CPT 28102 Talus/Calcaneus Autograft Reimbursement | OpenPayer

Summary & Overview

CPT 28102: Excision of Talus/Calcaneus Bone Cyst with Autograft

CPT code 28102 denotes surgical excision of a bone cyst or benign tumor of the talus or calcaneus with placement of an autograft to fill and repair the resulting defect. This code captures a targeted orthopedic procedure on the hindfoot that addresses benign osseous lesions and defect reconstruction using autologous bone. Nationally, accurate coding of such procedures affects surgical case mix reporting, facility and professional reimbursement, and quality measurement for musculoskeletal surgical care.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, common payer considerations, and operational benchmarks relevant to surgical care of talar and calcaneal bone lesions. The content outlines expected sites of service, typical service components, and common billing modifiers where applicable.

This publication helps clinicians, coding staff, and policy analysts understand what CPT code 28102 represents, how it is used in practice, and what elements to consider when documenting and submitting claims. Data not available in the input is noted explicitly where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 28102orthopedic surgeryhindfoot surgerybone cyst excisionautograft implantationsurgical codingambulatory surgeryhospital outpatient

Billing Code Overview

CPT code 28102 describes a surgical procedure in which a provider removes a bone cyst or benign tumor from the talus or calcaneus and repairs the defect by harvesting and implanting an autograft.

Service type: Surgical orthopedic procedure involving bone lesion excision and autograft implantation
Typical site of service: Hospital operating room or ambulatory surgery center, with postoperative recovery in the same facility or an affiliated outpatient recovery area

Clinical & Coding Specifications

Clinical Context

A 28-year-old active male presents with progressive deep ankle pain and intermittent swelling after months of activity-related discomfort. Imaging (radiograph and MRI) demonstrates a solitary benign-appearing bone lesion within the talus consistent with a unicameral bone cyst or benign tumor (eg, intraosseous ganglion or chondroblastoma). Conservative care (activity modification, immobilization, analgesics) failed. The orthopedic foot and ankle surgeon schedules an operative curettage of the lesion with harvest and implantation of an autogenous bone graft to fill the defect and promote structural healing.

Preoperative workflow includes history and physical, informed consent describing risks (infection, fracture, donor-site pain), preoperative imaging review, and anesthesia evaluation (general or regional). Intraoperatively, fluoroscopic guidance localizes the lesion, a cortical window is created, the cyst/tumor is curetted and sent for pathology, and autograft (often from distal tibia or iliac crest) is harvested and packed into the talar defect. Hemostasis, irrigation, and closure complete the case. Postoperative care includes immobilization (short leg cast or boot), non–weight-bearing instructions, pain control, and scheduled radiographic follow-up to assess graft incorporation and detect complications such as persistent lesion, collapse, or infection.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier	Rarely used; default when no modifier applies.

CPT 28171: Radical Resection of Tarsal Bone for Tumor

CPT-28060-PARTIAL-PLANTAR-FASCIECTOMY-PLANTAR-FASCIA-RELEASE

CPT 28060: Partial Plantar Fasciectomy for Plantar Fascia Decompression

CPT-28045-FOOT-TOE-SOFT-TISSUE-MASS-EXCISION

CPT 28045: Excision of Foot/Toe Soft-Tissue Mass

CPT-28090-FOOT-TENDON-LESION-EXCISION-SYNOVECTOMY

CPT 28090: Excision of Foot Tendon Lesion with Synovectomy

CPT-28088-FOOT-EXTENSOR-TENDON-SHEATH-SYNOVECTOMY

CPT 28088: Synovectomy of Extensor Tendon Sheath, Foot

CPT-28111-FIRST-METATARSAL-HEAD-RESECTION-NECROSIS-INFECTION

CPT 28111: Resection of First Metatarsal Head for Necrosis/Infection

CPT-28114-MULTIPLE-METATARSAL-HEAD-AND-PROXIMAL-PHALANGEAL-RESECTION

CPT 28114: Resection of 2nd–5th Metatarsal Heads and Proximal Phalanges

CPT-28041-FOOT-TOE-INTRINSIC-MUSCLE-MASS-EXCISION-15CM-OR-GREATER

CPT 28041: Excision of Intrinsic Foot/Toe Muscle Mass, Specimen ≥1.5 cm

CPT-28120-HINDFOOT-BONE-DEBRIDEMENT-TALUS-CALCANEUS

CPT 28120: Hindfoot Bone Debridement of Talus or Calcaneus

CPT-28054-DIGITAL-JOINT-BIOPSY-TOE-FINGER

CPT 28054: Surgical Biopsy of Toe or Finger Joint

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Taxonomy Code	Specialty	Notes
`208BX0206X`	Orthopedic Surgery of the Foot and Ankle	Foot and ankle surgeons commonly perform talar/calcaneal cyst curettage with grafting.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M85.88`	Other specified disorders of bone	Covers nonspecific benign bone lesions when a more specific code is not available; may be used for benign cysts.

| M89.9 | Disorder of bone, unspecified | General fallback for nonmalignant bone pathology when specific diagnosis is pending.

| D16.4 | Benign neoplasm of bone of lower limb, including hip | Specific category for benign bone tumors of the talus/calcaneus.

| M84.50XA | Pathological fracture, unspecified site, initial encounter | Used if the bone cyst has led to a pathologic fracture of the talus or calcaneus.

| M86.171 | Acute osteomyelitis, right ankle and foot | Relevant when lesion is infected and requires debridement and grafting after infection control.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`20610`	Arthrocentesis, aspiration and/or injection; major joint or bursa (eg, shoulder, hip)	May be used preoperatively for diagnostic aspiration if joint involvement suspected or for postoperative injections if indicated.

| 27075 | Excision of bone tumor or lesion, pelvis and proximal femur; with or without internal fixation | Represents similar oncologic bone excision technique at a different anatomic site; conceptually related for coding strategy.

| 27096 | Biopsy, bone, ilium, trocar or open; with image guidance | Common code for autograft harvest site biopsy or when iliac crest harvest requires separate coding for biopsy or graft harvest.

| 20930 | Allograft, morselized, or placement of osteopromotive material | Alternate grafting material; billed if allograft rather than autograft is used in augmentation.

| 11010 | Debridement of open wound, first 20 sq cm or less | May be relevant if there is infected lesion requiring debridement in the hindfoot prior to definitive grafting.

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