CPT code 28238: Tendon revision, foot tendon2026 Medicare rate & RVUs in Massachusetts

Reports operative revision of a foot tendon when the documented procedure revises previously treated tendon tissue rather than performing a straightforward primary repair.

CMS RVU26DEffective Oct 1, 20262 payment localities667 Medicare services in 2024

Medicare pays $704.00–$769.05 for 28238 in the office in Massachusetts, from Rest of Massachusetts to Metropolitan Boston, MA. Which amount applies depends on the service address.

$704.00–$769.05Office (non-facility)
$465.89–$499.06Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 9 sections
  1. Rate in Massachusetts
  2. What 28238 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 28238 covers

CPT 28238 covers operative revision of a tendon in the foot. An orthopedic foot-and-ankle surgeon or podiatric surgeon may perform the procedure when the tendon requires revision after prior treatment. The specific tendon, side, and operative approach depend on the patient’s condition and the surgeon’s findings. The operative report should make clear that the work is a revision of the foot tendon, not simply a new primary repair or a tendon release.

Select the code based on the procedure actually performed and documented. Identify the affected tendon and side, the reason for revision, and the revision work in the operative report. This major surgery has a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires 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.

Where 28238 pays more and less in Massachusetts

28238 office and facility rates by payment locality
Payment localityOfficeFacility
Metropolitan Boston, MA$769.05$499.06
Rest of Massachusetts$704.00$465.89

How the 28238 rate is calculated

Each of 28238’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 · 28238

RVUs × geographic indexes × conversion factor

Office or facility?

Work7.76

7.76 RVUs× 1.000 GPCI

Practice expense11.81

11.81 RVUs× 1.000 GPCI

Malpractice0.95

0.95 RVUs× 1.000 GPCI

Adjusted RVUs

20.5200

Conversion factor

$33.4009

Medicare rate

$685.39

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

Payment rules and modifiers for 28238

28238 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 28238

Tendon revision, foot 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)2Paid.
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 · 28238

Tendon revision, foot 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

28238 without 50 · national office

$685.39

Tendon revision, foot tendon

28238-50 · Bilateral: 150%

$1,028.09

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

28238 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 28238

    Tendon revision, foot tendon7.76 wRVU

    $685.39

  • 28200

    Foot tendon repair, flexor, without free graft4.62 wRVU

    $504.35−$181.04

  • 28202

    Tendon repair, flexor tendon with graft6.89 wRVU

    $608.56−$76.83

  • 28220

    Foot tendon release, single tendon4.55 wRVU

    $446.57−$238.82

How to choose

28200Foot tendon repairFlexor, without free graft
28200 is for foot flexor tendon repair without a free graft. Use 28238 when the operative service is a revision rather than that repair.
28202Tendon repairFlexor tendon with graft
28202 describes foot flexor tendon repair with a free graft. The documented service, not simply the presence of prior tendon treatment, determines whether revision or grafted repair applies.
28220Foot tendon releaseSingle tendon
28220 is for foot tendon release work. It is not the choice when the surgeon revises the tendon itself.

28238 billing questions

How does 28238 differ from a foot tendon repair code?

Use 28238 for a documented revision of a foot tendon. Codes such as 28200 or 28208 describe tendon repair services, with the code choice depending on the tendon and repair details.

Can tendon release or adhesion work be reported as 28238?

Choose the code for the work actually performed. A tendon release or adhesion procedure is distinct from revising the tendon itself.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

How is 28238 paid when other procedures are performed in the same session?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction at 50%.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

How should bilateral surgery be reported?

For bilateral surgery, report modifier 50; CMS pays the bilateral procedure at 150%.

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 28238PPRRVU2026_Oct_nonQPP.csv, line 3,158 (RVU26D)

Open CMS sourceHow we calculate rates

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