Billing code 28153: Toe bone removalMedicare rate & RVUs in Florida
Reports partial removal of toe bone, such as when a foot surgeon excises a painful bony prominence while preserving the remaining toe.
Medicare pays $392.97–$427.62 for 28153 in the office in Florida, from Rest Of Florida to Miami. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 28153 covers
A podiatrist or orthopedic foot and ankle surgeon may perform this procedure to remove part of a toe bone causing a painful prominence or pressure problem. The operation removes bone while leaving the rest of the toe in place; it is distinct from removing an entire toe. It is typically performed in an operating room or ambulatory surgery setting, with the operative report identifying the toe and the bone removed.
Report the code when the documented procedure matches partial toe-bone excision, not removal of a soft-tissue lesion or complete toe-bone excision. The note should support the indication, site, and extent of bone removal. Medicare assigns a 90-day global period, which includes the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard reduction. Modifier 50 is inappropriate; assistant-at-surgery payment is restricted, and co-surgeons and team surgery are not permitted.
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.
Where 28153 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$392.97 to $427.62
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | $411.60 | $262.05 |
| Miami | $427.62 | $273.94 |
| Rest Of Florida | $392.97 | $251.83 |
How the 28153 rate is calculated
Each of 28153’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 28153
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 3.71Practice expense 7.86Malpractice 0.36
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 28153
28153 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28153
Toe bone removal
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 28153
Toe bone removal
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
28153 without 51 · national office
$398.47
Toe bone removal
28153-51 · Second procedure: 50%
$199.24
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
28153 compared with similar codes
Compare codes
28153 vs 28124 vs 28126 vs 28150 vs 28160: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 28124Toe bone excision
- Both relate to partial toe-bone excision. Choose based on the specific procedure performed and the corresponding billing code descriptor, rather than treating the codes as interchangeable.
- 28126Toe bone excision
- This is another partial toe-bone procedure code. The operative report and exact procedure determine which code fits.
- 28150Toe amputation
- 28150 describes complete excision of a toe phalanx; this code is for partial removal, with bone remaining.
- 28160Toe bone excision
- Compare the documented extent and type of toe-bone removal with the code descriptor; do not substitute it based only on the general phrase 'partial removal of toe.'
28153 billing questions
How is this different from complete toe-bone removal?
This code represents partial removal, with bone remaining in the toe. Use a complete-excision code when the operative report documents removal of the entire specified bone.
What documentation supports reporting this code?
Document the toe and bone treated, the reason for surgery, and the extent of bone removed. The operative report should make clear that the excision was partial.
Can modifier 50 be used for both feet?
No. CMS identifies bilateral adjustment as inappropriate for this code. The descriptor or anatomy does not support modifier 50.
How does the 90-day global period affect follow-up visits?
The day-before preoperative visit and related postoperative care during the 90-day period are included in the global surgery package.
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.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures in that session are subject to the standard multiple-procedure reduction.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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