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Official Description

Closed treatment of fracture, phalanx or phalanges, other than great toe; with manipulation, each

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 28515 refers to the closed treatment of a fracture involving the phalanx or phalanges of a toe, specifically excluding the great toe. This procedure is characterized by the manipulation of the fractured bone fragments to restore proper alignment. In cases where the fracture is displaced, the physician will manually reduce the fragments, ensuring they are positioned correctly in relation to one another. Prior to the treatment, radiographs, or X-rays, are obtained to confirm the presence and extent of the fracture, as well as to verify that the manipulation has successfully restored the anatomical alignment. Following the manipulation, the fractured toe is typically buddy taped to an adjacent uninjured toe to provide additional support and stability. Furthermore, immobilization is often achieved using a rigid, flat shoe, although in some instances, a cast or boot may be applied for enhanced immobilization. It is important to note that if multiple toes, other than the great toe, are treated, each toe is reported separately using the appropriate CPT® codes, either 28510 for nondisplaced fractures or 28515 for displaced fractures.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The closed treatment of a fracture of the phalanx or phalanges, other than the great toe, is indicated in the following scenarios:

  • Displaced Fracture A fracture where the bone fragments are not aligned properly and require manipulation to restore anatomical position.
  • Confirmation of Fracture Situations where radiographs are necessary to confirm the presence and type of fracture before treatment.
  • Neurovascular Assessment Cases where a neurovascular examination is performed to ensure the integrity of nerves and blood vessels at the injury site.

2. Procedure

The procedure for closed treatment of a fracture of the phalanx or phalanges, other than the great toe, involves several key steps:

  • Step 1: Radiographic Evaluation Initially, the physician obtains radiographs to confirm the fracture and assess its displacement. This imaging is crucial for determining the appropriate treatment approach.
  • Step 2: Neurovascular Examination A thorough neurovascular examination is conducted to evaluate the status of the nerves and blood vessels surrounding the injury. This step is essential to ensure that there are no complications that could affect healing.
  • Step 3: Manipulation of Fracture If the fracture is determined to be displaced, the physician will manually manipulate the fractured bone fragments back into their proper anatomical alignment. This step is critical for ensuring optimal healing and function of the toe.
  • Step 4: Stabilization After successful manipulation, the fractured toe is typically buddy taped to an adjacent uninjured toe to provide additional support. In addition, the toe may be immobilized using a rigid, flat shoe, or in some cases, a cast or boot may be applied for further stabilization.

3. Post-Procedure

Post-procedure care involves monitoring the alignment and healing of the fractured toe. Patients are advised to keep the toe immobilized and to avoid putting weight on it until cleared by the physician. Follow-up appointments may be necessary to assess healing through additional radiographs and to make any adjustments to the treatment plan as needed. Patients should also be educated on signs of complications, such as increased pain, swelling, or changes in color, which may indicate issues with circulation or healing.

Short Descr TREATMENT OF TOE FRACTURE
Medium Descr CLTX FX PHLX/PHLG OTH/THN GRT TOE W/MANJ
Long Descr Closed treatment of fracture, phalanx or phalanges, other than great toe; with manipulation, each
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Procedure or Service, Multiple Reduction Applies
ASC Payment Indicator Office-based surgical procedure added to ASC list in CY 2008 or later with MPFS nonfacility PE RVUs; payment based on MPFS nonfacility PE RVUs.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P6B - Minor procedures - musculoskeletal
MUE 4
CCS Clinical Classification 147 - Treatment, fracture or dislocation of lower extremity (other than hip or femur)
T4 Left foot, fifth digit
LT Left side (used to identify procedures performed on the left side of the body)
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
54 Surgical care only: when 1 physician or other qualified health care professional performs a surgical procedure and another provides preoperative and/or postoperative management, surgical services may be identified by adding modifier 54 to the usual procedure number.
55 Postoperative management only: when 1 physician or other qualified health care professional performed the postoperative management and another performed the surgical procedure, the postoperative component may be identified by adding modifier 55 to the usual procedure number.
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
AG Primary physician
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
F3 Left hand, fourth digit
F4 Left hand, fifth digit
F8 Right hand, fourth digit
F9 Right hand, fifth digit
GC This service has been performed in part by a resident under the direction of a teaching physician
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GW Service not related to the hospice patient's terminal condition
PO Excepted service provided at an off-campus, outpatient, provider-based department of a hospital
Q6 Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
RT Right side (used to identify procedures performed on the right side of the body)
SG Ambulatory surgical center (asc) facility service
T1 Left foot, second digit
T2 Left foot, third digit
T3 Left foot, fourth digit
T5 Right foot, great toe
T6 Right foot, second digit
T7 Right foot, third digit
T8 Right foot, fourth digit
T9 Right foot, fifth digit
TA Left foot, great toe
X4 Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
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Pre-1990 Added Code added.
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