No office rate
28445 treats a talus fracture with open surgery. Choose 28446 for an osteochondral lesion treated with an autograft, not fracture fixation.
On this page
CMS RVU26D · Effective 2026-10-01
28446 in Beaumont
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$1078.55
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Orthopedic surgery
About 28446: Open talar osteochondral graft treatment
Open surgery uses a bone-and-cartilage autograft to treat a focal osteochondral lesion of the talus, such as a symptomatic talar dome defect.
The surgeon exposes the talus, addresses the osteochondral defect by drilling and removing loose fragments as indicated, and places an autograft to restore the damaged surface. This is typically performed by an orthopedic foot and ankle surgeon in a hospital or ambulatory surgical setting for a symptomatic talar lesion, including lesions that need graft reconstruction rather than fracture fixation or arthroscopic treatment alone. The graft harvest is included in the service.
Report the code when the operative record supports open treatment of a talar osteochondral lesion with autograft. Document the lesion, open approach, work performed, and graft use; do not select it for open fixation of a talus fracture. Medicare assigns a 90-day global period, including the day before surgery and related postoperative care. 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% reduction. Modifier 50 applies to bilateral reporting, with payment at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 28446
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU17.27 · 51%
- Practice expense (office) RVU12.76 · 38%
- Malpractice RVU3.67 · 11%
31
Medicare services in 2024 · #5638 by national volume
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.
28446 compared with similar codes
Office rates for Beaumont, from the same CMS release.
No office rate
29891 describes arthroscopic excision and drilling of an osteochondral defect; 28446 describes open treatment with autograft.
No office rate
29892 is for arthroscopic treatment of a talar osteochondritis dissecans lesion, with or without fixation. 28446 is the open autograft treatment.
The same code, a different location
How does Beaumont compare?
28446 across payment areas
Same release and payment basis · bars start at $0
Beaumont · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in Texas appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Rest Of Texas
Texas · 28446
Office
Unavailable
Facility
$1091.98
No comparable office rate is available.
Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)
California · 28446
Office
Unavailable
Facility
$1186.07
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 28446
Office
Unavailable
Facility
$1246.47
No comparable office rate is available.
Miami
Florida · 28446
Office
Unavailable
Facility
$1330.51
No comparable office rate is available.
Chicago
Illinois · 28446
Office
Unavailable
Facility
$1290.52
No comparable office rate is available.
Manhattan
New York · 28446
Office
Unavailable
Facility
$1303.40
No comparable office rate is available.
Alaska*
Alaska · 28446
Office
Unavailable
Facility
$1386.69
No comparable office rate is available.
Alabama
Alabama · 28446
Office
Unavailable
Facility
$1019.14
No comparable office rate is available.
Arkansas
Arkansas · 28446
Office
Unavailable
Facility
$1006.06
No comparable office rate is available.
Arizona
Arizona · 28446
Office
Unavailable
Facility
$1094.75
No comparable office rate is available.
Bakersfield
California · 28446
Office
Unavailable
Facility
$1129.56
No comparable office rate is available.
Chico
California · 28446
Office
Unavailable
Facility
$1119.45
No comparable office rate is available.
El Centro
California · 28446
Office
Unavailable
Facility
$1120.07
No comparable office rate is available.
Fresno
California · 28446
Office
Unavailable
Facility
$1119.45
No comparable office rate is available.
Hanford-Corcoran
California · 28446
Office
Unavailable
Facility
$1119.45
No comparable office rate is available.
Madera
California · 28446
Office
Unavailable
Facility
$1119.45
No comparable office rate is available.
Merced
California · 28446
Office
Unavailable
Facility
$1119.45
No comparable office rate is available.
Modesto
California · 28446
Office
Unavailable
Facility
$1119.45
No comparable office rate is available.
Napa
California · 28446
Office
Unavailable
Facility
$1237.17
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 28446
Office
Unavailable
Facility
$1173.12
No comparable office rate is available.
Redding
California · 28446
Office
Unavailable
Facility
$1119.45
No comparable office rate is available.
Rest Of California
California · 28446
Office
Unavailable
Facility
$1119.45
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 28446
Office
Unavailable
Facility
$1158.89
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 28446
Office
Unavailable
Facility
$1158.97
No comparable office rate is available.
Salinas
California · 28446
Office
Unavailable
Facility
$1154.38
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 28446
Office
Unavailable
Facility
$1170.31
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 28446
Office
Unavailable
Facility
$1288.83
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 28446
Office
Unavailable
Facility
$1284.67
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 28446
Office
Unavailable
Facility
$1320.56
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 28446
Office
Unavailable
Facility
$1303.52
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 28446
Office
Unavailable
Facility
$1137.78
No comparable office rate is available.
Santa Cruz-Watsonville
California · 28446
Office
Unavailable
Facility
$1172.48
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 28446
Office
Unavailable
Facility
$1155.63
No comparable office rate is available.
Santa Rosa-Petaluma
California · 28446
Office
Unavailable
Facility
$1183.21
No comparable office rate is available.
Stockton
California · 28446
Office
Unavailable
Facility
$1119.45
No comparable office rate is available.
Vallejo
California · 28446
Office
Unavailable
Facility
$1231.16
No comparable office rate is available.
Visalia
California · 28446
Office
Unavailable
Facility
$1119.45
No comparable office rate is available.
Yuba City
California · 28446
Office
Unavailable
Facility
$1119.45
No comparable office rate is available.
Colorado
Colorado · 28446
Office
Unavailable
Facility
$1132.96
No comparable office rate is available.
Connecticut
Connecticut · 28446
Office
Unavailable
Facility
$1195.71
No comparable office rate is available.
Delaware
Delaware · 28446
Office
Unavailable
Facility
$1111.00
No comparable office rate is available.
Fort Lauderdale
Florida · 28446
Office
Unavailable
Facility
$1230.20
No comparable office rate is available.
Rest Of Florida
Florida · 28446
Office
Unavailable
Facility
$1168.52
No comparable office rate is available.
Atlanta
Georgia · 28446
Office
Unavailable
Facility
$1158.80
No comparable office rate is available.
Rest Of Georgia
Georgia · 28446
Office
Unavailable
Facility
$1103.12
No comparable office rate is available.
Hawaii, Guam
Hawaii · 28446
Office
Unavailable
Facility
$1132.39
No comparable office rate is available.
Iowa
Iowa · 28446
Office
Unavailable
Facility
$1015.47
No comparable office rate is available.
Idaho
Idaho · 28446
Office
Unavailable
Facility
$1026.91
No comparable office rate is available.
East St. Louis
Illinois · 28446
Office
Unavailable
Facility
$1215.81
No comparable office rate is available.
Rest Of Illinois
Illinois · 28446
Office
Unavailable
Facility
$1157.54
No comparable office rate is available.
Suburban Chicago
Illinois · 28446
Office
Unavailable
Facility
$1235.79
No comparable office rate is available.
Indiana
Indiana · 28446
Office
Unavailable
Facility
$1031.49
No comparable office rate is available.
Kansas
Kansas · 28446
Office
Unavailable
Facility
$1023.90
No comparable office rate is available.
Kentucky
Kentucky · 28446
Office
Unavailable
Facility
$1067.88
No comparable office rate is available.
New Orleans
Louisiana · 28446
Office
Unavailable
Facility
$1117.14
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 28446
Office
Unavailable
Facility
$1071.45
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 28446
Office
Unavailable
Facility
$1218.46
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 28446
Office
Unavailable
Facility
$1132.54
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 28446
Office
Unavailable
Facility
$1195.00
No comparable office rate is available.
Rest Of Maryland
Maryland · 28446
Office
Unavailable
Facility
$1126.44
No comparable office rate is available.
Rest Of Maine
Maine · 28446
Office
Unavailable
Facility
$1045.18
No comparable office rate is available.
Southern Maine
Maine · 28446
Office
Unavailable
Facility
$1076.54
No comparable office rate is available.
Detroit
Michigan · 28446
Office
Unavailable
Facility
$1194.78
No comparable office rate is available.
Rest Of Michigan
Michigan · 28446
Office
Unavailable
Facility
$1104.34
No comparable office rate is available.
Minnesota
Minnesota · 28446
Office
Unavailable
Facility
$1051.67
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 28446
Office
Unavailable
Facility
$1096.79
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 28446
Office
Unavailable
Facility
$1105.40
No comparable office rate is available.
Rest Of Missouri
Missouri · 28446
Office
Unavailable
Facility
$1063.61
No comparable office rate is available.
Mississippi
Mississippi · 28446
Office
Unavailable
Facility
$1034.38
No comparable office rate is available.
Montana**
Montana · 28446
Office
Unavailable
Facility
$1125.37
No comparable office rate is available.
North Carolina
North Carolina · 28446
Office
Unavailable
Facility
$1052.80
No comparable office rate is available.
North Dakota**
North Dakota · 28446
Office
Unavailable
Facility
$1052.80
No comparable office rate is available.
Nebraska
Nebraska · 28446
Office
Unavailable
Facility
$1016.55
No comparable office rate is available.
New Hampshire
New Hampshire · 28446
Office
Unavailable
Facility
$1127.76
No comparable office rate is available.
Northern Nj
New Jersey · 28446
Office
Unavailable
Facility
$1238.48
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 28446
Office
Unavailable
Facility
$1199.78
No comparable office rate is available.
New Mexico
New Mexico · 28446
Office
Unavailable
Facility
$1114.87
No comparable office rate is available.
Nevada**
Nevada · 28446
Office
Unavailable
Facility
$1105.57
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 28446
Office
Unavailable
Facility
$1348.13
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 28446
Office
Unavailable
Facility
$1217.80
No comparable office rate is available.
Queens
New York · 28446
Office
Unavailable
Facility
$1294.28
No comparable office rate is available.
Rest Of New York
New York · 28446
Office
Unavailable
Facility
$1067.89
No comparable office rate is available.
Ohio
Ohio · 28446
Office
Unavailable
Facility
$1089.51
No comparable office rate is available.
Oklahoma
Oklahoma · 28446
Office
Unavailable
Facility
$1052.67
No comparable office rate is available.
Portland
Oregon · 28446
Office
Unavailable
Facility
$1150.77
No comparable office rate is available.
Rest Of Oregon
Oregon · 28446
Office
Unavailable
Facility
$1087.50
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 28446
Office
Unavailable
Facility
$1177.13
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 28446
Office
Unavailable
Facility
$1083.92
No comparable office rate is available.
Puerto Rico
Puerto Rico · 28446
Office
Unavailable
Facility
$1128.46
No comparable office rate is available.
Rhode Island
Rhode Island · 28446
Office
Unavailable
Facility
$1137.40
No comparable office rate is available.
South Carolina
South Carolina · 28446
Office
Unavailable
Facility
$1074.83
No comparable office rate is available.
South Dakota**
South Dakota · 28446
Office
Unavailable
Facility
$1044.22
No comparable office rate is available.
Tennessee
Tennessee · 28446
Office
Unavailable
Facility
$1030.07
No comparable office rate is available.
Utah
Utah · 28446
Office
Unavailable
Facility
$1087.54
No comparable office rate is available.
Virginia
Virginia · 28446
Office
Unavailable
Facility
$1082.33
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 28446
Office
Unavailable
Facility
$1128.46
No comparable office rate is available.
Vermont
Vermont · 28446
Office
Unavailable
Facility
$1060.79
No comparable office rate is available.
Rest Of Washington
Washington · 28446
Office
Unavailable
Facility
$1126.40
No comparable office rate is available.
Seattle (King Cnty)
Washington · 28446
Office
Unavailable
Facility
$1228.77
No comparable office rate is available.
Wisconsin
Wisconsin · 28446
Office
Unavailable
Facility
$1022.88
No comparable office rate is available.
West Virginia
West Virginia · 28446
Office
Unavailable
Facility
$1122.61
No comparable office rate is available.
Wyoming**
Wyoming · 28446
Office
Unavailable
Facility
$1093.74
No comparable office rate is available.
See how rates vary across the country
28446 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Where does this rate apply?
Beaumont is a Medicare payment area. Our Census mapping connects it to 13 cities and communities in Texas, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 28446 in Beaumont. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$1186.41
$1078.55 × 110% = $1186.41
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 28446 in Beaumont.
PPRRVU2026_Oct_nonQPP.csv
3,207
- Code
- 28446
- Physician work
- 17.27
- Practice expense
- 12.76
- Malpractice
- 3.67
GPCI2026.csv
97
- Locality
- Beaumont
- Physician work
- 1.000
- Practice expense
- 0.910
- Malpractice
- 0.929
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 17.27 | × 1.000 | 17.2700 |
| Practice expense | 12.76 | × 0.910 | 11.6116 |
| Malpractice | 3.67 | × 0.929 | 3.4094 |
| Total RVUs | 32.2910 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Beaumont$1078.55
Open 28446 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 17.27 | 1 |
| Practice expense | 12.76 | 0.91 |
| Malpractice | 3.67 | 0.929 |
(17.27 × 1 + 12.76 × 0.91 + 3.67 × 0.929) × $33.4009 = $1078.55
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
28446 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
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
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $1078.55 | RVU26D |
| 2026-07-01 | Not available in this setting | $1078.55 | RVU26C |
| 2026-04-01 | Not available in this setting | $1078.55 | RVU26B |
| 2026-01-01 | Not available in this setting | $1078.55 | RVU26A |
| 2025-10-01 | Not available in this setting | $1149.63 | RVU25D |
| 2025-07-01 | Not available in this setting | $1149.63 | RVU25C |
| 2025-04-01 | Not available in this setting | $1149.63 | RVU25B |
| 2025-01-01 | Not available in this setting | $1149.63 | RVU25A |
28446 billing questions
How is this different from open treatment of a talus fracture?
This code is for open graft treatment of an osteochondral lesion. Use the talus-fracture code when the operation treats a fracture rather than a focal cartilage-and-bone defect.
When would an arthroscopic talar lesion code be considered instead?
Consider the arthroscopic code that matches the documented lesion treatment when the surgeon works arthroscopically. This code describes open treatment with autograft.
Is graft harvest separately reported?
No. Obtaining the autograft is included in this service.
What documentation supports reporting this code?
The operative report should establish the talar osteochondral lesion, the open approach, the treatment performed, and use of an autograft.
How are bilateral procedures handled?
CMS lists this as a bilateral procedure; modifier 50 is paid at 150%.
What applies when other procedures are performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
3,20428435,,Cltx talus fracture w/mnpj,A,,3.45,8.21,,5.67,,0.73,12.39,9.85,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,20528436,,Prq skel fix talus fx w/mnpj,A,,4.78,9.07,NA,9.07,,1.03,14.88,14.88,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,20628445,,Optx talus fracture,A,,15.37,11.08,NA,11.08,,2.78,29.23,29.23,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,20728446,,Opn osteochondrl agrft talus,A,,17.27,12.76,NA,12.76,,3.67,33.70,33.70,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,20828450,,Tx tarsal b1 fx w/o mnpj ea,A,,1.98,4.67,,3.56,,0.28,6.93,5.82,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,20928455,,Tx tarsal b1 fx w/mnpj each,A,,3.16,4.37,,3.20,,0.26,7.79,6.62,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,21028456,,Prq skel fix tarsl fx w/mnpj,A,,2.79,8.10,NA,8.10,,0.59,11.48,11.48,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537
9604412,TX,31,AUSTIN,1.002,1.058,0.886
9704412,TX,20,BEAUMONT,1.000,0.910,0.929
9804412,TX,09,BRAZORIA,1.008,0.991,0.780
9904412,TX,11,DALLAS,1.009,0.996,0.858
10004412,TX,28,FORT WORTH,1.009,0.986,0.871