Closed reduction of a tarsal bone dislocation — excluding talotarsal joints — performed under anesthesia.

Verified May 8, 2026 · 5 sources ↓

Medicare: $347.37
Work RVU: 2.54
Global, days: 90
Region: Foot & ankle

Drawn from CMSAAPCGenhealthMdclarityAAOS

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 5 cited references ↓

Identify the specific tarsal bone(s) dislocated by name — navicular, cuboid, or cuneiform (medial, intermediate, or lateral); 'tarsal dislocation' alone is insufficient.
Confirm anesthesia was administered and document the type (general, regional, or monitored anesthesia care); this distinguishes 28545 from lower-level closed treatment codes.
Explicitly exclude talotarsal joint involvement — document that the talonavicular and talocalcaneal joints were not dislocated or were treated separately.
Record pre- and post-reduction imaging (fluoroscopy or plain films) confirming joint realignment and verifying no fracture-dislocation that would alter code selection.
Document the mechanism of injury and clinical findings supporting dislocation diagnosis to support the ICD-10 code pairing and establish medical necessity.
Note any immobilization applied post-reduction (splint, cast, boot) as part of the procedure record.

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 24 Unrelated E/M during global 25 Significant separate E/M 50 Bilateral procedure 51 Multiple procedures 52 Reduced services 58 Staged or related 76 Repeat, same physician 78 Unplanned return — related 79 Unrelated during global LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

CPT 28545 covers closed (non-surgical) reduction of a dislocated tarsal bone when anesthesia is required. The tarsal bones in scope are the navicular, cuboid, medial cuneiform, intermediate cuneiform, and lateral cuneiform — the talotarsal joints (talonavicular, talocalcaneal) are explicitly excluded and fall under separate codes such as 28575. If the dislocation involves one of those talotarsal articulations, 28545 is the wrong code regardless of the anesthesia used.

The 90-day global period means all routine follow-up — wound checks, cast changes, repeat imaging reads done in-office, and standard post-reduction visits — is bundled through day 90. Any visit for a problem unrelated to the dislocation during that window requires modifier 24. A staged or planned subsequent procedure (e.g., delayed open reduction if closed treatment fails) requires modifier 58. An unplanned return to the OR for a related complication uses modifier 78.

Site of service matters here: the HOPD and ASC payments differ substantially (see the Site of Service comparison table). When the procedure can safely be performed in an ASC, that setting typically lowers total facility cost — relevant for payers managing episode-of-care contracts and for practices negotiating outpatient facility agreements.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU vs. total RVU

The work RVU (2.54) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (10.4) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	2.54
Practice expense RVU	7.33
Malpractice RVU	0.53
Total RVU	10.4
Medicare national rate	$347.37
Global period	90 days

Payment by site of service

Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.

Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026

Setting	Medicare rate (national)
Office (PFS non-facility) Procedure performed in physician's office	$347.37
HOPD (APC 5113) Hospital outpatient department	$3,342.87
ASC (PI G2) Ambulatory surgical center (freestanding)	$1,644.87

Common denial reasons

The recurring reasons claims for CPT 28545 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

Code mismatch: billing 28545 when the dislocated joint is talotarsal (talonavicular or talocalcaneal), which requires a different code family — payers and NCCI edits flag this.
Missing anesthesia documentation: payers deny 28545 when operative or procedure notes don't confirm anesthesia was used, since anesthesia is a defining element of this code versus non-anesthesia closed treatment.
ICD-10 mismatch: using a fracture diagnosis code (S9x.x series) without a dislocation-specific code when the procedure is reduction of dislocation only — or vice versa when a fracture-dislocation is present.
Global period conflict: billing a routine post-reduction follow-up visit without modifier 24 during the 90-day global, triggering automatic bundling denial.
Lack of medical necessity documentation when imaging is absent or the operative note does not clearly establish that the joint was dislocated prior to reduction.

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 5 cited references ↓

01What's the difference between 28545 and 28575?

28545 covers closed reduction of tarsal bone dislocations excluding the talotarsal joints (talonavicular, talocalcaneal). 28575 covers closed reduction of talotarsal joint dislocations with anesthesia. The joint involved determines the code — not the technique.

02Does 28545 require anesthesia to bill correctly?

Yes. Anesthesia is a required element of 28545. If the closed reduction is performed without anesthesia, a different, lower-level code applies. Document the anesthesia type in the procedure note — its absence is a common denial trigger.

03Can 28545 be billed bilaterally?

Bilateral tarsal dislocations are rare but not impossible. If both feet are treated in the same session, append modifier 50 and report the code once. Some payers require separate line items with LT and RT instead — verify payer preference before submitting.

04What happens if closed reduction fails and open reduction is needed later?

If the open reduction is planned or staged after a failed closed attempt, append modifier 58 to the open reduction code. If the patient returns unexpectedly to the OR for a related complication, use modifier 78. Don't use modifier 79 — that's for unrelated procedures in the global period.

05Which ICD-10 codes pair with 28545?

Look to the S93.3xx series (dislocation of other and unspecified foot joints) for the primary diagnosis. Specificity matters — code to the affected joint and laterality. Using a fracture code alone without a dislocation code when the procedure is reduction of dislocation is a common mismatch denial.

06Is the 90-day global period standard for 28545?

Yes, 28545 carries a 090 global period under CMS Physician Fee Schedule 2026. Routine post-reduction visits, dressing changes, and cast checks are bundled through day 90. Visits for unrelated problems during that window need modifier 24; a new injury or unrelated procedure needs modifier 79.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira AI Scribe

Mira's AI scribe captures the specific tarsal bone name, confirms anesthesia type, documents pre- and post-reduction imaging findings, and flags whether any talotarsal joint was involved. That joint-specificity prevents the most common denial for 28545 — a vague operative note that doesn't rule out talotarsal involvement — and ensures the ICD-10 dislocation code maps cleanly to the procedure.

See how Mira captures CPT 28545 documentation