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CPT code 28088: Tendon sheath surgery, extensor tendon sheath2026 Medicare rate & RVUs in Houston, TX

Removal of diseased tissue from an extensor tendon sheath in the foot, typically reported for operative treatment of sheath inflammation or thickening.

CMS RVU26DEffective Oct 1, 2026One payment locality208 Medicare services in 2024

In Houston, TX, Medicare pays $486.61 for 28088 in the office and $291.59 when it’s performed in a hospital or facility.

$486.61Office (non-facility)
$291.59Hospital or facility
+1.0%vs the national office rate ($481.64)

Check a contract rate as a % of Medicare · 28088 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 28088 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Houston, TX
  2. What 28088 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 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.

How Houston, TX compares for 28088

Across 109 of 109 payment localities, the office rate for 28088 runs from $426.26 in Arkansas to $636.37 in San Benito County, CA. Houston, TX pays $486.61. The RVUs are the same everywhere; the geographic indexes change the dollars.

28088 in Houston, TX vs other payment areas
  1. Houston, TX · this page$486.61
  2. Austin, TX · Texas$499.45+$12.84
  3. Beaumont, TX · Texas$450.27−$36.34
  4. Brazoria, TX · Texas$475.99−$10.62
  5. Dallas, TX · Texas$479.09−$7.52
  6. Fort Worth, TX · Texas$475.96−$10.65
  7. Galveston, TX · Texas$477.46−$9.15

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

Every other payment area

28088 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$462.92$276.54
Los Angeles, CACalifornia$542.71$310.37
Washington, DC areaDistrict of Columbia$550.22$318.86
Miami, FLFlorida$520.93$316.48
Chicago, ILIllinois$505.85$308.47
Manhattan, NYNew York$554.05$325.83
AlaskaAlaska$560.74$351.57
AlabamaAlabama$432.47$260.63

28088 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.

$426.26

$572.33

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

View every state and territory as a table
28088 office rate range by state
State / territoryOffice rate rangeLocalities
AK$560.741
AL$432.471
AR$426.261
AZ$468.841
CA$508.29–$636.3729
CO$501.001
CT$513.561
DC$550.221
DE$476.581
FL$475.29–$520.933
GA$448.63–$490.752
GU$520.551
HI$520.551
IA$443.071
ID$446.011
IL$461.87–$505.854
IN$448.581
KS$441.161
KY$443.001
LA$442.37–$464.132
MA$498.10–$550.172
MD$485.59–$550.223
ME$448.50–$472.462
MI$454.62–$481.362
MN$479.611
MO$434.93–$465.583
MS$430.671
MT$481.611
NC$453.141
ND$471.721
NE$445.431
NH$493.301
NJ$519.30–$544.602
NM$457.161
NV$479.191
NY$459.91–$567.635
OH$452.601
OK$442.031
OR$475.34–$516.662
PA$453.22–$500.952
PR$485.081
RI$493.371
SC$453.651
SD$470.551
TN$443.391
TX$450.27–$499.458
UT$459.821
VA$471.03–$550.222
VI$485.081
VT$470.041
WA$497.11–$561.192
WI$456.001
WV$444.911
WY$477.301

See 28088 in every payment locality

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

Office or facility?

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.

The exact Houston, TX inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,114

Code
28088
Physician work
3.88
Practice expense
10.04
Malpractice
0.50

GPCI2026.csv

102

Locality
Houston, TX
Physician work
1.008
Practice expense
0.993
Malpractice
1.376
Office calculation for 28088 in Houston, TX
ComponentRVULocality factorAdjusted
Physician work3.88× 1.0083.9110
Practice expense10.04× 0.9939.9697
Malpractice0.50× 1.3760.6880
Total RVUs14.5688
Conversion factor× 33.4009

Office rate, Houston, TX$486.61

Office: (3.88 × 1.008 + 10.04 × 0.993 + 0.5 × 1.376) × $33.4009 = $486.61

Facility: (3.88 × 1.008 + 4.16 × 0.993 + 0.5 × 1.376) × $33.4009 = $291.59

Open 28088 in the RVU calculator

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

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)0Not paid without supporting documentation.
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 · 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.

  • 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

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).

When to use modifier 50

Codes related to 28088

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

Codes related to 28088
CodeHow it relatesOffice range, Houston, TX
Same family
28086Tendon sheath excision, single sheathCorresponding excision of a foot flexor tendon sheath rather than an extensor tendon sheath.$547.36
Used instead
28070Foot synovectomy, tarsometatarsal jointAddresses removal of foot-joint lining, not tissue surrounding an extensor tendon.$524.61
28010Toe tendon release, single tendon, percutaneousIncises a toe tendon for a different problem; it does not excise the tendon sheath.$238.61
28039Tumor excision, subcutaneous, 1.5 cm or largerFor an eligible subcutaneous foot or toe tumor, rather than diseased tendon-sheath tissue.$483.49

How 28088 has changed in Houston, TX

28088 · Office / nonfacility

$486.61

Effective 2026-10-01

The base rate is $28.64 higher than on 2025-10-01, moving from $457.97 to $486.61 (6.3%).

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

    $457.97changed to$486.61

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.98 changed to 3.88
    • Practice expense RVU 9.39 changed to 10.04
    • Work GPCI 1.014 changed to 1.008
    • Practice expense GPCI 1.003 changed to 0.993
    • Malpractice GPCI 1.409 changed to 1.376

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $473.70changed to$457.97

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 9.49 changed to 9.39
    • Malpractice RVU 0.48 changed to 0.50

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $465.97changed to$473.70

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $474.78changed to$465.97

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 9.26 changed to 9.49
    • Malpractice RVU 0.46 changed to 0.48
    • Work GPCI 1.023 changed to 1.014
    • Practice expense GPCI 1.016 changed to 1.003
    • Malpractice GPCI 1.154 changed to 1.409

  5. January 1, 2023

    RVU23A

    $478.82changed to$474.78

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 9.07 changed to 9.26
    • Malpractice RVU 0.44 changed to 0.46
    • Work GPCI 1.032 changed to 1.023
    • Practice expense GPCI 1.029 changed to 1.016
    • Malpractice GPCI 0.900 changed to 1.154

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $474.90changed to$478.82

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 8.85 changed to 9.07

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $459.38changed to$474.90

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 8.08 changed to 8.85
    • Work GPCI 1.026 changed to 1.032
    • Practice expense GPCI 1.020 changed to 1.029
    • Malpractice GPCI 0.918 changed to 0.900

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $475.42changed to$459.38

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 8.58 changed to 8.08
    • Malpractice RVU 0.48 changed to 0.44
    • Work GPCI 1.020 changed to 1.026
    • Practice expense GPCI 1.012 changed to 1.020
    • Malpractice GPCI 0.936 changed to 0.918

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $472.74changed to$475.42

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 8.53 changed to 8.58
    • Malpractice RVU 0.47 changed to 0.48

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $467.35changed to$472.74

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 8.47 changed to 8.53
    • Malpractice RVU 0.44 changed to 0.47
    • Practice expense GPCI 1.009 changed to 1.012
    • Malpractice GPCI 0.946 changed to 0.936

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $466.76changed to$467.35

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 8.50 changed to 8.47
    • Malpractice RVU 0.45 changed to 0.44
    • Work GPCI 1.019 changed to 1.020
    • Practice expense GPCI 1.006 changed to 1.009
    • Malpractice GPCI 0.955 changed to 0.946

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $458.98changed to$466.76

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 8.39 changed to 8.50
    • Malpractice RVU 0.29 changed to 0.45

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $456.69changed to$458.98

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $480.36changed to$456.69

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 8.85 changed to 8.39
    • Malpractice RVU 0.52 changed to 0.29
    • Work GPCI 1.014 changed to 1.019
    • Practice expense GPCI 1.004 changed to 1.006
    • Malpractice GPCI 0.939 changed to 0.955

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $506.77changed to$480.36

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 10.36 changed to 8.85
    • Malpractice RVU 0.54 changed to 0.52
    • Work GPCI 1.009 changed to 1.014
    • Practice expense GPCI 1.002 changed to 1.004
    • Malpractice GPCI 0.923 changed to 0.939

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $506.77

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$486.61$291.59RVU26D
2026-07-01$486.61$291.59RVU26C
2026-04-01$486.61$291.59RVU26B
2026-01-01$486.61$291.59RVU26A
2025-10-01$457.97$300.95RVU25D
2025-07-01$457.97$300.95RVU25C
2025-04-01$457.97$300.95RVU25B
2025-01-01$457.97$300.95RVU25A
2024-10-01$473.70$306.09RVU24D
2024-07-01$473.70$306.09RVU24C
2024-04-01$473.70$306.09RVU24B
2024-03-09$473.70$306.09RVU24AR
2024-01-01$465.97$301.10RVU24A
2023-10-01$474.78$302.98RVU23D
2023-07-01$474.78$302.98RVU23C
2023-04-01$474.78$302.98RVU23B
2023-01-01$474.78$302.98RVU23A
2022-10-01$478.82$300.06RVU22D
2022-07-01$478.82$300.06RVU22C
2022-04-01$478.82$300.06RVU22B
2022-01-01$478.82$300.06RVU22A
2021-10-01$474.90$294.29RVU21D
2021-07-01$474.90$294.29RVU21C
2021-04-01$474.90$294.29RVU21B
2021-01-01$474.90$294.29RVU21A
2020-10-01$459.38$290.79RVU20D
2020-07-01$459.38$290.79RVU20C
2020-04-01$459.38$290.79RVU20B
2020-01-01$459.38$290.79RVU20A
2019-10-01$475.42$299.63RVU19D
2019-07-01$475.42$299.63RVU19C
2019-04-01$475.42$299.63RVU19B
2019-01-01$475.42$299.63RVU19A
2018-10-01$472.74$297.51RVU18D
2018-07-01$472.74$297.51RVU18C
2018-04-01$472.74$297.51RVU18B
2018-01-01$472.74$297.51RVU18AR1
2017-10-01$467.35$294.62RVU17D
2017-07-01$467.35$294.62RVU17C
2017-04-01$467.35$294.62RVU17B
2017-01-01$467.35$294.62RVU17A
2016-10-01$466.76$293.87RVU16D
2016-07-01$466.76$293.87RVU16C
2016-04-01$466.76$293.87RVU16B
2016-01-01$466.76$293.87RVU16A
2015-10-01$458.98$286.54RVU15D
2015-07-01$458.98$286.54RVU15C
2015-04-01$456.69$285.12RVU15B
2015-01-01$456.69$285.12RVU15A
2014-10-01$480.36$302.69RVU14D
2014-07-01$480.36$302.69RVU14C
2014-04-01$480.36$302.69RVU14B
2014-01-01$480.36$302.69RVU14A
2013-10-01$506.77$309.38RVU13D
2013-07-01$506.77$309.38RVU13C
2013-04-01$506.77$309.38RVU13B
2013-01-01$506.77$309.38RVU13AR

Price 28088 for an earlier date of service

Where the Houston, TX rate applies

Houston, TX is a Medicare payment area, not a city. Our Census mapping connects it to 46 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Texas

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
RVUs for 28088PPRRVU2026_Oct_nonQPP.csv, line 3,114 (RVU26D)
Geographic factors for Houston, TXGPCI2026.csv, line 102 (RVU26D)

Open CMS sourceHow we calculate rates

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