Billing code
F064A — Metatarsal fracture – open reduction, one
One metatarsal fracture, open
Bill F064 for open reduction of a single metatarsal fracture, including internal or external fixation.
Watch for: For two or more metatarsals by open reduction, bill F065 instead.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $358.05 | $0.00 | $77.46 | $111.72 | $111.72 |
- Code
- F064A
- Description
- Metatarsal fracture – open reduction, one
- FHO+ basket
- Not in the FHO+ base rate basket (Schedule 2 or 2B).
- Effective date
- Apr 1, 2026
- Termination date
- No end date
Explanation
Updated October 26, 2026
Open reduction of one metatarsal fracture. Two or more metatarsals are F065.
What it covers
F064 is open reduction of a single metatarsal fracture (N57). Open reduction of two or more is F065; closed reduction of one or more is F063 (N57, N58).
Billing rules
- Open reduction means treating the fracture or dislocation by closed intramedullary fixation or by an operation that exposes it; the fee includes fixation by internal or external devices (N1).
- For two or more metatarsals by open reduction, bill F065 instead (N58).
- The major pre-operative visit (the consultation or assessment where you decide to treat) may be billed in addition to the fracture or dislocation fee (N1, SP2).
- Multiple fractures or dislocations: the major one is paid at 100% and each other one at 85% (N1).
- If after-care is transferred to another physician, the surgeon who did the open reduction claims 80% of the fee (N2).
- Non-elective and started after hours: add E409 (+50%, weekday evenings and weekend/holiday days and evenings) or E410 (+75%, nights 00:00–07:00) (GP103–GP104, SP2).
- Repeat reductions of the same fracture or dislocation: claim the full fee for the final reduction and after-care; earlier reductions by the same surgeon are claimed at 85% (N2).
- Age premiums of 10% to 30% apply for patients under 16 (GP64).
Related codes: F065, F063, F061, F062, D028
Source: Schedule of Benefits (July 1, 2026), Musculoskeletal System Surgical Procedures, Foot and Ankle, page N57. Fracture and dislocation rules N1–N2.
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