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CPT code 28225: Tendon release, flexor tendon2026 Medicare rate & RVUs in Puerto Rico

Reports surgical release of a flexor tendon in the foot when adhesions or restriction limit tendon movement and require operative treatment.

CMS RVU26DEffective Oct 1, 2026One payment locality574 Medicare services in 2024

In Puerto Rico, Medicare pays $413.32 for 28225 in the office and $252.24 when it’s performed in a hospital or facility.

$413.32Office (non-facility)
$252.24Hospital or facility
+0.7%vs the national office rate ($410.50)

Check a contract rate as a % of Medicare · 28225 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 28225 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 28225 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 28225 covers

This service involves freeing a flexor tendon in the foot when restricted glide interferes with movement. An orthopedic foot and ankle surgeon or podiatric surgeon may perform it in an operating room or other surgical setting, often for a tendon that remains tethered after prior surgery or injury. The operative work releases the tendon rather than repairing or grafting a damaged tendon or cutting it as a tenotomy.

Report the code when the operative note identifies the flexor tendon released, the foot and side treated, and the clinical restriction that prompted the procedure. This major surgery has a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care. For other procedures performed in the same session, the highest-valued procedure is paid in full and additional procedures are paid at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; 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 Puerto Rico compares for 28225

Across 109 of 109 payment localities, the office rate for 28225 runs from $365.51 in Arkansas to $539.22 in San Benito County, CA. Puerto Rico pays $413.32. The RVUs are the same everywhere; the geographic indexes change the dollars.

28225 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$413.32
  2. Los Angeles, CA · California$461.36+$48.04
  3. Washington, DC area · District of Columbia$467.44+$54.12
  4. Miami, FL · Florida$441.66+$28.34
  5. Chicago, IL · Illinois$429.60+$16.28
  6. Manhattan, NY · New York$470.44+$57.12
  7. Alaska · Alaska$484.10+$70.78

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

Every other payment area

28225 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$370.57$231.16
ArkansasArkansas$365.51$228.66
ArizonaArizona$400.12$245.74
Bakersfield, CACalifornia$434.07$259.45
Chico, CACalifornia$432.87$258.26
El Centro, CACalifornia$432.94$258.32
Fresno, CACalifornia$432.87$258.26
Hanford, CACalifornia$432.87$258.26

28225 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.

$365.51

$486.05

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

View every state and territory as a table
28225 office rate range by state
State / territoryOffice rate rangeLocalities
AK$484.101
AL$370.571
AR$365.511
AZ$400.121
CA$432.87–$539.2229
CO$426.671
CT$436.811
DC$467.441
DE$406.511
FL$404.98–$441.663
GA$383.38–$417.872
GU$442.581
HI$442.581
IA$379.331
ID$381.691
IL$393.97–$429.604
IN$383.781
KS$377.711
KY$378.951
LA$378.41–$396.092
MA$424.36–$467.322
MD$413.95–$467.443
ME$383.64–$403.222
MI$388.32–$409.842
MN$409.281
MO$372.32–$397.363
MS$368.981
MT$410.471
NC$387.421
ND$402.761
NE$381.281
NH$420.111
NJ$441.92–$463.022
NM$390.351
NV$408.601
NY$392.92–$481.385
OH$386.741
OK$378.251
OR$405.53–$439.572
PA$387.29–$426.472
PR$413.321
RI$420.481
SC$387.701
SD$401.851
TN$379.511
TX$384.89–$425.168
UT$392.721
VA$402.01–$467.442
VI$413.321
VT$401.321
WA$423.52–$476.522
WI$389.971
WV$380.191
WY$407.111

See 28225 in every payment locality

How the 28225 rate is calculated

Each of 28225’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 · 28225

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.69

3.69 RVUs× 1.000 GPCI

Practice expense8.21

8.21 RVUs× 1.000 GPCI

Malpractice0.39

0.39 RVUs× 1.000 GPCI

Adjusted RVUs

12.2900

Conversion factor

$33.4009

Medicare rate

$410.50

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

3,153

Code
28225
Physician work
3.69
Practice expense
8.21
Malpractice
0.39

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 28225 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work3.69× 1.0003.6900
Practice expense8.21× 1.0118.3003
Malpractice0.39× 0.9850.3841
Total RVUs12.3745
Conversion factor× 33.4009

Office rate, Puerto Rico$413.32

Office: (3.69 × 1 + 8.21 × 1.011 + 0.39 × 0.985) × $33.4009 = $413.32

Facility: (3.69 × 1 + 3.44 × 1.011 + 0.39 × 0.985) × $33.4009 = $252.24

Open 28225 in the RVU calculator

Payment rules and modifiers for 28225

28225 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 28225

Tendon release, flexor 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)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 · 28225

Tendon release, flexor 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

28225 without 50 · national office

$410.50

Tendon release, flexor tendon

28225-50 · Bilateral: 150%

$615.75

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 28225

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

Codes related to 28225
CodeHow it relatesOffice range, Puerto Rico
Same family
28226Tendon release, multiple flexor tendonsRelated foot tendon release code for the extensor tendon.$670.14
28220Foot tendon release, single tendonRelated code for release of a foot tendon; compare the documented procedure and scope.$449.43
28222Tendon release, single extensor tendonRelated code for release involving foot tendons; compare the documented procedure and scope.$546.81
Used instead
28230Tendon incision, single extensor tendonDescribes tendon incision rather than freeing a restricted flexor tendon.$433.34
28232Toe tendon incision, single flexor tendonDescribes flexor tendon incision in a toe, rather than foot tendon release.$376.65

How 28225 has changed in Puerto Rico

28225 · Office / nonfacility

$413.32

Effective 2026-10-01

The base rate is $11.56 higher than on 2025-10-01, moving from $401.76 to $413.32 (2.9%).

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

    $401.76changed to$413.32

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.78 changed to 3.69
    • Practice expense RVU 8.20 changed to 8.21
    • 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

    $414.78changed to$401.76

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 8.23 changed to 8.20
    • Malpractice RVU 0.40 changed to 0.39

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $408.01changed to$414.78

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $418.80changed to$408.01

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 8.12 changed to 8.23
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $416.81changed to$418.80

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

  6. January 1, 2023

    RVU23A

    $426.66changed to$416.81

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 8.08 changed to 8.12
    • Malpractice RVU 0.41 changed to 0.40
    • 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

    $436.52changed to$426.66

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 8.25 changed to 8.08
    • Malpractice RVU 0.42 changed to 0.41

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $436.98changed to$436.52

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 7.87 changed to 8.25
    • Malpractice RVU 0.40 changed to 0.42
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $440.11changed to$436.98

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 7.99 changed to 7.87
    • Malpractice RVU 0.39 changed to 0.40
    • 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

    $432.76changed to$440.11

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 7.83 changed to 7.99
    • Malpractice RVU 0.36 changed to 0.39

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $383.58changed to$432.76

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 7.80 changed to 7.83
    • 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

    $333.38changed to$383.58

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 7.70 changed to 7.80
    • Malpractice RVU 0.35 changed to 0.36
    • 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

    $333.31changed to$333.38

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 7.65 changed to 7.70

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $331.65changed to$333.31

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $326.77changed to$331.65

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 7.59 changed to 7.65
    • Malpractice RVU 0.33 changed to 0.35
    • 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

    $326.26changed to$326.77

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 8.44 changed to 7.59
    • Malpractice RVU 0.35 changed to 0.33
    • 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: $326.26

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$413.32$252.24RVU26D
2026-07-01$413.32$252.24RVU26C
2026-04-01$413.32$252.24RVU26B
2026-01-01$413.32$252.24RVU26A
2025-10-01$401.76$263.65RVU25D
2025-07-01$401.76$263.65RVU25C
2025-04-01$401.76$263.65RVU25B
2025-01-01$401.76$263.65RVU25A
2024-10-01$414.78$268.29RVU24D
2024-07-01$414.78$268.29RVU24C
2024-04-01$414.78$268.29RVU24B
2024-03-09$414.78$268.29RVU24AR
2024-01-01$408.01$263.91RVU24A
2023-10-01$418.80$267.82RVU23D
2023-07-01$416.81$267.03RVU23C
2023-04-01$416.81$267.03RVU23B
2023-01-01$416.81$267.03RVU23A
2022-10-01$426.66$269.68RVU22D
2022-07-01$426.66$269.68RVU22C
2022-04-01$426.66$269.68RVU22B
2022-01-01$426.66$269.68RVU22A
2021-10-01$436.52$270.86RVU21D
2021-07-01$436.52$270.86RVU21C
2021-04-01$436.52$270.86RVU21B
2021-01-01$436.52$270.86RVU21A
2020-10-01$436.98$274.73RVU20D
2020-07-01$436.98$274.73RVU20C
2020-04-01$436.98$274.73RVU20B
2020-01-01$436.98$274.73RVU20A
2019-10-01$440.11$276.44RVU19D
2019-07-01$440.11$276.44RVU19C
2019-04-01$440.11$276.44RVU19B
2019-01-01$440.11$276.44RVU19A
2018-10-01$432.76$271.80RVU18D
2018-07-01$432.76$271.80RVU18C
2018-04-01$432.76$271.80RVU18B
2018-01-01$432.76$271.80RVU18AR1
2017-10-01$383.58$247.79RVU17D
2017-07-01$383.58$247.79RVU17C
2017-04-01$383.58$247.79RVU17B
2017-01-01$383.58$247.79RVU17A
2016-10-01$333.38$223.07RVU16D
2016-07-01$333.38$223.07RVU16C
2016-04-01$333.38$223.07RVU16B
2016-01-01$333.38$223.07RVU16A
2015-10-01$333.31$222.86RVU15D
2015-07-01$333.31$222.86RVU15C
2015-04-01$331.65$221.75RVU15B
2015-01-01$331.65$221.75RVU15A
2014-10-01$326.77$220.17RVU14D
2014-07-01$326.77$220.17RVU14C
2014-04-01$326.77$220.17RVU14B
2014-01-01$326.77$220.17RVU14A
2013-10-01$326.26$215.31RVU13D
2013-07-01$326.26$215.31RVU13C
2013-04-01$326.26$215.31RVU13B
2013-01-01$326.26$215.31RVU13AR

Price 28225 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

28225 billing questions

How is this different from a foot tendon tenotomy?

This code describes freeing a restricted flexor tendon. Tenotomy codes describe cutting or incising a tendon, rather than releasing adhesions to restore its glide.

What should the operative note identify?

Document the flexor tendon released, the foot and laterality, the reason its movement was restricted, and the release performed.

Does the 90-day global period include postoperative visits?

Yes. Related postoperative care for 90 days and the day-before preoperative visit are included in the global period.

How is bilateral treatment reported?

When the procedure is performed on both feet, modifier 50 identifies the bilateral service; CMS pays it at 150%.

Can an assistant or co-surgeon be paid?

Assistant-at-surgery payment is restricted. 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 28225PPRRVU2026_Oct_nonQPP.csv, line 3,153 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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