CPT 28730 Midfoot Arthrodesis Reimbursement | OpenPayer

Summary & Overview

CPT 28730: Midtarsal and Tarsometatarsal Joint Arthrodesis with Fixation

CPT code 28730 represents surgical immobilization (arthrodesis) of multiple or transverse midtarsal or tarsometatarsal (Lisfranc) joints using fixation devices. This midfoot procedure is clinically important for stabilizing complex fractures, Lisfranc injuries, and degenerative conditions that compromise foot alignment and weightbearing. Nationally, accurate coding for these procedures affects hospital and ambulatory surgical center billing, quality measurement, and comparative utilization analyses.

Key payers covered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical indications and typical settings for service, guidance on common modifier use (listing provided in the input), and context for related procedural classification. The publication summarizes payer coverage patterns and benchmarking considerations where available and highlights policy or coding guidance updates that influence claims adjudication and documentation requirements.

The report is intended for clinicians, coding professionals, and policy analysts seeking a concise reference on procedure scope, service sites, and payer landscape for CPT code 28730. Data not available in the input is noted where relevant and omitted from specific tables.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT28730midfoot-surgeryLisfrancarthrodesissurgical-fixationorthopedicsambulatory-surgeryhospital-surgery

Billing Code Overview

CPT code 28730 describes a surgical procedure to immobilize multiple or transverse midtarsal or tarsometatarsal (Lisfranc) joints using fixation devices. The procedure targets combined midtarsal joints (talus with navicular or calcaneus with cuboid) and tarsometatarsal joints (the cuneiforms and cuboid with the metatarsal bases).

Service type: Surgical fixation/arthrodesis of multiple midfoot or tarsometatarsal joints.

Typical site of service: Hospital inpatient or outpatient operating room, or ambulatory surgical center, depending on patient condition and complexity.

Clinical & Coding Specifications

Clinical Context

A typical patient is a 45–65-year-old adult presenting with midfoot pain, deformity, and instability after a traumatic injury (for example, a high-energy motor vehicle collision or a twisting injury) or chronic degenerative collapse (such as progressive midfoot arthritis or diabetic Charcot arthropathy). Evaluation includes history, physical exam noting midtarsal or tarsometatarsal (Lisfranc) joint instability, weight-bearing radiographs, CT or MRI to define joint displacement and articular damage, and preoperative medical clearance.

The clinical workflow: the patient is consented for surgical fusion of multiple or transverse midtarsal or tarsometatarsal joints (CPT 28730). Preoperative planning identifies which joints require fixation and selection of hardware (plates, screws, or intramedullary devices). The procedure is typically performed in an operating room under regional or general anesthesia with fluoroscopic guidance. Postoperative care includes immobilization in a cast or boot, non‑weightbearing for an appropriate interval, serial radiographs to confirm fusion, and physical therapy once fusion is established. The typical site of service is an ambulatory surgery center or hospital operating room. This procedure is performed by orthopedic foot and ankle surgeons or podiatric surgeons with operative privileges for joint arthrodesis.

Coding Specifications

Modifier	Description	When to Use
`22`

CPT 28755: Great Toe Interphalangeal Joint Immobilization

CPT-28760-GREAT-TOE-INTERPHALANGEAL-ARTHRODESIS-WITH-TENDON-TRANSFER

CPT 28760: Great Toe Interphalangeal Arthrodesis with Tendon Transfer

CPT-28725-SUBTALAR-JOINT-FUSION-ARTHRODESIS

CPT 28725: Subtalar Joint Fusion for Degenerative Arthritis or Trauma

CPT-28705-PANTALAR-ARTHRODESIS-POSTERIOR-FOOT-ANKLE-FUSION

CPT 28705: Pantalar Arthrodesis (Extensive Hindfoot and Ankle Fusion)

CPT-28735-MIDTARSAL-TARSOMETATARSAL-ARTHRODESIS-OSTEOTOMY

CPT 28735: Midtarsal/Tarsometatarsal Arthrodesis with Metatarsal Osteotomy

CPT-28737-NAVICULAR-CUNEIFORM-ARTHRODESIS-WITH-TIBIALIS-POSTERIOR-LENGTHENING

CPT 28737: Navicular‑Cuneiform Arthrodesis with Tibialis Posterior Lengthening

CPT-28715-TRIPLE-ARTHRODESIS-HINDFOOT-FUSION

CPT 28715: Triple Arthrodesis (Hindfoot Fusion)

CPT-28740-MIDTARSAL-TARSOMETATARSAL-ARTHRODESIS-FIXATION

CPT 28740: Midtarsal or Tarsometatarsal Joint Arthrodesis with Fixation

CPT-28750-GREAT-TOE-METATARSOPHALANGEAL-JOINT-IMMOBILIZATION

CPT 28750: Great Toe Metatarsophalangeal Joint Immobilization

Taxonomy Code	Specialty	Notes
`207X00000X`	Orthopedic Surgery	Foot and ankle subspecialists commonly perform midtarsal and Lisfranc arthrodesis.
`207X00000P`	Podiatric Medicine & Surgery	Podiatric surgeons frequently perform tarsometatarsal and midtarsal joint fusions.
`2080P0003X`	General Surgery (Podiatric focus)	Some foot surgery is performed by surgeons credentialed in podiatric or foot and ankle care.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S83.241A`	Dislocation of tarsometatarsal joint, right foot, initial encounter	Acute Lisfranc dislocation often requires reduction and may require fusion of tarsometatarsal joints when instability or articular damage is severe.
`S83.242A`	Dislocation of tarsometatarsal joint, left foot, initial encounter	Same relevance for left-sided acute injury leading to possible arthrodesis.
`M21.67`	Other acquired deformity of foot, bilateral	Progressive deformities causing midfoot collapse may be treated with midtarsal or tarsometatarsal fusion.
`M16.9`	Osteoarthritis of hip, unspecified	Data not available in the input.
`M77.9`	Enthesopathy, unspecified	Data not available in the input.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`27792`	Reduction, dislocation, tarsometatarsal (Lisfranc) injury, open; with internal fixation	May be performed before or instead of arthrodesis when reduction with fixation is indicated for acute Lisfranc injuries.
`28122`	Arthrodesis, midtarsal or tarsometatarsal, single, including internal fixation when performed	Used when fusion is limited to a single joint rather than multiple/transverse joints covered by `CPT 28730`.
`28825`	Arthrodesis, midtarsal, multiple, with internal fixation, includes tarsometatarsal if documented	Sometimes reported for similar midfoot fusion procedures; choose the code that accurately describes the joints fused.
`20670`	Removal of implanted material, deep (e.g., buried wire, pin, screw, metal band, nail, rod), requiring incision; each single or multiple	May be billed later if hardware removal is required after fusion is consolidated.
`29900`	Arthroscopy, ankle, diagnostic, with or without synovial biopsy	May be performed preoperatively or in staged procedures for intraarticular assessment but is not typically part of `CPT 28730`.

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