Summary & Overview
CPT 28011: Percutaneous Tenotomy of Multiple Tendons for Hammer Toe
CPT code 28011 denotes a percutaneous tenotomy in which multiple tendons of a toe are incised or divided through a small skin incision to correct deformities such as hammer toe. As a targeted, minimally invasive soft-tissue procedure on the foot, this code is relevant to podiatry, orthopedic foot and ankle surgery, and outpatient surgical services nationally. Its use affects surgical coding, reimbursement for minor foot procedures, and billing practices across payers that cover ambulatory surgical and office-based procedures.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise synthesis of clinical context, typical sites of service, and the practical implications for coding and billing workflows. The publication outlines common billing considerations, how this procedure is categorized within surgical service lines, and what benchmarks and policy topics typically influence coverage and payment for percutaneous tenotomy procedures.
The content provides an executive overview for clinical administrators, coding professionals, and policy analysts seeking a clear reference on CPT code 28011, focusing on how the procedure is described and where it is typically performed. Data not available in the input.
Billing Code Overview
CPT code 28011 describes a percutaneous tenotomy of multiple tendons in a toe, performed through a small skin incision to correct deformities such as hammer toe. The procedure involves incising or dividing multiple tendons to release contractures and restore more normal toe alignment.
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Service type: Surgical, minor soft-tissue procedure on the foot
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Typical site of service: Outpatient surgical suite, ambulatory surgery center, or office-based procedure room
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting to a podiatry or orthopedic clinic with a painful, fixed or flexible hammer toe deformity of the lesser toes causing dorsal toe pressure, callus formation, ulceration risk, or pain in standard shoe gear. Conservative measures such as shoe modification, padding, orthotics, and steroid injection have been attempted and documented as ineffective or not tolerated. The patient is evaluated in clinic with focused history and physical exam, gait assessment, and weight-bearing forefoot radiographs when indicated to assess bony alignment and rule out arthritic changes.
The procedure, 28011 percutaneous tenotomy of flexor tendons of one or more toes, is typically performed in an ambulatory surgery center or office-based procedure room under local anesthesia with or without sedation. The workflow includes preoperative consent and marking, sterile prep, local infiltration, a small percutaneous incision to divide contracted tendon(s), intraoperative assessment of toe alignment and range of motion, hemostasis, dressing application, and postoperative instructions for wound care and activity restrictions. Follow-up is arranged within 7–14 days for wound check and to monitor correction, pain control, and mobility. Documentation should include indication, conservative treatments tried, informed consent, anesthesia type, tendons released, laterality, number of toes treated, and immediate outcome.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
52 |