FeeBase
Log inGet started
Menu

CPT code 28475: Metatarsal fracture, closed reduction, each bone2026 Medicare rate & RVUs in North Carolina

Reports closed reduction of a metatarsal fracture when the clinician manipulates the fracture to improve alignment, with separate reporting for each metatarsal treated.

CMS RVU26DEffective Oct 1, 2026One payment locality616 Medicare services in 2024

In North Carolina, Medicare pays $260.13 for 28475 in the office and $212.14 when it’s performed in a hospital or facility.

$260.13Office (non-facility)
$212.14Hospital or facility
−5.7%vs the national office rate ($275.89)

Check a contract rate as a % of Medicare · 28475 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 28475 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Carolina
  2. What 28475 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 28475 covers

This service covers closed management of a fractured metatarsal that requires manipulation to improve alignment. The clinician performs the reduction without an open incision or percutaneous skeletal fixation, then typically immobilizes the foot. Orthopedic surgeons and podiatrists may provide this treatment in an office, emergency department, or hospital setting.

Report one unit for each metatarsal treated with manipulation. Documentation should identify the fractured bone and support the need for manipulation, including the reduction performed and resulting alignment. The 90-day global period includes the day-before preoperative visit and related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service; 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 North Carolina compares for 28475

Across 109 of 109 payment localities, the office rate for 28475 runs from $246.31 in Arkansas to $353.54 in San Benito County, CA. North Carolina pays $260.13. The RVUs are the same everywhere; the geographic indexes change the dollars.

28475 in North Carolina vs other payment areas
  1. North Carolina · this page$260.13
  2. Los Angeles, CA · California$305.72+$45.59
  3. Washington, DC area · District of Columbia$312.02+$51.89
  4. Miami, FL · Florida$302.57+$42.44
  5. Chicago, IL · Illinois$294.27+$34.14
  6. Manhattan, NY · New York$316.52+$56.39
  7. Alaska · Alaska$329.70+$69.57

Other areas in North Carolina first, then benchmark localities. Bars start at $0.

Every other payment area

28475 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$249.61$204.61
ArkansasArkansas$246.31$202.12
ArizonaArizona$268.90$219.06
Bakersfield, CACalifornia$288.50$232.12
Chico, CACalifornia$287.35$230.98
El Centro, CACalifornia$287.42$231.04
Fresno, CACalifornia$287.35$230.98
Hanford, CACalifornia$287.35$230.98

28475 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.

$246.31

$329.70

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

View every state and territory as a table
28475 office rate range by state
State / territoryOffice rate rangeLocalities
AK$329.701
AL$249.611
AR$246.311
AZ$268.901
CA$287.35–$353.5429
CO$284.771
CT$293.291
DC$312.021
DE$273.091
FL$275.18–$302.573
GA$260.57–$281.442
GU$293.011
HI$293.011
IA$254.011
ID$255.831
IL$268.87–$294.274
IN$257.151
KS$253.591
KY$256.471
LA$256.37–$267.932
MA$283.56–$310.482
MD$277.78–$312.023
ME$257.77–$269.602
MI$263.22–$279.052
MN$271.511
MO$252.78–$268.003
MS$249.561
MT$275.871
NC$260.131
ND$268.151
NE$255.081
NH$281.031
NJ$296.25–$309.342
NM$264.811
NV$273.881
NY$263.77–$324.505
OH$261.641
OK$255.331
OR$271.36–$292.442
PA$261.64–$286.932
PR$277.511
RI$281.791
SC$261.401
SD$267.241
TN$254.851
TX$260.12–$284.178
UT$264.661
VA$269.26–$312.022
VI$277.511
VT$267.811
WA$282.80–$315.862
WI$259.951
WV$259.891
WY$272.501

See 28475 in every payment locality

How the 28475 rate is calculated

Each of 28475’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 · 28475

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.93

2.93 RVUs× 1.000 GPCI

Practice expense4.94

4.94 RVUs× 1.000 GPCI

Malpractice0.39

0.39 RVUs× 1.000 GPCI

Adjusted RVUs

8.2600

Conversion factor

$33.4009

Medicare rate

$275.89

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact North Carolina inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,213

Code
28475
Physician work
2.93
Practice expense
4.94
Malpractice
0.39

GPCI2026.csv

83

Locality
North Carolina
Physician work
1.000
Practice expense
0.933
Malpractice
0.639
Office calculation for 28475 in North Carolina
ComponentRVULocality factorAdjusted
Physician work2.93× 1.0002.9300
Practice expense4.94× 0.9334.6090
Malpractice0.39× 0.6390.2492
Total RVUs7.7882
Conversion factor× 33.4009

Office rate, North Carolina$260.13

Office: (2.93 × 1 + 4.94 × 0.933 + 0.39 × 0.639) × $33.4009 = $260.13

Facility: (2.93 × 1 + 3.4 × 0.933 + 0.39 × 0.639) × $33.4009 = $212.14

Open 28475 in the RVU calculator

Payment rules and modifiers for 28475

28475 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 28475

Metatarsal fracture, closed reduction, each bone

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 · 28475

Metatarsal fracture, closed reduction, each bone

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

28475 without 51 · national office

$275.89

Metatarsal fracture, closed reduction, each bone

28475-51 · Second procedure: 50%

$137.95

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 28475

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

Codes related to 28475
CodeHow it relatesOffice range, North Carolina
Same family
28470Metatarsal fracture care, without manipulation, eachClosed treatment of a metatarsal fracture without manipulation.$222.84
Used instead
28476Metatarsal fracture, percutaneous fixation with manipulationMetatarsal fracture treatment with percutaneous skeletal fixation and manipulation.No office rate
28485Metatarsal fracture surgery, open treatment, eachMetatarsal fracture treatment using open reduction and fixation.No office rate

How 28475 has changed in North Carolina

28475 · Office / nonfacility

$260.13

Effective 2026-10-01

The base rate is $13.22 higher than on 2025-10-01, moving from $246.91 to $260.13 (5.4%).

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

    $246.91changed to$260.13

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.01 changed to 2.93
    • Practice expense RVU 4.72 changed to 4.94
    • Malpractice RVU 0.38 changed to 0.39
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.665 changed to 0.639

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $252.03changed to$246.91

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.66 changed to 4.72
    • Malpractice RVU 0.37 changed to 0.38

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $247.91changed to$252.03

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $251.22changed to$247.91

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.47 changed to 4.66
    • Malpractice RVU 0.35 changed to 0.37
    • Practice expense GPCI 0.927 changed to 0.926
    • Malpractice GPCI 0.742 changed to 0.665

  5. January 1, 2023

    RVU23A

    $250.29changed to$251.22

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.25 changed to 4.47
    • Malpractice RVU 0.34 changed to 0.35
    • Practice expense GPCI 0.928 changed to 0.927
    • Malpractice GPCI 0.819 changed to 0.742

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $251.07changed to$250.29

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 4.21 changed to 4.25

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $252.66changed to$251.07

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.99 changed to 4.21
    • Malpractice RVU 0.37 changed to 0.34
    • Practice expense GPCI 0.930 changed to 0.928
    • Malpractice GPCI 0.757 changed to 0.819

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $251.12changed to$252.66

    • Conversion factor 36.0391 changed to 36.0896
    • Malpractice RVU 0.35 changed to 0.37
    • Practice expense GPCI 0.931 changed to 0.930
    • Malpractice GPCI 0.695 changed to 0.757

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $249.84changed to$251.12

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.96 changed to 3.99

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $249.13changed to$249.84

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.94 changed to 3.96
    • Malpractice RVU 0.36 changed to 0.35
    • Malpractice GPCI 0.732 changed to 0.695

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $250.80changed to$249.13

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 3.99 changed to 3.94
    • Malpractice RVU 0.37 changed to 0.36
    • Practice expense GPCI 0.930 changed to 0.931
    • Malpractice GPCI 0.768 changed to 0.732

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $251.04changed to$250.80

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 3.97 changed to 3.99

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $249.79changed to$251.04

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $247.72changed to$249.79

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.92 changed to 3.97
    • Malpractice RVU 0.36 changed to 0.37
    • Practice expense GPCI 0.929 changed to 0.930
    • Malpractice GPCI 0.732 changed to 0.768

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $246.07changed to$247.72

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 4.27 changed to 3.92
    • Malpractice RVU 0.38 changed to 0.36
    • Practice expense GPCI 0.927 changed to 0.929
    • Malpractice GPCI 0.695 changed to 0.732

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $246.07

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$260.13$212.14RVU26D
2026-07-01$260.13$212.14RVU26C
2026-04-01$260.13$212.14RVU26B
2026-01-01$260.13$212.14RVU26A
2025-10-01$246.91$217.86RVU25D
2025-07-01$246.91$217.86RVU25C
2025-04-01$246.91$217.86RVU25B
2025-01-01$246.91$217.86RVU25A
2024-10-01$252.03$222.44RVU24D
2024-07-01$252.03$222.44RVU24C
2024-04-01$252.03$222.44RVU24B
2024-03-09$252.03$222.44RVU24AR
2024-01-01$247.91$218.80RVU24A
2023-10-01$251.22$221.38RVU23D
2023-07-01$251.22$221.38RVU23C
2023-04-01$251.22$221.38RVU23B
2023-01-01$251.22$221.38RVU23A
2022-10-01$250.29$221.06RVU22D
2022-07-01$250.29$221.06RVU22C
2022-04-01$250.29$221.06RVU22B
2022-01-01$250.29$221.06RVU22A
2021-10-01$251.07$221.60RVU21D
2021-07-01$251.07$221.60RVU21C
2021-04-01$251.07$221.60RVU21B
2021-01-01$251.07$221.60RVU21A
2020-10-01$252.66$224.13RVU20D
2020-07-01$252.66$224.13RVU20C
2020-04-01$252.66$224.13RVU20B
2020-01-01$252.66$224.13RVU20A
2019-10-01$251.12$222.60RVU19D
2019-07-01$251.12$222.60RVU19C
2019-04-01$251.12$222.60RVU19B
2019-01-01$251.12$222.60RVU19A
2018-10-01$249.84$221.68RVU18D
2018-07-01$249.84$221.68RVU18C
2018-04-01$249.84$221.68RVU18B
2018-01-01$249.84$221.68RVU18AR1
2017-10-01$249.13$222.06RVU17D
2017-07-01$249.13$222.06RVU17C
2017-04-01$249.13$222.06RVU17B
2017-01-01$249.13$222.06RVU17A
2016-10-01$250.80$223.17RVU16D
2016-07-01$250.80$223.17RVU16C
2016-04-01$250.80$223.17RVU16B
2016-01-01$250.80$223.17RVU16A
2015-10-01$251.04$223.64RVU15D
2015-07-01$251.04$223.64RVU15C
2015-04-01$249.79$222.53RVU15B
2015-01-01$249.79$222.53RVU15A
2014-10-01$247.72$220.77RVU14D
2014-07-01$247.72$220.77RVU14C
2014-04-01$247.72$220.77RVU14B
2014-01-01$247.72$220.77RVU14A
2013-10-01$246.07$218.00RVU13D
2013-07-01$246.07$218.00RVU13C
2013-04-01$246.07$218.00RVU13B
2013-01-01$246.07$218.00RVU13AR

Price 28475 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Advance
  • Ahoskie
  • Alamance
  • Albemarle
  • Alexis
  • Alliance
  • Altamahaw

Browse all communities in North Carolina

28475 billing questions

How does this differ from 28470?

Use 28475 when the clinician manipulates the metatarsal fracture to improve alignment. Code 28470 describes closed treatment without manipulation.

When is 28476 more appropriate?

Use 28476 when percutaneous skeletal fixation is performed with manipulation. Code 28475 describes closed reduction without that fixation.

How many units should be reported?

Report one unit for each metatarsal treated with manipulation. Document the specific metatarsal or metatarsals addressed.

Should modifier 50 be used for fractures in both feet?

No. CMS identifies bilateral adjustment as inappropriate for this code. Report the service for each treated metatarsal rather than using modifier 50.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

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.

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 28475PPRRVU2026_Oct_nonQPP.csv, line 3,213 (RVU26D)
Geographic factors for North CarolinaGPCI2026.csv, line 83 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 28475 pays in North Carolina?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 28475 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Build my fee sheet