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CMS RVU26D · Effective 2026-10-01

28525 in Redding

Office / nonfacility

$601.18

Base rate per service

Facility setting

$395.45

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 28525: Open treatment of lesser toe fracture

Surgical exposure and treatment of a fracture in a toe other than the great toe, with internal fixation included when performed.

This service treats a fracture of a lesser-toe phalanx by surgically exposing the fracture and addressing its alignment. Internal fixation, such as pins or screws, is included when performed. “Open treatment” refers to the surgical approach; it does not mean the injury itself must be an open wound. Orthopedic surgeons and podiatrists may perform the procedure, commonly in an operating room for a displaced or unstable lesser-toe fracture requiring operative treatment.

Report this code for open treatment of a phalanx fracture in a toe other than the great toe; use the operative report to support the toe and fracture site, surgical exposure, reduction, and any fixation. The 90-day global period includes 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 other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.

CMS billing rules for 28525

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
Assistant at surgery is paid only with documentation of medical necessity.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU5.48 · 32%
  • Practice expense (office) RVU11.00 · 64%
  • Malpractice RVU0.69 · 4%

330

Medicare services in 2024 · #3920 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.

28525 compared with similar codes

Office rates for Redding, from the same CMS release.

28505

Toe fracture surgery

Great toe, open treatment

$695.61

Use 28505 for open treatment of a great-toe phalanx fracture. Use 28525 for a phalanx fracture in another toe.

28510

Toe fracture care

Without manipulation

$137.69

Code 28510 describes closed treatment of a lesser-toe fracture without manipulation; 28525 describes open surgical treatment.

28515

Toe fracture care

With manipulation

$183.71

Code 28515 describes closed treatment of a lesser-toe fracture with manipulation. Surgical exposure and treatment point to 28525 instead.

The same code, a different location

How does Redding compare?

In Bakersfield, the office rate for 28525 is $603.23—$2.05 higher than the $601.18 rate in Redding. Both use the same code, release and participation basis.

28525 across payment areas

Same release and payment basis · bars start at $0

  1. Redding · This locality

    $601.18

  2. Bakersfield

    $603.23

    $2.05 higher than Redding

  3. Chico

    $601.18

    The same base rate than Redding

  4. El Centro

    $601.30

    $0.12 higher than Redding

  5. Fresno

    $601.18

    The same base rate than Redding

  6. Hanford-Corcoran

    $601.18

    The same base rate than Redding

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

    $640.49

    $39.31 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, 28525 ranges from $510.51 in Arkansas to $745.33 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 · 28525

    Office

    $601.18

    Facility

    $395.45

    The same base rate than Redding for the office setting.

  • Merced

    California · 28525

    Office

    $601.18

    Facility

    $395.45

    The same base rate than Redding for the office setting.

  • Modesto

    California · 28525

    Office

    $601.18

    Facility

    $395.45

    The same base rate than Redding for the office setting.

  • Napa

    California · 28525

    Office

    $690.52

    Facility

    $443.12

    $89.34 higher than Redding for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 28525

    Office

    $636.80

    Facility

    $414.92

    $35.62 higher than Redding for the office setting.

  • Rest Of California

    California · 28525

    Office

    $601.18

    Facility

    $395.45

    The same base rate than Redding for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 28525

    Office

    $608.67

    Facility

    $402.94

    $7.49 higher than Redding for the office setting.

  • Sacramento-Roseville-Folsom

    California · 28525

    Office

    $629.28

    Facility

    $410.97

    $28.10 higher than Redding for the office setting.

  • Salinas

    California · 28525

    Office

    $626.89

    Facility

    $409.33

    $25.71 higher than Redding for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 28525

    Office

    $640.44

    Facility

    $415.94

    $39.26 higher than Redding for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 28525

    Office

    $729.05

    Facility

    $464.38

    $127.87 higher than Redding for the office setting.

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

    California · 28525

    Office

    $728.27

    Facility

    $463.59

    $127.09 higher than Redding for the office setting.

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

    California · 28525

    Office

    $745.33

    Facility

    $474.65

    $144.15 higher than Redding for the office setting.

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

    California · 28525

    Office

    $742.13

    Facility

    $471.44

    $140.95 higher than Redding for the office setting.

  • San Luis Obispo-Paso Robles

    California · 28525

    Office

    $616.98

    Facility

    $403.18

    $15.80 higher than Redding for the office setting.

  • Santa Cruz-Watsonville

    California · 28525

    Office

    $645.64

    Facility

    $417.57

    $44.46 higher than Redding for the office setting.

  • Santa Maria-Santa Barbara

    California · 28525

    Office

    $628.91

    Facility

    $410.04

    $27.73 higher than Redding for the office setting.

  • Santa Rosa-Petaluma

    California · 28525

    Office

    $652.06

    Facility

    $421.55

    $50.88 higher than Redding for the office setting.

  • Stockton

    California · 28525

    Office

    $601.18

    Facility

    $395.45

    The same base rate than Redding for the office setting.

  • Vallejo

    California · 28525

    Office

    $689.39

    Facility

    $441.99

    $88.21 higher than Redding for the office setting.

  • Visalia

    California · 28525

    Office

    $601.18

    Facility

    $395.45

    The same base rate than Redding for the office setting.

  • Yuba City

    California · 28525

    Office

    $601.18

    Facility

    $395.45

    The same base rate than Redding for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 28525

    Office

    $651.38

    Facility

    $430.25

    $50.20 higher than Redding for the office setting.

  • Miami

    Florida · 28525

    Office

    $623.80

    Facility

    $428.39

    $22.62 higher than Redding for the office setting.

  • Chicago

    Illinois · 28525

    Office

    $606.46

    Facility

    $417.81

    $5.28 higher than Redding for the office setting.

  • Manhattan

    New York · 28525

    Office

    $658.23

    Facility

    $440.11

    $57.05 higher than Redding for the office setting.

  • Alaska*

    Alaska · 28525

    Office

    $678.55

    Facility

    $478.63

    $77.37 higher than Redding for the office setting.

  • Alabama

    Alabama · 28525

    Office

    $517.56

    Facility

    $353.32

    $83.62 lower than Redding for the office setting.

  • Arkansas

    Arkansas · 28525

    Office

    $510.51

    Facility

    $349.27

    $90.67 lower than Redding for the office setting.

  • Arizona

    Arizona · 28525

    Office

    $558.79

    Facility

    $376.89

    $42.39 lower than Redding for the office setting.

  • Colorado

    Colorado · 28525

    Office

    $594.16

    Facility

    $394.43

    $7.02 lower than Redding for the office setting.

  • Connecticut

    Connecticut · 28525

    Office

    $610.28

    Facility

    $408.12

    $9.10 higher than Redding for the office setting.

  • Delaware

    Delaware · 28525

    Office

    $567.67

    Facility

    $382.21

    $33.51 lower than Redding for the office setting.

  • Fort Lauderdale

    Florida · 28525

    Office

    $596.89

    Facility

    $406.74

    $4.29 lower than Redding for the office setting.

  • Rest Of Florida

    Florida · 28525

    Office

    $568.92

    Facility

    $389.47

    $32.26 lower than Redding for the office setting.

  • Atlanta

    Georgia · 28525

    Office

    $584.55

    Facility

    $393.84

    $16.63 lower than Redding for the office setting.

  • Rest Of Georgia

    Georgia · 28525

    Office

    $538.24

    Facility

    $370.80

    $62.94 lower than Redding for the office setting.

  • Hawaii, Guam

    Hawaii · 28525

    Office

    $614.13

    Facility

    $400.70

    $12.95 higher than Redding for the office setting.

  • Iowa

    Iowa · 28525

    Office

    $528.37

    Facility

    $356.61

    $72.81 lower than Redding for the office setting.

  • Idaho

    Idaho · 28525

    Office

    $531.96

    Facility

    $359.26

    $69.22 lower than Redding for the office setting.

  • East St. Louis

    Illinois · 28525

    Office

    $567.47

    Facility

    $394.77

    $33.71 lower than Redding for the office setting.

  • Rest Of Illinois

    Illinois · 28525

    Office

    $554.50

    Facility

    $383.12

    $46.68 lower than Redding for the office setting.

  • Suburban Chicago

    Illinois · 28525

    Office

    $602.49

    Facility

    $409.71

    $1.31 higher than Redding for the office setting.

  • Indiana

    Indiana · 28525

    Office

    $534.83

    Facility

    $360.82

    $66.35 lower than Redding for the office setting.

  • Kansas

    Kansas · 28525

    Office

    $526.79

    Facility

    $357.10

    $74.39 lower than Redding for the office setting.

  • Kentucky

    Kentucky · 28525

    Office

    $530.75

    Facility

    $363.88

    $70.43 lower than Redding for the office setting.

  • New Orleans

    Louisiana · 28525

    Office

    $554.95

    Facility

    $378.31

    $46.23 lower than Redding for the office setting.

  • Rest Of Louisiana

    Louisiana · 28525

    Office

    $530.27

    Facility

    $364.15

    $70.91 lower than Redding for the office setting.

  • Metropolitan Boston

    Massachusetts · 28525

    Office

    $649.74

    Facility

    $425.61

    $48.56 higher than Redding for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 28525

    Office

    $591.22

    Facility

    $393.55

    $9.96 lower than Redding for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 28525

    Office

    $608.71

    Facility

    $407.29

    $7.53 higher than Redding for the office setting.

  • Rest Of Maryland

    Maryland · 28525

    Office

    $577.84

    Facility

    $387.88

    $23.34 lower than Redding for the office setting.

  • Rest Of Maine

    Maine · 28525

    Office

    $535.39

    Facility

    $362.69

    $65.79 lower than Redding for the office setting.

  • Southern Maine

    Maine · 28525

    Office

    $561.68

    Facility

    $375.66

    $39.50 lower than Redding for the office setting.

  • Detroit

    Michigan · 28525

    Office

    $576.44

    Facility

    $395.30

    $24.74 lower than Redding for the office setting.

  • Rest Of Michigan

    Michigan · 28525

    Office

    $544.50

    Facility

    $373.12

    $56.68 lower than Redding for the office setting.

  • Minnesota

    Minnesota · 28525

    Office

    $567.92

    Facility

    $374.77

    $33.26 lower than Redding for the office setting.

  • Metropolitan Kansas City

    Missouri · 28525

    Office

    $550.55

    Facility

    $374.29

    $50.63 lower than Redding for the office setting.

  • Metropolitan St. Louis

    Missouri · 28525

    Office

    $555.90

    Facility

    $377.20

    $45.28 lower than Redding for the office setting.

  • Rest Of Missouri

    Missouri · 28525

    Office

    $522.19

    Facility

    $360.38

    $78.99 lower than Redding for the office setting.

  • Mississippi

    Mississippi · 28525

    Office

    $516.41

    Facility

    $354.79

    $84.77 lower than Redding for the office setting.

  • Montana**

    Montana · 28525

    Office

    $573.45

    Facility

    $385.73

    $27.73 lower than Redding for the office setting.

  • North Carolina

    North Carolina · 28525

    Office

    $540.56

    Facility

    $365.42

    $60.62 lower than Redding for the office setting.

  • North Dakota**

    North Dakota · 28525

    Office

    $559.80

    Facility

    $372.09

    $41.38 lower than Redding for the office setting.

  • Nebraska

    Nebraska · 28525

    Office

    $530.87

    Facility

    $357.61

    $70.31 lower than Redding for the office setting.

  • New Hampshire

    New Hampshire · 28525

    Office

    $585.68

    Facility

    $390.27

    $15.50 lower than Redding for the office setting.

  • Northern Nj

    New Jersey · 28525

    Office

    $645.38

    Facility

    $427.63

    $44.20 higher than Redding for the office setting.

  • Rest Of New Jersey

    New Jersey · 28525

    Office

    $616.85

    Facility

    $411.87

    $15.67 higher than Redding for the office setting.

  • New Mexico

    New Mexico · 28525

    Office

    $547.63

    Facility

    $375.50

    $53.55 lower than Redding for the office setting.

  • Nevada**

    Nevada · 28525

    Office

    $570.01

    Facility

    $382.11

    $31.17 lower than Redding for the office setting.

  • Nyc Suburbs/Long Island

    New York · 28525

    Office

    $674.40

    Facility

    $451.21

    $73.22 higher than Redding for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 28525

    Office

    $621.47

    Facility

    $415.93

    $20.29 higher than Redding for the office setting.

  • Queens

    New York · 28525

    Office

    $662.26

    Facility

    $440.39

    $61.08 higher than Redding for the office setting.

  • Rest Of New York

    New York · 28525

    Office

    $548.28

    Facility

    $369.95

    $52.90 lower than Redding for the office setting.

  • Ohio

    Ohio · 28525

    Office

    $541.71

    Facility

    $370.33

    $59.47 lower than Redding for the office setting.

  • Oklahoma

    Oklahoma · 28525

    Office

    $529.04

    Facility

    $361.41

    $72.14 lower than Redding for the office setting.

  • Portland

    Oregon · 28525

    Office

    $611.30

    Facility

    $402.76

    $10.12 higher than Redding for the office setting.

  • Rest Of Oregon

    Oregon · 28525

    Office

    $565.18

    Facility

    $378.22

    $36.00 lower than Redding for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 28525

    Office

    $596.30

    Facility

    $400.89

    $4.88 lower than Redding for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 28525

    Office

    $542.10

    Facility

    $369.78

    $59.08 lower than Redding for the office setting.

  • Puerto Rico

    Puerto Rico · 28525

    Office

    $577.19

    Facility

    $387.41

    $23.99 lower than Redding for the office setting.

  • Rhode Island

    Rhode Island · 28525

    Office

    $586.61

    Facility

    $392.70

    $14.57 lower than Redding for the office setting.

  • South Carolina

    South Carolina · 28525

    Office

    $542.11

    Facility

    $368.67

    $59.07 lower than Redding for the office setting.

  • South Dakota**

    South Dakota · 28525

    Office

    $558.19

    Facility

    $370.48

    $42.99 lower than Redding for the office setting.

  • Tennessee

    Tennessee · 28525

    Office

    $529.39

    Facility

    $358.76

    $71.79 lower than Redding for the office setting.

  • Austin

    Texas · 28525

    Office

    $592.54

    Facility

    $393.94

    $8.64 lower than Redding for the office setting.

  • Beaumont

    Texas · 28525

    Office

    $538.79

    Facility

    $367.97

    $62.39 lower than Redding for the office setting.

  • Brazoria

    Texas · 28525

    Office

    $566.58

    Facility

    $380.56

    $34.60 lower than Redding for the office setting.

  • Dallas

    Texas · 28525

    Office

    $570.40

    Facility

    $383.44

    $30.78 lower than Redding for the office setting.

  • Fort Worth

    Texas · 28525

    Office

    $567.02

    Facility

    $381.94

    $34.16 lower than Redding for the office setting.

  • Galveston

    Texas · 28525

    Office

    $568.42

    Facility

    $382.02

    $32.76 lower than Redding for the office setting.

  • Houston

    Texas · 28525

    Office

    $581.05

    Facility

    $394.65

    $20.13 lower than Redding for the office setting.

  • Rest Of Texas

    Texas · 28525

    Office

    $552.52

    Facility

    $374.38

    $48.66 lower than Redding for the office setting.

  • Utah

    Utah · 28525

    Office

    $549.10

    Facility

    $372.65

    $52.08 lower than Redding for the office setting.

  • Virginia

    Virginia · 28525

    Office

    $560.47

    Facility

    $375.95

    $40.71 lower than Redding for the office setting.

  • Virgin Islands

    United States Virgin Islands · 28525

    Office

    $577.19

    Facility

    $387.41

    $23.99 lower than Redding for the office setting.

  • Vermont

    Vermont · 28525

    Office

    $558.43

    Facility

    $372.60

    $42.75 lower than Redding for the office setting.

  • Rest Of Washington

    Washington · 28525

    Office

    $589.84

    Facility

    $392.18

    $11.34 lower than Redding for the office setting.

  • Seattle (King Cnty)

    Washington · 28525

    Office

    $661.83

    Facility

    $431.51

    $60.65 higher than Redding for the office setting.

  • Wisconsin

    Wisconsin · 28525

    Office

    $542.11

    Facility

    $362.28

    $59.07 lower than Redding for the office setting.

  • West Virginia

    West Virginia · 28525

    Office

    $535.30

    Facility

    $372.17

    $65.88 lower than Redding for the office setting.

  • Wyoming**

    Wyoming · 28525

    Office

    $567.50

    Facility

    $379.79

    $33.68 lower than Redding for the office setting.

See how rates vary across the country

28525 · 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.

$510.51

$678.55

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$678.551
AL$517.561
AR$510.511
AZ$558.791
CA$601.18–$745.3329
CO$594.161
CT$610.281
DC$651.381
DE$567.671
FL$568.92–$623.803
GA$538.24–$584.552
GU$614.131
HI$614.131
IA$528.371
ID$531.961
IL$554.50–$606.464
IN$534.831
KS$526.791
KY$530.751
LA$530.27–$554.952
MA$591.22–$649.742
MD$577.84–$651.383
ME$535.39–$561.682
MI$544.50–$576.442
MN$567.921
MO$522.19–$555.903
MS$516.411
MT$573.451
NC$540.561
ND$559.801
NE$530.871
NH$585.681
NJ$616.85–$645.382
NM$547.631
NV$570.011
NY$548.28–$674.405
OH$541.711
OK$529.041
OR$565.18–$611.302
PA$542.10–$596.302
PR$577.191
RI$586.611
SC$542.111
SD$558.191
TN$529.391
TX$538.79–$592.548
UT$549.101
VA$560.47–$651.382
VI$577.191
VT$558.431
WA$589.84–$661.832
WI$542.111
WV$535.301
WY$567.501

Explore 28525 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 28525 in Redding, the physician’s office rate is $601.18 and the facility-setting rate is $395.45: a difference of $205.73.

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 28525 in Redding. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$661.30

$601.18 × 110% = $661.30

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 28525 in Redding.

PPRRVU2026_Oct_nonQPP.csv

3,222

Code
28525
Physician work
5.48
Practice expense
11.00
Malpractice
0.69

GPCI2026.csv

19

Locality
Redding
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 28525 in Redding
ComponentRVULocality factorAdjusted
Physician work5.48× 1.0175.5732
Practice expense11.00× 1.09612.0560
Malpractice0.69× 0.5360.3698
Total RVUs17.9990
Conversion factor× 33.4009

Office / nonfacility rate, Redding$601.18

Open 28525 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work5.481.017
Practice expense111.096
Malpractice0.690.536

(5.48 × 1.017 + 11 × 1.096 + 0.69 × 0.536) × $33.4009 = $601.18

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work5.481.017
Practice expense5.381.096
Malpractice0.690.536

(5.48 × 1.017 + 5.38 × 1.096 + 0.69 × 0.536) × $33.4009 = $395.45

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

28525 · Office / nonfacility

$601.18

Effective 2026-10-01

The base rate is $31.19 higher than on 2025-10-01, moving from $569.99 to $601.18 (5.5%).

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

    $569.99changed to$601.18

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 5.62 changed to 5.48
    • Practice expense RVU 10.57 changed to 11.00
    • Malpractice RVU 0.66 changed to 0.69
    • 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: $569.99

    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$601.18$395.45RVU26D
2026-07-01$601.18$395.45RVU26C
2026-04-01$601.18$395.45RVU26B
2026-01-01$601.18$395.45RVU26A
2025-10-01$569.99$409.83RVU25D
2025-07-01$569.99$409.83RVU25C
2025-04-01$569.99$409.83RVU25B
2025-01-01$569.99$409.83RVU25A

28525 billing questions

How is this different from code 28505?

Code 28525 is for open treatment of a fracture in a toe other than the great toe. Code 28505 is the corresponding open-treatment code for a great-toe fracture.

Is internal fixation separately reported?

Internal fixation is included in this service when performed. The operative report should describe the reduction and any pins, screws, or other fixation used.

How does this differ from codes 28510 and 28515?

Those codes describe closed treatment of a lesser-toe fracture, without manipulation for 28510 and with manipulation for 28515. Code 28525 describes open surgical treatment.

Can modifier 50 be used for fractures in both feet?

CMS identifies bilateral adjustment as inappropriate for this code based on its descriptor or anatomy. Modifier 50 should not be applied.

What postoperative care is included?

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

When is assistant-at-surgery payment allowed?

Payment for an assistant at surgery requires documentation of medical necessity. Co-surgeons and team surgery are not permitted for this code.

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 28525PPRRVU2026_Oct_nonQPP.csv, line 3,222 (RVU26D)
Geographic factors for ReddingGPCI2026.csv, line 19 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet