Excision or curettage of a bone cyst or benign tumor from a tarsal or metatarsal bone (excluding the talus and calcaneus), with placement of donor bone allograft to fill the defect.

Verified May 8, 2026 · 8 sources ↓

Medicare: $497.67
Work RVU: 5.59
Global, days: 90
Region: Foot & ankle

Drawn from CMSAAPCEmednyAacpmCgsmedicare

Documentation requirements

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

Source · Editorial brief grounded in 8 cited references ↓

Specify the exact bone(s) involved — identify each tarsal or metatarsal by name and confirm exclusion of talus and calcaneus
Confirm allograft use and document the allograft source (bone bank, product name/lot number per facility protocol)
Describe the lesion type — bone cyst vs. benign tumor — and include pathology submission or intraoperative gross description
Document operative approach, extent of curettage, and how the defect was prepared before allograft placement
Include pre-operative imaging (X-ray, MRI, or CT) confirming lesion location within the tarsal or metatarsal region
If a concurrent pathologic fracture was treated, document it as a separate diagnosis with its own surgical decision rationale

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 51 Multiple procedures 52 Reduced services 58 Staged or related 59 Distinct service 78 Unplanned return — related 79 Unrelated during global LT Left side RT Right side 80 Assistant surgeon AS PA/NP/CNS assistant

What this code covers

Source · Editorial summary grounded in 8 cited references ↓

CPT 28107 covers open surgical removal or curettage of a bone cyst or benign tumor located in the tarsal or metatarsal bones — specifically excluding the talus and calcaneus, which have their own code family (28100–28103). The procedure includes filling the resulting osseous defect with allograft (donor bone). If the surgeon instead harvests the patient's own iliac crest or other autogenous bone, that work falls under 28106, not 28107. The allograft itself is not separately billable under a bone graft harvest code since it is integral to the procedure.

The 90-day global period applies. All routine post-op foot care, wound checks, and cast or splint management through day 90 are bundled. If a pathologic fracture is present at the same site, a separate fracture repair code (e.g., 28485) may be reportable with modifier 59 when the fracture management constitutes a distinct service — document the fracture diagnosis and the separate surgical decision independently. Payers vary on whether they accept that unbundling; pull NCCI PTP edits before submitting.

On the same-day billing front, 28107 should not be reported alongside 28104 (excision without graft, same bone region) — use the code that best describes the complete procedure performed. Imaging guidance is not inherent to 28107; if fluoroscopy or other guidance is used intraoperatively, check whether separate reporting is supported by your payer.

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 (5.59) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (14.9) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	5.59
Practice expense RVU	8.84
Malpractice RVU	0.47
Total RVU	14.9
Medicare national rate	$497.67
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	$497.67
HOPD (APC 5114) Hospital outpatient department	$7,413.38
ASC (PI G2) Ambulatory surgical center (freestanding)	$3,695.53

Common denial reasons

The recurring reasons claims for CPT 28107 get rejected.

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

Wrong code family selected — talus or calcaneus involvement should be coded 28103, not 28107; mismatch triggers denial
Autograft performed but 28107 billed instead of 28106 — payers audit operative notes for graft source
Missing or mismatched ICD-10 diagnosis — benign bone tumor or cyst diagnosis required; malignant neoplasm codes may route to oncology review
Modifier 59 not appended when billing a same-day fracture repair code alongside 28107, triggering NCCI bundle denial
Allograft supply billed separately as a bone graft code when it is already integral to 28107

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 8 cited references ↓

01What is the difference between 28107 and 28106?

28106 is used when the surgeon fills the defect with the patient's own bone (autograft, including iliac crest harvest). 28107 is used when donor bone allograft is placed. The graft source in the operative note determines which code is correct — payers audit this.

02Can I bill 28107 if the cyst is in the talus or calcaneus?

No. Talus and calcaneus lesions with allograft are coded 28103. The 28104–28107 family is explicitly for tarsal or metatarsal bones excluding the talus and calcaneus. Filing 28107 for a talar lesion is a code-family mismatch and will deny.

03The patient also had a pathologic fracture at the cyst site. Can I bill a fracture repair code too?

Potentially yes, but it requires modifier 59 on the fracture code and a distinct diagnosis. Document the fracture as a separate surgical problem with its own decision-making. NCCI edits apply — run the pair through the PTP lookup before submitting. Payer acceptance varies.

04Is the 90-day global period standard for 28107?

Yes. The 090 global applies. Routine post-op visits, wound care, suture removal, and cast management through day 90 are bundled. Use modifier 24 for unrelated E/M visits and modifier 79 for unrelated procedures performed during the global window.

05Can the allograft material be billed separately?

The surgical work of placing the allograft is bundled into 28107. The allograft implant itself may be separately billable as a supply using the appropriate HCPCS code, depending on the facility and payer contract. Verify with your facility's implant billing policy.

06Is modifier 50 ever appropriate for 28107?

Rarely, but yes if bilateral tarsal or metatarsal cysts are excised with allograft in the same session. Append modifier 50 for professional claims; bill on two lines with LT and RT for ASC claims per NCCI Chapter 4 guidance.

Sources & references

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

Mira Scribe

Mira's AI scribe captures the specific bone name (e.g., second metatarsal, cuboid), lesion characterization (cyst vs. benign tumor), allograft confirmation with product details, and the surgical approach from dictation — preventing the most common audit flag on 28107: an operative note that doesn't distinguish tarsal/metatarsal location from talus or calcaneus, or fails to confirm allograft versus autograft, causing a code-family mismatch denial.

See how Mira captures CPT 28107 documentation