Summary & Overview
CPT 28307: First Metatarsal Osteotomy with Autogenous Bone Graft
CPT code 28307 represents a surgical foot procedure: osteotomy of the first metatarsal (excluding the bone that articulates with the first toe) combined with an autogenous bone graft to correct shortening and relieve pain. This code captures reconstructive work on the first metatarsal that may include lengthening, shortening, or angular correction and is relevant to orthopedic and podiatric surgical practices across the country. Nationally, accurate coding of such procedures affects claims processing, coverage determination, and comparative utilization for ambulatory and hospital-based surgical services.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical intent and service setting, typical payer coverage considerations, and the practical context needed for coding and billing workflows. The publication also outlines benchmarks and policy updates where available, clarifies clinical indications tied to deformity correction and pain relief, and highlights related coding considerations for surgical reconstruction of the first metatarsal.
This summary is intended for medical coders, revenue cycle professionals, and clinicians who need a national-level briefing on the purpose and billing context of CPT code 28307 without state-specific variations. Data not available in the input has been omitted.
Billing Code Overview
CPT code 28307 describes an osteotomy of the first metatarsal bone (not the bone that articulates with the first toe) with optional lengthening, shortening, or angular correction. The procedure specifically includes a bone graft harvested from the patient to address shortening of the first metatarsal and is performed to correct deformity and relieve pain.
Service type: Surgical — Foot/Forefoot Reconstruction (first metatarsal osteotomy with autogenous bone graft)
Typical site of service: Hospital outpatient department or ambulatory surgical center
Clinical & Coding Specifications
Clinical Context
A 52-year-old patient with a long-standing, symptomatic hallux valgus deformity presents with progressive forefoot pain, difficulty shoe fitting, and impaired ambulation. Conservative care including shoe modifications, orthotics, and NSAIDs provided inadequate relief. Clinical exam demonstrates a varus/valgus deformity and first metatarsal shortening contributing to pain and transfer metatarsalgia. Radiographs confirm angular deformity of the first metatarsal and relative shortening. The surgeon schedules an open first metatarsal osteotomy with autogenous bone grafting to correct shortening and realign the metatarsal, relieve pain, and restore function.
Preoperative workflow includes history and physical, informed consent, baseline labs as indicated, and imaging review. The procedure is performed in an ambulatory surgery center or hospital operating room under regional or general anesthesia. Intraoperative steps include exposure of the first metatarsal, osteotomy (with possible lengthening/shortening or angular correction), harvest of autologous bone graft (commonly from distal tibia or calcaneus), placement of graft to correct shortening, fixation (plates, screws, or K-wires), hemostasis, and layered closure. Postoperative workflow includes recovery room monitoring, pain control, dressing and immobilization (short leg cast or boot), weight-bearing restrictions, and arranged outpatient follow-up with wound checks and progressive rehabilitation to monitor bone healing and functional recovery.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default / No modifier | Rarely used explicitly; indicates no modifier applies when required by payer rules |
11 | Office or Other Outpatient Service | Use when reporting routine, uncomplicated performance of the procedure (typical primary service) |
22 | Increased Procedural Services | Use when work or time substantially greater than typical for the procedure (extensive dissection, additional procedures) |
23 | Unusual Anesthesia | Use when the procedure is performed under general anesthesia in a patient for whom local/regional would normally be used due to unusual circumstances |
26 | Professional Component | Use when billing only the physician professional component separate from technical/supply components (rare for surgical CPTs) |
59 | Distinct Procedural Service | Use when another procedure performed during the same session is distinct and not part of the global package (different anatomic site or separate procedure) |
62 | Two Surgeons | Use when two surgeons with distinct skills work together as primary surgeons throughout substantial portion of procedure |
76 | Repeat Procedure by Same Physician | Data not available in the input. |
78 | Return to OR for Related Procedure During Global Period | Use when patient returns to the operating room for a related procedure during the global postoperative period (e.g., complication requiring reoperation) |
79 | Unrelated Procedure or Service by the Same Physician During the Postoperative Period | Data not available in the input. |
50 | Bilateral Procedure | Use when identical procedure performed on both feet during same operative session (check payer bilateral rules) |
52 | Reduced Services | Use when procedure is partially reduced or not completed as originally planned (aborted or limited) |
53 | Discontinued Procedure | Use when procedure is discontinued due to extenuating circumstances or patient condition |
LT | Left Side | Use to identify left foot procedure when laterality is required by payer |
RT | Right Side | Use to identify right foot procedure when laterality is required by payer |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207N00000X | Orthopedic Surgery | Most common specialty performing first metatarsal osteotomy and bone grafting |
207XY0006X | Podiatric Medicine & Surgery | Frequent provider specialty for forefoot osteotomies and first metatarsal correction |
208000000X | General Surgery | Occasionally performs complex foot procedures in some settings |
2080S0126X | Family Medicine with Special Qualifications in Sports Medicine | May be involved in perioperative care in specialized practices |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
M20.11 | Hallux valgus (acquired), right foot | Primary deformity indication for first metatarsal osteotomy to correct alignment and relieve pain |
M20.12 | Hallux valgus (acquired), left foot | Primary deformity indication for first metatarsal osteotomy to correct alignment and relieve pain |
M21.6 | Acquired deformities of feet, not elsewhere classified | Used for complex or atypical metatarsal deformities requiring osteotomy and grafting |
M21.0 | Acquired deformity of limb | For documentation of limb deformity contributing to metatarsal shortening/angulation when more specific code not used |
M77.40 | Peroneal tendinitis, unspecified foot | May be listed when associated tendon pathology contributes to forefoot pain and surgical planning |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
28285 | Correction, hallux valgus (bunionette), with or without sesamoidectomy; proximal metatarsal osteotomy | Alternative or adjunct proximal first metatarsal osteotomy techniques for deformity correction |
28300 | Osteotomy, metatarsal, other than first or fifth, with internal fixation | Related osteotomy techniques on other metatarsals when concomitant correction of lesser rays is required |
28515 | Excision, bone; metatarsal head (excluding toe) | May be performed for osteophyte or symptomatic bone excision during forefoot procedures |
11010 | Debridement of open wound, includes removal of foreign material and/or devitalized tissue | Used if additional debridement is required for pre-existing ulceration or infected tissue at time of surgery |
20930 | Allograft, morselized, or placement of bone graft substitute (e.g., synthetic) | Alternative or adjunct to autogenous bone grafting when graft harvest is not performed |