$471.36–$516.75
Both involve manipulation of a calcaneal fracture, but 28406 includes percutaneous skeletal fixation; 28405 describes closed treatment without that fixation.
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CMS RVU26D · Effective 2026-10-01
28406 Calcaneal fracture repair Medicare reimbursement rates in Texas
Reports manipulative reduction and percutaneous skeletal fixation of a calcaneal fracture when pins or screws stabilize the repositioned bone. Compare 28406 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 28406 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
No 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 28406 pays more and less in Texas
Orthopedic surgery
About 28406: Percutaneous calcaneal fracture fixation with manipulation
Reports manipulative reduction and percutaneous skeletal fixation of a calcaneal fracture when pins or screws stabilize the repositioned bone.
An orthopedic trauma or foot-and-ankle surgeon uses manipulation to reposition a calcaneal fracture, then stabilizes it with skeletal fixation placed through the skin rather than through an open surgical exposure. The procedure is commonly performed in an operating room, often with imaging guidance, for a fracture requiring both reduction and percutaneous fixation. The service is specific to the calcaneus, the heel bone.
Report this code when the operative record supports both manipulation and percutaneous skeletal fixation; closed manipulation without fixation and open fixation are different services. Document the fracture site, laterality, reduction, and fixation performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with 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 28406
- 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 RVU6.40 · 39%
- Practice expense (office) RVU8.84 · 54%
- Malpractice RVU1.21 · 7%
110
Medicare services in 2024 · #4804 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.
28406 compared with similar codes
Office rates for Texas, from the same CMS release.
No office rate
Use 28415 for open treatment of a calcaneal fracture. Use 28406 when reduction and skeletal fixation are performed percutaneously.
$253.80–$280.61
28400 is closed treatment of a calcaneal fracture without manipulation. 28406 includes manipulation and percutaneous skeletal fixation.
No office rate
28420 describes open calcaneal fracture treatment with bone grafting; it is distinct from percutaneous fixation with manipulation.
Compare 28406 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 Unavailable | Facility $562.39 |
| Beaumont | Office Unavailable | Facility $520.00 |
| Brazoria | Office Unavailable | Facility $539.61 |
| Dallas | Office Unavailable | Facility $544.45 |
| Fort Worth | Office Unavailable | Facility $542.02 |
| Galveston | Office Unavailable | Facility $542.14 |
| Houston | Office Unavailable | Facility $564.28 |
| Rest Of Texas | Office Unavailable | Facility $530.47 |
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28406 billing questions
How is 28406 different from closed treatment with manipulation?
Use 28406 when the calcaneal fracture is manipulated and percutaneous skeletal fixation is placed. Closed treatment with manipulation alone is represented by 28405.
When is open treatment a better code choice?
When the surgeon exposes the fracture for open fixation, consider 28415 rather than 28406. The operative approach and fixation described in the record distinguish the services.
What should the operative note support?
Document the calcaneal fracture, laterality, manipulative reduction, and percutaneous skeletal fixation. The note should make clear that fixation was placed through the skin rather than through open exposure.
How does the 90-day global period affect related care?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period for this major surgery.
Can 28406 be reported bilaterally?
For bilateral procedures, CMS applies modifier 50 and pays the procedure at 150%. Document treatment of both calcanei.
When is assistant-at-surgery payment allowed?
CMS allows assistant-at-surgery payment only when medical necessity is documented. Co-surgeons and team surgery are not permitted for this code.
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.
3,19728360,,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
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