Summary & Overview
CPT 28210: Delayed Tendon Repair of Foot/Toes with Autograft
Headline: CPT code 28210 covers delayed surgical repair of ruptured foot and toe-straightening tendons using a free autograft, including graft harvest.
Lead: CPT code 28210 designates a delayed tendon repair procedure that restores the ability to straighten or unbend the foot and toes by using a free graft taken from the patient. The code is billed per tendon repaired and incorporates the graft harvest in the service description.
Why it matters: Nationally, surgical tendon repairs of the foot and toes are clinically significant for restoring ambulation and preventing long-term disability. Clear coding affects clinical documentation, billing accuracy, and payment policy for procedures that combine tendon reconstruction with autograft harvest.
Key payers in scope: Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
What readers will learn: The publication summarizes the clinical intent of CPT code 28210, common sites of service, and payer coverage context. Readers will find benchmarks related to utilization and reimbursement structures where available, guidance on coding scope (what the code includes), and relevant policy or payer considerations affecting surgical tendon repair billing. The report highlights areas where clinical documentation should align with the procedural description to support accurate reporting of each tendon repaired and the included graft harvest. Data not available in the input will be noted where applicable.
Billing Code Overview
CPT code 28210 describes a delayed repair of a ruptured tendon that straightens or unbends the foot and toes using a free autograft obtained from another site of the patient's body. The code is reported for each tendon repaired and explicitly includes the work of obtaining the graft used for the repair.
Service type: Surgical tendon repair with autograft (delayed repair)
Typical site of service: Hospital operating room or ambulatory surgical center, as this procedure involves surgical tendon reconstruction and graft harvest that generally requires a sterile operative environment and perioperative support.
Clinical & Coding Specifications
Clinical Context
A 38-year-old male presents to an orthopedic foot and ankle surgeon 6 weeks after a work-related laceration to the dorsal midfoot that transected the extensor tendons. Initial wound care and irrigation were performed in the emergency department; the patient has persistent inability to extend the toes and a palpable tendon gap. After wound maturation and resolution of acute inflammation, the surgeon schedules a delayed tendon repair using an autologous free tendon graft to reconstruct the ruptured extensor tendon. Preoperative workflow includes history and focused physical exam, confirmation of tendon discontinuity with ultrasound or MRI as needed, informed consent, preoperative medical optimization, and scheduling in an ambulatory surgery center or hospital operating room. Intraoperative steps include exploration of the tendon sheath, debridement of scar tissue, harvest of the autograft (commonly gracilis or palmaris longus), graft preparation and graft-to-tendon anastomosis, hemostasis, layered closure, and application of immobilization (splint or cast). Postoperative workflow includes recovery monitoring, pain control, immobilization, wound checks, and a staged rehabilitation plan with progressive protected range of motion and strengthening under the direction of physical therapy or hand/foot therapy.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
50 | Bilateral procedure | When identical tendon repairs are performed on both feet during the same operative session |