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CMS RVU26D · Effective 2026-10-01

28054 in Austin

Office / nonfacility

$370.30

Base rate per service

Facility setting

$227.18

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Foot surgery

About 28054: Toe joint lining biopsy

Reports surgical sampling of synovial lining from a toe joint when tissue is needed to investigate a joint condition.

A surgeon obtains a tissue sample from the synovial lining of a toe joint for diagnostic evaluation. This may be performed by a podiatric surgeon or an orthopedic foot and ankle surgeon in an operating room when a joint disorder requires tissue examination, such as suspected inflammatory or proliferative synovial disease. The specimen is submitted for examination; the service is sampling, not removal of the joint lining as treatment.

Report the code when the operative record identifies the toe joint sampled and documents that lining tissue was obtained for biopsy. It has a 90-day global period, including the day-before preoperative visit and 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 multiple procedure reduction. For bilateral reporting, modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.

CMS billing rules for 28054

Global period
Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
Multiple procedures
Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
Bilateral procedures
Bilateral procedure with modifier 50 is paid at 150%.
Assistant at surgery
Assistant at surgery is paid only with documentation of medical necessity.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU3.48 · 32%
  • Practice expense (office) RVU6.94 · 65%
  • Malpractice RVU0.29 · 3%

34

Medicare services in 2024 · #5578 by national volume

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.

28054 compared with similar codes

Office rates for Austin, from the same CMS release.

28050

Joint biopsy

Foot joint lining

$420.64

This code concerns a foot-joint lining biopsy; 28054 is for a toe-joint lining biopsy. Base selection on the joint sampled and the full code descriptor.

28052

Joint biopsy

Metatarsophalangeal joint

$393.79

Code 28052 is another foot-joint lining biopsy code. Code 28054 identifies biopsy of toe-joint lining.

28024

Toe joint exploration

Interphalangeal joint

$489.68

Code 28024 describes exploration of a toe joint. Use 28054 when the operative service includes sampling the joint lining for diagnostic evaluation.

28072

Joint synovectomy

Foot metatarsophalangeal joint

$519.72

Code 28072 concerns removal of toe-joint lining, whereas 28054 represents biopsy sampling rather than therapeutic removal.

The same code, a different location

How does Austin compare?

In Beaumont, the office rate for 28054 is $336.17—$34.13 lower than the $370.30 rate in Austin. Both use the same code, release and participation basis.

28054 across payment areas

Same release and payment basis · bars start at $0

  1. Austin · This locality

    $370.30

  2. Beaumont

    $336.17

    $34.13 lower than Austin

  3. Brazoria

    $354.44

    $15.86 lower than Austin

  4. Dallas

    $356.47

    $13.83 lower than Austin

  5. Fort Worth

    $354.27

    $16.03 lower than Austin

  6. Galveston

    $355.36

    $14.94 lower than Austin

  7. Houston

    $360.67

    $9.63 lower than Austin

Other payment areas listed in Texas appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 28054 ranges from $320.34 in Arkansas to $468.47 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Rest Of Texas

    Texas · 28054

    Office

    $344.96

    Facility

    $216.59

    $25.34 lower than Austin for the office setting.

  • Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    California · 28054

    Office

    $401.65

    Facility

    $241.63

    $31.35 higher than Austin for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 28054

    Office

    $406.36

    Facility

    $247.00

    $36.06 higher than Austin for the office setting.

  • Miami

    Florida · 28054

    Office

    $382.04

    Facility

    $241.22

    $11.74 higher than Austin for the office setting.

  • Chicago

    Illinois · 28054

    Office

    $372.24

    Facility

    $236.29

    $1.94 higher than Austin for the office setting.

  • Manhattan

    New York · 28054

    Office

    $408.39

    Facility

    $251.20

    $38.09 higher than Austin for the office setting.

  • Alaska*

    Alaska · 28054

    Office

    $426.56

    Facility

    $282.49

    $56.26 higher than Austin for the office setting.

  • Alabama

    Alabama · 28054

    Office

    $324.54

    Facility

    $206.18

    $45.76 lower than Austin for the office setting.

  • Arkansas

    Arkansas · 28054

    Office

    $320.34

    Facility

    $204.14

    $49.96 lower than Austin for the office setting.

  • Arizona

    Arizona · 28054

    Office

    $349.14

    Facility

    $218.06

    $21.16 lower than Austin for the office setting.

  • Bakersfield

    California · 28054

    Office

    $378.40

    Facility

    $230.14

    $8.10 higher than Austin for the office setting.

  • Chico

    California · 28054

    Office

    $377.46

    Facility

    $229.20

    $7.16 higher than Austin for the office setting.

  • El Centro

    California · 28054

    Office

    $377.51

    Facility

    $229.25

    $7.21 higher than Austin for the office setting.

  • Fresno

    California · 28054

    Office

    $377.46

    Facility

    $229.20

    $7.16 higher than Austin for the office setting.

  • Hanford-Corcoran

    California · 28054

    Office

    $377.46

    Facility

    $229.20

    $7.16 higher than Austin for the office setting.

  • Madera

    California · 28054

    Office

    $377.46

    Facility

    $229.20

    $7.16 higher than Austin for the office setting.

  • Merced

    California · 28054

    Office

    $377.46

    Facility

    $229.20

    $7.16 higher than Austin for the office setting.

  • Modesto

    California · 28054

    Office

    $377.46

    Facility

    $229.20

    $7.16 higher than Austin for the office setting.

  • Napa

    California · 28054

    Office

    $433.99

    Facility

    $255.70

    $63.69 higher than Austin for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 28054

    Office

    $399.51

    Facility

    $239.62

    $29.21 higher than Austin for the office setting.

  • Redding

    California · 28054

    Office

    $377.46

    Facility

    $229.20

    $7.16 higher than Austin for the office setting.

  • Rest Of California

    California · 28054

    Office

    $377.46

    Facility

    $229.20

    $7.16 higher than Austin for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 28054

    Office

    $380.65

    Facility

    $232.39

    $10.35 higher than Austin for the office setting.

  • Sacramento-Roseville-Folsom

    California · 28054

    Office

    $395.20

    Facility

    $237.87

    $24.90 higher than Austin for the office setting.

  • Salinas

    California · 28054

    Office

    $393.69

    Facility

    $236.91

    $23.39 higher than Austin for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 28054

    Office

    $402.21

    Facility

    $240.42

    $31.91 higher than Austin for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 28054

    Office

    $458.56

    Facility

    $267.83

    $88.26 higher than Austin for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 28054

    Office

    $458.24

    Facility

    $267.50

    $87.94 higher than Austin for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 28054

    Office

    $468.47

    Facility

    $273.41

    $98.17 higher than Austin for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 28054

    Office

    $467.13

    Facility

    $272.06

    $96.83 higher than Austin for the office setting.

  • San Luis Obispo-Paso Robles

    California · 28054

    Office

    $387.43

    Facility

    $233.35

    $17.13 higher than Austin for the office setting.

  • Santa Cruz-Watsonville

    California · 28054

    Office

    $405.51

    Facility

    $241.15

    $35.21 higher than Austin for the office setting.

  • Santa Maria-Santa Barbara

    California · 28054

    Office

    $394.96

    Facility

    $237.23

    $24.66 higher than Austin for the office setting.

  • Santa Rosa-Petaluma

    California · 28054

    Office

    $409.57

    Facility

    $243.45

    $39.27 higher than Austin for the office setting.

  • Stockton

    California · 28054

    Office

    $377.46

    Facility

    $229.20

    $7.16 higher than Austin for the office setting.

  • Vallejo

    California · 28054

    Office

    $433.52

    Facility

    $255.23

    $63.22 higher than Austin for the office setting.

  • Visalia

    California · 28054

    Office

    $377.46

    Facility

    $229.20

    $7.16 higher than Austin for the office setting.

  • Yuba City

    California · 28054

    Office

    $377.46

    Facility

    $229.20

    $7.16 higher than Austin for the office setting.

  • Colorado

    Colorado · 28054

    Office

    $371.83

    Facility

    $227.90

    $1.53 higher than Austin for the office setting.

  • Connecticut

    Connecticut · 28054

    Office

    $379.93

    Facility

    $234.24

    $9.63 higher than Austin for the office setting.

  • Delaware

    Delaware · 28054

    Office

    $354.54

    Facility

    $220.89

    $15.76 lower than Austin for the office setting.

  • Fort Lauderdale

    Florida · 28054

    Office

    $368.56

    Facility

    $231.53

    $1.74 lower than Austin for the office setting.

  • Rest Of Florida

    Florida · 28054

    Office

    $352.40

    Facility

    $223.07

    $17.90 lower than Austin for the office setting.

  • Atlanta

    Georgia · 28054

    Office

    $363.73

    Facility

    $226.29

    $6.57 lower than Austin for the office setting.

  • Rest Of Georgia

    Georgia · 28054

    Office

    $334.55

    Facility

    $213.88

    $35.75 lower than Austin for the office setting.

  • Hawaii, Guam

    Hawaii · 28054

    Office

    $385.40

    Facility

    $231.60

    $15.10 higher than Austin for the office setting.

  • Iowa

    Iowa · 28054

    Office

    $332.18

    Facility

    $208.40

    $38.12 lower than Austin for the office setting.

  • Idaho

    Idaho · 28054

    Office

    $334.07

    Facility

    $209.62

    $36.23 lower than Austin for the office setting.

  • East St. Louis

    Illinois · 28054

    Office

    $349.00

    Facility

    $224.55

    $21.30 lower than Austin for the office setting.

  • Rest Of Illinois

    Illinois · 28054

    Office

    $343.01

    Facility

    $219.51

    $27.29 lower than Austin for the office setting.

  • Suburban Chicago

    Illinois · 28054

    Office

    $372.27

    Facility

    $233.35

    $1.97 higher than Austin for the office setting.

  • Indiana

    Indiana · 28054

    Office

    $335.82

    Facility

    $210.42

    $34.48 lower than Austin for the office setting.

  • Kansas

    Kansas · 28054

    Office

    $330.67

    Facility

    $208.38

    $39.63 lower than Austin for the office setting.

  • Kentucky

    Kentucky · 28054

    Office

    $331.17

    Facility

    $210.91

    $39.13 lower than Austin for the office setting.

  • New Orleans

    Louisiana · 28054

    Office

    $345.36

    Facility

    $218.07

    $24.94 lower than Austin for the office setting.

  • Rest Of Louisiana

    Louisiana · 28054

    Office

    $330.66

    Facility

    $210.94

    $39.64 lower than Austin for the office setting.

  • Metropolitan Boston

    Massachusetts · 28054

    Office

    $406.39

    Facility

    $244.88

    $36.09 higher than Austin for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 28054

    Office

    $369.90

    Facility

    $227.46

    $0.40 lower than Austin for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 28054

    Office

    $378.80

    Facility

    $233.65

    $8.50 higher than Austin for the office setting.

  • Rest Of Maryland

    Maryland · 28054

    Office

    $360.87

    Facility

    $223.98

    $9.43 lower than Austin for the office setting.

  • Rest Of Maine

    Maine · 28054

    Office

    $335.52

    Facility

    $211.07

    $34.78 lower than Austin for the office setting.

  • Southern Maine

    Maine · 28054

    Office

    $352.06

    Facility

    $218.01

    $18.24 lower than Austin for the office setting.

  • Detroit

    Michigan · 28054

    Office

    $356.26

    Facility

    $225.72

    $14.04 lower than Austin for the office setting.

  • Rest Of Michigan

    Michigan · 28054

    Office

    $338.81

    Facility

    $215.30

    $31.49 lower than Austin for the office setting.

  • Minnesota

    Minnesota · 28054

    Office

    $357.63

    Facility

    $218.43

    $12.67 lower than Austin for the office setting.

  • Metropolitan Kansas City

    Missouri · 28054

    Office

    $343.36

    Facility

    $216.34

    $26.94 lower than Austin for the office setting.

  • Metropolitan St. Louis

    Missouri · 28054

    Office

    $346.62

    Facility

    $217.84

    $23.68 lower than Austin for the office setting.

  • Rest Of Missouri

    Missouri · 28054

    Office

    $325.48

    Facility

    $208.88

    $44.82 lower than Austin for the office setting.

  • Mississippi

    Mississippi · 28054

    Office

    $322.98

    Facility

    $206.50

    $47.32 lower than Austin for the office setting.

  • Montana**

    Montana · 28054

    Office

    $357.70

    Facility

    $222.43

    $12.60 lower than Austin for the office setting.

  • North Carolina

    North Carolina · 28054

    Office

    $338.70

    Facility

    $212.49

    $31.60 lower than Austin for the office setting.

  • North Dakota**

    North Dakota · 28054

    Office

    $351.97

    Facility

    $216.70

    $18.33 lower than Austin for the office setting.

  • Nebraska

    Nebraska · 28054

    Office

    $333.85

    Facility

    $208.99

    $36.45 lower than Austin for the office setting.

  • New Hampshire

    New Hampshire · 28054

    Office

    $366.02

    Facility

    $225.20

    $4.28 lower than Austin for the office setting.

  • Northern Nj

    New Jersey · 28054

    Office

    $402.79

    Facility

    $245.88

    $32.49 higher than Austin for the office setting.

  • Rest Of New Jersey

    New Jersey · 28054

    Office

    $384.64

    Facility

    $236.92

    $14.34 higher than Austin for the office setting.

  • New Mexico

    New Mexico · 28054

    Office

    $340.43

    Facility

    $216.39

    $29.87 lower than Austin for the office setting.

  • Nevada**

    Nevada · 28054

    Office

    $356.34

    Facility

    $220.93

    $13.96 lower than Austin for the office setting.

  • Nyc Suburbs/Long Island

    New York · 28054

    Office

    $417.27

    Facility

    $256.43

    $46.97 higher than Austin for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 28054

    Office

    $387.01

    Facility

    $238.88

    $16.71 higher than Austin for the office setting.

  • Queens

    New York · 28054

    Office

    $411.63

    Facility

    $251.74

    $41.33 higher than Austin for the office setting.

  • Rest Of New York

    New York · 28054

    Office

    $343.26

    Facility

    $214.75

    $27.04 lower than Austin for the office setting.

  • Ohio

    Ohio · 28054

    Office

    $337.63

    Facility

    $214.13

    $32.67 lower than Austin for the office setting.

  • Oklahoma

    Oklahoma · 28054

    Office

    $330.76

    Facility

    $209.96

    $39.54 lower than Austin for the office setting.

  • Portland

    Oregon · 28054

    Office

    $382.83

    Facility

    $232.54

    $12.53 higher than Austin for the office setting.

  • Rest Of Oregon

    Oregon · 28054

    Office

    $353.92

    Facility

    $219.19

    $16.38 lower than Austin for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 28054

    Office

    $371.19

    Facility

    $230.37

    $0.89 higher than Austin for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 28054

    Office

    $338.18

    Facility

    $214.00

    $32.12 lower than Austin for the office setting.

  • Puerto Rico

    Puerto Rico · 28054

    Office

    $360.13

    Facility

    $223.37

    $10.17 lower than Austin for the office setting.

  • Rhode Island

    Rhode Island · 28054

    Office

    $366.54

    Facility

    $226.80

    $3.76 lower than Austin for the office setting.

  • South Carolina

    South Carolina · 28054

    Office

    $338.65

    Facility

    $213.66

    $31.65 lower than Austin for the office setting.

  • South Dakota**

    South Dakota · 28054

    Office

    $351.29

    Facility

    $216.02

    $19.01 lower than Austin for the office setting.

  • Tennessee

    Tennessee · 28054

    Office

    $332.14

    Facility

    $209.18

    $38.16 lower than Austin for the office setting.

  • Utah

    Utah · 28054

    Office

    $342.83

    Facility

    $215.67

    $27.47 lower than Austin for the office setting.

  • Virginia

    Virginia · 28054

    Office

    $350.94

    Facility

    $217.96

    $19.36 lower than Austin for the office setting.

  • Virgin Islands

    United States Virgin Islands · 28054

    Office

    $360.13

    Facility

    $223.37

    $10.17 lower than Austin for the office setting.

  • Vermont

    Vermont · 28054

    Office

    $350.62

    Facility

    $216.70

    $19.68 lower than Austin for the office setting.

  • Rest Of Washington

    Washington · 28054

    Office

    $369.21

    Facility

    $226.76

    $1.09 lower than Austin for the office setting.

  • Seattle (King Cnty)

    Washington · 28054

    Office

    $414.38

    Facility

    $248.40

    $44.08 higher than Austin for the office setting.

  • Wisconsin

    Wisconsin · 28054

    Office

    $341.29

    Facility

    $211.69

    $29.01 lower than Austin for the office setting.

  • West Virginia

    West Virginia · 28054

    Office

    $331.53

    Facility

    $213.98

    $38.77 lower than Austin for the office setting.

  • Wyoming**

    Wyoming · 28054

    Office

    $355.21

    Facility

    $219.93

    $15.09 lower than Austin for the office setting.

See how rates vary across the country

28054 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

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.

$320.34

$426.56

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$426.561
AL$324.541
AR$320.341
AZ$349.141
CA$377.46–$468.4729
CO$371.831
CT$379.931
DC$406.361
DE$354.541
FL$352.40–$382.043
GA$334.55–$363.732
GU$385.401
HI$385.401
IA$332.181
ID$334.071
IL$343.01–$372.274
IN$335.821
KS$330.671
KY$331.171
LA$330.66–$345.362
MA$369.90–$406.392
MD$360.87–$406.363
ME$335.52–$352.062
MI$338.81–$356.262
MN$357.631
MO$325.48–$346.623
MS$322.981
MT$357.701
NC$338.701
ND$351.971
NE$333.851
NH$366.021
NJ$384.64–$402.792
NM$340.431
NV$356.341
NY$343.26–$417.275
OH$337.631
OK$330.761
OR$353.92–$382.832
PA$338.18–$371.192
PR$360.131
RI$366.541
SC$338.651
SD$351.291
TN$332.141
TX$336.17–$370.308
UT$342.831
VA$350.94–$406.362
VI$360.131
VT$350.621
WA$369.21–$414.382
WI$341.291
WV$331.531
WY$355.211

Explore 28054 on the national rate map →

Where does this rate apply?

Austin is a Medicare payment area. Our Census mapping connects it to 31 cities and communities in Texas, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in Texas →

Why are the office and facility amounts different?

For 28054 in Austin, the physician’s office rate is $370.30 and the facility-setting rate is $227.18: a difference of $143.12.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 28054 in Austin. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$407.33

$370.30 × 110% = $407.33

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

Compare your contract offer →

How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 28054 in Austin.

PPRRVU2026_Oct_nonQPP.csv

3,106

Code
28054
Physician work
3.48
Practice expense
6.94
Malpractice
0.29

GPCI2026.csv

96

Locality
Austin
Physician work
1.002
Practice expense
1.058
Malpractice
0.886
Office / nonfacility calculation for 28054 in Austin
ComponentRVULocality factorAdjusted
Physician work3.48× 1.0023.4870
Practice expense6.94× 1.0587.3425
Malpractice0.29× 0.8860.2569
Total RVUs11.0864
Conversion factor× 33.4009

Office / nonfacility rate, Austin$370.30

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 28054 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work3.481.002
Practice expense6.941.058
Malpractice0.290.886

(3.48 × 1.002 + 6.94 × 1.058 + 0.29 × 0.886) × $33.4009 = $370.30

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work3.481.002
Practice expense2.891.058
Malpractice0.290.886

(3.48 × 1.002 + 2.89 × 1.058 + 0.29 × 0.886) × $33.4009 = $227.18

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

28054 · Office / nonfacility

$370.30

Effective 2026-10-01

The base rate is $6.66 higher than on 2025-10-01, moving from $363.64 to $370.30 (1.8%).

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

    $363.64changed to$370.30

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.57 changed to 3.48
    • Practice expense RVU 7.09 changed to 6.94
    • Malpractice RVU 0.28 changed to 0.29
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 1.046 changed to 1.058
    • Malpractice GPCI 0.914 changed to 0.886

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $363.64

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$370.30$227.18RVU26D
2026-07-01$370.30$227.18RVU26C
2026-04-01$370.30$227.18RVU26B
2026-01-01$370.30$227.18RVU26A
2025-10-01$363.64$236.09RVU25D
2025-07-01$363.64$236.09RVU25C
2025-04-01$363.64$236.09RVU25B
2025-01-01$363.64$236.09RVU25A

28054 billing questions

How is this different from a foot-joint lining biopsy?

This code is for tissue sampled from a toe joint. Codes 28050 and 28052 describe foot-joint lining biopsies; select according to the joint and the applicable full code descriptor.

When would a toe-joint exploration code be used instead?

Code 28024 describes exploration of a toe joint. Report 28054 when synovial lining tissue is sampled for diagnostic evaluation, rather than reporting exploration alone.

How does biopsy differ from removal of toe-joint lining?

A biopsy takes tissue for diagnosis. Code 28072 is associated with removal of toe-joint lining as a therapeutic procedure.

What documentation supports reporting this code?

The operative note should identify the toe joint, describe obtaining synovial lining tissue, and state the diagnostic reason for the sample.

How is bilateral performance reported?

CMS treats this as a bilateral procedure: modifier 50 is paid at 150% when the procedure is performed bilaterally.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 28054PPRRVU2026_Oct_nonQPP.csv, line 3,106 (RVU26D)
Geographic factors for AustinGPCI2026.csv, line 96 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet