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

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 Utah, Medicare pays $264.66 for 28475 in the office and $216.31 when it’s performed in a hospital or facility.

$264.66Office (non-facility)
$216.31Hospital or facility
−4.1%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 Utah
  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 Utah 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. Utah pays $264.66. The RVUs are the same everywhere; the geographic indexes change the dollars.

28475 in Utah vs other payment areas
  1. Utah · this page$264.66
  2. Los Angeles, CA · California$305.72+$41.06
  3. Washington, DC area · District of Columbia$312.02+$47.36
  4. Miami, FL · Florida$302.57+$37.91
  5. Chicago, IL · Illinois$294.27+$29.61
  6. Manhattan, NY · New York$316.52+$51.86
  7. Alaska · Alaska$329.70+$65.04

Other areas in Utah 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 Utah 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

104

Locality
Utah
Physician work
1.000
Practice expense
0.940
Malpractice
0.898
Office calculation for 28475 in Utah
ComponentRVULocality factorAdjusted
Physician work2.93× 1.0002.9300
Practice expense4.94× 0.9404.6436
Malpractice0.39× 0.8980.3502
Total RVUs7.9238
Conversion factor× 33.4009

Office rate, Utah$264.66

Office: (2.93 × 1 + 4.94 × 0.94 + 0.39 × 0.898) × $33.4009 = $264.66

Facility: (2.93 × 1 + 3.4 × 0.94 + 0.39 × 0.898) × $33.4009 = $216.31

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, Utah
Same family
28470Metatarsal fracture care, without manipulation, eachClosed treatment of a metatarsal fracture without manipulation.$226.48
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 Utah

28475 · Office / nonfacility

$264.66

Effective 2026-10-01

The base rate is $13.42 higher than on 2025-10-01, moving from $251.24 to $264.66 (5.3%).

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

    $251.24changed to$264.66

    • 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 0.933 changed to 0.940
    • Malpractice GPCI 0.930 changed to 0.898

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $256.38changed to$251.24

    • 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

    $252.19changed to$256.38

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $252.53changed to$252.19

    • 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 0.926 changed to 0.933
    • Malpractice GPCI 0.865 changed to 0.930

  5. January 1, 2023

    RVU23A

    $248.73changed to$252.53

    • 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 0.919 changed to 0.926
    • Malpractice GPCI 0.799 changed to 0.865

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $249.51changed to$248.73

    • 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

    $254.65changed to$249.51

    • 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 0.923 changed to 0.919
    • Malpractice GPCI 0.982 changed to 0.799

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $256.47changed to$254.65

    • Conversion factor 36.0391 changed to 36.0896
    • Malpractice RVU 0.35 changed to 0.37
    • Practice expense GPCI 0.927 changed to 0.923
    • Malpractice GPCI 1.165 changed to 0.982

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $255.19changed to$256.47

    • 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

    $253.90changed to$255.19

    • 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
    • Practice expense GPCI 0.925 changed to 0.927
    • Malpractice GPCI 1.167 changed to 1.165

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $254.97changed to$253.90

    • 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 0.922 changed to 0.925
    • Malpractice GPCI 1.169 changed to 1.167

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $255.23changed to$254.97

    • 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

    $253.96changed to$255.23

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $251.53changed to$253.96

    • 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 0.919 changed to 0.922
    • Malpractice GPCI 1.136 changed to 1.169

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $249.73changed to$251.53

    • 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 0.916 changed to 0.919
    • Malpractice GPCI 1.102 changed to 1.136

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $249.73

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$264.66$216.31RVU26D
2026-07-01$264.66$216.31RVU26C
2026-04-01$264.66$216.31RVU26B
2026-01-01$264.66$216.31RVU26A
2025-10-01$251.24$221.97RVU25D
2025-07-01$251.24$221.97RVU25C
2025-04-01$251.24$221.97RVU25B
2025-01-01$251.24$221.97RVU25A
2024-10-01$256.38$226.56RVU24D
2024-07-01$256.38$226.56RVU24C
2024-04-01$256.38$226.56RVU24B
2024-03-09$256.38$226.56RVU24AR
2024-01-01$252.19$222.86RVU24A
2023-10-01$252.53$222.72RVU23D
2023-07-01$252.53$222.72RVU23C
2023-04-01$252.53$222.72RVU23B
2023-01-01$252.53$222.72RVU23A
2022-10-01$248.73$219.79RVU22D
2022-07-01$248.73$219.79RVU22C
2022-04-01$248.73$219.79RVU22B
2022-01-01$248.73$219.79RVU22A
2021-10-01$249.51$220.33RVU21D
2021-07-01$249.51$220.33RVU21C
2021-04-01$249.51$220.33RVU21B
2021-01-01$249.51$220.33RVU21A
2020-10-01$254.65$226.34RVU20D
2020-07-01$254.65$226.34RVU20C
2020-04-01$254.65$226.34RVU20B
2020-01-01$254.65$226.34RVU20A
2019-10-01$256.47$228.07RVU19D
2019-07-01$256.47$228.07RVU19C
2019-04-01$256.47$228.07RVU19B
2019-01-01$256.47$228.07RVU19A
2018-10-01$255.19$227.16RVU18D
2018-07-01$255.19$227.16RVU18C
2018-04-01$255.19$227.16RVU18B
2018-01-01$255.19$227.16RVU18AR1
2017-10-01$253.90$227.01RVU17D
2017-07-01$253.90$227.01RVU17C
2017-04-01$253.90$227.01RVU17B
2017-01-01$253.90$227.01RVU17A
2016-10-01$254.97$227.57RVU16D
2016-07-01$254.97$227.57RVU16C
2016-04-01$254.97$227.57RVU16B
2016-01-01$254.97$227.57RVU16A
2015-10-01$255.23$228.06RVU15D
2015-07-01$255.23$228.06RVU15C
2015-04-01$253.96$226.93RVU15B
2015-01-01$253.96$226.93RVU15A
2014-10-01$251.53$224.86RVU14D
2014-07-01$251.53$224.86RVU14C
2014-04-01$251.53$224.86RVU14B
2014-01-01$251.53$224.86RVU14A
2013-10-01$249.73$221.99RVU13D
2013-07-01$249.73$221.99RVU13C
2013-04-01$249.73$221.99RVU13B
2013-01-01$249.73$221.99RVU13AR

Price 28475 for an earlier date of service

Where the Utah rate applies

Utah is a Medicare payment area, not a city. Our Census mapping connects it to 334 cities and communities in Utah. Some span more than one payment area; confirm with the service ZIP.

  • Alpine
  • Alta
  • Altamont
  • Alton
  • Amalga
  • American Fork
  • Aneth
  • Annabella

Browse all communities in Utah

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 UtahGPCI2026.csv, line 104 (RVU26D)

Open CMS sourceHow we calculate rates

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