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CPT code 28103: Foot bone lesion, tarsal or metatarsal, autograft2026 Medicare rate & RVUs

Reports excision or curettage of a benign bone lesion in a tarsal or metatarsal bone when the defect is filled with autograft.

CMS RVU26DEffective Oct 1, 2026109 payment localities104 Medicare services in 2024

Medicare pays $361.73 for 28103 nationally in a facility.

Medicare rate · 28103

Foot bone lesion, tarsal or metatarsal, autograft

Office or facility?

Work RVUs
6.5
Total RVUs
10.83
Global days
090

National rate · 2026

$361.73

Facility setting, before claim adjustments.

See every locality for 28103 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 28103 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 28103 covers

An orthopedic or podiatric surgeon uses this service to remove or curette a bone cyst or benign tumor in a tarsal or metatarsal bone and fill the resulting defect with the patient’s bone graft. The procedure is performed in an operative setting; the graft may be harvested as part of the service. The code is specific to these foot bones, rather than the talus or calcaneus or a toe phalanx.

Report it when the operative record identifies the treated bone and lesion, describes excision or curettage, and documents autograft placement. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, CMS pays the highest-valued procedure in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; 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 28103 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

28103 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$337.98
AlaskaUnavailable$470.24
ArizonaUnavailable$355.17
ArkansasUnavailable$335.02
Atlanta, GAUnavailable$368.10
Austin, TXUnavailable$367.39
Bakersfield, CAUnavailable$370.79
Baltimore area, MDUnavailable$378.78
Beaumont, TXUnavailable$349.06
Brazoria, TXUnavailable$358.29

28103 rates by state

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

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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.

View every state and territory as a table
28103 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 28103 rate is calculated

Each of 28103’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 · 28103

RVUs × geographic indexes × conversion factor

Office or facility?

Work6.50

6.50 RVUs× 1.000 GPCI

Practice expense3.78

3.78 RVUs× 1.000 GPCI

Malpractice0.55

0.55 RVUs× 1.000 GPCI

Adjusted RVUs

10.8300

Conversion factor

$33.4009

Medicare rate

$361.73

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 28103

28103 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 28103

Foot bone lesion, tarsal or metatarsal, autograft

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)2Paid.
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 · 28103

Foot bone lesion, tarsal or metatarsal, autograft

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

28103 without 50 · national facility

$361.73

Foot bone lesion, tarsal or metatarsal, autograft

28103-50 · Bilateral: 150%

$542.60

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

28103 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 28103

    Foot bone lesion, tarsal or metatarsal, autograft6.5 wRVU

    Not priced

  • 28102

    Bone lesion excision, tarsal or metatarsal, autograft7.72 wRVU

    Not priced

  • 28104

    Bone lesion excision, tarsal or metatarsal, without graft5.13 wRVU

    $540.76

  • 28106

    Foot bone lesion, tarsal or metatarsal, autograft7.17 wRVU

    Not priced

  • 28108

    Toe bone lesion, phalanx of the foot4.19 wRVU

    $431.21

How to choose

28102Bone lesion excisionTarsal or metatarsal, autograft
Use 28102 for a lesion in the talus or calcaneus. Use 28103 for a tarsal or metatarsal bone.
28104Bone lesion excisionTarsal or metatarsal, without graft
Both address tarsal or metatarsal lesions, but 28103 uses autograft and 28104 uses allograft.
28106Foot bone lesionTarsal or metatarsal, autograft
28106 is for a lesion in a foot phalanx; 28103 is for a tarsal or metatarsal bone.
28108Toe bone lesionPhalanx of the foot
28108 addresses a toe-phalanx lesion without graft, while 28103 treats a tarsal or metatarsal lesion with autograft.

Codes related to 28103

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

Codes related to 28103
CodeHow it relatesNational office range
Same family
28102Bone lesion excision, tarsal or metatarsal, autograftTreats a lesion of the talus or calcaneus with graft rather than a tarsal or metatarsal lesion.No office rate
28104Bone lesion excision, tarsal or metatarsal, without graftAllograft counterpart for a tarsal or metatarsal bone lesion.$481.32–$703.52
28106Foot bone lesion, tarsal or metatarsal, autograftGraft procedure for a bone lesion in a foot phalanx.No office rate
28107Bone lesion surgery, tarsal or metatarsal, allograftAllograft procedure for a bone lesion in a foot phalanx.$448.43–$641.43
28108Toe bone lesion, phalanx of the footRemoval or curettage of a benign lesion in a toe phalanx without graft.$385.31–$562.63

28103 billing questions

How does 28103 differ from 28102?

28103 is for a tarsal or metatarsal bone. 28102 is for a lesion in the talus or calcaneus.

When should 28104 be considered instead?

28104 describes the corresponding tarsal or metatarsal lesion procedure using allograft. 28103 includes autograft.

Is graft harvesting separately reported?

The autograft harvest is included in 28103. Document the graft placement and its relationship to the treated bone defect.

What documentation supports this code?

Record the specific tarsal or metatarsal bone, lesion, excision or curettage performed, and autograft placement.

How does the 90-day global period affect follow-up care?

The day-before preoperative visit and 90 days of related postoperative care are included in the global period.

Can 28103 be reported bilaterally or with another procedure?

CMS pays bilateral reporting with modifier 50 at 150%. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and others at 50%.

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 28103PPRRVU2026_Oct_nonQPP.csv, line 3,119 (RVU26D)

Open CMS sourceHow we calculate rates

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