$165.22
28490 is for closed treatment of a great toe phalanx fracture without manipulation. Use 28505 when the fracture receives open surgical treatment.
On this page
CMS RVU26D · Effective 2026-10-01
28505 Toe fracture surgery Medicare reimbursement rates in Colorado
Reports open surgical treatment of a great toe phalanx fracture, with internal fixation included when performed as part of the procedure. Compare 28505 office and facility rates across CMS payment localities in Colorado.
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 28505 in Colorado?
Colorado 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
$689.55
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
Facility setting
$479.17
1 of 1 localities have a supported rate.
Payment area: Colorado
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 28505: Open treatment of great toe fracture
Reports open surgical treatment of a great toe phalanx fracture, with internal fixation included when performed as part of the procedure.
This code describes open treatment of a fracture in one or more phalanges of the great toe. The surgeon accesses the fracture site to reduce and treat the bone; internal fixation is included when performed. It applies to surgical treatment of the great toe, not to a fracture that is merely open through the skin. Orthopedic foot and ankle surgeons and podiatric surgeons commonly perform the service in an operating room or other surgical setting.
Report the code when the operative record supports open treatment of a great toe phalanx fracture. Documentation should identify the affected toe and fracture, describe the open treatment, and record fixation if used. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, Medicare pays the highest-valued procedure in full and other procedures at 50%. When both sides are treated, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery; co-surgeons and team surgery are not permitted.
CMS billing rules for 28505
- 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 RVU7.25 · 36%
- Practice expense (office) RVU11.81 · 59%
- Malpractice RVU0.95 · 5%
417
Medicare services in 2024 · #3703 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.
28505 compared with similar codes
Office rates for Colorado, from the same CMS release.
$203.52
28495 describes closed treatment of a great toe phalanx fracture with manipulation; 28505 describes open surgical treatment.
$594.16
28525 is open treatment for a phalanx fracture in a toe other than the great toe. Code 28505 is specific to the great toe.
Compare 28505 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
Colorado →
Office / nonfacility
$689.55
Facility
$479.17
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 28505 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
3,219
- Code
- 28505
- Physician work
- 7.25
- Practice expense
- 11.81
- Malpractice
- 0.95
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.25 | × 1.012 | 7.3370 |
| Practice expense | 11.81 | × 1.064 | 12.5658 |
| Malpractice | 0.95 | × 0.781 | 0.7419 |
| Total RVUs | 20.6448 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Colorado$689.55
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.25 | 1.012 |
| Practice expense | 11.81 | 1.064 |
| Malpractice | 0.95 | 0.781 |
(7.25 × 1.012 + 11.81 × 1.064 + 0.95 × 0.781) × $33.4009 = $689.55
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.25 | 1.012 |
| Practice expense | 5.89 | 1.064 |
| Malpractice | 0.95 | 0.781 |
(7.25 × 1.012 + 5.89 × 1.064 + 0.95 × 0.781) × $33.4009 = $479.17
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.
28505 billing questions
Does open treatment mean the fracture had an open wound?
No. Here, open treatment refers to surgical access to the fracture; it does not by itself mean the fracture was open through the skin.
How does this differ from closed treatment with manipulation?
Use this code for open surgical treatment of a great toe phalanx fracture. Closed treatment with manipulation is represented by 28495.
Is internal fixation separately reported?
Internal fixation is included when performed as part of this fracture treatment; it is not separately reported as a separate service under this code.
What documentation supports the code?
The operative record should identify the great toe phalanx fracture and describe the open treatment performed, including any fixation used.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
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.
3,21628490,,Treat big toe fracture,A,,1.14,3.44,,2.65,,0.17,4.75,3.96,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,21728495,,Treat big toe fracture,A,,1.64,4.02,,2.78,,0.20,5.86,4.62,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,21828496,,Treat big toe fracture,A,,2.42,13.50,,5.49,,0.50,16.42,8.41,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,21928505,,Treat big toe fracture,A,,7.25,11.81,,5.89,,0.95,20.01,14.09,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,22028510,,Treatment of toe fracture,A,,1.14,2.63,,2.45,,0.15,3.92,3.74,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,22128515,,Treatment of toe fracture,A,,1.52,3.52,,2.64,,0.18,5.22,4.34,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,22228525,,Treat toe fracture,A,,5.48,11.00,,5.38,,0.69,17.17,11.55,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3401112,CA,69,VISALIA,1.017,1.096,0.536
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899