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An osteotomy of the first metatarsal, as described by CPT® Code 28307, involves surgical intervention aimed at correcting angular deformities of the foot. This procedure can be performed with or without additional techniques such as lengthening, shortening, or angular correction. The first metatarsal is a critical bone in the foot, and its alignment is essential for proper foot function. Conditions that may necessitate this procedure include acquired or congenital deformities such as hallux valgus (commonly known as bunions), metatarsus primus varus, hallux varus, and dorsal bunions. During the procedure, the surgeon exposes the first metatarsal, and depending on the specific deformity and the location of the osteotomy, the surgical excision may extend to involve adjacent structures, including the proximal phalanx and/or the medial cuneiform bones. The metatarsophalangeal (MTP) joint capsule may be incised, and tendons may be divided as necessary to facilitate the correction. The technique employed can vary; for instance, a closing wedge osteotomy involves cutting the metatarsal and removing a wedge of bone, while an opening wedge osteotomy entails cutting the bone and using a laminar spreader to create space for alignment. In both cases, bone autograft may be utilized, particularly if harvested from a site other than the first toe, to support the healing process and maintain the structural integrity of the metatarsal post-surgery.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 28307 is indicated for the correction of various angular deformities of the first metatarsal. These indications include:
The procedure for CPT® Code 28307 involves several critical steps to ensure effective correction of the metatarsal deformity. The following procedural steps are typically performed:
After the osteotomy procedure is completed, post-operative care is essential for optimal recovery. Patients are typically monitored for any complications, and pain management strategies are implemented. The recovery process may involve immobilization of the foot using a cast or a walking boot to ensure proper healing of the metatarsal. Weight-bearing activities may be restricted for a specified period, and physical therapy may be recommended to restore function and strength in the foot. Follow-up appointments are crucial to assess the healing process and to make any necessary adjustments to the treatment plan.
| Short Descr | INCISION OF METATARSAL | Medium Descr | OSTEOT W/WO LNGTH SHRT/CORRJ METAR XCP 1ST TOE | Long Descr | Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; first metatarsal with autograft (other than first toe) | 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) | 1 - 150% payment adjustment for bilateral procedures applies. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - 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 | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P3D - Major procedure, orthopedic - other | MUE | 1 | CCS Clinical Classification | 161 - Other OR therapeutic procedures on bone |
| 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 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). | 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. | 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). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | 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) | T1 | Left foot, second digit | T4 | Left foot, fifth digit | T5 | Right foot, great toe | T6 | Right foot, second digit | T7 | Right foot, third digit | TA | Left foot, great toe | 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 |
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| Pre-1990 | Added | Code added. |
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