$398.93
Use 28232 for an open division of one flexor tendon in a toe. Use 28230 for an open incision of a single extensor tendon.
On this page
CMS RVU26D · Effective 2026-10-01
28232 Toe tendon incision Medicare reimbursement rates in Tennessee
Reports open division of one flexor tendon in a toe, commonly to address a tendon-driven toe contracture such as a claw or hammertoe deformity. Compare 28232 office and facility rates across CMS payment localities in Tennessee.
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 28232 in Tennessee?
Tennessee has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$346.22
1 of 1 localities have a supported rate.
Payment area: Tennessee
One mapped payment locality.
Facility setting
$216.27
1 of 1 localities have a supported rate.
Payment area: Tennessee
One mapped payment locality.
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 28232: Open flexor tenotomy of a toe
Reports open division of one flexor tendon in a toe, commonly to address a tendon-driven toe contracture such as a claw or hammertoe deformity.
The surgeon makes an incision and divides one flexor tendon in a toe to reduce a deforming pull or contracture. Orthopedic surgeons and podiatric surgeons commonly perform this procedure for a toe deformity in an operating room or other surgical setting. The defining details are an open approach, a flexor tendon, and one tendon in a toe; this is not repair of a damaged tendon or incision of an extensor tendon.
Select the code from the operative note’s documented tendon, toe, approach, and number of tendons treated. The note should support the deformity or contracture addressed and the specific tendon division. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery; co-surgeons and team surgery are not permitted.
CMS billing rules for 28232
- 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU3.42 · 31%
- Practice expense (office) RVU7.44 · 66%
- Malpractice RVU0.34 · 3%
19K
Medicare services in 2024 · #1165 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.
28232 compared with similar codes
Office rates for Tennessee, from the same CMS release.
$380.25
28234 involves multiple extensor tendons; 28232 involves one flexor tendon in a toe. The operative note should identify tendon type and count.
$350.04
28272 addresses release of a toe joint contracture. 28232 divides a flexor tendon, so distinguish the structure treated.
$507.49
28285 represents hammertoe correction, while 28232 describes an open flexor tenotomy. Determine whether the documented service is an isolated tendon division or part of a broader deformity correction.
Compare 28232 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.
1 of 1 payment localities
Tennessee →
Office / nonfacility
$346.22
Facility
$216.27
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 28232 in Tennessee.
PPRRVU2026_Oct_nonQPP.csv
3,156
- Code
- 28232
- Physician work
- 3.42
- Practice expense
- 7.44
- Malpractice
- 0.34
GPCI2026.csv
95
- Locality
- Tennessee
- Physician work
- 1.000
- Practice expense
- 0.909
- Malpractice
- 0.537
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.42 | × 1.000 | 3.4200 |
| Practice expense | 7.44 | × 0.909 | 6.7630 |
| Malpractice | 0.34 | × 0.537 | 0.1826 |
| Total RVUs | 10.3655 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Tennessee$346.22
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.42 | 1 |
| Practice expense | 7.44 | 0.909 |
| Malpractice | 0.34 | 0.537 |
(3.42 × 1 + 7.44 × 0.909 + 0.34 × 0.537) × $33.4009 = $346.22
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.42 | 1 |
| Practice expense | 3.16 | 0.909 |
| Malpractice | 0.34 | 0.537 |
(3.42 × 1 + 3.16 × 0.909 + 0.34 × 0.537) × $33.4009 = $216.27
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
28232 billing questions
How is 28232 different from 28230?
28232 is for open division of a flexor tendon in a toe. 28230 describes an open incision of a single extensor tendon.
When would 28234 be considered instead?
28234 is for open incision of multiple extensor tendons. Choose based on the tendon type and number documented, not simply because more than one toe is treated.
Can 28232 be separately reported with hammertoe correction?
Do not assume the tendon division is separately reportable when it is part of a broader hammertoe correction. Check applicable edits and document any distinct work supporting separate reporting.
Should modifier 50 be used when both feet are treated?
No. CMS identifies bilateral adjustment as inappropriate for this code. The descriptor and anatomy do not support modifier 50.
What documentation supports this code?
Record the affected toe, the flexor tendon divided, the open approach, the number of tendons treated, and the deformity or contracture addressed.
What global and multiple-procedure rules apply?
The code has a 90-day global period. For multiple procedures in the same session, Medicare pays the highest-valued procedure in full and the others at 50%.
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.
3,15328225,,Release of foot tendon,A,,3.69,8.21,,3.44,,0.39,12.29,7.52,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,15428226,,Release of foot tendons,A,,4.55,14.39,,6.17,,0.98,19.92,11.70,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,15528230,,Incision of foot tendon(s),A,,4.25,8.21,,3.40,,0.43,12.89,8.08,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,15628232,,Incision of toe tendon,A,,3.42,7.44,,3.16,,0.34,11.20,6.92,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,15728234,,Incision of foot tendon,A,,3.45,8.51,,3.99,,0.37,12.33,7.81,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,15828238,,Revision of foot tendon,A,,7.76,11.81,,5.04,,0.95,20.52,13.75,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,15928240,,Release of big toe,A,,4.37,8.37,,3.48,,0.44,13.18,8.29,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537
9604412,TX,31,AUSTIN,1.002,1.058,0.886
9704412,TX,20,BEAUMONT,1.000,0.910,0.929
9804412,TX,09,BRAZORIA,1.008,0.991,0.780