Billing code 28295: Bunion correctionMedicare rate & RVUs in Illinois
Corrects hallux valgus by realigning the first metatarsal with an osteotomy near its base, as part of surgical bunion treatment.
Medicare pays $1,023.27–$1,123.61 for 28295 in the office in Illinois, from Rest Of Illinois to Chicago. 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 28295 covers
A foot surgeon uses this procedure to correct hallux valgus by cutting and repositioning the first metatarsal near its proximal end. It is performed for a bunion deformity when the planned correction includes a proximal metatarsal osteotomy. The operation is typically done in a surgical setting by an orthopedic or podiatric surgeon; the operative report should identify the osteotomy site and describe how the first metatarsal was repositioned.
Select this code based on the documented proximal metatarsal osteotomy, rather than the apparent size of the bunion. The record should support hallux valgus correction and distinguish the procedure from a distal metatarsal or proximal phalanx osteotomy. This major surgery code includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, Medicare pays the highest-valued procedure in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons require 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 28295 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
4 payment localities
$1023.27 to $1123.61
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | $1,123.61 | $618.74 |
| East St. Louis | $1,046.86 | $584.70 |
| Rest Of Illinois | $1,023.27 | $564.62 |
| Suburban Chicago | $1,118.69 | $602.77 |
How the 28295 rate is calculated
Each of 28295’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 · 28295
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 8.36Practice expense 22.31Malpractice 1.22
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 28295
28295 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28295
Bunion correction
| 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 · 28295
Bunion correction
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
28295 without 50 · national office
$1,065.15
Bunion correction
28295-50 · Bilateral: 150%
$1,597.73
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).
28295 compared with similar codes
Compare codes
28295 vs 28296 vs 28298 vs 28297 vs 28299: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 28296Bunion correction
- Use 28295 for a proximal first metatarsal osteotomy; 28296 represents a distal metatarsal osteotomy.
- 28298Bunion correction
- Use 28298 when the correction uses an osteotomy of the proximal phalanx rather than the proximal first metatarsal.
- 28297Bunion correction
- 28297 describes hallux valgus correction with first metatarsophalangeal joint fusion, not a proximal metatarsal osteotomy.
- 28299Bunion correction
- 28299 is for hallux valgus correction involving a double osteotomy; 28295 identifies the proximal metatarsal osteotomy approach.
28295 billing questions
How is this code distinguished from 28296?
Choose 28295 when the hallux valgus correction includes an osteotomy near the base of the first metatarsal. Code 28296 describes correction using a distal metatarsal osteotomy.
When would 28298 be considered instead?
28298 is for hallux valgus correction using a proximal phalanx osteotomy. For 28295, the osteotomy is in the proximal first metatarsal.
How should bilateral procedures be reported?
For bilateral surgery, report modifier 50; CMS pays this code at 150% when reported bilaterally.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
What happens when other procedures are performed in the same session?
The highest-valued procedure is paid in full, and other procedures are paid at 50%. An assistant at surgery may be paid; co-surgeons require supporting documentation.
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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