$381.08
Use 28345 for separation of webbed toes. Use 28344 when the operative problem is an extra digit requiring correction.
On this page
CMS RVU26D · Effective 2026-10-01
28345 Webbed toe repair Medicare reimbursement rates in Iowa
Surgical separation and reconstruction of fused toes is reported for foot syndactyly, commonly a congenital webbing that limits toe separation or function. Compare 28345 office and facility rates across CMS payment localities in Iowa.
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 28345 in Iowa?
Iowa 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
$468.34
1 of 1 localities have a supported rate.
Payment area: Iowa
One mapped payment locality.
Facility setting
$318.28
1 of 1 localities have a supported rate.
Payment area: Iowa
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 28345: Foot syndactyly repair
Surgical separation and reconstruction of fused toes is reported for foot syndactyly, commonly a congenital webbing that limits toe separation or function.
This operation separates toes joined by skin or soft tissue and reshapes the web space between them. An orthopedic foot and ankle surgeon, podiatric surgeon, or plastic surgeon may perform it, often for congenital toe syndactyly when the webbing affects shoe fit, function, or appearance. Reconstruction may use local skin flaps and, when needed, a skin graft. The operative report should identify the affected toes and web space and describe the separation and reconstruction performed.
Report the code for surgical correction of webbed toes, not for removal of an extra digit or correction of a different toe deformity. CMS assigns a 90-day major-surgery global period, including the day-before preoperative visit and 90 days of related postoperative care. 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. Modifier 50 is inappropriate under the CMS bilateral rule for this code. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 28345
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are 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
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.94 · 39%
- Practice expense (office) RVU8.62 · 57%
- Malpractice RVU0.49 · 3%
55
Medicare services in 2024 · #5296 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.
28345 compared with similar codes
Office rates for Iowa, from the same CMS release.
$501.52
28345 addresses fused toes and web-space reconstruction; 28313 is for repair of a toe deformity that is not syndactyly.
No office rate
28345 treats toe webbing. 28360 is for reconstruction of a cleft foot, a broader congenital foot malformation.
Compare 28345 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
Iowa →
Office / nonfacility
$468.34
Facility
$318.28
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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 28345 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
3,196
- Code
- 28345
- Physician work
- 5.94
- Practice expense
- 8.62
- Malpractice
- 0.49
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.94 | × 1.000 | 5.9400 |
| Practice expense | 8.62 | × 0.915 | 7.8873 |
| Malpractice | 0.49 | × 0.397 | 0.1945 |
| Total RVUs | 14.0218 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Iowa$468.34
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.94 | 1 |
| Practice expense | 8.62 | 0.915 |
| Malpractice | 0.49 | 0.397 |
(5.94 × 1 + 8.62 × 0.915 + 0.49 × 0.397) × $33.4009 = $468.34
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.94 | 1 |
| Practice expense | 3.71 | 0.915 |
| Malpractice | 0.49 | 0.397 |
(5.94 × 1 + 3.71 × 0.915 + 0.49 × 0.397) × $33.4009 = $318.28
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.
28345 billing questions
How is this different from repair of an extra toe?
This code addresses separation of toes joined by webbing. Code 28344 is for correction of an extra digit, a different congenital toe condition.
Should modifier 50 be used when both feet are treated?
No. CMS identifies modifier 50 as inappropriate for this code. Document the treated foot or feet and the web spaces addressed.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon be reported?
Assistant-at-surgery payment is allowed only when medical necessity is documented. CMS does not permit co-surgeons or team surgery for this code.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures performed in that session 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.
3,19328340,,Resect enlarged toe tissue,A,,6.97,9.12,,3.84,,0.59,16.68,11.40,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,19428341,,Resect enlarged toe,A,,8.50,10.18,,4.27,,0.72,19.40,13.49,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,19528344,,Repair extra toe(s),A,,4.29,7.62,,3.24,,0.37,12.28,7.90,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,19628345,,Repair webbed toe(s),A,,5.94,8.62,,3.71,,0.49,15.05,10.14,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,19728360,,Reconstruct cleft foot,A,,14.55,13.05,NA,13.05,,3.09,30.69,30.69,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,19828400,,Cltx calcaneal fx w/o mnpj,A,,2.25,5.50,,4.39,,0.37,8.12,7.01,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,19928405,,Cltx calcaneal fx w/mnpj,A,,4.62,9.41,,6.35,,1.00,15.03,11.97,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136