CPT code 28470: Metatarsal fracture care, without manipulation, each2026 Medicare rate & RVUs in California
Reports closed care of an individual metatarsal fracture when the provider immobilizes it without manipulating or reducing the fracture.
Medicare pays $249.26–$311.23 for 28470 in the office in California, from Chico, CA to San Benito County, CA. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 28470 covers
This code covers closed treatment of a metatarsal fracture without manipulating the fracture. An orthopedist, podiatrist, or other qualified treating clinician may provide this care in an office, emergency department, or hospital setting. Treatment commonly involves immobilizing a stable fracture with a cast, splint, or walking boot; the code is for fracture care, not simply an evaluation or imaging service. It applies to each metatarsal treated, so the record should identify the affected bone and show that no manipulation was performed.
Report the code for the metatarsal receiving this treatment and document the fracture, treatment plan, and immobilization. CMS assigns a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. 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% multiple-procedure reduction. Bilateral adjustment is inappropriate for this code. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.
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.
Where 28470 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 payment localities
$249.26 to $311.23
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $250.10 | $218.99 |
| Chico, CA | $249.26 | $218.15 |
| El Centro, CA | $249.31 | $218.20 |
| Fresno, CA | $249.26 | $218.15 |
| Hanford, CA | $249.26 | $218.15 |
| Los Angeles, CA | $266.13 | $232.54 |
| Madera, CA | $249.26 | $218.15 |
| Marin County, CA | $304.33 | $264.30 |
| Merced, CA | $249.26 | $218.15 |
| Modesto, CA | $249.26 | $218.15 |
| Napa, CA | $287.85 | $250.43 |
| Oxnard, CA | $264.71 | $231.15 |
| Redding, CA | $249.26 | $218.15 |
| Rest of California | $249.26 | $218.15 |
| Riverside, CA | $252.40 | $221.28 |
| Sacramento, CA | $261.33 | $228.31 |
| Salinas, CA | $260.35 | $227.45 |
| San Benito County, CA | $311.23 | $270.29 |
| San Diego, CA | $266.31 | $232.36 |
| San Francisco, CA | $304.00 | $263.97 |
| San Luis Obispo, CA | $256.20 | $223.86 |
| Santa Clara County, CA | $309.89 | $268.95 |
| Santa Cruz, CA | $268.73 | $234.23 |
| Santa Maria, CA | $261.28 | $228.18 |
| Santa Rosa, CA | $271.42 | $236.55 |
| Stockton, CA | $249.26 | $218.15 |
| Vallejo, CA | $287.37 | $249.96 |
| Visalia, CA | $249.26 | $218.15 |
| Yuba City, CA | $249.26 | $218.15 |
How the 28470 rate is calculated
Each of 28470’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 28470
RVUs × geographic indexes × conversion factor
Work1.98
1.98 RVUs× 1.000 GPCI
Practice expense4.83
4.83 RVUs× 1.000 GPCI
Malpractice0.29
0.29 RVUs× 1.000 GPCI
Adjusted RVUs
7.1000
Conversion factor
$33.4009
Medicare rate
$237.15
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 28470
28470 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28470
Metatarsal fracture care, without manipulation, each
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 28470
Metatarsal fracture care, without manipulation, each
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
28470 without 51 · national office
$237.15
Metatarsal fracture care, without manipulation, each
28470-51 · Second procedure: 50%
$118.58
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
28470 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 28475Metatarsal fractureClosed reduction, each bone
- Both address closed treatment of a metatarsal fracture. Use 28475 when the provider manipulates the fracture; 28470 is for treatment without manipulation.
- 28476Metatarsal fracturePercutaneous fixation with manipulation
- 28476 involves percutaneous skeletal fixation of the metatarsal fracture. 28470 describes closed treatment without manipulation or fixation.
- 28485Metatarsal fracture surgeryOpen treatment, each
- 28485 is for open reduction and internal fixation of a metatarsal fracture. 28470 is closed treatment without manipulation.
28470 billing questions
When should 28470 be chosen instead of 28475?
Use 28470 when the metatarsal fracture is treated without manipulation. Choose 28475 when the provider manipulates the fracture.
How is the code reported when more than one metatarsal is treated?
The descriptor is for each metatarsal. Document which metatarsal bones were treated and the treatment provided to each.
Is immobilization included in fracture care?
Casting, splinting, or boot immobilization may be part of the closed fracture treatment. Related postoperative care during the 90-day global period is included.
Should modifier 50 be used for fractures in both feet?
No. CMS identifies bilateral adjustment as inappropriate for this code; report the treated metatarsals according to the code's each-unit structure.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard 50% 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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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