Summary & Overview
CPT 28615: Open Treatment of Tarsometatarsal Joint Dislocation
CPT code 28615 represents the open surgical treatment of tarsometatarsal joint dislocation, a procedure to restore alignment between tarsal and metatarsal bones in the midfoot and rearfoot. The code captures cases where the provider performs open reduction of the dislocation and may or may not use internal fixation such as pins or screws. This service is clinically important due to the potential for instability, chronic pain, and functional impairment if dislocations are not properly reduced and stabilized.
Key national payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical framing of the procedure, typical sites of service, and the scope of billing considerations relevant to surgical management of tarsometatarsal dislocations. The publication outlines benchmarks and coverage context, highlights common procedural variants (open reduction with or without internal fixation), and summarizes implications for surgical and coding workflows.
The content is intended for clinicians, coding professionals, and policy analysts seeking a national-level reference on CPT code 28615: what it denotes, where it is performed, and the practical billing context that surrounds operative management of midfoot tarsometatarsal injuries.
Billing Code Overview
CPT code 28615 describes open treatment of tarsometatarsal joint dislocation, a surgical procedure to correct abnormal separation between the tarsal and metatarsal bones of the foot. The procedure may include internal fixation using implants such as pins or screws but can be performed without them depending on clinical findings.
Service Type: Surgical — open reduction of tarsometatarsal dislocation
Typical Site of Service: Hospital inpatient or outpatient surgical center; may also occur in ambulatory surgery settings
Clinical & Coding Specifications
Clinical Context
A 42-year-old male presents to the emergency department after a motor vehicle collision with severe midfoot pain, swelling, and deformity after his foot was crushed. Plain radiographs demonstrate a tarsometatarsal (Lisfranc) joint dislocation with displacement between the first and second metatarsal bases and lateral column instability. Initial closed reduction attempts under sedation in the ED are only partially successful. The orthopedic foot and ankle surgeon evaluates the patient, confirms neurovascularly intact status, and schedules urgent operative open reduction and internal fixation to restore midfoot alignment and joint stability.
Preoperative workflow includes informed consent, review of imaging (weight-bearing radiographs and CT if obtained), medical optimization, and planning for possible implants (screws, plates, or wires). The procedure is performed in an operating room under regional block or general anesthesia. The surgeon performs an open approach to the tarsometatarsal joints, debridement of interposed tissue, reduction of joint alignment, and fixation with screws or pins as indicated. Postoperative workflow includes immobilization in a splint or cast, non–weight-bearing instructions, pain control, DVT prophylaxis as appropriate, and early follow-up for wound checks and radiographic evaluation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when the work required to treat extensive midfoot soft-tissue injury or multiple joint reconstructions significantly increases time and effort beyond the typical procedure. |