No office rate
This code describes talus or calcaneus lesion treatment without grafting; 28102 is the grafted sibling procedure.
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CMS RVU26D · Effective 2026-10-01
28100 Bone lesion excision Medicare reimbursement rates in Pennsylvania
Reports surgical curettage or excision of a bone cyst or benign tumor in the talus or calcaneus when the lesion is treated without a graft. Compare 28100 office and facility rates across CMS payment localities in Pennsylvania.
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 28100 in Pennsylvania?
Pennsylvania has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$608.75–$671.92
2 of 2 localities have a supported rate.
Facility setting
$386.76–$420.18
2 of 2 localities have a supported rate.
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.
Orthopedic surgery
About 28100: Talus or calcaneus lesion curettage
Reports surgical curettage or excision of a bone cyst or benign tumor in the talus or calcaneus when the lesion is treated without a graft.
This service removes or curettes a bone cyst or benign tumor in the talus or calcaneus. An orthopedic surgeon or podiatric surgeon typically performs it in an operating room, using an approach that exposes the affected bone and allows the lesion to be treated. The operative report should identify the bone and lesion and describe the work performed; the code is for these two bones, not other tarsal bones or toe bones.
Select this code when the lesion is in the talus or calcaneus and the procedure does not use a graft; grafted procedures have separate sibling codes. Document the diagnosis, exact site, and whether grafting was performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 28100
- 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
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.68 · 29%
- Practice expense (office) RVU12.75 · 66%
- Malpractice RVU0.89 · 5%
478
Medicare services in 2024 · #3605 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.
28100 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
No office rate
Use 28103 for the grafted sibling procedure, rather than this code for treatment without a graft.
$511.05–$562.24
The key distinction is the bone: 28104 is for another tarsal bone, while this code is for the talus or calcaneus.
$650.81–$714.27
Use 28120 when the operative work is partial excision of ankle or heel bone, rather than curettage or excision of a cyst or benign tumor.
Compare 28100 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.
2 of 2 payment localities
Metropolitan Philadelphia →
Office / nonfacility
$671.92
Facility
$420.18
Rest Of Pennsylvania →
Office / nonfacility
$608.75
Facility
$386.76
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28100 billing questions
When should I choose this code instead of 28102 or 28103?
Use 28100 for a talus or calcaneus lesion treated without a graft. Codes 28102 and 28103 are the grafted sibling procedures.
Can I report this for a lesion in another tarsal bone?
No. This code is specific to the talus or calcaneus. Code 28104 is for a bone cyst or benign tumor in another tarsal bone.
Is routine postoperative care separately reported?
Related postoperative care during the 90-day global period is included, as is the day-before preoperative visit.
How is bilateral surgery paid?
CMS lists bilateral reporting with modifier 50 at 150% payment. Document the procedure on both sides.
Can an assistant or co-surgeon be reported?
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 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.
3,11428088,,Excise foot tendon sheath,A,,3.88,10.04,,4.16,,0.50,14.42,8.54,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,11528090,,Removal of foot lesion,A,,4.44,9.13,,3.90,,0.48,14.05,8.82,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,11628092,,Removal of toe lesions,A,,3.69,8.57,,3.73,,0.39,12.65,7.81,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,11728100,,Removal of ankle/heel lesion,A,,5.68,12.75,,5.51,,0.89,19.32,12.08,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,11828102,,Remove/graft foot lesion,A,,7.72,8.10,NA,8.10,,1.64,17.46,17.46,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,11928103,,Remove/graft foot lesion,A,,6.50,3.78,NA,3.78,,0.55,10.83,10.83,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,12028104,,Removal of foot lesion,A,,5.13,10.42,,4.39,,0.64,16.19,10.16,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00