CPT code 28124: Toe bone excision, partial phalanx excision2026 Medicare rate & RVUs in Vermont
Reports removal of a portion of a toe phalanx, such as a diseased or prominent bone segment, when the procedure does not target a specific condyle.
In Vermont, Medicare pays $463.58 for 28124 in the office and $308.83 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 28124 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 28124 covers
A podiatrist or orthopedic surgeon removes a portion of a toe phalanx to treat localized bone disease or a painful bony prominence. The procedure may be performed in an office-based surgical setting or a hospital or ambulatory surgery facility. The operative report should identify the toe, the phalanx involved, the portion removed, and the clinical reason for the excision.
Select this code when the work is partial removal of phalangeal bone, rather than a defined resection of a distal or proximal condyle or removal of a broader phalangeal segment. Related preoperative care on the day before surgery and related postoperative care for 90 days are included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this service; 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 Vermont compares for 28124
Across 109 of 109 payment localities, the office rate for 28124 runs from $425.00 in Arkansas to $615.59 in San Benito County, CA. Vermont pays $463.58. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Vermont · this page$463.58
- Los Angeles, CA · California$529.80+$66.22
- Washington, DC area · District of Columbia$537.48+$73.90
- Miami, FL · Florida$510.42+$46.84
- Chicago, IL · Illinois$497.24+$33.66
- Manhattan, NY · New York$541.81+$78.23
- Alaska · Alaska$567.96+$104.38
Other areas in Vermont first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $430.53 | $293.75 |
| ArkansasArkansas | $425.00 | $290.72 |
| ArizonaArizona | $462.87 | $311.40 |
| Bakersfield, CACalifornia | $499.63 | $328.31 |
| Chico, CACalifornia | $498.16 | $326.83 |
| El Centro, CACalifornia | $498.24 | $326.91 |
| Fresno, CACalifornia | $498.16 | $326.83 |
| Hanford, CACalifornia | $498.16 | $326.83 |
| Madera, CACalifornia | $498.16 | $326.83 |
| Merced, CACalifornia | $498.16 | $326.83 |
| Modesto, CACalifornia | $498.16 | $326.83 |
| Napa, CACalifornia | $570.84 | $364.81 |
| Oxnard, CACalifornia | $526.74 | $341.97 |
| Redding, CACalifornia | $498.16 | $326.83 |
| Rest of CaliforniaCalifornia | $498.16 | $326.83 |
| Riverside, CACalifornia | $503.30 | $331.97 |
| Sacramento, CACalifornia | $521.06 | $339.26 |
| Salinas, CACalifornia | $519.06 | $337.89 |
| San Diego, CACalifornia | $529.93 | $342.98 |
| Marin County, CACalifornia | $602.48 | $382.07 |
| San Francisco, CACalifornia | $601.95 | $381.54 |
| San Benito County, CACalifornia | $615.59 | $390.18 |
| Santa Clara County, CACalifornia | $613.41 | $388.00 |
| San Luis Obispo, CACalifornia | $510.87 | $332.82 |
| Santa Cruz, CACalifornia | $533.99 | $344.06 |
| Santa Maria, CACalifornia | $520.64 | $338.38 |
| Santa Rosa, CACalifornia | $539.29 | $347.34 |
| Stockton, CACalifornia | $498.16 | $326.83 |
| Vallejo, CACalifornia | $570.07 | $364.04 |
| Visalia, CACalifornia | $498.16 | $326.83 |
| Yuba City, CACalifornia | $498.16 | $326.83 |
| ColoradoColorado | $491.73 | $325.41 |
| ConnecticutConnecticut | $503.61 | $335.26 |
| DelawareDelaware | $469.98 | $315.53 |
| Fort Lauderdale, FLFlorida | $490.82 | $332.47 |
| Rest of FloridaFlorida | $469.18 | $319.74 |
| Atlanta, GAGeorgia | $482.67 | $323.85 |
| Rest of GeorgiaGeorgia | $445.38 | $305.95 |
| Hawaii, Guam, HIHawaii | $508.18 | $330.45 |
| IowaIowa | $439.70 | $296.67 |
| IdahoIdaho | $442.37 | $298.56 |
| East St. Louis, ILIllinois | $466.56 | $322.75 |
| Rest of IllinoisIllinois | $457.41 | $314.70 |
| Suburban Chicago, ILIllinois | $495.53 | $335.00 |
| IndianaIndiana | $444.65 | $299.74 |
| KansasKansas | $438.13 | $296.82 |
| KentuckyKentucky | $440.15 | $301.18 |
| New Orleans, LALouisiana | $458.99 | $311.89 |
| Rest of LouisianaLouisiana | $439.64 | $301.30 |
| Metropolitan Boston, MAMassachusetts | $536.59 | $349.95 |
| Rest of MassachusettsMassachusetts | $489.38 | $324.78 |
| Baltimore area, MDMaryland | $502.20 | $334.47 |
| Rest of MarylandMaryland | $478.18 | $319.99 |
| Rest of MaineMaine | $444.71 | $300.90 |
| Southern Maine, MEMaine | $465.84 | $310.93 |
| Detroit, MIMichigan | $474.72 | $323.87 |
| Rest of MichiganMichigan | $450.60 | $307.88 |
| MinnesotaMinnesota | $471.81 | $310.96 |
| Metropolitan Kansas City, MOMissouri | $455.90 | $309.12 |
| Metropolitan St. Louis, MOMissouri | $460.14 | $311.32 |
| Rest of MissouriMissouri | $433.09 | $298.35 |
| MississippiMississippi | $429.11 | $294.52 |
| MontanaMontana | $474.26 | $317.95 |
| North CarolinaNorth Carolina | $448.82 | $302.98 |
| North DakotaNorth Dakota | $464.97 | $308.65 |
| NebraskaNebraska | $441.77 | $297.49 |
| New HampshireNew Hampshire | $484.45 | $321.72 |
| Northern New JerseyNew Jersey | $532.92 | $351.60 |
| Rest of New JerseyNew Jersey | $509.53 | $338.83 |
| New MexicoNew Mexico | $452.91 | $309.57 |
| NevadaNevada | $471.97 | $315.49 |
| NYC suburbs and Long Island, NYNew York | $554.05 | $368.19 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $513.01 | $341.84 |
| Queens, NYNew York | $545.46 | $360.70 |
| Rest of New YorkNew York | $454.85 | $306.35 |
| OhioOhio | $448.70 | $305.98 |
| OklahomaOklahoma | $439.16 | $299.57 |
| Portland, OROregon | $505.69 | $332.03 |
| Rest of OregonOregon | $468.45 | $312.76 |
| Metropolitan Philadelphia, PAPennsylvania | $492.38 | $329.65 |
| Rest of PennsylvaniaPennsylvania | $449.19 | $305.69 |
| Puerto RicoPuerto Rico | $477.31 | $319.27 |
| Rhode IslandRhode Island | $485.45 | $323.97 |
| South CarolinaSouth Carolina | $449.47 | $305.04 |
| South DakotaSouth Dakota | $463.87 | $307.55 |
| TennesseeTennessee | $440.12 | $298.03 |
| Austin, TXTexas | $489.97 | $324.59 |
| Beaumont, TXTexas | $446.57 | $304.33 |
| Brazoria, TXTexas | $469.48 | $314.57 |
| Dallas, TXTexas | $472.35 | $316.66 |
| Fort Worth, TXTexas | $469.60 | $315.47 |
| Galveston, TXTexas | $470.83 | $315.61 |
| Houston, TXTexas | $479.43 | $324.21 |
| Rest of TexasTexas | $457.69 | $309.35 |
| UtahUtah | $454.96 | $308.02 |
| VirginiaVirginia | $464.65 | $310.99 |
| Virgin Islands, VIUnited States Virgin Islands | $477.31 | $319.27 |
| Rest of WashingtonWashington | $488.33 | $323.73 |
| King County, WAWashington | $546.67 | $354.87 |
| WisconsinWisconsin | $451.01 | $301.26 |
| West VirginiaWest Virginia | $442.34 | $306.50 |
| WyomingWyoming | $470.21 | $313.89 |
28124 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.
$425.00
$567.96
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $567.96 | 1 |
| AL | $430.53 | 1 |
| AR | $425.00 | 1 |
| AZ | $462.87 | 1 |
| CA | $498.16–$615.59 | 29 |
| CO | $491.73 | 1 |
| CT | $503.61 | 1 |
| DC | $537.48 | 1 |
| DE | $469.98 | 1 |
| FL | $469.18–$510.42 | 3 |
| GA | $445.38–$482.67 | 2 |
| GU | $508.18 | 1 |
| HI | $508.18 | 1 |
| IA | $439.70 | 1 |
| ID | $442.37 | 1 |
| IL | $457.41–$497.24 | 4 |
| IN | $444.65 | 1 |
| KS | $438.13 | 1 |
| KY | $440.15 | 1 |
| LA | $439.64–$458.99 | 2 |
| MA | $489.38–$536.59 | 2 |
| MD | $478.18–$537.48 | 3 |
| ME | $444.71–$465.84 | 2 |
| MI | $450.60–$474.72 | 2 |
| MN | $471.81 | 1 |
| MO | $433.09–$460.14 | 3 |
| MS | $429.11 | 1 |
| MT | $474.26 | 1 |
| NC | $448.82 | 1 |
| ND | $464.97 | 1 |
| NE | $441.77 | 1 |
| NH | $484.45 | 1 |
| NJ | $509.53–$532.92 | 2 |
| NM | $452.91 | 1 |
| NV | $471.97 | 1 |
| NY | $454.85–$554.05 | 5 |
| OH | $448.70 | 1 |
| OK | $439.16 | 1 |
| OR | $468.45–$505.69 | 2 |
| PA | $449.19–$492.38 | 2 |
| PR | $477.31 | 1 |
| RI | $485.45 | 1 |
| SC | $449.47 | 1 |
| SD | $463.87 | 1 |
| TN | $440.12 | 1 |
| TX | $446.57–$489.97 | 8 |
| UT | $454.96 | 1 |
| VA | $464.65–$537.48 | 2 |
| VI | $477.31 | 1 |
| VT | $463.58 | 1 |
| WA | $488.33–$546.67 | 2 |
| WI | $451.01 | 1 |
| WV | $442.34 | 1 |
| WY | $470.21 | 1 |
How the 28124 rate is calculated
Each of 28124’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 · 28124
RVUs × geographic indexes × conversion factor
Work4.88
4.88 RVUs× 1.000 GPCI
Practice expense8.85
8.85 RVUs× 1.000 GPCI
Malpractice0.47
0.47 RVUs× 1.000 GPCI
Adjusted RVUs
14.2000
Conversion factor
$33.4009
Medicare rate
$474.29
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Vermont inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
3,134
- Code
- 28124
- Physician work
- 4.88
- Practice expense
- 8.85
- Malpractice
- 0.47
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.88 | × 1.000 | 4.8800 |
| Practice expense | 8.85 | × 0.990 | 8.7615 |
| Malpractice | 0.47 | × 0.506 | 0.2378 |
| Total RVUs | 13.8793 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Vermont$463.58
Office: (4.88 × 1 + 8.85 × 0.99 + 0.47 × 0.506) × $33.4009 = $463.58
Facility: (4.88 × 1 + 4.17 × 0.99 + 0.47 × 0.506) × $33.4009 = $308.83
Payment rules and modifiers for 28124
28124 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28124
Toe bone excision, partial phalanx excision
| 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) | 1 | Not paid (statutory restriction). |
| 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 · 28124
Toe bone excision, partial phalanx excision
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
28124 without 50 · national office
$474.29
Toe bone excision, partial phalanx excision
28124-50 · Bilateral: 150%
$711.44
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).
How 28124 has changed in Vermont
28124 · Office / nonfacility
$463.58
Effective 2026-10-01
The base rate is $9.86 higher than on 2025-10-01, moving from $453.72 to $463.58 (2.2%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$453.72changed to$463.58
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 5.00 changed to 4.88
- Practice expense RVU 8.84 changed to 8.85
- Malpractice RVU 0.48 changed to 0.47
- Practice expense GPCI 0.993 changed to 0.990
- Malpractice GPCI 0.518 changed to 0.506
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$468.05changed to$453.72
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 8.89 changed to 8.84
- Malpractice RVU 0.45 changed to 0.48
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$460.41changed to$468.05
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$471.13changed to$460.41
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 8.69 changed to 8.89
- Malpractice RVU 0.44 changed to 0.45
- Practice expense GPCI 0.997 changed to 0.993
- Malpractice GPCI 0.543 changed to 0.518
January 1, 2023
RVU23A
$479.95changed to$471.13
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 8.61 changed to 8.69
- Practice expense GPCI 1.001 changed to 0.997
- Malpractice GPCI 0.569 changed to 0.543
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$487.62changed to$479.95
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 8.71 changed to 8.61
- Malpractice RVU 0.45 changed to 0.44
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$493.81changed to$487.62
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 8.36 changed to 8.71
- Malpractice RVU 0.44 changed to 0.45
- Practice expense GPCI 1.008 changed to 1.001
- Malpractice GPCI 0.582 changed to 0.569
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$497.14changed to$493.81
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 8.43 changed to 8.36
- Malpractice RVU 0.40 changed to 0.44
- Practice expense GPCI 1.015 changed to 1.008
- Malpractice GPCI 0.595 changed to 0.582
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$496.02changed to$497.14
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 8.42 changed to 8.43
- Malpractice RVU 0.39 changed to 0.40
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$492.73changed to$496.02
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 8.39 changed to 8.42
- Malpractice RVU 0.40 changed to 0.39
- Practice expense GPCI 1.010 changed to 1.015
- Malpractice GPCI 0.639 changed to 0.595
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$489.43changed to$492.73
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 8.37 changed to 8.39
- Malpractice RVU 0.39 changed to 0.40
- Practice expense GPCI 1.004 changed to 1.010
- Malpractice GPCI 0.682 changed to 0.639
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$491.32changed to$489.43
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 8.36 changed to 8.37
- Malpractice RVU 0.41 changed to 0.39
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$488.88changed to$491.32
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$485.28changed to$488.88
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 8.25 changed to 8.36
- Malpractice RVU 0.40 changed to 0.41
- Practice expense GPCI 1.006 changed to 1.004
- Malpractice GPCI 0.618 changed to 0.682
Held through RVU15B.
January 1, 2014
RVU14A
No ratechanged to$485.28
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $463.58 | $308.83 | RVU26D |
| 2026-07-01 | $463.58 | $308.83 | RVU26C |
| 2026-04-01 | $463.58 | $308.83 | RVU26B |
| 2026-01-01 | $463.58 | $308.83 | RVU26A |
| 2025-10-01 | $453.72 | $323.31 | RVU25D |
| 2025-07-01 | $453.72 | $323.31 | RVU25C |
| 2025-04-01 | $453.72 | $323.31 | RVU25B |
| 2025-01-01 | $453.72 | $323.31 | RVU25A |
| 2024-10-01 | $468.05 | $329.22 | RVU24D |
| 2024-07-01 | $468.05 | $329.22 | RVU24C |
| 2024-04-01 | $468.05 | $329.22 | RVU24B |
| 2024-03-09 | $468.05 | $329.22 | RVU24AR |
| 2024-01-01 | $460.41 | $323.85 | RVU24A |
| 2023-10-01 | $471.13 | $329.23 | RVU23D |
| 2023-07-01 | $471.13 | $329.23 | RVU23C |
| 2023-04-01 | $471.13 | $329.23 | RVU23B |
| 2023-01-01 | $471.13 | $329.23 | RVU23A |
| 2022-10-01 | $479.95 | $331.69 | RVU22D |
| 2022-07-01 | $479.95 | $331.69 | RVU22C |
| 2022-04-01 | $479.95 | $331.69 | RVU22B |
| 2022-01-01 | $479.95 | $331.69 | RVU22A |
| 2021-10-01 | $487.62 | $331.84 | RVU21D |
| 2021-07-01 | $487.62 | $331.84 | RVU21C |
| 2021-04-01 | $487.62 | $331.84 | RVU21B |
| 2021-01-01 | $487.62 | $331.84 | RVU21A |
| 2020-10-01 | $493.81 | $339.20 | RVU20D |
| 2020-07-01 | $493.81 | $339.20 | RVU20C |
| 2020-04-01 | $493.81 | $339.20 | RVU20B |
| 2020-01-01 | $493.81 | $339.20 | RVU20A |
| 2019-10-01 | $497.14 | $340.21 | RVU19D |
| 2019-07-01 | $497.14 | $340.21 | RVU19C |
| 2019-04-01 | $497.14 | $340.21 | RVU19B |
| 2019-01-01 | $497.14 | $340.21 | RVU19A |
| 2018-10-01 | $496.02 | $338.53 | RVU18D |
| 2018-07-01 | $496.02 | $338.53 | RVU18C |
| 2018-04-01 | $496.02 | $338.53 | RVU18B |
| 2018-01-01 | $496.02 | $338.53 | RVU18AR1 |
| 2017-10-01 | $492.73 | $337.59 | RVU17D |
| 2017-07-01 | $492.73 | $337.59 | RVU17C |
| 2017-04-01 | $492.73 | $337.59 | RVU17B |
| 2017-01-01 | $492.73 | $337.59 | RVU17A |
| 2016-10-01 | $489.43 | $335.93 | RVU16D |
| 2016-07-01 | $489.43 | $335.93 | RVU16C |
| 2016-04-01 | $489.43 | $335.93 | RVU16B |
| 2016-01-01 | $489.43 | $335.93 | RVU16A |
| 2015-10-01 | $491.32 | $336.55 | RVU15D |
| 2015-07-01 | $491.32 | $336.55 | RVU15C |
| 2015-04-01 | $488.88 | $334.87 | RVU15B |
| 2015-01-01 | $488.88 | $334.87 | RVU15A |
| 2014-10-01 | $485.28 | $333.92 | RVU14D |
| 2014-07-01 | $485.28 | $333.92 | RVU14C |
| 2014-04-01 | $485.28 | $333.92 | RVU14B |
| 2014-01-01 | $485.28 | $333.92 | RVU14A |
| 2013-10-01 | Rate data unavailable | Rate data unavailable | RVU13D |
| 2013-07-01 | Rate data unavailable | Rate data unavailable | RVU13C |
| 2013-04-01 | Rate data unavailable | Rate data unavailable | RVU13B |
| 2013-01-01 | Rate data unavailable | Rate data unavailable | RVU13AR |
Where the Vermont rate applies
Vermont is a Medicare payment area, not a city. Our Census mapping connects it to 180 cities and communities in Vermont. Some span more than one payment area; confirm with the service ZIP.
- Albany
- Alburgh
- Algiers
- Arlington
- Ascutney
- Bakersfield
- Barnet
- Barre
28124 billing questions
When should I use this code instead of a condyle-resection code?
Use this code for partial removal of phalangeal bone without a specifically defined condylar resection. A distal condyle resection points to 28126; a proximal condyle resection points to 28153.
What documentation supports reporting this procedure?
Document the affected toe and phalanx, the segment of bone removed, the reason for excision, and the operative work performed. The record should distinguish a partial phalanx excision from a condylar resection or more extensive phalangectomy.
Is related postoperative care separately reported?
Related postoperative care is included in the 90-day global period, along with the preoperative visit on the day before surgery.
How does Medicare handle bilateral procedures and other procedures in the same session?
A bilateral procedure reported with modifier 50 is paid at 150%. For multiple procedures in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
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
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