$169.73
Use 28630 for closed MTP dislocation treatment without manipulation. Code 28635 represents a reduction performed with manipulation and without anesthesia.
On this page
CMS RVU26D · Effective 2026-10-01
28635 Toe dislocation Medicare reimbursement rates in Delaware
Closed reduction of a toe metatarsophalangeal dislocation with manipulation, reported when the joint is reduced without anesthesia. Compare 28635 office and facility rates across CMS payment localities in Delaware.
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 28635 in Delaware?
Delaware 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
$173.02
1 of 1 localities have a supported rate.
Payment area: Delaware
One mapped payment locality.
Facility setting
$121.87
1 of 1 localities have a supported rate.
Payment area: Delaware
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 procedure
About 28635: Closed reduction of toe MTP dislocation
Closed reduction of a toe metatarsophalangeal dislocation with manipulation, reported when the joint is reduced without anesthesia.
This service is a closed reduction of a dislocated toe metatarsophalangeal (MTP) joint using manipulation, without anesthesia. Orthopedic surgeons and podiatrists may perform it in an office, emergency department, or hospital when the joint can be realigned without an open approach. The record should identify the affected toe and MTP joint, the dislocation, and the reduction performed, including assessment of alignment afterward.
Choose this code when manipulation is performed without anesthesia; distinguish it from closed treatment without manipulation and treatment requiring anesthesia. Related postoperative visits during the 10-day global period are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are reduced to 50%. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 28635
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days 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 RVU1.91 · 37%
- Practice expense (office) RVU3.10 · 59%
- Malpractice RVU0.22 · 4%
117
Medicare services in 2024 · #4755 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.
28635 compared with similar codes
Office rates for Delaware, from the same CMS release.
$383.30
Both concern closed treatment of an MTP dislocation, but 28636 is for treatment requiring anesthesia; 28635 is for manipulation without anesthesia.
$147.48
Code 28660 concerns an interphalangeal joint dislocation. Code 28635 is for a dislocation at the toe's MTP joint.
$659.79
Code 28645 is for open treatment of an MTP dislocation. Use 28635 when the joint is reduced by closed manipulation.
Compare 28635 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
Delaware →
Office / nonfacility
$173.02
Facility
$121.87
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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 28635 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
3,238
- Code
- 28635
- Physician work
- 1.91
- Practice expense
- 3.10
- Malpractice
- 0.22
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.91 | × 1.005 | 1.9195 |
| Practice expense | 3.10 | × 0.988 | 3.0628 |
| Malpractice | 0.22 | × 0.899 | 0.1978 |
| Total RVUs | 5.1801 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Delaware$173.02
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.91 | 1.005 |
| Practice expense | 3.1 | 0.988 |
| Malpractice | 0.22 | 0.899 |
(1.91 × 1.005 + 3.1 × 0.988 + 0.22 × 0.899) × $33.4009 = $173.02
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.91 | 1.005 |
| Practice expense | 1.55 | 0.988 |
| Malpractice | 0.22 | 0.899 |
(1.91 × 1.005 + 1.55 × 0.988 + 0.22 × 0.899) × $33.4009 = $121.87
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.
28635 billing questions
How does this differ from 28630?
Both address closed treatment of an MTP joint dislocation. Report 28635 when manipulation is performed; 28630 is for treatment without manipulation.
When would 28636 be used instead?
Code 28636 describes closed treatment of an MTP dislocation requiring anesthesia. Code 28635 is for manipulation without anesthesia.
Can modifier 50 be used for dislocations on both feet?
No. Modifier 50 is inappropriate for this code, and the CMS bilateral adjustment does not apply.
Are related follow-up visits separately reported?
Related postoperative visits during the 10-day global period are included in this procedure.
What documentation supports reporting 28635?
Document the toe and MTP joint involved, the dislocation, the manipulation and reduction, and the post-reduction alignment assessment.
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.
3,23528606,,Treat foot dislocation,A,,4.96,5.71,NA,5.71,,0.92,11.59,11.59,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,23628615,,Repair foot dislocation,A,,10.43,11.48,NA,11.48,,1.84,23.75,23.75,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,23728630,,Treat toe dislocation,A,,1.71,3.14,,1.32,,0.29,5.14,3.32,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,23828635,,Treat toe dislocation,A,,1.91,3.10,,1.55,,0.22,5.23,3.68,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,23928636,,Treat toe dislocation,A,,2.70,8.35,,3.24,,0.57,11.62,6.51,0,010,0.10,0.80,0.10,2,0,1,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,24028645,,Repair toe dislocation,A,,7.25,11.80,,5.66,,0.90,19.95,13.81,0,090,0.10,0.69,0.21,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,24128660,,Treat toe dislocation,A,,1.25,2.97,,1.52,,0.25,4.47,3.02,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503