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CPT code 28436: Talus fracture fixation, percutaneous, with manipulation2026 Medicare rate & RVUs

Reports manipulation and percutaneous skeletal fixation of a talus fracture when reduction is stabilized without open surgical exposure.

CMS RVU26DEffective Oct 1, 2026109 payment localities19 Medicare services in 2024

Medicare pays $497.01 for 28436 nationally in a facility.

Medicare rate · 28436

Talus fracture fixation, percutaneous, with manipulation

Office or facility?

Work RVUs
4.78
Total RVUs
14.88
Global days
090

National rate · 2026

$497.01

Facility setting, before claim adjustments.

See every locality for 28436 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 28436 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 28436 covers

An orthopedic surgeon, commonly specializing in foot and ankle surgery, uses manipulation to reduce a talus fracture and places skeletal fixation percutaneously through the skin. The procedure stabilizes the fracture without open exposure of the fracture site. It is typically performed in a surgical facility for a fracture requiring both reduction and fixation.

Report this code when the operative documentation supports manipulation and percutaneous skeletal fixation of the talus; closed manipulation alone or open fixation describes a different service. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral procedures, modifier 50 results in payment at 150%. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery billing 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.

Where 28436 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

28436 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$444.21
AlaskaUnavailable$581.08
ArizonaUnavailable$482.66
ArkansasUnavailable$437.60
Atlanta, GAUnavailable$509.25
Austin, TXUnavailable$510.97
Bakersfield, CAUnavailable$515.67
Baltimore area, MDUnavailable$529.83
Beaumont, TXUnavailable$467.30
Brazoria, TXUnavailable$487.99

28436 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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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
28436 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

How the 28436 rate is calculated

Each of 28436’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 · 28436

RVUs × geographic indexes × conversion factor

Office or facility?

Work4.78

4.78 RVUs× 1.000 GPCI

Practice expense9.07

9.07 RVUs× 1.000 GPCI

Malpractice1.03

1.03 RVUs× 1.000 GPCI

Adjusted RVUs

14.8800

Conversion factor

$33.4009

Medicare rate

$497.01

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

Payment rules and modifiers for 28436

28436 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 28436

Talus fracture fixation, percutaneous, 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)1Not paid (statutory restriction).
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 · 28436

Talus fracture fixation, percutaneous, 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

28436 without 50 · national facility

$497.01

Talus fracture fixation, percutaneous, with manipulation

28436-50 · Bilateral: 150%

$745.52

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

28436 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 28436

    Talus fracture fixation, percutaneous, with manipulation4.78 wRVU

    Not priced

  • 28430

    Talus fracture care, without manipulation2.16 wRVU

    $265.87

  • 28435

    Talus fracture care, closed treatment with manipulation3.45 wRVU

    $413.84

  • 28445

    Talus fracture surgery, open treatment15.37 wRVU

    Not priced

How to choose

28430Talus fracture careWithout manipulation
Choose 28430 for talus fracture treatment without manipulation. This code includes manipulation and percutaneous skeletal fixation.
28435Talus fracture careClosed treatment with manipulation
Both involve manipulation of a talus fracture, but this code also includes percutaneous skeletal fixation.
28445Talus fracture surgeryOpen treatment
Use 28445 when the fracture is treated with open exposure; this code describes percutaneous fixation without open exposure.

Codes related to 28436

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

Codes related to 28436
CodeHow it relatesNational office range
Used instead
28430Talus fracture care, without manipulationTalus fracture treatment without manipulation or percutaneous skeletal fixation.$234.30–$348.24
28435Talus fracture care, closed treatment with manipulationTalus fracture treatment with manipulation but without percutaneous skeletal fixation.$363.35–$536.41
28445Talus fracture surgery, open treatmentOpen treatment of a talus fracture rather than percutaneous fixation.No office rate

28436 billing questions

How does this differ from closed treatment of a talus fracture?

This code describes manipulation followed by percutaneous skeletal fixation. Closed treatment codes describe fracture care without that percutaneous fixation.

How does this differ from open talus fracture treatment?

Use this code when fixation is placed percutaneously without open exposure of the fracture site. Open treatment is reported when the fracture is surgically exposed for treatment.

Does the 90-day global period include related postoperative care?

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

Can an assistant surgeon or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.

How is bilateral treatment handled?

For a bilateral procedure, modifier 50 is paid at 150%.

What happens when another procedure is performed in the same session?

The highest-valued procedure is paid in full; other procedures performed in the same session are subject to the standard multiple procedure reduction.

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 28436PPRRVU2026_Oct_nonQPP.csv, line 3,205 (RVU26D)

Open CMS sourceHow we calculate rates

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