CPT 28800
Global 090 ActiveAmputation of midfoot
CPT 28800 Billing & Documentation Guide
CPT code 28800 (Amputation of midfoot) is classified under Surgery (Musculoskeletal) with a global period indicator of 090. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 8.57, a non-facility practice expense RVU of 5.12, and a malpractice RVU of 1.02, a total non-facility RVU of 14.71 and facility RVU of 14.71. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $499.73, though rates vary from $450.69 to $630.27 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 28800, 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 28800 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 1 units of 28800 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 28800
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 8.57 | 8.57 |
| Practice Expense RVU | 5.12 | 5.12 |
| Malpractice RVU | 1.02 | 1.02 |
| Total RVU | 14.71 | 14.71 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 28800
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 | $517.33 | $517.33 | $496.8 - $582.59 | 29 |
| Florida | $524.15 | $524.15 | $500.94 - $550.43 | 3 |
| Georgia | $490.59 | $490.59 | $479.4 - $501.77 | 2 |
| Illinois | $517.6 | $517.6 | $495.63 - $538.31 | 4 |
| Michigan | $494.78 | $494.78 | $480.84 - $508.71 | 2 |
| North Carolina | $467.57 | $467.57 | $467.57 - $467.57 | 1 |
| New York | $536.92 | $536.92 | $472.66 - $571.17 | 5 |
| Ohio | $476.72 | $476.72 | $476.72 - $476.72 | 1 |
| Pennsylvania | $492.75 | $492.75 | $475.43 - $510.07 | 2 |
| Texas | $487.83 | $487.83 | $473.52 - $505.23 | 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 28800
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 28800 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 28800
What does CPT code 28800 mean? +
CPT code 28800 represents: Amputation of midfoot. It's in the Surgery (Musculoskeletal) category with a global period of 090.
What is the Medicare reimbursement for CPT 28800? +
The 2026 Medicare national average non-facility payment for CPT 28800 is $499.73. Rates range from $450.69 to $630.27 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 28800? +
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 28800? +
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 June 2, 2026.
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