Surgical incision of the capsule surrounding a toe interphalangeal joint to release a contracture, correct deformity, or restore range of motion — reported per joint released.

Verified May 8, 2026 · 6 sources ↓

Medicare: $377.10
Work RVU: 3.82
Global, days: 90
Region: Foot & ankle

Drawn from CMSAAPCNIHBeckersspineAbos

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

Identify the specific toe and joint level (e.g., proximal IP of 2nd toe, distal IP of 3rd toe) — 'toe capsulotomy' alone is not sufficient for audit.
State the clinical indication: contracture, acquired deformity, hammertoe, or congenital clubfoot deformity requiring IP joint release.
Describe the capsular structure incised and confirm the joint entered; do not use generic language like 'standard approach.'
If billing multiple units, document that each release was performed on a distinct, separately identified joint.
If unbundling from 28285, document that the capsulotomy was performed on a different joint than the hammertoe repair, and note both joint locations explicitly.

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 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 6 cited references ↓

28272 covers an open capsulotomy of a toe interphalangeal (IP) joint, where the surgeon incises the joint capsule to break down a contracture, improve alignment, or address a congenital deformity such as clubfoot. The descriptor reads 'each joint,' making it a per-joint code — if you release two IP joints on the same foot in the same session, you report 28272 twice with modifier 51 on the second unit. The 90-day global period means all routine follow-up through day 90 is bundled; unrelated services in that window need modifier 79, and related returns to the OR need modifier 78.

The critical NCCI trap with this code: 28272 is bundled into hammertoe repair 28285 when both are performed on the same joint at the same session. Modifier 59 (or XS for a distinct anatomical site) can unbundle them only when the capsulotomy is performed on a separate joint from the hammertoe repair — not the same joint, same session. Document the specific joint(s) operated on by name and anatomical position (e.g., proximal IP of the second toe, distal IP of the third toe) to support any unbundling.

This code is billed predominantly by podiatry. Orthopedic surgeons performing foot reconstruction should verify that their ICD-10 diagnosis (contracture, acquired deformity, hammertoe, clubfoot) directly supports the indication and that the operative note names the specific joint, the approach, and the capsular structure incised — not just 'capsulotomy performed.'

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 (3.82) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (11.29) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	3.82
Practice expense RVU	7.12
Malpractice RVU	0.35
Total RVU	11.29
Medicare national rate	$377.10
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	$377.10
HOPD (APC 5112) Hospital outpatient department	$1,642.82
ASC (PI P3) Ambulatory surgical center (freestanding)	$239.34

Common denial reasons

The recurring reasons claims for CPT 28272 get rejected.

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

Bundled into 28285 (hammertoe repair) when both codes are billed for the same joint at the same session without a valid distinct-site modifier.
Operative note lacks specific joint identification — payers and audit contractors flag notes that say 'toe joint released' without naming the toe and joint level.
Diagnosis code does not support surgical necessity; ensure ICD-10 reflects contracture, deformity, or clubfoot — not a vague pain diagnosis.
Multiple units of 28272 denied when modifier 51 is missing on the second and subsequent units billed in the same session.
Global period conflict — post-op services billed without modifier 79 (unrelated) or 78 (related return to OR) during the 90-day global window.

Frequently asked questions

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

01Can I bill 28272 and 28285 together on the same claim?

Only if the capsulotomy and the hammertoe repair are performed on different joints. NCCI bundles 28272 into 28285 when both are done on the same joint in the same session. If the sites are truly distinct, append modifier 59 or XS to 28272 and document both joint locations explicitly in the operative note.

02How do I bill when I release IP joints on three separate toes in one session?

Report 28272 for each joint released. The first unit is the primary procedure; append modifier 51 to the second and third units. Document each joint by toe number and joint level (proximal or distal IP) in the operative note.

03Is 28272 bilateral? Can I use modifier 50?

If you perform IP joint capsulotomies on both feet in the same session, modifier 50 applies to indicate a bilateral procedure. If the procedure is only on one foot, use LT or RT as appropriate — some payers require laterality modifiers on all foot and toe codes.

04What is the global period for 28272 and what does it include?

The global period is 90 days. It covers the day-before preoperative visit, the procedure, and all routine post-op care through day 90 — including office visits, dressings, and suture removal. Bill modifier 79 for unrelated procedures in that window; modifier 78 for an unplanned related return to the OR.

05Which ICD-10 codes most commonly pair with 28272?

M20.40–M20.42 (acquired hammertoe deformities), M24.37x (contracture of joint, ankle and foot), and Q66.89 (congenital foot deformity including clubfoot variants not covered by more specific codes) are the most common pairings. The diagnosis must reflect an anatomic deformity or contracture — not a pain-only code — to establish medical necessity.

06Does 28272 require modifier 22 for a more complex release?

Modifier 22 is defensible when the contracture severity, scarring from prior surgery, or anatomical complexity required substantially more work and operative time than typical. You must attach documentation quantifying the additional time and effort — a sentence in the operative note saying 'significantly increased complexity' without detail will not survive payer review.

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 toe, joint level (proximal vs. distal IP), laterality, surgical indication (contracture, deformity, clubfoot), and the capsular structure incised from the surgeon's dictation. That detail is written directly into the operative note, preventing the vague documentation that triggers NCCI audit flags and same-joint bundling denials with 28285.

See how Mira captures CPT 28272 documentation