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CPT code 28310: Toe osteotomy, first toe, proximal phalanx2026 Medicare rate & RVUs in Iowa

A foot surgeon reshapes the proximal phalanx of the great toe to correct angular or rotational deformity, including an Akin-type correction.

CMS RVU26DEffective Oct 1, 2026One payment locality1.9K Medicare services in 2024

In Iowa, Medicare pays $520.93 for 28310 in the office and $323.81 when it’s performed in a hospital or facility.

$520.93Office (non-facility)
$323.81Hospital or facility
−7.8%vs the national office rate ($565.14)

Check a contract rate as a % of Medicare · 28310 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 28310 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Iowa
  2. What 28310 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 28310 covers

This procedure uses a bone cut in the proximal phalanx of the great toe to change its alignment or length. Foot and ankle orthopedic surgeons and podiatrists may perform it for a phalangeal deformity, such as hallux valgus interphalangeus, or as an Akin-type correction during hallux valgus surgery. It is performed in an operating room or, in selected cases, an office-based procedure setting. It addresses the toe bone, not the first metatarsal.

Report the code when the operative work is an osteotomy of the great toe’s proximal phalanx. The operative report should identify the bone, the deformity and the correction performed, and clarify whether the osteotomy is part of a broader hallux valgus procedure. 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 one 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 is restricted; co-surgeons require 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 Iowa compares for 28310

Across 109 of 109 payment localities, the office rate for 28310 runs from $503.33 in Arkansas to $734.45 in San Benito County, CA. Iowa pays $520.93. The RVUs are the same everywhere; the geographic indexes change the dollars.

28310 in Iowa vs other payment areas
  1. Iowa · this page$520.93
  2. Los Angeles, CA · California$631.20+$110.27
  3. Washington, DC area · District of Columbia$641.79+$120.86
  4. Miami, FL · Florida$614.18+$93.25
  5. Chicago, IL · Illinois$597.20+$76.27
  6. Manhattan, NY · New York$648.41+$127.48
  7. Alaska · Alaska$669.27+$148.34

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

Every other payment area

28310 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$510.26$321.75
ArkansasArkansas$503.33$318.27
ArizonaArizona$550.72$341.96
Bakersfield, CACalifornia$594.53$358.42
Chico, CACalifornia$592.54$356.42
El Centro, CACalifornia$592.65$356.53
Fresno, CACalifornia$592.54$356.42
Hanford, CACalifornia$592.54$356.42

28310 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.

$503.33

$669.27

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

View every state and territory as a table
28310 office rate range by state
State / territoryOffice rate rangeLocalities
AK$669.271
AL$510.261
AR$503.331
AZ$550.721
CA$592.54–$734.4529
CO$585.551
CT$601.301
DC$641.791
DE$559.451
FL$560.50–$614.183
GA$530.41–$575.972
GU$605.231
HI$605.231
IA$520.931
ID$524.441
IL$546.30–$597.204
IN$527.261
KS$519.351
KY$523.131
LA$522.64–$546.862
MA$582.66–$640.232
MD$569.46–$641.793
ME$527.77–$553.632
MI$536.59–$567.852
MN$559.871
MO$514.69–$547.843
MS$509.071
MT$565.101
NC$532.851
ND$551.851
NE$523.401
NH$577.161
NJ$607.82–$635.912
NM$539.651
NV$561.771
NY$540.43–$664.235
OH$533.881
OK$521.481
OR$557.05–$602.432
PA$534.28–$587.542
PR$568.781
RI$578.101
SC$534.321
SD$550.281
TN$521.891
TX$531.03–$583.928
UT$541.181
VA$552.42–$641.792
VI$568.781
VT$550.471
WA$581.31–$652.152
WI$534.481
WV$527.451
WY$559.321

See 28310 in every payment locality

How the 28310 rate is calculated

Each of 28310’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 · 28310

RVUs × geographic indexes × conversion factor

Office or facility?

Work5.43

5.43 RVUs× 1.000 GPCI

Practice expense10.82

10.82 RVUs× 1.000 GPCI

Malpractice0.67

0.67 RVUs× 1.000 GPCI

Adjusted RVUs

16.9200

Conversion factor

$33.4009

Medicare rate

$565.14

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

The exact Iowa inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,187

Code
28310
Physician work
5.43
Practice expense
10.82
Malpractice
0.67

GPCI2026.csv

53

Locality
Iowa
Physician work
1.000
Practice expense
0.915
Malpractice
0.397
Office calculation for 28310 in Iowa
ComponentRVULocality factorAdjusted
Physician work5.43× 1.0005.4300
Practice expense10.82× 0.9159.9003
Malpractice0.67× 0.3970.2660
Total RVUs15.5963
Conversion factor× 33.4009

Office rate, Iowa$520.93

Office: (5.43 × 1 + 10.82 × 0.915 + 0.67 × 0.397) × $33.4009 = $520.93

Facility: (5.43 × 1 + 4.37 × 0.915 + 0.67 × 0.397) × $33.4009 = $323.81

Open 28310 in the RVU calculator

Payment rules and modifiers for 28310

28310 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 28310

Toe osteotomy, first toe, proximal phalanx

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)1Not paid (statutory restriction).
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 · 28310

Toe osteotomy, first toe, proximal phalanx

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

28310 without 50 · national office

$565.14

Toe osteotomy, first toe, proximal phalanx

28310-50 · Bilateral: 150%

$847.71

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 28310

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

Codes related to 28310
CodeHow it relatesOffice range, Iowa
Same family
28312Toe osteotomy, lesser toeOsteotomy for phalanges of toes other than the great toe.$545.74
Used instead
28298Bunion correction, proximal phalanx osteotomyHallux valgus correction that includes a proximal phalanx osteotomy.$791.61
28306Metatarsal osteotomy, first metatarsalOsteotomy targets the first metatarsal rather than the great-toe phalanx.$577.29

How 28310 has changed in Iowa

28310 · Office / nonfacility

$520.93

Effective 2026-10-01

The base rate is $27.41 higher than on 2025-10-01, moving from $493.52 to $520.93 (5.6%).

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

    $493.52changed to$520.93

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 5.57 changed to 5.43
    • Practice expense RVU 10.29 changed to 10.82
    • Malpractice RVU 0.64 changed to 0.67
    • Practice expense GPCI 0.913 changed to 0.915
    • Malpractice GPCI 0.457 changed to 0.397

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $505.90changed to$493.52

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 10.23 changed to 10.29
    • Malpractice RVU 0.63 changed to 0.64

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $497.64changed to$505.90

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $506.09changed to$497.64

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 10.00 changed to 10.23
    • Malpractice RVU 0.60 changed to 0.63
    • Practice expense GPCI 0.910 changed to 0.913
    • Malpractice GPCI 0.441 changed to 0.457

  5. January 1, 2023

    RVU23A

    $513.24changed to$506.09

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 9.92 changed to 10.00
    • Malpractice RVU 0.62 changed to 0.60
    • Practice expense GPCI 0.907 changed to 0.910
    • Malpractice GPCI 0.425 changed to 0.441

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $522.88changed to$513.24

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 10.09 changed to 9.92

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $525.12changed to$522.88

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 9.63 changed to 10.09
    • Malpractice RVU 0.58 changed to 0.62
    • Malpractice GPCI 0.424 changed to 0.425

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $523.92changed to$525.12

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 9.64 changed to 9.63
    • Malpractice RVU 0.53 changed to 0.58
    • Malpractice GPCI 0.423 changed to 0.424

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $525.79changed to$523.92

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 9.71 changed to 9.64
    • Malpractice RVU 0.54 changed to 0.53

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $523.59changed to$525.79

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 9.72 changed to 9.71
    • Malpractice RVU 0.55 changed to 0.54
    • Practice expense GPCI 0.902 changed to 0.907
    • Malpractice GPCI 0.458 changed to 0.423

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $520.00changed to$523.59

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 9.69 changed to 9.72
    • Practice expense GPCI 0.896 changed to 0.902
    • Malpractice GPCI 0.493 changed to 0.458

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $522.70changed to$520.00

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 9.71 changed to 9.69
    • Malpractice RVU 0.56 changed to 0.55

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $520.10changed to$522.70

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $509.71changed to$520.10

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 9.43 changed to 9.71
    • Malpractice RVU 0.52 changed to 0.56
    • Practice expense GPCI 0.892 changed to 0.896
    • Malpractice GPCI 0.475 changed to 0.493

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $512.95changed to$509.71

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 10.44 changed to 9.43
    • Malpractice RVU 0.54 changed to 0.52
    • Practice expense GPCI 0.887 changed to 0.892
    • Malpractice GPCI 0.456 changed to 0.475

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $512.95

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$520.93$323.81RVU26D
2026-07-01$520.93$323.81RVU26C
2026-04-01$520.93$323.81RVU26B
2026-01-01$520.93$323.81RVU26A
2025-10-01$493.52$337.29RVU25D
2025-07-01$493.52$337.29RVU25C
2025-04-01$493.52$337.29RVU25B
2025-01-01$493.52$337.29RVU25A
2024-10-01$505.90$341.79RVU24D
2024-07-01$505.90$341.79RVU24C
2024-04-01$505.90$341.79RVU24B
2024-03-09$505.90$341.79RVU24AR
2024-01-01$497.64$336.21RVU24A
2023-10-01$506.09$339.88RVU23D
2023-07-01$506.09$339.88RVU23C
2023-04-01$506.09$339.88RVU23B
2023-01-01$506.09$339.88RVU23A
2022-10-01$513.24$341.24RVU22D
2022-07-01$513.24$341.24RVU22C
2022-04-01$513.24$341.24RVU22B
2022-01-01$513.24$341.24RVU22A
2021-10-01$522.88$341.85RVU21D
2021-07-01$522.88$341.85RVU21C
2021-04-01$522.88$341.85RVU21B
2021-01-01$522.88$341.85RVU21A
2020-10-01$525.12$347.37RVU20D
2020-07-01$525.12$347.37RVU20C
2020-04-01$525.12$347.37RVU20B
2020-01-01$525.12$347.37RVU20A
2019-10-01$523.92$345.45RVU19D
2019-07-01$523.92$345.45RVU19C
2019-04-01$523.92$345.45RVU19B
2019-01-01$523.92$345.45RVU19A
2018-10-01$525.79$345.22RVU18D
2018-07-01$525.79$345.22RVU18C
2018-04-01$525.79$345.22RVU18B
2018-01-01$525.79$345.22RVU18AR1
2017-10-01$523.59$345.22RVU17D
2017-07-01$523.59$345.22RVU17C
2017-04-01$523.59$345.22RVU17B
2017-01-01$523.59$345.22RVU17A
2016-10-01$520.00$343.56RVU16D
2016-07-01$520.00$343.56RVU16C
2016-04-01$520.00$343.56RVU16B
2016-01-01$520.00$343.56RVU16A
2015-10-01$522.70$344.65RVU15D
2015-07-01$522.70$344.65RVU15C
2015-04-01$520.10$342.94RVU15B
2015-01-01$520.10$342.94RVU15A
2014-10-01$509.71$339.07RVU14D
2014-07-01$509.71$339.07RVU14C
2014-04-01$509.71$339.07RVU14B
2014-01-01$509.71$339.07RVU14A
2013-10-01$512.95$332.78RVU13D
2013-07-01$512.95$332.78RVU13C
2013-04-01$512.95$332.78RVU13B
2013-01-01$512.95$332.78RVU13AR

Price 28310 for an earlier date of service

Where the Iowa rate applies

Iowa is a Medicare payment area, not a city. Our Census mapping connects it to 1026 cities and communities in Iowa. Some span more than one payment area; confirm with the service ZIP.

  • Ackley
  • Ackworth
  • Adair
  • Adel
  • Afton
  • Agency
  • Ainsworth
  • Akron

Browse all communities in Iowa

28310 billing questions

How is this different from 28312?

This code is for an osteotomy of the proximal phalanx of the great toe. Code 28312 covers phalanges of other toes.

When should 28298 be considered instead?

Code 28298 represents hallux valgus correction that includes a proximal phalanx osteotomy. Use it when the documented work is that combined correction, rather than reporting the same osteotomy separately as 28310.

Can this be reported with a first metatarsal osteotomy?

The procedures address different bones: 28310 treats the great toe’s proximal phalanx, while codes such as 28306 treat a metatarsal. The operative report should support each distinct procedure reported.

What documentation supports reporting this code?

Document the great-toe proximal phalanx, the deformity being corrected, and the osteotomy and resulting change in alignment or length. Clarify whether the work is included in a broader hallux valgus correction.

How is bilateral surgery paid?

CMS lists this as a bilateral procedure: when both sides are performed and reported with modifier 50, payment is at 150%.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment is restricted for this code. 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 28310PPRRVU2026_Oct_nonQPP.csv, line 3,187 (RVU26D)
Geographic factors for IowaGPCI2026.csv, line 53 (RVU26D)

Open CMS sourceHow we calculate rates

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