Billing code 28450: Tarsal fracture careMedicare rate & RVUs in Guam
Report 28450 for closed treatment of an individual tarsal bone fracture, such as a navicular or cuboid fracture, when no manipulation is performed.
Medicare pays $248.90 for 28450 in the office in Guam (Hawaii, Guam). 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 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.
28450 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | $248.90 | $206.75 |
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
Swap in your local Medicare rate.
Work 1.98Practice expense 4.67Malpractice 0.28
All indexes start 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
| 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| 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 · 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.
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%).
28450 compared with similar codes
Compare codes
28450 vs 28455 vs 28456 vs 28465 vs 28430: national Medicare rates
Swap in your local Medicare rate.
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
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