Summary & Overview
CPT 28430: Stabilization of Nondisplaced Talus Fracture
CPT code 28430 denotes stabilization of a nondisplaced talus fracture, commonly performed by applying a cast to immobilize the small bone between the heel and the lower leg. This procedure matters nationally because talus fractures, while less common than other ankle injuries, carry risks for complications such as avascular necrosis and prolonged disability if not properly immobilized. Proper coding ensures accurate clinical documentation and supports appropriate outpatient or ambulatory surgical facility billing.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find context on clinical indications and typical sites of service, an outline of common billing modifiers and administrative considerations, and benchmarks for how payers commonly approach coverage for fracture stabilization services. The publication highlights coding specifics for CPT code 28430, notes the typical care pathway for nondisplaced talar fractures, and identifies where additional documentation is often needed for payer review.
The content is geared to clinicians, billing professionals, and policy analysts seeking a concise reference for CPT code 28430, offering practical clarity on its clinical scope, billing context, and the payer landscape at a national level.
Billing Code Overview
CPT code 28430 describes the stabilization of a nondisplaced fracture of the talus, the small bone situated between the calcaneus (heel bone) and the distal tibia and fibula. The service typically involves immobilization techniques such as cast application to maintain alignment and promote healing while the fracture is nondisplaced.
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Service type: Fracture stabilization/immobilization
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Typical site of service: Hospital outpatient department, ambulatory surgical center, or clinic setting where cast application and short-term fracture care are provided.
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A 34-year-old male presents to an urgent care clinic after an athletic injury with ankle pain, swelling, and point tenderness over the talus following an inversion-type mechanism. Plain radiographs demonstrate a nondisplaced fracture of the talus without evidence of dislocation. The provider performs closed stabilization by applying a short-leg cast to immobilize the hindfoot and ankle, documents neurovascular status before and after immobilization, provides activity and weight-bearing instructions, and schedules orthopedic follow-up within 1–2 weeks for repeat imaging and reassessment. Typical site of service is an outpatient clinic, urgent care center, or emergency department. The clinical workflow includes history and physical, imaging review, informed consent, analgesia as needed, cast application, documentation of cast type and materials, and discharge instructions with follow-up arrangements.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side | Used when the stabilized talus fracture is on the left side |
RT | Right side | Used when the stabilized talus fracture is on the right side |