$282.81–$308.40
Choose 28820 for removal through the metatarsophalangeal joint. Choose 28825 when the amputation is partial and occurs at the interphalangeal joint.
On this page
CMS RVU26D · Effective 2026-10-01
28820 Toe amputation Medicare reimbursement rates in Illinois
Reports complete removal of a toe through its metatarsophalangeal joint, commonly for gangrene, infection, or tissue loss confined to the toe. Compare 28820 office and facility rates across CMS payment localities in Illinois.
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 28820 in Illinois?
Illinois has 4 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 4 payment areas shown below, using the same CMS release.
Office / nonfacility
$290.46–$317.08
4 of 4 localities have a supported rate.
Facility setting
$166.65–$180.79
4 of 4 localities have a supported rate.
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.
Where 28820 pays more and less in Illinois
4 payment localities
$290.46 to $317.08
Foot surgery
About 28820: Complete toe amputation at metatarsophalangeal joint
Reports complete removal of a toe through its metatarsophalangeal joint, commonly for gangrene, infection, or tissue loss confined to the toe.
This procedure removes an entire toe through the joint where it meets the foot, without removing the metatarsal. Podiatric, orthopedic, or other surgeons may perform it for problems such as gangrene, infection, or nonhealing ulceration when the affected toe cannot be preserved. It is also used when trauma requires removal at this level. The code describes the operative level, not a specific diagnosis.
Report 28820 when the operative note supports removal through the metatarsophalangeal joint; a more distal partial toe removal or an amputation that includes metatarsal bone points to a different code. Document the affected toe, clinical reason, and actual level and extent of removal. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures are performed in one session, the highest-valued is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are not permitted.
CMS billing rules for 28820
- 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 RVU3.42 · 38%
- Practice expense (office) RVU5.06 · 57%
- Malpractice RVU0.42 · 5%
26.1K
Medicare services in 2024 · #1031 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.
28820 compared with similar codes
Office rates for Illinois, from the same CMS release.
No office rate
Choose 28820 when removal is limited to the toe through its metatarsophalangeal joint. Choose 28810 when the procedure also removes metatarsal bone.
No office rate
28805 describes a transmetatarsal amputation, a broader foot-level procedure; 28820 is limited to amputation of a toe through its metatarsophalangeal joint.
Compare 28820 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.
4 of 4 payment localities
Chicago →
Office / nonfacility
$317.08
Facility
$180.79
East St. Louis →
Office / nonfacility
$297.97
Facility
$173.21
Rest Of Illinois →
Office / nonfacility
$290.46
Facility
$166.65
Suburban Chicago →
Office / nonfacility
$313.46
Facility
$174.19
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28820 billing questions
How is 28820 different from 28825?
28820 is for removal through the metatarsophalangeal joint. Use 28825 for a partial toe amputation at the interphalangeal joint.
When is 28810 more appropriate?
Use 28810 when the amputation includes both a toe and its metatarsal. Code 28820 describes removal of the toe through the metatarsophalangeal joint without metatarsal removal.
Can modifier 50 be used for two toe amputations?
No. CMS identifies bilateral adjustment as inappropriate for this code. Do not report modifier 50.
How does the multiple-procedure reduction affect 28820?
When performed with other procedures in the same session, the highest-valued procedure is paid in full and the other procedures are subject to a 50% reduction.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for 28820. Co-surgeons and team surgery are not permitted.
What documentation supports reporting 28820?
Document the affected toe, the clinical reason for amputation, and the operative level. The note should support complete removal through the metatarsophalangeal joint.
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.
3,25528800,,Amputation of midfoot,A,,8.57,5.12,NA,5.12,,1.02,14.71,14.71,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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