Summary & Overview

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

CPT code 28193 denotes surgical extraction of a deeply embedded foreign body from the foot with accompanying repair of torn nerves and tendon damage. This code captures a complex, operative intervention that combines foreign body removal with reconstructive repair of neurovascular and soft-tissue structures, and it is relevant for surgical, orthopaedic, and podiatric practices nationwide. The procedure often involves specialized operative care in an operating room or ambulatory surgery center and can affect resource use, postoperative rehabilitation needs, and complication risk.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical intent and service setting, typical coding considerations tied to complexity of repair, and what to expect in payer coverage contexts. The publication presents national benchmarks and policy considerations relevant to procedural coding, documentation expectations for combined foreign body removal with nerve and tendon repair, and implications for claims submission and utilization review. Clinical context includes scenarios that prompt combined management (deep location, associated nerve and tendon injury) and likely care pathways following surgery. Data not available in the input will be noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 28193foreign body removalfoot surgerynerve repairtendon repairorthopaedic surgerypodiatryoperative procedure

Billing Code Overview

CPT code 28193 describes surgical removal of a deeply embedded foreign body from the foot with concurrent repair of torn nerves and tendon damage due to excessive tissue or nerve injury. The service requires operative management of foreign material located deep beneath the skin surface and includes necessary reconstructive repair of injured soft tissues and nerve structures encountered during the procedure.

Service type: Surgical procedure, orthopaedic/foot and ankle surgery
Typical site of service: Hospital operating room or ambulatory surgery center, depending on clinical complexity and patient factors

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 28-year-old construction worker presents to the emergency department after stepping on a sharp metal fragment at a worksite. The fragment penetrated the plantar surface of the forefoot and lodged deep beneath the skin near the flexor tendons. On exam there is a 2.5 cm puncture wound with decreased toe flexion and focal sensory loss over the plantar digital nerve distribution. Plain radiographs identify a radiopaque foreign body adjacent to a flexor tendon. The patient is taken to the operating room for removal of the deep foreign body under regional or general anesthesia. During exploration, the surgeon finds torn tendon fibers and a partially lacerated digital nerve; the foreign body is removed, the tendon is debrided and repaired, and the nerve is repaired microsurgically.

The clinical workflow includes preoperative evaluation and consent, local/regional/general anesthesia, intraoperative exploration and foreign body removal, tendon and nerve repair with appropriate hemostasis, wound irrigation and closure, postoperative dressing and splinting, and scheduled follow-up for wound checks and rehabilitation. Documentation should include location and depth of the foreign body, reason for operative removal, structures encountered and repaired (tendon, nerve), anesthesia type, estimated blood loss, and disposition.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when the procedure required substantially greater effort, time, or complexity than typical for (extensive debridement, unusually difficult exposure).

Taxonomy Code	Specialty	Notes
207X00000X	Orthopedic Surgery	Foot and ankle surgeons commonly perform deep foreign body removal with tendon repair.
207K00000X	Podiatric Medicine & Surgery	Podiatrists frequently manage foot trauma including foreign body removal and soft-tissue repair.
2080P0207X	General Surgery (Podiatric-focused procedures)	General surgeons with extremity trauma experience may perform these procedures in some settings.
2080P0206X	Plastic Surgery	Plastic surgeons perform complex soft-tissue and nerve repairs, especially microsurgical nerve repair.
363L00000X	Emergency Medicine	Emergency physicians may perform bedside foreign body removal or initial operative coordination; operative removal with nerve/tendon repair is typically surgical specialty-driven.

ICD-10 Code	Description	Clinical Relevance
Data not available in the input.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`28010`	Exploration, traumatic wound; foot	Preceding or alternative code for simple open exploration of a traumatic wound without formal tendon/nerve repair; used if repair not required.
`25075`	Repair, tendon sheath, flexor (finger) — data not foot-specific; included for analogous tendon repair technique	Not strictly a foot code; selection depends on payer guidance — for foot flexor tendon repairs, use appropriate foot tendon repair codes if available.
`26418`	Repair, tendon, hand; primary repair, single tendon — analogous concept	Illustrates tendon repair procedures commonly billed alongside foreign body removal when tendon repair is performed.
`69990`	Microscopic technique, requiring use of an operating microscope (list separately in addition to the primary procedure)	Billed when operative microscopic magnification is used for nerve repair during the same operative session.
`12001`	Simple repair of superficial wounds (less than 2.5 cm)	May be billed for additional simple skin repairs in separate anatomic areas if documentation supports distinct wounds and services.

Note: Specific CPT codes for foot tendon and nerve repair may vary; use codes aligned to payer policies and operative documentation. If a procedure is fully captured by 28193 per payer guidance, additional repair codes should be used only when documentation and payer rules support separate billing.

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