Billing code 28309: Metatarsal osteotomyMedicare rate & RVUs in Nebraska
Reports operative osteotomy of multiple metatarsals to correct forefoot alignment, length, or angulation when more than one metatarsal is treated.
CMS doesn’t publish an office rate for 28309 in Nebraska.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 28309 covers
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.
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 in Nebraska
| Payment locality | Office | Facility |
|---|---|---|
| Nebraska | Unavailable | $765.90 |
How the 28309 rate is calculated
Each of 28309’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 28309
RVUs × geographic indexes × conversion factor
Work13.81
13.81 RVUs× 1.000 GPCI
Practice expense8.96
8.96 RVUs× 1.000 GPCI
Malpractice2.25
2.25 RVUs× 1.000 GPCI
Adjusted RVUs
25.0200
Conversion factor
$33.4009
Medicare rate
$835.69
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 28309
28309 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28309
Metatarsal osteotomy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 28309
Metatarsal osteotomy
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
28309 without 50 · national facility
$835.69
Metatarsal osteotomy
28309-50 · Bilateral: 150%
$1,253.54
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
28309 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 28306Metatarsal osteotomy
- This code is for an osteotomy of the first metatarsal. Choose 28309 when multiple metatarsals are osteotomized.
- 28307Metatarsal osteotomy
- This code describes first-metatarsal osteotomy with autograft. 28309 is used for osteotomy of multiple metatarsals.
- 28308Metatarsal osteotomy
- This code applies to an osteotomy of a metatarsal other than the first, per metatarsal; 28309 applies when multiple metatarsals are treated.
- 28322Metatarsal repair
- This code addresses repair of a metatarsal nonunion or malunion. 28309 describes osteotomy to correct alignment, length, or angulation.
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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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