CPT code 28100: Bone lesion excision, talus or calcaneus2026 Medicare rate & RVUs

Medicare pays $645.31 for 28100 nationally in the office and $403.48 in a hospital or facility. Local office rates run $570.84–$840.61.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 28100 covers

This service removes or curettes a bone cyst or benign tumor in the talus or calcaneus. An orthopedic surgeon or podiatric surgeon typically performs it in an operating room, using an approach that exposes the affected bone and allows the lesion to be treated. The operative report should identify the bone and lesion and describe the work performed; the code is for these two bones, not other tarsal bones or toe bones.

Select this code when the lesion is in the talus or calcaneus and the procedure does not use a graft; grafted procedures have separate sibling codes. Document the diagnosis, exact site, and whether grafting was performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is 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 28100 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

28100 rates by state

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

How the 28100 rate is calculated

Each of 28100’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.

Payment rules and modifiers for 28100

28100 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

28100 compared with similar codes

How to choose

28102Bone lesion excisionTarsal or metatarsal, autograft

This code describes talus or calcaneus lesion treatment without grafting; 28102 is the grafted sibling procedure.

28103Foot bone lesionTarsal or metatarsal, autograft

Use 28103 for the grafted sibling procedure, rather than this code for treatment without a graft.

28104Bone lesion excisionTarsal or metatarsal, without graft

The key distinction is the bone: 28104 is for another tarsal bone, while this code is for the talus or calcaneus.

28120Bone excisionTalus or calcaneus

Use 28120 when the operative work is partial excision of ankle or heel bone, rather than curettage or excision of a cyst or benign tumor.

Codes related to 28100

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

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

Open CMS sourceHow we calculate rates