Surgical excision of a single interdigital (Morton) neuroma of the foot, performed as an open procedure.

Verified May 8, 2026 · 6 sources ↓

Medicare: $547.44
Work RVU: 4.74
Global, days: 90
Region: Foot & ankle

Drawn from CMSCgsmedicareAAPC

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

Specify which interspace(s) are affected (e.g., second, third) and laterality (left vs. right foot)
Document failed conservative treatment: duration, modalities tried (orthotics, corticosteroid injections, footwear modification), and patient response
Operative note must name the surgical approach (dorsal vs. plantar) and confirm the nerve segment was resected, not just released
Record nerve specimen dimensions and disposition — pathology submission supports medical necessity and audit defense
If billing multiple units for the same session, document each neuroma's interspace location distinctly in the operative note
Pre-op imaging or diagnostic workup (ultrasound or MRI) confirming neuroma, when obtained, should be referenced in the note

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 50 Bilateral procedure 51 Multiple procedures 58 Staged or related 59 Distinct service 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon 24 Unrelated E/M during global 25 Significant separate E/M LT Left side RT Right side XS Separate structure

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

CPT 28080 covers open excision of a single interdigital Morton neuroma — the benign perineural fibrosis that most commonly affects the third interspace, though first, second, and fourth interspaces are also treated with this code. The procedure involves resecting the affected segment of the common digital nerve, typically through a dorsal or plantar approach. Each neuroma excised is billed as a separate unit; if you remove neuromas from two distinct interspaces in the same foot during one session, you report 28080 twice with appropriate modifier 59 to distinguish separate lesions.

The 90-day global period means all routine post-op office visits, dressing changes, and wound checks through day 90 are bundled into the surgical payment. Any visit during that window for a separate, unrelated problem requires modifier 24 on the E&M. If the patient returns for a planned staged procedure, use modifier 58; for an unplanned return to the OR for a related complication, use modifier 78; for an unrelated return to the OR, use modifier 79. Distinguish these correctly — inverting 78 and 79 is an audit trigger.

Podiatry dominates the utilization data for 28080, but orthopedic foot and ankle surgeons bill it routinely. The HOPD and ASC settings carry materially different facility payments (see the Site of Service comparison table), making site selection a legitimate practice economics consideration. Payers including Medicare require conservative treatment failure documentation before authorizing surgical excision — missing that history is the most common prior auth and claim denial driver for this code.

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 (4.74) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (16.39) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	4.74
Practice expense RVU	11.1
Malpractice RVU	0.55
Total RVU	16.39
Medicare national rate	$547.44
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	$547.44
HOPD (APC 5112) Hospital outpatient department	$1,642.82
ASC (PI A2) Ambulatory surgical center (freestanding)	$872.87

Common denial reasons

The recurring reasons claims for CPT 28080 get rejected.

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

Absence of documented conservative treatment failure prior to surgery — most payers require 3–6 months of non-surgical management
Missing or ambiguous laterality and interspace identification, triggering a claim edit or request for records
Billing 28080 twice for the same interspace in the same foot without modifier 59 to establish separate lesion sites
Global period conflict: post-op E&M billed without modifier 24 when visit is unrelated, or modifier 24 applied incorrectly to routine follow-up
Upcoding flag when 28080 is billed with other foot soft-tissue excision codes on the same date without clear documentation of separate, distinct procedures

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 6 cited references ↓

01Can I bill 28080 twice if I excise neuromas from two interspaces in the same foot during one operative session?

Yes. 28080 is defined per lesion. Bill it twice with modifier 59 (or XS for a distinct structure) appended to the second unit to indicate separate lesion sites. The operative note must document each interspace individually by name.

02Does 28080 have a global period, and what does that mean for post-op visits?

28080 carries a 90-day global. Routine post-op visits, wound checks, and dressing changes within that window are bundled — bill no separate E&M. If you see the patient for an unrelated problem during the 90 days, append modifier 24 to the E&M code.

03What modifier applies if the patient returns to the OR for a wound complication related to the original neuroma excision?

Use modifier 78 for an unplanned return to the OR for a complication related to the original procedure. Modifier 79 is for an unrelated return to the OR — do not swap them.

04What ICD-10 diagnosis code typically pairs with 28080?

G57.6x (Lesion of plantar nerve — Morton metatarsalgia) is the primary diagnosis. Specify laterality with the appropriate 7th character: G57.61 (right foot), G57.62 (left foot), or G57.63 (bilateral). Mismatch between the operative laterality and the ICD-10 laterality is a common claim edit trigger.

05Is prior authorization commonly required for 28080?

Most commercial payers require it, and Medicare Advantage plans increasingly do as well. The standard threshold is documented failure of conservative treatment for 3–6 months. Prepare a summary of modalities attempted, duration, and patient response before submitting the auth request.

06Can 28080 be billed with a same-day E&M for the pre-operative decision to operate?

If the decision to perform the surgery is made at the same visit where the E&M occurs, modifier 57 applies to the E&M when the procedure has a 90-day global. Modifier 25 is for minor procedures (0 or 10-day global). Using 25 instead of 57 on a 90-day global procedure is a known audit flag.

Sources & references

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

Mira Scribe

Mira's AI scribe captures the specific interspace (e.g., third web space), foot laterality, surgical approach (dorsal or plantar), extent of nerve resection, and the surgeon's documentation of prior failed conservative care — all from dictation. That prevents the two most common denials for 28080: missing laterality on the claim and insufficient conservative-treatment history for prior authorization.

See how Mira captures CPT 28080 documentation