$571.60–$608.86
This code is for an osteotomy of the first metatarsal. Choose 28309 when multiple metatarsals are osteotomized.
On this page
CMS RVU26D · Effective 2026-10-01
28309 Metatarsal osteotomy Medicare reimbursement rates in Missouri
Reports operative osteotomy of multiple metatarsals to correct forefoot alignment, length, or angulation when more than one metatarsal is treated. Compare 28309 office and facility rates across CMS payment localities in Missouri.
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 28309 in Missouri?
Missouri has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$792.44–$821.48
3 of 3 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 28309 pays more and less in Missouri
Foot surgery
About 28309: Multiple metatarsal osteotomy
Reports operative osteotomy of multiple metatarsals to correct forefoot alignment, length, or angulation when more than one metatarsal is treated.
This procedure involves making planned bone cuts in multiple metatarsals to change forefoot alignment, length, or angulation. Podiatrists and orthopedic foot-and-ankle surgeons may use it to correct a multiray forefoot deformity or a metatarsal alignment pattern contributing to overload. It is generally performed in an operating room, often alongside other separately indicated forefoot procedures.
Select the code when the operative report supports osteotomy of multiple metatarsals; document the bones treated, side, deformity, and correction performed. A single-metatarsal procedure may fall under a different code in this family. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 28309
- 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 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 RVU13.81 · 55%
- Practice expense (office) RVU8.96 · 36%
- Malpractice RVU2.25 · 9%
892
Medicare services in 2024 · #3052 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.
28309 compared with similar codes
Office rates for Missouri, from the same CMS release.
$762.37–$816.57
This code describes first-metatarsal osteotomy with autograft. 28309 is used for osteotomy of multiple metatarsals.
$531.87–$567.11
This code applies to an osteotomy of a metatarsal other than the first, per metatarsal; 28309 applies when multiple metatarsals are treated.
$744.90–$790.44
This code addresses repair of a metatarsal nonunion or malunion. 28309 describes osteotomy to correct alignment, length, or angulation.
Compare 28309 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.
3 of 3 payment localities
Metropolitan Kansas City →
Office / nonfacility
Unavailable
Facility
$815.71
Metropolitan St. Louis →
Office / nonfacility
Unavailable
Facility
$821.48
Rest Of Missouri →
Office / nonfacility
Unavailable
Facility
$792.44
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28309 billing questions
When should 28309 be chosen over 28308?
Use 28309 when multiple metatarsals are osteotomized. Code 28308 is for an osteotomy of a metatarsal other than the first, reported per metatarsal.
What should the operative note identify?
Document the metatarsals treated, laterality, the deformity or alignment problem, and the correction performed. The record should support that multiple metatarsals underwent osteotomy.
How is bilateral surgery reported?
When the procedure is performed bilaterally, report modifier 50; CMS pays it at 150%.
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 paid?
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 does CMS handle other procedures in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.
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.
3,18328306,,Incision of metatarsal,A,,5.85,12.14,,4.88,,0.82,18.81,11.55,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,18428307,,Incision of metatarsal,A,,6.34,17.61,,7.21,,1.34,25.29,14.89,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,18528308,,Incision of metatarsal,A,,5.34,11.51,,5.11,,0.68,17.53,11.13,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,18628309,,Incision of metatarsals,A,,13.81,8.96,NA,8.96,,2.25,25.02,25.02,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,18728310,,Revision of big toe,A,,5.43,10.82,,4.37,,0.67,16.92,10.47,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,18828312,,Revision of toe,A,,4.57,12.55,,5.09,,0.72,17.84,10.38,0,090,0.10,0.69,0.21,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,18928313,,Repair deformity of toe,A,,5.02,10.62,,4.66,,0.70,16.34,10.38,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00