CPT code 28446: Talar lesion surgery, open treatment with autograft2026 Medicare rate & RVUs in New Mexico
Open surgery uses a bone-and-cartilage autograft to treat a focal osteochondral lesion of the talus, such as a symptomatic talar dome defect.
In New Mexico, Medicare pays $1,114.87 for 28446 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 28446 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 28446 covers
The surgeon exposes the talus, addresses the osteochondral defect by drilling and removing loose fragments as indicated, and places an autograft to restore the damaged surface. This is typically performed by an orthopedic foot and ankle surgeon in a hospital or ambulatory surgical setting for a symptomatic talar lesion, including lesions that need graft reconstruction rather than fracture fixation or arthroscopic treatment alone. The graft harvest is included in the service.
Report the code when the operative record supports open treatment of a talar osteochondral lesion with autograft. Document the lesion, open approach, work performed, and graft use; do not select it for open fixation of a talus fracture. Medicare assigns a 90-day global period, including the day before surgery and related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 applies to bilateral reporting, with payment at 150%. Assistant-at-surgery payment may be available; 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 28446
Across 109 of 109 payment localities, the facility rate for 28446 runs from $1,006.06 in Arkansas to $1,386.69 in Alaska. New Mexico pays $1,114.87. The RVUs are the same everywhere; the geographic indexes change the dollars.
- New Mexico · this page$1,114.87
- Los Angeles, CA · California$1,186.07+$71.20
- Washington, DC area · District of Columbia$1,246.47+$131.60
- Miami, FL · Florida$1,330.51+$215.64
- Chicago, IL · Illinois$1,290.52+$175.65
- Manhattan, NY · New York$1,303.40+$188.53
- Alaska · Alaska$1,386.69+$271.82
Other areas in New Mexico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $1,019.14 |
| ArkansasArkansas | — | $1,006.06 |
| ArizonaArizona | — | $1,094.75 |
| Bakersfield, CACalifornia | — | $1,129.56 |
| Chico, CACalifornia | — | $1,119.45 |
| El Centro, CACalifornia | — | $1,120.07 |
| Fresno, CACalifornia | — | $1,119.45 |
| Hanford, CACalifornia | — | $1,119.45 |
| Madera, CACalifornia | — | $1,119.45 |
| Merced, CACalifornia | — | $1,119.45 |
| Modesto, CACalifornia | — | $1,119.45 |
| Napa, CACalifornia | — | $1,237.17 |
| Oxnard, CACalifornia | — | $1,173.12 |
| Redding, CACalifornia | — | $1,119.45 |
| Rest of CaliforniaCalifornia | — | $1,119.45 |
| Riverside, CACalifornia | — | $1,158.89 |
| Sacramento, CACalifornia | — | $1,158.97 |
| Salinas, CACalifornia | — | $1,154.38 |
| San Diego, CACalifornia | — | $1,170.31 |
| Marin County, CACalifornia | — | $1,288.83 |
| San Francisco, CACalifornia | — | $1,284.67 |
| San Benito County, CACalifornia | — | $1,320.56 |
| Santa Clara County, CACalifornia | — | $1,303.52 |
| San Luis Obispo, CACalifornia | — | $1,137.78 |
| Santa Cruz, CACalifornia | — | $1,172.48 |
| Santa Maria, CACalifornia | — | $1,155.63 |
| Santa Rosa, CACalifornia | — | $1,183.21 |
| Stockton, CACalifornia | — | $1,119.45 |
| Vallejo, CACalifornia | — | $1,231.16 |
| Visalia, CACalifornia | — | $1,119.45 |
| Yuba City, CACalifornia | — | $1,119.45 |
| ColoradoColorado | — | $1,132.96 |
| ConnecticutConnecticut | — | $1,195.71 |
| DelawareDelaware | — | $1,111.00 |
| Fort Lauderdale, FLFlorida | — | $1,230.20 |
| Rest of FloridaFlorida | — | $1,168.52 |
| Atlanta, GAGeorgia | — | $1,158.80 |
| Rest of GeorgiaGeorgia | — | $1,103.12 |
| Hawaii, Guam, HIHawaii | — | $1,132.39 |
| IowaIowa | — | $1,015.47 |
| IdahoIdaho | — | $1,026.91 |
| East St. Louis, ILIllinois | — | $1,215.81 |
| Rest of IllinoisIllinois | — | $1,157.54 |
| Suburban Chicago, ILIllinois | — | $1,235.79 |
| IndianaIndiana | — | $1,031.49 |
| KansasKansas | — | $1,023.90 |
| KentuckyKentucky | — | $1,067.88 |
| New Orleans, LALouisiana | — | $1,117.14 |
| Rest of LouisianaLouisiana | — | $1,071.45 |
| Metropolitan Boston, MAMassachusetts | — | $1,218.46 |
| Rest of MassachusettsMassachusetts | — | $1,132.54 |
| Baltimore area, MDMaryland | — | $1,195.00 |
| Rest of MarylandMaryland | — | $1,126.44 |
| Rest of MaineMaine | — | $1,045.18 |
| Southern Maine, MEMaine | — | $1,076.54 |
| Detroit, MIMichigan | — | $1,194.78 |
| Rest of MichiganMichigan | — | $1,104.34 |
| MinnesotaMinnesota | — | $1,051.67 |
| Metropolitan Kansas City, MOMissouri | — | $1,096.79 |
| Metropolitan St. Louis, MOMissouri | — | $1,105.40 |
| Rest of MissouriMissouri | — | $1,063.61 |
| MississippiMississippi | — | $1,034.38 |
| MontanaMontana | — | $1,125.37 |
| North CarolinaNorth Carolina | — | $1,052.80 |
| North DakotaNorth Dakota | — | $1,052.80 |
| NebraskaNebraska | — | $1,016.55 |
| New HampshireNew Hampshire | — | $1,127.76 |
| Northern New JerseyNew Jersey | — | $1,238.48 |
| Rest of New JerseyNew Jersey | — | $1,199.78 |
| NevadaNevada | — | $1,105.57 |
| NYC suburbs and Long Island, NYNew York | — | $1,348.13 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $1,217.80 |
| Queens, NYNew York | — | $1,294.28 |
| Rest of New YorkNew York | — | $1,067.89 |
| OhioOhio | — | $1,089.51 |
| OklahomaOklahoma | — | $1,052.67 |
| Portland, OROregon | — | $1,150.77 |
| Rest of OregonOregon | — | $1,087.50 |
| Metropolitan Philadelphia, PAPennsylvania | — | $1,177.13 |
| Rest of PennsylvaniaPennsylvania | — | $1,083.92 |
| Puerto RicoPuerto Rico | — | $1,128.46 |
| Rhode IslandRhode Island | — | $1,137.40 |
| South CarolinaSouth Carolina | — | $1,074.83 |
| South DakotaSouth Dakota | — | $1,044.22 |
| TennesseeTennessee | — | $1,030.07 |
| Austin, TXTexas | — | $1,137.51 |
| Beaumont, TXTexas | — | $1,078.55 |
| Brazoria, TXTexas | — | $1,099.42 |
| Dallas, TXTexas | — | $1,111.69 |
| Fort Worth, TXTexas | — | $1,109.02 |
| Galveston, TXTexas | — | $1,106.16 |
| Houston, TXTexas | — | $1,173.33 |
| Rest of TexasTexas | — | $1,091.98 |
| UtahUtah | — | $1,087.54 |
| VirginiaVirginia | — | $1,082.33 |
| Virgin Islands, VIUnited States Virgin Islands | — | $1,128.46 |
| VermontVermont | — | $1,060.79 |
| Rest of WashingtonWashington | — | $1,126.40 |
| King County, WAWashington | — | $1,228.77 |
| WisconsinWisconsin | — | $1,022.88 |
| West VirginiaWest Virginia | — | $1,122.61 |
| WyomingWyoming | — | $1,093.74 |
28446 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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
How the 28446 rate is calculated
Each of 28446’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 · 28446
RVUs × geographic indexes × conversion factor
Work17.27
17.27 RVUs× 1.000 GPCI
Practice expense12.76
12.76 RVUs× 1.000 GPCI
Malpractice3.67
3.67 RVUs× 1.000 GPCI
Adjusted RVUs
33.7000
Conversion factor
$33.4009
Medicare rate
$1,125.61
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
3,207
- Code
- 28446
- Physician work
- 17.27
- Practice expense
- 12.76
- Malpractice
- 3.67
GPCI2026.csv
77
- Locality
- New Mexico
- Physician work
- 1.000
- Practice expense
- 0.917
- Malpractice
- 1.201
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 17.27 | × 1.000 | 17.2700 |
| Practice expense | 12.76 | × 0.917 | 11.7009 |
| Malpractice | 3.67 | × 1.201 | 4.4077 |
| Total RVUs | 33.3786 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, New Mexico$1114.87
Facility: (17.27 × 1 + 12.76 × 0.917 + 3.67 × 1.201) × $33.4009 = $1114.87
Payment rules and modifiers for 28446
28446 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28446
Talar lesion surgery, open treatment with autograft
| 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 · 28446
Talar lesion surgery, open treatment with autograft
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
28446 without 50 · national facility
$1,125.61
Talar lesion surgery, open treatment with autograft
28446-50 · Bilateral: 150%
$1,688.41
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).
How 28446 has changed in New Mexico
28446 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
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
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $1,114.87 | RVU26D |
| 2026-07-01 | Not available in this setting | $1,114.87 | RVU26C |
| 2026-04-01 | Not available in this setting | $1,114.87 | RVU26B |
| 2026-01-01 | Not available in this setting | $1,114.87 | RVU26A |
| 2025-10-01 | Not available in this setting | $1,178.55 | RVU25D |
| 2025-07-01 | Not available in this setting | $1,178.55 | RVU25C |
| 2025-04-01 | Not available in this setting | $1,178.55 | RVU25B |
| 2025-01-01 | Not available in this setting | $1,178.55 | RVU25A |
| 2024-10-01 | Not available in this setting | $1,204.12 | RVU24D |
| 2024-07-01 | Not available in this setting | $1,204.12 | RVU24C |
| 2024-04-01 | Not available in this setting | $1,204.12 | RVU24B |
| 2024-03-09 | Not available in this setting | $1,204.12 | RVU24AR |
| 2024-01-01 | Not available in this setting | $1,184.47 | RVU24A |
| 2023-10-01 | Not available in this setting | $1,212.90 | RVU23D |
| 2023-07-01 | Not available in this setting | $1,212.90 | RVU23C |
| 2023-04-01 | Not available in this setting | $1,212.90 | RVU23B |
| 2023-01-01 | Not available in this setting | $1,212.90 | RVU23A |
| 2022-10-01 | Not available in this setting | $1,224.12 | RVU22D |
| 2022-07-01 | Not available in this setting | $1,224.12 | RVU22C |
| 2022-04-01 | Not available in this setting | $1,224.12 | RVU22B |
| 2022-01-01 | Not available in this setting | $1,224.12 | RVU22A |
| 2021-10-01 | Not available in this setting | $1,226.88 | RVU21D |
| 2021-07-01 | Not available in this setting | $1,226.88 | RVU21C |
| 2021-04-01 | Not available in this setting | $1,226.88 | RVU21B |
| 2021-01-01 | Not available in this setting | $1,226.88 | RVU21A |
| 2020-10-01 | Not available in this setting | $1,254.53 | RVU20D |
| 2020-07-01 | Not available in this setting | $1,254.53 | RVU20C |
| 2020-04-01 | Not available in this setting | $1,254.53 | RVU20B |
| 2020-01-01 | Not available in this setting | $1,254.53 | RVU20A |
| 2019-10-01 | Not available in this setting | $1,267.40 | RVU19D |
| 2019-07-01 | Not available in this setting | $1,267.40 | RVU19C |
| 2019-04-01 | Not available in this setting | $1,258.86 | RVU19B |
| 2019-01-01 | Not available in this setting | $1,258.86 | RVU19A |
| 2018-10-01 | Not available in this setting | $1,264.88 | RVU18D |
| 2018-07-01 | Not available in this setting | $1,264.88 | RVU18C |
| 2018-04-01 | Not available in this setting | $1,264.88 | RVU18B |
| 2018-01-01 | Not available in this setting | $1,264.88 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $1,232.81 | RVU17D |
| 2017-07-01 | Not available in this setting | $1,232.81 | RVU17C |
| 2017-04-01 | Not available in this setting | $1,232.81 | RVU17B |
| 2017-01-01 | Not available in this setting | $1,232.81 | RVU17A |
| 2016-10-01 | Not available in this setting | $1,229.97 | RVU16D |
| 2016-07-01 | Not available in this setting | $1,229.97 | RVU16C |
| 2016-04-01 | Not available in this setting | $1,229.97 | RVU16B |
| 2016-01-01 | Not available in this setting | $1,229.97 | RVU16A |
| 2015-10-01 | Not available in this setting | $1,252.82 | RVU15D |
| 2015-07-01 | Not available in this setting | $1,252.82 | RVU15C |
| 2015-04-01 | Not available in this setting | $1,246.59 | RVU15B |
| 2015-01-01 | Not available in this setting | $1,246.59 | RVU15A |
| 2014-10-01 | Not available in this setting | $1,221.67 | RVU14D |
| 2014-07-01 | Not available in this setting | $1,221.67 | RVU14C |
| 2014-04-01 | Not available in this setting | $1,221.67 | RVU14B |
| 2014-01-01 | Not available in this setting | $1,221.67 | RVU14A |
| 2013-10-01 | Not available in this setting | $1,191.24 | RVU13D |
| 2013-07-01 | Not available in this setting | $1,191.24 | RVU13C |
| 2013-04-01 | Not available in this setting | $1,191.24 | RVU13B |
| 2013-01-01 | Not available in this setting | $1,191.24 | RVU13AR |
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
28446 billing questions
How is this different from open treatment of a talus fracture?
This code is for open graft treatment of an osteochondral lesion. Use the talus-fracture code when the operation treats a fracture rather than a focal cartilage-and-bone defect.
When would an arthroscopic talar lesion code be considered instead?
Consider the arthroscopic code that matches the documented lesion treatment when the surgeon works arthroscopically. This code describes open treatment with autograft.
Is graft harvest separately reported?
No. Obtaining the autograft is included in this service.
What documentation supports reporting this code?
The operative report should establish the talar osteochondral lesion, the open approach, the treatment performed, and use of an autograft.
How are bilateral procedures handled?
CMS lists this as a bilateral procedure; modifier 50 is paid at 150%.
What applies when other procedures are performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation.
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
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