Patient presents with complaints consistent with Haglund's deformity, also known as pump bump, retrocalcaneal exostosis, and Mulholland deformity.  Symptoms include posterior heel pain, exacerbated by footwear, particularly pumps or other rigid-backed shoes.  Physical examination reveals a prominent bony enlargement on the back of the heel, superior to the Achilles tendon insertion.  Palpation elicits tenderness over the retrocalcaneal bursa, with possible redness and swelling indicating bursitis.  Range of motion of the ankle is typically normal, though dorsiflexion may be painful.  Differential diagnosis includes Achilles tendinopathy, retrocalcaneal bursitis, and insertional Achilles tendinitis.  Diagnostic imaging, such as lateral radiographs of the foot and ankle, confirms the presence of a bony prominence on the posterosuperior calcaneus.  Conservative treatment options include shoe modifications, orthotics, nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy focusing on Achilles tendon stretching and strengthening exercises, and corticosteroid injections.  Surgical intervention, including resection of the bony exostosis and bursectomy, may be considered if conservative measures fail to provide adequate symptom relief.  ICD-10 code M77.3 is used for Haglund's deformity.  CPT codes for possible procedures include 27650 for exostectomy and 27654 for bursectomy.  Patient education regarding footwear choices and activity modification is essential.  Follow-up appointment scheduled to assess response to treatment and adjust management as needed.