Billing code 28340: Toe reconstructionMedicare rate & RVUs

Medicare pays $557.13 for 28340 nationally in the office and $380.77 in a hospital or facility. Local office rates run $504.62–$708.23.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 28340 covers

This procedure reduces an abnormally enlarged toe by surgically removing excess tissue as part of reconstructing the toe. A foot and ankle surgeon, orthopedic surgeon, or podiatric surgeon may perform it for macrodactyly or another documented condition causing substantial toe enlargement. The operative report should identify the affected toe, the enlargement being treated, and the reconstructive work performed.

Report the service when the operative work addresses enlargement of the toe, rather than an isolated angular deformity or a bone-alignment problem. Documentation should support the condition and the extent of the resection. Medicare assigns a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. 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 50% reduction. Do not append modifier 50; the descriptor or anatomy makes a bilateral adjustment inappropriate. Medicare does not pay an assistant at surgery, and 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 28340 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

28340 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 28340 rate is calculated

Each of 28340’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.

Payment rules and modifiers for 28340

28340 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

28340 compared with similar codes

How to choose

28341Toe reduction

Both codes concern reconstruction of an enlarged toe. Check the complete billing code descriptors and operative details to determine which specific procedure was performed.

28313Toe deformity repair

This code addresses correction of toe angular deformity. Select 28340 when the documented operative work reduces enlargement rather than correcting alignment.

28344Toe reconstruction

This code concerns reconstruction of extra toes. It is not the choice for resection intended to reduce an enlarged toe.

Codes related to 28340

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

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

Open CMS sourceHow we calculate rates