CPT code 28296: Bunion correction, distal first metatarsal osteotomy2026 Medicare rate & RVUs in Guam
Reports surgical correction of a bunion when the surgeon cuts and repositions the distal first metatarsal to realign the great toe.
Medicare pays $952.41 for 28296 in the office in Guam (Hawaii, Guam, HI). Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 28296 covers
Code 28296 covers hallux valgus correction centered on an osteotomy near the head of the first metatarsal. An Austin or chevron bunionectomy is a familiar example. An orthopedic foot and ankle surgeon or podiatric surgeon typically performs the operation in a hospital outpatient department or ambulatory surgery center. The surgeon repositions the bone to improve great-toe alignment and may perform associated soft-tissue work as part of the correction.
Select 28296 when the operative report documents a distal first metatarsal osteotomy for the bunion correction. The report should identify the side, osteotomy location, bone repositioning, and any additional osteotomy. A proximal metatarsal osteotomy, joint fusion, or double osteotomy points to another code. CMS assigns a 90-day global period that includes the day-before preoperative visit and related postoperative care. When multiple procedures are performed in one session, CMS pays the highest-valued procedure in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons require supporting documentation. 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.
28296 in Hawaii, Guam, HI
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam, HI | $952.41 | $498.59 |
How the 28296 rate is calculated
Each of 28296’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 · 28296
RVUs × geographic indexes × conversion factor
Work8.04
8.04 RVUs× 1.000 GPCI
Practice expense17.59
17.59 RVUs× 1.000 GPCI
Malpractice0.82
0.82 RVUs× 1.000 GPCI
Adjusted RVUs
26.4500
Conversion factor
$33.4009
Medicare rate
$883.45
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 28296
28296 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28296
Bunion correction, distal first metatarsal osteotomy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 28296
Bunion correction, distal first 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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
28296 without 50 · national office
$883.45
Bunion correction, distal first metatarsal osteotomy
28296-50 · Bilateral: 150%
$1,325.18
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).
28296 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 28295Bunion correctionProximal metatarsal osteotomy
- Use 28296 for an osteotomy near the first metatarsal head; 28295 describes correction with an osteotomy at the proximal first metatarsal.
- 28299Bunion correctionDouble osteotomy
- Code 28296 represents a single distal metatarsal osteotomy. Code 28299 identifies hallux valgus correction with two osteotomies.
- 28297Bunion correctionFirst tarsometatarsal fusion
- Code 28297 involves joint fusion to correct hallux valgus. Code 28296 repositions the distal first metatarsal through an osteotomy.
- 28298Bunion correctionProximal phalanx osteotomy
- Code 28298 identifies correction using a proximal phalanx osteotomy; 28296 identifies a distal first metatarsal osteotomy.
28296 billing questions
How is 28296 distinguished from 28295?
Both involve first metatarsal osteotomy for hallux valgus, but 28296 identifies an osteotomy at the distal metatarsal; 28295 identifies one at the proximal metatarsal.
What if the surgeon also performs a proximal phalanx osteotomy?
Review the operative report for a double osteotomy. Code 28299 describes hallux valgus correction using two osteotomies, rather than the single distal metatarsal osteotomy represented by 28296.
Is removal of the bunion prominence separately reported?
When removal of the medial prominence is part of the distal metatarsal osteotomy correction, it is included in 28296 rather than reported as a separate bunion procedure.
How is surgery on both feet reported?
CMS recognizes bilateral reporting of 28296 with modifier 50 and pays it at 150%. The operative report should document the distal metatarsal correction on each foot.
What postoperative visits are included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care for the bunion correction.
Can another surgeon participate in the operation?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; CMS does not permit team surgery for 28296.
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
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