$688.13
28100 is for a lesion in the talus or calcaneus. Use 28104 for a tarsal or metatarsal bone other than those sites.
On this page
CMS RVU26D · Effective 2026-10-01
28104 Bone lesion excision Medicare reimbursement rates in Connecticut
Reports excision or curettage of a bone cyst or benign tumor in a tarsal or metatarsal bone when the procedure does not include bone grafting. Compare 28104 office and facility rates across CMS payment localities in Connecticut.
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 28104 in Connecticut?
Connecticut 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
$575.48
1 of 1 localities have a supported rate.
Payment area: Connecticut
One mapped payment locality.
Facility setting
$358.56
1 of 1 localities have a supported rate.
Payment area: Connecticut
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 28104: Tarsal or metatarsal bone lesion excision
Reports excision or curettage of a bone cyst or benign tumor in a tarsal or metatarsal bone when the procedure does not include bone grafting.
An orthopedic surgeon or podiatric surgeon uses this service to remove or curette a bone cyst or benign tumor from a tarsal or metatarsal bone. The operative site is bone, not a skin or soft-tissue lesion. The procedure may be performed in a hospital or ambulatory surgical setting; less commonly, it is performed in an office setting. The surgeon’s report should identify the affected bone and describe the lesion removal or curettage.
Report this code for the tarsal or metatarsal site when the procedure does not include bone grafting. If grafting is performed, select the code that describes the grafted procedure instead. Medicare assigns a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 28104
- 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
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.13 · 32%
- Practice expense (office) RVU10.42 · 64%
- Malpractice RVU0.64 · 4%
1.5K
Medicare services in 2024 · #2656 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.
28104 compared with similar codes
Office rates for Connecticut, from the same CMS release.
No office rate
28106 describes a tarsal or metatarsal lesion procedure that includes autografting; 28104 is for the procedure without grafting.
$527.44
28107 describes a tarsal or metatarsal lesion procedure that includes allografting; 28104 is for the procedure without grafting.
$458.30
28108 applies to a lesion in a foot phalanx. 28104 applies to a tarsal or metatarsal bone.
Compare 28104 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
Connecticut →
Office / nonfacility
$575.48
Facility
$358.56
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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 28104 in Connecticut.
PPRRVU2026_Oct_nonQPP.csv
3,120
- Code
- 28104
- Physician work
- 5.13
- Practice expense
- 10.42
- Malpractice
- 0.64
GPCI2026.csv
38
- Locality
- Connecticut
- Physician work
- 1.020
- Practice expense
- 1.077
- Malpractice
- 1.210
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.13 | × 1.020 | 5.2326 |
| Practice expense | 10.42 | × 1.077 | 11.2223 |
| Malpractice | 0.64 | × 1.210 | 0.7744 |
| Total RVUs | 17.2293 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Connecticut$575.48
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.13 | 1.02 |
| Practice expense | 10.42 | 1.077 |
| Malpractice | 0.64 | 1.21 |
(5.13 × 1.02 + 10.42 × 1.077 + 0.64 × 1.21) × $33.4009 = $575.48
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.13 | 1.02 |
| Practice expense | 4.39 | 1.077 |
| Malpractice | 0.64 | 1.21 |
(5.13 × 1.02 + 4.39 × 1.077 + 0.64 × 1.21) × $33.4009 = $358.56
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.
28104 billing questions
Which bone lesions are reported with 28104?
Use it for excision or curettage of a bone cyst or benign tumor in a tarsal or metatarsal bone, without bone grafting. The operative note should identify the bone treated.
How does 28104 differ from 28106 or 28107?
28104 describes removal or curettage without grafting. Choose 28106 or 28107 when the procedure includes the graft type described by that code.
Can the surgeon separately report bone grafting with 28104?
When grafting is part of the lesion procedure, use the applicable graft-inclusive code rather than reporting 28104 and adding the graft procedure separately.
Should modifier 50 be used for lesions on both feet?
No. CMS identifies bilateral adjustment as inappropriate for this code. Modifier 50 should not be used.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be paid?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is 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.
3,11728100,,Removal of ankle/heel lesion,A,,5.68,12.75,,5.51,,0.89,19.32,12.08,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,11828102,,Remove/graft foot lesion,A,,7.72,8.10,NA,8.10,,1.64,17.46,17.46,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,11928103,,Remove/graft foot lesion,A,,6.50,3.78,NA,3.78,,0.55,10.83,10.83,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,12028104,,Removal of foot lesion,A,,5.13,10.42,,4.39,,0.64,16.19,10.16,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,12128106,,Remove/graft foot lesion,A,,7.17,4.11,NA,4.11,,0.60,11.88,11.88,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,12228107,,Remove/graft foot lesion,A,,5.59,8.84,,3.67,,0.47,14.90,9.73,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,12328108,,Removal of toe lesions,A,,4.19,8.30,,3.60,,0.42,12.91,8.21,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808