Summary & Overview
CPT 28070: Synovectomy of Intertarsal or Tarsometatarsal Joint
CPT code 28070 represents a surgical synovectomy of intertarsal or tarsometatarsal joints of the foot, used to remove inflamed or diseased synovium that can cause pain, stiffness, and impaired mobility. Nationally, this procedure is relevant for patients with inflammatory arthropathies, chronic synovitis, or joint disease refractory to conservative care, and it affects hospital and ambulatory surgery reimbursement workflows and utilization patterns.
Key payers considered include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Coverage policies and prior authorization requirements vary across commercial plans and the Medicare program, influencing site-of-service decisions and coding practice.
Readers will find clinical context explaining the procedure, comparisons of common payer considerations, and operational benchmarks where available. The publication outlines typical settings for the service (hospital outpatient department, ambulatory surgery center, or inpatient hospital), summarizes factors that commonly influence billing and payment, and notes where input data is not available. The goal is to provide clinicians, coders, and policy analysts a concise reference about what CPT code 28070 represents, who pays for it at a national level, and what topics to review when managing claims and coverage for foot and ankle synovectomy.
Billing Code Overview
CPT code 28070 describes a synovectomy of an intertarsal or tarsometatarsal joint, a surgical procedure that removes inflamed or diseased synovium — the thin membrane lining the joint cavity. The operation targets the intertarsal joints (between tarsal bones near the rear of the foot) or the tarsometatarsal joints (between tarsal and metatarsal bones).
Service type: Surgical — orthopaedic foot/ankle procedure
Typical site of service: Hospital outpatient department or ambulatory surgery center; may also be performed in inpatient hospital settings when medically necessary
Clinical & Coding Specifications
Clinical Context
A 52-year-old patient presents to a podiatric orthopedic clinic with several months of progressive dorsal midfoot pain, swelling, and limited range of motion localized to the tarsometatarsal and intertarsal joints. Conservative care including activity modification, NSAIDs, immobilization, and image-guided corticosteroid injection provided only temporary relief. Weight-bearing radiographs and MRI demonstrate synovial proliferation and chronic inflammatory change within a tarsometatarsal joint with associated focal pain and mechanical symptoms. The patient is scheduled for operative synovectomy of the affected intertarsal/tarsometatarsal joint to excise inflamed synovium, alleviate pain, and improve joint function.
The clinical workflow includes preoperative evaluation by the surgeon (history, focused exam, imaging review), informed consent documenting goals and risks, preoperative anesthesia assessment, intraoperative synovectomy performed under regional or general anesthesia with proper sterile technique, specimen handling if synovium is sent for pathology, perioperative monitoring, and postoperative instructions for wound care, activity restrictions, and follow-up visits for suture removal and rehabilitation as indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
51 | Multiple Procedures | When additional unrelated procedures are performed at the same operative session on the same foot and payer requires modifier for multiple procedures |