Billing code 28320: Bone repairMedicare rate & RVUs in Washington
Operative repair of a tarsal bone that has failed to unite or healed in poor alignment, typically after prior fracture treatment.
CMS doesn’t publish an office rate for 28320 in Washington.
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 28320 covers
This service addresses a tarsal bone that has not healed or has healed in a position that needs surgical correction. An orthopedic or podiatric surgeon may realign and stabilize the bone, with grafting when needed. Examples include a persistent nonunion or a symptomatic malunion involving a tarsal bone such as the navicular, talus, or calcaneus. These repairs are generally performed in an operating-room setting.
Report 28320 when the operative work treats a tarsal-bone nonunion or malunion, not when the procedure is an osteotomy for another corrective purpose or treatment of an acute fracture. The operative report should identify the bone, the healing problem, relevant prior treatment, and the repair performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For bilateral surgery, modifier 50 is paid at 150%. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and others at 50%. An assistant at surgery may be paid; co-surgeons require 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 28320 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $582.69 |
| Seattle (King Cnty) | Unavailable | $635.93 |
How the 28320 rate is calculated
Each of 28320’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 · 28320
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 9.14Practice expense 6.77Malpractice 1.39
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 28320
28320 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28320
Bone 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) | 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 · 28320
Bone 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 50 · payment effect
With and without the modifier
28320 without 50 · national facility
$577.84
Bone repair
28320-50 · Bilateral: 150%
$866.76
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).
28320 compared with similar codes
Compare codes
28320 vs 28322 vs 28300 vs 28445: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 28322Metatarsal repair
- Choose 28320 for a tarsal bone and 28322 for a metatarsal when repairing a nonunion or malunion.
- 28300Heel osteotomy
- 28300 describes a calcaneal osteotomy. Use 28320 when the operative problem is a tarsal-bone nonunion or malunion, not a planned bone cut for correction.
- 28445Talus fracture surgery
- 28445 is open treatment of a talus fracture. Code 28320 addresses a tarsal bone that has already developed a nonunion or malunion.
28320 billing questions
When should I choose 28320 instead of 28322?
Use 28320 for repair of a tarsal-bone nonunion or malunion. Code 28322 is the corresponding repair code for a metatarsal.
Does the 90-day global include postoperative visits?
Yes. Related postoperative care for 90 days is included, along with the day-before preoperative visit.
How is bilateral repair reported?
For bilateral surgery, report modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons are paid only with supporting documentation, and team surgery is not permitted.
What documentation supports 28320?
Identify the tarsal bone and document the nonunion or malunion, relevant prior treatment, and the operative steps used to repair it.
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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