Billing code 28575: Toe dislocationMedicare rate & RVUs

Medicare pays $422.52 for 28575 nationally in the office and $341.69 in a hospital or facility. Local office rates run $370.69–$549.78.

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

What 28575 covers

This code covers closed treatment of a dislocated joint between the bones of one toe, using manipulation to restore alignment when anesthesia is required. An orthopedic surgeon, podiatrist, or other qualified physician may perform the reduction, commonly in a hospital or ambulatory surgery setting. The service is distinct from treating a metatarsophalangeal or tarsometatarsal dislocation, which involves a different joint.

Report one unit for the treated interphalangeal joint. Documentation should identify the affected toe and joint, describe the dislocation and manipulation, and support the anesthesia requirement. 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% reduction. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery is paid only when medical necessity is documented; 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 28575 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

28575 rates by state

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

How the 28575 rate is calculated

Each of 28575’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 28575

28575 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 50

28575 compared with similar codes

How to choose

28570Foot dislocation

Both concern a single toe interphalangeal dislocation treated closed. Choose 28575 when manipulation is performed and anesthesia is required; 28570 is for treatment without manipulation.

28576Foot dislocation

Use 28575 for closed manipulation of the dislocated joint. Code 28576 describes open treatment of a single toe interphalangeal dislocation.

28540Tarsal dislocation

Code 28540 concerns a tarsometatarsal joint dislocation in the midfoot, not an interphalangeal joint within a toe.

Codes related to 28575

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