$463.58
Both relate to partial toe-bone excision. Choose based on the specific procedure performed and the corresponding CPT descriptor, rather than treating the codes as interchangeable.
On this page
CMS RVU26D · Effective 2026-10-01
28153 Toe bone removal Medicare reimbursement rates in Vermont
Reports partial removal of toe bone, such as when a foot surgeon excises a painful bony prominence while preserving the remaining toe. Compare 28153 office and facility rates across CMS payment localities in Vermont.
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 28153 in Vermont?
Vermont 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
$389.91
1 of 1 localities have a supported rate.
Payment area: Vermont
One mapped payment locality.
Facility setting
$243.75
1 of 1 localities have a supported rate.
Payment area: Vermont
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.
Orthopedic surgery
About 28153: Partial ostectomy of toe bone
Reports partial removal of toe bone, such as when a foot surgeon excises a painful bony prominence while preserving the remaining toe.
A podiatrist or orthopedic foot and ankle surgeon may perform this procedure to remove part of a toe bone causing a painful prominence or pressure problem. The operation removes bone while leaving the rest of the toe in place; it is distinct from removing an entire toe. It is typically performed in an operating room or ambulatory surgery setting, with the operative report identifying the toe and the bone removed.
Report the code when the documented procedure matches partial toe-bone excision, not removal of a soft-tissue lesion or complete toe-bone excision. The note should support the indication, site, and extent of bone removal. Medicare assigns a 90-day global period, which includes the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard reduction. Modifier 50 is inappropriate; assistant-at-surgery payment is restricted, and co-surgeons and team surgery are not permitted.
CMS billing rules for 28153
- 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU3.71 · 31%
- Practice expense (office) RVU7.86 · 66%
- Malpractice RVU0.36 · 3%
836
Medicare services in 2024 · #3109 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.
28153 compared with similar codes
Office rates for Vermont, from the same CMS release.
$378.29
This is another partial toe-bone procedure code. The operative report and exact procedure determine which code fits.
$404.45
28150 describes complete excision of a toe phalanx; this code is for partial removal, with bone remaining.
$397.71
Compare the documented extent and type of toe-bone removal with the code descriptor; do not substitute it based only on the general phrase 'partial removal of toe.'
Compare 28153 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
Vermont →
Office / nonfacility
$389.91
Facility
$243.75
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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 28153 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
3,139
- Code
- 28153
- Physician work
- 3.71
- Practice expense
- 7.86
- Malpractice
- 0.36
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.71 | × 1.000 | 3.7100 |
| Practice expense | 7.86 | × 0.990 | 7.7814 |
| Malpractice | 0.36 | × 0.506 | 0.1822 |
| Total RVUs | 11.6736 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Vermont$389.91
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.71 | 1 |
| Practice expense | 7.86 | 0.99 |
| Malpractice | 0.36 | 0.506 |
(3.71 × 1 + 7.86 × 0.99 + 0.36 × 0.506) × $33.4009 = $389.91
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.71 | 1 |
| Practice expense | 3.44 | 0.99 |
| Malpractice | 0.36 | 0.506 |
(3.71 × 1 + 3.44 × 0.99 + 0.36 × 0.506) × $33.4009 = $243.75
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.
28153 billing questions
How is this different from complete toe-bone removal?
This code represents partial removal, with bone remaining in the toe. Use a complete-excision code when the operative report documents removal of the entire specified bone.
What documentation supports reporting this code?
Document the toe and bone treated, the reason for surgery, and the extent of bone removed. The operative report should make clear that the excision was partial.
Can modifier 50 be used for both feet?
No. CMS identifies bilateral adjustment as inappropriate for this code. The descriptor or anatomy does not support modifier 50.
How does the 90-day global period affect follow-up visits?
The day-before preoperative visit and related postoperative care during the 90-day period are included in the global surgery package.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures in that session are subject to the standard multiple-procedure reduction.
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.
3,13628130,,Removal of ankle bone,A,,9.26,7.28,NA,7.28,,1.39,17.93,17.93,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,13728140,,Removal of metatarsal,A,,6.96,8.97,,4.01,,0.89,16.82,11.86,0,090,0.10,0.69,0.21,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,13828150,,Removal of toe,A,,4.12,7.85,,3.40,,0.43,12.40,7.95,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,13928153,,Partial removal of toe,A,,3.71,7.86,,3.44,,0.36,11.93,7.51,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,14028160,,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
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
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817