CPT code 28264: Midfoot release, extensive capsular release2026 Medicare rate & RVUs in California
Reports extensive surgical release of a contracted midfoot joint capsule to improve motion or correct a rigid foot deformity.
Medicare pays $991.98–$1,216.30 for 28264 in the office in California, from Chico, CA to San Benito County, CA. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 28264 covers
This code describes an extensive operative release of a contracted midfoot joint capsule. Foot and ankle surgeons may perform it for a rigid deformity or restricted midfoot motion, including in reconstructive treatment of a stiff or deformed foot. The operative report should identify the affected joint or joints, the contracture, and the specific release performed; the procedure is more extensive than a limited midfoot capsular release.
Report the service for the documented extensive midfoot release, not simply because the surgeon operated in the midfoot. The note should establish the extent and structures addressed so the work can be distinguished from a less extensive release or a release at another foot joint. CMS 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 other procedures are subject to the standard 50% multiple-procedure reduction. For bilateral performance, modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; 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.
Where 28264 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 payment localities
$991.98 to $1216.30
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $996.89 | $661.57 |
| Chico, CA | $991.98 | $656.66 |
| El Centro, CA | $992.27 | $656.95 |
| Fresno, CA | $991.98 | $656.66 |
| Hanford, CA | $991.98 | $656.66 |
| Los Angeles, CA | $1,055.99 | $694.05 |
| Madera, CA | $991.98 | $656.66 |
| Marin County, CA | $1,188.88 | $757.49 |
| Merced, CA | $991.98 | $656.66 |
| Modesto, CA | $991.98 | $656.66 |
| Napa, CA | $1,129.55 | $726.30 |
| Oxnard, CA | $1,048.56 | $686.93 |
| Redding, CA | $991.98 | $656.66 |
| Rest of California | $991.98 | $656.66 |
| Riverside, CA | $1,010.65 | $675.32 |
| Sacramento, CA | $1,035.76 | $679.94 |
| Salinas, CA | $1,031.81 | $677.21 |
| San Benito County, CA | $1,216.30 | $775.11 |
| San Diego, CA | $1,052.35 | $686.43 |
| San Francisco, CA | $1,186.92 | $755.53 |
| San Luis Obispo, CA | $1,015.85 | $667.37 |
| Santa Clara County, CA | $1,208.27 | $767.08 |
| Santa Cruz, CA | $1,059.43 | $687.70 |
| Santa Maria, CA | $1,034.65 | $677.91 |
| Santa Rosa, CA | $1,069.77 | $694.06 |
| Stockton, CA | $991.98 | $656.66 |
| Vallejo, CA | $1,126.72 | $723.47 |
| Visalia, CA | $991.98 | $656.66 |
| Yuba City, CA | $991.98 | $656.66 |
How the 28264 rate is calculated
Each of 28264’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 · 28264
RVUs × geographic indexes × conversion factor
Work10.38
10.38 RVUs× 1.000 GPCI
Practice expense16.62
16.62 RVUs× 1.000 GPCI
Malpractice1.73
1.73 RVUs× 1.000 GPCI
Adjusted RVUs
28.7300
Conversion factor
$33.4009
Medicare rate
$959.61
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 28264
28264 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28264
Midfoot release, extensive capsular release
| 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) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| 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 · 28264
Midfoot release, extensive capsular release
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 50 · payment effect
With and without the modifier
28264 without 50 · national office
$959.61
Midfoot release, extensive capsular release
28264-50 · Bilateral: 150%
$1,439.42
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).
28264 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 28260Midfoot releaseMidfoot joint capsule
- Both address midfoot capsular release, but 28264 represents the extensive release. Choose the code that matches the operative extent.
- 28262Midfoot releaseExtensive release
- This is another related midfoot release code. Compare the specific procedure performed and documented rather than choosing by diagnosis alone.
- 28270Foot contracture releaseMidfoot joint, each joint
- 28270 concerns release of a foot joint contracture; 28264 is for an extensive midfoot release.
28264 billing questions
How is this different from 28260?
28264 is for an extensive midfoot capsular release. Use 28260 when the documented release is the less extensive midfoot procedure.
What documentation supports the extensive-release level?
The operative report should describe the midfoot contracture, the joint or joints addressed, and the extent of the capsular release. A diagnosis of stiffness alone does not establish the operative extent.
Can the service be reported on both feet?
Yes, when the extensive release is performed bilaterally. CMS identifies modifier 50 for bilateral reporting and pays the procedure at 150%.
How does the multiple-procedure reduction affect this code?
When it is one of multiple procedures in the same session, the highest-valued procedure is paid in full and the other procedures are paid at 50% under the standard multiple-procedure rule.
Is an assistant at surgery payable?
CMS indicates that assistant-at-surgery payment may be made for this service. Co-surgeons and team surgery are not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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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