$147.13
Use 28660 for closed treatment of an interphalangeal dislocation without anesthesia; 28665 is for treatment requiring anesthesia.
On this page
CMS RVU26D · Effective 2026-10-01
28665 Toe dislocation Medicare reimbursement rates in Wyoming
Closed treatment of a toe interphalangeal joint dislocation when the procedure requires anesthesia, reported for reduction without open surgical repair. Compare 28665 office and facility rates across CMS payment localities in Wyoming.
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 28665 in Wyoming?
Wyoming 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
$153.33
1 of 1 localities have a supported rate.
Payment area: Wyoming**
One mapped payment locality.
Facility setting
$118.26
1 of 1 localities have a supported rate.
Payment area: Wyoming**
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 28665: Closed toe interphalangeal dislocation treatment
Closed treatment of a toe interphalangeal joint dislocation when the procedure requires anesthesia, reported for reduction without open surgical repair.
This service treats a dislocated joint between the phalanges of a toe by closed reduction, without opening the joint for surgical repair. It is distinct from treatment of a metatarsophalangeal dislocation at the base of a toe. Orthopedic physicians, podiatrists, and other clinicians qualified to manage toe injuries may perform the reduction in an emergency department, office, or operating or procedure room, depending on the circumstances and need for anesthesia.
Report the code when the treated joint is interphalangeal and anesthesia is required for the closed treatment. The record should identify the affected toe and joint, document the dislocation and closed reduction, and support the anesthetic requirement. 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 subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 28665
- 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
- 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 RVU1.92 · 41%
- Practice expense (office) RVU2.53 · 55%
- Malpractice RVU0.19 · 4%
255
Medicare services in 2024 · #4121 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.
28665 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
28666 applies to the related interphalangeal-joint treatment involving manipulation with anesthesia; distinguish it from 28665 by the documented maneuver.
$172.78
This code concerns a metatarsophalangeal dislocation at the base of the toe requiring anesthesia. Code 28665 is for an interphalangeal joint.
$581.78
28675 is for open treatment of an interphalangeal toe dislocation; 28665 represents closed treatment.
Compare 28665 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
Wyoming** →
Office / nonfacility
$153.33
Facility
$118.26
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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 28665 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
3,242
- Code
- 28665
- Physician work
- 1.92
- Practice expense
- 2.53
- Malpractice
- 0.19
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.92 | × 1.000 | 1.9200 |
| Practice expense | 2.53 | × 1.000 | 2.5300 |
| Malpractice | 0.19 | × 0.740 | 0.1406 |
| Total RVUs | 4.5906 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Wyoming**$153.33
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.92 | 1 |
| Practice expense | 2.53 | 1 |
| Malpractice | 0.19 | 0.74 |
(1.92 × 1 + 2.53 × 1 + 0.19 × 0.74) × $33.4009 = $153.33
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.92 | 1 |
| Practice expense | 1.48 | 1 |
| Malpractice | 0.19 | 0.74 |
(1.92 × 1 + 1.48 × 1 + 0.19 × 0.74) × $33.4009 = $118.26
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.
28665 billing questions
How does this differ from 28660?
Both address closed treatment of an interphalangeal joint dislocation. Use 28665 when anesthesia is required; 28660 is the counterpart for treatment without anesthesia.
When would 28666 be considered instead?
28666 is the related interphalangeal-joint treatment code when manipulation requiring anesthesia is performed. Document the treatment and manipulation to support code selection.
Can this code be used for a dislocation at the base of a toe?
No. The base-of-toe metatarsophalangeal joint is a different site; 28665 concerns an interphalangeal joint between toe bones.
Are follow-up visits separately reported during the global period?
Related postoperative visits for 10 days are included in the global period for this minor procedure.
Can modifier 50 be used when more than one toe is treated?
No. CMS identifies bilateral adjustment as inappropriate for this code. Report the service based on the treatment performed and applicable claim instructions.
What documentation supports 28665?
Document the affected toe and interphalangeal joint, the dislocation, the closed treatment performed, and why anesthesia was required.
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.
3,23928636,,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
3,24528705,,Arthrodesis pantalar,A,,19.82,10.20,NA,10.20,,3.11,33.13,33.13,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,