Summary & Overview
CPT 28546: Tarsal Bone Dislocation Fixation with Percutaneous Screws/Pins
CPT code 28546 covers surgical treatment of tarsal bone dislocations using percutaneous screws and pins with manipulation to reduce the dislocation. The code applies to dislocations among the midfoot and rearfoot tarsal bones (excluding talotarsal joints) and is relevant for orthopedic and podiatric surgical services. Nationally, accurate coding for this procedure matters for appropriate surgical billing, care classification, and communication across hospitals and ambulatory surgical centers.
Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find concise benchmarks for utilization and reimbursement patterns, clinical context clarifying the anatomic scope and exclusions of the code, and any notable recent policy updates or payer guidance affecting coverage or coding practice. The report also outlines typical sites of service and service type for operational planning.
This summary equips revenue cycle leaders, surgical clinicians, and coding professionals with the core facts needed to identify when 28546 is the appropriate code, what clinical scenario it represents, and which major payers are relevant to payer-specific policy review. Data not available in the input is noted where applicable in the full publication.
Billing Code Overview
CPT code 28546 describes surgical treatment of a tarsal bone dislocation using percutaneous fixation with screws and pins combined with manipulation (reduction) of the dislocated bones. The procedure addresses abnormal separation of joints among the tarsal bones of the midfoot and rearfoot (talus, calcaneus, navicular, cuboid, medial cuneiform, intermediate cuneiform, lateral cuneiform) and explicitly excludes talotarsal joints.
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Service type: Surgical treatment — percutaneous fixation and closed or open manipulation/reduction of a tarsal dislocation
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Typical site of service: Operative setting involving the midfoot or rearfoot (hospital operating room or ambulatory surgical center) involving the tarsal bones
Clinical & Coding Specifications
Clinical Context
A 42-year-old male presents to the emergency department after an inversion injury to the midfoot sustained while playing soccer. He has intense midfoot pain, swelling, and inability to bear weight. Radiographs and a CT scan demonstrate a dislocation of a non-talotarsal tarsal joint (for example, a cuboid-navicular disruption) with associated instability. After informed consent, the patient is taken to the operating room for closed and/or open manipulation to reduce the displaced tarsal joint followed by percutaneous fixation using screws and K-wires under fluoroscopic guidance. The clinical workflow typically includes preoperative imaging and medical clearance, intraoperative manipulation and percutaneous fixation with sterile technique, intraoperative imaging to confirm reduction and hardware placement, and postoperative immobilization with splint or cast and a period of non-weight-bearing with scheduled follow-up radiographs and wound checks.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Surgeon and primary physician service | Use for the primary surgical provider performing the procedure |
22 | Increased procedural services | Use when work required is substantially greater than typical for |