$621.50–$652.57
Both codes concern reconstruction of an enlarged toe. Check the complete CPT descriptors and operative details to determine which specific procedure was performed.
On this page
CMS RVU26D · Effective 2026-10-01
28340 Toe reconstruction Medicare reimbursement rates in Michigan
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. Compare 28340 office and facility rates across CMS payment localities in Michigan.
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 28340 in Michigan?
Michigan has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$533.17–$559.98
2 of 2 localities have a supported rate.
Facility setting
$372.15–$389.80
2 of 2 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.
Foot surgery
About 28340: Enlarged toe reconstructive resection
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.
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.
CMS billing rules for 28340
- 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
- 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 RVU6.97 · 42%
- Practice expense (office) RVU9.12 · 55%
- Malpractice RVU0.59 · 4%
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.
28340 compared with similar codes
Office rates for Michigan, from the same CMS release.
$517.93–$549.39
This code addresses correction of toe angular deformity. Select 28340 when the documented operative work reduces enlargement rather than correcting alignment.
$389.61–$409.73
This code concerns reconstruction of extra toes. It is not the choice for resection intended to reduce an enlarged toe.
Compare 28340 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.
2 of 2 payment localities
Detroit →
Office / nonfacility
$559.98
Facility
$389.80
Rest Of Michigan →
Office / nonfacility
$533.17
Facility
$372.15
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 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.
3,19028315,,Removal of sesamoid bone,A,,4.88,8.99,,3.89,,0.54,14.41,9.31,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,19128320,,Repair of foot bones,A,,9.14,6.77,NA,6.77,,1.39,17.30,17.30,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,19228322,,Repair of metatarsals,A,,8.32,14.74,,6.55,,1.31,24.37,16.18,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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