Billing code 28636: Toe dislocationMedicare rate & RVUs in Alaska
Closed reduction of a toe metatarsophalangeal joint dislocation with percutaneous skeletal fixation to stabilize the joint after manipulation.
Medicare pays $442.79 for 28636 in the office in Alaska (Alaska*). Which amount applies depends on the service address.
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 9 sections
What 28636 covers
This service treats a dislocated toe metatarsophalangeal (MTP) joint by manipulating the joint back into position and stabilizing it with skeletal fixation placed through the skin. It is typically performed by an orthopedic surgeon or podiatrist for an MTP dislocation that needs pin stabilization but can be managed without open exposure, often in a surgical facility setting.
Report the code when the documented treatment includes both manipulation and percutaneous skeletal fixation at the MTP joint. The operative note should identify the joint, reduction, and fixation performed. CMS assigns a 10-day global period, so related postoperative visits during that period are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this service. CMS 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.
28636 in Alaska*
| Payment locality | Office | Facility |
|---|---|---|
| Alaska* | $442.79 | $261.02 |
How the 28636 rate is calculated
Each of 28636’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 · 28636
RVUs × geographic indexes × conversion factor
Work2.70
2.70 RVUs× 1.000 GPCI
Practice expense8.35
8.35 RVUs× 1.000 GPCI
Malpractice0.57
0.57 RVUs× 1.000 GPCI
Adjusted RVUs
11.6200
Conversion factor
$33.4009
Medicare rate
$388.12
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 28636
28636 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28636
Toe dislocation
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 2 | Permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 28636
Toe dislocation
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
28636 without 51 · national office
$388.12
Toe dislocation
28636-51 · Second procedure: 50%
$194.06
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%).
28636 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 28630Toe dislocation
- This code is for MTP dislocation treatment without manipulation. Code 28636 involves manipulation and percutaneous skeletal fixation.
- 28635Toe dislocation
- Both address an MTP dislocation with manipulation; 28636 additionally includes percutaneous skeletal fixation.
- 28645Toe dislocation repair
- Code 28645 is used for open treatment of an MTP dislocation; 28636 describes closed reduction with percutaneous fixation.
- 28666Toe reduction
- Code 28666 concerns an interphalangeal joint dislocation, not the MTP joint treated by 28636.
28636 billing questions
How does this differ from code 28635?
Code 28636 includes percutaneous skeletal fixation after manipulation of the MTP dislocation. Code 28635 describes treatment with manipulation without that percutaneous fixation.
When is code 28630 more appropriate?
Use 28630 for closed treatment of an MTP dislocation without manipulation. The documented treatment for 28636 includes manipulation and percutaneous fixation.
Can the related postoperative visits be billed separately?
Related postoperative visits during the 10-day global period are included in the procedure.
Should modifier 50 be appended for dislocations on both sides?
No. CMS identifies modifier 50 as inappropriate for this service.
Can an assistant surgeon be reported?
CMS does not pay an assistant at surgery for this code. Co-surgeons are permitted, but team surgery is not.
What documentation supports reporting 28636?
Document the affected MTP joint, manipulation to reduce the dislocation, and percutaneous skeletal fixation used to stabilize it.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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