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CMS RVU26D · Effective 2026-10-01

28312 in Delaware

Office / nonfacility

$589.18

Base rate per service

Facility setting

$343.00

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Foot surgery

About 28312: Lesser toe proximal phalanx osteotomy

Reports surgical reshaping of a lesser toe’s proximal phalanx to correct shortening, angular alignment, or rotation when an osseous correction is performed.

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.

CMS billing rules for 28312

Global period
Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
Multiple procedures
Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
Bilateral procedures
Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
Assistant at surgery
Statutory restriction: assistant at surgery is not paid.
Co-surgeons
Co-surgeons paid only with supporting documentation.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU4.57 · 26%
  • Practice expense (office) RVU12.55 · 70%
  • Malpractice RVU0.72 · 4%

2K

Medicare services in 2024 · #2474 by national volume

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.

28312 compared with similar codes

Office rates for Delaware, from the same CMS release.

28310

Toe osteotomy

First toe, proximal phalanx

$559.45

28310 addresses the proximal phalanx of the great toe. This code addresses a toe other than the great toe.

28313

Toe deformity repair

Soft-tissue correction

$539.99

28313 is for toe deformity reconstruction using soft-tissue procedures only. This code represents a bony osteotomy of a lesser toe’s proximal phalanx.

28285

Hammertoe repair

Lesser-toe deformity correction

$543.13

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.

28308

Metatarsal osteotomy

Other than first metatarsal

$579.50

28308 addresses an osteotomy of a metatarsal. This code addresses the proximal phalanx of a lesser toe.

The same code, a different location

How does Delaware compare?

28312 across payment areas

Same release and payment basis · bars start at $0

  1. Delaware · This locality

    $589.18

  2. $81.58 higher than Delaware

  3. $92.27 higher than Delaware

  4. Miami

    $649.83

    $60.65 higher than Delaware

  5. Chicago

    $630.18

    $41.00 higher than Delaware

  6. Manhattan

    $687.64

    $98.46 higher than Delaware

  7. Alaska*

    $688.64

    $99.46 higher than Delaware

Other payment areas listed in Delaware appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 28312 ranges from $525.10 in Arkansas to $786.78 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas
  • Alabama

    Alabama · 28312

    Office

    $533.04

    Facility

    $315.01

    $56.14 lower than Delaware for the office setting.

  • Arkansas

    Arkansas · 28312

    Office

    $525.10

    Facility

    $311.07

    $64.08 lower than Delaware for the office setting.

  • Arizona

    Arizona · 28312

    Office

    $579.41

    Facility

    $337.97

    $9.77 lower than Delaware for the office setting.

  • Bakersfield

    California · 28312

    Office

    $629.61

    Facility

    $356.52

    $40.43 higher than Delaware for the office setting.

  • Chico

    California · 28312

    Office

    $627.55

    Facility

    $354.46

    $38.37 higher than Delaware for the office setting.

  • El Centro

    California · 28312

    Office

    $627.67

    Facility

    $354.58

    $38.49 higher than Delaware for the office setting.

  • Fresno

    California · 28312

    Office

    $627.55

    Facility

    $354.46

    $38.37 higher than Delaware for the office setting.

  • Hanford-Corcoran

    California · 28312

    Office

    $627.55

    Facility

    $354.46

    $38.37 higher than Delaware for the office setting.

  • Madera

    California · 28312

    Office

    $627.55

    Facility

    $354.46

    $38.37 higher than Delaware for the office setting.

  • Merced

    California · 28312

    Office

    $627.55

    Facility

    $354.46

    $38.37 higher than Delaware for the office setting.

  • Modesto

    California · 28312

    Office

    $627.55

    Facility

    $354.46

    $38.37 higher than Delaware for the office setting.

  • Napa

    California · 28312

    Office

    $726.96

    Facility

    $398.55

    $137.78 higher than Delaware for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 28312

    Office

    $667.37

    Facility

    $372.85

    $78.19 higher than Delaware for the office setting.

  • Redding

    California · 28312

    Office

    $627.55

    Facility

    $354.46

    $38.37 higher than Delaware for the office setting.

  • Rest Of California

    California · 28312

    Office

    $627.55

    Facility

    $354.46

    $38.37 higher than Delaware for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 28312

    Office

    $635.33

    Facility

    $362.23

    $46.15 higher than Delaware for the office setting.

  • Sacramento-Roseville-Folsom

    California · 28312

    Office

    $658.54

    Facility

    $368.75

    $69.36 higher than Delaware for the office setting.

  • Salinas

    California · 28312

    Office

    $656.10

    Facility

    $367.31

    $66.92 higher than Delaware for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 28312

    Office

    $671.60

    Facility

    $373.59

    $82.42 higher than Delaware for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 28312

    Office

    $769.23

    Facility

    $417.90

    $180.05 higher than Delaware for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 28312

    Office

    $768.41

    Facility

    $417.08

    $179.23 higher than Delaware for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 28312

    Office

    $786.78

    Facility

    $427.48

    $197.60 higher than Delaware for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 28312

    Office

    $783.44

    Facility

    $424.14

    $194.26 higher than Delaware for the office setting.

  • San Luis Obispo-Paso Robles

    California · 28312

    Office

    $645.57

    Facility

    $361.77

    $56.39 higher than Delaware for the office setting.

  • Santa Cruz-Watsonville

    California · 28312

    Office

    $678.04

    Facility

    $375.30

    $88.86 higher than Delaware for the office setting.

  • Santa Maria-Santa Barbara

    California · 28312

    Office

    $658.57

    Facility

    $368.04

    $69.39 higher than Delaware for the office setting.

  • Santa Rosa-Petaluma

    California · 28312

    Office

    $684.87

    Facility

    $378.88

    $95.69 higher than Delaware for the office setting.

  • Stockton

    California · 28312

    Office

    $627.55

    Facility

    $354.46

    $38.37 higher than Delaware for the office setting.

  • Vallejo

    California · 28312

    Office

    $725.78

    Facility

    $397.37

    $136.60 higher than Delaware for the office setting.

  • Visalia

    California · 28312

    Office

    $627.55

    Facility

    $354.46

    $38.37 higher than Delaware for the office setting.

  • Yuba City

    California · 28312

    Office

    $627.55

    Facility

    $354.46

    $38.37 higher than Delaware for the office setting.

  • Colorado

    Colorado · 28312

    Office

    $619.26

    Facility

    $354.15

    $30.08 higher than Delaware for the office setting.

  • Connecticut

    Connecticut · 28312

    Office

    $636.25

    Facility

    $367.90

    $47.07 higher than Delaware for the office setting.

  • Fort Lauderdale

    Florida · 28312

    Office

    $620.75

    Facility

    $368.34

    $31.57 higher than Delaware for the office setting.

  • Rest Of Florida

    Florida · 28312

    Office

    $589.52

    Facility

    $351.32

    $0.34 higher than Delaware for the office setting.

  • Atlanta

    Georgia · 28312

    Office

    $607.87

    Facility

    $354.71

    $18.69 higher than Delaware for the office setting.

  • Rest Of Georgia

    Georgia · 28312

    Office

    $555.22

    Facility

    $332.96

    $33.96 lower than Delaware for the office setting.

  • Hawaii, Guam

    Hawaii · 28312

    Office

    $643.18

    Facility

    $359.87

    $54.00 higher than Delaware for the office setting.

  • Iowa

    Iowa · 28312

    Office

    $545.74

    Facility

    $317.75

    $43.44 lower than Delaware for the office setting.

  • Idaho

    Idaho · 28312

    Office

    $549.66

    Facility

    $320.43

    $39.52 lower than Delaware for the office setting.

  • East St. Louis

    Illinois · 28312

    Office

    $586.72

    Facility

    $357.49

    $2.46 lower than Delaware for the office setting.

  • Rest Of Illinois

    Illinois · 28312

    Office

    $572.94

    Facility

    $345.45

    $16.24 lower than Delaware for the office setting.

  • Suburban Chicago

    Illinois · 28312

    Office

    $626.82

    Facility

    $370.93

    $37.64 higher than Delaware for the office setting.

  • Indiana

    Indiana · 28312

    Office

    $552.91

    Facility

    $321.93

    $36.27 lower than Delaware for the office setting.

  • Kansas

    Kansas · 28312

    Office

    $543.70

    Facility

    $318.45

    $45.48 lower than Delaware for the office setting.

  • Kentucky

    Kentucky · 28312

    Office

    $547.30

    Facility

    $325.79

    $41.88 lower than Delaware for the office setting.

  • New Orleans

    Louisiana · 28312

    Office

    $574.41

    Facility

    $339.94

    $14.77 lower than Delaware for the office setting.

  • Rest Of Louisiana

    Louisiana · 28312

    Office

    $546.66

    Facility

    $326.14

    $42.52 lower than Delaware for the office setting.

  • Metropolitan Boston

    Massachusetts · 28312

    Office

    $680.81

    Facility

    $383.30

    $91.63 higher than Delaware for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 28312

    Office

    $615.65

    Facility

    $353.27

    $26.47 higher than Delaware for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 28312

    Office

    $634.61

    Facility

    $367.25

    $45.43 higher than Delaware for the office setting.

  • Rest Of Maryland

    Maryland · 28312

    Office

    $600.46

    Facility

    $348.30

    $11.28 higher than Delaware for the office setting.

  • Rest Of Maine

    Maine · 28312

    Office

    $553.25

    Facility

    $324.01

    $35.93 lower than Delaware for the office setting.

  • Southern Maine

    Maine · 28312

    Office

    $583.23

    Facility

    $336.30

    $5.95 lower than Delaware for the office setting.

  • Detroit

    Michigan · 28312

    Office

    $597.70

    Facility

    $357.25

    $8.52 higher than Delaware for the office setting.

  • Rest Of Michigan

    Michigan · 28312

    Office

    $562.51

    Facility

    $335.01

    $26.67 lower than Delaware for the office setting.

  • Minnesota

    Minnesota · 28312

    Office

    $591.10

    Facility

    $334.70

    $1.92 higher than Delaware for the office setting.

  • Metropolitan Kansas City

    Missouri · 28312

    Office

    $569.75

    Facility

    $335.78

    $19.43 lower than Delaware for the office setting.

  • Metropolitan St. Louis

    Missouri · 28312

    Office

    $575.80

    Facility

    $338.59

    $13.38 lower than Delaware for the office setting.

  • Rest Of Missouri

    Missouri · 28312

    Office

    $537.40

    Facility

    $322.61

    $51.78 lower than Delaware for the office setting.

  • Mississippi

    Mississippi · 28312

    Office

    $531.33

    Facility

    $316.79

    $57.85 lower than Delaware for the office setting.

  • Montana**

    Montana · 28312

    Office

    $595.82

    Facility

    $346.65

    $6.64 higher than Delaware for the office setting.

  • North Carolina

    North Carolina · 28312

    Office

    $559.11

    Facility

    $326.63

    $30.07 lower than Delaware for the office setting.

  • North Dakota**

    North Dakota · 28312

    Office

    $581.59

    Facility

    $332.42

    $7.59 lower than Delaware for the office setting.

  • Nebraska

    Nebraska · 28312

    Office

    $548.64

    Facility

    $318.65

    $40.54 lower than Delaware for the office setting.

  • New Hampshire

    New Hampshire · 28312

    Office

    $610.05

    Facility

    $350.67

    $20.87 higher than Delaware for the office setting.

  • Northern Nj

    New Jersey · 28312

    Office

    $674.19

    Facility

    $385.15

    $85.01 higher than Delaware for the office setting.

  • Rest Of New Jersey

    New Jersey · 28312

    Office

    $642.88

    Facility

    $370.78

    $53.70 higher than Delaware for the office setting.

  • New Mexico

    New Mexico · 28312

    Office

    $565.91

    Facility

    $337.42

    $23.27 lower than Delaware for the office setting.

  • Nevada**

    Nevada · 28312

    Office

    $592.28

    Facility

    $342.86

    $3.10 higher than Delaware for the office setting.

  • Nyc Suburbs/Long Island

    New York · 28312

    Office

    $705.48

    Facility

    $409.21

    $116.30 higher than Delaware for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 28312

    Office

    $647.61

    Facility

    $374.77

    $58.43 higher than Delaware for the office setting.

  • Queens

    New York · 28312

    Office

    $692.56

    Facility

    $398.04

    $103.38 higher than Delaware for the office setting.

  • Rest Of New York

    New York · 28312

    Office

    $567.77

    Facility

    $331.06

    $21.41 lower than Delaware for the office setting.

  • Ohio

    Ohio · 28312

    Office

    $559.60

    Facility

    $332.10

    $29.58 lower than Delaware for the office setting.

  • Oklahoma

    Oklahoma · 28312

    Office

    $545.66

    Facility

    $323.15

    $43.52 lower than Delaware for the office setting.

  • Portland

    Oregon · 28312

    Office

    $638.69

    Facility

    $361.86

    $49.51 higher than Delaware for the office setting.

  • Rest Of Oregon

    Oregon · 28312

    Office

    $587.05

    Facility

    $338.88

    $2.13 lower than Delaware for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 28312

    Office

    $620.45

    Facility

    $361.06

    $31.27 higher than Delaware for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 28312

    Office

    $560.18

    Facility

    $331.44

    $29.00 lower than Delaware for the office setting.

  • Puerto Rico

    Puerto Rico · 28312

    Office

    $600.12

    Facility

    $348.21

    $10.94 higher than Delaware for the office setting.

  • Rhode Island

    Rhode Island · 28312

    Office

    $610.01

    Facility

    $352.61

    $20.83 higher than Delaware for the office setting.

  • South Carolina

    South Carolina · 28312

    Office

    $560.41

    Facility

    $330.17

    $28.77 lower than Delaware for the office setting.

  • South Dakota**

    South Dakota · 28312

    Office

    $579.90

    Facility

    $330.73

    $9.28 lower than Delaware for the office setting.

  • Tennessee

    Tennessee · 28312

    Office

    $546.59

    Facility

    $320.10

    $42.59 lower than Delaware for the office setting.

  • Austin

    Texas · 28312

    Office

    $617.75

    Facility

    $354.13

    $28.57 higher than Delaware for the office setting.

  • Beaumont

    Texas · 28312

    Office

    $556.44

    Facility

    $329.69

    $32.74 lower than Delaware for the office setting.

  • Brazoria

    Texas · 28312

    Office

    $588.03

    Facility

    $341.10

    $1.15 lower than Delaware for the office setting.

  • Dallas

    Texas · 28312

    Office

    $592.15

    Facility

    $343.98

    $2.97 higher than Delaware for the office setting.

  • Fort Worth

    Texas · 28312

    Office

    $588.28

    Facility

    $342.59

    $0.90 lower than Delaware for the office setting.

  • Galveston

    Texas · 28312

    Office

    $590.02

    Facility

    $342.60

    $0.84 higher than Delaware for the office setting.

  • Houston

    Texas · 28312

    Office

    $603.20

    Facility

    $355.77

    $14.02 higher than Delaware for the office setting.

  • Rest Of Texas

    Texas · 28312

    Office

    $572.16

    Facility

    $335.70

    $17.02 lower than Delaware for the office setting.

  • Utah

    Utah · 28312

    Office

    $568.27

    Facility

    $334.05

    $20.91 lower than Delaware for the office setting.

  • Virginia

    Virginia · 28312

    Office

    $581.68

    Facility

    $336.74

    $7.50 lower than Delaware for the office setting.

  • Virgin Islands

    United States Virgin Islands · 28312

    Office

    $600.12

    Facility

    $348.21

    $10.94 higher than Delaware for the office setting.

  • Vermont

    Vermont · 28312

    Office

    $579.80

    Facility

    $333.12

    $9.38 lower than Delaware for the office setting.

  • Rest Of Washington

    Washington · 28312

    Office

    $614.33

    Facility

    $351.95

    $25.15 higher than Delaware for the office setting.

  • Seattle (King Cnty)

    Washington · 28312

    Office

    $694.26

    Facility

    $388.52

    $105.08 higher than Delaware for the office setting.

  • Wisconsin

    Wisconsin · 28312

    Office

    $561.62

    Facility

    $322.92

    $27.56 lower than Delaware for the office setting.

  • West Virginia

    West Virginia · 28312

    Office

    $551.32

    Facility

    $334.79

    $37.86 lower than Delaware for the office setting.

  • Wyoming**

    Wyoming · 28312

    Office

    $589.62

    Facility

    $340.45

    $0.44 higher than Delaware for the office setting.

See how rates vary across the country

28312 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

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 all state and territory rates as a table
State / territoryRate rangeLocalities
AK$688.641
AL$533.041
AR$525.101
AZ$579.411
CA$627.55–$786.7829
CO$619.261
CT$636.251
DC$681.451
DE$589.181
FL$589.52–$649.833
GA$555.22–$607.872
GU$643.181
HI$643.181
IA$545.741
ID$549.661
IL$572.94–$630.184
IN$552.911
KS$543.701
KY$547.301
LA$546.66–$574.412
MA$615.65–$680.812
MD$600.46–$681.453
ME$553.25–$583.232
MI$562.51–$597.702
MN$591.101
MO$537.40–$575.803
MS$531.331
MT$595.821
NC$559.111
ND$581.591
NE$548.641
NH$610.051
NJ$642.88–$674.192
NM$565.911
NV$592.281
NY$567.77–$705.485
OH$559.601
OK$545.661
OR$587.05–$638.692
PA$560.18–$620.452
PR$600.121
RI$610.011
SC$560.411
SD$579.901
TN$546.591
TX$556.44–$617.758
UT$568.271
VA$581.68–$681.452
VI$600.121
VT$579.801
WA$614.33–$694.262
WI$561.621
WV$551.321
WY$589.621

Explore 28312 on the national rate map →

Where does this rate apply?

Delaware is a Medicare payment area. Our Census mapping connects it to 79 cities and communities in Delaware, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Why are the office and facility amounts different?

For 28312 in Delaware, the physician’s office rate is $589.18 and the facility-setting rate is $343.00: a difference of $246.18.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 28312 in Delaware. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$648.10

$589.18 × 110% = $648.10

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

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How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 28312 in Delaware.

PPRRVU2026_Oct_nonQPP.csv

3,188

Code
28312
Physician work
4.57
Practice expense
12.55
Malpractice
0.72

GPCI2026.csv

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office / nonfacility calculation for 28312 in Delaware
ComponentRVULocality factorAdjusted
Physician work4.57× 1.0054.5928
Practice expense12.55× 0.98812.3994
Malpractice0.72× 0.8990.6473
Total RVUs17.6395
Conversion factor× 33.4009

Office / nonfacility rate, Delaware$589.18

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 28312 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work4.571.005
Practice expense12.550.988
Malpractice0.720.899

(4.57 × 1.005 + 12.55 × 0.988 + 0.72 × 0.899) × $33.4009 = $589.18

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work4.571.005
Practice expense5.090.988
Malpractice0.720.899

(4.57 × 1.005 + 5.09 × 0.988 + 0.72 × 0.899) × $33.4009 = $343.00

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

28312 · Office / nonfacility

$589.18

Effective 2026-10-01

The base rate is $48.46 higher than on 2025-10-01, moving from $540.72 to $589.18 (9.0%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $540.72changed to$589.18

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 4.69 changed to 4.57
    • Practice expense RVU 11.44 changed to 12.55
    • Malpractice RVU 0.67 changed to 0.72
    • Work GPCI 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $540.72

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$589.18$343.00RVU26D
2026-07-01$589.18$343.00RVU26C
2026-04-01$589.18$343.00RVU26B
2026-01-01$589.18$343.00RVU26A
2025-10-01$540.72$350.76RVU25D
2025-07-01$540.72$350.76RVU25C
2025-04-01$540.72$350.76RVU25B
2025-01-01$540.72$350.76RVU25A

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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 28312PPRRVU2026_Oct_nonQPP.csv, line 3,188 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)