Billing code 28545: Foot dislocationMedicare rate & RVUs in Missouri
Report this service when a clinician treats a dislocated tarsal joint by closed reduction that requires manipulation rather than open repair.
Medicare pays $313.12–$335.65 for 28545 in the office in Missouri, from Rest Of Missouri to Metropolitan St. Louis. 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 28545 covers
This service covers closed reduction of a dislocated tarsal joint when the clinician must manipulate the joint to restore alignment. Orthopedic surgeons, podiatrists, and other qualified practitioners may provide it in an operating room, procedure area, or other setting appropriate to the reduction. The treatment is performed without opening the joint for repair; documentation should identify the affected joint and the manipulation used to reduce the dislocation.
Report this code when manipulation is required, rather than the related closed-treatment code for a tarsal dislocation treated without manipulation. The record should support the diagnosis, anatomic site, reduction, and need for manipulation. CMS assigns a 90-day major-surgery global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued is paid in full and others at 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 28545 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$313.12 to $335.65
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City | $332.03 | $266.16 |
| Metropolitan St. Louis | $335.65 | $268.88 |
| Rest Of Missouri | $313.12 | $252.66 |
How the 28545 rate is calculated
Each of 28545’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 · 28545
RVUs × geographic indexes × conversion factor
Work2.54
2.54 RVUs× 1.000 GPCI
Practice expense7.33
7.33 RVUs× 1.000 GPCI
Malpractice0.53
0.53 RVUs× 1.000 GPCI
Adjusted RVUs
10.4000
Conversion factor
$33.4009
Medicare rate
$347.37
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 28545
28545 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28545
Foot dislocation
| 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 · 28545
Foot dislocation
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
28545 without 50 · national office
$347.37
Foot dislocation
28545-50 · Bilateral: 150%
$521.06
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).
28545 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 28540Tarsal dislocation
- Choose 28540 when the tarsal dislocation is treated closed without manipulation; 28545 requires manipulation.
- 28546Tarsal dislocation
- Both describe closed manipulation treatment of a tarsal dislocation; 28546 specifies treatment with anesthesia.
- 28555Foot dislocation repair
- Use 28555 for open treatment of a tarsal joint dislocation. Code 28545 describes closed reduction with manipulation.
- 28575Toe dislocation
- Code 28575 concerns closed treatment with manipulation of a metatarsophalangeal joint dislocation, not a tarsal joint dislocation.
28545 billing questions
How does this differ from 28540?
Use 28545 when reduction requires manipulation. Code 28540 is for closed treatment of a tarsal joint dislocation without manipulation.
When would 28546 be more appropriate?
Code 28546 describes closed treatment of a tarsal joint dislocation requiring manipulation with anesthesia. Distinguish it from 28545 based on the service and anesthesia documented.
Is open repair included in this code?
No. This code describes closed treatment. Open treatment of a tarsal joint dislocation is represented by 28555.
What postoperative care is included?
The 90-day major-surgery global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral treatment paid?
CMS identifies this as a bilateral procedure; when both sides are treated and modifier 50 is reported, payment is at 150%.
Can an assistant surgeon be reported?
Assistant-at-surgery payment is allowed only when medical necessity is documented. 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
Fee sheets
Put 28545 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →