Summary & Overview
CPT 28450: Closed Treatment of Tarsal Bone Fracture, Non-manipulative
CPT code 28450 represents the closed treatment of a tarsal bone fracture (excluding talus and calcaneus) without manipulation or adjustment of the fractured bone. This procedural code captures nonopen management of midfoot and rearfoot fractures involving the navicular, cuboid, and cuneiform bones. The code matters nationally because tarsal fractures are managed across inpatient and outpatient settings and generate distinct billing, utilization, and coverage considerations for orthopedics and trauma care.
Key payers in national coverage and reimbursement discussions include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. These payers commonly determine facility and professional payment policies that influence site-of-care choices and claims adjudication for closed tarsal fracture treatments.
Readers will learn the clinical scope of CPT code 28450, the typical service setting and service type, and the payer landscape relevant to claims and coverage. The publication provides benchmarks and policy context for payers named above, outlines common billing modifiers and administrative notes (where available), and summarizes the clinical scenario that maps to this code. Data not available in the input is clearly identified and omitted.
Billing Code Overview
CPT code 28450 describes the closed treatment of a tarsal bone fracture, excluding fractures of the talus and calcaneus. The procedure involves nonopen management of a fracture in one of the tarsal bones (navicular, cuboid, medial cuneiform, intermediate cuneiform, lateral cuneiform) without manipulation or adjustment of the fractured bone.
Service Type: Closed fracture treatment (non-manipulative), foot/ankle orthopedic procedure
Typical Site of Service: Hospital outpatient department, ambulatory surgery center, or orthopedic clinic/procedural suite
Clinical & Coding Specifications
Clinical Context
A 42-year-old male construction worker presents to the emergency department after twisting his midfoot while stepping off a ladder. He has localized pain, swelling, and difficulty bearing weight over the dorsum and lateral aspect of the foot. Radiographs demonstrate a nondisplaced fracture of the cuboid tarsal bone without gross malalignment. The orthopedic on-call surgeon performs a closed treatment procedure under regional block: immobilization with a short leg cast and splinting, assessment of neurovascular status, and documentation of fracture stability. No open reduction or manipulation of the fracture fragments is required.
Clinical workflow: initial ED evaluation and imaging, orthopedic consultation, informed consent, regional or general anesthesia as indicated, closed treatment (casting/splinting) in the operating room or procedure area, post-procedure radiographs to confirm positioning, discharge with immobilization instructions, and scheduled outpatient follow-up for repeat imaging and cast management.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the surgeonphysician professional component for services billed separately from facility charges. |
50 |