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

Report this service when a clinician treats a calcaneal fracture by closed reduction requiring manipulation, rather than immobilization alone or operative fixation.

CMS RVU26DEffective Oct 1, 2026One payment locality92 Medicare services in 2024

In Houston, TX, Medicare pays $513.61 for 28405 in the office and $412.12 when it’s performed in a hospital or facility.

$513.61Office (non-facility)
$412.12Hospital or facility
+2.3%vs the national office rate ($502.02)

Check a contract rate as a % of Medicare · 28405 nationwide

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

We’ll open 28405 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Houston, TX
  2. What 28405 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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.

How Houston, TX compares for 28405

Across 109 of 109 payment localities, the office rate for 28405 runs from $441.50 in Arkansas to $642.41 in San Benito County, CA. Houston, TX pays $513.61. The RVUs are the same everywhere; the geographic indexes change the dollars.

28405 in Houston, TX vs other payment areas
  1. Houston, TX · this page$513.61
  2. Austin, TX · Texas$516.75+$3.14
  3. Beaumont, TX · Texas$471.36−$42.25
  4. Brazoria, TX · Texas$493.07−$20.54
  5. Dallas, TX · Texas$497.40−$16.21
  6. Fort Worth, TX · Texas$494.70−$18.91
  7. Galveston, TX · Texas$495.30−$18.31

Other areas in Texas first, then benchmark localities. Bars start at $0.

Every other payment area

28405 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$482.75$385.75
Los Angeles, CACalifornia$554.64$433.73
Washington, DC areaDistrict of Columbia$570.07$449.67
Miami, FLFlorida$565.97$459.57
Chicago, ILIllinois$547.92$445.20
Manhattan, NYNew York$582.38$463.62
AlaskaAlaska$584.60$475.75
AlabamaAlabama$448.23$358.80

28405 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$441.50

$584.60

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
28405 office rate range by state
State / territoryOffice rate rangeLocalities
AK$584.601
AL$448.231
AR$441.501
AZ$487.461
CA$519.31–$642.4129
CO$516.671
CT$536.321
DC$570.071
DE$495.641
FL$504.99–$565.973
GA$474.48–$514.222
GU$531.011
HI$531.011
IA$455.161
ID$459.271
IL$493.48–$547.924
IN$461.901
KS$455.281
KY$464.291
LA$464.47–$488.012
MA$514.36–$565.642
MD$504.59–$570.073
ME$464.25–$486.862
MI$478.98–$513.932
MN$487.621
MO$457.77–$487.003
MS$449.611
MT$501.951
NC$468.901
ND$482.181
NE$457.041
NH$510.731
NJ$540.34–$564.302
NM$482.641
NV$496.751
NY$476.38–$599.925
OH$474.941
OK$460.941
OR$490.84–$530.822
PA$474.41–$524.132
PR$504.971
RI$511.711
SC$473.121
SD$479.841
TN$457.951
TX$471.36–$516.758
UT$479.751
VA$486.85–$570.072
VI$504.971
VT$482.371
WA$512.70–$574.972
WI$465.701
WV$475.241
WY$493.331

See 28405 in every payment locality

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.

How the rate is built · 28405

RVUs × geographic indexes × conversion factor

Office or facility?

Work4.62

4.62 RVUs× 1.000 GPCI

Practice expense9.41

9.41 RVUs× 1.000 GPCI

Malpractice1.00

1.00 RVUs× 1.000 GPCI

Adjusted RVUs

15.0300

Conversion factor

$33.4009

Medicare rate

$502.02

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Houston, TX inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,199

Code
28405
Physician work
4.62
Practice expense
9.41
Malpractice
1.00

GPCI2026.csv

102

Locality
Houston, TX
Physician work
1.008
Practice expense
0.993
Malpractice
1.376
Office calculation for 28405 in Houston, TX
ComponentRVULocality factorAdjusted
Physician work4.62× 1.0084.6570
Practice expense9.41× 0.9939.3441
Malpractice1.00× 1.3761.3760
Total RVUs15.3771
Conversion factor× 33.4009

Office rate, Houston, TX$513.61

Office: (4.62 × 1.008 + 9.41 × 0.993 + 1 × 1.376) × $33.4009 = $513.61

Facility: (4.62 × 1.008 + 6.35 × 0.993 + 1 × 1.376) × $33.4009 = $412.12

Open 28405 in the RVU calculator

Payment rules and modifiers for 28405

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

CMS payment indicators · 28405

Heel fracture treatment, with manipulation

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 28405

Heel fracture treatment, with manipulation

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

28405 without 50 · national office

$502.02

Heel fracture treatment, with manipulation

28405-50 · Bilateral: 150%

$753.03

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

Codes related to 28405

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

Codes related to 28405
CodeHow it relatesOffice range, Houston, TX
Same family
28400Fracture treatment, calcaneus, no manipulationClosed treatment of a calcaneal fracture without manipulation.$275.18
Used instead
28406Calcaneal fracture repair, percutaneous fixation with manipulationUsed when treatment of the calcaneal fracture includes percutaneous skeletal fixation.No office rate
28415Heel fracture repair, open treatmentUsed for open treatment of a calcaneal fracture.No office rate
28420Calcaneal fracture repair, with bone graftOpen calcaneal fracture treatment that also includes bone grafting.No office rate
28435Talus fracture care, closed treatment with manipulationClosed treatment with manipulation for a talus fracture, rather than a calcaneal fracture.$422.01

How 28405 has changed in Houston, TX

28405 · Office / nonfacility

$513.61

Effective 2026-10-01

The base rate is $39.98 higher than on 2025-10-01, moving from $473.63 to $513.61 (8.4%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $473.63changed to$513.61

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 4.74 changed to 4.62
    • Practice expense RVU 8.43 changed to 9.41
    • Malpractice RVU 0.98 changed to 1.00
    • Work GPCI 1.014 changed to 1.008
    • Practice expense GPCI 1.003 changed to 0.993
    • Malpractice GPCI 1.409 changed to 1.376

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $482.40changed to$473.63

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 8.28 changed to 8.43

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $474.53changed to$482.40

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $480.00changed to$474.53

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 8.09 changed to 8.28
    • Malpractice RVU 0.95 changed to 0.98
    • Work GPCI 1.023 changed to 1.014
    • Practice expense GPCI 1.016 changed to 1.003
    • Malpractice GPCI 1.154 changed to 1.409

  5. January 1, 2023

    RVU23A

    $411.29changed to$480.00

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 6.21 changed to 8.09
    • Malpractice RVU 0.67 changed to 0.95
    • Work GPCI 1.032 changed to 1.023
    • Practice expense GPCI 1.029 changed to 1.016
    • Malpractice GPCI 0.900 changed to 1.154

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $415.10changed to$411.29

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 6.23 changed to 6.21
    • Malpractice RVU 0.66 changed to 0.67

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $408.01changed to$415.10

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.74 changed to 6.23
    • Malpractice RVU 0.64 changed to 0.66
    • Work GPCI 1.026 changed to 1.032
    • Practice expense GPCI 1.020 changed to 1.029
    • Malpractice GPCI 0.918 changed to 0.900

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $409.16changed to$408.01

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.84 changed to 5.74
    • Malpractice RVU 0.65 changed to 0.64
    • Work GPCI 1.020 changed to 1.026
    • Practice expense GPCI 1.012 changed to 1.020
    • Malpractice GPCI 0.936 changed to 0.918

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $408.35changed to$409.16

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 5.83 changed to 5.84

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $407.35changed to$408.35

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.82 changed to 5.83
    • Malpractice RVU 0.68 changed to 0.65
    • Practice expense GPCI 1.009 changed to 1.012
    • Malpractice GPCI 0.946 changed to 0.936

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $407.62changed to$407.35

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.87 changed to 5.82
    • Work GPCI 1.019 changed to 1.020
    • Practice expense GPCI 1.006 changed to 1.009
    • Malpractice GPCI 0.955 changed to 0.946

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $413.34changed to$407.62

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 5.94 changed to 5.87
    • Malpractice RVU 0.73 changed to 0.68

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $411.28changed to$413.34

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $398.40changed to$411.28

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 5.71 changed to 5.94
    • Malpractice RVU 0.62 changed to 0.73
    • Work GPCI 1.014 changed to 1.019
    • Practice expense GPCI 1.004 changed to 1.006
    • Malpractice GPCI 0.939 changed to 0.955

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $387.68changed to$398.40

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 6.00 changed to 5.71
    • Malpractice RVU 0.65 changed to 0.62
    • Work GPCI 1.009 changed to 1.014
    • Practice expense GPCI 1.002 changed to 1.004
    • Malpractice GPCI 0.923 changed to 0.939

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $387.68

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$513.61$412.12RVU26D
2026-07-01$513.61$412.12RVU26C
2026-04-01$513.61$412.12RVU26B
2026-01-01$513.61$412.12RVU26A
2025-10-01$473.63$427.24RVU25D
2025-07-01$473.63$427.24RVU25C
2025-04-01$473.63$427.24RVU25B
2025-01-01$473.63$427.24RVU25A
2024-10-01$482.40$434.33RVU24D
2024-07-01$482.40$434.33RVU24C
2024-04-01$482.40$434.33RVU24B
2024-03-09$482.40$434.33RVU24AR
2024-01-01$474.53$427.24RVU24A
2023-10-01$480.00$431.46RVU23D
2023-07-01$480.00$431.46RVU23C
2023-04-01$480.00$431.46RVU23B
2023-01-01$480.00$431.46RVU23A
2022-10-01$411.29$370.34RVU22D
2022-07-01$411.29$370.34RVU22C
2022-04-01$411.29$370.34RVU22B
2022-01-01$411.29$370.34RVU22A
2021-10-01$415.10$373.81RVU21D
2021-07-01$415.10$373.81RVU21C
2021-04-01$415.10$373.81RVU21B
2021-01-01$415.10$373.81RVU21A
2020-10-01$408.01$369.73RVU20D
2020-07-01$408.01$369.73RVU20C
2020-04-01$408.01$369.73RVU20B
2020-01-01$408.01$369.73RVU20A
2019-10-01$409.16$370.50RVU19D
2019-07-01$409.16$370.50RVU19C
2019-04-01$409.16$370.50RVU19B
2019-01-01$409.16$370.50RVU19A
2018-10-01$408.35$369.73RVU18D
2018-07-01$408.35$369.73RVU18C
2018-04-01$408.35$369.73RVU18B
2018-01-01$408.35$369.73RVU18AR1
2017-10-01$407.35$370.06RVU17D
2017-07-01$407.35$370.06RVU17C
2017-04-01$407.35$370.06RVU17B
2017-01-01$407.35$370.06RVU17A
2016-10-01$407.62$370.16RVU16D
2016-07-01$407.62$370.16RVU16C
2016-04-01$407.62$370.16RVU16B
2016-01-01$407.62$370.16RVU16A
2015-10-01$413.34$375.38RVU15D
2015-07-01$413.34$375.38RVU15C
2015-04-01$411.28$373.51RVU15B
2015-01-01$411.28$373.51RVU15A
2014-10-01$398.40$362.43RVU14D
2014-07-01$398.40$362.43RVU14C
2014-04-01$398.40$362.43RVU14B
2014-01-01$398.40$362.43RVU14A
2013-10-01$387.68$350.86RVU13D
2013-07-01$387.68$350.86RVU13C
2013-04-01$387.68$350.86RVU13B
2013-01-01$387.68$350.86RVU13AR

Price 28405 for an earlier date of service

Where the Houston, TX rate applies

Houston, TX is a Medicare payment area, not a city. Our Census mapping connects it to 46 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Texas

28405 billing questions

How does this differ from 28400?

Use 28405 when treatment includes manipulation to improve fracture alignment. Code 28400 describes closed treatment without manipulation.

When should 28406 be considered instead?

Code 28406 is for treatment using percutaneous skeletal fixation. This code describes closed manipulation without that fixation method.

What documentation supports reporting this code?

Document the calcaneal fracture and the manipulation performed to reduce or improve its alignment, along with the resulting treatment plan.

How is bilateral treatment reported?

For bilateral procedures, modifier 50 is paid at 150%.

What global and multiple-procedure rules apply?

The code has a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care. In the same session, the highest-valued procedure is paid in full and other procedures are reduced to 50%.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment requires documentation of medical necessity. 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 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

Show the CMS file lines behind this rate
RVUs for 28405PPRRVU2026_Oct_nonQPP.csv, line 3,199 (RVU26D)
Geographic factors for Houston, TXGPCI2026.csv, line 102 (RVU26D)

Open CMS sourceHow we calculate rates

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