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CMS RVU26D · Effective 2026-10-01

28645 in Austin

Office / nonfacility

$686.26

Base rate per service

Facility setting

$469.29

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Orthopedic surgery

About 28645: Open repair of toe metatarsophalangeal dislocation

Reports open surgical reduction and repair of a dislocated toe metatarsophalangeal joint, including internal fixation when performed.

This service treats a dislocation of a toe’s metatarsophalangeal joint through an open surgical approach. The surgeon exposes the joint, restores alignment, and addresses the dislocation; internal fixation may be used when needed. Orthopedic surgeons and podiatric surgeons commonly perform the procedure in an operating room, often when the joint requires open treatment rather than closed reduction.

Report the code for open treatment of a metatarsophalangeal dislocation, not for closed reduction or for an open dislocation of an interphalangeal joint. The operative note should identify the affected toe and joint, describe the open approach and treatment, and document any fixation. Medicare assigns a 90-day global period, including 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 others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment is restricted; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

CMS billing rules for 28645

Global period
Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
Multiple procedures
Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
Bilateral procedures
Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
Assistant at surgery
Statutory restriction: assistant at surgery is not paid.
Co-surgeons
Co-surgeons paid only with supporting documentation.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU7.25 · 36%
  • Practice expense (office) RVU11.80 · 59%
  • Malpractice RVU0.90 · 5%

1.9K

Medicare services in 2024 · #2490 by national volume

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.

28645 compared with similar codes

Office rates for Austin, from the same CMS release.

28636

Toe dislocation

MTP joint, percutaneous fixation

$402.30

Choose 28645 for open treatment of the metatarsophalangeal joint. Choose 28636 when the dislocation is treated closed with percutaneous skeletal fixation.

28635

Toe dislocation

Manipulation without anesthesia

$179.98

Code 28635 describes closed treatment of a metatarsophalangeal dislocation with anesthesia; 28645 is for open surgical treatment.

28675

Toe dislocation repair

Open interphalangeal joint

$607.68

Both involve open treatment, but 28675 is for an interphalangeal joint dislocation. Code 28645 is for a metatarsophalangeal joint dislocation.

The same code, a different location

How does Austin compare?

In Beaumont, the office rate for 28645 is $628.74—$57.52 lower than the $686.26 rate in Austin. Both use the same code, release and participation basis.

28645 across payment areas

Same release and payment basis · bars start at $0

  1. Austin · This locality

    $686.26

  2. Beaumont

    $628.74

    $57.52 lower than Austin

  3. Brazoria

    $658.12

    $28.14 lower than Austin

  4. Dallas

    $662.68

    $23.58 lower than Austin

  5. Fort Worth

    $659.13

    $27.13 lower than Austin

  6. Galveston

    $660.36

    $25.90 lower than Austin

  7. Houston

    $676.83

    $9.43 lower than Austin

Other payment areas listed in Texas appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 28645 ranges from $596.20 in Arkansas to $853.24 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Rest Of Texas

    Texas · 28645

    Office

    $643.33

    Facility

    $448.71

    $42.93 lower than Austin for the office setting.

  • Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    California · 28645

    Office

    $738.30

    Facility

    $495.69

    $52.04 higher than Austin for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 28645

    Office

    $752.98

    Facility

    $511.39

    $66.72 higher than Austin for the office setting.

  • Miami

    Florida · 28645

    Office

    $728.47

    Facility

    $514.98

    $42.21 higher than Austin for the office setting.

  • Chicago

    Illinois · 28645

    Office

    $708.94

    Facility

    $502.84

    $22.68 higher than Austin for the office setting.

  • Manhattan

    New York · 28645

    Office

    $763.31

    Facility

    $525.01

    $77.05 higher than Austin for the office setting.

  • Alaska*

    Alaska · 28645

    Office

    $799.55

    Facility

    $581.14

    $113.29 higher than Austin for the office setting.

  • Alabama

    Alabama · 28645

    Office

    $604.04

    Facility

    $424.59

    $82.22 lower than Austin for the office setting.

  • Arkansas

    Arkansas · 28645

    Office

    $596.20

    Facility

    $420.03

    $90.06 lower than Austin for the office setting.

  • Arizona

    Arizona · 28645

    Office

    $649.80

    Facility

    $451.08

    $36.46 lower than Austin for the office setting.

  • Bakersfield

    California · 28645

    Office

    $697.03

    Facility

    $472.26

    $10.77 higher than Austin for the office setting.

  • Chico

    California · 28645

    Office

    $694.35

    Facility

    $469.58

    $8.09 higher than Austin for the office setting.

  • El Centro

    California · 28645

    Office

    $694.50

    Facility

    $469.73

    $8.24 higher than Austin for the office setting.

  • Fresno

    California · 28645

    Office

    $694.35

    Facility

    $469.58

    $8.09 higher than Austin for the office setting.

  • Hanford-Corcoran

    California · 28645

    Office

    $694.35

    Facility

    $469.58

    $8.09 higher than Austin for the office setting.

  • Madera

    California · 28645

    Office

    $694.35

    Facility

    $469.58

    $8.09 higher than Austin for the office setting.

  • Merced

    California · 28645

    Office

    $694.35

    Facility

    $469.58

    $8.09 higher than Austin for the office setting.

  • Modesto

    California · 28645

    Office

    $694.35

    Facility

    $469.58

    $8.09 higher than Austin for the office setting.

  • Napa

    California · 28645

    Office

    $792.15

    Facility

    $521.85

    $105.89 higher than Austin for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 28645

    Office

    $733.53

    Facility

    $491.12

    $47.27 higher than Austin for the office setting.

  • Redding

    California · 28645

    Office

    $694.35

    Facility

    $469.58

    $8.09 higher than Austin for the office setting.

  • Rest Of California

    California · 28645

    Office

    $694.35

    Facility

    $469.58

    $8.09 higher than Austin for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 28645

    Office

    $704.12

    Facility

    $479.36

    $17.86 higher than Austin for the office setting.

  • Sacramento-Roseville-Folsom

    California · 28645

    Office

    $725.36

    Facility

    $486.85

    $39.10 higher than Austin for the office setting.

  • Salinas

    California · 28645

    Office

    $722.57

    Facility

    $484.88

    $36.31 higher than Austin for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 28645

    Office

    $737.09

    Facility

    $491.82

    $50.83 higher than Austin for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 28645

    Office

    $834.68

    Facility

    $545.52

    $148.42 higher than Austin for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 28645

    Office

    $833.66

    Facility

    $544.50

    $147.40 higher than Austin for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 28645

    Office

    $853.24

    Facility

    $557.52

    $166.98 higher than Austin for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 28645

    Office

    $849.06

    Facility

    $553.34

    $162.80 higher than Austin for the office setting.

  • San Luis Obispo-Paso Robles

    California · 28645

    Office

    $711.30

    Facility

    $477.71

    $25.04 higher than Austin for the office setting.

  • Santa Cruz-Watsonville

    California · 28645

    Office

    $742.22

    Facility

    $493.05

    $55.96 higher than Austin for the office setting.

  • Santa Maria-Santa Barbara

    California · 28645

    Office

    $724.61

    Facility

    $485.48

    $38.35 higher than Austin for the office setting.

  • Santa Rosa-Petaluma

    California · 28645

    Office

    $749.53

    Facility

    $497.69

    $63.27 higher than Austin for the office setting.

  • Stockton

    California · 28645

    Office

    $694.35

    Facility

    $469.58

    $8.09 higher than Austin for the office setting.

  • Vallejo

    California · 28645

    Office

    $790.67

    Facility

    $520.38

    $104.41 higher than Austin for the office setting.

  • Visalia

    California · 28645

    Office

    $694.35

    Facility

    $469.58

    $8.09 higher than Austin for the office setting.

  • Yuba City

    California · 28645

    Office

    $694.35

    Facility

    $469.58

    $8.09 higher than Austin for the office setting.

  • Colorado

    Colorado · 28645

    Office

    $687.89

    Facility

    $469.69

    $1.63 higher than Austin for the office setting.

  • Connecticut

    Connecticut · 28645

    Office

    $707.85

    Facility

    $486.98

    $21.59 higher than Austin for the office setting.

  • Delaware

    Delaware · 28645

    Office

    $659.79

    Facility

    $457.17

    $26.47 lower than Austin for the office setting.

  • Fort Lauderdale

    Florida · 28645

    Office

    $695.76

    Facility

    $488.01

    $9.50 higher than Austin for the office setting.

  • Rest Of Florida

    Florida · 28645

    Office

    $664.13

    Facility

    $468.07

    $22.13 lower than Austin for the office setting.

  • Atlanta

    Georgia · 28645

    Office

    $679.42

    Facility

    $471.06

    $6.84 lower than Austin for the office setting.

  • Rest Of Georgia

    Georgia · 28645

    Office

    $629.55

    Facility

    $446.62

    $56.71 lower than Austin for the office setting.

  • Hawaii, Guam

    Hawaii · 28645

    Office

    $707.69

    Facility

    $474.51

    $21.43 higher than Austin for the office setting.

  • Iowa

    Iowa · 28645

    Office

    $614.72

    Facility

    $427.07

    $71.54 lower than Austin for the office setting.

  • Idaho

    Idaho · 28645

    Office

    $618.98

    Facility

    $430.30

    $67.28 lower than Austin for the office setting.

  • East St. Louis

    Illinois · 28645

    Office

    $665.30

    Facility

    $476.62

    $20.96 lower than Austin for the office setting.

  • Rest Of Illinois

    Illinois · 28645

    Office

    $648.98

    Facility

    $461.74

    $37.28 lower than Austin for the office setting.

  • Suburban Chicago

    Illinois · 28645

    Office

    $701.89

    Facility

    $491.27

    $15.63 higher than Austin for the office setting.

  • Indiana

    Indiana · 28645

    Office

    $622.13

    Facility

    $432.01

    $64.13 lower than Austin for the office setting.

  • Kansas

    Kansas · 28645

    Office

    $613.60

    Facility

    $428.21

    $72.66 lower than Austin for the office setting.

  • Kentucky

    Kentucky · 28645

    Office

    $620.04

    Facility

    $437.73

    $66.22 lower than Austin for the office setting.

  • New Orleans

    Louisiana · 28645

    Office

    $647.18

    Facility

    $454.20

    $39.08 lower than Austin for the office setting.

  • Rest Of Louisiana

    Louisiana · 28645

    Office

    $619.76

    Facility

    $438.26

    $66.50 lower than Austin for the office setting.

  • Metropolitan Boston

    Massachusetts · 28645

    Office

    $749.43

    Facility

    $504.56

    $63.17 higher than Austin for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 28645

    Office

    $685.01

    Facility

    $469.06

    $1.25 lower than Austin for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 28645

    Office

    $706.12

    Facility

    $486.07

    $19.86 higher than Austin for the office setting.

  • Rest Of Maryland

    Maryland · 28645

    Office

    $671.03

    Facility

    $463.49

    $15.23 lower than Austin for the office setting.

  • Rest Of Maine

    Maine · 28645

    Office

    $623.45

    Facility

    $434.78

    $62.81 lower than Austin for the office setting.

  • Southern Maine

    Maine · 28645

    Office

    $651.71

    Facility

    $448.47

    $34.55 lower than Austin for the office setting.

  • Detroit

    Michigan · 28645

    Office

    $673.18

    Facility

    $475.27

    $13.08 lower than Austin for the office setting.

  • Rest Of Michigan

    Michigan · 28645

    Office

    $635.94

    Facility

    $448.70

    $50.32 lower than Austin for the office setting.

  • Minnesota

    Minnesota · 28645

    Office

    $656.61

    Facility

    $445.59

    $29.65 lower than Austin for the office setting.

  • Metropolitan Kansas City

    Missouri · 28645

    Office

    $641.61

    Facility

    $449.04

    $44.65 lower than Austin for the office setting.

  • Metropolitan St. Louis

    Missouri · 28645

    Office

    $647.49

    Facility

    $452.25

    $38.77 lower than Austin for the office setting.

  • Rest Of Missouri

    Missouri · 28645

    Office

    $611.18

    Facility

    $434.40

    $75.08 lower than Austin for the office setting.

  • Mississippi

    Mississippi · 28645

    Office

    $603.72

    Facility

    $427.14

    $82.54 lower than Austin for the office setting.

  • Montana**

    Montana · 28645

    Office

    $666.29

    Facility

    $461.21

    $19.97 lower than Austin for the office setting.

  • North Carolina

    North Carolina · 28645

    Office

    $629.09

    Facility

    $437.75

    $57.17 lower than Austin for the office setting.

  • North Dakota**

    North Dakota · 28645

    Office

    $648.49

    Facility

    $443.41

    $37.77 lower than Austin for the office setting.

  • Nebraska

    Nebraska · 28645

    Office

    $617.30

    Facility

    $428.01

    $68.96 lower than Austin for the office setting.

  • New Hampshire

    New Hampshire · 28645

    Office

    $678.75

    Facility

    $465.26

    $7.51 lower than Austin for the office setting.

  • Northern Nj

    New Jersey · 28645

    Office

    $746.71

    Facility

    $508.81

    $60.45 higher than Austin for the office setting.

  • Rest Of New Jersey

    New Jersey · 28645

    Office

    $715.21

    Facility

    $491.26

    $28.95 higher than Austin for the office setting.

  • New Mexico

    New Mexico · 28645

    Office

    $639.68

    Facility

    $451.62

    $46.58 lower than Austin for the office setting.

  • Nevada**

    Nevada · 28645

    Office

    $661.72

    Facility

    $456.44

    $24.54 lower than Austin for the office setting.

  • Nyc Suburbs/Long Island

    New York · 28645

    Office

    $782.10

    Facility

    $538.26

    $95.84 higher than Austin for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 28645

    Office

    $721.00

    Facility

    $496.44

    $34.74 higher than Austin for the office setting.

  • Queens

    New York · 28645

    Office

    $766.86

    Facility

    $524.46

    $80.60 higher than Austin for the office setting.

  • Rest Of New York

    New York · 28645

    Office

    $637.71

    Facility

    $442.89

    $48.55 lower than Austin for the office setting.

  • Ohio

    Ohio · 28645

    Office

    $632.30

    Facility

    $445.06

    $53.96 lower than Austin for the office setting.

  • Oklahoma

    Oklahoma · 28645

    Office

    $617.47

    Facility

    $434.33

    $68.79 lower than Austin for the office setting.

  • Portland

    Oregon · 28645

    Office

    $706.28

    Facility

    $478.43

    $20.02 higher than Austin for the office setting.

  • Rest Of Oregon

    Oregon · 28645

    Office

    $655.84

    Facility

    $451.58

    $30.42 lower than Austin for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 28645

    Office

    $692.67

    Facility

    $479.18

    $6.41 higher than Austin for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 28645

    Office

    $632.38

    Facility

    $444.11

    $53.88 lower than Austin for the office setting.

  • Puerto Rico

    Puerto Rico · 28645

    Office

    $670.23

    Facility

    $462.90

    $16.03 lower than Austin for the office setting.

  • Rhode Island

    Rhode Island · 28645

    Office

    $680.71

    Facility

    $468.86

    $5.55 lower than Austin for the office setting.

  • South Carolina

    South Carolina · 28645

    Office

    $631.88

    Facility

    $442.39

    $54.38 lower than Austin for the office setting.

  • South Dakota**

    South Dakota · 28645

    Office

    $646.39

    Facility

    $441.31

    $39.87 lower than Austin for the office setting.

  • Tennessee

    Tennessee · 28645

    Office

    $616.56

    Facility

    $430.14

    $69.70 lower than Austin for the office setting.

  • Utah

    Utah · 28645

    Office

    $639.63

    Facility

    $446.86

    $46.63 lower than Austin for the office setting.

  • Virginia

    Virginia · 28645

    Office

    $650.81

    Facility

    $449.21

    $35.45 lower than Austin for the office setting.

  • Virgin Islands

    United States Virgin Islands · 28645

    Office

    $670.23

    Facility

    $462.90

    $16.03 lower than Austin for the office setting.

  • Vermont

    Vermont · 28645

    Office

    $647.56

    Facility

    $444.53

    $38.70 lower than Austin for the office setting.

  • Rest Of Washington

    Washington · 28645

    Office

    $683.20

    Facility

    $467.25

    $3.06 lower than Austin for the office setting.

  • Seattle (King Cnty)

    Washington · 28645

    Office

    $762.42

    Facility

    $510.79

    $76.16 higher than Austin for the office setting.

  • Wisconsin

    Wisconsin · 28645

    Office

    $628.99

    Facility

    $432.52

    $57.27 lower than Austin for the office setting.

  • West Virginia

    West Virginia · 28645

    Office

    $627.67

    Facility

    $449.46

    $58.59 lower than Austin for the office setting.

  • Wyoming**

    Wyoming · 28645

    Office

    $658.53

    Facility

    $453.45

    $27.73 lower than Austin for the office setting.

See how rates vary across the country

28645 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$596.20

$799.55

Color shows the midpoint of each state’s locality range.

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$799.551
AL$604.041
AR$596.201
AZ$649.801
CA$694.35–$853.2429
CO$687.891
CT$707.851
DC$752.981
DE$659.791
FL$664.13–$728.473
GA$629.55–$679.422
GU$707.691
HI$707.691
IA$614.721
ID$618.981
IL$648.98–$708.944
IN$622.131
KS$613.601
KY$620.041
LA$619.76–$647.182
MA$685.01–$749.432
MD$671.03–$752.983
ME$623.45–$651.712
MI$635.94–$673.182
MN$656.611
MO$611.18–$647.493
MS$603.721
MT$666.291
NC$629.091
ND$648.491
NE$617.301
NH$678.751
NJ$715.21–$746.712
NM$639.681
NV$661.721
NY$637.71–$782.105
OH$632.301
OK$617.471
OR$655.84–$706.282
PA$632.38–$692.672
PR$670.231
RI$680.711
SC$631.881
SD$646.391
TN$616.561
TX$628.74–$686.268
UT$639.631
VA$650.81–$752.982
VI$670.231
VT$647.561
WA$683.20–$762.422
WI$628.991
WV$627.671
WY$658.531

Explore 28645 on the national rate map →

Where does this rate apply?

Austin is a Medicare payment area. Our Census mapping connects it to 31 cities and communities in Texas, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in Texas →

Why are the office and facility amounts different?

For 28645 in Austin, the physician’s office rate is $686.26 and the facility-setting rate is $469.29: a difference of $216.97.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 28645 in Austin. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$754.89

$686.26 × 110% = $754.89

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

Compare your contract offer →

How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 28645 in Austin.

PPRRVU2026_Oct_nonQPP.csv

3,240

Code
28645
Physician work
7.25
Practice expense
11.80
Malpractice
0.90

GPCI2026.csv

96

Locality
Austin
Physician work
1.002
Practice expense
1.058
Malpractice
0.886
Office / nonfacility calculation for 28645 in Austin
ComponentRVULocality factorAdjusted
Physician work7.25× 1.0027.2645
Practice expense11.80× 1.05812.4844
Malpractice0.90× 0.8860.7974
Total RVUs20.5463
Conversion factor× 33.4009

Office / nonfacility rate, Austin$686.26

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 28645 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work7.251.002
Practice expense11.81.058
Malpractice0.90.886

(7.25 × 1.002 + 11.8 × 1.058 + 0.9 × 0.886) × $33.4009 = $686.26

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work7.251.002
Practice expense5.661.058
Malpractice0.90.886

(7.25 × 1.002 + 5.66 × 1.058 + 0.9 × 0.886) × $33.4009 = $469.29

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

28645 · Office / nonfacility

$686.26

Effective 2026-10-01

The base rate is $39.12 higher than on 2025-10-01, moving from $647.14 to $686.26 (6.0%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $647.14changed to$686.26

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 7.44 changed to 7.25
    • Practice expense RVU 11.28 changed to 11.80
    • Malpractice RVU 0.84 changed to 0.90
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 1.046 changed to 1.058
    • Malpractice GPCI 0.914 changed to 0.886

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $647.14

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$686.26$469.29RVU26D
2026-07-01$686.26$469.29RVU26C
2026-04-01$686.26$469.29RVU26B
2026-01-01$686.26$469.29RVU26A
2025-10-01$647.14$488.12RVU25D
2025-07-01$647.14$488.12RVU25C
2025-04-01$647.14$488.12RVU25B
2025-01-01$647.14$488.12RVU25A

28645 billing questions

When should I report 28645 instead of 28636?

Use 28645 for open treatment of a metatarsophalangeal joint dislocation. Code 28636 describes closed treatment with percutaneous skeletal fixation.

How does 28645 differ from 28675?

The joint determines the choice: 28645 is for an open metatarsophalangeal dislocation, while 28675 is for an open interphalangeal dislocation.

What documentation supports reporting 28645?

Document the affected toe and metatarsophalangeal joint, the dislocation, the open surgical treatment, and any fixation performed.

Can modifier 50 be reported for bilateral toe treatment?

No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 should not be used.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

How are multiple procedures handled in the same session?

The highest-valued procedure is paid in full, and other procedures are paid at 50%. Assistant-at-surgery payment is restricted; co-surgeon payment requires supporting documentation.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 28645PPRRVU2026_Oct_nonQPP.csv, line 3,240 (RVU26D)
Geographic factors for AustinGPCI2026.csv, line 96 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet