CPT 28675: Open Treatment of Toe Interphalangeal Joint Dislocation

CPT code 28675 represents the open surgical treatment of an interphalangeal joint dislocation in a toe, a procedure performed to realign and stabilize the joint and may include internal fixation with pins or screws. Nationally, this code is important for billing of foot and orthopedic surgical services that address traumatic or chronic joint instability of the toes. It captures a defined surgical intervention distinct from closed reduction or nonoperative care, which affects procedural categorization, facility utilization, and payment pathway.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare and Medicare. Readers will find clinical context for when the procedure is used, the typical service setting, and how the code is positioned relative to related toe and foot procedures. The publication outlines common billing considerations and benchmarking topics that payers review for surgical foot procedures, as well as policy and coverage themes that influence authorization and payment.

This summary equips coders, surgical teams, and revenue staff with a concise reference to the clinical intent of 28675, the service type and typical sites of service, and the areas where payers commonly focus review and coverage rules.

Billing Code Overview

CPT code 28675 describes open treatment of an interphalangeal joint dislocation of a toe. The procedure addresses an abnormal separation of an interphalangeal joint between phalanges of a toe and may include fixation with internal implants such as pins or screws when needed. The focus is on restoring joint alignment and stability through an open surgical approach.

Service Type: Surgical — open reduction and internal fixation (when used)

Typical Site of Service: Hospital inpatient or outpatient surgical center; procedural setting for foot/orthopedic surgery

Clinical Context

A 38-year-old patient presents to the emergency department after stubbing their toe during a fall at home. On exam there is obvious deformity, pain, swelling, and limited range of motion at the interphalangeal joint of the second toe. Plain radiographs confirm a displaced dorsal dislocation of the distal interphalangeal joint with soft-tissue interposition and instability after attempted closed reduction in the ED. The orthopedic foot and ankle surgeon schedules the patient for open treatment of the interphalangeal joint dislocation under regional or general anesthesia. In the operating room, the surgeon makes an incision over the affected interphalangeal joint, directly visualizes and clears obstructing soft tissues, reduces the joint, and stabilizes the reduction. Internal fixation such as a percutaneous or buried pin may be placed at the surgeon’s discretion. Postoperative workflow includes dressing and splinting, neurovascular checks, radiographic confirmation of reduction and fixation, postoperative pain control, wound care instructions, and scheduled outpatient follow-up for pin removal and rehabilitation as indicated. Typical settings for this service are ambulatory surgical centers or hospital operating rooms.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when documented work, time, and complexity for the open reduction exceed typical expectations and payer allows additional reimbursement with supporting operative report.

Taxonomy Code	Specialty	Notes
207X00000X	Orthopedic Surgery	Foot and ankle surgeons commonly perform open IP joint dislocations; code used for general orthopedists.
207L00000X	Podiatric Medicine & Surgery	Podiatrists with surgical privileges frequently treat toe dislocations and perform open reductions and fixation.
2080P0002X	General Surgery	Rarely involved; may participate in trauma service managing multiple injuries including toe dislocations.
226E00000X	Emergency Medicine	Emergency physicians perform initial assessment and attempted closed reductions prior to operative referral.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S92.322A`	Dislocation of interphalangeal joint of right lesser toe, initial encounter	Represents closed or open dislocation of an interphalangeal joint of a lesser toe requiring reduction; commonly billed with open treatment when open reduction performed.
`S92.321A`	Dislocation of interphalangeal joint of left lesser toe, initial encounter	Left-side counterpart for an IP joint dislocation requiring operative management.
`S92.339A`	Dislocation of unspecified toe, initial encounter	Used when laterality or specific toe is not specified at initial encounter; may be amended when laterality clarified.
`S92.15XA`	Fracture of distal phalanx of toe(s), initial encounter for closed fracture	Included when dislocation is associated with an avulsion or phalangeal fracture requiring concurrent management.
`S91.311A`	Open wound, right great toe, initial encounter	Used when the dislocation is open with a skin wound that requires debridement and operative treatment.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`11042`	Debridement, subcutaneous tissue (simple or extensive)	Used if wound debridement of soft tissue around the dislocated joint is required prior to or during open reduction.
`20690`	Application of external fixation device (separate procedure)	May be used when temporary external stabilization of the toe is required in complex or open injuries.
`20670`	Removal of implanted material, deep (requiring incision)	Used in a later encounter if retained pins or other internal fixation require operative removal under anesthesia.
`12001`	Simple repair of superficial wounds (less than 2.5 cm)	Used for closure of simple skin incisions or lacerations made during the open procedure when appropriate.
`99024`	Postoperative follow-up visit global period, minor procedure	Used for routine postoperative follow-up visits within the global surgical period (facility/payor rules apply).

OpenPayer

Summary & Overview