2025 CPT code 28470

Closed treatment of a metatarsal fracture without manipulation; each metatarsal.

Follow all CPT coding guidelines, including those related to fracture care and the application of modifiers.

Modifiers may be applicable depending on the circumstances.Common modifiers may include those for laterality (LT, RT), multiple procedures (51), or bilateral procedures (50).

Medical necessity is established by the presence of a symptomatic metatarsal fracture requiring stabilization to promote healing and prevent further injury. Documentation of clinical findings and the rationale for the chosen treatment approach must be included.

The provider's responsibility includes examination, imaging (x-rays), assessment of fracture alignment, and application of the immobilization device.Post-operative care within the global period is included.

IMPORTANT If manipulation is performed, use 28475. If percutaneous skeletal fixation is used, use 28476.For multiple metatarsals, report 28470 for each metatarsal treated.Additional codes may be necessary for casting materials (HCPCS codes) or other associated services.

In simple words: This code covers treatment for a broken metatarsal bone (in the foot) without surgery or moving the bones back into place.The doctor stabilizes the break using a cast, splint, or similar device.

This CPT code reports the closed treatment of a metatarsal fracture without manipulation.The procedure involves stabilizing the fracture without surgical opening or manipulation of the fracture fragments.This typically includes applying a cast, splint, or other immobilization device.Each metatarsal treated is reported separately.

Example 1: A patient presents to the emergency department with a closed, non-displaced fracture of the 2nd metatarsal.After x-rays confirm the diagnosis, the physician applies a cast to the foot and lower leg.CPT code 28470 is reported., A patient sustains a closed fracture of the 5th metatarsal during a sporting event.The physician evaluates the fracture in the office and applies a short leg splint.CPT code 28470 is reported., A patient with diabetes presents with a closed fracture of the 3rd and 4th metatarsals. The physician applies a custom splint and orders x-rays.CPT code 28470 is reported twice, once for each metatarsal. Appropriate modifiers (LT and RT) are added for laterality.

Medical record should include documentation of the examination findings, x-ray results confirming the diagnosis and fracture alignment, details of the treatment provided (type of immobilization device used), and the specific metatarsal(s) treated.

** The initial splint or cast application is included in the payment for this code and cannot be billed separately.Subsequent visits for this fracture are also included in the global period.Walking boots and other supplies may be billed separately using appropriate HCPCS codes. The word "each" in the code description means each metatarsal.For example, if two metatarsals are fractured, then code 28470 is reported twice, once for each metatarsal.

  • Revenue Code: P6B (Minor Procedures - Musculoskeletal)
  • RVU: This information is not provided. RVUs vary based on location and payer.
  • Global Days : A 90-day global period typically applies.Only x-rays and other non-included services within the global period can be billed separately.
  • Payment Status: Active
  • Modifier TC rule: A technical component (TC) modifier is not typically applied to 28470 as it describes a complete procedure.
  • Fee Schedule : This information is not available.
  • Specialties:Orthopedic Surgery, Podiatry, Emergency Medicine
  • Place of Service:Office, Emergency Room - Hospital, Inpatient Hospital, Outpatient Hospital, Urgent Care Facility
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