Billing code 28630: Toe dislocationMedicare rate & RVUs
Reports closed reduction of a single toe interphalangeal joint dislocation when the provider restores alignment without anesthesia.
Medicare pays $171.68 for 28630 nationally in the office and $110.89 in a hospital or facility. Local office rates run $152.19–$219.83.
Medicare rate · 28630
Toe dislocation
Swap in your local Medicare rate.
- Work RVUs
- 1.71
- Total RVUs
- 5.14
- Global days
- 010
National rate · 2026
$171.68
Office setting, before claim adjustments.
See every locality for 28630 → · Billed by an NP, PA or therapist? →
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 10 sections
What 28630 covers
This service is the closed reduction of a dislocated toe interphalangeal joint, such as a proximal or distal joint, without anesthesia. An orthopedic surgeon, podiatrist, or other qualified clinician may perform the reduction in an office, emergency department, or other acute-care setting. The joint is realigned without opening the site; open repair is a different service. The code is for one interphalangeal joint, not a metatarsophalangeal joint or a foot-joint dislocation.
Document the affected toe and joint, the dislocation, and the closed reduction performed without anesthesia. Related postoperative visits during the 10-day global period are included. When multiple procedures are performed in the same session, Medicare pays the highest-valued procedure in full and reduces the others by 50%. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documented 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.
Where 28630 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$152.19 to $219.83
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $154.37 | $101.18 |
| Alaska* | $202.71 | $137.97 |
| Arizona | $167.03 | $108.13 |
| Arkansas | $152.19 | $99.98 |
| Atlanta | $175.48 | $113.71 |
| Austin | $176.77 | $112.46 |
| Bakersfield | $179.05 | $112.42 |
| Baltimore/Surr. Cntys | $182.55 | $117.32 |
| Beaumont | $161.55 | $106.24 |
| Brazoria | $169.06 | $108.82 |
| Chicago | $185.15 | $124.05 |
| Chico | $178.23 | $111.60 |
| Colorado | $176.96 | $112.28 |
| Connecticut | $182.93 | $117.46 |
| Dallas | $170.40 | $109.85 |
| Dc + Md/Va Suburbs | $194.53 | $122.92 |
| Delaware | $169.73 | $109.67 |
| Detroit | $174.65 | $115.99 |
| East St. Louis | $173.11 | $117.19 |
| El Centro | $178.27 | $111.65 |
| Fort Lauderdale | $180.87 | $119.29 |
| Fort Worth | $169.48 | $109.54 |
| Fresno | $178.23 | $111.60 |
| Galveston | $169.74 | $109.37 |
| Hanford-Corcoran | $178.23 | $111.60 |
| Hawaii, Guam | $181.97 | $112.85 |
| Houston | $175.05 | $114.68 |
| Idaho | $158.19 | $102.26 |
| Indiana | $159.05 | $102.69 |
| Iowa | $156.93 | $101.30 |
| Kansas | $156.81 | $101.85 |
| Kentucky | $159.22 | $105.17 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $189.96 | $118.05 |
| Madera | $178.23 | $111.60 |
| Manhattan | $198.00 | $127.36 |
| Merced | $178.23 | $111.60 |
| Metropolitan Boston | $193.30 | $120.72 |
| Metropolitan Kansas City | $165.06 | $107.98 |
| Metropolitan Philadelphia | $178.88 | $115.60 |
| Metropolitan St. Louis | $166.67 | $108.79 |
| Miami | $190.79 | $127.51 |
| Minnesota | $167.90 | $105.35 |
| Mississippi | $154.57 | $102.23 |
| Modesto | $178.23 | $111.60 |
| Montana** | $171.66 | $110.87 |
| Napa | $203.86 | $123.74 |
| Nebraska | $157.58 | $101.47 |
| Nevada** | $170.17 | $109.32 |
| New Hampshire | $174.77 | $111.49 |
| New Mexico | $164.92 | $109.18 |
| New Orleans | $166.81 | $109.61 |
| North Carolina | $161.16 | $104.44 |
| North Dakota** | $165.93 | $105.14 |
| Northern Nj | $192.72 | $122.20 |
| Nyc Suburbs/Long Island | $203.46 | $131.18 |
| Ohio | $162.63 | $107.13 |
| Oklahoma | $158.30 | $104.01 |
| Oxnard-Thousand Oaks-Ventura | $188.72 | $116.86 |
| Portland | $181.76 | $114.22 |
| Poughkpsie/N Nyc Suburbs | $186.25 | $119.68 |
| Puerto Rico | $172.69 | $111.23 |
| Queens | $198.71 | $126.85 |
| Redding | $178.23 | $111.60 |
| Rest Of California | $178.23 | $111.60 |
| Rest Of Florida | $171.94 | $113.82 |
| Rest Of Georgia | $162.21 | $107.99 |
| Rest Of Illinois | $168.01 | $112.51 |
| Rest Of Louisiana | $159.21 | $105.41 |
| Rest Of Maine | $159.63 | $103.70 |
| Rest Of Maryland | $172.72 | $111.20 |
| Rest Of Massachusetts | $176.19 | $112.18 |
| Rest Of Michigan | $163.81 | $108.30 |
| Rest Of Missouri | $156.96 | $104.55 |
| Rest Of New Jersey | $184.55 | $118.17 |
| Rest Of New York | $163.56 | $105.81 |
| Rest Of Oregon | $168.38 | $107.84 |
| Rest Of Pennsylvania | $162.55 | $106.74 |
| Rest Of Texas | $165.39 | $107.70 |
| Rest Of Washington | $175.67 | $111.66 |
| Rhode Island | $175.18 | $112.39 |
| Riverside-San Bernardino-Ontario | $181.35 | $114.73 |
| Sacramento-Roseville-Folsom | $186.34 | $115.64 |
| Salinas | $185.63 | $115.18 |
| San Diego-Chula Vista-Carlsbad | $189.51 | $116.81 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $214.87 | $129.15 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $214.54 | $128.82 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $219.83 | $132.17 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $218.48 | $130.82 |
| San Luis Obispo-Paso Robles | $182.74 | $113.50 |
| Santa Cruz-Watsonville | $190.93 | $117.08 |
| Santa Maria-Santa Barbara | $186.20 | $115.31 |
| Santa Rosa-Petaluma | $192.81 | $118.16 |
| Seattle (King Cnty) | $196.57 | $121.98 |
| South Carolina | $162.26 | $106.09 |
| South Dakota** | $165.25 | $104.46 |
| Southern Maine | $167.16 | $106.92 |
| Stockton | $178.23 | $111.60 |
| Suburban Chicago | $182.39 | $119.96 |
| Tennessee | $157.65 | $102.39 |
| Utah | $164.40 | $107.26 |
| Vallejo | $203.39 | $123.27 |
| Vermont | $165.85 | $105.67 |
| Virgin Islands | $172.69 | $111.23 |
| Virginia | $167.05 | $107.29 |
| Visalia | $178.23 | $111.60 |
| West Virginia | $162.12 | $109.29 |
| Wisconsin | $160.57 | $102.34 |
| Wyoming** | $169.16 | $108.37 |
| Yuba City | $178.23 | $111.60 |
28630 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.
$152.19
$202.71
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 | $202.71 | 1 |
| AL | $154.37 | 1 |
| AR | $152.19 | 1 |
| AZ | $167.03 | 1 |
| CA | $178.23–$219.83 | 29 |
| CO | $176.96 | 1 |
| CT | $182.93 | 1 |
| DC | $194.53 | 1 |
| DE | $169.73 | 1 |
| FL | $171.94–$190.79 | 3 |
| GA | $162.21–$175.48 | 2 |
| GU | $181.97 | 1 |
| HI | $181.97 | 1 |
| IA | $156.93 | 1 |
| ID | $158.19 | 1 |
| IL | $168.01–$185.15 | 4 |
| IN | $159.05 | 1 |
| KS | $156.81 | 1 |
| KY | $159.22 | 1 |
| LA | $159.21–$166.81 | 2 |
| MA | $176.19–$193.30 | 2 |
| MD | $172.72–$194.53 | 3 |
| ME | $159.63–$167.16 | 2 |
| MI | $163.81–$174.65 | 2 |
| MN | $167.90 | 1 |
| MO | $156.96–$166.67 | 3 |
| MS | $154.57 | 1 |
| MT | $171.66 | 1 |
| NC | $161.16 | 1 |
| ND | $165.93 | 1 |
| NE | $157.58 | 1 |
| NH | $174.77 | 1 |
| NJ | $184.55–$192.72 | 2 |
| NM | $164.92 | 1 |
| NV | $170.17 | 1 |
| NY | $163.56–$203.46 | 5 |
| OH | $162.63 | 1 |
| OK | $158.30 | 1 |
| OR | $168.38–$181.76 | 2 |
| PA | $162.55–$178.88 | 2 |
| PR | $172.69 | 1 |
| RI | $175.18 | 1 |
| SC | $162.26 | 1 |
| SD | $165.25 | 1 |
| TN | $157.65 | 1 |
| TX | $161.55–$176.77 | 8 |
| UT | $164.40 | 1 |
| VA | $167.05–$194.53 | 2 |
| VI | $172.69 | 1 |
| VT | $165.85 | 1 |
| WA | $175.67–$196.57 | 2 |
| WI | $160.57 | 1 |
| WV | $162.12 | 1 |
| WY | $169.16 | 1 |
How the 28630 rate is calculated
Each of 28630’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 · 28630
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.71Practice expense 3.14Malpractice 0.29
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 28630
28630 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28630
Toe dislocation
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 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) | 0 | Not paid without supporting documentation. |
| 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) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 28630
Toe dislocation
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
28630 without 51 · national office
$171.68
Toe dislocation
28630-51 · Second procedure: 50%
$85.84
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%).
28630 compared with similar codes
Compare codes
28630 vs 28635 vs 28636 vs 28675: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 28635Toe dislocation
- Both address toe interphalangeal joint dislocations. Choose 28630 when reduction is performed without anesthesia; 28635 is for manipulation requiring anesthesia.
- 28636Toe dislocation
- This code concerns a toe metatarsophalangeal joint dislocation. Choose 28630 when the dislocated joint is interphalangeal.
- 28675Toe dislocation repair
- This code is for open treatment of an interphalangeal joint dislocation. 28630 describes closed reduction without anesthesia.
28630 billing questions
When should 28630 be chosen instead of 28635?
Use 28630 for closed reduction of a toe interphalangeal joint dislocation without anesthesia. The related 28635 code is for treatment involving manipulation that requires anesthesia.
Does this code cover an MTP joint dislocation?
No. This code is for an interphalangeal joint in a toe. A metatarsophalangeal joint dislocation is represented by a different code.
Can modifier 50 be reported for both feet?
No. CMS identifies bilateral adjustment as inappropriate for this code. The descriptor or anatomy does not support modifier 50.
What documentation supports reporting 28630?
Record the dislocated toe interphalangeal joint and the closed reduction performed without anesthesia. The documentation should distinguish this service from an MTP joint reduction or open repair.
Are follow-up visits included?
Related postoperative visits for 10 days are included in the global period.
How does Medicare handle other procedures performed in the same session?
The highest-valued procedure is paid in full, and other procedures are reduced by 50%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
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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