Dorsal view
Calcaneus BodyFibular (peroneal) trochlea Tarsal sinus Transverse tarsal joint Cuboid
Metatarsal bones
Phalanges Proximal Middle Distal
Lateral tubercle Medial tubercle
Trochlea Neck Head
Navicular Tuberosity Lateral Intermediate Medial
Tarsometatarsal joint Base
Shaft (body)
Head Base Shaft (body) Head Base
Tuberosity
Plantar view
Talus
Calcaneus Tuberosity
Medial process Lateral process
Sustentaculum tali
Fibular (peroneal) trochlea
Tuberosity
l
Tuberosity of 5th metatarsal bone
Base Shaft (body) Head Base Shaft (body) Head Base Head Base Tuberosity Cuneiform bones
Transverse tarsal joint Navicular
Tuberosity Lateral Intermediate Medial Tarsometatarsal joint
Metatarsal bones Sesamoid bones Medial
Lateral
Phalanges
Proximal Middle Distal
Lateral tubercle Medial tubercle Posterior process Head
Talus 5
1 Cuneiform bones
2 3 4 5
4 3 2 1
Posterior process
Cuboid
Tuberosity of 5th metatarsal bone
Groove for tendon of flexor hallucis longus
Groove for fibularis (peroneus) longus tendon Groove for
tendon of flexor hallucis longus
Talus
Transverse tarsal joint Navicular Head
Neck Trochlea Lateral process Posterior process
Intermediate
Lateral Cuneiform bones Tarsometatarsal joint
Metatarsal bones
Phalanges Tarsal sinus
Calcaneus Body
Tuberosity Fibular (peroneal) trochlea
Cuboid Tuberosity
Medial view Transverse tarsal joint
Navicular Tuberosity Cuneiform bones Intermediate
Tarsometatarsal joint Metatarsal bones Phalanges
Talus Neck
Head Trochlea
Sesamoid bone
Posterior process
Tuberosity
Sustentaculum tali
Calcaneus 5
Medial 4
3 2
2 1 Groove for
fibularis (peroneus) longus tendon
Groove for fibularis (peroneus) longus tendon
Tuberosity of 5th metatarsal bone
Tuberosity of
1st metatarsal bone Groove for tendon of
flexor hallucis longus Lateral view
FIGURE 2-51. Bones of the Foot
The foot contains 26 bones (plus two tiny sesamoid bones): 7 tarsal, 5 metatarsal, and 14 phalanges.
The foot is divided into hindfoot, midfoot, and forefoot. The hindfoot contains two tarsal bones (calcaneus and talus). The midfoot contains the balance of the tarsal bones (three cuneiform, one navicular, and one cuboid). The forefoot contains the metatarsals and phalanges. The sesamoid bones are embedded in the muscles of the forefoot connected to the tendons.
Fracture and/or Dislocation
Coding Atlas
Percutaneous skeletal fixation describes the insertion of
Dorsal view
Calcaneus BodyFibular (peroneal) trochlea Tarsal sinus Transverse tarsal joint Cuboid
Metatarsal bones
Phalanges Proximal Middle Distal
Lateral tubercle Medial tubercle
Trochlea Neck Head
Navicular Tuberosity Lateral Intermediate Medial
Tarsometatarsal joint Base
Shaft (body)
Head Base Shaft (body) Head Base
Tuberosity
Plantar view
Talus
Calcaneus Tuberosity
Medial process Lateral process
Sustentaculum tali
Fibular (peroneal) trochlea
Tuberosity
l
Tuberosity of 5th metatarsal bone
Base Shaft (body) Head Base Shaft (body) Head Base HeadBase Tuberosity Cuneiform bones
Transverse tarsal joint Navicular
Tuberosity Lateral Intermediate Medial Tarsometatarsal joint
Metatarsal bones
Sesamoid bones Medial Lateral
Phalanges
Proximal Middle Distal
Lateral tubercle Medial tubercle Posterior process Head
Talus 5
1 Cuneiform bones
2 3 4 5
4 3 2 1
Posterior process
Cuboid
Tuberosity of 5th metatarsal bone
Groove for tendon of flexor hallucis longus
Groove for fibularis (peroneus) longus tendon Groove for
tendon of flexor hallucis longus
Talus
Transverse tarsal joint Navicular Head
Neck Trochlea Lateral process Posterior process
Intermediate
Lateral Cuneiform bones
Tarsometatarsal joint Metatarsal bones
Phalanges Tarsal sinus
Calcaneus Body
Tuberosity Fibular (peroneal) trochlea
Cuboid Tuberosity
Medial view Transverse tarsal joint
Navicular Tuberosity Cuneiform bones Intermediate
Tarsometatarsal joint Metatarsal bones Phalanges
Talus Neck
Head Trochlea
Sesamoid bone
Posterior process
Tuberosity
Sustentaculum tali
Calcaneus 5
Medial 4
3 2
2 1 Groove for
fibularis (peroneus) longus tendon
Groove for fibularis (peroneus) longus tendon
Tuberosity of 5th metatarsal bone
Tuberosity of
1st metatarsal bone Groove for tendon of
flexor hallucis longus Lateral view
28450 Treatment of tarsal bone fracture (except talus and calcaneus); without manipulation, each
28455 with manipulation, each
28456 Percutaneous skeletal fixation of tarsal bone fracture (except talus and calcaneus), with manipulation, each 28465 Open treatment of tarsal bone fracture (except talus and
calcaneus), includes internal fixation, when performed, each
28470 Closed treatment of metatarsal fracture; without manipulation, each
28475 with manipulation, each
28476 Percutaneous skeletal fixation of metatarsal fracture, with manipulation, each
28485 Open treatment of metatarsal fracture, includes internal fixation, when performed, each
28490 Closed treatment of fracture great toe, phalanx or phalanges; without manipulation
28495 with manipulation
28496 Percutaneous skeletal fixation of fracture great toe, phalanx or phalanges, with manipulation
28505 Open treatment of fracture, great toe, phalanx or phalanges, includes internal fixation, when performed 28510 Closed treatment of fracture, phalanx or phalanges, other
than great toe; without manipulation, each 28515 with manipulation, each
FIGURE 2-51. Bones of the Foot (continued)
Netter’s Atlas of Surgical Anatomy for CPT Coding
Musculoskeletal System
28450—28515Moderate sedation ✚Add-on code Modifier 51 exempt #Resequenced code © 2015 American Medical Association 115
28525 Open treatment of fracture, phalanx or phalanges, other than great toe, includes internal fixation, when performed, each
28530 Closed treatment of sesamoid fracture
28531 Open treatment of sesamoid fracture, with or without internal fixation
28540 Closed treatment of tarsal bone dislocation, other than talotarsal; without anesthesia
28545 requiring anesthesia
28546 Percutaneous skeletal fixation of tarsal bone dislocation, other than talotarsal, with manipulation
28555 Open treatment of tarsal bone dislocation, includes internal fixation, when performed
28570 Closed treatment of talotarsal joint dislocation; without anesthesia
28575 requiring anesthesia
28576 Percutaneous skeletal fixation of talotarsal joint dislocation, with manipulation
28585 Open treatment of talotarsal joint dislocation, includes internal fixation, when performed
28600 Closed treatment of tarsometatarsal joint dislocation;
without anesthesia 28605 requiring anesthesia
28606 Percutaneous skeletal fixation of tarsometatarsal joint dislocation, with manipulation
28615 Open treatment of tarsometatarsal joint dislocation, includes internal fixation, when performed 28630 Closed treatment of metatarsophalangeal joint
dislocation; without anesthesia 28635 requiring anesthesia
28636 Percutaneous skeletal fixation of metatarsophalangeal joint dislocation, with manipulation
28645 Open treatment of metatarsophalangeal joint dislocation, includes internal fixation, when performed
28660 Closed treatment of interphalangeal joint dislocation;
without anesthesia 28665 requiring anesthesia
28666 Percutaneous skeletal fixation of interphalangeal joint dislocation, with manipulation
28675 Open treatment of interphalangeal joint dislocation, includes internal fixation, when performed
Arthrodesis
Coding Atlas
In arthrodesis, a joint is surgically fused or immobilized.
Bone grafts may be placed to fix the joint; otherwise, hardware is placed.
28705 Arthrodesis; pantalar
28715 triple
28725 subtalar
28730 Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse;
28735 with osteotomy (eg, flatfoot correction)
28737 Arthrodesis, with tendon lengthening and advancement, midtarsal, tarsal navicular-cuneiform (eg, Miller type procedure)
28740 Arthrodesis, midtarsal or tarsometatarsal, single joint 28750 Arthrodesis, great toe; metatarsophalangeal joint 28755 interphalangeal joint
28760 Arthrodesis, with extensor hallucis longus transfer to first metatarsal neck, great toe, interphalangeal joint (eg, Jones type procedure)
Amputation
Coding Atlas
In a midtarsal amputation, the midfoot is amputated between the calcaneous and cuboid bones and the talus and navicular bones. In transmetatarsal amputation, all toes are excised at the level of the metatarsals. Toe amputation is coded according to the level of joint amputated.
28800 Amputation, foot; midtarsal (eg, Chopart type procedure) 28805 transmetatarsal
28810 Amputation, metatarsal, with toe, single 28820 Amputation, toe; metatarsophalangeal joint 28825 interphalangeal joint
Other Procedures
28890 Extracorporeal shock wave, high energy, performed by a physician or other qualified health care professional, requiring anesthesia other than local, including ultrasound guidance, involving the plantar fascia 28525—28890
Musculoskeletal System
Netter’s Atlas of Surgical Anatomy for CPT Coding116 Moderate sedation ✚Add-on code Modifier 51 exempt #Resequenced code
FIGURE 2-52. Amputation of the Foot
A partial foot amputation (PFA) may be performed to eliminate diseased tissue and preserve as much healthy foot as possible. CPT code selection is based on the level of amputation as defined by the bones removed, from midfoot amputations to amputations that involve removal of only the distal phalange. Note: Tools, implants, and/or equipment depicted in the illustration may be outdated but the procedural approach is valid.
Amputation of toe
Amputation of 5th ray Transmetatarsal amputation
Line of incision. Entire nail and part of distal phalanx excised
Plantar flap
5th ray removed.
with plantar flap.
Wound closed Line of incision
Plantar flap Fascial and skin flaps formed. Bones
transected and beveled.
Completed closure (blue line indicates fascial closure)
Moderate sedation ✚Add-on code Modifier 51 exempt #Resequenced code © 2015 American Medical Association 117
Netter’s Atlas of Surgical Anatomy for CPT Coding