CPT 28635: Toe dislocationMedicare rate & RVUs in Texas
Closed reduction of a toe metatarsophalangeal dislocation with manipulation, reported when the joint is reduced without anesthesia.
Medicare pays $164.85–$179.98 for 28635 in the office in Texas, from Beaumont to Austin. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 28635 covers
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.
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.
Where 28635 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$164.85 to $179.98
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $179.98 | $125.21 |
| Beaumont | $164.85 | $117.73 |
| Brazoria | $172.65 | $121.34 |
| Dallas | $173.80 | $122.24 |
| Fort Worth | $172.86 | $121.82 |
| Galveston | $173.21 | $121.80 |
| Houston | $177.24 | $125.83 |
| Rest Of Texas | $168.69 | $119.56 |
How the 28635 rate is calculated
Each of 28635’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 28635
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.91Practice expense 3.10Malpractice 0.22
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 28635
28635 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28635
Toe dislocation
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 28635
Toe dislocation
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
28635 without 51 · national office
$174.69
Toe dislocation
28635-51 · Second procedure: 50%
$87.35
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
28635 compared with similar codes
Compare codes
28635 vs 28630 vs 28636 vs 28660 vs 28645: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 28630Toe dislocation
- Use 28630 for closed MTP dislocation treatment without manipulation. Code 28635 represents a reduction performed with manipulation and without anesthesia.
- 28636Toe dislocation
- Both concern closed treatment of an MTP dislocation, but 28636 is for treatment requiring anesthesia; 28635 is for manipulation without anesthesia.
- 28660Toe dislocation
- Code 28660 concerns an interphalangeal joint dislocation. Code 28635 is for a dislocation at the toe's MTP joint.
- 28645Toe dislocation repair
- Code 28645 is for open treatment of an MTP dislocation. Use 28635 when the joint is reduced by closed manipulation.
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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
Fee sheets
Put 28635 and the rest of your codes on one sheet
Current Medicare rates for every code you bill at your locality, with what changed since last quarter.
Get a fee sheetOr price your code list free →