Billing code 28104: Bone lesion excisionMedicare rate & RVUs in Ohio
Reports excision or curettage of a bone cyst or benign tumor in a tarsal or metatarsal bone when the procedure does not include bone grafting.
Medicare pays $510.65 for 28104 in the office in Ohio (Ohio). 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 28104 covers
An orthopedic surgeon or podiatric surgeon uses this service to remove or curette a bone cyst or benign tumor from a tarsal or metatarsal bone. The operative site is bone, not a skin or soft-tissue lesion. The procedure may be performed in a hospital or ambulatory surgical setting; less commonly, it is performed in an office setting. The surgeon’s report should identify the affected bone and describe the lesion removal or curettage.
Report this code for the tarsal or metatarsal site when the procedure does not include bone grafting. If grafting is performed, select the code that describes the grafted procedure instead. Medicare assigns a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is 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.
28104 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | $510.65 | $326.77 |
How the 28104 rate is calculated
Each of 28104’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 · 28104
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 5.13Practice expense 10.42Malpractice 0.64
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 28104
28104 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28104
Bone lesion 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| 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 · 28104
Bone lesion 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
28104 without 51 · national office
$540.76
Bone lesion excision
28104-51 · Second procedure: 50%
$270.38
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%).
28104 compared with similar codes
Compare codes
28104 vs 28100 vs 28106 vs 28107 vs 28108: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 28100Bone lesion excision
- 28100 is for a lesion in the talus or calcaneus. Use 28104 for a tarsal or metatarsal bone other than those sites.
- 28106Foot bone lesion
- 28106 describes a tarsal or metatarsal lesion procedure that includes autografting; 28104 is for the procedure without grafting.
- 28107Bone lesion surgery
- 28107 describes a tarsal or metatarsal lesion procedure that includes allografting; 28104 is for the procedure without grafting.
- 28108Toe bone lesion
- 28108 applies to a lesion in a foot phalanx. 28104 applies to a tarsal or metatarsal bone.
28104 billing questions
Which bone lesions are reported with 28104?
Use it for excision or curettage of a bone cyst or benign tumor in a tarsal or metatarsal bone, without bone grafting. The operative note should identify the bone treated.
How does 28104 differ from 28106 or 28107?
28104 describes removal or curettage without grafting. Choose 28106 or 28107 when the procedure includes the graft type described by that code.
Can the surgeon separately report bone grafting with 28104?
When grafting is part of the lesion procedure, use the applicable graft-inclusive code rather than reporting 28104 and adding the graft procedure separately.
Should modifier 50 be used for lesions on both feet?
No. CMS identifies bilateral adjustment as inappropriate for this code. Modifier 50 should not be used.
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 or co-surgeon be paid?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is 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
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