CPT code 28291: Hallux rigidus surgery, with implant2026 Medicare rate & RVUs

Medicare pays $670.36 for 28291 nationally in the office and $442.90 in a hospital or facility. Local office rates run $604.34–$858.26.

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

What 28291 covers

A foot and ankle surgeon or podiatric surgeon uses this code for implant arthroplasty to treat symptomatic hallux rigidus at the first metatarsophalangeal joint. The procedure addresses degenerative joint changes and restricted, painful great-toe motion through joint debridement, removal of obstructive bone, capsular release, and implant placement. It is typically performed in an outpatient surgical setting when the operative plan includes an implant rather than correction without one.

Report 28291 for the documented implant procedure, not simply because imaging shows arthritis or an implant was considered. The operative report should support the hallux rigidus diagnosis, the work performed at the joint, and implant placement. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure case, the highest-valued procedure is paid in full and other procedures at 50%. 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 28291 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

28291 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 28291 rate is calculated

Each of 28291’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.

Payment rules and modifiers for 28291

28291 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

28291 compared with similar codes

How to choose

28289Hallux rigidus surgeryWithout implant

Both address hallux rigidus with joint debridement and release; 28291 includes implant placement, while 28289 is the choice without an implant.

28292Bunion correctionProximal phalanx base resection

This corrects hallux valgus, or bunion alignment, rather than implant-treated degenerative stiffness of the first metatarsophalangeal joint.

28295Bunion correctionProximal metatarsal osteotomy

This is a hallux valgus correction involving a proximal first-metatarsal osteotomy; 28291 treats hallux rigidus with an implant.

Codes related to 28291

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

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

Open CMS sourceHow we calculate rates