CPT code 28297: Bunion correction, first tarsometatarsal fusion2026 Medicare rate & RVUs

Reports hallux valgus correction using fusion of the first metatarsal–medial cuneiform joint, commonly a Lapidus-type procedure, with sesamoidectomy when performed.

CMS RVU26DEffective Oct 1, 2026109 payment localities4.6K Medicare services in 2024

Medicare pays $1,030.75 for 28297 nationally in the office and $561.80 in a hospital or facility. Local office rates run $915.22–$1,351.98.

Medicare rate · 28297

Bunion correction, first tarsometatarsal fusion

Office or facility?

Work RVUs
9.06
Total RVUs
30.86
Global days
090

National rate · 2026

$1,030.75

Office setting, before claim adjustments.

See every locality for 28297 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 28297 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 28297 covers

Code 28297 describes operative correction of a bunion deformity that includes fusion of the joint between the first metatarsal and medial cuneiform. This Lapidus-type approach is used when the surgeon selects fusion at that joint as part of the hallux valgus correction. The operation may include removal of the prominent bone and sesamoidectomy when performed. It is typically done by an orthopedic foot-and-ankle surgeon or podiatric surgeon in a hospital operating room or ambulatory surgery center.

Select this code when the documented correction includes the first tarsometatarsal joint fusion, rather than a metatarsal or phalangeal osteotomy alone. Record the deformity, operative work, joint fused, laterality, and any sesamoidectomy. The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 identifies bilateral surgery and payment is 150%. Assistant-at-surgery payment may be available; 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.

Where 28297 pays more and less

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

109 payment localities

$915.22 to $1351.98

$915.22$1133.60$1351.98
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

28297 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$928.17$517.84
Alaska$1,210.16$710.73
Arizona$1,003.95$549.54
Arkansas$915.22$512.39
Atlanta, GA$1,050.23$573.78
Austin, TX$1,067.15$571.01
Bakersfield, CA$1,088.18$574.22
Baltimore area, MD$1,094.88$591.70
Beaumont, TX$965.93$539.19
Brazoria, TX$1,018.73$554.00

28297 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.

$915.22

$1,218.42

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

View every state and territory as a table
28297 office rate range by state
State / territoryOffice rate rangeLocalities
AK$1,210.161
AL$928.171
AR$915.221
AZ$1,003.951
CA$1,084.85–$1,351.9829
CO$1,070.401
CT$1,097.851
DC$1,174.271
DE$1,020.201
FL$1,019.18–$1,116.273
GA$963.34–$1,050.232
GU$1,109.631
HI$1,109.631
IA$949.481
ID$955.781
IL$991.72–$1,084.774
IN$961.101
KS$945.891
KY$950.901
LA$949.75–$995.092
MA$1,064.61–$1,173.052
MD$1,039.00–$1,174.273
ME$961.35–$1,010.732
MI$975.48–$1,032.242
MN$1,024.451
MO$934.46–$997.673
MS$924.981
MT$1,030.681
NC$970.971
ND$1,008.531
NE$954.301
NH$1,054.401
NJ$1,110.03–$1,162.882
NM$980.941
NV$1,025.201
NY$985.10–$1,212.735
OH$970.961
OK$948.501
OR$1,016.88–$1,102.692
PA$972.05–$1,071.742
PR$1,037.791
RI$1,055.261
SC$972.641
SD$1,005.911
TN$950.571
TX$965.93–$1,067.158
UT$985.491
VA$1,008.01–$1,174.272
VI$1,037.791
VT$1,005.361
WA$1,062.35–$1,195.832
WI$975.851
WV$956.391
WY$1,021.031

How the 28297 rate is calculated

Each of 28297’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 · 28297

RVUs × geographic indexes × conversion factor

Office or facility?

Work9.06

9.06 RVUs× 1.000 GPCI

Practice expense20.68

20.68 RVUs× 1.000 GPCI

Malpractice1.12

1.12 RVUs× 1.000 GPCI

Adjusted RVUs

30.8600

Conversion factor

$33.4009

Medicare rate

$1,030.75

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

Payment rules and modifiers for 28297

28297 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 28297

Bunion correction, first tarsometatarsal fusion

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 · 28297

Bunion correction, first tarsometatarsal fusion

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

28297 without 50 · national office

$1,030.75

Bunion correction, first tarsometatarsal fusion

28297-50 · Bilateral: 150%

$1,546.13

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

28297 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 28297

    Bunion correction, first tarsometatarsal fusion9.06 wRVU

    $1,030.75

  • 28295

    Bunion correction, proximal metatarsal osteotomy8.36 wRVU

    $1,065.15+$34.40

  • 28296

    Bunion correction, distal first metatarsal osteotomy8.04 wRVU

    $883.45−$147.30

  • 28298

    Bunion correction, proximal phalanx osteotomy7.56 wRVU

    $860.41−$170.34

  • 28299

    Bunion correction, double osteotomy9.06 wRVU

    $1,036.43+$5.68

How to choose

28295Bunion correctionProximal metatarsal osteotomy
28295 describes hallux valgus correction with a proximal first-metatarsal osteotomy. Choose 28297 when the correction includes fusion of the first metatarsal–medial cuneiform joint.
28296Bunion correctionDistal first metatarsal osteotomy
28296 uses a distal first-metatarsal osteotomy for the correction. 28297 instead identifies correction with first tarsometatarsal joint fusion.
28298Bunion correctionProximal phalanx osteotomy
28298 is the phalangeal-osteotomy approach to hallux valgus correction. 28297 is distinguished by fusion at the first metatarsal–medial cuneiform joint.
28299Bunion correctionDouble osteotomy
28299 describes hallux valgus correction using double osteotomies. Use 28297 when the documented procedure includes first tarsometatarsal joint fusion.

28297 billing questions

When should 28297 be selected instead of a hallux valgus osteotomy code?

Use 28297 when the correction includes fusion of the first metatarsal–medial cuneiform joint. Osteotomy codes apply when the documented correction uses the specified metatarsal or phalangeal bone cut instead.

Is the sesamoidectomy separately reported?

Sesamoidectomy is included in 28297 when performed as part of the hallux valgus correction. The code also encompasses the first-joint fusion that distinguishes this procedure.

How is bilateral surgery reported?

For bilateral performance, report modifier 50; CMS payment is 150%.

What postoperative care is included in the global period?

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

Can an assistant or co-surgeon be paid?

Assistant-at-surgery payment may be made. Co-surgeon payment requires 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 28297PPRRVU2026_Oct_nonQPP.csv, line 3,176 (RVU26D)

Open CMS sourceHow we calculate rates

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