Summary & Overview
CPT 28470: Closed Treatment of Metatarsal Fracture, No Incision
CPT code 28470 denotes closed treatment of a metatarsal fracture performed without a skin incision and without manipulation of the fracture. This code captures nonoperative, percutaneous or immobilization-focused interventions used to manage metatarsal fractures when no open reduction or internal fixation is required. Nationally, the code is relevant for ambulatory orthopedics, podiatry, and emergency care settings where noninvasive fracture care is common.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of billing and clinical context for 28470, including typical sites of service and service type. The publication provides benchmarks and reference points for utilization and payment where available, summarizes applicable policy considerations and recent guidance affecting nonoperative foot fracture management, and outlines common clinical scenarios where 28470 is the appropriate code. Data not available in the input is noted where applicable. The content is intended for national audiences including billing professionals, clinical coders, and policy analysts seeking a clear, practical summary of CPT code 28470.
Billing Code Overview
CPT code 28470 describes treatment of a metatarsal fracture performed without making a skin incision and without manipulation of the fracture. This procedure is a closed treatment focused on immobilization or stabilization of the metatarsal bones without open surgical exposure.
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Service type: Closed treatment of metatarsal fracture
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Typical site of service: Ambulatory surgery center, hospital outpatient department, or physician office depending on clinical setting and resources
Clinical & Coding Specifications
Clinical Context
A 38-year-old recreational runner presents to the orthopedic clinic after acute forefoot pain and swelling following a fall during a trail run. Clinical exam reveals focal tenderness over the second metatarsal. Weight-bearing and non–weight-bearing foot radiographs confirm a nondisplaced shaft fracture of the second metatarsal without angulation. The provider elects conservative, noninvasive management that does not require a skin incision or fracture manipulation.
The clinical workflow includes: initial evaluation in clinic or emergency department, obtaining radiographs, counseling on treatment options, application of immobilization (short leg cast, walking boot, or rigid postoperative shoe), providing analgesia and return precautions, arranging follow-up imaging at 1–2 weeks to confirm alignment, and progressive weight-bearing as healing permits. Typical patient education and documentation include mechanism of injury, radiographic findings, neurovascular status, immobilization type, and planned follow-up.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management (E/M) service by the same physician on the same day of the procedure | Use when a significant E/M visit is performed before or after 28470 (for example, initial ED evaluation with decision-making leading to immobilization) |