CPT 28080 Morton’s Neuroma Reimbursement | OpenPayer

Summary & Overview

CPT 28080: Excision of Morton's Neuroma, Forefoot Surgery

CPT code 28080 denotes the surgical excision of a Morton’s neuroma, a compressive or degenerative enlargement of the interdigital plantar nerve that commonly causes forefoot pain and numbness. This code captures operative management when nonoperative care is inadequate and is relevant across outpatient surgical settings nationwide. Key national payers typically applying coverage and payment rules to this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

Readers will find a concise overview of the clinical indication for the procedure, typical site-of-service considerations, and payer coverage context. The publication summarizes common billing practices, how payers classify this outpatient foot/ankle surgery, and the clinical scenarios that justify surgical excision. It also highlights benchmarking topics and policy updates affecting coding and reimbursement for outpatient surgical procedures.

This summary is intended for billing professionals, surgical providers, and policy analysts seeking a national-level briefing on coding, clinical context, and payer coverage patterns for CPT code 28080. Data not available in the input where specific payer rates, associated taxonomies, and ICD-10 mappings would normally be presented.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 28080Mortons neuromafoot surgeryoutpatient surgerysurgical excisionbilling and codingprocedure codingorthopedicspodiatry

Billing Code Overview

CPT code 28080 describes the surgical excision of a Morton’s neuroma, a painful thickening of the plantar digital nerve located between the metatarsal heads of the foot. The procedure involves removal of the neuroma to relieve forefoot pain, often performed when conservative treatments fail.

Service type: Surgical excision / outpatient foot surgery
Typical site of service: Ambulatory surgical center or hospital outpatient setting (foot/ankle surgery clinic)

Clinical & Coding Specifications

Clinical Context

A 52-year-old recreational runner presents to a podiatry clinic with a 9-month history of focal forefoot pain localized to the third intermetatarsal space, worsened by walking in tight footwear and with weight-bearing. Conservative care including footwear modification, metatarsal pads, corticosteroid injection, and activity modification provided only temporary relief. Clinical exam demonstrates a positive Mulder’s click and localized tenderness between the metatarsal heads. Imaging (weight-bearing radiographs to exclude deformity and ultrasound to evaluate soft-tissue mass) supports the diagnosis of a symptomatic interdigital (Morton’s) neuroma. The patient elects for surgical excision.

The clinical workflow includes preoperative evaluation and informed consent, preoperative marking and nerve block or regional anesthesia, operative excision of the neuroma via a dorsal or plantar approach under sterile conditions, hemostasis and layered closure, postoperative dressing and immobilization (postoperative shoe or boot), pain control and wound care instructions, and follow-up visits for suture removal and assessment of pain and gait. Typical postoperative care includes activity modification and progressive return to weight-bearing as tolerated over weeks, with documentation of surgical findings and pathology if submitted.

Coding Specifications

Modifier	Description	When to Use
`50`	Bilateral procedure	When neuromas are excised from both feet during the same operative session and payer requires bilateral modifier reporting.

CPT 28173: Radical Resection of Metatarsal for Tumor

CPT-28111-FIRST-METATARSAL-HEAD-RESECTION-NECROSIS-INFECTION

CPT 28111: Resection of First Metatarsal Head for Necrosis/Infection

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

CPT 28126: Partial Resection of Infected Toe Bone

CPT-28060-PARTIAL-PLANTAR-FASCIECTOMY-PLANTAR-FASCIA-RELEASE

CPT 28060: Partial Plantar Fasciectomy for Plantar Fascia Decompression

CPT-28045-FOOT-TOE-SOFT-TISSUE-MASS-EXCISION

CPT 28045: Excision of Foot/Toe Soft-Tissue Mass

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

CPT 28043: Excision of Subcutaneous Foot or Toe Mass

CPT-28124-TOE-PHALANX-EXCISION-CRATERIZATION-SAUCERIZATION

CPT 28124: Toe Phalanx Excision with Craterization or Diaphysectomy

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-28140-METATARSAL-EXCISION-SURGICAL-REMOVAL

CPT 28140: Metatarsal Excision (Partial or Complete)

CPT-28153-TOE-AMPUTATION-DISTAL-PHALANX-CONDYLE-REMOVAL

CPT 28153: Toe Amputation, Distal Phalanx Condyle Removal

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Taxonomy Code	Specialty	Notes
`207P00000X`	Podiatry	Podiatrists commonly perform surgical excision of Morton’s neuroma.
`207L00000X`	Orthopedic Surgery	Foot and ankle orthopedic surgeons perform this procedure when referred for operative management.
`2080P0208X`	Physical Medicine & Rehabilitation	May be involved in preoperative optimization and postoperative rehabilitation.
`207R00000X`	Plastic Surgery	In select cases, plastic surgeons perform excision for complex soft-tissue reconstruction or recurrent neuromas.
`208D00000X`	General Surgery	General surgeons trained in foot surgery may perform the procedure in some settings.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M77.40`	Metatarsalgia, unspecified foot	Forefoot pain that may coexist with or be confused with Morton’s neuroma; sometimes a presenting symptom leading to neuroma evaluation.
`G57.6`	Pain and other symptoms due to lesion of plantar nerve	Directly relates to interdigital nerve pathology and symptomatic neuroma presentations.
`M79.671`	Pain in right foot	Localized foot pain that may be used in initial encounter when more specific code is not established.
`M79.672`	Pain in left foot	As above for the left foot.
`M21.679`	Other acquired deformity of foot, unspecified foot	Foot deformities (e.g., splay foot or hammertoes) that can predispose to interdigital nerve irritation.
`Z47.89`	Encounter for other orthopedic aftercare	Used in postoperative follow-up encounters and aftercare documentation.
`Z48.02`	Encounter for removal of surgical dressings and sutures	Postoperative care related to neuroma excision dressing and suture removal.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`28080`	Excision or destruction of plantar digital neuroma (e.g., Morton’s neuroma)	Primary procedure code for surgical removal of an interdigital neuroma.
`20610`	Arthrocentesis, aspiration and/or injection; major joint or bursa (e.g., ankle, subtalar)	Diagnostic or therapeutic injection may be used preoperatively to attempt conservative management.
`20550`	Injection(s); single tendon sheath, or ligament, aponeurosis (e.g., plantar fascia)	Local corticosteroid injection or anesthetic into the intermetatarsal space as a conservative treatment prior to surgery.
`11042`	Debridement, subcutaneous tissue (first stage) including removal of foreign material	Performed when concurrent debridement of infected or devitalized tissue is necessary at the time of neuroma excision.
`99024`	Postoperative follow-up visit global period or `99024` equivalent	Used for routine postoperative visits during the global surgical period (billing practices vary by payer).

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