CPT code 28140: Metatarsal excision, complete bone removal2026 Medicare rate & RVUs in California
Reports complete removal of a metatarsal, such as for severe bone infection or destructive disease requiring excision of the entire bone.
Medicare pays $580.72–$706.01 for 28140 in the office in California, from Chico, CA to San Benito County, CA. 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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What 28140 covers
This service removes an entire metatarsal bone in the foot. An orthopedic surgeon or podiatric surgeon may perform it when disease or damage requires complete bone excision, such as severe metatarsal osteomyelitis. The operative report should identify the metatarsal and describe removal of the whole bone, rather than only its head or a limited portion.
Report 28140 when the documented procedure removes the complete metatarsal; use a partial-excision code when only part is removed. The day-before preoperative visit and 90 days of related postoperative care are included in its major-surgery global period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery; 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 28140 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 payment localities
$580.72 to $706.01
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $583.36 | $401.79 |
| Chico, CA | $580.72 | $399.15 |
| El Centro, CA | $580.87 | $399.30 |
| Fresno, CA | $580.72 | $399.15 |
| Hanford, CA | $580.72 | $399.15 |
| Los Angeles, CA | $616.17 | $420.19 |
| Madera, CA | $580.72 | $399.15 |
| Marin County, CA | $690.64 | $457.05 |
| Merced, CA | $580.72 | $399.15 |
| Modesto, CA | $580.72 | $399.15 |
| Napa, CA | $657.10 | $438.75 |
| Oxnard, CA | $611.63 | $415.81 |
| Redding, CA | $580.72 | $399.15 |
| Rest of California | $580.72 | $399.15 |
| Riverside, CA | $590.38 | $408.81 |
| Sacramento, CA | $605.21 | $412.54 |
| Salinas, CA | $602.85 | $410.84 |
| San Benito County, CA | $706.01 | $467.11 |
| San Diego, CA | $613.89 | $415.75 |
| San Francisco, CA | $689.63 | $456.04 |
| San Luis Obispo, CA | $593.61 | $404.91 |
| Santa Clara County, CA | $701.88 | $462.98 |
| Santa Cruz, CA | $617.31 | $416.02 |
| Santa Maria, CA | $604.25 | $411.08 |
| Santa Rosa, CA | $623.29 | $419.85 |
| Stockton, CA | $580.72 | $399.15 |
| Vallejo, CA | $655.64 | $437.29 |
| Visalia, CA | $580.72 | $399.15 |
| Yuba City, CA | $580.72 | $399.15 |
How the 28140 rate is calculated
Each of 28140’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 · 28140
RVUs × geographic indexes × conversion factor
Work6.96
6.96 RVUs× 1.000 GPCI
Practice expense8.97
8.97 RVUs× 1.000 GPCI
Malpractice0.89
0.89 RVUs× 1.000 GPCI
Adjusted RVUs
16.8200
Conversion factor
$33.4009
Medicare rate
$561.80
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 28140
28140 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28140
Metatarsal excision, complete bone removal
| 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| 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 · 28140
Metatarsal excision, complete bone removal
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 51 · payment effect
With and without the modifier
28140 without 51 · national office
$561.80
Metatarsal excision, complete bone removal
28140-51 · Second procedure: 50%
$280.90
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
28140 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 28110Metatarsal resectionPartial fifth-head excision
- 28110 describes partial excision at the fifth metatarsal head. Use 28140 when the entire metatarsal is removed.
- 28114Metatarsal head excisionSecond through fourth metatarsal
- 28114 addresses metatarsal head removal. 28140 represents complete removal of the metatarsal, not just its head.
- 28122Tarsal bone excisionOther tarsal bones
- 28122 is for partial excision of a tarsal or metatarsal bone. Choose 28140 when the full metatarsal is excised.
- 28173Bone tumor surgeryMetatarsal
- 28173 is for resection of a metatarsal tumor. For complete metatarsal excision for another indication, consider 28140.
28140 billing questions
How does 28140 differ from a partial metatarsal excision?
Use 28140 when the operative report supports removal of the entire metatarsal. Codes for partial excision apply when only a portion is removed.
Does removing only a metatarsal head support 28140?
No. A procedure limited to the metatarsal head is distinct from complete removal of the metatarsal; select the code that matches the documented extent.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 be used when both feet are treated?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 is not appropriate.
How are multiple procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures in the session are subject to the standard 50% multiple-procedure reduction.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons are paid only when supporting documentation is provided.
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
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