Surgical amputation of a toe through the interphalangeal joint, removing the distal portion while preserving the proximal segment.

Verified May 8, 2026 · 7 sources ↓

Medicare: $289.92
Work RVU: 3.32
Global, days: 0
Region: Foot & ankle

Drawn from CMSTldsystemsAAPCNIH

Documentation requirements

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

Source · Editorial brief grounded in 7 cited references ↓

Specify which toe and which interphalangeal joint level (PIP vs. DIP) was amputated
Document the indication: infection, ischemia, trauma, necrosis, or other pathology
Include intraoperative description of the level of resection and tissue handling at the joint
Record wound closure technique and any specimen sent to pathology
If performed in-office, document that the setting was appropriate for the complexity and patient condition
Capture digit-specific laterality (foot and toe) to support correct T-modifier assignment

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 25 Significant separate E/M 50 Bilateral procedure 51 Multiple procedures 59 Distinct service 76 Repeat, same physician 78 Unplanned return — related 79 Unrelated during global LT Left side RT Right side XS Separate structure

What this code covers

Source · Editorial summary grounded in 7 cited references ↓

CPT 28825 covers partial amputation of a toe performed at the interphalangeal joint. The procedure is used when infection, ischemia, trauma, or progressive necrosis makes preservation of the distal phalanx impossible or unsafe. The level of resection is at the joint rather than through bone, distinguishing it from 28820 (metatarsophalangeal joint) and 28810 (metatarsal with toe).

The global period is 000, meaning no pre- or post-operative care is bundled into the payment. Routine post-op visits on a subsequent date of service are separately billable. Note: historical CPT reference materials listed 90 global days for this code, but CMS reduced the global period to 0 effective January 1, 2021 — follow the CMS Physician Fee Schedule, not older CPT companion guides, for global period determination.

Toe-specific digit modifiers (T-codes) are essential for claims accuracy. Without a digit modifier, payers cannot confirm laterality or distinguish which toe was amputated when multiple toes are at risk. The procedure is performed by podiatrists, orthopedic surgeons, and general surgeons, and is commonly performed in the office, ASC, or inpatient setting depending on the patient's comorbidity burden.

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 (3.32) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (8.68) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	3.32
Practice expense RVU	4.97
Malpractice RVU	0.39
Total RVU	8.68
Medicare national rate	$289.92
Global period	0 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	$289.92
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 28825 get rejected.

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

Missing digit modifier (T-code) — payer cannot confirm which toe was treated
Incorrect global period applied — some payers still default to 90-day global, triggering bundling denials on post-op visits billed without modifier 24
Upcoding to 28820 or 28810 when the resection was through the interphalangeal joint, not the metatarsophalangeal joint or metatarsal
E&M billed same-day without modifier 25 — 000-global minor surgical procedures require a significant, separately identifiable E&M to bill both on the same date
Modifier 78 applied incorrectly to an unrelated procedure performed during the post-op period — that requires modifier 79

Frequently asked questions

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

01What is the global period for CPT 28825?

Zero days per the CMS Physician Fee Schedule 2026. CMS reduced the global period from 90 to 0 effective January 1, 2021. Post-op visits after the date of service are separately billable. Do not rely on older CPT companion guides that still show 90 days.

02Which digit modifiers should I use with 28825?

Use T-modifiers to identify the specific toe: T1–T5 for left foot digits 1–5, T6–T9 and TA for right foot digits. For example, T6 = right foot, second digit. LT and RT alone are insufficient — toe-level specificity is required by most payers.

03How does 28825 differ from 28820 and 28810?

28825 is amputation through the interphalangeal joint. 28820 is amputation at the metatarsophalangeal joint, and 28810 includes the metatarsal with the toe. The level of resection documented in the operative note determines the correct code — these are not interchangeable.

04Can I bill an E&M on the same day as 28825?

Yes, but only if it's a significant and separately identifiable service unrelated to the decision to perform the amputation. Append modifier 25 to the E&M. The 000-global rule does not waive the modifier 25 requirement.

05If the patient returns for debridement during the post-op period, what modifier applies?

If the debridement is related to the amputation site, use modifier 78 (unplanned return for a related procedure). If it's a completely unrelated site or condition, use modifier 79. Don't swap these — inverting 78 and 79 is an audit flag and a denial trigger.

06Can 28825 be billed bilaterally on the same date?

Yes. If amputations are performed on corresponding toes on both feet in the same session, bill with modifier 50 or with LT and RT on separate lines per payer preference. Append appropriate T-modifiers for each digit on each foot.

07Is 28825 performed in-office or only in a facility?

It can be performed in the office, ASC, or inpatient hospital. The site of service affects reimbursement — see the Site of Service comparison table. Patient comorbidities (e.g., diabetes, peripheral vascular disease) often drive the decision toward a facility setting.

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 joint level (PIP vs. DIP), the specific toe and foot, the indication (infection, necrosis, trauma), and the closure technique directly from dictation. That detail populates the operative note with the specificity needed to defend the 28825 selection over 28820 or 28810, and auto-assigns the correct T-modifier — preventing the most common denial reason on this code: missing or incorrect digit identification.

See how Mira captures CPT 28825 documentation