CPT code 28515: Toe fracture care, with manipulation2026 Medicare rate & RVUs in Arkansas
Report this code for closed reduction of a phalangeal fracture in a toe other than the great toe when the clinician manipulates the fracture.
In Arkansas, Medicare pays $154.86 for 28515 in the office and $129.61 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 28515 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 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.
How Arkansas compares for 28515
Across 109 of 109 payment localities, the office rate for 28515 runs from $154.86 in Arkansas to $229.11 in San Benito County, CA. Arkansas pays $154.86. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Arkansas · this page$154.86
- Los Angeles, CA · California$195.93+$41.07
- Washington, DC area · District of Columbia$198.70+$43.84
- Miami, FL · Florida$188.37+$33.51
- Chicago, IL · Illinois$183.08+$28.22
- Manhattan, NY · New York$200.17+$45.31
- Alaska · Alaska$204.68+$49.82
Other areas in Arkansas first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $157.05 | $131.33 |
| ArizonaArizona | $169.84 | $141.36 |
| Bakersfield, CACalifornia | $184.25 | $152.04 |
| Chico, CACalifornia | $183.71 | $151.50 |
| El Centro, CACalifornia | $183.74 | $151.53 |
| Fresno, CACalifornia | $183.71 | $151.50 |
| Hanford, CACalifornia | $183.71 | $151.50 |
| Madera, CACalifornia | $183.71 | $151.50 |
| Merced, CACalifornia | $183.71 | $151.50 |
| Modesto, CACalifornia | $183.71 | $151.50 |
| Napa, CACalifornia | $211.98 | $173.24 |
| Oxnard, CACalifornia | $194.91 | $160.16 |
| Redding, CACalifornia | $183.71 | $151.50 |
| Rest of CaliforniaCalifornia | $183.71 | $151.50 |
| Riverside, CACalifornia | $185.67 | $153.46 |
| Sacramento, CACalifornia | $192.55 | $158.37 |
| Salinas, CACalifornia | $191.83 | $157.76 |
| San Diego, CACalifornia | $196.17 | $161.01 |
| Marin County, CACalifornia | $224.13 | $182.68 |
| San Francisco, CACalifornia | $223.92 | $182.48 |
| San Benito County, CACalifornia | $229.11 | $186.73 |
| Santa Clara County, CACalifornia | $228.28 | $185.89 |
| San Luis Obispo, CACalifornia | $188.77 | $155.29 |
| Santa Cruz, CACalifornia | $197.91 | $162.19 |
| Santa Maria, CACalifornia | $192.50 | $158.23 |
| Santa Rosa, CACalifornia | $199.89 | $163.80 |
| Stockton, CACalifornia | $183.71 | $151.50 |
| Vallejo, CACalifornia | $211.69 | $172.95 |
| Visalia, CACalifornia | $183.71 | $151.50 |
| Yuba City, CACalifornia | $183.71 | $151.50 |
| ColoradoColorado | $181.17 | $149.90 |
| ConnecticutConnecticut | $185.68 | $154.03 |
| DelawareDelaware | $172.59 | $143.55 |
| Fort Lauderdale, FLFlorida | $180.74 | $150.96 |
| Rest of FloridaFlorida | $172.20 | $144.10 |
| Atlanta, GAGeorgia | $177.59 | $147.73 |
| Rest of GeorgiaGeorgia | $162.81 | $136.59 |
| Hawaii, Guam, HIHawaii | $187.93 | $154.51 |
| IowaIowa | $160.73 | $133.84 |
| IdahoIdaho | $161.78 | $134.74 |
| East St. Louis, ILIllinois | $171.04 | $144.00 |
| Rest of IllinoisIllinois | $167.51 | $140.67 |
| Suburban Chicago, ILIllinois | $182.52 | $152.34 |
| IndianaIndiana | $162.68 | $135.43 |
| KansasKansas | $160.08 | $133.51 |
| KentuckyKentucky | $160.79 | $134.66 |
| New Orleans, LALouisiana | $168.23 | $140.58 |
| Rest of LouisianaLouisiana | $160.58 | $134.57 |
| Metropolitan Boston, MAMassachusetts | $198.58 | $163.49 |
| Rest of MassachusettsMassachusetts | $180.18 | $149.23 |
| Baltimore area, MDMaryland | $185.17 | $153.63 |
| Rest of MarylandMaryland | $175.78 | $146.03 |
| Rest of MaineMaine | $162.67 | $135.63 |
| Southern Maine, MEMaine | $171.08 | $141.95 |
| Detroit, MIMichigan | $174.36 | $146.00 |
| Rest of MichiganMichigan | $164.90 | $138.06 |
| MinnesotaMinnesota | $173.53 | $143.28 |
| Metropolitan Kansas City, MOMissouri | $167.04 | $139.44 |
| Metropolitan St. Louis, MOMissouri | $168.72 | $140.74 |
| Rest of MissouriMissouri | $157.97 | $132.63 |
| MississippiMississippi | $156.44 | $131.13 |
| MontanaMontana | $174.34 | $144.95 |
| North CarolinaNorth Carolina | $164.31 | $136.88 |
| North DakotaNorth Dakota | $170.78 | $141.39 |
| NebraskaNebraska | $161.56 | $134.43 |
| New HampshireNew Hampshire | $178.42 | $147.82 |
| Northern New JerseyNew Jersey | $196.77 | $162.68 |
| Rest of New JerseyNew Jersey | $187.78 | $155.69 |
| New MexicoNew Mexico | $165.80 | $138.85 |
| NevadaNevada | $173.47 | $144.04 |
| NYC suburbs and Long Island, NYNew York | $204.98 | $170.03 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $189.07 | $156.88 |
| Queens, NYNew York | $201.66 | $166.91 |
| Rest of New YorkNew York | $166.69 | $138.77 |
| OhioOhio | $164.17 | $137.34 |
| OklahomaOklahoma | $160.43 | $134.18 |
| Portland, OROregon | $186.68 | $154.02 |
| Rest of OregonOregon | $172.10 | $142.82 |
| Metropolitan Philadelphia, PAPennsylvania | $181.25 | $150.65 |
| Rest of PennsylvaniaPennsylvania | $164.38 | $137.40 |
| Puerto RicoPuerto Rico | $175.56 | $145.84 |
| Rhode IslandRhode Island | $178.55 | $148.19 |
| South CarolinaSouth Carolina | $164.52 | $137.36 |
| South DakotaSouth Dakota | $170.36 | $140.97 |
| TennesseeTennessee | $160.87 | $134.15 |
| Austin, TXTexas | $180.59 | $149.49 |
| Beaumont, TXTexas | $163.34 | $136.60 |
| Brazoria, TXTexas | $172.38 | $143.25 |
| Dallas, TXTexas | $173.49 | $144.21 |
| Fort Worth, TXTexas | $172.39 | $143.41 |
| Galveston, TXTexas | $172.90 | $143.71 |
| Houston, TXTexas | $176.20 | $147.01 |
| Rest of TexasTexas | $167.77 | $139.88 |
| UtahUtah | $166.69 | $139.06 |
| VirginiaVirginia | $170.59 | $141.69 |
| Virgin Islands, VIUnited States Virgin Islands | $175.56 | $145.84 |
| VermontVermont | $170.21 | $141.11 |
| Rest of WashingtonWashington | $179.81 | $148.86 |
| King County, WAWashington | $202.48 | $166.41 |
| WisconsinWisconsin | $165.25 | $137.10 |
| West VirginiaWest Virginia | $161.54 | $136.00 |
| WyomingWyoming | $172.79 | $143.40 |
28515 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.
$154.86
$206.41
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 | $204.68 | 1 |
| AL | $157.05 | 1 |
| AR | $154.86 | 1 |
| AZ | $169.84 | 1 |
| CA | $183.71–$229.11 | 29 |
| CO | $181.17 | 1 |
| CT | $185.68 | 1 |
| DC | $198.70 | 1 |
| DE | $172.59 | 1 |
| FL | $172.20–$188.37 | 3 |
| GA | $162.81–$177.59 | 2 |
| GU | $187.93 | 1 |
| HI | $187.93 | 1 |
| IA | $160.73 | 1 |
| ID | $161.78 | 1 |
| IL | $167.51–$183.08 | 4 |
| IN | $162.68 | 1 |
| KS | $160.08 | 1 |
| KY | $160.79 | 1 |
| LA | $160.58–$168.23 | 2 |
| MA | $180.18–$198.58 | 2 |
| MD | $175.78–$198.70 | 3 |
| ME | $162.67–$171.08 | 2 |
| MI | $164.90–$174.36 | 2 |
| MN | $173.53 | 1 |
| MO | $157.97–$168.72 | 3 |
| MS | $156.44 | 1 |
| MT | $174.34 | 1 |
| NC | $164.31 | 1 |
| ND | $170.78 | 1 |
| NE | $161.56 | 1 |
| NH | $178.42 | 1 |
| NJ | $187.78–$196.77 | 2 |
| NM | $165.80 | 1 |
| NV | $173.47 | 1 |
| NY | $166.69–$204.98 | 5 |
| OH | $164.17 | 1 |
| OK | $160.43 | 1 |
| OR | $172.10–$186.68 | 2 |
| PA | $164.38–$181.25 | 2 |
| PR | $175.56 | 1 |
| RI | $178.55 | 1 |
| SC | $164.52 | 1 |
| SD | $170.36 | 1 |
| TN | $160.87 | 1 |
| TX | $163.34–$180.59 | 8 |
| UT | $166.69 | 1 |
| VA | $170.59–$198.70 | 2 |
| VI | $175.56 | 1 |
| VT | $170.21 | 1 |
| WA | $179.81–$202.48 | 2 |
| WI | $165.25 | 1 |
| WV | $161.54 | 1 |
| WY | $172.79 | 1 |
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.
How the rate is built · 28515
RVUs × geographic indexes × conversion factor
Work1.52
1.52 RVUs× 1.000 GPCI
Practice expense3.52
3.52 RVUs× 1.000 GPCI
Malpractice0.18
0.18 RVUs× 1.000 GPCI
Adjusted RVUs
5.2200
Conversion factor
$33.4009
Medicare rate
$174.35
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Arkansas inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
3,221
- Code
- 28515
- Physician work
- 1.52
- Practice expense
- 3.52
- Malpractice
- 0.18
GPCI2026.csv
7
- Locality
- Arkansas
- Physician work
- 1.000
- Practice expense
- 0.859
- Malpractice
- 0.515
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.52 | × 1.000 | 1.5200 |
| Practice expense | 3.52 | × 0.859 | 3.0237 |
| Malpractice | 0.18 | × 0.515 | 0.0927 |
| Total RVUs | 4.6364 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Arkansas$154.86
Office: (1.52 × 1 + 3.52 × 0.859 + 0.18 × 0.515) × $33.4009 = $154.86
Facility: (1.52 × 1 + 2.64 × 0.859 + 0.18 × 0.515) × $33.4009 = $129.61
Payment rules and modifiers for 28515
28515 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28515
Toe fracture care, with manipulation
| 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| 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 · 28515
Toe fracture care, with manipulation
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 51 · payment effect
With and without the modifier
28515 without 51 · national office
$174.35
Toe fracture care, with manipulation
28515-51 · Second procedure: 50%
$87.18
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
How 28515 has changed in Arkansas
28515 · Office / nonfacility
$154.86
Effective 2026-10-01
The base rate is $7.14 higher than on 2025-10-01, moving from $147.72 to $154.86 (4.8%).
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
$147.72changed to$154.86
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 1.56 changed to 1.52
- Practice expense RVU 3.40 changed to 3.52
- Malpractice RVU 0.16 changed to 0.18
- Practice expense GPCI 0.860 changed to 0.859
- Malpractice GPCI 0.518 changed to 0.515
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$151.33changed to$147.72
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 3.37 changed to 3.40
- Malpractice RVU 0.17 changed to 0.16
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$148.86changed to$151.33
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$149.23changed to$148.86
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 3.23 changed to 3.37
- Malpractice RVU 0.18 changed to 0.17
- Practice expense GPCI 0.853 changed to 0.860
- Malpractice GPCI 0.492 changed to 0.518
January 1, 2023
RVU23A
$148.04changed to$149.23
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 3.11 changed to 3.23
- Practice expense GPCI 0.847 changed to 0.853
- Malpractice GPCI 0.465 changed to 0.492
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$147.17changed to$148.04
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 3.05 changed to 3.11
- Malpractice RVU 0.16 changed to 0.18
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$150.52changed to$147.17
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 2.93 changed to 3.05
- Malpractice RVU 0.18 changed to 0.16
- Practice expense GPCI 0.859 changed to 0.847
- Malpractice GPCI 0.521 changed to 0.465
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$152.25changed to$150.52
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 2.95 changed to 2.93
- Malpractice RVU 0.16 changed to 0.18
- Practice expense GPCI 0.872 changed to 0.859
- Malpractice GPCI 0.576 changed to 0.521
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$151.77changed to$152.25
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 2.94 changed to 2.95
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$150.03changed to$151.77
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 2.91 changed to 2.94
- Practice expense GPCI 0.870 changed to 0.872
- Malpractice GPCI 0.555 changed to 0.576
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$149.25changed to$150.03
- Conversion factor 35.8043 changed to 35.8887
- Practice expense GPCI 0.867 changed to 0.870
- Malpractice GPCI 0.534 changed to 0.555
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$150.91changed to$149.25
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 2.94 changed to 2.91
- Malpractice RVU 0.17 changed to 0.16
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$150.16changed to$150.91
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$146.98changed to$150.16
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 2.84 changed to 2.94
- Practice expense GPCI 0.866 changed to 0.867
- Malpractice GPCI 0.492 changed to 0.534
Held through RVU15B.
January 1, 2014
RVU14A
$148.83changed to$146.98
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 3.16 changed to 2.84
- Malpractice RVU 0.18 changed to 0.17
- Practice expense GPCI 0.865 changed to 0.866
- Malpractice GPCI 0.450 changed to 0.492
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $148.83
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $154.86 | $129.61 | RVU26D |
| 2026-07-01 | $154.86 | $129.61 | RVU26C |
| 2026-04-01 | $154.86 | $129.61 | RVU26B |
| 2026-01-01 | $154.86 | $129.61 | RVU26A |
| 2025-10-01 | $147.72 | $129.92 | RVU25D |
| 2025-07-01 | $147.72 | $129.92 | RVU25C |
| 2025-04-01 | $147.72 | $129.92 | RVU25B |
| 2025-01-01 | $147.72 | $129.92 | RVU25A |
| 2024-10-01 | $151.33 | $132.73 | RVU24D |
| 2024-07-01 | $151.33 | $132.73 | RVU24C |
| 2024-04-01 | $151.33 | $132.73 | RVU24B |
| 2024-03-09 | $151.33 | $132.73 | RVU24AR |
| 2024-01-01 | $148.86 | $130.56 | RVU24A |
| 2023-10-01 | $149.23 | $131.02 | RVU23D |
| 2023-07-01 | $149.23 | $131.02 | RVU23C |
| 2023-04-01 | $149.23 | $131.02 | RVU23B |
| 2023-01-01 | $149.23 | $131.02 | RVU23A |
| 2022-10-01 | $148.04 | $129.57 | RVU22D |
| 2022-07-01 | $148.04 | $129.57 | RVU22C |
| 2022-04-01 | $148.04 | $129.57 | RVU22B |
| 2022-01-01 | $148.04 | $129.57 | RVU22A |
| 2021-10-01 | $147.17 | $128.55 | RVU21D |
| 2021-07-01 | $147.17 | $128.55 | RVU21C |
| 2021-04-01 | $147.17 | $128.55 | RVU21B |
| 2021-01-01 | $147.17 | $128.55 | RVU21A |
| 2020-10-01 | $150.52 | $132.23 | RVU20D |
| 2020-07-01 | $150.52 | $132.23 | RVU20C |
| 2020-04-01 | $150.52 | $132.23 | RVU20B |
| 2020-01-01 | $150.52 | $132.23 | RVU20A |
| 2019-10-01 | $152.25 | $133.71 | RVU19D |
| 2019-07-01 | $152.25 | $133.71 | RVU19C |
| 2019-04-01 | $152.25 | $133.71 | RVU19B |
| 2019-01-01 | $152.25 | $133.71 | RVU19A |
| 2018-10-01 | $151.77 | $133.56 | RVU18D |
| 2018-07-01 | $151.77 | $133.56 | RVU18C |
| 2018-04-01 | $151.77 | $133.56 | RVU18B |
| 2018-01-01 | $151.77 | $133.56 | RVU18AR1 |
| 2017-10-01 | $150.03 | $133.17 | RVU17D |
| 2017-07-01 | $150.03 | $133.17 | RVU17C |
| 2017-04-01 | $150.03 | $133.17 | RVU17B |
| 2017-01-01 | $150.03 | $133.17 | RVU17A |
| 2016-10-01 | $149.25 | $132.48 | RVU16D |
| 2016-07-01 | $149.25 | $132.48 | RVU16C |
| 2016-04-01 | $149.25 | $132.48 | RVU16B |
| 2016-01-01 | $149.25 | $132.48 | RVU16A |
| 2015-10-01 | $150.91 | $133.78 | RVU15D |
| 2015-07-01 | $150.91 | $133.78 | RVU15C |
| 2015-04-01 | $150.16 | $133.11 | RVU15B |
| 2015-01-01 | $150.16 | $133.11 | RVU15A |
| 2014-10-01 | $146.98 | $130.54 | RVU14D |
| 2014-07-01 | $146.98 | $130.54 | RVU14C |
| 2014-04-01 | $146.98 | $130.54 | RVU14B |
| 2014-01-01 | $146.98 | $130.54 | RVU14A |
| 2013-10-01 | $148.83 | $131.47 | RVU13D |
| 2013-07-01 | $148.83 | $131.47 | RVU13C |
| 2013-04-01 | $148.83 | $131.47 | RVU13B |
| 2013-01-01 | $148.83 | $131.47 | RVU13AR |
Where the Arkansas rate applies
Arkansas is a Medicare payment area, not a city. Our Census mapping connects it to 626 cities and communities in Arkansas. Some span more than one payment area; confirm with the service ZIP.
- Acorn
- Adona
- Alexander
- Alicia
- Alix
- Alleene
- Allport
- Alma
28515 billing questions
How does this differ from 28510?
28515 is for closed treatment with manipulation. Use 28510 when the lesser-toe phalanx fracture is treated without manipulation.
Can this code be used for a great toe fracture?
No. This code is for toes other than the great toe; 28495 describes closed treatment with manipulation of a great-toe fracture.
What should the documentation show?
Document the lesser toe and side, the phalangeal fracture treated, and the manipulation or reduction performed. The record should distinguish the service from treatment without manipulation.
Is routine follow-up separately reported?
Related postoperative care during the 90-day global period is included, along with the day-before preoperative visit.
Should modifier 50 be reported for fractures on both feet?
No. CMS identifies modifier 50 as inappropriate for this code, and a bilateral adjustment does not apply.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures are subject to the standard multiple-procedure reduction.
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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