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CMS RVU26D · Effective 2026-10-01

28124 in Houston

Office / nonfacility

$479.43

Base rate per service

Facility setting

$324.21

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 28124: Partial toe phalanx bone excision

Reports removal of a portion of a toe phalanx, such as a diseased or prominent bone segment, when the procedure does not target a specific condyle.

A podiatrist or orthopedic surgeon removes a portion of a toe phalanx to treat localized bone disease or a painful bony prominence. The procedure may be performed in an office-based surgical setting or a hospital or ambulatory surgery facility. The operative report should identify the toe, the phalanx involved, the portion removed, and the clinical reason for the excision.

Select this code when the work is partial removal of phalangeal bone, rather than a defined resection of a distal or proximal condyle or removal of a broader phalangeal segment. Related preoperative care on the day before surgery and related postoperative care for 90 days are included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.

CMS billing rules for 28124

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
Statutory restriction: assistant at surgery is not paid.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU4.88 · 34%
  • Practice expense (office) RVU8.85 · 62%
  • Malpractice RVU0.47 · 3%

10.1K

Medicare services in 2024 · #1462 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.

28124 compared with similar codes

Office rates for Houston, from the same CMS release.

28126

Toe bone excision

Complete phalanx removal

$391.05

28126 is specific to resection of the distal phalanx condyle. Choose 28124 for partial phalangeal bone removal that is not a defined distal condyle resection.

28153

Toe bone removal

Partial excision

$402.15

28153 describes resection of a proximal phalanx condyle. 28124 is the better fit when the documented work is partial bone excision without that specific condylar target.

28150

Toe amputation

At the MTP joint

$418.84

28150 is for phalangectomy, a more extensive removal of toe phalangeal bone. Use 28124 when only a portion of the phalanx is excised.

28160

Toe bone excision

Joint or partial phalanx

$410.86

28160 covers hemiphalangectomy or excision involving a toe interphalangeal joint. 28124 describes partial bone excision without that joint-focused procedure.

The same code, a different location

How does Houston compare?

In Austin, the office rate for 28124 is $489.97—$10.54 higher than the $479.43 rate in Houston. Both use the same code, release and participation basis.

28124 across payment areas

Same release and payment basis · bars start at $0

  1. Houston · This locality

    $479.43

  2. Austin

    $489.97

    $10.54 higher than Houston

  3. Beaumont

    $446.57

    $32.86 lower than Houston

  4. Brazoria

    $469.48

    $9.95 lower than Houston

  5. Dallas

    $472.35

    $7.08 lower than Houston

  6. Fort Worth

    $469.60

    $9.83 lower than Houston

  7. Galveston

    $470.83

    $8.60 lower than Houston

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, 28124 ranges from $425.00 in Arkansas to $615.59 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 · 28124

    Office

    $457.69

    Facility

    $309.35

    $21.74 lower than Houston for the office setting.

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

    California · 28124

    Office

    $529.80

    Facility

    $344.87

    $50.37 higher than Houston for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 28124

    Office

    $537.48

    Facility

    $353.34

    $58.05 higher than Houston for the office setting.

  • Miami

    Florida · 28124

    Office

    $510.42

    Facility

    $347.69

    $30.99 higher than Houston for the office setting.

  • Chicago

    Illinois · 28124

    Office

    $497.24

    Facility

    $340.14

    $17.81 higher than Houston for the office setting.

  • Manhattan

    New York · 28124

    Office

    $541.81

    Facility

    $360.17

    $62.38 higher than Houston for the office setting.

  • Alaska*

    Alaska · 28124

    Office

    $567.96

    Facility

    $401.48

    $88.53 higher than Houston for the office setting.

  • Alabama

    Alabama · 28124

    Office

    $430.53

    Facility

    $293.75

    $48.90 lower than Houston for the office setting.

  • Arkansas

    Arkansas · 28124

    Office

    $425.00

    Facility

    $290.72

    $54.43 lower than Houston for the office setting.

  • Arizona

    Arizona · 28124

    Office

    $462.87

    Facility

    $311.40

    $16.56 lower than Houston for the office setting.

  • Bakersfield

    California · 28124

    Office

    $499.63

    Facility

    $328.31

    $20.20 higher than Houston for the office setting.

  • Chico

    California · 28124

    Office

    $498.16

    Facility

    $326.83

    $18.73 higher than Houston for the office setting.

  • El Centro

    California · 28124

    Office

    $498.24

    Facility

    $326.91

    $18.81 higher than Houston for the office setting.

  • Fresno

    California · 28124

    Office

    $498.16

    Facility

    $326.83

    $18.73 higher than Houston for the office setting.

  • Hanford-Corcoran

    California · 28124

    Office

    $498.16

    Facility

    $326.83

    $18.73 higher than Houston for the office setting.

  • Madera

    California · 28124

    Office

    $498.16

    Facility

    $326.83

    $18.73 higher than Houston for the office setting.

  • Merced

    California · 28124

    Office

    $498.16

    Facility

    $326.83

    $18.73 higher than Houston for the office setting.

  • Modesto

    California · 28124

    Office

    $498.16

    Facility

    $326.83

    $18.73 higher than Houston for the office setting.

  • Napa

    California · 28124

    Office

    $570.84

    Facility

    $364.81

    $91.41 higher than Houston for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 28124

    Office

    $526.74

    Facility

    $341.97

    $47.31 higher than Houston for the office setting.

  • Redding

    California · 28124

    Office

    $498.16

    Facility

    $326.83

    $18.73 higher than Houston for the office setting.

  • Rest Of California

    California · 28124

    Office

    $498.16

    Facility

    $326.83

    $18.73 higher than Houston for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 28124

    Office

    $503.30

    Facility

    $331.97

    $23.87 higher than Houston for the office setting.

  • Sacramento-Roseville-Folsom

    California · 28124

    Office

    $521.06

    Facility

    $339.26

    $41.63 higher than Houston for the office setting.

  • Salinas

    California · 28124

    Office

    $519.06

    Facility

    $337.89

    $39.63 higher than Houston for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 28124

    Office

    $529.93

    Facility

    $342.98

    $50.50 higher than Houston for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 28124

    Office

    $602.48

    Facility

    $382.07

    $123.05 higher than Houston for the office setting.

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

    California · 28124

    Office

    $601.95

    Facility

    $381.54

    $122.52 higher than Houston for the office setting.

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

    California · 28124

    Office

    $615.59

    Facility

    $390.18

    $136.16 higher than Houston for the office setting.

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

    California · 28124

    Office

    $613.41

    Facility

    $388.00

    $133.98 higher than Houston for the office setting.

  • San Luis Obispo-Paso Robles

    California · 28124

    Office

    $510.87

    Facility

    $332.82

    $31.44 higher than Houston for the office setting.

  • Santa Cruz-Watsonville

    California · 28124

    Office

    $533.99

    Facility

    $344.06

    $54.56 higher than Houston for the office setting.

  • Santa Maria-Santa Barbara

    California · 28124

    Office

    $520.64

    Facility

    $338.38

    $41.21 higher than Houston for the office setting.

  • Santa Rosa-Petaluma

    California · 28124

    Office

    $539.29

    Facility

    $347.34

    $59.86 higher than Houston for the office setting.

  • Stockton

    California · 28124

    Office

    $498.16

    Facility

    $326.83

    $18.73 higher than Houston for the office setting.

  • Vallejo

    California · 28124

    Office

    $570.07

    Facility

    $364.04

    $90.64 higher than Houston for the office setting.

  • Visalia

    California · 28124

    Office

    $498.16

    Facility

    $326.83

    $18.73 higher than Houston for the office setting.

  • Yuba City

    California · 28124

    Office

    $498.16

    Facility

    $326.83

    $18.73 higher than Houston for the office setting.

  • Colorado

    Colorado · 28124

    Office

    $491.73

    Facility

    $325.41

    $12.30 higher than Houston for the office setting.

  • Connecticut

    Connecticut · 28124

    Office

    $503.61

    Facility

    $335.26

    $24.18 higher than Houston for the office setting.

  • Delaware

    Delaware · 28124

    Office

    $469.98

    Facility

    $315.53

    $9.45 lower than Houston for the office setting.

  • Fort Lauderdale

    Florida · 28124

    Office

    $490.82

    Facility

    $332.47

    $11.39 higher than Houston for the office setting.

  • Rest Of Florida

    Florida · 28124

    Office

    $469.18

    Facility

    $319.74

    $10.25 lower than Houston for the office setting.

  • Atlanta

    Georgia · 28124

    Office

    $482.67

    Facility

    $323.85

    $3.24 higher than Houston for the office setting.

  • Rest Of Georgia

    Georgia · 28124

    Office

    $445.38

    Facility

    $305.95

    $34.05 lower than Houston for the office setting.

  • Hawaii, Guam

    Hawaii · 28124

    Office

    $508.18

    Facility

    $330.45

    $28.75 higher than Houston for the office setting.

  • Iowa

    Iowa · 28124

    Office

    $439.70

    Facility

    $296.67

    $39.73 lower than Houston for the office setting.

  • Idaho

    Idaho · 28124

    Office

    $442.37

    Facility

    $298.56

    $37.06 lower than Houston for the office setting.

  • East St. Louis

    Illinois · 28124

    Office

    $466.56

    Facility

    $322.75

    $12.87 lower than Houston for the office setting.

  • Rest Of Illinois

    Illinois · 28124

    Office

    $457.41

    Facility

    $314.70

    $22.02 lower than Houston for the office setting.

  • Suburban Chicago

    Illinois · 28124

    Office

    $495.53

    Facility

    $335.00

    $16.10 higher than Houston for the office setting.

  • Indiana

    Indiana · 28124

    Office

    $444.65

    Facility

    $299.74

    $34.78 lower than Houston for the office setting.

  • Kansas

    Kansas · 28124

    Office

    $438.13

    Facility

    $296.82

    $41.30 lower than Houston for the office setting.

  • Kentucky

    Kentucky · 28124

    Office

    $440.15

    Facility

    $301.18

    $39.28 lower than Houston for the office setting.

  • New Orleans

    Louisiana · 28124

    Office

    $458.99

    Facility

    $311.89

    $20.44 lower than Houston for the office setting.

  • Rest Of Louisiana

    Louisiana · 28124

    Office

    $439.64

    Facility

    $301.30

    $39.79 lower than Houston for the office setting.

  • Metropolitan Boston

    Massachusetts · 28124

    Office

    $536.59

    Facility

    $349.95

    $57.16 higher than Houston for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 28124

    Office

    $489.38

    Facility

    $324.78

    $9.95 higher than Houston for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 28124

    Office

    $502.20

    Facility

    $334.47

    $22.77 higher than Houston for the office setting.

  • Rest Of Maryland

    Maryland · 28124

    Office

    $478.18

    Facility

    $319.99

    $1.25 lower than Houston for the office setting.

  • Rest Of Maine

    Maine · 28124

    Office

    $444.71

    Facility

    $300.90

    $34.72 lower than Houston for the office setting.

  • Southern Maine

    Maine · 28124

    Office

    $465.84

    Facility

    $310.93

    $13.59 lower than Houston for the office setting.

  • Detroit

    Michigan · 28124

    Office

    $474.72

    Facility

    $323.87

    $4.71 lower than Houston for the office setting.

  • Rest Of Michigan

    Michigan · 28124

    Office

    $450.60

    Facility

    $307.88

    $28.83 lower than Houston for the office setting.

  • Minnesota

    Minnesota · 28124

    Office

    $471.81

    Facility

    $310.96

    $7.62 lower than Houston for the office setting.

  • Metropolitan Kansas City

    Missouri · 28124

    Office

    $455.90

    Facility

    $309.12

    $23.53 lower than Houston for the office setting.

  • Metropolitan St. Louis

    Missouri · 28124

    Office

    $460.14

    Facility

    $311.32

    $19.29 lower than Houston for the office setting.

  • Rest Of Missouri

    Missouri · 28124

    Office

    $433.09

    Facility

    $298.35

    $46.34 lower than Houston for the office setting.

  • Mississippi

    Mississippi · 28124

    Office

    $429.11

    Facility

    $294.52

    $50.32 lower than Houston for the office setting.

  • Montana**

    Montana · 28124

    Office

    $474.26

    Facility

    $317.95

    $5.17 lower than Houston for the office setting.

  • North Carolina

    North Carolina · 28124

    Office

    $448.82

    Facility

    $302.98

    $30.61 lower than Houston for the office setting.

  • North Dakota**

    North Dakota · 28124

    Office

    $464.97

    Facility

    $308.65

    $14.46 lower than Houston for the office setting.

  • Nebraska

    Nebraska · 28124

    Office

    $441.77

    Facility

    $297.49

    $37.66 lower than Houston for the office setting.

  • New Hampshire

    New Hampshire · 28124

    Office

    $484.45

    Facility

    $321.72

    $5.02 higher than Houston for the office setting.

  • Northern Nj

    New Jersey · 28124

    Office

    $532.92

    Facility

    $351.60

    $53.49 higher than Houston for the office setting.

  • Rest Of New Jersey

    New Jersey · 28124

    Office

    $509.53

    Facility

    $338.83

    $30.10 higher than Houston for the office setting.

  • New Mexico

    New Mexico · 28124

    Office

    $452.91

    Facility

    $309.57

    $26.52 lower than Houston for the office setting.

  • Nevada**

    Nevada · 28124

    Office

    $471.97

    Facility

    $315.49

    $7.46 lower than Houston for the office setting.

  • Nyc Suburbs/Long Island

    New York · 28124

    Office

    $554.05

    Facility

    $368.19

    $74.62 higher than Houston for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 28124

    Office

    $513.01

    Facility

    $341.84

    $33.58 higher than Houston for the office setting.

  • Queens

    New York · 28124

    Office

    $545.46

    Facility

    $360.70

    $66.03 higher than Houston for the office setting.

  • Rest Of New York

    New York · 28124

    Office

    $454.85

    Facility

    $306.35

    $24.58 lower than Houston for the office setting.

  • Ohio

    Ohio · 28124

    Office

    $448.70

    Facility

    $305.98

    $30.73 lower than Houston for the office setting.

  • Oklahoma

    Oklahoma · 28124

    Office

    $439.16

    Facility

    $299.57

    $40.27 lower than Houston for the office setting.

  • Portland

    Oregon · 28124

    Office

    $505.69

    Facility

    $332.03

    $26.26 higher than Houston for the office setting.

  • Rest Of Oregon

    Oregon · 28124

    Office

    $468.45

    Facility

    $312.76

    $10.98 lower than Houston for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 28124

    Office

    $492.38

    Facility

    $329.65

    $12.95 higher than Houston for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 28124

    Office

    $449.19

    Facility

    $305.69

    $30.24 lower than Houston for the office setting.

  • Puerto Rico

    Puerto Rico · 28124

    Office

    $477.31

    Facility

    $319.27

    $2.12 lower than Houston for the office setting.

  • Rhode Island

    Rhode Island · 28124

    Office

    $485.45

    Facility

    $323.97

    $6.02 higher than Houston for the office setting.

  • South Carolina

    South Carolina · 28124

    Office

    $449.47

    Facility

    $305.04

    $29.96 lower than Houston for the office setting.

  • South Dakota**

    South Dakota · 28124

    Office

    $463.87

    Facility

    $307.55

    $15.56 lower than Houston for the office setting.

  • Tennessee

    Tennessee · 28124

    Office

    $440.12

    Facility

    $298.03

    $39.31 lower than Houston for the office setting.

  • Utah

    Utah · 28124

    Office

    $454.96

    Facility

    $308.02

    $24.47 lower than Houston for the office setting.

  • Virginia

    Virginia · 28124

    Office

    $464.65

    Facility

    $310.99

    $14.78 lower than Houston for the office setting.

  • Virgin Islands

    United States Virgin Islands · 28124

    Office

    $477.31

    Facility

    $319.27

    $2.12 lower than Houston for the office setting.

  • Vermont

    Vermont · 28124

    Office

    $463.58

    Facility

    $308.83

    $15.85 lower than Houston for the office setting.

  • Rest Of Washington

    Washington · 28124

    Office

    $488.33

    Facility

    $323.73

    $8.90 higher than Houston for the office setting.

  • Seattle (King Cnty)

    Washington · 28124

    Office

    $546.67

    Facility

    $354.87

    $67.24 higher than Houston for the office setting.

  • Wisconsin

    Wisconsin · 28124

    Office

    $451.01

    Facility

    $301.26

    $28.42 lower than Houston for the office setting.

  • West Virginia

    West Virginia · 28124

    Office

    $442.34

    Facility

    $306.50

    $37.09 lower than Houston for the office setting.

  • Wyoming**

    Wyoming · 28124

    Office

    $470.21

    Facility

    $313.89

    $9.22 lower than Houston for the office setting.

See how rates vary across the country

28124 · 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.

$425.00

$567.96

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$567.961
AL$430.531
AR$425.001
AZ$462.871
CA$498.16–$615.5929
CO$491.731
CT$503.611
DC$537.481
DE$469.981
FL$469.18–$510.423
GA$445.38–$482.672
GU$508.181
HI$508.181
IA$439.701
ID$442.371
IL$457.41–$497.244
IN$444.651
KS$438.131
KY$440.151
LA$439.64–$458.992
MA$489.38–$536.592
MD$478.18–$537.483
ME$444.71–$465.842
MI$450.60–$474.722
MN$471.811
MO$433.09–$460.143
MS$429.111
MT$474.261
NC$448.821
ND$464.971
NE$441.771
NH$484.451
NJ$509.53–$532.922
NM$452.911
NV$471.971
NY$454.85–$554.055
OH$448.701
OK$439.161
OR$468.45–$505.692
PA$449.19–$492.382
PR$477.311
RI$485.451
SC$449.471
SD$463.871
TN$440.121
TX$446.57–$489.978
UT$454.961
VA$464.65–$537.482
VI$477.311
VT$463.581
WA$488.33–$546.672
WI$451.011
WV$442.341
WY$470.211

Explore 28124 on the national rate map →

Where does this rate apply?

Houston is a Medicare payment area. Our Census mapping connects it to 46 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 28124 in Houston, the physician’s office rate is $479.43 and the facility-setting rate is $324.21: a difference of $155.22.

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 28124 in Houston. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$527.37

$479.43 × 110% = $527.37

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 28124 in Houston.

PPRRVU2026_Oct_nonQPP.csv

3,134

Code
28124
Physician work
4.88
Practice expense
8.85
Malpractice
0.47

GPCI2026.csv

102

Locality
Houston
Physician work
1.008
Practice expense
0.993
Malpractice
1.376
Office / nonfacility calculation for 28124 in Houston
ComponentRVULocality factorAdjusted
Physician work4.88× 1.0084.9190
Practice expense8.85× 0.9938.7881
Malpractice0.47× 1.3760.6467
Total RVUs14.3538
Conversion factor× 33.4009

Office / nonfacility rate, Houston$479.43

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

Open 28124 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work4.881.008
Practice expense8.850.993
Malpractice0.471.376

(4.88 × 1.008 + 8.85 × 0.993 + 0.47 × 1.376) × $33.4009 = $479.43

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work4.881.008
Practice expense4.170.993
Malpractice0.471.376

(4.88 × 1.008 + 4.17 × 0.993 + 0.47 × 1.376) × $33.4009 = $324.21

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

28124 · Office / nonfacility

$479.43

Effective 2026-10-01

The base rate is $6.76 higher than on 2025-10-01, moving from $472.67 to $479.43 (1.4%).

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

    $472.67changed to$479.43

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 5.00 changed to 4.88
    • Practice expense RVU 8.84 changed to 8.85
    • Malpractice RVU 0.48 changed to 0.47
    • Work GPCI 1.014 changed to 1.008
    • Practice expense GPCI 1.003 changed to 0.993
    • Malpractice GPCI 1.409 changed to 1.376

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $472.67

    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$479.43$324.21RVU26D
2026-07-01$479.43$324.21RVU26C
2026-04-01$479.43$324.21RVU26B
2026-01-01$479.43$324.21RVU26A
2025-10-01$472.67$340.95RVU25D
2025-07-01$472.67$340.95RVU25C
2025-04-01$472.67$340.95RVU25B
2025-01-01$472.67$340.95RVU25A

28124 billing questions

When should I use this code instead of a condyle-resection code?

Use this code for partial removal of phalangeal bone without a specifically defined condylar resection. A distal condyle resection points to 28126; a proximal condyle resection points to 28153.

What documentation supports reporting this procedure?

Document the affected toe and phalanx, the segment of bone removed, the reason for excision, and the operative work performed. The record should distinguish a partial phalanx excision from a condylar resection or more extensive phalangectomy.

Is related postoperative care separately reported?

Related postoperative care is included in the 90-day global period, along with the preoperative visit on the day before surgery.

How does Medicare handle bilateral procedures and other procedures in the same session?

A bilateral procedure reported with modifier 50 is paid at 150%. For multiple procedures in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction.

Can an assistant surgeon or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this code. 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 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 28124PPRRVU2026_Oct_nonQPP.csv, line 3,134 (RVU26D)
Geographic factors for HoustonGPCI2026.csv, line 102 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet