Billing code 28304: Midfoot osteotomyMedicare rate & RVUs in Texas
A surgeon cuts and reshapes a midfoot tarsal bone, other than the heel or talus, to correct alignment or structural deformity.
Medicare pays $821.80–$896.79 for 28304 in the office in Texas, from Beaumont to Austin. 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 28304 covers
This service involves a planned cut in a midfoot tarsal bone, such as a cuneiform, navicular, or cuboid, to change its alignment or shape. Orthopedic foot-and-ankle surgeons and podiatrists perform these procedures to address structural deformity or abnormal foot mechanics, commonly in an operating room. The operated bone distinguishes this service from osteotomy of the calcaneus, talus, or a metatarsal. A tarsal osteotomy with autograft is reported with a different code.
Select this code when the operative work is a midfoot tarsal osteotomy without the autograft service represented by 28305. The operative report should identify the bone and side, the condition being corrected, the osteotomy and correction performed, and whether graft was used. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For same-session multiple procedures, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 bilateral procedures are paid at 150%. Assistant-at-surgery payment may be made; 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 28304 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$821.80 to $896.79
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $896.79 | $589.70 |
| Beaumont | $821.80 | $557.67 |
| Brazoria | $858.84 | $571.19 |
| Dallas | $865.53 | $576.44 |
| Fort Worth | $861.00 | $574.81 |
| Galveston | $862.21 | $573.99 |
| Houston | $888.93 | $600.71 |
| Rest Of Texas | $840.68 | $565.23 |
How the 28304 rate is calculated
Each of 28304’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 · 28304
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 9.17Practice expense 15.47Malpractice 1.46
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 28304
28304 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28304
Midfoot osteotomy
| 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) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| 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 · 28304
Midfoot osteotomy
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 50 · payment effect
With and without the modifier
28304 without 50 · national office
$871.76
Midfoot osteotomy
28304-50 · Bilateral: 150%
$1,307.64
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).
28304 compared with similar codes
Compare codes
28304 vs 28305 vs 28300 vs 28306: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 28305Midfoot osteotomy
- Choose 28304 for a midfoot tarsal osteotomy without the autograft service. Choose 28305 when the tarsal osteotomy includes autograft.
- 28300Heel osteotomy
- 28300 is for an osteotomy of the calcaneus. Use 28304 when the operated bone is a midfoot tarsal bone instead.
- 28306Metatarsal osteotomy
- 28306 applies to first-metatarsal osteotomy. 28304 is for a midfoot tarsal bone, not a metatarsal.
28304 billing questions
How does 28304 differ from 28305?
Both describe osteotomy of a midfoot tarsal bone other than the calcaneus or talus. Use 28305 when the tarsal osteotomy includes autograft; 28304 is the option without that graft service.
Which bone determines whether this code applies?
The osteotomy must involve a midfoot tarsal bone, such as a cuneiform, navicular, or cuboid. A calcaneal, talar, or metatarsal osteotomy belongs to a different code.
What should the operative report document?
Document the specific bone and side, the deformity or alignment problem, the osteotomy and correction performed, and whether autograft was used.
How is a bilateral procedure handled under the CMS facts?
A bilateral procedure reported with modifier 50 is paid at 150%.
What postoperative care is included in the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be paid?
Assistant-at-surgery payment may be made. Co-surgeons are paid only with supporting documentation; team surgery 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 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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