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

Reports open repair of a calcaneal fracture when the surgeon uses bone graft as part of reconstruction, with fixation included when performed.

CMS RVU26DEffective Oct 1, 2026One payment locality59 Medicare services in 2024

In New Mexico, Medicare pays $1,190.23 for 28420 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$1,190.23Hospital or facility

Check a contract rate as a % of Medicare · 28420 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 28420 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in New Mexico
  2. What 28420 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 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.

How New Mexico compares for 28420

Across 109 of 109 payment localities, the facility rate for 28420 runs from $1,077.07 in Arkansas to $1,473.19 in Alaska. New Mexico pays $1,190.23. The RVUs are the same everywhere; the geographic indexes change the dollars.

28420 in New Mexico vs other payment areas
  1. New Mexico · this page$1,190.23
  2. Los Angeles, CA · California$1,286.05+$95.82
  3. Washington, DC area · District of Columbia$1,345.32+$155.09
  4. Miami, FL · Florida$1,415.36+$225.13
  5. Chicago, IL · Illinois$1,372.37+$182.14
  6. Manhattan, NY · New York$1,400.10+$209.87
  7. Alaska · Alaska$1,473.19+$282.96

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

Every other payment area

28420 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$1,091.53
ArkansasArkansas—$1,077.07
ArizonaArizona—$1,175.29
Bakersfield, CACalifornia—$1,221.85
Chico, CACalifornia—$1,211.86
El Centro, CACalifornia—$1,212.46
Fresno, CACalifornia—$1,211.86
Hanford, CACalifornia—$1,211.86

28420 rates by state

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

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.

View every state and territory as a table
28420 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

See 28420 in every payment locality

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

Office or facility?

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.

The exact New Mexico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,202

Code
28420
Physician work
17.08
Practice expense
15.48
Malpractice
3.63

GPCI2026.csv

77

Locality
New Mexico
Physician work
1.000
Practice expense
0.917
Malpractice
1.201
Facility calculation for 28420 in New Mexico
ComponentRVULocality factorAdjusted
Physician work17.08× 1.00017.0800
Practice expense15.48× 0.91714.1952
Malpractice3.63× 1.2014.3596
Total RVUs35.6348
Conversion factor× 33.4009

Facility rate, New Mexico$1190.23

Facility: (17.08 × 1 + 15.48 × 0.917 + 3.63 × 1.201) × $33.4009 = $1190.23

Open 28420 in the RVU calculator

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

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)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
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 · 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.

  • 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

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).

When to use modifier 50

How 28420 has changed in New Mexico

28420 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

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
Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Not available in this setting$1,190.23RVU26D
2026-07-01Not available in this setting$1,190.23RVU26C
2026-04-01Not available in this setting$1,190.23RVU26B
2026-01-01Not available in this setting$1,190.23RVU26A
2025-10-01Not available in this setting$1,240.41RVU25D
2025-07-01Not available in this setting$1,240.41RVU25C
2025-04-01Not available in this setting$1,240.41RVU25B
2025-01-01Not available in this setting$1,240.41RVU25A
2024-10-01Not available in this setting$1,270.20RVU24D
2024-07-01Not available in this setting$1,270.20RVU24C
2024-04-01Not available in this setting$1,270.20RVU24B
2024-03-09Not available in this setting$1,270.20RVU24AR
2024-01-01Not available in this setting$1,249.47RVU24A
2023-10-01Not available in this setting$1,281.50RVU23D
2023-07-01Not available in this setting$1,281.50RVU23C
2023-04-01Not available in this setting$1,281.50RVU23B
2023-01-01Not available in this setting$1,281.50RVU23A
2022-10-01Not available in this setting$1,295.21RVU22D
2022-07-01Not available in this setting$1,295.21RVU22C
2022-04-01Not available in this setting$1,295.21RVU22B
2022-01-01Not available in this setting$1,295.21RVU22A
2021-10-01Not available in this setting$1,294.69RVU21D
2021-07-01Not available in this setting$1,294.69RVU21C
2021-04-01Not available in this setting$1,294.69RVU21B
2021-01-01Not available in this setting$1,294.69RVU21A
2020-10-01Not available in this setting$1,311.25RVU20D
2020-07-01Not available in this setting$1,311.25RVU20C
2020-04-01Not available in this setting$1,311.25RVU20B
2020-01-01Not available in this setting$1,311.25RVU20A
2019-10-01Not available in this setting$1,315.30RVU19D
2019-07-01Not available in this setting$1,315.30RVU19C
2019-04-01Not available in this setting$1,308.56RVU19B
2019-01-01Not available in this setting$1,308.56RVU19A
2018-10-01Not available in this setting$1,302.00RVU18D
2018-07-01Not available in this setting$1,302.00RVU18C
2018-04-01Not available in this setting$1,302.00RVU18B
2018-01-01Not available in this setting$1,302.00RVU18AR1
2017-10-01Not available in this setting$1,294.85RVU17D
2017-07-01Not available in this setting$1,294.85RVU17C
2017-04-01Not available in this setting$1,294.85RVU17B
2017-01-01Not available in this setting$1,294.85RVU17A
2016-10-01Not available in this setting$1,272.08RVU16D
2016-07-01Not available in this setting$1,272.08RVU16C
2016-04-01Not available in this setting$1,272.08RVU16B
2016-01-01Not available in this setting$1,272.08RVU16A
2015-10-01Not available in this setting$1,279.99RVU15D
2015-07-01Not available in this setting$1,279.99RVU15C
2015-04-01Not available in this setting$1,273.62RVU15B
2015-01-01Not available in this setting$1,273.62RVU15A
2014-10-01Not available in this setting$1,247.85RVU14D
2014-07-01Not available in this setting$1,247.85RVU14C
2014-04-01Not available in this setting$1,247.85RVU14B
2014-01-01Not available in this setting$1,247.85RVU14A
2013-10-01Not available in this setting$1,220.51RVU13D
2013-07-01Not available in this setting$1,220.51RVU13C
2013-04-01Not available in this setting$1,220.51RVU13B
2013-01-01Not available in this setting$1,220.51RVU13AR

Price 28420 for an earlier date of service

Where the New Mexico rate applies

New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.

  • Abeytas
  • Abiquiu
  • Acomita Lake
  • Adelino
  • Agua Fria
  • Alamillo
  • Alamo
  • Alamogordo

Browse all communities in New Mexico

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

Show the CMS file lines behind this rate
RVUs for 28420PPRRVU2026_Oct_nonQPP.csv, line 3,202 (RVU26D)
Geographic factors for New MexicoGPCI2026.csv, line 77 (RVU26D)

Open CMS sourceHow we calculate rates

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