Summary & Overview
CPT 28456: Percutaneous Fixation of Tarsal Bone Fracture, Excluding Talus/Calcaneus
CPT code 28456 identifies percutaneous fixation of tarsal bone fractures (excluding the talus and calcaneus) using screws and pins and includes manipulation of the fracture. This code captures a common orthopedic procedure for midfoot and rearfoot injuries that can impact hospital and ambulatory surgery center case mix, resource use, and post‑operative care pathways nationwide. Payers analyzed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will gain a concise clinical and billing profile of the code, including where the procedure is typically performed (hospital operating rooms and ambulatory surgery centers), key service characteristics, and practical context for coding and claims workflows. The publication summarizes benchmarks and reimbursement patterns where available, highlights common modifier usage supplied in the input, and outlines relevant clinical context for orthopedic and trauma care teams. Data not available in the input is noted where applicable. The goal is to provide clinicians, coding professionals, and policy analysts a focused reference on use, site of service considerations, and payer coverage scope for CPT code 28456 at a national level.
Billing Code Overview
CPT code 28456 describes percutaneous fixation of a tarsal bone fracture (excluding the talus and calcaneus) using screws and pins through the skin. The procedure includes manipulation or adjustment of the fractured tarsal bone. Tarsal bones are located in the midfoot and rearfoot and include the navicular, cuboid, medial cuneiform, intermediate cuneiform, and lateral cuneiform.
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Service type: Percutaneous surgical fixation of tarsal bone fracture, including closed manipulation
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Typical site of service: Hospital operating room or ambulatory surgery center where orthopedic surgical fixation procedures are performed
Clinical & Coding Specifications
Clinical Context
A 42-year-old patient presents to the emergency department after a fall onto the lateral aspect of the foot with acute midfoot pain, swelling, and inability to bear weight. Clinical evaluation and radiographs identify a displaced fracture of the cuboid (a tarsal bone). The orthopedic surgeon schedules percutaneous fixation using screws and/or pins with closed reduction. The procedure is typically performed in an operating room or ambulatory surgery center under regional or general anesthesia. Preoperative workflow includes imaging confirmation (x-ray ± CT), informed consent, preoperative marking, sterile prep, and administration of antibiotics per facility protocol. Postoperative care includes immobilization in a splint or cast, wound checks, radiographic follow-up to confirm hardware position and fracture alignment, analgesia, and activity restrictions. Rehabilitation and progressive weight bearing are guided by fracture stability and radiographic healing.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
50 | Bilateral procedure | When both feet require separate percutaneous tarsal fixation during the same operative session (rare for tarsal fractures). |
51 | Multiple procedures |