$276.35
28825 reaches an interphalangeal joint; 28820 reaches the metatarsophalangeal joint. Select based on the documented amputation level.
On this page
CMS RVU26D · Effective 2026-10-01
28825 Toe amputation Medicare reimbursement rates in Idaho
Reports partial toe removal through an interphalangeal joint, commonly for localized infection, bone disease, or nonviable tissue confined to the distal toe. Compare 28825 office and facility rates across CMS payment localities in Idaho.
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.
What does Medicare pay for 28825 in Idaho?
Idaho has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$269.77
1 of 1 localities have a supported rate.
Payment area: Idaho
One mapped payment locality.
Facility setting
$146.86
1 of 1 localities have a supported rate.
Payment area: Idaho
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Foot surgery
About 28825: Toe amputation through an interphalangeal joint
Reports partial toe removal through an interphalangeal joint, commonly for localized infection, bone disease, or nonviable tissue confined to the distal toe.
A surgeon or podiatrist removes the distal portion of a toe by dividing it through an interphalangeal joint, leaving the more proximal portion of the toe in place. This level may be selected when infection, osteomyelitis, gangrene, or other nonviable tissue is limited enough that removal at the metatarsophalangeal joint is unnecessary. The service is commonly performed in a surgical facility, though office services are also reported.
Choose this code when the operative level is an interphalangeal joint, rather than the metatarsophalangeal joint or a more proximal foot level. The operative report should identify the toe, the joint level, the extent of tissue removed, and the clinical reason for amputation. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. 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; assistant-at-surgery services are not paid, and co-surgeons and team surgery are not permitted.
CMS billing rules for 28825
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU3.32 · 38%
- Practice expense (office) RVU4.97 · 57%
- Malpractice RVU0.39 · 4%
13.7K
Medicare services in 2024 · #1307 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.
28825 compared with similar codes
Office rates for Idaho, from the same CMS release.
No office rate
28805 is used for amputation through the metatarsal level, not isolated removal of the distal portion of a toe.
No office rate
28810 includes removal of a toe and its metatarsal; 28825 is limited to toe amputation through an interphalangeal joint.
Compare 28825 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Idaho →
Office / nonfacility
$269.77
Facility
$146.86
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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 28825 in Idaho.
PPRRVU2026_Oct_nonQPP.csv
3,259
- Code
- 28825
- Physician work
- 3.32
- Practice expense
- 4.97
- Malpractice
- 0.39
GPCI2026.csv
47
- Locality
- Idaho
- Physician work
- 1.000
- Practice expense
- 0.920
- Malpractice
- 0.473
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.32 | × 1.000 | 3.3200 |
| Practice expense | 4.97 | × 0.920 | 4.5724 |
| Malpractice | 0.39 | × 0.473 | 0.1845 |
| Total RVUs | 8.0769 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Idaho$269.77
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.32 | 1 |
| Practice expense | 4.97 | 0.92 |
| Malpractice | 0.39 | 0.473 |
(3.32 × 1 + 4.97 × 0.92 + 0.39 × 0.473) × $33.4009 = $269.77
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.32 | 1 |
| Practice expense | 0.97 | 0.92 |
| Malpractice | 0.39 | 0.473 |
(3.32 × 1 + 0.97 × 0.92 + 0.39 × 0.473) × $33.4009 = $146.86
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.
28825 billing questions
How does this differ from 28820?
Use 28825 when the toe is amputated through an interphalangeal joint. Code 28820 describes removal at the metatarsophalangeal joint.
What documentation supports the joint-level choice?
The operative report should identify the toe and state the level of division. It should support that the amputation passed through an interphalangeal joint.
Is same-day preoperative or postoperative care separately included?
Same-day preoperative and postoperative care is included in the 0-day global period.
Should modifier 50 be used for opposite feet?
No. CMS identifies bilateral adjustment as inapplicable for this code and modifier 50 as inappropriate.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery services are not paid. Co-surgeons and team surgery are not permitted under the CMS rules for this code.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full; other procedures are subject to the standard multiple procedure reduction.
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.
3,25628805,,Amputation thru metatarsal,A,,12.39,5.49,NA,5.49,,1.56,19.44,19.44,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,25728810,,Amputation toe & metatarsal,A,,6.47,4.45,NA,4.45,,0.96,11.88,11.88,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,25828820,,Amputation of toe,A,,3.42,5.06,,1.00,,0.42,8.90,4.84,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,25928825,,Partial amputation of toe,A,,3.32,4.97,,0.97,,0.39,8.68,4.68,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,26028890,,Hi enrgy eswt plantar fascia,A,,3.36,5.45,,2.51,,0.29,9.10,6.16,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,26128899,,Unlisted px foot/toes,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
3,26229000,,Appl halo type body cast,A,,2.19,10.81,,3.19,,0.92,13.92,6.30,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772