Billing code 28313: Toe deformity repairMedicare rate & RVUs in Guam
Reports soft-tissue reconstruction to correct an angular toe deformity, such as an overlapping toe, when the repair does not involve bone work.
Medicare pays $584.52 for 28313 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 28313 covers
billing code 28313 covers surgical correction of an angular toe deformity using soft-tissue procedures alone. A common clinical situation is an overlapping lesser toe, such as a second toe that crosses over an adjacent toe. The surgeon or podiatrist rebalances soft tissue around the affected toe to improve its alignment; the procedure is performed in an operating room or ambulatory surgery setting. This code is not the choice when the documented correction includes an osteotomy of a toe bone.
Report the service for each toe corrected and document the deformity, the toe involved, and the soft-tissue work performed. Medicare assigns a 90-day global period, which includes the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery, and co-surgeon and team-surgery billing 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.
28313 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | $584.52 | $358.18 |
How the 28313 rate is calculated
Each of 28313’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 · 28313
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 5.02Practice expense 10.62Malpractice 0.70
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 28313
28313 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28313
Toe deformity repair
| 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) | 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. |
| 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 · 28313
Toe deformity repair
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 51 · payment effect
With and without the modifier
28313 without 51 · national office
$545.77
Toe deformity repair
28313-51 · Second procedure: 50%
$272.89
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%).
28313 compared with similar codes
Compare codes
28313 vs 28312 vs 28310 vs 28285 vs 28286: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 28312Toe osteotomy
- 28313 is for soft-tissue correction of an angular toe deformity. Choose 28312 when the operative correction includes an osteotomy of a toe phalanx.
- 28310Toe osteotomy
- 28310 is a bony correction of the great toe's proximal phalanx. 28313 describes soft-tissue correction of an angular deformity, not that osteotomy.
- 28285Hammertoe repair
- 28285 addresses hammertoe correction. 28313 is for angular toe reconstruction using soft-tissue procedures alone, such as correction of an overlapping toe.
- 28286Hammertoe repair
- 28286 is specific to correction of a cock-up fifth toe. 28313 describes soft-tissue correction of other angular toe deformities.
28313 billing questions
When is 28313 preferable to 28312?
Use 28313 for angular toe correction performed with soft-tissue procedures alone. billing code 28312 describes a bony osteotomy of a toe phalanx.
Does 28313 include correction of an overlapping toe?
Yes. Soft-tissue reconstruction of an overlapping toe is a typical reason to report 28313, when the documented correction does not include bone work.
How should the number of toes be documented?
Identify each corrected toe and describe its deformity and the soft-tissue work performed. The code is reported for each toe corrected.
Can modifier 50 be used when both feet are treated?
No. CMS identifies bilateral adjustment as inappropriate for 28313. Modifier 50 should not be appended.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How does Medicare handle other procedures in the same session?
The highest-valued procedure is paid in full, and other procedures in the session are subject to the standard multiple-procedure reduction. Medicare does not pay an assistant at surgery; co-surgeons and team surgery are 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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