$281.79
Both address closed treatment of a metatarsal fracture. Use 28475 when the provider manipulates the fracture; 28470 is for treatment without manipulation.
On this page
CMS RVU26D · Effective 2026-10-01
28470 Metatarsal fracture care Medicare reimbursement rates in Rhode Island
Reports closed care of an individual metatarsal fracture when the provider immobilizes it without manipulating or reducing the fracture. Compare 28470 office and facility rates across CMS payment localities in Rhode Island.
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.
What does Medicare pay for 28470 in Rhode Island?
Rhode Island has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$242.68
1 of 1 localities have a supported rate.
Payment area: Rhode Island
One mapped payment locality.
Facility setting
$213.35
1 of 1 localities have a supported rate.
Payment area: Rhode Island
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Fracture care
About 28470: Closed treatment of metatarsal fracture without manipulation
Reports closed care of an individual metatarsal fracture when the provider immobilizes it without manipulating or reducing the fracture.
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.
CMS billing rules for 28470
- 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 RVU1.98 · 28%
- Practice expense (office) RVU4.83 · 68%
- Malpractice RVU0.29 · 4%
19.9K
Medicare services in 2024 · #1152 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.
28470 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
No office rate
28476 involves percutaneous skeletal fixation of the metatarsal fracture. 28470 describes closed treatment without manipulation or fixation.
No office rate
28485 is for open reduction and internal fixation of a metatarsal fracture. 28470 is closed treatment without manipulation.
Compare 28470 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Rhode Island →
Office / nonfacility
$242.68
Facility
$213.35
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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 28470 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
3,212
- Code
- 28470
- Physician work
- 1.98
- Practice expense
- 4.83
- Malpractice
- 0.29
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.98 | × 1.019 | 2.0176 |
| Practice expense | 4.83 | × 1.033 | 4.9894 |
| Malpractice | 0.29 | × 0.892 | 0.2587 |
| Total RVUs | 7.2657 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Rhode Island$242.68
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.98 | 1.019 |
| Practice expense | 4.83 | 1.033 |
| Malpractice | 0.29 | 0.892 |
(1.98 × 1.019 + 4.83 × 1.033 + 0.29 × 0.892) × $33.4009 = $242.68
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.98 | 1.019 |
| Practice expense | 3.98 | 1.033 |
| Malpractice | 0.29 | 0.892 |
(1.98 × 1.019 + 3.98 × 1.033 + 0.29 × 0.892) × $33.4009 = $213.35
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.
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 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.
3,20928455,,Tx tarsal b1 fx w/mnpj each,A,,3.16,4.37,,3.20,,0.26,7.79,6.62,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,21028456,,Prq skel fix tarsl fx w/mnpj,A,,2.79,8.10,NA,8.10,,0.59,11.48,11.48,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,21128465,,Optx tarsal bone fx each,A,,8.58,8.61,NA,8.61,,1.36,18.55,18.55,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,21228470,,Cltx metatarsal fx wo mnp ea,A,,1.98,4.83,,3.98,,0.29,7.10,6.25,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,21328475,,Cltx metatarsal fx w/mnpj ea,A,,2.93,4.94,,3.40,,0.39,8.26,6.72,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,21428476,,Prq skel fix metar fx w/mnpj,A,,3.51,7.55,NA,7.55,,0.55,11.61,11.61,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,21528485,,Optx metatarsal fx each,A,,7.25,7.96,NA,7.96,,1.02,16.23,16.23,0,090,0.10,0.69,0.21,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537