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CPT code 28435: Talus fracture care, closed treatment with manipulation2026 Medicare rate & RVUs in Utah

Reports closed reduction of a talus fracture when the clinician manipulates the fracture to improve alignment without open exposure or percutaneous fixation.

CMS RVU26DEffective Oct 1, 2026One payment locality103 Medicare services in 2024

In Utah, Medicare pays $394.90 for 28435 in the office and $315.15 when it’s performed in a hospital or facility.

$394.90Office (non-facility)
$315.15Hospital or facility
−4.6%vs the national office rate ($413.84)

Check a contract rate as a % of Medicare · 28435 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 28435 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Utah
  2. What 28435 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 28435 covers

An orthopedic surgeon or foot and ankle specialist uses external manipulation to restore alignment of a talus fracture, commonly when displacement requires reduction but treatment can remain closed. The service may be performed in a hospital or ambulatory setting, with imaging used to assess the fracture and confirm the result. The fracture is then managed with appropriate immobilization and follow-up.

Choose this code when the clinician performs manipulation as part of closed fracture treatment; document the talus fracture, the reduction maneuver, and the resulting alignment. Do not use it for treatment without manipulation or when percutaneous fixation or open reduction is performed. The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with 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 Utah compares for 28435

Across 109 of 109 payment localities, the office rate for 28435 runs from $363.35 in Arkansas to $536.41 in San Benito County, CA. Utah pays $394.90. The RVUs are the same everywhere; the geographic indexes change the dollars.

28435 in Utah vs other payment areas
  1. Utah · this page$394.90
  2. Los Angeles, CA · California$460.55+$65.65
  3. Washington, DC area · District of Columbia$471.63+$76.73
  4. Miami, FL · Florida$462.36+$67.46
  5. Chicago, IL · Illinois$447.59+$52.69
  6. Manhattan, NY · New York$479.92+$85.02
  7. Alaska · Alaska$478.33+$83.43

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

Every other payment area

28435 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$368.98$294.74
ArkansasArkansas$363.35$290.47
ArizonaArizona$401.83$319.62
Bakersfield, CACalifornia$432.82$339.84
Chico, CACalifornia$430.81$337.83
El Centro, CACalifornia$430.93$337.95
Fresno, CACalifornia$430.81$337.83
Hanford, CACalifornia$430.81$337.83

28435 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.

$363.35

$483.61

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

View every state and territory as a table
28435 office rate range by state
State / territoryOffice rate rangeLocalities
AK$478.331
AL$368.981
AR$363.351
AZ$401.831
CA$430.81–$536.4129
CO$427.431
CT$442.381
DC$471.631
DE$408.661
FL$414.04–$462.363
GA$388.90–$423.472
GU$441.141
HI$441.141
IA$375.831
ID$379.051
IL$403.71–$447.594
IN$381.291
KS$375.421
KY$381.331
LA$381.28–$400.972
MA$425.26–$469.082
MD$416.28–$471.633
ME$382.68–$402.372
MI$393.13–$420.972
MN$404.621
MO$375.36–$400.723
MS$369.361
MT$413.791
NC$386.661
ND$399.351
NE$377.561
NH$422.031
NJ$446.04–$466.632
NM$395.981
NV$410.041
NY$392.88–$493.945
OH$390.171
OK$379.061
OR$405.50–$439.882
PA$390.01–$431.862
PR$416.491
RI$422.441
SC$389.341
SD$397.651
TN$377.591
TX$387.43–$427.198
UT$394.901
VA$402.01–$471.632
VI$416.491
VT$399.051
WA$424.04–$477.392
WI$385.451
WV$388.421
WY$407.501

See 28435 in every payment locality

How the 28435 rate is calculated

Each of 28435’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 · 28435

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.45

3.45 RVUs× 1.000 GPCI

Practice expense8.21

8.21 RVUs× 1.000 GPCI

Malpractice0.73

0.73 RVUs× 1.000 GPCI

Adjusted RVUs

12.3900

Conversion factor

$33.4009

Medicare rate

$413.84

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

The exact Utah inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,204

Code
28435
Physician work
3.45
Practice expense
8.21
Malpractice
0.73

GPCI2026.csv

104

Locality
Utah
Physician work
1.000
Practice expense
0.940
Malpractice
0.898
Office calculation for 28435 in Utah
ComponentRVULocality factorAdjusted
Physician work3.45× 1.0003.4500
Practice expense8.21× 0.9407.7174
Malpractice0.73× 0.8980.6555
Total RVUs11.8229
Conversion factor× 33.4009

Office rate, Utah$394.90

Office: (3.45 × 1 + 8.21 × 0.94 + 0.73 × 0.898) × $33.4009 = $394.90

Facility: (3.45 × 1 + 5.67 × 0.94 + 0.73 × 0.898) × $33.4009 = $315.15

Open 28435 in the RVU calculator

Payment rules and modifiers for 28435

28435 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 28435

Talus fracture care, closed 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 · 28435

Talus fracture care, closed 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

28435 without 50 · national office

$413.84

Talus fracture care, closed treatment with manipulation

28435-50 · Bilateral: 150%

$620.76

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 28435

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

Codes related to 28435
CodeHow it relatesOffice range, Utah
Same family
28430Talus fracture care, without manipulationClosed talus fracture treatment without manipulation.$253.73
Used instead
28436Talus fracture fixation, percutaneous, with manipulationUsed when percutaneous skeletal fixation accompanies manipulation.No office rate
28445Talus fracture surgery, open treatmentUsed for open reduction and internal fixation of a talus fracture.No office rate

How 28435 has changed in Utah

28435 · Office / nonfacility

$394.90

Effective 2026-10-01

The base rate is $36.31 higher than on 2025-10-01, moving from $358.59 to $394.90 (10.1%).

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

    $358.59changed to$394.90

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.54 changed to 3.45
    • Practice expense RVU 7.37 changed to 8.21
    • Malpractice RVU 0.72 changed to 0.73
    • Practice expense GPCI 0.933 changed to 0.940
    • Malpractice GPCI 0.930 changed to 0.898

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $365.29changed to$358.59

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 7.24 changed to 7.37
    • Malpractice RVU 0.73 changed to 0.72

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $359.33changed to$365.29

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $362.92changed to$359.33

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 7.07 changed to 7.24
    • Malpractice RVU 0.72 changed to 0.73
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.865 changed to 0.930

  5. January 1, 2023

    RVU23A

    $359.27changed to$362.92

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 6.81 changed to 7.07
    • Malpractice RVU 0.73 changed to 0.72
    • Practice expense GPCI 0.919 changed to 0.926
    • Malpractice GPCI 0.799 changed to 0.865

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $323.07changed to$359.27

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.71 changed to 6.81
    • Malpractice RVU 0.59 changed to 0.73

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $359.72changed to$323.07

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 6.24 changed to 5.71
    • Malpractice RVU 0.68 changed to 0.59
    • Practice expense GPCI 0.923 changed to 0.919
    • Malpractice GPCI 0.982 changed to 0.799

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $364.27changed to$359.72

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 6.18 changed to 6.24
    • Malpractice RVU 0.72 changed to 0.68
    • Practice expense GPCI 0.927 changed to 0.923
    • Malpractice GPCI 1.165 changed to 0.982

    Held through RVU20B, RVU20C, RVU20D.

  9. July 1, 2019

    RVU19C

    $363.85changed to$364.27

    • Malpractice RVU 0.71 changed to 0.72

    Held through RVU19D.

  10. January 1, 2019

    RVU19A

    $362.87changed to$363.85

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 6.15 changed to 6.18
    • Malpractice RVU 0.72 changed to 0.71

    Held through RVU19B.

  11. January 1, 2018

    RVU18AR1

    $319.54changed to$362.87

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.13 changed to 6.15
    • Malpractice RVU 0.53 changed to 0.72
    • Practice expense GPCI 0.925 changed to 0.927
    • Malpractice GPCI 1.167 changed to 1.165

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $315.37changed to$319.54

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.08 changed to 5.13
    • Malpractice RVU 0.50 changed to 0.53
    • Practice expense GPCI 0.922 changed to 0.925
    • Malpractice GPCI 1.169 changed to 1.167

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $323.94changed to$315.37

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 5.00 changed to 5.08
    • Malpractice RVU 0.74 changed to 0.50

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $322.33changed to$323.94

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $321.24changed to$322.33

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 5.09 changed to 5.00
    • Malpractice RVU 0.66 changed to 0.74
    • Practice expense GPCI 0.919 changed to 0.922
    • Malpractice GPCI 1.136 changed to 1.169

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $352.62changed to$321.24

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 6.62 changed to 5.09
    • Malpractice RVU 0.69 changed to 0.66
    • Practice expense GPCI 0.916 changed to 0.919
    • Malpractice GPCI 1.102 changed to 1.136

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $352.62

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$394.90$315.15RVU26D
2026-07-01$394.90$315.15RVU26C
2026-04-01$394.90$315.15RVU26B
2026-01-01$394.90$315.15RVU26A
2025-10-01$358.59$319.05RVU25D
2025-07-01$358.59$319.05RVU25C
2025-04-01$358.59$319.05RVU25B
2025-01-01$358.59$319.05RVU25A
2024-10-01$365.29$324.61RVU24D
2024-07-01$365.29$324.61RVU24C
2024-04-01$365.29$324.61RVU24B
2024-03-09$365.29$324.61RVU24AR
2024-01-01$359.33$319.31RVU24A
2023-10-01$362.92$322.13RVU23D
2023-07-01$362.92$322.13RVU23C
2023-04-01$362.92$322.13RVU23B
2023-01-01$362.92$322.13RVU23A
2022-10-01$359.27$319.20RVU22D
2022-07-01$359.27$319.20RVU22C
2022-04-01$359.27$319.20RVU22B
2022-01-01$359.27$319.20RVU22A
2021-10-01$323.07$286.52RVU21D
2021-07-01$323.07$286.52RVU21C
2021-04-01$323.07$286.52RVU21B
2021-01-01$323.07$286.52RVU21A
2020-10-01$359.72$321.41RVU20D
2020-07-01$359.72$321.41RVU20C
2020-04-01$359.72$321.41RVU20B
2020-01-01$359.72$321.41RVU20A
2019-10-01$364.27$325.85RVU19D
2019-07-01$364.27$325.85RVU19C
2019-04-01$363.85$325.43RVU19B
2019-01-01$363.85$325.43RVU19A
2018-10-01$362.87$324.83RVU18D
2018-07-01$362.87$324.83RVU18C
2018-04-01$362.87$324.83RVU18B
2018-01-01$362.87$324.83RVU18AR1
2017-10-01$319.54$287.34RVU17D
2017-07-01$319.54$287.34RVU17C
2017-04-01$319.54$287.34RVU17B
2017-01-01$319.54$287.34RVU17A
2016-10-01$315.37$283.35RVU16D
2016-07-01$315.37$283.35RVU16C
2016-04-01$315.37$283.35RVU16B
2016-01-01$315.37$283.35RVU16A
2015-10-01$323.94$292.14RVU15D
2015-07-01$323.94$292.14RVU15C
2015-04-01$322.33$290.68RVU15B
2015-01-01$322.33$290.68RVU15A
2014-10-01$321.24$289.31RVU14D
2014-07-01$321.24$289.31RVU14C
2014-04-01$321.24$289.31RVU14B
2014-01-01$321.24$289.31RVU14A
2013-10-01$352.62$315.54RVU13D
2013-07-01$352.62$315.54RVU13C
2013-04-01$352.62$315.54RVU13B
2013-01-01$352.62$315.54RVU13AR

Price 28435 for an earlier date of service

Where the Utah rate applies

Utah is a Medicare payment area, not a city. Our Census mapping connects it to 334 cities and communities in Utah. Some span more than one payment area; confirm with the service ZIP.

  • Alpine
  • Alta
  • Altamont
  • Alton
  • Amalga
  • American Fork
  • Aneth
  • Annabella

Browse all communities in Utah

28435 billing questions

When is 28435 chosen instead of 28430?

Use 28435 when the clinician manipulates the talus fracture to improve alignment. Code 28430 describes closed treatment without manipulation.

How does 28435 differ from percutaneous fixation?

This code describes reduction through external manipulation without percutaneous skeletal fixation. Use 28436 when percutaneous skeletal fixation is performed.

What documentation supports 28435?

Document the talus fracture, the manipulation or reduction performed, and the resulting alignment. The record should also make clear whether treatment remained closed or involved fixation or open reduction.

Are related postoperative visits included?

The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are not permitted for this code.

How is bilateral treatment reported?

When the procedure is performed bilaterally, report modifier 50; CMS pays the bilateral procedure at 150%.

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 28435PPRRVU2026_Oct_nonQPP.csv, line 3,204 (RVU26D)
Geographic factors for UtahGPCI2026.csv, line 104 (RVU26D)

Open CMS sourceHow we calculate rates

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