CPT 28420 Surgery - Musculoskeletal
Optx calcaneal fx w/bone grf Cost
Body System: Musculoskeletal
Medicare Facility Rate
$1,209
CMS PFS CY2026
Medicare Non-Facility Rate
$1,209
Office/clinic setting
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
17.08
Work RVU
15.48
Facility PE RVU
3.63
Malpractice RVU
36.19
Total RVU
Frequently Asked Questions
How much does Optx calcaneal fx w/bone grf cost?
The Medicare facility rate is $1,209. Commercial insurance typically pays 150-250% of Medicare rates (varies).
How much does Optx calcaneal fx w/bone grf cost without insurance?
Without insurance, you may pay the hospital's chargemaster rate, which is often 300-500% of Medicare. Ask about cash-pay discounts — many facilities offer 20-40% off for self-pay patients. The Medicare baseline for this procedure is $1,209.