$978.98
28295 describes hallux valgus correction with a proximal first-metatarsal osteotomy. Choose 28297 when the correction includes fusion of the first metatarsal–medial cuneiform joint.
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CMS RVU26D · Effective 2026-10-01
28297 Bunion correction Medicare reimbursement rates in Kentucky
Reports hallux valgus correction using fusion of the first metatarsal–medial cuneiform joint, commonly a Lapidus-type procedure, with sesamoidectomy when performed. Compare 28297 office and facility rates across CMS payment localities in Kentucky.
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 28297 in Kentucky?
Kentucky 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
$950.90
1 of 1 localities have a supported rate.
Payment area: Kentucky
One mapped payment locality.
Facility setting
$534.01
1 of 1 localities have a supported rate.
Payment area: Kentucky
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 28297: Hallux valgus correction with first-joint fusion
Reports hallux valgus correction using fusion of the first metatarsal–medial cuneiform joint, commonly a Lapidus-type procedure, with sesamoidectomy when performed.
Code 28297 describes operative correction of a bunion deformity that includes fusion of the joint between the first metatarsal and medial cuneiform. This Lapidus-type approach is used when the surgeon selects fusion at that joint as part of the hallux valgus correction. The operation may include removal of the prominent bone and sesamoidectomy when performed. It is typically done by an orthopedic foot-and-ankle surgeon or podiatric surgeon in a hospital operating room or ambulatory surgery center.
Select this code when the documented correction includes the first tarsometatarsal joint fusion, rather than a metatarsal or phalangeal osteotomy alone. Record the deformity, operative work, joint fused, laterality, and any sesamoidectomy. The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 identifies bilateral surgery and payment is 150%. Assistant-at-surgery payment may be available; co-surgeons require supporting documentation. Team surgery is not permitted.
CMS billing rules for 28297
- 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 RVU9.06 · 29%
- Practice expense (office) RVU20.68 · 67%
- Malpractice RVU1.12 · 4%
4.6K
Medicare services in 2024 · #1936 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.
28297 compared with similar codes
Office rates for Kentucky, from the same CMS release.
$815.91
28296 uses a distal first-metatarsal osteotomy for the correction. 28297 instead identifies correction with first tarsometatarsal joint fusion.
$793.79
28298 is the phalangeal-osteotomy approach to hallux valgus correction. 28297 is distinguished by fusion at the first metatarsal–medial cuneiform joint.
$955.96
28299 describes hallux valgus correction using double osteotomies. Use 28297 when the documented procedure includes first tarsometatarsal joint fusion.
Compare 28297 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
Kentucky →
Office / nonfacility
$950.90
Facility
$534.01
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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 28297 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
3,176
- Code
- 28297
- Physician work
- 9.06
- Practice expense
- 20.68
- Malpractice
- 1.12
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.06 | × 1.000 | 9.0600 |
| Practice expense | 20.68 | × 0.889 | 18.3845 |
| Malpractice | 1.12 | × 0.915 | 1.0248 |
| Total RVUs | 28.4693 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Kentucky$950.90
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.06 | 1 |
| Practice expense | 20.68 | 0.889 |
| Malpractice | 1.12 | 0.915 |
(9.06 × 1 + 20.68 × 0.889 + 1.12 × 0.915) × $33.4009 = $950.90
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.06 | 1 |
| Practice expense | 6.64 | 0.889 |
| Malpractice | 1.12 | 0.915 |
(9.06 × 1 + 6.64 × 0.889 + 1.12 × 0.915) × $33.4009 = $534.01
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.
28297 billing questions
When should 28297 be selected instead of a hallux valgus osteotomy code?
Use 28297 when the correction includes fusion of the first metatarsal–medial cuneiform joint. Osteotomy codes apply when the documented correction uses the specified metatarsal or phalangeal bone cut instead.
Is the sesamoidectomy separately reported?
Sesamoidectomy is included in 28297 when performed as part of the hallux valgus correction. The code also encompasses the first-joint fusion that distinguishes this procedure.
How is bilateral surgery reported?
For bilateral performance, report modifier 50; CMS payment is 150%.
What postoperative care is included in the global period?
The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be paid?
Assistant-at-surgery payment may be made. Co-surgeon payment requires 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 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.
3,17328292,,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
3,17628297,,Cor hlx vlgs jt arthrd,A,,9.06,20.68,,6.64,,1.12,30.86,16.82,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,17728298,,Cor hlx vlgs prx phlx osteot,A,,7.56,17.21,,5.92,,0.99,25.76,14.47,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,17828299,,Cor hlx vlgs double osteot,A,,9.06,20.84,,6.68,,1.13,31.03,16.87,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,17928300,,Incision of heel bone,A,,9.49,7.20,NA,7.20,,1.61,18.30,18.30,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631