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

Reports excision at a toe interphalangeal joint or removal of part of a phalanx, such as for a painful rigid toe deformity.

CMS RVU26DEffective Oct 1, 2026One payment locality1.2K Medicare services in 2024

In Queens, NY, Medicare pays $469.35 for 28160 in the office and $290.51 when it’s performed in a hospital or facility.

$469.35Office (non-facility)
$290.51Hospital or facility
+15.4%vs the national office rate ($406.82)

Check a contract rate as a % of Medicare · 28160 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 28160 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Queens, NY
  2. What 28160 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 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.

How Queens, NY compares for 28160

Across 109 of 109 payment localities, the office rate for 28160 runs from $362.78 in Arkansas to $532.92 in San Benito County, CA. Queens, NY pays $469.35. The RVUs are the same everywhere; the geographic indexes change the dollars.

28160 in Queens, NY vs other payment areas
  1. Queens, NY · this page$469.35
  2. Manhattan, NY · New York$465.88−$3.47
  3. NYC suburbs and Long Island, NY · New York$476.63+$7.28
  4. Poughkeepsie and northern NYC suburbs, NY · New York$440.66−$28.69
  5. Rest of New York · New York$389.58−$79.77
  6. Los Angeles, CA · California$456.58−$12.77
  7. Washington, DC area · District of Columbia$462.74−$6.61

Other areas in New York first, then benchmark localities. Bars start at $0.

Every other payment area

28160 in every other Medicare payment locality
Payment localityOfficeFacility
Miami, FLFlorida$437.71$280.20
Chicago, ILIllinois$425.91$273.85
AlaskaAlaska$481.49$320.35
AlabamaAlabama$367.73$235.33
ArkansasArkansas$362.78$232.81
ArizonaArizona$396.65$250.04
Bakersfield, CACalifornia$429.81$263.98
Chico, CACalifornia$428.61$262.78

28160 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$362.78

$481.49

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

View every state and territory as a table
28160 office rate range by state
State / territoryOffice rate rangeLocalities
AK$481.491
AL$367.731
AR$362.781
AZ$396.651
CA$428.61–$532.9229
CO$422.611
CT$432.681
DC$462.741
DE$402.931
FL$401.60–$437.713
GA$380.43–$414.102
GU$437.991
HI$437.991
IA$376.231
ID$378.551
IL$390.88–$425.914
IN$380.601
KS$374.681
KY$376.021
LA$375.51–$392.812
MA$420.38–$462.472
MD$410.23–$462.743
ME$380.50–$399.612
MI$385.23–$406.402
MN$405.411
MO$369.56–$394.013
MS$366.231
MT$406.801
NC$384.201
ND$399.091
NE$378.121
NH$416.161
NJ$437.75–$458.472
NM$387.241
NV$404.921
NY$389.58–$476.635
OH$383.651
OK$375.291
OR$401.88–$435.212
PA$384.17–$422.582
PR$409.571
RI$416.641
SC$384.541
SD$398.171
TN$376.451
TX$381.82–$421.118
UT$389.441
VA$398.45–$462.742
VI$409.571
VT$397.711
WA$419.53–$471.482
WI$386.571
WV$377.391
WY$403.441

See 28160 in every payment locality

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.

How the rate is built · 28160

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.78

3.78 RVUs× 1.000 GPCI

Practice expense8.01

8.01 RVUs× 1.000 GPCI

Malpractice0.39

0.39 RVUs× 1.000 GPCI

Adjusted RVUs

12.1800

Conversion factor

$33.4009

Medicare rate

$406.82

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

The exact Queens, NY inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,140

Code
28160
Physician work
3.78
Practice expense
8.01
Malpractice
0.39

GPCI2026.csv

81

Locality
Queens, NY
Physician work
1.064
Practice expense
1.182
Malpractice
1.442
Office calculation for 28160 in Queens, NY
ComponentRVULocality factorAdjusted
Physician work3.78× 1.0644.0219
Practice expense8.01× 1.1829.4678
Malpractice0.39× 1.4420.5624
Total RVUs14.0521
Conversion factor× 33.4009

Office rate, Queens, NY$469.35

Office: (3.78 × 1.064 + 8.01 × 1.182 + 0.39 × 1.442) × $33.4009 = $469.35

Facility: (3.78 × 1.064 + 3.48 × 1.182 + 0.39 × 1.442) × $33.4009 = $290.51

Open 28160 in the RVU calculator

Payment rules and modifiers for 28160

28160 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 28160

Toe bone excision, joint or partial phalanx

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 · 28160

Toe bone excision, joint or partial phalanx

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

28160 without 51 · national office

$406.82

Toe bone excision, joint or partial phalanx

28160-51 · Second procedure: 50%

$203.41

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

Codes related to 28160

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

Codes related to 28160
CodeHow it relatesOffice range, Queens, NY
Used instead
28124Toe bone excision, partial phalanx excisionUsed for partial phalanx excision when the documented work fits that code.$545.46
28126Toe bone excision, complete phalanx removalFor resection of toe phalanx condyle(s), rather than the joint or partial-phalanx work here.$446.88
28150Toe amputation, at the MTP jointRepresents more extensive removal of a toe rather than the excision described here.$477.05
28285Hammertoe repair, lesser-toe deformity correctionFor hammertoe correction when the operative work meets that code's description.$632.05

How 28160 has changed in Queens, NY

28160 · Office / nonfacility

$469.35

Effective 2026-10-01

The base rate is $11.19 higher than on 2025-10-01, moving from $458.16 to $469.35 (2.4%).

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

    $458.16changed to$469.35

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.88 changed to 3.78
    • Practice expense RVU 7.93 changed to 8.01
    • Malpractice RVU 0.38 changed to 0.39
    • Work GPCI 1.065 changed to 1.064
    • Practice expense GPCI 1.195 changed to 1.182
    • Malpractice GPCI 1.462 changed to 1.442

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $474.18changed to$458.16

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 8.01 changed to 7.93
    • Malpractice RVU 0.37 changed to 0.38

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $466.44changed to$474.18

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $488.70changed to$466.44

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 7.89 changed to 8.01
    • Malpractice RVU 0.36 changed to 0.37
    • Work GPCI 1.061 changed to 1.065
    • Practice expense GPCI 1.212 changed to 1.195
    • Malpractice GPCI 2.061 changed to 1.462

  5. January 1, 2023

    RVU23A

    $513.00changed to$488.70

    • Conversion factor 34.6062 changed to 33.8872
    • Malpractice RVU 0.39 changed to 0.36
    • Work GPCI 1.056 changed to 1.061
    • Practice expense GPCI 1.228 changed to 1.212
    • Malpractice GPCI 2.661 changed to 2.061

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $520.90changed to$513.00

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 8.04 changed to 7.89
    • Malpractice RVU 0.36 changed to 0.39

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $518.19changed to$520.90

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 7.73 changed to 8.04
    • Malpractice RVU 0.37 changed to 0.36
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.214 changed to 1.228
    • Malpractice GPCI 2.391 changed to 2.661

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $511.72changed to$518.19

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 7.83 changed to 7.73
    • Malpractice RVU 0.34 changed to 0.37
    • Work GPCI 1.052 changed to 1.054
    • Practice expense GPCI 1.200 changed to 1.214
    • Malpractice GPCI 2.121 changed to 2.391

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $512.45changed to$511.72

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 7.86 changed to 7.83

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $513.73changed to$512.45

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 7.90 changed to 7.86
    • Malpractice RVU 0.35 changed to 0.34
    • Malpractice GPCI 2.151 changed to 2.121

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $514.69changed to$513.73

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 7.93 changed to 7.90
    • Malpractice RVU 0.36 changed to 0.35
    • Practice expense GPCI 1.199 changed to 1.200
    • Malpractice GPCI 2.181 changed to 2.151

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $518.19changed to$514.69

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 7.95 changed to 7.93
    • Malpractice RVU 0.37 changed to 0.36

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $515.61changed to$518.19

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $505.06changed to$515.61

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 7.80 changed to 7.95
    • Malpractice RVU 0.36 changed to 0.37
    • Work GPCI 1.057 changed to 1.052
    • Practice expense GPCI 1.197 changed to 1.199
    • Malpractice GPCI 1.836 changed to 2.181

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $507.91changed to$505.06

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 8.57 changed to 7.80
    • Malpractice RVU 0.38 changed to 0.36
    • Work GPCI 1.062 changed to 1.057
    • Practice expense GPCI 1.195 changed to 1.197
    • Malpractice GPCI 1.491 changed to 1.836

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $507.91

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$469.35$290.51RVU26D
2026-07-01$469.35$290.51RVU26C
2026-04-01$469.35$290.51RVU26B
2026-01-01$469.35$290.51RVU26A
2025-10-01$458.16$303.16RVU25D
2025-07-01$458.16$303.16RVU25C
2025-04-01$458.16$303.16RVU25B
2025-01-01$458.16$303.16RVU25A
2024-10-01$474.18$308.70RVU24D
2024-07-01$474.18$308.70RVU24C
2024-04-01$474.18$308.70RVU24B
2024-03-09$474.18$308.70RVU24AR
2024-01-01$466.44$303.67RVU24A
2023-10-01$488.70$316.20RVU23D
2023-07-01$488.70$316.20RVU23C
2023-04-01$488.70$316.20RVU23B
2023-01-01$488.70$316.20RVU23A
2022-10-01$513.00$330.27RVU22D
2022-07-01$513.00$330.27RVU22C
2022-04-01$513.00$330.27RVU22B
2022-01-01$513.00$330.27RVU22A
2021-10-01$520.90$328.08RVU21D
2021-07-01$520.90$328.08RVU21C
2021-04-01$520.90$328.08RVU21B
2021-01-01$520.90$328.08RVU21A
2020-10-01$518.19$330.23RVU20D
2020-07-01$518.19$330.23RVU20C
2020-04-01$518.19$330.23RVU20B
2020-01-01$518.19$330.23RVU20A
2019-10-01$511.72$323.59RVU19D
2019-07-01$511.72$323.59RVU19C
2019-04-01$511.72$323.59RVU19B
2019-01-01$511.72$323.59RVU19A
2018-10-01$512.45$323.67RVU18D
2018-07-01$512.45$323.67RVU18C
2018-04-01$512.45$323.67RVU18B
2018-01-01$512.45$323.67RVU18AR1
2017-10-01$513.73$324.67RVU17D
2017-07-01$513.73$324.67RVU17C
2017-04-01$513.73$324.67RVU17B
2017-01-01$513.73$324.67RVU17A
2016-10-01$514.69$325.80RVU16D
2016-07-01$514.69$325.80RVU16C
2016-04-01$514.69$325.80RVU16B
2016-01-01$514.69$325.80RVU16A
2015-10-01$518.19$327.76RVU15D
2015-07-01$518.19$327.76RVU15C
2015-04-01$515.61$326.13RVU15B
2015-01-01$515.61$326.13RVU15A
2014-10-01$505.06$319.81RVU14D
2014-07-01$505.06$319.81RVU14C
2014-04-01$505.06$319.81RVU14B
2014-01-01$505.06$319.81RVU14A
2013-10-01$507.91$313.56RVU13D
2013-07-01$507.91$313.56RVU13C
2013-04-01$507.91$313.56RVU13B
2013-01-01$507.91$313.56RVU13AR

Price 28160 for an earlier date of service

Where the Queens, NY rate applies

Queens, NY is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in New York. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in New York

28160 billing questions

How does this differ from partial phalanx excision code 28124?

Choose based on the operative work documented. Code 28160 describes excision involving a toe interphalangeal joint or part of a phalanx; 28124 is for partial phalanx excision.

Is this the same as hammertoe correction?

No. Code 28160 represents the specified joint or phalanx excision. Use 28285 when the surgeon performs the hammertoe correction described by that code.

Can modifier 50 be reported when both feet are treated?

No. CMS identifies bilateral adjustment as inappropriate for this code. Do not use modifier 50.

What postoperative care is included?

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

Can an assistant surgeon or co-surgeon be paid?

Medicare does not pay an assistant at surgery for this code, and 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
RVUs for 28160PPRRVU2026_Oct_nonQPP.csv, line 3,140 (RVU26D)
Geographic factors for Queens, NYGPCI2026.csv, line 81 (RVU26D)

Open CMS sourceHow we calculate rates

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