Surgical removal of a single metatarsal bone along with its attached toe (ray resection), used when the digit and associated long bone must both be excised.

Verified May 8, 2026 · 7 sources ↓

Medicare: $396.80
Work RVU: 6.47
Global, days: 90
Region: Foot & ankle

Drawn from CMSMdclarityAAPCMedcaremsoPodiatrym

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 7 cited references ↓

Operative note must use the word 'amputation' — 'bone excision' or 'debridement' alone does not support 28810.
Specify which ray (1st through 5th) and laterality (right or left foot) in both the op note and the claim.
Document the indication: failed conservative treatment, vascular status, presence of diabetes, peripheral vascular disease, or osteomyelitis with ICD-10 linkage (e.g., E11.621, M86.67x).
Record the extent of metatarsal resection (partial shaft vs. complete) — this distinguishes 28810 from 28820 and 28122.
Note pre-operative vascular assessment (ABI, pulse exam, or vascular surgery consultation) when peripheral vascular disease is a contributing factor.
Document systemic conditions — diabetes, neuropathy, PVD — as they establish medical necessity and support diagnosis coding.

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 50 Bilateral procedure 51 Multiple procedures 58 Staged or related 59 Distinct service 76 Repeat, same physician 78 Unplanned return — related 79 Unrelated during global LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 7 cited references ↓

CPT 28810 covers a single-ray amputation: the surgeon removes one metatarsal and its corresponding toe as a unit. The procedure is most often performed for diabetic foot complications (osteomyelitis, gangrene, non-healing ulcers), severe infection, or traumatic injury where the digit and metatarsal shaft are both nonviable. It applies whether the entire metatarsal or a partial shaft is removed along with the toe — the defining element is that both the toe and metatarsal bone are addressed in the same resection.

Do not confuse 28810 with 28820, which covers toe amputation at the metatarsophalangeal joint without metatarsal resection. The NCCI bundles 28820 into 28810 for the same toe — you cannot bill both for the same digit. If the operative note documents only bone excision without digital amputation, 28122 (partial metatarsal excision) may be the correct code; the operative report must explicitly state amputation to support 28810.

The 90-day global period covers the day of surgery, the day-before pre-op visit, and all routine post-op care through day 90. Wound checks, dressing changes, and suture removal are bundled. Use modifier 24 for unrelated E/M visits and modifier 78 for an unplanned return to the OR for a related complication within the global window.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU vs. total RVU

The work RVU (6.47) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (11.88) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	6.47
Practice expense RVU	4.45
Malpractice RVU	0.96
Total RVU	11.88
Medicare national rate	$396.80
Global period	90 days

Payment by site of service

Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.

Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026

Setting	Medicare rate (national)
Office (PFS non-facility) Procedure performed in physician's office	$396.80
HOPD (APC 5113) Hospital outpatient department	$3,342.87
ASC (PI A2) Ambulatory surgical center (freestanding)	$1,644.87

Common denial reasons

The recurring reasons claims for CPT 28810 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

Operative note describes 'bone excision' or 'debridement' without explicitly documenting amputation, triggering a code mismatch to 28122 or 28820.
Missing laterality or digit-level modifier (LT/RT or T-codes) causes claim rejection or bundling errors on multi-toe cases.
28820 billed same day on the same toe — NCCI bundles 28820 into 28810; modifier 59 is not appropriate here because the procedures are not distinct.
Medical necessity not established: no documentation of failed conservative treatment, vascular evaluation, or systemic condition driving the amputation.
Post-op E/M or wound care billed without modifier 24 inside the 90-day global, resulting in automatic bundling denial.

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 7 cited references ↓

01Does 28810 cover partial metatarsal resection, or must the entire metatarsal be removed?

28810 applies whether part or all of the metatarsal is removed, as long as the toe is amputated in the same procedure. The key is that both the digit and the metatarsal bone are addressed together. A partial metatarsal excision without digital amputation maps to 28122.

02Can I bill 28810 and 28820 together when multiple toes are amputated on the same foot?

Not on the same toe — NCCI bundles 28820 into 28810 for the same digit. If different toes are amputated at different levels on the same day, bill 28810 for the ray resection and 28820 for the MTP-level amputation, using modifier 59 and digit-level T-codes to identify each distinct toe.

03Which digit modifiers should I use with 28810?

Use LT or RT for laterality plus T-code modifiers to identify the specific toe (e.g., T5 for right great toe, T9 for right fifth digit). Many payers — especially Medicare and Medicaid — require digit-level specificity to process foot surgery claims without rejecting for missing laterality.

04What is the global period for 28810, and what does it bundle?

28810 carries a 90-day global. That covers the day-before pre-op visit, the surgery itself, and all routine post-op care through day 90 — including wound checks, dressing changes, and suture removal. Bill unrelated E/M visits with modifier 24. Use modifier 78 for an unplanned return to the OR for a related complication, modifier 79 for an unrelated procedure.

05What ICD-10 codes most commonly support medical necessity for 28810?

E11.621 (type 2 diabetes with foot ulcer) combined with L97.4xx (non-pressure ulcer of heel/midfoot) or L97.5xx codes is the most common pairing. Osteomyelitis is coded with M86.671 or M86.672 depending on laterality. Gangrene secondary to PVD uses I70.261–I70.269 range. Always link the amputation to the specific complication driving the procedure.

06How does Medicaid reimbursement for 28810 compare to Medicare?

Medicaid rates for 28810 are inconsistent across states and on average run below Medicare rates — one PMC study found 28810 averaged approximately $50 less under Medicaid than Medicare, while the related code 28820 actually averaged higher under Medicaid. Verify your state Medicaid fee schedule before assuming parity.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira AI Scribe

Mira's AI scribe captures the ray number, laterality, extent of metatarsal resection, and the explicit term 'amputation' directly from surgeon dictation — then flags if the note says only 'excision' or 'debridement,' which are the two word choices that trigger downcoding to 28122 or 28820 on audit. It also pulls the documented indication (osteomyelitis, diabetic ulcer, gangrene, trauma) and links it to the correct ICD-10, preventing medical-necessity denials before the claim is submitted.

See how Mira captures CPT 28810 documentation