No office rate
Use 28102 for a lesion in the talus or calcaneus. Use 28103 for a tarsal or metatarsal bone.
On this page
CMS RVU26D · Effective 2026-10-01
28103 Foot bone lesion Medicare reimbursement rates in Hawaii
Reports excision or curettage of a benign bone lesion in a tarsal or metatarsal bone when the defect is filled with autograft. Compare 28103 office and facility rates across CMS payment localities in Hawaii.
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 28103 in Hawaii?
Hawaii 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
No supported rate
Facility setting
$371.29
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
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.
Orthopedic surgery
About 28103: Foot bone lesion excision with autograft
Reports excision or curettage of a benign bone lesion in a tarsal or metatarsal bone when the defect is filled with autograft.
An orthopedic or podiatric surgeon uses this service to remove or curette a bone cyst or benign tumor in a tarsal or metatarsal bone and fill the resulting defect with the patient’s bone graft. The procedure is performed in an operative setting; the graft may be harvested as part of the service. The code is specific to these foot bones, rather than the talus or calcaneus or a toe phalanx.
Report it when the operative record identifies the treated bone and lesion, describes excision or curettage, and documents autograft placement. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, CMS pays the highest-valued procedure in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 28103
- 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 may be paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU6.50 · 60%
- Practice expense (office) RVU3.78 · 35%
- Malpractice RVU0.55 · 5%
104
Medicare services in 2024 · #4849 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.
28103 compared with similar codes
Office rates for Hawaii, from the same CMS release.
$579.44
Both address tarsal or metatarsal lesions, but 28103 uses autograft and 28104 uses allograft.
No office rate
28106 is for a lesion in a foot phalanx; 28103 is for a tarsal or metatarsal bone.
$463.28
28108 addresses a toe-phalanx lesion without graft, while 28103 treats a tarsal or metatarsal lesion with autograft.
Compare 28103 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
Hawaii, Guam →
Office / nonfacility
Unavailable
Facility
$371.29
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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 28103 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
3,119
- Code
- 28103
- Physician work
- 6.50
- Practice expense
- 3.78
- Malpractice
- 0.55
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.50 | × 1.000 | 6.5000 |
| Practice expense | 3.78 | × 1.137 | 4.2979 |
| Malpractice | 0.55 | × 0.579 | 0.3185 |
| Total RVUs | 11.1163 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$371.29
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.5 | 1 |
| Practice expense | 3.78 | 1.137 |
| Malpractice | 0.55 | 0.579 |
(6.5 × 1 + 3.78 × 1.137 + 0.55 × 0.579) × $33.4009 = $371.29
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.
28103 billing questions
How does 28103 differ from 28102?
28103 is for a tarsal or metatarsal bone. 28102 is for a lesion in the talus or calcaneus.
When should 28104 be considered instead?
28104 describes the corresponding tarsal or metatarsal lesion procedure using allograft. 28103 includes autograft.
Is graft harvesting separately reported?
The autograft harvest is included in 28103. Document the graft placement and its relationship to the treated bone defect.
What documentation supports this code?
Record the specific tarsal or metatarsal bone, lesion, excision or curettage performed, and autograft placement.
How does the 90-day global period affect follow-up care?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can 28103 be reported bilaterally or with another procedure?
CMS pays bilateral reporting with modifier 50 at 150%. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and others at 50%.
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.
3,11628092,,Removal of toe lesions,A,,3.69,8.57,,3.73,,0.39,12.65,7.81,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014