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CPT code 28220: Foot tendon release, single tendon2026 Medicare rate & RVUs in Puerto Rico

Reports surgical release of adhesions restricting one flexor or extensor tendon in the foot, typically to restore tendon glide after injury or prior surgery.

CMS RVU26DEffective Oct 1, 2026One payment locality497 Medicare services in 2024

In Puerto Rico, Medicare pays $449.43 for 28220 in the office and $289.70 when it’s performed in a hospital or facility.

$449.43Office (non-facility)
$289.70Hospital or facility
+0.6%vs the national office rate ($446.57)

Check a contract rate as a % of Medicare · 28220 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 28220 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 28220 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 28220 covers

This operation frees a single flexor or extensor tendon in the foot from restrictive scar tissue or adhesions that limit its movement. An orthopedic or podiatric surgeon typically performs it in an operating room, often when motion remains restricted after trauma or a prior procedure. The operative work addresses tendon glide by releasing surrounding adhesions; it is distinct from repairing a torn tendon or cutting a tendon to change its function.

Report this code when the operative record identifies the treated foot tendon and documents adhesion release involving one tendon. Distinguish it from codes for multiple-tendon release and tendon repair by the structures treated and the work performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For same-session procedures, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery services are not paid; co-surgeons and team surgery are 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 Puerto Rico compares for 28220

Across 109 of 109 payment localities, the office rate for 28220 runs from $399.98 in Arkansas to $580.18 in San Benito County, CA. Puerto Rico pays $449.43. The RVUs are the same everywhere; the geographic indexes change the dollars.

28220 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$449.43
  2. Los Angeles, CA · California$499.08+$49.65
  3. Washington, DC area · District of Columbia$506.26+$56.83
  4. Miami, FL · Florida$480.52+$31.09
  5. Chicago, IL · Illinois$468.07+$18.64
  6. Manhattan, NY · New York$510.25+$60.82
  7. Alaska · Alaska$534.15+$84.72

Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.

Every other payment area

28220 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$405.20$266.97
ArkansasArkansas$399.98$264.27
ArizonaArizona$435.78$282.69
Bakersfield, CACalifornia$470.58$297.43
Chico, CACalifornia$469.20$296.05
El Centro, CACalifornia$469.28$296.13
Fresno, CACalifornia$469.20$296.05
Hanford, CACalifornia$469.20$296.05

28220 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.

$399.98

$534.15

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

View every state and territory as a table
28220 office rate range by state
State / territoryOffice rate rangeLocalities
AK$534.151
AL$405.201
AR$399.981
AZ$435.781
CA$469.20–$580.1829
CO$463.091
CT$474.251
DC$506.261
DE$442.491
FL$441.65–$480.523
GA$419.16–$454.462
GU$478.731
HI$478.731
IA$413.921
ID$416.431
IL$430.49–$468.074
IN$418.581
KS$412.411
KY$414.251
LA$413.76–$432.052
MA$460.85–$505.482
MD$450.24–$506.263
ME$418.62–$438.632
MI$424.11–$446.862
MN$444.341
MO$407.56–$433.163
MS$403.831
MT$446.541
NC$422.511
ND$437.841
NE$415.881
NH$456.211
NJ$479.83–$501.932
NM$426.291
NV$444.401
NY$428.21–$521.795
OH$422.341
OK$413.341
OR$441.09–$476.312
PA$422.81–$463.622
PR$449.431
RI$457.111
SC$423.091
SD$436.811
TN$414.291
TX$420.34–$461.438
UT$428.281
VA$437.49–$506.262
VI$449.431
VT$436.511
WA$459.87–$515.022
WI$424.641
WV$416.241
WY$442.751

See 28220 in every payment locality

How the 28220 rate is calculated

Each of 28220’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 · 28220

RVUs × geographic indexes × conversion factor

Office or facility?

Work4.55

4.55 RVUs× 1.000 GPCI

Practice expense8.38

8.38 RVUs× 1.000 GPCI

Malpractice0.44

0.44 RVUs× 1.000 GPCI

Adjusted RVUs

13.3700

Conversion factor

$33.4009

Medicare rate

$446.57

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,151

Code
28220
Physician work
4.55
Practice expense
8.38
Malpractice
0.44

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 28220 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work4.55× 1.0004.5500
Practice expense8.38× 1.0118.4722
Malpractice0.44× 0.9850.4334
Total RVUs13.4556
Conversion factor× 33.4009

Office rate, Puerto Rico$449.43

Office: (4.55 × 1 + 8.38 × 1.011 + 0.44 × 0.985) × $33.4009 = $449.43

Facility: (4.55 × 1 + 3.65 × 1.011 + 0.44 × 0.985) × $33.4009 = $289.70

Open 28220 in the RVU calculator

Payment rules and modifiers for 28220

28220 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 28220

Foot tendon release, single tendon

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)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
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 · 28220

Foot tendon release, single tendon

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

28220 without 50 · national office

$446.57

Foot tendon release, single tendon

28220-50 · Bilateral: 150%

$669.86

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 28220

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 28220
CodeHow it relatesOffice range, Puerto Rico
Same family
28222Tendon release, single extensor tendonFoot tendon adhesion release involving multiple tendons rather than a single tendon.$546.81
28225Tendon release, flexor tendonA related foot tendon release code with a different scope of tendon work.$413.32
Used instead
28200Foot tendon repair, flexor, without free graftRepairs a foot flexor tendon rather than releasing adhesions around it.$507.72
28208Tendon repair, foot extensor, no graftRepairs a foot extensor tendon rather than releasing tendon adhesions.$501.72
28230Tendon incision, single extensor tendonIncises a foot tendon; this code addresses release of tendon adhesions.$433.34

How 28220 has changed in Puerto Rico

28220 · Office / nonfacility

$449.43

Effective 2026-10-01

The base rate is $14.39 higher than on 2025-10-01, moving from $435.04 to $449.43 (3.3%).

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

    $435.04changed to$449.43

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 4.67 changed to 4.55
    • Practice expense RVU 8.26 changed to 8.38
    • Malpractice RVU 0.47 changed to 0.44
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $452.41changed to$435.04

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 8.42 changed to 8.26
    • Malpractice RVU 0.45 changed to 0.47

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $445.02changed to$452.41

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $455.42changed to$445.02

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 8.28 changed to 8.42
    • Malpractice RVU 0.43 changed to 0.45
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $453.41changed to$455.42

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $462.32changed to$453.41

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 8.20 changed to 8.28
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $468.97changed to$462.32

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 8.28 changed to 8.20

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $471.62changed to$468.97

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 7.90 changed to 8.28
    • Malpractice RVU 0.44 changed to 0.43
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $473.63changed to$471.62

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 8.02 changed to 7.90
    • Malpractice RVU 0.40 changed to 0.44
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $470.95changed to$473.63

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 7.98 changed to 8.02
    • Malpractice RVU 0.38 changed to 0.40

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $422.35changed to$470.95

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 8.00 changed to 7.98
    • Malpractice RVU 0.39 changed to 0.38
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $371.61changed to$422.35

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 7.94 changed to 8.00
    • Malpractice RVU 0.38 changed to 0.39
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $373.78changed to$371.61

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 7.96 changed to 7.94
    • Malpractice RVU 0.41 changed to 0.38

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $371.92changed to$373.78

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $363.44changed to$371.92

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 7.76 changed to 7.96
    • Malpractice RVU 0.39 changed to 0.41
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $359.13changed to$363.44

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 8.53 changed to 7.76
    • Malpractice RVU 0.41 changed to 0.39
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $359.13

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$449.43$289.70RVU26D
2026-07-01$449.43$289.70RVU26C
2026-04-01$449.43$289.70RVU26B
2026-01-01$449.43$289.70RVU26A
2025-10-01$435.04$301.82RVU25D
2025-07-01$435.04$301.82RVU25C
2025-04-01$435.04$301.82RVU25B
2025-01-01$435.04$301.82RVU25A
2024-10-01$452.41$308.94RVU24D
2024-07-01$452.41$308.94RVU24C
2024-04-01$452.41$308.94RVU24B
2024-03-09$452.41$308.94RVU24AR
2024-01-01$445.02$303.89RVU24A
2023-10-01$455.42$308.54RVU23D
2023-07-01$453.41$307.70RVU23C
2023-04-01$453.41$307.70RVU23B
2023-01-01$453.41$307.70RVU23A
2022-10-01$462.32$310.23RVU22D
2022-07-01$462.32$310.23RVU22C
2022-04-01$462.32$310.23RVU22B
2022-01-01$462.32$310.23RVU22A
2021-10-01$468.97$309.29RVU21D
2021-07-01$468.97$309.29RVU21C
2021-04-01$468.97$309.29RVU21B
2021-01-01$468.97$309.29RVU21A
2020-10-01$471.62$315.55RVU20D
2020-07-01$471.62$315.55RVU20C
2020-04-01$471.62$315.55RVU20B
2020-01-01$471.62$315.55RVU20A
2019-10-01$473.63$315.40RVU19D
2019-07-01$473.63$315.40RVU19C
2019-04-01$473.63$315.40RVU19B
2019-01-01$473.63$315.40RVU19A
2018-10-01$470.95$313.25RVU18D
2018-07-01$470.95$313.25RVU18C
2018-04-01$470.95$313.25RVU18B
2018-01-01$470.95$313.25RVU18AR1
2017-10-01$422.35$289.02RVU17D
2017-07-01$422.35$289.02RVU17C
2017-04-01$422.35$289.02RVU17B
2017-01-01$422.35$289.02RVU17A
2016-10-01$371.61$262.57RVU16D
2016-07-01$371.61$262.57RVU16C
2016-04-01$371.61$262.57RVU16B
2016-01-01$371.61$262.57RVU16A
2015-10-01$373.78$263.58RVU15D
2015-07-01$373.78$263.58RVU15C
2015-04-01$371.92$262.27RVU15B
2015-01-01$371.92$262.27RVU15A
2014-10-01$363.44$259.08RVU14D
2014-07-01$363.44$259.08RVU14C
2014-04-01$363.44$259.08RVU14B
2014-01-01$363.44$259.08RVU14A
2013-10-01$359.13$251.63RVU13D
2013-07-01$359.13$251.63RVU13C
2013-04-01$359.13$251.63RVU13B
2013-01-01$359.13$251.63RVU13AR

Price 28220 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

28220 billing questions

When is this code appropriate instead of a tendon repair code?

Use it for release of adhesions restricting one foot tendon, rather than repair of a tendon injury. The operative note should support adhesion release as the work performed.

How does this differ from 28222?

28220 describes release involving a single tendon. 28222 is the nearby multiple-tendon release code.

What should the operative note document?

Identify the foot tendon treated and describe the adhesions and their release. The record should make clear that the work involved one tendon, not tendon repair or a different type of release.

How is bilateral reporting paid?

CMS lists this as a bilateral procedure. Reporting modifier 50 results in payment at 150%.

Are assistant-at-surgery or co-surgeon services payable?

CMS lists a statutory restriction on assistant-at-surgery payment for this code. Co-surgeons and team surgery are not permitted.

What happens when another procedure is performed in the same session?

Under the standard multiple-procedure rule, the highest-valued procedure is paid in full and other procedures are paid at 50%.

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 28220PPRRVU2026_Oct_nonQPP.csv, line 3,151 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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