CPT code 28114: Metatarsal head excision, second through fourth metatarsal2026 Medicare rate & RVUs in Texas
Reports complete surgical removal of a second, third, or fourth metatarsal head, commonly to address forefoot pressure, pain, or deformity.
Medicare pays $1,049.30–$1,146.23 for 28114 in the office in Texas, from Beaumont, TX to Austin, TX. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
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 in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$1049.30 to $1146.23
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | $1,146.23 | $812.28 |
| Beaumont, TX | $1,049.30 | $762.07 |
| Brazoria, TX | $1,097.97 | $785.17 |
| Dallas, TX | $1,106.09 | $791.71 |
| Fort Worth, TX | $1,100.16 | $788.94 |
| Galveston, TX | $1,102.01 | $788.58 |
| Houston, TX | $1,132.94 | $819.51 |
| Rest of Texas | $1,073.81 | $774.27 |
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
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.
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share 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.
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).
28114 compared with similar codes
Compare codes · National
5 codes, side by side
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.
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
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