$441.98
Both apply to subcutaneous foot or toe tumors; choose 28039 when the lesion measures 1.5 cm or greater.
On this page
CMS RVU26D · Effective 2026-10-01
28043 Tumor excision Medicare reimbursement rates in Tennessee
Reports excision of a small soft-tissue tumor in the subcutaneous tissue of the foot or toe, when the lesion measures less than 1.5 cm. Compare 28043 office and facility rates across CMS payment localities in Tennessee.
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 28043 in Tennessee?
Tennessee 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
$354.10
1 of 1 localities have a supported rate.
Payment area: Tennessee
One mapped payment locality.
Facility setting
$231.74
1 of 1 localities have a supported rate.
Payment area: Tennessee
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 28043: Small superficial foot or toe tumor excision
Reports excision of a small soft-tissue tumor in the subcutaneous tissue of the foot or toe, when the lesion measures less than 1.5 cm.
This code describes removing a soft-tissue tumor located in the subcutaneous layer of the foot or toe, with a size under 1.5 cm. The lesion lies beneath the skin but does not extend into deeper tissue such as fascia or muscle. Podiatric and orthopedic surgeons commonly perform this procedure for a localized mass in an office or surgical facility; the excised tissue may be sent for pathologic examination.
Select the code based on both the lesion’s size and its depth, not simply the incision length. The operative report should identify the foot or toe site, document the tumor’s size, and show that it was subcutaneous. This major surgery code has a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 28043
- 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 RVU3.86 · 34%
- Practice expense (office) RVU7.18 · 63%
- Malpractice RVU0.40 · 3%
2K
Medicare services in 2024 · #2450 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.
28043 compared with similar codes
Office rates for Tennessee, from the same CMS release.
$450.28
Both apply to tumors under 1.5 cm, but 28045 is for a deep, rather than subcutaneous, location.
No office rate
This code is for a subcutaneous tumor under 1.5 cm. Code 28041 describes a deep tumor measuring 1.5 cm or greater.
Compare 28043 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
Tennessee →
Office / nonfacility
$354.10
Facility
$231.74
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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 28043 in Tennessee.
PPRRVU2026_Oct_nonQPP.csv
3,100
- Code
- 28043
- Physician work
- 3.86
- Practice expense
- 7.18
- Malpractice
- 0.40
GPCI2026.csv
95
- Locality
- Tennessee
- Physician work
- 1.000
- Practice expense
- 0.909
- Malpractice
- 0.537
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.86 | × 1.000 | 3.8600 |
| Practice expense | 7.18 | × 0.909 | 6.5266 |
| Malpractice | 0.40 | × 0.537 | 0.2148 |
| Total RVUs | 10.6014 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Tennessee$354.10
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.86 | 1 |
| Practice expense | 7.18 | 0.909 |
| Malpractice | 0.4 | 0.537 |
(3.86 × 1 + 7.18 × 0.909 + 0.4 × 0.537) × $33.4009 = $354.10
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.86 | 1 |
| Practice expense | 3.15 | 0.909 |
| Malpractice | 0.4 | 0.537 |
(3.86 × 1 + 3.15 × 0.909 + 0.4 × 0.537) × $33.4009 = $231.74
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.
28043 billing questions
How does this code differ from 28039?
Both describe removal of a subcutaneous foot or toe tumor. Use this code for a lesion under 1.5 cm and 28039 for one measuring 1.5 cm or greater.
How does this code differ from 28045?
This code is for a subcutaneous tumor under 1.5 cm. Code 28045 describes a tumor under 1.5 cm located in deeper tissue, such as beneath fascia or within muscle.
What should the operative note document?
Document the foot or toe site, tumor size, and its subcutaneous location. The note should distinguish the lesion from a deeper mass involving fascia or muscle.
Can modifier 50 be used for tumors on both feet?
The CMS bilateral rule specifies payment at 150% when this bilateral procedure is reported with modifier 50. Document the treated site on each side.
What postoperative care is included?
The code has a 90-day global period that 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.
3,09728035,,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
3,10228046,,Resect foot/toe tumor < 3 cm,A,,12.07,6.28,NA,6.28,,1.46,19.81,19.81,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,10328047,,Resect foot/toe tumor 3 cm/>,A,,17.01,8.94,NA,8.94,,2.71,28.66,28.66,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
9604412,TX,31,AUSTIN,1.002,1.058,0.886
9704412,TX,20,BEAUMONT,1.000,0.910,0.929
9804412,TX,09,BRAZORIA,1.008,0.991,0.780