CPT code 28160: Toe bone excision, joint or partial phalanx2026 Medicare rate & RVUs

Medicare pays $406.82 for 28160 nationally in the office and $255.52 in a hospital or facility. Local office rates run $362.78–$532.92.

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

What 28160 covers

This service covers operative removal involving a toe interphalangeal joint or part of a toe phalanx. Podiatrists and orthopedic foot and ankle surgeons may perform it for a painful toe deformity when the planned procedure is joint excision or removal of part of the phalanx. For example, documentation may describe the specific toe and the bone or joint excised to address a rigid deformity or focal pressure.

Select this code from the operative work, not just the diagnosis: document the affected toe, the extent of bone removed, and whether the surgeon excised the joint or part of a phalanx. Medicare assigns a 90-day global period, including 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 for this code. Medicare does not pay an assistant at surgery; 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 28160 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

28160 rates by state

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

How the 28160 rate is calculated

Each of 28160’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 28160

28160 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

28160 compared with similar codes

How to choose

28124Toe bone excisionPartial phalanx excision

Use 28124 for partial excision of a toe phalanx when that is the documented procedure. This code describes excision involving an interphalangeal joint or part of a phalanx.

28126Toe bone excisionComplete phalanx removal

28126 concerns resection of toe phalanx condyle(s). Distinguish it from the joint or partial-phalanx excision documented for 28160.

28150Toe amputationAt the MTP joint

28150 describes more extensive removal of a toe. Use 28160 when the documented work is limited to the specified joint or part of a phalanx.

28285Hammertoe repairLesser-toe deformity correction

28285 is for hammertoe correction. Code 28160 describes joint or partial-phalanx excision; select according to the procedure actually performed.

Codes related to 28160

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