28153 Partial removal of toe
What 28153 is
CMS fee schedule short descriptor: Partial removal of toe.
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 28153 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 3.71 | 7.86 | 0.36 | 11.93 | $398.47 |
| Facility (hospital, ASC) | 3.71 | 3.44 | 0.36 | 7.51 | $250.84 |
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 28153 at 4 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 28153? These codes are bundled into it
28153 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 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 |
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 |
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 |
11000 | Dbrdmt ecz/infected skin<10% | 1 - modifier may bypass | Check pair |
11001 | Dbrdmt ecz/infct skn ea addl | 1 - modifier may bypass | Check pair |
11004 | Dbrdmt skin xtrnl gent&per | 1 - modifier may bypass | Check pair |
11005 | Dbrdmt skin abdominal wall | 1 - modifier may bypass | Check pair |
11006 | Dbrdmt skin xtrnl gent per | 1 - modifier may bypass | Check pair |
11010 | Debride skin at fx site | 1 - modifier may bypass | Check pair |
11011 | Debride skin musc at fx site | 1 - modifier may bypass | Check pair |
11012 | Deb skin bone at fx site | 1 - modifier may bypass | Check pair |
11042 | Dbrdmt subq tis 1st 20sqcm/< | 1 - modifier may bypass | Check pair |
11043 | Dbrdmt musc&/fsca 1st 20/< | 1 - modifier may bypass | Check pair |
11044 | Dbrdmt bone 1st 20 sq cm/< | 1 - modifier may bypass | Check pair |
11045 | Dbrdmt subq tiss each addl | 1 - modifier may bypass | Check pair |
11046 | Dbrdmt musc&/fsca ea addl | 1 - modifier may bypass | Check pair |
11047 | Dbrdmt bone each addl | 1 - modifier may bypass | Check pair |
11400 | Exc tr-ext b9+marg 0.5 cm< | 1 - modifier may bypass | Check pair |
11401 | Exc tr-ext b9+marg 0.6-1 cm | 1 - modifier may bypass | Check pair |
11402 | Exc tr-ext b9+marg 1.1-2 cm | 1 - modifier may bypass | Check pair |
11403 | Exc tr-ext b9+marg 2.1-3cm | 1 - modifier may bypass | Check pair |
Showing 30 of 286 column 2 codes. Use the pair checker for any specific combination.
28153 is bundled into these codes
28153 appears as a Column 2 code in 24 active edits. Reported with one of these Column 1 codes on the same date of service, 28153 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
28124 | Partial removal of toe | 1 | Check pair |
28150 | Removal of toe | 1 | Check pair |
28160 | Partial removal of toe | 1 | Check pair |
28175 | Resect phalanx of toe tumor | 1 | Check pair |
28280 | Fusion of toes | 1 | Check pair |
28286 | Repair of hammertoe | 1 | Check pair |
28289 | Corrj halux rigdus w/o implt | 1 | Check pair |
28291 | Corrj halux rigdus w/implt | 1 | Check pair |
28292 | Cor hlx vlgs rsc prx phlx bs | 1 | Check pair |
28297 | Cor hlx vlgs jt arthrd | 1 | Check pair |
28298 | Cor hlx vlgs prx phlx osteot | 1 | Check pair |
28299 | Cor hlx vlgs double osteot | 1 | Check pair |
28313 | Repair deformity of toe | 1 | Check pair |
28340 | Resect enlarged toe tissue | 1 | Check pair |
28341 | Resect enlarged toe | 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.