$433.09–$460.14
28124 is for partial phalanx excision; 28126 is for complete excision. Select according to the extent documented in the operative report.
On this page
CMS RVU26D · Effective 2026-10-01
28126 Toe bone excision Medicare reimbursement rates in Missouri
Reports complete excision of a toe phalanx, such as for a bone problem requiring removal of the phalanx while preserving the toe. Compare 28126 office and facility rates across CMS payment localities in Missouri.
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 28126 in Missouri?
Missouri has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
$351.48–$374.86
3 of 3 localities have a supported rate.
Facility setting
$223.07–$233.04
3 of 3 localities have a supported rate.
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.
Where 28126 pays more and less in Missouri
3 payment localities
$351.48 to $374.86
Foot surgery
About 28126: Complete toe phalanx excision
Reports complete excision of a toe phalanx, such as for a bone problem requiring removal of the phalanx while preserving the toe.
This procedure removes an entire phalanx—the bone segment in a toe—while leaving the toe itself in place. A foot and ankle surgeon, podiatrist, or other qualified surgeon may perform it for conditions such as bone infection or a painful deformity when complete removal of that phalanx is part of the operative plan. The operative report should identify the toe and phalanx and make clear that the entire phalanx, rather than only part of it, was excised.
Report the code for complete phalanx excision; partial removal belongs to a different code. The 90-day global period 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 other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.
CMS billing rules for 28126
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU3.55 · 31%
- Practice expense (office) RVU7.66 · 66%
- Malpractice RVU0.38 · 3%
948
Medicare services in 2024 · #3010 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.
28126 compared with similar codes
Office rates for Missouri, from the same CMS release.
$377.61–$401.61
28150 describes toe phalangectomy. Distinguish it from 28126 by the specific procedure documented and whether the service is reported as a phalanx excision or phalangectomy.
$361.93–$385.90
28153 is for resection of distal phalanx condyle(s), not complete removal of the phalanx.
$369.56–$394.01
28160 describes hemiphalangectomy or interphalangeal joint excision involving the proximal phalanx; 28126 represents complete phalanx excision.
Compare 28126 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.
3 of 3 payment localities
Metropolitan Kansas City →
Office / nonfacility
$371.22
Facility
$231.34
Metropolitan St. Louis →
Office / nonfacility
$374.86
Facility
$233.04
Rest Of Missouri →
Office / nonfacility
$351.48
Facility
$223.07
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28126 billing questions
How does this differ from 28124?
28126 describes complete excision of a toe phalanx. Use 28124 when the operative work is a partial excision instead.
Is this a toe amputation?
No. It describes removal of a phalanx, not removal of the toe as a whole.
What documentation supports reporting 28126?
The operative report should identify the toe and phalanx treated and document complete excision, rather than partial bone removal.
Can modifier 50 be used when both feet are treated?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
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 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.
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.
3,13228120,,Part removal of ankle/heel,A,,7.13,12.47,,5.94,,0.96,20.56,14.03,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,13328122,,Partial removal of foot bone,A,,6.59,10.60,,5.13,,0.75,17.94,12.47,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,13428124,,Partial removal of toe,A,,4.88,8.85,,4.17,,0.47,14.20,9.52,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,13528126,,Partial removal of toe,A,,3.55,7.66,,3.20,,0.38,11.59,7.13,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,13628130,,Removal of ankle bone,A,,9.26,7.28,NA,7.28,,1.39,17.93,17.93,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,13728140,,Removal of metatarsal,A,,6.96,8.97,,4.01,,0.89,16.82,11.86,0,090,0.10,0.69,0.21,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,13828150,,Removal of toe,A,,4.12,7.85,,3.40,,0.43,12.40,7.95,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00