CPT® Code 28415

The procedure described by CPT® Code 28415 refers to the open treatment of a calcaneal fracture, which involves the surgical intervention to repair a fracture in the calcaneus, the largest bone in the foot that forms the heel. This type of fracture typically occurs due to significant trauma, such as a fall from a height or a motor vehicle accident, resulting in a high-impact force to the heel. The calcaneus articulates with the cuboid bone in the front and the talus bone above, and fractures in this area can lead to complications, including damage to the subtalar joint, which may restrict the foot's ability to move inward (inversion) and outward (eversion). During the procedure, a surgical incision is made in an L-shape over the posterolateral aspect of the foot, positioned behind and below the lateral malleolus. This incision allows the surgeon to access the fracture site directly and inspect the subtalar joint for any associated injuries. The fracture is then reduced using bone elevators, and temporary wire fixation is applied to maintain the reduction while confirming the proper alignment through radiographic imaging. If necessary, internal fixation devices such as screws or a plate and screw system are utilized to stabilize the fracture. In cases where autogenous bone grafting is performed, indicated by the use of CPT® Code 28420, a separate incision is made to harvest bone graft material from the iliac crest or another donor site, which is then packed into the fracture site before securing the fixation device. Finally, the surgical site is irrigated, and the incision is closed with sutures to promote healing.