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Official Description

Open treatment of metatarsal fracture, includes internal fixation, when performed, each

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 28485 refers to the open treatment of a fracture in a single metatarsal bone, which includes the application of internal fixation if it is performed. The metatarsal bones are five long bones located in the foot, each connecting proximally to the cuboid and cuneiform bones and distally to the proximal row of phalanges. When a fracture occurs in one of these bones, it is essential to repair it to restore function and alleviate pain. The procedure involves making an incision directly over the fracture site to gain access to the affected bone. Once the fracture is exposed, any debris is cleared away, and the bone fragments are carefully repositioned, a process known as reduction. If necessary, internal fixation devices such as pins, screws, or a multifragment plate and screw system are utilized to stabilize the fracture and promote proper healing. After the fixation is applied, the surgical site is irrigated to prevent infection, and the incision is closed with sutures. It is important to note that if multiple metatarsal bones are treated using this open technique, the code 28485 should be reported for each metatarsal that is repaired.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The open treatment of a metatarsal fracture, as described by CPT® Code 28485, is indicated for patients who have sustained a fracture in one of the metatarsal bones of the foot. This procedure is typically performed when the fracture is displaced, unstable, or when there is a need for precise alignment and stabilization to ensure proper healing. Indications for this procedure may include:

  • Displaced Fracture A fracture where the bone fragments are not aligned properly and require surgical intervention to restore normal anatomy.
  • Unstable Fracture A fracture that is likely to shift or move out of alignment without surgical fixation.
  • Multiple Fractures Situations where more than one metatarsal bone is fractured and requires surgical repair.
  • Nonunion or Malunion Cases where previous fractures have not healed correctly, necessitating surgical correction.

2. Procedure

The procedure for the open treatment of a metatarsal fracture involves several critical steps to ensure successful repair and stabilization of the fracture. The following procedural steps are performed:

  • Step 1: Incision An incision is made over the site of the fracture in the metatarsal bone. This incision allows the surgeon to access the fracture directly and is typically made along the length of the metatarsal to provide adequate exposure.
  • Step 2: Exposure and Debridement Once the incision is made, the fracture site is carefully exposed. Any debris, such as bone fragments or soft tissue, is cleared away to ensure a clean working area. This step is crucial for reducing the risk of infection and promoting healing.
  • Step 3: Reduction The bone fragments are then reduced, meaning they are repositioned back into their correct anatomical alignment. This step is essential for restoring the normal function of the foot and ensuring that the bones heal properly.
  • Step 4: Internal Fixation If necessary, internal fixation devices such as pins, screws, or a multifragment plate and screw system are applied to stabilize the fracture. The choice of fixation method depends on the specific characteristics of the fracture and the surgeon's preference.
  • Step 5: Wound Irrigation and Closure After the fixation is in place, the surgical site is thoroughly irrigated to remove any remaining debris and reduce the risk of infection. Finally, the incision is closed using sutures, completing the surgical procedure.

3. Post-Procedure

After the open treatment of a metatarsal fracture, patients typically require post-operative care to ensure proper healing and recovery. This may include monitoring for signs of infection, managing pain, and following specific rehabilitation protocols. Patients are often advised to keep weight off the affected foot for a designated period, which may vary depending on the severity of the fracture and the surgical technique used. Follow-up appointments are essential to assess the healing process and to determine when it is safe to resume normal activities. Physical therapy may also be recommended to restore strength and mobility to the foot as healing progresses.

Short Descr TREAT METATARSAL FRACTURE
Medium Descr OPEN TREATMENT METATARSAL FRACTURE EACH
Long Descr Open treatment of metatarsal fracture, includes internal fixation, when performed, each
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 1 - Co-surgeons could be paid, though supporting documentation is required...
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Device-intensive procedure added to ASC list in CY 2008 or later; paid at adjusted rate.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P5B - Ambulatory procedures - musculoskeletal
MUE 5
CCS Clinical Classification 147 - Treatment, fracture or dislocation of lower extremity (other than hip or femur)
RT Right side (used to identify procedures performed on the right side of the body)
LT Left side (used to identify procedures performed on the left side of the body)
T9 Right foot, fifth digit
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
74 Discontinued out-patient hospital/ambulatory surgery center (asc) procedure after administration of anesthesia: due to extenuating circumstances or those that threaten the well being of the patient, the physician may terminate a surgical or diagnostic procedure after the administration of anesthesia (local, regional block(s), general) or after the procedure was started (incision made, intubation started, scope inserted, etc). under these circumstances, the procedure started but terminated can be reported by its usual procedure number and the addition of modifier 74. note: the elective cancellation of a service prior to the administration of anesthesia and/or surgical preparation of the patient should not be reported. for physician reporting of a discontinued procedure, see modifier 53.
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
82 Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s).
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
F3 Left hand, fourth digit
F4 Left hand, fifth digit
F5 Right hand, thumb
F7 Right hand, third digit
F8 Right hand, fourth digit
F9 Right hand, fifth digit
GC This service has been performed in part by a resident under the direction of a teaching physician
GW Service not related to the hospice patient's terminal condition
GZ Item or service expected to be denied as not reasonable and necessary
PO Excepted service provided at an off-campus, outpatient, provider-based department of a hospital
SA Nurse practitioner rendering service in collaboration with a physician
SG Ambulatory surgical center (asc) facility service
T1 Left foot, second digit
T2 Left foot, third digit
T3 Left foot, fourth digit
T4 Left foot, fifth digit
T5 Right foot, great toe
T6 Right foot, second digit
T7 Right foot, third digit
T8 Right foot, fourth digit
TA Left foot, great toe
TT Individualized service provided to more than one patient in same setting
XP Separate practitioner, a service that is distinct because it was performed by a different practitioner
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
2008-01-01 Changed Code description changed.
Pre-1990 Added Code added.
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