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28104 Removal of foot lesion

What 28104 is

CMS fee schedule short descriptor: Removal of foot 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 28104 (CY2026)

Work RVUPractice expense RVUMalpractice RVUTotalMedicare rate
Non-facility (office)5.1310.420.6416.19$540.76
Facility (hospital, ASC)5.134.390.6410.16$339.35

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.

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Medically Unlikely Edit (MUE)

Medicare caps 28104 at 2 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 28104? These codes are bundled into it

28104 is a Column 1 code in 286 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 codeShort descriptionModifier indicator
01470Anes px nrv msc lw l/a/f nos0 - no modifier bypassCheck pair
0213TNjx paravert w/us cer/thor0 - no modifier bypassCheck pair
0216TNjx paravert w/us lumb/sac0 - no modifier bypassCheck pair
0490TRegn cell tx scldr h mlt inj1 - modifier may bypassCheck pair
0596TTemp fml iu vlv-pmp 1st insj1 - modifier may bypassCheck pair
0597TTemp fml iu valve-pmp rplcmt1 - modifier may bypassCheck pair
0707TNjx b1 sub mtrl sbchdrl dfct1 - modifier may bypassCheck pair
0708TId ca immntx prep & 1st njx1 - modifier may bypassCheck pair
0709TId ca immntx each addl njx1 - modifier may bypassCheck pair
0718TAdrc ther prtl rc tear njx1 - modifier may bypassCheck pair
0869TNjx b1 sub mtrl hw fixj aug1 - modifier may bypassCheck pair
0903TEcg alg 12 lead reduced i&r1 - modifier may bypassCheck pair
0904TEcg alg 12 ld rdcd trcg only1 - modifier may bypassCheck pair
0905TEcg alg 12 ld rdcd i&r only1 - modifier may bypassCheck pair
10030Img gid flu coll drg sft tis1 - modifier may bypassCheck pair
10060I&d abscess simple/single1 - modifier may bypassCheck pair
10140I&d hmtma seroma/fluid collj1 - modifier may bypassCheck pair
10160Pnxr aspir absc hmtma bulla1 - modifier may bypassCheck pair
11000Dbrdmt ecz/infected skin<10%1 - modifier may bypassCheck pair
11001Dbrdmt ecz/infct skn ea addl1 - modifier may bypassCheck pair
11004Dbrdmt skin xtrnl gent&per1 - modifier may bypassCheck pair
11005Dbrdmt skin abdominal wall1 - modifier may bypassCheck pair
11006Dbrdmt skin xtrnl gent per1 - modifier may bypassCheck pair
11011Debride skin musc at fx site1 - modifier may bypassCheck pair
11012Deb skin bone at fx site1 - modifier may bypassCheck pair
11042Dbrdmt subq tis 1st 20sqcm/<1 - modifier may bypassCheck pair
11043Dbrdmt musc&/fsca 1st 20/<1 - modifier may bypassCheck pair
11044Dbrdmt bone 1st 20 sq cm/<1 - modifier may bypassCheck pair
11045Dbrdmt subq tiss each addl1 - modifier may bypassCheck pair
11046Dbrdmt musc&/fsca ea addl1 - modifier may bypassCheck pair

Showing 30 of 286 column 2 codes. Use the pair checker for any specific combination.

28104 is bundled into these codes

28104 appears as a Column 2 code in 24 active edits. Reported with one of these Column 1 codes on the same date of service, 28104 is the code that denies.

Column 1 codeShort descriptionModifier indicator
11010Debride skin at fx site1Check pair
28106Remove/graft foot lesion1Check pair
28107Remove/graft foot lesion1Check pair
28114Removal of metatarsal heads1Check pair
28116Revision of foot1Check pair
28171Resect tarsal tumor1Check pair
28173Resect metatarsal tumor1Check pair
28289Corrj halux rigdus w/o implt1Check pair
28291Corrj halux rigdus w/implt1Check pair
28292Cor hlx vlgs rsc prx phlx bs1Check pair
28295Cor hlx vlgs prx mtar osteot1Check pair
28296Cor hlx vlgs dstl mtar osteo1Check pair
28297Cor hlx vlgs jt arthrd1Check pair
28298Cor hlx vlgs prx phlx osteot1Check pair
28299Cor hlx vlgs double osteot1Check 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.