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    v1.0.28
    OpenPayerBilling CodesExcision Procedures on the Foot and ToesCPT cpt-28112-metatarsal-head-resection-necrosis-infection
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    CPT 28112: Resection of 2nd–4th Metatarsal Head

    Medicare pays $499 on average nationally for this procedure.

    CPT code 28112 describes a surgical procedure removing the bone of the second, third, or fourth metatarsal head for necrosis or infection of the metatarsal head; service type: surgical debridement/resection of metatarsal head; typical site of service: inpatient or outpatient surgical setting, including hospital operating room or ambulatory surgery center, depending on clinical severity and patient needs.

    For related coverage guidance, see recent payer policy updates: Hip Arthroplasty (partial and total hip replacement), Shoulder Arthroplasty (Total, Partial, Reverse, Revision and Resurfacing), Artificial Lumbar Intervertebral Disc (Lumbar Total Disc Arthroplasty).

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    Table of contents

    Progress1 / 7

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    Clinical & Coding Specifications

    Clinical Context

    A 64-year-old patient with poorly controlled diabetes presents with persistent forefoot pain, swelling, and draining sinus adjacent to the second metatarsal head. Imaging (plain radiographs and MRI) demonstrates osteonecrosis and cortical destruction of the second metatarsal head with adjacent soft-tissue abscess. The patient has failed conservative therapy including antibiotics and offloading for several weeks and is scheduled for operative management.

    The clinical workflow begins with preoperative evaluation by the foot and ankle surgeon including review of imaging, optimization of glycemic control, and perioperative antibiotic planning. On the day of service, the patient undergoes regional or general anesthesia in an ambulatory surgical center or hospital operating room. The surgeon performs a dorsal or plantar incision, performs debridement of infected soft tissue, and surgically removes the necrotic metatarsal head (second, third, or fourth as appropriate). Intraoperative cultures and bone biopsy are commonly obtained. Postoperative care includes wound management, partial-weight-bearing or immobilization, and directed antibiotic therapy based on culture results. Follow-up includes wound checks, monitoring for recurrent infection, and assessment of forefoot biomechanics with possible need for orthotics or further reconstructive procedures.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    11042Debridement, subcutaneous tissue, first 20 sq cm or less; simple incision and drainage (includes removal of necrotic tissue)Often performed concurrently for soft-tissue debridement adjacent to infected metatarsal head.
    23120Excision of bone lesion; toe or foot (metatarsal head resection is more specific)Alternative code sometimes reported for excision of bone lesions of the foot when coding guidance varies.
    20550Injection(s); single tendon sheath, or ligament, aponeurosis (e.g., for preoperative pain control)May be performed in preoperative pain management or during conservative care prior to surgery.
    11044Debridement, muscle and/or fascia and skin, first 20 sq cm or lessUsed when deeper soft-tissue debridement accompanies bone resection for infection.
    87070Culture, bacterial; any other source except blood, aerobic cultureIntraoperative wound or bone cultures are commonly obtained to guide antibiotic therapy.

    Related Modifiers

    11 rows

    ModifierDescriptionWhen to Use
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    79Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    24Modifier 24 denotes an unrelated evaluation and management (E/M) service performed by the same physician or qualified healthcare professional during a postoperative global period. Per CPT guidance,…- Use modifier 24 when you report an evaluation and management (E/M) service performed by the same physician or same-specialty group during a procedure’s postoperative global period that is unrelated…
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…

    Showing 1–10 of 11

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207X00000XOrthopaedic Surgery PhysicianAn orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated…
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    207K00000XAllergy & Immunology PhysicianAn allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Select…
    235Z00000XSpeech-Language PathologistThe speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in…
    133VN1401XPediatric Critical Care Nutrition Registered DietitianAn individual who is a Board Certified Specialist in Pediatric Critical Care Nutrition and applies evidence-based nutrition knowledge in providing med…
    2865X1600XOperational (Transportable) Military General Acute Care HospitalA Department of Defense (DoD) health care organization furnishing inpatient care 24 hours per day in "non-fixed" or deployed facilities. Entity is not…
    261QR0208XMobile Radiology Clinic/CenterAmbulatory Health Care Facilities · Clinic/Center
    363LN0000XNeonatal Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers · Nurse Practitioner

    Related ICD-10-CM Codes

    6 rows

    ICD-10-CM CodeDescription
    M86.30Chronic multifocal osteomyelitis, unspecified site
    M86.38Chronic multifocal osteomyelitis, other site
    M86.39Chronic multifocal osteomyelitis, multiple sites
    M86.671Other chronic osteomyelitis, right ankle and foot
    M86.672Other chronic osteomyelitis, left ankle and foot
    M86.679Other chronic osteomyelitis, unspecified ankle and foot

    Related Payer Policy Updates

    Specialty: Orthopedics/Musculoskeletal1 / 3

    7 rows

    PolicyPayerEffective Date
    Hip Arthroplasty (partial and total hip replacement)univerahealthcare2026-10-15
    Shoulder Arthroplasty (Total, Partial, Reverse, Revision and Resurfacing)univerahealthcare2026-10-15
    Artificial Lumbar Intervertebral Disc (Lumbar Total Disc Arthroplasty)univerahealthcare2026-10-15
    Metal-on-Metal Total Hip Resurfacinguniverahealthcare2026-10-15
    Lumbar Fusion (arthrodesis) with decompressionuniverahealthcare2026-10-15
    Osteochondral Grafting of the Kneeuniverahealthcare2026-10-15
    Sacroiliac Joint Fusion or Stabilizationuniverahealthcare2026-10-15

    Related Codes

    CPT-28039-FOOT-TOE-SOFT-TISSUE-MASS-EXCISION-1-5CM-OR-GREATER

    CPT 28039: Excision of Soft Tissue Mass, Foot or Toe (≥1.5 cm)

    CPT-28041-FOOT-TOE-INTRINSIC-MUSCLE-MASS-EXCISION-15CM-OR-GREATER

    CPT 28041: Excision of Intrinsic Foot/Toe Muscle Mass, ≥1.5 cm

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

    CPT 28043: Excision of Subcutaneous Foot/Toe Mass (<1.5 cm)

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

    CPT 28045: Excision of Intrinsic Foot/Toe Muscle Mass, <1.5 cm

    CPT-28046-EXTENSIVE-EXCISION-FOOT-TOE-SOFT-TISSUE-TUMOR

    CPT 28046: Extensive Excision of Soft-Tissue Tumor of Foot or Toe, <3 cm

    CPT-28047-EXTENSIVE-SOFT-TISSUE-TUMOR-EXCISION-FOOT-TOE-3CM-OR-MORE

    CPT 28047: Extensive Excision of Foot/Toe Soft Tissue Tumor ≥3 cm

    CPT-28050-FOOT-JOINT-EXPLORATION-SOFT-TISSUE-BIOPSY

    CPT 28050: Open Foot Joint Biopsy of Soft Tissue

    CPT-28052-METATARSOPHALANGEAL-JOINT-SOFT-TISSUE-BIOPSY

    CPT 28052: Open Biopsy of Metatarsophalangeal Joint Soft Tissue

    CPT-28054-DIGITAL-JOINT-BIOPSY-TOE-FINGER

    CPT 28054: Incision for Toe or Finger Joint Biopsy

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

    CPT 28055: Bursal Debridement with Neurectomy, Upper Ankle/Foot

    Showing 1–10 of 45

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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