CPT code 28420: Calcaneal fracture repair, with bone graft2026 Medicare rate & RVUs in Missouri
Reports open repair of a calcaneal fracture when the surgeon uses bone graft as part of reconstruction, with fixation included when performed.
CMS doesn’t publish an office rate for 28420 in Missouri.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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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 in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $1,174.45 |
| Metropolitan St. Louis, MO | Unavailable | $1,184.20 |
| Rest of Missouri | Unavailable | $1,134.27 |
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.
How the rate is built · 28420
RVUs × geographic indexes × conversion factor
Work17.08
17.08 RVUs× 1.000 GPCI
Practice expense15.48
15.48 RVUs× 1.000 GPCI
Malpractice3.63
3.63 RVUs× 1.000 GPCI
Adjusted RVUs
36.1900
Conversion factor
$33.4009
Medicare rate
$1,208.78
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 28420
28420 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28420
Calcaneal fracture repair, with bone graft
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 28420
Calcaneal fracture repair, with bone graft
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
28420 without 50 · national facility
$1,208.78
Calcaneal fracture repair, with bone graft
28420-50 · Bilateral: 150%
$1,813.17
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).
28420 compared with similar codes
Compare codes · National
4 codes, side by side
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.
28420 billing questions
When should 28420 be chosen over 28415?
Use 28420 when the open calcaneal fracture repair includes bone graft. Use 28415 for open treatment without bone graft.
Is internal fixation included?
Yes. Internal fixation is included when performed as part of the open repair; do not separately report the fixation as another treatment of that same fracture.
Does 28420 include routine postoperative fracture care?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral repair reported under the CMS rule?
For bilateral procedures, report modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What operative documentation supports this code?
Document the calcaneal fracture, open treatment, and use of bone graft in the reconstruction. Include the fixation performed, if any.
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
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