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CMS RVU26D · Effective 2026-10-01

28475 in Austin

Office / nonfacility

$284.17

Base rate per service

Facility setting

$229.75

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Orthopedic surgery

About 28475: Closed metatarsal fracture reduction

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

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.

CMS billing rules for 28475

Global period
Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
Multiple procedures
Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
Bilateral procedures
Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
Assistant at surgery
Statutory restriction: assistant at surgery is not paid.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU2.93 · 35%
  • Practice expense (office) RVU4.94 · 60%
  • Malpractice RVU0.39 · 5%

616

Medicare services in 2024 · #3366 by national volume

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.

28475 compared with similar codes

Office rates for Austin, from the same CMS release.

28470

Metatarsal fracture care

Without manipulation, each

$245.53

Choose 28470 for closed treatment without manipulation; choose 28475 when manipulation is performed to improve fracture alignment.

28476

Metatarsal fracture

Percutaneous fixation with manipulation

No office rate

Choose 28476 when percutaneous skeletal fixation accompanies manipulation. Use 28475 for closed manipulation without percutaneous skeletal fixation.

28485

Metatarsal fracture surgery

Open treatment, each

No office rate

Choose 28485 for open reduction and fixation of the metatarsal fracture. Code 28475 represents closed treatment with manipulation.

The same code, a different location

How does Austin compare?

In Beaumont, the office rate for 28475 is $260.12—$24.05 lower than the $284.17 rate in Austin. Both use the same code, release and participation basis.

28475 across payment areas

Same release and payment basis · bars start at $0

  1. Austin · This locality

    $284.17

  2. Beaumont

    $260.12

    $24.05 lower than Austin

  3. Brazoria

    $272.32

    $11.85 lower than Austin

  4. Dallas

    $274.26

    $9.91 lower than Austin

  5. Fort Worth

    $272.78

    $11.39 lower than Austin

  6. Galveston

    $273.28

    $10.89 lower than Austin

  7. Houston

    $280.42

    $3.75 lower than Austin

Other payment areas listed in Texas appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 28475 ranges from $246.31 in Arkansas to $353.54 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Rest Of Texas

    Texas · 28475

    Office

    $266.21

    Facility

    $217.40

    $17.96 lower than Austin for the office setting.

  • Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    California · 28475

    Office

    $305.72

    Facility

    $244.87

    $21.55 higher than Austin for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 28475

    Office

    $312.02

    Facility

    $251.42

    $27.85 higher than Austin for the office setting.

  • Miami

    Florida · 28475

    Office

    $302.57

    Facility

    $249.03

    $18.40 higher than Austin for the office setting.

  • Chicago

    Illinois · 28475

    Office

    $294.27

    Facility

    $242.58

    $10.10 higher than Austin for the office setting.

  • Manhattan

    New York · 28475

    Office

    $316.52

    Facility

    $256.75

    $32.35 higher than Austin for the office setting.

  • Alaska*

    Alaska · 28475

    Office

    $329.70

    Facility

    $274.92

    $45.53 higher than Austin for the office setting.

  • Alabama

    Alabama · 28475

    Office

    $249.61

    Facility

    $204.61

    $34.56 lower than Austin for the office setting.

  • Arkansas

    Arkansas · 28475

    Office

    $246.31

    Facility

    $202.12

    $37.86 lower than Austin for the office setting.

  • Arizona

    Arizona · 28475

    Office

    $268.90

    Facility

    $219.06

    $15.27 lower than Austin for the office setting.

  • Bakersfield

    California · 28475

    Office

    $288.50

    Facility

    $232.12

    $4.33 higher than Austin for the office setting.

  • Chico

    California · 28475

    Office

    $287.35

    Facility

    $230.98

    $3.18 higher than Austin for the office setting.

  • El Centro

    California · 28475

    Office

    $287.42

    Facility

    $231.04

    $3.25 higher than Austin for the office setting.

  • Fresno

    California · 28475

    Office

    $287.35

    Facility

    $230.98

    $3.18 higher than Austin for the office setting.

  • Hanford-Corcoran

    California · 28475

    Office

    $287.35

    Facility

    $230.98

    $3.18 higher than Austin for the office setting.

  • Madera

    California · 28475

    Office

    $287.35

    Facility

    $230.98

    $3.18 higher than Austin for the office setting.

  • Merced

    California · 28475

    Office

    $287.35

    Facility

    $230.98

    $3.18 higher than Austin for the office setting.

  • Modesto

    California · 28475

    Office

    $287.35

    Facility

    $230.98

    $3.18 higher than Austin for the office setting.

  • Napa

    California · 28475

    Office

    $328.12

    Facility

    $260.32

    $43.95 higher than Austin for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 28475

    Office

    $303.75

    Facility

    $242.95

    $19.58 higher than Austin for the office setting.

  • Redding

    California · 28475

    Office

    $287.35

    Facility

    $230.98

    $3.18 higher than Austin for the office setting.

  • Rest Of California

    California · 28475

    Office

    $287.35

    Facility

    $230.98

    $3.18 higher than Austin for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 28475

    Office

    $291.58

    Facility

    $235.20

    $7.41 higher than Austin for the office setting.

  • Sacramento-Roseville-Folsom

    California · 28475

    Office

    $300.27

    Facility

    $240.44

    $16.10 higher than Austin for the office setting.

  • Salinas

    California · 28475

    Office

    $299.12

    Facility

    $239.50

    $14.95 higher than Austin for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 28475

    Office

    $305.20

    Facility

    $243.68

    $21.03 higher than Austin for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 28475

    Office

    $345.79

    Facility

    $273.26

    $61.62 higher than Austin for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 28475

    Office

    $345.35

    Facility

    $272.82

    $61.18 higher than Austin for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 28475

    Office

    $353.54

    Facility

    $279.37

    $69.37 higher than Austin for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 28475

    Office

    $351.73

    Facility

    $277.56

    $67.56 higher than Austin for the office setting.

  • San Luis Obispo-Paso Robles

    California · 28475

    Office

    $294.45

    Facility

    $235.86

    $10.28 higher than Austin for the office setting.

  • Santa Cruz-Watsonville

    California · 28475

    Office

    $307.38

    Facility

    $244.88

    $23.21 higher than Austin for the office setting.

  • Santa Maria-Santa Barbara

    California · 28475

    Office

    $299.98

    Facility

    $240.00

    $15.81 higher than Austin for the office setting.

  • Santa Rosa-Petaluma

    California · 28475

    Office

    $310.40

    Facility

    $247.24

    $26.23 higher than Austin for the office setting.

  • Stockton

    California · 28475

    Office

    $287.35

    Facility

    $230.98

    $3.18 higher than Austin for the office setting.

  • Vallejo

    California · 28475

    Office

    $327.48

    Facility

    $259.69

    $43.31 higher than Austin for the office setting.

  • Visalia

    California · 28475

    Office

    $287.35

    Facility

    $230.98

    $3.18 higher than Austin for the office setting.

  • Yuba City

    California · 28475

    Office

    $287.35

    Facility

    $230.98

    $3.18 higher than Austin for the office setting.

  • Colorado

    Colorado · 28475

    Office

    $284.77

    Facility

    $230.04

    $0.60 higher than Austin for the office setting.

  • Connecticut

    Connecticut · 28475

    Office

    $293.29

    Facility

    $237.89

    $9.12 higher than Austin for the office setting.

  • Delaware

    Delaware · 28475

    Office

    $273.09

    Facility

    $222.26

    $11.08 lower than Austin for the office setting.

  • Fort Lauderdale

    Florida · 28475

    Office

    $288.56

    Facility

    $236.46

    $4.39 higher than Austin for the office setting.

  • Rest Of Florida

    Florida · 28475

    Office

    $275.18

    Facility

    $226.01

    $8.99 lower than Austin for the office setting.

  • Atlanta

    Georgia · 28475

    Office

    $281.44

    Facility

    $229.18

    $2.73 lower than Austin for the office setting.

  • Rest Of Georgia

    Georgia · 28475

    Office

    $260.57

    Facility

    $214.69

    $23.60 lower than Austin for the office setting.

  • Hawaii, Guam

    Hawaii · 28475

    Office

    $293.01

    Facility

    $234.53

    $8.84 higher than Austin for the office setting.

  • Iowa

    Iowa · 28475

    Office

    $254.01

    Facility

    $206.95

    $30.16 lower than Austin for the office setting.

  • Idaho

    Idaho · 28475

    Office

    $255.83

    Facility

    $208.50

    $28.34 lower than Austin for the office setting.

  • East St. Louis

    Illinois · 28475

    Office

    $275.90

    Facility

    $228.58

    $8.27 lower than Austin for the office setting.

  • Rest Of Illinois

    Illinois · 28475

    Office

    $268.87

    Facility

    $221.91

    $15.30 lower than Austin for the office setting.

  • Suburban Chicago

    Illinois · 28475

    Office

    $291.09

    Facility

    $238.26

    $6.92 higher than Austin for the office setting.

  • Indiana

    Indiana · 28475

    Office

    $257.15

    Facility

    $209.47

    $27.02 lower than Austin for the office setting.

  • Kansas

    Kansas · 28475

    Office

    $253.59

    Facility

    $207.09

    $30.58 lower than Austin for the office setting.

  • Kentucky

    Kentucky · 28475

    Office

    $256.47

    Facility

    $210.74

    $27.70 lower than Austin for the office setting.

  • New Orleans

    Louisiana · 28475

    Office

    $267.93

    Facility

    $219.53

    $16.24 lower than Austin for the office setting.

  • Rest Of Louisiana

    Louisiana · 28475

    Office

    $256.37

    Facility

    $210.85

    $27.80 lower than Austin for the office setting.

  • Metropolitan Boston

    Massachusetts · 28475

    Office

    $310.48

    Facility

    $249.06

    $26.31 higher than Austin for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 28475

    Office

    $283.56

    Facility

    $229.39

    $0.61 lower than Austin for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 28475

    Office

    $292.59

    Facility

    $237.40

    $8.42 higher than Austin for the office setting.

  • Rest Of Maryland

    Maryland · 28475

    Office

    $277.78

    Facility

    $225.73

    $6.39 lower than Austin for the office setting.

  • Rest Of Maine

    Maine · 28475

    Office

    $257.77

    Facility

    $210.45

    $26.40 lower than Austin for the office setting.

  • Southern Maine

    Maine · 28475

    Office

    $269.60

    Facility

    $218.63

    $14.57 lower than Austin for the office setting.

  • Detroit

    Michigan · 28475

    Office

    $279.05

    Facility

    $229.42

    $5.12 lower than Austin for the office setting.

  • Rest Of Michigan

    Michigan · 28475

    Office

    $263.22

    Facility

    $216.25

    $20.95 lower than Austin for the office setting.

  • Minnesota

    Minnesota · 28475

    Office

    $271.51

    Facility

    $218.58

    $12.66 lower than Austin for the office setting.

  • Metropolitan Kansas City

    Missouri · 28475

    Office

    $265.53

    Facility

    $217.23

    $18.64 lower than Austin for the office setting.

  • Metropolitan St. Louis

    Missouri · 28475

    Office

    $268.00

    Facility

    $219.03

    $16.17 lower than Austin for the office setting.

  • Rest Of Missouri

    Missouri · 28475

    Office

    $252.78

    Facility

    $208.44

    $31.39 lower than Austin for the office setting.

  • Mississippi

    Mississippi · 28475

    Office

    $249.56

    Facility

    $205.27

    $34.61 lower than Austin for the office setting.

  • Montana**

    Montana · 28475

    Office

    $275.87

    Facility

    $224.43

    $8.30 lower than Austin for the office setting.

  • North Carolina

    North Carolina · 28475

    Office

    $260.13

    Facility

    $212.14

    $24.04 lower than Austin for the office setting.

  • North Dakota**

    North Dakota · 28475

    Office

    $268.15

    Facility

    $216.72

    $16.02 lower than Austin for the office setting.

  • Nebraska

    Nebraska · 28475

    Office

    $255.08

    Facility

    $207.61

    $29.09 lower than Austin for the office setting.

  • New Hampshire

    New Hampshire · 28475

    Office

    $281.03

    Facility

    $227.48

    $3.14 lower than Austin for the office setting.

  • Northern Nj

    New Jersey · 28475

    Office

    $309.34

    Facility

    $249.68

    $25.17 higher than Austin for the office setting.

  • Rest Of New Jersey

    New Jersey · 28475

    Office

    $296.25

    Facility

    $240.08

    $12.08 higher than Austin for the office setting.

  • New Mexico

    New Mexico · 28475

    Office

    $264.81

    Facility

    $217.65

    $19.36 lower than Austin for the office setting.

  • Nevada**

    Nevada · 28475

    Office

    $273.88

    Facility

    $222.39

    $10.29 lower than Austin for the office setting.

  • Nyc Suburbs/Long Island

    New York · 28475

    Office

    $324.50

    Facility

    $263.34

    $40.33 higher than Austin for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 28475

    Office

    $298.71

    Facility

    $242.38

    $14.54 higher than Austin for the office setting.

  • Queens

    New York · 28475

    Office

    $317.94

    Facility

    $257.14

    $33.77 higher than Austin for the office setting.

  • Rest Of New York

    New York · 28475

    Office

    $263.77

    Facility

    $214.91

    $20.40 lower than Austin for the office setting.

  • Ohio

    Ohio · 28475

    Office

    $261.64

    Facility

    $214.68

    $22.53 lower than Austin for the office setting.

  • Oklahoma

    Oklahoma · 28475

    Office

    $255.33

    Facility

    $209.40

    $28.84 lower than Austin for the office setting.

  • Portland

    Oregon · 28475

    Office

    $292.44

    Facility

    $235.29

    $8.27 higher than Austin for the office setting.

  • Rest Of Oregon

    Oregon · 28475

    Office

    $271.36

    Facility

    $220.13

    $12.81 lower than Austin for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 28475

    Office

    $286.93

    Facility

    $233.39

    $2.76 higher than Austin for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 28475

    Office

    $261.64

    Facility

    $214.43

    $22.53 lower than Austin for the office setting.

  • Puerto Rico

    Puerto Rico · 28475

    Office

    $277.51

    Facility

    $225.51

    $6.66 lower than Austin for the office setting.

  • Rhode Island

    Rhode Island · 28475

    Office

    $281.79

    Facility

    $228.65

    $2.38 lower than Austin for the office setting.

  • South Carolina

    South Carolina · 28475

    Office

    $261.40

    Facility

    $213.87

    $22.77 lower than Austin for the office setting.

  • South Dakota**

    South Dakota · 28475

    Office

    $267.24

    Facility

    $215.80

    $16.93 lower than Austin for the office setting.

  • Tennessee

    Tennessee · 28475

    Office

    $254.85

    Facility

    $208.09

    $29.32 lower than Austin for the office setting.

  • Utah

    Utah · 28475

    Office

    $264.66

    Facility

    $216.31

    $19.51 lower than Austin for the office setting.

  • Virginia

    Virginia · 28475

    Office

    $269.26

    Facility

    $218.69

    $14.91 lower than Austin for the office setting.

  • Virgin Islands

    United States Virgin Islands · 28475

    Office

    $277.51

    Facility

    $225.51

    $6.66 lower than Austin for the office setting.

  • Vermont

    Vermont · 28475

    Office

    $267.81

    Facility

    $216.88

    $16.36 lower than Austin for the office setting.

  • Rest Of Washington

    Washington · 28475

    Office

    $282.80

    Facility

    $228.63

    $1.37 lower than Austin for the office setting.

  • Seattle (King Cnty)

    Washington · 28475

    Office

    $315.86

    Facility

    $252.74

    $31.69 higher than Austin for the office setting.

  • Wisconsin

    Wisconsin · 28475

    Office

    $259.95

    Facility

    $210.67

    $24.22 lower than Austin for the office setting.

  • West Virginia

    West Virginia · 28475

    Office

    $259.89

    Facility

    $215.19

    $24.28 lower than Austin for the office setting.

  • Wyoming**

    Wyoming · 28475

    Office

    $272.50

    Facility

    $221.07

    $11.67 lower than Austin for the office setting.

See how rates vary across the country

28475 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

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 all state and territory rates as a table
State / territoryRate 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

Explore 28475 on the national rate map →

Where does this rate apply?

Austin is a Medicare payment area. Our Census mapping connects it to 31 cities and communities in Texas, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in Texas →

Why are the office and facility amounts different?

For 28475 in Austin, the physician’s office rate is $284.17 and the facility-setting rate is $229.75: a difference of $54.42.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 28475 in Austin. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$312.59

$284.17 × 110% = $312.59

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

Compare your contract offer →

How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 28475 in Austin.

PPRRVU2026_Oct_nonQPP.csv

3,213

Code
28475
Physician work
2.93
Practice expense
4.94
Malpractice
0.39

GPCI2026.csv

96

Locality
Austin
Physician work
1.002
Practice expense
1.058
Malpractice
0.886
Office / nonfacility calculation for 28475 in Austin
ComponentRVULocality factorAdjusted
Physician work2.93× 1.0022.9359
Practice expense4.94× 1.0585.2265
Malpractice0.39× 0.8860.3455
Total RVUs8.5079
Conversion factor× 33.4009

Office / nonfacility rate, Austin$284.17

Open 28475 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work2.931.002
Practice expense4.941.058
Malpractice0.390.886

(2.93 × 1.002 + 4.94 × 1.058 + 0.39 × 0.886) × $33.4009 = $284.17

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work2.931.002
Practice expense3.41.058
Malpractice0.390.886

(2.93 × 1.002 + 3.4 × 1.058 + 0.39 × 0.886) × $33.4009 = $229.75

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

28475 · Office / nonfacility

$284.17

Effective 2026-10-01

The base rate is $15.87 higher than on 2025-10-01, moving from $268.30 to $284.17 (5.9%).

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

    $268.30changed to$284.17

    • 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
    • Work GPCI 1.000 changed to 1.002
    • Practice expense GPCI 1.046 changed to 1.058
    • Malpractice GPCI 0.914 changed to 0.886

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $268.30

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$284.17$229.75RVU26D
2026-07-01$284.17$229.75RVU26C
2026-04-01$284.17$229.75RVU26B
2026-01-01$284.17$229.75RVU26A
2025-10-01$268.30$235.48RVU25D
2025-07-01$268.30$235.48RVU25C
2025-04-01$268.30$235.48RVU25B
2025-01-01$268.30$235.48RVU25A

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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 28475PPRRVU2026_Oct_nonQPP.csv, line 3,213 (RVU26D)
Geographic factors for AustinGPCI2026.csv, line 96 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet