$625.71–$913.32
Both address hallux rigidus with joint debridement and release; 28291 includes implant placement, while 28289 is the choice without an implant.
On this page
CMS RVU26D · Effective 2026-10-01
28291 Hallux rigidus surgery Medicare reimbursement rates
Corrects painful, stiff first metatarsophalangeal joint arthritis with joint debridement and an implant when motion-preserving surgery is selected. Compare 28291 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 28291?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
$604.34–$858.26
109 of 109 localities have a supported rate.
Lowest: Arkansas
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $253.92 per service.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 28291 pays more and less
109 payment localities
$604.34 to $858.26
Foot surgery
About 28291: Hallux rigidus correction with implant
Corrects painful, stiff first metatarsophalangeal joint arthritis with joint debridement and an implant when motion-preserving surgery is selected.
A foot and ankle surgeon or podiatric surgeon uses this code for implant arthroplasty to treat symptomatic hallux rigidus at the first metatarsophalangeal joint. The procedure addresses degenerative joint changes and restricted, painful great-toe motion through joint debridement, removal of obstructive bone, capsular release, and implant placement. It is typically performed in an outpatient surgical setting when the operative plan includes an implant rather than correction without one.
Report 28291 for the documented implant procedure, not simply because imaging shows arthritis or an implant was considered. The operative report should support the hallux rigidus diagnosis, the work performed at the joint, and implant placement. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure case, the highest-valued procedure is paid in full and other procedures at 50%. 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.
CMS billing rules for 28291
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU7.81 · 39%
- Practice expense (office) RVU11.54 · 57%
- Malpractice RVU0.72 · 4%
2.7K
Medicare services in 2024 · #2249 by national volume
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.
28291 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
$629.14–$909.85
This corrects hallux valgus, or bunion alignment, rather than implant-treated degenerative stiffness of the first metatarsophalangeal joint.
$940.32–$1,406.33
This is a hallux valgus correction involving a proximal first-metatarsal osteotomy; 28291 treats hallux rigidus with an implant.
See how rates vary across the country
28291 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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.
$604.34
$815.04
Color shows the midpoint of each state’s locality range.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | $815.04 | 1 |
| AL | $611.74 | 1 |
| AR | $604.34 | 1 |
| AZ | $654.94 | 1 |
| CA | $700.63–$858.26 | 29 |
| CO | $692.89 | 1 |
| CT | $710.30 | 1 |
| DC | $755.77 | 1 |
| DE | $664.61 | 1 |
| FL | $665.49–$722.93 | 3 |
| GA | $633.35–$682.14 | 2 |
| GU | $713.04 | 1 |
| HI | $713.04 | 1 |
| IA | $623.09 | 1 |
| ID | $626.85 | 1 |
| IL | $650.36–$705.25 | 4 |
| IN | $629.86 | 1 |
| KS | $621.43 | 1 |
| KY | $625.53 | 1 |
| LA | $625.02–$650.89 | 2 |
| MA | $690.08–$753.18 | 2 |
| MD | $675.62–$755.77 | 3 |
| ME | $630.43–$658.01 | 2 |
| MI | $639.92–$673.36 | 2 |
| MN | $664.60 | 1 |
| MO | $616.54–$651.90 | 3 |
| MS | $610.50 | 1 |
| MT | $670.31 | 1 |
| NC | $635.85 | 1 |
| ND | $656.07 | 1 |
| NE | $625.72 | 1 |
| NH | $683.15 | 1 |
| NJ | $718.58–$750.10 | 2 |
| NM | $643.20 | 1 |
| NV | $666.73 | 1 |
| NY | $643.94–$780.51 | 5 |
| OH | $637.01 | 1 |
| OK | $623.75 | 1 |
| OR | $661.67–$711.16 | 2 |
| PA | $637.43–$695.50 | 2 |
| PR | $674.24 | 1 |
| RI | $685.43 | 1 |
| SC | $637.45 | 1 |
| SD | $654.39 | 1 |
| TN | $624.15 | 1 |
| TX | $633.96–$690.49 | 8 |
| UT | $644.78 | 1 |
| VA | $656.73–$755.77 | 2 |
| VI | $674.24 | 1 |
| VT | $654.62 | 1 |
| WA | $688.43–$766.49 | 2 |
| WI | $637.53 | 1 |
| WV | $630.23 | 1 |
| WY | $664.10 | 1 |
Compare 28291 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office $611.74 | Facility $412.71 |
| Alaska* | Office $815.04 | Facility $572.80 |
| Arizona | Office $654.94 | Facility $434.54 |
| Arkansas | Office $604.34 | Facility $408.96 |
| Atlanta | Office $682.14 | Facility $451.04 |
| Austin | Office $690.49 | Facility $449.84 |
| Bakersfield | Office $702.91 | Facility $453.62 |
| Baltimore/Surr. Cntys | Office $708.37 | Facility $464.30 |
| Beaumont | Office $633.96 | Facility $426.97 |
| Brazoria | Office $663.68 | Facility $438.27 |
| Chicago | Office $705.25 | Facility $476.65 |
| Chico | Office $700.63 | Facility $451.34 |
| Colorado | Office $692.89 | Facility $450.87 |
| Connecticut | Office $710.30 | Facility $465.33 |
| Dallas | Office $667.75 | Facility $441.20 |
| Dc + Md/Va Suburbs | Office $755.77 | Facility $487.82 |
| Delaware | Office $664.61 | Facility $439.88 |
| Detroit | Office $673.36 | Facility $453.86 |
| East St. Louis | Office $663.91 | Facility $454.64 |
| El Centro | Office $700.76 | Facility $451.46 |
| Fort Lauderdale | Office $694.80 | Facility $464.38 |
| Fort Worth | Office $664.21 | Facility $439.93 |
| Fresno | Office $700.63 | Facility $451.34 |
| Galveston | Office $665.61 | Facility $439.74 |
| Hanford-Corcoran | Office $700.63 | Facility $451.34 |
| Hawaii, Guam | Office $713.04 | Facility $454.42 |
| Houston | Office $678.79 | Facility $452.92 |
| Idaho | Office $626.85 | Facility $417.58 |
| Indiana | Office $629.86 | Facility $419.00 |
| Iowa | Office $623.09 | Facility $414.97 |
| Kansas | Office $621.43 | Facility $415.80 |
| Kentucky | Office $625.53 | Facility $423.32 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $743.51 | Facility $474.42 |
| Madera | Office $700.63 | Facility $451.34 |
| Manhattan | Office $763.59 | Facility $499.28 |
| Merced | Office $700.63 | Facility $451.34 |
| Metropolitan Boston | Office $753.18 | Facility $481.60 |
| Metropolitan Kansas City | Office $646.29 | Facility $432.71 |
| Metropolitan Philadelphia | Office $695.50 | Facility $458.71 |
| Metropolitan St. Louis | Office $651.90 | Facility $435.36 |
| Miami | Office $722.93 | Facility $486.14 |
| Minnesota | Office $664.60 | Facility $430.55 |
| Mississippi | Office $610.50 | Facility $414.66 |
| Modesto | Office $700.63 | Facility $451.34 |
| Montana** | Office $670.31 | Facility $442.85 |
| Napa | Office $797.53 | Facility $497.74 |
| Nebraska | Office $625.72 | Facility $415.77 |
| Nevada** | Office $666.73 | Facility $439.04 |
| New Hampshire | Office $683.15 | Facility $446.37 |
| New Mexico | Office $643.20 | Facility $434.62 |
| New Orleans | Office $650.89 | Facility $436.85 |
| North Carolina | Office $635.85 | Facility $423.63 |
| North Dakota** | Office $656.07 | Facility $428.61 |
| Northern Nj | Office $750.10 | Facility $486.24 |
| Nyc Suburbs/Long Island | Office $780.51 | Facility $510.06 |
| Ohio | Office $637.01 | Facility $429.34 |
| Oklahoma | Office $623.75 | Facility $420.63 |
| Oxnard-Thousand Oaks-Ventura | Office $738.75 | Facility $469.89 |
| Portland | Office $711.16 | Facility $458.45 |
| Poughkpsie/N Nyc Suburbs | Office $723.76 | Facility $474.69 |
| Puerto Rico | Office $674.24 | Facility $444.27 |
| Queens | Office $767.83 | Facility $498.97 |
| Redding | Office $700.63 | Facility $451.34 |
| Rest Of California | Office $700.63 | Facility $451.34 |
| Rest Of Florida | Office $665.49 | Facility $448.04 |
| Rest Of Georgia | Office $633.35 | Facility $430.45 |
| Rest Of Illinois | Office $650.36 | Facility $442.69 |
| Rest Of Louisiana | Office $625.02 | Facility $423.72 |
| Rest Of Maine | Office $630.43 | Facility $421.17 |
| Rest Of Maryland | Office $675.62 | Facility $445.43 |
| Rest Of Massachusetts | Office $690.08 | Facility $450.56 |
| Rest Of Michigan | Office $639.92 | Facility $432.25 |
| Rest Of Missouri | Office $616.54 | Facility $420.47 |
| Rest Of New Jersey | Office $718.58 | Facility $470.20 |
| Rest Of New York | Office $643.94 | Facility $427.85 |
| Rest Of Oregon | Office $661.67 | Facility $435.12 |
| Rest Of Pennsylvania | Office $637.43 | Facility $428.62 |
| Rest Of Texas | Office $648.37 | Facility $432.51 |
| Rest Of Washington | Office $688.43 | Facility $448.91 |
| Rhode Island | Office $685.43 | Facility $450.47 |
| Riverside-San Bernardino-Ontario | Office $708.52 | Facility $459.22 |
| Sacramento-Roseville-Folsom | Office $731.42 | Facility $466.88 |
| Salinas | Office $728.57 | Facility $464.94 |
| San Diego-Chula Vista-Carlsbad | Office $742.72 | Facility $470.67 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $840.16 | Facility $519.44 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $839.34 | Facility $518.62 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $858.26 | Facility $530.26 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $854.92 | Facility $526.92 |
| San Luis Obispo-Paso Robles | Office $717.21 | Facility $458.13 |
| Santa Cruz-Watsonville | Office $747.55 | Facility $471.18 |
| Santa Maria-Santa Barbara | Office $730.49 | Facility $465.27 |
| Santa Rosa-Petaluma | Office $754.91 | Facility $475.58 |
| Seattle (King Cnty) | Office $766.49 | Facility $487.40 |
| South Carolina | Office $637.45 | Facility $427.28 |
| South Dakota** | Office $654.39 | Facility $426.93 |
| Southern Maine | Office $658.01 | Facility $432.60 |
| Stockton | Office $700.63 | Facility $451.34 |
| Suburban Chicago | Office $701.15 | Facility $467.55 |
| Tennessee | Office $624.15 | Facility $417.38 |
| Utah | Office $644.78 | Facility $430.96 |
| Vallejo | Office $796.35 | Facility $496.56 |
| Vermont | Office $654.62 | Facility $429.44 |
| Virgin Islands | Office $674.24 | Facility $444.27 |
| Virginia | Office $656.73 | Facility $433.14 |
| Visalia | Office $700.63 | Facility $451.34 |
| West Virginia | Office $630.23 | Facility $432.56 |
| Wisconsin | Office $637.53 | Facility $419.62 |
| Wyoming** | Office $664.10 | Facility $436.64 |
| Yuba City | Office $700.63 | Facility $451.34 |
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28291 billing questions
When should 28291 be chosen instead of 28289?
Use 28291 when the hallux rigidus correction includes implant placement. Code 28289 describes the corresponding correction without an implant.
Does the code include the joint debridement and capsular release?
Yes. These are part of the described hallux rigidus correction; do not separately report them as though they were unrelated procedures.
What operative documentation supports 28291?
Document the symptomatic first metatarsophalangeal joint condition, the correction performed, and placement of the implant. The operative note should make clear that the procedure was an implant correction rather than correction without an implant.
How is modifier 50 handled for bilateral surgery?
CMS pays bilateral reporting with modifier 50 at 150%. The record should support that the same procedure was performed on both sides.
How does CMS handle other procedures performed in the same session?
The highest-valued procedure is paid in full, and other procedures are paid at 50%. Related postoperative care is included in the 90-day global period.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
3,16928286,,Repair of hammertoe,A,,4.58,7.90,,3.34,,0.40,12.88,8.32,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,17028288,,Partial removal of foot bone,A,,5.87,11.73,,5.92,,0.68,18.28,12.47,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,17128289,,Corrj halux rigdus w/o implt,A,,6.73,13.47,,5.57,,0.84,21.04,13.14,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,17228291,,Corrj halux rigdus w/implt,A,,7.81,11.54,,4.73,,0.72,20.07,13.26,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,17328292,,Cor hlx vlgs rsc prx phlx bs,A,,7.25,13.02,,5.74,,0.78,21.05,13.77,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,17428295,,Cor hlx vlgs prx mtar osteot,A,,8.36,22.31,,7.27,,1.22,31.89,16.85,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,17528296,,Cor hlx vlgs dstl mtar osteo,A,,8.04,17.59,,5.64,,0.82,26.45,14.50,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00