CPT code 28405: Heel fracture treatment, with manipulation2026 Medicare rate & RVUs

Medicare pays $502.02 for 28405 nationally in the office and $399.81 in a hospital or facility. Local office rates run $441.50–$642.41.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 28405 covers

This service covers closed treatment of a fracture of the calcaneus, the heel bone, when the clinician manipulates the fracture to improve alignment without an open surgical approach. Orthopedic surgeons and foot-and-ankle specialists commonly provide this care after a heel injury, using imaging and examination to assess alignment and guide treatment. The fracture may then be supported with external immobilization as part of the treatment plan.

Select this code when the documented treatment includes manipulation; treatment without manipulation is represented by 28400. The record should identify the calcaneal fracture, the reduction or manipulation performed, and the treatment plan. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are reduced to 50%. For bilateral treatment, modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are 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 28405 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

28405 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 28405 rate is calculated

Each of 28405’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.

Payment rules and modifiers for 28405

28405 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

28405 compared with similar codes

How to choose

28400Fracture treatmentCalcaneus, no manipulation

Both describe closed treatment of a calcaneal fracture. Choose 28405 when manipulation is performed; 28400 is for treatment without manipulation.

28406Calcaneal fracture repairPercutaneous fixation with manipulation

Both concern a calcaneal fracture treated without open exposure. Use 28406 when percutaneous skeletal fixation is performed; use 28405 for closed manipulation without that fixation.

28415Heel fracture repairOpen treatment

Code 28415 describes open treatment of a calcaneal fracture. This code is for closed treatment with manipulation.

28435Talus fracture careClosed treatment with manipulation

Both describe closed treatment with manipulation, but 28435 is for a talus fracture. This code is for a calcaneal fracture.

Codes related to 28405

Related codes aren’t interchangeable: bill the code that matches the service performed.

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

Open CMS sourceHow we calculate rates