CPT code 28043: Tumor excision, subcutaneous, under 1.5 cm2026 Medicare rate & RVUs in California
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.
Medicare pays $401.12–$496.09 for 28043 in the office in California, from Chico, CA to San Benito County, CA. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
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.
Where 28043 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 payment localities
$401.12 to $496.09
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $402.35 | $254.83 |
| Chico, CA | $401.12 | $253.59 |
| El Centro, CA | $401.19 | $253.66 |
| Fresno, CA | $401.12 | $253.59 |
| Hanford, CA | $401.12 | $253.59 |
| Los Angeles, CA | $426.79 | $267.55 |
| Madera, CA | $401.12 | $253.59 |
| Marin County, CA | $485.45 | $295.66 |
| Merced, CA | $401.12 | $253.59 |
| Modesto, CA | $401.12 | $253.59 |
| Napa, CA | $459.92 | $282.51 |
| Oxnard, CA | $424.33 | $265.22 |
| Redding, CA | $401.12 | $253.59 |
| Rest of California | $401.12 | $253.59 |
| Riverside, CA | $405.49 | $257.96 |
| Sacramento, CA | $419.64 | $263.09 |
| Salinas, CA | $418.03 | $262.03 |
| San Benito County, CA | $496.09 | $301.99 |
| San Diego, CA | $426.86 | $265.87 |
| San Francisco, CA | $485.00 | $295.20 |
| San Luis Obispo, CA | $411.43 | $258.12 |
| Santa Clara County, CA | $494.23 | $300.13 |
| Santa Cruz, CA | $430.18 | $266.63 |
| Santa Maria, CA | $419.33 | $262.38 |
| Santa Rosa, CA | $434.45 | $269.16 |
| Stockton, CA | $401.12 | $253.59 |
| Vallejo, CA | $459.26 | $281.85 |
| Visalia, CA | $401.12 | $253.59 |
| Yuba City, CA | $401.12 | $253.59 |
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
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.
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
| 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) | 1 | Not paid (statutory restriction). |
| 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 · 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.
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).
28043 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 28039Tumor excisionSubcutaneous, 1.5 cm or larger
- Both apply to subcutaneous foot or toe tumors; choose 28039 when the lesion measures 1.5 cm or greater.
- 28045Foot mass excisionDeep, under 1.5 cm
- Both apply to tumors under 1.5 cm, but 28045 is for a deep, rather than subcutaneous, location.
- 28041Tumor excisionDeep, 1.5 cm or larger
- This code is for a subcutaneous tumor under 1.5 cm. Code 28041 describes a deep tumor measuring 1.5 cm or greater.
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
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