Summary & Overview
CPT 28308: Metatarsal Osteotomy (Non‑First Metatarsal)
CPT code 28308 represents a surgical osteotomy of any metatarsal bone other than the first, performed to correct deformity by realigning, lengthening, shortening, or correcting angular abnormalities of the metatarsal and associated toe. Nationally, this code captures common forefoot reconstructive procedures that affect orthopedic surgical volumes, coverage determinations, and reimbursement patterns across payers.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find a concise clinical description, expected sites of service, and the typical use cases for CPT code 28308. The publication outlines benchmark payment and utilization considerations across major payers, summarizes relevant policy themes that influence coverage and prior authorization, and situates the code within the clinical care pathway for forefoot deformity correction.
This overview is intended for billing professionals, orthopedic surgeons, practice managers, and policy analysts seeking a national-level reference on coding, service context, and payer landscape for metatarsal osteotomy procedures represented by CPT code 28308. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 28308 describes an osteotomy of any metatarsal bone other than the first. The procedure may involve lengthening, shortening, or correcting an angular deformity of the metatarsal to repair a foot deformity and realign the metatarsal bone and the toe.
Service Type: Forefoot surgical procedure (metatarsal osteotomy)
Typical Site of Service: Hospital outpatient department or ambulatory surgery center; may also occur in inpatient settings when clinically indicated
Clinical & Coding Specifications
Clinical Context
A 46-year-old patient presents to an orthopedic foot and ankle surgeon with progressive pain, callus formation, and toe malalignment of the second metatarsal after conservative care (shoe modification, orthotics, activity modification) failed. Weightbearing radiographs show a malaligned and shortened second metatarsal with transfer metatarsalgia and associated hammertoe deformity. The surgeon schedules an operative correction: an osteotomy of the second metatarsal to correct angular deformity and realign the toe with possible lengthening or shortening as needed. The typical workflow: preoperative evaluation and informed consent in the clinic, preoperative clearance and imaging, operative procedure in an ambulatory surgery center or hospital outpatient surgical suite under regional or general anesthesia, intraoperative fluoroscopic confirmation of alignment after osteotomy and fixation, postoperative recovery with dressings and crutches, and follow-up visits for wound check, radiographic healing assessment, and progressive weightbearing and physical therapy as indicated. Typical site of service is an ambulatory surgery center or hospital outpatient department. Service type is surgical — open orthopedic foot reconstructive procedure.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when the osteotomy requires substantially greater work than typical (extensive dissection, prolonged time) with documentation explaining increased work. |