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

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, 20268 payment localities994 Medicare services in 2024

Medicare pays $405.26–$445.97 for 28108 in the office in Texas, from Beaumont, TX to Austin, TX. Which amount applies depends on the service address.

$405.26–$445.97Office (non-facility)
$262.40–$279.88Hospital or facility

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 9 sections
  1. Rate in Texas
  2. What 28108 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. 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.

Where 28108 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 payment localities

$405.26 to $445.97

$405.26$425.62$445.97
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

8 of 8 payment localities

28108 office and facility rates by payment locality
Payment localityOfficeFacility
Austin, TX$445.97$279.88
Beaumont, TX$405.26$262.40
Brazoria, TX$426.74$271.17
Dallas, TX$429.36$273.01
Fort Worth, TX$426.77$271.99
Galveston, TX$427.97$272.09
Houston, TX$435.66$279.77
Rest of Texas$415.71$266.73

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.

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

28108 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 28108

    Toe bone lesion, phalanx of the foot4.19 wRVU

    $431.21

  • 28106

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

    Not priced

  • 28104

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

    $540.76+$109.55

  • 28124

    Toe bone excision, partial phalanx excision4.88 wRVU

    $474.29+$43.08

  • 28126

    Toe bone excision, complete phalanx removal3.55 wRVU

    $387.12−$44.09

How to choose

28106Foot bone lesionTarsal or metatarsal, autograft
Use 28106 for a benign bone lesion in a metatarsal. Use 28108 when the involved bone is a toe phalanx.
28104Bone lesion excisionTarsal or metatarsal, without graft
28104 applies to specified tarsal bones, not toe phalanges. Identify the bone containing the lesion before choosing between them.
28124Toe bone excisionPartial phalanx excision
28124 describes partial excision of toe bone. Choose 28108 when the documented service is removal or curettage of a benign lesion in a phalanx.
28126Toe bone excisionComplete phalanx removal
28126 describes partial excision of a toe, while 28108 addresses a benign bone lesion in a toe phalanx.

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)

Open CMS sourceHow we calculate rates

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