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CMS RVU26D · Effective 2026-10-01

28175 Bone tumor resection Medicare reimbursement rates in California

Reports operative resection of a tumor involving a toe phalanx, when the surgeon removes the tumor-bearing bone rather than a soft-tissue lesion. Compare 28175 office and facility rates across CMS payment localities in California.

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 28175 in California?

California has 29 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 29 payment areas shown below, using the same CMS release.

Office / nonfacility

No supported rate

Facility setting

$444.79–$519.81

29 of 29 localities have a supported rate.

Lowest: Chico

Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

A spread of $75.02 per service.

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.

Find 28175 in your payment locality →

Where 28175 pays more and less in California

Foot surgery

About 28175: Toe phalanx tumor resection

Reports operative resection of a tumor involving a toe phalanx, when the surgeon removes the tumor-bearing bone rather than a soft-tissue lesion.

An orthopedic or podiatric surgeon uses this operation to remove a tumor involving a toe phalanx through operative exposure and resection of the affected bone. It is generally performed in an operating-room setting when a bone lesion requires removal beyond a superficial soft-tissue excision. The operative report should identify the involved toe and phalanx, the lesion, and the extent of bone removed.

Report 28175 for resection of a tumor in a toe phalanx, not for a lesion confined to skin or soft tissue. Documentation should connect the tumor to the phalanx and describe the resection; distinguish it from excision or curettage of a benign bone lesion. 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 one session, the highest-valued procedure is paid in full and other procedures at 50%. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

CMS billing rules for 28175

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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
Assistant at surgery
Statutory restriction: assistant at surgery is not paid.
Co-surgeons
Co-surgeons paid only with supporting documentation.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU8.08 · 62%
  • Practice expense (office) RVU4.32 · 33%
  • Malpractice RVU0.68 · 5%

12

Medicare services in 2024 · #6142 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.

28175 compared with similar codes

Office rates for California, from the same CMS release.

28108

Toe bone lesion

Phalanx of the foot

$453.69–$562.63

Use 28175 for resection of a tumor involving a toe phalanx. Code 28108 describes excision or curettage of a bone cyst or benign tumor in a foot phalanx.

28173

Bone tumor surgery

Metatarsal

No office rate

Both codes describe tumor resection, but 28173 is for a metatarsal; 28175 is for a toe phalanx.

28171

Bone tumor resection

Tarsal bone

No office rate

Both codes describe tumor resection, but 28171 is for a tarsal bone; 28175 is for a toe phalanx.

28124

Toe bone excision

Partial phalanx excision

$498.16–$615.59

Code 28124 describes partial excision of a toe bone. Use 28175 when the documented procedure is resection of a tumor involving the phalanx.

Compare 28175 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.

29 of 29 payment localities

28175 office and facility rates by payment locality
Payment localityOfficeFacility
Bakersfield

Office

Unavailable

Facility

$446.98
Chico

Office

Unavailable

Facility

$444.79
El Centro

Office

Unavailable

Facility

$444.90
Fresno

Office

Unavailable

Facility

$444.79
Hanford-Corcoran

Office

Unavailable

Facility

$444.79
Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

Office

Unavailable

Facility

$466.72
Madera

Office

Unavailable

Facility

$444.79
Merced

Office

Unavailable

Facility

$444.79
Modesto

Office

Unavailable

Facility

$444.79
Napa

Office

Unavailable

Facility

$488.60
Oxnard-Thousand Oaks-Ventura

Office

Unavailable

Facility

$462.14
Redding

Office

Unavailable

Facility

$444.79
Rest Of California

Office

Unavailable

Facility

$444.79
Riverside-San Bernardino-Ontario

Office

Unavailable

Facility

$452.25
Sacramento-Roseville-Folsom

Office

Unavailable

Facility

$459.58
Salinas

Office

Unavailable

Facility

$457.65
San Diego-Chula Vista-Carlsbad

Office

Unavailable

Facility

$462.86
San Francisco-Oakland-Berkeley (Marin Cnty)

Office

Unavailable

Facility

$509.39
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

Office

Unavailable

Facility

$508.62
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

Office

Unavailable

Facility

$519.81
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

Office

Unavailable

Facility

$516.65
San Luis Obispo-Paso Robles

Office

Unavailable

Facility

$450.99
Santa Cruz-Watsonville

Office

Unavailable

Facility

$463.04
Santa Maria-Santa Barbara

Office

Unavailable

Facility

$457.85
Santa Rosa-Petaluma

Office

Unavailable

Facility

$467.34
Stockton

Office

Unavailable

Facility

$444.79
Vallejo

Office

Unavailable

Facility

$487.48
Visalia

Office

Unavailable

Facility

$444.79
Yuba City

Office

Unavailable

Facility

$444.79

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28175 billing questions

How does 28175 differ from 28108?

28175 is for resection of a tumor involving a toe phalanx. Code 28108 describes excision or curettage of a bone cyst or benign tumor in a foot phalanx; the documented procedure and lesion determine which code fits.

Does the code include related postoperative care?

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

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures are paid at 50% under the standard multiple procedure reduction.

Can modifier 50 be used for tumors in both feet?

No. CMS identifies bilateral adjustment as inappropriate for this code. The operative documentation should specify the treated toe and side.

What should the operative report document?

Identify the toe phalanx containing the tumor and describe the bone resected. The record should support that the service was tumor resection rather than treatment of a soft-tissue lesion or a different bone condition.

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 28175PPRRVU2026_Oct_nonQPP.csv, line 3,143 (RVU26D)