$262.66
Choose 28430 for talus fracture treatment without manipulation. This code includes manipulation and percutaneous skeletal fixation.
On this page
CMS RVU26D · Effective 2026-10-01
28436 Talus fracture fixation Medicare reimbursement rates in Wyoming
Reports manipulation and percutaneous skeletal fixation of a talus fracture when reduction is stabilized without open surgical exposure. Compare 28436 office and facility rates across CMS payment localities in Wyoming.
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 28436 in Wyoming?
Wyoming 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
$488.06
1 of 1 localities have a supported rate.
Payment area: Wyoming**
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.
Fracture treatment
About 28436: Percutaneous talus fracture fixation
Reports manipulation and percutaneous skeletal fixation of a talus fracture when reduction is stabilized without open surgical exposure.
An orthopedic surgeon, commonly specializing in foot and ankle surgery, uses manipulation to reduce a talus fracture and places skeletal fixation percutaneously through the skin. The procedure stabilizes the fracture without open exposure of the fracture site. It is typically performed in a surgical facility for a fracture requiring both reduction and fixation.
Report this code when the operative documentation supports manipulation and percutaneous skeletal fixation of the talus; closed manipulation alone or open fixation describes a different service. The 90-day global period 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 procedures, modifier 50 results in payment at 150%. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 28436
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU4.78 · 32%
- Practice expense (office) RVU9.07 · 61%
- Malpractice RVU1.03 · 7%
19
Medicare services in 2024 · #5941 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.
28436 compared with similar codes
Office rates for Wyoming, from the same CMS release.
$407.50
Both involve manipulation of a talus fracture, but this code also includes percutaneous skeletal fixation.
No office rate
Use 28445 when the fracture is treated with open exposure; this code describes percutaneous fixation without open exposure.
Compare 28436 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
Wyoming** →
Office / nonfacility
Unavailable
Facility
$488.06
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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 28436 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
3,205
- Code
- 28436
- Physician work
- 4.78
- Practice expense
- 9.07
- Malpractice
- 1.03
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.78 | × 1.000 | 4.7800 |
| Practice expense | 9.07 | × 1.000 | 9.0700 |
| Malpractice | 1.03 | × 0.740 | 0.7622 |
| Total RVUs | 14.6122 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$488.06
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.78 | 1 |
| Practice expense | 9.07 | 1 |
| Malpractice | 1.03 | 0.74 |
(4.78 × 1 + 9.07 × 1 + 1.03 × 0.74) × $33.4009 = $488.06
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.
28436 billing questions
How does this differ from closed treatment of a talus fracture?
This code describes manipulation followed by percutaneous skeletal fixation. Closed treatment codes describe fracture care without that percutaneous fixation.
How does this differ from open talus fracture treatment?
Use this code when fixation is placed percutaneously without open exposure of the fracture site. Open treatment is reported when the fracture is surgically exposed for treatment.
Does the 90-day global period include related postoperative care?
Yes. The global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.
How is bilateral treatment handled?
For a bilateral procedure, modifier 50 is paid at 150% under the CMS rule supplied for this code.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full; other procedures performed in the same session are subject to the standard multiple procedure reduction.
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.
3,20228420,,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
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
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,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,