Billing code 28450: Tarsal fracture careMedicare rate & RVUs in Florida

Report 28450 for closed treatment of an individual tarsal bone fracture, such as a navicular or cuboid fracture, when no manipulation is performed.

CMS RVU26DEffective Oct 1, 20263 payment localities1.5K Medicare services in 2024

Medicare pays $229.31–$252.16 for 28450 in the office in Florida, from Rest Of Florida to Miami. Which amount applies depends on the service address.

$229.31–$252.16Office (non-facility)
$193.87–$213.57Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 28450 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Florida
  2. What 28450 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 28450 covers

An orthopedist or podiatrist reports this service for definitive closed care of a tarsal bone fracture other than a talus or calcaneus fracture, when the bone is treated without manipulating it to restore alignment. Examples include navicular, cuboid, and cuneiform fractures. Care may involve immobilization and a treatment plan with follow-up in an office, emergency department, or facility setting.

Select the code for each tarsal bone treated, and document the specific bone, fracture, and that treatment did not involve manipulation. This code has a 90-day global period: the day-before preoperative visit and related postoperative care during that period are included. 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% multiple-procedure reduction. Modifier 50 is inappropriate; the code is reported by bone treated. Medicare does not pay an assistant at surgery, and 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 28450 pays more and less in Florida

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

3 payment localities

$229.31 to $252.16

$229.31$240.74$252.16
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.
28450 office and facility rates by payment locality
Payment localityOfficeFacility
Fort Lauderdale$241.05$203.50
Miami$252.16$213.57
Rest Of Florida$229.31$193.87

How the 28450 rate is calculated

Each of 28450’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 · 28450

RVUs × geographic indexes × conversion factor

Work1.98

1.98 RVUs× 1.000 GPCI

Practice expense4.67

4.67 RVUs× 1.000 GPCI

Malpractice0.28

0.28 RVUs× 1.000 GPCI

Adjusted RVUs

6.9300

Conversion factor

$33.4009

Medicare rate

$231.47

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 28450

28450 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 28450

Tarsal fracture care

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 · 28450

Tarsal fracture care

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.

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

28450 without 51 · national office

$231.47

Tarsal fracture care

28450-51 · Second procedure: 50%

$115.74

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

28450 compared with similar codes

Compare codes · National

5 codes, side by side

  • 28450

    Tarsal fracture care1.98 wRVU

    $231.47

  • 28455

    Tarsal fracture care3.16 wRVU

    $260.19+$28.72

  • 28456

    Tarsal fracture fixation2.79 wRVU

    Not priced

  • 28465

    Tarsal fracture repair8.58 wRVU

    Not priced

  • 28430

    Talus fracture care2.16 wRVU

    $265.87+$34.40

How to choose

28455Tarsal fracture care
Choose 28450 for closed tarsal fracture treatment without manipulation; choose 28455 when manipulation is performed.
28456Tarsal fracture fixation
28456 describes percutaneous skeletal fixation with manipulation. 28450 is closed treatment without manipulation or percutaneous fixation.
28465Tarsal fracture repair
28465 is for open treatment of a tarsal bone fracture. 28450 is closed treatment without manipulation.
28430Talus fracture care
28430 is for closed treatment without manipulation of a talus fracture. 28450 is for another tarsal bone, such as the navicular or cuboid.

28450 billing questions

How is 28450 different from 28455?

Both address closed treatment of a tarsal bone fracture other than the talus or calcaneus. Use 28450 when no manipulation is performed; 28455 is for treatment with manipulation.

How many units should be reported?

The code is reported for each tarsal bone treated. Document the bone involved and the treatment provided for each fracture.

Can modifier 50 be used for fractures on both sides?

No. Modifier 50 is inappropriate for this code; its descriptor identifies treatment by each bone.

Is related fracture follow-up separately reported during the global period?

The 90-day global period includes related postoperative care, as well as the day-before preoperative visit.

What documentation supports reporting 28450?

Document the specific tarsal bone and fracture, the closed treatment plan, and that no manipulation was performed.

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 28450PPRRVU2026_Oct_nonQPP.csv, line 3,208 (RVU26D)

Open CMS sourceHow we calculate rates

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