28345 Repair webbed toe(s)
What 28345 is
CMS fee schedule short descriptor: Repair webbed toe(s).
Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.
Medicare payment for 28345 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 5.94 | 8.62 | 0.49 | 15.05 | $502.68 |
| Facility (hospital, ASC) | 5.94 | 3.71 | 0.49 | 10.14 | $338.69 |
National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.
Status: Active - payable under the Physician Fee Schedule. Global period: 90-day global period.
Medically Unlikely Edit (MUE)
Medicare caps 28345 at 2 units per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Clinical: Data. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 28345? These codes are bundled into it
28345 is a Column 1 code in 271 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.
| Column 2 code | Short description | Modifier indicator | |
|---|---|---|---|
01470 | Anes px nrv msc lw l/a/f nos | 0 - no modifier bypass | Check pair |
0213T | Njx paravert w/us cer/thor | 0 - no modifier bypass | Check pair |
0216T | Njx paravert w/us lumb/sac | 0 - no modifier bypass | Check pair |
0490T | Regn cell tx scldr h mlt inj | 1 - modifier may bypass | Check pair |
0596T | Temp fml iu vlv-pmp 1st insj | 1 - modifier may bypass | Check pair |
0597T | Temp fml iu valve-pmp rplcmt | 1 - modifier may bypass | Check pair |
0708T | Id ca immntx prep & 1st njx | 1 - modifier may bypass | Check pair |
0709T | Id ca immntx each addl njx | 1 - modifier may bypass | Check pair |
0718T | Adrc ther prtl rc tear njx | 1 - modifier may bypass | Check pair |
0903T | Ecg alg 12 lead reduced i&r | 1 - modifier may bypass | Check pair |
0904T | Ecg alg 12 ld rdcd trcg only | 1 - modifier may bypass | Check pair |
0905T | Ecg alg 12 ld rdcd i&r only | 1 - modifier may bypass | Check pair |
11012 | Deb skin bone at fx site | 1 - modifier may bypass | Check pair |
11420 | Exc h-f-nk-sp b9+marg 0.5/< | 1 - modifier may bypass | Check pair |
11421 | Exc h-f-nk-sp b9+marg 0.6-1 | 1 - modifier may bypass | Check pair |
11422 | Exc h-f-nk-sp b9+marg 1.1-2 | 1 - modifier may bypass | Check pair |
11423 | Exc h-f-nk-sp b9+marg 2.1-3 | 1 - modifier may bypass | Check pair |
11424 | Exc h-f-nk-sp b9+marg 3.1-4 | 1 - modifier may bypass | Check pair |
11730 | Avulsion nail plate simple 1 | 1 - modifier may bypass | Check pair |
11750 | Excision nail&nail matrix | 1 - modifier may bypass | Check pair |
11760 | Repair of nail bed | 1 - modifier may bypass | Check pair |
11762 | Reconstruction of nail bed | 1 - modifier may bypass | Check pair |
11765 | Wedge excision skn nail fold | 1 - modifier may bypass | Check pair |
12001 | Rpr s/n/ax/gen/trnk 2.5cm/< | 1 - modifier may bypass | Check pair |
12002 | Rpr s/n/ax/gen/trnk2.6-7.5cm | 1 - modifier may bypass | Check pair |
12004 | Rpr s/n/ax/gen/trk7.6-12.5cm | 1 - modifier may bypass | Check pair |
12005 | Rpr s/n/a/gen/trk12.6-20.0cm | 1 - modifier may bypass | Check pair |
12006 | Rpr s/n/a/gen/trk20.1-30.0cm | 1 - modifier may bypass | Check pair |
12007 | Rpr s/n/ax/gen/trnk >30.0 cm | 1 - modifier may bypass | Check pair |
12011 | Rpr f/e/e/n/l/m 2.5 cm/< | 1 - modifier may bypass | Check pair |
Showing 30 of 271 column 2 codes. Use the pair checker for any specific combination.
28345 is bundled into these codes
28345 appears as a Column 2 code in 2 active edits. Reported with one of these Column 1 codes on the same date of service, 28345 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
11010 | Debride skin at fx site | 1 | Check pair |
11011 | Debride skin musc at fx site | 1 | Check pair |
Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.