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

Reports complete surgical removal of a second, third, or fourth metatarsal head, commonly to address forefoot pressure, pain, or deformity.

CMS RVU26DEffective Oct 1, 2026One payment locality592 Medicare services in 2024

In Delaware, Medicare pays $1,101.51 for 28114 in the office and $789.66 when it’s performed in a hospital or facility.

$1,101.51Office (non-facility)
$789.66Hospital or facility
−1.1%vs the national office rate ($1,113.25)

Check a contract rate as a % of Medicare · 28114 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 28114 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Delaware
  2. What 28114 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 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.

How Delaware compares for 28114

Across 109 of 109 payment localities, the office rate for 28114 runs from $991.97 in Arkansas to $1,424.43 in San Benito County, CA. Delaware pays $1,101.51. The RVUs are the same everywhere; the geographic indexes change the dollars.

28114 in Delaware vs other payment areas
  1. Delaware · this page$1,101.51
  2. Los Angeles, CA · California$1,232.19+$130.68
  3. Washington, DC area · District of Columbia$1,259.28+$157.77
  4. Miami, FL · Florida$1,226.87+$125.36
  5. Chicago, IL · Illinois$1,192.42+$90.91
  6. Manhattan, NY · New York$1,279.24+$177.73
  7. Alaska · Alaska$1,326.59+$225.08

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

Every other payment area

28114 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$1,005.50$729.32
ArkansasArkansas$991.97$720.83
ArizonaArizona$1,084.48$778.62
Bakersfield, CACalifornia$1,162.54$816.60
Chico, CACalifornia$1,157.64$811.70
El Centro, CACalifornia$1,157.92$811.98
Fresno, CACalifornia$1,157.64$811.70
Hanford, CACalifornia$1,157.64$811.70

28114 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.

$991.97

$1,326.59

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

View every state and territory as a table
28114 office rate range by state
State / territoryOffice rate rangeLocalities
AK$1,326.591
AL$1,005.501
AR$991.971
AZ$1,084.481
CA$1,157.64–$1,424.4329
CO$1,148.201
CT$1,184.201
DC$1,259.281
DE$1,101.511
FL$1,112.34–$1,226.873
GA$1,052.16–$1,136.432
GU$1,180.731
HI$1,180.731
IA$1,022.601
ID$1,030.221
IL$1,087.09–$1,192.424
IN$1,035.621
KS$1,021.321
KY$1,034.531
LA$1,034.29–$1,081.632
MA$1,143.34–$1,252.272
MD$1,120.52–$1,259.283
ME$1,038.63–$1,086.432
MI$1,062.59–$1,128.662
MN$1,092.831
MO$1,019.87–$1,081.403
MS$1,005.941
MT$1,113.141
NC$1,048.251
ND$1,079.721
NE$1,026.861
NH$1,133.501
NJ$1,195.63–$1,248.272
NM$1,069.321
NV$1,104.491
NY$1,063.19–$1,312.515
OH$1,055.761
OK$1,029.401
OR$1,093.82–$1,178.982
PA$1,055.53–$1,158.492
PR$1,119.731
RI$1,136.561
SC$1,054.171
SD$1,075.771
TN$1,026.511
TX$1,049.30–$1,146.238
UT$1,067.531
VA$1,085.33–$1,259.282
VI$1,119.731
VT$1,078.711
WA$1,140.14–$1,273.652
WI$1,046.221
WV$1,050.331
WY$1,098.581

See 28114 in every payment locality

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.

How the rate is built · 28114

RVUs × geographic indexes × conversion factor

Office or facility?

Work11.70

11.70 RVUs× 1.000 GPCI

Practice expense19.94

19.94 RVUs× 1.000 GPCI

Malpractice1.69

1.69 RVUs× 1.000 GPCI

Adjusted RVUs

33.3300

Conversion factor

$33.4009

Medicare rate

$1,113.25

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Delaware inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,128

Code
28114
Physician work
11.70
Practice expense
19.94
Malpractice
1.69

GPCI2026.csv

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office calculation for 28114 in Delaware
ComponentRVULocality factorAdjusted
Physician work11.70× 1.00511.7585
Practice expense19.94× 0.98819.7007
Malpractice1.69× 0.8991.5193
Total RVUs32.9785
Conversion factor× 33.4009

Office rate, Delaware$1101.51

Office: (11.7 × 1.005 + 19.94 × 0.988 + 1.69 × 0.899) × $33.4009 = $1101.51

Facility: (11.7 × 1.005 + 10.49 × 0.988 + 1.69 × 0.899) × $33.4009 = $789.66

Open 28114 in the RVU calculator

Payment rules and modifiers for 28114

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

CMS payment indicators · 28114

Metatarsal head excision, second through fourth 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)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
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 · 28114

Metatarsal head excision, second through fourth 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

28114 without 50 · national office

$1,113.25

Metatarsal head excision, second through fourth metatarsal

28114-50 · Bilateral: 150%

$1,669.88

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 28114

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

Codes related to 28114
CodeHow it relatesOffice range, Delaware
Same family
28111Metatarsal excision, first metatarsal headRelated complete excision code for another metatarsal-head coding circumstance.$468.50
28112Metatarsal head resection, second metatarsal headUsed for complete excision of the first metatarsal head.$477.30
28113Metatarsal excision, third, fourth, or fifth metatarsalUsed for complete excision of the fifth metatarsal head.$579.10
Used instead
28110Metatarsal resection, partial fifth-head excisionPartial excision of the fifth metatarsal head, rather than complete excision of a second through fourth head.$462.64
28140Metatarsal excision, complete bone removalRemoval of a metatarsal, rather than excision limited to its head.$556.37

How 28114 has changed in Delaware

28114 · Office / nonfacility

$1101.51

Effective 2026-10-01

The base rate is $63.95 higher than on 2025-10-01, moving from $1037.56 to $1101.51 (6.2%).

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

    $1037.56changed to$1101.51

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 12.00 changed to 11.70
    • Practice expense RVU 18.57 changed to 19.94
    • Malpractice RVU 1.63 changed to 1.69
    • Work GPCI 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $1063.12changed to$1037.56

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 18.43 changed to 18.57

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $1045.77changed to$1063.12

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $1081.71changed to$1045.77

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 18.19 changed to 18.43
    • Malpractice RVU 1.62 changed to 1.63
    • Work GPCI 1.007 changed to 1.009
    • Practice expense GPCI 1.007 changed to 0.992
    • Malpractice GPCI 0.938 changed to 0.949

  5. January 1, 2023

    RVU23A

    $1102.91changed to$1081.71

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 17.86 changed to 18.19
    • Malpractice RVU 1.68 changed to 1.62
    • Work GPCI 1.005 changed to 1.007
    • Practice expense GPCI 1.022 changed to 1.007
    • Malpractice GPCI 0.927 changed to 0.938

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $1112.35changed to$1102.91

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 17.95 changed to 17.86
    • Malpractice RVU 1.59 changed to 1.68

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $1117.10changed to$1112.35

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 16.93 changed to 17.95
    • Malpractice RVU 1.56 changed to 1.59
    • Work GPCI 1.006 changed to 1.005
    • Practice expense GPCI 1.021 changed to 1.022
    • Malpractice GPCI 1.023 changed to 0.927

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $1129.25changed to$1117.10

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 17.20 changed to 16.93
    • Malpractice RVU 1.54 changed to 1.56
    • Work GPCI 1.007 changed to 1.006
    • Practice expense GPCI 1.019 changed to 1.021
    • Malpractice GPCI 1.119 changed to 1.023

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $1137.95changed to$1129.25

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 17.46 changed to 17.20
    • Malpractice RVU 1.55 changed to 1.54

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $1138.98changed to$1137.95

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 17.43 changed to 17.46
    • Malpractice RVU 1.59 changed to 1.55
    • Work GPCI 1.010 changed to 1.007
    • Practice expense GPCI 1.025 changed to 1.019
    • Malpractice GPCI 1.101 changed to 1.119

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $1138.77changed to$1138.98

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 17.40 changed to 17.43
    • Work GPCI 1.012 changed to 1.010
    • Practice expense GPCI 1.031 changed to 1.025
    • Malpractice GPCI 1.083 changed to 1.101

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $1151.14changed to$1138.77

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 17.56 changed to 17.40
    • Malpractice RVU 1.65 changed to 1.59

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $1145.41changed to$1151.14

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $1123.55changed to$1145.41

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 17.18 changed to 17.56
    • Malpractice RVU 1.58 changed to 1.65
    • Practice expense GPCI 1.038 changed to 1.031
    • Malpractice GPCI 0.878 changed to 1.083

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $1121.87changed to$1123.55

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 18.89 changed to 17.18
    • Malpractice RVU 1.65 changed to 1.58
    • Practice expense GPCI 1.044 changed to 1.038
    • Malpractice GPCI 0.672 changed to 0.878

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $1121.87

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$1,101.51$789.66RVU26D
2026-07-01$1,101.51$789.66RVU26C
2026-04-01$1,101.51$789.66RVU26B
2026-01-01$1,101.51$789.66RVU26A
2025-10-01$1,037.56$825.78RVU25D
2025-07-01$1,037.56$825.78RVU25C
2025-04-01$1,037.56$825.78RVU25B
2025-01-01$1,037.56$825.78RVU25A
2024-10-01$1,063.12$840.22RVU24D
2024-07-01$1,063.12$840.22RVU24C
2024-04-01$1,063.12$840.22RVU24B
2024-03-09$1,063.12$840.22RVU24AR
2024-01-01$1,045.77$826.51RVU24A
2023-10-01$1,081.71$849.66RVU23D
2023-07-01$1,081.71$849.66RVU23C
2023-04-01$1,081.71$849.66RVU23B
2023-01-01$1,081.71$849.66RVU23A
2022-10-01$1,102.91$860.29RVU22D
2022-07-01$1,102.91$860.29RVU22C
2022-04-01$1,102.91$860.29RVU22B
2022-01-01$1,102.91$860.29RVU22A
2021-10-01$1,112.35$858.45RVU21D
2021-07-01$1,112.35$858.45RVU21C
2021-04-01$1,112.35$858.45RVU21B
2021-01-01$1,112.35$858.45RVU21A
2020-10-01$1,117.10$871.69RVU20D
2020-07-01$1,117.10$871.69RVU20C
2020-04-01$1,117.10$871.69RVU20B
2020-01-01$1,117.10$871.69RVU20A
2019-10-01$1,129.25$880.26RVU19D
2019-07-01$1,129.25$880.26RVU19C
2019-04-01$1,129.25$880.26RVU19B
2019-01-01$1,129.25$880.26RVU19A
2018-10-01$1,137.95$884.10RVU18D
2018-07-01$1,137.95$884.10RVU18C
2018-04-01$1,137.95$884.10RVU18B
2018-01-01$1,137.95$884.10RVU18AR1
2017-10-01$1,138.98$885.89RVU17D
2017-07-01$1,138.98$885.89RVU17C
2017-04-01$1,138.98$885.89RVU17B
2017-01-01$1,138.98$885.89RVU17A
2016-10-01$1,138.77$884.80RVU16D
2016-07-01$1,138.77$884.80RVU16C
2016-04-01$1,138.77$884.80RVU16B
2016-01-01$1,138.77$884.80RVU16A
2015-10-01$1,151.14$893.66RVU15D
2015-07-01$1,151.14$893.66RVU15C
2015-04-01$1,145.41$889.21RVU15B
2015-01-01$1,145.41$889.21RVU15A
2014-10-01$1,123.55$872.18RVU14D
2014-07-01$1,123.55$872.18RVU14C
2014-04-01$1,123.55$872.18RVU14B
2014-01-01$1,123.55$872.18RVU14A
2013-10-01$1,121.87$854.41RVU13D
2013-07-01$1,121.87$854.41RVU13C
2013-04-01$1,121.87$854.41RVU13B
2013-01-01$1,121.87$854.41RVU13AR

Price 28114 for an earlier date of service

Where the Delaware rate applies

Delaware is a Medicare payment area, not a city. Our Census mapping connects it to 79 cities and communities in Delaware. Some span more than one payment area; confirm with the service ZIP.

  • Arden
  • Ardencroft
  • Ardentown
  • Bear
  • Bellefonte
  • Bethany Beach
  • Bethel
  • Blades

Browse all communities in Delaware

28114 billing questions

Which metatarsal heads are covered by this code?

It applies to complete excision of a second, third, or fourth metatarsal head. The first and fifth metatarsal heads have distinct codes.

How does this differ from a partial metatarsal excision?

Use this code when the metatarsal head is completely excised. A limited removal or reshaping of part of the metatarsal is a different service.

What should the operative note identify?

Document the side, the specific metatarsal head removed, complete excision, and the condition prompting surgery, such as a painful pressure prominence or deformity.

How is bilateral surgery reported?

For bilateral procedures, modifier 50 is paid at 150%.

Are assistant or co-surgeon services payable?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.

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 28114PPRRVU2026_Oct_nonQPP.csv, line 3,128 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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