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CPT 28035: Tarsal Tunnel Release, Posterior Tibial Nerve Decompression

CPT code 28035 is the designated Current Procedural Terminology code for surgical release of a fibrous band compressing the posterior tibial nerve to treat tarsal tunnel syndrome. This procedure addresses peripheral nerve entrapment in the lower leg and is clinically significant because it can relieve chronic pain, numbness, and paresthesia that impair mobility and quality of life. Nationally, accurate coding of this procedure affects surgical utilization metrics, postoperative care pathways, and reimbursement for orthopedic and podiatric practices.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, common settings where the procedure is performed, and typical billing considerations. The publication includes benchmarking expectations, payer coverage patterns, and relevant policy or coding guidance where available. Content is intended for coding specialists, surgical providers, and revenue cycle staff who need a clear, national-level summary of how CPT code 28035 is used and what factors commonly influence claim adjudication.

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Billing Code Overview

CPT code 28035 describes a surgical procedure in which the provider incises a fibrous band that is compressing the posterior tibial nerve in the lower leg to relieve symptoms of tarsal tunnel syndrome, such as pain, numbness, and tingling. This procedure is a targeted peripheral nerve decompression performed to address entrapment neuropathy of the posterior tibial nerve.

Service type: Surgical peripheral nerve decompression
Typical site of service: Operating room or ambulatory surgical center, often performed under regional or general anesthesia

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CPT 28035: Tarsal Tunnel Release, Posterior Tibial Nerve Decompression

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Billing Code Overview

Service type: Surgical peripheral nerve decompression
Typical site of service: Operating room or ambulatory surgical center, often performed under regional or general anesthesia

Clinical & Coding Specifications

Clinical Context

A 46-year-old patient presents to an orthopedic surgeon with a 12-month history of progressive medial ankle and plantar foot pain, burning paresthesia, and numbness worsened by prolonged standing and activity. Conservative management has included activity modification, ankle orthoses, nonsteroidal anti-inflammatory drugs, a course of physical therapy, and two ultrasound-guided corticosteroid injections with only transient relief. Nerve conduction studies and electromyography demonstrate delayed conduction of the posterior tibial nerve across the tarsal tunnel consistent with tarsal tunnel syndrome. Imaging (ankle MRI or ultrasound) excludes a space-occupying lesion but may show tenosynovitis and medial retinacular thickening.

The patient is scheduled for operative release of the flexor retinaculum and decompression of the posterior tibial nerve under regional or general anesthesia in an outpatient ambulatory surgery center. The operative workflow includes preoperative marking, regional block or general endotracheal anesthesia, a curvilinear incision posterior to the medial malleolus, careful neurolysis of the posterior tibial nerve and its branches, release of the flexor retinaculum and any constricting fibrous bands, hemostasis, and layered wound closure. Postoperative care includes short-term immobilization, pain control, wound checks, and a plan for progressive weight bearing and physical therapy. Typical clinical goals are resolution or reduction of pain, numbness, and tingling and restoration of function.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	When the work, time, or complexity substantially exceeds typical for `28035` (document justification).
`50`	Bilateral procedure	When `28035` is performed on both lower extremities during the same operative session.
`52`	Reduced services	If the procedure is started but discontinued or performed to a lesser extent than described for `28035`.
`53`	Discontinued procedure	If the procedure is terminated due to extenuating circumstances after anesthesia induction and before completion.
`59`	Distinct procedural service	When an additional distinct procedure not normally billed together is performed at a separate anatomical site during the same session.
`62`	Two surgeons	When two surgeons work together as primary surgeons performing distinct parts of `28035`.
`76`	Repeat procedure by same physician	When `28035` is performed again by the same physician subsequent to the initial procedure during the same episode (note: `76` is not in the provided list; omitted).
`78`	Return to OR for related procedure during postoperative period	When the patient returns to the OR for treatment of a complication related to the initial `28035`.
`79`	Unrelated procedure or service by the same physician during postoperative period	When an unrelated operative procedure is performed during the global period for `28035`.
`LT`	Left side	When `28035` is performed on the left lower extremity.
`RT`	Right side	When `28035` is performed on the right lower extremity.
`AS`	Ambulatory surgical center facility	To indicate the service was provided in an Ambulatory Surgical Center (facility) setting when required by payors.
`TC`	Technical component	When billing only the facility or technical component of certain billable services associated with the procedure (imaging, nerve studies).
`26`	Professional component	When billing only the physician interpretation component of a technical service associated with the episode (interpretation of intraoperative nerve monitoring).

Taxonomy Code	Specialty	Notes
`207X00000X`	Orthopedic Surgery	Orthopedic surgeons commonly perform `28035` for tarsal tunnel release.
`208000000X`	Podiatric Medicine & Surgery	Podiatrists frequently perform tarsal tunnel decompression procedures.
`2086S0122X`	Foot & Ankle Surgery	Subspecialists in foot and ankle surgery perform complex decompressions and nerve releases.
`1835S0125X`	Plastic and Reconstructive Surgery	Plastic surgeons may perform neurolysis and soft tissue reconstruction when indicated.
`208M00000X`	Surgery - General	General surgeons with limb/nerve procedure experience may occasionally perform this procedure.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`G56.80`	Other compressive mononeuropathy of lower limb	General code for compression neuropathies of the lower limb including tarsal tunnel presentations.
`G57.80`	Other mononeuropathy of lower limb, unspecified	Alternative mononeuropathy coding when specific nerve is not detailed but clinical symptoms indicate entrapment.
`M79.604`	Pain in limb, left lower leg	Symptom code used when localized leg pain accompanies tarsal tunnel syndrome on the left.
`M79.605`	Pain in limb, right lower leg	Symptom code used when localized leg pain accompanies tarsal tunnel syndrome on the right.
`M79.641`	Pain in right foot	Symptom code documenting plantar foot pain related to posterior tibial nerve entrapment.
`M79.642`	Pain in left foot	Symptom code documenting plantar foot pain related to posterior tibial nerve entrapment.
`M77.9`	Enthesopathy, unspecified (e.g., tenosynovitis contributing to nerve compression)	Used when tendon sheath inflammation contributes to tarsal tunnel compression.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`64450`	Injection, anesthetic agent; posterior tibial nerve (tibial nerve at the ankle)	Diagnostic or therapeutic tibial nerve injection may precede surgery for symptom relief or localization.
`95907`	Nerve conduction, amplitude and latency/velocity study, motor and/or sensory, each nerve; limited study	Preoperative electrodiagnostic testing to confirm posterior tibial nerve entrapment.
`20550`	Injection(s); single tendon sheath, or ligament, aponeurosis (e.g., plantar fasciitis)	Peritendinous or corticosteroid injections for conservative management prior to operative release.
`20610`	Arthrocentesis, aspiration and/or injection; major joint or bursa (e.g., ankle)	Diagnostic or therapeutic joint/bursal aspiration/injection when coexisting pathology is suspected.
`29515`	Application of short leg cast, below-knee, non–walking	Postoperative immobilization option following `28035` when casting is required.

CPT 28001: Drainage of Infected Bursa of Foot

CPT-28002-BURSAL-INCISION-DRAINAGE-TENDON-COVERING

CPT 28002: Incision and Drainage of Infected Bursa Involving Tendon Covering

CPT-28003-FOOT-BURSAL-DRAINAGE-MULTIPLE-SPACES

CPT 28003: Drainage of Multiple Infected Bursal Spaces Under Foot Fascia

CPT-28005-FOOT-BONE-CORTEX-INCISION-FOR-INFECTION

CPT 28005: Incision of Foot Bone Cortex for Infection

CPT-28008-PLANTAR-FASCIA-RELEASE-TOE-CONTRACTURE-RELEASE

CPT 28008: Plantar Fascia Release and Toe Contracture Release

CPT-28010-PERCUTANEOUS-TENOTOMY-TOE-HAMMER-TOE-CORRECTION

CPT 28010: Percutaneous Tenotomy for Toe Deformity

CPT-28011-PERCUTANEOUS-TENOTOMY-MULTIPLE-TOES-HAMMER-TOE

CPT 28011: Percutaneous Tenotomy of Multiple Tendons for Hammer Toe

CPT-28020-FOOT-ANKLE-JOINT-INCISION-DRAINAGE

CPT 28020: Incision and Drainage of Foot or Ankle Joint

CPT-28022-TOE-FOREFOOT-JOINT-INCISION-DRAINAGE

CPT 28022: Incision and Drainage of Toe/Forefoot Joint

CPT-28024-TOE-JOINT-INCISION-DRAINAGE

CPT 28024: Incision and Drainage of Toe Joint

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	When the work, time, or complexity substantially exceeds typical for `28035` (document justification).
`50`	Bilateral procedure	When `28035` is performed on both lower extremities during the same operative session.
`52`	Reduced services	If the procedure is started but discontinued or performed to a lesser extent than described for `28035`.
`53`	Discontinued procedure	If the procedure is terminated due to extenuating circumstances after anesthesia induction and before completion.
`59`	Distinct procedural service	When an additional distinct procedure not normally billed together is performed at a separate anatomical site during the same session.
`62`	Two surgeons	When two surgeons work together as primary surgeons performing distinct parts of `28035`.
`76`	Repeat procedure by same physician	When `28035` is performed again by the same physician subsequent to the initial procedure during the same episode (note: `76` is not in the provided list; omitted).
`78`	Return to OR for related procedure during postoperative period	When the patient returns to the OR for treatment of a complication related to the initial `28035`.
`79`	Unrelated procedure or service by the same physician during postoperative period	When an unrelated operative procedure is performed during the global period for `28035`.
`LT`	Left side	When `28035` is performed on the left lower extremity.
`RT`	Right side	When `28035` is performed on the right lower extremity.
`AS`	Ambulatory surgical center facility	To indicate the service was provided in an Ambulatory Surgical Center (facility) setting when required by payors.
`TC`	Technical component	When billing only the facility or technical component of certain billable services associated with the procedure (imaging, nerve studies).
`26`	Professional component	When billing only the physician interpretation component of a technical service associated with the episode (interpretation of intraoperative nerve monitoring).

Taxonomy Code	Specialty	Notes
`207X00000X`	Orthopedic Surgery	Orthopedic surgeons commonly perform `28035` for tarsal tunnel release.
`208000000X`	Podiatric Medicine & Surgery	Podiatrists frequently perform tarsal tunnel decompression procedures.
`2086S0122X`	Foot & Ankle Surgery	Subspecialists in foot and ankle surgery perform complex decompressions and nerve releases.
`1835S0125X`	Plastic and Reconstructive Surgery	Plastic surgeons may perform neurolysis and soft tissue reconstruction when indicated.
`208M00000X`	Surgery - General	General surgeons with limb/nerve procedure experience may occasionally perform this procedure.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`G56.80`	Other compressive mononeuropathy of lower limb	General code for compression neuropathies of the lower limb including tarsal tunnel presentations.
`G57.80`	Other mononeuropathy of lower limb, unspecified	Alternative mononeuropathy coding when specific nerve is not detailed but clinical symptoms indicate entrapment.
`M79.604`	Pain in limb, left lower leg	Symptom code used when localized leg pain accompanies tarsal tunnel syndrome on the left.
`M79.605`	Pain in limb, right lower leg	Symptom code used when localized leg pain accompanies tarsal tunnel syndrome on the right.
`M79.641`	Pain in right foot	Symptom code documenting plantar foot pain related to posterior tibial nerve entrapment.
`M79.642`	Pain in left foot	Symptom code documenting plantar foot pain related to posterior tibial nerve entrapment.
`M77.9`	Enthesopathy, unspecified (e.g., tenosynovitis contributing to nerve compression)	Used when tendon sheath inflammation contributes to tarsal tunnel compression.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`64450`	Injection, anesthetic agent; posterior tibial nerve (tibial nerve at the ankle)	Diagnostic or therapeutic tibial nerve injection may precede surgery for symptom relief or localization.
`95907`	Nerve conduction, amplitude and latency/velocity study, motor and/or sensory, each nerve; limited study	Preoperative electrodiagnostic testing to confirm posterior tibial nerve entrapment.
`20550`	Injection(s); single tendon sheath, or ligament, aponeurosis (e.g., plantar fasciitis)	Peritendinous or corticosteroid injections for conservative management prior to operative release.
`20610`	Arthrocentesis, aspiration and/or injection; major joint or bursa (e.g., ankle)	Diagnostic or therapeutic joint/bursal aspiration/injection when coexisting pathology is suspected.
`29515`	Application of short leg cast, below-knee, non–walking	Postoperative immobilization option following `28035` when casting is required.

CPT 28001: Drainage of Infected Bursa of Foot

CPT-28002-BURSAL-INCISION-DRAINAGE-TENDON-COVERING

CPT 28002: Incision and Drainage of Infected Bursa Involving Tendon Covering

CPT-28003-FOOT-BURSAL-DRAINAGE-MULTIPLE-SPACES

CPT 28003: Drainage of Multiple Infected Bursal Spaces Under Foot Fascia

CPT-28005-FOOT-BONE-CORTEX-INCISION-FOR-INFECTION

CPT 28005: Incision of Foot Bone Cortex for Infection

CPT-28008-PLANTAR-FASCIA-RELEASE-TOE-CONTRACTURE-RELEASE

CPT 28008: Plantar Fascia Release and Toe Contracture Release

CPT-28010-PERCUTANEOUS-TENOTOMY-TOE-HAMMER-TOE-CORRECTION

CPT 28010: Percutaneous Tenotomy for Toe Deformity

CPT-28011-PERCUTANEOUS-TENOTOMY-MULTIPLE-TOES-HAMMER-TOE

CPT 28011: Percutaneous Tenotomy of Multiple Tendons for Hammer Toe

CPT-28020-FOOT-ANKLE-JOINT-INCISION-DRAINAGE

CPT 28020: Incision and Drainage of Foot or Ankle Joint

CPT-28022-TOE-FOREFOOT-JOINT-INCISION-DRAINAGE

CPT 28022: Incision and Drainage of Toe/Forefoot Joint

CPT-28024-TOE-JOINT-INCISION-DRAINAGE

CPT 28024: Incision and Drainage of Toe Joint

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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CPT 28035: Tarsal Tunnel Release, Posterior Tibial Nerve Decompression

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Billing Code Overview

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CPT 28035: Tarsal Tunnel Release, Posterior Tibial Nerve Decompression

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References