No office rate
Both describe radical soft-tissue tumor resection; choose 28046 for a tumor under 3 cm and 28047 for one 3 cm or larger.
On this page
CMS RVU26D · Effective 2026-10-01
28046 Tumor resection Medicare reimbursement rates in Nevada
Reports radical removal of a small soft-tissue tumor from the foot or toe when the operative approach involves resection rather than routine local excision. Compare 28046 office and facility rates across CMS payment localities in Nevada.
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 28046 in Nevada?
Nevada 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
$653.74
1 of 1 localities have a supported rate.
Payment area: Nevada**
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 surgery
About 28046: Radical foot or toe tumor resection
Reports radical removal of a small soft-tissue tumor from the foot or toe when the operative approach involves resection rather than routine local excision.
This code describes radical resection of a soft-tissue tumor in the foot or toe when the tumor is less than 3 cm. The surgeon removes the tumor with a wider operative resection than a routine local excision. Orthopedic surgeons, podiatric surgeons, and surgeons treating soft-tissue tumors may perform the operation, commonly in a facility operating room. The operative report should identify the foot or toe site and document the tumor’s size and the extent of tissue removed.
Select this code for the radical resection approach and size threshold, not simply because a tumor was removed; use the appropriate local-excision code when the operative method and tissue depth fit that code instead. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. CMS does not pay an assistant at surgery; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 28046
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU12.07 · 61%
- Practice expense (office) RVU6.28 · 32%
- Malpractice RVU1.46 · 7%
100
Medicare services in 2024 · #4881 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.
28046 compared with similar codes
Office rates for Nevada, from the same CMS release.
$482.26
Code 28045 is for local excision of a deep tumor under 1.5 cm. Code 28046 describes radical resection and uses the under-3-cm threshold.
$473.62
Code 28039 is for local excision of a subcutaneous tumor 1.5 cm or larger. Code 28046 is for radical resection, not a size-and-depth local-excision category.
Compare 28046 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
Nevada** →
Office / nonfacility
Unavailable
Facility
$653.74
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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 28046 in Nevada**.
PPRRVU2026_Oct_nonQPP.csv
3,102
- Code
- 28046
- Physician work
- 12.07
- Practice expense
- 6.28
- Malpractice
- 1.46
GPCI2026.csv
73
- Locality
- Nevada**
- Physician work
- 1.000
- Practice expense
- 1.001
- Malpractice
- 0.833
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 12.07 | × 1.000 | 12.0700 |
| Practice expense | 6.28 | × 1.001 | 6.2863 |
| Malpractice | 1.46 | × 0.833 | 1.2162 |
| Total RVUs | 19.5725 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Nevada**$653.74
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 12.07 | 1 |
| Practice expense | 6.28 | 1.001 |
| Malpractice | 1.46 | 0.833 |
(12.07 × 1 + 6.28 × 1.001 + 1.46 × 0.833) × $33.4009 = $653.74
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.
28046 billing questions
How is this different from the local-excision codes for foot or toe tumors?
Code 28046 describes radical resection of a soft-tissue tumor under 3 cm. Local-excision codes are selected by whether the tumor is subcutaneous or deep and by its size threshold.
When should 28047 be used instead?
Use 28047 for the corresponding radical soft-tissue tumor resection when the tumor is 3 cm or larger. Code 28046 is for tumors under 3 cm.
What should the operative report document?
Document the foot or toe location, tumor size, and the extent of the resection so the record supports both the size category and the radical approach.
Does the 90-day global period include related postoperative care?
Yes. CMS includes the day-before preoperative visit and 90 days of related postoperative care in the global period.
Can an assistant surgeon or co-surgeon be reported?
CMS does not pay an assistant at surgery for this code. Co-surgeons are paid only when supporting documentation is provided.
How does CMS handle bilateral procedures or other procedures in the same session?
With modifier 50, the bilateral procedure is paid at 150%. For multiple procedures in one session, the highest-valued procedure is paid in full and the 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.
3,09928041,,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
3,10328047,,Resect foot/toe tumor 3 cm/>,A,,17.01,8.94,NA,8.94,,2.71,28.66,28.66,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,10428050,,Biopsy of foot joint lining,A,,4.28,7.54,,3.23,,0.37,12.19,7.88,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,10528052,,Biopsy of foot joint lining,A,,3.96,7.10,,2.95,,0.35,11.41,7.26,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068
7612402,NJ,99,REST OF NEW JERSEY,1.040,1.092,1.097