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Billing code 28445: Talus fracture surgeryMedicare rate & RVUs

Reports open surgical treatment of a talus fracture, including reduction and internal fixation when performed, such as for a displaced fracture requiring exposure.

CMS RVU26DEffective Oct 1, 2026109 payment localities458 Medicare services in 2024

Medicare pays $976.31 for 28445 nationally in a facility.

Medicare rate · 28445

Talus fracture surgery

Swap in your local Medicare rate.

Work RVUs
15.37
Total RVUs
29.23
Global days
090

National rate · 2026

$976.31

Facility setting, before claim adjustments.

See every locality for 28445 → · 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.

On this page 10 sections
  1. Medicare rate
  2. What 28445 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 28445 covers

An orthopedic surgeon typically reports this service when the talus fracture is treated through an open surgical approach to expose and reduce the fracture. Internal fixation, such as plates or screws, is included when performed. A common setting is an operating room for a displaced talar fracture requiring direct access; the code is specific to fracture treatment of the talus, not a neighboring tarsal bone or an osteochondral graft procedure.

The operative report should identify the talus fracture and document the open approach and reduction; describe fixation when used. This major surgery has a 90-day global period that 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 treatment, modifier 50 is paid 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.

Where 28445 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

28445 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$889.75
Alaska*Unavailable$1,215.36
ArizonaUnavailable$951.46
ArkansasUnavailable$879.09
AtlantaUnavailable$1,002.43
AustinUnavailable$988.21
BakersfieldUnavailable$985.28
Baltimore/Surr. CntysUnavailable$1,033.54
BeaumontUnavailable$936.41
BrazoriaUnavailable$956.66

28445 rates by state

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

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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
28445 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 28445 rate is calculated

Each of 28445’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 · 28445

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 15.37Practice expense 11.08Malpractice 2.78

29.2300 adjusted RVUs×$33.4009 conversion factor=$976.31

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 28445

28445 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 28445

Talus fracture surgery

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)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
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 · 28445

Talus fracture surgery

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

28445 without 50 · national facility

$976.31

Talus fracture surgery

28445-50 · Bilateral: 150%

$1,464.47

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

28445 compared with similar codes

Compare codes

28445 vs 28436 vs 28435 vs 28415 vs 28446: national Medicare rates

Swap in your local Medicare rate.

  • 28445
    Talus fracture surgery · 15.37 wRVU
    —
  • 28436
    Talus fracture fixation · 4.78 wRVU
    —
  • 28435
    Talus fracture care · 3.45 wRVU
    $413.84
  • 28415
    Heel fracture repair · 15.79 wRVU
    —
  • 28446
    Talar lesion surgery · 17.27 wRVU
    —

How to choose

28436Talus fracture fixation
28445 is for open fracture treatment. Choose 28436 when the talus fracture is managed with percutaneous skeletal fixation.
28435Talus fracture care
28435 describes closed treatment with manipulation; 28445 describes treatment through an open surgical approach.
28415Heel fracture repair
28415 is open treatment of a calcaneal fracture. Select by the fractured bone: calcaneus versus talus.
28446Talar lesion surgery
28446 concerns open treatment of an osteochondral talar problem with grafting, rather than open treatment of a talus fracture.

Codes related to 28445

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

Codes related to 28445
CodeHow it relatesNational office range
Used instead
28430Talus fracture careClosed talus fracture treatment without manipulation.$234.30–$348.24
28435Talus fracture careClosed treatment of a talus fracture with manipulation.$363.35–$536.41
28436Talus fracture fixationPercutaneous skeletal fixation of a talus fracture with manipulation.No office rate

28445 billing questions

How does 28445 differ from percutaneous talus fixation?

Use 28445 when the fracture is treated through an open approach. Code 28436 describes percutaneous skeletal fixation rather than open treatment.

Is internal fixation separately reported with 28445?

No separate fracture-treatment code is needed for internal fixation when it is performed as part of the open treatment; fixation is included in 28445.

When is modifier 50 appropriate?

For bilateral talus fracture treatment, CMS lists modifier 50 payment at 150%. The operative documentation should support treatment of both sides.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

What documentation supports choosing 28445 over closed treatment?

Document the talus fracture, open surgical approach, and fracture reduction. For 28445, the record should support open treatment rather than closed management or percutaneous fixation.

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 28445PPRRVU2026_Oct_nonQPP.csv, line 3,206 (RVU26D)

Open CMS sourceHow we calculate rates

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