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CPT code 28470: Metatarsal fracture care, without manipulation, each2026 Medicare rate & RVUs in Puerto Rico

Reports closed care of an individual metatarsal fracture when the provider immobilizes it without manipulating or reducing the fracture.

CMS RVU26DEffective Oct 1, 2026One payment locality19.9K Medicare services in 2024

In Puerto Rico, Medicare pays $238.78 for 28470 in the office and $210.07 when it’s performed in a hospital or facility.

$238.78Office (non-facility)
$210.07Hospital or facility
+0.7%vs the national office rate ($237.15)

Check a contract rate as a % of Medicare · 28470 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 28470 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 28470 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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.

How Puerto Rico compares for 28470

Across 109 of 109 payment localities, the office rate for 28470 runs from $209.70 in Arkansas to $311.23 in San Benito County, CA. Puerto Rico pays $238.78. The RVUs are the same everywhere; the geographic indexes change the dollars.

28470 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$238.78
  2. Los Angeles, CA · California$266.13+$27.35
  3. Washington, DC area · District of Columbia$270.53+$31.75
  4. Miami, FL · Florida$258.57+$19.79
  5. Chicago, IL · Illinois$250.96+$12.18
  6. Manhattan, NY · New York$273.19+$34.41
  7. Alaska · Alaska$276.35+$37.57

Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.

Every other payment area

28470 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$212.78$187.93
ArkansasArkansas$209.70$185.31
ArizonaArizona$230.75$203.24
Bakersfield, CACalifornia$250.10$218.99
Chico, CACalifornia$249.26$218.15
El Centro, CACalifornia$249.31$218.20
Fresno, CACalifornia$249.26$218.15
Hanford, CACalifornia$249.26$218.15

28470 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$209.70

$280.25

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
28470 office rate range by state
State / territoryOffice rate rangeLocalities
AK$276.351
AL$212.781
AR$209.701
AZ$230.751
CA$249.26–$311.2329
CO$246.141
CT$252.931
DC$270.531
DE$234.561
FL$234.92–$258.573
GA$221.58–$241.872
GU$255.171
HI$255.171
IA$217.591
ID$219.141
IL$228.56–$250.964
IN$220.391
KS$216.851
KY$218.421
LA$218.19–$228.952
MA$244.79–$270.092
MD$238.95–$270.533
ME$220.58–$232.122
MI$224.36–$238.142
MN$235.011
MO$214.63–$229.423
MS$212.191
MT$237.131
NC$222.841
ND$231.391
NE$218.701
NH$242.551
NJ$255.57–$267.782
NM$225.701
NV$235.691
NY$226.20–$280.175
OH$223.191
OK$217.721
OR$233.62–$253.632
PA$223.38–$246.822
PR$238.781
RI$242.681
SC$223.431
SD$230.711
TN$217.981
TX$221.94–$245.538
UT$226.481
VA$231.56–$270.532
VI$238.781
VT$230.751
WA$244.24–$275.302
WI$223.671
WV$220.191
WY$234.631

See 28470 in every payment locality

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

Office or facility?

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.

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,212

Code
28470
Physician work
1.98
Practice expense
4.83
Malpractice
0.29

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 28470 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work1.98× 1.0001.9800
Practice expense4.83× 1.0114.8831
Malpractice0.29× 0.9850.2856
Total RVUs7.1488
Conversion factor× 33.4009

Office rate, Puerto Rico$238.78

Office: (1.98 × 1 + 4.83 × 1.011 + 0.29 × 0.985) × $33.4009 = $238.78

Facility: (1.98 × 1 + 3.98 × 1.011 + 0.29 × 0.985) × $33.4009 = $210.07

Open 28470 in the RVU calculator

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

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share 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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

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%).

When to use modifier 51

Codes related to 28470

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 28470
CodeHow it relatesOffice range, Puerto Rico
Same family
28475Metatarsal fracture, closed reduction, each boneMetatarsal fracture treatment when manipulation is performed.$277.51
28476Metatarsal fracture, percutaneous fixation with manipulationMetatarsal fracture treatment using percutaneous skeletal fixation.No office rate
28485Metatarsal fracture surgery, open treatment, eachMetatarsal fracture treatment using open reduction and internal fixation.No office rate

How 28470 has changed in Puerto Rico

28470 · Office / nonfacility

$238.78

Effective 2026-10-01

The base rate is $17.64 higher than on 2025-10-01, moving from $221.14 to $238.78 (8.0%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $221.14changed to$238.78

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.03 changed to 1.98
    • Practice expense RVU 4.50 changed to 4.83
    • Malpractice RVU 0.28 changed to 0.29
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $226.22changed to$221.14

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.45 changed to 4.50
    • Malpractice RVU 0.29 changed to 0.28

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $222.53changed to$226.22

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $225.70changed to$222.53

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.33 changed to 4.45
    • Malpractice RVU 0.27 changed to 0.29
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $224.67changed to$225.70

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $226.31changed to$224.67

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.19 changed to 4.33
    • Malpractice RVU 0.29 changed to 0.27
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $226.08changed to$226.31

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 4.14 changed to 4.19
    • Malpractice RVU 0.28 changed to 0.29

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $226.93changed to$226.08

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.93 changed to 4.14
    • Malpractice RVU 0.30 changed to 0.28
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $226.50changed to$226.93

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.95 changed to 3.93
    • Malpractice RVU 0.28 changed to 0.30
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $227.70changed to$226.50

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.98 changed to 3.95
    • Malpractice RVU 0.29 changed to 0.28

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $200.27changed to$227.70

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.93 changed to 3.98
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $175.54changed to$200.27

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 3.95 changed to 3.93
    • Malpractice RVU 0.30 changed to 0.29
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $176.17changed to$175.54

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $175.29changed to$176.17

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $173.25changed to$175.29

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.93 changed to 3.95
    • Malpractice RVU 0.32 changed to 0.30
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $172.21changed to$173.25

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 4.35 changed to 3.93
    • Malpractice RVU 0.33 changed to 0.32
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $172.21

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$238.78$210.07RVU26D
2026-07-01$238.78$210.07RVU26C
2026-04-01$238.78$210.07RVU26B
2026-01-01$238.78$210.07RVU26A
2025-10-01$221.14$208.76RVU25D
2025-07-01$221.14$208.76RVU25C
2025-04-01$221.14$208.76RVU25B
2025-01-01$221.14$208.76RVU25A
2024-10-01$226.22$213.15RVU24D
2024-07-01$226.22$213.15RVU24C
2024-04-01$226.22$213.15RVU24B
2024-03-09$226.22$213.15RVU24AR
2024-01-01$222.53$209.67RVU24A
2023-10-01$225.70$212.04RVU23D
2023-07-01$224.67$211.12RVU23C
2023-04-01$224.67$211.12RVU23B
2023-01-01$224.67$211.12RVU23A
2022-10-01$226.31$212.70RVU22D
2022-07-01$226.31$212.70RVU22C
2022-04-01$226.31$212.70RVU22B
2022-01-01$226.31$212.70RVU22A
2021-10-01$226.08$211.31RVU21D
2021-07-01$226.08$211.31RVU21C
2021-04-01$226.08$211.31RVU21B
2021-01-01$226.08$211.31RVU21A
2020-10-01$226.93$212.01RVU20D
2020-07-01$226.93$212.01RVU20C
2020-04-01$226.93$212.01RVU20B
2020-01-01$226.93$212.01RVU20A
2019-10-01$226.50$210.90RVU19D
2019-07-01$226.50$210.90RVU19C
2019-04-01$226.50$210.90RVU19B
2019-01-01$226.50$210.90RVU19A
2018-10-01$227.70$211.38RVU18D
2018-07-01$227.70$211.38RVU18C
2018-04-01$227.70$211.38RVU18B
2018-01-01$227.70$211.38RVU18AR1
2017-10-01$200.27$187.67RVU17D
2017-07-01$200.27$187.67RVU17C
2017-04-01$200.27$187.67RVU17B
2017-01-01$200.27$187.67RVU17A
2016-10-01$175.54$165.19RVU16D
2016-07-01$175.54$165.19RVU16C
2016-04-01$175.54$165.19RVU16B
2016-01-01$175.54$165.19RVU16A
2015-10-01$176.17$165.53RVU15D
2015-07-01$176.17$165.53RVU15C
2015-04-01$175.29$164.71RVU15B
2015-01-01$175.29$164.71RVU15A
2014-10-01$173.25$163.09RVU14D
2014-07-01$173.25$163.09RVU14C
2014-04-01$173.25$163.09RVU14B
2014-01-01$173.25$163.09RVU14A
2013-10-01$172.21$161.60RVU13D
2013-07-01$172.21$161.60RVU13C
2013-04-01$172.21$161.60RVU13B
2013-01-01$172.21$161.60RVU13AR

Price 28470 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

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
RVUs for 28470PPRRVU2026_Oct_nonQPP.csv, line 3,212 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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