$230.75
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 Metatarsal fracture Medicare reimbursement rates in Vermont
Reports closed reduction of a metatarsal fracture when the clinician manipulates the fracture to improve alignment, with separate reporting for each metatarsal treated. Compare 28475 office and facility rates across CMS payment localities in Vermont.
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 28475 in Vermont?
Vermont 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
$267.81
1 of 1 localities have a supported rate.
Payment area: Vermont
One mapped payment locality.
Facility setting
$216.88
1 of 1 localities have a supported rate.
Payment area: Vermont
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 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 Vermont, from the same CMS release.
No office rate
Choose 28476 when percutaneous skeletal fixation accompanies manipulation. Use 28475 for closed manipulation without percutaneous skeletal fixation.
No office rate
Choose 28485 for open reduction and fixation of the metatarsal fracture. Code 28475 represents closed treatment with manipulation.
Compare 28475 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
Vermont →
Office / nonfacility
$267.81
Facility
$216.88
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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 28475 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
3,213
- Code
- 28475
- Physician work
- 2.93
- Practice expense
- 4.94
- Malpractice
- 0.39
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.93 | × 1.000 | 2.9300 |
| Practice expense | 4.94 | × 0.990 | 4.8906 |
| Malpractice | 0.39 | × 0.506 | 0.1973 |
| Total RVUs | 8.0179 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Vermont$267.81
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.93 | 1 |
| Practice expense | 4.94 | 0.99 |
| Malpractice | 0.39 | 0.506 |
(2.93 × 1 + 4.94 × 0.99 + 0.39 × 0.506) × $33.4009 = $267.81
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.93 | 1 |
| Practice expense | 3.4 | 0.99 |
| Malpractice | 0.39 | 0.506 |
(2.93 × 1 + 3.4 × 0.99 + 0.39 × 0.506) × $33.4009 = $216.88
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.
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.
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
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
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817