$395.83–$437.89
Both address lesions associated with a tendon sheath or joint capsule; 28090 is for the foot, while 28092 is for a toe.
On this page
CMS RVU26D · Effective 2026-10-01
28090 Foot lesion excision Medicare reimbursement rates in Texas
Report excision of a lesion, such as a ganglion cyst, arising from a foot tendon sheath or joint capsule. Compare 28090 office and facility rates across CMS payment localities in Texas.
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 28090 in Texas?
Texas has 8 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 8 payment areas shown below, using the same CMS release.
Office / nonfacility
$440.70–$485.44
8 of 8 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.
Where 28090 pays more and less in Texas
8 payment localities
$440.70 to $485.44
Foot surgery
About 28090: Foot tendon sheath or joint capsule lesion excision
Report excision of a lesion, such as a ganglion cyst, arising from a foot tendon sheath or joint capsule.
Code 28090 describes surgical removal of a lesion arising from a tendon sheath or joint capsule in the foot, commonly a ganglion cyst. A podiatrist or orthopedic foot and ankle surgeon may perform the procedure in an office-based operating room or outpatient surgical facility. The surgeon exposes the affected structure, separates the lesion from its origin, and removes it; tissue may be submitted for pathology.
Choose this code when the lesion originates from a foot tendon sheath or joint capsule, rather than coding a soft-tissue tumor by depth and size or a lesion of a toe. Document the foot site, the involved sheath or capsule, the lesion and its origin, and the excision performed. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. For bilateral reporting with modifier 50, payment is at 150%. Assistant-at-surgery payment is statutorily restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 28090
- 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 RVU4.44 · 32%
- Practice expense (office) RVU9.13 · 65%
- Malpractice RVU0.48 · 3%
3.6K
Medicare services in 2024 · #2058 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.
28090 compared with similar codes
Office rates for Texas, from the same CMS release.
$449.98–$491.01
Use 28039 for a subcutaneous foot or toe soft-tissue tumor at least 1.5 cm, rather than a lesion arising from a tendon sheath or joint capsule.
$359.57–$394.75
Use 28043 for a subcutaneous soft-tissue tumor under 1.5 cm; 28090 identifies a lesion by its tendon sheath or joint capsule origin.
$512.77–$567.17
Code 28080 describes excision of an interdigital neuroma, not removal of a tendon sheath or joint capsule lesion.
Compare 28090 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.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Office $485.44 | Facility $300.62 |
| Beaumont | Office $440.70 | Facility $281.73 |
| Brazoria | Office $464.20 | Facility $291.08 |
| Dallas | Office $467.12 | Facility $293.13 |
| Fort Worth | Office $464.28 | Facility $292.04 |
| Galveston | Office $465.58 | Facility $292.11 |
| Houston | Office $474.36 | Facility $300.90 |
| Rest Of Texas | Office $452.18 | Facility $286.40 |
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28090 billing questions
When should 28090 be chosen over 28092?
Use 28090 for a lesion of a foot tendon sheath or joint capsule. Code 28092 is for the corresponding lesion in a toe.
How does 28090 differ from foot soft-tissue tumor excision codes?
Code 28090 is selected for a lesion arising from a tendon sheath or joint capsule. Codes 28039–28045 classify soft-tissue tumor excisions by depth and size.
What documentation supports reporting 28090?
Document the foot location, the tendon sheath or joint capsule involved, the lesion’s origin, and the surgical excision. This distinguishes the service from removal of a soft-tissue mass or toe lesion.
How is bilateral 28090 reported?
For a bilateral procedure, report modifier 50; CMS payment is at 150%.
Are the preoperative visit and postoperative care included?
Yes. 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.
3,11228080,,Removal of foot lesion,A,,4.74,11.10,,5.78,,0.55,16.39,11.07,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,11328086,,Excise foot tendon sheath,A,,4.80,10.73,,4.60,,0.65,16.18,10.05,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,11428088,,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