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

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, 2026One payment locality4.6K Medicare services in 2024

In North Carolina, Medicare pays $970.97 for 28297 in the office and $533.44 when it’s performed in a hospital or facility.

$970.97Office (non-facility)
$533.44Hospital or facility
−5.8%vs the national office rate ($1,030.75)

Check a contract rate as a % of Medicare · 28297 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 28297 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Carolina
  2. What 28297 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 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.

How North Carolina compares for 28297

Across 109 of 109 payment localities, the office rate for 28297 runs from $915.22 in Arkansas to $1,351.98 in San Benito County, CA. North Carolina pays $970.97. The RVUs are the same everywhere; the geographic indexes change the dollars.

28297 in North Carolina vs other payment areas
  1. North Carolina · this page$970.97
  2. Los Angeles, CA · California$1,156.99+$186.02
  3. Washington, DC area · District of Columbia$1,174.27+$203.30
  4. Miami, FL · Florida$1,116.27+$145.30
  5. Chicago, IL · Illinois$1,084.77+$113.80
  6. Manhattan, NY · New York$1,183.94+$212.97
  7. Alaska · Alaska$1,210.16+$239.19

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

Every other payment area

28297 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$928.17$517.84
ArkansasArkansas$915.22$512.39
ArizonaArizona$1,003.95$549.54
Bakersfield, CACalifornia$1,088.18$574.22
Chico, CACalifornia$1,084.85$570.88
El Centro, CACalifornia$1,085.04$571.07
Fresno, CACalifornia$1,084.85$570.88
Hanford, CACalifornia$1,084.85$570.88

28297 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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

See 28297 in every payment locality

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.

The exact North Carolina inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,176

Code
28297
Physician work
9.06
Practice expense
20.68
Malpractice
1.12

GPCI2026.csv

83

Locality
North Carolina
Physician work
1.000
Practice expense
0.933
Malpractice
0.639
Office calculation for 28297 in North Carolina
ComponentRVULocality factorAdjusted
Physician work9.06× 1.0009.0600
Practice expense20.68× 0.93319.2944
Malpractice1.12× 0.6390.7157
Total RVUs29.0701
Conversion factor× 33.4009

Office rate, North Carolina$970.97

Office: (9.06 × 1 + 20.68 × 0.933 + 1.12 × 0.639) × $33.4009 = $970.97

Facility: (9.06 × 1 + 6.64 × 0.933 + 1.12 × 0.639) × $33.4009 = $533.44

Open 28297 in the RVU calculator

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

Codes related to 28297

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 28297
CodeHow it relatesOffice range, North Carolina
Same family
28295Bunion correction, proximal metatarsal osteotomyHallux valgus correction using a proximal first-metatarsal osteotomy rather than first-joint fusion.$1,000.52
28296Bunion correction, distal first metatarsal osteotomyHallux valgus correction using a distal first-metatarsal osteotomy.$834.20
28298Bunion correction, proximal phalanx osteotomyHallux valgus correction using a proximal phalanx osteotomy.$809.96
28299Bunion correction, double osteotomyHallux valgus correction using double osteotomies.$976.17

How 28297 has changed in North Carolina

28297 · Office / nonfacility

$970.97

Effective 2026-10-01

The base rate is $53.87 higher than on 2025-10-01, moving from $917.10 to $970.97 (5.9%).

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

    $917.10changed to$970.97

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 9.29 changed to 9.06
    • Practice expense RVU 19.81 changed to 20.68
    • Malpractice RVU 1.08 changed to 1.12
    • 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

    $958.45changed to$917.10

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 20.25 changed to 19.81
    • Malpractice RVU 1.13 changed to 1.08

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $942.80changed to$958.45

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $979.79changed to$942.80

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 20.28 changed to 20.25
    • Malpractice RVU 1.11 changed to 1.13
    • Practice expense GPCI 0.927 changed to 0.926
    • Malpractice GPCI 0.742 changed to 0.665

  5. January 1, 2023

    RVU23A

    $1008.54changed to$979.79

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 20.37 changed to 20.28
    • Malpractice RVU 1.16 changed to 1.11
    • 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

    $1030.73changed to$1008.54

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 20.85 changed to 20.37
    • Malpractice RVU 1.10 changed to 1.16

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $1032.96changed to$1030.73

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 19.90 changed to 20.85
    • Malpractice RVU 1.09 changed to 1.10
    • 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

    $1029.80changed to$1032.96

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 19.93 changed to 19.90
    • Malpractice RVU 1.05 changed to 1.09
    • 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

    $1027.50changed to$1029.80

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 19.91 changed to 19.93
    • Malpractice RVU 1.03 changed to 1.05

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $1026.23changed to$1027.50

    • Conversion factor 35.8887 changed to 35.9996
    • Malpractice RVU 1.05 changed to 1.03
    • Malpractice GPCI 0.732 changed to 0.695

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $797.60changed to$1026.23

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 9.43 changed to 9.29
    • Practice expense RVU 12.93 changed to 19.91
    • Malpractice RVU 1.07 changed to 1.05
    • Practice expense GPCI 0.930 changed to 0.931
    • Malpractice GPCI 0.768 changed to 0.732

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $800.30changed to$797.60

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 12.90 changed to 12.93
    • Malpractice RVU 1.10 changed to 1.07

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $796.32changed to$800.30

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $793.42changed to$796.32

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 12.80 changed to 12.90
    • Malpractice RVU 1.13 changed to 1.10
    • Practice expense GPCI 0.929 changed to 0.930
    • Malpractice GPCI 0.732 changed to 0.768

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $796.28changed to$793.42

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 14.19 changed to 12.80
    • Malpractice RVU 1.18 changed to 1.13
    • Practice expense GPCI 0.927 changed to 0.929
    • Malpractice GPCI 0.695 changed to 0.732

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $796.28

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$970.97$533.44RVU26D
2026-07-01$970.97$533.44RVU26C
2026-04-01$970.97$533.44RVU26B
2026-01-01$970.97$533.44RVU26A
2025-10-01$917.10$559.16RVU25D
2025-07-01$917.10$559.16RVU25C
2025-04-01$917.10$559.16RVU25B
2025-01-01$917.10$559.16RVU25A
2024-10-01$958.45$573.76RVU24D
2024-07-01$958.45$573.76RVU24C
2024-04-01$958.45$573.76RVU24B
2024-03-09$958.45$573.76RVU24AR
2024-01-01$942.80$564.39RVU24A
2023-10-01$979.79$580.84RVU23D
2023-07-01$979.79$580.84RVU23C
2023-04-01$979.79$580.84RVU23B
2023-01-01$979.79$580.84RVU23A
2022-10-01$1,008.54$590.41RVU22D
2022-07-01$1,008.54$590.41RVU22C
2022-04-01$1,008.54$590.41RVU22B
2022-01-01$1,008.54$590.41RVU22A
2021-10-01$1,030.73$590.03RVU21D
2021-07-01$1,030.73$590.03RVU21C
2021-04-01$1,030.73$590.03RVU21B
2021-01-01$1,030.73$590.03RVU21A
2020-10-01$1,032.96$600.67RVU20D
2020-07-01$1,032.96$600.67RVU20C
2020-04-01$1,032.96$600.67RVU20B
2020-01-01$1,032.96$600.67RVU20A
2019-10-01$1,029.80$596.31RVU19D
2019-07-01$1,029.80$596.31RVU19C
2019-04-01$1,029.80$596.31RVU19B
2019-01-01$1,029.80$596.31RVU19A
2018-10-01$1,027.50$593.81RVU18D
2018-07-01$1,027.50$593.81RVU18C
2018-04-01$1,027.50$593.81RVU18B
2018-01-01$1,027.50$593.81RVU18AR1
2017-10-01$1,026.23$595.21RVU17D
2017-07-01$1,026.23$595.21RVU17C
2017-04-01$1,026.23$595.21RVU17B
2017-01-01$1,026.23$595.21RVU17A
2016-10-01$797.60$575.17RVU16D
2016-07-01$797.60$575.17RVU16C
2016-04-01$797.60$575.17RVU16B
2016-01-01$797.60$575.17RVU16A
2015-10-01$800.30$577.07RVU15D
2015-07-01$800.30$577.07RVU15C
2015-04-01$796.32$574.20RVU15B
2015-01-01$796.32$574.20RVU15A
2014-10-01$793.42$574.44RVU14D
2014-07-01$793.42$574.44RVU14C
2014-04-01$793.42$574.44RVU14B
2014-01-01$793.42$574.44RVU14A
2013-10-01$796.28$563.52RVU13D
2013-07-01$796.28$563.52RVU13C
2013-04-01$796.28$563.52RVU13B
2013-01-01$796.28$563.52RVU13AR

Price 28297 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

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)
Geographic factors for North CarolinaGPCI2026.csv, line 83 (RVU26D)

Open CMS sourceHow we calculate rates

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