Interactive Tool

Nonoperative Fracture Billing Calculator

Closed-treatment fracture codes with a four-step workflow. Find the right code and see its wRVU value instantly.

Non-operative fracture billing, wRVU strategy guide

Closed treatment codes · Excludes open/ORIF, spine, sternum, rib · 2026 CMS National Physician Fee Schedule

Step 1, Select fracture code(s)
Filter by type and region, or pick a specific code. Multiple selections combine.
Treatment type
Body region
Specific code
Step 2, Initial visit
Configure the first encounter when fracture care is initiated.
New or established patient?
E/M level documented?
Will you document and bill a separate E/M at this encounter?
Step 3, Follow-up visits
Under the fracture code strategy, all follow-ups within 90 days are bundled. Under E/M-only, each visit is billed individually.
E/M level at follow-up visits?
99214 (Moderate MDM): imaging review, management decisions. 99213 (Low MDM): straightforward follow-up.
Follow-up visits planned?
Typical: 2w, 6w, 12w = 3 visits. Chart marks your planned endpoint.
Include G2211 complexity add-on? (+0.33 wRVU per visit, all visits except the final discharge visit)
G2211 is a CMS add-on for office E/M visits where you are the ongoing or principal care physician for a complex patient. It applies to all visits except the last. G2211 cannot be billed on the same date as any procedure with a 0, 10, or 90-day global, it is blocked under E/M + fracture code and fracture code only strategies. It is available only under the E/M-only strategy, and is one of the factors that most tips the balance toward E/M-only at higher visit counts.
Step 4, Cast and splint codes
Separately billable under E/M-only strategy. Bundled in the 90-day global under the fracture code strategy. Walking boots are DME, not billable as cast codes.
Immobilization at initial visit?
Cast work at follow-up visits?
Important notice: This tool is an educational reference only. wRVU values are based on the 2026 CMS National Physician Fee Schedule and subject to annual revision. All coding decisions must reflect complete, accurate, and contemporaneous documentation. Code what you did, never what the wRVU suggests. Consult your compliance team for specific guidance.
Created by Michael MacKechnie, MD CM FRCSC FABOS FAAOS
© March 2026  ·  For institutional educational use only  ·  Not for distribution without permission

Educational tool. wRVU values reflect the current Medicare Physician Fee Schedule and change annually. Verify against official sources before relying on them for coding decisions.