Billing code 28108: Toe bone lesionMedicare rate & RVUs
Reports operative removal or curettage of a benign bone lesion in a toe phalanx, rather than a lesion in the metatarsal or tarsal bones.
Medicare pays $431.21 for 28108 nationally in the office and $274.22 in a hospital or facility. Local office rates run $385.31–$562.63.
Medicare rate · 28108
Toe bone lesion
Swap in your local Medicare rate.
- Work RVUs
- 4.19
- Total RVUs
- 12.91
- Global days
- 090
National rate · 2026
$431.21
Office setting, before claim adjustments.
See every locality for 28108 → · Billed by an NP, PA or therapist? →
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 10 sections
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
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$385.31 to $562.63
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $390.46 | $253.10 |
| Alaska* | $512.90 | $345.71 |
| Arizona | $420.59 | $268.47 |
| Arkansas | $385.31 | $250.46 |
| Atlanta | $438.88 | $279.38 |
| Austin | $445.97 | $279.88 |
| Bakersfield | $454.99 | $282.94 |
| Baltimore/Surr. Cntys | $457.01 | $288.56 |
| Beaumont | $405.26 | $262.40 |
| Brazoria | $426.74 | $271.17 |
| Chicago | $451.74 | $293.97 |
| Chico | $453.69 | $281.63 |
| Colorado | $447.56 | $280.52 |
| Connecticut | $458.30 | $289.23 |
| Dallas | $429.36 | $273.01 |
| Dc + Md/Va Suburbs | $489.69 | $304.77 |
| Delaware | $427.16 | $272.06 |
| Detroit | $431.13 | $279.64 |
| East St. Louis | $423.25 | $278.83 |
| El Centro | $453.76 | $281.70 |
| Fort Lauderdale | $446.14 | $287.12 |
| Fort Worth | $426.77 | $271.99 |
| Fresno | $453.69 | $281.63 |
| Galveston | $427.97 | $272.09 |
| Hanford-Corcoran | $453.69 | $281.63 |
| Hawaii, Guam | $463.28 | $284.79 |
| Houston | $435.66 | $279.77 |
| Idaho | $401.63 | $257.21 |
| Indiana | $403.76 | $258.23 |
| Iowa | $399.18 | $255.54 |
| Kansas | $397.63 | $255.72 |
| Kentucky | $399.24 | $259.68 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $482.96 | $297.25 |
| Madera | $453.69 | $281.63 |
| Manhattan | $493.29 | $310.88 |
| Merced | $453.69 | $281.63 |
| Metropolitan Boston | $489.18 | $301.74 |
| Metropolitan Kansas City | $413.97 | $266.56 |
| Metropolitan Philadelphia | $447.80 | $284.38 |
| Metropolitan St. Louis | $417.93 | $268.48 |
| Miami | $464.02 | $300.60 |
| Minnesota | $429.37 | $267.83 |
| Mississippi | $389.01 | $253.85 |
| Modesto | $453.69 | $281.63 |
| Montana** | $431.18 | $274.19 |
| Napa | $521.28 | $314.37 |
| Nebraska | $401.13 | $256.24 |
| Nevada** | $429.14 | $272.00 |
| New Hampshire | $440.82 | $277.40 |
| New Mexico | $411.02 | $267.06 |
| New Orleans | $416.76 | $269.03 |
| North Carolina | $407.57 | $261.10 |
| North Dakota** | $422.87 | $265.89 |
| Northern Nj | $485.33 | $303.23 |
| Nyc Suburbs/Long Island | $504.58 | $317.93 |
| Ohio | $407.20 | $263.87 |
| Oklahoma | $398.41 | $258.23 |
| Oxnard-Thousand Oaks-Ventura | $480.29 | $294.74 |
| Portland | $460.63 | $286.22 |
| Poughkpsie/N Nyc Suburbs | $466.79 | $294.89 |
| Puerto Rico | $434.04 | $275.33 |
| Queens | $496.82 | $311.26 |
| Redding | $453.69 | $281.63 |
| Rest Of California | $453.69 | $281.63 |
| Rest Of Florida | $426.06 | $275.99 |
| Rest Of Georgia | $403.96 | $263.93 |
| Rest Of Illinois | $414.98 | $271.66 |
| Rest Of Louisiana | $398.74 | $259.80 |
| Rest Of Maine | $403.72 | $259.30 |
| Rest Of Maryland | $434.78 | $275.91 |
| Rest Of Massachusetts | $445.29 | $279.99 |
| Rest Of Michigan | $408.90 | $265.57 |
| Rest Of Missouri | $392.58 | $257.26 |
| Rest Of New Jersey | $463.67 | $292.24 |
| Rest Of New York | $413.18 | $264.04 |
| Rest Of Oregon | $425.93 | $269.57 |
| Rest Of Pennsylvania | $407.70 | $263.59 |
| Rest Of Texas | $415.71 | $266.73 |
| Rest Of Washington | $444.37 | $279.06 |
| Rhode Island | $441.50 | $279.33 |
| Riverside-San Bernardino-Ontario | $458.28 | $286.22 |
| Sacramento-Roseville-Folsom | $474.92 | $292.35 |
| Salinas | $473.11 | $291.17 |
| San Diego-Chula Vista-Carlsbad | $483.32 | $295.56 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $550.57 | $329.23 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $550.10 | $328.75 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $562.63 | $336.25 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $560.68 | $334.30 |
| San Luis Obispo-Paso Robles | $465.61 | $286.81 |
| Santa Cruz-Watsonville | $487.24 | $296.50 |
| Santa Maria-Santa Barbara | $474.63 | $291.59 |
| Santa Rosa-Petaluma | $492.10 | $299.33 |
| Seattle (King Cnty) | $498.57 | $305.95 |
| South Carolina | $408.03 | $262.98 |
| South Dakota** | $421.89 | $264.91 |
| Southern Maine | $423.53 | $267.96 |
| Stockton | $453.69 | $281.63 |
| Suburban Chicago | $450.50 | $289.28 |
| Tennessee | $399.48 | $256.78 |
| Utah | $413.14 | $265.58 |
| Vallejo | $520.59 | $313.69 |
| Vermont | $421.50 | $266.09 |
| Virgin Islands | $434.04 | $275.33 |
| Virginia | $422.37 | $268.05 |
| Visalia | $453.69 | $281.63 |
| West Virginia | $400.94 | $264.52 |
| Wisconsin | $409.85 | $259.46 |
| Wyoming** | $427.56 | $270.57 |
| Yuba City | $453.69 | $281.63 |
28108 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.
$385.31
$512.90
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 | $512.90 | 1 |
| AL | $390.46 | 1 |
| AR | $385.31 | 1 |
| AZ | $420.59 | 1 |
| CA | $453.69–$562.63 | 29 |
| CO | $447.56 | 1 |
| CT | $458.30 | 1 |
| DC | $489.69 | 1 |
| DE | $427.16 | 1 |
| FL | $426.06–$464.02 | 3 |
| GA | $403.96–$438.88 | 2 |
| GU | $463.28 | 1 |
| HI | $463.28 | 1 |
| IA | $399.18 | 1 |
| ID | $401.63 | 1 |
| IL | $414.98–$451.74 | 4 |
| IN | $403.76 | 1 |
| KS | $397.63 | 1 |
| KY | $399.24 | 1 |
| LA | $398.74–$416.76 | 2 |
| MA | $445.29–$489.18 | 2 |
| MD | $434.78–$489.69 | 3 |
| ME | $403.72–$423.53 | 2 |
| MI | $408.90–$431.13 | 2 |
| MN | $429.37 | 1 |
| MO | $392.58–$417.93 | 3 |
| MS | $389.01 | 1 |
| MT | $431.18 | 1 |
| NC | $407.57 | 1 |
| ND | $422.87 | 1 |
| NE | $401.13 | 1 |
| NH | $440.82 | 1 |
| NJ | $463.67–$485.33 | 2 |
| NM | $411.02 | 1 |
| NV | $429.14 | 1 |
| NY | $413.18–$504.58 | 5 |
| OH | $407.20 | 1 |
| OK | $398.41 | 1 |
| OR | $425.93–$460.63 | 2 |
| PA | $407.70–$447.80 | 2 |
| PR | $434.04 | 1 |
| RI | $441.50 | 1 |
| SC | $408.03 | 1 |
| SD | $421.89 | 1 |
| TN | $399.48 | 1 |
| TX | $405.26–$445.97 | 8 |
| UT | $413.14 | 1 |
| VA | $422.37–$489.69 | 2 |
| VI | $434.04 | 1 |
| VT | $421.50 | 1 |
| WA | $444.37–$498.57 | 2 |
| WI | $409.85 | 1 |
| WV | $400.94 | 1 |
| WY | $427.56 | 1 |
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
Swap in your local Medicare rate.
Work 4.19Practice expense 8.30Malpractice 0.42
All indexes start 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
| 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| 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 · 28108
Toe bone lesion
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 51 · payment effect
With and without the modifier
28108 without 51 · national office
$431.21
Toe bone lesion
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%).
28108 compared with similar codes
Compare codes
28108 vs 28106 vs 28104 vs 28124 vs 28126: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 28106Foot bone lesion
- Use 28106 for a benign bone lesion in a metatarsal. Use 28108 when the involved bone is a toe phalanx.
- 28104Bone lesion excision
- 28104 applies to specified tarsal bones, not toe phalanges. Identify the bone containing the lesion before choosing between them.
- 28124Toe bone 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 excision
- 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
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