$443.80
Both codes use the 1.5 cm threshold, but 28039 applies to a subcutaneous tumor. This code requires a tumor beneath the fascia.
On this page
CMS RVU26D · Effective 2026-10-01
28041 Tumor excision Medicare reimbursement rates in Idaho
Reports removal of a foot or toe tumor located beneath the fascia when the tumor measures at least 1.5 cm. Compare 28041 office and facility rates across CMS payment localities in Idaho.
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 28041 in Idaho?
Idaho 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
$393.67
1 of 1 localities have a supported rate.
Payment area: Idaho
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 and ankle surgery
About 28041: Deep foot or toe tumor excision, large
Reports removal of a foot or toe tumor located beneath the fascia when the tumor measures at least 1.5 cm.
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.
CMS billing rules for 28041
- 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 is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU6.95 · 55%
- Practice expense (office) RVU4.83 · 38%
- Malpractice RVU0.83 · 7%
1K
Medicare services in 2024 · #2952 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.
28041 compared with similar codes
Office rates for Idaho, from the same CMS release.
$452.31
Both codes describe deep foot or toe tumor excision; choose 28045 when the tumor is smaller than 1.5 cm.
No office rate
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.
Compare 28041 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
Idaho →
Office / nonfacility
Unavailable
Facility
$393.67
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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 28041 in Idaho.
PPRRVU2026_Oct_nonQPP.csv
3,099
- Code
- 28041
- Physician work
- 6.95
- Practice expense
- 4.83
- Malpractice
- 0.83
GPCI2026.csv
47
- Locality
- Idaho
- Physician work
- 1.000
- Practice expense
- 0.920
- Malpractice
- 0.473
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.95 | × 1.000 | 6.9500 |
| Practice expense | 4.83 | × 0.920 | 4.4436 |
| Malpractice | 0.83 | × 0.473 | 0.3926 |
| Total RVUs | 11.7862 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Idaho$393.67
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.95 | 1 |
| Practice expense | 4.83 | 0.92 |
| Malpractice | 0.83 | 0.473 |
(6.95 × 1 + 4.83 × 0.92 + 0.83 × 0.473) × $33.4009 = $393.67
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.
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 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.
3,09628024,,Exploration of toe joint,A,,4.41,9.27,,4.02,,0.49,14.17,8.92,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,09728035,,Decompression of tibia nerve,A,,5.10,10.57,,4.53,,0.66,16.33,10.29,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,09828039,,Exc foot/toe tum sc 1.5 cm/>,A,,5.28,8.40,,3.57,,0.59,14.27,9.44,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,09928041,,Exc foot/toe tum dep 1.5cm/>,A,,6.95,4.83,NA,4.83,,0.83,12.61,12.61,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,10028043,,Exc foot/toe tum sc < 1.5 cm,A,,3.86,7.18,,3.15,,0.40,11.44,7.41,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,10128045,,Exc foot/toe tum deep <1.5cm,A,,5.31,8.67,,4.01,,0.54,14.52,9.86,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,10228046,,Resect foot/toe tumor < 3 cm,A,,12.07,6.28,NA,6.28,,1.46,19.81,19.81,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772