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CPT code 28450: Tarsal fracture care, without manipulation2026 Medicare rate & RVUs in Houston, TX

Report 28450 for closed treatment of an individual tarsal bone fracture, such as a navicular or cuboid fracture, when no manipulation is performed.

CMS RVU26DEffective Oct 1, 2026One payment locality1.5K Medicare services in 2024

In Houston, TX, Medicare pays $234.42 for 28450 in the office and $197.61 when it’s performed in a hospital or facility.

$234.42Office (non-facility)
$197.61Hospital or facility
+1.3%vs the national office rate ($231.47)

Check a contract rate as a % of Medicare · 28450 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 28450 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Houston, TX
  2. What 28450 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 28450 covers

An orthopedist or podiatrist reports this service for definitive closed care of a tarsal bone fracture other than a talus or calcaneus fracture, when the bone is treated without manipulating it to restore alignment. Examples include navicular, cuboid, and cuneiform fractures. Care may involve immobilization and a treatment plan with follow-up in an office, emergency department, or facility setting.

Select the code for each tarsal bone treated, and document the specific bone, fracture, and that treatment did not involve manipulation. This code has a 90-day global period: the day-before preoperative visit and related postoperative care during that period are included. 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% multiple-procedure reduction. Modifier 50 is inappropriate; the code is reported by bone treated. Medicare does not pay an assistant at surgery, and 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 Houston, TX compares for 28450

Across 109 of 109 payment localities, the office rate for 28450 runs from $204.94 in Arkansas to $303.35 in San Benito County, CA. Houston, TX pays $234.42. The RVUs are the same everywhere; the geographic indexes change the dollars.

28450 in Houston, TX vs other payment areas
  1. Houston, TX · this page$234.42
  2. Austin, TX · Texas$239.58+$5.16
  3. Beaumont, TX · Texas$216.77−$17.65
  4. Brazoria, TX · Texas$228.54−$5.88
  5. Dallas, TX · Texas$230.11−$4.31
  6. Fort Worth, TX · Texas$228.67−$5.75
  7. Galveston, TX · Texas$229.30−$5.12

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

Every other payment area

28450 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$222.61$187.42
Los Angeles, CACalifornia$259.58$215.72
Washington, DC areaDistrict of Columbia$263.86$220.19
Miami, FLFlorida$252.16$213.57
Chicago, ILIllinois$244.82$207.56
Manhattan, NYNew York$266.45$223.37
AlaskaAlaska$270.47$230.99
AlabamaAlabama$207.91$175.47

28450 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.

$204.94

$273.29

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

View every state and territory as a table
28450 office rate range by state
State / territoryOffice rate rangeLocalities
AK$270.471
AL$207.911
AR$204.941
AZ$225.291
CA$243.23–$303.3529
CO$240.201
CT$246.771
DC$263.861
DE$228.981
FL$229.31–$252.163
GA$216.42–$236.042
GU$248.901
HI$248.901
IA$212.571
ID$214.061
IL$223.16–$244.824
IN$215.271
KS$211.861
KY$213.361
LA$213.14–$223.542
MA$238.89–$263.412
MD$233.23–$263.863
ME$215.45–$226.612
MI$219.10–$232.422
MN$229.411
MO$209.70–$224.003
MS$207.351
MT$231.451
NC$217.641
ND$225.911
NE$213.641
NH$236.691
NJ$249.37–$261.232
NM$220.401
NV$230.061
NY$220.89–$273.205
OH$217.971
OK$212.691
OR$228.07–$247.452
PA$218.16–$240.862
PR$233.041
RI$236.861
SC$218.211
SD$225.261
TN$212.941
TX$216.77–$239.588
UT$221.161
VA$226.07–$263.862
VI$233.041
VT$225.291
WA$238.36–$268.472
WI$218.451
WV$215.071
WY$229.041

See 28450 in every payment locality

How the 28450 rate is calculated

Each of 28450’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 · 28450

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.98

1.98 RVUs× 1.000 GPCI

Practice expense4.67

4.67 RVUs× 1.000 GPCI

Malpractice0.28

0.28 RVUs× 1.000 GPCI

Adjusted RVUs

6.9300

Conversion factor

$33.4009

Medicare rate

$231.47

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

The exact Houston, TX inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,208

Code
28450
Physician work
1.98
Practice expense
4.67
Malpractice
0.28

GPCI2026.csv

102

Locality
Houston, TX
Physician work
1.008
Practice expense
0.993
Malpractice
1.376
Office calculation for 28450 in Houston, TX
ComponentRVULocality factorAdjusted
Physician work1.98× 1.0081.9958
Practice expense4.67× 0.9934.6373
Malpractice0.28× 1.3760.3853
Total RVUs7.0184
Conversion factor× 33.4009

Office rate, Houston, TX$234.42

Office: (1.98 × 1.008 + 4.67 × 0.993 + 0.28 × 1.376) × $33.4009 = $234.42

Facility: (1.98 × 1.008 + 3.56 × 0.993 + 0.28 × 1.376) × $33.4009 = $197.61

Open 28450 in the RVU calculator

Payment rules and modifiers for 28450

28450 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 28450

Tarsal fracture care, without 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)0The 150% bilateral adjustment doesn’t apply.
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 · 28450

Tarsal fracture care, without 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 51 · payment effect

With and without the modifier

28450 without 51 · national office

$231.47

Tarsal fracture care, without manipulation

28450-51 · Second procedure: 50%

$115.74

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Codes related to 28450

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

Codes related to 28450
CodeHow it relatesOffice range, Houston, TX
Same family
28455Tarsal fracture care, each tarsal boneClosed treatment of a tarsal bone fracture when manipulation is performed.$263.28
Used instead
28456Tarsal fracture fixation, percutaneous, with manipulationPercutaneous skeletal fixation for a tarsal fracture treated with manipulation.No office rate
28465Tarsal fracture repair, open treatment, each boneOpen treatment of a tarsal bone fracture, rather than closed treatment without manipulation.No office rate

How 28450 has changed in Houston, TX

28450 · Office / nonfacility

$234.42

Effective 2026-10-01

The base rate is $15.24 higher than on 2025-10-01, moving from $219.18 to $234.42 (7.0%).

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

    $219.18changed to$234.42

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.03 changed to 1.98
    • Practice expense RVU 4.31 changed to 4.67
    • Work GPCI 1.014 changed to 1.008
    • Practice expense GPCI 1.003 changed to 0.993
    • Malpractice GPCI 1.409 changed to 1.376

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $223.41changed to$219.18

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.26 changed to 4.31
    • Malpractice RVU 0.27 changed to 0.28

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $219.77changed to$223.41

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $222.44changed to$219.77

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.11 changed to 4.26
    • Work GPCI 1.023 changed to 1.014
    • Practice expense GPCI 1.016 changed to 1.003
    • Malpractice GPCI 1.154 changed to 1.409

  5. January 1, 2023

    RVU23A

    $223.66changed to$222.44

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.00 changed to 4.11
    • Malpractice RVU 0.28 changed to 0.27
    • Work GPCI 1.032 changed to 1.023
    • Practice expense GPCI 1.029 changed to 1.016
    • Malpractice GPCI 0.900 changed to 1.154

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $222.73changed to$223.66

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 3.94 changed to 4.00
    • Malpractice RVU 0.26 changed to 0.28

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $222.85changed to$222.73

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.76 changed to 3.94
    • Malpractice RVU 0.28 changed to 0.26
    • Work GPCI 1.026 changed to 1.032
    • Practice expense GPCI 1.020 changed to 1.029
    • Malpractice GPCI 0.918 changed to 0.900

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $221.96changed to$222.85

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.79 changed to 3.76
    • Malpractice RVU 0.27 changed to 0.28
    • Work GPCI 1.020 changed to 1.026
    • Practice expense GPCI 1.012 changed to 1.020
    • Malpractice GPCI 0.936 changed to 0.918

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $224.99changed to$221.96

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.88 changed to 3.79

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $223.59changed to$224.99

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.86 changed to 3.88
    • Malpractice RVU 0.28 changed to 0.27
    • Practice expense GPCI 1.009 changed to 1.012
    • Malpractice GPCI 0.946 changed to 0.936

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $223.37changed to$223.59

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 3.87 changed to 3.86
    • Malpractice RVU 0.29 changed to 0.28
    • Work GPCI 1.019 changed to 1.020
    • Practice expense GPCI 1.006 changed to 1.009
    • Malpractice GPCI 0.955 changed to 0.946

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $223.82changed to$223.37

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 3.86 changed to 3.87

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $222.70changed to$223.82

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $221.60changed to$222.70

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.84 changed to 3.86
    • Work GPCI 1.014 changed to 1.019
    • Practice expense GPCI 1.004 changed to 1.006
    • Malpractice GPCI 0.939 changed to 0.955

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $223.66changed to$221.60

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 4.24 changed to 3.84
    • Malpractice RVU 0.30 changed to 0.29
    • Work GPCI 1.009 changed to 1.014
    • Practice expense GPCI 1.002 changed to 1.004
    • Malpractice GPCI 0.923 changed to 0.939

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $223.66

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$234.42$197.61RVU26D
2026-07-01$234.42$197.61RVU26C
2026-04-01$234.42$197.61RVU26B
2026-01-01$234.42$197.61RVU26A
2025-10-01$219.18$199.06RVU25D
2025-07-01$219.18$199.06RVU25C
2025-04-01$219.18$199.06RVU25B
2025-01-01$219.18$199.06RVU25A
2024-10-01$223.41$202.71RVU24D
2024-07-01$223.41$202.71RVU24C
2024-04-01$223.41$202.71RVU24B
2024-03-09$223.41$202.71RVU24AR
2024-01-01$219.77$199.40RVU24A
2023-10-01$222.44$201.43RVU23D
2023-07-01$222.44$201.43RVU23C
2023-04-01$222.44$201.43RVU23B
2023-01-01$222.44$201.43RVU23A
2022-10-01$223.66$201.94RVU22D
2022-07-01$223.66$201.94RVU22C
2022-04-01$223.66$201.94RVU22B
2022-01-01$223.66$201.94RVU22A
2021-10-01$222.73$200.47RVU21D
2021-07-01$222.73$200.47RVU21C
2021-04-01$222.73$200.47RVU21B
2021-01-01$222.73$200.47RVU21A
2020-10-01$222.85$200.77RVU20D
2020-07-01$222.85$200.77RVU20C
2020-04-01$222.85$200.77RVU20B
2020-01-01$222.85$200.77RVU20A
2019-10-01$221.96$199.35RVU19D
2019-07-01$221.96$199.35RVU19C
2019-04-01$221.96$199.35RVU19B
2019-01-01$221.96$199.35RVU19A
2018-10-01$224.99$199.49RVU18D
2018-07-01$224.99$199.49RVU18C
2018-04-01$224.99$199.49RVU18B
2018-01-01$224.99$199.49RVU18AR1
2017-10-01$223.59$199.33RVU17D
2017-07-01$223.59$199.33RVU17C
2017-04-01$223.59$199.33RVU17B
2017-01-01$223.59$199.33RVU17A
2016-10-01$223.37$199.24RVU16D
2016-07-01$223.37$199.24RVU16C
2016-04-01$223.37$199.24RVU16B
2016-01-01$223.37$199.24RVU16A
2015-10-01$223.82$199.60RVU15D
2015-07-01$223.82$199.60RVU15C
2015-04-01$222.70$198.61RVU15B
2015-01-01$222.70$198.61RVU15A
2014-10-01$221.60$197.51RVU14D
2014-07-01$221.60$197.51RVU14C
2014-04-01$221.60$197.51RVU14B
2014-01-01$221.60$197.51RVU14A
2013-10-01$223.66$198.09RVU13D
2013-07-01$223.66$198.09RVU13C
2013-04-01$223.66$198.09RVU13B
2013-01-01$223.66$198.09RVU13AR

Price 28450 for an earlier date of service

Where the Houston, TX rate applies

Houston, TX is a Medicare payment area, not a city. Our Census mapping connects it to 46 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Texas

28450 billing questions

How is 28450 different from 28455?

Both address closed treatment of a tarsal bone fracture other than the talus or calcaneus. Use 28450 when no manipulation is performed; 28455 is for treatment with manipulation.

How many units should be reported?

The code is reported for each tarsal bone treated. Document the bone involved and the treatment provided for each fracture.

Can modifier 50 be used for fractures on both sides?

No. Modifier 50 is inappropriate for this code; its descriptor identifies treatment by each bone.

Is related fracture follow-up separately reported during the global period?

The 90-day global period includes related postoperative care, as well as the day-before preoperative visit.

What documentation supports reporting 28450?

Document the specific tarsal bone and fracture, the closed treatment plan, and that no manipulation was performed.

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 28450PPRRVU2026_Oct_nonQPP.csv, line 3,208 (RVU26D)
Geographic factors for Houston, TXGPCI2026.csv, line 102 (RVU26D)

Open CMS sourceHow we calculate rates

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