$391.03
Both codes are for subcutaneous foot or toe masses; 28043 applies when the mass is smaller than 1.5 cm.
On this page
CMS RVU26D · Effective 2026-10-01
28039 Tumor excision Medicare reimbursement rates in Rhode Island
Removal of a subcutaneous soft-tissue mass of the foot or toe measuring at least 1.5 cm, selected by its tissue plane and size. Compare 28039 office and facility rates across CMS payment localities in Rhode Island.
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 28039 in Rhode Island?
Rhode Island 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
$487.11
1 of 1 localities have a supported rate.
Payment area: Rhode Island
One mapped payment locality.
Facility setting
$320.46
1 of 1 localities have a supported rate.
Payment area: Rhode Island
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 28039: Subcutaneous foot or toe tumor excision
Removal of a subcutaneous soft-tissue mass of the foot or toe measuring at least 1.5 cm, selected by its tissue plane and size.
This code describes surgical removal of a soft-tissue mass beneath the skin of a foot or toe when the mass measures 1.5 cm or more. A podiatrist or orthopedic foot surgeon may remove a palpable mass, such as a subcutaneous lipoma, in an operating room or another appropriate surgical setting. The defining features are the subcutaneous location and the size of the lesion, not the length of the incision.
Choose this code when the operative findings place the mass in subcutaneous tissue and document its size at or above the threshold. The report should identify the foot or toe, describe the tissue plane and mass, and record its dimensions. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. For multiple procedures in one session, 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-surgeons and team surgery are not permitted.
CMS billing rules for 28039
- 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.28 · 37%
- Practice expense (office) RVU8.40 · 59%
- Malpractice RVU0.59 · 4%
1.8K
Medicare services in 2024 · #2531 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.
28039 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
Compare 28039 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
Rhode Island →
Office / nonfacility
$487.11
Facility
$320.46
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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 28039 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
3,098
- Code
- 28039
- Physician work
- 5.28
- Practice expense
- 8.40
- Malpractice
- 0.59
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.28 | × 1.019 | 5.3803 |
| Practice expense | 8.40 | × 1.033 | 8.6772 |
| Malpractice | 0.59 | × 0.892 | 0.5263 |
| Total RVUs | 14.5838 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Rhode Island$487.11
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.28 | 1.019 |
| Practice expense | 8.4 | 1.033 |
| Malpractice | 0.59 | 0.892 |
(5.28 × 1.019 + 8.4 × 1.033 + 0.59 × 0.892) × $33.4009 = $487.11
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.28 | 1.019 |
| Practice expense | 3.57 | 1.033 |
| Malpractice | 0.59 | 0.892 |
(5.28 × 1.019 + 3.57 × 1.033 + 0.59 × 0.892) × $33.4009 = $320.46
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.
28039 billing questions
How does this differ from code 28043?
Both describe subcutaneous soft-tissue tumor excision on the foot or toe. Use 28039 for a mass at least 1.5 cm; 28043 is for one smaller than 1.5 cm.
When is 28041 more appropriate?
Use 28041 when the foot or toe mass is subfascial, such as intramuscular, and measures at least 1.5 cm. This code is for a subcutaneous mass.
What documentation supports reporting this code?
Document the foot or toe site, the subcutaneous tissue plane, and the mass dimensions showing it meets the 1.5 cm threshold. The operative report should support that the mass was removed.
Is routine closure separately reported?
Routine exposure, removal, hemostasis, and closure are part of the excision. A separate diagnostic biopsy of the same mass is not reported when that mass is removed in the same session.
How does Medicare handle bilateral excision and multiple procedures?
Bilateral reporting with modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%.
What is included in the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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.
3,09528022,,Exploration of foot joint,A,,4.69,9.66,,4.16,,0.55,14.90,9.40,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,09628024,,Exploration of toe joint,A,,4.41,9.27,,4.02,,0.49,14.17,8.92,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,09728035,,Decompression of tibia nerve,A,,5.10,10.57,,4.53,,0.66,16.33,10.29,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,09828039,,Exc foot/toe tum sc 1.5 cm/>,A,,5.28,8.40,,3.57,,0.59,14.27,9.44,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,09928041,,Exc foot/toe tum dep 1.5cm/>,A,,6.95,4.83,NA,4.83,,0.83,12.61,12.61,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,10028043,,Exc foot/toe tum sc < 1.5 cm,A,,3.86,7.18,,3.15,,0.40,11.44,7.41,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,10128045,,Exc foot/toe tum deep <1.5cm,A,,5.31,8.67,,4.01,,0.54,14.52,9.86,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537