Summary & Overview
CPT 28140: Metatarsal Excision (Partial or Complete)
CPT code 28140 denotes surgical removal (partial or complete) of a metatarsal bone to address disease or deformity. This code is relevant nationally because metatarsal pathology—ranging from severe infection and tumor to structural deformities—can require definitive surgical management, and accurate coding affects clinical documentation, care coordination, and claims processing across payers. Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will gain a concise understanding of what the code represents clinically and operationally, plus an overview of payer coverage considerations and typical settings for service delivery. The publication provides benchmarks for utilization and reimbursement under major payers where available, highlights common clinical contexts that prompt use of the code, and summarizes policy or coding guidance relevant to hospitals and ambulatory surgery centers. The content is designed to help coding professionals, surgical teams, and billing managers recognize when 28140 applies and what factors commonly influence claim adjudication and site-of-service decisions. Data not available in the input will be noted explicitly in relevant sections.
Billing Code Overview
CPT code 28140 describes the surgical excision of a metatarsal bone or a portion of a metatarsal bone to treat disease or deformity of that bone. The procedure involves partial or complete removal of the affected metatarsal when less extensive interventions are insufficient.
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Service type: Surgical procedure (metatarsal excision)
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Typical site of service: Hospital operating room or ambulatory surgery center
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Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with progressive forefoot pain, localized over a metatarsal, who has failed conservative care (shoe modifications, orthotics, corticosteroid injections). Presentation may include a rigid deformity, recurrent stress fracture, osteomyelitis limited to the metatarsal, or tumor/dysplasia of the metatarsal. The workflow begins with history and focused foot exam, weight-bearing radiographs and/or MRI or CT to define bone involvement, and discussion of risks and alternatives. Preoperative assessment documents medical comorbidities and anesthesia risk. On the day of surgery the patient receives regional or general anesthesia; the surgeon makes a dorsal or plantar incision, isolates the affected metatarsal, and performs a partial or complete metatarsal excision as indicated by disease severity. Hemostasis, possible bone smoothing or tenotomy, and layered closure follow. Postoperative care includes pain control, dressing and immobilization (postoperative shoe or splint), instructions for limited weight-bearing, wound checks, and follow-up radiographs to assess healing and alignment. Typical site of service is an ambulatory surgery center or hospital operating room. Service type is operative foot/orthopedic surgery focused on osseous resection of a metatarsal.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
51 | Multiple procedures | When the metatarsal excision is billed on the same operative date with other procedures on the same foot or different anatomic regions. |