CPT code 28088: Tendon sheath surgery, extensor tendon sheath2026 Medicare rate & RVUs in Massachusetts
Removal of diseased tissue from an extensor tendon sheath in the foot, typically reported for operative treatment of sheath inflammation or thickening.
Medicare pays $498.10–$550.17 for 28088 in the office in Massachusetts, from Rest of Massachusetts to Metropolitan Boston, MA. 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 28088 covers
This operation removes abnormal synovial tissue from around an extensor tendon in the foot, a procedure also known as extensor tenosynovectomy. A podiatrist or orthopedic foot and ankle surgeon may perform it when the tendon sheath is persistently inflamed or thickened and operative removal is indicated. The operative report should make clear that the tissue treated surrounds an extensor tendon, rather than a flexor tendon or a foot joint.
Report the service for the sheath excision itself, supported by documentation of the affected tendon and side, the operative findings, and the tissue removed. This major surgery code includes the day-before preoperative visit and 90 days of related postoperative care. For bilateral surgery, modifier 50 is paid at 150%. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others at 50%. Assistant-at-surgery payment requires documented medical necessity; 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 28088 pays more and less in Massachusetts
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Boston, MA | $550.17 | $315.68 |
| Rest of Massachusetts | $498.10 | $291.29 |
How the 28088 rate is calculated
Each of 28088’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 · 28088
RVUs × geographic indexes × conversion factor
Work3.88
3.88 RVUs× 1.000 GPCI
Practice expense10.04
10.04 RVUs× 1.000 GPCI
Malpractice0.50
0.50 RVUs× 1.000 GPCI
Adjusted RVUs
14.4200
Conversion factor
$33.4009
Medicare rate
$481.64
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 28088
28088 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28088
Tendon sheath surgery, extensor tendon sheath
| 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) | 0 | Not paid without supporting documentation. |
| 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 · 28088
Tendon sheath surgery, extensor tendon sheath
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
28088 without 50 · national office
$481.64
Tendon sheath surgery, extensor tendon sheath
28088-50 · Bilateral: 150%
$722.46
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).
28088 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 28086Tendon sheath excisionSingle sheath
- Choose 28088 for an extensor tendon sheath and 28086 for a flexor tendon sheath. The tendon group involved distinguishes these related procedures.
- 28070Foot synovectomyTarsometatarsal joint
- Use 28088 when the excised tissue is around an extensor tendon. Use the applicable joint-lining procedure when the target is synovium within a foot joint.
- 28010Toe tendon releaseSingle tendon, percutaneous
- 28010 describes incision of a toe tendon, not excision of an extensor tendon sheath. The operative target and procedure distinguish the codes.
- 28039Tumor excisionSubcutaneous, 1.5 cm or larger
- 28039 applies to an eligible subcutaneous foot or toe tumor. 28088 addresses excision of an extensor tendon sheath, not a separately classified tumor by size and depth.
28088 billing questions
How is 28088 different from 28086?
28088 is for excision of an extensor tendon sheath in the foot. Use 28086 for the corresponding flexor tendon sheath procedure.
Does 28088 cover removal of tissue from a foot joint?
No. This code concerns tissue surrounding an extensor tendon. Removal of joint lining is a different service, such as the applicable foot-joint synovectomy code.
What should the operative report document?
Document the foot and side, the extensor tendon sheath involved, the abnormal findings, and the excision performed. The record should distinguish sheath tissue from joint lining or a separate soft-tissue lesion.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral surgery reported, and can an assistant be paid?
Modifier 50 applies to bilateral procedures, with payment at 150%. Assistant-at-surgery payment requires documentation of medical necessity.
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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