Billing code 28296: Bunion correctionMedicare rate & RVUs in Ohio

Reports surgical correction of a bunion when the surgeon cuts and repositions the distal first metatarsal to realign the great toe.

CMS RVU26DEffective Oct 1, 20261 payment locality7.6K Medicare services in 2024

Medicare pays $832.56 for 28296 in the office in Ohio (Ohio). Which amount applies depends on the service address.

$832.56Office (non-facility)
$468.14Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 28296 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Ohio
  2. What 28296 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 28296 covers

Code 28296 covers hallux valgus correction centered on an osteotomy near the head of the first metatarsal. An Austin or chevron bunionectomy is a familiar example. An orthopedic foot and ankle surgeon or podiatric surgeon typically performs the operation in a hospital outpatient department or ambulatory surgery center. The surgeon repositions the bone to improve great-toe alignment and may perform associated soft-tissue work as part of the correction.

Select 28296 when the operative report documents a distal first metatarsal osteotomy for the bunion correction. The report should identify the side, osteotomy location, bone repositioning, and any additional osteotomy. A proximal metatarsal osteotomy, joint fusion, or double osteotomy points to another code. CMS assigns a 90-day global period that includes the day-before preoperative visit and related postoperative care. When multiple procedures are performed in one session, CMS pays the highest-valued procedure in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons require supporting documentation. 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.

28296 in Ohio

28296 office and facility rates by payment locality
Payment localityOfficeFacility
Ohio$832.56$468.14

How the 28296 rate is calculated

Each of 28296’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 · 28296

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 8.04Practice expense 17.59Malpractice 0.82

26.4500 adjusted RVUs×$33.4009 conversion factor=$883.45

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 28296

28296 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 28296

Bunion correction

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 28296

Bunion correction

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

28296 without 50 · national office

$883.45

Bunion correction

28296-50 · Bilateral: 150%

$1,325.18

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).

When to use modifier 50

28296 compared with similar codes

Compare codes

28296 vs 28295 vs 28299 vs 28297 vs 28298: national Medicare rates

Swap in your local Medicare rate.

  • 28296
    Bunion correction · 8.04 wRVU
    $883.45
  • 28295
    Bunion correction · 8.36 wRVU
    $1,065.15+$181.70
  • 28299
    Bunion correction · 9.06 wRVU
    $1,036.43+$152.98
  • 28297
    Bunion correction · 9.06 wRVU
    $1,030.75+$147.30
  • 28298
    Bunion correction · 7.56 wRVU
    $860.41−$23.04

How to choose

28295Bunion correction
Use 28296 for an osteotomy near the first metatarsal head; 28295 describes correction with an osteotomy at the proximal first metatarsal.
28299Bunion correction
Code 28296 represents a single distal metatarsal osteotomy. Code 28299 identifies hallux valgus correction with two osteotomies.
28297Bunion correction
Code 28297 involves joint fusion to correct hallux valgus. Code 28296 repositions the distal first metatarsal through an osteotomy.
28298Bunion correction
Code 28298 identifies correction using a proximal phalanx osteotomy; 28296 identifies a distal first metatarsal osteotomy.

28296 billing questions

How is 28296 distinguished from 28295?

Both involve first metatarsal osteotomy for hallux valgus, but 28296 identifies an osteotomy at the distal metatarsal; 28295 identifies one at the proximal metatarsal.

What if the surgeon also performs a proximal phalanx osteotomy?

Review the operative report for a double osteotomy. Code 28299 describes hallux valgus correction using two osteotomies, rather than the single distal metatarsal osteotomy represented by 28296.

Is removal of the bunion prominence separately reported?

When removal of the medial prominence is part of the distal metatarsal osteotomy correction, it is included in 28296 rather than reported as a separate bunion procedure.

How is surgery on both feet reported?

CMS recognizes bilateral reporting of 28296 with modifier 50 and pays it at 150%. The operative report should document the distal metatarsal correction on each foot.

What postoperative visits are included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care for the bunion correction.

Can another surgeon participate in the operation?

An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; CMS does not permit team surgery for 28296.

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
RVUs for 28296PPRRVU2026_Oct_nonQPP.csv, line 3,175 (RVU26D)
Geographic factors for OhioGPCI2026.csv, line 85 (RVU26D)

Open CMS sourceHow we calculate rates

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