Summary & Overview
CPT 28299: Bunion Correction with Double Osteotomy
CPT code 28299 represents a surgical bunion procedure involving bone removal and a double osteotomy to cut and realign toe bones, and may include excision of sesamoid bones. Nationally, this code captures a range of corrective foot surgeries for hallux valgus and related deformities; accurate reporting affects claims processing, clinical documentation, and payment across payers. Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise clinical and billing overview of the procedure, typical sites of service, and the common modifiers associated with reporting. The publication provides benchmarks and payer coverage context, clarifies typical clinical scenarios that generate use of the code, and outlines documentation elements that underlie appropriate coding. The material also highlights where policy updates or payer-specific guidelines commonly affect authorization and reimbursement decisions. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 28299 describes a surgical procedure to correct a bunion deformity by removing bone from the affected area of the foot. The procedure includes a double osteotomy, which involves cutting and realigning one or more toe bones, and may include removal of the sesamoid bones beneath the big toe joint.
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Service type: Surgical bunion correction with osteotomy (open foot surgery)
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Typical site of service: Hospital outpatient department or ambulatory surgery center; may also be performed in an inpatient setting when clinically indicated
Clinical & Coding Specifications
Clinical Context
A 56-year-old ambulatory patient presents to an orthopaedic foot and ankle surgeon with progressive hallux valgus causing pain, difficulty fitting shoes, and occasional metatarsalgia. Conservative measures (shoe modifications, orthotics, NSAIDs) have failed. Preoperative evaluation includes weight-bearing foot radiographs demonstrating a symptomatic bunion with intermetatarsal angle and hallux valgus angle requiring realignment. The patient is scheduled for operative correction that includes removal of the bony prominence and double osteotomy of the first metatarsal and proximal phalanx; sesamoid debridement or excision may be performed if indicated. The typical clinical workflow: pre-op assessment in clinic, informed consent, baseline vitals and anesthesia evaluation (general or regional block), operative procedure in an ambulatory surgery center or hospital outpatient department, post-anesthesia recovery, short-term immobilization in a postoperative shoe or cast, and follow-up visits for wound check and progressive weight-bearing and physical therapy as indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
52 | Reduced services | Use when the surgeon performs an abbreviated version of the procedure with substantially reduced work. |
53 |