$151.00
Both describe closed treatment of a single toe interphalangeal dislocation; 28665 is selected when anesthesia is used, while 28660 is for treatment without anesthesia.
On this page
CMS RVU26D · Effective 2026-10-01
28660 Toe dislocation Medicare reimbursement rates in Vermont
Reports closed treatment of a single toe interphalangeal joint dislocation when the clinician treats it without anesthesia and without percutaneous fixation. Compare 28660 office and facility rates across CMS payment localities in Vermont.
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 28660 in Vermont?
Vermont 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
$144.19
1 of 1 localities have a supported rate.
Payment area: Vermont
One mapped payment locality.
Facility setting
$96.24
1 of 1 localities have a supported rate.
Payment area: Vermont
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 28660: Closed treatment of toe interphalangeal dislocation
Reports closed treatment of a single toe interphalangeal joint dislocation when the clinician treats it without anesthesia and without percutaneous fixation.
This code describes closed treatment of one dislocated toe interphalangeal joint without anesthesia. A physician, podiatrist, or other qualified clinician may reduce the joint and provide immediate stabilization, such as taping or splinting, in an emergency department, office, or facility. It is distinct from treatment of a metatarsophalangeal joint dislocation, which involves the toe’s joint with the foot.
Select the code when the record supports a single interphalangeal dislocation treated closed without anesthesia; document the joint, dislocation, treatment method, and whether anesthesia or percutaneous fixation was used. Medicare includes related postoperative visits during the 10-day global period. 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 descriptor. Medicare does not pay an assistant at surgery for this procedure, and co-surgeons and team surgery are not permitted.
CMS billing rules for 28660
- 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU1.25 · 28%
- Practice expense (office) RVU2.97 · 66%
- Malpractice RVU0.25 · 6%
557
Medicare services in 2024 · #3461 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.
28660 compared with similar codes
Office rates for Vermont, from the same CMS release.
No office rate
Use 28666 when percutaneous skeletal fixation accompanies closed treatment. 28660 describes closed treatment without that fixation.
$165.85
28630 concerns a metatarsophalangeal joint dislocation treated without anesthesia. 28660 is for an interphalangeal joint dislocation.
$572.49
28675 describes open treatment of a toe interphalangeal dislocation; 28660 is for closed treatment without anesthesia.
Compare 28660 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
Vermont →
Office / nonfacility
$144.19
Facility
$96.24
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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 28660 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
3,241
- Code
- 28660
- Physician work
- 1.25
- Practice expense
- 2.97
- Malpractice
- 0.25
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.25 | × 1.000 | 1.2500 |
| Practice expense | 2.97 | × 0.990 | 2.9403 |
| Malpractice | 0.25 | × 0.506 | 0.1265 |
| Total RVUs | 4.3168 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Vermont$144.19
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.25 | 1 |
| Practice expense | 2.97 | 0.99 |
| Malpractice | 0.25 | 0.506 |
(1.25 × 1 + 2.97 × 0.99 + 0.25 × 0.506) × $33.4009 = $144.19
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.25 | 1 |
| Practice expense | 1.52 | 0.99 |
| Malpractice | 0.25 | 0.506 |
(1.25 × 1 + 1.52 × 0.99 + 0.25 × 0.506) × $33.4009 = $96.24
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.
28660 billing questions
How does 28660 differ from 28665?
28660 is for closed treatment of a single toe interphalangeal dislocation without anesthesia. Use 28665 when anesthesia is used.
When is 28666 more appropriate?
Use 28666 when closed treatment of the interphalangeal dislocation includes percutaneous skeletal fixation. 28660 describes treatment without that fixation.
Can modifier 50 be used for dislocations of two toes?
No. CMS identifies modifier 50 as inappropriate for this descriptor and anatomy. Document each treated dislocation and follow applicable coding guidance for multiple injuries.
Are related postoperative visits separately billable?
Related postoperative visits during the 10-day global period are included in the procedure.
What documentation supports 28660?
Document the single interphalangeal joint involved, the dislocation, closed treatment, and that treatment was performed without anesthesia or percutaneous fixation.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this procedure. Co-surgeons and team surgery are not permitted.
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.
3,23828635,,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
3,24328666,,Treat toe dislocation,A,,2.59,2.11,NA,2.11,,0.21,4.91,4.91,0,010,0.10,0.80,0.10,2,0,1,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,24428675,,Repair of toe dislocation,A,,5.48,11.42,,5.62,,0.70,17.60,11.80,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817