Billing code 28345: Webbed toe repairMedicare rate & RVUs
Surgical separation and reconstruction of fused toes is reported for foot syndactyly, commonly a congenital webbing that limits toe separation or function.
Medicare pays $502.68 for 28345 nationally in the office and $338.69 in a hospital or facility. Local office rates run $454.15–$644.17.
Medicare rate · 28345
Webbed toe repair
- Work RVUs
- 5.94
- Total RVUs
- 15.05
- Global days
- 090
National rate · 2026
$502.68
Office setting, before claim adjustments.
See every locality for 28345 →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 28345 covers
This operation separates toes joined by skin or soft tissue and reshapes the web space between them. An orthopedic foot and ankle surgeon, podiatric surgeon, or plastic surgeon may perform it, often for congenital toe syndactyly when the webbing affects shoe fit, function, or appearance. Reconstruction may use local skin flaps and, when needed, a skin graft. The operative report should identify the affected toes and web space and describe the separation and reconstruction performed.
Report the code for surgical correction of webbed toes, not for removal of an extra digit or correction of a different toe deformity. CMS assigns a 90-day major-surgery 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 other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate under the CMS bilateral rule for this code. Assistant-at-surgery payment requires documented medical necessity; 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 28345 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
$454.15 to $644.17
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $459.59 | $316.09 |
| Alaska* | $613.25 | $438.59 |
| Arizona | $491.40 | $332.49 |
| Arkansas | $454.15 | $313.28 |
| Atlanta | $511.18 | $344.55 |
| Austin | $517.91 | $344.40 |
| Bakersfield | $527.69 | $347.95 |
| Baltimore/Surr. Cntys | $530.75 | $354.78 |
| Beaumont | $475.61 | $326.37 |
| Brazoria | $498.08 | $335.56 |
| Chicago | $526.71 | $361.89 |
| Chico | $526.10 | $346.36 |
| Colorado | $519.91 | $345.41 |
| Connecticut | $532.26 | $355.63 |
| Dallas | $500.99 | $337.65 |
| Dc + Md/Va Suburbs | $566.50 | $373.31 |
| Delaware | $498.57 | $336.54 |
| Detroit | $503.83 | $345.58 |
| East St. Louis | $496.25 | $345.37 |
| El Centro | $526.18 | $346.44 |
| Fort Lauderdale | $519.65 | $353.52 |
| Fort Worth | $498.33 | $336.62 |
| Fresno | $526.10 | $346.36 |
| Galveston | $499.44 | $336.59 |
| Hanford-Corcoran | $526.10 | $346.36 |
| Hawaii, Guam | $535.24 | $348.77 |
| Houston | $508.41 | $345.56 |
| Idaho | $471.03 | $320.15 |
| Indiana | $473.25 | $321.23 |
| Iowa | $468.34 | $318.28 |
| Kansas | $466.93 | $318.67 |
| Kentucky | $469.33 | $323.54 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $558.01 | $364.00 |
| Madera | $526.10 | $346.36 |
| Manhattan | $571.61 | $381.05 |
| Merced | $526.10 | $346.36 |
| Metropolitan Boston | $564.87 | $369.06 |
| Metropolitan Kansas City | $484.74 | $330.75 |
| Metropolitan Philadelphia | $521.22 | $350.50 |
| Metropolitan St. Louis | $488.90 | $332.77 |
| Miami | $539.51 | $368.79 |
| Minnesota | $499.51 | $330.76 |
| Mississippi | $458.39 | $317.19 |
| Modesto | $526.10 | $346.36 |
| Montana** | $502.65 | $338.65 |
| Napa | $598.69 | $382.54 |
| Nebraska | $470.33 | $318.96 |
| Nevada** | $500.24 | $336.08 |
| New Hampshire | $512.44 | $341.72 |
| New Mexico | $482.08 | $331.69 |
| New Orleans | $487.92 | $333.60 |
| North Carolina | $477.48 | $324.47 |
| North Dakota** | $492.96 | $328.96 |
| Northern Nj | $562.36 | $372.12 |
| Nyc Suburbs/Long Island | $583.82 | $388.83 |
| Ohio | $477.77 | $328.04 |
| Oklahoma | $468.23 | $321.78 |
| Oxnard-Thousand Oaks-Ventura | $554.47 | $360.62 |
| Portland | $533.63 | $351.42 |
| Poughkpsie/N Nyc Suburbs | $542.40 | $362.82 |
| Puerto Rico | $505.61 | $339.80 |
| Queens | $575.02 | $381.17 |
| Redding | $526.10 | $346.36 |
| Rest Of California | $526.10 | $346.36 |
| Rest Of Florida | $498.25 | $341.47 |
| Rest Of Georgia | $474.73 | $328.44 |
| Rest Of Illinois | $486.85 | $337.12 |
| Rest Of Louisiana | $468.89 | $323.75 |
| Rest Of Maine | $473.46 | $322.59 |
| Rest Of Maryland | $506.78 | $340.81 |
| Rest Of Massachusetts | $517.80 | $345.10 |
| Rest Of Michigan | $479.75 | $330.02 |
| Rest Of Missouri | $462.53 | $321.16 |
| Rest Of New Jersey | $538.70 | $359.61 |
| Rest Of New York | $483.43 | $327.63 |
| Rest Of Oregon | $496.67 | $333.33 |
| Rest Of Pennsylvania | $478.17 | $327.62 |
| Rest Of Texas | $486.41 | $330.78 |
| Rest Of Washington | $516.61 | $343.92 |
| Rhode Island | $514.19 | $344.78 |
| Riverside-San Bernardino-Ontario | $531.49 | $351.75 |
| Sacramento-Roseville-Folsom | $549.16 | $358.43 |
| Salinas | $547.02 | $356.94 |
| San Diego-Chula Vista-Carlsbad | $557.57 | $361.43 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $630.72 | $399.49 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $630.17 | $398.93 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $644.17 | $407.69 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $641.90 | $405.41 |
| San Luis Obispo-Paso Robles | $538.48 | $351.69 |
| Santa Cruz-Watsonville | $561.16 | $361.90 |
| Santa Maria-Santa Barbara | $548.44 | $357.22 |
| Santa Rosa-Petaluma | $566.69 | $365.30 |
| Seattle (King Cnty) | $574.97 | $373.74 |
| South Carolina | $478.35 | $326.81 |
| South Dakota** | $491.82 | $327.82 |
| Southern Maine | $494.05 | $331.53 |
| Stockton | $526.10 | $346.36 |
| Suburban Chicago | $524.48 | $356.05 |
| Tennessee | $468.91 | $319.83 |
| Utah | $483.74 | $329.58 |
| Vallejo | $597.89 | $381.74 |
| Vermont | $491.72 | $329.36 |
| Virgin Islands | $505.61 | $339.80 |
| Virginia | $492.98 | $331.77 |
| Visalia | $526.10 | $346.36 |
| West Virginia | $472.02 | $329.51 |
| Wisconsin | $479.27 | $322.16 |
| Wyoming** | $498.43 | $334.43 |
| Yuba City | $526.10 | $346.36 |
28345 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.
$454.15
$613.25
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 | $613.25 | 1 |
| AL | $459.59 | 1 |
| AR | $454.15 | 1 |
| AZ | $491.40 | 1 |
| CA | $526.10–$644.17 | 29 |
| CO | $519.91 | 1 |
| CT | $532.26 | 1 |
| DC | $566.50 | 1 |
| DE | $498.57 | 1 |
| FL | $498.25–$539.51 | 3 |
| GA | $474.73–$511.18 | 2 |
| GU | $535.24 | 1 |
| HI | $535.24 | 1 |
| IA | $468.34 | 1 |
| ID | $471.03 | 1 |
| IL | $486.85–$526.71 | 4 |
| IN | $473.25 | 1 |
| KS | $466.93 | 1 |
| KY | $469.33 | 1 |
| LA | $468.89–$487.92 | 2 |
| MA | $517.80–$564.87 | 2 |
| MD | $506.78–$566.50 | 3 |
| ME | $473.46–$494.05 | 2 |
| MI | $479.75–$503.83 | 2 |
| MN | $499.51 | 1 |
| MO | $462.53–$488.90 | 3 |
| MS | $458.39 | 1 |
| MT | $502.65 | 1 |
| NC | $477.48 | 1 |
| ND | $492.96 | 1 |
| NE | $470.33 | 1 |
| NH | $512.44 | 1 |
| NJ | $538.70–$562.36 | 2 |
| NM | $482.08 | 1 |
| NV | $500.24 | 1 |
| NY | $483.43–$583.82 | 5 |
| OH | $477.77 | 1 |
| OK | $468.23 | 1 |
| OR | $496.67–$533.63 | 2 |
| PA | $478.17–$521.22 | 2 |
| PR | $505.61 | 1 |
| RI | $514.19 | 1 |
| SC | $478.35 | 1 |
| SD | $491.82 | 1 |
| TN | $468.91 | 1 |
| TX | $475.61–$517.91 | 8 |
| UT | $483.74 | 1 |
| VA | $492.98–$566.50 | 2 |
| VI | $505.61 | 1 |
| VT | $491.72 | 1 |
| WA | $516.61–$574.97 | 2 |
| WI | $479.27 | 1 |
| WV | $472.02 | 1 |
| WY | $498.43 | 1 |
How the 28345 rate is calculated
Each of 28345’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 · 28345
RVUs × geographic indexes × conversion factor
Work5.94
5.94 RVUs× 1.000 GPCI
Practice expense8.62
8.62 RVUs× 1.000 GPCI
Malpractice0.49
0.49 RVUs× 1.000 GPCI
Adjusted RVUs
15.0500
Conversion factor
$33.4009
Medicare rate
$502.68
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 28345
28345 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28345
Webbed toe repair
| 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) | 0 | Not paid without supporting documentation. |
| 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 · 28345
Webbed toe repair
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
28345 without 51 · national office
$502.68
Webbed toe repair
28345-51 · Second procedure: 50%
$251.34
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%).
28345 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 28344Toe reconstruction
- Use 28345 for separation of webbed toes. Use 28344 when the operative problem is an extra digit requiring correction.
- 28313Toe deformity repair
- 28345 addresses fused toes and web-space reconstruction; 28313 is for repair of a toe deformity that is not syndactyly.
- 28360Foot reconstruction
- 28345 treats toe webbing. 28360 is for reconstruction of a cleft foot, a broader congenital foot malformation.
28345 billing questions
How is this different from repair of an extra toe?
This code addresses separation of toes joined by webbing. Code 28344 is for correction of an extra digit, a different congenital toe condition.
Should modifier 50 be used when both feet are treated?
No. CMS identifies modifier 50 as inappropriate for this code. Document the treated foot or feet and the web spaces addressed.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon be reported?
Assistant-at-surgery payment is allowed only when medical necessity is documented. CMS does not permit co-surgeons or team surgery for this code.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures performed in that session are subject to the standard multiple-procedure reduction.
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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