$439.16
Use 28124 for partial excision of a toe phalanx when that is the documented procedure. This code describes excision involving an interphalangeal joint or part of a phalanx.
On this page
CMS RVU26D · Effective 2026-10-01
28160 Toe bone excision Medicare reimbursement rates in Oklahoma
Reports excision at a toe interphalangeal joint or removal of part of a phalanx, such as for a painful rigid toe deformity. Compare 28160 office and facility rates across CMS payment localities in Oklahoma.
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 28160 in Oklahoma?
Oklahoma 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
$375.29
1 of 1 localities have a supported rate.
Payment area: Oklahoma
One mapped payment locality.
Facility setting
$240.17
1 of 1 localities have a supported rate.
Payment area: Oklahoma
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 28160: Toe interphalangeal joint or phalanx excision
Reports excision at a toe interphalangeal joint or removal of part of a phalanx, such as for a painful rigid toe deformity.
This service covers operative removal involving a toe interphalangeal joint or part of a toe phalanx. Podiatrists and orthopedic foot and ankle surgeons may perform it for a painful toe deformity when the planned procedure is joint excision or removal of part of the phalanx. For example, documentation may describe the specific toe and the bone or joint excised to address a rigid deformity or focal pressure.
Select this code from the operative work, not just the diagnosis: document the affected toe, the extent of bone removed, and whether the surgeon excised the joint or part of a phalanx. Medicare assigns a 90-day global period, including 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 for this code. Medicare does not pay an assistant at surgery; co-surgeons and team surgery are not permitted.
CMS billing rules for 28160
- 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 RVU3.78 · 31%
- Practice expense (office) RVU8.01 · 66%
- Malpractice RVU0.39 · 3%
1.2K
Medicare services in 2024 · #2850 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.
28160 compared with similar codes
Office rates for Oklahoma, from the same CMS release.
$356.91
28126 concerns resection of toe phalanx condyle(s). Distinguish it from the joint or partial-phalanx excision documented for 28160.
$382.91
28150 describes more extensive removal of a toe. Use 28160 when the documented work is limited to the specified joint or part of a phalanx.
$506.94
28285 is for hammertoe correction. Code 28160 describes joint or partial-phalanx excision; select according to the procedure actually performed.
Compare 28160 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
Oklahoma →
Office / nonfacility
$375.29
Facility
$240.17
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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 28160 in Oklahoma.
PPRRVU2026_Oct_nonQPP.csv
3,140
- Code
- 28160
- Physician work
- 3.78
- Practice expense
- 8.01
- Malpractice
- 0.39
GPCI2026.csv
86
- Locality
- Oklahoma
- Physician work
- 1.000
- Practice expense
- 0.893
- Malpractice
- 0.777
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.78 | × 1.000 | 3.7800 |
| Practice expense | 8.01 | × 0.893 | 7.1529 |
| Malpractice | 0.39 | × 0.777 | 0.3030 |
| Total RVUs | 11.2360 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Oklahoma$375.29
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.78 | 1 |
| Practice expense | 8.01 | 0.893 |
| Malpractice | 0.39 | 0.777 |
(3.78 × 1 + 8.01 × 0.893 + 0.39 × 0.777) × $33.4009 = $375.29
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.78 | 1 |
| Practice expense | 3.48 | 0.893 |
| Malpractice | 0.39 | 0.777 |
(3.78 × 1 + 3.48 × 0.893 + 0.39 × 0.777) × $33.4009 = $240.17
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.
28160 billing questions
How does this differ from partial phalanx excision code 28124?
Choose based on the operative work documented. Code 28160 describes excision involving a toe interphalangeal joint or part of a phalanx; 28124 is for partial phalanx excision.
Is this the same as hammertoe correction?
No. Code 28160 represents the specified joint or phalanx excision. Use 28285 when the surgeon performs the hammertoe correction described by that code.
Can modifier 50 be reported when both feet are treated?
No. CMS identifies bilateral adjustment as inappropriate for this code. Do not use modifier 50.
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 paid?
Medicare does not pay an assistant at surgery for this code, and 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.
3,13728140,,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
3,13928153,,Partial removal of toe,A,,3.71,7.86,,3.44,,0.36,11.93,7.51,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,14028160,,Partial removal of toe,A,,3.78,8.01,,3.48,,0.39,12.18,7.65,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,14128171,,Resect tarsal tumor,A,,16.00,10.91,NA,10.91,,3.40,30.31,30.31,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,14228173,,Resect metatarsal tumor,A,,13.81,4.93,NA,4.93,,1.19,19.93,19.93,0,090,0.10,0.69,0.21,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,14328175,,Resect phalanx of toe tumor,A,,8.08,4.32,NA,4.32,,0.68,13.08,13.08,0,090,0.10,0.69,0.21,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
8802302,OR,99,REST OF OREGON,1.000,0.996,0.703
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193