Billing code 28020: Foot joint arthrotomyMedicare rate & RVUs in Oregon
Report this open joint procedure for exploration, drainage, or removal of material from an intertarsal or tarsometatarsal joint.
Medicare pays $555.37–$601.88 for 28020 in the office in Oregon, from Rest Of Oregon to Portland. 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 28020 covers
This code describes an open incision into an intertarsal or tarsometatarsal joint to inspect the joint, drain it, or remove a loose body or foreign material. A foot and ankle orthopedic surgeon or podiatric surgeon typically performs the procedure in an operating room, for example when addressing a suspected joint loose body or an infection requiring drainage. The joint location distinguishes this service from arthrotomy codes for the metatarsophalangeal or toe interphalangeal joints.
Report the code when the operative record identifies the joint entered and documents the arthrotomy and work performed. Exploration, drainage, or removal through that same joint opening is included in this service. Medicare 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 other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. 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.
Where 28020 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | $601.88 | $365.50 |
| Rest Of Oregon | $555.37 | $343.46 |
How the 28020 rate is calculated
Each of 28020’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 · 28020
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 5.02Practice expense 11.16Malpractice 0.70
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 28020
28020 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28020
Foot joint arthrotomy
| 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| 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 · 28020
Foot joint arthrotomy
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 51 · payment effect
With and without the modifier
28020 without 51 · national office
$563.81
Foot joint arthrotomy
28020-51 · Second procedure: 50%
$281.91
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
28020 compared with similar codes
Compare codes
28020 vs 28022 vs 28024 vs 28050 vs 28070: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 28022Joint exploration
- Choose 28020 for an intertarsal or tarsometatarsal joint; choose 28022 for a metatarsophalangeal joint.
- 28024Toe joint exploration
- Code 28024 identifies arthrotomy of a toe interphalangeal joint. Code 28020 covers the more proximal intertarsal or tarsometatarsal joints.
- 28050Joint biopsy
- Code 28050 specifies arthrotomy with biopsy at an intertarsal or tarsometatarsal joint. Use 28020 for exploration, drainage, or removal rather than a biopsy-focused service.
- 28070Foot synovectomy
- Code 28070 describes removal of tarsal-joint synovium. Code 28020 describes joint exploration, drainage, or removal of a loose body or foreign material.
28020 billing questions
How do I distinguish this from 28022?
Use 28020 for an intertarsal or tarsometatarsal joint. Code 28022 is for a metatarsophalangeal joint.
When is 28024 the better choice?
Use 28024 when the arthrotomy is at a toe interphalangeal joint, rather than an intertarsal or tarsometatarsal joint.
Can exploration, drainage, and loose-body removal be reported separately?
Those actions are included when performed through the arthrotomy represented by this code. Document the joint entered and the work performed.
What documentation supports code selection?
The operative report should identify the specific intertarsal or tarsometatarsal joint and describe the arthrotomy and its purpose, such as exploration, drainage, or removal.
Can modifier 50 be used for bilateral procedures?
No. CMS identifies bilateral adjustment as inapplicable and modifier 50 as inappropriate for this code.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures in the session are subject to the standard multiple-procedure reduction. The code also has a 90-day global period.
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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