Billing code 28340: Toe reconstructionMedicare rate & RVUs in Illinois
Reconstructive surgery to reduce an enlarged toe, typically for macrodactyly, is reported when the surgeon removes excessive toe tissue to improve its size or function.
Medicare pays $541.72–$585.80 for 28340 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 28340 covers
This procedure reduces an abnormally enlarged toe by surgically removing excess tissue as part of reconstructing the toe. A foot and ankle surgeon, orthopedic surgeon, or podiatric surgeon may perform it for macrodactyly or another documented condition causing substantial toe enlargement. The operative report should identify the affected toe, the enlargement being treated, and the reconstructive work performed.
Report the service when the operative work addresses enlargement of the toe, rather than an isolated angular deformity or a bone-alignment problem. Documentation should support the condition and the extent of the resection. Medicare assigns a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are 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 50% reduction. Do not append modifier 50; the descriptor or anatomy makes a bilateral adjustment inappropriate. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery 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.
Where 28340 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
$541.72 to $585.80
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | $585.80 | $408.56 |
| East St. Louis | $552.74 | $390.49 |
| Rest Of Illinois | $541.72 | $380.71 |
| Suburban Chicago | $582.19 | $401.08 |
How the 28340 rate is calculated
Each of 28340’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 · 28340
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 6.97Practice expense 9.12Malpractice 0.59
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 28340
28340 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28340
Toe reconstruction
| 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 · 28340
Toe reconstruction
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
28340 without 51 · national office
$557.13
Toe reconstruction
28340-51 · Second procedure: 50%
$278.57
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%).
28340 compared with similar codes
Compare codes
28340 vs 28341 vs 28313 vs 28344: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 28341Toe reduction
- Both codes concern reconstruction of an enlarged toe. Check the complete billing code descriptors and operative details to determine which specific procedure was performed.
- 28313Toe deformity repair
- This code addresses correction of toe angular deformity. Select 28340 when the documented operative work reduces enlargement rather than correcting alignment.
- 28344Toe reconstruction
- This code concerns reconstruction of extra toes. It is not the choice for resection intended to reduce an enlarged toe.
28340 billing questions
When should this code be selected instead of a toe deformity repair code?
Use this code when the operative goal is reducing an enlarged toe through resection. A code for angular deformity repair is more appropriate when the work corrects toe alignment rather than enlargement.
Does the 90-day global period include postoperative care?
Yes. It includes the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 be used when both feet are treated?
No. CMS identifies bilateral adjustment as inappropriate for this code because of its descriptor or anatomy.
How are other procedures performed in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this service. 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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