Summary & Overview
CPT 28575: Closed Treatment of Talotarsal Joint Dislocation
CPT code 28575 represents the closed reduction of a talotarsal joint dislocation performed under anesthesia, a focused surgical procedure addressing abnormal separation between the talus and adjacent tarsal bones in the midfoot or rearfoot. Nationally, this code is used in orthopedic and podiatric operative settings to document and bill for a non-open (closed) manipulation and stabilization of a tarsal joint.
Key payers included in the analysis: Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Coverage and reimbursement policies can vary across commercial insurers and Medicare, affecting site-of-service decisions between hospital operating rooms and ambulatory surgery centers.
Readers will learn the clinical context for use of CPT code 28575, typical sites of service, common modifiers encountered, and how payers generally approach reimbursement for closed tarsal joint reductions. The publication summarizes benchmarks where available, highlights relevant coding and billing considerations, and outlines potential points of payer variation. Data not available in the input are explicitly noted where applicable.
Billing Code Overview
CPT code 28575 describes the closed treatment of a talotarsal joint dislocation performed under anesthesia. The procedure addresses abnormal separation between the talus and another tarsal bone in the midfoot or rearfoot.
-
Service type: Surgical, closed reduction of a tarsal joint dislocation under anesthesia
-
Typical site of service: Hospital operating room or ambulatory surgery center, depending on clinical setting and patient needs
Clinical & Coding Specifications
Clinical Context
A 34-year-old male presents to the emergency department after an inversion injury to the ankle while playing soccer. He has severe midfoot and hindfoot pain, swelling, and deformity with inability to bear weight. Plain radiographs suggest a talotarsal joint dislocation (talus articulating abnormally with adjacent tarsal bone). The orthopaedic foot and ankle surgeon evaluates the patient, documents neurovascular status and informed consent, and orders procedural sedation and regional or general anesthesia. In the operating room or procedure suite the provider performs a closed reduction of the talotarsal joint under anesthesia with fluoroscopic guidance. Post-reduction radiographs confirm alignment. The patient is immobilized in a short leg cast or splint and given postoperative instructions including non-weightbearing, analgesics, and follow-up for repeat imaging and possible definitive management if instability persists.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
23 | Unusual anesthesia | Use when procedure is performed with general anesthesia for an emergent closed reduction that is normally done with local/regional but required general anesthesia due to clinical circumstances. |
52 | Reduced services |