Summary & Overview
CPT 28435: Closed Treatment of Talus Fracture with Manipulation
CPT code 28435 represents the closed treatment of a fractured talus through manipulation or adjustment of the bone. This procedural code is used to document non‑open reduction techniques for talar fractures, a clinically significant injury due to the talus’s role in ankle and hindfoot stability and high risk for complications such as avascular necrosis. Nationally, accurate coding of talus fracture management supports appropriate clinical tracking, care coordination, and payer reimbursement for urgent and outpatient fracture care.
Key payers covered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for closed talus fracture treatment, benchmarks and fee schedule perspectives from major payers where available, and policy or coverage considerations that affect site‑of‑service decisions. The publication highlights typical settings for the service — ambulatory surgical centers, hospital outpatient departments, and emergency departments — and explains how CPT code 28435 fits into fracture management workflows.
The content is intended to help billing, clinical, and administrative stakeholders understand the clinical description, coding intent, and payer relevance for CPT code 28435. Data not available in the input will be noted where applicable.
Billing Code Overview
CPT code 28435 describes a closed treatment of a talus fracture with manipulation or adjustment of the fractured bone. The procedure involves non‑open, manual reduction techniques performed by the provider to realign the talus following fracture.
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Service type: Closed fracture treatment / manipulation
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Typical site of service: Ambulatory surgical center or hospital outpatient setting; may also be performed in an emergency department setting depending on clinical circumstances.
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Clinical & Coding Specifications
Clinical Context
A 28-year-old male presents to the emergency department after a fall from a ladder with acute pain, swelling, and inability to bear weight on the right ankle/foot. Radiographs demonstrate a nondisplaced or minimally displaced talus fracture without open wound. The orthopedic team evaluates neurovascular status and obtains imaging (plain films ± CT). The patient is taken to the procedure area or operating room for closed reduction and stabilization under regional or general anesthesia. The provider performs closed manipulation of the talus fracture to restore alignment and joint congruity; fracture stability is assessed clinically and radiographically. Post-reduction immobilization is applied (short leg splint or cast) and post-procedure imaging confirms reduction. Typical workflow includes pre-procedure consent and anesthesia evaluation, procedural sedation or anesthesia, closed reduction under fluoroscopic guidance, post-reduction imaging, application of immobilization, documentation of the reduction maneuver, neurovascular check, and discharge with activity restrictions and follow-up arranged with orthopedic clinic for definitive management and monitoring for avascular necrosis or displacement.
Coding Specifications
| Modifier | Description | When to Use |
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25 | Data not available in the input. | Data not available in the input. |