$217.98
28470 describes closed treatment without manipulation. Choose 28485 when the surgeon opens the fracture site for treatment.
On this page
CMS RVU26D · Effective 2026-10-01
28485 Metatarsal fracture surgery Medicare reimbursement rates in Tennessee
Reports open surgical reduction of a metatarsal fracture, counted for each metatarsal treated and including internal fixation when performed. Compare 28485 office and facility rates across CMS payment localities in Tennessee.
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 28485 in Tennessee?
Tennessee 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
No supported rate
Facility setting
$502.13
1 of 1 localities have a supported rate.
Payment area: Tennessee
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.
Orthopedic surgery
About 28485: Open metatarsal fracture treatment
Reports open surgical reduction of a metatarsal fracture, counted for each metatarsal treated and including internal fixation when performed.
This service involves surgically exposing a fractured metatarsal and reducing the bone through an open approach. The surgeon may stabilize the reduction with internal fixation, such as screws or a plate, when needed. Orthopedic and podiatric surgeons commonly perform the procedure in an operating room for fractures requiring open treatment rather than closed reduction or percutaneous fixation.
Select the code when the operative report documents open treatment of a metatarsal fracture. Report each metatarsal treated and document the specific bone, fracture, open approach, reduction, and fixation performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 28485
- 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 paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU7.25 · 45%
- Practice expense (office) RVU7.96 · 49%
- Malpractice RVU1.02 · 6%
4.4K
Medicare services in 2024 · #1964 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.
28485 compared with similar codes
Office rates for Tennessee, from the same CMS release.
$254.85
28475 is closed treatment with manipulation. Open reduction through surgical exposure supports 28485 instead.
No office rate
28476 describes percutaneous skeletal fixation with manipulation. Use 28485 for open treatment of the metatarsal fracture.
Compare 28485 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
Tennessee →
Office / nonfacility
Unavailable
Facility
$502.13
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 28485 in Tennessee.
PPRRVU2026_Oct_nonQPP.csv
3,215
- Code
- 28485
- Physician work
- 7.25
- Practice expense
- 7.96
- Malpractice
- 1.02
GPCI2026.csv
95
- Locality
- Tennessee
- Physician work
- 1.000
- Practice expense
- 0.909
- Malpractice
- 0.537
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.25 | × 1.000 | 7.2500 |
| Practice expense | 7.96 | × 0.909 | 7.2356 |
| Malpractice | 1.02 | × 0.537 | 0.5477 |
| Total RVUs | 15.0334 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Tennessee$502.13
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.25 | 1 |
| Practice expense | 7.96 | 0.909 |
| Malpractice | 1.02 | 0.537 |
(7.25 × 1 + 7.96 × 0.909 + 1.02 × 0.537) × $33.4009 = $502.13
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.
28485 billing questions
How is 28485 different from closed treatment of a metatarsal fracture?
Use 28485 when the fracture is treated through an open surgical approach. Closed treatment codes apply when the fracture is managed without surgically exposing the fracture site.
How many units should be reported?
The code is reported for each metatarsal treated. The operative documentation should identify the metatarsal or metatarsals that underwent open treatment.
Should modifier 50 be used for fractures in both feet?
No. CMS identifies bilateral adjustment as inappropriate for this code; report the service according to the each-metatarsal unit.
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 paid for this procedure?
Medicare does not pay an assistant at surgery for this code. Co-surgeons are paid only when supporting documentation is provided; team surgery is not permitted.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.
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.
3,21228470,,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
3,21628490,,Treat big toe fracture,A,,1.14,3.44,,2.65,,0.17,4.75,3.96,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,21728495,,Treat big toe fracture,A,,1.64,4.02,,2.78,,0.20,5.86,4.62,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,21828496,,Treat big toe fracture,A,,2.42,13.50,,5.49,,0.50,16.42,8.41,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
9604412,TX,31,AUSTIN,1.002,1.058,0.886
9704412,TX,20,BEAUMONT,1.000,0.910,0.929
9804412,TX,09,BRAZORIA,1.008,0.991,0.780