$534.28–$587.54
28310 addresses the proximal phalanx of the great toe. This code addresses a toe other than the great toe.
On this page
CMS RVU26D · Effective 2026-10-01
28312 Toe osteotomy Medicare reimbursement rates in Pennsylvania
Reports surgical reshaping of a lesser toe’s proximal phalanx to correct shortening, angular alignment, or rotation when an osseous correction is performed. Compare 28312 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 28312 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
$560.18–$620.45
2 of 2 localities have a supported rate.
Facility setting
$331.44–$361.06
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 28312: Lesser toe proximal phalanx osteotomy
Reports surgical reshaping of a lesser toe’s proximal phalanx to correct shortening, angular alignment, or rotation when an osseous correction is performed.
This procedure reshapes the proximal phalanx of a toe other than the great toe to correct a bony alignment problem, such as angular or rotational deformity. An orthopedic foot and ankle surgeon or podiatric surgeon typically performs it in an operating room, often as part of forefoot reconstruction. The operative report should identify the treated lesser toe, the phalanx addressed, the deformity, and the osteotomy and correction performed.
Report this code for the proximal-phalanx osteotomy, not merely because a toe deformity was treated. The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days. When multiple procedures are performed in the same session, Medicare pays the highest-valued procedure in full and reduces the others to 50%. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 28312
- 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU4.57 · 26%
- Practice expense (office) RVU12.55 · 70%
- Malpractice RVU0.72 · 4%
2K
Medicare services in 2024 · #2474 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.
28312 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
$515.40–$567.84
28313 is for toe deformity reconstruction using soft-tissue procedures only. This code represents a bony osteotomy of a lesser toe’s proximal phalanx.
$519.04–$569.87
28285 is used for hammertoe correction. Choose between the codes based on the documented procedure; a hammertoe diagnosis by itself does not establish a proximal-phalanx osteotomy.
$552.74–$608.87
28308 addresses an osteotomy of a metatarsal. This code addresses the proximal phalanx of a lesser toe.
Compare 28312 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
$620.45
Facility
$361.06
Rest Of Pennsylvania →
Office / nonfacility
$560.18
Facility
$331.44
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28312 billing questions
When is this code appropriate instead of 28310?
Use 28312 for a proximal-phalanx osteotomy of a toe other than the great toe. Code 28310 is for the great toe’s proximal phalanx.
Does a hammertoe diagnosis alone support this code?
No. Documentation should establish that the surgeon performed a proximal-phalanx osteotomy to correct the lesser toe’s bony alignment. A hammertoe procedure without that osteotomy does not establish the service.
Can this be reported with a metatarsal osteotomy?
It may be reported with a metatarsal osteotomy when both distinct bony corrections are performed and documented. Same-session procedures are subject to Medicare’s multiple procedure reduction.
Can modifier 50 be used when both feet are treated?
No. CMS identifies bilateral adjustment as inappropriate for this code. Follow the applicable reporting instructions for services performed on separate toes or feet.
How does the global period affect postoperative visits?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
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.
3,18528308,,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
3,18928313,,Repair deformity of toe,A,,5.02,10.62,,4.66,,0.70,16.34,10.38,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,19028315,,Removal of sesamoid bone,A,,4.88,8.99,,3.89,,0.54,14.41,9.31,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,19128320,,Repair of foot bones,A,,9.14,6.77,NA,6.77,,1.39,17.30,17.30,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00