Summary & Overview
CPT 28010: Percutaneous Tenotomy for Toe Deformity
CPT code 28010 covers a percutaneous tenotomy involving incision or division of a single toe tendon to correct deformities such as hammer toe. This minor surgical code is relevant nationally because it represents a commonly performed podiatric procedure for symptomatic digital deformities that can be done in outpatient and office-based settings, affecting utilization, coding consistency, and payment policy across payers. Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for how the procedure is described, typical settings where it is furnished, and the national payer landscape that affects coverage and billing practices. The publication outlines benchmarked payment considerations and common billing complexities tied to procedure setting, global periods, and code bundling — where applicable — as well as policy updates that influence prior authorization and site-of-service determinations. The material also highlights coding pitfalls and documentation elements that typically drive payer review. Data not available in the input is noted where specific reimbursement rates, associated taxonomies, and ICD-10 pairings would normally be presented.
Billing Code Overview
CPT code 28010 describes a percutaneous tenotomy of a single tendon in a toe, performed through a small skin incision to correct a toe deformity such as hammer toe. The procedure involves incising or dividing the affected tendon to relieve abnormal tension and restore toe alignment.
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Service type: Minor outpatient surgical procedure (percutaneous tendon release)
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Typical site of service: Ambulatory surgical center, hospital outpatient department, or office-based procedure room
Clinical & Coding Specifications
Clinical Context
A 62-year-old female presents to a podiatry clinic with a painful flexible hammer toe deformity of the second toe causing callus and difficulty fitting footwear. Conservative measures including wider shoes, orthotic padding, and toe splinting failed over several months. The podiatrist evaluates range of motion, neurovascular status, and obtains weight-bearing foot radiographs to exclude osseous deformity. After informed consent, the provider schedules a percutaneous toe tendon release (tenotomy) under local anesthesia in an ambulatory procedure room. The procedure involves a small percutaneous incision over the flexor tendon, a controlled division of the single involved tendon to correct the contracture, hemostasis, sterile dressing, and brief postprocedure instructions. The patient is discharged the same day with analgesics and wound care instructions and returns for routine dressing check and progressive range-of-motion exercises.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Data not available in the input. | Data not available in the input. |
50 | Data not available in the input. | Data not available in the input. |