Summary & Overview
CPT 28545: Closed Treatment of Tarsal Bone Dislocation
CPT code 28545 covers the closed treatment of a tarsal bone dislocation performed under anesthesia. Nationally, this code identifies a specific foot procedure addressing dislocations among the tarsal bones in the midfoot and rearfoot, excluding talotarsal joint dislocations. Accurate coding of this procedure matters for clinical documentation, surgical workflow, and consistent claims processing for foot and ankle services.
Key payers referenced in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for CPT code 28545, the common sites where the service is delivered, and the service type classification. The publication outlines how the code is used in claims, typical operative settings, and what to expect in payer coverage discussions.
This summary provides benchmarks and policy-relevant context for coding and billing teams, revenue cycle stakeholders, and clinical leaders who manage foot and ankle procedural coding. It highlights where CPT code 28545 fits among related procedural codes and clarifies the clinical scope to reduce miscoding. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 28545 describes a closed treatment of tarsal bone dislocation under anesthesia. This procedure involves realigning an abnormal separation of a joint involving one of the tarsal bones in the midfoot or rearfoot (talus, calcaneus, navicular, cuboid, medial cuneiform, intermediate cuneiform, lateral cuneiform). The code explicitly excludes talotarsal joints.
Service Type: Closed surgical treatment of a tarsal dislocation under anesthesia
Typical Site of Service: Operating room or ambulatory surgical center
Clinical & Coding Specifications
Clinical Context
A 34-year-old male presents to the emergency department after an inversion injury to the midfoot during a soccer match. He reports acute midfoot pain, swelling, and inability to bear weight. Physical exam demonstrates deformity and point tenderness over the tarsal region with limited motion of a tarsal joint. Plain radiographs confirm a closed dislocation of a tarsal bone (for example, navicular or cuboid) without skin breach and no associated talotarsal joint involvement. The orthopedic surgeon evaluates the patient, obtains informed consent, and schedules a closed reduction under regional or general anesthesia in the operating room. Preoperative planning includes neurovascular exam documentation, analgesia/anesthesia planning, and imaging review. The procedure consists of closed manipulation and reduction of the dislocated tarsal bone, post-reduction imaging to confirm alignment, and immobilization with a splint or cast. The patient is monitored in recovery, receives post-reduction weight-bearing and activity instructions, and is scheduled for follow-up to assess stability and healing and to consider advanced imaging or open reduction if instability persists.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing physician documents interpretation-only services (rare for this surgical code). |