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CPT code 28264: Midfoot release, extensive capsular release2026 Medicare rate & RVUs in Washington, DC area

Reports extensive surgical release of a contracted midfoot joint capsule to improve motion or correct a rigid foot deformity.

CMS RVU26DEffective Oct 1, 2026One payment locality221 Medicare services in 2024

In Washington, DC area, Medicare pays $1,083.67 for 28264 in the office and $723.26 when it’s performed in a hospital or facility.

$1,083.67Office (non-facility)
$723.26Hospital or facility
+12.9%vs the national office rate ($959.61)

Check a contract rate as a % of Medicare · 28264 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 28264 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 28264 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 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.

How Washington, DC area compares for 28264

Across 109 of 109 payment localities, the office rate for 28264 runs from $853.31 in Arkansas to $1,216.30 in San Benito County, CA. Washington, DC area pays $1,083.67. The RVUs are the same everywhere; the geographic indexes change the dollars.

28264 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$1,083.67
  2. Los Angeles, CA · California$1,055.99−$27.68
  3. Miami, FL · Florida$1,070.72−$12.95
  4. Chicago, IL · Illinois$1,039.64−$44.03
  5. Manhattan, NY · New York$1,105.59+$21.92
  6. Alaska · Alaska$1,143.10+$59.43
  7. Alabama · Alabama$865.14−$218.53

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

28264 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$853.31$590.50
ArizonaArizona$934.08$637.61
Bakersfield, CACalifornia$996.89$661.57
Chico, CACalifornia$991.98$656.66
El Centro, CACalifornia$992.27$656.95
Fresno, CACalifornia$991.98$656.66
Hanford, CACalifornia$991.98$656.66
Madera, CACalifornia$991.98$656.66

28264 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.

$853.31

$1,143.10

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

View every state and territory as a table
28264 office rate range by state
State / territoryOffice rate rangeLocalities
AK$1,143.101
AL$865.141
AR$853.311
AZ$934.081
CA$991.98–$1,216.3029
CO$986.641
CT$1,021.421
DC$1,083.671
DE$948.841
FL$964.25–$1,070.723
GA$910.75–$981.142
GU$1,011.331
HI$1,011.331
IA$877.581
ID$884.751
IL$943.84–$1,039.644
IN$889.381
KS$877.661
KY$893.081
LA$893.34–$934.712
MA$982.85–$1,075.162
MD$965.00–$1,083.673
ME$893.36–$933.292
MI$918.77–$979.822
MN$935.031
MO$881.50–$933.083
MS$867.361
MT$959.491
NC$901.551
ND$925.281
NE$880.921
NH$975.141
NJ$1,030.15–$1,074.202
NM$925.151
NV$950.511
NY$914.69–$1,136.245
OH$911.771
OK$887.321
OR$940.23–$1,011.982
PA$910.91–$999.762
PR$964.851
RI$978.271
SC$908.751
SD$921.241
TN$882.341
TX$905.54–$985.918
UT$920.411
VA$933.18–$1,083.672
VI$964.851
VT$925.511
WA$979.73–$1,092.382
WI$896.311
WV$911.791
WY$944.581

See 28264 in every payment locality

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

Office or facility?

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.

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,164

Code
28264
Physician work
10.38
Practice expense
16.62
Malpractice
1.73

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 28264 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work10.38× 1.05410.9405
Practice expense16.62× 1.17819.5784
Malpractice1.73× 1.1131.9255
Total RVUs32.4444
Conversion factor× 33.4009

Office rate, Washington, DC area$1083.67

Office: (10.38 × 1.054 + 16.62 × 1.178 + 1.73 × 1.113) × $33.4009 = $1083.67

Facility: (10.38 × 1.054 + 7.46 × 1.178 + 1.73 × 1.113) × $33.4009 = $723.26

Open 28264 in the RVU calculator

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

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)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 · 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.

  • 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

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).

When to use modifier 50

Codes related to 28264

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

Codes related to 28264
CodeHow it relatesOffice range, Washington, DC area
Same family
28260Midfoot release, midfoot joint capsuleA less extensive midfoot capsular release in the same procedure family.$857.38
28262Midfoot release, extensive releaseA related midfoot release code; select based on the documented procedure and extent.$1,667.38
Used instead
28270Foot contracture release, midfoot joint, each jointFor release of a foot joint contracture when the procedure is not the extensive midfoot release described here.$554.63
28272Toe joint release, interphalangeal joint, eachFor release of a toe joint contracture, rather than an extensive midfoot joint release.$427.64

How 28264 has changed in Washington, DC area

28264 · Office / nonfacility

$1083.67

Effective 2026-10-01

The base rate is $91.91 higher than on 2025-10-01, moving from $991.76 to $1083.67 (9.3%).

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

    $991.76changed to$1083.67

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 10.65 changed to 10.38
    • Practice expense RVU 14.72 changed to 16.62
    • Malpractice RVU 1.59 changed to 1.73
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $989.76changed to$991.76

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 14.07 changed to 14.72
    • Malpractice RVU 1.46 changed to 1.59

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $973.61changed to$989.76

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $1020.44changed to$973.61

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 14.04 changed to 14.07
    • Malpractice RVU 1.48 changed to 1.46
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $1082.56changed to$1020.44

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 14.50 changed to 14.04
    • Malpractice RVU 1.65 changed to 1.48
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $1098.74changed to$1082.56

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 14.73 changed to 14.50
    • Malpractice RVU 1.59 changed to 1.65

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $1223.56changed to$1098.74

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 16.40 changed to 14.73
    • Malpractice RVU 2.12 changed to 1.59
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $1209.32changed to$1223.56

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 16.33 changed to 16.40
    • Malpractice RVU 2.18 changed to 2.12
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. July 1, 2019

    RVU19C

    $1206.60changed to$1209.32

    • Malpractice RVU 2.12 changed to 2.18

    Held through RVU19D.

  10. January 1, 2019

    RVU19A

    $1210.15changed to$1206.60

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 16.39 changed to 16.33
    • Malpractice RVU 2.17 changed to 2.12

    Held through RVU19B.

  11. January 1, 2018

    RVU18AR1

    $1035.31changed to$1210.15

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 13.18 changed to 16.39
    • Malpractice RVU 1.42 changed to 2.17
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $1192.17changed to$1035.31

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 16.07 changed to 13.18
    • Malpractice RVU 2.14 changed to 1.42
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $998.82changed to$1192.17

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 12.95 changed to 16.07
    • Malpractice RVU 0.78 changed to 2.14

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $993.85changed to$998.82

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $1127.51changed to$993.85

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 16.10 changed to 12.95
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $1135.11changed to$1127.51

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 17.75 changed to 16.10
    • Malpractice RVU 0.82 changed to 0.78
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $1135.11

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$1,083.67$723.26RVU26D
2026-07-01$1,083.67$723.26RVU26C
2026-04-01$1,083.67$723.26RVU26B
2026-01-01$1,083.67$723.26RVU26A
2025-10-01$991.76$760.03RVU25D
2025-07-01$991.76$760.03RVU25C
2025-04-01$991.76$760.03RVU25B
2025-01-01$991.76$760.03RVU25A
2024-10-01$989.76$754.07RVU24D
2024-07-01$989.76$754.07RVU24C
2024-04-01$989.76$754.07RVU24B
2024-03-09$989.76$754.07RVU24AR
2024-01-01$973.61$741.76RVU24A
2023-10-01$1,020.44$773.19RVU23D
2023-07-01$1,020.44$773.19RVU23C
2023-04-01$1,020.44$773.19RVU23B
2023-01-01$1,020.44$773.19RVU23A
2022-10-01$1,082.56$813.51RVU22D
2022-07-01$1,082.56$813.51RVU22C
2022-04-01$1,082.56$813.51RVU22B
2022-01-01$1,082.56$813.51RVU22A
2021-10-01$1,098.74$816.26RVU21D
2021-07-01$1,098.74$816.26RVU21C
2021-04-01$1,098.74$816.26RVU21B
2021-01-01$1,098.74$816.26RVU21A
2020-10-01$1,223.56$917.31RVU20D
2020-07-01$1,223.56$917.31RVU20C
2020-04-01$1,223.56$917.31RVU20B
2020-01-01$1,223.56$917.31RVU20A
2019-10-01$1,209.32$906.64RVU19D
2019-07-01$1,209.32$906.64RVU19C
2019-04-01$1,206.60$903.91RVU19B
2019-01-01$1,206.60$903.91RVU19A
2018-10-01$1,210.15$905.19RVU18D
2018-07-01$1,210.15$905.19RVU18C
2018-04-01$1,210.15$905.19RVU18B
2018-01-01$1,210.15$905.19RVU18AR1
2017-10-01$1,035.31$781.03RVU17D
2017-07-01$1,035.31$781.03RVU17C
2017-04-01$1,035.31$781.03RVU17B
2017-01-01$1,035.31$781.03RVU17A
2016-10-01$1,192.17$895.33RVU16D
2016-07-01$1,192.17$895.33RVU16C
2016-04-01$1,192.17$895.33RVU16B
2016-01-01$1,192.17$895.33RVU16A
2015-10-01$998.82$746.81RVU15D
2015-07-01$998.82$746.81RVU15C
2015-04-01$993.85$743.10RVU15B
2015-01-01$993.85$743.10RVU15A
2014-10-01$1,127.51$832.55RVU14D
2014-07-01$1,127.51$832.55RVU14C
2014-04-01$1,127.51$832.55RVU14B
2014-01-01$1,127.51$832.55RVU14A
2013-10-01$1,135.11$822.07RVU13D
2013-07-01$1,135.11$822.07RVU13C
2013-04-01$1,135.11$822.07RVU13B
2013-01-01$1,135.11$822.07RVU13AR

Price 28264 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

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
RVUs for 28264PPRRVU2026_Oct_nonQPP.csv, line 3,164 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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