CPT code 28296: Bunion correction, distal first metatarsal osteotomy2026 Medicare rate & RVUs in Vermont

Reports surgical correction of a bunion when the surgeon cuts and repositions the distal first metatarsal to realign the great toe.

CMS RVU26DEffective Oct 1, 2026One payment locality7.6K Medicare services in 2024

In Vermont, Medicare pays $864.05 for 28296 in the office and $468.90 when it’s performed in a hospital or facility.

$864.05Office (non-facility)
$468.90Hospital or facility
−2.2%vs the national office rate ($883.45)

Check a contract rate as a % of Medicare · 28296 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 28296 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Vermont
  2. What 28296 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 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.

How Vermont compares for 28296

Across 109 of 109 payment localities, the office rate for 28296 runs from $787.33 in Arkansas to $1,159.97 in San Benito County, CA. Vermont pays $864.05. The RVUs are the same everywhere; the geographic indexes change the dollars.

28296 in Vermont vs other payment areas
  1. Vermont · this page$864.05
  2. Los Angeles, CA · California$992.78+$128.73
  3. Washington, DC area · District of Columbia$1,005.63+$141.58
  4. Miami, FL · Florida$949.42+$85.37
  5. Chicago, IL · Illinois$923.74+$59.69
  6. Manhattan, NY · New York$1,011.87+$147.82
  7. Alaska · Alaska$1,043.62+$179.57

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

Every other payment area

28296 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$798.13$448.88
ArkansasArkansas$787.33$444.47
ArizonaArizona$861.30$474.53
Bakersfield, CACalifornia$934.25$496.79
Chico, CACalifornia$931.71$494.25
El Centro, CACalifornia$931.85$494.39
Fresno, CACalifornia$931.71$494.25
Hanford, CACalifornia$931.71$494.25

28296 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.

$787.33

$1,045.84

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

View every state and territory as a table
28296 office rate range by state
State / territoryOffice rate rangeLocalities
AK$1,043.621
AL$798.131
AR$787.331
AZ$861.301
CA$931.71–$1,159.9729
CO$918.281
CT$939.821
DC$1,005.631
DE$874.981
FL$871.38–$949.423
GA$825.26–$899.162
GU$952.411
HI$952.411
IA$817.001
ID$822.021
IL$847.76–$923.744
IN$826.491
KS$813.471
KY$815.911
LA$814.74–$852.512
MA$913.33–$1,005.432
MD$890.94–$1,005.633
ME$826.10–$868.062
MI$835.87–$881.682
MN$881.211
MO$801.66–$855.313
MS$794.641
MT$883.401
NC$834.201
ND$867.181
NE$821.181
NH$904.121
NJ$950.90–$996.242
NM$840.191
NV$879.471
NY$845.94–$1,035.155
OH$832.561
OK$814.481
OR$872.97–$945.952
PA$833.77–$917.662
PR$889.511
RI$904.991
SC$834.691
SD$865.271
TN$817.311
TX$828.63–$914.948
UT$845.411
VA$865.41–$1,005.632
VI$889.511
VT$864.051
WA$911.54–$1,025.242
WI$839.821
WV$818.291
WY$876.331

See 28296 in every payment locality

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

Office or facility?

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.

The exact Vermont inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,175

Code
28296
Physician work
8.04
Practice expense
17.59
Malpractice
0.82

GPCI2026.csv

105

Locality
Vermont
Physician work
1.000
Practice expense
0.990
Malpractice
0.506
Office calculation for 28296 in Vermont
ComponentRVULocality factorAdjusted
Physician work8.04× 1.0008.0400
Practice expense17.59× 0.99017.4141
Malpractice0.82× 0.5060.4149
Total RVUs25.8690
Conversion factor× 33.4009

Office rate, Vermont$864.05

Office: (8.04 × 1 + 17.59 × 0.99 + 0.82 × 0.506) × $33.4009 = $864.05

Facility: (8.04 × 1 + 5.64 × 0.99 + 0.82 × 0.506) × $33.4009 = $468.90

Open 28296 in the RVU calculator

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

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 · 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.

  • 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

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).

When to use modifier 50

How 28296 has changed in Vermont

28296 · Office / nonfacility

$864.05

Effective 2026-10-01

The base rate is $29.24 higher than on 2025-10-01, moving from $834.81 to $864.05 (3.5%).

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

    $834.81changed to$864.05

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 8.25 changed to 8.04
    • Practice expense RVU 17.27 changed to 17.59
    • Malpractice RVU 0.79 changed to 0.82
    • Practice expense GPCI 0.993 changed to 0.990
    • Malpractice GPCI 0.518 changed to 0.506

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $866.35changed to$834.81

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 17.50 changed to 17.27
    • Malpractice RVU 0.77 changed to 0.79

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $852.21changed to$866.35

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $879.89changed to$852.21

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 17.36 changed to 17.50
    • Malpractice RVU 0.75 changed to 0.77
    • Practice expense GPCI 0.997 changed to 0.993
    • Malpractice GPCI 0.543 changed to 0.518
  5. January 1, 2023

    RVU23A

    $902.03changed to$879.89

    • Conversion factor 34.6062 changed to 33.8872
    • Malpractice RVU 0.77 changed to 0.75
    • Practice expense GPCI 1.001 changed to 0.997
    • Malpractice GPCI 0.569 changed to 0.543

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $926.37changed to$902.03

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 17.86 changed to 17.36
    • Malpractice RVU 0.74 changed to 0.77

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $938.32changed to$926.37

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 17.17 changed to 17.86
    • Malpractice RVU 0.76 changed to 0.74
    • Practice expense GPCI 1.008 changed to 1.001
    • Malpractice GPCI 0.582 changed to 0.569

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $947.72changed to$938.32

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 17.37 changed to 17.17
    • Malpractice RVU 0.70 changed to 0.76
    • Practice expense GPCI 1.015 changed to 1.008
    • Malpractice GPCI 0.595 changed to 0.582

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $947.78changed to$947.72

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 17.40 changed to 17.37

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $942.12changed to$947.78

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 17.38 changed to 17.40
    • Practice expense GPCI 1.010 changed to 1.015
    • Malpractice GPCI 0.639 changed to 0.595

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $729.58changed to$942.12

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 8.35 changed to 8.25
    • Practice expense RVU 11.49 changed to 17.38
    • Malpractice RVU 0.72 changed to 0.70
    • Practice expense GPCI 1.004 changed to 1.010
    • Malpractice GPCI 0.682 changed to 0.639

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $733.08changed to$729.58

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 11.48 changed to 11.49
    • Malpractice RVU 0.77 changed to 0.72

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $729.43changed to$733.08

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $724.31changed to$729.43

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 11.35 changed to 11.48
    • Malpractice RVU 0.73 changed to 0.77
    • Practice expense GPCI 1.006 changed to 1.004
    • Malpractice GPCI 0.618 changed to 0.682

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$724.31

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$864.05$468.90RVU26D
2026-07-01$864.05$468.90RVU26C
2026-04-01$864.05$468.90RVU26B
2026-01-01$864.05$468.90RVU26A
2025-10-01$834.81$494.34RVU25D
2025-07-01$834.81$494.34RVU25C
2025-04-01$834.81$494.34RVU25B
2025-01-01$834.81$494.34RVU25A
2024-10-01$866.35$503.08RVU24D
2024-07-01$866.35$503.08RVU24C
2024-04-01$866.35$503.08RVU24B
2024-03-09$866.35$503.08RVU24AR
2024-01-01$852.21$494.87RVU24A
2023-10-01$879.89$504.53RVU23D
2023-07-01$879.89$504.53RVU23C
2023-04-01$879.89$504.53RVU23B
2023-01-01$879.89$504.53RVU23A
2022-10-01$902.03$509.20RVU22D
2022-07-01$902.03$509.20RVU22C
2022-04-01$902.03$509.20RVU22B
2022-01-01$902.03$509.20RVU22A
2021-10-01$926.37$510.03RVU21D
2021-07-01$926.37$510.03RVU21C
2021-04-01$926.37$510.03RVU21B
2021-01-01$926.37$510.03RVU21A
2020-10-01$938.32$524.70RVU20D
2020-07-01$938.32$524.70RVU20C
2020-04-01$938.32$524.70RVU20B
2020-01-01$938.32$524.70RVU20A
2019-10-01$947.72$527.06RVU19D
2019-07-01$947.72$527.06RVU19C
2019-04-01$947.72$527.06RVU19B
2019-01-01$947.72$527.06RVU19A
2018-10-01$947.78$526.48RVU18D
2018-07-01$947.78$526.48RVU18C
2018-04-01$947.78$526.48RVU18B
2018-01-01$947.78$526.48RVU18AR1
2017-10-01$942.12$525.27RVU17D
2017-07-01$942.12$525.27RVU17C
2017-04-01$942.12$525.27RVU17B
2017-01-01$942.12$525.27RVU17A
2016-10-01$729.58$529.00RVU16D
2016-07-01$729.58$529.00RVU16C
2016-04-01$729.58$529.00RVU16B
2016-01-01$729.58$529.00RVU16A
2015-10-01$733.08$531.41RVU15D
2015-07-01$733.08$531.41RVU15C
2015-04-01$729.43$528.77RVU15B
2015-01-01$729.43$528.77RVU15A
2014-10-01$724.31$526.10RVU14D
2014-07-01$724.31$526.10RVU14C
2014-04-01$724.31$526.10RVU14B
2014-01-01$724.31$526.10RVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 28296 for an earlier date of service

Where the Vermont rate applies

Vermont is a Medicare payment area, not a city. Our Census mapping connects it to 180 cities and communities in Vermont. Some span more than one payment area; confirm with the service ZIP.

  • Albany
  • Alburgh
  • Algiers
  • Arlington
  • Ascutney
  • Bakersfield
  • Barnet
  • Barre

Browse all communities in Vermont

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
RVUs for 28296PPRRVU2026_Oct_nonQPP.csv, line 3,175 (RVU26D)
Geographic factors for VermontGPCI2026.csv, line 105 (RVU26D)

Open CMS sourceHow we calculate rates

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