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CPT code 28286: Hammertoe repair, with MTP joint release2026 Medicare rate & RVUs in Puerto Rico

Reports surgical correction of a hammertoe that includes release of the metatarsophalangeal joint when performed to address associated toe contracture.

CMS RVU26DEffective Oct 1, 2026One payment locality240 Medicare services in 2024

In Puerto Rico, Medicare pays $432.91 for 28286 in the office and $278.92 when it’s performed in a hospital or facility.

$432.91Office (non-facility)
$278.92Hospital or facility
+0.6%vs the national office rate ($430.20)

Check a contract rate as a % of Medicare · 28286 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 28286 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 28286 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 28286 covers

A foot and ankle surgeon or podiatrist uses this code for operative correction of a hammertoe that also involves release of the metatarsophalangeal (MTP) joint when performed. The correction addresses the toe deformity, such as through work at an interphalangeal joint, while the MTP release addresses contracture at the toe’s base. These procedures are commonly performed in an outpatient surgical setting for a painful or function-limiting hammertoe.

Choose this code when the operative report supports hammertoe correction with the MTP release included in the service; use 28285 when the correction does not include MTP release. Document the affected toe, the deformity, and the correction and release performed. CMS assigns a 90-day major-surgery global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted, 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 Puerto Rico compares for 28286

Across 109 of 109 payment localities, the office rate for 28286 runs from $386.52 in Arkansas to $557.46 in San Benito County, CA. Puerto Rico pays $432.91. The RVUs are the same everywhere; the geographic indexes change the dollars.

28286 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$432.91
  2. Los Angeles, CA · California$480.27+$47.36
  3. Washington, DC area · District of Columbia$486.94+$54.03
  4. Miami, FL · Florida$461.45+$28.54
  5. Chicago, IL · Illinois$449.90+$16.99
  6. Manhattan, NY · New York$490.57+$57.66
  7. Alaska · Alaska$517.84+$84.93

Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.

Every other payment area

28286 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$391.42$258.15
ArkansasArkansas$386.52$255.69
ArizonaArizona$420.10$272.51
Bakersfield, CACalifornia$453.22$286.29
Chico, CACalifornia$451.94$285.01
El Centro, CACalifornia$452.00$285.07
Fresno, CACalifornia$451.94$285.01
Hanford, CACalifornia$451.94$285.01

28286 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.

$386.52

$517.84

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

View every state and territory as a table
28286 office rate range by state
State / territoryOffice rate rangeLocalities
AK$517.841
AL$391.421
AR$386.521
AZ$420.101
CA$451.94–$557.4629
CO$446.001
CT$456.391
DC$486.941
DE$426.451
FL$425.31–$461.453
GA$404.27–$437.572
GU$460.731
HI$460.731
IA$399.721
ID$402.051
IL$414.77–$449.904
IN$404.071
KS$398.251
KY$399.781
LA$399.30–$416.452
MA$443.92–$486.202
MD$433.80–$486.943
ME$404.04–$422.902
MI$408.97–$430.132
MN$428.451
MO$393.44–$417.563
MS$390.041
MT$430.181
NC$407.701
ND$422.271
NE$401.581
NH$439.351
NJ$461.89–$482.972
NM$410.991
NV$428.241
NY$413.04–$501.315
OH$407.351
OK$398.991
OR$425.18–$458.522
PA$407.83–$446.352
PR$432.911
RI$440.371
SC$408.151
SD$421.331
TN$400.011
TX$405.51–$444.298
UT$413.011
VA$421.79–$486.942
VI$432.911
VT$420.961
WA$442.98–$495.312
WI$409.881
WV$401.401
WY$426.731

See 28286 in every payment locality

How the 28286 rate is calculated

Each of 28286’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 · 28286

RVUs × geographic indexes × conversion factor

Office or facility?

Work4.58

4.58 RVUs× 1.000 GPCI

Practice expense7.90

7.90 RVUs× 1.000 GPCI

Malpractice0.40

0.40 RVUs× 1.000 GPCI

Adjusted RVUs

12.8800

Conversion factor

$33.4009

Medicare rate

$430.20

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

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,169

Code
28286
Physician work
4.58
Practice expense
7.90
Malpractice
0.40

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 28286 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work4.58× 1.0004.5800
Practice expense7.90× 1.0117.9869
Malpractice0.40× 0.9850.3940
Total RVUs12.9609
Conversion factor× 33.4009

Office rate, Puerto Rico$432.91

Office: (4.58 × 1 + 7.9 × 1.011 + 0.4 × 0.985) × $33.4009 = $432.91

Facility: (4.58 × 1 + 3.34 × 1.011 + 0.4 × 0.985) × $33.4009 = $278.92

Open 28286 in the RVU calculator

Payment rules and modifiers for 28286

28286 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 28286

Hammertoe repair, with MTP joint 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)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 · 28286

Hammertoe repair, with MTP joint 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

28286 without 50 · national office

$430.20

Hammertoe repair, with MTP joint release

28286-50 · Bilateral: 150%

$645.30

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 28286

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

Codes related to 28286
CodeHow it relatesOffice range, Puerto Rico
Same family
28285Hammertoe repair, lesser-toe deformity correctionHammertoe correction without the MTP release included in 28286.$551.92
Used instead
28270Foot contracture release, midfoot joint, each jointFor an isolated MTP joint capsulotomy without hammertoe correction.$491.83
28272Toe joint release, interphalangeal joint, eachFor isolated capsulotomy of a toe interphalangeal joint.$379.54

How 28286 has changed in Puerto Rico

28286 · Office / nonfacility

$432.91

Effective 2026-10-01

The base rate is $6.93 higher than on 2025-10-01, moving from $425.98 to $432.91 (1.6%).

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

    $425.98changed to$432.91

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 4.70 changed to 4.58
    • Practice expense RVU 8.03 changed to 7.90
    • Malpractice RVU 0.39 changed to 0.40
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $444.39changed to$425.98

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 8.20 changed to 8.03
    • Malpractice RVU 0.40 changed to 0.39

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $437.14changed to$444.39

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $445.21changed to$437.14

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 8.00 changed to 8.20
    • Malpractice RVU 0.38 changed to 0.40
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $443.24changed to$445.21

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $453.62changed to$443.24

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 7.95 changed to 8.00
    • Malpractice RVU 0.40 changed to 0.38
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $460.56changed to$453.62

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 8.06 changed to 7.95
    • Malpractice RVU 0.38 changed to 0.40

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $467.28changed to$460.56

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 7.80 changed to 8.06
    • Malpractice RVU 0.39 changed to 0.38
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $469.66changed to$467.28

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 7.93 changed to 7.80
    • Malpractice RVU 0.35 changed to 0.39
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $472.05changed to$469.66

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 8.01 changed to 7.93

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $421.59changed to$472.05

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 7.97 changed to 8.01
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $373.99changed to$421.59

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 8.00 changed to 7.97
    • Malpractice RVU 0.36 changed to 0.35
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $373.57changed to$373.99

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 7.93 changed to 8.00

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $371.71changed to$373.57

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $368.54changed to$371.71

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 0.37 changed to 0.36
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $363.44changed to$368.54

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 8.68 changed to 7.93
    • Malpractice RVU 0.39 changed to 0.37
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $363.44

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$432.91$278.92RVU26D
2026-07-01$432.91$278.92RVU26C
2026-04-01$432.91$278.92RVU26B
2026-01-01$432.91$278.92RVU26A
2025-10-01$425.98$292.43RVU25D
2025-07-01$425.98$292.43RVU25C
2025-04-01$425.98$292.43RVU25B
2025-01-01$425.98$292.43RVU25A
2024-10-01$444.39$300.93RVU24D
2024-07-01$444.39$300.93RVU24C
2024-04-01$444.39$300.93RVU24B
2024-03-09$444.39$300.93RVU24AR
2024-01-01$437.14$296.02RVU24A
2023-10-01$445.21$299.35RVU23D
2023-07-01$443.24$298.55RVU23C
2023-04-01$443.24$298.55RVU23B
2023-01-01$443.24$298.55RVU23A
2022-10-01$453.62$302.23RVU22D
2022-07-01$453.62$302.23RVU22C
2022-04-01$453.62$302.23RVU22B
2022-01-01$453.62$302.23RVU22A
2021-10-01$460.56$301.58RVU21D
2021-07-01$460.56$301.58RVU21C
2021-04-01$460.56$301.58RVU21B
2021-01-01$460.56$301.58RVU21A
2020-10-01$467.28$309.76RVU20D
2020-07-01$467.28$309.76RVU20C
2020-04-01$467.28$309.76RVU20B
2020-01-01$467.28$309.76RVU20A
2019-10-01$469.66$309.62RVU19D
2019-07-01$469.66$309.62RVU19C
2019-04-01$469.66$309.62RVU19B
2019-01-01$469.66$309.62RVU19A
2018-10-01$472.05$310.37RVU18D
2018-07-01$472.05$310.37RVU18C
2018-04-01$472.05$310.37RVU18B
2018-01-01$472.05$310.37RVU18AR1
2017-10-01$421.59$285.80RVU17D
2017-07-01$421.59$285.80RVU17C
2017-04-01$421.59$285.80RVU17B
2017-01-01$421.59$285.80RVU17A
2016-10-01$373.99$261.92RVU16D
2016-07-01$373.99$261.92RVU16C
2016-04-01$373.99$261.92RVU16B
2016-01-01$373.99$261.92RVU16A
2015-10-01$373.57$261.60RVU15D
2015-07-01$373.57$261.60RVU15C
2015-04-01$371.71$260.30RVU15B
2015-01-01$371.71$260.30RVU15A
2014-10-01$368.54$259.71RVU14D
2014-07-01$368.54$259.71RVU14C
2014-04-01$368.54$259.71RVU14B
2014-01-01$368.54$259.71RVU14A
2013-10-01$363.44$251.56RVU13D
2013-07-01$363.44$251.56RVU13C
2013-04-01$363.44$251.56RVU13B
2013-01-01$363.44$251.56RVU13AR

Price 28286 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

28286 billing questions

How does this code differ from 28285?

Use 28286 for hammertoe correction that includes MTP joint release when performed. Use 28285 for hammertoe correction without that MTP release.

Can the MTP release be reported separately?

The MTP release is part of this hammertoe service when performed. Do not separately report the same release as a standalone service in addition to 28286.

What should the operative note document?

Identify the affected toe and describe the hammertoe correction and MTP release performed. The note should support why the MTP joint required release as part of the correction.

How are bilateral procedures paid?

CMS pays bilateral reporting with modifier 50 at 150%. The code also follows the standard multiple procedure reduction when other procedures are performed in the same session.

Does the global period include postoperative visits?

Yes. The 90-day major-surgery global 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 28286PPRRVU2026_Oct_nonQPP.csv, line 3,169 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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