Billing code 28635: Toe dislocationMedicare rate & RVUs

Medicare pays $174.69 for 28635 nationally in the office and $122.92 in a hospital or facility. Local office rates run $156.52–$224.06.

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

What 28635 covers

This service is a closed reduction of a dislocated toe metatarsophalangeal (MTP) joint using manipulation, without anesthesia. Orthopedic surgeons and podiatrists may perform it in an office, emergency department, or hospital when the joint can be realigned without an open approach. The record should identify the affected toe and MTP joint, the dislocation, and the reduction performed, including assessment of alignment afterward.

Choose this code when manipulation is performed without anesthesia; distinguish it from closed treatment without manipulation and treatment requiring anesthesia. Related postoperative visits during the 10-day global period are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are reduced to 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 28635 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

28635 rates by state

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

How the 28635 rate is calculated

Each of 28635’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 28635

28635 has a 10-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

28635 compared with similar codes

How to choose

28630Toe dislocation

Use 28630 for closed MTP dislocation treatment without manipulation. Code 28635 represents a reduction performed with manipulation and without anesthesia.

28636Toe dislocation

Both concern closed treatment of an MTP dislocation, but 28636 is for treatment requiring anesthesia; 28635 is for manipulation without anesthesia.

28660Toe dislocation

Code 28660 concerns an interphalangeal joint dislocation. Code 28635 is for a dislocation at the toe's MTP joint.

28645Toe dislocation repair

Code 28645 is for open treatment of an MTP dislocation. Use 28635 when the joint is reduced by closed manipulation.

Codes related to 28635

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