CPT 28740 Midtarsal/Tarsometatarsal Arthrodesis Reimbursement | OpenPayer

Summary & Overview

CPT 28740: Midtarsal or Tarsometatarsal Joint Arthrodesis with Fixation

CPT code 28740 denotes surgical arthrodesis with fixation of a single midtarsal or tarsometatarsal (Lisfranc) joint. This procedure is used to permanently immobilize degenerative, traumatic, or deformity-related midfoot joints to relieve pain, restore stability, and correct alignment. Nationally, it represents a focused orthopedic foot surgery with implications for surgical utilization, device use, and post-operative care pathways.

Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the code, typical sites of service, and payer coverage considerations. The publication summarizes benchmark utilization patterns, relevant coding guidance, and common modifier usage where applicable. It also outlines expected service line placement for hospital billing and ambulatory surgical settings.

The content is designed for billing managers, orthopedic clinicians, and policy analysts seeking a clear operational view of CPT code 28740, including how it fits into surgical workflows and payer interactions. Data not available in the input is identified where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 28740midtarsal arthrodesistarsometatarsal fusionfoot surgeryorthopedic procedureoperative fixationambulatory surgeryhospital surgery

Billing Code Overview

CPT code 28740 describes the surgical immobilization (arthrodesis) of a single midtarsal or tarsometatarsal (Lisfranc) joint using fixation devices. Midtarsal joints include the talus-navicular or calcaneus-cuboid articulations; tarsometatarsal joints include the cuneiforms and cuboid articulating with the metatarsal bases.

Service type: Surgical arthrodesis of a single midfoot joint using internal fixation.

Typical site of service: Hospital operating room or ambulatory surgery center for operative fixation of midtarsal or tarsometatarsal joints.

Clinical & Coding Specifications

Clinical Context

A 48-year-old recreational runner presents with persistent midfoot pain and instability after a twisting injury to the forefoot six weeks prior. Imaging (weight-bearing radiographs and CT) demonstrates disruption and subluxation of a single tarsometatarsal (Lisfranc) joint with incongruity and early post-traumatic arthritic change. Conservative management including immobilization and limited weight-bearing failed to relieve symptoms. The orthopedic foot and ankle surgeon schedules operative surgical arthrodesis of the affected single midtarsal/tarsometatarsal joint with internal fixation devices (screws and/or plates).

Clinical workflow: preoperative evaluation and informed consent in clinic; pre-op clearance and anesthesia assessment; intraoperative immobilization of the single midtarsal or tarsometatarsal joint using open exposure, joint preparation (cartilage removal), and fixation with appropriate implants; intraoperative fluoroscopic confirmation of alignment; postoperative recovery in PACU and immobilization in a cast or boot, with outpatient follow-up for wound check, radiographic union assessment, and progressive weight-bearing guidance.

Coding Specifications

Modifier	Description	When to Use
`50`	Bilateral Procedure	Use if identical arthrodesis is performed on both feet during the same operative session.

CPT 28737: Navicular‑Cuneiform Arthrodesis with Tibialis Posterior Lengthening

CPT-28725-SUBTALAR-JOINT-FUSION-ARTHRODESIS

CPT 28725: Subtalar Joint Fusion for Degenerative Arthritis or Trauma

CPT-28730-MIDTARSAL-TARSOMETATARSAL-JOINT-ARTHRODESIS-FIXATION

CPT 28730: Midtarsal and Tarsometatarsal Joint Arthrodesis with Fixation

CPT-28755-GREAT-TOE-INTERPHALANGEAL-JOINT-IMMOBILIZATION

CPT 28755: Great Toe Interphalangeal Joint Immobilization

CPT-28715-TRIPLE-ARTHRODESIS-HINDFOOT-FUSION

CPT 28715: Triple Arthrodesis (Hindfoot Fusion)

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

CPT 28760: Great Toe Interphalangeal Arthrodesis with Tendon Transfer

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

CPT 28750: Great Toe Metatarsophalangeal Joint Immobilization

LT

Taxonomy Code	Specialty	Notes
207X00000X	Orthopedic Surgery	Foot and ankle surgeons commonly perform tarsometatarsal or midtarsal arthrodesis.
2080P0221X	Podiatry	Podiatric surgeons perform forefoot and midfoot arthrodeses including Lisfranc procedures.
208000000X	General Surgery (Subspecialty: none)	Occasionally general surgeons with foot training in resource-limited settings perform such procedures; less common.
206E00000X	Physical Medicine & Rehabilitation	Involved in postoperative rehabilitation planning and nonoperative management prior to surgery.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M21.27`	Acquired deformity, other specified foot	Midfoot deformity leading to symptomatic joint dysfunction treated by arthrodesis.
`M20.14`	Hallux valgus (acquired), left foot	Concomitant forefoot deformity that may be evaluated and occasionally addressed in the same episode of care.
`S93.241A`	Sprain of tarsometatarsal joint of right foot, initial encounter	Acute Lisfranc injury that can progress to chronic instability requiring arthrodesis if unstable or malreduced.
`S93.242A`	Sprain of tarsometatarsal joint of left foot, initial encounter	Same as above for the left foot.
`M25.67`	Pain in ankle and joints of foot	Symptomatic midfoot pain indicating surgical consideration when refractory to conservative care.
`M19.071`	Primary osteoarthritis, right ankle and foot	Degenerative joint disease involving midfoot joints that may necessitate fusion.
`M19.072`	Primary osteoarthritis, left ankle and foot	Same as above for the left side.
`S93.231A`	Dislocation of tarsometatarsal joint of right foot, initial encounter	Severe Lisfranc dislocation that often requires surgical stabilization or fusion.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`28820`	Fusion, ankle, arthrodesis, with or without manipulation; tibiotalar and subtalar, combined	Performed in more proximal/rearfoot arthrodesis when adjacent joint disease exists or when combined fusion is required.
`28705`	Tenotomy, open, toe; flexor or extensor, single	Performed adjunctively for deformity correction of toes associated with midfoot pathology.
`20670`	Removal of deep implant, requires anesthesia only	Performed if previously placed hardware needs removal prior to or concurrent with arthrodesis.
`27630`	Transfer or repair procedures around the ankle/foot (example: not exact code)	Related soft-tissue procedures that may be performed in the same operative session to address deforming forces; surgeon documents exact code selection.
`28825`	Arthrodesis, midtarsal or tarsometatarsal, combined (multiple joints)	Performed when more than a single midtarsal/tarsometatarsal joint requires fusion; contrasts with `28740` which is a single-joint arthrodesis.

Note: The codes above represent commonly associated procedures performed before, during, or after single-joint midtarsal/tarsometatarsal arthrodesis for comprehensive management of midfoot pathology.

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