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CPT code 28306: Metatarsal osteotomy, first metatarsal2026 Medicare rate & RVUs in King County, WA

Reports a first metatarsal bone cut used to correct its alignment or length when the work is not included in a broader procedure.

CMS RVU26DEffective Oct 1, 2026One payment locality1.5K Medicare services in 2024

In King County, WA, Medicare pays $725.07 for 28306 in the office and $427.54 when it’s performed in a hospital or facility.

$725.07Office (non-facility)
$427.54Hospital or facility
+15.4%vs the national office rate ($628.27)

Check a contract rate as a % of Medicare · 28306 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 28306 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in King County, WA
  2. What 28306 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 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.

How King County, WA compares for 28306

Across 109 of 109 payment localities, the office rate for 28306 runs from $557.81 in Arkansas to $816.28 in San Benito County, CA. King County, WA pays $725.07. The RVUs are the same everywhere; the geographic indexes change the dollars.

28306 in King County, WA vs other payment areas
  1. King County, WA · this page$725.07
  2. Rest of Washington · Washington$645.76−$79.31
  3. Los Angeles, CA · California$701.28−$23.79
  4. Washington, DC area · District of Columbia$714.09−$10.98
  5. Miami, FL · Florida$686.77−$38.30
  6. Chicago, IL · Illinois$667.13−$57.94
  7. Manhattan, NY · New York$722.51−$2.56

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

Every other payment area

28306 in every other Medicare payment locality
Payment localityOfficeFacility
AlaskaAlaska$740.03$481.78
AlabamaAlabama$565.70$353.52
ArkansasArkansas$557.81$349.51
ArizonaArizona$611.76$376.78
Bakersfield, CACalifornia$660.20$394.43
Chico, CACalifornia$657.81$392.04
El Centro, CACalifornia$657.95$392.18
Fresno, CACalifornia$657.81$392.04

28306 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.

$557.81

$740.03

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

View every state and territory as a table
28306 office rate range by state
State / territoryOffice rate rangeLocalities
AK$740.031
AL$565.701
AR$557.811
AZ$611.761
CA$657.81–$816.2829
CO$650.571
CT$669.151
DC$714.091
DE$621.621
FL$624.21–$686.773
GA$589.74–$640.852
GU$672.291
HI$672.291
IA$577.291
ID$581.401
IL$608.41–$667.134
IN$584.591
KS$575.761
KY$580.931
LA$580.49–$608.072
MA$647.33–$711.932
MD$632.84–$714.093
ME$585.48–$614.522
MI$596.53–$632.872
MN$620.751
MO$571.60–$608.863
MS$564.761
MT$628.221
NC$591.221
ND$612.001
NE$580.011
NH$641.471
NJ$676.05–$707.322
NM$600.121
NV$624.101
NY$599.86–$740.895
OH$593.211
OK$578.781
OR$618.51–$669.392
PA$593.51–$653.702
PR$632.321
RI$642.411
SC$593.351
SD$610.081
TN$578.691
TX$589.83–$649.068
UT$601.151
VA$613.33–$714.092
VI$632.321
VT$610.691
WA$645.76–$725.072
WI$592.291
WV$586.961
WY$621.151

See 28306 in every payment locality

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

Office or facility?

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.

The exact King County, WA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,183

Code
28306
Physician work
5.85
Practice expense
12.14
Malpractice
0.82

GPCI2026.csv

108

Locality
King County, WA
Physician work
1.050
Practice expense
1.227
Malpractice
0.817
Office calculation for 28306 in King County, WA
ComponentRVULocality factorAdjusted
Physician work5.85× 1.0506.1425
Practice expense12.14× 1.22714.8958
Malpractice0.82× 0.8170.6699
Total RVUs21.7082
Conversion factor× 33.4009

Office rate, King County, WA$725.07

Office: (5.85 × 1.05 + 12.14 × 1.227 + 0.82 × 0.817) × $33.4009 = $725.07

Facility: (5.85 × 1.05 + 4.88 × 1.227 + 0.82 × 0.817) × $33.4009 = $427.54

Open 28306 in the RVU calculator

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

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 · 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.

  • 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

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).

When to use modifier 50

Codes related to 28306

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

Codes related to 28306
CodeHow it relatesOffice range, King County, WA
Same family
28307Metatarsal osteotomy, with autograftFirst metatarsal osteotomy with autograft.$980.63
28308Metatarsal osteotomy, other than first metatarsalOsteotomy of a metatarsal other than the first.$677.55
28309Metatarsal osteotomy, multiple metatarsalsMultiple-metatarsal osteotomy with autograft.No office rate

How 28306 has changed in King County, WA

28306 · Office / nonfacility

$725.07

Effective 2026-10-01

The base rate is $50.30 higher than on 2025-10-01, moving from $674.77 to $725.07 (7.5%).

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

    $674.77changed to$725.07

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 6.00 changed to 5.85
    • Practice expense RVU 11.41 changed to 12.14
    • Malpractice RVU 0.80 changed to 0.82
    • 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

    $700.37changed to$674.77

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 11.55 changed to 11.41
    • Malpractice RVU 0.81 changed to 0.80

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $688.94changed to$700.37

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $697.44changed to$688.94

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 11.36 changed to 11.55
    • Malpractice RVU 0.78 changed to 0.81
    • 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

    $696.36changed to$697.44

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 11.14 changed to 11.36
    • 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

    $703.13changed to$696.36

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 11.19 changed to 11.14
    • Malpractice RVU 0.74 changed to 0.78

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $699.75changed to$703.13

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 10.73 changed to 11.19
    • Malpractice RVU 0.76 changed to 0.74
    • 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

    $698.73changed to$699.75

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 10.94 changed to 10.73
    • Malpractice RVU 0.74 changed to 0.76
    • 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

    $702.84changed to$698.73

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 11.05 changed to 10.94
    • Malpractice RVU 0.75 changed to 0.74

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $694.92changed to$702.84

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 11.01 changed to 11.05
    • 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

    $687.32changed to$694.92

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 10.97 changed to 11.01
    • Malpractice RVU 0.76 changed to 0.75
    • 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

    $690.15changed to$687.32

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.78 changed to 0.76

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $686.72changed to$690.15

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $686.35changed to$686.72

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 10.84 changed to 10.97
    • Malpractice RVU 0.79 changed to 0.78
    • 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

    $700.80changed to$686.35

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 11.99 changed to 10.84
    • Malpractice RVU 0.83 changed to 0.79
    • 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: $700.80

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$725.07$427.54RVU26D
2026-07-01$725.07$427.54RVU26C
2026-04-01$725.07$427.54RVU26B
2026-01-01$725.07$427.54RVU26A
2025-10-01$674.77$446.67RVU25D
2025-07-01$674.77$446.67RVU25C
2025-04-01$674.77$446.67RVU25B
2025-01-01$674.77$446.67RVU25A
2024-10-01$700.37$456.70RVU24D
2024-07-01$700.37$456.70RVU24C
2024-04-01$700.37$456.70RVU24B
2024-03-09$700.37$456.70RVU24AR
2024-01-01$688.94$449.25RVU24A
2023-10-01$697.44$451.21RVU23D
2023-07-01$697.44$451.21RVU23C
2023-04-01$697.44$451.21RVU23B
2023-01-01$697.44$451.21RVU23A
2022-10-01$696.36$446.79RVU22D
2022-07-01$696.36$446.79RVU22C
2022-04-01$696.36$446.79RVU22B
2022-01-01$696.36$446.79RVU22A
2021-10-01$703.13$443.16RVU21D
2021-07-01$703.13$443.16RVU21C
2021-04-01$703.13$443.16RVU21B
2021-01-01$703.13$443.16RVU21A
2020-10-01$699.75$448.93RVU20D
2020-07-01$699.75$448.93RVU20C
2020-04-01$699.75$448.93RVU20B
2020-01-01$699.75$448.93RVU20A
2019-10-01$698.73$448.04RVU19D
2019-07-01$698.73$448.04RVU19C
2019-04-01$698.73$448.04RVU19B
2019-01-01$698.73$448.04RVU19A
2018-10-01$702.84$449.12RVU18D
2018-07-01$702.84$449.12RVU18C
2018-04-01$702.84$449.12RVU18B
2018-01-01$702.84$449.12RVU18AR1
2017-10-01$694.92$441.70RVU17D
2017-07-01$694.92$441.70RVU17C
2017-04-01$694.92$441.70RVU17B
2017-01-01$694.92$441.70RVU17A
2016-10-01$687.32$435.06RVU16D
2016-07-01$687.32$435.06RVU16C
2016-04-01$687.32$435.06RVU16B
2016-01-01$687.32$435.06RVU16A
2015-10-01$690.15$436.16RVU15D
2015-07-01$690.15$436.16RVU15C
2015-04-01$686.72$433.99RVU15B
2015-01-01$686.72$433.99RVU15A
2014-10-01$686.35$438.76RVU14D
2014-07-01$686.35$438.76RVU14C
2014-04-01$686.35$438.76RVU14B
2014-01-01$686.35$438.76RVU14A
2013-10-01$700.80$439.63RVU13D
2013-07-01$700.80$439.63RVU13C
2013-04-01$700.80$439.63RVU13B
2013-01-01$700.80$439.63RVU13AR

Price 28306 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
  • 28306 in Auburn · multiple payment areas
  • Baring
  • Beaux Arts Village
  • Bellevue
  • Black Diamond

Browse all communities in Washington

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
RVUs for 28306PPRRVU2026_Oct_nonQPP.csv, line 3,183 (RVU26D)
Geographic factors for King County, WAGPCI2026.csv, line 108 (RVU26D)

Open CMS sourceHow we calculate rates

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