Closed treatment of a talotarsal joint dislocation performed under anesthesia — meaning the dislocated joint between the talus and an adjacent tarsal bone is manually reduced without surgical opening, but anesthesia is required to achieve it.

Verified May 8, 2026 · 6 sources ↓

Medicare: $422.52
Total RVUs: 12.65
Global, days: 90
Region: Foot & ankle

Drawn from CMSAAPCFindacodeAcepEmedny

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

Specify which talotarsal joint(s) were dislocated — talonavicular, talocalcaneal, or both — by name
Document the clinical indication for anesthesia, including neuromuscular guarding or inability to reduce without it
Record the type of anesthesia used (general, regional, or sedation) and who administered it
Note pre- and post-reduction neurovascular status of the foot
Confirm fluoroscopic or radiographic verification of reduction post-procedure
If multiple talotarsal joints were reduced, document each joint separately with distinct findings

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 50 Bilateral procedure 51 Multiple procedures 52 Reduced services 58 Staged or related 59 Distinct service 76 Repeat, same physician 77 Repeat, another physician 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

28575 covers closed reduction of a talotarsal joint dislocation when anesthesia is required to accomplish the manipulation. The talotarsal complex includes all articulations between the talus and the surrounding tarsal bones — talonavicular, talocalcaneal, and related joints. When muscle guarding or injury severity prevents reduction without anesthesia, this code applies instead of 28570 (the no-anesthesia version).

The 90-day global period means initial casting, splinting, or strapping is bundled — do not separately bill a casting or strapping code for the same encounter. All routine post-reduction follow-up visits through day 90 are also included. Use modifier 24 for unrelated E/M visits during the global window, modifier 78 for an unplanned return to the OR for a related complication, and modifier 79 for an unrelated surgical procedure during the global period.

If both the talonavicular and talocalcaneal joints are dislocated and treated at the same encounter, payers vary on whether a second unit is payable. Some allow modifier 59 with documentation of distinct dislocations at anatomically separate joints; others bundle both reductions into one unit. Verify NCCI edits and payer policy before billing 28575 twice on the same date.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	3.4
Practice expense RVU	8.53
Malpractice RVU	0.72
Total RVU	12.65
Medicare national rate	$422.52
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	$422.52
HOPD (APC 5113) Hospital outpatient department	$3,342.87
ASC (PI A2) Ambulatory surgical center (freestanding)	$1,644.87

Common denial reasons

The recurring reasons claims for CPT 28575 get rejected.

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

Casting or strapping billed separately on the same date — initial immobilization is bundled into 28575
Missing documentation of why anesthesia was required, triggering a downcode to 28570
Fluoroscopy or imaging guidance billed separately when used solely to confirm reduction — it is integral to the procedure
Duplicate units for bilateral or multi-joint dislocations without supporting documentation of anatomically distinct joints and applicable modifier
Global period conflict when a related E/M visit is billed within the 90-day window without modifier 24

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 6 cited references ↓

01What is the difference between 28570 and 28575?

Both cover closed reduction of a talotarsal joint dislocation. 28570 is used when no anesthesia is required. 28575 applies when anesthesia — general, regional, or sedation — is necessary to achieve reduction. The distinction must be documented clearly; undocumented anesthesia use will result in a downcode to 28570.

02Can I bill a casting or splinting code separately with 28575?

No. Per NCCI policy, fracture and dislocation treatment codes include the initial casting, splinting, or strapping. Billing a separate immobilization code on the same date of service will be denied as bundled.

03Can 28575 be billed twice if both the talonavicular and talocalcaneal joints are dislocated?

Payers vary. Some allow a second unit with modifier 59 when documentation confirms distinct dislocations at anatomically separate joints. Others bundle both reductions into a single unit. Check NCCI PTP edits and your specific payer policy before billing a second unit.

04Is fluoroscopy separately billable with 28575?

Not when used solely to confirm reduction of the same dislocation — that imaging is integral to the procedure. If fluoroscopy is performed for a separate, distinct procedure at the same encounter, it may be billed separately with the appropriate modifier.

05What modifier applies if the treating physician won't provide the post-op follow-up?

Append modifier 54 to 28575 when the treating provider performs the reduction but another provider will handle the 90-day global follow-up. The subsequent provider bills modifier 55 for post-operative management only.

06What code applies if closed reduction fails and open surgery is needed?

If the decision to proceed to open treatment is made and performed, report 28585 (open treatment of talotarsal joint dislocation, with or without internal fixation) instead of 28575. Do not bill both codes for the same dislocation at the same encounter.

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 talotarsal joint(s) involved, the clinical reason anesthesia was required, the reduction technique, and post-reduction neurovascular and radiographic findings from the provider's dictation. That documentation prevents downcoding to 28570 and flags if a separate casting or strapping code was inadvertently ordered on the same date.

See how Mira captures CPT 28575 documentation