28420 Calcaneal fracture repair Medicare reimbursement rates in Wyoming

An orthopedic surgeon uses this code for open repair of a heel bone fracture that requires bone graft as part of the reconstruction. The fracture is exposed surgically, reduced, and reconstructed with graft; internal fixation is included when performed. This approach may be used when the fracture pattern leaves a defect that the surgeon addresses with graft. These repairs are generally performed in a facility setting, such as a hospital or ambulatory surgery center.

Select this code when the operative report supports both open fracture treatment and use of bone graft in the repair. Open treatment without graft is represented by a different calcaneal fracture code; closed reduction and percutaneous fixation are different treatment methods. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral procedures reported with modifier 50, CMS pays at 150%. Assistant-at-surgery services may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.