Summary & Overview
CPT 28090: Excision of Foot Tendon Lesion with Synovectomy
CPT code 28090 denotes surgical excision of a lesion involving a tendon, tendon sheath, or capsule in the foot and may include synovectomy of the extensor tendon sheath. This procedure is clinically significant for treating painful or function-limiting tendon sheath disease, tenosynovitis, and localized lesions that do not respond to conservative measures. Nationally, accurate coding of this intervention affects clinical documentation, surgical quality monitoring, and facility billing workflows.
Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for the procedure, common service settings, and billing considerations related to procedure characterization and reporting. The publication summarizes typical utilization and coding benchmarks, highlights policy and coverage factors relevant to payers, and outlines areas where documentation affects claim acceptance and reimbursement processes.
This concise guide is intended for revenue cycle teams, orthopedic and podiatric surgical practices, and compliance officers seeking a national perspective on coding and administrative implications for CPT code 28090.
Billing Code Overview
CPT code 28090 describes the excision of a lesion affecting a tendon, tendon sheath, or joint capsule in the foot. The procedure may include a synovectomy, the removal of inflamed or diseased synovium from the extensor tendon sheath of the foot to relieve pain and restore tendon function.
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Service type: Surgical procedure on the foot involving tendon and tendon sheath lesion excision with possible synovectomy
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Typical site of service: Hospital outpatient department, ambulatory surgery center, or specialized outpatient orthopedic clinic
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A 54-year-old patient presents to an outpatient orthopedic clinic with progressive dorsal foot pain and swelling localized over the extensor tendons of the forefoot. Conservative management including anti-inflammatory medications, activity modification, orthotics, and a corticosteroid injection provided limited and temporary relief. Physical exam demonstrates focal tenderness and crepitus over the extensor tendon sheath and reduced toe extension strength. Imaging (ultrasound or MRI) shows tenosynovitis with thickened synovium and a discrete inflamed lesion adherent to the extensor tendon sheath. The patient is scheduled for an operative procedure under regional or general anesthesia in an ambulatory surgery center or hospital outpatient department where the surgeon performs excision of the lesion affecting the tendon, tendon sheath, or capsule and a synovectomy of the extensor tendon sheath to remove diseased synovium and relieve pain. Typical workflow includes preoperative evaluation, informed consent documenting the indication and targeted tendon sheath, intraoperative documentation of lesion size and tissues removed, and postoperative instructions for wound care and progressive range-of-motion and strengthening. Billing uses 28090 for the excision with possible modifier additions to indicate laterality, anesthesia or unusual circumstances.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
50 | Bilateral procedure |