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CMS RVU26D · Effective 2026-10-01

28496 in Redding

Office / nonfacility

$585.36

Base rate per service

Facility setting

$292.13

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 28496: Great toe fracture percutaneous fixation

Percutaneous skeletal fixation with manipulation treats a great toe fracture when the fracture requires reduction and pin fixation rather than closed treatment alone.

An orthopedic surgeon or podiatric surgeon uses manipulation to reduce a great toe fracture and places skeletal fixation through the skin, typically with pins, to stabilize the fracture. This approach is used when the fracture needs fixation but is treated percutaneously rather than through open exposure. The service is generally performed in a surgical facility; the 2024 Medicare file reports facility services for this code.

Choose this code when the documented treatment includes both manipulation and percutaneous skeletal fixation of a great toe fracture. The operative report should identify the great toe fracture, reduction, and percutaneous fixation performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For same-session procedures, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.

CMS billing rules for 28496

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 procedure with modifier 50 is paid at 150%.
Assistant at surgery
Statutory restriction: assistant at surgery is not paid.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU2.42 · 15%
  • Practice expense (office) RVU13.50 · 82%
  • Malpractice RVU0.50 · 3%

81

Medicare services in 2024 · #5036 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.

28496 compared with similar codes

Office rates for Redding, from the same CMS release.

28490

Toe fracture care

Without manipulation

$167.70

Use 28490 for closed treatment of a great toe fracture without manipulation. Use 28496 when manipulation and percutaneous skeletal fixation are performed.

28495

Toe fracture treatment

Great toe, with manipulation

$206.45

Use 28495 for closed treatment with manipulation but without skeletal fixation. Use 28496 when percutaneous fixation is added to the treatment.

28505

Toe fracture surgery

Great toe, open treatment

$695.61

28505 describes open treatment of a great toe phalangeal fracture. Choose 28496 when the fracture is reduced and fixed percutaneously rather than treated through open exposure.

The same code, a different location

How does Redding compare?

In Bakersfield, the office rate for 28496 is $586.74—$1.38 higher than the $585.36 rate in Redding. Both use the same code, release and participation basis.

28496 across payment areas

Same release and payment basis · bars start at $0

  1. Redding · This locality

    $585.36

  2. Bakersfield

    $586.74

    $1.38 higher than Redding

  3. Chico

    $585.36

    The same base rate than Redding

  4. El Centro

    $585.44

    $0.08 higher than Redding

  5. Fresno

    $585.36

    The same base rate than Redding

  6. Hanford-Corcoran

    $585.36

    The same base rate than Redding

  7. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $628.66

    $43.30 higher than Redding

Other payment areas listed in California 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, 28496 ranges from $476.76 in Arkansas to $748.89 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

  • Madera

    California · 28496

    Office

    $585.36

    Facility

    $292.13

    The same base rate than Redding for the office setting.

  • Merced

    California · 28496

    Office

    $585.36

    Facility

    $292.13

    The same base rate than Redding for the office setting.

  • Modesto

    California · 28496

    Office

    $585.36

    Facility

    $292.13

    The same base rate than Redding for the office setting.

  • Napa

    California · 28496

    Office

    $688.71

    Facility

    $336.09

    $103.35 higher than Redding for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 28496

    Office

    $626.48

    Facility

    $310.24

    $41.12 higher than Redding for the office setting.

  • Rest Of California

    California · 28496

    Office

    $585.36

    Facility

    $292.13

    The same base rate than Redding for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 28496

    Office

    $590.73

    Facility

    $297.51

    $5.37 higher than Redding for the office setting.

  • Sacramento-Roseville-Folsom

    California · 28496

    Office

    $617.10

    Facility

    $305.95

    $31.74 higher than Redding for the office setting.

  • Salinas

    California · 28496

    Office

    $614.89

    Facility

    $304.81

    $29.53 higher than Redding for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 28496

    Office

    $631.60

    Facility

    $311.62

    $46.24 higher than Redding for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 28496

    Office

    $731.96

    Facility

    $354.73

    $146.60 higher than Redding for the office setting.

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

    California · 28496

    Office

    $731.39

    Facility

    $354.16

    $146.03 higher than Redding for the office setting.

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

    California · 28496

    Office

    $748.89

    Facility

    $363.09

    $163.53 higher than Redding for the office setting.

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

    California · 28496

    Office

    $746.57

    Facility

    $360.77

    $161.21 higher than Redding for the office setting.

  • San Luis Obispo-Paso Robles

    California · 28496

    Office

    $604.74

    Facility

    $300.02

    $19.38 higher than Redding for the office setting.

  • Santa Cruz-Watsonville

    California · 28496

    Office

    $639.34

    Facility

    $314.27

    $53.98 higher than Redding for the office setting.

  • Santa Maria-Santa Barbara

    California · 28496

    Office

    $617.81

    Facility

    $305.86

    $32.45 higher than Redding for the office setting.

  • Santa Rosa-Petaluma

    California · 28496

    Office

    $645.93

    Facility

    $317.39

    $60.57 higher than Redding for the office setting.

  • Stockton

    California · 28496

    Office

    $585.36

    Facility

    $292.13

    The same base rate than Redding for the office setting.

  • Vallejo

    California · 28496

    Office

    $687.89

    Facility

    $335.27

    $102.53 higher than Redding for the office setting.

  • Visalia

    California · 28496

    Office

    $585.36

    Facility

    $292.13

    The same base rate than Redding for the office setting.

  • Yuba City

    California · 28496

    Office

    $585.36

    Facility

    $292.13

    The same base rate than Redding for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 28496

    Office

    $634.96

    Facility

    $319.79

    $49.60 higher than Redding for the office setting.

  • Miami

    Florida · 28496

    Office

    $592.47

    Facility

    $313.95

    $7.11 higher than Redding for the office setting.

  • Chicago

    Illinois · 28496

    Office

    $572.89

    Facility

    $304.01

    $12.47 lower than Redding for the office setting.

  • Manhattan

    New York · 28496

    Office

    $636.45

    Facility

    $325.57

    $51.09 higher than Redding for the office setting.

  • Alaska*

    Alaska · 28496

    Office

    $610.67

    Facility

    $325.74

    $25.31 higher than Redding for the office setting.

  • Alabama

    Alabama · 28496

    Office

    $484.83

    Facility

    $250.73

    $100.53 lower than Redding for the office setting.

  • Arkansas

    Arkansas · 28496

    Office

    $476.76

    Facility

    $246.95

    $108.60 lower than Redding for the office setting.

  • Arizona

    Arizona · 28496

    Office

    $532.06

    Facility

    $272.81

    $53.30 lower than Redding for the office setting.

  • Colorado

    Colorado · 28496

    Office

    $574.61

    Facility

    $289.95

    $10.75 lower than Redding for the office setting.

  • Connecticut

    Connecticut · 28496

    Office

    $588.29

    Facility

    $300.14

    $2.93 higher than Redding for the office setting.

  • Delaware

    Delaware · 28496

    Office

    $541.75

    Facility

    $277.42

    $43.61 lower than Redding for the office setting.

  • Fort Lauderdale

    Florida · 28496

    Office

    $567.80

    Facility

    $296.78

    $17.56 lower than Redding for the office setting.

  • Rest Of Florida

    Florida · 28496

    Office

    $537.00

    Facility

    $281.23

    $48.36 lower than Redding for the office setting.

  • Atlanta

    Georgia · 28496

    Office

    $559.26

    Facility

    $287.43

    $26.10 lower than Redding for the office setting.

  • Rest Of Georgia

    Georgia · 28496

    Office

    $502.95

    Facility

    $264.30

    $82.41 lower than Redding for the office setting.

  • Hawaii, Guam

    Hawaii · 28496

    Office

    $603.19

    Facility

    $298.99

    $17.83 higher than Redding for the office setting.

  • Iowa

    Iowa · 28496

    Office

    $500.04

    Facility

    $255.24

    $85.32 lower than Redding for the office setting.

  • Idaho

    Idaho · 28496

    Office

    $503.57

    Facility

    $257.43

    $81.79 lower than Redding for the office setting.

  • East St. Louis

    Illinois · 28496

    Office

    $529.30

    Facility

    $283.17

    $56.06 lower than Redding for the office setting.

  • Rest Of Illinois

    Illinois · 28496

    Office

    $518.62

    Facility

    $274.35

    $66.74 lower than Redding for the office setting.

  • Suburban Chicago

    Illinois · 28496

    Office

    $574.08

    Facility

    $299.31

    $11.28 lower than Redding for the office setting.

  • Indiana

    Indiana · 28496

    Office

    $506.94

    Facility

    $258.93

    $78.42 lower than Redding for the office setting.

  • Kansas

    Kansas · 28496

    Office

    $496.87

    Facility

    $255.01

    $88.49 lower than Redding for the office setting.

  • Kentucky

    Kentucky · 28496

    Office

    $496.97

    Facility

    $259.13

    $88.39 lower than Redding for the office setting.

  • New Orleans

    Louisiana · 28496

    Office

    $524.11

    Facility

    $272.35

    $61.25 lower than Redding for the office setting.

  • Rest Of Louisiana

    Louisiana · 28496

    Office

    $495.89

    Facility

    $259.11

    $89.47 lower than Redding for the office setting.

  • Metropolitan Boston

    Massachusetts · 28496

    Office

    $637.40

    Facility

    $317.95

    $52.04 higher than Redding for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 28496

    Office

    $570.24

    Facility

    $288.52

    $15.12 lower than Redding for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 28496

    Office

    $586.61

    Facility

    $299.54

    $1.25 higher than Redding for the office setting.

  • Rest Of Maryland

    Maryland · 28496

    Office

    $553.29

    Facility

    $282.54

    $32.07 lower than Redding for the office setting.

  • Rest Of Maine

    Maine · 28496

    Office

    $506.06

    Facility

    $259.92

    $79.30 lower than Redding for the office setting.

  • Southern Maine

    Maine · 28496

    Office

    $538.22

    Facility

    $273.09

    $47.14 lower than Redding for the office setting.

  • Detroit

    Michigan · 28496

    Office

    $544.12

    Facility

    $285.94

    $41.24 lower than Redding for the office setting.

  • Rest Of Michigan

    Michigan · 28496

    Office

    $511.37

    Facility

    $267.10

    $73.99 lower than Redding for the office setting.

  • Minnesota

    Minnesota · 28496

    Office

    $549.76

    Facility

    $274.46

    $35.60 lower than Redding for the office setting.

  • Metropolitan Kansas City

    Missouri · 28496

    Office

    $520.55

    Facility

    $269.33

    $64.81 lower than Redding for the office setting.

  • Metropolitan St. Louis

    Missouri · 28496

    Office

    $526.83

    Facility

    $272.13

    $58.53 lower than Redding for the office setting.

  • Rest Of Missouri

    Missouri · 28496

    Office

    $485.78

    Facility

    $255.16

    $99.58 lower than Redding for the office setting.

  • Mississippi

    Mississippi · 28496

    Office

    $481.41

    Facility

    $251.05

    $103.95 lower than Redding for the office setting.

  • Montana**

    Montana · 28496

    Office

    $548.41

    Facility

    $280.87

    $36.95 lower than Redding for the office setting.

  • North Carolina

    North Carolina · 28496

    Office

    $512.20

    Facility

    $262.59

    $73.16 lower than Redding for the office setting.

  • North Dakota**

    North Dakota · 28496

    Office

    $538.52

    Facility

    $270.98

    $46.84 lower than Redding for the office setting.

  • Nebraska

    Nebraska · 28496

    Office

    $503.33

    Facility

    $256.39

    $82.03 lower than Redding for the office setting.

  • New Hampshire

    New Hampshire · 28496

    Office

    $564.84

    Facility

    $286.33

    $20.52 lower than Redding for the office setting.

  • Northern Nj

    New Jersey · 28496

    Office

    $626.82

    Facility

    $316.47

    $41.46 higher than Redding for the office setting.

  • Rest Of New Jersey

    New Jersey · 28496

    Office

    $594.78

    Facility

    $302.62

    $9.42 higher than Redding for the office setting.

  • New Mexico

    New Mexico · 28496

    Office

    $514.37

    Facility

    $269.04

    $70.99 lower than Redding for the office setting.

  • Nevada**

    Nevada · 28496

    Office

    $546.10

    Facility

    $278.30

    $39.26 lower than Redding for the office setting.

  • Nyc Suburbs/Long Island

    New York · 28496

    Office

    $653.15

    Facility

    $335.04

    $67.79 higher than Redding for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 28496

    Office

    $598.42

    Facility

    $305.47

    $13.06 higher than Redding for the office setting.

  • Queens

    New York · 28496

    Office

    $643.06

    Facility

    $326.83

    $57.70 higher than Redding for the office setting.

  • Rest Of New York

    New York · 28496

    Office

    $520.94

    Facility

    $266.77

    $64.42 lower than Redding for the office setting.

  • Ohio

    Ohio · 28496

    Office

    $509.35

    Facility

    $265.08

    $76.01 lower than Redding for the office setting.

  • Oklahoma

    Oklahoma · 28496

    Office

    $496.47

    Facility

    $257.56

    $88.89 lower than Redding for the office setting.

  • Portland

    Oregon · 28496

    Office

    $595.51

    Facility

    $298.27

    $10.15 higher than Redding for the office setting.

  • Rest Of Oregon

    Oregon · 28496

    Office

    $541.68

    Facility

    $275.21

    $43.68 lower than Redding for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 28496

    Office

    $571.61

    Facility

    $293.10

    $13.75 lower than Redding for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 28496

    Office

    $510.55

    Facility

    $264.95

    $74.81 lower than Redding for the office setting.

  • Puerto Rico

    Puerto Rico · 28496

    Office

    $553.15

    Facility

    $282.67

    $32.21 lower than Redding for the office setting.

  • Rhode Island

    Rhode Island · 28496

    Office

    $563.06

    Facility

    $286.68

    $22.30 lower than Redding for the office setting.

  • South Carolina

    South Carolina · 28496

    Office

    $511.67

    Facility

    $264.46

    $73.69 lower than Redding for the office setting.

  • South Dakota**

    South Dakota · 28496

    Office

    $537.35

    Facility

    $269.81

    $48.01 lower than Redding for the office setting.

  • Tennessee

    Tennessee · 28496

    Office

    $499.68

    Facility

    $256.48

    $85.68 lower than Redding for the office setting.

  • Austin

    Texas · 28496

    Office

    $572.85

    Facility

    $289.79

    $12.51 lower than Redding for the office setting.

  • Beaumont

    Texas · 28496

    Office

    $506.67

    Facility

    $263.21

    $78.69 lower than Redding for the office setting.

  • Brazoria

    Texas · 28496

    Office

    $541.36

    Facility

    $276.22

    $44.00 lower than Redding for the office setting.

  • Dallas

    Texas · 28496

    Office

    $545.00

    Facility

    $278.52

    $40.36 lower than Redding for the office setting.

  • Fort Worth

    Texas · 28496

    Office

    $540.70

    Facility

    $276.91

    $44.66 lower than Redding for the office setting.

  • Galveston

    Texas · 28496

    Office

    $543.06

    Facility

    $277.39

    $42.30 lower than Redding for the office setting.

  • Houston

    Texas · 28496

    Office

    $552.21

    Facility

    $286.54

    $33.15 lower than Redding for the office setting.

  • Rest Of Texas

    Texas · 28496

    Office

    $523.83

    Facility

    $269.93

    $61.53 lower than Redding for the office setting.

  • Utah

    Utah · 28496

    Office

    $519.68

    Facility

    $268.20

    $65.68 lower than Redding for the office setting.

  • Virginia

    Virginia · 28496

    Office

    $535.87

    Facility

    $272.87

    $49.49 lower than Redding for the office setting.

  • Virgin Islands

    United States Virgin Islands · 28496

    Office

    $553.15

    Facility

    $282.67

    $32.21 lower than Redding for the office setting.

  • Vermont

    Vermont · 28496

    Office

    $535.68

    Facility

    $270.82

    $49.68 lower than Redding for the office setting.

  • Rest Of Washington

    Washington · 28496

    Office

    $569.40

    Facility

    $287.68

    $15.96 lower than Redding for the office setting.

  • Seattle (King Cnty)

    Washington · 28496

    Office

    $651.79

    Facility

    $323.51

    $66.43 higher than Redding for the office setting.

  • Wisconsin

    Wisconsin · 28496

    Office

    $517.95

    Facility

    $261.64

    $67.41 lower than Redding for the office setting.

  • West Virginia

    West Virginia · 28496

    Office

    $496.57

    Facility

    $264.08

    $88.79 lower than Redding for the office setting.

  • Wyoming**

    Wyoming · 28496

    Office

    $544.10

    Facility

    $276.56

    $41.26 lower than Redding for the office setting.

See how rates vary across the country

28496 · 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.

$476.76

$667.13

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$610.671
AL$484.831
AR$476.761
AZ$532.061
CA$585.36–$748.8929
CO$574.611
CT$588.291
DC$634.961
DE$541.751
FL$537.00–$592.473
GA$502.95–$559.262
GU$603.191
HI$603.191
IA$500.041
ID$503.571
IL$518.62–$574.084
IN$506.941
KS$496.871
KY$496.971
LA$495.89–$524.112
MA$570.24–$637.402
MD$553.29–$634.963
ME$506.06–$538.222
MI$511.37–$544.122
MN$549.761
MO$485.78–$526.833
MS$481.411
MT$548.411
NC$512.201
ND$538.521
NE$503.331
NH$564.841
NJ$594.78–$626.822
NM$514.371
NV$546.101
NY$520.94–$653.155
OH$509.351
OK$496.471
OR$541.68–$595.512
PA$510.55–$571.612
PR$553.151
RI$563.061
SC$511.671
SD$537.351
TN$499.681
TX$506.67–$572.858
UT$519.681
VA$535.87–$634.962
VI$553.151
VT$535.681
WA$569.40–$651.792
WI$517.951
WV$496.571
WY$544.101

Explore 28496 on the national rate map →

Where does this rate apply?

Redding is a Medicare payment area. Our Census mapping connects it to 32 cities and communities in California, 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 California →

Why are the office and facility amounts different?

For 28496 in Redding, the physician’s office rate is $585.36 and the facility-setting rate is $292.13: a difference of $293.23.

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 28496 in Redding. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$643.90

$585.36 × 110% = $643.90

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 28496 in Redding.

PPRRVU2026_Oct_nonQPP.csv

3,218

Code
28496
Physician work
2.42
Practice expense
13.50
Malpractice
0.50

GPCI2026.csv

19

Locality
Redding
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 28496 in Redding
ComponentRVULocality factorAdjusted
Physician work2.42× 1.0172.4611
Practice expense13.50× 1.09614.7960
Malpractice0.50× 0.5360.2680
Total RVUs17.5251
Conversion factor× 33.4009

Office / nonfacility rate, Redding$585.36

Open 28496 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work2.421.017
Practice expense13.51.096
Malpractice0.50.536

(2.42 × 1.017 + 13.5 × 1.096 + 0.5 × 0.536) × $33.4009 = $585.36

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work2.421.017
Practice expense5.491.096
Malpractice0.50.536

(2.42 × 1.017 + 5.49 × 1.096 + 0.5 × 0.536) × $33.4009 = $292.13

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

28496 · Office / nonfacility

$585.36

Effective 2026-10-01

The base rate is $63.45 higher than on 2025-10-01, moving from $521.91 to $585.36 (12.2%).

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

    $521.91changed to$585.36

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.48 changed to 2.42
    • Practice expense RVU 12.20 changed to 13.50
    • Malpractice RVU 0.51 changed to 0.50
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $521.91

    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$585.36$292.13RVU26D
2026-07-01$585.36$292.13RVU26C
2026-04-01$585.36$292.13RVU26B
2026-01-01$585.36$292.13RVU26A
2025-10-01$521.91$286.80RVU25D
2025-07-01$521.91$286.80RVU25C
2025-04-01$521.91$286.80RVU25B
2025-01-01$521.91$286.80RVU25A

28496 billing questions

How does this differ from 28495?

28495 describes closed treatment with manipulation. Use 28496 when the great toe fracture is also treated with percutaneous skeletal fixation.

How does this differ from 28490?

28490 is closed treatment without manipulation. This code represents manipulation plus percutaneous skeletal fixation.

Can the fixation be reported separately from the fracture treatment?

Percutaneous skeletal fixation is part of the service represented by 28496. Do not report a separate fracture-treatment code for the same great toe fracture.

What should the operative note document?

Document the great toe fracture, manipulation or reduction, and the percutaneous skeletal fixation performed. The record should support that the treatment went beyond closed reduction alone.

How is bilateral treatment reported?

When both great toes are treated, report bilateral services with modifier 50. CMS pays bilateral reporting at 150%.

Does the code include related postoperative visits?

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

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 28496PPRRVU2026_Oct_nonQPP.csv, line 3,218 (RVU26D)
Geographic factors for ReddingGPCI2026.csv, line 19 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet