$645.65
Both address hallux rigidus with joint debridement and release; 28291 includes implant placement, while 28289 is the choice without an implant.
On this page
CMS RVU26D · Effective 2026-10-01
28291 Hallux rigidus surgery Medicare reimbursement rates in Kansas
Corrects painful, stiff first metatarsophalangeal joint arthritis with joint debridement and an implant when motion-preserving surgery is selected. Compare 28291 office and facility rates across CMS payment localities in Kansas.
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 28291 in Kansas?
Kansas 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
$621.43
1 of 1 localities have a supported rate.
Payment area: Kansas
One mapped payment locality.
Facility setting
$415.80
1 of 1 localities have a supported rate.
Payment area: Kansas
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 28291: Hallux rigidus correction with implant
Corrects painful, stiff first metatarsophalangeal joint arthritis with joint debridement and an implant when motion-preserving surgery is selected.
A foot and ankle surgeon or podiatric surgeon uses this code for implant arthroplasty to treat symptomatic hallux rigidus at the first metatarsophalangeal joint. The procedure addresses degenerative joint changes and restricted, painful great-toe motion through joint debridement, removal of obstructive bone, capsular release, and implant placement. It is typically performed in an outpatient surgical setting when the operative plan includes an implant rather than correction without one.
Report 28291 for the documented implant procedure, not simply because imaging shows arthritis or an implant was considered. The operative report should support the hallux rigidus diagnosis, the work performed at the joint, and implant placement. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure case, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 28291
- 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 procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU7.81 · 39%
- Practice expense (office) RVU11.54 · 57%
- Malpractice RVU0.72 · 4%
2.7K
Medicare services in 2024 · #2249 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.
28291 compared with similar codes
Office rates for Kansas, from the same CMS release.
$648.42
This corrects hallux valgus, or bunion alignment, rather than implant-treated degenerative stiffness of the first metatarsophalangeal joint.
$973.41
This is a hallux valgus correction involving a proximal first-metatarsal osteotomy; 28291 treats hallux rigidus with an implant.
Compare 28291 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
Kansas →
Office / nonfacility
$621.43
Facility
$415.80
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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 28291 in Kansas.
PPRRVU2026_Oct_nonQPP.csv
3,172
- Code
- 28291
- Physician work
- 7.81
- Practice expense
- 11.54
- Malpractice
- 0.72
GPCI2026.csv
54
- Locality
- Kansas
- Physician work
- 1.000
- Practice expense
- 0.904
- Malpractice
- 0.504
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.81 | × 1.000 | 7.8100 |
| Practice expense | 11.54 | × 0.904 | 10.4322 |
| Malpractice | 0.72 | × 0.504 | 0.3629 |
| Total RVUs | 18.6050 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Kansas$621.43
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.81 | 1 |
| Practice expense | 11.54 | 0.904 |
| Malpractice | 0.72 | 0.504 |
(7.81 × 1 + 11.54 × 0.904 + 0.72 × 0.504) × $33.4009 = $621.43
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.81 | 1 |
| Practice expense | 4.73 | 0.904 |
| Malpractice | 0.72 | 0.504 |
(7.81 × 1 + 4.73 × 0.904 + 0.72 × 0.504) × $33.4009 = $415.80
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.
28291 billing questions
When should 28291 be chosen instead of 28289?
Use 28291 when the hallux rigidus correction includes implant placement. Code 28289 describes the corresponding correction without an implant.
Does the code include the joint debridement and capsular release?
Yes. These are part of the described hallux rigidus correction; do not separately report them as though they were unrelated procedures.
What operative documentation supports 28291?
Document the symptomatic first metatarsophalangeal joint condition, the correction performed, and placement of the implant. The operative note should make clear that the procedure was an implant correction rather than correction without an implant.
How is modifier 50 handled for bilateral surgery?
CMS pays bilateral reporting with modifier 50 at 150%. The record should support that the same procedure was performed on both sides.
How does CMS handle other procedures performed in the same session?
The highest-valued procedure is paid in full, and other procedures are paid at 50%. Related postoperative care is included in the 90-day global period.
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.
3,16928286,,Repair of hammertoe,A,,4.58,7.90,,3.34,,0.40,12.88,8.32,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,17028288,,Partial removal of foot bone,A,,5.87,11.73,,5.92,,0.68,18.28,12.47,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,17128289,,Corrj halux rigdus w/o implt,A,,6.73,13.47,,5.57,,0.84,21.04,13.14,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,17228291,,Corrj halux rigdus w/implt,A,,7.81,11.54,,4.73,,0.72,20.07,13.26,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,17328292,,Cor hlx vlgs rsc prx phlx bs,A,,7.25,13.02,,5.74,,0.78,21.05,13.77,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,17428295,,Cor hlx vlgs prx mtar osteot,A,,8.36,22.31,,7.27,,1.22,31.89,16.85,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,17528296,,Cor hlx vlgs dstl mtar osteo,A,,8.04,17.59,,5.64,,0.82,26.45,14.50,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958