Surgical removal of one or more phalanges from a toe, reported per toe, for conditions including osteomyelitis, tumor, severe deformity, or failed conservative management.

Verified May 8, 2026 · 6 sources ↓

Medicare: $414.17
Work RVU: 4.12
Global, days: 90
Region: Foot & ankle

Drawn from AAPCPodiatrymSurgeryAAOSCMS

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

Specify which phalanx was removed (proximal, middle, or distal) and which toe by name and number
Document the operative indication explicitly — osteomyelitis, tumor, deformity, or prior surgical complication — by diagnosis name, not just ICD-10 code
Record failed conservative treatment attempts before surgery (orthotics, medications, wound care) to support medical necessity
Operative note must describe the surgical approach, extent of bone removed, condition of surrounding soft tissue, and closure technique
Pathology specimen handling documented if tissue was sent — required when malignancy or osteomyelitis is the indication
Laterality and digit identification must be explicit in the note to support use of LT/RT and T-code digit modifiers

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 51 Multiple procedures 59 Distinct service 78 Unplanned return — related 79 Unrelated during global LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

CPT 28150 covers complete phalangectomy of a toe — removal of an entire phalanx when partial excision won't resolve the pathology. Common indications include osteomyelitis with bone involvement, malignancy, severe deformity unresponsive to conservative care, and complications from prior surgery. The code is reported per toe, so bilateral or multi-toe procedures require appropriate laterality and multiple-procedure modifiers.

Distinguishing 28150 from adjacent codes is critical. Use 28124 when only partial phalanx removal is performed. Use 28126 when resecting the phalangeal base. Use 28160 for hemiphalangectomy or interphalangeal joint excision at the proximal end. Use 28153 for condyle resection at the distal phalanx. 28150 and 28124 are NCCI bundles for the same toe — don't report both on the same digit.

The 90-day global period covers all routine post-op visits through day 90. E/M services unrelated to the phalangectomy during that window need modifier 24. A return to the OR for a related complication (e.g., wound dehiscence, hardware issue) takes modifier 78. An unrelated procedure during the global period takes modifier 79. Document the specific phalanx removed, the operative indication by name, and which toe and foot — digit modifiers (T-codes) are required by most payers to distinguish one toe from another.

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 (4.12) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (12.4) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	4.12
Practice expense RVU	7.85
Malpractice RVU	0.43
Total RVU	12.4
Medicare national rate	$414.17
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	$414.17
HOPD (APC 5113) Hospital outpatient department	$3,342.87
ASC (PI A2) Ambulatory surgical center (freestanding)	$1,644.87

Common denial reasons

The recurring reasons claims for CPT 28150 get rejected.

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

Missing or unspecified digit identification — payers require T-code digit modifiers to distinguish which toe was treated
Bundling with 28124 on the same toe — these codes are NCCI bundles when reported for the same digit on the same date
Medical necessity not established — documentation lacks evidence of failed conservative treatment or doesn't name the operative diagnosis
Incorrect code selection when only partial phalanx was removed — 28124 or 28160 may be correct depending on extent and location
E/M services billed during the 90-day global period without modifier 24 when the visit is for a separate, unrelated condition

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 6 cited references ↓

01Is 28150 reported per toe or per phalanx?

Per toe. If you remove phalanges from two separate toes in the same session, report 28150 twice — once per toe — with modifier 51 on the second unit and distinct T-code digit modifiers on each.

02Can I bill 28150 and 28124 together for the same toe?

No. These two codes are NCCI bundles for the same digit. If you performed a partial excision on one phalanx and a complete phalangectomy on another phalanx of the same toe, the more extensive procedure (28150) should be reported. Modifier 59 does not override this bundle for the same toe.

03What's the difference between 28150 and 28285 for hammertoe?

28285 is the hammertoe correction code and includes soft tissue and bony work specific to that deformity. 28150 is a complete phalangectomy — removal of an entire phalanx — which is a more extensive resection. If the toe deformity required full phalanx removal rather than a hammertoe-type correction, 28150 is appropriate. Don't substitute 28285 when the phalanx was fully excised.

04Do I need digit (T-code) modifiers when billing 28150?

Yes. Most payers require T-code modifiers to identify which specific toe was treated. LT and RT alone are insufficient. Failure to append the correct T-code modifier is a leading denial reason for toe procedure codes.

05What modifier applies if the patient returns to the OR for wound dehiscence after 28150?

Modifier 78 — unplanned return to the OR for a related procedure during the 90-day global period. Only intraoperative services are reimbursed on the return; the global period is not reset. Don't use modifier 79 here — that's reserved for unrelated procedures.

06Can 28150 be billed for a toe amputation secondary to osteomyelitis in a diabetic patient?

Yes, if the procedure involved removal of a phalanx without extending through a metatarsophalangeal joint. If the amputation was at or through the MTP joint, 28820 or 28825 may be more appropriate. Document the extent of resection precisely — 'back to mid proximal phalanx' versus 'disarticulation at MTP joint' changes the code.

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 phalanx removed, the affected toe by name and number, the operative indication by diagnosis, the surgical approach, and the disposition of any excised tissue — including whether specimen was sent to pathology. This prevents the two most common 28150 denials: missing digit specificity (required for T-code modifier assignment) and medical necessity gaps when the note doesn't explicitly name the condition driving the resection.

See how Mira captures CPT 28150 documentation