CPT code 28200: Foot tendon repair, flexor, without free graft2026 Medicare rate & RVUs in Virginia
Reports repair of a flexor tendon in the foot without a free graft, whether performed as a primary repair or a secondary repair.
In Virginia, Medicare pays $493.22 for 28200 in the office and $305.09 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 28200 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 28200 covers
This service repairs a flexor tendon in the foot without using a free graft. A podiatrist or orthopedic foot and ankle surgeon may perform it for a tendon laceration or rupture requiring surgical repair. The operative report should identify the tendon and foot site, describe the injury and repair, and support that no free graft was used. The code is reported for each tendon repaired; it is not the code for extensor tendon repair or tendon release.
The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery; co-surgeons are paid only with 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 Virginia compares for 28200
Across 109 of 109 payment localities, the office rate for 28200 runs from $448.56 in Arkansas to $659.10 in San Benito County, CA. Virginia pays $493.22. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Virginia · this page$493.22
- Los Angeles, CA · California$565.03+$71.81
- Washington, DC area · District of Columbia$573.78+$80.56
- Miami, FL · Florida$546.54+$53.32
- Chicago, IL · Illinois$531.31+$38.09
- Manhattan, NY · New York$578.87+$85.65
- Alaska · Alaska$594.65+$101.43
Other areas in Virginia first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $454.82 | $287.35 |
| ArkansasArkansas | $448.56 | $284.16 |
| ArizonaArizona | $491.39 | $305.93 |
| Bakersfield, CACalifornia | $531.78 | $322.02 |
| Chico, CACalifornia | $530.11 | $320.35 |
| El Centro, CACalifornia | $530.20 | $320.44 |
| Fresno, CACalifornia | $530.11 | $320.35 |
| Hanford, CACalifornia | $530.11 | $320.35 |
| Madera, CACalifornia | $530.11 | $320.35 |
| Merced, CACalifornia | $530.11 | $320.35 |
| Modesto, CACalifornia | $530.11 | $320.35 |
| Napa, CACalifornia | $610.24 | $357.99 |
| Oxnard, CACalifornia | $561.93 | $335.71 |
| Redding, CACalifornia | $530.11 | $320.35 |
| Rest of CaliforniaCalifornia | $530.11 | $320.35 |
| Riverside, CACalifornia | $536.19 | $326.43 |
| Sacramento, CACalifornia | $555.24 | $332.65 |
| Salinas, CACalifornia | $553.14 | $331.32 |
| San Diego, CACalifornia | $565.36 | $336.46 |
| Marin County, CACalifornia | $644.74 | $374.89 |
| San Francisco, CACalifornia | $644.11 | $374.25 |
| San Benito County, CACalifornia | $659.10 | $383.12 |
| Santa Clara County, CACalifornia | $656.50 | $380.52 |
| San Luis Obispo, CACalifornia | $544.35 | $326.36 |
| Santa Cruz, CACalifornia | $570.15 | $337.62 |
| Santa Maria, CACalifornia | $555.00 | $331.84 |
| Santa Rosa, CACalifornia | $575.85 | $340.83 |
| Stockton, CACalifornia | $530.11 | $320.35 |
| Vallejo, CACalifornia | $609.32 | $357.07 |
| Visalia, CACalifornia | $530.11 | $320.35 |
| Yuba City, CACalifornia | $530.11 | $320.35 |
| ColoradoColorado | $523.31 | $319.68 |
| ConnecticutConnecticut | $536.88 | $330.76 |
| DelawareDelaware | $499.26 | $310.17 |
| Fort Lauderdale, FLFlorida | $523.77 | $329.90 |
| Rest of FloridaFlorida | $499.18 | $316.22 |
| Atlanta, GAGeorgia | $513.88 | $319.43 |
| Rest of GeorgiaGeorgia | $472.16 | $301.44 |
| Hawaii, Guam, HIHawaii | $541.87 | $324.26 |
| IowaIowa | $464.91 | $289.79 |
| IdahoIdaho | $467.99 | $291.91 |
| East St. Louis, ILIllinois | $496.81 | $320.74 |
| Rest of IllinoisIllinois | $486.06 | $311.32 |
| Suburban Chicago, ILIllinois | $528.82 | $332.27 |
| IndianaIndiana | $470.55 | $293.14 |
| KansasKansas | $463.27 | $290.25 |
| KentuckyKentucky | $465.99 | $295.84 |
| New Orleans, LALouisiana | $487.35 | $307.25 |
| Rest of LouisianaLouisiana | $465.46 | $296.09 |
| Metropolitan Boston, MAMassachusetts | $572.90 | $344.39 |
| Rest of MassachusettsMassachusetts | $520.59 | $319.06 |
| Baltimore area, MDMaryland | $535.44 | $330.08 |
| Rest of MarylandMaryland | $508.34 | $314.66 |
| Rest of MaineMaine | $470.78 | $294.70 |
| Southern Maine, MEMaine | $494.47 | $304.80 |
| Detroit, MIMichigan | $505.59 | $320.90 |
| Rest of MichiganMichigan | $477.94 | $303.20 |
| MinnesotaMinnesota | $500.79 | $303.86 |
| Metropolitan Kansas City, MOMissouri | $483.71 | $304.00 |
| Metropolitan St. Louis, MOMissouri | $488.49 | $306.29 |
| Rest of MissouriMissouri | $458.14 | $293.17 |
| MississippiMississippi | $453.42 | $288.63 |
| MontanaMontana | $504.32 | $312.93 |
| North CarolinaNorth Carolina | $475.40 | $296.84 |
| North DakotaNorth Dakota | $493.24 | $301.86 |
| NebraskaNebraska | $467.21 | $290.56 |
| New HampshireNew Hampshire | $515.60 | $316.37 |
| Northern New JerseyNew Jersey | $568.36 | $346.35 |
| Rest of New JerseyNew Jersey | $542.82 | $333.83 |
| New MexicoNew Mexico | $480.61 | $305.11 |
| NevadaNevada | $501.56 | $309.98 |
| NYC suburbs and Long Island, NYNew York | $592.88 | $365.32 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $546.70 | $337.13 |
| Queens, NYNew York | $582.80 | $356.58 |
| Rest of New YorkNew York | $482.23 | $300.41 |
| OhioOhio | $475.68 | $300.94 |
| OklahomaOklahoma | $464.73 | $293.82 |
| Portland, OROregon | $538.81 | $326.18 |
| Rest of OregonOregon | $497.47 | $306.85 |
| Metropolitan Philadelphia, PAPennsylvania | $524.33 | $325.09 |
| Rest of PennsylvaniaPennsylvania | $476.16 | $300.46 |
| Puerto RicoPuerto Rico | $507.72 | $314.23 |
| Rhode IslandRhode Island | $516.20 | $318.50 |
| South CarolinaSouth Carolina | $476.37 | $299.52 |
| South DakotaSouth Dakota | $491.93 | $300.55 |
| TennesseeTennessee | $465.54 | $291.57 |
| Austin, TXTexas | $521.75 | $319.26 |
| Beaumont, TXTexas | $473.21 | $299.04 |
| Brazoria, TXTexas | $498.49 | $308.83 |
| Dallas, TXTexas | $501.76 | $311.14 |
| Fort Worth, TXTexas | $498.69 | $309.98 |
| Galveston, TXTexas | $500.05 | $310.00 |
| Houston, TXTexas | $510.30 | $320.25 |
| Rest of TexasTexas | $485.64 | $304.01 |
| UtahUtah | $482.57 | $302.66 |
| Virgin Islands, VIUnited States Virgin Islands | $507.72 | $314.23 |
| VermontVermont | $491.80 | $302.33 |
| Rest of WashingtonWashington | $519.45 | $317.92 |
| King County, WAWashington | $583.86 | $349.03 |
| WisconsinWisconsin | $477.49 | $294.15 |
| West VirginiaWest Virginia | $469.01 | $302.69 |
| WyomingWyoming | $499.49 | $308.10 |
28200 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.
$448.56
$594.65
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $594.65 | 1 |
| AL | $454.82 | 1 |
| AR | $448.56 | 1 |
| AZ | $491.39 | 1 |
| CA | $530.11–$659.10 | 29 |
| CO | $523.31 | 1 |
| CT | $536.88 | 1 |
| DC | $573.78 | 1 |
| DE | $499.26 | 1 |
| FL | $499.18–$546.54 | 3 |
| GA | $472.16–$513.88 | 2 |
| GU | $541.87 | 1 |
| HI | $541.87 | 1 |
| IA | $464.91 | 1 |
| ID | $467.99 | 1 |
| IL | $486.06–$531.31 | 4 |
| IN | $470.55 | 1 |
| KS | $463.27 | 1 |
| KY | $465.99 | 1 |
| LA | $465.46–$487.35 | 2 |
| MA | $520.59–$572.90 | 2 |
| MD | $508.34–$573.78 | 3 |
| ME | $470.78–$494.47 | 2 |
| MI | $477.94–$505.59 | 2 |
| MN | $500.79 | 1 |
| MO | $458.14–$488.49 | 3 |
| MS | $453.42 | 1 |
| MT | $504.32 | 1 |
| NC | $475.40 | 1 |
| ND | $493.24 | 1 |
| NE | $467.21 | 1 |
| NH | $515.60 | 1 |
| NJ | $542.82–$568.36 | 2 |
| NM | $480.61 | 1 |
| NV | $501.56 | 1 |
| NY | $482.23–$592.88 | 5 |
| OH | $475.68 | 1 |
| OK | $464.73 | 1 |
| OR | $497.47–$538.81 | 2 |
| PA | $476.16–$524.33 | 2 |
| PR | $507.72 | 1 |
| RI | $516.20 | 1 |
| SC | $476.37 | 1 |
| SD | $491.93 | 1 |
| TN | $465.54 | 1 |
| TX | $473.21–$521.75 | 8 |
| UT | $482.57 | 1 |
| VA | $493.22–$573.78 | 2 |
| VI | $507.72 | 1 |
| VT | $491.80 | 1 |
| WA | $519.45–$583.86 | 2 |
| WI | $477.49 | 1 |
| WV | $469.01 | 1 |
| WY | $499.49 | 1 |
How the 28200 rate is calculated
Each of 28200’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 · 28200
RVUs × geographic indexes × conversion factor
Work4.62
4.62 RVUs× 1.000 GPCI
Practice expense9.92
9.92 RVUs× 1.000 GPCI
Malpractice0.56
0.56 RVUs× 1.000 GPCI
Adjusted RVUs
15.1000
Conversion factor
$33.4009
Medicare rate
$504.35
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Virginia inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
3,147
- Code
- 28200
- Physician work
- 4.62
- Practice expense
- 9.92
- Malpractice
- 0.56
GPCI2026.csv
106
- Locality
- Virginia
- Physician work
- 1.000
- Practice expense
- 0.983
- Malpractice
- 0.706
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.62 | × 1.000 | 4.6200 |
| Practice expense | 9.92 | × 0.983 | 9.7514 |
| Malpractice | 0.56 | × 0.706 | 0.3954 |
| Total RVUs | 14.7667 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Virginia$493.22
Office: (4.62 × 1 + 9.92 × 0.983 + 0.56 × 0.706) × $33.4009 = $493.22
Facility: (4.62 × 1 + 4.19 × 0.983 + 0.56 × 0.706) × $33.4009 = $305.09
Payment rules and modifiers for 28200
28200 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28200
Foot tendon repair, flexor, without free graft
| 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 · 28200
Foot tendon repair, flexor, without free graft
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
28200 without 51 · national office
$504.35
Foot tendon repair, flexor, without free graft
28200-51 · Second procedure: 50%
$252.18
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%).
How 28200 has changed in Virginia
28200 · Office / nonfacility
$493.22
Effective 2026-10-01
The base rate is $23.39 higher than on 2025-10-01, moving from $469.83 to $493.22 (5.0%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$469.83changed to$493.22
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 4.74 changed to 4.62
- Practice expense RVU 9.52 changed to 9.92
- Malpractice RVU 0.54 changed to 0.56
- Work GPCI 1.002 changed to 1.000
- Practice expense GPCI 0.984 changed to 0.983
- Malpractice GPCI 0.755 changed to 0.706
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$484.81changed to$469.83
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 9.56 changed to 9.52
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$476.89changed to$484.81
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$492.77changed to$476.89
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 9.45 changed to 9.56
- Work GPCI 1.000 changed to 1.002
- Practice expense GPCI 0.990 changed to 0.984
- Malpractice GPCI 0.826 changed to 0.755
January 1, 2023
RVU23A
$505.09changed to$492.77
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 9.40 changed to 9.45
- Malpractice RVU 0.56 changed to 0.54
- Practice expense GPCI 0.995 changed to 0.990
- Malpractice GPCI 0.897 changed to 0.826
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$509.07changed to$505.09
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 9.43 changed to 9.40
- Malpractice RVU 0.52 changed to 0.56
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$509.18changed to$509.07
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 8.98 changed to 9.43
- Practice expense GPCI 0.991 changed to 0.995
- Malpractice GPCI 0.903 changed to 0.897
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$508.09changed to$509.18
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 9.04 changed to 8.98
- Malpractice RVU 0.49 changed to 0.52
- Practice expense GPCI 0.986 changed to 0.991
- Malpractice GPCI 0.908 changed to 0.903
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$507.86changed to$508.09
- Conversion factor 35.9996 changed to 36.0391
- Malpractice RVU 0.50 changed to 0.49
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$502.08changed to$507.86
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 8.96 changed to 9.04
- Malpractice RVU 0.49 changed to 0.50
- Practice expense GPCI 0.985 changed to 0.986
- Malpractice GPCI 0.866 changed to 0.908
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$497.76changed to$502.08
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 8.91 changed to 8.96
- Practice expense GPCI 0.983 changed to 0.985
- Malpractice GPCI 0.824 changed to 0.866
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$499.15changed to$497.76
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 8.89 changed to 8.91
- Malpractice RVU 0.50 changed to 0.49
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$496.66changed to$499.15
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$488.96changed to$496.66
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 8.75 changed to 8.89
- Malpractice RVU 0.43 changed to 0.50
- Practice expense GPCI 0.980 changed to 0.983
- Malpractice GPCI 0.778 changed to 0.824
Held through RVU15B.
January 1, 2014
RVU14A
$490.57changed to$488.96
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 9.57 changed to 8.75
- Malpractice RVU 0.45 changed to 0.43
- Practice expense GPCI 0.977 changed to 0.980
- Malpractice GPCI 0.731 changed to 0.778
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $490.57
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $493.22 | $305.09 | RVU26D |
| 2026-07-01 | $493.22 | $305.09 | RVU26C |
| 2026-04-01 | $493.22 | $305.09 | RVU26B |
| 2026-01-01 | $493.22 | $305.09 | RVU26A |
| 2025-10-01 | $469.83 | $317.05 | RVU25D |
| 2025-07-01 | $469.83 | $317.05 | RVU25C |
| 2025-04-01 | $469.83 | $317.05 | RVU25B |
| 2025-01-01 | $469.83 | $317.05 | RVU25A |
| 2024-10-01 | $484.81 | $323.32 | RVU24D |
| 2024-07-01 | $484.81 | $323.32 | RVU24C |
| 2024-04-01 | $484.81 | $323.32 | RVU24B |
| 2024-03-09 | $484.81 | $323.32 | RVU24AR |
| 2024-01-01 | $476.89 | $318.05 | RVU24A |
| 2023-10-01 | $492.77 | $326.37 | RVU23D |
| 2023-07-01 | $492.77 | $326.37 | RVU23C |
| 2023-04-01 | $492.77 | $326.37 | RVU23B |
| 2023-01-01 | $492.77 | $326.37 | RVU23A |
| 2022-10-01 | $505.09 | $331.20 | RVU22D |
| 2022-07-01 | $505.09 | $331.20 | RVU22C |
| 2022-04-01 | $505.09 | $331.20 | RVU22B |
| 2022-01-01 | $505.09 | $331.20 | RVU22A |
| 2021-10-01 | $509.07 | $328.53 | RVU21D |
| 2021-07-01 | $509.07 | $328.53 | RVU21C |
| 2021-04-01 | $509.07 | $328.53 | RVU21B |
| 2021-01-01 | $509.07 | $328.53 | RVU21A |
| 2020-10-01 | $509.18 | $333.57 | RVU20D |
| 2020-07-01 | $509.18 | $333.57 | RVU20C |
| 2020-04-01 | $509.18 | $333.57 | RVU20B |
| 2020-01-01 | $509.18 | $333.57 | RVU20A |
| 2019-10-01 | $508.09 | $332.20 | RVU19D |
| 2019-07-01 | $508.09 | $332.20 | RVU19C |
| 2019-04-01 | $508.09 | $332.20 | RVU19B |
| 2019-01-01 | $508.09 | $332.20 | RVU19A |
| 2018-10-01 | $507.86 | $331.45 | RVU18D |
| 2018-07-01 | $507.86 | $331.45 | RVU18C |
| 2018-04-01 | $507.86 | $331.45 | RVU18B |
| 2018-01-01 | $507.86 | $331.45 | RVU18AR1 |
| 2017-10-01 | $502.08 | $328.16 | RVU17D |
| 2017-07-01 | $502.08 | $328.16 | RVU17C |
| 2017-04-01 | $502.08 | $328.16 | RVU17B |
| 2017-01-01 | $502.08 | $328.16 | RVU17A |
| 2016-10-01 | $497.76 | $325.66 | RVU16D |
| 2016-07-01 | $497.76 | $325.66 | RVU16C |
| 2016-04-01 | $497.76 | $325.66 | RVU16B |
| 2016-01-01 | $497.76 | $325.66 | RVU16A |
| 2015-10-01 | $499.15 | $325.71 | RVU15D |
| 2015-07-01 | $499.15 | $325.71 | RVU15C |
| 2015-04-01 | $496.66 | $324.09 | RVU15B |
| 2015-01-01 | $496.66 | $324.09 | RVU15A |
| 2014-10-01 | $488.96 | $320.45 | RVU14D |
| 2014-07-01 | $488.96 | $320.45 | RVU14C |
| 2014-04-01 | $488.96 | $320.45 | RVU14B |
| 2014-01-01 | $488.96 | $320.45 | RVU14A |
| 2013-10-01 | $490.57 | $314.40 | RVU13D |
| 2013-07-01 | $490.57 | $314.40 | RVU13C |
| 2013-04-01 | $490.57 | $314.40 | RVU13B |
| 2013-01-01 | $490.57 | $314.40 | RVU13AR |
Where the Virginia rate applies
Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.
- Abbs Valley
- Abingdon
- Accomac
- Adwolf
- Afton
- Alberta
- Aldie
- Allison Gap
28200 billing questions
How does this differ from 28202?
Both concern flexor tendon repair in the foot. Use 28200 when the repair does not use a free graft; 28202 is the graft-repair counterpart.
Can this code report an extensor tendon repair?
No. This code is for a flexor tendon. Use the corresponding extensor repair code when the repaired tendon is an extensor tendon.
How many units should be reported?
Report one unit for each flexor tendon repaired. The operative documentation should identify the tendon or tendons treated.
Does the code include postoperative visits?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 be used for bilateral repairs?
No. The descriptor or anatomy makes modifier 50 inappropriate for this code.
How are assistant and co-surgeon claims handled?
Medicare does not pay an assistant at surgery for this code. Co-surgeons are paid only when supporting documentation is provided; team surgery is not permitted.
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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