CPT 28515: Closed Treatment of Toe Phalanx Fracture, Non-Great Toe

CPT code 28515 denotes the closed treatment with manipulation of a phalanx or phalanges fracture in a toe other than the great toe. This procedure is commonly performed to realign fractured toe bones without an open surgical approach, typically in outpatient settings such as emergency departments, ambulatory surgery centers, or clinic procedure rooms. Nationally, accurate coding for such minor orthopedic procedures affects appropriate claims processing, care setting decisions, and payment consistency across commercial and public payers.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical context for closed toe phalanx fracture management, typical sites of service, and common billing considerations tied to this procedure. The publication also provides benchmarks and policy-relevant notes to help revenue and clinical teams understand reimbursement patterns and documentation expectations for closed manipulations of lesser toe phalanges.

The report is intended for billing managers, orthopedic clinics, emergency medicine teams, and payor policy analysts seeking concise guidance on the code’s clinical meaning, where the service is usually rendered, and which payers commonly cover the procedure. Data not available in the input: associated taxonomies, specific ICD-10 diagnosis codes, related codes, and payer-specific payment rates.

Billing Code Overview

CPT code 28515 describes the closed treatment of a phalanx or phalanges fracture in a toe other than the great toe with manipulation. The procedure involves manual manipulation or adjustment of one or more fractured toe bones (phalanges) to achieve alignment without an open surgical approach.

Service Type: Fracture closed treatment with manipulation

Typical Site of Service: Outpatient clinic, emergency department, or ambulatory surgery center

Clinical Context

A 34-year-old recreational soccer player presents to the emergency department after stubbing the fourth toe of the right foot during a match. He reports immediate pain, swelling, and difficulty bearing weight. Physical exam reveals deformity and point tenderness over the proximal phalanx of the fourth toe with limited passive range of motion. Plain radiographs demonstrate a displaced, closed fracture of the proximal phalanx of the fourth toe without open wound or gross neurovascular compromise. The provider performs a closed manipulation and reduction under local digital block and applies a short leg posterior splint and buddy taping. Post-procedure radiographs confirm acceptable alignment. The clinical workflow includes triage and initial assessment, analgesia and local/regional anesthesia (digital block), radiographic imaging, closed reduction/manipulation, immobilization, post-reduction imaging, and discharge instructions with outpatient follow-up for re-evaluation and possible repeat imaging within 1–2 weeks.

Coding Specifications

Modifier	Description	When to Use
`RT`	Right side	Use when the procedure is performed on the right toe.
`LT`	Left side	Use when the procedure is performed on the left toe.

Taxonomy Code	Specialty	Notes
207L00000X	Podiatry	Podiatrists commonly perform closed reduction and management of toes and phalanx fractures.
207K00000X	Orthopedic Surgery	Orthopedic surgeons manage foot fractures including manipulative reductions and follow-up care.
2080P0003X	Family Medicine	Family medicine physicians in urgent care settings often perform closed manipulations and immobilization for toe fractures.
207Q00000X	Emergency Medicine	Emergency physicians frequently evaluate and perform acute closed reductions of toe fractures in the ED.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S92.32XA`	Displaced fracture of proximal phalanx of right lesser toe, initial encounter for closed fracture	Common presentation for a displaced proximal phalanx fracture of a non–great toe treated with closed reduction.
`S92.33XA`	Displaced fracture of middle phalanx of right lesser toe, initial encounter for closed fracture	Relevant when the middle phalanx of a lesser toe is fractured and requires manipulation.
`S92.34XA`	Displaced fracture of distal phalanx of right lesser toe, initial encounter for closed fracture	Distal phalanx fractures of lesser toes may be managed with closed treatment when appropriate.
`S92.35XA`	Displaced fracture of proximal phalanx of left lesser toe, initial encounter for closed fracture	Left-sided equivalent for coding laterality when treatment is on the left foot.
`S92.39XA`	Other fracture of phalanx of lesser toe, initial encounter for closed fracture	Captures less common phalangeal fracture patterns in lesser toes.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`28515`	Closed treatment of phalanx fracture, toe other than great toe, with manipulation, or adjustment	Primary procedure for closed reduction of a non–great-toe phalanx fracture.
`28820`	Application of short leg cast (below knee)	May be used after reduction when a cast is required instead of splinting or buddy taping.
`11730`	Paring or cutting of benign hyperkeratotic lesion (eg, corn, callus) — Data not available in the input.	Data not available in the input.
`11042`	Debridement, subcutaneous tissue (first 20 sq cm or less) — Data not available in the input.	Data not available in the input.
`20692`	Injection, therapeutic, of foot/ankle tendons, ligaments? — Data not available in the input.	Data not available in the input.

Note: For fields above marked as "Data not available in the input.", the input did not provide related codes; other commonly associated codes for immobilization, imaging, or anesthesia are considered in clinical workflows.

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Summary & Overview