    $609.33changed to$611.60

    • 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
    • Practice expense GPCI 1.010 changed to 1.015
    • Malpractice GPCI 0.639 changed to 0.595

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $606.18changed to$609.33

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 10.39 changed to 10.40
    • Practice expense GPCI 1.004 changed to 1.010
    • Malpractice GPCI 0.682 changed to 0.639

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $611.87changed to$606.18

    • 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

    $608.83changed to$611.87

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $602.27changed to$608.83

    • 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 1.006 changed to 1.004
    • Malpractice GPCI 0.618 changed to 0.682

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$602.27

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$570.96$394.72RVU26D
2026-07-01$570.96$394.72RVU26C
2026-04-01$570.96$394.72RVU26B
2026-01-01$570.96$394.72RVU26A
2025-10-01$556.51$412.62RVU25D
2025-07-01$556.51$412.62RVU25C
2025-04-01$556.51$412.62RVU25B
2025-01-01$556.51$412.62RVU25A
2024-10-01$572.53$419.49RVU24D
2024-07-01$572.53$419.49RVU24C
2024-04-01$572.53$419.49RVU24B
2024-03-09$572.53$419.49RVU24AR
2024-01-01$563.19$412.64RVU24A
2023-10-01$579.41$420.96RVU23D
2023-07-01$579.41$420.96RVU23C
2023-04-01$579.41$420.96RVU23B
2023-01-01$579.41$420.96RVU23A
2022-10-01$588.22$422.99RVU22D
2022-07-01$588.22$422.99RVU22C
2022-04-01$588.22$422.99RVU22B
2022-01-01$588.22$422.99RVU22A
2021-10-01$598.34$423.35RVU21D
2021-07-01$598.34$423.35RVU21C
2021-04-01$598.34$423.35RVU21B
2021-01-01$598.34$423.35RVU21A
2020-10-01$605.26$432.10RVU20D
2020-07-01$605.26$432.10RVU20C
2020-04-01$605.26$432.10RVU20B
2020-01-01$605.26$432.10RVU20A
2019-10-01$610.96$434.64RVU19D
2019-07-01$610.96$434.64RVU19C
2019-04-01$610.96$434.64RVU19B
2019-01-01$610.96$434.64RVU19A
2018-10-01$611.60$434.02RVU18D
2018-07-01$611.60$434.02RVU18C
2018-04-01$611.60$434.02RVU18B
2018-01-01$611.60$434.02RVU18AR1
2017-10-01$609.33$433.89RVU17D
2017-07-01$609.33$433.89RVU17C
2017-04-01$609.33$433.89RVU17B
2017-01-01$609.33$433.89RVU17A
2016-10-01$606.18$432.19RVU16D
2016-07-01$606.18$432.19RVU16C
2016-04-01$606.18$432.19RVU16B
2016-01-01$606.18$432.19RVU16A
2015-10-01$611.87$435.81RVU15D
2015-07-01$611.87$435.81RVU15C
2015-04-01$608.83$433.65RVU15B
2015-01-01$608.83$433.65RVU15A
2014-10-01$602.27$430.37RVU14D
2014-07-01$602.27$430.37RVU14C
2014-04-01$602.27$430.37RVU14B
2014-01-01$602.27$430.37RVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 28113 for an earlier date of service

Where the Vermont rate applies

Vermont is a Medicare payment area, not a city. Our Census mapping connects it to 180 cities and communities in Vermont. Some span more than one payment area; confirm with the service ZIP.

  • Albany
  • Alburgh
  • Algiers
  • Arlington
  • Ascutney
  • Bakersfield
  • Barnet
  • Barre

Browse all communities in Vermont

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 VermontGPCI2026.csv, line 105 (RVU26D)

Open CMS sourceHow we calculate rates

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