CPT code 28140: Metatarsal excision, complete bone removal2026 Medicare rate & RVUs in North Dakota

Reports complete removal of a metatarsal, such as for severe bone infection or destructive disease requiring excision of the entire bone.

CMS RVU26DEffective Oct 1, 2026One payment locality752 Medicare services in 2024

In North Dakota, Medicare pays $544.15 for 28140 in the office and $378.48 when it’s performed in a hospital or facility.

$544.15Office (non-facility)
$378.48Hospital or facility
−3.1%vs the national office rate ($561.80)

Check a contract rate as a % of Medicare · 28140 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 28140 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Dakota
  2. What 28140 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 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.

How North Dakota compares for 28140

Across 109 of 109 payment localities, the office rate for 28140 runs from $505.14 in Arkansas to $706.01 in San Benito County, CA. North Dakota pays $544.15. The RVUs are the same everywhere; the geographic indexes change the dollars.

28140 in North Dakota vs other payment areas
  1. North Dakota · this page$544.15
  2. Los Angeles, CA · California$616.17+$72.02
  3. Washington, DC area · District of Columbia$631.05+$86.90
  4. Miami, FL · Florida$619.54+$75.39
  5. Chicago, IL · Illinois$603.42+$59.27
  6. Manhattan, NY · New York$642.64+$98.49
  7. Alaska · Alaska$684.17+$140.02

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

Every other payment area

28140 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$511.45$366.49
ArkansasArkansas$505.14$362.83
ArizonaArizona$548.23$387.70
Bakersfield, CACalifornia$583.36$401.79
Chico, CACalifornia$580.72$399.15
El Centro, CACalifornia$580.87$399.30
Fresno, CACalifornia$580.72$399.15
Hanford, CACalifornia$580.72$399.15

28140 rates by state

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

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.

$505.14

$684.17

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

View every state and territory as a table
28140 office rate range by state
State / territoryOffice rate rangeLocalities
AK$684.171
AL$511.451
AR$505.141
AZ$548.231
CA$580.72–$706.0129
CO$577.261
CT$595.761
DC$631.051
DE$556.371
FL$563.57–$619.543
GA$535.15–$573.272
GU$590.331
HI$590.331
IA$518.411
ID$522.171
IL$552.47–$603.424
IN$524.651
KS$518.301
KY$526.021
LA$526.10–$548.172
MA$575.37–$626.192
MD$565.29–$631.053
ME$526.60–$548.142
MI$539.57–$571.712
MN$549.561
MO$519.68–$547.483
MS$512.401
MT$561.741
NC$531.001
ND$544.151
NE$520.241
NH$570.371
NJ$601.55–$626.412
NM$542.911
NV$557.141
NY$537.99–$658.785
OH$535.981
OK$523.121
OR$551.78–$591.172
PA$535.60–$584.012
PR$564.651
RI$572.901
SC$534.571
SD$542.061
TN$520.781
TX$532.73–$576.268
UT$540.791
VA$547.97–$631.052
VI$564.651
VT$544.121
WA$573.60–$636.002
WI$528.651
WV$535.371
WY$554.071

See 28140 in every payment locality

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

Office or facility?

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.

The exact North Dakota inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,137

Code
28140
Physician work
6.96
Practice expense
8.97
Malpractice
0.89

GPCI2026.csv

84

Locality
North Dakota
Physician work
1.000
Practice expense
1.000
Malpractice
0.406
Office calculation for 28140 in North Dakota
ComponentRVULocality factorAdjusted
Physician work6.96× 1.0006.9600
Practice expense8.97× 1.0008.9700
Malpractice0.89× 0.4060.3613
Total RVUs16.2913
Conversion factor× 33.4009

Office rate, North Dakota$544.15

Office: (6.96 × 1 + 8.97 × 1 + 0.89 × 0.406) × $33.4009 = $544.15

Facility: (6.96 × 1 + 4.01 × 1 + 0.89 × 0.406) × $33.4009 = $378.48

Open 28140 in the RVU calculator

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

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)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
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 · 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.

  • 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 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%).

When to use modifier 51

How 28140 has changed in North Dakota

28140 · Office / nonfacility

$544.15

Effective 2026-10-01

The base rate is $9.30 higher than on 2025-10-01, moving from $534.85 to $544.15 (1.7%).

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

    $534.85changed to$544.15

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 7.14 changed to 6.96
    • Practice expense RVU 8.94 changed to 8.97
    • Malpractice RVU 0.88 changed to 0.89
    • Malpractice GPCI 0.517 changed to 0.406

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $552.93changed to$534.85

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 8.99 changed to 8.94
    • Malpractice RVU 0.93 changed to 0.88

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $543.91changed to$552.93

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $559.52changed to$543.91

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 8.94 changed to 8.99
    • Malpractice RVU 0.91 changed to 0.93
    • Malpractice GPCI 0.474 changed to 0.517
  5. January 1, 2023

    RVU23A

    $571.68changed to$559.52

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 8.97 changed to 8.94
    • Malpractice RVU 0.95 changed to 0.91
    • Malpractice GPCI 0.431 changed to 0.474

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $582.39changed to$571.68

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 9.15 changed to 8.97
    • Malpractice RVU 0.93 changed to 0.95

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $595.89changed to$582.39

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 8.93 changed to 9.15
    • Malpractice RVU 0.91 changed to 0.93
    • Malpractice GPCI 0.485 changed to 0.431

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $602.18changed to$595.89

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 9.11 changed to 8.93
    • Malpractice RVU 0.85 changed to 0.91
    • Malpractice GPCI 0.540 changed to 0.485

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $606.59changed to$602.18

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 9.24 changed to 9.11
    • Malpractice RVU 0.87 changed to 0.85

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $603.30changed to$606.59

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 9.20 changed to 9.24
    • Malpractice RVU 0.86 changed to 0.87
    • Malpractice GPCI 0.547 changed to 0.540

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $603.97changed to$603.30

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 9.23 changed to 9.20
    • Malpractice RVU 0.90 changed to 0.86
    • Malpractice GPCI 0.554 changed to 0.547

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $603.79changed to$603.97

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 9.17 changed to 9.23
    • Malpractice RVU 0.89 changed to 0.90

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $600.79changed to$603.79

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $602.93changed to$600.79

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 9.23 changed to 9.17
    • Malpractice RVU 0.86 changed to 0.89
    • Malpractice GPCI 0.536 changed to 0.554

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $604.43changed to$602.93

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 10.16 changed to 9.23
    • Malpractice RVU 0.90 changed to 0.86
    • Malpractice GPCI 0.517 changed to 0.536

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $604.43

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$544.15$378.48RVU26D
2026-07-01$544.15$378.48RVU26C
2026-04-01$544.15$378.48RVU26B
2026-01-01$544.15$378.48RVU26A
2025-10-01$534.85$402.87RVU25D
2025-07-01$534.85$402.87RVU25C
2025-04-01$534.85$402.87RVU25B
2025-01-01$534.85$402.87RVU25A
2024-10-01$552.93$412.46RVU24D
2024-07-01$552.93$412.46RVU24C
2024-04-01$552.93$412.46RVU24B
2024-03-09$552.93$412.46RVU24AR
2024-01-01$543.91$405.73RVU24A
2023-10-01$559.52$415.16RVU23D
2023-07-01$559.52$415.16RVU23C
2023-04-01$559.52$415.16RVU23B
2023-01-01$559.52$415.16RVU23A
2022-10-01$571.68$420.10RVU22D
2022-07-01$571.68$420.10RVU22C
2022-04-01$571.68$420.10RVU22B
2022-01-01$571.68$420.10RVU22A
2021-10-01$582.39$422.58RVU21D
2021-07-01$582.39$422.58RVU21C
2021-04-01$582.39$422.58RVU21B
2021-01-01$582.39$422.58RVU21A
2020-10-01$595.89$436.37RVU20D
2020-07-01$595.89$436.37RVU20C
2020-04-01$595.89$436.37RVU20B
2020-01-01$595.89$436.37RVU20A
2019-10-01$602.18$439.64RVU19D
2019-07-01$602.18$439.64RVU19C
2019-04-01$602.18$439.64RVU19B
2019-01-01$602.18$439.64RVU19A
2018-10-01$606.59$441.35RVU18D
2018-07-01$606.59$441.35RVU18C
2018-04-01$606.59$441.35RVU18B
2018-01-01$606.59$441.35RVU18AR1
2017-10-01$603.30$440.01RVU17D
2017-07-01$603.30$440.01RVU17C
2017-04-01$603.30$440.01RVU17B
2017-01-01$603.30$440.01RVU17A
2016-10-01$603.97$440.70RVU16D
2016-07-01$603.97$440.70RVU16C
2016-04-01$603.97$440.70RVU16B
2016-01-01$603.97$440.70RVU16A
2015-10-01$603.79$439.94RVU15D
2015-07-01$603.79$439.94RVU15C
2015-04-01$600.79$437.75RVU15B
2015-01-01$600.79$437.75RVU15A
2014-10-01$602.93$440.65RVU14D
2014-07-01$602.93$440.65RVU14C
2014-04-01$602.93$440.65RVU14B
2014-01-01$602.93$440.65RVU14A
2013-10-01$604.43$432.27RVU13D
2013-07-01$604.43$432.27RVU13C
2013-04-01$604.43$432.27RVU13B
2013-01-01$604.43$432.27RVU13AR

Price 28140 for an earlier date of service

Where the North Dakota rate applies

North Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 406 cities and communities in North Dakota. Some span more than one payment area; confirm with the service ZIP.

  • Abercrombie
  • Adams
  • Alamo
  • Alexander
  • Alice
  • Almont
  • Alsen
  • Ambrose

Browse all communities in North Dakota

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
RVUs for 28140PPRRVU2026_Oct_nonQPP.csv, line 3,137 (RVU26D)
Geographic factors for North DakotaGPCI2026.csv, line 84 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 28140 pays in North Dakota?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 28140 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Build my fee sheet