Both describe open treatment of a toe dislocation, but 28645 is for the metatarsophalangeal joint; this code is for an interphalangeal joint.
On this page
CMS RVU26D · Effective 2026-10-01
28675 Toe dislocation repair Medicare reimbursement rates in Arizona
Reports open surgical reduction of a dislocated toe interphalangeal joint when exposure is needed to restore alignment, with stabilization when performed. Compare 28675 office and facility rates across CMS payment localities in Arizona.
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.
What does Medicare pay for 28675 in Arizona?
Arizona has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$572.66
1 of 1 localities have a supported rate.
Payment area: Arizona
One mapped payment locality.
Facility setting
$384.94
1 of 1 localities have a supported rate.
Payment area: Arizona
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Orthopedic surgery
About 28675: Open interphalangeal toe dislocation repair
Reports open surgical reduction of a dislocated toe interphalangeal joint when exposure is needed to restore alignment, with stabilization when performed.
This code describes operative exposure and reduction of a dislocated joint between toe phalanges. An orthopedic surgeon or podiatric surgeon may perform the procedure when the joint cannot be adequately reduced or kept aligned with closed treatment, such as when soft tissue blocks reduction or the joint remains unstable. It is generally performed in a surgical setting, and fixation may be used when needed to maintain the reduction.
Select the code based on the joint involved and the operative method: this code is for open treatment of an interphalangeal joint, not an open metatarsophalangeal joint procedure or a closed or percutaneous treatment. The operative report should identify the affected toe and joint, describe the open approach and reduction, and document any stabilization. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures 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, and co-surgeons and team surgery are not permitted.
CMS billing rules for 28675
- 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.48 · 31%
- Practice expense (office) RVU11.42 · 65%
- Malpractice RVU0.70 · 4%
175
Medicare services in 2024 · #4441 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.
28675 compared with similar codes
Office rates for Arizona, from the same CMS release.
28660 describes closed treatment of an interphalangeal toe dislocation without anesthesia. Use this code when the joint is treated through an open approach.
28665 is closed treatment of an interphalangeal toe dislocation with anesthesia, rather than open operative treatment.
28666 describes percutaneous skeletal fixation of an interphalangeal toe dislocation. This code applies to open treatment.
Compare 28675 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Arizona →
Office / nonfacility
$572.66
Facility
$384.94
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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 28675 in Arizona.
PPRRVU2026_Oct_nonQPP.csv
3,244
- Code
- 28675
- Physician work
- 5.48
- Practice expense
- 11.42
- Malpractice
- 0.70
GPCI2026.csv
6
- Locality
- Arizona
- Physician work
- 1.000
- Practice expense
- 0.969
- Malpractice
- 0.856
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.48 | × 1.000 | 5.4800 |
| Practice expense | 11.42 | × 0.969 | 11.0660 |
| Malpractice | 0.70 | × 0.856 | 0.5992 |
| Total RVUs | 17.1452 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Arizona$572.66
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.48 | 1 |
| Practice expense | 11.42 | 0.969 |
| Malpractice | 0.7 | 0.856 |
(5.48 × 1 + 11.42 × 0.969 + 0.7 × 0.856) × $33.4009 = $572.66
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.48 | 1 |
| Practice expense | 5.62 | 0.969 |
| Malpractice | 0.7 | 0.856 |
(5.48 × 1 + 5.62 × 0.969 + 0.7 × 0.856) × $33.4009 = $384.94
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.
28675 billing questions
When should this code be selected instead of 28645?
Use this code for open treatment of a dislocation between toe phalanges. Code 28645 is for open treatment of a metatarsophalangeal joint dislocation.
How does this differ from 28660, 28665, or 28666?
Those codes describe closed or percutaneous treatment of an interphalangeal toe joint dislocation. This code is for open treatment.
Does the 90-day global include postoperative visits?
Yes. The global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 be used for dislocations on both feet?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
Can an assistant surgeon or co-surgeon be reported?
Medicare payment for an assistant at surgery is restricted for this code. Co-surgeons and team surgery are not permitted.
What documentation supports reporting this code?
Document the affected toe and interphalangeal joint, the open operative approach, the reduction performed, and any stabilization used.
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.
