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CPT code 28232: Toe tendon incision, single flexor tendon2026 Medicare rate & RVUs in North Carolina

Reports open division of one flexor tendon in a toe, commonly to address a tendon-driven toe contracture such as a claw or hammertoe deformity.

CMS RVU26DEffective Oct 1, 2026One payment locality19K Medicare services in 2024

In North Carolina, Medicare pays $353.34 for 28232 in the office and $219.96 when it’s performed in a hospital or facility.

$353.34Office (non-facility)
$219.96Hospital or facility
−5.5%vs the national office rate ($374.09)

Check a contract rate as a % of Medicare · 28232 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 28232 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Carolina
  2. What 28232 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 28232 covers

The surgeon makes an incision and divides one flexor tendon in a toe to reduce a deforming pull or contracture. Orthopedic surgeons and podiatric surgeons commonly perform this procedure for a toe deformity in an operating room or other surgical setting. The defining details are an open approach, a flexor tendon, and one tendon in a toe; this is not repair of a damaged tendon or incision of an extensor tendon.

Select the code from the operative note’s documented tendon, toe, approach, and number of tendons treated. The note should support the deformity or contracture addressed and the specific tendon division. Medicare assigns 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 others at 50%. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery; 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 North Carolina compares for 28232

Across 109 of 109 payment localities, the office rate for 28232 runs from $333.54 in Arkansas to $491.22 in San Benito County, CA. North Carolina pays $353.34. The RVUs are the same everywhere; the geographic indexes change the dollars.

28232 in North Carolina vs other payment areas
  1. North Carolina · this page$353.34
  2. Los Angeles, CA · California$420.43+$67.09
  3. Washington, DC area · District of Columbia$425.78+$72.44
  4. Miami, FL · Florida$401.64+$48.30
  5. Chicago, IL · Illinois$390.84+$37.50
  6. Manhattan, NY · New York$428.31+$74.97
  7. Alaska · Alaska$442.26+$88.92

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

Every other payment area

28232 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$338.10$213.01
ArkansasArkansas$333.54$210.74
ArizonaArizona$364.75$226.23
Bakersfield, CACalifornia$395.68$239.00
Chico, CACalifornia$394.62$237.94
El Centro, CACalifornia$394.68$238.00
Fresno, CACalifornia$394.62$237.94
Hanford, CACalifornia$394.62$237.94

28232 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.

$333.54

$442.92

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

View every state and territory as a table
28232 office rate range by state
State / territoryOffice rate rangeLocalities
AK$442.261
AL$338.101
AR$333.541
AZ$364.751
CA$394.62–$491.2229
CO$388.881
CT$397.891
DC$425.781
DE$370.531
FL$368.87–$401.643
GA$349.43–$380.692
GU$403.351
HI$403.351
IA$346.121
ID$348.231
IL$358.86–$390.844
IN$350.111
KS$344.601
KY$345.541
LA$345.04–$360.972
MA$386.78–$425.732
MD$377.28–$425.783
ME$349.92–$367.662
MI$353.94–$373.182
MN$373.301
MO$339.50–$362.183
MS$336.581
MT$374.071
NC$353.341
ND$367.341
NE$347.891
NH$382.861
NJ$402.62–$421.822
NM$355.751
NV$372.441
NY$358.29–$438.105
OH$352.561
OK$344.971
OR$369.72–$400.592
PA$353.09–$388.532
PR$376.651
RI$383.231
SC$353.501
SD$366.551
TN$346.221
TX$350.92–$387.448
UT$358.021
VA$366.53–$425.782
VI$376.651
VT$366.001
WA$386.03–$434.132
WI$355.791
WV$346.431
WY$371.141

See 28232 in every payment locality

How the 28232 rate is calculated

Each of 28232’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 · 28232

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.42

3.42 RVUs× 1.000 GPCI

Practice expense7.44

7.44 RVUs× 1.000 GPCI

Malpractice0.34

0.34 RVUs× 1.000 GPCI

Adjusted RVUs

11.2000

Conversion factor

$33.4009

Medicare rate

$374.09

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

The exact North Carolina inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,156

Code
28232
Physician work
3.42
Practice expense
7.44
Malpractice
0.34

GPCI2026.csv

83

Locality
North Carolina
Physician work
1.000
Practice expense
0.933
Malpractice
0.639
Office calculation for 28232 in North Carolina
ComponentRVULocality factorAdjusted
Physician work3.42× 1.0003.4200
Practice expense7.44× 0.9336.9415
Malpractice0.34× 0.6390.2173
Total RVUs10.5788
Conversion factor× 33.4009

Office rate, North Carolina$353.34

Office: (3.42 × 1 + 7.44 × 0.933 + 0.34 × 0.639) × $33.4009 = $353.34

Facility: (3.42 × 1 + 3.16 × 0.933 + 0.34 × 0.639) × $33.4009 = $219.96

Open 28232 in the RVU calculator

Payment rules and modifiers for 28232

28232 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 28232

Toe tendon incision, single 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)0The 150% bilateral adjustment doesn’t apply.
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 · 28232

Toe tendon incision, single 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 51 · payment effect

With and without the modifier

28232 without 51 · national office

$374.09

Toe tendon incision, single flexor tendon

28232-51 · Second procedure: 50%

$187.05

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

Codes related to 28232

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

Codes related to 28232
CodeHow it relatesOffice range, North Carolina
Used instead
28230Tendon incision, single extensor tendonOpen incision of a single extensor tendon, rather than a toe flexor tendon.$406.98
28234Extensor tenotomy, single tendonOpen incision of multiple extensor tendons; 28232 addresses one toe flexor tendon.$388.33
28272Toe joint release, interphalangeal joint, eachReleases a toe joint contracture rather than dividing a flexor tendon.$356.94
28285Hammertoe repair, lesser-toe deformity correctionCorrects a hammertoe deformity; distinguish the broader correction from an isolated tendon division.$517.87

How 28232 has changed in North Carolina

28232 · Office / nonfacility

$353.34

Effective 2026-10-01

The base rate is $11.40 higher than on 2025-10-01, moving from $341.94 to $353.34 (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

    $341.94changed to$353.34

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.51 changed to 3.42
    • Practice expense RVU 7.41 changed to 7.44
    • Malpractice RVU 0.30 changed to 0.34
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.665 changed to 0.639

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $354.80changed to$341.94

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 7.49 changed to 7.41
    • Malpractice RVU 0.32 changed to 0.30

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $349.01changed to$354.80

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $358.63changed to$349.01

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 7.39 changed to 7.49
    • Malpractice RVU 0.30 changed to 0.32
    • Practice expense GPCI 0.927 changed to 0.926
    • Malpractice GPCI 0.742 changed to 0.665

  5. January 1, 2023

    RVU23A

    $366.90changed to$358.63

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 7.36 changed to 7.39
    • Malpractice RVU 0.32 changed to 0.30
    • Practice expense GPCI 0.928 changed to 0.927
    • Malpractice GPCI 0.819 changed to 0.742

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $375.48changed to$366.90

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 7.54 changed to 7.36
    • Malpractice RVU 0.31 changed to 0.32

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $379.42changed to$375.48

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 7.27 changed to 7.54
    • Malpractice RVU 0.32 changed to 0.31
    • Practice expense GPCI 0.930 changed to 0.928
    • Malpractice GPCI 0.757 changed to 0.819

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $381.63changed to$379.42

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 7.38 changed to 7.27
    • Malpractice RVU 0.30 changed to 0.32
    • Practice expense GPCI 0.931 changed to 0.930
    • Malpractice GPCI 0.695 changed to 0.757

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $381.29changed to$381.63

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 7.39 changed to 7.38
    • Malpractice RVU 0.29 changed to 0.30

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $380.77changed to$381.29

    • Conversion factor 35.8887 changed to 35.9996
    • Malpractice RVU 0.30 changed to 0.29
    • Malpractice GPCI 0.732 changed to 0.695

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $379.66changed to$380.77

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 7.38 changed to 7.39
    • Practice expense GPCI 0.930 changed to 0.931
    • Malpractice GPCI 0.768 changed to 0.732

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $381.25changed to$379.66

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 7.37 changed to 7.38
    • Malpractice RVU 0.32 changed to 0.30

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $379.35changed to$381.25

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $377.00changed to$379.35

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 7.29 changed to 7.37
    • Malpractice RVU 0.33 changed to 0.32
    • Practice expense GPCI 0.929 changed to 0.930
    • Malpractice GPCI 0.732 changed to 0.768

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $382.30changed to$377.00

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 8.08 changed to 7.29
    • Malpractice RVU 0.34 changed to 0.33
    • Practice expense GPCI 0.927 changed to 0.929
    • Malpractice GPCI 0.695 changed to 0.732

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $382.30

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$353.34$219.96RVU26D
2026-07-01$353.34$219.96RVU26C
2026-04-01$353.34$219.96RVU26B
2026-01-01$353.34$219.96RVU26A
2025-10-01$341.94$226.32RVU25D
2025-07-01$341.94$226.32RVU25C
2025-04-01$341.94$226.32RVU25B
2025-01-01$341.94$226.32RVU25A
2024-10-01$354.80$231.50RVU24D
2024-07-01$354.80$231.50RVU24C
2024-04-01$354.80$231.50RVU24B
2024-03-09$354.80$231.50RVU24AR
2024-01-01$349.01$227.72RVU24A
2023-10-01$358.63$231.72RVU23D
2023-07-01$358.63$231.72RVU23C
2023-04-01$358.63$231.72RVU23B
2023-01-01$358.63$231.72RVU23A
2022-10-01$366.90$234.27RVU22D
2022-07-01$366.90$234.27RVU22C
2022-04-01$366.90$234.27RVU22B
2022-01-01$366.90$234.27RVU22A
2021-10-01$375.48$234.95RVU21D
2021-07-01$375.48$234.95RVU21C
2021-04-01$375.48$234.95RVU21B
2021-01-01$375.48$234.95RVU21A
2020-10-01$379.42$240.13RVU20D
2020-07-01$379.42$240.13RVU20C
2020-04-01$379.42$240.13RVU20B
2020-01-01$379.42$240.13RVU20A
2019-10-01$381.63$240.37RVU19D
2019-07-01$381.63$240.37RVU19C
2019-04-01$381.63$240.37RVU19B
2019-01-01$381.63$240.37RVU19A
2018-10-01$381.29$240.19RVU18D
2018-07-01$381.29$240.19RVU18C
2018-04-01$381.29$240.19RVU18B
2018-01-01$381.29$240.19RVU18AR1
2017-10-01$380.77$240.44RVU17D
2017-07-01$380.77$240.44RVU17C
2017-04-01$380.77$240.44RVU17B
2017-01-01$380.77$240.44RVU17A
2016-10-01$379.66$239.81RVU16D
2016-07-01$379.66$239.81RVU16C
2016-04-01$379.66$239.81RVU16B
2016-01-01$379.66$239.81RVU16A
2015-10-01$381.25$240.89RVU15D
2015-07-01$381.25$240.89RVU15C
2015-04-01$379.35$239.69RVU15B
2015-01-01$379.35$239.69RVU15A
2014-10-01$377.00$239.22RVU14D
2014-07-01$377.00$239.22RVU14C
2014-04-01$377.00$239.22RVU14B
2014-01-01$377.00$239.22RVU14A
2013-10-01$382.30$236.90RVU13D
2013-07-01$382.30$236.90RVU13C
2013-04-01$382.30$236.90RVU13B
2013-01-01$382.30$236.90RVU13AR

Price 28232 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Advance
  • Ahoskie
  • Alamance
  • Albemarle
  • Alexis
  • Alliance
  • Altamahaw

Browse all communities in North Carolina

28232 billing questions

How is 28232 different from 28230?

28232 is for open division of a flexor tendon in a toe. 28230 describes an open incision of a single extensor tendon.

When would 28234 be considered instead?

28234 is for open incision of multiple extensor tendons. Choose based on the tendon type and number documented, not simply because more than one toe is treated.

Can 28232 be separately reported with hammertoe correction?

Do not assume the tendon division is separately reportable when it is part of a broader hammertoe correction. Check applicable edits and document any distinct work supporting separate reporting.

Should modifier 50 be used when both feet are treated?

No. CMS identifies bilateral adjustment as inappropriate for this code. The descriptor and anatomy do not support modifier 50.

What documentation supports this code?

Record the affected toe, the flexor tendon divided, the open approach, the number of tendons treated, and the deformity or contracture addressed.

What global and multiple-procedure rules apply?

The code has a 90-day global period. For multiple procedures in the same session, Medicare pays the highest-valued procedure in full and the others 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 28232PPRRVU2026_Oct_nonQPP.csv, line 3,156 (RVU26D)
Geographic factors for North CarolinaGPCI2026.csv, line 83 (RVU26D)

Open CMS sourceHow we calculate rates

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