Choose 28470 for closed treatment without manipulation; choose 28475 when manipulation is performed to improve fracture alignment.
On this page
CMS RVU26D · Effective 2026-10-01
28475 in Modesto
Office / nonfacility
$287.35
Base rate per service
Facility setting
$230.98
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 Modesto, from the same CMS release.
Choose 28476 when percutaneous skeletal fixation accompanies manipulation. Use 28475 for closed manipulation without percutaneous skeletal fixation.
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 Modesto compare?
In Bakersfield, the office rate for 28475 is $288.50—$1.15 higher than the $287.35 rate in Modesto. Both use the same code, release and participation basis.
28475 across payment areas
Same release and payment basis · bars start at $0
Modesto · This locality
$287.35
$288.50
$1.15 higher than Modesto
$287.35
The same base rate than Modesto
$287.42
$0.07 higher than Modesto
$287.35
The same base rate than Modesto
$287.35
The same base rate than Modesto
$18.37 higher than Modesto
Other payment areas listed in California 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
Madera
California · 28475
Office
$287.35
Facility
$230.98
The same base rate than Modesto for the office setting.
Merced
California · 28475
Office
$287.35
Facility
$230.98
The same base rate than Modesto for the office setting.
Napa
California · 28475
Office
$328.12
Facility
$260.32
$40.77 higher than Modesto for the office setting.
Oxnard-Thousand Oaks-Ventura
California · 28475
Office
$303.75
Facility
$242.95
$16.40 higher than Modesto for the office setting.
Redding
California · 28475
Office
$287.35
Facility
$230.98
The same base rate than Modesto for the office setting.
Rest Of California
California · 28475
Office
$287.35
Facility
$230.98
The same base rate than Modesto for the office setting.
Riverside-San Bernardino-Ontario
California · 28475
Office
$291.58
Facility
$235.20
$4.23 higher than Modesto for the office setting.
Sacramento-Roseville-Folsom
California · 28475
Office
$300.27
Facility
$240.44
$12.92 higher than Modesto for the office setting.
Salinas
California · 28475
Office
$299.12
Facility
$239.50
$11.77 higher than Modesto for the office setting.
San Diego-Chula Vista-Carlsbad
California · 28475
Office
$305.20
Facility
$243.68
$17.85 higher than Modesto for the office setting.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 28475
Office
$345.79
Facility
$273.26
$58.44 higher than Modesto for the office setting.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 28475
Office
$345.35
Facility
$272.82
$58.00 higher than Modesto for the office setting.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 28475
Office
$353.54
Facility
$279.37
$66.19 higher than Modesto for the office setting.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 28475
Office
$351.73
Facility
$277.56
$64.38 higher than Modesto for the office setting.
San Luis Obispo-Paso Robles
California · 28475
Office
$294.45
Facility
$235.86
$7.10 higher than Modesto for the office setting.
Santa Cruz-Watsonville
California · 28475
Office
$307.38
Facility
$244.88
$20.03 higher than Modesto for the office setting.
Santa Maria-Santa Barbara
California · 28475
Office
$299.98
Facility
$240.00
$12.63 higher than Modesto for the office setting.
Santa Rosa-Petaluma
California · 28475
Office
$310.40
Facility
$247.24
$23.05 higher than Modesto for the office setting.
Stockton
California · 28475
Office
$287.35
Facility
$230.98
The same base rate than Modesto for the office setting.
Vallejo
California · 28475
Office
$327.48
Facility
$259.69
$40.13 higher than Modesto for the office setting.
Visalia
California · 28475
Office
$287.35
Facility
$230.98
The same base rate than Modesto for the office setting.
Yuba City
California · 28475
Office
$287.35
Facility
$230.98
The same base rate than Modesto for the office setting.
Dc + Md/Va Suburbs
District of Columbia · 28475
Office
$312.02
Facility
$251.42
$24.67 higher than Modesto for the office setting.
Miami
Florida · 28475
Office
$302.57
Facility
$249.03
$15.22 higher than Modesto for the office setting.
Chicago
Illinois · 28475
Office
$294.27
Facility
$242.58
$6.92 higher than Modesto for the office setting.
Manhattan
New York · 28475
Office
$316.52
Facility
$256.75
$29.17 higher than Modesto for the office setting.
Alaska*
Alaska · 28475
Office
$329.70
Facility
$274.92
$42.35 higher than Modesto for the office setting.
Alabama
Alabama · 28475
Office
$249.61
Facility
$204.61
$37.74 lower than Modesto for the office setting.
Arkansas
Arkansas · 28475
Office
$246.31
Facility
$202.12
$41.04 lower than Modesto for the office setting.
Arizona
Arizona · 28475
Office
$268.90
Facility
$219.06
$18.45 lower than Modesto for the office setting.
Colorado
Colorado · 28475
Office
$284.77
Facility
$230.04
$2.58 lower than Modesto for the office setting.
Connecticut
Connecticut · 28475
Office
$293.29
Facility
$237.89
$5.94 higher than Modesto for the office setting.
Delaware
Delaware · 28475
Office
$273.09
Facility
$222.26
$14.26 lower than Modesto for the office setting.
Fort Lauderdale
Florida · 28475
Office
$288.56
Facility
$236.46
$1.21 higher than Modesto for the office setting.
Rest Of Florida
Florida · 28475
Office
$275.18
Facility
$226.01
$12.17 lower than Modesto for the office setting.
Atlanta
Georgia · 28475
Office
$281.44
Facility
$229.18
$5.91 lower than Modesto for the office setting.
Rest Of Georgia
Georgia · 28475
Office
$260.57
Facility
$214.69
$26.78 lower than Modesto for the office setting.
Hawaii, Guam
Hawaii · 28475
Office
$293.01
Facility
$234.53
$5.66 higher than Modesto for the office setting.
Iowa
Iowa · 28475
Office
$254.01
Facility
$206.95
$33.34 lower than Modesto for the office setting.
Idaho
Idaho · 28475
Office
$255.83
Facility
$208.50
$31.52 lower than Modesto for the office setting.
East St. Louis
Illinois · 28475
Office
$275.90
Facility
$228.58
$11.45 lower than Modesto for the office setting.
Rest Of Illinois
Illinois · 28475
Office
$268.87
Facility
$221.91
$18.48 lower than Modesto for the office setting.
Suburban Chicago
Illinois · 28475
Office
$291.09
Facility
$238.26
$3.74 higher than Modesto for the office setting.
Indiana
Indiana · 28475
Office
$257.15
Facility
$209.47
$30.20 lower than Modesto for the office setting.
Kansas
Kansas · 28475
Office
$253.59
Facility
$207.09
$33.76 lower than Modesto for the office setting.
Kentucky
Kentucky · 28475
Office
$256.47
Facility
$210.74
$30.88 lower than Modesto for the office setting.
New Orleans
Louisiana · 28475
Office
$267.93
Facility
$219.53
$19.42 lower than Modesto for the office setting.
Rest Of Louisiana
Louisiana · 28475
Office
$256.37
Facility
$210.85
$30.98 lower than Modesto for the office setting.
Metropolitan Boston
Massachusetts · 28475
Office
$310.48
Facility
$249.06
$23.13 higher than Modesto for the office setting.
Rest Of Massachusetts
Massachusetts · 28475
Office
$283.56
Facility
$229.39
$3.79 lower than Modesto for the office setting.
Baltimore/Surr. Cntys
Maryland · 28475
Office
$292.59
Facility
$237.40
$5.24 higher than Modesto for the office setting.
Rest Of Maryland
Maryland · 28475
Office
$277.78
Facility
$225.73
$9.57 lower than Modesto for the office setting.
Rest Of Maine
Maine · 28475
Office
$257.77
Facility
$210.45
$29.58 lower than Modesto for the office setting.
Southern Maine
Maine · 28475
Office
$269.60
Facility
$218.63
$17.75 lower than Modesto for the office setting.
Detroit
Michigan · 28475
Office
$279.05
Facility
$229.42
$8.30 lower than Modesto for the office setting.
Rest Of Michigan
Michigan · 28475
Office
$263.22
Facility
$216.25
$24.13 lower than Modesto for the office setting.
Minnesota
Minnesota · 28475
Office
$271.51
Facility
$218.58
$15.84 lower than Modesto for the office setting.
Metropolitan Kansas City
Missouri · 28475
Office
$265.53
Facility
$217.23
$21.82 lower than Modesto for the office setting.
Metropolitan St. Louis
Missouri · 28475
Office
$268.00
Facility
$219.03
$19.35 lower than Modesto for the office setting.
Rest Of Missouri
Missouri · 28475
Office
$252.78
Facility
$208.44
$34.57 lower than Modesto for the office setting.
Mississippi
Mississippi · 28475
Office
$249.56
Facility
$205.27
$37.79 lower than Modesto for the office setting.
Montana**
Montana · 28475
Office
$275.87
Facility
$224.43
$11.48 lower than Modesto for the office setting.
North Carolina
North Carolina · 28475
Office
$260.13
Facility
$212.14
$27.22 lower than Modesto for the office setting.
North Dakota**
North Dakota · 28475
Office
$268.15
Facility
$216.72
$19.20 lower than Modesto for the office setting.
Nebraska
Nebraska · 28475
Office
$255.08
Facility
$207.61
$32.27 lower than Modesto for the office setting.
New Hampshire
New Hampshire · 28475
Office
$281.03
Facility
$227.48
$6.32 lower than Modesto for the office setting.
Northern Nj
New Jersey · 28475
Office
$309.34
Facility
$249.68
$21.99 higher than Modesto for the office setting.
Rest Of New Jersey
New Jersey · 28475
Office
$296.25
Facility
$240.08
$8.90 higher than Modesto for the office setting.
New Mexico
New Mexico · 28475
Office
$264.81
Facility
$217.65
$22.54 lower than Modesto for the office setting.
Nevada**
Nevada · 28475
Office
$273.88
Facility
$222.39
$13.47 lower than Modesto for the office setting.
Nyc Suburbs/Long Island
New York · 28475
Office
$324.50
Facility
$263.34
$37.15 higher than Modesto for the office setting.
Poughkpsie/N Nyc Suburbs
New York · 28475
Office
$298.71
Facility
$242.38
$11.36 higher than Modesto for the office setting.
Queens
New York · 28475
Office
$317.94
Facility
$257.14
$30.59 higher than Modesto for the office setting.
Rest Of New York
New York · 28475
Office
$263.77
Facility
$214.91
$23.58 lower than Modesto for the office setting.
Ohio
Ohio · 28475
Office
$261.64
Facility
$214.68
$25.71 lower than Modesto for the office setting.
Oklahoma
Oklahoma · 28475
Office
$255.33
Facility
$209.40
$32.02 lower than Modesto for the office setting.
Portland
Oregon · 28475
Office
$292.44
Facility
$235.29
$5.09 higher than Modesto for the office setting.
Rest Of Oregon
Oregon · 28475
Office
$271.36
Facility
$220.13
$15.99 lower than Modesto for the office setting.
Metropolitan Philadelphia
Pennsylvania · 28475
Office
$286.93
Facility
$233.39
$0.42 lower than Modesto for the office setting.
Rest Of Pennsylvania
Pennsylvania · 28475
Office
$261.64
Facility
$214.43
$25.71 lower than Modesto for the office setting.
Puerto Rico
Puerto Rico · 28475
Office
$277.51
Facility
$225.51
$9.84 lower than Modesto for the office setting.
Rhode Island
Rhode Island · 28475
Office
$281.79
Facility
$228.65
$5.56 lower than Modesto for the office setting.
South Carolina
South Carolina · 28475
Office
$261.40
Facility
$213.87
$25.95 lower than Modesto for the office setting.
South Dakota**
South Dakota · 28475
Office
$267.24
Facility
$215.80
$20.11 lower than Modesto for the office setting.
Tennessee
Tennessee · 28475
Office
$254.85
Facility
$208.09
$32.50 lower than Modesto for the office setting.
Austin
Texas · 28475
Office
$284.17
Facility
$229.75
$3.18 lower than Modesto for the office setting.
Beaumont
Texas · 28475
Office
$260.12
Facility
$213.31
$27.23 lower than Modesto for the office setting.
Brazoria
Texas · 28475
Office
$272.32
Facility
$221.35
$15.03 lower than Modesto for the office setting.
Dallas
Texas · 28475
Office
$274.26
Facility
$223.03
$13.09 lower than Modesto for the office setting.
Fort Worth
Texas · 28475
Office
$272.78
Facility
$222.06
$14.57 lower than Modesto for the office setting.
Galveston
Texas · 28475
Office
$273.28
Facility
$222.20
$14.07 lower than Modesto for the office setting.
Houston
Texas · 28475
Office
$280.42
Facility
$229.34
$6.93 lower than Modesto for the office setting.
Rest Of Texas
Texas · 28475
Office
$266.21
Facility
$217.40
$21.14 lower than Modesto for the office setting.
Utah
Utah · 28475
Office
$264.66
Facility
$216.31
$22.69 lower than Modesto for the office setting.
Virginia
Virginia · 28475
Office
$269.26
Facility
$218.69
$18.09 lower than Modesto for the office setting.
Virgin Islands
United States Virgin Islands · 28475
Office
$277.51
Facility
$225.51
$9.84 lower than Modesto for the office setting.
Vermont
Vermont · 28475
Office
$267.81
Facility
$216.88
$19.54 lower than Modesto for the office setting.
Rest Of Washington
Washington · 28475
Office
$282.80
Facility
$228.63
$4.55 lower than Modesto for the office setting.
Seattle (King Cnty)
Washington · 28475
Office
$315.86
Facility
$252.74
$28.51 higher than Modesto for the office setting.
Wisconsin
Wisconsin · 28475
Office
$259.95
Facility
$210.67
$27.40 lower than Modesto for the office setting.
West Virginia
West Virginia · 28475
Office
$259.89
Facility
$215.19
$27.46 lower than Modesto for the office setting.
Wyoming**
Wyoming · 28475
Office
$272.50
Facility
$221.07
$14.85 lower than Modesto 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.
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 / territory | Rate range | Localities |
|---|---|---|
| AK | $329.70 | 1 |
| AL | $249.61 | 1 |
| AR | $246.31 | 1 |
| AZ | $268.90 | 1 |
| CA | $287.35–$353.54 | 29 |
| CO | $284.77 | 1 |
| CT | $293.29 | 1 |
| DC | $312.02 | 1 |
| DE | $273.09 | 1 |
| FL | $275.18–$302.57 | 3 |
| GA | $260.57–$281.44 | 2 |
| GU | $293.01 | 1 |
| HI | $293.01 | 1 |
| IA | $254.01 | 1 |
| ID | $255.83 | 1 |
| IL | $268.87–$294.27 | 4 |
| IN | $257.15 | 1 |
| KS | $253.59 | 1 |
| KY | $256.47 | 1 |
| LA | $256.37–$267.93 | 2 |
| MA | $283.56–$310.48 | 2 |
| MD | $277.78–$312.02 | 3 |
| ME | $257.77–$269.60 | 2 |
| MI | $263.22–$279.05 | 2 |
| MN | $271.51 | 1 |
| MO | $252.78–$268.00 | 3 |
| MS | $249.56 | 1 |
| MT | $275.87 | 1 |
| NC | $260.13 | 1 |
| ND | $268.15 | 1 |
| NE | $255.08 | 1 |
| NH | $281.03 | 1 |
| NJ | $296.25–$309.34 | 2 |
| NM | $264.81 | 1 |
| NV | $273.88 | 1 |
| NY | $263.77–$324.50 | 5 |
| OH | $261.64 | 1 |
| OK | $255.33 | 1 |
| OR | $271.36–$292.44 | 2 |
| PA | $261.64–$286.93 | 2 |
| PR | $277.51 | 1 |
| RI | $281.79 | 1 |
| SC | $261.40 | 1 |
| SD | $267.24 | 1 |
| TN | $254.85 | 1 |
| TX | $260.12–$284.17 | 8 |
| UT | $264.66 | 1 |
| VA | $269.26–$312.02 | 2 |
| VI | $277.51 | 1 |
| VT | $267.81 | 1 |
| WA | $282.80–$315.86 | 2 |
| WI | $259.95 | 1 |
| WV | $259.89 | 1 |
| WY | $272.50 | 1 |
Where does this rate apply?
Modesto is a Medicare payment area. Our Census mapping connects it to 33 cities and communities in California, 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.
Why are the office and facility amounts different?
For 28475 in Modesto, the physician’s office rate is $287.35 and the facility-setting rate is $230.98: a difference of $56.37.
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.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 28475 in Modesto. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$316.09
$287.35 × 110% = $316.09
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.
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 Modesto.
PPRRVU2026_Oct_nonQPP.csv
3,213
- Code
- 28475
- Physician work
- 2.93
- Practice expense
- 4.94
- Malpractice
- 0.39
GPCI2026.csv
16
- Locality
- Modesto
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.93 | × 1.017 | 2.9798 |
| Practice expense | 4.94 | × 1.096 | 5.4142 |
| Malpractice | 0.39 | × 0.536 | 0.2090 |
| Total RVUs | 8.6031 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Modesto$287.35
Open 28475 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.93 | 1.017 |
| Practice expense | 4.94 | 1.096 |
| Malpractice | 0.39 | 0.536 |
(2.93 × 1.017 + 4.94 × 1.096 + 0.39 × 0.536) × $33.4009 = $287.35
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.93 | 1.017 |
| Practice expense | 3.4 | 1.096 |
| Malpractice | 0.39 | 0.536 |
(2.93 × 1.017 + 3.4 × 1.096 + 0.39 × 0.536) × $33.4009 = $230.98
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
$287.35
Effective 2026-10-01
The base rate is $14.87 higher than on 2025-10-01, moving from $272.48 to $287.35 (5.5%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$272.48changed to$287.35
- 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 1.014 changed to 1.017
- Practice expense GPCI 1.093 changed to 1.096
- Malpractice GPCI 0.560 changed to 0.536
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
Earliest loaded release: $272.48
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
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.
