Summary & Overview
CPT 28576: Percutaneous Fixation for Talotarsal Joint Dislocation
CPT code 28576 denotes percutaneous fixation with manipulation for a talotarsal joint dislocation — a surgical procedure to reduce and stabilize abnormal separation between the talus and adjacent tarsal bones using screws or pins. This code is clinically important for foot and ankle surgery, addressing midfoot and rearfoot instability that can cause pain, deformity, and impaired function. Nationally, proper coding affects surgical claims, payment consistency, and access to operative care for tarsal injuries and dislocations.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, expected site-of-service implications (ambulatory surgery center or hospital operating room), and how the code maps to surgical service lines. The publication outlines benchmarks and policy-relevant topics such as coding accuracy, payer coverage considerations, and common billing modifiers (listed separately), plus implications for claims processing and reimbursement workflows. Data not available in the input is clearly indicated where relevant.
Billing Code Overview
CPT code 28576 describes surgical treatment of a talotarsal joint dislocation using percutaneous fixation with screws and/or pins combined with manipulation (closed reduction) of the displaced tarsal bones. The procedure targets the talus and one or more adjacent tarsal bones to restore normal joint alignment.
Service Type: Surgical — percutaneous fixation with manipulation (closed reduction)
Typical Site of Service: Operative setting such as an ambulatory surgery center or hospital operating room, focused on the midfoot/rearfoot (tarsal region)
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A 34-year-old male presents to the emergency department after an inversion ankle injury sustained during soccer. Imaging (plain radiographs and CT) demonstrates a dislocation of the talus relative to adjacent tarsal bones with associated midfoot instability and displaced fragments. The orthopedic foot and ankle surgeon evaluates the patient, documents neurovascular status, discusses risks and benefits, and schedules urgent operative management.
In the operating room under general or regional anesthesia, closed or open manipulation of the talotarsal joint is performed to reduce the dislocation. Percutaneous fixation is placed using pins and/or cannulated screws across the talotarsal articulation(s) to maintain reduction. Intraoperative fluoroscopy confirms alignment. The surgeon provides wound care, applies a short leg splint or cast, and gives postoperative instructions for nonweightbearing and follow-up radiographs to monitor fixation and healing. Typical postoperative workflow includes clinic visits at 2 weeks for wound check and at 6–12 weeks for radiographic assessment and progression of weightbearing as indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when substantial additional work beyond the typical is documented (e.g., extensive dissection or prolonged time for complex reduction). |