$413.14
Use 28175 for resection of a tumor involving a toe phalanx. Code 28108 describes excision or curettage of a bone cyst or benign tumor in a foot phalanx.
On this page
CMS RVU26D · Effective 2026-10-01
28175 Bone tumor resection Medicare reimbursement rates in Utah
Reports operative resection of a tumor involving a toe phalanx, when the surgeon removes the tumor-bearing bone rather than a soft-tissue lesion. Compare 28175 office and facility rates across CMS payment localities in Utah.
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 28175 in Utah?
Utah 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
No supported rate
Facility setting
$425.91
1 of 1 localities have a supported rate.
Payment area: Utah
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 28175: Toe phalanx tumor resection
Reports operative resection of a tumor involving a toe phalanx, when the surgeon removes the tumor-bearing bone rather than a soft-tissue lesion.
An orthopedic or podiatric surgeon uses this operation to remove a tumor involving a toe phalanx through operative exposure and resection of the affected bone. It is generally performed in an operating-room setting when a bone lesion requires removal beyond a superficial soft-tissue excision. The operative report should identify the involved toe and phalanx, the lesion, and the extent of bone removed.
Report 28175 for resection of a tumor in a toe phalanx, not for a lesion confined to skin or soft tissue. Documentation should connect the tumor to the phalanx and describe the resection; distinguish it from excision or curettage of a benign bone lesion. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures at 50%. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 28175
- 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU8.08 · 62%
- Practice expense (office) RVU4.32 · 33%
- Malpractice RVU0.68 · 5%
12
Medicare services in 2024 · #6142 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.
28175 compared with similar codes
Office rates for Utah, from the same CMS release.
No office rate
Both codes describe tumor resection, but 28173 is for a metatarsal; 28175 is for a toe phalanx.
No office rate
Both codes describe tumor resection, but 28171 is for a tarsal bone; 28175 is for a toe phalanx.
$454.96
Code 28124 describes partial excision of a toe bone. Use 28175 when the documented procedure is resection of a tumor involving the phalanx.
Compare 28175 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
Utah →
Office / nonfacility
Unavailable
Facility
$425.91
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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 28175 in Utah.
PPRRVU2026_Oct_nonQPP.csv
3,143
- Code
- 28175
- Physician work
- 8.08
- Practice expense
- 4.32
- Malpractice
- 0.68
GPCI2026.csv
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.08 | × 1.000 | 8.0800 |
| Practice expense | 4.32 | × 0.940 | 4.0608 |
| Malpractice | 0.68 | × 0.898 | 0.6106 |
| Total RVUs | 12.7514 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Utah$425.91
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.08 | 1 |
| Practice expense | 4.32 | 0.94 |
| Malpractice | 0.68 | 0.898 |
(8.08 × 1 + 4.32 × 0.94 + 0.68 × 0.898) × $33.4009 = $425.91
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.
28175 billing questions
How does 28175 differ from 28108?
28175 is for resection of a tumor involving a toe phalanx. Code 28108 describes excision or curettage of a bone cyst or benign tumor in a foot phalanx; the documented procedure and lesion determine which code fits.
Does the code include related postoperative care?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are paid at 50% under the standard multiple procedure reduction.
Can modifier 50 be used for tumors in both feet?
No. CMS identifies bilateral adjustment as inappropriate for this code. The operative documentation should specify the treated toe and side.
What should the operative report document?
Identify the toe phalanx containing the tumor and describe the bone resected. The record should support that the service was tumor resection rather than treatment of a soft-tissue lesion or a different bone condition.
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.
3,14028160,,Partial removal of toe,A,,3.78,8.01,,3.48,,0.39,12.18,7.65,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,14128171,,Resect tarsal tumor,A,,16.00,10.91,NA,10.91,,3.40,30.31,30.31,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,14228173,,Resect metatarsal tumor,A,,13.81,4.93,NA,4.93,,1.19,19.93,19.93,0,090,0.10,0.69,0.21,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,14328175,,Resect phalanx of toe tumor,A,,8.08,4.32,NA,4.32,,0.68,13.08,13.08,0,090,0.10,0.69,0.21,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,14428190,,Removal of foot foreign body,A,,1.96,5.00,,1.65,,0.21,7.17,3.82,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,14528192,,Removal of foot foreign body,A,,4.66,8.56,,3.67,,0.46,13.68,8.79,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,14628193,,Removal of foot foreign body,A,,5.75,9.02,,3.93,,0.53,15.30,10.21,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10104412,TX,15,GALVESTON,1.008,0.993,0.828
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985