Billing code 28308: Metatarsal osteotomyMedicare rate & RVUs in Nevada
Reports an osteotomy of a lesser metatarsal to change its length or alignment, commonly for a structural forefoot problem such as metatarsalgia.
Medicare pays $582.11 for 28308 in the office in Nevada (Nevada**). Which amount applies depends on the service address.
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 28308 covers
A foot and ankle orthopedic surgeon or podiatric surgeon cuts a metatarsal other than the first to change its length or alignment. The procedure may address a lesser metatarsal that contributes to forefoot pain or abnormal pressure, including metatarsalgia associated with a long or malaligned bone. The bone may be repositioned and stabilized as part of the correction. These operations are commonly performed in an ambulatory surgery center or hospital outpatient department; some are done in an office-based surgical setting.
Select this code for an osteotomy of a lesser metatarsal, rather than an osteotomy of the first metatarsal or a multiple-metatarsal realignment procedure. Document the specific bone, the reason for changing its length or alignment, and the work performed; report the treated lesser metatarsal count as supported by the operative record. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same 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 may be available; co-surgeon payment requires supporting documentation, and team-surgery payment is 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.
28308 in Nevada**
| Payment locality | Office | Facility |
|---|---|---|
| Nevada** | $582.11 | $368.13 |
How the 28308 rate is calculated
Each of 28308’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 · 28308
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 5.34Practice expense 11.51Malpractice 0.68
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 28308
28308 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28308
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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| 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 · 28308
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
28308 without 50 · national office
$585.52
Metatarsal osteotomy
28308-50 · Bilateral: 150%
$878.28
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).
28308 compared with similar codes
Compare codes
28308 vs 28306 vs 28307 vs 28309: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 28306Metatarsal osteotomy
- Choose 28306 when the osteotomy involves the first metatarsal. Code 28308 is for a metatarsal other than the first.
- 28307Metatarsal osteotomy
- 28307 involves a first-metatarsal osteotomy with an autogenous graft. It is not the code for an osteotomy of a lesser metatarsal.
- 28309Metatarsal osteotomy
- 28309 applies to multiple metatarsal osteotomies with realignment. Distinguish it from 28308 by the number and nature of the osteotomies documented.
28308 billing questions
How does this differ from 28306?
28306 is for an osteotomy of the first metatarsal. Use 28308 when the osteotomy is on a metatarsal other than the first.
When would 28309 be considered instead?
28309 describes multiple metatarsal osteotomies with realignment. Use 28308 for an individual lesser-metatarsal osteotomy when the operative work does not meet that multiple-osteotomy description.
What should the operative report document?
Document which lesser metatarsal was treated, the structural problem prompting the procedure, and the osteotomy and resulting change in length or alignment. The record should support the number of metatarsals reported.
Are related postoperative visits separately included?
The 90-day global period includes related postoperative care, as well as the day-before preoperative visit. Services unrelated to the surgery are not described by that global-care rule.
How is bilateral surgery reported under these CMS facts?
For a bilateral procedure, modifier 50 is paid at 150%. The operative documentation should support treatment on both sides.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team-surgery payment is 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 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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