Billing code 28665: Toe dislocationMedicare rate & RVUs
Closed treatment of a toe interphalangeal joint dislocation when the procedure requires anesthesia, reported for reduction without open surgical repair.
Medicare pays $154.98 for 28665 nationally in the office and $119.91 in a hospital or facility. Local office rates run $139.99–$196.44.
Medicare rate · 28665
Toe dislocation
Swap in your local Medicare rate.
- Work RVUs
- 1.92
- Total RVUs
- 4.64
- Global days
- 010
National rate · 2026
$154.98
Office setting, before claim adjustments.
See every locality for 28665 → · 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 28665 covers
This service treats a dislocated joint between the phalanges of a toe by closed reduction, without opening the joint for surgical repair. It is distinct from treatment of a metatarsophalangeal dislocation at the base of a toe. Orthopedic physicians, podiatrists, and other clinicians qualified to manage toe injuries may perform the reduction in an emergency department, office, or operating or procedure room, depending on the circumstances and need for anesthesia.
Report the code when the treated joint is interphalangeal and anesthesia is required for the closed treatment. The record should identify the affected toe and joint, document the dislocation and closed reduction, and support the anesthetic requirement. 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 subject to the standard 50% reduction. Modifier 50 is inappropriate. 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 28665 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
$139.99 to $196.44
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $141.66 | $110.98 |
| Alaska* | $189.69 | $152.34 |
| Arizona | $151.45 | $117.46 |
| Arkansas | $139.99 | $109.86 |
| Atlanta | $157.80 | $122.17 |
| Austin | $159.29 | $122.18 |
| Bakersfield | $161.83 | $123.39 |
| Baltimore/Surr. Cntys | $163.68 | $126.05 |
| Beaumont | $146.92 | $115.01 |
| Brazoria | $153.34 | $118.58 |
| Chicago | $164.07 | $128.82 |
| Chico | $161.24 | $122.80 |
| Colorado | $159.77 | $122.45 |
| Connecticut | $164.10 | $126.33 |
| Dallas | $154.32 | $119.39 |
| Dc + Md/Va Suburbs | $174.20 | $132.89 |
| Delaware | $153.65 | $119.00 |
| Detroit | $156.38 | $122.53 |
| East St. Louis | $154.65 | $122.39 |
| El Centro | $161.27 | $122.83 |
| Fort Lauderdale | $161.21 | $125.68 |
| Fort Worth | $153.56 | $118.98 |
| Fresno | $161.24 | $122.80 |
| Galveston | $153.81 | $118.98 |
| Hanford-Corcoran | $161.24 | $122.80 |
| Hawaii, Guam | $163.89 | $124.01 |
| Houston | $157.29 | $122.46 |
| Idaho | $144.88 | $112.61 |
| Indiana | $145.55 | $113.04 |
| Iowa | $143.97 | $111.88 |
| Kansas | $143.72 | $112.02 |
| Kentucky | $145.06 | $113.88 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $170.94 | $129.45 |
| Madera | $161.24 | $122.80 |
| Manhattan | $176.49 | $135.74 |
| Merced | $161.24 | $122.80 |
| Metropolitan Boston | $173.31 | $131.43 |
| Metropolitan Kansas City | $149.68 | $116.75 |
| Metropolitan Philadelphia | $160.82 | $124.32 |
| Metropolitan St. Louis | $150.94 | $117.55 |
| Miami | $168.15 | $131.64 |
| Minnesota | $152.96 | $116.88 |
| Mississippi | $141.58 | $111.38 |
| Modesto | $161.24 | $122.80 |
| Montana** | $154.97 | $119.90 |
| Napa | $182.77 | $136.55 |
| Nebraska | $144.53 | $112.16 |
| Nevada** | $154.00 | $118.90 |
| New Hampshire | $157.65 | $121.14 |
| New Mexico | $149.24 | $117.08 |
| New Orleans | $150.86 | $117.86 |
| North Carolina | $147.03 | $114.31 |
| North Dakota** | $151.21 | $116.14 |
| Northern Nj | $172.97 | $132.29 |
| Nyc Suburbs/Long Island | $180.49 | $138.80 |
| Ohio | $147.68 | $115.66 |
| Oklahoma | $144.52 | $113.20 |
| Oxnard-Thousand Oaks-Ventura | $169.76 | $128.31 |
| Portland | $163.76 | $124.80 |
| Poughkpsie/N Nyc Suburbs | $167.23 | $128.82 |
| Puerto Rico | $155.81 | $120.36 |
| Queens | $177.27 | $135.82 |
| Redding | $161.24 | $122.80 |
| Rest Of California | $161.24 | $122.80 |
| Rest Of Florida | $154.45 | $120.93 |
| Rest Of Georgia | $147.07 | $115.79 |
| Rest Of Illinois | $151.20 | $119.18 |
| Rest Of Louisiana | $145.00 | $113.96 |
| Rest Of Maine | $145.82 | $113.56 |
| Rest Of Maryland | $156.12 | $120.62 |
| Rest Of Massachusetts | $159.20 | $122.27 |
| Rest Of Michigan | $148.45 | $116.43 |
| Rest Of Missouri | $143.15 | $112.92 |
| Rest Of New Jersey | $165.94 | $127.64 |
| Rest Of New York | $148.87 | $115.55 |
| Rest Of Oregon | $152.76 | $117.83 |
| Rest Of Pennsylvania | $147.70 | $115.51 |
| Rest Of Texas | $150.05 | $116.77 |
| Rest Of Washington | $158.78 | $121.85 |
| Rhode Island | $158.30 | $122.07 |
| Riverside-San Bernardino-Ontario | $163.31 | $124.88 |
| Sacramento-Roseville-Folsom | $168.12 | $127.33 |
| Salinas | $167.46 | $126.81 |
| San Diego-Chula Vista-Carlsbad | $170.56 | $128.62 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $192.29 | $142.84 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $192.07 | $142.62 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $196.44 | $145.87 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $195.56 | $144.99 |
| San Luis Obispo-Paso Robles | $164.87 | $124.93 |
| Santa Cruz-Watsonville | $171.55 | $128.94 |
| Santa Maria-Santa Barbara | $167.86 | $126.97 |
| Santa Rosa-Petaluma | $173.23 | $130.16 |
| Seattle (King Cnty) | $176.21 | $133.18 |
| South Carolina | $147.61 | $115.20 |
| South Dakota** | $150.77 | $115.70 |
| Southern Maine | $151.88 | $117.12 |
| Stockton | $161.24 | $122.80 |
| Suburban Chicago | $162.61 | $126.59 |
| Tennessee | $144.35 | $112.47 |
| Utah | $149.26 | $116.30 |
| Vallejo | $182.46 | $136.24 |
| Vermont | $151.00 | $116.28 |
| Virgin Islands | $155.81 | $120.36 |
| Virginia | $151.68 | $117.20 |
| Visalia | $161.24 | $122.80 |
| West Virginia | $146.65 | $116.17 |
| Wisconsin | $147.04 | $113.44 |
| Wyoming** | $153.33 | $118.26 |
| Yuba City | $161.24 | $122.80 |
28665 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.
$139.99
$189.69
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 | $189.69 | 1 |
| AL | $141.66 | 1 |
| AR | $139.99 | 1 |
| AZ | $151.45 | 1 |
| CA | $161.24–$196.44 | 29 |
| CO | $159.77 | 1 |
| CT | $164.10 | 1 |
| DC | $174.20 | 1 |
| DE | $153.65 | 1 |
| FL | $154.45–$168.15 | 3 |
| GA | $147.07–$157.80 | 2 |
| GU | $163.89 | 1 |
| HI | $163.89 | 1 |
| IA | $143.97 | 1 |
| ID | $144.88 | 1 |
| IL | $151.20–$164.07 | 4 |
| IN | $145.55 | 1 |
| KS | $143.72 | 1 |
| KY | $145.06 | 1 |
| LA | $145.00–$150.86 | 2 |
| MA | $159.20–$173.31 | 2 |
| MD | $156.12–$174.20 | 3 |
| ME | $145.82–$151.88 | 2 |
| MI | $148.45–$156.38 | 2 |
| MN | $152.96 | 1 |
| MO | $143.15–$150.94 | 3 |
| MS | $141.58 | 1 |
| MT | $154.97 | 1 |
| NC | $147.03 | 1 |
| ND | $151.21 | 1 |
| NE | $144.53 | 1 |
| NH | $157.65 | 1 |
| NJ | $165.94–$172.97 | 2 |
| NM | $149.24 | 1 |
| NV | $154.00 | 1 |
| NY | $148.87–$180.49 | 5 |
| OH | $147.68 | 1 |
| OK | $144.52 | 1 |
| OR | $152.76–$163.76 | 2 |
| PA | $147.70–$160.82 | 2 |
| PR | $155.81 | 1 |
| RI | $158.30 | 1 |
| SC | $147.61 | 1 |
| SD | $150.77 | 1 |
| TN | $144.35 | 1 |
| TX | $146.92–$159.29 | 8 |
| UT | $149.26 | 1 |
| VA | $151.68–$174.20 | 2 |
| VI | $155.81 | 1 |
| VT | $151.00 | 1 |
| WA | $158.78–$176.21 | 2 |
| WI | $147.04 | 1 |
| WV | $146.65 | 1 |
| WY | $153.33 | 1 |
How the 28665 rate is calculated
Each of 28665’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 · 28665
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.92Practice expense 2.53Malpractice 0.19
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 28665
28665 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28665
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 · 28665
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
28665 without 51 · national office
$154.98
Toe dislocation
28665-51 · Second procedure: 50%
$77.49
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%).
28665 compared with similar codes
Compare codes
28665 vs 28660 vs 28666 vs 28635 vs 28675: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 28660Toe dislocation
- Use 28660 for closed treatment of an interphalangeal dislocation without anesthesia; 28665 is for treatment requiring anesthesia.
- 28666Toe reduction
- 28666 applies to the related interphalangeal-joint treatment involving manipulation with anesthesia; distinguish it from 28665 by the documented maneuver.
- 28635Toe dislocation
- This code concerns a metatarsophalangeal dislocation at the base of the toe requiring anesthesia. Code 28665 is for an interphalangeal joint.
- 28675Toe dislocation repair
- 28675 is for open treatment of an interphalangeal toe dislocation; 28665 represents closed treatment.
28665 billing questions
How does this differ from 28660?
Both address closed treatment of an interphalangeal joint dislocation. Use 28665 when anesthesia is required; 28660 is the counterpart for treatment without anesthesia.
When would 28666 be considered instead?
28666 is the related interphalangeal-joint treatment code when manipulation requiring anesthesia is performed. Document the treatment and manipulation to support code selection.
Can this code be used for a dislocation at the base of a toe?
No. The base-of-toe metatarsophalangeal joint is a different site; 28665 concerns an interphalangeal joint between toe bones.
Are follow-up visits separately reported during the global period?
Related postoperative visits for 10 days are included in the global period for this minor procedure.
Can modifier 50 be used when more than one toe is treated?
No. CMS identifies bilateral adjustment as inappropriate for this code. Report the service based on the treatment performed and applicable claim instructions.
What documentation supports 28665?
Document the affected toe and interphalangeal joint, the dislocation, the closed treatment performed, and why anesthesia was required.
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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