CPT code 28043: Tumor excision, subcutaneous, under 1.5 cm2026 Medicare rate & RVUs in Alabama

Reports excision of a small soft-tissue tumor in the subcutaneous tissue of the foot or toe, when the lesion measures less than 1.5 cm.

CMS RVU26DEffective Oct 1, 2026One payment locality2K Medicare services in 2024

In Alabama, Medicare pays $346.33 for 28043 in the office and $228.55 when it’s performed in a hospital or facility.

$346.33Office (non-facility)
$228.55Hospital or facility
−9.4%vs the national office rate ($382.11)

Check a contract rate as a % of Medicare · 28043 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 28043 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Alabama
  2. What 28043 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 28043 covers

This code describes removing a soft-tissue tumor located in the subcutaneous layer of the foot or toe, with a size under 1.5 cm. The lesion lies beneath the skin but does not extend into deeper tissue such as fascia or muscle. Podiatric and orthopedic surgeons commonly perform this procedure for a localized mass in an office or surgical facility; the excised tissue may be sent for pathologic examination.

Select the code based on both the lesion’s size and its depth, not simply the incision length. The operative report should identify the foot or toe site, document the tumor’s size, and show that it was subcutaneous. This major surgery code has a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; 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 Alabama compares for 28043

Across 109 of 109 payment localities, the office rate for 28043 runs from $341.81 in Arkansas to $496.09 in San Benito County, CA. Alabama pays $346.33. The RVUs are the same everywhere; the geographic indexes change the dollars.

28043 in Alabama vs other payment areas
  1. Alabama · this page$346.33
  2. Los Angeles, CA · California$426.79+$80.46
  3. Washington, DC area · District of Columbia$433.27+$86.94
  4. Miami, FL · Florida$412.37+$66.04
  5. Chicago, IL · Illinois$401.51+$55.18
  6. Manhattan, NY · New York$437.04+$90.71
  7. Alaska · Alaska$456.16+$109.83

Other areas in Alabama first, then benchmark localities. Bars start at $0.

Every other payment area

28043 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$341.81$226.19
ArizonaArizona$372.75$242.32
Bakersfield, CACalifornia$402.35$254.83
Chico, CACalifornia$401.12$253.59
El Centro, CACalifornia$401.19$253.66
Fresno, CACalifornia$401.12$253.59
Hanford, CACalifornia$401.12$253.59
Madera, CACalifornia$401.12$253.59

28043 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.

$341.81

$456.16

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
28043 office rate range by state
State / territoryOffice rate rangeLocalities
AK$456.161
AL$346.331
AR$341.811
AZ$372.751
CA$401.12–$496.0929
CO$396.081
CT$405.961
DC$433.271
DE$378.521
FL$378.27–$412.373
GA$358.77–$389.022
GU$409.341
HI$409.341
IA$353.671
ID$355.881
IL$368.76–$401.514
IN$357.731
KS$352.461
KY$354.351
LA$353.97–$369.772
MA$394.17–$432.452
MD$385.18–$433.273
ME$357.87–$375.022
MI$362.97–$382.882
MN$379.661
MO$348.66–$370.623
MS$345.281
MT$382.081
NC$361.221
ND$374.171
NE$355.331
NH$390.271
NJ$410.62–$429.512
NM$364.891
NV$380.111
NY$366.15–$447.135
OH$361.351
OK$353.471
OR$377.18–$407.372
PA$361.71–$396.842
PR$384.541
RI$391.031
SC$361.881
SD$373.241
TN$354.101
TX$359.57–$394.758
UT$366.351
VA$374.10–$433.272
VI$384.541
VT$373.111
WA$393.30–$440.552
WI$362.791
WV$356.451
WY$378.631

See 28043 in every payment locality

How the 28043 rate is calculated

Each of 28043’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 · 28043

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.86

3.86 RVUs× 1.000 GPCI

Practice expense7.18

7.18 RVUs× 1.000 GPCI

Malpractice0.40

0.40 RVUs× 1.000 GPCI

Adjusted RVUs

11.4400

Conversion factor

$33.4009

Medicare rate

$382.11

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Alabama inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,100

Code
28043
Physician work
3.86
Practice expense
7.18
Malpractice
0.40

GPCI2026.csv

4

Locality
Alabama
Physician work
1.000
Practice expense
0.875
Malpractice
0.566
Office calculation for 28043 in Alabama
ComponentRVULocality factorAdjusted
Physician work3.86× 1.0003.8600
Practice expense7.18× 0.8756.2825
Malpractice0.40× 0.5660.2264
Total RVUs10.3689
Conversion factor× 33.4009

Office rate, Alabama$346.33

Office: (3.86 × 1 + 7.18 × 0.875 + 0.4 × 0.566) × $33.4009 = $346.33

Facility: (3.86 × 1 + 3.15 × 0.875 + 0.4 × 0.566) × $33.4009 = $228.55

Open 28043 in the RVU calculator

Payment rules and modifiers for 28043

28043 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 28043

Tumor excision, subcutaneous, under 1.5 cm

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 28043

Tumor excision, subcutaneous, under 1.5 cm

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

28043 without 50 · national office

$382.11

Tumor excision, subcutaneous, under 1.5 cm

28043-50 · Bilateral: 150%

$573.17

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).

When to use modifier 50

How 28043 has changed in Alabama

28043 · Office / nonfacility

$346.33

Effective 2026-10-01

The base rate is $12.81 higher than on 2025-10-01, moving from $333.52 to $346.33 (3.8%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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
  1. January 1, 2026

    RVU26A

    $333.52changed to$346.33

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.96 changed to 3.86
    • Practice expense RVU 7.05 changed to 7.18
    • Malpractice RVU 0.39 changed to 0.40
    • Practice expense GPCI 0.869 changed to 0.875
    • Malpractice GPCI 0.575 changed to 0.566

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $346.40changed to$333.52

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 7.16 changed to 7.05

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $340.75changed to$346.40

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $354.82changed to$340.75

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 7.10 changed to 7.16
    • Malpractice RVU 0.37 changed to 0.39
    • Practice expense GPCI 0.878 changed to 0.869
    • Malpractice GPCI 0.748 changed to 0.575
  5. January 1, 2023

    RVU23A

    $364.28changed to$354.82

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 6.99 changed to 7.10
    • Malpractice RVU 0.39 changed to 0.37
    • Practice expense GPCI 0.888 changed to 0.878
    • Malpractice GPCI 0.921 changed to 0.748

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $374.10changed to$364.28

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 7.22 changed to 6.99
    • Malpractice RVU 0.38 changed to 0.39

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $376.88changed to$374.10

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 6.99 changed to 7.22
    • Practice expense GPCI 0.889 changed to 0.888
    • Malpractice GPCI 0.707 changed to 0.921

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $379.07changed to$376.88

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 7.17 changed to 6.99
    • Malpractice RVU 0.36 changed to 0.38
    • Practice expense GPCI 0.890 changed to 0.889
    • Malpractice GPCI 0.492 changed to 0.707

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $382.01changed to$379.07

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 7.28 changed to 7.17
    • Malpractice RVU 0.35 changed to 0.36

    Held through RVU19B, RVU19C, RVU19D.

  10. April 1, 2018

    RVU18B

    No ratechanged to$382.01

    Held through RVU18C, RVU18D.

  11. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$346.33$228.55RVU26D
2026-07-01$346.33$228.55RVU26C
2026-04-01$346.33$228.55RVU26B
2026-01-01$346.33$228.55RVU26A
2025-10-01$333.52$236.54RVU25D
2025-07-01$333.52$236.54RVU25C
2025-04-01$333.52$236.54RVU25B
2025-01-01$333.52$236.54RVU25A
2024-10-01$346.40$242.26RVU24D
2024-07-01$346.40$242.26RVU24C
2024-04-01$346.40$242.26RVU24B
2024-03-09$346.40$242.26RVU24AR
2024-01-01$340.75$238.31RVU24A
2023-10-01$354.82$245.92RVU23D
2023-07-01$354.82$245.92RVU23C
2023-04-01$354.82$245.92RVU23B
2023-01-01$354.82$245.92RVU23A
2022-10-01$364.28$250.27RVU22D
2022-07-01$364.28$250.27RVU22C
2022-04-01$364.28$250.27RVU22B
2022-01-01$364.28$250.27RVU22A
2021-10-01$374.10$251.09RVU21D
2021-07-01$374.10$251.09RVU21C
2021-04-01$374.10$251.09RVU21B
2021-01-01$374.10$251.09RVU21A
2020-10-01$376.88$254.64RVU20D
2020-07-01$376.88$254.64RVU20C
2020-04-01$376.88$254.64RVU20B
2020-01-01$376.88$254.64RVU20A
2019-10-01$379.07$253.02RVU19D
2019-07-01$379.07$253.02RVU19C
2019-04-01$379.07$253.02RVU19B
2019-01-01$379.07$253.02RVU19A
2018-10-01$382.01$253.21RVU18D
2018-07-01$382.01$253.21RVU18C
2018-04-01$382.01$253.21RVU18B
2018-01-01Rate data unavailableRate data unavailableRVU18AR1
2017-10-01Rate data unavailableRate data unavailableRVU17D
2017-07-01Rate data unavailableRate data unavailableRVU17C
2017-04-01Rate data unavailableRate data unavailableRVU17B
2017-01-01Rate data unavailableRate data unavailableRVU17A
2016-10-01Rate data unavailableRate data unavailableRVU16D
2016-07-01Rate data unavailableRate data unavailableRVU16C
2016-04-01Rate data unavailableRate data unavailableRVU16B
2016-01-01Rate data unavailableRate data unavailableRVU16A
2015-10-01Rate data unavailableRate data unavailableRVU15D
2015-07-01Rate data unavailableRate data unavailableRVU15C
2015-04-01Rate data unavailableRate data unavailableRVU15B
2015-01-01Rate data unavailableRate data unavailableRVU15A
2014-10-01Rate data unavailableRate data unavailableRVU14D
2014-07-01Rate data unavailableRate data unavailableRVU14C
2014-04-01Rate data unavailableRate data unavailableRVU14B
2014-01-01Rate data unavailableRate data unavailableRVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 28043 for an earlier date of service

Where the Alabama rate applies

Alabama is a Medicare payment area, not a city. Our Census mapping connects it to 595 cities and communities in Alabama. Some span more than one payment area; confirm with the service ZIP.

  • Abanda
  • Abbeville
  • Adamsville
  • Addison
  • Akron
  • Alabaster
  • Albertville
  • Alexander City

Browse all communities in Alabama

28043 billing questions

How does this code differ from 28039?

Both describe removal of a subcutaneous foot or toe tumor. Use this code for a lesion under 1.5 cm and 28039 for one measuring 1.5 cm or greater.

How does this code differ from 28045?

This code is for a subcutaneous tumor under 1.5 cm. Code 28045 describes a tumor under 1.5 cm located in deeper tissue, such as beneath fascia or within muscle.

What should the operative note document?

Document the foot or toe site, tumor size, and its subcutaneous location. The note should distinguish the lesion from a deeper mass involving fascia or muscle.

Can modifier 50 be used for tumors on both feet?

The CMS bilateral rule specifies payment at 150% when this bilateral procedure is reported with modifier 50. Document the treated site on each side.

What postoperative care is included?

The code has a 90-day global period that 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
RVUs for 28043PPRRVU2026_Oct_nonQPP.csv, line 3,100 (RVU26D)
Geographic factors for AlabamaGPCI2026.csv, line 4 (RVU26D)

Open CMS sourceHow we calculate rates

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