Summary & Overview
CPT 28606: Tarsometatarsal Joint Dislocation Fixation, Percutaneous
CPT code 28606 denotes closed reduction and percutaneous fixation of a tarsometatarsal joint dislocation using screws and pins. The code captures a focused surgical intervention to restore alignment between tarsal and metatarsal bones in the midfoot and rearfoot, a procedure that affects mobility and weight-bearing function. Nationally, this code is relevant to surgical orthopedics, trauma care, and post-injury rehabilitation pathways, and it factors into utilization, coverage, and payment discussions for foot and ankle procedures.
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 sites of service, and typical service classification. The publication presents benchmark information and policy-relevant considerations tied to coding and reimbursement for percutaneous fixation of tarsometatarsal dislocations, plus practical notes on billing modifiers where applicable. The goal is to equip coding managers, revenue cycle staff, and clinical leaders with a clear understanding of what the code represents, how it is used in surgical practice, and which payers and programmatic frameworks commonly apply. Data not available in the input are identified where applicable.
Billing Code Overview
CPT code 28606 describes surgical treatment of a tarsometatarsal joint dislocation with percutaneous fixation using screws and pins and includes manipulation (reduction) of the displaced bones. The procedure targets the joints between the tarsal and metatarsal bones in the midfoot and rearfoot, addressing abnormal separation of those joint surfaces.
Service type: Surgical — closed reduction with percutaneous internal fixation
Typical site of service: Operating room or ambulatory surgery center for surgical fixation of midfoot/rearfoot joint dislocations.
Clinical & Coding Specifications
Clinical Context
A 37-year-old male presents to the emergency department after a fall from a ladder with midfoot pain, deformity, and inability to bear weight. Clinical exam demonstrates swelling and tenderness across the tarsometatarsal (Lisfranc) region with forefoot widening. Radiographs and CT confirm a tarsometatarsal joint dislocation with associated instability. The patient is taken to the operating room for closed and/or open reduction of the tarsometatarsal joints with percutaneous fixation using screws and Kirschner wires.
Preoperative workflow includes trauma evaluation, informed consent, imaging review, and documentation of neurovascular status. Intraoperative actions include manipulation (closed reduction) or limited open exposure to anatomically reduce the tarsometatarsal articulations, fixation across involved joints with appropriate-sized screws and percutaneous pins, confirmation of reduction with fluoroscopy, and sterile wound closure or pin care as indicated. Postoperative workflow includes immobilization in a splint or boot, non–weight-bearing instructions, pain management, follow-up radiographs, and planned hardware removal if pins are percutaneous or if clinically indicated later. Typical site of service is an operating room within a hospital or ambulatory surgical center for definitive fixation; initial evaluation and stabilization may occur in the emergency department or urgent care.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services |