Surgical capsulotomy or capsulectomy releasing contracture at one or more midfoot joints to restore mobility.

Verified May 8, 2026 · 5 sources ↓

Medicare: $758.20
Total RVUs: 22.7
Global, days: 90
Region: Foot & ankle

Drawn from CMSAAOS

Documentation requirements

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

Source · Editorial brief grounded in 5 cited references ↓

Identify the specific midfoot joint(s) released by anatomical name (e.g., tarsometatarsal, calcaneocuboid, talonavicular)
Document failed conservative treatment prior to surgical intervention, including duration and modalities tried
Describe the surgical approach — incision location, capsular structures incised or excised, and extent of release
Record pre- and post-release range of motion or intraoperative findings demonstrating deformity correction
Specify laterality (left vs. right foot) in both the operative note and on the claim
If multiple procedures performed same session, document each as a distinct surgical step with independent medical necessity

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 51 Multiple procedures 59 Distinct service LT Left side RT Right side 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon AS PA/NP/CNS assistant XS Separate structure

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

CPT 28260 covers open surgical release of a midfoot joint — most commonly performed to address capsular contracture, rigid midfoot deformity, or stiffness that hasn't responded to conservative care. The procedure involves incising or excising the joint capsule at the midfoot (e.g., tarsometatarsal, midtarsal, or related articulations) to restore range of motion. It carries a 90-day global period, meaning all routine postoperative care through day 90 is bundled into the surgical payment.

Podiatry dominates utilization of this code per CMS Physician Utilization File data. When 28260 is performed alongside other foot reconstructive procedures — osteotomies, tendon transfers, or hardware removal — sequencing matters. List the highest-RVU code first and append modifier 51 to secondary procedures. If a separate capsulotomy is performed on a different anatomic site during the same session, modifier 59 or XS may be required to bypass NCCI bundling edits.

Documentation must establish medical necessity: conservative treatment failure, functional limitation, and a clear description of which joint(s) were released. Vague operative notes citing only 'midfoot release' without naming the specific joint(s) are a top audit trigger. Intraoperative findings, the surgical approach, and the extent of capsular work performed should all be explicit.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	7.99
Practice expense RVU	13.47
Malpractice RVU	1.24
Total RVU	22.7
Medicare national rate	$758.20
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	$758.20
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 28260 get rejected.

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

Operative note lacks specific joint identification — 'midfoot release' without naming the joint triggers medical necessity denials
Bundling conflict when 28260 is billed alongside another foot reconstruction code without modifier 51 or 59
Missing laterality modifier (LT or RT) causing claim rejection or payer-specific denial
Insufficient documentation of conservative treatment failure to support medical necessity of surgical release
Global period conflict — billing a related E/M or procedure within the 90-day post-op window without modifier 24 or 79

Frequently asked questions

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

01What is the global period for CPT 28260?

28260 carries a 90-day global period. All routine postoperative visits, wound checks, and stitch removals through day 90 are bundled. Use modifier 24 for unrelated E/M visits and modifier 79 for unrelated procedures within that window.

02Do I need a laterality modifier for 28260?

Yes. Append LT or RT on every claim. Most payers require laterality for foot/ankle codes, and missing it is a common clean-claim failure.

03Can 28260 be billed with an osteotomy like 28300 on the same day?

Yes, but sequence the higher-RVU procedure first and append modifier 51 to 28260 as the secondary procedure. Verify there are no active NCCI PTP edits between the two codes before submitting.

04What ICD-10 diagnoses best support 28260?

Acquired midfoot deformity, joint contracture of the foot, and rigid flatfoot diagnoses align with this procedure. The diagnosis must reflect a structural or functional midfoot problem that necessitates surgical release, not just pain alone.

05When would modifier 22 apply to 28260?

Append modifier 22 when the capsular release is significantly more complex than typical — for example, extensive adhesion takedown following prior surgery or trauma. You need contemporaneous documentation describing the increased time and difficulty; a cover letter with the claim accelerates adjudication.

06Is 28260 performed in an ASC or HOPD setting?

Both settings are viable. HOPD and ASC facility payments differ — see the Site of Service comparison on this page. The professional fee is the same regardless of setting, but site-of-service differential can affect patient cost-sharing and payer authorization requirements.

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 specific midfoot joint(s) released, the surgical approach, intraoperative range-of-motion findings, and extent of capsular work directly from dictation. It also flags laterality and links the procedure to documented conservative treatment failure in the record — preventing the vague 'midfoot release' operative note that draws audit scrutiny and medical necessity denials.

See how Mira captures CPT 28260 documentation