CPT code 28306: Metatarsal osteotomy, first metatarsal2026 Medicare rate & RVUs in California
Reports a first metatarsal bone cut used to correct its alignment or length when the work is not included in a broader procedure.
Medicare pays $657.81–$816.28 for 28306 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 28306 covers
The surgeon makes a controlled cut in the first metatarsal and repositions or reshapes the bone to address a deformity or alignment problem. Orthopedic foot and ankle surgeons and podiatrists commonly perform this work in an operating room. The operative report should identify the bone treated, the deformity, the osteotomy performed, and the correction achieved.
Select this code for the first metatarsal when the documented work is not part of a more comprehensive procedure that includes the osteotomy. Use the graft-specific sibling when an autograft is used. The code has a 90-day global period, including 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 the others at 50%. Bilateral reporting with modifier 50 is 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.
Where 28306 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
$657.81 to $816.28
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $660.20 | $394.43 |
| Chico, CA | $657.81 | $392.04 |
| El Centro, CA | $657.95 | $392.18 |
| Fresno, CA | $657.81 | $392.04 |
| Hanford, CA | $657.81 | $392.04 |
| Los Angeles, CA | $701.28 | $414.42 |
| Madera, CA | $657.81 | $392.04 |
| Marin County, CA | $798.27 | $456.35 |
| Merced, CA | $657.81 | $392.04 |
| Modesto, CA | $657.81 | $392.04 |
| Napa, CA | $756.05 | $436.45 |
| Oxnard, CA | $697.22 | $410.59 |
| Redding, CA | $657.81 | $392.04 |
| Rest of California | $657.81 | $392.04 |
| Riverside, CA | $666.69 | $400.92 |
| Sacramento, CA | $688.69 | $406.67 |
| Salinas, CA | $686.09 | $405.05 |
| San Benito County, CA | $816.28 | $466.61 |
| San Diego, CA | $701.06 | $411.05 |
| San Francisco, CA | $797.33 | $455.42 |
| San Luis Obispo, CA | $675.25 | $399.05 |
| Santa Clara County, CA | $812.47 | $462.80 |
| Santa Cruz, CA | $706.85 | $412.22 |
| Santa Maria, CA | $688.34 | $405.60 |
| Santa Rosa, CA | $713.88 | $416.10 |
| Stockton, CA | $657.81 | $392.04 |
| Vallejo, CA | $754.71 | $435.11 |
| Visalia, CA | $657.81 | $392.04 |
| Yuba City, CA | $657.81 | $392.04 |
How the 28306 rate is calculated
Each of 28306’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 · 28306
RVUs × geographic indexes × conversion factor
Work5.85
5.85 RVUs× 1.000 GPCI
Practice expense12.14
12.14 RVUs× 1.000 GPCI
Malpractice0.82
0.82 RVUs× 1.000 GPCI
Adjusted RVUs
18.8100
Conversion factor
$33.4009
Medicare rate
$628.27
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 28306
28306 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28306
Metatarsal osteotomy, first metatarsal
| 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 · 28306
Metatarsal osteotomy, first metatarsal
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
28306 without 50 · national office
$628.27
Metatarsal osteotomy, first metatarsal
28306-50 · Bilateral: 150%
$942.41
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).
28306 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 28307Metatarsal osteotomyWith autograft
- Choose 28307 when autograft is part of the first metatarsal osteotomy; 28306 is the first-metatarsal osteotomy code without that graft-specific distinction.
- 28308Metatarsal osteotomyOther than first metatarsal
- 28308 applies to an osteotomy of a metatarsal other than the first. Use 28306 when the treated bone is the first metatarsal.
- 28296Bunion correctionDistal first metatarsal osteotomy
- 28296 describes a bunion correction that includes a distal metatarsal osteotomy. Do not separately report 28306 for that included osteotomy.
- 28309Metatarsal osteotomyMultiple metatarsals
- 28309 is the graft-specific code for osteotomy involving multiple metatarsals; 28306 is for the first metatarsal.
28306 billing questions
How does 28306 differ from 28307?
Both address an osteotomy of the first metatarsal. Use 28307 when the procedure includes autograft; 28306 describes the osteotomy without that graft-specific distinction.
Can 28306 be reported with a bunion correction code?
Do not separately report 28306 for an osteotomy already included in a comprehensive bunion correction procedure, such as a procedure that includes a distal metatarsal osteotomy. The operative documentation must support distinct work before separate reporting is considered.
What documentation supports 28306?
Document the first metatarsal as the treated bone, the reason for correction, the osteotomy and any repositioning performed, and the resulting alignment. Identify any autograft, which may point to the graft-specific sibling code.
How is bilateral 28306 reported?
For procedures on both first metatarsals, report bilateral surgery with modifier 50; CMS pays the bilateral procedure at 150%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. Related routine follow-up during that period is included in the surgical payment.
Can an assistant or co-surgeon be paid?
Assistant-at-surgery payment may be made. Co-surgeon payment requires 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
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