$379.58
28126 is specific to resection of the distal phalanx condyle. Choose 28124 for partial phalangeal bone removal that is not a defined distal condyle resection.
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CMS RVU26D · Effective 2026-10-01
28124 Toe bone excision Medicare reimbursement rates in North Dakota
Reports removal of a portion of a toe phalanx, such as a diseased or prominent bone segment, when the procedure does not target a specific condyle. Compare 28124 office and facility rates across CMS payment localities in North Dakota.
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 28124 in North Dakota?
North Dakota 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
$464.97
1 of 1 localities have a supported rate.
Payment area: North Dakota**
One mapped payment locality.
Facility setting
$308.65
1 of 1 localities have a supported rate.
Payment area: North Dakota**
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 28124: Partial toe phalanx bone excision
Reports removal of a portion of a toe phalanx, such as a diseased or prominent bone segment, when the procedure does not target a specific condyle.
A podiatrist or orthopedic surgeon removes a portion of a toe phalanx to treat localized bone disease or a painful bony prominence. The procedure may be performed in an office-based surgical setting or a hospital or ambulatory surgery facility. The operative report should identify the toe, the phalanx involved, the portion removed, and the clinical reason for the excision.
Select this code when the work is partial removal of phalangeal bone, rather than a defined resection of a distal or proximal condyle or removal of a broader phalangeal segment. Related preoperative care on the day before surgery and related postoperative care for 90 days are included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.
CMS billing rules for 28124
- 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU4.88 · 34%
- Practice expense (office) RVU8.85 · 62%
- Malpractice RVU0.47 · 3%
10.1K
Medicare services in 2024 · #1462 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.
28124 compared with similar codes
Office rates for North Dakota, from the same CMS release.
$391.33
28153 describes resection of a proximal phalanx condyle. 28124 is the better fit when the documented work is partial bone excision without that specific condylar target.
$405.64
28150 is for phalangectomy, a more extensive removal of toe phalangeal bone. Use 28124 when only a portion of the phalanx is excised.
$399.09
28160 covers hemiphalangectomy or excision involving a toe interphalangeal joint. 28124 describes partial bone excision without that joint-focused procedure.
Compare 28124 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
North Dakota** →
Office / nonfacility
$464.97
Facility
$308.65
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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 28124 in North Dakota**.
PPRRVU2026_Oct_nonQPP.csv
3,134
- Code
- 28124
- Physician work
- 4.88
- Practice expense
- 8.85
- Malpractice
- 0.47
GPCI2026.csv
84
- Locality
- North Dakota**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.406
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.88 | × 1.000 | 4.8800 |
| Practice expense | 8.85 | × 1.000 | 8.8500 |
| Malpractice | 0.47 | × 0.406 | 0.1908 |
| Total RVUs | 13.9208 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, North Dakota**$464.97
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.88 | 1 |
| Practice expense | 8.85 | 1 |
| Malpractice | 0.47 | 0.406 |
(4.88 × 1 + 8.85 × 1 + 0.47 × 0.406) × $33.4009 = $464.97
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.88 | 1 |
| Practice expense | 4.17 | 1 |
| Malpractice | 0.47 | 0.406 |
(4.88 × 1 + 4.17 × 1 + 0.47 × 0.406) × $33.4009 = $308.65
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.
28124 billing questions
When should I use this code instead of a condyle-resection code?
Use this code for partial removal of phalangeal bone without a specifically defined condylar resection. A distal condyle resection points to 28126; a proximal condyle resection points to 28153.
What documentation supports reporting this procedure?
Document the affected toe and phalanx, the segment of bone removed, the reason for excision, and the operative work performed. The record should distinguish a partial phalanx excision from a condylar resection or more extensive phalangectomy.
Is related postoperative care separately reported?
Related postoperative care is included in the 90-day global period, along with the preoperative visit on the day before surgery.
How does Medicare handle bilateral procedures and other procedures in the same session?
A bilateral procedure reported with modifier 50 is paid at 150%. For multiple procedures in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction.
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.
3,13128119,,Removal of heel spur,A,,5.42,9.87,,4.35,,0.59,15.88,10.36,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,13228120,,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
8113292,NY,04,QUEENS,1.064,1.182,1.442
8213282,NY,99,REST OF NEW YORK,1.000,0.950,0.703
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744