CPT code 28103: Foot bone lesion, tarsal or metatarsal, autograft2026 Medicare rate & RVUs in Texas
Reports excision or curettage of a benign bone lesion in a tarsal or metatarsal bone when the defect is filled with autograft.
CMS doesn’t publish an office rate for 28103 in Texas.
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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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 in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | $367.39 |
| Beaumont, TX | Unavailable | $349.06 |
| Brazoria, TX | Unavailable | $358.29 |
| Dallas, TX | Unavailable | $360.57 |
| Fort Worth, TX | Unavailable | $359.55 |
| Galveston, TX | Unavailable | $359.43 |
| Houston, TX | Unavailable | $369.49 |
| Rest of Texas | Unavailable | $353.51 |
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
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
| 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) | 2 | Paid. |
| 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 · 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.
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).
28103 compared with similar codes
Compare codes · National
5 codes, side by side
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.
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
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