$372.75
Both codes address a foot or toe lesion under 1.5 cm; choose 28045 for a deep lesion and 28043 when it is subcutaneous.
On this page
CMS RVU26D · Effective 2026-10-01
28045 Foot mass excision Medicare reimbursement rates in Arizona
Reports surgical removal of a deep soft-tissue mass in the foot or toe when the lesion measures less than 1.5 cm. Compare 28045 office and facility rates across CMS payment localities in Arizona.
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.
What does Medicare pay for 28045 in Arizona?
Arizona has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$473.41
1 of 1 localities have a supported rate.
Payment area: Arizona
One mapped payment locality.
Facility setting
$322.58
1 of 1 localities have a supported rate.
Payment area: Arizona
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Foot surgery
About 28045: Deep foot or toe mass excision under 1.5 cm
Reports surgical removal of a deep soft-tissue mass in the foot or toe when the lesion measures less than 1.5 cm.
A foot or ankle surgeon, often an orthopedic surgeon or podiatrist, uses this code for excision of a small mass in the foot or toe that lies in deeper tissue rather than being confined to the subcutaneous layer. The service involves surgically exposing and removing the lesion; the setting may be an operating room or an office procedure setting, depending on the case and resources needed.
Select this code when the documented lesion is in the foot or toe, is deep, and measures less than 1.5 cm. The operative report should identify the site, depth, lesion size, and removal performed; pathology findings may further describe the specimen. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with 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 28045
- 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 RVU5.31 · 37%
- Practice expense (office) RVU8.67 · 60%
- Malpractice RVU0.54 · 4%
1.1K
Medicare services in 2024 · #2893 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.
28045 compared with similar codes
Office rates for Arizona, from the same CMS release.
No office rate
Both describe excision of a deep foot or toe lesion. The size threshold separates them: 28045 is under 1.5 cm, while 28041 is 1.5 cm or greater.
No office rate
This code describes excision of a deep lesion under 1.5 cm. Code 28046 is for resection of a foot or toe tumor under 3 cm.
Compare 28045 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Arizona →
Office / nonfacility
$473.41
Facility
$322.58
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 28045 in Arizona.
PPRRVU2026_Oct_nonQPP.csv
3,101
- Code
- 28045
- Physician work
- 5.31
- Practice expense
- 8.67
- Malpractice
- 0.54
GPCI2026.csv
6
- Locality
- Arizona
- Physician work
- 1.000
- Practice expense
- 0.969
- Malpractice
- 0.856
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.31 | × 1.000 | 5.3100 |
| Practice expense | 8.67 | × 0.969 | 8.4012 |
| Malpractice | 0.54 | × 0.856 | 0.4622 |
| Total RVUs | 14.1735 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Arizona$473.41
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.31 | 1 |
| Practice expense | 8.67 | 0.969 |
| Malpractice | 0.54 | 0.856 |
(5.31 × 1 + 8.67 × 0.969 + 0.54 × 0.856) × $33.4009 = $473.41
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.31 | 1 |
| Practice expense | 4.01 | 0.969 |
| Malpractice | 0.54 | 0.856 |
(5.31 × 1 + 4.01 × 0.969 + 0.54 × 0.856) × $33.4009 = $322.58
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.
28045 billing questions
How does this code differ from 28043?
Use 28045 for a deep lesion under 1.5 cm. Code 28043 is for a lesion of that size confined to the subcutaneous layer.
Does lesion size refer to the incision?
No. Document the size of the lesion, along with its depth and foot or toe location; the incision length does not establish the size category.
When should 28041 be considered instead?
Use 28041 for a deep foot or toe lesion measuring 1.5 cm or greater. The distinction from 28045 is the documented lesion size.
How is bilateral surgery reported?
For bilateral procedures, report modifier 50; CMS pays this code at 150% under the stated bilateral rule.
Are routine postoperative visits separately included?
Related postoperative care during the 90-day global period is included, as is the day-before preoperative visit.
Can an assistant surgeon be paid for this procedure?
Assistant-at-surgery payment is available only with documentation of medical necessity. 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.
3,09828039,,Exc foot/toe tum sc 1.5 cm/>,A,,5.28,8.40,,3.57,,0.59,14.27,9.44,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,09928041,,Exc foot/toe tum dep 1.5cm/>,A,,6.95,4.83,NA,4.83,,0.83,12.61,12.61,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,10028043,,Exc foot/toe tum sc < 1.5 cm,A,,3.86,7.18,,3.15,,0.40,11.44,7.41,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,10128045,,Exc foot/toe tum deep <1.5cm,A,,5.31,8.67,,4.01,,0.54,14.52,9.86,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,10228046,,Resect foot/toe tumor < 3 cm,A,,12.07,6.28,NA,6.28,,1.46,19.81,19.81,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,10328047,,Resect foot/toe tumor 3 cm/>,A,,17.01,8.94,NA,8.94,,2.71,28.66,28.66,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,10428050,,Biopsy of foot joint lining,A,,4.28,7.54,,3.23,,0.37,12.19,7.88,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515
801112,CA,54,BAKERSFIELD,1.019,1.096,0.609
901112,CA,55,CHICO,1.017,1.096,0.536