CPT code 28515: Toe fracture care, with manipulation2026 Medicare rate & RVUs

Medicare pays $174.35 for 28515 nationally in the office and $144.96 in a hospital or facility. Local office rates run $154.86–$229.11.

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

What 28515 covers

This service covers closed treatment of a fracture in one or more phalanges of a toe other than the great toe, with manipulation to reduce or realign the fracture. Orthopedic surgeons, podiatrists, and other clinicians who manage acute fractures may perform it in an office, emergency department, or facility. The fracture is treated without open surgical exposure; the manipulation is the feature that distinguishes this service from closed treatment without manipulation.

Report the code for each treated fracture, supporting the record with the affected toe and side, fracture findings, and the reduction or other manipulation performed. Routine related care during the 90-day global period, including the day-before preoperative visit, is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. CMS does not apply a bilateral adjustment, and modifier 50 is inappropriate. Assistant-at-surgery payment is statutorily restricted; 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.

Where 28515 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

28515 rates by state

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

How the 28515 rate is calculated

Each of 28515’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.

Payment rules and modifiers for 28515

28515 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

28515 compared with similar codes

How to choose

28510Toe fracture careWithout manipulation

Use 28510 for closed treatment of a lesser-toe phalanx fracture without manipulation; 28515 requires manipulation.

28495Toe fracture treatmentGreat toe, with manipulation

Both describe closed treatment with manipulation, but 28495 is for the great toe and 28515 is for other toes.

28525Toe fracture repairLesser toe, open treatment

28525 is open treatment of a lesser-toe phalanx fracture. This code describes closed treatment with manipulation.

Codes related to 28515

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

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

Open CMS sourceHow we calculate rates