$159.63–$167.16
This code is for MTP dislocation treatment without manipulation. Code 28636 involves manipulation and percutaneous skeletal fixation.
On this page
CMS RVU26D · Effective 2026-10-01
28636 Toe dislocation Medicare reimbursement rates in Maine
Closed reduction of a toe metatarsophalangeal joint dislocation with percutaneous skeletal fixation to stabilize the joint after manipulation. Compare 28636 office and facility rates across CMS payment localities in Maine.
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 28636 in Maine?
Maine has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$358.61–$378.58
2 of 2 localities have a supported rate.
Facility setting
$201.59–$209.44
2 of 2 localities have a supported rate.
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 28636: Closed toe MTP reduction with fixation
Closed reduction of a toe metatarsophalangeal joint dislocation with percutaneous skeletal fixation to stabilize the joint after manipulation.
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.
CMS billing rules for 28636
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU2.70 · 23%
- Practice expense (office) RVU8.35 · 72%
- Malpractice RVU0.57 · 5%
131
Medicare services in 2024 · #4659 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.
28636 compared with similar codes
Office rates for Maine, from the same CMS release.
$163.63–$171.04
Both address an MTP dislocation with manipulation; 28636 additionally includes percutaneous skeletal fixation.
$623.45–$651.71
Code 28645 is used for open treatment of an MTP dislocation; 28636 describes closed reduction with percutaneous fixation.
No office rate
Code 28666 concerns an interphalangeal joint dislocation, not the MTP joint treated by 28636.
Compare 28636 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.
2 of 2 payment localities
Rest Of Maine →
Office / nonfacility
$358.61
Facility
$201.59
Southern Maine →
Office / nonfacility
$378.58
Facility
$209.44
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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 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.
3,23628615,,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
3,24228665,,Treat toe dislocation,A,,1.92,2.53,,1.48,,0.19,4.64,3.59,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00