Surgical incision of the metatarsophalangeal joint capsule to release contracture and restore range of motion, with optional tendon repair at the same joint.

Verified May 8, 2026 · 7 sources ↓

Medicare: $488.66
Total RVUs: 14.63
Global, days: 90
Region: Foot & ankle

Drawn from CMSAAPCTldsystemsAAOSAetna

Documentation requirements

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

Source · Editorial brief grounded in 7 cited references ↓

Identify the specific MTP joint(s) released by toe number and laterality (left/right)
Document whether tenorrhaphy was performed and describe tendon work in detail
Describe the surgical approach — open incision versus percutaneous technique
Record pre-operative range of motion deficit and intra-operative findings supporting contracture diagnosis
If billing alongside 28285, document that the capsulotomy was performed at a separate, distinct joint with clear anatomical justification for modifier 59 or XS
Include anesthesia type and any intraoperative complications or additional work supporting modifier 22 if applicable

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 25 Significant separate E/M 51 Multiple procedures 57 Decision for surgery 58 Staged or related 59 Distinct service 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 7 cited references ↓

CPT 28270 covers an open or percutaneous capsulotomy at one metatarsophalangeal (MTP) joint, performed to correct a fixed contracture that limits motion and causes pain. The surgeon incises the joint capsule to release tight soft-tissue structures; if the tendon requires repositioning or reinforcement, tenorrhaphy is performed at the same operative site. The code is reported per joint — if multiple MTP joints are released in the same session, bill 28270 for each with the appropriate anatomical modifier.

The 90-day global period means all routine post-op visits, wound checks, and dressing changes through day 90 are bundled. Any unrelated procedure during that window needs modifier 79; an unplanned return to the OR for a related complication requires modifier 78. If the decision for surgery is made the day of or day before, append modifier 57 to the E/M.

The most consequential NCCI issue for this code: 28270 is a column 2 component code to 28285 (hammertoe correction). CCI bundles them by default, but the edit carries a modifier indicator of '1', meaning you can break the bundle with modifier 59 or XS when the capsulotomy is performed on a distinct structure or at a distinctly separate joint from the hammertoe repair. Verify payer policy before doing so — some payers require additional documentation.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	4.81
Practice expense RVU	9.32
Malpractice RVU	0.5
Total RVU	14.63
Medicare national rate	$488.66
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	$488.66
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 28270 get rejected.

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

Bundled into 28285 hammertoe repair without modifier 59 or XS to unbundle the NCCI column 2 edit
Missing laterality — claim submitted without LT or RT when payer requires anatomical modifier
ICD-10 diagnosis does not support MTP contracture (e.g., sprain or subluxation codes instead of contracture/deformity codes)
Multiple units billed without per-joint documentation specifying each toe treated
Post-op visit billed without modifier 24 or 79 during the 90-day global period

Frequently asked questions

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

01Can I bill 28270 for every MTP joint released in the same session?

Yes. The code is defined per joint. Bill one unit of 28270 per MTP joint released, appending LT or RT and listing each toe. Use modifier 51 on the secondary units when required by the payer.

02Can I bill 28270 and 28285 together on the same claim?

Not without a modifier. NCCI designates 28270 as a column 2 component code to 28285. The edit has a modifier indicator of '1', so you can unbundle with modifier 59 or XS — but only when the capsulotomy is genuinely performed at a separate, distinct joint from the hammertoe repair. Document the anatomical distinction clearly, and confirm the payer accepts the unbundle before submitting.

03Is a percutaneous capsulotomy at the MTP joint still billed as 28270?

Yes. There is no separate CPT code for a percutaneous MTP capsulotomy. Whether the approach is open or percutaneous, 28270 is the correct code. Append RT or LT for laterality.

04What ICD-10 codes support medical necessity for 28270?

Contracture and rigid deformity codes are the strongest support — M20 series (acquired deformities of fingers/toes) and M72 series are commonly used. Sprain and subluxation codes (S93.1xx range) are listed by at least one major payer as not covered for this procedure, so verify diagnosis accuracy before billing.

05Does modifier 57 apply when the decision for surgery is made at a same-day E/M?

Yes. Because 28270 carries a 90-day global period, modifier 57 is required on the E/M when the decision for surgery is made the day of or the day before the procedure. Without it, the E/M folds into the global and won't pay separately.

06Can 28270 and 28010 (percutaneous tenotomy, toe) be billed together at the same MTP joint?

No, even though NCCI does not bundle them as a code pair. When both are performed at the same anatomical site as part of the same operative encounter, billing both is not supportable. Report only 28270 in that scenario, per published podiatric coding guidance.

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 MTP joint number and laterality, surgical approach, presence or absence of tenorrhaphy, pre-op range of motion findings, and intraoperative contracture confirmation from dictation. That detail directly prevents the two most common denials for 28270: missing laterality causing automated rejections and insufficient documentation when modifier 59 is needed to unbundle from a same-session 28285.

See how Mira captures CPT 28270 documentation