Billing code 28405: Heel fracture treatmentMedicare rate & RVUs in Georgia
Report this service when a clinician treats a calcaneal fracture by closed reduction requiring manipulation, rather than immobilization alone or operative fixation.
Medicare pays $474.48–$514.22 for 28405 in the office in Georgia, from Rest Of Georgia to Atlanta. Which amount applies depends on the service address.
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 9 sections
What 28405 covers
This service covers closed treatment of a fracture of the calcaneus, the heel bone, when the clinician manipulates the fracture to improve alignment without an open surgical approach. Orthopedic surgeons and foot-and-ankle specialists commonly provide this care after a heel injury, using imaging and examination to assess alignment and guide treatment. The fracture may then be supported with external immobilization as part of the treatment plan.
Select this code when the documented treatment includes manipulation; treatment without manipulation is represented by 28400. The record should identify the calcaneal fracture, the reduction or manipulation performed, and the treatment plan. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are reduced to 50%. For bilateral treatment, modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; 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 28405 pays more and less in Georgia
| Payment locality | Office | Facility |
|---|---|---|
| Atlanta | $514.22 | $410.38 |
| Rest Of Georgia | $474.48 | $383.32 |
How the 28405 rate is calculated
Each of 28405’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 · 28405
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 4.62Practice expense 9.41Malpractice 1.00
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 28405
28405 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28405
Heel fracture treatment
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 28405
Heel fracture treatment
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
28405 without 50 · national office
$502.02
Heel fracture treatment
28405-50 · Bilateral: 150%
$753.03
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
28405 compared with similar codes
Compare codes
28405 vs 28400 vs 28406 vs 28415 vs 28435: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 28400Fracture treatment
- Both describe closed treatment of a calcaneal fracture. Choose 28405 when manipulation is performed; 28400 is for treatment without manipulation.
- 28406Calcaneal fracture repair
- Both concern a calcaneal fracture treated without open exposure. Use 28406 when percutaneous skeletal fixation is performed; use 28405 for closed manipulation without that fixation.
- 28415Heel fracture repair
- Code 28415 describes open treatment of a calcaneal fracture. This code is for closed treatment with manipulation.
- 28435Talus fracture care
- Both describe closed treatment with manipulation, but 28435 is for a talus fracture. This code is for a calcaneal fracture.
28405 billing questions
How does this differ from 28400?
Use 28405 when treatment includes manipulation to improve fracture alignment. Code 28400 describes closed treatment without manipulation.
When should 28406 be considered instead?
Code 28406 is for treatment using percutaneous skeletal fixation. This code describes closed manipulation without that fixation method.
What documentation supports reporting this code?
Document the calcaneal fracture and the manipulation performed to reduce or improve its alignment, along with the resulting treatment plan.
How is bilateral treatment reported under the CMS facts?
For bilateral procedures, modifier 50 is paid at 150%.
What global and multiple-procedure rules apply?
The code has a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care. In the same session, the highest-valued procedure is paid in full and other procedures are reduced to 50%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. 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
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