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

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 Iowa, Medicare pays $1,022.60 for 28114 in the office and $733.79 when it’s performed in a hospital or facility.

$1,022.60Office (non-facility)
$733.79Hospital or facility
−8.1%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 Iowa
  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 Iowa 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. Iowa pays $1,022.60. The RVUs are the same everywhere; the geographic indexes change the dollars.

28114 in Iowa vs other payment areas
  1. Iowa · this page$1,022.60
  2. Los Angeles, CA · California$1,232.19+$209.59
  3. Washington, DC area · District of Columbia$1,259.28+$236.68
  4. Miami, FL · Florida$1,226.87+$204.27
  5. Chicago, IL · Illinois$1,192.42+$169.82
  6. Manhattan, NY · New York$1,279.24+$256.64
  7. Alaska · Alaska$1,326.59+$303.99

Other areas in Iowa 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 Iowa 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

53

Locality
Iowa
Physician work
1.000
Practice expense
0.915
Malpractice
0.397
Office calculation for 28114 in Iowa
ComponentRVULocality factorAdjusted
Physician work11.70× 1.00011.7000
Practice expense19.94× 0.91518.2451
Malpractice1.69× 0.3970.6709
Total RVUs30.6160
Conversion factor× 33.4009

Office rate, Iowa$1022.60

Office: (11.7 × 1 + 19.94 × 0.915 + 1.69 × 0.397) × $33.4009 = $1022.60

Facility: (11.7 × 1 + 10.49 × 0.915 + 1.69 × 0.397) × $33.4009 = $733.79

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, Iowa
Same family
28111Metatarsal excision, first metatarsal headRelated complete excision code for another metatarsal-head coding circumstance.$437.49
28112Metatarsal head resection, second metatarsal headUsed for complete excision of the first metatarsal head.$445.33
28113Metatarsal excision, third, fourth, or fifth metatarsalUsed for complete excision of the fifth metatarsal head.$541.37
Used instead
28110Metatarsal resection, partial fifth-head excisionPartial excision of the fifth metatarsal head, rather than complete excision of a second through fourth head.$431.27
28140Metatarsal excision, complete bone removalRemoval of a metatarsal, rather than excision limited to its head.$518.41

How 28114 has changed in Iowa

28114 · Office / nonfacility

$1022.60

Effective 2026-10-01

The base rate is $61.93 higher than on 2025-10-01, moving from $960.67 to $1022.60 (6.4%).

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

    $960.67changed to$1022.60

    • 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
    • Practice expense GPCI 0.913 changed to 0.915
    • Malpractice GPCI 0.457 changed to 0.397

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $984.36changed to$960.67

    • 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

    $968.30changed to$984.36

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $991.79changed to$968.30

    • 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
    • Practice expense GPCI 0.910 changed to 0.913
    • Malpractice GPCI 0.441 changed to 0.457

  5. January 1, 2023

    RVU23A

    $1000.57changed to$991.79

    • 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
    • Practice expense GPCI 0.907 changed to 0.910
    • Malpractice GPCI 0.425 changed to 0.441

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $1010.38changed to$1000.57

    • 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

    $1011.12changed to$1010.38

    • 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
    • Malpractice GPCI 0.424 changed to 0.425

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $1018.17changed to$1011.12

    • 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
    • Malpractice GPCI 0.423 changed to 0.424

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $1025.70changed to$1018.17

    • 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

    $1021.04changed to$1025.70

    • 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
    • Practice expense GPCI 0.902 changed to 0.907
    • Malpractice GPCI 0.458 changed to 0.423

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $1015.92changed to$1021.04

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 17.40 changed to 17.43
    • Practice expense GPCI 0.896 changed to 0.902
    • Malpractice GPCI 0.493 changed to 0.458

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $1025.80changed to$1015.92

    • 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

    $1020.70changed to$1025.80

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $1005.73changed to$1020.70

    • 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 0.892 changed to 0.896
    • Malpractice GPCI 0.475 changed to 0.493

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $1003.94changed to$1005.73

    • 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 0.887 changed to 0.892
    • Malpractice GPCI 0.456 changed to 0.475

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $1003.94

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$1,022.60$733.79RVU26D
2026-07-01$1,022.60$733.79RVU26C
2026-04-01$1,022.60$733.79RVU26B
2026-01-01$1,022.60$733.79RVU26A
2025-10-01$960.67$765.76RVU25D
2025-07-01$960.67$765.76RVU25C
2025-04-01$960.67$765.76RVU25B
2025-01-01$960.67$765.76RVU25A
2024-10-01$984.36$779.22RVU24D
2024-07-01$984.36$779.22RVU24C
2024-04-01$984.36$779.22RVU24B
2024-03-09$984.36$779.22RVU24AR
2024-01-01$968.30$766.50RVU24A
2023-10-01$991.79$782.09RVU23D
2023-07-01$991.79$782.09RVU23C
2023-04-01$991.79$782.09RVU23B
2023-01-01$991.79$782.09RVU23A
2022-10-01$1,000.57$785.25RVU22D
2022-07-01$1,000.57$785.25RVU22C
2022-04-01$1,000.57$785.25RVU22B
2022-01-01$1,000.57$785.25RVU22A
2021-10-01$1,010.38$785.04RVU21D
2021-07-01$1,010.38$785.04RVU21C
2021-04-01$1,010.38$785.04RVU21B
2021-01-01$1,010.38$785.04RVU21A
2020-10-01$1,011.12$793.12RVU20D
2020-07-01$1,011.12$793.12RVU20C
2020-04-01$1,011.12$793.12RVU20B
2020-01-01$1,011.12$793.12RVU20A
2019-10-01$1,018.17$796.55RVU19D
2019-07-01$1,018.17$796.55RVU19C
2019-04-01$1,018.17$796.55RVU19B
2019-01-01$1,018.17$796.55RVU19A
2018-10-01$1,025.70$799.75RVU18D
2018-07-01$1,025.70$799.75RVU18C
2018-04-01$1,025.70$799.75RVU18B
2018-01-01$1,025.70$799.75RVU18AR1
2017-10-01$1,021.04$798.32RVU17D
2017-07-01$1,021.04$798.32RVU17C
2017-04-01$1,021.04$798.32RVU17B
2017-01-01$1,021.04$798.32RVU17A
2016-10-01$1,015.92$795.21RVU16D
2016-07-01$1,015.92$795.21RVU16C
2016-04-01$1,015.92$795.21RVU16B
2016-01-01$1,015.92$795.21RVU16A
2015-10-01$1,025.80$802.04RVU15D
2015-07-01$1,025.80$802.04RVU15C
2015-04-01$1,020.70$798.05RVU15B
2015-01-01$1,020.70$798.05RVU15A
2014-10-01$1,005.73$789.72RVU14D
2014-07-01$1,005.73$789.72RVU14C
2014-04-01$1,005.73$789.72RVU14B
2014-01-01$1,005.73$789.72RVU14A
2013-10-01$1,003.94$776.70RVU13D
2013-07-01$1,003.94$776.70RVU13C
2013-04-01$1,003.94$776.70RVU13B
2013-01-01$1,003.94$776.70RVU13AR

Price 28114 for an earlier date of service

Where the Iowa rate applies

Iowa is a Medicare payment area, not a city. Our Census mapping connects it to 1026 cities and communities in Iowa. Some span more than one payment area; confirm with the service ZIP.

  • Ackley
  • Ackworth
  • Adair
  • Adel
  • Afton
  • Agency
  • Ainsworth
  • Akron

Browse all communities in Iowa

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 IowaGPCI2026.csv, line 53 (RVU26D)

Open CMS sourceHow we calculate rates

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