CPT code 28295: Bunion correction, proximal metatarsal osteotomy2026 Medicare rate & RVUs in North Carolina

Corrects hallux valgus by realigning the first metatarsal with an osteotomy near its base, as part of surgical bunion treatment.

CMS RVU26DEffective Oct 1, 2026One payment locality425 Medicare services in 2024

In North Carolina, Medicare pays $1,000.52 for 28295 in the office and $531.83 when it’s performed in a hospital or facility.

$1,000.52Office (non-facility)
$531.83Hospital or facility
−6.1%vs the national office rate ($1,065.15)

Check a contract rate as a % of Medicare · 28295 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 28295 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Carolina
  2. What 28295 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 28295 covers

A foot surgeon uses this procedure to correct hallux valgus by cutting and repositioning the first metatarsal near its proximal end. It is performed for a bunion deformity when the planned correction includes a proximal metatarsal osteotomy. The operation is typically done in a surgical setting by an orthopedic or podiatric surgeon; the operative report should identify the osteotomy site and describe how the first metatarsal was repositioned.

Select this code based on the documented proximal metatarsal osteotomy, rather than the apparent size of the bunion. The record should support hallux valgus correction and distinguish the procedure from a distal metatarsal or proximal phalanx osteotomy. This major surgery code includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, Medicare pays the highest-valued procedure in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons require 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 North Carolina compares for 28295

Across 109 of 109 payment localities, the office rate for 28295 runs from $940.32 in Arkansas to $1,406.33 in San Benito County, CA. North Carolina pays $1,000.52. The RVUs are the same everywhere; the geographic indexes change the dollars.

28295 in North Carolina vs other payment areas
  1. North Carolina · this page$1,000.52
  2. Los Angeles, CA · California$1,199.28+$198.76
  3. Washington, DC area · District of Columbia$1,217.48+$216.96
  4. Miami, FL · Florida$1,158.01+$157.49
  5. Chicago, IL · Illinois$1,123.61+$123.09
  6. Manhattan, NY · New York$1,227.62+$227.10
  7. Alaska · Alaska$1,234.91+$234.39

Other areas in North Carolina first, then benchmark localities. Bars start at $0.

Every other payment area

28295 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$954.32$514.77
ArkansasArkansas$940.32$508.80
ArizonaArizona$1,036.19$549.41
Bakersfield, CACalifornia$1,126.06$575.49
Chico, CACalifornia$1,122.53$571.96
El Centro, CACalifornia$1,122.73$572.16
Fresno, CACalifornia$1,122.53$571.96
Hanford, CACalifornia$1,122.53$571.96

28295 rates by state

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

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.

$940.32

$1,264.43

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

View every state and territory as a table
28295 office rate range by state
State / territoryOffice rate rangeLocalities
AK$1,234.911
AL$954.321
AR$940.321
AZ$1,036.191
CA$1,122.53–$1,406.3329
CO$1,107.271
CT$1,136.681
DC$1,217.481
DE$1,053.491
FL$1,052.86–$1,158.013
GA$992.50–$1,086.112
GU$1,150.091
HI$1,150.091
IA$977.241
ID$984.071
IL$1,023.27–$1,123.614
IN$989.811
KS$973.411
KY$978.981
LA$977.75–$1,026.732
MA$1,100.84–$1,216.682
MD$1,073.55–$1,217.483
ME$990.14–$1,043.412
MI$1,005.58–$1,067.032
MN$1,058.081
MO$961.26–$1,029.473
MS$950.941
MT$1,065.071
NC$1,000.521
ND$1,040.951
NE$982.431
NH$1,090.611
NJ$1,148.83–$1,204.752
NM$1,011.501
NV$1,059.091
NY$1,015.79–$1,258.795
OH$1,000.651
OK$976.331
OR$1,050.07–$1,141.902
PA$1,001.81–$1,108.602
PR$1,072.741
RI$1,090.651
SC$1,002.411
SD$1,038.101
TN$978.481
TX$995.20–$1,104.298
UT$1,016.291
VA$1,040.51–$1,217.482
VI$1,072.741
VT$1,037.571
WA$1,098.54–$1,240.812
WI$1,005.661
WV$985.101
WY$1,054.561

See 28295 in every payment locality

How the 28295 rate is calculated

Each of 28295’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 · 28295

RVUs × geographic indexes × conversion factor

Office or facility?

Work8.36

8.36 RVUs× 1.000 GPCI

Practice expense22.31

22.31 RVUs× 1.000 GPCI

Malpractice1.22

1.22 RVUs× 1.000 GPCI

Adjusted RVUs

31.8900

Conversion factor

$33.4009

Medicare rate

$1,065.15

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

The exact North Carolina inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,174

Code
28295
Physician work
8.36
Practice expense
22.31
Malpractice
1.22

GPCI2026.csv

83

Locality
North Carolina
Physician work
1.000
Practice expense
0.933
Malpractice
0.639
Office calculation for 28295 in North Carolina
ComponentRVULocality factorAdjusted
Physician work8.36× 1.0008.3600
Practice expense22.31× 0.93320.8152
Malpractice1.22× 0.6390.7796
Total RVUs29.9548
Conversion factor× 33.4009

Office rate, North Carolina$1000.52

Office: (8.36 × 1 + 22.31 × 0.933 + 1.22 × 0.639) × $33.4009 = $1000.52

Facility: (8.36 × 1 + 7.27 × 0.933 + 1.22 × 0.639) × $33.4009 = $531.83

Open 28295 in the RVU calculator

Payment rules and modifiers for 28295

28295 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 28295

Bunion correction, proximal metatarsal osteotomy

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 · 28295

Bunion correction, proximal metatarsal osteotomy

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

28295 without 50 · national office

$1,065.15

Bunion correction, proximal metatarsal osteotomy

28295-50 · Bilateral: 150%

$1,597.73

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

How 28295 has changed in North Carolina

28295 · Office / nonfacility

$1000.52

Effective 2026-10-01

The base rate is $65.32 higher than on 2025-10-01, moving from $935.20 to $1000.52 (7.0%).

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

    $935.20changed to$1000.52

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 8.57 changed to 8.36
    • Practice expense RVU 21.12 changed to 22.31
    • Malpractice RVU 1.18 changed to 1.22
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.665 changed to 0.639

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $979.54changed to$935.20

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 21.64 changed to 21.12
    • Malpractice RVU 1.23 changed to 1.18

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $963.55changed to$979.54

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $1019.47changed to$963.55

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 22.24 changed to 21.64
    • Malpractice RVU 1.21 changed to 1.23
    • Practice expense GPCI 0.927 changed to 0.926
    • Malpractice GPCI 0.742 changed to 0.665
  5. January 1, 2023

    RVU23A

    $1060.10changed to$1019.47

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 22.61 changed to 22.24
    • Malpractice RVU 1.32 changed to 1.21
    • Practice expense GPCI 0.928 changed to 0.927
    • Malpractice GPCI 0.819 changed to 0.742

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $1093.25changed to$1060.10

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 23.38 changed to 22.61
    • Malpractice RVU 1.30 changed to 1.32

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $973.22changed to$1093.25

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 19.00 changed to 23.38
    • Malpractice RVU 0.96 changed to 1.30
    • Practice expense GPCI 0.930 changed to 0.928
    • Malpractice GPCI 0.757 changed to 0.819

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $940.47changed to$973.22

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 18.22 changed to 19.00
    • Malpractice RVU 0.81 changed to 0.96
    • Practice expense GPCI 0.931 changed to 0.930
    • Malpractice GPCI 0.695 changed to 0.757

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $926.37changed to$940.47

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 17.86 changed to 18.22
    • Malpractice RVU 0.77 changed to 0.81

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $921.48changed to$926.37

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 17.80 changed to 17.86
    • Malpractice RVU 0.73 changed to 0.77
    • Malpractice GPCI 0.732 changed to 0.695

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    No ratechanged to$921.48

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$1,000.52$531.83RVU26D
2026-07-01$1,000.52$531.83RVU26C
2026-04-01$1,000.52$531.83RVU26B
2026-01-01$1,000.52$531.83RVU26A
2025-10-01$935.20$557.19RVU25D
2025-07-01$935.20$557.19RVU25C
2025-04-01$935.20$557.19RVU25B
2025-01-01$935.20$557.19RVU25A
2024-10-01$979.54$572.35RVU24D
2024-07-01$979.54$572.35RVU24C
2024-04-01$979.54$572.35RVU24B
2024-03-09$979.54$572.35RVU24AR
2024-01-01$963.55$563.01RVU24A
2023-10-01$1,019.47$586.60RVU23D
2023-07-01$1,019.47$586.60RVU23C
2023-04-01$1,019.47$586.60RVU23B
2023-01-01$1,019.47$586.60RVU23A
2022-10-01$1,060.10$601.18RVU22D
2022-07-01$1,060.10$601.18RVU22C
2022-04-01$1,060.10$601.18RVU22B
2022-01-01$1,060.10$601.18RVU22A
2021-10-01$1,093.25$604.62RVU21D
2021-07-01$1,093.25$604.62RVU21C
2021-04-01$1,093.25$604.62RVU21B
2021-01-01$1,093.25$604.62RVU21A
2020-10-01$973.22$558.04RVU20D
2020-07-01$973.22$558.04RVU20C
2020-04-01$973.22$558.04RVU20B
2020-01-01$973.22$558.04RVU20A
2019-10-01$940.47$539.85RVU19D
2019-07-01$940.47$539.85RVU19C
2019-04-01$940.47$539.85RVU19B
2019-01-01$940.47$539.85RVU19A
2018-10-01$926.37$532.90RVU18D
2018-07-01$926.37$532.90RVU18C
2018-04-01$926.37$532.90RVU18B
2018-01-01$926.37$532.90RVU18AR1
2017-10-01$921.48$531.23RVU17D
2017-07-01$921.48$531.23RVU17C
2017-04-01$921.48$531.23RVU17B
2017-01-01$921.48$531.23RVU17A
2016-10-01Not in this releaseNot in this releaseRVU16D
2016-07-01Not in this releaseNot in this releaseRVU16C
2016-04-01Not in this releaseNot in this releaseRVU16B
2016-01-01Not in this releaseNot in this releaseRVU16A
2015-10-01Not in this releaseNot in this releaseRVU15D
2015-07-01Not in this releaseNot in this releaseRVU15C
2015-04-01Not in this releaseNot in this releaseRVU15B
2015-01-01Not in this releaseNot in this releaseRVU15A
2014-10-01Not in this releaseNot in this releaseRVU14D
2014-07-01Not in this releaseNot in this releaseRVU14C
2014-04-01Not in this releaseNot in this releaseRVU14B
2014-01-01Not in this releaseNot in this releaseRVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price 28295 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Advance
  • Ahoskie
  • Alamance
  • Albemarle
  • Alexis
  • Alliance
  • Altamahaw

Browse all communities in North Carolina

28295 billing questions

How is this code distinguished from 28296?

Choose 28295 when the hallux valgus correction includes an osteotomy near the base of the first metatarsal. Code 28296 describes correction using a distal metatarsal osteotomy.

When would 28298 be considered instead?

28298 is for hallux valgus correction using a proximal phalanx osteotomy. For 28295, the osteotomy is in the proximal first metatarsal.

How should bilateral procedures be reported?

For bilateral surgery, report modifier 50; CMS pays this code at 150% when reported bilaterally.

How does the 90-day global period affect postoperative billing?

The day-before preoperative visit and 90 days of related postoperative care are included in the global period.

What happens when other procedures are performed in the same session?

The highest-valued procedure is paid in full, and other procedures are paid at 50%. An assistant at surgery may be paid; co-surgeons require supporting documentation.

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 28295PPRRVU2026_Oct_nonQPP.csv, line 3,174 (RVU26D)
Geographic factors for North CarolinaGPCI2026.csv, line 83 (RVU26D)

Open CMS sourceHow we calculate rates

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