CPT® Code 28540

The CPT® Code 28540 refers to the closed treatment of tarsal bone dislocation, excluding the talotarsal joint, and is performed without the use of anesthesia. The tarsal bones consist of seven individual bones, including the talus, which is not included in this specific procedure. The remaining six tarsal bones are the calcaneus, cuboid, navicular, and three cuneiform bones (medial, intermediate, and lateral). Dislocations of the tarsal bones are considered rare injuries, and the management of such dislocations requires careful evaluation of the neurovascular status of the foot. In cases where a pulse is absent, an emergent reduction of the affected mid-foot joint is necessary, and this may be performed without pre-reduction radiographs. If the neurovascular status is intact, it is essential to obtain separately reportable radiographs to assess the extent of the dislocation. The procedure involves applying longitudinal traction to the foot while exerting pressure on the involved bones to facilitate the reduction of the dislocation. After the reduction is successfully achieved, the neurovascular status is re-evaluated, and a second set of radiographs is obtained to confirm proper alignment. Following the procedure, the foot is immobilized in a splint, and the patient is advised to ice and elevate the foot to aid in recovery. It is important to use code 28540 specifically when the dislocation is treated without anesthesia, while code 28545 should be used when anesthesia is required for the procedure.