Podiatry CPT surgical codes change every few years. Knowing these changes is not only necessary for the billing and coding team, but it also serves as the backbone for a seamless revenue cycle. In this blog, we will delve into the most common surgical CPT codes used in podiatry and explore how to maximize the benefits from them. Read till the end and get the latest news to improve your podiatry practices today. Still, if you are facing constant billing challenges, Medheave is here to sort them out.
What Are CPT Codes?
CPT or current procedural terminology codes are 5-digit numeric and alphanumeric codes that correspond to the medical services provided by the doctor. Podiatry CPT codes are specifically used for surgical procedures about foot care surgeries. There are four categories of CPT codes used for a specific purpose. These four categories are:
Category I
Category I codes are numeric codes used for common procedures and don’t contain alphabets, like bunionectomy CPT code 28296.
Category II
These are performance measurement codes that have four digits followed by the letter “F”, like 2022F, 2023F, etc.
Category III
These CPT codes contain 4-digit numbers followed by the letter “T” that describe tracking of results from new devices or technologies, like 0648T, etc.
Proprietary Laboratory Analyses (PLA) Codes
These CPT codes are a subset of CPT codes used for a specific (proprietary) laboratory test performed at a certain laboratory or company.
Understanding the Complexities of CPT Codes in Podiatry
Understanding the nuances of CPT codes is an important factor for podiatry clinics. CPT codes are updated regularly; thus, knowing them eases the billing process. Before moving towards the CPT codes used in podiatry surgeries, we will first look for the answer to why CPT codes are so complex.
Frequent Updates & Variability
AMA (American Medical Association) updates the CPT codes frequently, requiring podiatry coders to use new codes for various procedures. These annual updates also outline steps to avoid using outdated codes.
Modifier Challenges
Besides frequent CPT and ICD-10 code updates, the medical billing team also needs to add modifiers like (e.g.,-25,-59). These modifiers help define whether the rendered services are bundled or separate.
Documentation Requirements
Medical necessity for podiatry surgery is compulsory for procedures like ingrown toenail surgery, bunion correction, hammertoe repair, corn/callus removal, and treatments for plantar fasciitis involving injections, etc. If you fail to do so, it will result in claim denial.
Preauthorization & Coverage Rules
Prior authorization is required for every DME and orthotic device issued to patients. Coverage of Medicare, Medicaid, and commercial payers varies significantly, thus it presents a unique challenge for the podiatry revenue cycle management.
Overlap of CPT & HCPCS Codes
Foot and ankle surgical coding may overlap with HCPCS coding if the procedure involves follow-up visits for DME and orthotic measurements for device setup. Any misalignment between these codes triggers compliance issues, resulting in audits.
Payer Scrutiny & Compliance
Foot and ankle care clinics are under 24/7 monitoring by the payers due to high-value claims and compilation of procedures. For providers, 2026 may prove to be even more challenging, and a small coding error may trigger lengthy compliance audits by the payers.
Common Surgical CPT Codes in Podiatry
Most commonly used surgical current procedural terminology codes in podiatry are as follows:
Bunion Surgery (Hallux Valgus)
- 28292 – Correction, hallux valgus (bunion), with or without sesamoidectomy
- 28296 – Bunionectomy with metatarsal osteotomy
Hammer Toe Surgery
28285 – Correction of hammer toe (single toe)
Neuroma Excision
- 28080 – Excision of interdigital neuroma (e.g., Morton’s neuroma)
Arthrodesis (Joint Fusion)
- 28750 – Arthrodesis, great toe
- 28740 – Arthrodesis, midtarsal or tarsometatarsal joint
Achilles Tendon Repair
- 27691 – Repair, primary, open or percutaneous, Achilles tendon
Bone Excision
- 28160 – Partial excision of bone (tarsal/metatarsal)
- 28110 – Excision of bone cyst or benign tumor, foot
Osteotomy
- 28308 – Osteotomy of metatarsal (single), often combined with bunion or deformity correction.
Essential Modifiers for Podiatry Surgery
Modifiers play a vital role in podiatry billing and coding. Here we will share the list of some common podiatry surgery modifiers so your team can bill patients easily.
Laterality Modifiers
Laterality modifiers are used to describe which side of the foot is treated by the podiatrist. In podiatry coding and billing, –RT is used for procedures performed on the right foot, ankle, or leg. Similarly, LT means surgery or a debridement procedure on the left leg, foot, or ankle.
Toe Modifiers (TA–T9)
Procedures performed on the toe are billed using a specific modifier, like:
| Left Foot Modifiers | Right Foot Modifiers |
| TA: Left Great Toe | T5: Right Great Toe |
| T1: Left 2nd Digit | T6: Right 2nd Digit |
| T2: Left 3rd Digit | T7: Right 3rd Digit |
| T3: Left 4th Digit | T8: Right 4th Digit |
| T4: Left 5th Digit (Pinky) | T9: Right 5th Digit (Pinky) |
When to Use Modifier -50 (Bilateral)
If the same procedure is performed on both the left and right foot, then providers can add -50 modifiers in the billing. In case the procedure is inherently bilateral, then podiatry practices should avoid using it.
Common Pitfalls: Why Podiatry Claims Get Denied
In 2026, podiatry practices can take various steps to minimize claim denials. Let’s see what the overlooked causes of where you practice might be losing revenue.
Lack of Medical Necessity
In 2025, lack of medical necessity was the biggest culprit for all podiatry practices across the US. It resulted in more than 31% claim denials, resulting in $262 billion alone. Foot and ankle care hospitals have to be proactive in securing their hard-earned revenue by appropriately documenting systemic conditions like (e.g., Diabetes E11.42, Peripheral Vascular Disease I70.20).
Mandatory Laterality and Specificity (2026 Updates)
In the 2026 CPT coding guidelines, podiatry clinics are required to be specific about treatments being given. Laterality is key to expediting the claim process by accurately adding a modifier for the leg that received treatment. Additionally, details like the depth of the wound must be mentioned, like (e.g., subcutaneous vs. muscle vs. bone) for debridement procedures.
Prior Authorization & Timely Filing
Failure to obtain pre-auth from payers for procedures and DME devices mostly results in denials. In the case of Medicare and Medicaid, the claim filing time is 0-365 days, leading to complacency from the billing team. If the podiatry billing team obtains the prior authorization from the payers, the time that will be spent on rework can be reduced to zero, promoting a timely claim-filing culture.
Conclusion
In 2026, podiatry will remain a discipline under heavy scrutiny from the insurance companies. Many foot and ankle care treatments are under the routine care segment, requiring additional paperwork. Our guide containing this valuable information will help many podiatry practices in updating their billing knowledge. Understanding the nuances of medical billing can help clinicians increase their first pass rate and secure reimbursement from payers.
Outsourcing our podiatry billing services helps lower the claim denials and AR days. You can expect a minimum of 30% increase in the revenue collections and zero non-compliance risks or penalties
Frequently Asked Questions
Are CPT codes for surgical podiatry procedures changing frequently or occasionally?
Yes, CPT codes do change frequently, and it is utmost important for your billing team to stay abreast with new codes.
What are the most common CPT codes used in podiatric surgery?
Some of the most common CPT codes procedures include:
28292 – Bunionectomy (hallux valgus correction)
28285 – Hammer toe correction
28080 – Neuroma excision (Morton’s neuroma)
28750 – Arthrodesis of the great toe joint
How can podiatry practices reduce claim denials for surgical CPT codes?
Podiatry clinics can reduce their total claim denials by:
- Document medical necessity clearly (pain, functional impairment, failed conservative care)
- Use correct modifiers for laterality and multiple procedures.
- Stay updated on payer-specific rules and Local Coverage Determinations (LCDs), ICD-10, CPT, and HCPCS coding standards.
- Performing regular audits on gaps with the industry
