Billing code 28400: Fracture treatmentMedicare rate & RVUs

Medicare pays $271.22 for 28400 nationally in the office and $234.14 in a hospital or facility. Local office rates run $239.32–$354.95.

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

What 28400 covers

This service covers nonoperative treatment of a heel bone fracture when the treating clinician manages the fracture without manipulating it to change its alignment. An orthopedic surgeon or podiatrist may provide care in an office, emergency department, or outpatient setting. Treatment commonly includes immobilization in a cast or boot and planned clinical and imaging follow-up. The key distinction is the treatment performed, not simply whether the fracture is displaced on imaging.

Report the code when the documented plan and service support closed fracture care without manipulation. The record should identify the calcaneal fracture and show that manipulation or fixation was not performed. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are paid at 50%. For bilateral treatment with modifier 50, payment is 150%. Medicare does not pay an assistant at surgery for this code; 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.

Where 28400 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

28400 rates by state

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

How the 28400 rate is calculated

Each of 28400’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.

Payment rules and modifiers for 28400

28400 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

28400 compared with similar codes

How to choose

28405Heel fracture treatment

Both codes concern closed treatment of a calcaneal fracture. Choose 28400 when no manipulation is performed; choose 28405 when treatment includes manipulation.

28406Calcaneal fracture repair

This code represents treatment without manipulation or fixation. Code 28406 involves percutaneous skeletal fixation with manipulation.

28415Heel fracture repair

Code 28400 describes nonoperative closed care without manipulation. Code 28415 is for open treatment of the calcaneal fracture.

28430Talus fracture care

Code 28400 is for a calcaneal fracture; 28430 concerns closed treatment without manipulation of a talus fracture.

Codes related to 28400

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

Open CMS sourceHow we calculate rates