Billing code 28312: Toe osteotomyMedicare rate & RVUs
Reports surgical reshaping of a lesser toe’s proximal phalanx to correct shortening, angular alignment, or rotation when an osseous correction is performed.
Medicare pays $595.87 for 28312 nationally in the office and $346.70 in a hospital or facility. Local office rates run $525.10–$786.78.
Medicare rate · 28312
Toe osteotomy
Swap in your local Medicare rate.
- Work RVUs
- 4.57
- Total RVUs
- 17.84
- Global days
- 090
National rate · 2026
$595.87
Office setting, before claim adjustments.
See every locality for 28312 → · 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 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.
Where 28312 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
$525.10 to $786.78
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $533.04 | $315.01 |
| Alaska* | $688.64 | $423.28 |
| Arizona | $579.41 | $337.97 |
| Arkansas | $525.10 | $311.07 |
| Atlanta | $607.87 | $354.71 |
| Austin | $617.75 | $354.13 |
| Bakersfield | $629.61 | $356.52 |
| Baltimore/Surr. Cntys | $634.61 | $367.25 |
| Beaumont | $556.44 | $329.69 |
| Brazoria | $588.03 | $341.10 |
| Chicago | $630.18 | $379.76 |
| Chico | $627.55 | $354.46 |
| Colorado | $619.26 | $354.15 |
| Connecticut | $636.25 | $367.90 |
| Dallas | $592.15 | $343.98 |
| Dc + Md/Va Suburbs | $681.45 | $387.92 |
| Delaware | $589.18 | $343.00 |
| Detroit | $597.70 | $357.25 |
| East St. Louis | $586.72 | $357.49 |
| El Centro | $627.67 | $354.58 |
| Fort Lauderdale | $620.75 | $368.34 |
| Fort Worth | $588.28 | $342.59 |
| Fresno | $627.55 | $354.46 |
| Galveston | $590.02 | $342.60 |
| Hanford-Corcoran | $627.55 | $354.46 |
| Hawaii, Guam | $643.18 | $359.87 |
| Houston | $603.20 | $355.77 |
| Idaho | $549.66 | $320.43 |
| Indiana | $552.91 | $321.93 |
| Iowa | $545.74 | $317.75 |
| Kansas | $543.70 | $318.45 |
| Kentucky | $547.30 | $325.79 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $670.76 | $375.99 |
| Madera | $627.55 | $354.46 |
| Manhattan | $687.64 | $398.10 |
| Merced | $627.55 | $354.46 |
| Metropolitan Boston | $680.81 | $383.30 |
| Metropolitan Kansas City | $569.75 | $335.78 |
| Metropolitan Philadelphia | $620.45 | $361.06 |
| Metropolitan St. Louis | $575.80 | $338.59 |
| Miami | $649.83 | $390.44 |
| Minnesota | $591.10 | $334.70 |
| Mississippi | $531.33 | $316.79 |
| Modesto | $627.55 | $354.46 |
| Montana** | $595.82 | $346.65 |
| Napa | $726.96 | $398.55 |
| Nebraska | $548.64 | $318.65 |
| Nevada** | $592.28 | $342.86 |
| New Hampshire | $610.05 | $350.67 |
| New Mexico | $565.91 | $337.42 |
| New Orleans | $574.41 | $339.94 |
| North Carolina | $559.11 | $326.63 |
| North Dakota** | $581.59 | $332.42 |
| Northern Nj | $674.19 | $385.15 |
| Nyc Suburbs/Long Island | $705.48 | $409.21 |
| Ohio | $559.60 | $332.10 |
| Oklahoma | $545.66 | $323.15 |
| Oxnard-Thousand Oaks-Ventura | $667.37 | $372.85 |
| Portland | $638.69 | $361.86 |
| Poughkpsie/N Nyc Suburbs | $647.61 | $374.77 |
| Puerto Rico | $600.12 | $348.21 |
| Queens | $692.56 | $398.04 |
| Redding | $627.55 | $354.46 |
| Rest Of California | $627.55 | $354.46 |
| Rest Of Florida | $589.52 | $351.32 |
| Rest Of Georgia | $555.22 | $332.96 |
| Rest Of Illinois | $572.94 | $345.45 |
| Rest Of Louisiana | $546.66 | $326.14 |
| Rest Of Maine | $553.25 | $324.01 |
| Rest Of Maryland | $600.46 | $348.30 |
| Rest Of Massachusetts | $615.65 | $353.27 |
| Rest Of Michigan | $562.51 | $335.01 |
| Rest Of Missouri | $537.40 | $322.61 |
| Rest Of New Jersey | $642.88 | $370.78 |
| Rest Of New York | $567.77 | $331.06 |
| Rest Of Oregon | $587.05 | $338.88 |
| Rest Of Pennsylvania | $560.18 | $331.44 |
| Rest Of Texas | $572.16 | $335.70 |
| Rest Of Washington | $614.33 | $351.95 |
| Rhode Island | $610.01 | $352.61 |
| Riverside-San Bernardino-Ontario | $635.33 | $362.23 |
| Sacramento-Roseville-Folsom | $658.54 | $368.75 |
| Salinas | $656.10 | $367.31 |
| San Diego-Chula Vista-Carlsbad | $671.60 | $373.59 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $769.23 | $417.90 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $768.41 | $417.08 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $786.78 | $427.48 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $783.44 | $424.14 |
| San Luis Obispo-Paso Robles | $645.57 | $361.77 |
| Santa Cruz-Watsonville | $678.04 | $375.30 |
| Santa Maria-Santa Barbara | $658.57 | $368.04 |
| Santa Rosa-Petaluma | $684.87 | $378.88 |
| Seattle (King Cnty) | $694.26 | $388.52 |
| South Carolina | $560.41 | $330.17 |
| South Dakota** | $579.90 | $330.73 |
| Southern Maine | $583.23 | $336.30 |
| Stockton | $627.55 | $354.46 |
| Suburban Chicago | $626.82 | $370.93 |
| Tennessee | $546.59 | $320.10 |
| Utah | $568.27 | $334.05 |
| Vallejo | $725.78 | $397.37 |
| Vermont | $579.80 | $333.12 |
| Virgin Islands | $600.12 | $348.21 |
| Virginia | $581.68 | $336.74 |
| Visalia | $627.55 | $354.46 |
| West Virginia | $551.32 | $334.79 |
| Wisconsin | $561.62 | $322.92 |
| Wyoming** | $589.62 | $340.45 |
| Yuba City | $627.55 | $354.46 |
28312 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.
$525.10
$707.17
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 | $688.64 | 1 |
| AL | $533.04 | 1 |
| AR | $525.10 | 1 |
| AZ | $579.41 | 1 |
| CA | $627.55–$786.78 | 29 |
| CO | $619.26 | 1 |
| CT | $636.25 | 1 |
| DC | $681.45 | 1 |
| DE | $589.18 | 1 |
| FL | $589.52–$649.83 | 3 |
| GA | $555.22–$607.87 | 2 |
| GU | $643.18 | 1 |
| HI | $643.18 | 1 |
| IA | $545.74 | 1 |
| ID | $549.66 | 1 |
| IL | $572.94–$630.18 | 4 |
| IN | $552.91 | 1 |
| KS | $543.70 | 1 |
| KY | $547.30 | 1 |
| LA | $546.66–$574.41 | 2 |
| MA | $615.65–$680.81 | 2 |
| MD | $600.46–$681.45 | 3 |
| ME | $553.25–$583.23 | 2 |
| MI | $562.51–$597.70 | 2 |
| MN | $591.10 | 1 |
| MO | $537.40–$575.80 | 3 |
| MS | $531.33 | 1 |
| MT | $595.82 | 1 |
| NC | $559.11 | 1 |
| ND | $581.59 | 1 |
| NE | $548.64 | 1 |
| NH | $610.05 | 1 |
| NJ | $642.88–$674.19 | 2 |
| NM | $565.91 | 1 |
| NV | $592.28 | 1 |
| NY | $567.77–$705.48 | 5 |
| OH | $559.60 | 1 |
| OK | $545.66 | 1 |
| OR | $587.05–$638.69 | 2 |
| PA | $560.18–$620.45 | 2 |
| PR | $600.12 | 1 |
| RI | $610.01 | 1 |
| SC | $560.41 | 1 |
| SD | $579.90 | 1 |
| TN | $546.59 | 1 |
| TX | $556.44–$617.75 | 8 |
| UT | $568.27 | 1 |
| VA | $581.68–$681.45 | 2 |
| VI | $600.12 | 1 |
| VT | $579.80 | 1 |
| WA | $614.33–$694.26 | 2 |
| WI | $561.62 | 1 |
| WV | $551.32 | 1 |
| WY | $589.62 | 1 |
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
Swap in your local Medicare rate.
Work 4.57Practice expense 12.55Malpractice 0.72
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
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
| 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) | 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 · 28312
Toe osteotomy
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
28312 without 51 · national office
$595.87
Toe osteotomy
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%).
28312 compared with similar codes
Compare codes
28312 vs 28310 vs 28313 vs 28285 vs 28308: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 28310Toe osteotomy
- 28310 addresses the proximal phalanx of the great toe. This code addresses a toe other than the great toe.
- 28313Toe deformity repair
- 28313 is for toe deformity reconstruction using soft-tissue procedures only. This code represents a bony osteotomy of a lesser toe’s proximal phalanx.
- 28285Hammertoe repair
- 28285 is used for hammertoe correction. Choose between the codes based on the documented procedure; a hammertoe diagnosis by itself does not establish a proximal-phalanx osteotomy.
- 28308Metatarsal osteotomy
- 28308 addresses an osteotomy of a metatarsal. This code addresses the proximal phalanx of a lesser toe.
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
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