2025 CPT code 28476
(Active) Effective Date: N/A Revision Date: N/A Surgery - Fracture and/or Dislocation Procedures on the Foot and Toes Musculoskeletal System Feed
Percutaneous skeletal fixation of a metatarsal fracture, with manipulation, for each metatarsal.
Modifiers may be applicable depending on the circumstances of the procedure.For example, modifier 59 (distinct procedural service) might be used if the procedure is distinct from other services performed on the same day, or modifier 76 (repeat procedure by the same physician) if the procedure is repeated.
Medical necessity for percutaneous skeletal fixation of a metatarsal fracture would be established by the presence of a displaced fracture that is not amenable to non-surgical management.Documentation should support that conservative measures failed or are unlikely to achieve acceptable healing and function.
The orthopedic surgeon or qualified healthcare professional is responsible for performing the percutaneous skeletal fixation, including the manipulation of the fractured metatarsal.Post-operative care and follow-up are also the responsibility of the physician.
In simple words: This code describes a minimally invasive surgery to fix a broken bone in the foot (metatarsal). The doctor uses small incisions and imaging to guide the placement of pins or screws to hold the bone pieces together.The broken bone is also put back into the correct position. This is done for each broken metatarsal.
This CPT code, 28476, reports percutaneous skeletal fixation of a metatarsal fracture with manipulation.The procedure involves the placement of pins and/or screws across the fracture site through small incisions, guided by imaging, without direct visualization of the fracture. Manipulation, or the realignment of the fractured bone fragments, is included. The code is reported for each metatarsal bone treated.Additional procedures like extensive wound repair, vessel exploration, or nerve repair are billed separately.
Example 1: A patient presents with a closed, displaced fracture of the second metatarsal after a sports injury.Percutaneous skeletal fixation with manipulation is performed to realign and stabilize the fracture., A patient suffers a comminuted (multiple fragments) fracture of the fifth metatarsal due to a fall.The surgeon utilizes percutaneous fixation and manipulation to reduce and stabilize the fracture fragments., A patient experiences a fracture of the third and fourth metatarsals in a motor vehicle accident.The physician performs percutaneous skeletal fixation with manipulation on both metatarsals.Each metatarsal is coded separately using 28476.
* Preoperative and postoperative x-rays to demonstrate the fracture and reduction.* Operative report detailing the procedure, including the approach, fixation method, and any complications.* Anesthesia record.* Pathology report if a tissue sample is taken.
** Imaging guidance (fluoroscopy) is usually required for accurate pin placement during this procedure. The use of a C-arm fluoroscopy unit is often necessary and may be reported separately, if not bundled.Always verify payer policies regarding bundled services.
- Revenue Code: P6B (Minor Procedures - Musculoskeletal)
- RVU: The relative value units (RVUs) for this code vary based on geographic location, facility type (inpatient/outpatient), and other factors. Consult your local payer's fee schedule for specific RVU values and reimbursement rates.
- Global Days : The global surgical period for this procedure varies depending on the payer and the complexity of the case.Clarification may be needed for exact global days.
- Payment Status: Active
- Modifier TC rule: The technical component (TC) modifier would not apply to this code. This is because the entire procedure, including manipulation and fixation, is considered part of the global service.
- Fee Schedule : Historical fee schedule data for CPT code 28476 is not readily available, but it can be obtained from payer-specific fee schedules and historical medical billing databases.
- Specialties:Orthopedic Surgery, Podiatry
- Place of Service:Office, Ambulatory Surgical Center, Hospital (Inpatient and Outpatient)