Billing code 28465: Tarsal fracture repairMedicare rate & RVUs in Virginia
Report open surgical treatment for each fractured tarsal bone other than the talus or calcaneus when the fracture is exposed and reduced.
CMS doesn’t publish an office rate for 28465 in Virginia.
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 28465 covers
An orthopedic foot-and-ankle surgeon uses this code when surgically exposing and reducing a fracture of a tarsal bone other than the talus or calcaneus. Examples of included bones are the navicular, cuboid, and cuneiforms. Internal fixation may be used as part of the repair. These procedures are commonly performed in an operating room for fractures requiring open correction rather than closed treatment or percutaneous fixation.
Report the service for each treated bone and document the bone involved, fracture, open surgical approach, and reduction performed. Choose a closed-treatment or percutaneous-fixation code when that is the method used. The 90-day global period includes 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%. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code; 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 28465 pays more and less in Virginia
| Payment locality | Office | Facility |
|---|---|---|
| Dc + Md/Va Suburbs | Unavailable | $691.38 |
| Virginia | Unavailable | $601.34 |
How the 28465 rate is calculated
Each of 28465’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 · 28465
RVUs × geographic indexes × conversion factor
Work8.58
8.58 RVUs× 1.000 GPCI
Practice expense8.61
8.61 RVUs× 1.000 GPCI
Malpractice1.36
1.36 RVUs× 1.000 GPCI
Adjusted RVUs
18.5500
Conversion factor
$33.4009
Medicare rate
$619.59
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 28465
28465 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28465
Tarsal fracture repair
| 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| 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 · 28465
Tarsal fracture repair
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 51 · payment effect
With and without the modifier
28465 without 51 · national facility
$619.59
Tarsal fracture repair
28465-51 · Second procedure: 50%
$309.80
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
28465 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 28455Tarsal fracture care
- Use 28455 when the tarsal fracture is treated closed with manipulation. Use 28465 when treatment involves open surgical exposure and reduction.
- 28456Tarsal fracture fixation
- Code 28456 is for percutaneous skeletal fixation with manipulation; 28465 represents open treatment of the fracture.
- 28445Talus fracture surgery
- Code 28445 is for open treatment of a talus fracture. Code 28465 applies to other tarsal bones, not the talus or calcaneus.
28465 billing questions
Which tarsal bones are included?
This code covers open treatment of tarsal bones other than the talus and calcaneus, such as the navicular, cuboid, or cuneiforms. Talus and calcaneus fractures have their own codes.
How does this differ from 28455?
Use 28465 for open treatment. Code 28455 describes closed treatment with manipulation, without open surgical treatment.
Is internal fixation included?
Yes. Internal fixation may be part of the open fracture treatment represented by this code; do not separately report a percutaneous fixation service for the same fracture.
How should units be reported for multiple bones?
The code is reported for each treated tarsal bone. Document the specific bone treated; do not use the code for a talus or calcaneus fracture.
Can modifier 50 be used for bilateral treatment?
No. CMS identifies bilateral adjustment as inappropriate for this code. The descriptor is reported per bone.
Can an assistant or co-surgeon be billed?
Medicare does not pay an assistant at surgery for this code. 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
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