Summary & Overview
CPT 28240: Abductor Hallucis Tendon Release/Lengthening
CPT code 28240 designates a surgical tendon incision of the abductor hallucis at its insertion on the big toe to lengthen the tendon or release tension and relieve forefoot pain. The procedure is relevant for treating mechanical or soft-tissue causes of medial forefoot discomfort and is performed by foot and ankle surgeons or orthopedic specialists in outpatient surgical centers or hospital operating rooms. Nationally, the code matters for coverage policy, surgical authorization, and payment consistency for common foot procedures addressing deformity or tendon contracture.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, common sites of service, and typical billing considerations. The publication outlines benchmarks and utilization context, highlights recent policy updates affecting foot surgery coverage, and summarizes coding relationships relevant to preauthorization and claim adjudication. Clinical implications for patient selection and procedural intent (tendon lengthening/release to relieve pain) are described to aid payers, clinicians, and billing professionals in aligning documentation with coding and coverage expectations.
Data not available in the input: associated taxonomies, specific ICD-10 diagnosis codes, and related billing codes.
Billing Code Overview
CPT code 28240 describes a surgical procedure in which the provider incises the tendon of the abductor hallucis muscle at its insertion on the big toe to lengthen the tendon or release tension, with the goal of relieving foot pain. This procedure is a tendon release/lengthening of the abductor hallucis.
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Service type: Surgical soft-tissue procedure of the foot involving tendon lengthening or release
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Typical site of service: Outpatient surgical center or hospital operating room, often performed by foot and ankle surgeons or orthopedic specialists
Clinical & Coding Specifications
Clinical Context
A typical patient is a middle-aged to older adult presenting to a podiatry or orthopedic foot and ankle clinic with medial forefoot pain and a symptomatic hallux valgus or abductor hallucis contracture causing bunion deformity or metatarsalgia. The patient reports activity-related pain along the medial aspect of the big toe, difficulty fitting shoes, and focal tenderness over the abductor hallucis tendon insertion. Conservative care including shoe modification, orthotics, NSAIDs, and physical therapy has failed after several months.
The clinical workflow begins with a focused history and physical exam documenting range of motion, toe alignment, and tenderness. Weight-bearing radiographs of the foot assess hallux valgus angle and joint alignment. If surgery is indicated, the procedure is scheduled in an ambulatory surgery center or hospital outpatient operating room. Preoperative evaluation includes medical clearance, consent, and documentation of failed conservative therapy. Intraoperatively, the surgeon performs an incision and selective lengthening or release of the abductor hallucis tendon to reduce medial tension and improve alignment; concomitant procedures (e.g., bunionectomy, osteotomy, sesamoid procedures) may be performed during the same anesthetic when clinically indicated. Postoperative care includes wound care instructions, weight-bearing limitations, analgesia, and follow-up visits to monitor healing and rehabilitation with progressive footwear and orthotic support.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 |