Summary & Overview
CPT 28540: Closed Treatment of Tarsal Bone Dislocation
CPT code 28540 covers the closed treatment of tarsal bone dislocation (excluding talotarsal joints), a nonoperative joint reduction of midfoot or rearfoot tarsal bones performed without anesthesia. Nationally, this code captures a specific, typically outpatient procedure used by orthopedic and podiatric providers to manage acute or subacute tarsal dislocations, and it is relevant for clinical documentation, claims submission, and payer coverage determinations.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for when 28540 is used, common sites of service, and an overview of typical billing considerations. The publication outlines benchmarking elements and policy-relevant topics such as coverage criteria and billing documentation expectations where available. It also identifies gaps where input data are not provided and signals areas for follow-up, including related procedure coding and diagnosis mapping.
This summary is intended for national audiences including providers, billing professionals, and policy analysts seeking a clear reference on the clinical meaning, typical use, and payer landscape for CPT code 28540.
Billing Code Overview
CPT code 28540 describes the closed treatment of tarsal bone dislocation, a procedure to correct abnormal separation of a joint involving one or more tarsal bones (excluding talotarsal joints). The procedure is performed without anesthesia on the patient.
Service Type: Closed manipulative treatment of tarsal dislocation
Typical Site of Service: Outpatient procedure setting or ambulatory clinic specializing in foot and ankle care, including orthopedics and podiatry clinics. Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 42-year-old patient presents to the emergency department after an inversion injury to the midfoot sustained during a fall. The patient has localized pain, swelling, and deformity over the tarsal region on the lateral aspect of the foot. Neurovascular exam is intact. Weight-bearing radiographs show a displaced dislocation of a tarsal joint (excluding a talotarsal joint). The treating orthopedic surgeon performs a closed reduction of the tarsal dislocation in the ED without general or regional anesthesia, using local analgesia and manual manipulation, then immobilizes the foot in a splint or cast. Post-reduction radiographs confirm satisfactory alignment. The typical workflow includes triage and examination, radiographic evaluation, informed consent, closed reduction procedure (code 28540), immobilization, post-reduction imaging, discharge instructions, and arranged orthopedic follow-up within 7–14 days for reassessment and definitive care planning.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
23 | Unusual anesthesia — medically necessary but not general anesthesia | Use when the procedure is performed with significant, medically necessary local or minimal sedation that is not usual for the procedure. |