CPT code 28108: Toe bone lesion, phalanx of the foot2026 Medicare rate & RVUs in North Dakota

Reports operative removal or curettage of a benign bone lesion in a toe phalanx, rather than a lesion in the metatarsal or tarsal bones.

CMS RVU26DEffective Oct 1, 2026One payment locality994 Medicare services in 2024

In North Dakota, Medicare pays $422.87 for 28108 in the office and $265.89 when it’s performed in a hospital or facility.

$422.87Office (non-facility)
$265.89Hospital or facility
−1.9%vs the national office rate ($431.21)

Check a contract rate as a % of Medicare · 28108 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 28108 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Dakota
  2. What 28108 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 28108 covers

This service covers operative removal or curettage of a benign bone cyst or tumor in a toe phalanx. An orthopedic surgeon or podiatrist may perform it when a lesion in the toe bone requires surgical treatment. The surgeon identifies the involved phalanx, exposes the lesion, and removes or curettes the affected bone tissue. The code is specific to a lesion in a toe bone; a soft-tissue mass on the toe is a different service.

Select the code by the involved bone and the procedure documented, distinguishing a toe phalanx from a metatarsal or tarsal bone. The operative report should identify the toe and phalanx, describe the lesion and the removal or curettage performed, and support that the target was bone. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment is statutorily restricted; 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 North Dakota compares for 28108

Across 109 of 109 payment localities, the office rate for 28108 runs from $385.31 in Arkansas to $562.63 in San Benito County, CA. North Dakota pays $422.87. The RVUs are the same everywhere; the geographic indexes change the dollars.

28108 in North Dakota vs other payment areas
  1. North Dakota · this page$422.87
  2. Los Angeles, CA · California$482.96+$60.09
  3. Washington, DC area · District of Columbia$489.69+$66.82
  4. Miami, FL · Florida$464.02+$41.15
  5. Chicago, IL · Illinois$451.74+$28.87
  6. Manhattan, NY · New York$493.29+$70.42
  7. Alaska · Alaska$512.90+$90.03

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

Every other payment area

28108 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$390.46$253.10
ArkansasArkansas$385.31$250.46
ArizonaArizona$420.59$268.47
Bakersfield, CACalifornia$454.99$282.94
Chico, CACalifornia$453.69$281.63
El Centro, CACalifornia$453.76$281.70
Fresno, CACalifornia$453.69$281.63
Hanford, CACalifornia$453.69$281.63

28108 rates by state

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

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.

$385.31

$512.90

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

View every state and territory as a table
28108 office rate range by state
State / territoryOffice rate rangeLocalities
AK$512.901
AL$390.461
AR$385.311
AZ$420.591
CA$453.69–$562.6329
CO$447.561
CT$458.301
DC$489.691
DE$427.161
FL$426.06–$464.023
GA$403.96–$438.882
GU$463.281
HI$463.281
IA$399.181
ID$401.631
IL$414.98–$451.744
IN$403.761
KS$397.631
KY$399.241
LA$398.74–$416.762
MA$445.29–$489.182
MD$434.78–$489.693
ME$403.72–$423.532
MI$408.90–$431.132
MN$429.371
MO$392.58–$417.933
MS$389.011
MT$431.181
NC$407.571
ND$422.871
NE$401.131
NH$440.821
NJ$463.67–$485.332
NM$411.021
NV$429.141
NY$413.18–$504.585
OH$407.201
OK$398.411
OR$425.93–$460.632
PA$407.70–$447.802
PR$434.041
RI$441.501
SC$408.031
SD$421.891
TN$399.481
TX$405.26–$445.978
UT$413.141
VA$422.37–$489.692
VI$434.041
VT$421.501
WA$444.37–$498.572
WI$409.851
WV$400.941
WY$427.561

See 28108 in every payment locality

How the 28108 rate is calculated

Each of 28108’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 · 28108

RVUs × geographic indexes × conversion factor

Office or facility?

Work4.19

4.19 RVUs× 1.000 GPCI

Practice expense8.30

8.30 RVUs× 1.000 GPCI

Malpractice0.42

0.42 RVUs× 1.000 GPCI

Adjusted RVUs

12.9100

Conversion factor

$33.4009

Medicare rate

$431.21

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

The exact North Dakota inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,123

Code
28108
Physician work
4.19
Practice expense
8.30
Malpractice
0.42

GPCI2026.csv

84

Locality
North Dakota
Physician work
1.000
Practice expense
1.000
Malpractice
0.406
Office calculation for 28108 in North Dakota
ComponentRVULocality factorAdjusted
Physician work4.19× 1.0004.1900
Practice expense8.30× 1.0008.3000
Malpractice0.42× 0.4060.1705
Total RVUs12.6605
Conversion factor× 33.4009

Office rate, North Dakota$422.87

Office: (4.19 × 1 + 8.3 × 1 + 0.42 × 0.406) × $33.4009 = $422.87

Facility: (4.19 × 1 + 3.6 × 1 + 0.42 × 0.406) × $33.4009 = $265.89

Open 28108 in the RVU calculator

Payment rules and modifiers for 28108

28108 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 28108

Toe bone lesion, phalanx of the foot

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)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
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 · 28108

Toe bone lesion, phalanx of the foot

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 51 · payment effect

With and without the modifier

28108 without 51 · national office

$431.21

Toe bone lesion, phalanx of the foot

28108-51 · Second procedure: 50%

$215.61

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

How 28108 has changed in North Dakota

28108 · Office / nonfacility

$422.87

Effective 2026-10-01

The base rate is $8.29 higher than on 2025-10-01, moving from $414.58 to $422.87 (2.0%).

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

    $414.58changed to$422.87

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 4.30 changed to 4.19
    • Practice expense RVU 8.31 changed to 8.30
    • Malpractice RVU 0.40 changed to 0.42
    • Malpractice GPCI 0.517 changed to 0.406

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $427.30changed to$414.58

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 8.33 changed to 8.31

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $420.33changed to$427.30

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $430.37changed to$420.33

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 8.22 changed to 8.33
    • Malpractice RVU 0.38 changed to 0.40
    • Malpractice GPCI 0.474 changed to 0.517
  5. January 1, 2023

    RVU23A

    $436.12changed to$430.37

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 8.13 changed to 8.22
    • Malpractice RVU 0.40 changed to 0.38
    • Malpractice GPCI 0.431 changed to 0.474

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $444.12changed to$436.12

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 8.26 changed to 8.13
    • Malpractice RVU 0.39 changed to 0.40

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $449.46changed to$444.12

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 7.96 changed to 8.26
    • Malpractice RVU 0.40 changed to 0.39
    • Malpractice GPCI 0.485 changed to 0.431

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $453.00changed to$449.46

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 8.07 changed to 7.96
    • Malpractice RVU 0.37 changed to 0.40
    • Malpractice GPCI 0.540 changed to 0.485

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $452.51changed to$453.00

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $450.13changed to$452.51

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 8.04 changed to 8.07
    • Malpractice GPCI 0.547 changed to 0.540

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $449.52changed to$450.13

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 8.05 changed to 8.04
    • Malpractice GPCI 0.554 changed to 0.547

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $453.90changed to$449.52

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 8.11 changed to 8.05
    • Malpractice RVU 0.40 changed to 0.37

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $451.64changed to$453.90

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $446.82changed to$451.64

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 7.98 changed to 8.11
    • Malpractice RVU 0.36 changed to 0.40
    • Malpractice GPCI 0.536 changed to 0.554

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $448.64changed to$446.82

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 8.69 changed to 7.98
    • Malpractice RVU 0.38 changed to 0.36
    • Malpractice GPCI 0.517 changed to 0.536

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $448.64

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$422.87$265.89RVU26D
2026-07-01$422.87$265.89RVU26C
2026-04-01$422.87$265.89RVU26B
2026-01-01$422.87$265.89RVU26A
2025-10-01$414.58$280.02RVU25D
2025-07-01$414.58$280.02RVU25C
2025-04-01$414.58$280.02RVU25B
2025-01-01$414.58$280.02RVU25A
2024-10-01$427.30$284.83RVU24D
2024-07-01$427.30$284.83RVU24C
2024-04-01$427.30$284.83RVU24B
2024-03-09$427.30$284.83RVU24AR
2024-01-01$420.33$280.19RVU24A
2023-10-01$430.37$283.98RVU23D
2023-07-01$430.37$283.98RVU23C
2023-04-01$430.37$283.98RVU23B
2023-01-01$430.37$283.98RVU23A
2022-10-01$436.12$284.55RVU22D
2022-07-01$436.12$284.55RVU22C
2022-04-01$436.12$284.55RVU22B
2022-01-01$436.12$284.55RVU22A
2021-10-01$444.12$284.31RVU21D
2021-07-01$444.12$284.31RVU21C
2021-04-01$444.12$284.31RVU21B
2021-01-01$444.12$284.31RVU21A
2020-10-01$449.46$291.75RVU20D
2020-07-01$449.46$291.75RVU20C
2020-04-01$449.46$291.75RVU20B
2020-01-01$449.46$291.75RVU20A
2019-10-01$453.00$292.99RVU19D
2019-07-01$453.00$292.99RVU19C
2019-04-01$453.00$292.99RVU19B
2019-01-01$453.00$292.99RVU19A
2018-10-01$452.51$292.67RVU18D
2018-07-01$452.51$292.67RVU18C
2018-04-01$452.51$292.67RVU18B
2018-01-01$452.51$292.67RVU18AR1
2017-10-01$450.13$291.86RVU17D
2017-07-01$450.13$291.86RVU17C
2017-04-01$450.13$291.86RVU17B
2017-01-01$450.13$291.86RVU17A
2016-10-01$449.52$290.91RVU16D
2016-07-01$449.52$290.91RVU16C
2016-04-01$449.52$290.91RVU16B
2016-01-01$449.52$290.91RVU16A
2015-10-01$453.90$292.92RVU15D
2015-07-01$453.90$292.92RVU15C
2015-04-01$451.64$291.46RVU15B
2015-01-01$451.64$291.46RVU15A
2014-10-01$446.82$290.27RVU14D
2014-07-01$446.82$290.27RVU14C
2014-04-01$446.82$290.27RVU14B
2014-01-01$446.82$290.27RVU14A
2013-10-01$448.64$285.33RVU13D
2013-07-01$448.64$285.33RVU13C
2013-04-01$448.64$285.33RVU13B
2013-01-01$448.64$285.33RVU13AR

Price 28108 for an earlier date of service

Where the North Dakota rate applies

North Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 406 cities and communities in North Dakota. Some span more than one payment area; confirm with the service ZIP.

  • Abercrombie
  • Adams
  • Alamo
  • Alexander
  • Alice
  • Almont
  • Alsen
  • Ambrose

Browse all communities in North Dakota

28108 billing questions

How does this differ from removal of a metatarsal lesion?

This code is for a lesion in a toe phalanx. A lesion in a metatarsal is reported with the applicable metatarsal lesion code, such as 28106 or 28107.

Can this code be used for a soft-tissue mass on a toe?

No. The operative service described here targets a bone lesion in a toe phalanx, not a skin or soft-tissue mass.

Is the related preoperative visit or postoperative care separately included?

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

Should modifier 50 be appended when lesions are treated on both feet?

No. CMS identifies bilateral adjustment as inappropriate for this code. The descriptor or anatomy does not support modifier 50.

How are other procedures in the same session paid?

CMS pays the highest-valued procedure in full and applies the standard multiple procedure reduction to the other procedures. Assistant-at-surgery payment is statutorily restricted, and co-surgeons and team surgery are not permitted.

What operative documentation supports reporting this code?

Document the involved toe and phalanx, the bone lesion treated, and the removal or curettage performed. The record should make clear that the target was in bone rather than soft tissue.

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 28108PPRRVU2026_Oct_nonQPP.csv, line 3,123 (RVU26D)
Geographic factors for North DakotaGPCI2026.csv, line 84 (RVU26D)

Open CMS sourceHow we calculate rates

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