$253.80–$280.61
Both describe closed treatment of a calcaneal fracture. Choose 28405 when manipulation is performed; 28400 is for treatment without manipulation.
On this page
CMS RVU26D · Effective 2026-10-01
28405 Heel fracture treatment Medicare reimbursement rates in Texas
Report this service when a clinician treats a calcaneal fracture by closed reduction requiring manipulation, rather than immobilization alone or operative fixation. Compare 28405 office and facility rates across CMS payment localities in Texas.
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 28405 in Texas?
Texas has 8 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 8 payment areas shown below, using the same CMS release.
Office / nonfacility
$471.36–$516.75
8 of 8 localities have a supported rate.
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.
Where 28405 pays more and less in Texas
8 payment localities
$471.36 to $516.75
Orthopedic fracture care
About 28405: Closed reduction of calcaneal fracture
Report this service when a clinician treats a calcaneal fracture by closed reduction requiring manipulation, rather than immobilization alone or operative fixation.
This service covers closed treatment of a fracture of the calcaneus, the heel bone, when the clinician manipulates the fracture to improve alignment without an open surgical approach. Orthopedic surgeons and foot-and-ankle specialists commonly provide this care after a heel injury, using imaging and examination to assess alignment and guide treatment. The fracture may then be supported with external immobilization as part of the treatment plan.
Select this code when the documented treatment includes manipulation; treatment without manipulation is represented by 28400. The record should identify the calcaneal fracture, the reduction or manipulation performed, and the treatment plan. Medicare assigns a 90-day global period, including 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 reduced to 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.
CMS billing rules for 28405
- 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 is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU4.62 · 31%
- Practice expense (office) RVU9.41 · 63%
- Malpractice RVU1.00 · 7%
92
Medicare services in 2024 · #4939 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.
28405 compared with similar codes
Office rates for Texas, from the same CMS release.
No office rate
Both concern a calcaneal fracture treated without open exposure. Use 28406 when percutaneous skeletal fixation is performed; use 28405 for closed manipulation without that fixation.
No office rate
Code 28415 describes open treatment of a calcaneal fracture. This code is for closed treatment with manipulation.
$387.43–$427.19
Both describe closed treatment with manipulation, but 28435 is for a talus fracture. This code is for a calcaneal fracture.
Compare 28405 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.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Office $516.75 | Facility $408.61 |
| Beaumont | Office $471.36 | Facility $378.35 |
| Brazoria | Office $493.07 | Facility $391.79 |
| Dallas | Office $497.40 | Facility $395.61 |
| Fort Worth | Office $494.70 | Facility $393.92 |
| Galveston | Office $495.30 | Facility $393.81 |
| Houston | Office $513.61 | Facility $412.12 |
| Rest Of Texas | Office $482.75 | Facility $385.75 |
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28405 billing questions
How does this differ from 28400?
Use 28405 when treatment includes manipulation to improve fracture alignment. Code 28400 describes closed treatment without manipulation.
When should 28406 be considered instead?
Code 28406 is for treatment using percutaneous skeletal fixation. This code describes closed manipulation without that fixation method.
What documentation supports reporting this code?
Document the calcaneal fracture and the manipulation performed to reduce or improve its alignment, along with the resulting treatment plan.
How is bilateral treatment reported under the CMS facts?
For bilateral procedures, modifier 50 is paid at 150%.
What global and multiple-procedure rules apply?
The code has a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care. In the same session, the highest-valued procedure is paid in full and other procedures are reduced to 50%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. 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 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.
3,19628345,,Repair webbed toe(s),A,,5.94,8.62,,3.71,,0.49,15.05,10.14,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,19728360,,Reconstruct cleft foot,A,,14.55,13.05,NA,13.05,,3.09,30.69,30.69,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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