2025 CPT code 28475
(Active) Effective Date: N/A Revision Date: N/A Surgery - Fracture and Dislocation Treatment Musculoskeletal System Feed
Closed treatment of a metatarsal fracture with manipulation, for each bone.
Modifiers may be applicable depending on the circumstances of service (e.g., modifier 54 for surgical care only if subsequent care is provided by another provider, modifier 76 for a repeat procedure by the same physician).
Medical necessity is established by the presence of a clinically significant metatarsal fracture requiring closed treatment with manipulation to restore anatomical alignment.Post-operative immobilization is necessary to allow for healing and prevent further injury.
The physician or qualified healthcare professional is responsible for the reduction (realignment) of the fractured metatarsal bone and subsequent immobilization with casting or bracing. They may also order and interpret associated imaging studies.
In simple words: This code covers fixing a broken bone in your foot (a metatarsal bone). The doctor will gently put the broken pieces back together and then put your foot in a cast or brace to keep it still and help it heal.
This CPT code reports the closed treatment of a metatarsal fracture, which involves manipulation or adjustment of the fractured bone fragments to restore proper alignment.Metatarsals are the long bones in the foot connecting the tarsal bones and phalanges. The procedure includes reduction (realignment) of the fracture using manual force, followed by immobilization using a cast or brace.This code is reported for each metatarsal bone treated.Separate procedures such as radiographic imaging to confirm reduction are reported separately.
Example 1: A patient presents with a closed fracture of the second metatarsal, sustained during a sporting event. The physician performs closed treatment with manipulation, realigns the bone, and applies a cast. Code 28475 is reported., A patient sustains a closed fracture to the 3rd and 5th metatarsals in a fall.The physician performs closed treatment with manipulation on both fractures and applies a cast. Two units of code 28475 are reported., A patient with a complex closed fracture involving multiple metatarsals requires manipulation and open reduction.The physician uses a combination of closed treatment (for some metatarsals) and open reduction and internal fixation (ORIF).The codes for ORIF would be reported in addition to 28475 for those metatarsals treated with closed manipulation.
* Detailed history and physical examination documenting the injury.* Pre-operative and post-operative radiographic images (X-rays) showing the fracture and reduction.* Operative report detailing the manipulation technique and immobilization method.* Documentation of the type and location of the fracture(s).* Number of metatarsals treated.
** Always confirm the number of metatarsal bones treated and report the appropriate number of units.
- Revenue Code: P6B (Minor Procedures - Musculoskeletal)
- RVU: This information is not available in the provided text.RVUs vary by location, payer, and other factors. Consult your local fee schedule for specific values.
- Global Days : The global period for this procedure is not specified in the provided text, but it typically aligns with the timeframe required for healing and cast immobilization (e.g., 4-6 weeks).Additional services within this period, like cast changes, may be reported separately.
- Payment Status: Active
- Modifier TC rule: No TC modifier is applicable to this code.
- Fee Schedule : Fee schedule data is not provided, and varies by payer and location.Consult your local fee schedule for historical fee data.
- Specialties:Orthopedic Surgery, Podiatry
- Place of Service:Office, Hospital Outpatient, Ambulatory Surgical Center, Urgent Care Facility