$421.79–$486.94
Choose 28285 for hammertoe correction. 28286 is specific to correction of a cock-up fifth toe.
On this page
CMS RVU26D · Effective 2026-10-01
28285 Hammertoe repair Medicare reimbursement rates in Virginia
Reports surgical correction of a hammertoe deformity, commonly involving a contracted lesser toe treated with joint fusion or bone resection. Compare 28285 office and facility rates across CMS payment localities in Virginia.
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 28285 in Virginia?
Virginia 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
$536.49–$622.02
2 of 2 localities have a supported rate.
Facility setting
$361.82–$412.70
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 28285: Lesser-toe hammertoe surgical correction
Reports surgical correction of a hammertoe deformity, commonly involving a contracted lesser toe treated with joint fusion or bone resection.
This procedure corrects a hammertoe, typically a lesser toe with a flexed, contracted joint that cannot be adequately addressed by conservative care. A foot and ankle surgeon or podiatrist may correct the deformity by treating the interphalangeal joint, for example with fusion or partial bone resection. The operation is commonly performed in an outpatient surgical setting. The specific technique depends on the deformity and operative findings.
Report the service for each toe surgically corrected, identifying the toe and side in the claim and operative documentation. The record should describe the deformity, the toe treated, and the corrective work performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Modifier 50 applies to bilateral performance, paid at 150%. Medicare does not pay an assistant at surgery for this service; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 28285
- 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
- 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 RVU5.48 · 33%
- Practice expense (office) RVU10.32 · 63%
- Malpractice RVU0.62 · 4%
74.8K
Medicare services in 2024 · #648 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.
28285 compared with similar codes
Office rates for Virginia, from the same CMS release.
$369.62–$427.64
28272 describes interphalangeal joint contracture release. Use 28285 when the operation corrects the hammertoe deformity rather than reporting only a joint release.
$478.45–$554.63
28270 describes metatarsophalangeal joint contracture release. It is not the code for surgical correction of the hammertoe itself.
Compare 28285 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
Dc + Md/Va Suburbs →
Office / nonfacility
$622.02
Facility
$412.70
Virginia →
Office / nonfacility
$536.49
Facility
$361.82
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28285 billing questions
How is 28285 different from 28286?
28285 is for hammertoe correction. 28286 describes correction of a cock-up fifth toe, a distinct deformity and procedure.
What documentation supports 28285?
Document the hammertoe deformity, the specific toe and side, and the operative correction performed, such as interphalangeal joint fusion or bone resection.
How should multiple corrected toes be reported?
Report the service for each corrected toe and identify the individual toe and side using the applicable toe modifiers. The operative note should make the treated toes clear.
How does Medicare handle bilateral correction?
CMS identifies this as a bilateral procedure: modifier 50 is paid at 150%. Document the procedures performed on each side.
Is postoperative care included?
Yes. The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeon payment is allowed 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 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.
3,16528270,,Release of foot contracture,A,,4.81,9.32,,4.21,,0.50,14.63,9.52,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,16628272,,Release of toe joint each,A,,3.82,7.12,,3.00,,0.35,11.29,7.17,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,16728280,,Fusion of toes,A,,5.20,9.17,,3.90,,0.54,14.91,9.64,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,16828285,,Repair of hammertoe,A,,5.48,10.32,,5.00,,0.62,16.42,11.10,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,16928286,,Repair of hammertoe,A,,4.58,7.90,,3.34,,0.40,12.88,8.32,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,17028288,,Partial removal of foot bone,A,,5.87,11.73,,5.92,,0.68,18.28,12.47,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,17128289,,Corrj halux rigdus w/o implt,A,,6.73,13.47,,5.57,,0.84,21.04,13.14,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00