Non union metatarsal

This is fairly straight forward with the appropriate code to use here is described very well by CPT as 28322. This is defined by CPT as:

Repairing a non union of a metatrsal with or without bone graft. (Includes obtaining a graft). The last sentence is key. Hence there is no additional fee for either obtaining or placing the graft! It could be bone graft from the patient or from a bottle. Doesn't matter. It also doesn't matter whether you use a graft or not.

The payment is the same.

It seems unfair, but sometimes that's just the way it is.

If you feel you did more work then as the CPT described, then submit the claim as is. Once paid, file an appeal with the modifier 22 and provide an OR report.

Your chances of being paid an addtional amount here are slim, simply because the code states with or without a graft.

Good luck!