CPT 28110 Excision 5th Metatarsal | Reimbursement | OpenPayer

Summary & Overview

CPT 28110: Excision of Bony Lesion, Head of Fifth Metatarsal

CPT code 28110 represents a surgical procedure to incise the head of the fifth metatarsal and remove a bony lesion from the lateral foot. Nationally, this code is used to document focused orthopedic or podiatric surgery addressing symptomatic bony prominences, exostoses, or localized lesions that cause pain, irritation, or functional impairment. Accurate use of the code supports appropriate clinical documentation, coding consistency, and claims adjudication for outpatient and inpatient surgical settings.

Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, common sites of service, and expected billing patterns. The publication outlines typical places where the service is performed, summarizes payer coverage considerations, and highlights areas where documentation drives coding validity. It also provides benchmarking context and notes on policy updates relevant to surgical foot procedures where available. Data not available in the input is clearly identified, and the content is presented for a national audience to support coding accuracy and administrative clarity for providers and billing teams.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare28110CPTfoot surgerymetatarsalorthopedic surgerypodiatryoutpatient surgerybony lesion excision

Billing Code Overview

CPT code 28110 describes an incision into the head of the fifth metatarsal (the portion of the bone nearest the toes) to remove a bony lesion from the lateral aspect of the foot. This procedure involves surgical exposure and excision of a focal bony abnormality on the outer side of the foot.

Service type: Surgical excision of a bony lesion of the foot
Typical site of service: Ambulatory surgical center or hospital operating room

Clinical & Coding Specifications

Clinical Context

A 45-year-old ambulatory patient presents to a podiatry clinic with a painful, palpable bony prominence on the lateral aspect of the forefoot over the head of the fifth metatarsal. Conservative care (shoe modification, padding, NSAIDs) has failed and imaging (weight-bearing radiographs) demonstrates an exostosis consistent with a symptomatic bony lesion. The provider schedules a minor operative procedure in an ambulatory surgical center or hospital outpatient department. The procedure involves a small incision over the lateral dorsal foot, exposure of the head of the fifth metatarsal, and excision of the exostosis or bony lesion. Local or regional anesthesia with monitored sedation is used per facility practice. Typical workflow includes preoperative evaluation, informed consent, surgical excision under sterile technique, hemostasis, wound closure with sutures, dressing application, and instructions for weight-bearing limitations and follow-up for suture removal and pathology if tissue was submitted.

Coding Specifications

Modifier	Description	When to Use
`LT`	Left side	When the procedure is performed on the left fifth metatarsal head
`RT`	Right side

CPT 28112: Metatarsal Head Resection for Necrosis or Infection

CPT-28118-CALCANEUS-EXCISION-HEEL-BONE-RESECTION

CPT 28118: Excision of Calcaneus for Infection or Necrosis

CPT-28122-TARSAL-METATARSAL-BONE-DEBRIDEMENT

CPT 28122: Resection of Infected Tarsal or Metatarsal Bone

CPT-28113-FIFTH-METATARSAL-HEAD-EXCISION-NECROSIS-INFECTION

CPT 28113: Excision of Fifth Metatarsal Head for Necrosis or Infection

CPT-28062-PLANTAR-FASCIA-RELEASE-PLANTAR-FASCIOTOMY

CPT 28062: Plantar Fascia Removal to Relieve Tension

CPT-28108-FOOT-PHALANGEAL-BONE-LESION-EXCISION

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

CPT-28055-BURSAL-EXCISION-WITH-NERVE-DISSECTION-NEURECTOMY

CPT 28055: Bursal Excision with Nerve Dissection/Neurectomy

CPT-28175-PHALANX-TUMOR-RESECTION-RADICAL-RESECTION

CPT 28175: Radical Resection of Phalanx for Tumor

CPT-28086-FOOT-FLEXOR-TENDON-SHEATH-SYNOVECTOMY

CPT 28086: Synovectomy, Flexor Tendon Sheath of Foot

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

CPT 28126: Partial Resection of Infected Toe Bone

Showing 1–10 of 45

Taxonomy Code	Specialty	Notes
`206F00000X`	Podiatry	Most common specialty performing excision of fifth metatarsal head lesions
`207K00000X`	Orthopedic Surgery	Orthopedic foot and ankle surgeons perform this procedure, especially for complex lesions
`207X00000X`	General Surgery (Foot/Ankle fellowship)	Performed by foot/ankle fellowship-trained surgeons in some settings
`207L00000X`	Plastic Surgery	Rarely involved for complex reconstructive needs after excision
`174400000X`	Hospitalist/Anesthesia (Perioperative)	Provides perioperative anesthesia services and documentation support

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M71.2`	Exostosis, unspecified	Represents bony overgrowths such as an exostosis at the fifth metatarsal head that may require excision
`M20.2`	Hallux valgus (acquired)	Forefoot deformities that can be associated with bony prominences and require concurrent procedures
`M77.9`	Enthesopathy, unspecified	Periosteal irritation or enthesopathy near the metatarsal head contributing to pain and bony changes
`M89.0`	Osteitis deformans [Paget]	Bony pathology that can produce localized bony lesions requiring excision in select cases
`M84.49`	Pathologic fracture, other site, not elsewhere classified	When a bony lesion is associated with or results in a pathologic fracture of the metatarsal head
`L84`	Corns and callosities	Conservative differential diagnosis; may coexist and influence surgical planning
`M25.57`	Pain in joint, ankle and foot	Symptom code commonly used to capture presenting complaint leading to excision
`S92.31`	Nondisplaced fracture of fifth metatarsal bone	Acute bony injuries that may be managed surgically in conjunction with excision when indicated

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`28100`	Excision, tendon sheath or tumor, foot; superficial	Performed for soft tissue lesions adjacent to the metatarsal head when a soft tissue rather than bony lesion is excised
`28010`	Incision and drainage, foot or toe, simple; without anesthesia	May be used when drainage of an abscess is required prior to or instead of bony excision
`28820`	Excision and removal of bone cyst or tumor, phalanx, toe, with or without local bone graft	Used when additional osseous work on toe phalanges is required in the same operative setting
`20680`	Application, open treatment of fracture of metatarsal, each	If the lesion is associated with a pathological fracture requiring open treatment during the same encounter
`99024`	Postoperative follow-up visit, global period, related to the original procedure	Used by facilities or providers to report routine postoperative care visits within the global period
`11042`	Debridement, skin, subcutaneous tissue and muscle	If additional debridement of infected or necrotic tissue is necessary at the time of bony excision

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