Billing code 28306: Metatarsal osteotomyMedicare rate & RVUs in Florida

Reports a first metatarsal bone cut used to correct its alignment or length when the work is not included in a broader procedure.

CMS RVU26DEffective Oct 1, 20263 payment localities1.5K Medicare services in 2024

Medicare pays $624.21–$686.77 for 28306 in the office in Florida, from Rest Of Florida to Miami. Which amount applies depends on the service address.

$624.21–$686.77Office (non-facility)
$392.39–$434.34Hospital or facility

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

We’ll open 28306 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Florida
  2. What 28306 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 28306 covers

The surgeon makes a controlled cut in the first metatarsal and repositions or reshapes the bone to address a deformity or alignment problem. Orthopedic foot and ankle surgeons and podiatrists commonly perform this work in an operating room. The operative report should identify the bone treated, the deformity, the osteotomy performed, and the correction achieved.

Select this code for the first metatarsal when the documented work is not part of a more comprehensive procedure that includes the osteotomy. Use the graft-specific sibling when an autograft is used. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is 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 28306 pays more and less in Florida

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

3 payment localities

$624.21 to $686.77

$624.21$655.49$686.77
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.
28306 office and facility rates by payment locality
Payment localityOfficeFacility
Fort Lauderdale$655.67$410.03
Miami$686.77$434.34
Rest Of Florida$624.21$392.39

How the 28306 rate is calculated

Each of 28306’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 · 28306

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 5.85Practice expense 12.14Malpractice 0.82

18.8100 adjusted RVUs×$33.4009 conversion factor=$628.27

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 28306

28306 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 28306

Metatarsal osteotomy

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 28306

Metatarsal osteotomy

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

28306 without 50 · national office

$628.27

Metatarsal osteotomy

28306-50 · Bilateral: 150%

$942.41

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).

When to use modifier 50

28306 compared with similar codes

Compare codes

28306 vs 28307 vs 28308 vs 28296 vs 28309: national Medicare rates

Swap in your local Medicare rate.

  • 28306
    Metatarsal osteotomy · 5.85 wRVU
    $628.27
  • 28307
    Metatarsal osteotomy · 6.34 wRVU
    $844.71+$216.44
  • 28308
    Metatarsal osteotomy · 5.34 wRVU
    $585.52−$42.75
  • 28296
    Bunion correction · 8.04 wRVU
    $883.45+$255.18
  • 28309
    Metatarsal osteotomy · 13.81 wRVU
    —

How to choose

28307Metatarsal osteotomy
Choose 28307 when autograft is part of the first metatarsal osteotomy; 28306 is the first-metatarsal osteotomy code without that graft-specific distinction.
28308Metatarsal osteotomy
28308 applies to an osteotomy of a metatarsal other than the first. Use 28306 when the treated bone is the first metatarsal.
28296Bunion correction
28296 describes a bunion correction that includes a distal metatarsal osteotomy. Do not separately report 28306 for that included osteotomy.
28309Metatarsal osteotomy
28309 is the graft-specific code for osteotomy involving multiple metatarsals; 28306 is for the first metatarsal.

28306 billing questions

How does 28306 differ from 28307?

Both address an osteotomy of the first metatarsal. Use 28307 when the procedure includes autograft; 28306 describes the osteotomy without that graft-specific distinction.

Can 28306 be reported with a bunion correction code?

Do not separately report 28306 for an osteotomy already included in a comprehensive bunion correction procedure, such as a procedure that includes a distal metatarsal osteotomy. The operative documentation must support distinct work before separate reporting is considered.

What documentation supports 28306?

Document the first metatarsal as the treated bone, the reason for correction, the osteotomy and any repositioning performed, and the resulting alignment. Identify any autograft, which may point to the graft-specific sibling code.

How is bilateral 28306 reported?

For procedures on both first metatarsals, report bilateral surgery with modifier 50; CMS pays the bilateral procedure at 150%.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. Related routine follow-up during that period is included in the surgical payment.

Can an assistant or co-surgeon be paid?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

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
RVUs for 28306PPRRVU2026_Oct_nonQPP.csv, line 3,183 (RVU26D)

Open CMS sourceHow we calculate rates

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