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Billing code

E504A — Metacarpal fracture – each additional

Additional metacarpal fracture

Add for each additional metacarpal fracture treated at the same time as one billed with F008 or F009.

Watch for: Must be billed with the base metacarpal fracture code; additional open reductions use E559 instead.

Code

E504A

Description

Metacarpal fracture – each additional

FHO+ basket

Not in the FHO+ base rate basket (Schedule 2 or 2B).

Effective date

Apr 1, 2025

Termination date

No end date

Explanation

Updated October 26, 2026

Add-on for each additional metacarpal fracture treated at the same time as a metacarpal fracture billed with F008 or F009.

What it covers

E504 is listed under metacarpal fractures as 'each additional' (N14). It pays for each additional metacarpal fracture treated at the same time.

The FHO agreement describes it as each additional metacarpal fracture, to F008A (no reduction, rigid immobilization) or F009A (closed reduction) (Agreement p.92). Additional fractures treated by open reduction use E559 with F011 (N14).

Billing rules

• Add-on only: bill it with the base metacarpal fracture code (N14; Agreement p.92).
• For additional open reductions, use E559 instead (N14).
• A cast or corrective splint applied during the first 2 weeks is included in the fracture or dislocation fee; later casts are billed from the cast listings (N7).
• Patients under 16: payment is increased by 10% to 30% depending on age (GP64).
• FHO: a Schedule 4 code that counts toward the office procedures special payment when done in your office for enrolled patients (Agreement p.67 §8.7, p.92).

Often billed with

• F009 metacarpal fracture, closed reduction (N14).
• F008 metacarpal fracture, no reduction, rigid immobilization (Agreement p.92).

Common rejections

• ADF: The base metacarpal fracture code is missing, invalid or paid at zero on the claim; E504 is only payable with it (N14).

Related codes: F008, F009, F011, E559, E558

Source: Schedule of Benefits (July 1, 2026), Musculoskeletal System Surgical Procedures, Hand and Wrist, page N14.

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