28415 Heel fracture repair Medicare reimbursement rates in Michigan

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.