CPT 28047 Reimbursement & Policy Benchmarks | OpenPayer

Summary & Overview

CPT 28047: Extensive Soft Tissue Tumor Excision of Foot or Toe, ≥3 cm

CPT code 28047 denotes an extensive surgical excision of a soft tissue tumor in the foot or toe measuring 3 cm or greater. This procedure code is used to report removal of a large lesion and associated surrounding tissue and is relevant across surgical, podiatric, and oncologic practice settings. Nationally, correct use of this code affects clinical documentation, surgical case mix reporting, and accurate claims adjudication for procedures performed in operative suites and ambulatory surgical centers.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a concise reference on clinical context for the procedure, typical sites of service, and common modifiers associated with surgical services. Readers will find benchmarks for utilization and reimbursement practices, summaries of relevant policy considerations, and guidance on coding accuracy and documentation expectations. The content is presented for a national audience and is designed to support coding professionals, billing teams, and clinical staff in understanding when to apply CPT code 28047 and what operational and policy areas are most likely to affect claims for extensive foot or toe soft tissue tumor excisions.

Data not available in the input for associated taxonomies, specific ICD-10 diagnoses, and related codes.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 28047soft tissue tumor excisionfoot surgerypodiatrysurgical codingoperative careambulatory surgeryprocedure coding

Billing Code Overview

CPT code 28047 describes extensive surgical excision of a soft tissue tumor of the foot or toe measuring 3 cm or more. This code captures a procedure that removes a large soft tissue mass and surrounding tissues in the foot or toe region.

Service type: Surgical excision of soft tissue tumor (extensive)
Typical site of service: Operating room or ambulatory surgical center for foot or toe procedures

Clinical & Coding Specifications

Clinical Context

A 56-year-old patient presents to a podiatric surgery clinic with a progressively enlarging, firm, subcutaneous mass on the dorsal aspect of the forefoot measuring 3.5 cm on clinical exam and confirmed by MRI. The patient reports intermittent pain with weightbearing and difficulty fitting footwear. After evaluation, the surgeon schedules an operative procedure for extensive excision of a soft tissue tumor of the foot under regional or general anesthesia. Preoperative workflow includes history and physical, informed consent, imaging review, marking the operative site (right foot), perioperative antibiotic prophylaxis as indicated, and ensuring vascular and neurologic status documented. Intraoperative steps include incision, wide soft tissue dissection with removal of the tumor and a cuff of surrounding tissue to achieve clear margins, hemostasis, possible frozen section consultation, and layered closure with drain if needed. Postoperative care includes wound care instructions, weightbearing restrictions, pain control, pathology submission of the specimen, and scheduled follow-up for wound check and pathology discussion. Typical site of service is an ambulatory surgery center or hospital outpatient surgery unit. Service type: surgical excision (extensive) of a soft tissue tumor of the foot or toe, 3 cm or greater (28047).

Coding Specifications

Modifier	Description	When to Use
`RT` / `LT`

CPT 28108: Excision of Bone Cyst or Benign Tumor, Foot Phalanges

CPT-28126-PARTIAL-TOE-BONE-RESECTION-INFECTED-TOE

CPT 28126: Partial Resection of Infected Toe Bone

CPT-28041-FOOT-TOE-INTRINSIC-MUSCLE-MASS-EXCISION-15CM-OR-GREATER

CPT 28041: Excision of Intrinsic Foot/Toe Muscle Mass, Specimen ≥1.5 cm

CPT-28173-RADICAL-RESECTION-METATARSAL-TUMOR

CPT 28173: Radical Resection of Metatarsal for Tumor

CPT-28072-METATARSOPHALANGEAL-JOINT-SYNOVECTOMY

CPT 28072: Synovectomy, Metatarsophalangeal Joint

CPT-28050-FOOT-JOINT-EXPLORATION-SOFT-TISSUE-BIOPSY

CPT 28050: Foot Joint Exploration with Soft Tissue Biopsy

CPT-28070-INTERTARSAL-TARSOMETATARSAL-SYNOVECTOMY

CPT 28070: Synovectomy of Intertarsal or Tarsometatarsal Joint

CPT-28107-TARSAL-METATARSAL-BONE-CYST-EXCISION-ALLOGRAFT

CPT 28107: Excision of Tarsal/Metatarsal Bone Cyst with Allograft

CPT-28043-FOOT-TOE-SUBCUTANEOUS-MASS-EXCISION

CPT 28043: Excision of Subcutaneous Foot or Toe Mass

CPT-28112-METATARSAL-HEAD-RESECTION-NECROSIS-INFECTION

CPT 28112: Metatarsal Head Resection for Necrosis or Infection

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Taxonomy Code	Specialty	Notes
`207P00000X`	Podiatric Surgery	Most common specialty performing foot soft tissue tumor excision.
`207L00000X`	Orthopedic Surgery	Foot and ankle orthopedic surgeons commonly perform extensive soft tissue tumor resections.
`207XS0101X`	Plastic Surgery (Reconstructive)	Involvement when complex closure or reconstruction is required.
`208000000X`	General Surgery	May perform foot tumor excisions in certain settings.
`2084P0800X`	Surgical Oncology	Consulted when malignancy is suspected or confirmed.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M79.60`	Pain in limb, unspecified	Symptom that may prompt evaluation of a painful foot mass.
`D17.6`	Benign lipomatous neoplasm of lower limb, including hip	Represents a common benign soft tissue tumor that can occur in the foot and require excision when symptomatic or large.
`C49.3`	Malignant neoplasm of connective and soft tissue of lower limb, including hip	Used when pathology confirms a malignant soft tissue tumor of the foot/leg requiring wide excision and oncology follow-up.
`M86.171`	Other osteomyelitis, right ankle and foot	Relevant when chronic infection and associated soft tissue mass require combined debridement/excision.
`L97.421`	Non-pressure chronic ulcer of right heel and midfoot with necrosis of bone	May coexist with soft tissue abnormalities leading to extensive excision procedures.
`S90.02xA`	Contusion of right foot, initial encounter	Trauma-related mass or hematoma may require surgical evacuation and could be part of differential diagnosis.
`M79.671`	Pain in right foot	Symptom code commonly associated with presentation of a symptomatic soft tissue mass.
`R22.41`	Localized swelling, mass and lump, right lower limb	General presenting sign that prompts imaging and consideration of `28047` when mass is ≥3 cm.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`28047`	Excision of soft tissue tumor, foot or toe; 3 cm or greater	Primary procedure for extensive excision of a soft tissue tumor of the foot or toe measuring 3 cm or more.
`88305`	Level IV surgical pathology, gross and microscopic examination	Commonly billed for histopathologic evaluation of the excised tumor specimen to establish diagnosis and margins.
`11042`	Debridement; subcutaneous tissue (includes epidermis and dermis when performed)	May be used for additional debridement when there is infected or necrotic tissue contiguous with the tumor site.
`27370`	Excision of soft tissue tumor, knee area (example of analogous code)	Listed as a related code for reference to soft tissue tumor excision in nearby anatomical regions; not billed in foot cases but useful for comparative coding.
`20550`	Injection(s); single tendon sheath, ligament, or ganglion cyst	May be performed preoperatively for diagnostic or therapeutic management of peri-tumoral cystic lesions (occasionally in workup).

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