Surgical removal or division of a nerve in the foot, typically performed to relieve pain from a neuroma or nerve entrapment.

Verified May 8, 2026 · 5 sources ↓

Medicare: $371.75
Work RVU: 6.13
Global, days: 90
Region: Foot & ankle

Drawn from CMSAAPCMdclarityMortonsneuromaNeuromatreatmentcenternyc

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 5 cited references ↓

Specific nerve and web space involved (e.g., third interdigital nerve, third web space) — 'foot nerve' alone is insufficient
Surgical approach documented by name (dorsal vs. plantar incision) with incision location
Confirmation that the transverse metatarsal ligament was divided and nerve was resected proximal to the neuroma
Failed conservative treatment documented in the pre-op record (e.g., orthotics, corticosteroid injections, alcohol sclerosing) to support medical necessity
Pathology submission noted if specimen sent — supports completeness of excision
Laterality explicitly stated (left vs. right foot) in the operative note and on the claim

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 24 Unrelated E/M during global 50 Bilateral procedure 51 Multiple procedures 59 Distinct service 76 Repeat, same physician 78 Unplanned return — related 79 Unrelated during global LT Left side RT Right side XS Separate structure

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

CPT 28055 covers excision of a foot nerve — most often the interdigital nerve in the setting of Morton's neuroma, but applicable to other painful foot nerve conditions as well. The surgeon exposes the nerve through a dorsal or plantar incision, divides the transverse metatarsal ligament to access the web space, frees the nerve from surrounding soft tissue, and resects it proximal to the neuroma to prevent recurrence. The excised segment is typically sent to pathology. Permanent numbness in the affected web space is an expected outcome, not a complication.

The 90-day global period covers all routine post-op care through day 90. New or unrelated problems evaluated during that window require modifier 24 on the E/M. If a complication forces a return to the OR for a related procedure — such as hematoma evacuation or stump neuroma revision — bill modifier 78. An unrelated surgical procedure in the same global window takes modifier 79.

Site of service matters here. The HOPD and ASC payment rates differ substantially; when the procedure is performed at an ASC, the facility fee drops significantly compared to hospital outpatient. Surgeons doing high volume of Morton's neuroma cases should confirm their preferred site of service is reflected accurately on the claim, as mismatched POS codes are a common audit trigger.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU vs. total RVU

The work RVU (6.13) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (11.13) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	6.13
Practice expense RVU	4.31
Malpractice RVU	0.69
Total RVU	11.13
Medicare national rate	$371.75
Global period	90 days

Payment by site of service

Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.

Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026

Setting	Medicare rate (national)
Office (PFS non-facility) Procedure performed in physician's office	$371.75
HOPD (APC 5431) Hospital outpatient department	$1,995.02
ASC (PI A2) Ambulatory surgical center (freestanding)	$948.66

Common denial reasons

The recurring reasons claims for CPT 28055 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

Lack of documented conservative treatment failure before surgical authorization — most payers require a defined trial period
Laterality missing or mismatched between operative note, claim form, and modifier (LT/RT)
Bundling with same-day injection or other foot procedure without modifier 59 or XS when separate anatomic sites are involved
ICD-10 diagnosis code not mapped to a nerve-specific condition — using a generic foot pain code instead of G57.6x (Morton's neuroma) triggers medical necessity edits
Global period violation — post-op E/M billed without modifier 24 when visit is flagged as routine follow-up

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 5 cited references ↓

01Can 28055 be billed bilaterally in the same session?

Yes. If neurectomies are performed on both feet in the same operative session, append modifier 50. Some payers require LT and RT on separate line items instead — verify your payer's preference before submitting.

02What ICD-10 code supports 28055 for Morton's neuroma?

G57.60 (Morton's neuroma, unspecified lower limb), G57.61 (right), or G57.62 (left) are the primary diagnosis codes. Use the laterality-specific code and confirm it matches your LT/RT modifier. Generic M79.671–M79.672 foot pain codes are frequently flagged as insufficient to establish medical necessity for a neurectomy.

03Is an injection at the same visit bundled with 28055?

A corticosteroid injection into the same web space on the same day will likely bundle. If the injection is at a distinct anatomic site, append modifier 59 or XS and document the separate site clearly in the operative note.

04What modifier applies if the patient returns for a stump neuroma revision within the global period?

Modifier 78 — unplanned return to the OR for a procedure related to the original surgery. Do not use modifier 79, which is reserved for procedures unrelated to the original surgery.

05Does 28055 require prior authorization?

Most commercial payers and Medicare Advantage plans require documented failure of conservative care — typically 3–6 months of orthotics, padding, and/or injections. Check each plan's LCD or coverage policy; some require imaging (MRI or ultrasound) confirming the neuroma before approving surgical intervention.

06How does the 90-day global period affect post-op E/M billing?

Routine post-op visits within 90 days are included in the global package — bill nothing for those. If you evaluate a new, unrelated problem at a post-op visit, bill the appropriate E/M with modifier 24 and document clearly that the visit addressed a condition separate from the neurectomy.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira Scribe

Mira's AI scribe captures the web space number, surgical approach (dorsal vs. plantar), laterality, ligament division, proximal nerve transection point, and whether the specimen was sent to pathology — all from the surgeon's dictation. That prevents the two most common audit flags: a vague operative note that just says 'neuroma excised' and a laterality mismatch between the note and the claim.

See how Mira captures CPT 28055 documentation