Summary & Overview
CPT 28208: Extensor Tendon Repair of Foot
CPT code 28208 denotes surgical repair of an extensor tendon of the foot, a procedure performed to restore toe extension and improve foot function after tendon injury or laceration. This code is important nationally because extensor tendon injuries impact mobility and postoperative care can affect functional outcomes and downstream costs. Analysis of this code informs surgical utilization, payment policy, and care pathway planning across payers.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for extensor tendon repair, expected sites of service, and typical service type. The publication also summarizes benchmarking metrics and reimbursement patterns where available, highlights relevant policy considerations impacting coverage and prior authorization, and provides operational context for coding and claims submission.
This summary is intended for national audiences including payers, provider groups, and policy analysts seeking concise information on procedure classification, expected care settings, and the payer landscape for surgical repair of foot extensor tendons. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 28208 describes a surgical procedure in which the provider repairs an extensor tendon of the foot. This procedure is a reconstructive/repair service focused on restoring extension function to toes and improving gait mechanics.
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Service type: Surgical tendon repair
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Typical site of service: Ambulatory surgery center or hospital operating room
Clinical & Coding Specifications
Clinical Context
A 32-year-old recreational soccer player presents to the orthopedic clinic after sustaining a dorsal laceration to the foot when his toe was caught under an opponent’s cleat. Physical exam demonstrates loss of active extension of the great toe and tenderness along the extensor hallucis longus tendon with an open 2.5 cm wound over the dorsal midfoot. Imaging (radiographs) shows no displaced fracture. The provider schedules operative repair of the extensor tendon of the foot to restore function and prevent long-term extensor lag. The procedure is performed in an ambulatory surgery center under regional block with sedation. Preoperative workflow includes wound assessment, tetanus status check, informed consent, marking of laterality (LT or RT), and documentation of neurovascular status. Intraoperative workflow includes exploration, debridement, tendon identification, primary repair with nonabsorbable suture, and irrigation. Postoperative care includes immobilization in a splint or short postoperative shoe, instructions for nonweightbearing or protective weightbearing as indicated, wound care, and a follow-up visit for suture removal and rehabilitation planning.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side | Use when the procedure is performed on the left foot |