$200.28
Use 28600 for closed treatment without manipulation. This code requires manipulation and percutaneous skeletal fixation.
On this page
CMS RVU26D · Effective 2026-10-01
28606 in Merced
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$393.98
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 28606: Percutaneous fixation of tarsometatarsal dislocation
Reports manipulation and percutaneous skeletal fixation of a dislocated tarsometatarsal joint, commonly used to stabilize a Lisfranc injury without open exposure.
This service treats a tarsometatarsal joint dislocation, often part of a Lisfranc injury, by manipulating the joint into alignment and stabilizing it with skeletal fixation placed percutaneously. An orthopedic foot-and-ankle surgeon or podiatrist typically performs the procedure in an operative setting. The fixation is placed through the skin rather than through an open surgical exposure; simple closed reduction without fixation is not this service.
Report the code when the record supports both manipulation and percutaneous skeletal fixation of the dislocated joint. Document the affected joint, reduction, and fixation method. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. 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 is inappropriate. Assistant-at-surgery payment is statutorily restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 28606
- 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- 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 RVU4.96 · 43%
- Practice expense (office) RVU5.71 · 49%
- Malpractice RVU0.92 · 8%
193
Medicare services in 2024 · #4353 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.
28606 compared with similar codes
Office rates for Merced, from the same CMS release.
$402.14
Use 28605 for closed treatment with manipulation but without skeletal fixation. This code includes percutaneous fixation.
No office rate
Use 28615 when the tarsometatarsal dislocation is treated through open exposure; this code describes percutaneous fixation.
The same code, a different location
How does Merced compare?
28606 across payment areas
Same release and payment basis · bars start at $0
Merced · 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.
No comparable rate is available in this setting.
Other payment areas listed in California 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
Madera
California · 28606
Office
Unavailable
Facility
$393.98
No comparable office rate is available.
Modesto
California · 28606
Office
Unavailable
Facility
$393.98
No comparable office rate is available.
Napa
California · 28606
Office
Unavailable
Facility
$443.08
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 28606
Office
Unavailable
Facility
$414.88
No comparable office rate is available.
Redding
California · 28606
Office
Unavailable
Facility
$393.98
No comparable office rate is available.
Rest Of California
California · 28606
Office
Unavailable
Facility
$393.98
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 28606
Office
Unavailable
Facility
$403.89
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 28606
Office
Unavailable
Facility
$409.91
No comparable office rate is available.
Salinas
California · 28606
Office
Unavailable
Facility
$408.32
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 28606
Office
Unavailable
Facility
$415.39
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 28606
Office
Unavailable
Facility
$464.43
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 28606
Office
Unavailable
Facility
$463.38
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 28606
Office
Unavailable
Facility
$475.38
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 28606
Office
Unavailable
Facility
$471.11
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 28606
Office
Unavailable
Facility
$402.18
No comparable office rate is available.
Santa Cruz-Watsonville
California · 28606
Office
Unavailable
Facility
$417.34
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 28606
Office
Unavailable
Facility
$409.16
No comparable office rate is available.
Santa Rosa-Petaluma
California · 28606
Office
Unavailable
Facility
$421.31
No comparable office rate is available.
Stockton
California · 28606
Office
Unavailable
Facility
$393.98
No comparable office rate is available.
Vallejo
California · 28606
Office
Unavailable
Facility
$441.58
No comparable office rate is available.
Visalia
California · 28606
Office
Unavailable
Facility
$393.98
No comparable office rate is available.
Yuba City
California · 28606
Office
Unavailable
Facility
$393.98
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 28606
Office
Unavailable
Facility
$433.48
No comparable office rate is available.
Miami
Florida · 28606
Office
Unavailable
Facility
$441.92
No comparable office rate is available.
Chicago
Illinois · 28606
Office
Unavailable
Facility
$429.02
No comparable office rate is available.
Manhattan
New York · 28606
Office
Unavailable
Facility
$446.62
No comparable office rate is available.
Alaska*
Alaska · 28606
Office
Unavailable
Facility
$468.55
No comparable office rate is available.
Alabama
Alabama · 28606
Office
Unavailable
Facility
$349.94
No comparable office rate is available.
Arkansas
Arkansas · 28606
Office
Unavailable
Facility
$345.32
No comparable office rate is available.
Arizona
Arizona · 28606
Office
Unavailable
Facility
$376.78
No comparable office rate is available.
Colorado
Colorado · 28606
Office
Unavailable
Facility
$394.58
No comparable office rate is available.
Connecticut
Connecticut · 28606
Office
Unavailable
Facility
$411.57
No comparable office rate is available.
Delaware
Delaware · 28606
Office
Unavailable
Facility
$382.55
No comparable office rate is available.
Fort Lauderdale
Florida · 28606
Office
Unavailable
Facility
$414.42
No comparable office rate is available.
Rest Of Florida
Florida · 28606
Office
Unavailable
Facility
$394.18
No comparable office rate is available.
Atlanta
Georgia · 28606
Office
Unavailable
Facility
$396.84
No comparable office rate is available.
Rest Of Georgia
Georgia · 28606
Office
Unavailable
Facility
$372.42
No comparable office rate is available.
Hawaii, Guam
Hawaii · 28606
Office
Unavailable
Facility
$400.31
No comparable office rate is available.
Iowa
Iowa · 28606
Office
Unavailable
Facility
$352.38
No comparable office rate is available.
Idaho
Idaho · 28606
Office
Unavailable
Facility
$355.66
No comparable office rate is available.
East St. Louis
Illinois · 28606
Office
Unavailable
Facility
$403.02
No comparable office rate is available.
Rest Of Illinois
Illinois · 28606
Office
Unavailable
Facility
$387.82
No comparable office rate is available.
Suburban Chicago
Illinois · 28606
Office
Unavailable
Facility
$417.15
No comparable office rate is available.
Indiana
Indiana · 28606
Office
Unavailable
Facility
$357.40
No comparable office rate is available.
Kansas
Kansas · 28606
Office
Unavailable
Facility
$353.57
No comparable office rate is available.
Kentucky
Kentucky · 28606
Office
Unavailable
Facility
$363.33
No comparable office rate is available.
New Orleans
Louisiana · 28606
Office
Unavailable
Facility
$380.04
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 28606
Office
Unavailable
Facility
$363.89
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 28606
Office
Unavailable
Facility
$427.53
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 28606
Office
Unavailable
Facility
$393.64
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 28606
Office
Unavailable
Facility
$410.97
No comparable office rate is available.
Rest Of Maryland
Maryland · 28606
Office
Unavailable
Facility
$388.54
No comparable office rate is available.
Rest Of Maine
Maine · 28606
Office
Unavailable
Facility
$360.24
No comparable office rate is available.
Southern Maine
Maine · 28606
Office
Unavailable
Facility
$374.06
No comparable office rate is available.
Detroit
Michigan · 28606
Office
Unavailable
Facility
$401.52
No comparable office rate is available.
Rest Of Michigan
Michigan · 28606
Office
Unavailable
Facility
$374.49
No comparable office rate is available.
Minnesota
Minnesota · 28606
Office
Unavailable
Facility
$371.01
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 28606
Office
Unavailable
Facility
$374.78
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 28606
Office
Unavailable
Facility
$378.02
No comparable office rate is available.
Rest Of Missouri
Missouri · 28606
Office
Unavailable
Facility
$360.00
No comparable office rate is available.
Mississippi
Mississippi · 28606
Office
Unavailable
Facility
$352.59
No comparable office rate is available.
Montana**
Montana · 28606
Office
Unavailable
Facility
$387.05
No comparable office rate is available.
North Carolina
North Carolina · 28606
Office
Unavailable
Facility
$363.25
No comparable office rate is available.
North Dakota**
North Dakota · 28606
Office
Unavailable
Facility
$368.86
No comparable office rate is available.
Nebraska
Nebraska · 28606
Office
Unavailable
Facility
$353.32
No comparable office rate is available.
New Hampshire
New Hampshire · 28606
Office
Unavailable
Facility
$391.09
No comparable office rate is available.
Northern Nj
New Jersey · 28606
Office
Unavailable
Facility
$430.16
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 28606
Office
Unavailable
Facility
$414.27
No comparable office rate is available.
New Mexico
New Mexico · 28606
Office
Unavailable
Facility
$377.46
No comparable office rate is available.
Nevada**
Nevada · 28606
Office
Unavailable
Facility
$382.18
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 28606
Office
Unavailable
Facility
$460.10
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 28606
Office
Unavailable
Facility
$419.14
No comparable office rate is available.
Queens
New York · 28606
Office
Unavailable
Facility
$446.01
No comparable office rate is available.
Rest Of New York
New York · 28606
Office
Unavailable
Facility
$368.45
No comparable office rate is available.
Ohio
Ohio · 28606
Office
Unavailable
Facility
$370.77
No comparable office rate is available.
Oklahoma
Oklahoma · 28606
Office
Unavailable
Facility
$359.86
No comparable office rate is available.
Portland
Oregon · 28606
Office
Unavailable
Facility
$403.07
No comparable office rate is available.
Rest Of Oregon
Oregon · 28606
Office
Unavailable
Facility
$377.23
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 28606
Office
Unavailable
Facility
$403.85
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 28606
Office
Unavailable
Facility
$369.79
No comparable office rate is available.
Puerto Rico
Puerto Rico · 28606
Office
Unavailable
Facility
$388.75
No comparable office rate is available.
Rhode Island
Rhode Island · 28606
Office
Unavailable
Facility
$393.24
No comparable office rate is available.
South Carolina
South Carolina · 28606
Office
Unavailable
Facility
$368.01
No comparable office rate is available.
South Dakota**
South Dakota · 28606
Office
Unavailable
Facility
$366.71
No comparable office rate is available.
Tennessee
Tennessee · 28606
Office
Unavailable
Facility
$355.53
No comparable office rate is available.
Austin
Texas · 28606
Office
Unavailable
Facility
$395.01
No comparable office rate is available.
Beaumont
Texas · 28606
Office
Unavailable
Facility
$367.77
No comparable office rate is available.
Brazoria
Texas · 28606
Office
Unavailable
Facility
$379.96
No comparable office rate is available.
Dallas
Texas · 28606
Office
Unavailable
Facility
$383.48
No comparable office rate is available.
Fort Worth
Texas · 28606
Office
Unavailable
Facility
$381.97
No comparable office rate is available.
Galveston
Texas · 28606
Office
Unavailable
Facility
$381.82
No comparable office rate is available.
Houston
Texas · 28606
Office
Unavailable
Facility
$398.66
No comparable office rate is available.
Rest Of Texas
Texas · 28606
Office
Unavailable
Facility
$374.41
No comparable office rate is available.
Utah
Utah · 28606
Office
Unavailable
Facility
$372.54
No comparable office rate is available.
Virginia
Virginia · 28606
Office
Unavailable
Facility
$374.84
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 28606
Office
Unavailable
Facility
$388.75
No comparable office rate is available.
Vermont
Vermont · 28606
Office
Unavailable
Facility
$370.03
No comparable office rate is available.
Rest Of Washington
Washington · 28606
Office
Unavailable
Facility
$392.03
No comparable office rate is available.
Seattle (King Cnty)
Washington · 28606
Office
Unavailable
Facility
$433.07
No comparable office rate is available.
Wisconsin
Wisconsin · 28606
Office
Unavailable
Facility
$357.84
No comparable office rate is available.
West Virginia
West Virginia · 28606
Office
Unavailable
Facility
$375.38
No comparable office rate is available.
Wyoming**
Wyoming · 28606
Office
Unavailable
Facility
$379.13
No comparable office rate is available.
See how rates vary across the country
28606 · 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?
Merced is a Medicare payment area. Our Census mapping connects it to 24 cities and communities in California, 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 28606 in Merced. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$433.38
$393.98 × 110% = $433.38
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 28606 in Merced.
PPRRVU2026_Oct_nonQPP.csv
3,235
- Code
- 28606
- Physician work
- 4.96
- Practice expense
- 5.71
- Malpractice
- 0.92
GPCI2026.csv
15
- Locality
- Merced
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.96 | × 1.017 | 5.0443 |
| Practice expense | 5.71 | × 1.096 | 6.2582 |
| Malpractice | 0.92 | × 0.536 | 0.4931 |
| Total RVUs | 11.7956 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Merced$393.98
Open 28606 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.96 | 1.017 |
| Practice expense | 5.71 | 1.096 |
| Malpractice | 0.92 | 0.536 |
(4.96 × 1.017 + 5.71 × 1.096 + 0.92 × 0.536) × $33.4009 = $393.98
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
28606 · 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 | $393.98 | RVU26D |
| 2026-07-01 | Not available in this setting | $393.98 | RVU26C |
| 2026-04-01 | Not available in this setting | $393.98 | RVU26B |
| 2026-01-01 | Not available in this setting | $393.98 | RVU26A |
| 2025-10-01 | Not available in this setting | $406.68 | RVU25D |
| 2025-07-01 | Not available in this setting | $406.68 | RVU25C |
| 2025-04-01 | Not available in this setting | $406.68 | RVU25B |
| 2025-01-01 | Not available in this setting | $406.68 | RVU25A |
28606 billing questions
How does this differ from 28605?
28606 includes percutaneous skeletal fixation after manipulation. Use 28605 for closed treatment with manipulation when skeletal fixation is not performed.
When would 28615 be reported instead?
28615 describes open treatment of the tarsometatarsal dislocation. This code is for manipulation and fixation placed percutaneously, without open exposure.
What documentation supports reporting 28606?
Document the tarsometatarsal dislocation, manipulation to reduce it, and the percutaneous skeletal fixation used to stabilize the joint.
Can modifier 50 be used for bilateral treatment?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
How does the global period affect postoperative care?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
How are other same-session procedures paid?
The highest-valued procedure is paid in full, with other procedures subject to the standard multiple-procedure reduction. Assistant-at-surgery payment is statutorily restricted, 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 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.
3,23228585,,Repair foot dislocation,A,,10.85,16.05,,7.87,,1.51,28.41,20.23,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,23328600,,Treat foot dislocation,A,,1.97,3.56,,2.59,,0.17,5.70,4.73,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,23428605,,Treat foot dislocation,A,,2.82,8.08,,5.94,,0.59,11.49,9.35,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,23528606,,Treat foot dislocation,A,,4.96,5.71,NA,5.71,,0.92,11.59,11.59,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,23628615,,Repair foot dislocation,A,,10.43,11.48,NA,11.48,,1.84,23.75,23.75,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,23728630,,Treat toe dislocation,A,,1.71,3.14,,1.32,,0.29,5.14,3.32,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,23828635,,Treat toe dislocation,A,,1.91,3.10,,1.55,,0.22,5.23,3.68,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1201112,CA,57,HANFORD-CORCORAN,1.017,1.096,0.536
1301182,CA,18,LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY),1.041,1.183,0.664
1401112,CA,58,MADERA,1.017,1.096,0.536
1501112,CA,59,MERCED,1.017,1.096,0.536
1601112,CA,60,MODESTO,1.017,1.096,0.536
1701112,CA,51,NAPA,1.063,1.318,0.508
1801182,CA,17,OXNARD-THOUSAND OAKS-VENTURA,1.028,1.182,0.623