Summary & Overview
CPT 28264: Midtarsal Joint Capsulotomy and Soft-Tissue Release
CPT code 28264 denotes a surgical capsulotomy of the midtarsal joint and associated soft-tissue release performed to increase range of motion or correct resistant joint contractures in the foot. Clinically, the procedure is relevant for patients with deformities, post-traumatic stiffness, or chronic contractures that impair mobility and function. Nationally, this code matters because it captures a specific foot and ankle reconstructive intervention used across outpatient surgical centers and hospital operating rooms, with implications for specialty surgical billing and postoperative care planning. Key payers included in this review are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context and typical settings for the service, an outline of common billing modifiers and payer considerations, and what to expect in terms of documentation and coding specificity. The publication also summarizes benchmark elements and policy-relevant details where available. Data not available in the input is noted when applicable. This piece is written for a national audience of coders, billing managers, and clinical leaders seeking clarity on the use and reporting of CPT code 28264 in surgical practice.
Billing Code Overview
CPT code 28264 describes a surgical procedure in which the provider incises the capsule of a midtarsal joint in the foot to increase range of motion or release a joint contracture. The procedure includes incision of soft tissues to treat resistant contractures of the foot.
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Service type: Surgical procedure for release of midtarsal joint contracture and soft-tissue release in the foot
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Typical site of service: Ambulatory surgical center or hospital operating room; may also be performed in specialized outpatient surgical settings for foot and ankle surgery
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with long-standing dorsiflexion limitation and persistent midfoot equinus due to post-traumatic scarring presents for surgical management. Conservative treatment including physical therapy, serial casting, and orthotics failed to restore functional range of motion. The orthopedic foot and ankle surgeon evaluates the patient, documents contracture of the midtarsal joint with reduced range of motion and pain with ambulation, obtains informed consent, and schedules a focused outpatient operative procedure. In the operating room or ambulatory surgery center under regional or general anesthesia, the surgeon makes a limited incision to access and incise the capsule and contracted soft tissues of the midtarsal joint to release the contracture and improve range of motion. Intraoperative findings, estimated blood loss, and neurovascular status are recorded. Postoperative care includes wound checks, activity restrictions, pain control, and referral for rehabilitation to restore strength and gait. Typical site of service: ambulatory surgery center or hospital outpatient department.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing separate professional services for the surgical interpretation or intraoperative decision-making if technical component billed by another entity |
50 |