CPT code 28525: Toe fracture repair, lesser toe, open treatment2026 Medicare rate & RVUs in Arkansas

Surgical exposure and treatment of a fracture in a toe other than the great toe, with internal fixation included when performed.

CMS RVU26DEffective Oct 1, 2026One payment locality330 Medicare services in 2024

In Arkansas, Medicare pays $510.51 for 28525 in the office and $349.27 when it’s performed in a hospital or facility.

$510.51Office (non-facility)
$349.27Hospital or facility
−11.0%vs the national office rate ($573.49)

Check a contract rate as a % of Medicare · 28525 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 28525 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Arkansas
  2. What 28525 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 28525 covers

This service treats a fracture of a lesser-toe phalanx by surgically exposing the fracture and addressing its alignment. Internal fixation, such as pins or screws, is included when performed. “Open treatment” refers to the surgical approach; it does not mean the injury itself must be an open wound. Orthopedic surgeons and podiatrists may perform the procedure, commonly in an operating room for a displaced or unstable lesser-toe fracture requiring operative treatment.

Report this code for open treatment of a phalanx fracture in a toe other than the great toe; use the operative report to support the toe and fracture site, surgical exposure, reduction, and any fixation. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. 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. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documentation of medical necessity; 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 28525

Across 109 of 109 payment localities, the office rate for 28525 runs from $510.51 in Arkansas to $745.33 in San Benito County, CA. Arkansas pays $510.51. The RVUs are the same everywhere; the geographic indexes change the dollars.

28525 in Arkansas vs other payment areas
  1. Arkansas · this page$510.51
  2. Los Angeles, CA · California$640.49+$129.98
  3. Washington, DC area · District of Columbia$651.38+$140.87
  4. Miami, FL · Florida$623.80+$113.29
  5. Chicago, IL · Illinois$606.46+$95.95
  6. Manhattan, NY · New York$658.23+$147.72
  7. Alaska · Alaska$678.55+$168.04

Other areas in Arkansas first, then benchmark localities. Bars start at $0.

Every other payment area

28525 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$517.56$353.32
ArizonaArizona$558.79$376.89
Bakersfield, CACalifornia$603.23$397.50
Chico, CACalifornia$601.18$395.45
El Centro, CACalifornia$601.30$395.56
Fresno, CACalifornia$601.18$395.45
Hanford, CACalifornia$601.18$395.45
Madera, CACalifornia$601.18$395.45

28525 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.

$510.51

$678.55

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
28525 office rate range by state
State / territoryOffice rate rangeLocalities
AK$678.551
AL$517.561
AR$510.511
AZ$558.791
CA$601.18–$745.3329
CO$594.161
CT$610.281
DC$651.381
DE$567.671
FL$568.92–$623.803
GA$538.24–$584.552
GU$614.131
HI$614.131
IA$528.371
ID$531.961
IL$554.50–$606.464
IN$534.831
KS$526.791
KY$530.751
LA$530.27–$554.952
MA$591.22–$649.742
MD$577.84–$651.383
ME$535.39–$561.682
MI$544.50–$576.442
MN$567.921
MO$522.19–$555.903
MS$516.411
MT$573.451
NC$540.561
ND$559.801
NE$530.871
NH$585.681
NJ$616.85–$645.382
NM$547.631
NV$570.011
NY$548.28–$674.405
OH$541.711
OK$529.041
OR$565.18–$611.302
PA$542.10–$596.302
PR$577.191
RI$586.611
SC$542.111
SD$558.191
TN$529.391
TX$538.79–$592.548
UT$549.101
VA$560.47–$651.382
VI$577.191
VT$558.431
WA$589.84–$661.832
WI$542.111
WV$535.301
WY$567.501

See 28525 in every payment locality

How the 28525 rate is calculated

Each of 28525’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 · 28525

RVUs × geographic indexes × conversion factor

Office or facility?

Work5.48

5.48 RVUs× 1.000 GPCI

Practice expense11.00

11.00 RVUs× 1.000 GPCI

Malpractice0.69

0.69 RVUs× 1.000 GPCI

Adjusted RVUs

17.1700

Conversion factor

$33.4009

Medicare rate

$573.49

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

3,222

Code
28525
Physician work
5.48
Practice expense
11.00
Malpractice
0.69

GPCI2026.csv

7

Locality
Arkansas
Physician work
1.000
Practice expense
0.859
Malpractice
0.515
Office calculation for 28525 in Arkansas
ComponentRVULocality factorAdjusted
Physician work5.48× 1.0005.4800
Practice expense11.00× 0.8599.4490
Malpractice0.69× 0.5150.3553
Total RVUs15.2843
Conversion factor× 33.4009

Office rate, Arkansas$510.51

Office: (5.48 × 1 + 11 × 0.859 + 0.69 × 0.515) × $33.4009 = $510.51

Facility: (5.48 × 1 + 5.38 × 0.859 + 0.69 × 0.515) × $33.4009 = $349.27

Open 28525 in the RVU calculator

Payment rules and modifiers for 28525

28525 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 28525

Toe fracture repair, lesser toe, open treatment

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)0Not paid without supporting documentation.
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 · 28525

Toe fracture repair, lesser 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.

  • 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

28525 without 51 · national office

$573.49

Toe fracture repair, lesser toe, open treatment

28525-51 · Second procedure: 50%

$286.75

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

How 28525 has changed in Arkansas

28525 · Office / nonfacility

$510.51

Effective 2026-10-01

The base rate is $23.63 higher than on 2025-10-01, moving from $486.88 to $510.51 (4.9%).

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

    $486.88changed to$510.51

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 5.62 changed to 5.48
    • Practice expense RVU 10.57 changed to 11.00
    • Malpractice RVU 0.66 changed to 0.69
    • Practice expense GPCI 0.860 changed to 0.859
    • Malpractice GPCI 0.518 changed to 0.515

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $509.87changed to$486.88

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 10.86 changed to 10.57
    • Malpractice RVU 0.69 changed to 0.66

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $501.54changed to$509.87

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $509.75changed to$501.54

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 10.66 changed to 10.86
    • Malpractice RVU 0.67 changed to 0.69
    • Practice expense GPCI 0.853 changed to 0.860
    • Malpractice GPCI 0.492 changed to 0.518
  5. January 1, 2023

    RVU23A

    $514.69changed to$509.75

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 10.54 changed to 10.66
    • Malpractice RVU 0.70 changed to 0.67
    • Practice expense GPCI 0.847 changed to 0.853
    • Malpractice GPCI 0.465 changed to 0.492

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $523.07changed to$514.69

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 10.69 changed to 10.54
    • Malpractice RVU 0.68 changed to 0.70

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $532.06changed to$523.07

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 10.22 changed to 10.69
    • Malpractice RVU 0.66 changed to 0.68
    • Practice expense GPCI 0.859 changed to 0.847
    • Malpractice GPCI 0.521 changed to 0.465

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $536.06changed to$532.06

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 10.19 changed to 10.22
    • Malpractice RVU 0.64 changed to 0.66
    • Practice expense GPCI 0.872 changed to 0.859
    • Malpractice GPCI 0.576 changed to 0.521

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $535.16changed to$536.06

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 10.18 changed to 10.19

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $527.10changed to$535.16

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 10.02 changed to 10.18
    • Malpractice RVU 0.63 changed to 0.64
    • Practice expense GPCI 0.870 changed to 0.872
    • Malpractice GPCI 0.555 changed to 0.576

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $526.36changed to$527.10

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 10.08 changed to 10.02
    • Malpractice RVU 0.64 changed to 0.63
    • Practice expense GPCI 0.867 changed to 0.870
    • Malpractice GPCI 0.534 changed to 0.555

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $521.84changed to$526.36

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 9.88 changed to 10.08
    • Malpractice RVU 0.63 changed to 0.64

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $519.24changed to$521.84

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $524.47changed to$519.24

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 10.03 changed to 9.88
    • Malpractice RVU 0.68 changed to 0.63
    • Practice expense GPCI 0.866 changed to 0.867
    • Malpractice GPCI 0.492 changed to 0.534

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $525.51changed to$524.47

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 10.99 changed to 10.03
    • Malpractice RVU 0.71 changed to 0.68
    • Practice expense GPCI 0.865 changed to 0.866
    • Malpractice GPCI 0.450 changed to 0.492

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $525.51

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$510.51$349.27RVU26D
2026-07-01$510.51$349.27RVU26C
2026-04-01$510.51$349.27RVU26B
2026-01-01$510.51$349.27RVU26A
2025-10-01$486.88$360.87RVU25D
2025-07-01$486.88$360.87RVU25C
2025-04-01$486.88$360.87RVU25B
2025-01-01$486.88$360.87RVU25A
2024-10-01$509.87$373.03RVU24D
2024-07-01$509.87$373.03RVU24C
2024-04-01$509.87$373.03RVU24B
2024-03-09$509.87$373.03RVU24AR
2024-01-01$501.54$366.94RVU24A
2023-10-01$509.75$370.72RVU23D
2023-07-01$509.75$370.72RVU23C
2023-04-01$509.75$370.72RVU23B
2023-01-01$509.75$370.72RVU23A
2022-10-01$514.69$371.07RVU22D
2022-07-01$514.69$371.07RVU22C
2022-04-01$514.69$371.07RVU22B
2022-01-01$514.69$371.07RVU22A
2021-10-01$523.07$370.57RVU21D
2021-07-01$523.07$370.57RVU21C
2021-04-01$523.07$370.57RVU21B
2021-01-01$523.07$370.57RVU21A
2020-10-01$532.06$380.47RVU20D
2020-07-01$532.06$380.47RVU20C
2020-04-01$532.06$380.47RVU20B
2020-01-01$532.06$380.47RVU20A
2019-10-01$536.06$381.75RVU19D
2019-07-01$536.06$381.75RVU19C
2019-04-01$536.06$381.75RVU19B
2019-01-01$536.06$381.75RVU19A
2018-10-01$535.16$379.77RVU18D
2018-07-01$535.16$379.77RVU18C
2018-04-01$535.16$379.77RVU18B
2018-01-01$535.16$379.77RVU18AR1
2017-10-01$527.10$375.35RVU17D
2017-07-01$527.10$375.35RVU17C
2017-04-01$527.10$375.35RVU17B
2017-01-01$527.10$375.35RVU17A
2016-10-01$526.36$375.19RVU16D
2016-07-01$526.36$375.19RVU16C
2016-04-01$526.36$375.19RVU16B
2016-01-01$526.36$375.19RVU16A
2015-10-01$521.84$371.68RVU15D
2015-07-01$521.84$371.68RVU15C
2015-04-01$519.24$369.83RVU15B
2015-01-01$519.24$369.83RVU15A
2014-10-01$524.47$374.32RVU14D
2014-07-01$524.47$374.32RVU14C
2014-04-01$524.47$374.32RVU14B
2014-01-01$524.47$374.32RVU14A
2013-10-01$525.51$368.36RVU13D
2013-07-01$525.51$368.36RVU13C
2013-04-01$525.51$368.36RVU13B
2013-01-01$525.51$368.36RVU13AR

Price 28525 for an earlier date of service

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

Browse all communities in Arkansas

28525 billing questions

How is this different from code 28505?

Code 28525 is for open treatment of a fracture in a toe other than the great toe. Code 28505 is the corresponding open-treatment code for a great-toe fracture.

Is internal fixation separately reported?

Internal fixation is included in this service when performed. The operative report should describe the reduction and any pins, screws, or other fixation used.

How does this differ from codes 28510 and 28515?

Those codes describe closed treatment of a lesser-toe fracture, without manipulation for 28510 and with manipulation for 28515. Code 28525 describes open surgical treatment.

Can modifier 50 be used for fractures in both feet?

CMS identifies bilateral adjustment as inappropriate for this code based on its descriptor or anatomy. Modifier 50 should not be applied.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

When is assistant-at-surgery payment allowed?

Payment for an assistant at surgery requires documentation of medical necessity. Co-surgeons and team surgery are not permitted for this code.

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 28525PPRRVU2026_Oct_nonQPP.csv, line 3,222 (RVU26D)
Geographic factors for ArkansasGPCI2026.csv, line 7 (RVU26D)

Open CMS sourceHow we calculate rates

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