Surgical removal of a calcaneal bone spur, with or without release of the plantar fascia performed during the same operative session.

Verified May 8, 2026 · 7 sources ↓

Medicare: $530.41
Total RVUs: 15.88
Global, days: 90
Region: Foot & ankle

Drawn from CMSAAPCNyspmaMolinahealthcareFindacode

Documentation requirements

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

Source · Editorial brief grounded in 7 cited references ↓

Confirm the operative note names a calcaneal spur as the resected structure — not a general bone segment
State whether plantar fascial release was performed, even though it does not change code selection
Include preoperative imaging (X-ray or MRI) locating the spur to support medical necessity
Document failed conservative care (orthotics, injections, stretching, night splints) for at least 6 weeks prior to surgical authorization
Specify laterality — left foot, right foot, or bilateral — to support LT, RT, or 50 modifier use
Record anesthesia type and surgical approach in the operative note to satisfy audit requirements

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 50 Bilateral procedure 52 Reduced services 59 Distinct service 78 Unplanned return — related 79 Unrelated during global LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 7 cited references ↓

28119 covers ostectomy of the calcaneus performed specifically to excise a heel spur. The code applies regardless of whether the surgeon also releases the plantar fascia — that component is bundled into 28119 and does not warrant a separate fasciotomy code. The operative approach (open lateral incision, endoscopic-assisted, etc.) does not change the code selection; 28119 is approach-agnostic.

The critical distinction from a neighboring code: if the surgeon removes a portion of the calcaneus itself rather than a discrete spur, use 28118 instead. Miscoding the two is a common audit flag. Document explicitly that a spur was the target of excision, not a general ostectomy of calcaneal bone.

This code carries a 90-day global period. Any E/M visit or procedure billed during that window for a related reason requires modifier 24 or 79 respectively. If the patient returns to the OR for a complication directly tied to the spur removal, use modifier 78. An unrelated foot or ankle procedure during the global period uses modifier 79.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	5.42
Practice expense RVU	9.87
Malpractice RVU	0.59
Total RVU	15.88
Medicare national rate	$530.41
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	$530.41
HOPD (APC 5113) Hospital outpatient department	$3,342.87
ASC (PI A2) Ambulatory surgical center (freestanding)	$1,644.87

Common denial reasons

The recurring reasons claims for CPT 28119 get rejected.

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

Medical necessity denied when conservative treatment documentation is absent or less than 6 weeks
Claim miscoded as 28118 (general calcaneal ostectomy) when operative note describes spur excision — or vice versa
Separate fasciotomy or fascial release code (28060, 28062) billed alongside 28119, triggering a bundling edit
Missing laterality modifier causing claim rejection or processing delay with Medicare and many commercial payers
E/M or return visit billed during the 90-day global without modifier 24, leading to automatic denial

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 7 cited references ↓

01Can I separately bill a plantar fascial release (28060) when I also perform 28119?

No. Plantar fascial release is bundled into 28119 — the code description explicitly includes 'with or without plantar fascial release.' Billing 28060 or 28062 alongside 28119 for the same session will trigger a bundling edit.

02What is the difference between 28118 and 28119?

28119 is for excision of a discrete heel spur from the calcaneus. 28118 is for removal of a portion of the calcaneus itself without a specific spur target. The operative note must clearly identify which structure was removed — auditors flag cases where documentation is vague.

03How do I bill if the patient needs the same procedure on both feet during the same surgical session?

Append modifier 50 to 28119 for a bilateral procedure. Some payers require separate line items with LT and RT instead. Verify the payer's bilateral billing preference before submitting.

04What ICD-10 code supports 28119?

M77.31 (calcaneal spur, right foot) and M77.32 (calcaneal spur, left foot) are the primary diagnosis codes. M72.2 (plantar fascial fibromatosis) may apply when fascial pathology is the dominant finding, but confirm laterality-specific coding.

05Does 28119 have a global period, and what does that mean for post-op care?

28119 carries a 90-day global. Routine post-op visits, dressing changes, and suture removal within that window are bundled — bill them separately only with modifier 24 (unrelated E/M) or 79 (unrelated procedure). A related return to the OR uses modifier 78.

06Is a corticosteroid injection billed separately if given during the same session?

If the surgeon performs a corticosteroid injection at the plantar fascia or spur site on the same day as 28119, use 20551 with modifier 59 to indicate a distinct service. Document the injection separately in the operative or procedure note.

Sources & references

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

Mira AI Scribe

Mira's AI scribe captures the spur location on the calcaneus, whether plantar fascial release was performed, the surgical approach, and laterality directly from dictation. It also flags conservative treatment duration from the clinical note to pre-populate medical necessity documentation. This prevents the two most common denials: missing laterality and inadequate documentation of failed non-surgical management.

See how Mira captures CPT 28119 documentation