$593.51–$653.70
Choose 28306 when the osteotomy involves the first metatarsal. Code 28308 is for a metatarsal other than the first.
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CMS RVU26D · Effective 2026-10-01
28308 Metatarsal osteotomy Medicare reimbursement rates in Pennsylvania
Reports an osteotomy of a lesser metatarsal to change its length or alignment, commonly for a structural forefoot problem such as metatarsalgia. Compare 28308 office and facility rates across CMS payment localities in Pennsylvania.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 28308 in Pennsylvania?
Pennsylvania has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$552.74–$608.87
2 of 2 localities have a supported rate.
Facility setting
$356.51–$386.34
2 of 2 localities have a supported rate.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Foot surgery
About 28308: Lesser metatarsal osteotomy
Reports an osteotomy of a lesser metatarsal to change its length or alignment, commonly for a structural forefoot problem such as metatarsalgia.
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.
CMS billing rules for 28308
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.34 · 30%
- Practice expense (office) RVU11.51 · 66%
- Malpractice RVU0.68 · 4%
26K
Medicare services in 2024 · #1034 by national volume
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 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
$794.02–$881.27
28307 involves a first-metatarsal osteotomy with an autogenous graft. It is not the code for an osteotomy of a lesser metatarsal.
No office rate
28309 applies to multiple metatarsal osteotomies with realignment. Distinguish it from 28308 by the number and nature of the osteotomies documented.
Compare 28308 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
2 of 2 payment localities
Metropolitan Philadelphia →
Office / nonfacility
$608.87
Facility
$386.34
Rest Of Pennsylvania →
Office / nonfacility
$552.74
Facility
$356.51
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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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
3,18228305,,Incise/graft midfoot bones,A,,10.50,6.70,NA,6.70,,1.52,18.72,18.72,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,18328306,,Incision of metatarsal,A,,5.85,12.14,,4.88,,0.82,18.81,11.55,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,18428307,,Incision of metatarsal,A,,6.34,17.61,,7.21,,1.34,25.29,14.89,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,18528308,,Incision of metatarsal,A,,5.34,11.51,,5.11,,0.68,17.53,11.13,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,18628309,,Incision of metatarsals,A,,13.81,8.96,NA,8.96,,2.25,25.02,25.02,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,18728310,,Revision of big toe,A,,5.43,10.82,,4.37,,0.67,16.92,10.47,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,18828312,,Revision of toe,A,,4.57,12.55,,5.09,,0.72,17.84,10.38,0,090,0.10,0.69,0.21,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00