No office rate
28445 is for open fracture treatment. Choose 28436 when the talus fracture is managed with percutaneous skeletal fixation.
On this page
CMS RVU26D · Effective 2026-10-01
28445 Talus fracture surgery Medicare reimbursement rates in Wisconsin
Reports open surgical treatment of a talus fracture, including reduction and internal fixation when performed, such as for a displaced fracture requiring exposure. Compare 28445 office and facility rates across CMS payment localities in Wisconsin.
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 28445 in Wisconsin?
Wisconsin has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$896.51
1 of 1 localities have a supported rate.
Payment area: Wisconsin
One mapped payment locality.
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.
Orthopedic surgery
About 28445: Open treatment of talus fracture
Reports open surgical treatment of a talus fracture, including reduction and internal fixation when performed, such as for a displaced fracture requiring exposure.
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.
CMS billing rules for 28445
- 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 may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU15.37 · 53%
- Practice expense (office) RVU11.08 · 38%
- Malpractice RVU2.78 · 10%
458
Medicare services in 2024 · #3639 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.
28445 compared with similar codes
Office rates for Wisconsin, from the same CMS release.
$385.45
28435 describes closed treatment with manipulation; 28445 describes treatment through an open surgical approach.
No office rate
28415 is open treatment of a calcaneal fracture. Select by the fractured bone: calcaneus versus talus.
No office rate
28446 concerns open treatment of an osteochondral talar problem with grafting, rather than open treatment of a talus fracture.
Compare 28445 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.
1 of 1 payment localities
Wisconsin →
Office / nonfacility
Unavailable
Facility
$896.51
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 28445 in Wisconsin.
PPRRVU2026_Oct_nonQPP.csv
3,206
- Code
- 28445
- Physician work
- 15.37
- Practice expense
- 11.08
- Malpractice
- 2.78
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 15.37 | × 1.000 | 15.3700 |
| Practice expense | 11.08 | × 0.958 | 10.6146 |
| Malpractice | 2.78 | × 0.308 | 0.8562 |
| Total RVUs | 26.8409 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wisconsin$896.51
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 15.37 | 1 |
| Practice expense | 11.08 | 0.958 |
| Malpractice | 2.78 | 0.308 |
(15.37 × 1 + 11.08 × 0.958 + 2.78 × 0.308) × $33.4009 = $896.51
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
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 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.
3,20328430,,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
3,20428435,,Cltx talus fracture w/mnpj,A,,3.45,8.21,,5.67,,0.73,12.39,9.85,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,20528436,,Prq skel fix talus fx w/mnpj,A,,4.78,9.07,NA,9.07,,1.03,14.88,14.88,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,20628445,,Optx talus fracture,A,,15.37,11.08,NA,11.08,,2.78,29.23,29.23,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,20728446,,Opn osteochondrl agrft talus,A,,17.27,12.76,NA,12.76,,3.67,33.70,33.70,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,20828450,,Tx tarsal b1 fx w/o mnpj ea,A,,1.98,4.67,,3.56,,0.28,6.93,5.82,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,20928455,,Tx tarsal b1 fx w/mnpj each,A,,3.16,4.37,,3.20,,0.26,7.79,6.62,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,