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CPT code 28304: Midfoot osteotomy, without bone graft2026 Medicare rate & RVUs in King County, WA

A surgeon cuts and reshapes a midfoot tarsal bone, other than the heel or talus, to correct alignment or structural deformity.

CMS RVU26DEffective Oct 1, 2026One payment locality937 Medicare services in 2024

In King County, WA, Medicare pays $995.45 for 28304 in the office and $639.31 when it’s performed in a hospital or facility.

$995.45Office (non-facility)
$639.31Hospital or facility
+14.2%vs the national office rate ($871.76)

Check a contract rate as a % of Medicare · 28304 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 28304 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in King County, WA
  2. What 28304 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 28304 covers

This service involves a planned cut in a midfoot tarsal bone, such as a cuneiform, navicular, or cuboid, to change its alignment or shape. Orthopedic foot-and-ankle surgeons and podiatrists perform these procedures to address structural deformity or abnormal foot mechanics, commonly in an operating room. The operated bone distinguishes this service from osteotomy of the calcaneus, talus, or a metatarsal. A tarsal osteotomy with autograft is reported with a different code.

Select this code when the operative work is a midfoot tarsal osteotomy without the autograft service represented by 28305. The operative report should identify the bone and side, the condition being corrected, the osteotomy and correction performed, and whether graft was used. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For same-session multiple procedures, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 bilateral procedures are paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and 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 King County, WA compares for 28304

Across 109 of 109 payment localities, the office rate for 28304 runs from $775.26 in Arkansas to $1,111.21 in San Benito County, CA. King County, WA pays $995.45. The RVUs are the same everywhere; the geographic indexes change the dollars.

28304 in King County, WA vs other payment areas
  1. King County, WA · this page$995.45
  2. Rest of Washington · Washington$891.48−$103.97
  3. Los Angeles, CA · California$962.49−$32.96
  4. Washington, DC area · District of Columbia$985.79−$9.66
  5. Miami, FL · Florida$967.51−$27.94
  6. Chicago, IL · Illinois$939.64−$55.81
  7. Manhattan, NY · New York$1,003.65+$8.20

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

Every other payment area

28304 in every other Medicare payment locality
Payment localityOfficeFacility
AlaskaAlaska$1,036.60$727.48
AlabamaAlabama$786.01$532.04
ArkansasArkansas$775.26$525.93
ArizonaArizona$848.72$567.47
Bakersfield, CACalifornia$908.12$590.00
Chico, CACalifornia$903.95$585.83
El Centro, CACalifornia$904.19$586.07
Fresno, CACalifornia$903.95$585.83

28304 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.

$775.26

$1,036.60

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

View every state and territory as a table
28304 office rate range by state
State / territoryOffice rate rangeLocalities
AK$1,036.601
AL$786.011
AR$775.261
AZ$848.721
CA$903.95–$1,111.2129
CO$897.831
CT$927.921
DC$985.791
DE$862.171
FL$873.56–$967.513
GA$825.32–$890.752
GU$922.021
HI$922.021
IA$798.441
ID$804.731
IL$854.26–$939.644
IN$808.981
KS$797.971
KY$810.261
LA$810.29–$847.912
MA$894.15–$979.202
MD$877.03–$985.793
ME$811.99–$849.122
MI$833.10–$887.132
MN$852.421
MO$799.19–$847.063
MS$787.211
MT$871.671
NC$819.541
ND$842.801
NE$801.641
NH$886.851
NJ$936.28–$977.052
NM$838.681
NV$864.141
NY$831.44–$1,030.825
OH$827.201
OK$805.601
OR$855.21–$921.542
PA$826.71–$907.872
PR$876.721
RI$889.371
SC$825.181
SD$839.381
TN$802.161
TX$821.80–$896.798
UT$835.791
VA$848.64–$985.792
VI$876.721
VT$842.511
WA$891.48–$995.452
WI$816.321
WV$825.091
WY$859.081

See 28304 in every payment locality

How the 28304 rate is calculated

Each of 28304’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 · 28304

RVUs × geographic indexes × conversion factor

Office or facility?

Work9.17

9.17 RVUs× 1.000 GPCI

Practice expense15.47

15.47 RVUs× 1.000 GPCI

Malpractice1.46

1.46 RVUs× 1.000 GPCI

Adjusted RVUs

26.1000

Conversion factor

$33.4009

Medicare rate

$871.76

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

The exact King County, WA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,181

Code
28304
Physician work
9.17
Practice expense
15.47
Malpractice
1.46

GPCI2026.csv

108

Locality
King County, WA
Physician work
1.050
Practice expense
1.227
Malpractice
0.817
Office calculation for 28304 in King County, WA
ComponentRVULocality factorAdjusted
Physician work9.17× 1.0509.6285
Practice expense15.47× 1.22718.9817
Malpractice1.46× 0.8171.1928
Total RVUs29.8030
Conversion factor× 33.4009

Office rate, King County, WA$995.45

Office: (9.17 × 1.05 + 15.47 × 1.227 + 1.46 × 0.817) × $33.4009 = $995.45

Facility: (9.17 × 1.05 + 6.78 × 1.227 + 1.46 × 0.817) × $33.4009 = $639.31

Open 28304 in the RVU calculator

Payment rules and modifiers for 28304

28304 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 28304

Midfoot osteotomy, without bone graft

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 · 28304

Midfoot osteotomy, without bone graft

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

28304 without 50 · national office

$871.76

Midfoot osteotomy, without bone graft

28304-50 · Bilateral: 150%

$1,307.64

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 28304

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

Codes related to 28304
CodeHow it relatesOffice range, King County, WA
Same family
28305Midfoot osteotomy, with autograftMidfoot tarsal osteotomy with autograft.No office rate
Used instead
28300Heel osteotomy, calcaneus realignmentOsteotomy is performed on the calcaneus rather than a midfoot tarsal bone.No office rate
28302Ankle osteotomy, ankle bone alignmentOsteotomy is performed on the talus rather than a midfoot tarsal bone.No office rate
28306Metatarsal osteotomy, first metatarsalFor osteotomy of the first metatarsal, not a midfoot tarsal bone.$725.07
28307Metatarsal osteotomy, with autograftFor osteotomy of a metatarsal other than the first.$980.63

How 28304 has changed in King County, WA

28304 · Office / nonfacility

$995.45

Effective 2026-10-01

The base rate is $81.66 higher than on 2025-10-01, moving from $913.79 to $995.45 (8.9%).

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

    $913.79changed to$995.45

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 9.41 changed to 9.17
    • Practice expense RVU 14.16 changed to 15.47
    • Malpractice RVU 1.36 changed to 1.46
    • Work GPCI 1.043 changed to 1.050
    • Practice expense GPCI 1.220 changed to 1.227
    • Malpractice GPCI 0.853 changed to 0.817

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $939.31changed to$913.79

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 14.12 changed to 14.16
    • Malpractice RVU 1.38 changed to 1.36

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $923.98changed to$939.31

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $942.72changed to$923.98

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 14.05 changed to 14.12
    • Malpractice RVU 1.33 changed to 1.38
    • Work GPCI 1.039 changed to 1.043
    • Practice expense GPCI 1.207 changed to 1.220
    • Malpractice GPCI 0.815 changed to 0.853

  5. January 1, 2023

    RVU23A

    $940.80changed to$942.72

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 13.72 changed to 14.05
    • Malpractice RVU 1.36 changed to 1.33
    • Work GPCI 1.036 changed to 1.039
    • Practice expense GPCI 1.194 changed to 1.207
    • Malpractice GPCI 0.776 changed to 0.815

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $949.35changed to$940.80

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 13.79 changed to 13.72
    • Malpractice RVU 1.28 changed to 1.36

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $935.47changed to$949.35

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 12.95 changed to 13.79
    • Malpractice RVU 1.25 changed to 1.28
    • Work GPCI 1.031 changed to 1.036
    • Practice expense GPCI 1.170 changed to 1.194
    • Malpractice GPCI 0.854 changed to 0.776

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $928.53changed to$935.47

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 13.05 changed to 12.95
    • Malpractice RVU 1.23 changed to 1.25
    • Work GPCI 1.027 changed to 1.031
    • Practice expense GPCI 1.146 changed to 1.170
    • Malpractice GPCI 0.931 changed to 0.854

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $936.77changed to$928.53

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 13.25 changed to 13.05
    • Malpractice RVU 1.26 changed to 1.23

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $925.40changed to$936.77

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 13.24 changed to 13.25
    • Malpractice RVU 1.25 changed to 1.26
    • Work GPCI 1.026 changed to 1.027
    • Practice expense GPCI 1.151 changed to 1.146
    • Malpractice GPCI 0.713 changed to 0.931

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $912.30changed to$925.40

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 13.17 changed to 13.24
    • Malpractice RVU 1.26 changed to 1.25
    • Work GPCI 1.025 changed to 1.026
    • Practice expense GPCI 1.155 changed to 1.151
    • Malpractice GPCI 0.495 changed to 0.713

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $919.63changed to$912.30

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 13.25 changed to 13.17
    • Malpractice RVU 1.30 changed to 1.26

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $915.05changed to$919.63

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $897.30changed to$915.05

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 12.70 changed to 13.25
    • Malpractice RVU 1.16 changed to 1.30
    • Practice expense GPCI 1.150 changed to 1.155
    • Malpractice GPCI 0.688 changed to 0.495

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $907.01changed to$897.30

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 13.94 changed to 12.70
    • Malpractice RVU 1.21 changed to 1.16
    • Practice expense GPCI 1.144 changed to 1.150
    • Malpractice GPCI 0.881 changed to 0.688

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $907.01

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$995.45$639.31RVU26D
2026-07-01$995.45$639.31RVU26C
2026-04-01$995.45$639.31RVU26B
2026-01-01$995.45$639.31RVU26A
2025-10-01$913.79$670.70RVU25D
2025-07-01$913.79$670.70RVU25C
2025-04-01$913.79$670.70RVU25B
2025-01-01$913.79$670.70RVU25A
2024-10-01$939.31$682.25RVU24D
2024-07-01$939.31$682.25RVU24C
2024-04-01$939.31$682.25RVU24B
2024-03-09$939.31$682.25RVU24AR
2024-01-01$923.98$671.11RVU24A
2023-10-01$942.72$680.95RVU23D
2023-07-01$942.72$680.95RVU23C
2023-04-01$942.72$680.95RVU23B
2023-01-01$942.72$680.95RVU23A
2022-10-01$940.80$675.11RVU22D
2022-07-01$940.80$675.11RVU22C
2022-04-01$940.80$675.11RVU22B
2022-01-01$940.80$675.11RVU22A
2021-10-01$949.35$671.46RVU21D
2021-07-01$949.35$671.46RVU21C
2021-04-01$949.35$671.46RVU21B
2021-01-01$949.35$671.46RVU21A
2020-10-01$935.47$673.25RVU20D
2020-07-01$935.47$673.25RVU20C
2020-04-01$935.47$673.25RVU20B
2020-01-01$935.47$673.25RVU20A
2019-10-01$928.53$667.92RVU19D
2019-07-01$928.53$667.92RVU19C
2019-04-01$928.53$667.92RVU19B
2019-01-01$928.53$667.92RVU19A
2018-10-01$936.77$671.50RVU18D
2018-07-01$936.77$671.50RVU18C
2018-04-01$936.77$671.50RVU18B
2018-01-01$936.77$671.50RVU18AR1
2017-10-01$925.40$661.02RVU17D
2017-07-01$925.40$661.02RVU17C
2017-04-01$925.40$661.02RVU17B
2017-01-01$925.40$661.02RVU17A
2016-10-01$912.30$648.47RVU16D
2016-07-01$912.30$648.47RVU16C
2016-04-01$912.30$648.47RVU16B
2016-01-01$912.30$648.47RVU16A
2015-10-01$919.63$653.18RVU15D
2015-07-01$919.63$653.18RVU15C
2015-04-01$915.05$649.93RVU15B
2015-01-01$915.05$649.93RVU15A
2014-10-01$897.30$643.94RVU14D
2014-07-01$897.30$643.94RVU14C
2014-04-01$897.30$643.94RVU14B
2014-01-01$897.30$643.94RVU14A
2013-10-01$907.01$640.39RVU13D
2013-07-01$907.01$640.39RVU13C
2013-04-01$907.01$640.39RVU13B
2013-01-01$907.01$640.39RVU13AR

Price 28304 for an earlier date of service

Where the King County, WA rate applies

King County, WA is a Medicare payment area, not a city. Our Census mapping connects it to 63 cities and communities in Washington. Some span more than one payment area; confirm with the service ZIP.

  • Seattle
  • Algona
  • Ames Lake
  • 28304 in Auburn · multiple payment areas
  • Baring
  • Beaux Arts Village
  • Bellevue
  • Black Diamond

Browse all communities in Washington

28304 billing questions

How does 28304 differ from 28305?

Both describe osteotomy of a midfoot tarsal bone other than the calcaneus or talus. Use 28305 when the tarsal osteotomy includes autograft; 28304 is the option without that graft service.

Which bone determines whether this code applies?

The osteotomy must involve a midfoot tarsal bone, such as a cuneiform, navicular, or cuboid. A calcaneal, talar, or metatarsal osteotomy belongs to a different code.

What should the operative report document?

Document the specific bone and side, the deformity or alignment problem, the osteotomy and correction performed, and whether autograft was used.

How is a bilateral procedure handled?

A bilateral procedure reported with modifier 50 is paid at 150%.

What postoperative care is included in the global period?

The 90-day global period 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-surgeons are paid only with supporting documentation; team surgery is not permitted.

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 28304PPRRVU2026_Oct_nonQPP.csv, line 3,181 (RVU26D)
Geographic factors for King County, WAGPCI2026.csv, line 108 (RVU26D)

Open CMS sourceHow we calculate rates

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