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

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 Virginia, Medicare pays $366.53 for 28232 in the office and $226.00 when it’s performed in a hospital or facility.

$366.53Office (non-facility)
$226.00Hospital or facility
−2.0%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 Virginia
  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 Virginia 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. Virginia pays $366.53. The RVUs are the same everywhere; the geographic indexes change the dollars.

28232 in Virginia vs other payment areas
  1. Virginia · this page$366.53
  2. Los Angeles, CA · California$420.43+$53.90
  3. Washington, DC area · District of Columbia$425.78+$59.25
  4. Miami, FL · Florida$401.64+$35.11
  5. Chicago, IL · Illinois$390.84+$24.31
  6. Manhattan, NY · New York$428.31+$61.78
  7. Alaska · Alaska$442.26+$75.73

Other areas in Virginia 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 Virginia 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

106

Locality
Virginia
Physician work
1.000
Practice expense
0.983
Malpractice
0.706
Office calculation for 28232 in Virginia
ComponentRVULocality factorAdjusted
Physician work3.42× 1.0003.4200
Practice expense7.44× 0.9837.3135
Malpractice0.34× 0.7060.2400
Total RVUs10.9736
Conversion factor× 33.4009

Office rate, Virginia$366.53

Office: (3.42 × 1 + 7.44 × 0.983 + 0.34 × 0.706) × $33.4009 = $366.53

Facility: (3.42 × 1 + 3.16 × 0.983 + 0.34 × 0.706) × $33.4009 = $226.00

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, Virginia
Used instead
28230Tendon incision, single extensor tendonOpen incision of a single extensor tendon, rather than a toe flexor tendon.$421.65
28234Extensor tenotomy, single tendonOpen incision of multiple extensor tendons; 28232 addresses one toe flexor tendon.$403.37
28272Toe joint release, interphalangeal joint, eachReleases a toe joint contracture rather than dividing a flexor tendon.$369.62
28285Hammertoe repair, lesser-toe deformity correctionCorrects a hammertoe deformity; distinguish the broader correction from an isolated tendon division.$536.49

How 28232 has changed in Virginia

28232 · Office / nonfacility

$366.53

Effective 2026-10-01

The base rate is $9.59 higher than on 2025-10-01, moving from $356.94 to $366.53 (2.7%).

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

    $356.94changed to$366.53

    • 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
    • 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.

  2. January 1, 2025

    RVU25A

    $370.45changed to$356.94

    • 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

    $364.40changed to$370.45

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $375.26changed to$364.40

    • 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
    • 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

  5. January 1, 2023

    RVU23A

    $384.83changed to$375.26

    • 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 0.995 changed to 0.990
    • Malpractice GPCI 0.897 changed to 0.826

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $393.96changed to$384.83

    • 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

    $397.11changed to$393.96

    • 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 0.991 changed to 0.995
    • Malpractice GPCI 0.903 changed to 0.897

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $398.56changed to$397.11

    • 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 0.986 changed to 0.991
    • Malpractice GPCI 0.908 changed to 0.903

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $398.15changed to$398.56

    • 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

    $396.53changed to$398.15

    • Conversion factor 35.8887 changed to 35.9996
    • Malpractice RVU 0.30 changed to 0.29
    • Practice expense GPCI 0.985 changed to 0.986
    • Malpractice GPCI 0.866 changed to 0.908

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $394.27changed to$396.53

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 7.38 changed to 7.39
    • Practice expense GPCI 0.983 changed to 0.985
    • Malpractice GPCI 0.824 changed to 0.866

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $395.93changed to$394.27

    • 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

    $393.96changed to$395.93

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $390.86changed to$393.96

    • 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 0.980 changed to 0.983
    • Malpractice GPCI 0.778 changed to 0.824

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $396.46changed to$390.86

    • 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 0.977 changed to 0.980
    • Malpractice GPCI 0.731 changed to 0.778

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $396.46

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$366.53$226.00RVU26D
2026-07-01$366.53$226.00RVU26C
2026-04-01$366.53$226.00RVU26B
2026-01-01$366.53$226.00RVU26A
2025-10-01$356.94$234.08RVU25D
2025-07-01$356.94$234.08RVU25C
2025-04-01$356.94$234.08RVU25B
2025-01-01$356.94$234.08RVU25A
2024-10-01$370.45$239.43RVU24D
2024-07-01$370.45$239.43RVU24C
2024-04-01$370.45$239.43RVU24B
2024-03-09$370.45$239.43RVU24AR
2024-01-01$364.40$235.52RVU24A
2023-10-01$375.26$239.73RVU23D
2023-07-01$375.26$239.73RVU23C
2023-04-01$375.26$239.73RVU23B
2023-01-01$375.26$239.73RVU23A
2022-10-01$384.83$242.62RVU22D
2022-07-01$384.83$242.62RVU22C
2022-04-01$384.83$242.62RVU22B
2022-01-01$384.83$242.62RVU22A
2021-10-01$393.96$243.28RVU21D
2021-07-01$393.96$243.28RVU21C
2021-04-01$393.96$243.28RVU21B
2021-01-01$393.96$243.28RVU21A
2020-10-01$397.11$248.69RVU20D
2020-07-01$397.11$248.69RVU20C
2020-04-01$397.11$248.69RVU20B
2020-01-01$397.11$248.69RVU20A
2019-10-01$398.56$248.96RVU19D
2019-07-01$398.56$248.96RVU19C
2019-04-01$398.56$248.96RVU19B
2019-01-01$398.56$248.96RVU19A
2018-10-01$398.15$248.71RVU18D
2018-07-01$398.15$248.71RVU18C
2018-04-01$398.15$248.71RVU18B
2018-01-01$398.15$248.71RVU18AR1
2017-10-01$396.53$248.06RVU17D
2017-07-01$396.53$248.06RVU17C
2017-04-01$396.53$248.06RVU17B
2017-01-01$396.53$248.06RVU17A
2016-10-01$394.27$246.45RVU16D
2016-07-01$394.27$246.45RVU16C
2016-04-01$394.27$246.45RVU16B
2016-01-01$394.27$246.45RVU16A
2015-10-01$395.93$247.57RVU15D
2015-07-01$395.93$247.57RVU15C
2015-04-01$393.96$246.34RVU15B
2015-01-01$393.96$246.34RVU15A
2014-10-01$390.86$245.52RVU14D
2014-07-01$390.86$245.52RVU14C
2014-04-01$390.86$245.52RVU14B
2014-01-01$390.86$245.52RVU14A
2013-10-01$396.46$243.22RVU13D
2013-07-01$396.46$243.22RVU13C
2013-04-01$396.46$243.22RVU13B
2013-01-01$396.46$243.22RVU13AR

Price 28232 for an earlier date of service

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

Browse all communities in Virginia

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 VirginiaGPCI2026.csv, line 106 (RVU26D)

Open CMS sourceHow we calculate rates

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