CPT code 28114: Metatarsal head excision, second through fourth metatarsal2026 Medicare rate & RVUs

Medicare pays $1,113.25 for 28114 nationally in the office and $797.61 in a hospital or facility. Local office rates run $991.97–$1,424.43.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 28114 covers

A foot and ankle surgeon or podiatric surgeon removes the metatarsal head at the end of the second, third, or fourth metatarsal. The procedure may be performed for a painful prominent head, pressure-related plantar keratosis or ulceration, or forefoot deformity such as rheumatoid metatarsalgia. It is generally performed in an operating-room setting; the operative note should identify the metatarsal head removed and describe complete excision rather than a limited bone shave or removal of the entire metatarsal.

Select this code for complete excision of a second, third, or fourth metatarsal head, and document the side, specific head, extent of bone removal, and clinical indication. The code is subject to a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. 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% multiple-procedure reduction. For bilateral surgery, modifier 50 is paid at 150%. Assistant-at-surgery payment may be allowed; co-surgeon payment requires 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.

Where 28114 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

28114 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 28114 rate is calculated

Each of 28114’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.

Payment rules and modifiers for 28114

28114 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

28114 compared with similar codes

How to choose

28111Metatarsal excisionFirst metatarsal head

This is a closely related complete-excision code for a different metatarsal-head coding circumstance. Confirm the exact CPT descriptor and documented extent before selecting between them.

28112Metatarsal head resectionSecond metatarsal head

This code is for complete excision of the first metatarsal head; 28114 concerns a second, third, or fourth metatarsal head.

28113Metatarsal excisionThird, fourth, or fifth metatarsal

This code is for complete excision of the fifth metatarsal head; 28114 concerns a second, third, or fourth metatarsal head.

28110Metatarsal resectionPartial fifth-head excision

This code describes partial excision of the fifth metatarsal head. Choose 28114 for complete excision of a second, third, or fourth metatarsal head.

Codes related to 28114

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

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

Open CMS sourceHow we calculate rates