CPT 28192 Reimbursement & Benchmarks | OpenPayer

Summary & Overview

CPT 28192: Removal of Deep Foreign Body from Foot

CPT code 28192 designates the surgical removal of a foreign body located deep beneath the skin in the foot. This code captures procedures that require dissection into subcutaneous or deeper soft tissues to extract embedded material and is relevant to surgical, podiatric, and emergency care settings. Nationally, accurate reporting of this code affects quality measurement, resource allocation, and claims processing for procedures involving retained foreign bodies in the lower extremity.

Key payers included in the national context are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical indications and typical settings for use, common billing modifiers and administrative considerations, and benchmarking context where available. The publication highlights procedural definitions, documentation elements that support medical necessity, and common coding pitfalls to avoid. It also summarizes typical sites of service and the clinical scenarios that commonly prompt use of this code, such as penetrating injuries or retained surgical materials causing pain or infection.

This resource is intended to clarify the clinical meaning of CPT code 28192, improve coding consistency across settings, and provide payers and providers with concise operational context. Data not available in the input will be identified where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare28192CPTforeign body removalfoot surgerypodiatrysurgical procedureambulatory surgerymedical coding

Billing Code Overview

CPT code 28192 describes the surgical removal of a foreign body located deep beneath the skin of the foot. This procedure involves dissection to access and extract material embedded within subcutaneous or deeper soft tissues of the foot.

Service type: Surgical foreign body removal of the foot
Typical site of service: Ambulatory surgical center or hospital operating room, or procedure room in an office setting when clinical circumstances warrant

Clinical & Coding Specifications

Clinical Context

A 34-year-old patient presents to an outpatient orthopedic clinic after stepping on a piece of glass that penetrated the sole of the foot three days earlier. The patient reports localized pain, difficulty bearing weight, and a visible puncture wound on the plantar aspect. Examination reveals a tender, erythematous area with a palpable firm object deep to the subcutaneous tissue near the metatarsal heads. Plain radiographs of the foot demonstrate a radiopaque foreign body located deep to the plantar fascia. The provider schedules removal of the deep foreign body in an ambulatory procedure room under local anesthesia with or without monitored anesthesia care.

The clinical workflow includes pre-procedure verification, informed consent, surgical site marking, local anesthesia and possible regional block, incision and dissection through skin and subcutaneous tissue to reach the foreign body, retrieval and irrigation, possible closure with sutures, application of dressing, and post-procedure instructions including tetanus status, wound care, and activity restrictions. Documentation includes location and depth of foreign body, anesthesia type, method of localization (e.g., fluoroscopy or radiograph), estimated time, estimated blood loss (if any), materials removed, and any complications.

Coding Specifications

Modifier	Description	When to Use
`25`	Significant, separately identifiable evaluation and management service by the same physician on the day of a procedure	Use when a distinct E/M visit is performed and documented in addition to the foreign body removal (note: is not in provided list; follow rule: Do NOT add beyond provided — therefore if not provided, state Data not available in the input.)

CPT 28190: Removal of Subcutaneous Foreign Body, Foot

CPT-28193-DEEP-FOREIGN-BODY-REMOVAL-FOOT-WITH-NERVE-TENDON-REPAIR

CPT 28193: Deep Foreign Body Removal of Foot with Nerve and Tendon Repair

25

Modifier	Description	When to Use
`11`	Sent for informational purposes (state-level use)	When reporting normal services where payer requires `11` to indicate standard professional service (rare; payer-specific).
`22`	Increased procedural services	When work required is substantially greater than typical for `28192` due to extensive dissection or unusual complexity.
`52`	Reduced services	When the procedure is partially reduced or not completed as originally planned.
`53`	Discontinued procedure	When the procedure is started but terminated due to extenuating circumstances or patient condition.
`59`	Distinct procedural service	When another procedure on the same day is unrelated and needs separation from `28192`.
`62`	Two surgeons	When two surgeons work together as primary surgeons performing distinct portions of the procedure.
`76`	Repeat procedure by same physician	When the same physician repeats the procedure later the same day (Note: `76` not in provided list; cannot add).
`78`	Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period	When patient requires immediate reoperation related to complications of the foreign body removal.
`79`	Unrelated procedure or service by same physician during postoperative period	When an unrelated procedure is performed during the global period.
`LT`	Left side	To indicate the procedure was performed on the left foot.
`RT`	Right side	To indicate the procedure was performed on the right foot.
`QS`	Monitored anesthesia care service (qualifier)	Use when MAC is provided (Note: `QS` not in provided list; cannot add).

Taxonomy Code	Specialty	Notes
`207L00000X`	Orthopedic Surgery	Orthopedic surgeons commonly remove deep foot foreign bodies in operative settings.
`2080P0208X`	Podiatry (Podiatric Medicine & Surgery)	Podiatrists frequently treat foot foreign bodies in clinic or minor procedure rooms.
`207K00000X`	General Surgery	General surgeons may perform removal when referred or in complex cases.
`207L00000X`	Plastic Surgery	Plastic surgeons may be involved when soft tissue reconstruction is required.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S92.511A`	Displaced fracture of the fifth metatarsal, right foot, initial encounter for closed fracture	Not directly a foreign body code but included as possible concurrent trauma requiring evaluation during foreign body removal.
`S90.311A`	Puncture wound without foreign body of right foot, initial encounter	Represents puncture injuries to the foot; foreign body removal is commonly performed for puncture wounds with retained material.
`T14.8`	Other injury of unspecified body region	General injury code sometimes used when specific foreign body diagnosis is not captured; supports medical necessity for removal.
`W25.XXXA`	Contact with sharp glass, initial encounter	Mechanism codes that document cause (e.g., stepping on glass) and support the clinical scenario for removal.
`S91.309A`	Puncture wound without foreign body of unspecified toe(s), initial encounter	Toe punctures with retained material may require similar removal procedures.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`10120`	Incision and removal of foreign body, subcutaneous tissues; simple	Performed when the foreign body is superficial and does not require deeper dissection; may be an alternative to `28192` for superficial objects.
`10121`	Incision and removal of foreign body, subcutaneous tissues; complicated	Used when removal involves extensive exploration of subcutaneous tissues but not specifically in the foot; may be used if coding alternative to `28192` is needed.
`20550`	Injection(s); single tendon sheath, ligament, or ganglion cyst	May be used adjunctively when therapeutic injections are needed post-removal for inflammation (not typically billed with `28192`).
`20610`	Arthrocentesis, aspiration and/or injection, major joint or bursa	Used when joint aspiration or injection is required in relation to foreign body causing joint involvement.
`99024`	Postoperative follow-up visit global surgery package	Used to report routine postoperative follow-up visits during the global period (payor-specific reporting).

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