Summary & Overview
CPT 28760: Great Toe Interphalangeal Arthrodesis with Tendon Transfer
CPT code 28760 represents surgical arthrodesis of the great toe interphalangeal joint combined with transfer of the extensor hallucis longus tendon to the metatarsal. This procedure is used primarily to address pain and functional loss from end-stage osteoarthritis or severe deformity of the interphalangeal joint of the hallux. Nationally, the code denotes a targeted foot and ankle reconstructive service that intersects orthopedics and podiatry and has implications for surgical utilization, coverage determinations, and postacute care planning.
Key payers relevant to coverage and payment include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context for the procedure, typical sites of service (ambulatory surgery centers and hospital operating rooms), and the reasons the code is used. The publication outlines billing-related elements such as common modifiers (provided separately), expected service line placement, and typical clinical indications. It also highlights areas where payers commonly focus prior authorization, medical necessity review, and documentation expectations for reimbursement. Data not available in the input are noted where applicable.
Billing Code Overview
CPT code 28760 describes a surgical procedure to arthrodese (immobilize) the interphalangeal joint of the great toe accompanied by transfer of the extensor hallucis longus tendon from its phalangeal insertion to the metatarsal. The operation is typically performed to relieve pain and dysfunction associated with end-stage osteoarthritis or severe degenerative conditions of the great toe interphalangeal joint.
-
Service type: Surgical procedure — toe joint arthrodesis with tendon transfer
-
Typical site of service: Ambulatory surgery center or hospital operating room with postoperative recovery; may involve same-day or short inpatient stay depending on clinical circumstances
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A typical patient is an older adult with chronic, progressive pain and deformity of the great toe interphalangeal (IP) joint after failed conservative care. The patient reports worsening dorsomedial pain, activity-limiting stiffness, and difficulty with ambulation despite shoe modifications, orthotics, nonsteroidal anti-inflammatory drugs, and corticosteroid injection. Examination shows painful end-range motion at the great toe IP joint, dorsal prominence, and weakness of toe extension. Radiographs demonstrate end-stage osteoarthritis of the hallux interphalangeal joint with joint space loss and osteophyte formation.
The clinical workflow begins with an office evaluation by an orthopedic foot and ankle surgeon or podiatric surgeon, review of imaging, and documentation of failed conservative therapy and surgical indication. Preoperative clearance and informed consent occur in clinic. On the day of surgery, the patient undergoes regional or general anesthesia in an ambulatory surgery center or hospital operating room. The procedure includes surgical arthrodesis (fusion) of the great toe interphalangeal joint with fixation and concurrent transfer of the extensor hallucis longus (EHL) tendon from its distal phalangeal insertion to a metatarsal insertion to rebalance extensor forces. Postoperative care includes wound checks, weight-bearing instructions (varies by fixation method), pain control, and physical therapy as indicated, with radiographic follow-up to confirm fusion.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT |