CPT code 28515: Toe fracture care, with manipulation2026 Medicare rate & RVUs in California
Report this code for closed reduction of a phalangeal fracture in a toe other than the great toe when the clinician manipulates the fracture.
Medicare pays $183.71–$229.11 for 28515 in the office in California, from Chico, CA to San Benito County, CA. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 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.
Where 28515 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 payment localities
$183.71 to $229.11
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $184.25 | $152.04 |
| Chico, CA | $183.71 | $151.50 |
| El Centro, CA | $183.74 | $151.53 |
| Fresno, CA | $183.71 | $151.50 |
| Hanford, CA | $183.71 | $151.50 |
| Los Angeles, CA | $195.93 | $161.16 |
| Madera, CA | $183.71 | $151.50 |
| Marin County, CA | $224.13 | $182.68 |
| Merced, CA | $183.71 | $151.50 |
| Modesto, CA | $183.71 | $151.50 |
| Napa, CA | $211.98 | $173.24 |
| Oxnard, CA | $194.91 | $160.16 |
| Redding, CA | $183.71 | $151.50 |
| Rest of California | $183.71 | $151.50 |
| Riverside, CA | $185.67 | $153.46 |
| Sacramento, CA | $192.55 | $158.37 |
| Salinas, CA | $191.83 | $157.76 |
| San Benito County, CA | $229.11 | $186.73 |
| San Diego, CA | $196.17 | $161.01 |
| San Francisco, CA | $223.92 | $182.48 |
| San Luis Obispo, CA | $188.77 | $155.29 |
| Santa Clara County, CA | $228.28 | $185.89 |
| Santa Cruz, CA | $197.91 | $162.19 |
| Santa Maria, CA | $192.50 | $158.23 |
| Santa Rosa, CA | $199.89 | $163.80 |
| Stockton, CA | $183.71 | $151.50 |
| Vallejo, CA | $211.69 | $172.95 |
| Visalia, CA | $183.71 | $151.50 |
| Yuba City, CA | $183.71 | $151.50 |
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.
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%).
28515 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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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