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CPT code 28505: Toe fracture surgery, great toe, open treatment2026 Medicare rate & RVUs in Ohio

Reports open surgical treatment of a great toe phalanx fracture, with internal fixation included when performed as part of the procedure.

CMS RVU26DEffective Oct 1, 2026One payment locality417 Medicare services in 2024

In Ohio, Medicare pays $634.29 for 28505 in the office and $453.76 when it’s performed in a hospital or facility.

$634.29Office (non-facility)
$453.76Hospital or facility
−5.1%vs the national office rate ($668.35)

Check a contract rate as a % of Medicare · 28505 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 28505 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Ohio
  2. What 28505 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 28505 covers

This code describes open treatment of a fracture in one or more phalanges of the great toe. The surgeon accesses the fracture site to reduce and treat the bone; internal fixation is included when performed. It applies to surgical treatment of the great toe, not to a fracture that is merely open through the skin. Orthopedic foot and ankle surgeons and podiatric surgeons commonly perform the service in an operating room or other surgical setting.

Report the code when the operative record supports open treatment of a great toe phalanx fracture. Documentation should identify the affected toe and fracture, describe the open treatment, and record fixation if used. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, Medicare pays the highest-valued procedure in full and other procedures at 50%. When both sides are treated, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery; co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Ohio compares for 28505

Across 109 of 109 payment localities, the office rate for 28505 runs from $597.34 in Arkansas to $854.62 in San Benito County, CA. Ohio pays $634.29. The RVUs are the same everywhere; the geographic indexes change the dollars.

28505 in Ohio vs other payment areas
  1. Ohio · this page$634.29
  2. Los Angeles, CA · California$739.81+$105.52
  3. Washington, DC area · District of Columbia$755.23+$120.94
  4. Miami, FL · Florida$733.04+$98.75
  5. Chicago, IL · Illinois$713.11+$78.82
  6. Manhattan, NY · New York$766.35+$132.06
  7. Alaska · Alaska$800.82+$166.53

Other areas in Ohio first, then benchmark localities. Bars start at $0.

Every other payment area

28505 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$605.27$432.26
ArkansasArkansas$597.34$427.49
ArizonaArizona$651.55$459.95
Bakersfield, CACalifornia$698.41$481.70
Chico, CACalifornia$695.61$478.90
El Centro, CACalifornia$695.77$479.06
Fresno, CACalifornia$695.61$478.90
Hanford, CACalifornia$695.61$478.90

28505 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$597.34

$800.82

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
28505 office rate range by state
State / territoryOffice rate rangeLocalities
AK$800.821
AL$605.271
AR$597.341
AZ$651.551
CA$695.61–$854.6229
CO$689.551
CT$710.231
DC$755.231
DE$661.621
FL$666.96–$733.043
GA$631.84–$681.772
GU$709.031
HI$709.031
IA$615.691
ID$620.071
IL$651.90–$713.114
IN$623.251
KS$614.741
KY$621.871
LA$621.66–$649.392
MA$686.69–$751.322
MD$672.91–$755.233
ME$624.80–$653.092
MI$638.13–$676.312
MN$657.451
MO$613.09–$649.483
MS$605.241
MT$668.291
NC$630.471
ND$649.501
NE$618.241
NH$680.561
NJ$717.41–$748.882
NM$641.991
NV$663.451
NY$639.20–$785.605
OH$634.291
OK$619.071
OR$657.35–$707.892
PA$634.26–$695.012
PR$672.221
RI$682.541
SC$633.611
SD$647.281
TN$617.761
TX$630.60–$688.108
UT$641.451
VA$652.32–$755.232
VI$672.221
VT$648.731
WA$684.82–$764.202
WI$629.831
WV$630.351
WY$660.101

See 28505 in every payment locality

How the 28505 rate is calculated

Each of 28505’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 28505

RVUs × geographic indexes × conversion factor

Office or facility?

Work7.25

7.25 RVUs× 1.000 GPCI

Practice expense11.81

11.81 RVUs× 1.000 GPCI

Malpractice0.95

0.95 RVUs× 1.000 GPCI

Adjusted RVUs

20.0100

Conversion factor

$33.4009

Medicare rate

$668.35

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Ohio inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,219

Code
28505
Physician work
7.25
Practice expense
11.81
Malpractice
0.95

GPCI2026.csv

85

Locality
Ohio
Physician work
1.000
Practice expense
0.913
Malpractice
1.008
Office calculation for 28505 in Ohio
ComponentRVULocality factorAdjusted
Physician work7.25× 1.0007.2500
Practice expense11.81× 0.91310.7825
Malpractice0.95× 1.0080.9576
Total RVUs18.9901
Conversion factor× 33.4009

Office rate, Ohio$634.29

Office: (7.25 × 1 + 11.81 × 0.913 + 0.95 × 1.008) × $33.4009 = $634.29

Facility: (7.25 × 1 + 5.89 × 0.913 + 0.95 × 1.008) × $33.4009 = $453.76

Open 28505 in the RVU calculator

Payment rules and modifiers for 28505

28505 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 28505

Toe fracture surgery, great toe, open treatment

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 28505

Toe fracture surgery, great toe, open treatment

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

28505 without 50 · national office

$668.35

Toe fracture surgery, great toe, open treatment

28505-50 · Bilateral: 150%

$1,002.53

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

Codes related to 28505

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 28505
CodeHow it relatesOffice range, Ohio
Used instead
28490Toe fracture care, without manipulationClosed treatment of a great toe phalanx fracture without manipulation.$148.70
28495Toe fracture treatment, great toe, with manipulationClosed treatment of a great toe phalanx fracture with manipulation.$184.10
28510Toe fracture care, without manipulationClosed treatment without manipulation for a phalanx fracture in a toe other than the great toe.$123.33
28515Toe fracture care, with manipulationClosed treatment with manipulation for a phalanx fracture in a toe other than the great toe.$164.17
Same family
28525Toe fracture repair, lesser toe, open treatmentOpen treatment of a phalanx fracture in a toe other than the great toe.$541.71

How 28505 has changed in Ohio

28505 · Office / nonfacility

$634.29

Effective 2026-10-01

The base rate is $33.56 higher than on 2025-10-01, moving from $600.73 to $634.29 (5.6%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $600.73changed to$634.29

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 7.44 changed to 7.25
    • Practice expense RVU 11.21 changed to 11.81
    • Malpractice RVU 0.89 changed to 0.95
    • Practice expense GPCI 0.911 changed to 0.913
    • Malpractice GPCI 1.033 changed to 1.008

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $621.06changed to$600.73

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 11.27 changed to 11.21
    • Malpractice RVU 0.92 changed to 0.89

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $610.92changed to$621.06

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $628.51changed to$610.92

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 11.13 changed to 11.27
    • Malpractice RVU 0.90 changed to 0.92
    • Practice expense GPCI 0.912 changed to 0.911
    • Malpractice GPCI 1.063 changed to 1.033

  5. January 1, 2023

    RVU23A

    $645.98changed to$628.51

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 11.17 changed to 11.13
    • Malpractice RVU 0.94 changed to 0.90
    • Practice expense GPCI 0.913 changed to 0.912
    • Malpractice GPCI 1.094 changed to 1.063

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $652.74changed to$645.98

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 11.25 changed to 11.17
    • Malpractice RVU 0.91 changed to 0.94

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $658.56changed to$652.74

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 10.78 changed to 11.25
    • Malpractice RVU 0.90 changed to 0.91
    • Practice expense GPCI 0.915 changed to 0.913
    • Malpractice GPCI 1.049 changed to 1.094

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $658.60changed to$658.56

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 10.84 changed to 10.78
    • Malpractice RVU 0.89 changed to 0.90
    • Practice expense GPCI 0.917 changed to 0.915
    • Malpractice GPCI 1.005 changed to 1.049

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $661.51changed to$658.60

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 10.95 changed to 10.84

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $660.39changed to$661.51

    • Conversion factor 35.8887 changed to 35.9996
    • Malpractice RVU 0.91 changed to 0.89
    • Practice expense GPCI 0.918 changed to 0.917
    • Malpractice GPCI 0.999 changed to 1.005

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $656.67changed to$660.39

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 10.89 changed to 10.95
    • Malpractice GPCI 0.993 changed to 0.999

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $667.78changed to$656.67

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 11.09 changed to 10.89
    • Malpractice RVU 0.97 changed to 0.91

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $664.46changed to$667.78

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $653.61changed to$664.46

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 10.63 changed to 11.09
    • Malpractice RVU 0.89 changed to 0.97
    • Practice expense GPCI 0.923 changed to 0.918
    • Malpractice GPCI 1.117 changed to 0.993

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $666.11changed to$653.61

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 11.85 changed to 10.63
    • Malpractice RVU 0.93 changed to 0.89
    • Practice expense GPCI 0.927 changed to 0.923
    • Malpractice GPCI 1.240 changed to 1.117

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $666.11

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$634.29$453.76RVU26D
2026-07-01$634.29$453.76RVU26C
2026-04-01$634.29$453.76RVU26B
2026-01-01$634.29$453.76RVU26A
2025-10-01$600.73$471.07RVU25D
2025-07-01$600.73$471.07RVU25C
2025-04-01$600.73$471.07RVU25B
2025-01-01$600.73$471.07RVU25A
2024-10-01$621.06$482.17RVU24D
2024-07-01$621.06$482.17RVU24C
2024-04-01$621.06$482.17RVU24B
2024-03-09$621.06$482.17RVU24AR
2024-01-01$610.92$474.30RVU24A
2023-10-01$628.51$484.50RVU23D
2023-07-01$628.51$484.50RVU23C
2023-04-01$628.51$484.50RVU23B
2023-01-01$628.51$484.50RVU23A
2022-10-01$645.98$493.37RVU22D
2022-07-01$645.98$493.37RVU22C
2022-04-01$645.98$493.37RVU22B
2022-01-01$645.98$493.37RVU22A
2021-10-01$652.74$491.86RVU21D
2021-07-01$652.74$491.86RVU21C
2021-04-01$652.74$491.86RVU21B
2021-01-01$652.74$491.86RVU21A
2020-10-01$658.56$500.05RVU20D
2020-07-01$658.56$500.05RVU20C
2020-04-01$658.56$500.05RVU20B
2020-01-01$658.56$500.05RVU20A
2019-10-01$658.60$498.65RVU19D
2019-07-01$658.60$498.65RVU19C
2019-04-01$658.60$498.65RVU19B
2019-01-01$658.60$498.65RVU19A
2018-10-01$661.51$499.76RVU18D
2018-07-01$661.51$499.76RVU18C
2018-04-01$661.51$499.76RVU18B
2018-01-01$661.51$499.76RVU18AR1
2017-10-01$660.39$499.29RVU17D
2017-07-01$660.39$499.29RVU17C
2017-04-01$660.39$499.29RVU17B
2017-01-01$660.39$499.29RVU17A
2016-10-01$656.67$496.61RVU16D
2016-07-01$656.67$496.61RVU16C
2016-04-01$656.67$496.61RVU16B
2016-01-01$656.67$496.61RVU16A
2015-10-01$667.78$504.50RVU15D
2015-07-01$667.78$504.50RVU15C
2015-04-01$664.46$501.99RVU15B
2015-01-01$664.46$501.99RVU15A
2014-10-01$653.61$496.88RVU14D
2014-07-01$653.61$496.88RVU14C
2014-04-01$653.61$496.88RVU14B
2014-01-01$653.61$496.88RVU14A
2013-10-01$666.11$497.69RVU13D
2013-07-01$666.11$497.69RVU13C
2013-04-01$666.11$497.69RVU13B
2013-01-01$666.11$497.69RVU13AR

Price 28505 for an earlier date of service

Where the Ohio rate applies

Ohio is a Medicare payment area, not a city. Our Census mapping connects it to 1265 cities and communities in Ohio. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Ada
  • Adamsville
  • Addyston
  • Adelphi
  • Adena
  • Ai
  • Akron

Browse all communities in Ohio

28505 billing questions

Does open treatment mean the fracture had an open wound?

No. Here, open treatment refers to surgical access to the fracture; it does not by itself mean the fracture was open through the skin.

How does this differ from closed treatment with manipulation?

Use this code for open surgical treatment of a great toe phalanx fracture. Closed treatment with manipulation is represented by 28495.

Is internal fixation separately reported?

Internal fixation is included when performed as part of this fracture treatment; it is not separately reported as a separate service under this code.

What documentation supports the code?

The operative record should identify the great toe phalanx fracture and describe the open treatment performed, including any fixation used.

How does the 90-day global period affect postoperative billing?

The day-before preoperative visit and 90 days of related postoperative care are included in the global period.

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 28505PPRRVU2026_Oct_nonQPP.csv, line 3,219 (RVU26D)
Geographic factors for OhioGPCI2026.csv, line 85 (RVU26D)

Open CMS sourceHow we calculate rates

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