CPT code 28505: Toe fracture surgery, great toe, open treatment2026 Medicare rate & RVUs in King County, WA
Reports open surgical treatment of a great toe phalanx fracture, with internal fixation included when performed as part of the procedure.
In King County, WA, Medicare pays $764.20 for 28505 in the office and $521.58 when it’s performed in a hospital or facility.
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.
On this page 11 sections
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 King County, WA 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. King County, WA pays $764.20. The RVUs are the same everywhere; the geographic indexes change the dollars.
- King County, WA · this page$764.20
- Rest of Washington · Washington$684.82−$79.38
- Los Angeles, CA · California$739.81−$24.39
- Washington, DC area · District of Columbia$755.23−$8.97
- Miami, FL · Florida$733.04−$31.16
- Chicago, IL · Illinois$713.11−$51.09
- Manhattan, NY · New York$766.35+$2.15
Other areas in Washington first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlaskaAlaska | $800.82 | $590.24 |
| 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 |
| Madera, CACalifornia | $695.61 | $478.90 |
| Merced, CACalifornia | $695.61 | $478.90 |
| Modesto, CACalifornia | $695.61 | $478.90 |
| Napa, CACalifornia | $793.44 | $532.82 |
| Oxnard, CACalifornia | $734.96 | $501.24 |
| Redding, CACalifornia | $695.61 | $478.90 |
| Rest of CaliforniaCalifornia | $695.61 | $478.90 |
| Riverside, CACalifornia | $705.91 | $489.20 |
| Sacramento, CACalifornia | $726.64 | $496.68 |
| Salinas, CACalifornia | $723.86 | $494.68 |
| San Diego, CACalifornia | $738.40 | $501.91 |
| Marin County, CACalifornia | $835.92 | $557.12 |
| San Francisco, CACalifornia | $834.84 | $556.04 |
| San Benito County, CACalifornia | $854.62 | $569.49 |
| Santa Clara County, CACalifornia | $850.21 | $565.08 |
| San Luis Obispo, CACalifornia | $712.58 | $487.36 |
| Santa Cruz, CACalifornia | $743.52 | $503.28 |
| Santa Maria, CACalifornia | $725.89 | $495.33 |
| Santa Rosa, CACalifornia | $750.83 | $508.01 |
| Stockton, CACalifornia | $695.61 | $478.90 |
| Vallejo, CACalifornia | $791.88 | $531.27 |
| Visalia, CACalifornia | $695.61 | $478.90 |
| Yuba City, CACalifornia | $695.61 | $478.90 |
| ColoradoColorado | $689.55 | $479.17 |
| ConnecticutConnecticut | $710.23 | $497.27 |
| DelawareDelaware | $661.62 | $466.26 |
| Fort Lauderdale, FLFlorida | $699.12 | $498.81 |
| Rest of FloridaFlorida | $666.96 | $477.92 |
| Atlanta, GAGeorgia | $681.77 | $480.87 |
| Rest of GeorgiaGeorgia | $631.84 | $455.46 |
| Hawaii, Guam, HIHawaii | $709.03 | $484.21 |
| IowaIowa | $615.69 | $434.76 |
| IdahoIdaho | $620.07 | $438.16 |
| East St. Louis, ILIllinois | $668.97 | $487.06 |
| Rest of IllinoisIllinois | $651.90 | $471.37 |
| Suburban Chicago, ILIllinois | $705.19 | $502.12 |
| IndianaIndiana | $623.25 | $439.95 |
| KansasKansas | $614.74 | $435.99 |
| KentuckyKentucky | $621.87 | $446.08 |
| New Orleans, LALouisiana | $649.39 | $463.33 |
| Rest of LouisianaLouisiana | $621.66 | $446.66 |
| Metropolitan Boston, MAMassachusetts | $751.32 | $515.22 |
| Rest of MassachusettsMassachusetts | $686.69 | $478.48 |
| Baltimore area, MDMaryland | $708.54 | $496.37 |
| Rest of MarylandMaryland | $672.91 | $472.80 |
| Rest of MaineMaine | $624.80 | $442.89 |
| Southern Maine, MEMaine | $653.09 | $457.14 |
| Detroit, MIMichigan | $676.31 | $485.50 |
| Rest of MichiganMichigan | $638.13 | $457.60 |
| MinnesotaMinnesota | $657.45 | $453.99 |
| Metropolitan Kansas City, MOMissouri | $643.56 | $457.89 |
| Metropolitan St. Louis, MOMissouri | $649.48 | $461.24 |
| Rest of MissouriMissouri | $613.09 | $442.64 |
| MississippiMississippi | $605.24 | $434.99 |
| MontanaMontana | $668.29 | $470.56 |
| North CarolinaNorth Carolina | $630.47 | $445.98 |
| North DakotaNorth Dakota | $649.50 | $451.77 |
| NebraskaNebraska | $618.24 | $435.73 |
| New HampshireNew Hampshire | $680.56 | $474.72 |
| Northern New JerseyNew Jersey | $748.88 | $519.51 |
| Rest of New JerseyNew Jersey | $717.41 | $501.48 |
| New MexicoNew Mexico | $641.99 | $460.67 |
| NevadaNevada | $663.45 | $465.52 |
| NYC suburbs and Long Island, NYNew York | $785.60 | $550.49 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $723.39 | $506.87 |
| Queens, NYNew York | $769.67 | $535.95 |
| Rest of New YorkNew York | $639.20 | $451.36 |
| OhioOhio | $634.29 | $453.76 |
| OklahomaOklahoma | $619.07 | $442.49 |
| Portland, OROregon | $707.89 | $488.21 |
| Rest of OregonOregon | $657.35 | $460.41 |
| Metropolitan Philadelphia, PAPennsylvania | $695.01 | $489.17 |
| Rest of PennsylvaniaPennsylvania | $634.26 | $452.74 |
| Puerto RicoPuerto Rico | $672.22 | $472.31 |
| Rhode IslandRhode Island | $682.54 | $478.28 |
| South CarolinaSouth Carolina | $633.61 | $450.91 |
| South DakotaSouth Dakota | $647.28 | $449.55 |
| TennesseeTennessee | $617.76 | $438.02 |
| Austin, TXTexas | $688.10 | $478.90 |
| Beaumont, TXTexas | $630.60 | $450.66 |
| Brazoria, TXTexas | $659.76 | $463.80 |
| Dallas, TXTexas | $664.45 | $467.51 |
| Fort Worth, TXTexas | $660.92 | $465.95 |
| Galveston, TXTexas | $662.07 | $465.72 |
| Houston, TXTexas | $679.46 | $483.11 |
| Rest of TexasTexas | $645.16 | $457.51 |
| UtahUtah | $641.45 | $455.58 |
| VirginiaVirginia | $652.32 | $457.95 |
| Virgin Islands, VIUnited States Virgin Islands | $672.22 | $472.31 |
| VermontVermont | $648.73 | $452.98 |
| WisconsinWisconsin | $629.83 | $440.40 |
| West VirginiaWest Virginia | $630.35 | $458.52 |
| WyomingWyoming | $660.10 | $462.37 |
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $800.82 | 1 |
| AL | $605.27 | 1 |
| AR | $597.34 | 1 |
| AZ | $651.55 | 1 |
| CA | $695.61–$854.62 | 29 |
| CO | $689.55 | 1 |
| CT | $710.23 | 1 |
| DC | $755.23 | 1 |
| DE | $661.62 | 1 |
| FL | $666.96–$733.04 | 3 |
| GA | $631.84–$681.77 | 2 |
| GU | $709.03 | 1 |
| HI | $709.03 | 1 |
| IA | $615.69 | 1 |
| ID | $620.07 | 1 |
| IL | $651.90–$713.11 | 4 |
| IN | $623.25 | 1 |
| KS | $614.74 | 1 |
| KY | $621.87 | 1 |
| LA | $621.66–$649.39 | 2 |
| MA | $686.69–$751.32 | 2 |
| MD | $672.91–$755.23 | 3 |
| ME | $624.80–$653.09 | 2 |
| MI | $638.13–$676.31 | 2 |
| MN | $657.45 | 1 |
| MO | $613.09–$649.48 | 3 |
| MS | $605.24 | 1 |
| MT | $668.29 | 1 |
| NC | $630.47 | 1 |
| ND | $649.50 | 1 |
| NE | $618.24 | 1 |
| NH | $680.56 | 1 |
| NJ | $717.41–$748.88 | 2 |
| NM | $641.99 | 1 |
| NV | $663.45 | 1 |
| NY | $639.20–$785.60 | 5 |
| OH | $634.29 | 1 |
| OK | $619.07 | 1 |
| OR | $657.35–$707.89 | 2 |
| PA | $634.26–$695.01 | 2 |
| PR | $672.22 | 1 |
| RI | $682.54 | 1 |
| SC | $633.61 | 1 |
| SD | $647.28 | 1 |
| TN | $617.76 | 1 |
| TX | $630.60–$688.10 | 8 |
| UT | $641.45 | 1 |
| VA | $652.32–$755.23 | 2 |
| VI | $672.22 | 1 |
| VT | $648.73 | 1 |
| WA | $684.82–$764.20 | 2 |
| WI | $629.83 | 1 |
| WV | $630.35 | 1 |
| WY | $660.10 | 1 |
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
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 King County, WA 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
108
- Locality
- King County, WA
- Physician work
- 1.050
- Practice expense
- 1.227
- Malpractice
- 0.817
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.25 | × 1.050 | 7.6125 |
| Practice expense | 11.81 | × 1.227 | 14.4909 |
| Malpractice | 0.95 | × 0.817 | 0.7761 |
| Total RVUs | 22.8795 | ||
| Conversion factor | × 33.4009 | ||
Office rate, King County, WA$764.20
Office: (7.25 × 1.05 + 11.81 × 1.227 + 0.95 × 0.817) × $33.4009 = $764.20
Facility: (7.25 × 1.05 + 5.89 × 1.227 + 0.95 × 0.817) × $33.4009 = $521.58
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share 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.
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).
How 28505 has changed in King County, WA
28505 · Office / nonfacility
$764.20
Effective 2026-10-01
The base rate is $46.26 higher than on 2025-10-01, moving from $717.94 to $764.20 (6.4%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$717.94changed to$764.20
- 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
- Work GPCI 1.043 changed to 1.050
- Practice expense GPCI 1.220 changed to 1.227
- Malpractice GPCI 0.853 changed to 0.817
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$742.11changed to$717.94
- 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.
March 9, 2024
RVU24AR
$730.00changed to$742.11
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$742.05changed to$730.00
- 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
- Work GPCI 1.039 changed to 1.043
- Practice expense GPCI 1.207 changed to 1.220
- Malpractice GPCI 0.815 changed to 0.853
January 1, 2023
RVU23A
$753.52changed to$742.05
- 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
- Work GPCI 1.036 changed to 1.039
- Practice expense GPCI 1.194 changed to 1.207
- Malpractice GPCI 0.776 changed to 0.815
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$762.29changed to$753.52
- 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.
January 1, 2021
RVU21A
$759.75changed to$762.29
- 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
- Work GPCI 1.031 changed to 1.036
- Practice expense GPCI 1.170 changed to 1.194
- Malpractice GPCI 0.854 changed to 0.776
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$752.93changed to$759.75
- 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
- Work GPCI 1.027 changed to 1.031
- Practice expense GPCI 1.146 changed to 1.170
- Malpractice GPCI 0.931 changed to 0.854
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$756.65changed to$752.93
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 10.95 changed to 10.84
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$749.56changed to$756.65
- Conversion factor 35.8887 changed to 35.9996
- Malpractice RVU 0.91 changed to 0.89
- Work GPCI 1.026 changed to 1.027
- Practice expense GPCI 1.151 changed to 1.146
- Malpractice GPCI 0.713 changed to 0.931
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$739.52changed to$749.56
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 10.89 changed to 10.95
- Work GPCI 1.025 changed to 1.026
- Practice expense GPCI 1.155 changed to 1.151
- Malpractice GPCI 0.495 changed to 0.713
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$751.55changed to$739.52
- 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.
July 1, 2015
RVU15C
$747.81changed to$751.55
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$733.04changed to$747.81
- 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 1.150 changed to 1.155
- Malpractice GPCI 0.688 changed to 0.495
Held through RVU15B.
January 1, 2014
RVU14A
$748.56changed to$733.04
- 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 1.144 changed to 1.150
- Malpractice GPCI 0.881 changed to 0.688
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $748.56
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $764.20 | $521.58 | RVU26D |
| 2026-07-01 | $764.20 | $521.58 | RVU26C |
| 2026-04-01 | $764.20 | $521.58 | RVU26B |
| 2026-01-01 | $764.20 | $521.58 | RVU26A |
| 2025-10-01 | $717.94 | $544.30 | RVU25D |
| 2025-07-01 | $717.94 | $544.30 | RVU25C |
| 2025-04-01 | $717.94 | $544.30 | RVU25B |
| 2025-01-01 | $717.94 | $544.30 | RVU25A |
| 2024-10-01 | $742.11 | $556.12 | RVU24D |
| 2024-07-01 | $742.11 | $556.12 | RVU24C |
| 2024-04-01 | $742.11 | $556.12 | RVU24B |
| 2024-03-09 | $742.11 | $556.12 | RVU24AR |
| 2024-01-01 | $730.00 | $547.04 | RVU24A |
| 2023-10-01 | $742.05 | $551.44 | RVU23D |
| 2023-07-01 | $742.05 | $551.44 | RVU23C |
| 2023-04-01 | $742.05 | $551.44 | RVU23B |
| 2023-01-01 | $742.05 | $551.44 | RVU23A |
| 2022-10-01 | $753.52 | $553.95 | RVU22D |
| 2022-07-01 | $753.52 | $553.95 | RVU22C |
| 2022-04-01 | $753.52 | $553.95 | RVU22B |
| 2022-01-01 | $753.52 | $553.95 | RVU22A |
| 2021-10-01 | $762.29 | $551.90 | RVU21D |
| 2021-07-01 | $762.29 | $551.90 | RVU21C |
| 2021-04-01 | $762.29 | $551.90 | RVU21B |
| 2021-01-01 | $762.29 | $551.90 | RVU21A |
| 2020-10-01 | $759.75 | $557.07 | RVU20D |
| 2020-07-01 | $759.75 | $557.07 | RVU20C |
| 2020-04-01 | $759.75 | $557.07 | RVU20B |
| 2020-01-01 | $759.75 | $557.07 | RVU20A |
| 2019-10-01 | $752.93 | $553.04 | RVU19D |
| 2019-07-01 | $752.93 | $553.04 | RVU19C |
| 2019-04-01 | $752.93 | $553.04 | RVU19B |
| 2019-01-01 | $752.93 | $553.04 | RVU19A |
| 2018-10-01 | $756.65 | $554.49 | RVU18D |
| 2018-07-01 | $756.65 | $554.49 | RVU18C |
| 2018-04-01 | $756.65 | $554.49 | RVU18B |
| 2018-01-01 | $756.65 | $554.49 | RVU18AR1 |
| 2017-10-01 | $749.56 | $547.57 | RVU17D |
| 2017-07-01 | $749.56 | $547.57 | RVU17C |
| 2017-04-01 | $749.56 | $547.57 | RVU17B |
| 2017-01-01 | $749.56 | $547.57 | RVU17A |
| 2016-10-01 | $739.52 | $538.12 | RVU16D |
| 2016-07-01 | $739.52 | $538.12 | RVU16C |
| 2016-04-01 | $739.52 | $538.12 | RVU16B |
| 2016-01-01 | $739.52 | $538.12 | RVU16A |
| 2015-10-01 | $751.55 | $546.11 | RVU15D |
| 2015-07-01 | $751.55 | $546.11 | RVU15C |
| 2015-04-01 | $747.81 | $543.39 | RVU15B |
| 2015-01-01 | $747.81 | $543.39 | RVU15A |
| 2014-10-01 | $733.04 | $537.77 | RVU14D |
| 2014-07-01 | $733.04 | $537.77 | RVU14C |
| 2014-04-01 | $733.04 | $537.77 | RVU14B |
| 2014-01-01 | $733.04 | $537.77 | RVU14A |
| 2013-10-01 | $748.56 | $540.72 | RVU13D |
| 2013-07-01 | $748.56 | $540.72 | RVU13C |
| 2013-04-01 | $748.56 | $540.72 | RVU13B |
| 2013-01-01 | $748.56 | $540.72 | RVU13AR |
Where the King County, WA rate applies
King County, WA is a Medicare payment area, not a city. Our Census mapping connects it to 63 cities and communities in Washington. Some span more than one payment area; confirm with the service ZIP.
- Seattle
- Algona
- Ames Lake
- 28505 in Auburn · multiple payment areas
- Baring
- Beaux Arts Village
- Bellevue
- Black Diamond
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
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Your codes at your locality, with payer contracts beside Medicare.
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