Billing code 28820: Toe amputationMedicare rate & RVUs
Reports complete removal of a toe through its metatarsophalangeal joint, commonly for gangrene, infection, or tissue loss confined to the toe.
Medicare pays $297.27 for 28820 nationally in the office and $161.66 in a hospital or facility. Local office rates run $266.63–$378.03.
Medicare rate · 28820
Toe amputation
Swap in your local Medicare rate.
- Work RVUs
- 3.42
- Total RVUs
- 8.90
- Global days
- 000
National rate · 2026
$297.27
Office setting, before claim adjustments.
See every locality for 28820 → · 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 28820 covers
This procedure removes an entire toe through the joint where it meets the foot, without removing the metatarsal. Podiatric, orthopedic, or other surgeons may perform it for problems such as gangrene, infection, or nonhealing ulceration when the affected toe cannot be preserved. It is also used when trauma requires removal at this level. The code describes the operative level, not a specific diagnosis.
Report 28820 when the operative note supports removal through the metatarsophalangeal joint; a more distal partial toe removal or an amputation that includes metatarsal bone points to a different code. Document the affected toe, clinical reason, and actual level and extent of removal. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures are performed in one session, the highest-valued is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code; 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 28820 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
$266.63 to $378.03
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $270.05 | $151.40 |
| Alaska* | $359.07 | $214.65 |
| Arizona | $290.01 | $158.60 |
| Arkansas | $266.63 | $150.15 |
| Atlanta | $303.13 | $165.36 |
| Austin | $305.70 | $162.23 |
| Bakersfield | $310.18 | $161.55 |
| Baltimore/Surr. Cntys | $314.76 | $169.25 |
| Beaumont | $281.06 | $157.66 |
| Brazoria | $293.57 | $159.19 |
| Chicago | $317.08 | $180.79 |
| Chico | $308.93 | $160.30 |
| Colorado | $306.38 | $162.10 |
| Connecticut | $315.51 | $169.46 |
| Dallas | $295.63 | $160.56 |
| Dc + Md/Va Suburbs | $335.11 | $175.36 |
| Delaware | $294.39 | $160.41 |
| Detroit | $300.98 | $170.11 |
| East St. Louis | $297.97 | $173.21 |
| El Centro | $309.00 | $160.37 |
| Fort Lauderdale | $310.80 | $173.43 |
| Fort Worth | $294.12 | $160.41 |
| Fresno | $308.93 | $160.30 |
| Galveston | $294.59 | $159.93 |
| Hanford-Corcoran | $308.93 | $160.30 |
| Hawaii, Guam | $314.52 | $160.33 |
| Houston | $302.27 | $167.62 |
| Idaho | $276.35 | $151.60 |
| Indiana | $277.72 | $152.01 |
| Iowa | $274.44 | $150.36 |
| Kansas | $274.09 | $151.50 |
| Kentucky | $277.32 | $156.76 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $328.17 | $167.74 |
| Madera | $308.93 | $160.30 |
| Manhattan | $340.18 | $182.60 |
| Merced | $308.93 | $160.30 |
| Metropolitan Boston | $333.20 | $171.28 |
| Metropolitan Kansas City | $286.64 | $159.30 |
| Metropolitan Philadelphia | $308.96 | $167.79 |
| Metropolitan St. Louis | $289.18 | $160.09 |
| Miami | $325.65 | $184.48 |
| Minnesota | $292.29 | $152.75 |
| Mississippi | $270.11 | $153.36 |
| Modesto | $308.93 | $160.30 |
| Montana** | $297.24 | $161.63 |
| Napa | $351.31 | $172.58 |
| Nebraska | $275.53 | $150.36 |
| Nevada** | $295.09 | $159.35 |
| New Hampshire | $302.44 | $161.28 |
| New Mexico | $286.06 | $161.71 |
| New Orleans | $289.20 | $161.60 |
| North Carolina | $280.88 | $154.36 |
| North Dakota** | $288.94 | $153.33 |
| Northern Nj | $332.46 | $175.15 |
| Nyc Suburbs/Long Island | $348.54 | $187.31 |
| Ohio | $282.68 | $158.87 |
| Oklahoma | $276.06 | $154.96 |
| Oxnard-Thousand Oaks-Ventura | $325.94 | $165.65 |
| Portland | $314.26 | $163.60 |
| Poughkpsie/N Nyc Suburbs | $321.41 | $172.92 |
| Puerto Rico | $298.92 | $161.82 |
| Queens | $341.54 | $181.25 |
| Redding | $308.93 | $160.30 |
| Rest Of California | $308.93 | $160.30 |
| Rest Of Florida | $296.89 | $167.25 |
| Rest Of Georgia | $281.71 | $160.75 |
| Rest Of Illinois | $290.46 | $166.65 |
| Rest Of Louisiana | $277.24 | $157.23 |
| Rest Of Maine | $278.44 | $153.69 |
| Rest Of Maryland | $299.29 | $162.05 |
| Rest Of Massachusetts | $305.21 | $162.41 |
| Rest Of Michigan | $284.37 | $160.56 |
| Rest Of Missouri | $273.58 | $156.69 |
| Rest Of New Jersey | $318.75 | $170.66 |
| Rest Of New York | $284.65 | $155.82 |
| Rest Of Oregon | $292.43 | $157.36 |
| Rest Of Pennsylvania | $282.64 | $158.15 |
| Rest Of Texas | $287.29 | $158.60 |
| Rest Of Washington | $304.36 | $161.56 |
| Rhode Island | $303.50 | $163.42 |
| Riverside-San Bernardino-Ontario | $313.49 | $164.86 |
| Sacramento-Roseville-Folsom | $322.42 | $164.71 |
| Salinas | $321.17 | $164.00 |
| San Diego-Chula Vista-Carlsbad | $327.40 | $165.21 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $369.82 | $178.62 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $369.35 | $178.14 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $378.03 | $182.48 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $376.08 | $180.53 |
| San Luis Obispo-Paso Robles | $316.19 | $161.74 |
| Santa Cruz-Watsonville | $329.49 | $164.73 |
| Santa Maria-Santa Barbara | $322.01 | $163.89 |
| Santa Rosa-Petaluma | $332.72 | $166.19 |
| Seattle (King Cnty) | $338.78 | $172.39 |
| South Carolina | $282.32 | $157.02 |
| South Dakota** | $287.95 | $152.35 |
| Southern Maine | $290.57 | $156.18 |
| Stockton | $308.93 | $160.30 |
| Suburban Chicago | $313.46 | $174.19 |
| Tennessee | $275.39 | $152.13 |
| Utah | $285.70 | $158.23 |
| Vallejo | $350.62 | $171.89 |
| Vermont | $288.65 | $154.40 |
| Virgin Islands | $298.92 | $161.82 |
| Virginia | $290.27 | $156.97 |
| Visalia | $308.93 | $160.30 |
| West Virginia | $281.17 | $163.33 |
| Wisconsin | $280.46 | $150.55 |
| Wyoming** | $293.62 | $158.01 |
| Yuba City | $308.93 | $160.30 |
28820 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.
$266.63
$359.07
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 | $359.07 | 1 |
| AL | $270.05 | 1 |
| AR | $266.63 | 1 |
| AZ | $290.01 | 1 |
| CA | $308.93–$378.03 | 29 |
| CO | $306.38 | 1 |
| CT | $315.51 | 1 |
| DC | $335.11 | 1 |
| DE | $294.39 | 1 |
| FL | $296.89–$325.65 | 3 |
| GA | $281.71–$303.13 | 2 |
| GU | $314.52 | 1 |
| HI | $314.52 | 1 |
| IA | $274.44 | 1 |
| ID | $276.35 | 1 |
| IL | $290.46–$317.08 | 4 |
| IN | $277.72 | 1 |
| KS | $274.09 | 1 |
| KY | $277.32 | 1 |
| LA | $277.24–$289.20 | 2 |
| MA | $305.21–$333.20 | 2 |
| MD | $299.29–$335.11 | 3 |
| ME | $278.44–$290.57 | 2 |
| MI | $284.37–$300.98 | 2 |
| MN | $292.29 | 1 |
| MO | $273.58–$289.18 | 3 |
| MS | $270.11 | 1 |
| MT | $297.24 | 1 |
| NC | $280.88 | 1 |
| ND | $288.94 | 1 |
| NE | $275.53 | 1 |
| NH | $302.44 | 1 |
| NJ | $318.75–$332.46 | 2 |
| NM | $286.06 | 1 |
| NV | $295.09 | 1 |
| NY | $284.65–$348.54 | 5 |
| OH | $282.68 | 1 |
| OK | $276.06 | 1 |
| OR | $292.43–$314.26 | 2 |
| PA | $282.64–$308.96 | 2 |
| PR | $298.92 | 1 |
| RI | $303.50 | 1 |
| SC | $282.32 | 1 |
| SD | $287.95 | 1 |
| TN | $275.39 | 1 |
| TX | $281.06–$305.70 | 8 |
| UT | $285.70 | 1 |
| VA | $290.27–$335.11 | 2 |
| VI | $298.92 | 1 |
| VT | $288.65 | 1 |
| WA | $304.36–$338.78 | 2 |
| WI | $280.46 | 1 |
| WV | $281.17 | 1 |
| WY | $293.62 | 1 |
How the 28820 rate is calculated
Each of 28820’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 · 28820
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 3.42Practice expense 5.06Malpractice 0.42
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 28820
The CMS indicators that decide how 28820 is paid alongside other services.
CMS payment indicators · 28820
Toe amputation
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is 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) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
28820 without 51 · national office
$297.27
Toe amputation
28820-51 · Second procedure: 50%
$148.64
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%).
28820 compared with similar codes
Compare codes
28820 vs 28825 vs 28810 vs 28805: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 28825Toe amputation
- Choose 28820 for removal through the metatarsophalangeal joint. Choose 28825 when the amputation is partial and occurs at the interphalangeal joint.
- 28810Ray amputation
- Choose 28820 when removal is limited to the toe through its metatarsophalangeal joint. Choose 28810 when the procedure also removes metatarsal bone.
- 28805Foot amputation
- 28805 describes a transmetatarsal amputation, a broader foot-level procedure; 28820 is limited to amputation of a toe through its metatarsophalangeal joint.
28820 billing questions
How is 28820 different from 28825?
28820 is for removal through the metatarsophalangeal joint. Use 28825 for a partial toe amputation at the interphalangeal joint.
When is 28810 more appropriate?
Use 28810 when the amputation includes both a toe and its metatarsal. Code 28820 describes removal of the toe through the metatarsophalangeal joint without metatarsal removal.
Can modifier 50 be used for two toe amputations?
No. CMS identifies bilateral adjustment as inappropriate for this code. Do not report modifier 50.
How does the multiple-procedure reduction affect 28820?
When performed with other procedures in the same session, the highest-valued procedure is paid in full and the other procedures are subject to a 50% reduction.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for 28820. Co-surgeons and team surgery are not permitted.
What documentation supports reporting 28820?
Document the affected toe, the clinical reason for amputation, and the operative level. The note should support complete removal through the metatarsophalangeal joint.
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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