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CPT code 28455: Tarsal fracture care, each tarsal bone2026 Medicare rate & RVUs in Virginia

Report 28455 for closed treatment of a qualifying tarsal bone fracture when the clinician manipulates the fracture to restore alignment.

CMS RVU26DEffective Oct 1, 2026One payment locality69 Medicare services in 2024

In Virginia, Medicare pays $255.16 for 28455 in the office and $216.74 when it’s performed in a hospital or facility.

$255.16Office (non-facility)
$216.74Hospital or facility
−1.9%vs the national office rate ($260.19)

Check a contract rate as a % of Medicare · 28455 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 28455 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Virginia
  2. What 28455 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 28455 covers

This code describes closed treatment of a tarsal bone fracture with manipulation to improve alignment, without open exposure or percutaneous skeletal fixation. Typical examples include manipulated fractures of the navicular, cuboid, or a cuneiform; calcaneus and talus fractures have separate codes. Orthopedic surgeons and podiatrists commonly provide this treatment in an office, emergency department, or hospital setting, followed by immobilization and fracture follow-up.

Report one unit for each tarsal bone treated, supported by documentation identifying the fracture site and the reduction or manipulation performed. Choose the code based on the bone and treatment method: manipulation distinguishes this service from closed treatment without manipulation, while fixation or open treatment points to other codes. CMS assigns a 90-day global period, including 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 other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. 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 Virginia compares for 28455

Across 109 of 109 payment localities, the office rate for 28455 runs from $235.40 in Arkansas to $332.29 in San Benito County, CA. Virginia pays $255.16. The RVUs are the same everywhere; the geographic indexes change the dollars.

28455 in Virginia vs other payment areas
  1. Virginia · this page$255.16
  2. Los Angeles, CA · California$288.31+$33.15
  3. Washington, DC area · District of Columbia$292.86+$37.70
  4. Miami, FL · Florida$279.46+$24.30
  5. Chicago, IL · Illinois$272.91+$17.75
  6. Manhattan, NY · New York$295.68+$40.52
  7. Alaska · Alaska$318.55+$63.39

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

Every other payment area

28455 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$238.18$203.98
ArkansasArkansas$235.40$201.83
ArizonaArizona$254.42$216.55
Bakersfield, CACalifornia$272.82$229.98
Chico, CACalifornia$271.97$229.14
El Centro, CACalifornia$272.01$229.18
Fresno, CACalifornia$271.97$229.14
Hanford, CACalifornia$271.97$229.14

28455 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.

$235.40

$318.55

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

View every state and territory as a table
28455 office rate range by state
State / territoryOffice rate rangeLocalities
AK$318.551
AL$238.181
AR$235.401
AZ$254.421
CA$271.97–$332.2929
CO$268.901
CT$275.371
DC$292.861
DE$258.091
FL$258.14–$279.463
GA$246.10–$264.592
GU$276.531
HI$276.531
IA$242.551
ID$243.941
IL$252.38–$272.914
IN$245.071
KS$241.871
KY$243.251
LA$243.04–$252.762
MA$267.85–$291.882
MD$262.29–$292.863
ME$245.23–$255.672
MI$248.61–$261.042
MN$258.311
MO$239.82–$253.203
MS$237.641
MT$260.181
NC$247.281
ND$255.031
NE$243.551
NH$265.091
NJ$278.69–$290.792
NM$249.821
NV$258.891
NY$250.32–$301.985
OH$247.561
OK$242.641
OR$257.03–$275.862
PA$247.75–$269.752
PR$261.671
RI$266.081
SC$247.801
SD$254.431
TN$242.891
TX$246.44–$267.888
UT$250.551
VA$255.16–$292.862
VI$261.671
VT$254.441
WA$267.23–$297.012
WI$248.051
WV$244.811
WY$257.941

See 28455 in every payment locality

How the 28455 rate is calculated

Each of 28455’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 · 28455

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.16

3.16 RVUs× 1.000 GPCI

Practice expense4.37

4.37 RVUs× 1.000 GPCI

Malpractice0.26

0.26 RVUs× 1.000 GPCI

Adjusted RVUs

7.7900

Conversion factor

$33.4009

Medicare rate

$260.19

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

The exact Virginia inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,209

Code
28455
Physician work
3.16
Practice expense
4.37
Malpractice
0.26

GPCI2026.csv

106

Locality
Virginia
Physician work
1.000
Practice expense
0.983
Malpractice
0.706
Office calculation for 28455 in Virginia
ComponentRVULocality factorAdjusted
Physician work3.16× 1.0003.1600
Practice expense4.37× 0.9834.2957
Malpractice0.26× 0.7060.1836
Total RVUs7.6393
Conversion factor× 33.4009

Office rate, Virginia$255.16

Office: (3.16 × 1 + 4.37 × 0.983 + 0.26 × 0.706) × $33.4009 = $255.16

Facility: (3.16 × 1 + 3.2 × 0.983 + 0.26 × 0.706) × $33.4009 = $216.74

Open 28455 in the RVU calculator

Payment rules and modifiers for 28455

28455 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 28455

Tarsal fracture care, each tarsal bone

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)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 · 28455

Tarsal fracture care, each tarsal bone

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

28455 without 51 · national office

$260.19

Tarsal fracture care, each tarsal bone

28455-51 · Second procedure: 50%

$130.10

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 28455

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

Codes related to 28455
CodeHow it relatesOffice range, Virginia
Same family
28450Tarsal fracture care, without manipulationClosed treatment of a tarsal fracture without manipulation.$226.07
Used instead
28456Tarsal fracture fixation, percutaneous, with manipulationTarsal fracture treatment using percutaneous skeletal fixation with manipulation.No office rate
28465Tarsal fracture repair, open treatment, each boneOpen treatment of a tarsal bone fracture.No office rate
28435Talus fracture care, closed treatment with manipulationClosed treatment with manipulation when the fractured bone is the talus.$402.01
28405Heel fracture treatment, with manipulationClosed treatment with manipulation when the fractured bone is the calcaneus.$486.85

How 28455 has changed in Virginia

28455 · Office / nonfacility

$255.16

Effective 2026-10-01

The base rate is $3.68 higher than on 2025-10-01, moving from $251.48 to $255.16 (1.5%).

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

    $251.48changed to$255.16

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.24 changed to 3.16
    • Practice expense RVU 4.41 changed to 4.37
    • Malpractice RVU 0.25 changed to 0.26
    • Work GPCI 1.002 changed to 1.000
    • Practice expense GPCI 0.984 changed to 0.983
    • Malpractice GPCI 0.755 changed to 0.706

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $256.83changed to$251.48

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.35 changed to 4.41

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $252.64changed to$256.83

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $297.29changed to$252.64

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.28 changed to 4.35
    • Malpractice RVU 0.37 changed to 0.25
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 0.990 changed to 0.984
    • Malpractice GPCI 0.826 changed to 0.755

  5. January 1, 2023

    RVU23A

    $297.43changed to$297.29

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.03 changed to 5.28
    • Malpractice RVU 0.39 changed to 0.37
    • Practice expense GPCI 0.995 changed to 0.990
    • Malpractice GPCI 0.897 changed to 0.826

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $295.80changed to$297.43

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 4.93 changed to 5.03
    • Malpractice RVU 0.37 changed to 0.39

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $295.62changed to$295.80

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.65 changed to 4.93
    • Malpractice RVU 0.38 changed to 0.37
    • Practice expense GPCI 0.991 changed to 0.995
    • Malpractice GPCI 0.903 changed to 0.897

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $294.82changed to$295.62

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.67 changed to 4.65
    • Malpractice RVU 0.37 changed to 0.38
    • Practice expense GPCI 0.986 changed to 0.991
    • Malpractice GPCI 0.908 changed to 0.903

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $294.17changed to$294.82

    • Conversion factor 35.9996 changed to 36.0391
    • Malpractice RVU 0.36 changed to 0.37

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $291.10changed to$294.17

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.62 changed to 4.67
    • Malpractice RVU 0.37 changed to 0.36
    • Practice expense GPCI 0.985 changed to 0.986
    • Malpractice GPCI 0.866 changed to 0.908

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $291.99changed to$291.10

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.69 changed to 4.62
    • Practice expense GPCI 0.983 changed to 0.985
    • Malpractice GPCI 0.824 changed to 0.866

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $291.93changed to$291.99

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 4.65 changed to 4.69
    • Malpractice RVU 0.38 changed to 0.37

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $290.47changed to$291.93

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $298.04changed to$290.47

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 4.85 changed to 4.65
    • Malpractice RVU 0.42 changed to 0.38
    • Practice expense GPCI 0.980 changed to 0.983
    • Malpractice GPCI 0.778 changed to 0.824

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $259.46changed to$298.04

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 4.16 changed to 4.85
    • Malpractice RVU 0.44 changed to 0.42
    • Practice expense GPCI 0.977 changed to 0.980
    • Malpractice GPCI 0.731 changed to 0.778

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $259.46

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$255.16$216.74RVU26D
2026-07-01$255.16$216.74RVU26C
2026-04-01$255.16$216.74RVU26B
2026-01-01$255.16$216.74RVU26A
2025-10-01$251.48$225.70RVU25D
2025-07-01$251.48$225.70RVU25C
2025-04-01$251.48$225.70RVU25B
2025-01-01$251.48$225.70RVU25A
2024-10-01$256.83$229.98RVU24D
2024-07-01$256.83$229.98RVU24C
2024-04-01$256.83$229.98RVU24B
2024-03-09$256.83$229.98RVU24AR
2024-01-01$252.64$226.22RVU24A
2023-10-01$297.29$264.74RVU23D
2023-07-01$297.29$264.74RVU23C
2023-04-01$297.29$264.74RVU23B
2023-01-01$297.29$264.74RVU23A
2022-10-01$297.43$264.72RVU22D
2022-07-01$297.43$264.72RVU22C
2022-04-01$297.43$264.72RVU22B
2022-01-01$297.43$264.72RVU22A
2021-10-01$295.80$262.81RVU21D
2021-07-01$295.80$262.81RVU21C
2021-04-01$295.80$262.81RVU21B
2021-01-01$295.80$262.81RVU21A
2020-10-01$295.62$264.51RVU20D
2020-07-01$295.62$264.51RVU20C
2020-04-01$295.62$264.51RVU20B
2020-01-01$295.62$264.51RVU20A
2019-10-01$294.82$263.91RVU19D
2019-07-01$294.82$263.91RVU19C
2019-04-01$294.82$263.91RVU19B
2019-01-01$294.82$263.91RVU19A
2018-10-01$294.17$263.64RVU18D
2018-07-01$294.17$263.64RVU18C
2018-04-01$294.17$263.64RVU18B
2018-01-01$294.17$263.64RVU18AR1
2017-10-01$291.10$261.76RVU17D
2017-07-01$291.10$261.76RVU17C
2017-04-01$291.10$261.76RVU17B
2017-01-01$291.10$261.76RVU17A
2016-10-01$291.99$262.78RVU16D
2016-07-01$291.99$262.78RVU16C
2016-04-01$291.99$262.78RVU16B
2016-01-01$291.99$262.78RVU16A
2015-10-01$291.93$262.26RVU15D
2015-07-01$291.93$262.26RVU15C
2015-04-01$290.47$260.95RVU15B
2015-01-01$290.47$260.95RVU15A
2014-10-01$298.04$267.85RVU14D
2014-07-01$298.04$267.85RVU14C
2014-04-01$298.04$267.85RVU14B
2014-01-01$298.04$267.85RVU14A
2013-10-01$259.46$233.86RVU13D
2013-07-01$259.46$233.86RVU13C
2013-04-01$259.46$233.86RVU13B
2013-01-01$259.46$233.86RVU13AR

Price 28455 for an earlier date of service

Where the Virginia rate applies

Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.

  • Abbs Valley
  • Abingdon
  • Accomac
  • Adwolf
  • Afton
  • Alberta
  • Aldie
  • Allison Gap

Browse all communities in Virginia

28455 billing questions

How does 28455 differ from 28450?

Use 28455 when the tarsal fracture is manipulated to restore alignment. Code 28450 describes treatment without manipulation.

When would 28456 be more appropriate?

Use 28456 when the tarsal fracture is treated with percutaneous skeletal fixation and manipulation. Code 28455 describes closed treatment with manipulation without that fixation method.

Is the code reported once per fracture or once per bone?

The code is reported for each tarsal bone treated. Document the specific bone and the manipulation performed for each reported unit.

Can modifier 50 be used for fractures on both feet?

No. CMS identifies bilateral adjustment as inappropriate for this code; report the services according to the number of bones treated.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. Routine follow-up related to the fracture treatment falls within that period.

When is an assistant-at-surgery service payable?

CMS permits assistant-at-surgery payment only when medical necessity is documented. Co-surgeons and team surgery are not permitted.

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 28455PPRRVU2026_Oct_nonQPP.csv, line 3,209 (RVU26D)
Geographic factors for VirginiaGPCI2026.csv, line 106 (RVU26D)

Open CMS sourceHow we calculate rates

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