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Official Description

Treatment of tarsal bone fracture (except talus and calcaneus); without manipulation, each

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 28450 refers to the treatment of a fracture involving the tarsal bones, specifically excluding the talus and calcaneus. This procedure is categorized as a closed treatment, meaning that it does not involve any surgical manipulation of the fracture fragments. The tarsal bones in question include the cuboid, navicular, and three cuneiform bones. In cases where multiple tarsal bones are fractured, each individual fracture must be reported separately to ensure accurate coding and billing. Prior to treatment, radiographs are obtained to confirm the presence of the fracture, which is a critical step in the diagnostic process. Additionally, a neurovascular examination is conducted to assess the integrity of the nerves and blood vessels surrounding the injury site, ensuring that there are no complications that could affect healing. The treatment for a nondisplaced or minimally displaced fracture, as indicated by CPT® Code 28450, involves the application of a cast or brace to immobilize the affected area, promoting proper healing without the need for invasive procedures. This code is distinct from CPT® Code 28455, which is used for displaced fractures that require manual reduction to restore proper alignment of the bone fragments.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure associated with CPT® Code 28450 is indicated for the treatment of fractures of the anterior tarsal bones, which include the cuboid, navicular, and three cuneiform bones. The specific indications for this procedure include:

  • Nondisplaced Fracture - A fracture where the bone fragments remain in their normal anatomical position.
  • Minimally Displaced Fracture - A fracture where the bone fragments are slightly out of alignment but do not require manipulation to restore proper positioning.

2. Procedure

The procedure for CPT® Code 28450 involves several key steps to ensure proper treatment of the tarsal bone fracture:

  • Step 1: Radiographic Confirmation - The first step in the procedure is obtaining radiographs to confirm the presence of a fracture in one of the anterior tarsal bones. This imaging is essential for accurate diagnosis and treatment planning.
  • Step 2: Neurovascular Examination - Following the confirmation of the fracture, a thorough neurovascular examination is performed. This assessment checks the integrity of the nerves and blood vessels in the area surrounding the fracture to rule out any potential complications that could affect healing.
  • Step 3: Application of Cast or Brace - Once the fracture is confirmed and the neurovascular status is deemed intact, a cast or brace is applied to immobilize the affected tarsal bone. This immobilization is crucial for allowing the fracture to heal properly without the risk of further displacement or injury.

3. Post-Procedure

After the application of the cast or brace, the patient will typically be monitored for any signs of complications. It is important to provide instructions regarding care for the cast or brace, including keeping it dry and clean. Follow-up appointments may be scheduled to assess the healing process through additional radiographs. The expected recovery time can vary depending on the severity of the fracture and the patient's overall health, but immobilization is generally required for several weeks to ensure proper healing of the tarsal bone.

Short Descr TREAT MIDFOOT FRACTURE EACH
Medium Descr TX TARSAL BONE FX XCP TALUS&CALCN W/O MANJ
Long Descr Treatment of tarsal bone fracture (except talus and calcaneus); without manipulation, each
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Procedure or Service, Multiple Reduction Applies
ASC Payment Indicator Office-based surgical procedure added to ASC list in CY 2008 or later with MPFS nonfacility PE RVUs; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P6B - Minor procedures - musculoskeletal
MUE 2
CCS Clinical Classification 147 - Treatment, fracture or dislocation of lower extremity (other than hip or femur)
LT Left side (used to identify procedures performed on the left side of the body)
RT Right side (used to identify procedures performed on the right side of the body)
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
54 Surgical care only: when 1 physician or other qualified health care professional performs a surgical procedure and another provides preoperative and/or postoperative management, surgical services may be identified by adding modifier 54 to the usual procedure number.
55 Postoperative management only: when 1 physician or other qualified health care professional performed the postoperative management and another performed the surgical procedure, the postoperative component may be identified by adding modifier 55 to the usual procedure number.
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
81 Minimum assistant surgeon: minimum surgical assistant services are identified by adding modifier 81 to the usual procedure number.
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
CR Catastrophe/disaster related
GC This service has been performed in part by a resident under the direction of a teaching physician
T2 Left foot, third digit
T4 Left foot, fifth digit
T5 Right foot, great toe
T6 Right foot, second digit
T7 Right foot, third digit
T8 Right foot, fourth digit
T9 Right foot, fifth digit
X4 Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
2013-01-01 Changed Medium Descriptor changed.
2011-01-01 Changed Short description changed.
Pre-1990 Added Code added.
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