Billing code 28666: Toe reductionMedicare rate & RVUs in Texas
Closed reduction of a dislocated toe interphalangeal joint with manipulation under anesthesia, reported when the documented treatment meets both requirements.
CMS doesn’t publish an office rate for 28666 in Texas.
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 28666 covers
This service realigns a dislocated interphalangeal (IP) joint in a toe by manipulating it externally while the patient receives anesthesia. Orthopedic surgeons, podiatrists, and other qualified clinicians may perform the reduction in a facility setting, such as an operating room or emergency department. The treatment is closed; it does not involve surgically exposing the joint.
Select this code when the documentation identifies an IP joint dislocation and supports both manipulation and the need for anesthesia. Record the affected toe and joint, the dislocation, the closed reduction performed, and the anesthesia requirement. Medicare assigns a 10-day minor-procedure global period, which includes related postoperative visits during that period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction. Modifier 50 is inappropriate for this code. Medicare does not pay an assistant at surgery; co-surgeons are permitted, while team surgery is 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 28666 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 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $167.46 |
| Beaumont | Unavailable | $157.16 |
| Brazoria | Unavailable | $162.51 |
| Dallas | Unavailable | $163.50 |
| Fort Worth | Unavailable | $162.89 |
| Galveston | Unavailable | $162.99 |
| Houston | Unavailable | $166.83 |
| Rest Of Texas | Unavailable | $159.72 |
How the 28666 rate is calculated
Each of 28666’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 · 28666
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.59Practice expense 2.11Malpractice 0.21
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 28666
28666 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28666
Toe reduction
| 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 2 | 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 · 28666
Toe reduction
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
28666 without 51 · national facility
$164.00
Toe reduction
28666-51 · Second procedure: 50%
$82.00
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%).
28666 compared with similar codes
Compare codes
28666 vs 28665 vs 28660 vs 28636 vs 28675: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 28665Toe dislocation
- Both address a toe interphalangeal joint dislocation requiring anesthesia; choose 28666 when manipulation is documented.
- 28660Toe dislocation
- This code is for treatment without anesthesia. Use 28666 when anesthesia and manipulation are part of the closed reduction.
- 28636Toe dislocation
- This code addresses a metatarsophalangeal joint dislocation with anesthesia and manipulation. Code 28666 is for an interphalangeal joint.
- 28675Toe dislocation repair
- This code is for open treatment of a toe interphalangeal dislocation; 28666 is for closed reduction with manipulation under anesthesia.
28666 billing questions
How does 28666 differ from 28665?
Use 28666 when the closed reduction involves manipulation under anesthesia. Code 28665 describes treatment requiring anesthesia without the manipulation specified for 28666.
Can 28666 be used for a dislocation at the base of the toe?
Only when the dislocated joint is an interphalangeal joint. A metatarsophalangeal joint dislocation is a different site and belongs to the applicable MTP code family.
Should modifier 50 be reported for dislocations on both feet?
No. CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
Are related postoperative visits separately included?
Related postoperative visits during the 10-day global period are included in the procedure's global package.
Can an assistant-at-surgery service be paid with 28666?
No. CMS lists a statutory restriction on assistant-at-surgery payment for this code. Co-surgeons are permitted, but team surgery is not.
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
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