Billing code 28041: Tumor excisionMedicare rate & RVUs in Guam
Reports removal of a foot or toe tumor located beneath the fascia when the tumor measures at least 1.5 cm.
CMS doesn’t publish an office rate for 28041 in Guam.
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 28041 covers
A surgeon, commonly an orthopedic surgeon or podiatrist, uses this code to remove a tumor in the foot or toe that lies deep to the fascia and measures 1.5 cm or more. The procedure may be performed in an operating room or another setting appropriate for the surgical approach. The operative report should identify the foot or toe site, describe the tumor’s depth and measured size, and explain the extent of removal.
Choose this code when both the deep location and size threshold are supported; a superficial lesion or a smaller deep lesion falls under a different code in the family. Medicare assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction. For bilateral surgery, modifier 50 results in payment at 150%. Assistant-at-surgery payment requires documented medical necessity; 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.
28041 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $431.62 |
How the 28041 rate is calculated
Each of 28041’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 · 28041
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 6.95Practice expense 4.83Malpractice 0.83
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 28041
28041 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28041
Tumor excision
| 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) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| 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 · 28041
Tumor excision
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 50 · payment effect
With and without the modifier
28041 without 50 · national facility
$421.19
Tumor excision
28041-50 · Bilateral: 150%
$631.79
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
28041 compared with similar codes
Compare codes
28041 vs 28039 vs 28045 vs 28046: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 28039Tumor excision
- Both codes use the 1.5 cm threshold, but 28039 applies to a subcutaneous tumor. This code requires a tumor beneath the fascia.
- 28045Foot mass excision
- Both codes describe deep foot or toe tumor excision; choose 28045 when the tumor is smaller than 1.5 cm.
- 28046Tumor resection
- Code 28046 describes resection of a foot or toe tumor under a different resection category. Use this code for the deep excision defined by the 1.5 cm threshold, not based on size alone.
28041 billing questions
How is this different from 28039?
This code is for a tumor beneath the fascia measuring at least 1.5 cm. Code 28039 is for a tumor at the subcutaneous level measuring at least 1.5 cm.
When should 28045 be reported instead?
Use 28045 for a deep foot or toe tumor smaller than 1.5 cm. The operative documentation should support both the depth and the size used for code selection.
What documentation supports this code?
Document the specific foot or toe site, the tumor’s relationship to the fascia, its measured size, and the removal performed. The record should make clear that the lesion is deep and at least 1.5 cm.
Does the 90-day global include related follow-up?
Yes. The global period includes the day-before preoperative visit and 90 days of related postoperative care.
How does Medicare handle bilateral reporting and assistants?
Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires 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 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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