CPT code 28420: Calcaneal fracture repair, with bone graft2026 Medicare rate & RVUs

Medicare pays $1,208.78 for 28420 nationally in a facility.

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

What 28420 covers

An orthopedic surgeon uses this code for open repair of a heel bone fracture that requires bone graft as part of the reconstruction. The fracture is exposed surgically, reduced, and reconstructed with graft; internal fixation is included when performed. This approach may be used when the fracture pattern leaves a defect that the surgeon addresses with graft. These repairs are generally performed in a facility setting, such as a hospital or ambulatory surgery center.

Select this code when the operative report supports both open fracture treatment and use of bone graft in the repair. Open treatment without graft is represented by a different calcaneal fracture code; closed reduction and percutaneous fixation are different treatment methods. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral procedures reported with modifier 50, CMS pays at 150%. Assistant-at-surgery services may be paid; 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 28420 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

28420 rates by state

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

How the 28420 rate is calculated

Each of 28420’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 28420

28420 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

28420 compared with similar codes

How to choose

28415Heel fracture repairOpen treatment

Both describe open treatment of a calcaneal fracture, but 28420 is the choice when bone graft is used in the repair; 28415 is for repair without graft.

28406Calcaneal fracture repairPercutaneous fixation with manipulation

28406 describes percutaneous skeletal fixation, not open reconstruction with bone graft.

28405Heel fracture treatmentWith manipulation

28405 is closed treatment with manipulation. Choose 28420 when the fracture is treated through an open approach and bone graft is used.

Codes related to 28420

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