$273.48
Both concern a single toe interphalangeal dislocation treated closed. Choose 28575 when manipulation is performed and anesthesia is required; 28570 is for treatment without manipulation.
On this page
CMS RVU26D · Effective 2026-10-01
28575 Toe dislocation Medicare reimbursement rates in Rhode Island
Reports closed reduction of a single toe interphalangeal joint dislocation when manipulation is performed and anesthesia is required. Compare 28575 office and facility rates across CMS payment localities in Rhode Island.
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 28575 in Rhode Island?
Rhode Island 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
$431.48
1 of 1 localities have a supported rate.
Payment area: Rhode Island
One mapped payment locality.
Facility setting
$347.99
1 of 1 localities have a supported rate.
Payment area: Rhode Island
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 28575: Closed toe interphalangeal dislocation reduction
Reports closed reduction of a single toe interphalangeal joint dislocation when manipulation is performed and anesthesia is required.
This code covers closed treatment of a dislocated joint between the bones of one toe, using manipulation to restore alignment when anesthesia is required. An orthopedic surgeon, podiatrist, or other qualified physician may perform the reduction, commonly in a hospital or ambulatory surgery setting. The service is distinct from treating a metatarsophalangeal or tarsometatarsal dislocation, which involves a different joint.
Report one unit for the treated interphalangeal joint. Documentation should identify the affected toe and joint, describe the dislocation and manipulation, and support the anesthesia requirement. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. 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. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery is paid only when medical necessity is documented; co-surgeons and team surgery are not permitted.
CMS billing rules for 28575
- 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
- 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 RVU3.40 · 27%
- Practice expense (office) RVU8.53 · 67%
- Malpractice RVU0.72 · 6%
26
Medicare services in 2024 · #5749 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.
28575 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
No office rate
Use 28575 for closed manipulation of the dislocated joint. Code 28576 describes open treatment of a single toe interphalangeal dislocation.
$203.79
Code 28540 concerns a tarsometatarsal joint dislocation in the midfoot, not an interphalangeal joint within a toe.
Compare 28575 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
Rhode Island →
Office / nonfacility
$431.48
Facility
$347.99
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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 28575 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
3,230
- Code
- 28575
- Physician work
- 3.40
- Practice expense
- 8.53
- Malpractice
- 0.72
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.40 | × 1.019 | 3.4646 |
| Practice expense | 8.53 | × 1.033 | 8.8115 |
| Malpractice | 0.72 | × 0.892 | 0.6422 |
| Total RVUs | 12.9183 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Rhode Island$431.48
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.4 | 1.019 |
| Practice expense | 8.53 | 1.033 |
| Malpractice | 0.72 | 0.892 |
(3.4 × 1.019 + 8.53 × 1.033 + 0.72 × 0.892) × $33.4009 = $431.48
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.4 | 1.019 |
| Practice expense | 6.11 | 1.033 |
| Malpractice | 0.72 | 0.892 |
(3.4 × 1.019 + 6.11 × 1.033 + 0.72 × 0.892) × $33.4009 = $347.99
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.
28575 billing questions
When should 28575 be selected instead of 28570?
Use 28575 for a single toe interphalangeal dislocation treated with manipulation when anesthesia is required. Code 28570 is the related closed-treatment option without manipulation.
Does this code cover a dislocation at the base of the toe?
No. This code concerns an interphalangeal joint within one toe. A metatarsophalangeal or tarsometatarsal dislocation involves a different joint and should be evaluated under the code for that site.
Is the reduction included in this service?
Yes. The closed manipulation to restore the single interphalangeal joint is the procedure represented by the code; do not separately report that same reduction.
What documentation supports reporting 28575?
Document the affected toe and interphalangeal joint, the dislocation, the manipulation performed, and why anesthesia was required.
How is bilateral treatment reported?
For qualifying treatment on both sides, CMS lists bilateral reporting with modifier 50 and payment at 150%. Documentation should identify the treated joint on each side.
Can an assistant surgeon or co-surgeon be reported?
An assistant at surgery is paid only with documentation of medical necessity. Co-surgeons and team surgery are not permitted for this code.
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.
3,22728546,,Treat foot dislocation,A,,3.32,15.07,,6.69,,0.70,19.09,10.71,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,22828555,,Repair foot dislocation,A,,9.41,15.57,,7.42,,1.49,26.47,18.32,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,22928570,,Treat foot dislocation,A,,1.72,5.91,,4.05,,0.37,8.00,6.14,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,23028575,,Treat foot dislocation,A,,3.40,8.53,,6.11,,0.72,12.65,10.23,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,23128576,,Treat foot dislocation,A,,4.49,6.12,NA,6.12,,0.96,11.57,11.57,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,23228585,,Repair foot dislocation,A,,10.85,16.05,,7.87,,1.51,28.41,20.23,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,23328600,,Treat foot dislocation,A,,1.97,3.56,,2.59,,0.17,5.70,4.73,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537