CPT code 28039: Tumor excision, subcutaneous, 1.5 cm or larger2026 Medicare rate & RVUs in New Mexico
Removal of a subcutaneous soft-tissue mass of the foot or toe measuring at least 1.5 cm, selected by its tissue plane and size.
In New Mexico, Medicare pays $457.30 for 28039 in the office and $309.37 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 28039 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 28039 covers
This code describes surgical removal of a soft-tissue mass beneath the skin of a foot or toe when the mass measures 1.5 cm or more. A podiatrist or orthopedic foot surgeon may remove a palpable mass, such as a subcutaneous lipoma, in an operating room or another appropriate surgical setting. The defining features are the subcutaneous location and the size of the lesion, not the length of the incision.
Choose this code when the operative findings place the mass in subcutaneous tissue and document its size at or above the threshold. The report should identify the foot or toe, describe the tissue plane and mass, and record its dimensions. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeons and team surgery are not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
How New Mexico compares for 28039
Across 109 of 109 payment localities, the office rate for 28039 runs from $427.51 in Arkansas to $610.90 in San Benito County, CA. New Mexico pays $457.30. The RVUs are the same everywhere; the geographic indexes change the dollars.
- New Mexico · this page$457.30
- Los Angeles, CA · California$528.58+$71.28
- Washington, DC area · District of Columbia$538.32+$81.02
- Miami, FL · Florida$518.27+$60.97
- Chicago, IL · Illinois$504.79+$47.49
- Manhattan, NY · New York$544.92+$87.62
- Alaska · Alaska$574.20+$116.90
Other areas in New Mexico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $433.01 | $291.85 |
| ArkansasArkansas | $427.51 | $288.93 |
| ArizonaArizona | $465.10 | $308.77 |
| Bakersfield, CACalifornia | $499.21 | $322.40 |
| Chico, CACalifornia | $497.42 | $320.61 |
| El Centro, CACalifornia | $497.52 | $320.70 |
| Fresno, CACalifornia | $497.42 | $320.61 |
| Hanford, CACalifornia | $497.42 | $320.61 |
| Madera, CACalifornia | $497.42 | $320.61 |
| Merced, CACalifornia | $497.42 | $320.61 |
| Modesto, CACalifornia | $497.42 | $320.61 |
| Napa, CACalifornia | $567.27 | $354.64 |
| Oxnard, CACalifornia | $525.20 | $334.52 |
| Redding, CACalifornia | $497.42 | $320.61 |
| Rest of CaliforniaCalifornia | $497.42 | $320.61 |
| Riverside, CACalifornia | $503.84 | $327.03 |
| Sacramento, CACalifornia | $519.57 | $331.95 |
| Salinas, CACalifornia | $517.56 | $330.59 |
| San Diego, CACalifornia | $527.89 | $334.94 |
| Marin County, CACalifornia | $597.76 | $370.29 |
| San Francisco, CACalifornia | $597.09 | $369.62 |
| San Benito County, CACalifornia | $610.90 | $378.26 |
| Santa Clara County, CACalifornia | $608.16 | $375.53 |
| San Luis Obispo, CACalifornia | $509.48 | $325.73 |
| Santa Cruz, CACalifornia | $531.51 | $335.50 |
| Santa Maria, CACalifornia | $519.00 | $330.89 |
| Santa Rosa, CACalifornia | $536.75 | $338.64 |
| Stockton, CACalifornia | $497.42 | $320.61 |
| Vallejo, CACalifornia | $566.30 | $353.67 |
| Visalia, CACalifornia | $497.42 | $320.61 |
| Yuba City, CACalifornia | $497.42 | $320.61 |
| ColoradoColorado | $492.39 | $320.74 |
| ConnecticutConnecticut | $505.90 | $332.15 |
| DelawareDelaware | $472.16 | $312.77 |
| Fort Lauderdale, FLFlorida | $496.20 | $332.78 |
| Rest of FloridaFlorida | $474.20 | $319.97 |
| Atlanta, GAGeorgia | $485.61 | $321.70 |
| Rest of GeorgiaGeorgia | $450.11 | $306.21 |
| Hawaii, Guam, HIHawaii | $506.77 | $323.34 |
| IowaIowa | $440.90 | $293.29 |
| IdahoIdaho | $443.80 | $295.38 |
| East St. Louis, ILIllinois | $474.17 | $325.75 |
| Rest of IllinoisIllinois | $463.32 | $316.03 |
| Suburban Chicago, ILIllinois | $500.65 | $334.97 |
| IndianaIndiana | $446.02 | $296.47 |
| KansasKansas | $439.92 | $294.08 |
| KentuckyKentucky | $443.81 | $300.39 |
| New Orleans, LALouisiana | $462.76 | $310.95 |
| Rest of LouisianaLouisiana | $443.54 | $300.76 |
| Metropolitan Boston, MAMassachusetts | $536.12 | $343.50 |
| Rest of MassachusettsMassachusetts | $490.32 | $320.45 |
| Baltimore area, MDMaryland | $504.60 | $331.50 |
| Rest of MarylandMaryland | $480.15 | $316.88 |
| Rest of MaineMaine | $446.74 | $298.32 |
| Southern Maine, MEMaine | $466.83 | $306.96 |
| Detroit, MIMichigan | $480.33 | $324.65 |
| Rest of MichiganMichigan | $454.76 | $307.47 |
| MinnesotaMinnesota | $470.89 | $304.89 |
| Metropolitan Kansas City, MOMissouri | $459.06 | $307.58 |
| Metropolitan St. Louis, MOMissouri | $463.20 | $309.62 |
| Rest of MissouriMissouri | $437.40 | $298.34 |
| MississippiMississippi | $432.49 | $293.59 |
| MontanaMontana | $476.59 | $315.27 |
| North CarolinaNorth Carolina | $450.72 | $300.20 |
| North DakotaNorth Dakota | $464.93 | $303.60 |
| NebraskaNebraska | $442.77 | $293.87 |
| New HampshireNew Hampshire | $485.67 | $317.73 |
| Northern New JerseyNew Jersey | $533.97 | $346.83 |
| Rest of New JerseyNew Jersey | $511.41 | $335.24 |
| NevadaNevada | $473.62 | $312.13 |
| NYC suburbs and Long Island, NYNew York | $557.83 | $366.02 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $515.36 | $338.71 |
| Queens, NYNew York | $547.69 | $357.00 |
| Rest of New YorkNew York | $456.75 | $303.49 |
| OhioOhio | $452.38 | $305.09 |
| OklahomaOklahoma | $442.22 | $298.15 |
| Portland, OROregon | $505.55 | $326.32 |
| Rest of OregonOregon | $469.66 | $308.97 |
| Metropolitan Philadelphia, PAPennsylvania | $495.11 | $327.17 |
| Rest of PennsylvaniaPennsylvania | $452.54 | $304.44 |
| Puerto RicoPuerto Rico | $479.42 | $316.32 |
| Rhode IslandRhode Island | $487.11 | $320.46 |
| South CarolinaSouth Carolina | $452.35 | $303.29 |
| South DakotaSouth Dakota | $463.55 | $302.22 |
| TennesseeTennessee | $441.98 | $295.33 |
| Austin, TXTexas | $491.01 | $320.33 |
| Beaumont, TXTexas | $449.98 | $303.17 |
| Brazoria, TXTexas | $471.18 | $311.31 |
| Dallas, TXTexas | $474.30 | $313.62 |
| Fort Worth, TXTexas | $471.75 | $312.68 |
| Galveston, TXTexas | $472.69 | $312.49 |
| Houston, TXTexas | $483.49 | $323.29 |
| Rest of TexasTexas | $460.41 | $307.31 |
| UtahUtah | $457.79 | $306.14 |
| VirginiaVirginia | $466.07 | $307.48 |
| Virgin Islands, VIUnited States Virgin Islands | $479.42 | $316.32 |
| VermontVermont | $464.09 | $304.38 |
| Rest of WashingtonWashington | $489.08 | $319.21 |
| King County, WAWashington | $545.53 | $347.58 |
| WisconsinWisconsin | $451.21 | $296.66 |
| West VirginiaWest Virginia | $448.37 | $308.18 |
| WyomingWyoming | $471.51 | $310.18 |
28039 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$427.51
$574.20
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $574.20 | 1 |
| AL | $433.01 | 1 |
| AR | $427.51 | 1 |
| AZ | $465.10 | 1 |
| CA | $497.42–$610.90 | 29 |
| CO | $492.39 | 1 |
| CT | $505.90 | 1 |
| DC | $538.32 | 1 |
| DE | $472.16 | 1 |
| FL | $474.20–$518.27 | 3 |
| GA | $450.11–$485.61 | 2 |
| GU | $506.77 | 1 |
| HI | $506.77 | 1 |
| IA | $440.90 | 1 |
| ID | $443.80 | 1 |
| IL | $463.32–$504.79 | 4 |
| IN | $446.02 | 1 |
| KS | $439.92 | 1 |
| KY | $443.81 | 1 |
| LA | $443.54–$462.76 | 2 |
| MA | $490.32–$536.12 | 2 |
| MD | $480.15–$538.32 | 3 |
| ME | $446.74–$466.83 | 2 |
| MI | $454.76–$480.33 | 2 |
| MN | $470.89 | 1 |
| MO | $437.40–$463.20 | 3 |
| MS | $432.49 | 1 |
| MT | $476.59 | 1 |
| NC | $450.72 | 1 |
| ND | $464.93 | 1 |
| NE | $442.77 | 1 |
| NH | $485.67 | 1 |
| NJ | $511.41–$533.97 | 2 |
| NM | $457.30 | 1 |
| NV | $473.62 | 1 |
| NY | $456.75–$557.83 | 5 |
| OH | $452.38 | 1 |
| OK | $442.22 | 1 |
| OR | $469.66–$505.55 | 2 |
| PA | $452.54–$495.11 | 2 |
| PR | $479.42 | 1 |
| RI | $487.11 | 1 |
| SC | $452.35 | 1 |
| SD | $463.55 | 1 |
| TN | $441.98 | 1 |
| TX | $449.98–$491.01 | 8 |
| UT | $457.79 | 1 |
| VA | $466.07–$538.32 | 2 |
| VI | $479.42 | 1 |
| VT | $464.09 | 1 |
| WA | $489.08–$545.53 | 2 |
| WI | $451.21 | 1 |
| WV | $448.37 | 1 |
| WY | $471.51 | 1 |
How the 28039 rate is calculated
Each of 28039’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 28039
RVUs × geographic indexes × conversion factor
Work5.28
5.28 RVUs× 1.000 GPCI
Practice expense8.40
8.40 RVUs× 1.000 GPCI
Malpractice0.59
0.59 RVUs× 1.000 GPCI
Adjusted RVUs
14.2700
Conversion factor
$33.4009
Medicare rate
$476.63
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact New Mexico inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
3,098
- Code
- 28039
- Physician work
- 5.28
- Practice expense
- 8.40
- Malpractice
- 0.59
GPCI2026.csv
77
- Locality
- New Mexico
- Physician work
- 1.000
- Practice expense
- 0.917
- Malpractice
- 1.201
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.28 | × 1.000 | 5.2800 |
| Practice expense | 8.40 | × 0.917 | 7.7028 |
| Malpractice | 0.59 | × 1.201 | 0.7086 |
| Total RVUs | 13.6914 | ||
| Conversion factor | × 33.4009 | ||
Office rate, New Mexico$457.30
Office: (5.28 × 1 + 8.4 × 0.917 + 0.59 × 1.201) × $33.4009 = $457.30
Facility: (5.28 × 1 + 3.57 × 0.917 + 0.59 × 1.201) × $33.4009 = $309.37
Payment rules and modifiers for 28039
28039 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28039
Tumor excision, subcutaneous, 1.5 cm or larger
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 28039
Tumor excision, subcutaneous, 1.5 cm or larger
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
28039 without 50 · national office
$476.63
Tumor excision, subcutaneous, 1.5 cm or larger
28039-50 · Bilateral: 150%
$714.95
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
How 28039 has changed in New Mexico
28039 · Office / nonfacility
$457.30
Effective 2026-10-01
The base rate is $21.13 higher than on 2025-10-01, moving from $436.17 to $457.30 (4.8%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
$436.17changed to$457.30
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 5.42 changed to 5.28
- Practice expense RVU 8.12 changed to 8.40
- Practice expense GPCI 0.908 changed to 0.917
- Malpractice GPCI 1.172 changed to 1.201
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$455.08changed to$436.17
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 8.30 changed to 8.12
- Malpractice RVU 0.61 changed to 0.59
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$447.66changed to$455.08
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$462.81changed to$447.66
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 8.29 changed to 8.30
- Malpractice RVU 0.65 changed to 0.61
- Practice expense GPCI 0.902 changed to 0.908
- Malpractice GPCI 1.169 changed to 1.172
January 1, 2023
RVU23A
$477.64changed to$462.81
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 8.34 changed to 8.29
- Malpractice RVU 0.78 changed to 0.65
- Practice expense GPCI 0.896 changed to 0.902
- Malpractice GPCI 1.166 changed to 1.169
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$487.16changed to$477.64
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 8.57 changed to 8.34
- Malpractice RVU 0.74 changed to 0.78
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$493.50changed to$487.16
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 8.24 changed to 8.57
- Malpractice RVU 0.64 changed to 0.74
- Practice expense GPCI 0.908 changed to 0.896
- Malpractice GPCI 1.207 changed to 1.166
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$500.11changed to$493.50
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 8.37 changed to 8.24
- Malpractice RVU 0.60 changed to 0.64
- Practice expense GPCI 0.921 changed to 0.908
- Malpractice GPCI 1.247 changed to 1.207
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$506.20changed to$500.11
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 8.57 changed to 8.37
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$505.46changed to$506.20
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 8.58 changed to 8.57
- Malpractice RVU 0.64 changed to 0.60
- Practice expense GPCI 0.920 changed to 0.921
- Malpractice GPCI 1.204 changed to 1.247
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$505.70changed to$505.46
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 8.65 changed to 8.58
- Malpractice RVU 0.65 changed to 0.64
- Practice expense GPCI 0.919 changed to 0.920
- Malpractice GPCI 1.161 changed to 1.204
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$506.29changed to$505.70
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 8.60 changed to 8.65
- Malpractice RVU 0.66 changed to 0.65
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$503.77changed to$506.29
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$501.02changed to$503.77
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 8.72 changed to 8.60
- Malpractice RVU 0.52 changed to 0.66
- Practice expense GPCI 0.918 changed to 0.919
- Malpractice GPCI 1.079 changed to 1.161
Held through RVU15B.
January 1, 2014
RVU14A
$508.45changed to$501.02
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 9.81 changed to 8.72
- Malpractice RVU 0.54 changed to 0.52
- Practice expense GPCI 0.916 changed to 0.918
- Malpractice GPCI 0.997 changed to 1.079
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $508.45
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $457.30 | $309.37 | RVU26D |
| 2026-07-01 | $457.30 | $309.37 | RVU26C |
| 2026-04-01 | $457.30 | $309.37 | RVU26B |
| 2026-01-01 | $457.30 | $309.37 | RVU26A |
| 2025-10-01 | $436.17 | $321.63 | RVU25D |
| 2025-07-01 | $436.17 | $321.63 | RVU25C |
| 2025-04-01 | $436.17 | $321.63 | RVU25B |
| 2025-01-01 | $436.17 | $321.63 | RVU25A |
| 2024-10-01 | $455.08 | $331.16 | RVU24D |
| 2024-07-01 | $455.08 | $331.16 | RVU24C |
| 2024-04-01 | $455.08 | $331.16 | RVU24B |
| 2024-03-09 | $455.08 | $331.16 | RVU24AR |
| 2024-01-01 | $447.66 | $325.76 | RVU24A |
| 2023-10-01 | $462.81 | $335.35 | RVU23D |
| 2023-07-01 | $462.81 | $335.35 | RVU23C |
| 2023-04-01 | $462.81 | $335.35 | RVU23B |
| 2023-01-01 | $462.81 | $335.35 | RVU23A |
| 2022-10-01 | $477.64 | $344.31 | RVU22D |
| 2022-07-01 | $477.64 | $344.31 | RVU22C |
| 2022-04-01 | $477.64 | $344.31 | RVU22B |
| 2022-01-01 | $477.64 | $344.31 | RVU22A |
| 2021-10-01 | $487.16 | $344.28 | RVU21D |
| 2021-07-01 | $487.16 | $344.28 | RVU21C |
| 2021-04-01 | $487.16 | $344.28 | RVU21B |
| 2021-01-01 | $487.16 | $344.28 | RVU21A |
| 2020-10-01 | $493.50 | $350.63 | RVU20D |
| 2020-07-01 | $493.50 | $350.63 | RVU20C |
| 2020-04-01 | $493.50 | $350.63 | RVU20B |
| 2020-01-01 | $493.50 | $350.63 | RVU20A |
| 2019-10-01 | $500.11 | $352.41 | RVU19D |
| 2019-07-01 | $500.11 | $352.41 | RVU19C |
| 2019-04-01 | $500.11 | $352.41 | RVU19B |
| 2019-01-01 | $500.11 | $352.41 | RVU19A |
| 2018-10-01 | $506.20 | $353.68 | RVU18D |
| 2018-07-01 | $506.20 | $353.68 | RVU18C |
| 2018-04-01 | $506.20 | $353.68 | RVU18B |
| 2018-01-01 | $506.20 | $353.68 | RVU18AR1 |
| 2017-10-01 | $505.46 | $354.57 | RVU17D |
| 2017-07-01 | $505.46 | $354.57 | RVU17C |
| 2017-04-01 | $505.46 | $354.57 | RVU17B |
| 2017-01-01 | $505.46 | $354.57 | RVU17A |
| 2016-10-01 | $505.70 | $354.01 | RVU16D |
| 2016-07-01 | $505.70 | $354.01 | RVU16C |
| 2016-04-01 | $505.70 | $354.01 | RVU16B |
| 2016-01-01 | $505.70 | $354.01 | RVU16A |
| 2015-10-01 | $506.29 | $354.06 | RVU15D |
| 2015-07-01 | $506.29 | $354.06 | RVU15C |
| 2015-04-01 | $503.77 | $352.29 | RVU15B |
| 2015-01-01 | $503.77 | $352.29 | RVU15A |
| 2014-10-01 | $501.02 | $349.42 | RVU14D |
| 2014-07-01 | $501.02 | $349.42 | RVU14C |
| 2014-04-01 | $501.02 | $349.42 | RVU14B |
| 2014-01-01 | $501.02 | $349.42 | RVU14A |
| 2013-10-01 | $508.45 | $345.77 | RVU13D |
| 2013-07-01 | $508.45 | $345.77 | RVU13C |
| 2013-04-01 | $508.45 | $345.77 | RVU13B |
| 2013-01-01 | $508.45 | $345.77 | RVU13AR |
Where the New Mexico rate applies
New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.
- Abeytas
- Abiquiu
- Acomita Lake
- Adelino
- Agua Fria
- Alamillo
- Alamo
- Alamogordo
28039 billing questions
How does this differ from code 28043?
Both describe subcutaneous soft-tissue tumor excision on the foot or toe. Use 28039 for a mass at least 1.5 cm; 28043 is for one smaller than 1.5 cm.
When is 28041 more appropriate?
Use 28041 when the foot or toe mass is subfascial, such as intramuscular, and measures at least 1.5 cm. This code is for a subcutaneous mass.
What documentation supports reporting this code?
Document the foot or toe site, the subcutaneous tissue plane, and the mass dimensions showing it meets the 1.5 cm threshold. The operative report should support that the mass was removed.
Is routine closure separately reported?
Routine exposure, removal, hemostasis, and closure are part of the excision. A separate diagnostic biopsy of the same mass is not reported when that mass is removed in the same session.
How does Medicare handle bilateral excision and multiple procedures?
Bilateral reporting with modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%.
What is included in the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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