Summary & Overview

CPT 28570: Closed Reduction of Talotarsal Joint Dislocation Without Anesthesia

CPT code 28570 represents the closed reduction of a talotarsal joint dislocation performed without anesthesia. This code captures a specific, typically urgent orthopedic procedure to correct abnormal separation between the talus and another tarsal bone in the midfoot or rearfoot. Nationally, accurate coding of such reductions matters for clinical documentation, appropriate claims adjudication, and consistent reporting of foot and ankle procedures.

Key payers 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 28570, common settings where the service is performed, and the types of benchmarks and policy topics that affect coverage and payment for foot and ankle reductions. The publication covers coding definitions, typical sites of service, and likely areas of payer review such as medical necessity, documentation of closed reduction, and anesthesia use.

The material offers a national perspective useful to billing managers, revenue cycle staff, and clinical coders seeking clear interpretation of the procedure code, expected service lines, and the policy questions that commonly arise when payers evaluate claims for closed talotarsal joint dislocations. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare28570CPTfoot-and-ankleclosed-reductionorthopedicsoutpatientemergency-careprocedural-coding

Billing Code Overview

CPT code 28570 describes the closed treatment of a talotarsal joint dislocation without anesthesia. The procedure addresses an abnormal separation between the talus and another tarsal bone and is typically performed to restore normal joint alignment in the midfoot or rearfoot.

Service type: Closed joint reduction of a talotarsal dislocation without anesthesia.

Typical site of service: Outpatient clinic or emergency department setting involving foot and ankle treatment; procedure performed on the midfoot/rearfoot (tarsal bones).

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 28-year-old patient presents to an outpatient orthopedic clinic after a twisting injury to the foot sustained while playing soccer. The patient reports acute midfoot pain, visible deformity over the talus region, and difficulty bearing weight. Physical exam demonstrates point tenderness over the talotarsal region with suspected joint subluxation or dislocation. Plain radiographs of the foot are obtained to confirm talotarsal displacement. The provider performs a closed reduction of the talotarsal joint without anesthesia (local anesthesia or no anesthesia documented) using manual manipulation and external traction, then reassesses alignment with repeat radiographs. The patient is placed in a short leg cast or immobilizing boot with post-reduction instructions and arranged follow-up in 7–14 days for re-evaluation and possible repeat imaging.

Coding Specifications

Modifier	Description	When to Use
`23`	Unusual anesthesia	Use when significant anesthesia was administered for a procedure usually done without general anesthesia (rare for this code).
`50`	Bilateral procedure	Use when closed treatment is performed on both left and right talotarsal joints in the same operative session.
`52`	Reduced services	Use when the procedure is partially reduced or not completed as originally planned.
`53`	Discontinued procedure	Use when the closed treatment is attempted but discontinued due to clinical reasons.
`59`	Distinct procedural service	Use to indicate this closed treatment is distinct from another service performed on the same day (e.g., separate region).
`62`	Two surgeons	Use when two surgeons from different specialties simultaneously perform distinct parts of the procedure.
`76`	Repeat procedure by same physician	Data not available in the input.
`RT`	Right side	Use to indicate the procedure was performed on the right talotarsal joint.
`LT`	Left side	Use to indicate the procedure was performed on the left talotarsal joint.
`52`	Reduced services	Use when the service provided is less than the full description (e.g., partial reduction).
`22`	Increased procedural services	Use when the procedure required substantially greater work than usual (extensive manipulation or complexity).
`79`	Unrelated procedure or service by the same physician during the postoperative period	Data not available in the input.

Taxonomy Code	Specialty	Notes
`207L00000X`	Podiatry (Doctor of Podiatric Medicine)	Podiatrists commonly manage foot dislocations and closed reductions of tarsal joints.
`207X00000X`	Orthopedic Surgery	Orthopedic foot and ankle surgeons perform closed reductions and follow-up care.
`208000000X`	Emergency Medicine	Emergency physicians frequently perform closed reductions in the ED setting prior to orthopedic follow-up.
`293Z00000X`	Sports Medicine	Sports medicine physicians manage acute joint dislocations related to athletic injuries.
`3336C0003X`	General Practice	Primary care or urgent care clinicians may perform initial assessment and immobilization prior to referral.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S93.101A`	Dislocation of talus, unspecified ankle, initial encounter	Represents acute talotarsal dislocation requiring closed reduction.
`S93.102A`	Dislocation of talus, right ankle, initial encounter	Specifies right-sided talotarsal dislocation for coding laterality.
`S93.103A`	Dislocation of talus, left ankle, initial encounter	Specifies left-sided talotarsal dislocation for coding laterality.
`S93.401A`	Subluxation of talus, unspecified ankle, initial encounter	Used when partial displacement (subluxation) of the talotarsal joint is reduced closed.
`S93.402A`	Subluxation of talus, right ankle, initial encounter	Right-sided subluxation requiring closed management.
`S93.403A`	Subluxation of talus, left ankle, initial encounter	Left-sided subluxation requiring closed management.
`M24.871`	Other specific joint derangement, right ankle and foot	Chronic or residual joint derangement that may require closed manipulation in non-acute settings.
`M24.872`	Other specific joint derangement, left ankle and foot	Same as above for left side.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`28570`	Closed treatment of talotarsal joint dislocation; without anesthesia	Primary procedure for closed reduction of a talotarsal dislocation performed without anesthesia.
`11042`	Debridement, muscle and/or fascia	Data not available in the input.
`73630`	Radiologic examination, ankle; complete, minimum 3 views	Often obtained pre- and post-reduction to document alignment and confirm successful reduction.
`73610`	Radiologic examination, foot; complete, minimum 3 views	Used when imaging of the midfoot/tarsal bones is required to evaluate the talotarsal joint prior to and after reduction.
`29515`	Application of short leg cast (below knee)	Common immobilization applied after closed reduction to protect the reduced talotarsal joint during healing.
`28800`	Closed treatment of dislocation, foot; other than talotarsal	Related closed treatment codes for different foot joints; used if another tarsal joint is treated in same episode.