CPT code 28297: Bunion correction, first tarsometatarsal fusion2026 Medicare rate & RVUs in California
Reports hallux valgus correction using fusion of the first metatarsal–medial cuneiform joint, commonly a Lapidus-type procedure, with sesamoidectomy when performed.
Medicare pays $1,084.85–$1,351.98 for 28297 in the office in California, from Chico, CA to San Benito County, CA. 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 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 in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 payment localities
$1084.85 to $1351.98
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $1,088.18 | $574.22 |
| Chico, CA | $1,084.85 | $570.88 |
| El Centro, CA | $1,085.04 | $571.07 |
| Fresno, CA | $1,084.85 | $570.88 |
| Hanford, CA | $1,084.85 | $570.88 |
| Los Angeles, CA | $1,156.99 | $602.23 |
| Madera, CA | $1,084.85 | $570.88 |
| Marin County, CA | $1,322.46 | $661.24 |
| Merced, CA | $1,084.85 | $570.88 |
| Modesto, CA | $1,084.85 | $570.88 |
| Napa, CA | $1,251.06 | $632.99 |
| Oxnard, CA | $1,150.83 | $596.54 |
| Redding, CA | $1,084.85 | $570.88 |
| Rest of California | $1,084.85 | $570.88 |
| Riverside, CA | $1,097.01 | $583.04 |
| Sacramento, CA | $1,136.88 | $591.49 |
| Salinas, CA | $1,132.60 | $589.09 |
| San Benito County, CA | $1,351.98 | $675.76 |
| San Diego, CA | $1,158.08 | $597.22 |
| San Francisco, CA | $1,321.19 | $659.97 |
| San Luis Obispo, CA | $1,114.55 | $580.42 |
| Santa Clara County, CA | $1,346.78 | $670.56 |
| Santa Cruz, CA | $1,168.26 | $598.48 |
| Santa Maria, CA | $1,136.53 | $589.73 |
| Santa Rosa, CA | $1,179.96 | $604.09 |
| Stockton, CA | $1,084.85 | $570.88 |
| Vallejo, CA | $1,249.23 | $631.16 |
| Visalia, CA | $1,084.85 | $570.88 |
| Yuba City, CA | $1,084.85 | $570.88 |
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
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
| 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 · 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.
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).
28297 compared with similar codes
Compare codes · National
5 codes, side by side
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
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