Billing code 28232: Toe tendon incisionMedicare rate & RVUs
Reports open division of one flexor tendon in a toe, commonly to address a tendon-driven toe contracture such as a claw or hammertoe deformity.
Medicare pays $374.09 for 28232 nationally in the office and $231.13 in a hospital or facility. Local office rates run $333.54–$491.22.
Medicare rate · 28232
Toe tendon incision
Swap in your local Medicare rate.
- Work RVUs
- 3.42
- Total RVUs
- 11.20
- Global days
- 090
National rate · 2026
$374.09
Office setting, before claim adjustments.
See every locality for 28232 → · Billed by an NP, PA or therapist? →
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 10 sections
What 28232 covers
The surgeon makes an incision and divides one flexor tendon in a toe to reduce a deforming pull or contracture. Orthopedic surgeons and podiatric surgeons commonly perform this procedure for a toe deformity in an operating room or other surgical setting. The defining details are an open approach, a flexor tendon, and one tendon in a toe; this is not repair of a damaged tendon or incision of an extensor tendon.
Select the code from the operative note’s documented tendon, toe, approach, and number of tendons treated. The note should support the deformity or contracture addressed and the specific tendon division. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery; co-surgeons and team surgery 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.
Where 28232 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$333.54 to $491.22
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $338.10 | $213.01 |
| Alaska* | $442.26 | $290.01 |
| Arizona | $364.75 | $226.23 |
| Arkansas | $333.54 | $210.74 |
| Atlanta | $380.69 | $235.45 |
| Austin | $387.44 | $236.19 |
| Bakersfield | $395.68 | $239.00 |
| Baltimore/Surr. Cntys | $396.75 | $243.36 |
| Beaumont | $350.92 | $220.83 |
| Brazoria | $370.27 | $228.60 |
| Chicago | $390.84 | $247.17 |
| Chico | $394.62 | $237.94 |
| Colorado | $388.88 | $236.77 |
| Connecticut | $397.89 | $243.93 |
| Dallas | $372.51 | $230.13 |
| Dc + Md/Va Suburbs | $425.78 | $257.37 |
| Delaware | $370.53 | $229.29 |
| Detroit | $373.18 | $235.23 |
| East St. Louis | $365.73 | $234.21 |
| El Centro | $394.68 | $238.00 |
| Fort Lauderdale | $386.50 | $241.68 |
| Fort Worth | $370.17 | $229.22 |
| Fresno | $394.62 | $237.94 |
| Galveston | $371.31 | $229.36 |
| Hanford-Corcoran | $394.62 | $237.94 |
| Hawaii, Guam | $403.35 | $240.81 |
| Houston | $377.53 | $235.58 |
| Idaho | $348.23 | $216.71 |
| Indiana | $350.11 | $217.59 |
| Iowa | $346.12 | $215.31 |
| Kansas | $344.60 | $215.37 |
| Kentucky | $345.54 | $218.45 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $420.43 | $251.32 |
| Madera | $394.62 | $237.94 |
| Manhattan | $428.31 | $262.20 |
| Merced | $394.62 | $237.94 |
| Metropolitan Boston | $425.73 | $255.04 |
| Metropolitan Kansas City | $358.67 | $224.43 |
| Metropolitan Philadelphia | $388.53 | $239.71 |
| Metropolitan St. Louis | $362.18 | $226.09 |
| Miami | $401.64 | $252.83 |
| Minnesota | $373.30 | $226.20 |
| Mississippi | $336.58 | $213.50 |
| Modesto | $394.62 | $237.94 |
| Montana** | $374.07 | $231.11 |
| Napa | $454.72 | $266.31 |
| Nebraska | $347.89 | $215.94 |
| Nevada** | $372.44 | $229.34 |
| New Hampshire | $382.86 | $234.04 |
| New Mexico | $355.75 | $224.66 |
| New Orleans | $360.97 | $226.45 |
| North Carolina | $353.34 | $219.96 |
| North Dakota** | $367.34 | $224.39 |
| Northern Nj | $421.82 | $255.99 |
| Nyc Suburbs/Long Island | $438.10 | $268.13 |
| Ohio | $352.56 | $222.04 |
| Oklahoma | $344.97 | $217.31 |
| Oxnard-Thousand Oaks-Ventura | $418.23 | $249.26 |
| Portland | $400.59 | $241.77 |
| Poughkpsie/N Nyc Suburbs | $405.22 | $248.69 |
| Puerto Rico | $376.65 | $232.12 |
| Queens | $431.65 | $262.67 |
| Redding | $394.62 | $237.94 |
| Rest Of California | $394.62 | $237.94 |
| Rest Of Florida | $368.87 | $232.20 |
| Rest Of Georgia | $349.43 | $221.92 |
| Rest Of Illinois | $358.86 | $228.35 |
| Rest Of Louisiana | $345.04 | $218.52 |
| Rest Of Maine | $349.92 | $218.40 |
| Rest Of Maryland | $377.28 | $232.61 |
| Rest Of Massachusetts | $386.78 | $236.25 |
| Rest Of Michigan | $353.94 | $223.42 |
| Rest Of Missouri | $339.50 | $216.27 |
| Rest Of New Jersey | $402.62 | $246.52 |
| Rest Of New York | $358.29 | $222.48 |
| Rest Of Oregon | $369.72 | $227.34 |
| Rest Of Pennsylvania | $353.09 | $221.85 |
| Rest Of Texas | $360.31 | $224.65 |
| Rest Of Washington | $386.03 | $235.50 |
| Rhode Island | $383.23 | $235.56 |
| Riverside-San Bernardino-Ontario | $398.33 | $241.65 |
| Sacramento-Roseville-Folsom | $413.44 | $247.18 |
| Salinas | $411.87 | $246.19 |
| San Diego-Chula Vista-Carlsbad | $421.02 | $250.05 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $480.68 | $279.12 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $480.30 | $278.73 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $491.22 | $285.08 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $489.65 | $283.50 |
| San Luis Obispo-Paso Robles | $405.30 | $242.48 |
| Santa Cruz-Watsonville | $424.65 | $250.96 |
| Santa Maria-Santa Barbara | $413.27 | $246.58 |
| Santa Rosa-Petaluma | $428.91 | $253.36 |
| Seattle (King Cnty) | $434.13 | $258.73 |
| South Carolina | $353.50 | $221.41 |
| South Dakota** | $366.55 | $223.59 |
| Southern Maine | $367.66 | $225.99 |
| Stockton | $394.62 | $237.94 |
| Suburban Chicago | $390.37 | $243.55 |
| Tennessee | $346.22 | $216.27 |
| Utah | $358.02 | $223.64 |
| Vallejo | $454.17 | $265.75 |
| Vermont | $366.00 | $224.47 |
| Virgin Islands | $376.65 | $232.12 |
| Virginia | $366.53 | $226.00 |
| Visalia | $394.62 | $237.94 |
| West Virginia | $346.43 | $222.20 |
| Wisconsin | $355.79 | $218.84 |
| Wyoming** | $371.14 | $228.18 |
| Yuba City | $394.62 | $237.94 |
28232 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.
$333.54
$442.92
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $442.26 | 1 |
| AL | $338.10 | 1 |
| AR | $333.54 | 1 |
| AZ | $364.75 | 1 |
| CA | $394.62–$491.22 | 29 |
| CO | $388.88 | 1 |
| CT | $397.89 | 1 |
| DC | $425.78 | 1 |
| DE | $370.53 | 1 |
| FL | $368.87–$401.64 | 3 |
| GA | $349.43–$380.69 | 2 |
| GU | $403.35 | 1 |
| HI | $403.35 | 1 |
| IA | $346.12 | 1 |
| ID | $348.23 | 1 |
| IL | $358.86–$390.84 | 4 |
| IN | $350.11 | 1 |
| KS | $344.60 | 1 |
| KY | $345.54 | 1 |
| LA | $345.04–$360.97 | 2 |
| MA | $386.78–$425.73 | 2 |
| MD | $377.28–$425.78 | 3 |
| ME | $349.92–$367.66 | 2 |
| MI | $353.94–$373.18 | 2 |
| MN | $373.30 | 1 |
| MO | $339.50–$362.18 | 3 |
| MS | $336.58 | 1 |
| MT | $374.07 | 1 |
| NC | $353.34 | 1 |
| ND | $367.34 | 1 |
| NE | $347.89 | 1 |
| NH | $382.86 | 1 |
| NJ | $402.62–$421.82 | 2 |
| NM | $355.75 | 1 |
| NV | $372.44 | 1 |
| NY | $358.29–$438.10 | 5 |
| OH | $352.56 | 1 |
| OK | $344.97 | 1 |
| OR | $369.72–$400.59 | 2 |
| PA | $353.09–$388.53 | 2 |
| PR | $376.65 | 1 |
| RI | $383.23 | 1 |
| SC | $353.50 | 1 |
| SD | $366.55 | 1 |
| TN | $346.22 | 1 |
| TX | $350.92–$387.44 | 8 |
| UT | $358.02 | 1 |
| VA | $366.53–$425.78 | 2 |
| VI | $376.65 | 1 |
| VT | $366.00 | 1 |
| WA | $386.03–$434.13 | 2 |
| WI | $355.79 | 1 |
| WV | $346.43 | 1 |
| WY | $371.14 | 1 |
How the 28232 rate is calculated
Each of 28232’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 · 28232
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 3.42Practice expense 7.44Malpractice 0.34
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 28232
28232 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28232
Toe tendon incision
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 28232
Toe tendon incision
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
28232 without 51 · national office
$374.09
Toe tendon incision
28232-51 · Second procedure: 50%
$187.05
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%).
28232 compared with similar codes
Compare codes
28232 vs 28230 vs 28234 vs 28272 vs 28285: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 28230Tendon incision
- Use 28232 for an open division of one flexor tendon in a toe. Use 28230 for an open incision of a single extensor tendon.
- 28234Extensor tenotomy
- 28234 involves multiple extensor tendons; 28232 involves one flexor tendon in a toe. The operative note should identify tendon type and count.
- 28272Toe joint release
- 28272 addresses release of a toe joint contracture. 28232 divides a flexor tendon, so distinguish the structure treated.
- 28285Hammertoe repair
- 28285 represents hammertoe correction, while 28232 describes an open flexor tenotomy. Determine whether the documented service is an isolated tendon division or part of a broader deformity correction.
28232 billing questions
How is 28232 different from 28230?
28232 is for open division of a flexor tendon in a toe. 28230 describes an open incision of a single extensor tendon.
When would 28234 be considered instead?
28234 is for open incision of multiple extensor tendons. Choose based on the tendon type and number documented, not simply because more than one toe is treated.
Can 28232 be separately reported with hammertoe correction?
Do not assume the tendon division is separately reportable when it is part of a broader hammertoe correction. Check applicable edits and document any distinct work supporting separate reporting.
Should modifier 50 be used when both feet are treated?
No. CMS identifies bilateral adjustment as inappropriate for this code. The descriptor and anatomy do not support modifier 50.
What documentation supports this code?
Record the affected toe, the flexor tendon divided, the open approach, the number of tendons treated, and the deformity or contracture addressed.
What global and multiple-procedure rules apply?
The code has a 90-day global period. For multiple procedures in the same session, Medicare pays the highest-valued procedure in full and the others at 50%.
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
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