Billing code 28126: Toe bone excisionMedicare rate & RVUs in Nevada
Reports complete excision of a toe phalanx, such as for a bone problem requiring removal of the phalanx while preserving the toe.
Medicare pays $385.25 for 28126 in the office in Nevada (Nevada**). Which amount applies depends on the service address.
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 28126 covers
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.
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 in Nevada**
| Payment locality | Office | Facility |
|---|---|---|
| Nevada** | $385.25 | $236.14 |
How the 28126 rate is calculated
Each of 28126’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 · 28126
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 3.55Practice expense 7.66Malpractice 0.38
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 28126
28126 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28126
Toe bone 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| 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 · 28126
Toe bone 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 51 · payment effect
With and without the modifier
28126 without 51 · national office
$387.12
Toe bone excision
28126-51 · Second procedure: 50%
$193.56
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
28126 compared with similar codes
Compare codes
28126 vs 28124 vs 28150 vs 28153 vs 28160: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 28124Toe bone excision
- 28124 is for partial phalanx excision; 28126 is for complete excision. Select according to the extent documented in the operative report.
- 28150Toe amputation
- 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.
- 28153Toe bone removal
- 28153 is for resection of distal phalanx condyle(s), not complete removal of the phalanx.
- 28160Toe bone excision
- 28160 describes hemiphalangectomy or interphalangeal joint excision involving the proximal phalanx; 28126 represents complete phalanx excision.
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 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
Fee sheets
Put 28126 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →