Summary & Overview
CPT 28735: Midtarsal/Tarsometatarsal Arthrodesis with Metatarsal Osteotomy
CPT code 28735 covers surgical immobilization (arthrodesis) of multiple or transverse midtarsal or tarsometatarsal joints with fixation devices and includes a metatarsal osteotomy to correct flat foot deformity. This procedure addresses pain from end-stage osteoarthritis of the midtarsal or tarsometatarsal joints and is an important reconstructive option in foot and ankle surgery. Nationally, the code is used to document complex joint-sparing or joint-fusing interventions that can impact utilization, payment policy, and surgical quality measurement for foot and ankle care.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical intent and service setting, common billing and coding considerations tied to surgical arthrodesis with osteotomy, and the typical sites where this service is delivered. The publication also summarizes typical modifiers and related billing contexts when available. Where specific payer policy details or benchmark data are unavailable in the input, the report notes that data are not provided.
This summary equips clinicians, coding professionals, and policy analysts with the clinical context and billing definition of CPT code 28735, supporting accurate documentation and payer communication across inpatient and ambulatory surgical settings.
Billing Code Overview
CPT code 28735 describes a surgical procedure that immobilizes multiple or transverse midtarsal or tarsometatarsal joints using fixation devices and includes an osteotomy of the metatarsal shaft to correct flat foot deformity. The procedure is intended to relieve pain for patients with end-stage osteoarthritis of the midtarsal or tarsometatarsal joints.
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Service type: Surgical reconstruction/arthrodesis with osteotomy of the foot
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Typical site of service: Inpatient or outpatient hospital operating room or ambulatory surgical center for foot/orthopedic surgery
Clinical & Coding Specifications
Clinical Context
A 62-year-old ambulatory patient with long-standing pain and functional limitation from end-stage osteoarthritis of the midtarsal and tarsometatarsal joints presents for surgical management. Conservative care including activity modification, orthotics, NSAIDs, physical therapy, and image-guided corticosteroid injections has failed to provide durable relief. Imaging (weight-bearing radiographs and CT) demonstrates advanced joint space loss, subchondral sclerosis, and osteophyte formation with forefoot malalignment and a planovalgus deformity. The orthopedic foot and ankle surgeon schedules a primary operative plan for midfoot arthrodesis with internal fixation and a corrective metatarsal osteotomy to restore alignment and off-load painful joints.
The typical clinical workflow includes preoperative clearance by primary care and, as needed, medical specialists; pre-op templating and marking; general or regional anesthesia in an ambulatory surgery center or hospital operating room; intraoperative fixation of the involved midtarsal and tarsometatarsal joints using plates, screws, or rods; performance of a metatarsal osteotomy to correct the flatfoot deformity; radiographic verification of hardware and correction; postoperative immobilization in a cast or boot; routine orthopedic follow-up with serial radiographs to assess fusion; and progressive weight-bearing and rehabilitation once fusion is confirmed.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side |