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Billing code 28456: Tarsal fracture fixationMedicare rate & RVUs

Reports percutaneous skeletal fixation with manipulation of a tarsal bone fracture other than the talus or calcaneus, counted for each bone treated.

CMS RVU26DEffective Oct 1, 2026109 payment localities43 Medicare services in 2024

Medicare pays $383.44 for 28456 nationally in a facility.

Medicare rate · 28456

Tarsal fracture fixation

Swap in your local Medicare rate.

Work RVUs
2.79
Total RVUs
11.48
Global days
090

National rate · 2026

$383.44

Facility setting, before claim adjustments.

See every locality for 28456 → · 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 28456 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 28456 covers

This procedure treats a fracture of a tarsal bone other than the talus or calcaneus. The surgeon manipulates the fracture to improve alignment and stabilizes it with skeletal fixation placed percutaneously, without open exposure of the fracture. Orthopedic and foot-and-ankle surgeons typically perform it in an operating room when closed manipulation alone is not sufficient and fixation is needed.

Report the code for each qualifying tarsal bone treated. The operative report should identify the bone, document manipulation and percutaneous skeletal fixation, and support the number of bones billed. The 90-day global period 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% multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service; 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 28456 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

28456 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$341.07
Alaska*Unavailable$438.77
ArizonaUnavailable$372.22
ArkansasUnavailable$335.74
AtlantaUnavailable$392.01
AustinUnavailable$397.07
BakersfieldUnavailable$403.48
Baltimore/Surr. CntysUnavailable$409.35
BeaumontUnavailable$357.69
BrazoriaUnavailable$377.42

28456 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
28456 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 28456 rate is calculated

Each of 28456’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 · 28456

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 2.79Practice expense 8.10Malpractice 0.59

11.4800 adjusted RVUs×$33.4009 conversion factor=$383.44

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

Payment rules and modifiers for 28456

28456 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 28456

Tarsal fracture fixation

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 · 28456

Tarsal fracture fixation

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 51 · payment effect

With and without the modifier

28456 without 51 · national facility

$383.44

Tarsal fracture fixation

28456-51 · Second procedure: 50%

$191.72

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

28456 compared with similar codes

Compare codes

28456 vs 28455 vs 28465 vs 28436: national Medicare rates

Swap in your local Medicare rate.

  • 28456
    Tarsal fracture fixation · 2.79 wRVU
    —
  • 28455
    Tarsal fracture care · 3.16 wRVU
    $260.19
  • 28465
    Tarsal fracture repair · 8.58 wRVU
    —
  • 28436
    Talus fracture fixation · 4.78 wRVU
    —

How to choose

28455Tarsal fracture care
Choose 28456 when manipulation is accompanied by percutaneous skeletal fixation. Code 28455 describes tarsal fracture treatment with manipulation without that fixation.
28465Tarsal fracture repair
Code 28465 describes open treatment of a qualifying tarsal bone fracture. Code 28456 is for percutaneous skeletal fixation with manipulation.
28436Talus fracture fixation
Code 28436 is the percutaneous fixation option for a talus fracture with manipulation. Code 28456 is for other tarsal bones, excluding the talus and calcaneus.

Codes related to 28456

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

Codes related to 28456
CodeHow it relatesNational office range
Same family
28450Tarsal fracture careTreatment of another tarsal bone fracture without manipulation, counted for each bone.$204.94–$303.35
28455Tarsal fracture careTarsal fracture treatment with manipulation but without this code's percutaneous skeletal fixation.$235.40–$332.29
Used instead
28465Tarsal fracture repairOpen treatment for a qualifying tarsal bone fracture rather than percutaneous fixation.No office rate
28436Talus fracture fixationPercutaneous skeletal fixation with manipulation when the fractured bone is the talus.No office rate

28456 billing questions

How does this differ from 28455?

Code 28456 includes percutaneous skeletal fixation as well as manipulation. Code 28455 is for manipulation without the percutaneous skeletal fixation described by 28456.

Which tarsal bones are included?

The code covers tarsal bones other than the talus and calcaneus. Those two bones have separate fracture-treatment codes.

How should units be counted?

The descriptor specifies each bone treated. Document the individual qualifying tarsal bone or bones that received manipulation and percutaneous fixation.

Can modifier 50 be used for bilateral treatment?

No. CMS identifies bilateral adjustment as inappropriate for this code. Report the service based on each qualifying bone treated.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant or co-surgeon be billed?

Medicare does not pay an assistant at surgery for this procedure, and 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 28456PPRRVU2026_Oct_nonQPP.csv, line 3,210 (RVU26D)

Open CMS sourceHow we calculate rates

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