CPT code 28308: Metatarsal osteotomy, other than first metatarsal2026 Medicare rate & RVUs in Vermont

Reports an osteotomy of a lesser metatarsal to change its length or alignment, commonly for a structural forefoot problem such as metatarsalgia.

CMS RVU26DEffective Oct 1, 2026One payment locality26K Medicare services in 2024

In Vermont, Medicare pays $570.45 for 28308 in the office and $358.83 when it’s performed in a hospital or facility.

$570.45Office (non-facility)
$358.83Hospital or facility
−2.6%vs the national office rate ($585.52)

Check a contract rate as a % of Medicare · 28308 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 28308 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Vermont
  2. What 28308 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 28308 covers

A foot and ankle orthopedic surgeon or podiatric surgeon cuts a metatarsal other than the first to change its length or alignment. The procedure may address a lesser metatarsal that contributes to forefoot pain or abnormal pressure, including metatarsalgia associated with a long or malaligned bone. The bone may be repositioned and stabilized as part of the correction. These operations are commonly performed in an ambulatory surgery center or hospital outpatient department; some are done in an office-based surgical setting.

Select this code for an osteotomy of a lesser metatarsal, rather than an osteotomy of the first metatarsal or a multiple-metatarsal realignment procedure. Document the specific bone, the reason for changing its length or alignment, and the work performed; report the treated lesser metatarsal count as supported by the operative record. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team-surgery payment 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 Vermont compares for 28308

Across 109 of 109 payment localities, the office rate for 28308 runs from $520.30 in Arkansas to $764.52 in San Benito County, CA. Vermont pays $570.45. The RVUs are the same everywhere; the geographic indexes change the dollars.

28308 in Vermont vs other payment areas
  1. Vermont · this page$570.45
  2. Los Angeles, CA · California$655.55+$85.10
  3. Washington, DC area · District of Columbia$666.15+$95.70
  4. Miami, FL · Florida$636.01+$65.56
  5. Chicago, IL · Illinois$618.10+$47.65
  6. Manhattan, NY · New York$672.52+$102.07
  7. Alaska · Alaska$689.49+$119.04

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

Every other payment area

28308 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$527.60$340.56
ArkansasArkansas$520.30$336.67
ArizonaArizona$570.33$363.19
Bakersfield, CACalifornia$616.93$382.65
Chico, CACalifornia$614.92$380.63
El Centro, CACalifornia$615.03$380.74
Fresno, CACalifornia$614.92$380.63
Hanford, CACalifornia$614.92$380.63

28308 rates by state

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

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.

$520.30

$689.72

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

View every state and territory as a table
28308 office rate range by state
State / territoryOffice rate rangeLocalities
AK$689.491
AL$527.601
AR$520.301
AZ$570.331
CA$614.92–$764.5229
CO$607.291
CT$623.461
DC$666.151
DE$579.501
FL$580.03–$636.013
GA$548.36–$596.772
GU$628.621
HI$628.621
IA$539.141
ID$542.791
IL$564.86–$618.104
IN$545.781
KS$537.351
KY$540.911
LA$540.35–$565.922
MA$604.14–$664.912
MD$590.05–$666.153
ME$546.18–$573.682
MI$555.00–$587.642
MN$580.681
MO$531.87–$567.113
MS$526.151
MT$585.471
NC$551.561
ND$572.031
NE$541.791
NH$598.441
NJ$630.22–$659.812
NM$558.171
NV$582.111
NY$559.55–$689.065
OH$552.251
OK$539.321
OR$577.23–$625.232
PA$552.74–$608.872
PR$589.411
RI$599.141
SC$552.891
SD$570.441
TN$540.021
TX$549.31–$605.588
UT$560.131
VA$572.30–$666.152
VI$589.411
VT$570.451
WA$602.78–$677.552
WI$553.651
WV$544.941
WY$579.611

See 28308 in every payment locality

How the 28308 rate is calculated

Each of 28308’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 · 28308

RVUs × geographic indexes × conversion factor

Office or facility?

Work5.34

5.34 RVUs× 1.000 GPCI

Practice expense11.51

11.51 RVUs× 1.000 GPCI

Malpractice0.68

0.68 RVUs× 1.000 GPCI

Adjusted RVUs

17.5300

Conversion factor

$33.4009

Medicare rate

$585.52

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

The exact Vermont inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,185

Code
28308
Physician work
5.34
Practice expense
11.51
Malpractice
0.68

GPCI2026.csv

105

Locality
Vermont
Physician work
1.000
Practice expense
0.990
Malpractice
0.506
Office calculation for 28308 in Vermont
ComponentRVULocality factorAdjusted
Physician work5.34× 1.0005.3400
Practice expense11.51× 0.99011.3949
Malpractice0.68× 0.5060.3441
Total RVUs17.0790
Conversion factor× 33.4009

Office rate, Vermont$570.45

Office: (5.34 × 1 + 11.51 × 0.99 + 0.68 × 0.506) × $33.4009 = $570.45

Facility: (5.34 × 1 + 5.11 × 0.99 + 0.68 × 0.506) × $33.4009 = $358.83

Open 28308 in the RVU calculator

Payment rules and modifiers for 28308

28308 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 28308

Metatarsal osteotomy, other than 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 · 28308

Metatarsal osteotomy, other than 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

28308 without 50 · national office

$585.52

Metatarsal osteotomy, other than first metatarsal

28308-50 · Bilateral: 150%

$878.28

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

How 28308 has changed in Vermont

28308 · Office / nonfacility

$570.45

Effective 2026-10-01

The base rate is $29.94 higher than on 2025-10-01, moving from $540.51 to $570.45 (5.5%).

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

    $540.51changed to$570.45

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 5.48 changed to 5.34
    • Practice expense RVU 10.97 changed to 11.51
    • Malpractice RVU 0.65 changed to 0.68
    • Practice expense GPCI 0.993 changed to 0.990
    • Malpractice GPCI 0.518 changed to 0.506

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $558.89changed to$540.51

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 11.04 changed to 10.97
    • Malpractice RVU 0.67 changed to 0.65

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $549.77changed to$558.89

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $564.24changed to$549.77

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 10.85 changed to 11.04
    • Malpractice RVU 0.65 changed to 0.67
    • Practice expense GPCI 0.997 changed to 0.993
    • Malpractice GPCI 0.543 changed to 0.518
  5. January 1, 2023

    RVU23A

    $574.14changed to$564.24

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 10.73 changed to 10.85
    • Practice expense GPCI 1.001 changed to 0.997
    • Malpractice GPCI 0.569 changed to 0.543

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $583.59changed to$574.14

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 10.87 changed to 10.73
    • Malpractice RVU 0.64 changed to 0.65

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $586.58changed to$583.59

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 10.33 changed to 10.87
    • Malpractice RVU 0.62 changed to 0.64
    • Practice expense GPCI 1.008 changed to 1.001
    • Malpractice GPCI 0.582 changed to 0.569

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $589.63changed to$586.58

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 10.38 changed to 10.33
    • Malpractice RVU 0.58 changed to 0.62
    • Practice expense GPCI 1.015 changed to 1.008
    • Malpractice GPCI 0.595 changed to 0.582

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $588.25changed to$589.63

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 10.36 changed to 10.38

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $584.41changed to$588.25

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 10.33 changed to 10.36
    • Practice expense GPCI 1.010 changed to 1.015
    • Malpractice GPCI 0.639 changed to 0.595

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $579.55changed to$584.41

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 10.27 changed to 10.33
    • Practice expense GPCI 1.004 changed to 1.010
    • Malpractice GPCI 0.682 changed to 0.639

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $581.17changed to$579.55

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 10.25 changed to 10.27
    • Malpractice RVU 0.59 changed to 0.58

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $578.27changed to$581.17

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $571.33changed to$578.27

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 10.05 changed to 10.25
    • Malpractice RVU 0.58 changed to 0.59
    • Practice expense GPCI 1.006 changed to 1.004
    • Malpractice GPCI 0.618 changed to 0.682

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$571.33

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$570.45$358.83RVU26D
2026-07-01$570.45$358.83RVU26C
2026-04-01$570.45$358.83RVU26B
2026-01-01$570.45$358.83RVU26A
2025-10-01$540.51$372.52RVU25D
2025-07-01$540.51$372.52RVU25C
2025-04-01$540.51$372.52RVU25B
2025-01-01$540.51$372.52RVU25A
2024-10-01$558.89$380.07RVU24D
2024-07-01$558.89$380.07RVU24C
2024-04-01$558.89$380.07RVU24B
2024-03-09$558.89$380.07RVU24AR
2024-01-01$549.77$373.86RVU24A
2023-10-01$564.24$380.44RVU23D
2023-07-01$564.24$380.44RVU23C
2023-04-01$564.24$380.44RVU23B
2023-01-01$564.24$380.44RVU23A
2022-10-01$574.14$382.92RVU22D
2022-07-01$574.14$382.92RVU22C
2022-04-01$574.14$382.92RVU22B
2022-01-01$574.14$382.92RVU22A
2021-10-01$583.59$382.05RVU21D
2021-07-01$583.59$382.05RVU21C
2021-04-01$583.59$382.05RVU21B
2021-01-01$583.59$382.05RVU21A
2020-10-01$586.58$387.96RVU20D
2020-07-01$586.58$387.96RVU20C
2020-04-01$586.58$387.96RVU20B
2020-01-01$586.58$387.96RVU20A
2019-10-01$589.63$387.71RVU19D
2019-07-01$589.63$387.71RVU19C
2019-04-01$589.63$387.71RVU19B
2019-01-01$589.63$387.71RVU19A
2018-10-01$588.25$385.82RVU18D
2018-07-01$588.25$385.82RVU18C
2018-04-01$588.25$385.82RVU18B
2018-01-01$588.25$385.82RVU18AR1
2017-10-01$584.41$384.32RVU17D
2017-07-01$584.41$384.32RVU17C
2017-04-01$584.41$384.32RVU17B
2017-01-01$584.41$384.32RVU17A
2016-10-01$579.55$382.56RVU16D
2016-07-01$579.55$382.56RVU16C
2016-04-01$579.55$382.56RVU16B
2016-01-01$579.55$382.56RVU16A
2015-10-01$581.17$382.74RVU15D
2015-07-01$581.17$382.74RVU15C
2015-04-01$578.27$380.84RVU15B
2015-01-01$578.27$380.84RVU15A
2014-10-01$571.33$378.17RVU14D
2014-07-01$571.33$378.17RVU14C
2014-04-01$571.33$378.17RVU14B
2014-01-01$571.33$378.17RVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 28308 for an earlier date of service

Where the Vermont rate applies

Vermont is a Medicare payment area, not a city. Our Census mapping connects it to 180 cities and communities in Vermont. Some span more than one payment area; confirm with the service ZIP.

  • Albany
  • Alburgh
  • Algiers
  • Arlington
  • Ascutney
  • Bakersfield
  • Barnet
  • Barre

Browse all communities in Vermont

28308 billing questions

How does this differ from 28306?

28306 is for an osteotomy of the first metatarsal. Use 28308 when the osteotomy is on a metatarsal other than the first.

When would 28309 be considered instead?

28309 describes multiple metatarsal osteotomies with realignment. Use 28308 for an individual lesser-metatarsal osteotomy when the operative work does not meet that multiple-osteotomy description.

What should the operative report document?

Document which lesser metatarsal was treated, the structural problem prompting the procedure, and the osteotomy and resulting change in length or alignment. The record should support the number of metatarsals reported.

Are related postoperative visits separately included?

The 90-day global period includes related postoperative care, as well as the day-before preoperative visit. Services unrelated to the surgery are not described by that global-care rule.

How is bilateral surgery reported?

For a bilateral procedure, modifier 50 is paid at 150%. The operative documentation should support treatment on both sides.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team-surgery payment 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 28308PPRRVU2026_Oct_nonQPP.csv, line 3,185 (RVU26D)
Geographic factors for VermontGPCI2026.csv, line 105 (RVU26D)

Open CMS sourceHow we calculate rates

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