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Official Description

Endoscopic plantar fasciotomy

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The endoscopic plantar fasciotomy, as described by CPT® Code 29893, is a minimally invasive surgical procedure aimed at alleviating pain and discomfort associated with severe strain and inflammation of the plantar fascia. The plantar fascia is a thick band of connective tissue that runs along the bottom of the foot, providing support to the arch and facilitating movement. When this tissue becomes inflamed or strained, it can lead to conditions such as plantar fasciitis, which is characterized by sharp heel pain, particularly with the first steps in the morning or after prolonged periods of rest. The procedure involves making a small vertical incision on the medial side of the heel, allowing the physician to access the plantar fascia with the aid of an endoscope. This technique minimizes tissue damage and promotes quicker recovery compared to traditional open surgery. The endoscopic approach enables the surgeon to visualize the fascia directly, ensuring precise severing of the medial fascial band while preserving the integrity of the lateral fascial band, which is crucial for maintaining foot function. Overall, this procedure is designed to relieve pain and restore mobility for patients suffering from chronic plantar fasciitis.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The endoscopic plantar fasciotomy is indicated for patients experiencing severe strain and inflammation of the plantar fascia, which may manifest as chronic heel pain. This procedure is typically considered when conservative treatments, such as physical therapy, orthotics, and anti-inflammatory medications, have failed to provide adequate relief. The primary indications for performing this procedure include:

  • Chronic Plantar Fasciitis Persistent pain in the heel or arch of the foot due to inflammation of the plantar fascia that has not responded to non-surgical treatments.
  • Severe Foot Pain Significant discomfort that interferes with daily activities and quality of life, particularly pain that occurs with the first steps after rest.
  • Functional Limitations Difficulty in performing weight-bearing activities or sports due to heel pain, necessitating surgical intervention for relief.

2. Procedure

The endoscopic plantar fasciotomy involves several key procedural steps to ensure effective treatment of the plantar fascia. The steps are as follows:

  • Step 1: Incision A vertical incision is made at the medial aspect of the heel, specifically located just anterior and inferior to the medial calcaneal tubercle. This strategic placement allows for optimal access to the plantar fascia while minimizing damage to surrounding tissues.
  • Step 2: Blunt Dissection Following the incision, blunt dissection is performed to carefully expose the plantar fascia. This technique helps to separate the fascia from the underlying structures without causing unnecessary trauma.
  • Step 3: Introduction of Obturator/Cannula System An obturator/cannula system is then introduced and advanced laterally. This system facilitates the insertion of the endoscope and provides a pathway for surgical instruments.
  • Step 4: Endoscope Introduction The endoscope is introduced medially to inspect the medial fascial band. This visualization is crucial for assessing the condition of the fascia and determining the extent of the procedure required.
  • Step 5: Severing the Medial Band A surgical knife is utilized to sever the medial fascial band, which is the primary target of the procedure. This step is essential for relieving tension and pain associated with the inflamed fascia.
  • Step 6: Additional Fiber Severing The endoscope is then repositioned laterally, and a probe is introduced medially to address any remaining fibers of the medial band. Any residual fibers are carefully severed to ensure complete release of the medial band.
  • Step 7: Irrigation and Closure After the medial band is fully released, the surgical area is irrigated to remove any debris or blood. Subsequently, the cannula is removed, and the incision is closed, completing the procedure.

3. Post-Procedure

Post-procedure care following an endoscopic plantar fasciotomy typically involves monitoring for any signs of complications, such as infection or excessive swelling. Patients are often advised to rest and avoid weight-bearing activities for a specified period to promote healing. Pain management may be addressed with prescribed medications, and physical therapy may be recommended to aid in recovery and restore function. Follow-up appointments are essential to assess healing and ensure that the desired outcomes of pain relief and improved mobility are achieved.

Short Descr SCOPE PLANTAR FASCIOTOMY
Medium Descr ENDOSCOPIC PLANTAR FASCIOTOMY
Long Descr Endoscopic plantar fasciotomy
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) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 1 - Co-surgeons could be paid, though supporting documentation is required...
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) P8I - Endoscopy - other
MUE 1
CCS Clinical Classification 170 - Excision of skin lesion
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)
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).
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.
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).
82 Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s).
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
SG Ambulatory surgical center (asc) facility service
T5 Right foot, great toe
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
2011-01-01 Changed Short description changed.
1998-01-01 Added First appearance in code book in 1998.
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