Billing code 28750: Great toe fusionMedicare rate & RVUs
Reports fusion of the great toe metatarsophalangeal joint, commonly performed for painful arthritis, advanced hallux rigidus, or deformity requiring joint stabilization.
Medicare pays $1,040.10 for 28750 nationally in the office and $536.42 in a hospital or facility. Local office rates run $920.18–$1,369.83.
Medicare rate · 28750
Great toe fusion
Swap in your local Medicare rate.
- Work RVUs
- 8.53
- Total RVUs
- 31.14
- Global days
- 090
National rate · 2026
$1,040.10
Office setting, before claim adjustments.
See every locality for 28750 → · 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 28750 covers
This service fuses the joint between the first metatarsal and the great toe. The surgeon removes joint cartilage and stabilizes the bones so they can unite, typically using fixation such as screws or a plate. Orthopedic foot and ankle surgeons and podiatric surgeons perform it for conditions such as painful first MTP arthritis, advanced hallux rigidus, or selected deformities and salvage situations. It is distinct from fusion of the great toe interphalangeal joint.
Report one unit for the treated MTP joint, with documentation identifying the joint, side, indication, and arthrodesis performed. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For bilateral procedures, modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. 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 28750 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
$920.18 to $1369.83
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $933.63 | $492.90 |
| Alaska* | $1,211.56 | $675.13 |
| Arizona | $1,012.28 | $524.21 |
| Arkansas | $920.18 | $487.51 |
| Atlanta | $1,060.27 | $548.53 |
| Austin | $1,077.75 | $544.85 |
| Bakersfield | $1,098.98 | $546.95 |
| Baltimore/Surr. Cntys | $1,106.20 | $565.75 |
| Beaumont | $972.88 | $514.53 |
| Brazoria | $1,027.34 | $528.19 |
| Chicago | $1,096.29 | $590.08 |
| Chico | $1,095.56 | $543.52 |
| Colorado | $1,080.80 | $544.87 |
| Connecticut | $1,109.15 | $566.68 |
| Dallas | $1,034.25 | $532.58 |
| Dc + Md/Va Suburbs | $1,187.37 | $594.03 |
| Delaware | $1,028.99 | $531.35 |
| Detroit | $1,041.85 | $555.79 |
| East St. Louis | $1,022.44 | $559.05 |
| El Centro | $1,095.76 | $543.72 |
| Fort Lauderdale | $1,080.99 | $570.76 |
| Fort Worth | $1,027.60 | $530.97 |
| Fresno | $1,095.56 | $543.52 |
| Galveston | $1,030.65 | $530.49 |
| Hanford-Corcoran | $1,095.56 | $543.52 |
| Hawaii, Guam | $1,121.76 | $549.07 |
| Houston | $1,052.06 | $551.90 |
| Idaho | $962.22 | $498.83 |
| Indiana | $967.74 | $500.82 |
| Iowa | $955.67 | $494.80 |
| Kansas | $951.97 | $496.64 |
| Kentucky | $957.29 | $509.52 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $1,169.70 | $573.84 |
| Madera | $1,095.56 | $543.52 |
| Manhattan | $1,197.25 | $611.97 |
| Merced | $1,095.56 | $543.52 |
| Metropolitan Boston | $1,186.41 | $585.01 |
| Metropolitan Kansas City | $995.52 | $522.56 |
| Metropolitan Philadelphia | $1,082.14 | $557.80 |
| Metropolitan St. Louis | $1,005.81 | $526.30 |
| Miami | $1,129.22 | $604.88 |
| Minnesota | $1,033.36 | $515.07 |
| Mississippi | $930.36 | $496.69 |
| Modesto | $1,095.56 | $543.52 |
| Montana** | $1,040.03 | $536.34 |
| Napa | $1,266.55 | $602.69 |
| Nebraska | $960.66 | $495.75 |
| Nevada** | $1,034.29 | $530.10 |
| New Hampshire | $1,064.58 | $540.24 |
| New Mexico | $988.52 | $526.64 |
| New Orleans | $1,003.17 | $529.20 |
| North Carolina | $978.02 | $508.08 |
| North Dakota** | $1,016.89 | $513.21 |
| Northern Nj | $1,175.29 | $591.01 |
| Nyc Suburbs/Long Island | $1,227.17 | $628.29 |
| Ohio | $978.11 | $518.25 |
| Oklahoma | $954.77 | $504.97 |
| Oxnard-Thousand Oaks-Ventura | $1,163.68 | $568.33 |
| Portland | $1,114.15 | $554.55 |
| Poughkpsie/N Nyc Suburbs | $1,129.16 | $577.63 |
| Puerto Rico | $1,047.40 | $538.17 |
| Queens | $1,205.94 | $610.59 |
| Redding | $1,095.56 | $543.52 |
| Rest Of California | $1,095.56 | $543.52 |
| Rest Of Florida | $1,028.25 | $546.73 |
| Rest Of Georgia | $970.27 | $520.98 |
| Rest Of Illinois | $999.80 | $539.94 |
| Rest Of Louisiana | $956.11 | $510.35 |
| Rest Of Maine | $968.04 | $504.65 |
| Rest Of Maryland | $1,048.34 | $538.61 |
| Rest Of Massachusetts | $1,074.68 | $544.30 |
| Rest Of Michigan | $982.84 | $522.98 |
| Rest Of Missouri | $940.26 | $506.09 |
| Rest Of New Jersey | $1,121.17 | $571.15 |
| Rest Of New York | $992.69 | $514.19 |
| Rest Of Oregon | $1,025.63 | $523.96 |
| Rest Of Pennsylvania | $979.23 | $516.85 |
| Rest Of Texas | $999.79 | $521.79 |
| Rest Of Washington | $1,072.42 | $542.04 |
| Rhode Island | $1,064.93 | $544.62 |
| Riverside-San Bernardino-Ontario | $1,108.23 | $556.20 |
| Sacramento-Roseville-Folsom | $1,148.95 | $563.17 |
| Salinas | $1,144.67 | $560.89 |
| San Diego-Chula Vista-Carlsbad | $1,171.11 | $568.70 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $1,339.64 | $629.44 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $1,338.31 | $628.11 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $1,369.83 | $643.52 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $1,364.40 | $638.09 |
| San Luis Obispo-Paso Robles | $1,126.35 | $552.66 |
| Santa Cruz-Watsonville | $1,181.92 | $569.94 |
| Santa Maria-Santa Barbara | $1,148.82 | $561.53 |
| Santa Rosa-Petaluma | $1,193.79 | $575.27 |
| Seattle (King Cnty) | $1,209.76 | $591.73 |
| South Carolina | $979.82 | $514.41 |
| South Dakota** | $1,014.16 | $510.47 |
| Southern Maine | $1,019.24 | $520.09 |
| Stockton | $1,095.56 | $543.52 |
| Suburban Chicago | $1,091.60 | $574.32 |
| Tennessee | $956.84 | $498.99 |
| Utah | $993.15 | $519.69 |
| Vallejo | $1,264.64 | $600.78 |
| Vermont | $1,013.64 | $514.99 |
| Virgin Islands | $1,047.40 | $538.17 |
| Virginia | $1,016.44 | $521.32 |
| Visalia | $1,095.56 | $543.52 |
| West Virginia | $963.14 | $525.43 |
| Wisconsin | $982.98 | $500.45 |
| Wyoming** | $1,029.94 | $526.26 |
| Yuba City | $1,095.56 | $543.52 |
28750 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.
$920.18
$1,232.70
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 | $1,211.56 | 1 |
| AL | $933.63 | 1 |
| AR | $920.18 | 1 |
| AZ | $1,012.28 | 1 |
| CA | $1,095.56–$1,369.83 | 29 |
| CO | $1,080.80 | 1 |
| CT | $1,109.15 | 1 |
| DC | $1,187.37 | 1 |
| DE | $1,028.99 | 1 |
| FL | $1,028.25–$1,129.22 | 3 |
| GA | $970.27–$1,060.27 | 2 |
| GU | $1,121.76 | 1 |
| HI | $1,121.76 | 1 |
| IA | $955.67 | 1 |
| ID | $962.22 | 1 |
| IL | $999.80–$1,096.29 | 4 |
| IN | $967.74 | 1 |
| KS | $951.97 | 1 |
| KY | $957.29 | 1 |
| LA | $956.11–$1,003.17 | 2 |
| MA | $1,074.68–$1,186.41 | 2 |
| MD | $1,048.34–$1,187.37 | 3 |
| ME | $968.04–$1,019.24 | 2 |
| MI | $982.84–$1,041.85 | 2 |
| MN | $1,033.36 | 1 |
| MO | $940.26–$1,005.81 | 3 |
| MS | $930.36 | 1 |
| MT | $1,040.03 | 1 |
| NC | $978.02 | 1 |
| ND | $1,016.89 | 1 |
| NE | $960.66 | 1 |
| NH | $1,064.58 | 1 |
| NJ | $1,121.17–$1,175.29 | 2 |
| NM | $988.52 | 1 |
| NV | $1,034.29 | 1 |
| NY | $992.69–$1,227.17 | 5 |
| OH | $978.11 | 1 |
| OK | $954.77 | 1 |
| OR | $1,025.63–$1,114.15 | 2 |
| PA | $979.23–$1,082.14 | 2 |
| PR | $1,047.40 | 1 |
| RI | $1,064.93 | 1 |
| SC | $979.82 | 1 |
| SD | $1,014.16 | 1 |
| TN | $956.84 | 1 |
| TX | $972.88–$1,077.75 | 8 |
| UT | $993.15 | 1 |
| VA | $1,016.44–$1,187.37 | 2 |
| VI | $1,047.40 | 1 |
| VT | $1,013.64 | 1 |
| WA | $1,072.42–$1,209.76 | 2 |
| WI | $982.98 | 1 |
| WV | $963.14 | 1 |
| WY | $1,029.94 | 1 |
How the 28750 rate is calculated
Each of 28750’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 · 28750
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 8.53Practice expense 21.44Malpractice 1.17
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 28750
28750 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28750
Great toe fusion
| 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) | 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 · 28750
Great toe fusion
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
28750 without 50 · national office
$1,040.10
Great toe fusion
28750-50 · Bilateral: 150%
$1,560.15
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).
28750 compared with similar codes
Compare codes
28750 vs 28755 vs 28760 vs 28289: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 28755Big toe fusion
- This code fuses the first MTP joint. Code 28755 is for fusion of the great toe interphalangeal joint.
- 28760Big toe fusion
- Code 28760 is another great toe interphalangeal arthrodesis option. Confirm the joint and operative procedure before choosing between the codes.
- 28289Hallux rigidus surgery
- Code 28289 reports hallux rigidus treatment by cheilectomy, not fusion. It may be selected when the surgeon treats the joint while preserving motion.
28750 billing questions
How is this code distinguished from great toe interphalangeal fusion?
This code is for fusion at the first metatarsophalangeal joint, where the great toe meets the foot. Use the interphalangeal fusion code when the fusion is at the joint within the great toe.
Does the 90-day global period include routine postoperative care?
Yes. The global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is a bilateral procedure reported for Medicare payment?
Use modifier 50 for a bilateral procedure; CMS pays the bilateral service at 150%.
What documentation supports reporting this fusion?
Document the first MTP joint and side treated, the clinical indication, and that the surgeon performed arthrodesis. The operative report should distinguish the MTP joint from the great toe interphalangeal joint.
How does the multiple-procedure rule affect payment?
When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. CMS does not permit co-surgeon or team-surgery payment for this code.
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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