Billing code 28445: Talus fracture surgeryMedicare rate & RVUs in Oregon
Reports open surgical treatment of a talus fracture, including reduction and internal fixation when performed, such as for a displaced fracture requiring exposure.
CMS doesn’t publish an office rate for 28445 in Oregon.
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 28445 covers
An orthopedic surgeon typically reports this service when the talus fracture is treated through an open surgical approach to expose and reduce the fracture. Internal fixation, such as plates or screws, is included when performed. A common setting is an operating room for a displaced talar fracture requiring direct access; the code is specific to fracture treatment of the talus, not a neighboring tarsal bone or an osteochondral graft procedure.
The operative report should identify the talus fracture and document the open approach and reduction; describe fixation when used. This major surgery has a 90-day global period that 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 treatment, 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.
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 28445 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $1,001.83 |
| Rest Of Oregon | Unavailable | $947.25 |
How the 28445 rate is calculated
Each of 28445’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 · 28445
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 15.37Practice expense 11.08Malpractice 2.78
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 28445
28445 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28445
Talus fracture surgery
| 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| 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 · 28445
Talus fracture surgery
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
28445 without 50 · national facility
$976.31
Talus fracture surgery
28445-50 · Bilateral: 150%
$1,464.47
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).
28445 compared with similar codes
Compare codes
28445 vs 28436 vs 28435 vs 28415 vs 28446: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 28436Talus fracture fixation
- 28445 is for open fracture treatment. Choose 28436 when the talus fracture is managed with percutaneous skeletal fixation.
- 28435Talus fracture care
- 28435 describes closed treatment with manipulation; 28445 describes treatment through an open surgical approach.
- 28415Heel fracture repair
- 28415 is open treatment of a calcaneal fracture. Select by the fractured bone: calcaneus versus talus.
- 28446Talar lesion surgery
- 28446 concerns open treatment of an osteochondral talar problem with grafting, rather than open treatment of a talus fracture.
28445 billing questions
How does 28445 differ from percutaneous talus fixation?
Use 28445 when the fracture is treated through an open approach. Code 28436 describes percutaneous skeletal fixation rather than open treatment.
Is internal fixation separately reported with 28445?
No separate fracture-treatment code is needed for internal fixation when it is performed as part of the open treatment; fixation is included in 28445.
When is modifier 50 appropriate?
For bilateral talus fracture treatment, CMS lists modifier 50 payment at 150%. The operative documentation should support treatment of both sides.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What documentation supports choosing 28445 over closed treatment?
Document the talus fracture, open surgical approach, and fracture reduction. For 28445, the record should support open treatment rather than closed management or percutaneous fixation.
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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