CPT code 28289: Hallux rigidus surgery2026 Medicare rate & RVUs in Guam
Reports operative treatment of hallux rigidus at the first metatarsophalangeal joint using cheilectomy, debridement, and capsular release without an implant.
Medicare pays $752.58 for 28289 in the office in Guam (Hawaii, Guam). Which amount applies depends on the service address.
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 9 sections
What 28289 covers
This operation treats hallux rigidus, a painful, stiff first metatarsophalangeal joint, by removing limiting bone and diseased tissue and releasing the joint capsule. It is typically performed by an orthopedic foot and ankle surgeon or podiatric surgeon in an operating room or ambulatory surgery setting. The defining distinction from the related implant procedure is that no implant is used.
Report the service when the operative note supports the hallux rigidus correction and its components at the first metatarsophalangeal joint. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery services may be paid; 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.
28289 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | $752.58 | $452.56 |
How the 28289 rate is calculated
Each of 28289’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 · 28289
RVUs × geographic indexes × conversion factor
Work6.73
6.73 RVUs× 1.000 GPCI
Practice expense13.47
13.47 RVUs× 1.000 GPCI
Malpractice0.84
0.84 RVUs× 1.000 GPCI
Adjusted RVUs
21.0400
Conversion factor
$33.4009
Medicare rate
$702.75
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 28289
28289 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28289
Hallux rigidus surgery
| 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| 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 · 28289
Hallux rigidus surgery
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
28289 without 50 · national office
$702.75
Hallux rigidus surgery
28289-50 · Bilateral: 150%
$1,054.13
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).
28289 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 28291Hallux rigidus surgery
- Choose 28289 when the hallux rigidus correction is performed without an implant. Choose 28291 when an implant is used.
- 28292Bunion correction
- 28292 addresses hallux valgus (bunion) correction; 28289 addresses hallux rigidus at the first metatarsophalangeal joint.
- 28296Bunion correction
- 28296 is a hallux valgus correction involving a distal metatarsal osteotomy. It is not the hallux rigidus correction reported with 28289.
28289 billing questions
How does this differ from 28291?
Both address hallux rigidus at the first metatarsophalangeal joint. Use 28289 for the correction without an implant; 28291 is the implant procedure.
What should the operative note support?
Document hallux rigidus, the affected first metatarsophalangeal joint, the correction performed, and whether an implant was used. The note should support the reported service rather than only describing a general bunion or toe procedure.
Does the code include postoperative visits?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral surgery reported?
When the procedure is performed bilaterally, modifier 50 applies, and CMS pays the bilateral procedure at 150%.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. 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
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