CPT code 28415: Heel fracture repair, open treatment2026 Medicare rate & RVUs in California

CMS doesn’t publish an office rate for 28415 in California.

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

What 28415 covers

An orthopedic surgeon, often a foot and ankle specialist, uses an open approach to expose and reduce a fracture of the calcaneus. Fixation may be used to maintain the reduction. The service is typically performed in a hospital operating room or another surgical facility for a fracture requiring open operative care; the fracture must involve the heel bone rather than the talus or another tarsal bone.

Report the code for the open treatment of the calcaneal fracture, supported by the operative report documenting the fracture site, open approach, reduction, and fixation performed. A calcaneal fracture treated with primary bone grafting belongs to the separate graft-related code, 28420. The 90-day global period includes 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 subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is 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 28415 pays more and less in California

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

29 of 29 payment localities

How the 28415 rate is calculated

Each of 28415’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 28415

28415 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

28415 compared with similar codes

How to choose

28420Calcaneal fracture repairWith bone graft

Both address open treatment of a calcaneal fracture; 28420 is distinguished by primary bone grafting.

28406Calcaneal fracture repairPercutaneous fixation with manipulation

Use 28406 for percutaneous skeletal fixation with manipulation. Use 28415 for an open approach to the fracture.

28405Heel fracture treatmentWith manipulation

Code 28405 is closed treatment with manipulation, rather than open operative treatment.

28445Talus fracture surgeryOpen treatment

Code 28445 concerns open treatment of a talus fracture. This code is for a fracture of the calcaneus.

Codes related to 28415

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