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Billing code 28666: Toe reductionMedicare rate & RVUs

Closed reduction of a dislocated toe interphalangeal joint with manipulation under anesthesia, reported when the documented treatment meets both requirements.

CMS RVU26DEffective Oct 1, 2026109 payment localities53 Medicare services in 2024

Medicare pays $164.00 for 28666 nationally in a facility.

Medicare rate · 28666

Toe reduction

Swap in your local Medicare rate.

Work RVUs
2.59
Total RVUs
4.91
Global days
010

National rate · 2026

$164.00

Facility setting, before claim adjustments.

See every locality for 28666 → · 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
  1. Medicare rate
  2. What 28666 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 28666 covers

This service realigns a dislocated interphalangeal (IP) joint in a toe by manipulating it externally while the patient receives anesthesia. Orthopedic surgeons, podiatrists, and other qualified clinicians may perform the reduction in a facility setting, such as an operating room or emergency department. The treatment is closed; it does not involve surgically exposing the joint.

Select this code when the documentation identifies an IP joint dislocation and supports both manipulation and the need for anesthesia. Record the affected toe and joint, the dislocation, the closed reduction performed, and the anesthesia requirement. Medicare assigns a 10-day minor-procedure global period, which includes related postoperative visits during that period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery; co-surgeons are permitted, while team surgery is 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 28666 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

28666 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$152.14
Alaska*Unavailable$208.68
ArizonaUnavailable$160.80
ArkansasUnavailable$150.66
AtlantaUnavailable$166.80
AustinUnavailable$167.46
BakersfieldUnavailable$169.67
Baltimore/Surr. CntysUnavailable$172.19
BeaumontUnavailable$157.16
BrazoriaUnavailable$162.51

28666 rates by state

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

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
28666 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 28666 rate is calculated

Each of 28666’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 · 28666

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 2.59Practice expense 2.11Malpractice 0.21

4.9100 adjusted RVUs×$33.4009 conversion factor=$164.00

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 28666

28666 has a 10-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 28666

Toe reduction

RuleCMS valueWhat it means
Global period010Minor procedure: the day of the procedure plus 10 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)1Not paid (statutory restriction).
Co-surgeons (62)2Permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 28666

Toe reduction

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.

SurgeryVisit
Sep 28, 2026Oct 14, 2026

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

28666 without 51 · national facility

$164.00

Toe reduction

28666-51 · Second procedure: 50%

$82.00

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

28666 compared with similar codes

Compare codes

28666 vs 28665 vs 28660 vs 28636 vs 28675: national Medicare rates

Swap in your local Medicare rate.

  • 28666
    Toe reduction · 2.59 wRVU
    —
  • 28665
    Toe dislocation · 1.92 wRVU
    $154.98
  • 28660
    Toe dislocation · 1.25 wRVU
    $149.30
  • 28636
    Toe dislocation · 2.7 wRVU
    $388.12
  • 28675
    Toe dislocation repair · 5.48 wRVU
    $587.86

How to choose

28665Toe dislocation
Both address a toe interphalangeal joint dislocation requiring anesthesia; choose 28666 when manipulation is documented.
28660Toe dislocation
This code is for treatment without anesthesia. Use 28666 when anesthesia and manipulation are part of the closed reduction.
28636Toe dislocation
This code addresses a metatarsophalangeal joint dislocation with anesthesia and manipulation. Code 28666 is for an interphalangeal joint.
28675Toe dislocation repair
This code is for open treatment of a toe interphalangeal dislocation; 28666 is for closed reduction with manipulation under anesthesia.

Codes related to 28666

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 28666
CodeHow it relatesNational office range
Same family
28665Toe dislocationTreats a toe IP joint dislocation requiring anesthesia, without the manipulation specified for 28666.$139.99–$196.44
28660Toe dislocationTreats a toe IP joint dislocation without anesthesia.$131.26–$193.87
Used instead
28675Toe dislocation repairOpen treatment for a toe IP joint dislocation when closed reduction is not the treatment performed.$522.73–$765.74
28636Toe dislocationClosed treatment with anesthesia and manipulation for a metatarsophalangeal, rather than interphalangeal, joint dislocation.$339.56–$512.48
28635Toe dislocationTreats a metatarsophalangeal joint dislocation requiring anesthesia.$156.52–$224.06

28666 billing questions

How does 28666 differ from 28665?

Use 28666 when the closed reduction involves manipulation under anesthesia. Code 28665 describes treatment requiring anesthesia without the manipulation specified for 28666.

Can 28666 be used for a dislocation at the base of the toe?

Only when the dislocated joint is an interphalangeal joint. A metatarsophalangeal joint dislocation is a different site and belongs to the applicable MTP code family.

Should modifier 50 be reported for dislocations on both feet?

No. CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.

Are related postoperative visits separately included?

Related postoperative visits during the 10-day global period are included in the procedure's global package.

Can an assistant-at-surgery service be paid with 28666?

No. CMS lists a statutory restriction on assistant-at-surgery payment for this code. Co-surgeons are permitted, but team surgery is not.

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 28666PPRRVU2026_Oct_nonQPP.csv, line 3,243 (RVU26D)

Open CMS sourceHow we calculate rates

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