Summary & Overview
CPT 28605: Closed Treatment of Tarsometatarsal Joint Dislocation
CPT code 28605 represents the closed treatment (closed reduction) of a tarsometatarsal joint dislocation performed under anesthesia. This code captures a non-open (closed) procedure to realign the joint between tarsal and metatarsal bones in the midfoot/rearfoot region. Nationally, accurate coding of injuries to the tarsometatarsal complex matters for clinical tracking, appropriate payer reimbursement, and quality measurement for foot and ankle trauma care.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context and typical site of service, plus benchmarks and policy-relevant details where available. The publication clarifies coding scope, expected service setting, and common billing considerations for traumatic midfoot injuries, and highlights implications for claims processing and payer coverage patterns.
What readers will learn: the clinical intent of CPT code 28605, where the procedure is typically performed, and which national payers commonly cover such services. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 28605 describes the closed treatment of a tarsometatarsal joint dislocation. The procedure involves realigning an abnormal separation between a tarsal bone and a metatarsal bone without an open surgical approach, performed under anesthesia.
Service type: Closed reduction of tarsometatarsal joint dislocation
Typical site of service: Operating room or ambulatory surgical center (procedures performed under anesthesia in a procedural setting)
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 34-year-old male presents to the emergency department after a fall from a ladder, complaining of midfoot pain, swelling, and inability to bear weight on the affected foot. Examination and weight-bearing radiographs demonstrate a tarsometatarsal (Lisfranc-type) dislocation without an open wound. The orthopedic surgeon orders conscious sedation or general anesthesia and performs a closed reduction of the tarsometatarsal joint under fluoroscopic guidance in the operating room or procedure suite. Post-reduction radiographs confirm adequate alignment. The patient remains non–weight-bearing in a splint or cast and is scheduled for outpatient follow-up to assess stability and need for further fixation or continued immobilization.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work or time is substantially greater than typical for closed reduction of a tarsometatarsal joint (documentation must support). |
23 | Unusual anesthesia | Use when general anesthesia is required for a procedure that normally uses local or regional anesthesia. |