$477.30
28086 covers the primary tendon sheath excision; 28088 is reported for each additional sheath excised.
On this page
CMS RVU26D · Effective 2026-10-01
28086 Tendon sheath excision Medicare reimbursement rates in Wyoming
Surgical excision of diseased foot tendon sheath tissue, commonly for a sheath-associated ganglion, when the surgeon removes one tendon sheath. Compare 28086 office and facility rates across CMS payment localities in Wyoming.
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 28086 in Wyoming?
Wyoming 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
$534.78
1 of 1 localities have a supported rate.
Payment area: Wyoming**
One mapped payment locality.
Facility setting
$330.03
1 of 1 localities have a supported rate.
Payment area: Wyoming**
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 28086: Foot tendon sheath excision
Surgical excision of diseased foot tendon sheath tissue, commonly for a sheath-associated ganglion, when the surgeon removes one tendon sheath.
This procedure removes abnormal tissue from a tendon sheath in the foot, often when a ganglion arises from or involves the sheath. An orthopedic surgeon or podiatric surgeon typically performs the excision in an operating room or ambulatory surgery setting. The operative report should identify the tendon and foot location, describe the sheath tissue removed, and clarify whether the target was a sheath-associated lesion rather than a joint, nerve, or separate soft-tissue mass.
Report 28086 for the primary tendon sheath excision; 28088 is the add-on code for an additional sheath. 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 the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 28086
- 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
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU4.80 · 30%
- Practice expense (office) RVU10.73 · 66%
- Malpractice RVU0.65 · 4%
671
Medicare services in 2024 · #3297 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.
28086 compared with similar codes
Office rates for Wyoming, from the same CMS release.
$233.22
28010 is for incision of a toe tendon. Choose 28086 when the surgeon excises tendon sheath tissue rather than releasing the tendon.
$471.51
28039 addresses a qualifying subcutaneous foot or toe tumor. Use 28086 when the excised target is tendon sheath tissue or a sheath-associated ganglion.
Compare 28086 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
Wyoming** →
Office / nonfacility
$534.78
Facility
$330.03
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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 28086 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
3,113
- Code
- 28086
- Physician work
- 4.80
- Practice expense
- 10.73
- Malpractice
- 0.65
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.80 | × 1.000 | 4.8000 |
| Practice expense | 10.73 | × 1.000 | 10.7300 |
| Malpractice | 0.65 | × 0.740 | 0.4810 |
| Total RVUs | 16.0110 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Wyoming**$534.78
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.8 | 1 |
| Practice expense | 10.73 | 1 |
| Malpractice | 0.65 | 0.74 |
(4.8 × 1 + 10.73 × 1 + 0.65 × 0.74) × $33.4009 = $534.78
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.8 | 1 |
| Practice expense | 4.6 | 1 |
| Malpractice | 0.65 | 0.74 |
(4.8 × 1 + 4.6 × 1 + 0.65 × 0.74) × $33.4009 = $330.03
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.
28086 billing questions
When is 28086 used instead of 28088?
Use 28086 for the primary tendon sheath excision. Use 28088 for each additional sheath excised in the same operative session.
Is a tendon sheath ganglion included in this procedure?
Yes, a ganglion arising from or involving a foot tendon sheath is a typical reason for excision. The operative note should establish the sheath relationship and tissue removed.
How does 28086 differ from tendon incision codes 28010 and 28011?
28086 reports excision of tendon sheath tissue. Codes 28010 and 28011 describe tendon incision or release, not removal of the sheath.
What documentation supports reporting 28086?
Document the foot and tendon location, the sheath or sheath-associated lesion excised, and the extent of removal. If another sheath is excised, identify it to support the additional-sheath code.
What global and multiple-procedure payment rules apply?
The code has a 90-day global period. When procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%.
Can modifier 50 or an assistant-at-surgery service be reported?
Bilateral reporting with modifier 50 is paid at 150%, and assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation.
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.
3,11028070,,Removal of foot joint lining,A,,5.11,9.84,,4.14,,0.57,15.52,9.82,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,11128072,,Removal of foot joint lining,A,,4.60,9.89,,4.20,,0.55,15.04,9.35,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,11228080,,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
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,