Summary & Overview
CPT 28475: Closed Treatment of Metatarsal Fracture with Manipulation
CPT code 28475 represents closed treatment of a metatarsal fracture with manipulation, a non‑open procedure to realign one of the five long bones of the forefoot. This code is important nationally because metatarsal fractures are common in both acute injury and sports-related care, and appropriate coding affects clinical documentation, site-of-service decisions, and claims adjudication across payers. Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will learn the clinical context for using CPT code 28475, typical sites of service where the procedure is performed (outpatient clinics, emergency departments, and ambulatory surgical centers), and the procedural scope it covers. The publication also outlines common billing considerations, benchmarking themes, and policy or coverage issues that often affect payment and authorization for closed fracture manipulation. Data not provided in the input (such as associated ICD-10 diagnoses, taxonomies, and payer-specific edits) are noted as unavailable. This summary is intended to support coding accuracy and administrative clarity for providers, billing staff, and payers operating at a national level.
Billing Code Overview
CPT code 28475 describes the closed treatment of a metatarsal fracture with manipulation. In this procedure, the provider performs manipulation or adjustment of one of the metatarsal bones of the foot to achieve alignment following a fracture. The procedure typically involves manual realignment without open surgical exposure.
Service Type: Fracture care / closed manipulation
Typical Site of Service: Outpatient clinic, emergency department, or ambulatory surgical center (procedural treatment of foot fractures)
Clinical & Coding Specifications
Clinical Context
A 34-year-old male presents to the emergency department after twisting his forefoot while playing soccer. He has acute pain, swelling, and focal tenderness over the dorsum of the foot centered at the second metatarsal. Plain radiographs demonstrate a displaced transverse fracture of the second metatarsal without open skin disruption. The orthopedic or podiatric provider obtains informed consent, performs procedural timeout, administers local anesthesia with or without conscious sedation in the ED or ambulatory surgery center, and performs a closed reduction with manipulation of the metatarsal under fluoroscopic guidance. After anatomical alignment is confirmed, the foot is immobilized in a short leg splint or walking boot. Post-procedure documentation includes pre- and post-reduction neurovascular exam, fluoroscopic images, details of the reduction maneuver, level of sedation or anesthesia, estimated blood loss (usually minimal), and aftercare instructions including weight-bearing precautions and follow-up in the orthopedic clinic within 1–2 weeks for re-evaluation and possible definitive immobilization or fixation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
50 | Bilateral Procedure | When closed reduction is performed on metatarsal fractures of both feet during the same encounter. |
52 |