CPT code 28126: Toe bone excision, complete phalanx removal2026 Medicare rate & RVUs

Medicare pays $387.12 for 28126 nationally in the office and $238.15 in a hospital or facility. Local office rates run $344.89–$507.36.

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

What 28126 covers

This procedure removes an entire phalanx—the bone segment in a toe—while leaving the toe itself in place. A foot and ankle surgeon, podiatrist, or other qualified surgeon may perform it for conditions such as bone infection or a painful deformity when complete removal of that phalanx is part of the operative plan. The operative report should identify the toe and phalanx and make clear that the entire phalanx, rather than only part of it, was excised.

Report the code for complete phalanx excision; partial removal belongs to a different code. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery, and 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 28126 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

28126 rates by state

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

How the 28126 rate is calculated

Each of 28126’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.

Payment rules and modifiers for 28126

28126 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

28126 compared with similar codes

How to choose

28124Toe bone excisionPartial phalanx excision

28124 is for partial phalanx excision; 28126 is for complete excision. Select according to the extent documented in the operative report.

28150Toe amputationAt the MTP joint

28150 describes toe phalangectomy. Distinguish it from 28126 by the specific procedure documented and whether the service is reported as a phalanx excision or phalangectomy.

28153Toe bone removalPartial excision

28153 is for resection of distal phalanx condyle(s), not complete removal of the phalanx.

28160Toe bone excisionJoint or partial phalanx

28160 describes hemiphalangectomy or interphalangeal joint excision involving the proximal phalanx; 28126 represents complete phalanx excision.

Codes related to 28126

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

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

Open CMS sourceHow we calculate rates