Billing code 28100: Bone lesion excisionMedicare rate & RVUs in Utah
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.
Medicare pays $616.72 for 28100 in the office in Utah (Utah). Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 28100 covers
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.
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 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | $616.72 | $389.41 |
How the 28100 rate is calculated
Each of 28100’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 28100
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 5.68Practice expense 12.75Malpractice 0.89
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 28100
28100 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28100
Bone lesion excision
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 28100
Bone lesion excision
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
28100 without 50 · national office
$645.31
Bone lesion excision
28100-50 · Bilateral: 150%
$967.96
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
28100 compared with similar codes
Compare codes
28100 vs 28102 vs 28103 vs 28104 vs 28120: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 28102Bone lesion excision
- This code describes talus or calcaneus lesion treatment without grafting; 28102 is the grafted sibling procedure.
- 28103Foot bone lesion
- Use 28103 for the grafted sibling procedure, rather than this code for treatment without a graft.
- 28104Bone lesion excision
- The key distinction is the bone: 28104 is for another tarsal bone, while this code is for the talus or calcaneus.
- 28120Bone excision
- 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.
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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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