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

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 South Carolina, Medicare pays $361.88 for 28043 in the office and $237.50 when it’s performed in a hospital or facility.

$361.88Office (non-facility)
$237.50Hospital or facility
−5.3%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 South Carolina
  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 South Carolina 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. South Carolina pays $361.88. The RVUs are the same everywhere; the geographic indexes change the dollars.

28043 in South Carolina vs other payment areas
  1. South Carolina · this page$361.88
  2. Los Angeles, CA · California$426.79+$64.91
  3. Washington, DC area · District of Columbia$433.27+$71.39
  4. Miami, FL · Florida$412.37+$50.49
  5. Chicago, IL · Illinois$401.51+$39.63
  6. Manhattan, NY · New York$437.04+$75.16
  7. Alaska · Alaska$456.16+$94.28

Other areas in South Carolina 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 South Carolina 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

93

Locality
South Carolina
Physician work
1.000
Practice expense
0.924
Malpractice
0.850
Office calculation for 28043 in South Carolina
ComponentRVULocality factorAdjusted
Physician work3.86× 1.0003.8600
Practice expense7.18× 0.9246.6343
Malpractice0.40× 0.8500.3400
Total RVUs10.8343
Conversion factor× 33.4009

Office rate, South Carolina$361.88

Office: (3.86 × 1 + 7.18 × 0.924 + 0.4 × 0.85) × $33.4009 = $361.88

Facility: (3.86 × 1 + 3.15 × 0.924 + 0.4 × 0.85) × $33.4009 = $237.50

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, South Carolina
Same family
28039Tumor excision, subcutaneous, 1.5 cm or largerSubcutaneous foot or toe tumor at least 1.5 cm.$452.35
28045Foot mass excision, deep, under 1.5 cmDeep foot or toe tumor under 1.5 cm.$460.27
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 South Carolina

28043 · Office / nonfacility

$361.88

Effective 2026-10-01

The base rate is $15.28 higher than on 2025-10-01, moving from $346.60 to $361.88 (4.4%).

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

    $346.60changed to$361.88

    • 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 0.913 changed to 0.924
    • Malpractice GPCI 0.817 changed to 0.850

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $360.03changed to$346.60

    • 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

    $354.15changed to$360.03

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $362.14changed to$354.15

    • 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 0.908 changed to 0.913
    • Malpractice GPCI 0.756 changed to 0.817

  5. January 1, 2023

    RVU23A

    $364.85changed to$362.14

    • 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 0.903 changed to 0.908
    • Malpractice GPCI 0.695 changed to 0.756

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $374.88changed to$364.85

    • 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

    $380.28changed to$374.88

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 6.99 changed to 7.22
    • Practice expense GPCI 0.907 changed to 0.903
    • Malpractice GPCI 0.624 changed to 0.695

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $385.55changed to$380.28

    • 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 0.912 changed to 0.907
    • Malpractice GPCI 0.553 changed to 0.624

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $388.54changed to$385.55

    • 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. January 1, 2018

    RVU18AR1

    $387.93changed to$388.54

    • 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
    • Malpractice GPCI 0.634 changed to 0.553

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $386.50changed to$387.93

    • 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
    • Malpractice GPCI 0.715 changed to 0.634

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $387.83changed to$386.50

    • 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.

  13. July 1, 2015

    RVU15C

    $385.90changed to$387.83

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $381.43changed to$385.90

    • 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 0.911 changed to 0.912
    • Malpractice GPCI 0.618 changed to 0.715

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $385.33changed to$381.43

    • 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 0.909 changed to 0.911
    • Malpractice GPCI 0.520 changed to 0.618

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $385.33

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$361.88$237.50RVU26D
2026-07-01$361.88$237.50RVU26C
2026-04-01$361.88$237.50RVU26B
2026-01-01$361.88$237.50RVU26A
2025-10-01$346.60$244.72RVU25D
2025-07-01$346.60$244.72RVU25C
2025-04-01$346.60$244.72RVU25B
2025-01-01$346.60$244.72RVU25A
2024-10-01$360.03$250.62RVU24D
2024-07-01$360.03$250.62RVU24C
2024-04-01$360.03$250.62RVU24B
2024-03-09$360.03$250.62RVU24AR
2024-01-01$354.15$246.53RVU24A
2023-10-01$362.14$249.52RVU23D
2023-07-01$362.14$249.52RVU23C
2023-04-01$362.14$249.52RVU23B
2023-01-01$362.14$249.52RVU23A
2022-10-01$364.85$248.92RVU22D
2022-07-01$364.85$248.92RVU22C
2022-04-01$364.85$248.92RVU22B
2022-01-01$364.85$248.92RVU22A
2021-10-01$374.88$249.79RVU21D
2021-07-01$374.88$249.79RVU21C
2021-04-01$374.88$249.79RVU21B
2021-01-01$374.88$249.79RVU21A
2020-10-01$380.28$255.56RVU20D
2020-07-01$380.28$255.56RVU20C
2020-04-01$380.28$255.56RVU20B
2020-01-01$380.28$255.56RVU20A
2019-10-01$385.55$256.38RVU19D
2019-07-01$385.55$256.38RVU19C
2019-04-01$385.55$256.38RVU19B
2019-01-01$385.55$256.38RVU19A
2018-10-01$388.54$256.56RVU18D
2018-07-01$388.54$256.56RVU18C
2018-04-01$388.54$256.56RVU18B
2018-01-01$388.54$256.56RVU18AR1
2017-10-01$387.93$257.01RVU17D
2017-07-01$387.93$257.01RVU17C
2017-04-01$387.93$257.01RVU17B
2017-01-01$387.93$257.01RVU17A
2016-10-01$386.50$256.54RVU16D
2016-07-01$386.50$256.54RVU16C
2016-04-01$386.50$256.54RVU16B
2016-01-01$386.50$256.54RVU16A
2015-10-01$387.83$257.07RVU15D
2015-07-01$387.83$257.07RVU15C
2015-04-01$385.90$255.79RVU15B
2015-01-01$385.90$255.79RVU15A
2014-10-01$381.43$253.83RVU14D
2014-07-01$381.43$253.83RVU14C
2014-04-01$381.43$253.83RVU14B
2014-01-01$381.43$253.83RVU14A
2013-10-01$385.33$250.18RVU13D
2013-07-01$385.33$250.18RVU13C
2013-04-01$385.33$250.18RVU13B
2013-01-01$385.33$250.18RVU13AR

Price 28043 for an earlier date of service

Where the South Carolina rate applies

South Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 475 cities and communities in South Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Abbeville
  • Abney Crossroads
  • Adams Run
  • Aiken
  • Alcolu
  • Allendale
  • Anderson
  • Andrews

Browse all communities in South Carolina

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 South CarolinaGPCI2026.csv, line 93 (RVU26D)

Open CMS sourceHow we calculate rates

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