Billing code 28238: Tendon revisionMedicare rate & RVUs
Reports operative revision of a foot tendon when the documented procedure revises previously treated tendon tissue rather than performing a straightforward primary repair.
Medicare pays $685.39 for 28238 nationally in the office and $459.26 in a hospital or facility. Local office rates run $614.38–$873.53.
Medicare rate · 28238
Tendon revision
Swap in your local Medicare rate.
- Work RVUs
- 7.76
- Total RVUs
- 20.52
- Global days
- 090
National rate · 2026
$685.39
Office setting, before claim adjustments.
See every locality for 28238 → · 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 28238 covers
billing code 28238 covers operative revision of a tendon in the foot. An orthopedic foot-and-ankle surgeon or podiatric surgeon may perform the procedure when the tendon requires revision after prior treatment. The specific tendon, side, and operative approach depend on the patient’s condition and the surgeon’s findings. The operative report should make clear that the work is a revision of the foot tendon, not simply a new primary repair or a tendon release.
Select the code based on the procedure actually performed and documented. Identify the affected tendon and side, the reason for revision, and the revision work in the operative report. This major surgery has a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; 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.
Where 28238 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
$614.38 to $873.53
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $622.31 | $424.45 |
| Alaska* | $826.38 | $585.55 |
| Arizona | $668.59 | $449.47 |
| Arkansas | $614.38 | $420.14 |
| Atlanta | $698.85 | $469.11 |
| Austin | $705.17 | $465.93 |
| Bakersfield | $715.77 | $467.94 |
| Baltimore/Surr. Cntys | $725.85 | $483.22 |
| Beaumont | $647.63 | $441.86 |
| Brazoria | $676.93 | $452.84 |
| Chicago | $730.26 | $503.01 |
| Chico | $712.94 | $465.11 |
| Colorado | $706.79 | $466.20 |
| Connecticut | $727.61 | $484.07 |
| Dallas | $681.64 | $456.42 |
| Dc + Md/Va Suburbs | $773.18 | $506.81 |
| Delaware | $678.74 | $455.33 |
| Detroit | $693.35 | $475.14 |
| East St. Louis | $686.00 | $477.97 |
| El Centro | $713.10 | $465.26 |
| Fort Lauderdale | $716.15 | $487.09 |
| Fort Worth | $678.10 | $455.15 |
| Fresno | $712.94 | $465.11 |
| Galveston | $679.24 | $454.70 |
| Hanford-Corcoran | $712.94 | $465.11 |
| Hawaii, Guam | $726.07 | $468.97 |
| Houston | $696.63 | $472.09 |
| Idaho | $637.11 | $429.07 |
| Indiana | $640.28 | $430.66 |
| Iowa | $632.72 | $425.82 |
| Kansas | $631.78 | $427.36 |
| Kentucky | $638.90 | $437.88 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $757.54 | $490.03 |
| Madera | $712.94 | $465.11 |
| Manhattan | $784.47 | $521.72 |
| Merced | $712.94 | $465.11 |
| Metropolitan Boston | $769.05 | $499.06 |
| Metropolitan Kansas City | $660.59 | $448.26 |
| Metropolitan Philadelphia | $712.35 | $476.95 |
| Metropolitan St. Louis | $666.52 | $451.25 |
| Miami | $750.08 | $514.68 |
| Minnesota | $674.49 | $441.81 |
| Mississippi | $622.27 | $427.58 |
| Modesto | $712.94 | $465.11 |
| Montana** | $685.32 | $459.20 |
| Napa | $811.54 | $513.51 |
| Nebraska | $635.28 | $426.56 |
| Nevada** | $680.48 | $454.13 |
| New Hampshire | $697.59 | $462.20 |
| New Mexico | $659.02 | $451.67 |
| New Orleans | $666.43 | $453.65 |
| North Carolina | $647.50 | $436.53 |
| North Dakota** | $666.54 | $440.41 |
| Northern Nj | $766.99 | $504.68 |
| Nyc Suburbs/Long Island | $803.72 | $534.86 |
| Ohio | $651.32 | $444.87 |
| Oklahoma | $636.10 | $434.17 |
| Oxnard-Thousand Oaks-Ventura | $752.47 | $485.20 |
| Portland | $725.20 | $473.97 |
| Poughkpsie/N Nyc Suburbs | $741.19 | $493.58 |
| Puerto Rico | $689.25 | $460.64 |
| Queens | $787.79 | $520.51 |
| Redding | $712.94 | $465.11 |
| Rest Of California | $712.94 | $465.11 |
| Rest Of Florida | $683.99 | $467.82 |
| Rest Of Georgia | $648.88 | $447.17 |
| Rest Of Illinois | $668.93 | $462.48 |
| Rest Of Louisiana | $638.69 | $438.57 |
| Rest Of Maine | $641.84 | $433.80 |
| Rest Of Maryland | $690.11 | $461.27 |
| Rest Of Massachusetts | $704.00 | $465.89 |
| Rest Of Michigan | $655.16 | $448.71 |
| Rest Of Missouri | $630.13 | $435.21 |
| Rest Of New Jersey | $735.12 | $488.20 |
| Rest Of New York | $656.24 | $441.42 |
| Rest Of Oregon | $674.38 | $449.16 |
| Rest Of Pennsylvania | $651.30 | $443.71 |
| Rest Of Texas | $662.19 | $447.60 |
| Rest Of Washington | $702.08 | $463.97 |
| Rhode Island | $699.90 | $466.32 |
| Riverside-San Bernardino-Ontario | $723.26 | $475.42 |
| Sacramento-Roseville-Folsom | $744.29 | $481.31 |
| Salinas | $741.42 | $479.34 |
| San Diego-Chula Vista-Carlsbad | $755.94 | $485.50 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $854.57 | $535.74 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $853.49 | $534.66 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $873.53 | $547.46 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $869.12 | $543.05 |
| San Luis Obispo-Paso Robles | $729.90 | $472.34 |
| Santa Cruz-Watsonville | $760.92 | $486.18 |
| Santa Maria-Santa Barbara | $743.40 | $479.74 |
| Santa Rosa-Petaluma | $768.38 | $490.70 |
| Seattle (King Cnty) | $782.08 | $504.63 |
| South Carolina | $650.65 | $441.71 |
| South Dakota** | $664.32 | $438.19 |
| Southern Maine | $670.13 | $446.04 |
| Stockton | $712.94 | $465.11 |
| Suburban Chicago | $722.35 | $490.12 |
| Tennessee | $634.80 | $429.25 |
| Utah | $658.48 | $445.93 |
| Vallejo | $809.99 | $511.96 |
| Vermont | $665.77 | $441.90 |
| Virgin Islands | $689.25 | $460.64 |
| Virginia | $669.35 | $447.07 |
| Visalia | $712.94 | $465.11 |
| West Virginia | $647.39 | $450.89 |
| Wisconsin | $646.86 | $430.23 |
| Wyoming** | $677.14 | $451.01 |
| Yuba City | $712.94 | $465.11 |
28238 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.
$614.38
$826.38
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 | $826.38 | 1 |
| AL | $622.31 | 1 |
| AR | $614.38 | 1 |
| AZ | $668.59 | 1 |
| CA | $712.94–$873.53 | 29 |
| CO | $706.79 | 1 |
| CT | $727.61 | 1 |
| DC | $773.18 | 1 |
| DE | $678.74 | 1 |
| FL | $683.99–$750.08 | 3 |
| GA | $648.88–$698.85 | 2 |
| GU | $726.07 | 1 |
| HI | $726.07 | 1 |
| IA | $632.72 | 1 |
| ID | $637.11 | 1 |
| IL | $668.93–$730.26 | 4 |
| IN | $640.28 | 1 |
| KS | $631.78 | 1 |
| KY | $638.90 | 1 |
| LA | $638.69–$666.43 | 2 |
| MA | $704.00–$769.05 | 2 |
| MD | $690.11–$773.18 | 3 |
| ME | $641.84–$670.13 | 2 |
| MI | $655.16–$693.35 | 2 |
| MN | $674.49 | 1 |
| MO | $630.13–$666.52 | 3 |
| MS | $622.27 | 1 |
| MT | $685.32 | 1 |
| NC | $647.50 | 1 |
| ND | $666.54 | 1 |
| NE | $635.28 | 1 |
| NH | $697.59 | 1 |
| NJ | $735.12–$766.99 | 2 |
| NM | $659.02 | 1 |
| NV | $680.48 | 1 |
| NY | $656.24–$803.72 | 5 |
| OH | $651.32 | 1 |
| OK | $636.10 | 1 |
| OR | $674.38–$725.20 | 2 |
| PA | $651.30–$712.35 | 2 |
| PR | $689.25 | 1 |
| RI | $699.90 | 1 |
| SC | $650.65 | 1 |
| SD | $664.32 | 1 |
| TN | $634.80 | 1 |
| TX | $647.63–$705.17 | 8 |
| UT | $658.48 | 1 |
| VA | $669.35–$773.18 | 2 |
| VI | $689.25 | 1 |
| VT | $665.77 | 1 |
| WA | $702.08–$782.08 | 2 |
| WI | $646.86 | 1 |
| WV | $647.39 | 1 |
| WY | $677.14 | 1 |
How the 28238 rate is calculated
Each of 28238’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 · 28238
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 7.76Practice expense 11.81Malpractice 0.95
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 28238
28238 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28238
Tendon revision
| 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) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| 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 · 28238
Tendon revision
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 50 · payment effect
With and without the modifier
28238 without 50 · national office
$685.39
Tendon revision
28238-50 · Bilateral: 150%
$1,028.09
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).
28238 compared with similar codes
Compare codes
28238 vs 28200 vs 28202 vs 28220: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 28200Foot tendon repair
- 28200 is for foot flexor tendon repair without a free graft. Use 28238 when the operative service is a revision rather than that repair.
- 28202Tendon repair
- 28202 describes foot flexor tendon repair with a free graft. The documented service, not simply the presence of prior tendon treatment, determines whether revision or grafted repair applies.
- 28220Foot tendon release
- 28220 is for foot tendon release work. It is not the choice when the surgeon revises the tendon itself.
28238 billing questions
How does 28238 differ from a foot tendon repair code?
Use 28238 for a documented revision of a foot tendon. Codes such as 28200 or 28208 describe tendon repair services, with the code choice depending on the tendon and repair details.
Can tendon release or adhesion work be reported as 28238?
Choose the code for the work actually performed. A tendon release or adhesion procedure is distinct from revising the tendon itself.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is 28238 paid when other 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 at 50%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How should bilateral surgery be reported?
For bilateral surgery, report modifier 50; CMS pays the bilateral procedure at 150%.
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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