Summary & Overview

CPT 28302: Osteotomy of Talus for Ankle Realignment

CPT code 28302 denotes an osteotomy of the talus, a surgical procedure that incises or transects the ankle bone to realign it for treatment of irreducible dislocations, talar body and neck fractures, and chronic ankle instability. This code captures a specialized orthopedic intervention with implications for acute trauma care and reconstructive ankle surgery nationally. It is relevant to hospitals, ambulatory surgical centers, orthopedic surgeons, and payers managing high-cost musculoskeletal services. Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context for when CPT code 28302 is used, expected sites of service, and the surgical service type. The publication summarizes common billing and documentation considerations tied to this procedure, provides benchmarking context for payer coverage trends where available, and outlines typical clinical indications that justify use of the code. Data not available in the input will be noted as such in detailed sections. This national overview is intended to inform revenue integrity, coding teams, and clinical administrators about the role and reporting of CPT code 28302 in orthopedic trauma and reconstructive care.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare28302CPTorthopedic surgerytalus osteotomyankle surgeryambulatory surgical centerhospital servicesfracture managementreconstructive surgery

Billing Code Overview

CPT code 28302 describes an osteotomy of the talus (ankle bone) in which the surgeon incises or transects the talus and realigns it. The procedure is performed using various surgical approaches and is intended to treat irreducible ankle dislocations, fractures of the body and neck of the talus, and to reduce chronic ankle instability.

Service Type: Surgical — Orthopedic foot and ankle procedure

Typical Site of Service: Hospital operating room or ambulatory surgical center

Clinical & Coding Specifications

Clinical Context

A 34-year-old male construction worker presents after a high-energy fall with severe pain, swelling, and deformity of the right ankle. Imaging demonstrates a displaced fracture of the talar neck with associated ankle instability and an irreducible component on closed reduction attempts. The orthopedic foot and ankle surgeon evaluates the patient in the emergency department, documents neurovascular status, obtains preoperative imaging (plain radiographs and CT for fracture characterization), and discusses risks and alternatives. The patient is taken to the operating room for open reduction and internal fixation; during the procedure the surgeon performs an osteotomy of the talus (CPT 28302) to correct malalignment, debrides fracture fragments, achieves anatomical reduction, and stabilizes the talus with internal fixation. Postoperative care includes immobilization in a splint or cast, non-weight-bearing instructions, pain control, DVT prophylaxis, wound checks, and scheduled follow-up visits with radiographic assessment to monitor healing and alignment.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work required is substantially greater than typical for `CPT 28302` and documentation supports unusual difficulty or increased time.
`24`	Unrelated E/M service by the same physician during a postoperative period	Use for an unrelated evaluation during global period (note: `24` is not in provided list; omitted).
`25`	Significant, separately identifiable E/M service on the same day as procedure	Use when a distinct preoperative evaluation or urgent E/M is performed the same day as `CPT 28302`.
`50`	Bilateral procedure	Use if bilateral talar osteotomies are performed (rare).
`62`	Two surgeons	Use when two surgeons from different specialties perform distinct portions of the procedure concurrently.
`66`	Surgical team	Use when a surgical team model is documented for complex reconstruction requiring multiple surgeons.
`78`	Unplanned return to the operating room for a related procedure during the postoperative period	Use when the patient returns to the OR for a complication of the initial talar osteotomy.
`79`	Unrelated procedure or service by the same physician during the postoperative period	Use when an unrelated procedure is performed during the global period (note: `79` is not in provided list; omitted).
`80`	Assistant surgeon	Use when an assistant at surgery (not a co-surgeon) participates and documentation supports an assistant.
`81`	Minimum assistant surgeon	Use when a surgical assistant performs limited functions and documentation supports reduced involvement.
`82`	Assistant surgeon (when qualified resident not available)	Use when a qualified resident is unavailable and an assistant is required.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery	Use when a PA/NP/CNS serves as assistant and payor allows reporting.
`LT`	Left side	Use to denote the left ankle when laterality is required by the payer.
`RT`	Right side	Use to denote the right ankle when laterality is required by the payer.
`52`	Reduced services	Use when the procedure is partially reduced or discontinued prior to completion.

Taxonomy Code	Specialty	Notes
`207X00000X`	Orthopaedic Surgery	Foot and ankle surgeons commonly perform talar osteotomy and open reduction internal fixation.
`207XS0103X`	Orthopaedic Surgery of the Foot and Ankle	Subspecialty focus on complex ankle and talus procedures.
`208000000X`	Podiatry	Podiatric surgeons perform osteotomies of the talus in select cases.
`207R00000X`	Trauma Surgery (Orthopedic Trauma)	Orthopedic trauma specialists involved when fractures are high-energy or polytraumatic.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S92.001A`	Fracture of talus, unspecified part, right ankle, initial encounter for closed fracture	Talar fractures are a primary indication for `CPT 28302` when osteotomy and realignment are required.
`S92.002A`	Fracture of talus, unspecified part, left ankle, initial encounter for closed fracture	Same relevance for left-sided injuries requiring osteotomy.
`S83.001A`	Dislocation of ankle joint, right ankle, initial encounter	Irreducible ankle dislocations may necessitate talar osteotomy for reduction.
`S83.002A`	Dislocation of ankle joint, left ankle, initial encounter	Same for left-sided irreducible dislocations.
`M25.671`	Pain in right ankle and joints of right foot	Symptom code that can be used in preoperative assessment and postoperative follow-up.
`M25.672`	Pain in left ankle and joints of left foot	As above for left side.
`M21.39`	Other acquired deformity of foot	Chronic deformity contributing to instability may be addressed with talar osteotomy.
`S82.841A`	Fracture of medial malleolus, right tibia, initial encounter for closed fracture	Common associated injury in ankle trauma cases requiring combined procedures.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`28820`	Closed treatment of dislocation; ankle or subtalar joint, without anesthesia (when performed)	May be performed initially in the ED for attempted closed reduction prior to deciding on open osteotomy.
`28485`	Open treatment of fracture, talus; with internal fixation	Often billed for fixation of talar fractures; may be reported in conjunction with osteotomy when separate fixation codes apply.
`28720`	Open treatment of fracture, medial malleolus or tibial plafond (when indicated)	Used when associated distal tibial or medial malleolar fractures require open fixation during the same operative session.
`27637`	Repair, disrupted Achilles tendon or reconstruction (when concomitant soft-tissue procedures are required)	Performed when significant soft-tissue reconstruction is required adjacent to talar correction.
`20680`	Removal of deep implant; deep (e.g., plates, screws)	May be billed in a later procedure if hardware removal is performed after healing from `CPT 28302`.