Closed reduction of a talotarsal joint dislocation performed without anesthesia, restoring alignment between the talus and adjacent tarsal bones through manual manipulation.
Verified May 8, 2026 · 5 sources ↓
- Medicare
- $267.21
- Work RVU
- 1.72
- Global, days
- 90
- Region
- Foot & ankle
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 5 cited references ↓
- Specify which talotarsal joint was dislocated (e.g., talonavicular, talocalcaneal) — vague 'foot dislocation' language invites downcoding.
- Confirm no anesthesia was used to justify 28570 over 28575; document patient tolerance and technique.
- Record pre- and post-reduction neurovascular status of the foot and toes.
- Include laterality (left/right) explicitly — required for ICD-10 code selection and bilateral modifier decisions.
- Document post-reduction immobilization method (cast, splint, boot) and weight-bearing instructions.
- Note imaging used to confirm reduction; radiology reports should be linked in the encounter record.
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 5 cited references ↓
28570 covers closed treatment of a talotarsal joint dislocation — meaning the talus has displaced relative to one or more of the other tarsal bones (calcaneus, navicular, cuboid, or cuneiforms) — performed without anesthesia. No incision is made; the provider manually reduces the joint and confirms alignment, typically with post-reduction imaging. The 90-day global period bundles the initial splint or cast application and all routine follow-up through day 90. Replacement casts, splints, supplies, and imaging are billable separately within the global window.
If the same encounter includes a separately identifiable E/M service, append modifier 25. If the decision for a more invasive procedure (e.g., open reduction) is made at the visit that precedes surgery, modifier 57 applies to that E/M. The paired code 28575 covers the same talotarsal reduction when anesthesia is required — select the correct code based on whether anesthesia was used, not on procedural complexity alone.
ICD-10 alignment is a common denial trigger. Primary diagnosis codes must reflect talotarsal or foot dislocation (e.g., M24.374–M24.376 for pathological dislocation of foot; appropriate S-codes for traumatic dislocation). Stress fracture or pathological fracture codes may be co-listed when clinically applicable per payer policy, but the primary must match the dislocation laterality and acuity documented in the record.
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 (1.72) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (8) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 1.72 |
| Practice expense RVU | 5.91 |
| Malpractice RVU | 0.37 |
| Total RVU | 8 |
| Medicare national rate | $267.21 |
| 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 | $267.21 |
HOPD (APC 5111) Hospital outpatient department | $252.01 |
ASC (PI P2) Ambulatory surgical center (freestanding) | $135.54 |
Common denial reasons
The recurring reasons claims for CPT 28570 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- ICD-10 code does not specify talotarsal joint — generic foot dislocation codes without laterality or joint specificity fail to support 28570.
- Anesthesia administered but 28570 billed instead of 28575 — payer flags the anesthesia claim against the no-anesthesia code.
- E/M billed same-day without modifier 25, causing the evaluation service to be bundled into the global package.
- Bilateral procedure billed as two units without modifier 50 or separate line items with LT/RT — MUE limits will cause one claim to deny.
- Missing or incomplete operative/procedural note — closed reduction without documented technique and confirmation of reduction is treated as not medically necessary by audit reviewers.
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 5 cited references ↓
01When do I use 28570 versus 28575?
02Can I bill a separate E/M on the same day as 28570?
03What is included in the 90-day global period for 28570?
04How do I bill if both feet require talotarsal reduction in the same session?
05What ICD-10 codes support 28570?
06If closed reduction fails and I proceed to open reduction the same day, how do I code that?
Sources & references
Editorial content was developed using the following public sources. Last verified May 8, 2026.
Mira Scribe
Mira's AI scribe captures the specific talotarsal joint involved, laterality, absence of anesthesia, reduction technique, pre- and post-reduction neurovascular exam, and immobilization applied — the exact details auditors look for when distinguishing 28570 from 28575 and validating ICD-10 joint specificity. This prevents the two most common denial patterns: anesthesia mismatch and nonspecific diagnosis codes.
See how Mira captures CPT 28570 documentation