Summary & Overview
CPT 28086: Synovectomy, Flexor Tendon Sheath of Foot
CPT code 28086 represents a surgical synovectomy of the flexor tendon sheath of the foot, a targeted operative procedure to remove inflamed or diseased synovium that causes pain and limits tendon function. This intervention has relevance nationally for patients with tenosynovitis, rheumatoid or inflammatory arthropathies, infectious synovitis, or refractory degenerative conditions where conservative treatments have failed. Payers commonly covering this service in national analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise policy and clinical context for CPT code 28086, including expected sites of service and the clinical rationale for synovectomy in the foot. The publication provides benchmarking and reimbursement context where available, outlines common documentation and coding considerations, and summarizes relevant clinical indications and procedural scope. Data limitations are noted where input fields were not provided. The goal is to equip clinical managers, coders, and policy analysts with a clear description of the procedure, payer coverage landscape, and the types of operational and documentation issues to consider when CPT code 28086 appears on the claim.
Billing Code Overview
CPT code 28086 describes a synovectomy of the flexor tendon sheath of the foot, a surgical procedure in which the provider removes inflamed or diseased synovium surrounding the flexor tendons to relieve pain and improve function. The service type is a surgical orthopedic procedure on the foot focused on tendon sheath pathology.
The typical site of service for this procedure is an outpatient or inpatient surgical setting, such as an ambulatory surgery center or hospital operating room, depending on clinical complexity and patient needs.
Clinical & Coding Specifications
Clinical Context
A 54-year-old patient presents to an outpatient orthopedic clinic with several months of progressive forefoot pain, swelling, and crepitus localized to the plantar aspect of the toes. The patient reports worsening pain with toe flexion and point tenderness over the flexor tendon sheaths. Conservative care including NSAIDs, activity modification, and corticosteroid injection provided only temporary relief. Imaging (ultrasound or MRI) demonstrates synovial thickening around the flexor tendons of the foot without abscess. The patient is scheduled for an open synovectomy of the flexor tendon sheath to remove chronically inflamed synovium, relieve pain, and restore tendon gliding.
Perioperative workflow: preoperative assessment and informed consent in clinic; anesthesia evaluation for regional or general anesthesia; intraoperative procedure performed in an ambulatory surgery center or hospital outpatient department with sterile preparation of the foot, incision over affected sheath, excision of pathologic synovium, hemostasis, and layered closure. Postoperative plan includes wound care, short period of immobilization or stiff-soled shoe, analgesia, and outpatient physical therapy for tendon mobilization as needed.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side | When the synovectomy is performed on the left foot |