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CPT code 28289: Hallux rigidus surgery, without implant2026 Medicare rate & RVUs in Washington, DC area

Reports operative treatment of hallux rigidus at the first metatarsophalangeal joint using cheilectomy, debridement, and capsular release without an implant.

CMS RVU26DEffective Oct 1, 2026One payment locality6.4K Medicare services in 2024

In Washington, DC area, Medicare pays $798.15 for 28289 in the office and $487.31 when it’s performed in a hospital or facility.

$798.15Office (non-facility)
$487.31Hospital or facility
+13.6%vs the national office rate ($702.75)

Check a contract rate as a % of Medicare · 28289 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 28289 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 28289 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 28289 covers

This operation treats hallux rigidus, a painful, stiff first metatarsophalangeal joint, by removing limiting bone and diseased tissue and releasing the joint capsule. It is typically performed by an orthopedic foot and ankle surgeon or podiatric surgeon in an operating room or ambulatory surgery setting. The defining distinction from the related implant procedure is that no implant is used.

Report the service when the operative note supports the hallux rigidus correction and its components at the first metatarsophalangeal joint. The code has a 90-day 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 other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery services may be paid; 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.

How Washington, DC area compares for 28289

Across 109 of 109 payment localities, the office rate for 28289 runs from $625.71 in Arkansas to $913.32 in San Benito County, CA. Washington, DC area pays $798.15. The RVUs are the same everywhere; the geographic indexes change the dollars.

28289 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$798.15
  2. Los Angeles, CA · California$784.88−$13.27
  3. Miami, FL · Florida$764.10−$34.05
  4. Chicago, IL · Illinois$742.91−$55.24
  5. Manhattan, NY · New York$806.47+$8.32
  6. Alaska · Alaska$831.80+$33.65
  7. Alabama · Alabama$634.34−$163.81

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

Every other payment area

28289 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$625.71$399.05
ArizonaArizona$684.77$429.08
Bakersfield, CACalifornia$739.25$450.05
Chico, CACalifornia$736.75$447.55
El Centro, CACalifornia$736.89$447.69
Fresno, CACalifornia$736.75$447.55
Hanford, CACalifornia$736.75$447.55
Madera, CACalifornia$736.75$447.55

28289 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.

$625.71

$831.80

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

View every state and territory as a table
28289 office rate range by state
State / territoryOffice rate rangeLocalities
AK$831.801
AL$634.341
AR$625.711
AZ$684.771
CA$736.75–$913.3229
CO$728.101
CT$747.791
DC$798.151
DE$695.651
FL$697.07–$764.103
GA$659.55–$716.272
GU$752.581
HI$752.581
IA$647.591
ID$651.981
IL$679.41–$742.914
IN$655.491
KS$645.651
KY$650.431
LA$649.84–$680.032
MA$724.50–$796.172
MD$708.10–$798.153
ME$656.16–$688.352
MI$667.23–$706.262
MN$696.051
MO$639.94–$681.223
MS$632.891
MT$702.701
NC$662.481
ND$686.091
NE$650.661
NH$717.691
NJ$755.86–$790.812
NM$671.051
NV$698.521
NY$671.93–$826.225
OH$663.841
OK$648.361
OR$692.62–$749.112
PA$664.32–$730.662
PR$707.281
RI$718.841
SC$664.351
SD$684.131
TN$648.821
TX$660.27–$726.108
UT$672.901
VA$686.86–$798.152
VI$707.281
VT$684.401
WA$722.82–$810.992
WI$664.441
WV$655.911
WY$695.461

See 28289 in every payment locality

How the 28289 rate is calculated

Each of 28289’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 · 28289

RVUs × geographic indexes × conversion factor

Office or facility?

Work6.73

6.73 RVUs× 1.000 GPCI

Practice expense13.47

13.47 RVUs× 1.000 GPCI

Malpractice0.84

0.84 RVUs× 1.000 GPCI

Adjusted RVUs

21.0400

Conversion factor

$33.4009

Medicare rate

$702.75

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

3,171

Code
28289
Physician work
6.73
Practice expense
13.47
Malpractice
0.84

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 28289 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work6.73× 1.0547.0934
Practice expense13.47× 1.17815.8677
Malpractice0.84× 1.1130.9349
Total RVUs23.8960
Conversion factor× 33.4009

Office rate, Washington, DC area$798.15

Office: (6.73 × 1.054 + 13.47 × 1.178 + 0.84 × 1.113) × $33.4009 = $798.15

Facility: (6.73 × 1.054 + 5.57 × 1.178 + 0.84 × 1.113) × $33.4009 = $487.31

Open 28289 in the RVU calculator

Payment rules and modifiers for 28289

28289 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 28289

Hallux rigidus surgery, without implant

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 · 28289

Hallux rigidus surgery, without implant

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

28289 without 50 · national office

$702.75

Hallux rigidus surgery, without implant

28289-50 · Bilateral: 150%

$1,054.13

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 28289

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

Codes related to 28289
CodeHow it relatesOffice range, Washington, DC area
Same family
28291Hallux rigidus surgery, with implantHallux rigidus correction at the same joint, distinguished by use of an implant.$755.77

How 28289 has changed in Washington, DC area

28289 · Office / nonfacility

$798.15

Effective 2026-10-01

The base rate is $34.63 higher than on 2025-10-01, moving from $763.52 to $798.15 (4.5%).

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

    $763.52changed to$798.15

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 6.90 changed to 6.73
    • Practice expense RVU 12.89 changed to 13.47
    • Malpractice RVU 0.81 changed to 0.84
    • 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

    $788.91changed to$763.52

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 12.98 changed to 12.89
    • Malpractice RVU 0.80 changed to 0.81

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $776.03changed to$788.91

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $807.27changed to$776.03

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 12.82 changed to 12.98
    • Malpractice RVU 0.79 changed to 0.80
    • 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

    $828.14changed to$807.27

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 12.65 changed to 12.82
    • 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

    $856.05changed to$828.14

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 13.18 changed to 12.65
    • Malpractice RVU 0.75 changed to 0.79

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $866.05changed to$856.05

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 12.91 changed to 13.18
    • Malpractice RVU 0.78 changed to 0.75
    • 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

    $876.30changed to$866.05

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 13.41 changed to 12.91
    • Malpractice RVU 0.75 changed to 0.78
    • 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. January 1, 2019

    RVU19A

    $895.75changed to$876.30

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 13.87 changed to 13.41
    • Malpractice RVU 0.76 changed to 0.75

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $896.19changed to$895.75

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 13.91 changed to 13.87
    • Malpractice RVU 0.77 changed to 0.76
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $868.37changed to$896.19

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 8.31 changed to 6.90
    • Practice expense RVU 11.87 changed to 13.91
    • Malpractice RVU 0.95 changed to 0.77
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $874.18changed to$868.37

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 11.90 changed to 11.87
    • Malpractice RVU 0.98 changed to 0.95

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $869.83changed to$874.18

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $862.11changed to$869.83

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 11.79 changed to 11.90
    • Malpractice RVU 0.97 changed to 0.98
    • 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.

  15. January 1, 2014

    RVU14A

    $867.33changed to$862.11

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 13.05 changed to 11.79
    • Malpractice RVU 1.01 changed to 0.97
    • 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.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $867.33

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$798.15$487.31RVU26D
2026-07-01$798.15$487.31RVU26C
2026-04-01$798.15$487.31RVU26B
2026-01-01$798.15$487.31RVU26A
2025-10-01$763.52$513.67RVU25D
2025-07-01$763.52$513.67RVU25C
2025-04-01$763.52$513.67RVU25B
2025-01-01$763.52$513.67RVU25A
2024-10-01$788.91$523.06RVU24D
2024-07-01$788.91$523.06RVU24C
2024-04-01$788.91$523.06RVU24B
2024-03-09$788.91$523.06RVU24AR
2024-01-01$776.03$514.52RVU24A
2023-10-01$807.27$529.17RVU23D
2023-07-01$807.27$529.17RVU23C
2023-04-01$807.27$529.17RVU23B
2023-01-01$807.27$529.17RVU23A
2022-10-01$828.14$535.14RVU22D
2022-07-01$828.14$535.14RVU22C
2022-04-01$828.14$535.14RVU22B
2022-01-01$828.14$535.14RVU22A
2021-10-01$856.05$534.32RVU21D
2021-07-01$856.05$534.32RVU21C
2021-04-01$856.05$534.32RVU21B
2021-01-01$856.05$534.32RVU21A
2020-10-01$866.05$541.29RVU20D
2020-07-01$866.05$541.29RVU20C
2020-04-01$866.05$541.29RVU20B
2020-01-01$866.05$541.29RVU20A
2019-10-01$876.30$538.44RVU19D
2019-07-01$876.30$538.44RVU19C
2019-04-01$876.30$538.44RVU19B
2019-01-01$876.30$538.44RVU19A
2018-10-01$895.75$540.04RVU18D
2018-07-01$895.75$540.04RVU18C
2018-04-01$895.75$540.04RVU18B
2018-01-01$895.75$540.04RVU18AR1
2017-10-01$896.19$541.58RVU17D
2017-07-01$896.19$541.58RVU17C
2017-04-01$896.19$541.58RVU17B
2017-01-01$896.19$541.58RVU17A
2016-10-01$868.37$635.39RVU16D
2016-07-01$868.37$635.39RVU16C
2016-04-01$868.37$635.39RVU16B
2016-01-01$868.37$635.39RVU16A
2015-10-01$874.18$639.49RVU15D
2015-07-01$874.18$639.49RVU15C
2015-04-01$869.83$636.31RVU15B
2015-01-01$869.83$636.31RVU15A
2014-10-01$862.11$632.17RVU14D
2014-07-01$862.11$632.17RVU14C
2014-04-01$862.11$632.17RVU14B
2014-01-01$862.11$632.17RVU14A
2013-10-01$867.33$623.99RVU13D
2013-07-01$867.33$623.99RVU13C
2013-04-01$867.33$623.99RVU13B
2013-01-01$867.33$623.99RVU13AR

Price 28289 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

28289 billing questions

How does this differ from 28291?

Both address hallux rigidus at the first metatarsophalangeal joint. Use 28289 for the correction without an implant; 28291 is the implant procedure.

What should the operative note support?

Document hallux rigidus, the affected first metatarsophalangeal joint, the correction performed, and whether an implant was used. The note should support the reported service rather than only describing a general bunion or toe procedure.

Does the code include postoperative visits?

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

How is bilateral surgery reported?

When the procedure is performed bilaterally, modifier 50 applies, and CMS pays the bilateral procedure at 150%.

How are other procedures in the same session paid?

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

Can an assistant or co-surgeon be reported?

Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation; team surgery is 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
RVUs for 28289PPRRVU2026_Oct_nonQPP.csv, line 3,171 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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