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CPT code 28515: Toe fracture care, with manipulation2026 Medicare rate & RVUs in Washington, DC area

Report this code for closed reduction of a phalangeal fracture in a toe other than the great toe when the clinician manipulates the fracture.

CMS RVU26DEffective Oct 1, 2026One payment locality1.4K Medicare services in 2024

In Washington, DC area, Medicare pays $198.70 for 28515 in the office and $164.08 when it’s performed in a hospital or facility.

$198.70Office (non-facility)
$164.08Hospital or facility
+14.0%vs the national office rate ($174.35)

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.

We’ll open 28515 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 28515 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 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 Washington, DC area 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. Washington, DC area pays $198.70. The RVUs are the same everywhere; the geographic indexes change the dollars.

28515 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$198.70
  2. Los Angeles, CA · California$195.93−$2.77
  3. Miami, FL · Florida$188.37−$10.33
  4. Chicago, IL · Illinois$183.08−$15.62
  5. Manhattan, NY · New York$200.17+$1.47
  6. Alaska · Alaska$204.68+$5.98
  7. Alabama · Alabama$157.05−$41.65

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

28515 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$154.86$129.61
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

28515 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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
28515 office rate range by state
State / territoryOffice rate rangeLocalities
AK$204.681
AL$157.051
AR$154.861
AZ$169.841
CA$183.71–$229.1129
CO$181.171
CT$185.681
DC$198.701
DE$172.591
FL$172.20–$188.373
GA$162.81–$177.592
GU$187.931
HI$187.931
IA$160.731
ID$161.781
IL$167.51–$183.084
IN$162.681
KS$160.081
KY$160.791
LA$160.58–$168.232
MA$180.18–$198.582
MD$175.78–$198.703
ME$162.67–$171.082
MI$164.90–$174.362
MN$173.531
MO$157.97–$168.723
MS$156.441
MT$174.341
NC$164.311
ND$170.781
NE$161.561
NH$178.421
NJ$187.78–$196.772
NM$165.801
NV$173.471
NY$166.69–$204.985
OH$164.171
OK$160.431
OR$172.10–$186.682
PA$164.38–$181.252
PR$175.561
RI$178.551
SC$164.521
SD$170.361
TN$160.871
TX$163.34–$180.598
UT$166.691
VA$170.59–$198.702
VI$175.561
VT$170.211
WA$179.81–$202.482
WI$165.251
WV$161.541
WY$172.791

See 28515 in every payment locality

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

Office or facility?

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 Washington, DC area 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

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 28515 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work1.52× 1.0541.6021
Practice expense3.52× 1.1784.1466
Malpractice0.18× 1.1130.2003
Total RVUs5.9490
Conversion factor× 33.4009

Office rate, Washington, DC area$198.70

Office: (1.52 × 1.054 + 3.52 × 1.178 + 0.18 × 1.113) × $33.4009 = $198.70

Facility: (1.52 × 1.054 + 2.64 × 1.178 + 0.18 × 1.113) × $33.4009 = $164.08

Open 28515 in the RVU calculator

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

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)0The 150% bilateral adjustment doesn’t apply.
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 · 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.

  • 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 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%).

When to use modifier 51

Codes related to 28515

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

Codes related to 28515
CodeHow it relatesOffice range, Washington, DC area
Same family
28510Toe fracture care, without manipulationClosed treatment of a lesser-toe phalanx fracture without manipulation.$149.19
Used instead
28525Toe fracture repair, lesser toe, open treatmentOpen treatment for a lesser-toe phalanx fracture rather than closed manipulation.$651.38
28495Toe fracture treatment, great toe, with manipulationClosed treatment with manipulation when the fracture involves the great toe.$223.34
28505Toe fracture surgery, great toe, open treatmentOpen treatment of a great-toe fracture, rather than closed treatment of a lesser toe.$755.23

How 28515 has changed in Washington, DC area

28515 · Office / nonfacility

$198.70

Effective 2026-10-01

The base rate is $8.22 higher than on 2025-10-01, moving from $190.48 to $198.70 (4.3%).

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

    $190.48changed to$198.70

    • 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
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $195.22changed to$190.48

    • 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.

  3. March 9, 2024

    RVU24AR

    $192.03changed to$195.22

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $196.21changed to$192.03

    • 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
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $197.99changed to$196.21

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 3.11 changed to 3.23
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $196.14changed to$197.99

    • 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.

  7. January 1, 2021

    RVU21A

    $196.47changed to$196.14

    • 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
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $194.13changed to$196.47

    • 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
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $193.49changed to$194.13

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 2.94 changed to 2.95

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $191.82changed to$193.49

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 2.91 changed to 2.94
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $191.59changed to$191.82

    • Conversion factor 35.8043 changed to 35.8887
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $194.04changed to$191.59

    • 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.

  13. July 1, 2015

    RVU15C

    $193.07changed to$194.04

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $188.30changed to$193.07

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 2.84 changed to 2.94
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $191.40changed to$188.30

    • 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
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $191.40

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$198.70$164.08RVU26D
2026-07-01$198.70$164.08RVU26C
2026-04-01$198.70$164.08RVU26B
2026-01-01$198.70$164.08RVU26A
2025-10-01$190.48$165.80RVU25D
2025-07-01$190.48$165.80RVU25C
2025-04-01$190.48$165.80RVU25B
2025-01-01$190.48$165.80RVU25A
2024-10-01$195.22$169.42RVU24D
2024-07-01$195.22$169.42RVU24C
2024-04-01$195.22$169.42RVU24B
2024-03-09$195.22$169.42RVU24AR
2024-01-01$192.03$166.66RVU24A
2023-10-01$196.21$170.29RVU23D
2023-07-01$196.21$170.29RVU23C
2023-04-01$196.21$170.29RVU23B
2023-01-01$196.21$170.29RVU23A
2022-10-01$197.99$171.04RVU22D
2022-07-01$197.99$171.04RVU22C
2022-04-01$197.99$171.04RVU22B
2022-01-01$197.99$171.04RVU22A
2021-10-01$196.14$168.97RVU21D
2021-07-01$196.14$168.97RVU21C
2021-04-01$196.14$168.97RVU21B
2021-01-01$196.14$168.97RVU21A
2020-10-01$196.47$170.47RVU20D
2020-07-01$196.47$170.47RVU20C
2020-04-01$196.47$170.47RVU20B
2020-01-01$196.47$170.47RVU20A
2019-10-01$194.13$168.51RVU19D
2019-07-01$194.13$168.51RVU19C
2019-04-01$194.13$168.51RVU19B
2019-01-01$194.13$168.51RVU19A
2018-10-01$193.49$168.33RVU18D
2018-07-01$193.49$168.33RVU18C
2018-04-01$193.49$168.33RVU18B
2018-01-01$193.49$168.33RVU18AR1
2017-10-01$191.82$168.46RVU17D
2017-07-01$191.82$168.46RVU17C
2017-04-01$191.82$168.46RVU17B
2017-01-01$191.82$168.46RVU17A
2016-10-01$191.59$168.29RVU16D
2016-07-01$191.59$168.29RVU16C
2016-04-01$191.59$168.29RVU16B
2016-01-01$191.59$168.29RVU16A
2015-10-01$194.04$170.22RVU15D
2015-07-01$194.04$170.22RVU15C
2015-04-01$193.07$169.37RVU15B
2015-01-01$193.07$169.37RVU15A
2014-10-01$188.30$165.48RVU14D
2014-07-01$188.30$165.48RVU14C
2014-04-01$188.30$165.48RVU14B
2014-01-01$188.30$165.48RVU14A
2013-10-01$191.40$167.35RVU13D
2013-07-01$191.40$167.35RVU13C
2013-04-01$191.40$167.35RVU13B
2013-01-01$191.40$167.35RVU13AR

Price 28515 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

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
RVUs for 28515PPRRVU2026_Oct_nonQPP.csv, line 3,221 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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