CPT code 28234: Extensor tenotomy, single tendon2026 Medicare rate & RVUs in Mississippi
Reports open division of one extensor tendon in the foot or toe to reduce tendon pull contributing to a deformity or contracture.
In Mississippi, Medicare pays $369.10 for 28234 in the office and $239.11 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 28234 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 28234 covers
The surgeon makes an incision to expose and divide a single extensor tendon in the foot or toe. This may be performed by an orthopedic or podiatric surgeon to reduce tendon pull contributing to a deformity or contracture. The procedure is distinct from freeing a tendon from adhesions and from repairing a damaged tendon. It is typically performed in an operating room or outpatient surgical setting.
Report the code for one extensor tendon divided through an open approach; document the tendon and site, the clinical problem, and the work performed. The 90-day global period includes 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 other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery, and 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 Mississippi compares for 28234
Across 109 of 109 payment localities, the office rate for 28234 runs from $365.76 in Arkansas to $544.41 in San Benito County, CA. Mississippi pays $369.10. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Mississippi · this page$369.10
- Los Angeles, CA · California$464.42+$95.32
- Washington, DC area · District of Columbia$470.05+$100.95
- Miami, FL · Florida$442.38+$73.28
- Chicago, IL · Illinois$430.06+$60.96
- Manhattan, NY · New York$472.50+$103.40
- Alaska · Alaska$482.38+$113.28
Other areas in Mississippi first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $370.94 | $238.84 |
| ArkansasArkansas | $365.76 | $236.08 |
| ArizonaArizona | $401.24 | $254.95 |
| Bakersfield, CACalifornia | $436.48 | $271.01 |
| Chico, CACalifornia | $435.34 | $269.88 |
| El Centro, CACalifornia | $435.41 | $269.94 |
| Fresno, CACalifornia | $435.34 | $269.88 |
| Hanford, CACalifornia | $435.34 | $269.88 |
| Madera, CACalifornia | $435.34 | $269.88 |
| Merced, CACalifornia | $435.34 | $269.88 |
| Modesto, CACalifornia | $435.34 | $269.88 |
| Napa, CACalifornia | $503.40 | $304.42 |
| Oxnard, CACalifornia | $462.13 | $283.68 |
| Redding, CACalifornia | $435.34 | $269.88 |
| Rest of CaliforniaCalifornia | $435.34 | $269.88 |
| Riverside, CACalifornia | $439.38 | $273.91 |
| Sacramento, CACalifornia | $456.58 | $281.00 |
| Salinas, CACalifornia | $454.87 | $279.89 |
| San Diego, CACalifornia | $465.34 | $284.78 |
| Marin County, CACalifornia | $532.63 | $319.76 |
| San Francisco, CACalifornia | $532.21 | $319.34 |
| San Benito County, CACalifornia | $544.41 | $326.71 |
| Santa Clara County, CACalifornia | $542.69 | $324.99 |
| San Luis Obispo, CACalifornia | $447.57 | $275.61 |
| Santa Cruz, CACalifornia | $469.63 | $286.20 |
| Santa Maria, CACalifornia | $456.51 | $280.48 |
| Santa Rosa, CACalifornia | $474.36 | $288.97 |
| Stockton, CACalifornia | $435.34 | $269.88 |
| Vallejo, CACalifornia | $502.80 | $303.81 |
| Visalia, CACalifornia | $435.34 | $269.88 |
| Yuba City, CACalifornia | $435.34 | $269.88 |
| ColoradoColorado | $428.70 | $268.07 |
| ConnecticutConnecticut | $438.62 | $276.02 |
| DelawareDelaware | $407.75 | $258.59 |
| Fort Lauderdale, FLFlorida | $425.51 | $272.58 |
| Rest of FloridaFlorida | $405.54 | $261.21 |
| Atlanta, GAGeorgia | $419.21 | $265.82 |
| Rest of GeorgiaGeorgia | $383.51 | $248.84 |
| Hawaii, Guam, HIHawaii | $445.57 | $273.92 |
| IowaIowa | $380.22 | $242.08 |
| IdahoIdaho | $382.58 | $243.69 |
| East St. Louis, ILIllinois | $401.63 | $262.73 |
| Rest of IllinoisIllinois | $394.06 | $256.22 |
| Suburban Chicago, ILIllinois | $429.85 | $274.81 |
| IndianaIndiana | $384.73 | $244.78 |
| KansasKansas | $378.42 | $241.94 |
| KentuckyKentucky | $379.23 | $245.02 |
| New Orleans, LALouisiana | $396.74 | $254.68 |
| Rest of LouisianaLouisiana | $378.63 | $245.02 |
| Metropolitan Boston, MAMassachusetts | $470.34 | $290.08 |
| Rest of MassachusettsMassachusetts | $426.23 | $267.26 |
| Baltimore area, MDMaryland | $437.36 | $275.36 |
| Rest of MarylandMaryland | $415.38 | $262.60 |
| Rest of MaineMaine | $384.42 | $245.53 |
| Southern Maine, MEMaine | $404.71 | $255.10 |
| Detroit, MIMichigan | $410.36 | $264.67 |
| Rest of MichiganMichigan | $388.70 | $250.86 |
| MinnesotaMinnesota | $411.38 | $256.03 |
| Metropolitan Kansas City, MOMissouri | $394.21 | $252.45 |
| Metropolitan St. Louis, MOMissouri | $398.21 | $254.49 |
| Rest of MissouriMissouri | $372.29 | $242.15 |
| MontanaMontana | $411.81 | $260.84 |
| North CarolinaNorth Carolina | $388.33 | $247.47 |
| North DakotaNorth Dakota | $404.49 | $253.52 |
| NebraskaNebraska | $382.26 | $242.91 |
| New HampshireNew Hampshire | $421.94 | $264.78 |
| Northern New JerseyNew Jersey | $465.41 | $290.28 |
| Rest of New JerseyNew Jersey | $443.79 | $278.93 |
| New MexicoNew Mexico | $390.73 | $252.28 |
| NevadaNevada | $410.05 | $258.93 |
| NYC suburbs and Long Island, NYNew York | $483.52 | $304.01 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $446.62 | $281.30 |
| Queens, NYNew York | $476.40 | $297.95 |
| Rest of New YorkNew York | $393.95 | $250.53 |
| OhioOhio | $387.20 | $249.37 |
| OklahomaOklahoma | $378.66 | $243.85 |
| Portland, OROregon | $442.06 | $274.33 |
| Rest of OregonOregon | $407.03 | $256.66 |
| Metropolitan Philadelphia, PAPennsylvania | $427.95 | $270.78 |
| Rest of PennsylvaniaPennsylvania | $387.85 | $249.25 |
| Puerto RicoPuerto Rico | $414.77 | $262.14 |
| Rhode IslandRhode Island | $422.07 | $266.11 |
| South CarolinaSouth Carolina | $388.38 | $248.88 |
| South DakotaSouth Dakota | $403.63 | $252.66 |
| TennesseeTennessee | $380.25 | $243.01 |
| Austin, TXTexas | $427.14 | $267.41 |
| Beaumont, TXTexas | $385.37 | $247.99 |
| Brazoria, TXTexas | $407.48 | $257.86 |
| Dallas, TXTexas | $409.98 | $259.61 |
| Fort Worth, TXTexas | $407.30 | $258.44 |
| Galveston, TXTexas | $408.64 | $258.72 |
| Houston, TXTexas | $415.41 | $265.50 |
| Rest of TexasTexas | $396.14 | $252.87 |
| UtahUtah | $393.52 | $251.60 |
| VirginiaVirginia | $403.37 | $254.96 |
| Virgin Islands, VIUnited States Virgin Islands | $414.77 | $262.14 |
| VermontVermont | $402.89 | $253.42 |
| Rest of WashingtonWashington | $425.44 | $266.47 |
| King County, WAWashington | $479.86 | $294.61 |
| WisconsinWisconsin | $391.34 | $246.71 |
| West VirginiaWest Virginia | $379.92 | $248.73 |
| WyomingWyoming | $408.62 | $257.65 |
28234 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.
$365.76
$489.88
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 | $482.38 | 1 |
| AL | $370.94 | 1 |
| AR | $365.76 | 1 |
| AZ | $401.24 | 1 |
| CA | $435.34–$544.41 | 29 |
| CO | $428.70 | 1 |
| CT | $438.62 | 1 |
| DC | $470.05 | 1 |
| DE | $407.75 | 1 |
| FL | $405.54–$442.38 | 3 |
| GA | $383.51–$419.21 | 2 |
| GU | $445.57 | 1 |
| HI | $445.57 | 1 |
| IA | $380.22 | 1 |
| ID | $382.58 | 1 |
| IL | $394.06–$430.06 | 4 |
| IN | $384.73 | 1 |
| KS | $378.42 | 1 |
| KY | $379.23 | 1 |
| LA | $378.63–$396.74 | 2 |
| MA | $426.23–$470.34 | 2 |
| MD | $415.38–$470.05 | 3 |
| ME | $384.42–$404.71 | 2 |
| MI | $388.70–$410.36 | 2 |
| MN | $411.38 | 1 |
| MO | $372.29–$398.21 | 3 |
| MS | $369.10 | 1 |
| MT | $411.81 | 1 |
| NC | $388.33 | 1 |
| ND | $404.49 | 1 |
| NE | $382.26 | 1 |
| NH | $421.94 | 1 |
| NJ | $443.79–$465.41 | 2 |
| NM | $390.73 | 1 |
| NV | $410.05 | 1 |
| NY | $393.95–$483.52 | 5 |
| OH | $387.20 | 1 |
| OK | $378.66 | 1 |
| OR | $407.03–$442.06 | 2 |
| PA | $387.85–$427.95 | 2 |
| PR | $414.77 | 1 |
| RI | $422.07 | 1 |
| SC | $388.38 | 1 |
| SD | $403.63 | 1 |
| TN | $380.25 | 1 |
| TX | $385.37–$427.14 | 8 |
| UT | $393.52 | 1 |
| VA | $403.37–$470.05 | 2 |
| VI | $414.77 | 1 |
| VT | $402.89 | 1 |
| WA | $425.44–$479.86 | 2 |
| WI | $391.34 | 1 |
| WV | $379.92 | 1 |
| WY | $408.62 | 1 |
How the 28234 rate is calculated
Each of 28234’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 · 28234
RVUs × geographic indexes × conversion factor
Work3.45
3.45 RVUs× 1.000 GPCI
Practice expense8.51
8.51 RVUs× 1.000 GPCI
Malpractice0.37
0.37 RVUs× 1.000 GPCI
Adjusted RVUs
12.3300
Conversion factor
$33.4009
Medicare rate
$411.83
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Mississippi inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
3,157
- Code
- 28234
- Physician work
- 3.45
- Practice expense
- 8.51
- Malpractice
- 0.37
GPCI2026.csv
67
- Locality
- Mississippi
- Physician work
- 1.000
- Practice expense
- 0.861
- Malpractice
- 0.739
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.45 | × 1.000 | 3.4500 |
| Practice expense | 8.51 | × 0.861 | 7.3271 |
| Malpractice | 0.37 | × 0.739 | 0.2734 |
| Total RVUs | 11.0505 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Mississippi$369.10
Office: (3.45 × 1 + 8.51 × 0.861 + 0.37 × 0.739) × $33.4009 = $369.10
Facility: (3.45 × 1 + 3.99 × 0.861 + 0.37 × 0.739) × $33.4009 = $239.11
Payment rules and modifiers for 28234
28234 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28234
Extensor tenotomy, single tendon
| 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) | 0 | Not permitted. |
| 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 · 28234
Extensor tenotomy, 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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
28234 without 51 · national office
$411.83
Extensor tenotomy, single tendon
28234-51 · Second procedure: 50%
$205.92
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 28234 has changed in Mississippi
28234 · Office / nonfacility
$369.10
Effective 2026-10-01
The base rate is $14.43 higher than on 2025-10-01, moving from $354.67 to $369.10 (4.1%).
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
$354.67changed to$369.10
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 3.54 changed to 3.45
- Practice expense RVU 8.39 changed to 8.51
- Malpractice RVU 0.36 changed to 0.37
- Practice expense GPCI 0.852 changed to 0.861
- Malpractice GPCI 0.768 changed to 0.739
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$365.84changed to$354.67
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 8.42 changed to 8.39
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$359.87changed to$365.84
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$366.16changed to$359.87
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 8.28 changed to 8.42
- Malpractice RVU 0.35 changed to 0.36
- Practice expense GPCI 0.847 changed to 0.852
- Malpractice GPCI 0.720 changed to 0.768
January 1, 2023
RVU23A
$368.75changed to$366.16
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 8.18 changed to 8.28
- Malpractice RVU 0.34 changed to 0.35
- Practice expense GPCI 0.842 changed to 0.847
- Malpractice GPCI 0.671 changed to 0.720
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$376.22changed to$368.75
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 8.33 changed to 8.18
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$379.01changed to$376.22
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 7.92 changed to 8.33
- Malpractice RVU 0.35 changed to 0.34
- Practice expense GPCI 0.856 changed to 0.842
- Malpractice GPCI 0.521 changed to 0.671
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$381.42changed to$379.01
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 7.96 changed to 7.92
- Malpractice RVU 0.32 changed to 0.35
- Practice expense GPCI 0.870 changed to 0.856
- Malpractice GPCI 0.370 changed to 0.521
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$379.62changed to$381.42
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 7.92 changed to 7.96
- Malpractice RVU 0.31 changed to 0.32
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$379.75changed to$379.62
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 7.94 changed to 7.92
- Malpractice RVU 0.32 changed to 0.31
- Practice expense GPCI 0.867 changed to 0.870
- Malpractice GPCI 0.492 changed to 0.370
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$379.39changed to$379.75
- Conversion factor 35.8043 changed to 35.8887
- Practice expense GPCI 0.864 changed to 0.867
- Malpractice GPCI 0.613 changed to 0.492
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$382.13changed to$379.39
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 7.97 changed to 7.94
- Malpractice RVU 0.34 changed to 0.32
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$380.23changed to$382.13
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$376.94changed to$380.23
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 7.81 changed to 7.97
- Malpractice RVU 0.33 changed to 0.34
- Practice expense GPCI 0.865 changed to 0.864
- Malpractice GPCI 0.687 changed to 0.613
Held through RVU15B.
January 1, 2014
RVU14A
$385.25changed to$376.94
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 8.68 changed to 7.81
- Malpractice RVU 0.35 changed to 0.33
- Practice expense GPCI 0.866 changed to 0.865
- Malpractice GPCI 0.761 changed to 0.687
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $385.25
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $369.10 | $239.11 | RVU26D |
| 2026-07-01 | $369.10 | $239.11 | RVU26C |
| 2026-04-01 | $369.10 | $239.11 | RVU26B |
| 2026-01-01 | $369.10 | $239.11 | RVU26A |
| 2025-10-01 | $354.67 | $244.71 | RVU25D |
| 2025-07-01 | $354.67 | $244.71 | RVU25C |
| 2025-04-01 | $354.67 | $244.71 | RVU25B |
| 2025-01-01 | $354.67 | $244.71 | RVU25A |
| 2024-10-01 | $365.84 | $248.99 | RVU24D |
| 2024-07-01 | $365.84 | $248.99 | RVU24C |
| 2024-04-01 | $365.84 | $248.99 | RVU24B |
| 2024-03-09 | $365.84 | $248.99 | RVU24AR |
| 2024-01-01 | $359.87 | $244.93 | RVU24A |
| 2023-10-01 | $366.16 | $246.75 | RVU23D |
| 2023-07-01 | $366.16 | $246.75 | RVU23C |
| 2023-04-01 | $366.16 | $246.75 | RVU23B |
| 2023-01-01 | $366.16 | $246.75 | RVU23A |
| 2022-10-01 | $368.75 | $245.79 | RVU22D |
| 2022-07-01 | $368.75 | $245.79 | RVU22C |
| 2022-04-01 | $368.75 | $245.79 | RVU22B |
| 2022-01-01 | $368.75 | $245.79 | RVU22A |
| 2021-10-01 | $376.22 | $245.77 | RVU21D |
| 2021-07-01 | $376.22 | $245.77 | RVU21C |
| 2021-04-01 | $376.22 | $245.77 | RVU21B |
| 2021-01-01 | $376.22 | $245.77 | RVU21A |
| 2020-10-01 | $379.01 | $249.57 | RVU20D |
| 2020-07-01 | $379.01 | $249.57 | RVU20C |
| 2020-04-01 | $379.01 | $249.57 | RVU20B |
| 2020-01-01 | $379.01 | $249.57 | RVU20A |
| 2019-10-01 | $381.42 | $248.80 | RVU19D |
| 2019-07-01 | $381.42 | $248.80 | RVU19C |
| 2019-04-01 | $381.42 | $248.80 | RVU19B |
| 2019-01-01 | $381.42 | $248.80 | RVU19A |
| 2018-10-01 | $379.62 | $247.45 | RVU18D |
| 2018-07-01 | $379.62 | $247.45 | RVU18C |
| 2018-04-01 | $379.62 | $247.45 | RVU18B |
| 2018-01-01 | $379.62 | $247.45 | RVU18AR1 |
| 2017-10-01 | $379.75 | $248.76 | RVU17D |
| 2017-07-01 | $379.75 | $248.76 | RVU17C |
| 2017-04-01 | $379.75 | $248.76 | RVU17B |
| 2017-01-01 | $379.75 | $248.76 | RVU17A |
| 2016-10-01 | $379.39 | $248.85 | RVU16D |
| 2016-07-01 | $379.39 | $248.85 | RVU16C |
| 2016-04-01 | $379.39 | $248.85 | RVU16B |
| 2016-01-01 | $379.39 | $248.85 | RVU16A |
| 2015-10-01 | $382.13 | $250.19 | RVU15D |
| 2015-07-01 | $382.13 | $250.19 | RVU15C |
| 2015-04-01 | $380.23 | $248.94 | RVU15B |
| 2015-01-01 | $380.23 | $248.94 | RVU15A |
| 2014-10-01 | $376.94 | $248.66 | RVU14D |
| 2014-07-01 | $376.94 | $248.66 | RVU14C |
| 2014-04-01 | $376.94 | $248.66 | RVU14B |
| 2014-01-01 | $376.94 | $248.66 | RVU14A |
| 2013-10-01 | $385.25 | $249.13 | RVU13D |
| 2013-07-01 | $385.25 | $249.13 | RVU13C |
| 2013-04-01 | $385.25 | $249.13 | RVU13B |
| 2013-01-01 | $385.25 | $249.13 | RVU13AR |
Where the Mississippi rate applies
Mississippi is a Medicare payment area, not a city. Our Census mapping connects it to 427 cities and communities in Mississippi. Some span more than one payment area; confirm with the service ZIP.
- Abbeville
- Aberdeen
- Ackerman
- Agricola
- Alcorn State University
- Algoma
- Alligator
- Amory
28234 billing questions
How does this differ from code 28230?
Code 28234 is for dividing an extensor tendon. Code 28230 describes an open division of a flexor tendon in the foot.
When is code 28232 a closer fit?
Code 28232 describes an open division of a flexor tendon in a toe. Code 28234 is for an extensor tendon.
Can code 28234 be reported with hammertoe correction?
Do not separately report it for tendon division that is part of the hammertoe correction. Documentation should support a distinct tendon procedure rather than repeating work included in the correction.
What documentation supports the code?
Record the foot or toe site, the specific extensor tendon divided, the open approach, and the deformity or other clinical reason for the procedure.
Can modifier 50 be used for bilateral procedures?
No. The descriptor or anatomy makes bilateral adjustment inappropriate for this code.
Is an assistant or co-surgeon payable?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are 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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