CPT 28210
Global 090 ActiveRepair/graft of foot tendon
CPT 28210 Billing & Documentation Guide
CPT code 28210 (Repair/graft 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 6.36, a non-facility practice expense RVU of 10.76, and a malpractice RVU of 0.78, a total non-facility RVU of 17.9 and facility RVU of 11.9. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $614.15, though rates vary from $534.57 to $768.01 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 28210, 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 28210 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 2 units of 28210 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 28210
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 6.36 | 6.36 |
| Practice Expense RVU | 10.76 | 4.76 |
| Malpractice RVU | 0.78 | 0.78 |
| Total RVU | 17.9 | 11.9 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 28210
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 | $659.43 | $422.3 | $623.9 - $768.01 | 29 |
| Florida | $623.74 | $422.66 | $595.17 - $652.45 | 3 |
| Georgia | $586.78 | $395.6 | $564.06 - $609.5 | 2 |
| Illinois | $610.23 | $416.58 | $581.28 - $634.9 | 4 |
| Michigan | $586.57 | $398.39 | $569.97 - $603.17 | 2 |
| North Carolina | $564.39 | $377.41 | $564.39 - $564.39 | 1 |
| New York | $658.86 | $435.29 | $572.17 - $701.72 | 5 |
| Ohio | $566.82 | $383.85 | $566.82 - $566.82 | 1 |
| Pennsylvania | $594.22 | $397.92 | $566.97 - $621.46 | 2 |
| Texas | $591.62 | $394.32 | $563.68 - $616.18 | 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 28210
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 28210 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 |
| 0565T | Column 1 (primary), can be billed with modifier | Yes | HCPCS/CPT procedure code definition |
| 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 |
Frequently Asked Questions, CPT 28210
What does CPT code 28210 mean? +
CPT code 28210 represents: Repair/graft of foot tendon. It's in the Surgery (Musculoskeletal) category with a global period of 090.
What is the Medicare reimbursement for CPT 28210? +
The 2026 Medicare national average non-facility payment for CPT 28210 is $614.15. Rates range from $534.57 to $768.01 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 28210? +
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 28210? +
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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