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CPT code 28312: Toe osteotomy, lesser toe2026 Medicare rate & RVUs in North Carolina

Reports surgical reshaping of a lesser toe’s proximal phalanx to correct shortening, angular alignment, or rotation when an osseous correction is performed.

CMS RVU26DEffective Oct 1, 2026One payment locality2K Medicare services in 2024

In North Carolina, Medicare pays $559.11 for 28312 in the office and $326.63 when it’s performed in a hospital or facility.

$559.11Office (non-facility)
$326.63Hospital or facility
−6.2%vs the national office rate ($595.87)

Check a contract rate as a % of Medicare · 28312 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 28312 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Carolina
  2. What 28312 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 28312 covers

This procedure reshapes the proximal phalanx of a toe other than the great toe to correct a bony alignment problem, such as angular or rotational deformity. An orthopedic foot and ankle surgeon or podiatric surgeon typically performs it in an operating room, often as part of forefoot reconstruction. The operative report should identify the treated lesser toe, the phalanx addressed, the deformity, and the osteotomy and correction performed.

Report this code for the proximal-phalanx osteotomy, not merely because a toe deformity was treated. The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days. When multiple procedures are performed in the same session, Medicare pays the highest-valued procedure in full and reduces the others to 50%. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery; 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 North Carolina compares for 28312

Across 109 of 109 payment localities, the office rate for 28312 runs from $525.10 in Arkansas to $786.78 in San Benito County, CA. North Carolina pays $559.11. The RVUs are the same everywhere; the geographic indexes change the dollars.

28312 in North Carolina vs other payment areas
  1. North Carolina · this page$559.11
  2. Los Angeles, CA · California$670.76+$111.65
  3. Washington, DC area · District of Columbia$681.45+$122.34
  4. Miami, FL · Florida$649.83+$90.72
  5. Chicago, IL · Illinois$630.18+$71.07
  6. Manhattan, NY · New York$687.64+$128.53
  7. Alaska · Alaska$688.64+$129.53

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

Every other payment area

28312 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$533.04$315.01
ArkansasArkansas$525.10$311.07
ArizonaArizona$579.41$337.97
Bakersfield, CACalifornia$629.61$356.52
Chico, CACalifornia$627.55$354.46
El Centro, CACalifornia$627.67$354.58
Fresno, CACalifornia$627.55$354.46
Hanford, CACalifornia$627.55$354.46

28312 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.

$525.10

$707.17

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

View every state and territory as a table
28312 office rate range by state
State / territoryOffice rate rangeLocalities
AK$688.641
AL$533.041
AR$525.101
AZ$579.411
CA$627.55–$786.7829
CO$619.261
CT$636.251
DC$681.451
DE$589.181
FL$589.52–$649.833
GA$555.22–$607.872
GU$643.181
HI$643.181
IA$545.741
ID$549.661
IL$572.94–$630.184
IN$552.911
KS$543.701
KY$547.301
LA$546.66–$574.412
MA$615.65–$680.812
MD$600.46–$681.453
ME$553.25–$583.232
MI$562.51–$597.702
MN$591.101
MO$537.40–$575.803
MS$531.331
MT$595.821
NC$559.111
ND$581.591
NE$548.641
NH$610.051
NJ$642.88–$674.192
NM$565.911
NV$592.281
NY$567.77–$705.485
OH$559.601
OK$545.661
OR$587.05–$638.692
PA$560.18–$620.452
PR$600.121
RI$610.011
SC$560.411
SD$579.901
TN$546.591
TX$556.44–$617.758
UT$568.271
VA$581.68–$681.452
VI$600.121
VT$579.801
WA$614.33–$694.262
WI$561.621
WV$551.321
WY$589.621

See 28312 in every payment locality

How the 28312 rate is calculated

Each of 28312’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 · 28312

RVUs × geographic indexes × conversion factor

Office or facility?

Work4.57

4.57 RVUs× 1.000 GPCI

Practice expense12.55

12.55 RVUs× 1.000 GPCI

Malpractice0.72

0.72 RVUs× 1.000 GPCI

Adjusted RVUs

17.8400

Conversion factor

$33.4009

Medicare rate

$595.87

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

The exact North Carolina inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,188

Code
28312
Physician work
4.57
Practice expense
12.55
Malpractice
0.72

GPCI2026.csv

83

Locality
North Carolina
Physician work
1.000
Practice expense
0.933
Malpractice
0.639
Office calculation for 28312 in North Carolina
ComponentRVULocality factorAdjusted
Physician work4.57× 1.0004.5700
Practice expense12.55× 0.93311.7092
Malpractice0.72× 0.6390.4601
Total RVUs16.7392
Conversion factor× 33.4009

Office rate, North Carolina$559.11

Office: (4.57 × 1 + 12.55 × 0.933 + 0.72 × 0.639) × $33.4009 = $559.11

Facility: (4.57 × 1 + 5.09 × 0.933 + 0.72 × 0.639) × $33.4009 = $326.63

Open 28312 in the RVU calculator

Payment rules and modifiers for 28312

28312 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 28312

Toe osteotomy, lesser toe

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)0The 150% bilateral adjustment doesn’t apply.
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 · 28312

Toe osteotomy, lesser toe

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 51 · payment effect

With and without the modifier

28312 without 51 · national office

$595.87

Toe osteotomy, lesser toe

28312-51 · Second procedure: 50%

$297.94

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Codes related to 28312

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

Codes related to 28312
CodeHow it relatesOffice range, North Carolina
Same family
28310Toe osteotomy, first toe, proximal phalanxSame proximal-phalanx osteotomy family, but for the great toe.$532.85
Used instead
28313Toe deformity repair, soft-tissue correctionToe deformity reconstruction using soft-tissue procedures rather than a proximal-phalanx osteotomy.$513.56
28285Hammertoe repair, lesser-toe deformity correctionHammertoe correction code; select based on the procedure performed, not the diagnosis alone.$517.87
Often billed with
28308Metatarsal osteotomy, other than first metatarsalMay accompany a distinct metatarsal osteotomy during forefoot reconstruction.$551.56

How 28312 has changed in North Carolina

28312 · Office / nonfacility

$559.11

Effective 2026-10-01

The base rate is $50.33 higher than on 2025-10-01, moving from $508.78 to $559.11 (9.9%).

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

    $508.78changed to$559.11

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 4.69 changed to 4.57
    • Practice expense RVU 11.44 changed to 12.55
    • Malpractice RVU 0.67 changed to 0.72
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.665 changed to 0.639

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $510.76changed to$508.78

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 11.06 changed to 11.44
    • Malpractice RVU 0.62 changed to 0.67

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $502.42changed to$510.76

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $507.75changed to$502.42

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 10.64 changed to 11.06
    • Malpractice RVU 0.58 changed to 0.62
    • Practice expense GPCI 0.927 changed to 0.926
    • Malpractice GPCI 0.742 changed to 0.665

  5. January 1, 2023

    RVU23A

    $501.89changed to$507.75

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 10.08 changed to 10.64
    • Malpractice RVU 0.56 changed to 0.58
    • Practice expense GPCI 0.928 changed to 0.927
    • Malpractice GPCI 0.819 changed to 0.742

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $500.49changed to$501.89

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 9.97 changed to 10.08
    • Malpractice RVU 0.49 changed to 0.56

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $495.12changed to$500.49

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 9.31 changed to 9.97
    • Practice expense GPCI 0.930 changed to 0.928
    • Malpractice GPCI 0.757 changed to 0.819

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $495.60changed to$495.12

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 9.39 changed to 9.31
    • Malpractice RVU 0.46 changed to 0.49
    • Practice expense GPCI 0.931 changed to 0.930
    • Malpractice GPCI 0.695 changed to 0.757

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $498.66changed to$495.60

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 9.49 changed to 9.39
    • Malpractice RVU 0.47 changed to 0.46

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $499.35changed to$498.66

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 9.53 changed to 9.49
    • Malpractice RVU 0.48 changed to 0.47
    • Malpractice GPCI 0.732 changed to 0.695

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $498.78changed to$499.35

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 9.54 changed to 9.53
    • Practice expense GPCI 0.930 changed to 0.931
    • Malpractice GPCI 0.768 changed to 0.732

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $509.32changed to$498.78

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 9.76 changed to 9.54
    • Malpractice RVU 0.53 changed to 0.48

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $506.78changed to$509.32

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $496.08changed to$506.78

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 9.48 changed to 9.76
    • Malpractice RVU 0.48 changed to 0.53
    • Practice expense GPCI 0.929 changed to 0.930
    • Malpractice GPCI 0.732 changed to 0.768

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $499.72changed to$496.08

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 10.41 changed to 9.48
    • Malpractice RVU 0.50 changed to 0.48
    • Practice expense GPCI 0.927 changed to 0.929
    • Malpractice GPCI 0.695 changed to 0.732

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $499.72

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$559.11$326.63RVU26D
2026-07-01$559.11$326.63RVU26C
2026-04-01$559.11$326.63RVU26B
2026-01-01$559.11$326.63RVU26A
2025-10-01$508.78$331.46RVU25D
2025-07-01$508.78$331.46RVU25C
2025-04-01$508.78$331.46RVU25B
2025-01-01$508.78$331.46RVU25A
2024-10-01$510.76$329.20RVU24D
2024-07-01$510.76$329.20RVU24C
2024-04-01$510.76$329.20RVU24B
2024-03-09$510.76$329.20RVU24AR
2024-01-01$502.42$323.83RVU24A
2023-10-01$507.75$325.56RVU23D
2023-07-01$507.75$325.56RVU23C
2023-04-01$507.75$325.56RVU23B
2023-01-01$507.75$325.56RVU23A
2022-10-01$501.89$320.12RVU22D
2022-07-01$501.89$320.12RVU22C
2022-04-01$501.89$320.12RVU22B
2022-01-01$501.89$320.12RVU22A
2021-10-01$500.49$313.97RVU21D
2021-07-01$500.49$313.97RVU21C
2021-04-01$500.49$313.97RVU21B
2021-01-01$500.49$313.97RVU21A
2020-10-01$495.12$314.89RVU20D
2020-07-01$495.12$314.89RVU20C
2020-04-01$495.12$314.89RVU20B
2020-01-01$495.12$314.89RVU20A
2019-10-01$495.60$313.41RVU19D
2019-07-01$495.60$313.41RVU19C
2019-04-01$495.60$313.41RVU19B
2019-01-01$495.60$313.41RVU19A
2018-10-01$498.66$313.65RVU18D
2018-07-01$498.66$313.65RVU18C
2018-04-01$498.66$313.65RVU18B
2018-01-01$498.66$313.65RVU18AR1
2017-10-01$499.35$314.91RVU17D
2017-07-01$499.35$314.91RVU17C
2017-04-01$499.35$314.91RVU17B
2017-01-01$499.35$314.91RVU17A
2016-10-01$498.78$314.98RVU16D
2016-07-01$498.78$314.98RVU16C
2016-04-01$498.78$314.98RVU16B
2016-01-01$498.78$314.98RVU16A
2015-10-01$509.32$320.17RVU15D
2015-07-01$509.32$320.17RVU15C
2015-04-01$506.78$318.58RVU15B
2015-01-01$506.78$318.58RVU15A
2014-10-01$496.08$314.05RVU14D
2014-07-01$496.08$314.05RVU14C
2014-04-01$496.08$314.05RVU14B
2014-01-01$496.08$314.05RVU14A
2013-10-01$499.72$308.59RVU13D
2013-07-01$499.72$308.59RVU13C
2013-04-01$499.72$308.59RVU13B
2013-01-01$499.72$308.59RVU13AR

Price 28312 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Advance
  • Ahoskie
  • Alamance
  • Albemarle
  • Alexis
  • Alliance
  • Altamahaw

Browse all communities in North Carolina

28312 billing questions

When is this code appropriate instead of 28310?

Use 28312 for a proximal-phalanx osteotomy of a toe other than the great toe. Code 28310 is for the great toe’s proximal phalanx.

Does a hammertoe diagnosis alone support this code?

No. Documentation should establish that the surgeon performed a proximal-phalanx osteotomy to correct the lesser toe’s bony alignment. A hammertoe procedure without that osteotomy does not establish the service.

Can this be reported with a metatarsal osteotomy?

It may be reported with a metatarsal osteotomy when both distinct bony corrections are performed and documented. Same-session procedures are subject to Medicare’s multiple procedure reduction.

Can modifier 50 be used when both feet are treated?

No. CMS identifies bilateral adjustment as inappropriate for this code. Follow the applicable reporting instructions for services performed on separate toes or feet.

How does the global period affect postoperative visits?

The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.

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 28312PPRRVU2026_Oct_nonQPP.csv, line 3,188 (RVU26D)
Geographic factors for North CarolinaGPCI2026.csv, line 83 (RVU26D)

Open CMS sourceHow we calculate rates

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