Summary & Overview
CPT 28304: Tarsal Osteotomy for Foot Bone Realignment
Headline: CPT code 28304 defines surgical tarsal osteotomy for realignment of foot bones to address instability, coalition, dislocation, or fracture.
Lead: CPT code 28304 represents an operative tarsal osteotomy that surgically incises or transects tarsal bones (excluding the calcaneus and talus) and realigns them. The procedure is clinically important for restoring foot alignment and function following chronic ankle instability, congenital or acquired tarsal coalition, traumatic dislocation, or fracture.
Why it matters nationally: This code captures a specialized orthopedic foot surgery performed in operating room or ambulatory surgery center settings. Accurate coding determines appropriate claims processing, cost allocation, and national utilization tracking for complex foot reconstruction procedures.
Payers covered: Analysis typically considers major national payers including Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
What readers will learn: The publication provides benchmarks relevant to CPT code 28304, a clinical context for when the procedure is used, typical sites of service, and common billing considerations. It summarizes payer coverage patterns and coding implications for surgeons, billing teams, and policy analysts. If specific data elements are missing from the input, the text notes that those data are not available in the input.
Billing Code Overview
CPT code 28304 describes an osteotomy of the tarsal bones in the foot, involving surgical incision or transection and realignment of tarsal bone(s) adjacent to the articulation between the foot and the leg. The procedure specifically excludes the calcaneus and talus and is used to address conditions such as chronic ankle instability, tarsal coalition, dislocation, or fracture.
-
Service type: Surgical procedure — tarsal osteotomy
-
Typical site of service: Hospital operating room or ambulatory surgery center (inpatient or outpatient surgical setting)
Clinical & Coding Specifications
Clinical Context
A typical patient is a 28–45-year-old adult with persistent lateral ankle pain, recurrent ankle sprains, and mechanical instability after failed conservative treatment. The patient reports chronic giving way, recurrent inversion injuries, and limited activity due to instability. Examination shows laxity of the tibiotalar or subtalar joints and possible hindfoot malalignment. Imaging (weight-bearing radiographs and CT or MRI) demonstrates malalignment of the midfoot/tarsal bones, a symptomatic tarsal coalition, malunited tarsal fracture, or chronic instability requiring structural correction. The orthopedic foot and ankle surgeon schedules an operative osteotomy of the tarsal bones to resect, transect, and realign affected tarsal elements (excluding the calcaneus and talus) under general or regional anesthesia in an ambulatory surgery center or hospital operating room. Preoperative workflow includes history and physical, informed consent documenting surgical plan and risks, preop imaging review, antibiotic prophylaxis, and limb marking. Postoperative care involves immobilization in a splint or cast, non-weightbearing instructions, pain control, wound checks, and arranged physical therapy and follow-up radiographs to confirm alignment and healing.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT / RT | Left or right side indicator | Use to report laterality when the osteotomy is performed on one foot. |