Excision or curettage of a bone cyst or benign tumor from the talus or calcaneus, with autograft harvested from the iliac crest or another donor site to fill the defect — graft harvest is included in the code.

Verified May 8, 2026 · 5 sources ↓

Medicare: $583.18
Work RVU: 7.72
Global, days: 90
Region: Foot & ankle

Drawn from CMSAAPCNIHGenhealth

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 5 cited references ↓

Specify the exact bone involved — talus or calcaneus — by name; 'foot bone' is insufficient for code selection.
Confirm pathology type: bone cyst (e.g., unicameral, aneurysmal) or benign tumor, with imaging or pathology correlation.
Document the autograft donor site (iliac crest or alternative) and the harvest technique in the operative note.
Record dimensions or extent of the cystic or tumor lesion to support medical necessity.
Note why autograft was selected over no-graft or allograft alternatives — relevant if payer audits code level.
Include pre-op imaging (X-ray, MRI, or CT) in the record to establish diagnosis and operative planning.

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 50 Bilateral procedure 51 Multiple procedures 58 Staged or related 78 Unplanned return — related 79 Unrelated during global LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

28102 covers surgical removal or curettage of a bone cyst or benign tumor located in the talus or calcaneus, followed by packing the resulting defect with autogenous bone graft. The graft harvest — most commonly from the iliac crest — is bundled into 28102; do not separately report a graft-harvest code. This distinguishes 28102 from 28100 (no graft) and 28103 (allograft rather than autograft).

The 90-day global period means all routine post-op visits, wound checks, and cast/splint management through day 90 are bundled. Unrelated problems treated in that window require modifier 24 on the E&M. A staged or unplanned return to the OR for a related complication bills with modifier 78; an unrelated return uses modifier 79.

Site-of-service matters here. The HOPD and ASC facility payments differ substantially — see the Site of Service comparison table on this page. Most payers follow Medicare's bilateral reporting rule: one line with modifier 50 for professional claims, separate LT/RT lines for ASC facility claims.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU vs. total RVU

The work RVU (7.72) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (17.46) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	7.72
Practice expense RVU	8.1
Malpractice RVU	1.64
Total RVU	17.46
Medicare national rate	$583.18
Global period	90 days

Payment by site of service

Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.

Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026

Setting	Medicare rate (national)
Office (PFS non-facility) Procedure performed in physician's office	$583.18
HOPD (APC 5114) Hospital outpatient department	$7,413.38
ASC (PI J8) Ambulatory surgical center (freestanding)	$5,297.25

Common denial reasons

The recurring reasons claims for CPT 28102 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

Miscoded as 28100 (no graft) or 28103 (allograft) when autograft was used — code selection must match graft type documented.
Graft harvest billed separately with an additional CPT code, triggering a bundling edit since harvest is included in 28102.
Missing or vague pathology documentation — payers deny when the operative note doesn't distinguish cyst from benign tumor or confirm the talus/calcaneus site.
Insufficient medical necessity support when pre-operative imaging is absent from the submitted record.
Modifier 50 omitted on bilateral claims, causing a second unit to deny as a duplicate rather than a bilateral procedure.

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 5 cited references ↓

01What separates 28102 from 28100 and 28103?

28100 covers excision or curettage without any graft. 28102 requires autograft (patient's own bone, harvest included). 28103 uses allograft instead. Code to what was actually placed — payers and auditors check operative notes for graft type.

02Can I bill separately for harvesting the iliac crest graft?

No. The autograft harvest is bundled into 28102. Billing a separate harvest code will trigger an NCCI bundling edit and denial.

03How do I bill 28102 if the procedure is performed on both feet at the same encounter?

On professional claims, report one line with modifier 50. For ASC facility claims, report two lines — one with LT and one with RT — each with one unit of service.

04What ICD-10 diagnoses support 28102?

Unicameral bone cyst (M85.67x), aneurysmal bone cyst (M85.57x), and other benign bone neoplasms of the ankle and foot (D16.3x) are common supporting diagnoses. Match the laterality suffix to the operative site.

05If I perform an E&M visit the day before surgery to obtain consent, is that billable?

The day-before pre-op visit is included in the 90-day global. Only if that visit addressed a separate, unrelated problem can you bill it with modifier 24.

06Does 28102 require inpatient admission, or is ASC appropriate?

Most payers and CMS support ASC placement for 28102. The procedure appears on the ASC covered procedures list. Inpatient may be appropriate for patients with comorbidities requiring overnight monitoring, but outpatient/ASC is the default setting.

07How should a return to the OR for a wound complication be billed within the global period?

An unplanned return to the OR for a complication related to 28102 — such as wound dehiscence or graft site infection requiring surgical intervention — bills with modifier 78 on the return procedure. If the return is for a completely unrelated problem, use modifier 79.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira Scribe

Mira's AI scribe captures the bone involved (talus vs. calcaneus), graft type (autograft), and donor site from dictation — the three variables that differentiate 28102 from adjacent codes 28100 and 28103. It also flags when the operative note lacks defect dimensions or pathology characterization, preventing the documentation gaps that drive medical-necessity denials on audit.

See how Mira captures CPT 28102 documentation