Billing code 28315: SesamoidectomyMedicare rate & RVUs in Nevada
Reports surgical removal of a symptomatic foot sesamoid, commonly beneath the great toe, for persistent pain from sesamoid disease or injury.
Medicare pays $478.60 for 28315 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 28315 covers
This procedure removes a sesamoid bone in the foot, most often one of the small bones beneath the first metatarsal head at the great toe. Podiatrists and orthopedic surgeons may perform it for persistent focal pain associated with sesamoiditis, fracture, nonunion, or avascular change when surgery is chosen. The work may take place in an operating room or an appropriately equipped outpatient surgical setting.
Report the procedure for removal of the sesamoid itself, not an osteotomy of a metatarsal or correction of a toe deformity alone. The operative report should identify the treated foot and sesamoid, the indication, and the removal performed. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 bilateral procedures are paid at 150%. Assistant-at-surgery payment is restricted; co-surgeon payment requires supporting documentation, and team surgery 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.
28315 in Nevada**
| Payment locality | Office | Facility |
|---|---|---|
| Nevada** | $478.60 | $308.08 |
How the 28315 rate is calculated
Each of 28315’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 · 28315
RVUs × geographic indexes × conversion factor
Work4.88
4.88 RVUs× 1.000 GPCI
Practice expense8.99
8.99 RVUs× 1.000 GPCI
Malpractice0.54
0.54 RVUs× 1.000 GPCI
Adjusted RVUs
14.4100
Conversion factor
$33.4009
Medicare rate
$481.31
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 28315
28315 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28315
Sesamoidectomy
| 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) | 1 | Not paid (statutory restriction). |
| 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 · 28315
Sesamoidectomy
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
28315 without 50 · national office
$481.31
Sesamoidectomy
28315-50 · Bilateral: 150%
$721.97
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).
28315 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 28308Metatarsal osteotomy
- This code concerns a metatarsal osteotomy. Choose sesamoid removal when the operative target is the sesamoid bone rather than a metatarsal cut or realignment.
- 28124Toe bone excision
- This code describes partial excision of a toe phalanx. It is not the code for removal of a sesamoid beneath the great toe.
- 28296Bunion correction
- This code describes hallux valgus correction with a distal metatarsal osteotomy. Sesamoid removal alone does not represent that deformity-correction procedure.
28315 billing questions
When is this code appropriate instead of a metatarsal osteotomy code?
Use this code when the surgeon removes a foot sesamoid. A metatarsal osteotomy code describes cutting or realigning a metatarsal, not removing the sesamoid.
Does the global period include related postoperative care?
Yes. CMS assigns a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral sesamoid removal handled?
CMS identifies the procedure as bilateral-eligible with modifier 50; the bilateral procedure is paid at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is restricted by statute. Co-surgeons are paid only when supporting documentation is provided; team surgery is not permitted.
What happens when another procedure is performed in the same session?
CMS pays the highest-valued procedure in full and applies the standard multiple procedure reduction to the others. Document the distinct work performed for each reported procedure.
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
Fee sheets
Put 28315 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →