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CPT code 28313: Toe deformity repair, soft-tissue correction2026 Medicare rate & RVUs in Queens, NY

Reports soft-tissue reconstruction to correct an angular toe deformity, such as an overlapping toe, when the repair does not involve bone work.

CMS RVU26DEffective Oct 1, 2026One payment locality4.7K Medicare services in 2024

In Queens, NY, Medicare pays $631.39 for 28313 in the office and $396.09 when it’s performed in a hospital or facility.

$631.39Office (non-facility)
$396.09Hospital or facility
+15.7%vs the national office rate ($545.77)

Check a contract rate as a % of Medicare · 28313 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 28313 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Queens, NY
  2. What 28313 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 28313 covers

CPT 28313 covers surgical correction of an angular toe deformity using soft-tissue procedures alone. A common clinical situation is an overlapping lesser toe, such as a second toe that crosses over an adjacent toe. The surgeon or podiatrist rebalances soft tissue around the affected toe to improve its alignment; the procedure is performed in an operating room or ambulatory surgery setting. This code is not the choice when the documented correction includes an osteotomy of a toe bone.

Report the service for each toe corrected and document the deformity, the toe involved, and the soft-tissue work performed. Medicare assigns a 90-day global period, which includes the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery, and co-surgeon and team-surgery billing are 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 Queens, NY compares for 28313

Across 109 of 109 payment localities, the office rate for 28313 runs from $484.42 in Arkansas to $710.15 in San Benito County, CA. Queens, NY pays $631.39. The RVUs are the same everywhere; the geographic indexes change the dollars.

28313 in Queens, NY vs other payment areas
  1. Queens, NY · this page$631.39
  2. Manhattan, NY · New York$627.67−$3.72
  3. NYC suburbs and Long Island, NY · New York$643.58+$12.19
  4. Poughkeepsie and northern NYC suburbs, NY · New York$591.92−$39.47
  5. Rest of New York · New York$521.09−$110.30
  6. Los Angeles, CA · California$609.70−$21.69
  7. Washington, DC area · District of Columbia$620.61−$10.78

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

Every other payment area

28313 in every other Medicare payment locality
Payment localityOfficeFacility
Miami, FLFlorida$596.06$388.83
Chicago, ILIllinois$579.00$378.93
AlaskaAlaska$642.17$430.16
AlabamaAlabama$491.28$317.10
ArkansasArkansas$484.42$313.42
ArizonaArizona$531.41$338.51
Bakersfield, CACalifornia$573.87$355.69
Chico, CACalifornia$571.83$353.65

28313 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.

$484.42

$642.17

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

View every state and territory as a table
28313 office rate range by state
State / territoryOffice rate rangeLocalities
AK$642.171
AL$491.281
AR$484.421
AZ$531.411
CA$571.83–$710.1529
CO$565.361
CT$581.351
DC$620.611
DE$539.991
FL$541.92–$596.063
GA$511.95–$556.652
GU$584.521
HI$584.521
IA$501.521
ID$505.071
IL$528.07–$579.004
IN$507.861
KS$500.121
KY$504.411
LA$504.00–$528.022
MA$562.51–$618.892
MD$549.79–$620.613
ME$508.56–$533.952
MI$517.93–$549.392
MN$539.601
MO$496.21–$528.793
MS$490.361
MT$545.721
NC$513.561
ND$531.881
NE$503.911
NH$557.391
NJ$587.38–$614.682
NM$521.031
NV$542.221
NY$521.09–$643.585
OH$515.101
OK$502.601
OR$537.41–$581.842
PA$515.40–$567.842
PR$549.321
RI$558.141
SC$515.311
SD$530.251
TN$502.671
TX$512.19–$564.018
UT$522.101
VA$532.87–$620.612
VI$549.321
VT$530.671
WA$561.16–$630.402
WI$514.691
WV$509.381
WY$539.691

See 28313 in every payment locality

How the 28313 rate is calculated

Each of 28313’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 · 28313

RVUs × geographic indexes × conversion factor

Office or facility?

Work5.02

5.02 RVUs× 1.000 GPCI

Practice expense10.62

10.62 RVUs× 1.000 GPCI

Malpractice0.70

0.70 RVUs× 1.000 GPCI

Adjusted RVUs

16.3400

Conversion factor

$33.4009

Medicare rate

$545.77

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

The exact Queens, NY inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,189

Code
28313
Physician work
5.02
Practice expense
10.62
Malpractice
0.70

GPCI2026.csv

81

Locality
Queens, NY
Physician work
1.064
Practice expense
1.182
Malpractice
1.442
Office calculation for 28313 in Queens, NY
ComponentRVULocality factorAdjusted
Physician work5.02× 1.0645.3413
Practice expense10.62× 1.18212.5528
Malpractice0.70× 1.4421.0094
Total RVUs18.9035
Conversion factor× 33.4009

Office rate, Queens, NY$631.39

Office: (5.02 × 1.064 + 10.62 × 1.182 + 0.7 × 1.442) × $33.4009 = $631.39

Facility: (5.02 × 1.064 + 4.66 × 1.182 + 0.7 × 1.442) × $33.4009 = $396.09

Open 28313 in the RVU calculator

Payment rules and modifiers for 28313

28313 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 28313

Toe deformity repair, soft-tissue correction

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)0Not permitted.
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 · 28313

Toe deformity repair, soft-tissue correction

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

28313 without 51 · national office

$545.77

Toe deformity repair, soft-tissue correction

28313-51 · Second procedure: 50%

$272.89

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 28313

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

Codes related to 28313
CodeHow it relatesOffice range, Queens, NY
Used instead
28312Toe osteotomy, lesser toeToe angular correction requiring osteotomy of a phalanx rather than soft-tissue procedures alone.$692.56
28310Toe osteotomy, first toe, proximal phalanxBony angular or rotational correction involving the proximal phalanx of the great toe.$652.42
28285Hammertoe repair, lesser-toe deformity correctionUsed for hammertoe correction rather than soft-tissue repair of an angular overlapping toe.$632.05
28286Hammertoe repair, with MTP joint releaseSpecific correction for a cock-up fifth toe, rather than general angular toe reconstruction.$493.92

How 28313 has changed in Queens, NY

28313 · Office / nonfacility

$631.39

Effective 2026-10-01

The base rate is $29.78 higher than on 2025-10-01, moving from $601.61 to $631.39 (5.0%).

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

    $601.61changed to$631.39

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 5.15 changed to 5.02
    • Practice expense RVU 10.13 changed to 10.62
    • Malpractice RVU 0.69 changed to 0.70
    • Work GPCI 1.065 changed to 1.064
    • Practice expense GPCI 1.195 changed to 1.182
    • Malpractice GPCI 1.462 changed to 1.442

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $616.02changed to$601.61

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 10.04 changed to 10.13
    • Malpractice RVU 0.70 changed to 0.69

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $605.96changed to$616.02

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $639.92changed to$605.96

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 9.95 changed to 10.04
    • Malpractice RVU 0.66 changed to 0.70
    • Work GPCI 1.061 changed to 1.065
    • Practice expense GPCI 1.212 changed to 1.195
    • Malpractice GPCI 2.061 changed to 1.462

  5. January 1, 2023

    RVU23A

    $665.44changed to$639.92

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 9.80 changed to 9.95
    • Work GPCI 1.056 changed to 1.061
    • Practice expense GPCI 1.228 changed to 1.212
    • Malpractice GPCI 2.661 changed to 2.061

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $677.75changed to$665.44

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 9.98 changed to 9.80
    • Malpractice RVU 0.65 changed to 0.66

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $659.49changed to$677.75

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 9.36 changed to 9.98
    • Malpractice RVU 0.62 changed to 0.65
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.214 changed to 1.228
    • Malpractice GPCI 2.391 changed to 2.661

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $642.88changed to$659.49

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 9.29 changed to 9.36
    • Malpractice RVU 0.60 changed to 0.62
    • Work GPCI 1.052 changed to 1.054
    • Practice expense GPCI 1.200 changed to 1.214
    • Malpractice GPCI 2.121 changed to 2.391

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $645.53changed to$642.88

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 9.35 changed to 9.29
    • Malpractice RVU 0.61 changed to 0.60

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $649.62changed to$645.53

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 9.44 changed to 9.35
    • Malpractice RVU 0.63 changed to 0.61
    • Malpractice GPCI 2.151 changed to 2.121

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $651.36changed to$649.62

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 9.49 changed to 9.44
    • Malpractice RVU 0.64 changed to 0.63
    • Practice expense GPCI 1.199 changed to 1.200
    • Malpractice GPCI 2.181 changed to 2.151

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $656.06changed to$651.36

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.67 changed to 0.64

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $652.79changed to$656.06

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $643.20changed to$652.79

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 9.44 changed to 9.49
    • Malpractice RVU 0.66 changed to 0.67
    • Work GPCI 1.057 changed to 1.052
    • Practice expense GPCI 1.197 changed to 1.199
    • Malpractice GPCI 1.836 changed to 2.181

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $634.16changed to$643.20

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 10.16 changed to 9.44
    • Malpractice RVU 0.69 changed to 0.66
    • Work GPCI 1.062 changed to 1.057
    • Practice expense GPCI 1.195 changed to 1.197
    • Malpractice GPCI 1.491 changed to 1.836

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $634.16

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$631.39$396.09RVU26D
2026-07-01$631.39$396.09RVU26C
2026-04-01$631.39$396.09RVU26B
2026-01-01$631.39$396.09RVU26A
2025-10-01$601.61$415.30RVU25D
2025-07-01$601.61$415.30RVU25C
2025-04-01$601.61$415.30RVU25B
2025-01-01$601.61$415.30RVU25A
2024-10-01$616.02$420.70RVU24D
2024-07-01$616.02$420.70RVU24C
2024-04-01$616.02$420.70RVU24B
2024-03-09$616.02$420.70RVU24AR
2024-01-01$605.96$413.84RVU24A
2023-10-01$639.92$435.38RVU23D
2023-07-01$639.92$435.38RVU23C
2023-04-01$639.92$435.38RVU23B
2023-01-01$639.92$435.38RVU23A
2022-10-01$665.44$451.69RVU22D
2022-07-01$665.44$451.69RVU22C
2022-04-01$665.44$451.69RVU22B
2022-01-01$665.44$451.69RVU22A
2021-10-01$677.75$452.36RVU21D
2021-07-01$677.75$452.36RVU21C
2021-04-01$677.75$452.36RVU21B
2021-01-01$677.75$452.36RVU21A
2020-10-01$659.49$444.80RVU20D
2020-07-01$659.49$444.80RVU20C
2020-04-01$659.49$444.80RVU20B
2020-01-01$659.49$444.80RVU20A
2019-10-01$642.88$432.70RVU19D
2019-07-01$642.88$432.70RVU19C
2019-04-01$642.88$432.70RVU19B
2019-01-01$642.88$432.70RVU19A
2018-10-01$645.53$433.85RVU18D
2018-07-01$645.53$433.85RVU18C
2018-04-01$645.53$433.85RVU18B
2018-01-01$645.53$433.85RVU18AR1
2017-10-01$649.62$437.30RVU17D
2017-07-01$649.62$437.30RVU17C
2017-04-01$649.62$437.30RVU17B
2017-01-01$649.62$437.30RVU17A
2016-10-01$651.36$438.86RVU16D
2016-07-01$651.36$438.86RVU16C
2016-04-01$651.36$438.86RVU16B
2016-01-01$651.36$438.86RVU16A
2015-10-01$656.06$441.50RVU15D
2015-07-01$656.06$441.50RVU15C
2015-04-01$652.79$439.30RVU15B
2015-01-01$652.79$439.30RVU15A
2014-10-01$643.20$433.09RVU14D
2014-07-01$643.20$433.09RVU14C
2014-04-01$643.20$433.09RVU14B
2014-01-01$643.20$433.09RVU14A
2013-10-01$634.16$416.24RVU13D
2013-07-01$634.16$416.24RVU13C
2013-04-01$634.16$416.24RVU13B
2013-01-01$634.16$416.24RVU13AR

Price 28313 for an earlier date of service

Where the Queens, NY rate applies

Queens, NY is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in New York. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in New York

28313 billing questions

When is 28313 preferable to 28312?

Use 28313 for angular toe correction performed with soft-tissue procedures alone. CPT 28312 describes a bony osteotomy of a toe phalanx.

Does 28313 include correction of an overlapping toe?

Yes. Soft-tissue reconstruction of an overlapping toe is a typical reason to report 28313, when the documented correction does not include bone work.

How should the number of toes be documented?

Identify each corrected toe and describe its deformity and the soft-tissue work performed. The code is reported for each toe corrected.

Can modifier 50 be used when both feet are treated?

No. CMS identifies bilateral adjustment as inappropriate for 28313. Modifier 50 should not be appended.

What postoperative care is included?

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

How does Medicare handle other procedures in the same session?

The highest-valued procedure is paid in full, and other procedures in the session are subject to the standard multiple-procedure reduction. Medicare does not pay an assistant at surgery; co-surgeons and team surgery are 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 28313PPRRVU2026_Oct_nonQPP.csv, line 3,189 (RVU26D)
Geographic factors for Queens, NYGPCI2026.csv, line 81 (RVU26D)

Open CMS sourceHow we calculate rates

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