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

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 Puerto Rico, Medicare pays $384.54 for 28043 in the office and $248.46 when it’s performed in a hospital or facility.

$384.54Office (non-facility)
$248.46Hospital or facility
+0.6%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 Puerto Rico
  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 Puerto Rico 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. Puerto Rico pays $384.54. The RVUs are the same everywhere; the geographic indexes change the dollars.

28043 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$384.54
  2. Los Angeles, CA · California$426.79+$42.25
  3. Washington, DC area · District of Columbia$433.27+$48.73
  4. Miami, FL · Florida$412.37+$27.83
  5. Chicago, IL · Illinois$401.51+$16.97
  6. Manhattan, NY · New York$437.04+$52.50
  7. Alaska · Alaska$456.16+$71.62

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

Every other payment area

28043 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$346.33$228.55
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

28043 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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 Puerto Rico 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

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 28043 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work3.86× 1.0003.8600
Practice expense7.18× 1.0117.2590
Malpractice0.40× 0.9850.3940
Total RVUs11.5130
Conversion factor× 33.4009

Office rate, Puerto Rico$384.54

Office: (3.86 × 1 + 7.18 × 1.011 + 0.4 × 0.985) × $33.4009 = $384.54

Facility: (3.86 × 1 + 3.15 × 1.011 + 0.4 × 0.985) × $33.4009 = $248.46

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

Codes related to 28043

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 28043
CodeHow it relatesOffice range, Puerto Rico
Same family
28039Tumor excision, subcutaneous, 1.5 cm or largerSubcutaneous foot or toe tumor at least 1.5 cm.$479.42
28045Foot mass excision, deep, under 1.5 cmDeep foot or toe tumor under 1.5 cm.$487.90
28041Tumor excision, deep, 1.5 cm or largerDeep foot or toe tumor at least 1.5 cm.No office rate

How 28043 has changed in Puerto Rico

28043 · Office / nonfacility

$384.54

Effective 2026-10-01

The base rate is $14.42 higher than on 2025-10-01, moving from $370.12 to $384.54 (3.9%).

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

    $370.12changed to$384.54

    • 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 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $384.57changed to$370.12

    • 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

    $378.30changed to$384.57

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $389.05changed to$378.30

    • 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 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $387.33changed to$389.05

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $394.18changed to$387.33

    • 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 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $405.19changed to$394.18

    • 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.

  8. January 1, 2021

    RVU21A

    $410.75changed to$405.19

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 6.99 changed to 7.22
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $415.77changed to$410.75

    • 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 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $418.94changed to$415.77

    • 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.

  11. January 1, 2018

    RVU18AR1

    $373.45changed to$418.94

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 7.26 changed to 7.28
    • Malpractice RVU 0.36 changed to 0.35
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $327.70changed to$373.45

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 7.22 changed to 7.26
    • Malpractice RVU 0.35 changed to 0.36
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $328.74changed to$327.70

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 7.21 changed to 7.22
    • Malpractice RVU 0.36 changed to 0.35

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $327.10changed to$328.74

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $321.21changed to$327.10

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 7.09 changed to 7.21
    • Malpractice RVU 0.37 changed to 0.36
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $319.81changed to$321.21

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 7.88 changed to 7.09
    • Malpractice RVU 0.39 changed to 0.37
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $319.81

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$384.54$248.46RVU26D
2026-07-01$384.54$248.46RVU26C
2026-04-01$384.54$248.46RVU26B
2026-01-01$384.54$248.46RVU26A
2025-10-01$370.12$257.74RVU25D
2025-07-01$370.12$257.74RVU25C
2025-04-01$370.12$257.74RVU25B
2025-01-01$370.12$257.74RVU25A
2024-10-01$384.57$263.90RVU24D
2024-07-01$384.57$263.90RVU24C
2024-04-01$384.57$263.90RVU24B
2024-03-09$384.57$263.90RVU24AR
2024-01-01$378.30$259.59RVU24A
2023-10-01$389.05$264.04RVU23D
2023-07-01$387.33$263.30RVU23C
2023-04-01$387.33$263.30RVU23B
2023-01-01$387.33$263.30RVU23A
2022-10-01$394.18$264.76RVU22D
2022-07-01$394.18$264.76RVU22C
2022-04-01$394.18$264.76RVU22B
2022-01-01$394.18$264.76RVU22A
2021-10-01$405.19$265.56RVU21D
2021-07-01$405.19$265.56RVU21C
2021-04-01$405.19$265.56RVU21B
2021-01-01$405.19$265.56RVU21A
2020-10-01$410.75$272.15RVU20D
2020-07-01$410.75$272.15RVU20C
2020-04-01$410.75$272.15RVU20B
2020-01-01$410.75$272.15RVU20A
2019-10-01$415.77$273.14RVU19D
2019-07-01$415.77$273.14RVU19C
2019-04-01$415.77$273.14RVU19B
2019-01-01$415.77$273.14RVU19A
2018-10-01$418.94$273.21RVU18D
2018-07-01$418.94$273.21RVU18C
2018-04-01$418.94$273.21RVU18B
2018-01-01$418.94$273.21RVU18AR1
2017-10-01$373.45$250.56RVU17D
2017-07-01$373.45$250.56RVU17C
2017-04-01$373.45$250.56RVU17B
2017-01-01$373.45$250.56RVU17A
2016-10-01$327.70$227.24RVU16D
2016-07-01$327.70$227.24RVU16C
2016-04-01$327.70$227.24RVU16B
2016-01-01$327.70$227.24RVU16A
2015-10-01$328.74$227.66RVU15D
2015-07-01$328.74$227.66RVU15C
2015-04-01$327.10$226.53RVU15B
2015-01-01$327.10$226.53RVU15A
2014-10-01$321.21$224.28RVU14D
2014-07-01$321.21$224.28RVU14C
2014-04-01$321.21$224.28RVU14B
2014-01-01$321.21$224.28RVU14A
2013-10-01$319.81$219.00RVU13D
2013-07-01$319.81$219.00RVU13C
2013-04-01$319.81$219.00RVU13B
2013-01-01$319.81$219.00RVU13AR

Price 28043 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

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 Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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