28005 Treat foot bone lesion
What 28005 is
CMS fee schedule short descriptor: Treat foot bone lesion.
Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.
Medicare payment for 28005 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 9.20 | 5.85 | 0.96 | 16.01 | $534.75 |
| Facility (hospital, ASC) | 9.20 | 5.85 | 0.96 | 16.01 | $534.75 |
National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.
Status: Active - payable under the Physician Fee Schedule. Global period: 90-day global period.
Medically Unlikely Edit (MUE)
Medicare caps 28005 at 3 units per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Clinical: Data. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 28005? These codes are bundled into it
28005 is a Column 1 code in 268 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.
| Column 2 code | Short description | Modifier indicator | |
|---|---|---|---|
01470 | Anes px nrv msc lw l/a/f nos | 0 - no modifier bypass | Check pair |
0213T | Njx paravert w/us cer/thor | 0 - no modifier bypass | Check pair |
0216T | Njx paravert w/us lumb/sac | 0 - no modifier bypass | Check pair |
0490T | Regn cell tx scldr h mlt inj | 1 - modifier may bypass | Check pair |
0596T | Temp fml iu vlv-pmp 1st insj | 1 - modifier may bypass | Check pair |
0597T | Temp fml iu valve-pmp rplcmt | 1 - modifier may bypass | Check pair |
0707T | Njx b1 sub mtrl sbchdrl dfct | 1 - modifier may bypass | Check pair |
0708T | Id ca immntx prep & 1st njx | 1 - modifier may bypass | Check pair |
0709T | Id ca immntx each addl njx | 1 - modifier may bypass | Check pair |
0718T | Adrc ther prtl rc tear njx | 1 - modifier may bypass | Check pair |
0869T | Njx b1 sub mtrl hw fixj aug | 1 - modifier may bypass | Check pair |
0903T | Ecg alg 12 lead reduced i&r | 1 - modifier may bypass | Check pair |
0904T | Ecg alg 12 ld rdcd trcg only | 1 - modifier may bypass | Check pair |
0905T | Ecg alg 12 ld rdcd i&r only | 1 - modifier may bypass | Check pair |
10030 | Img gid flu coll drg sft tis | 1 - modifier may bypass | Check pair |
10060 | I&d abscess simple/single | 1 - modifier may bypass | Check pair |
10061 | I&d abscess comp/multiple | 1 - modifier may bypass | Check pair |
10140 | I&d hmtma seroma/fluid collj | 1 - modifier may bypass | Check pair |
10160 | Pnxr aspir absc hmtma bulla | 1 - modifier may bypass | Check pair |
10180 | I&d complex po wound infctj | 1 - modifier may bypass | Check pair |
11000 | Dbrdmt ecz/infected skin<10% | 1 - modifier may bypass | Check pair |
11042 | Dbrdmt subq tis 1st 20sqcm/< | 1 - modifier may bypass | Check pair |
11044 | Dbrdmt bone 1st 20 sq cm/< | 1 - modifier may bypass | Check pair |
12001 | Rpr s/n/ax/gen/trnk 2.5cm/< | 1 - modifier may bypass | Check pair |
12002 | Rpr s/n/ax/gen/trnk2.6-7.5cm | 1 - modifier may bypass | Check pair |
12004 | Rpr s/n/ax/gen/trk7.6-12.5cm | 1 - modifier may bypass | Check pair |
12005 | Rpr s/n/a/gen/trk12.6-20.0cm | 1 - modifier may bypass | Check pair |
12006 | Rpr s/n/a/gen/trk20.1-30.0cm | 1 - modifier may bypass | Check pair |
12007 | Rpr s/n/ax/gen/trnk >30.0 cm | 1 - modifier may bypass | Check pair |
12011 | Rpr f/e/e/n/l/m 2.5 cm/< | 1 - modifier may bypass | Check pair |
Showing 30 of 268 column 2 codes. Use the pair checker for any specific combination.
28005 is bundled into these codes
28005 appears as a Column 2 code in 18 active edits. Reported with one of these Column 1 codes on the same date of service, 28005 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
11010 | Debride skin at fx site | 1 | Check pair |
11011 | Debride skin musc at fx site | 1 | Check pair |
11012 | Deb skin bone at fx site | 1 | Check pair |
28111 | Part removal of metatarsal | 1 | Check pair |
28112 | Part removal of metatarsal | 1 | Check pair |
28113 | Part removal of metatarsal | 1 | Check pair |
28114 | Removal of metatarsal heads | 1 | Check pair |
28116 | Revision of foot | 1 | Check pair |
28120 | Part removal of ankle/heel | 1 | Check pair |
28122 | Partial removal of foot bone | 1 | Check pair |
28124 | Partial removal of toe | 1 | Check pair |
28171 | Resect tarsal tumor | 1 | Check pair |
28173 | Resect metatarsal tumor | 1 | Check pair |
28175 | Resect phalanx of toe tumor | 1 | Check pair |
28800 | Amputation of midfoot | 1 | Check pair |
Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.