Summary & Overview
CPT 28300: Calcaneal Osteotomy for Heel Bone Realignment
CPT code 28300 represents an open osteotomy of the calcaneus performed to correct foot alignment abnormalities such as high or low arches and other structural deformities. This surgical code captures procedures where the provider creates a controlled break in the heel bone and realigns it to restore function and alleviate pain. Nationally, CPT code 28300 is relevant to orthopedic and podiatric surgical practice patterns, utilization tracking, and surgical quality assessment.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context about the indication and operative approach for calcaneal osteotomy, typical sites of service (hospital inpatient, outpatient surgical facility, ambulatory surgical center), and the kinds of information payers commonly review for authorization and claims adjudication. The publication also summarizes benchmarks and policy considerations relevant to coverage and billing for calcaneal osteotomies, highlights common billing modifiers used in surgical reporting, and outlines implications for surgical service lines and facility billing.
Intended for revenue cycle leaders, orthopedic and podiatric clinicians, and payers, the content provides a concise reference to the clinical purpose and administrative handling of CPT code 28300 without state-specific guidance.
Billing Code Overview
CPT code 28300 describes an osteotomy of the calcaneus (heel bone). The procedure involves surgically incising the calcaneus to create a controlled fracture and realigning the bone to correct deformity.
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Service type: Surgical procedure — open calcaneal osteotomy for correction of foot alignment
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Typical site of service: Hospital inpatient or outpatient surgical facility, or ambulatory surgical center
Clinical & Coding Specifications
Clinical Context
A 46-year-old patient with chronic hindfoot malalignment and long-standing lateral hindfoot pain presents after failure of conservative care including orthotics, physical therapy, and activity modification. Imaging shows a malunited calcaneal fracture with varus deformity and hindfoot valgus/varus contributing to peroneal tendinopathy and abnormal gait. The orthopedic foot and ankle surgeon schedules a lateral closing wedge calcaneal osteotomy (code 28300) to realign the calcaneus, restore hindfoot alignment, and relieve tendon impingement.
Preoperative workflow includes history and physical, weight-bearing radiographs and CT for deformity planning, informed consent, and anesthesia evaluation. On the day of surgery the patient receives regional or general anesthesia; the surgeon makes an approach to the calcaneus, performs the controlled osteotomy, realigns the fragments, and fixes the osteotomy with internal fixation (plates or screws). Postoperative workflow includes pain control, immobilization in a splint or cast, DVT prophylaxis as indicated, discharge planning with weight-bearing restrictions, and outpatient follow-up with radiographic assessment for healing.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work, time, or complexity substantially exceeds usual for (document increased work). |