CPT 28200
Global 090 ActiveRepair of foot tendon
CPT 28200 Billing & Documentation Guide
CPT code 28200 (Repair of foot tendon) is classified under Surgery (Musculoskeletal) with a global period indicator of 090. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 4.62, a non-facility practice expense RVU of 9.92, and a malpractice RVU of 0.56, a total non-facility RVU of 15.1 and facility RVU of 9.37. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $519.27, though rates vary from $448.56 to $659.1 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 28200, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 28200 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
90-day global period (major surgery: 1 day pre-op + procedure + 90 days post-op)
MUE Limit (Medically Unlikely Edits)
Submitting more than 4 units of 28200 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 28200
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 4.62 | 4.62 |
| Practice Expense RVU | 9.92 | 4.19 |
| Malpractice RVU | 0.56 | 0.56 |
| Total RVU | 15.1 | 9.37 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 28200
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $562.05 | $335.59 | $530.11 - $659.1 | 29 |
| Florida | $523.16 | $331.14 | $499.18 - $546.54 | 3 |
| Georgia | $493.02 | $310.44 | $472.16 - $513.88 | 2 |
| Illinois | $510.75 | $325.83 | $486.06 - $531.31 | 4 |
| Michigan | $491.77 | $312.05 | $477.94 - $505.59 | 2 |
| North Carolina | $475.4 | $296.84 | $475.4 - $475.4 | 1 |
| New York | $556.7 | $343.18 | $482.23 - $592.88 | 5 |
| Ohio | $475.68 | $300.94 | $475.68 - $475.68 | 1 |
| Pennsylvania | $500.25 | $312.78 | $476.16 - $524.33 | 2 |
| Texas | $498.74 | $310.31 | $473.21 - $521.75 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 28200
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 28200 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 01470 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01995 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0490T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
Frequently Asked Questions, CPT 28200
What does CPT code 28200 mean? +
CPT code 28200 represents: Repair of foot tendon. It's in the Surgery (Musculoskeletal) category with a global period of 090.
What is the Medicare reimbursement for CPT 28200? +
The 2026 Medicare national average non-facility payment for CPT 28200 is $519.27. Rates range from $448.56 to $659.1 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 28200? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 28200? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on April 17, 2026.
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