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

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 South Dakota, Medicare pays $647.28 for 28505 in the office and $449.55 when it’s performed in a hospital or facility.

$647.28Office (non-facility)
$449.55Hospital or facility
−3.2%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 South Dakota
  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 South Dakota 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. South Dakota pays $647.28. The RVUs are the same everywhere; the geographic indexes change the dollars.

28505 in South Dakota vs other payment areas
  1. South Dakota · this page$647.28
  2. Los Angeles, CA · California$739.81+$92.53
  3. Washington, DC area · District of Columbia$755.23+$107.95
  4. Miami, FL · Florida$733.04+$85.76
  5. Chicago, IL · Illinois$713.11+$65.83
  6. Manhattan, NY · New York$766.35+$119.07
  7. Alaska · Alaska$800.82+$153.54

Other areas in South Dakota 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.

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 South Dakota 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

94

Locality
South Dakota
Physician work
1.000
Practice expense
1.000
Malpractice
0.336
Office calculation for 28505 in South Dakota
ComponentRVULocality factorAdjusted
Physician work7.25× 1.0007.2500
Practice expense11.81× 1.00011.8100
Malpractice0.95× 0.3360.3192
Total RVUs19.3792
Conversion factor× 33.4009

Office rate, South Dakota$647.28

Office: (7.25 × 1 + 11.81 × 1 + 0.95 × 0.336) × $33.4009 = $647.28

Facility: (7.25 × 1 + 5.89 × 1 + 0.95 × 0.336) × $33.4009 = $449.55

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

How 28505 has changed in South Dakota

28505 · Office / nonfacility

$647.28

Effective 2026-10-01

The base rate is $33.02 higher than on 2025-10-01, moving from $614.26 to $647.28 (5.4%).

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

    $614.26changed to$647.28

    • 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
    • Malpractice GPCI 0.382 changed to 0.336

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $634.51changed to$614.26

    • 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

    $624.15changed to$634.51

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $640.39changed to$624.15

    • 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
    • Malpractice GPCI 0.364 changed to 0.382
  5. January 1, 2023

    RVU23A

    $655.31changed to$640.39

    • 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
    • Malpractice GPCI 0.347 changed to 0.364

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $663.17changed to$655.31

    • 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

    $669.51changed to$663.17

    • 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
    • Malpractice GPCI 0.368 changed to 0.347

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $671.27changed to$669.51

    • 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
    • Malpractice GPCI 0.389 changed to 0.368

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $674.50changed to$671.27

    • 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

    $672.89changed to$674.50

    • Conversion factor 35.8887 changed to 35.9996
    • Malpractice RVU 0.91 changed to 0.89
    • Malpractice GPCI 0.395 changed to 0.389

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $669.33changed to$672.89

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 10.89 changed to 10.95
    • Malpractice GPCI 0.400 changed to 0.395

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $679.79changed to$669.33

    • 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

    $676.41changed to$679.79

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $660.58changed to$676.41

    • 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
    • Malpractice GPCI 0.416 changed to 0.400

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $669.97changed to$660.58

    • 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
    • Malpractice GPCI 0.432 changed to 0.416

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $669.97

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$647.28$449.55RVU26D
2026-07-01$647.28$449.55RVU26C
2026-04-01$647.28$449.55RVU26B
2026-01-01$647.28$449.55RVU26A
2025-10-01$614.26$471.93RVU25D
2025-07-01$614.26$471.93RVU25C
2025-04-01$614.26$471.93RVU25B
2025-01-01$614.26$471.93RVU25A
2024-10-01$634.51$482.05RVU24D
2024-07-01$634.51$482.05RVU24C
2024-04-01$634.51$482.05RVU24B
2024-03-09$634.51$482.05RVU24AR
2024-01-01$624.15$474.18RVU24A
2023-10-01$640.39$482.47RVU23D
2023-07-01$640.39$482.47RVU23C
2023-04-01$640.39$482.47RVU23B
2023-01-01$640.39$482.47RVU23A
2022-10-01$655.31$488.16RVU22D
2022-07-01$655.31$488.16RVU22C
2022-04-01$655.31$488.16RVU22B
2022-01-01$655.31$488.16RVU22A
2021-10-01$663.17$486.96RVU21D
2021-07-01$663.17$486.96RVU21C
2021-04-01$663.17$486.96RVU21B
2021-01-01$663.17$486.96RVU21A
2020-10-01$669.51$496.28RVU20D
2020-07-01$669.51$496.28RVU20C
2020-04-01$669.51$496.28RVU20B
2020-01-01$669.51$496.28RVU20A
2019-10-01$671.27$496.84RVU19D
2019-07-01$671.27$496.84RVU19C
2019-04-01$671.27$496.84RVU19B
2019-01-01$671.27$496.84RVU19A
2018-10-01$674.50$498.10RVU18D
2018-07-01$674.50$498.10RVU18C
2018-04-01$674.50$498.10RVU18B
2018-01-01$674.50$498.10RVU18AR1
2017-10-01$672.89$497.40RVU17D
2017-07-01$672.89$497.40RVU17C
2017-04-01$672.89$497.40RVU17B
2017-01-01$672.89$497.40RVU17A
2016-10-01$669.33$494.96RVU16D
2016-07-01$669.33$494.96RVU16C
2016-04-01$669.33$494.96RVU16B
2016-01-01$669.33$494.96RVU16A
2015-10-01$679.79$501.92RVU15D
2015-07-01$679.79$501.92RVU15C
2015-04-01$676.41$499.42RVU15B
2015-01-01$676.41$499.42RVU15A
2014-10-01$660.58$490.78RVU14D
2014-07-01$660.58$490.78RVU14C
2014-04-01$660.58$490.78RVU14B
2014-01-01$660.58$490.78RVU14A
2013-10-01$669.97$488.29RVU13D
2013-07-01$669.97$488.29RVU13C
2013-04-01$669.97$488.29RVU13B
2013-01-01$669.97$488.29RVU13AR

Price 28505 for an earlier date of service

Where the South Dakota rate applies

South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Agar
  • Agency Village
  • Akaska
  • Albee
  • Alcester
  • Alexandria
  • Allen

Browse all communities in South Dakota

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 South DakotaGPCI2026.csv, line 94 (RVU26D)

Open CMS sourceHow we calculate rates

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