$262.81
Choose 28430 for talus fracture treatment without manipulation. This code includes manipulation and percutaneous skeletal fixation.
On this page
CMS RVU26D · Effective 2026-10-01
28436 in Delaware
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$490.69
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.
Fracture treatment
About 28436: Percutaneous talus fracture fixation
Reports manipulation and percutaneous skeletal fixation of a talus fracture when reduction is stabilized without open surgical exposure.
An orthopedic surgeon, commonly specializing in foot and ankle surgery, uses manipulation to reduce a talus fracture and places skeletal fixation percutaneously through the skin. The procedure stabilizes the fracture without open exposure of the fracture site. It is typically performed in a surgical facility for a fracture requiring both reduction and fixation.
Report this code when the operative documentation supports manipulation and percutaneous skeletal fixation of the talus; closed manipulation alone or open fixation describes a different service. 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% reduction. For bilateral procedures, modifier 50 results in payment at 150%. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 28436
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU4.78 · 32%
- Practice expense (office) RVU9.07 · 61%
- Malpractice RVU1.03 · 7%
19
Medicare services in 2024 · #5941 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.
28436 compared with similar codes
Office rates for Delaware, from the same CMS release.
$408.66
Both involve manipulation of a talus fracture, but this code also includes percutaneous skeletal fixation.
No office rate
Use 28445 when the fracture is treated with open exposure; this code describes percutaneous fixation without open exposure.
The same code, a different location
How does Delaware compare?
28436 across payment areas
Same release and payment basis · bars start at $0
Delaware · This locality
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 Delaware 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
Alabama
Alabama · 28436
Office
Unavailable
Facility
$444.21
No comparable office rate is available.
Arkansas
Arkansas · 28436
Office
Unavailable
Facility
$437.60
No comparable office rate is available.
Arizona
Arizona · 28436
Office
Unavailable
Facility
$482.66
No comparable office rate is available.
Bakersfield
California · 28436
Office
Unavailable
Facility
$515.67
No comparable office rate is available.
Chico
California · 28436
Office
Unavailable
Facility
$512.84
No comparable office rate is available.
El Centro
California · 28436
Office
Unavailable
Facility
$513.01
No comparable office rate is available.
Fresno
California · 28436
Office
Unavailable
Facility
$512.84
No comparable office rate is available.
Hanford-Corcoran
California · 28436
Office
Unavailable
Facility
$512.84
No comparable office rate is available.
Madera
California · 28436
Office
Unavailable
Facility
$512.84
No comparable office rate is available.
Merced
California · 28436
Office
Unavailable
Facility
$512.84
No comparable office rate is available.
Modesto
California · 28436
Office
Unavailable
Facility
$512.84
No comparable office rate is available.
Napa
California · 28436
Office
Unavailable
Facility
$586.47
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 28436
Office
Unavailable
Facility
$543.64
No comparable office rate is available.
Redding
California · 28436
Office
Unavailable
Facility
$512.84
No comparable office rate is available.
Rest Of California
California · 28436
Office
Unavailable
Facility
$512.84
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 28436
Office
Unavailable
Facility
$523.90
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 28436
Office
Unavailable
Facility
$536.17
No comparable office rate is available.
Salinas
California · 28436
Office
Unavailable
Facility
$534.16
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 28436
Office
Unavailable
Facility
$545.42
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 28436
Office
Unavailable
Facility
$617.77
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 28436
Office
Unavailable
Facility
$616.60
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 28436
Office
Unavailable
Facility
$632.51
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 28436
Office
Unavailable
Facility
$627.72
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 28436
Office
Unavailable
Facility
$525.87
No comparable office rate is available.
Santa Cruz-Watsonville
California · 28436
Office
Unavailable
Facility
$549.53
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 28436
Office
Unavailable
Facility
$535.80
No comparable office rate is available.
Santa Rosa-Petaluma
California · 28436
Office
Unavailable
Facility
$554.90
No comparable office rate is available.
Stockton
California · 28436
Office
Unavailable
Facility
$512.84
No comparable office rate is available.
Vallejo
California · 28436
Office
Unavailable
Facility
$584.79
No comparable office rate is available.
Visalia
California · 28436
Office
Unavailable
Facility
$512.84
No comparable office rate is available.
Yuba City
California · 28436
Office
Unavailable
Facility
$512.84
No comparable office rate is available.
Colorado
Colorado · 28436
Office
Unavailable
Facility
$510.78
No comparable office rate is available.
Connecticut
Connecticut · 28436
Office
Unavailable
Facility
$530.75
No comparable office rate is available.
Fort Lauderdale
Florida · 28436
Office
Unavailable
Facility
$528.74
No comparable office rate is available.
Rest Of Florida
Florida · 28436
Office
Unavailable
Facility
$500.98
No comparable office rate is available.
Atlanta
Georgia · 28436
Office
Unavailable
Facility
$509.25
No comparable office rate is available.
Rest Of Georgia
Georgia · 28436
Office
Unavailable
Facility
$470.89
No comparable office rate is available.
Hawaii, Guam
Hawaii · 28436
Office
Unavailable
Facility
$524.03
No comparable office rate is available.
Iowa
Iowa · 28436
Office
Unavailable
Facility
$450.51
No comparable office rate is available.
Idaho
Idaho · 28436
Office
Unavailable
Facility
$454.64
No comparable office rate is available.
East St. Louis
Illinois · 28436
Office
Unavailable
Facility
$507.65
No comparable office rate is available.
Rest Of Illinois
Illinois · 28436
Office
Unavailable
Facility
$490.02
No comparable office rate is available.
Suburban Chicago
Illinois · 28436
Office
Unavailable
Facility
$532.86
No comparable office rate is available.
Indiana
Indiana · 28436
Office
Unavailable
Facility
$457.21
No comparable office rate is available.
Kansas
Kansas · 28436
Office
Unavailable
Facility
$450.86
No comparable office rate is available.
Kentucky
Kentucky · 28436
Office
Unavailable
Facility
$460.45
No comparable office rate is available.
New Orleans
Louisiana · 28436
Office
Unavailable
Facility
$483.81
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 28436
Office
Unavailable
Facility
$460.72
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 28436
Office
Unavailable
Facility
$558.54
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 28436
Office
Unavailable
Facility
$508.63
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 28436
Office
Unavailable
Facility
$529.83
No comparable office rate is available.
Rest Of Maryland
Maryland · 28436
Office
Unavailable
Facility
$499.42
No comparable office rate is available.
Rest Of Maine
Maine · 28436
Office
Unavailable
Facility
$459.77
No comparable office rate is available.
Southern Maine
Maine · 28436
Office
Unavailable
Facility
$481.58
No comparable office rate is available.
Detroit
Michigan · 28436
Office
Unavailable
Facility
$510.00
No comparable office rate is available.
Rest Of Michigan
Michigan · 28436
Office
Unavailable
Facility
$475.09
No comparable office rate is available.
Minnesota
Minnesota · 28436
Office
Unavailable
Facility
$481.57
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 28436
Office
Unavailable
Facility
$477.73
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 28436
Office
Unavailable
Facility
$482.53
No comparable office rate is available.
Rest Of Missouri
Missouri · 28436
Office
Unavailable
Facility
$454.30
No comparable office rate is available.
Mississippi
Mississippi · 28436
Office
Unavailable
Facility
$445.92
No comparable office rate is available.
Montana**
Montana · 28436
Office
Unavailable
Facility
$496.94
No comparable office rate is available.
North Carolina
North Carolina · 28436
Office
Unavailable
Facility
$464.29
No comparable office rate is available.
North Dakota**
North Dakota · 28436
Office
Unavailable
Facility
$476.57
No comparable office rate is available.
Nebraska
Nebraska · 28436
Office
Unavailable
Facility
$452.28
No comparable office rate is available.
New Hampshire
New Hampshire · 28436
Office
Unavailable
Facility
$505.13
No comparable office rate is available.
Northern Nj
New Jersey · 28436
Office
Unavailable
Facility
$557.87
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 28436
Office
Unavailable
Facility
$534.60
No comparable office rate is available.
New Mexico
New Mexico · 28436
Office
Unavailable
Facility
$478.78
No comparable office rate is available.
Nevada**
Nevada · 28436
Office
Unavailable
Facility
$491.56
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 28436
Office
Unavailable
Facility
$593.96
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 28436
Office
Unavailable
Facility
$540.19
No comparable office rate is available.
Queens
New York · 28436
Office
Unavailable
Facility
$577.57
No comparable office rate is available.
Rest Of New York
New York · 28436
Office
Unavailable
Facility
$471.64
No comparable office rate is available.
Ohio
Ohio · 28436
Office
Unavailable
Facility
$470.92
No comparable office rate is available.
Oklahoma
Oklahoma · 28436
Office
Unavailable
Facility
$456.92
No comparable office rate is available.
Portland
Oregon · 28436
Office
Unavailable
Facility
$524.38
No comparable office rate is available.
Rest Of Oregon
Oregon · 28436
Office
Unavailable
Facility
$485.58
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 28436
Office
Unavailable
Facility
$518.94
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 28436
Office
Unavailable
Facility
$470.27
No comparable office rate is available.
Puerto Rico
Puerto Rico · 28436
Office
Unavailable
Facility
$499.82
No comparable office rate is available.
Rhode Island
Rhode Island · 28436
Office
Unavailable
Facility
$506.32
No comparable office rate is available.
South Carolina
South Carolina · 28436
Office
Unavailable
Facility
$468.82
No comparable office rate is available.
South Dakota**
South Dakota · 28436
Office
Unavailable
Facility
$474.16
No comparable office rate is available.
Tennessee
Tennessee · 28436
Office
Unavailable
Facility
$453.51
No comparable office rate is available.
Austin
Texas · 28436
Office
Unavailable
Facility
$510.97
No comparable office rate is available.
Beaumont
Texas · 28436
Office
Unavailable
Facility
$467.30
No comparable office rate is available.
Brazoria
Texas · 28436
Office
Unavailable
Facility
$487.99
No comparable office rate is available.
Dallas
Texas · 28436
Office
Unavailable
Facility
$492.35
No comparable office rate is available.
Fort Worth
Texas · 28436
Office
Unavailable
Facility
$489.76
No comparable office rate is available.
Galveston
Texas · 28436
Office
Unavailable
Facility
$490.24
No comparable office rate is available.
Houston
Texas · 28436
Office
Unavailable
Facility
$509.10
No comparable office rate is available.
Rest Of Texas
Texas · 28436
Office
Unavailable
Facility
$478.22
No comparable office rate is available.
Utah
Utah · 28436
Office
Unavailable
Facility
$475.32
No comparable office rate is available.
Virginia
Virginia · 28436
Office
Unavailable
Facility
$481.74
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 28436
Office
Unavailable
Facility
$499.82
No comparable office rate is available.
Vermont
Vermont · 28436
Office
Unavailable
Facility
$476.98
No comparable office rate is available.
Rest Of Washington
Washington · 28436
Office
Unavailable
Facility
$506.91
No comparable office rate is available.
Seattle (King Cnty)
Washington · 28436
Office
Unavailable
Facility
$567.46
No comparable office rate is available.
Wisconsin
Wisconsin · 28436
Office
Unavailable
Facility
$460.47
No comparable office rate is available.
West Virginia
West Virginia · 28436
Office
Unavailable
Facility
$472.15
No comparable office rate is available.
Wyoming**
Wyoming · 28436
Office
Unavailable
Facility
$488.06
No comparable office rate is available.
See how rates vary across the country
28436 · 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?
Delaware is a Medicare payment area. Our Census mapping connects it to 79 cities and communities in Delaware, 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 28436 in Delaware. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$539.76
$490.69 × 110% = $539.76
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 28436 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
3,205
- Code
- 28436
- Physician work
- 4.78
- Practice expense
- 9.07
- Malpractice
- 1.03
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.78 | × 1.005 | 4.8039 |
| Practice expense | 9.07 | × 0.988 | 8.9612 |
| Malpractice | 1.03 | × 0.899 | 0.9260 |
| Total RVUs | 14.6910 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$490.69
Open 28436 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.78 | 1.005 |
| Practice expense | 9.07 | 0.988 |
| Malpractice | 1.03 | 0.899 |
(4.78 × 1.005 + 9.07 × 0.988 + 1.03 × 0.899) × $33.4009 = $490.69
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
28436 · 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 | $490.69 | RVU26D |
| 2026-07-01 | Not available in this setting | $490.69 | RVU26C |
| 2026-04-01 | Not available in this setting | $490.69 | RVU26B |
| 2026-01-01 | Not available in this setting | $490.69 | RVU26A |
| 2025-10-01 | Not available in this setting | $492.23 | RVU25D |
| 2025-07-01 | Not available in this setting | $492.23 | RVU25C |
| 2025-04-01 | Not available in this setting | $492.23 | RVU25B |
| 2025-01-01 | Not available in this setting | $492.23 | RVU25A |
28436 billing questions
How does this differ from closed treatment of a talus fracture?
This code describes manipulation followed by percutaneous skeletal fixation. Closed treatment codes describe fracture care without that percutaneous fixation.
How does this differ from open talus fracture treatment?
Use this code when fixation is placed percutaneously without open exposure of the fracture site. Open treatment is reported when the fracture is surgically exposed for treatment.
Does the 90-day global period include related postoperative care?
Yes. The global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.
How is bilateral treatment handled?
For a bilateral procedure, modifier 50 is paid at 150% under the CMS rule supplied for this code.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full; other procedures performed in the same session are subject to the standard multiple procedure reduction.
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.
3,20228420,,Optx calcaneal fx w/bone grf,A,,17.08,15.48,NA,15.48,,3.63,36.19,36.19,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,20328430,,Cltx talus fracture w/o mnpj,A,,2.16,5.43,,3.96,,0.37,7.96,6.49,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,20428435,,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
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503