No office rate
Both address open treatment of a calcaneal fracture; 28420 is distinguished by primary bone grafting.
On this page
CMS RVU26D · Effective 2026-10-01
28415 Heel fracture repair Medicare reimbursement rates in Iowa
Open operative reduction of a calcaneal fracture is reported when the heel bone is surgically exposed and repositioned, with fixation when performed. Compare 28415 office and facility rates across CMS payment localities in Iowa.
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.
What does Medicare pay for 28415 in Iowa?
Iowa has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$957.58
1 of 1 localities have a supported rate.
Payment area: Iowa
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Orthopedic surgery
About 28415: Open reduction of calcaneal fracture
Open operative reduction of a calcaneal fracture is reported when the heel bone is surgically exposed and repositioned, with fixation when performed.
An orthopedic surgeon, often a foot and ankle specialist, uses an open approach to expose and reduce a fracture of the calcaneus. Fixation may be used to maintain the reduction. The service is typically performed in a hospital operating room or another surgical facility for a fracture requiring open operative care; the fracture must involve the heel bone rather than the talus or another tarsal bone.
Report the code for the open treatment of the calcaneal fracture, supported by the operative report documenting the fracture site, open approach, reduction, and fixation performed. A calcaneal fracture treated with primary bone grafting belongs to the separate graft-related code, 28420. The 90-day global period includes 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 subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 28415
- 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 procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU15.79 · 50%
- Practice expense (office) RVU12.90 · 41%
- Malpractice RVU2.71 · 9%
1.5K
Medicare services in 2024 · #2664 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.
28415 compared with similar codes
Office rates for Iowa, from the same CMS release.
No office rate
Use 28406 for percutaneous skeletal fixation with manipulation. Use 28415 for an open approach to the fracture.
$455.16
Code 28405 is closed treatment with manipulation, rather than open operative treatment.
No office rate
Code 28445 concerns open treatment of a talus fracture. This code is for a fracture of the calcaneus.
Compare 28415 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Iowa →
Office / nonfacility
Unavailable
Facility
$957.58
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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 28415 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
3,201
- Code
- 28415
- Physician work
- 15.79
- Practice expense
- 12.90
- Malpractice
- 2.71
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 15.79 | × 1.000 | 15.7900 |
| Practice expense | 12.90 | × 0.915 | 11.8035 |
| Malpractice | 2.71 | × 0.397 | 1.0759 |
| Total RVUs | 28.6694 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$957.58
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 15.79 | 1 |
| Practice expense | 12.9 | 0.915 |
| Malpractice | 2.71 | 0.397 |
(15.79 × 1 + 12.9 × 0.915 + 2.71 × 0.397) × $33.4009 = $957.58
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.
28415 billing questions
How does this differ from 28420?
Use 28415 for open treatment of the calcaneal fracture without the primary bone graft distinction. Code 28420 is the alternative when primary bone grafting is part of the open fracture treatment.
When is 28406 more appropriate?
Code 28406 describes percutaneous skeletal fixation of a calcaneal fracture with manipulation. Use 28415 when the surgeon treats the fracture through an open approach.
How does this differ from 28405 or 28400?
Codes 28400 and 28405 describe closed treatment, respectively without and with manipulation. This code is for open operative treatment of the calcaneal fracture.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can this be reported for both heels?
For bilateral calcaneal fracture treatment, modifier 50 applies; CMS pays the bilateral procedure at 150%.
What supports assistant or co-surgeon reporting?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation, and team surgery is 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.
3,19828400,,Cltx calcaneal fx w/o mnpj,A,,2.25,5.50,,4.39,,0.37,8.12,7.01,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,19928405,,Cltx calcaneal fx w/mnpj,A,,4.62,9.41,,6.35,,1.00,15.03,11.97,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,20028406,,Prq skel fix clcnl fx w/mnpj,A,,6.40,8.84,NA,8.84,,1.21,16.45,16.45,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,20128415,,Optx calcaneal fracture,A,,15.79,12.90,NA,12.90,,2.71,31.40,31.40,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,20228420,,Optx calcaneal fx w/bone grf,A,,17.08,15.48,NA,15.48,,3.63,36.19,36.19,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,20328430,,Cltx talus fracture w/o mnpj,A,,2.16,5.43,,3.96,,0.37,7.96,6.49,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,20428435,,Cltx talus fracture w/mnpj,A,,3.45,8.21,,5.67,,0.73,12.39,9.85,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136