Billing code 28436: Talus fracture fixationMedicare rate & RVUs in Illinois
Reports manipulation and percutaneous skeletal fixation of a talus fracture when reduction is stabilized without open surgical exposure.
CMS doesn’t publish an office rate for 28436 in Illinois.
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 28436 covers
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.
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 28436 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | Unavailable | $544.19 |
| East St. Louis | Unavailable | $507.65 |
| Rest Of Illinois | Unavailable | $490.02 |
| Suburban Chicago | Unavailable | $532.86 |
How the 28436 rate is calculated
Each of 28436’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 · 28436
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 4.78Practice expense 9.07Malpractice 1.03
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 28436
28436 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28436
Talus fracture fixation
| 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) | 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 · 28436
Talus fracture fixation
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
28436 without 50 · national facility
$497.01
Talus fracture fixation
28436-50 · Bilateral: 150%
$745.52
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).
28436 compared with similar codes
Compare codes
28436 vs 28430 vs 28435 vs 28445: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 28430Talus fracture care
- Choose 28430 for talus fracture treatment without manipulation. This code includes manipulation and percutaneous skeletal fixation.
- 28435Talus fracture care
- Both involve manipulation of a talus fracture, but this code also includes percutaneous skeletal fixation.
- 28445Talus fracture surgery
- Use 28445 when the fracture is treated with open exposure; this code describes percutaneous fixation without open exposure.
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 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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