Surgical correction of hallux rigidus at the first metatarsophalangeal joint without implant, involving cheilectomy, joint debridement, and capsular release to restore motion and reduce pain.

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

• Confirmed diagnosis of hallux rigidus with documented clinical findings — pain, restricted dorsiflexion, and radiographic evidence of first MTP joint arthritis or osteophyte formation
• Operative note must specify each component performed: cheilectomy (with extent of bone resection), joint debridement, and capsular release — not just 'standard correction'
• Laterality clearly documented (left, right, or bilateral) in both the preoperative diagnosis and the operative note
• Implant status explicitly stated — note must confirm no implant was placed to distinguish 28289 from implant arthroplasty codes (28293 et al.)
• If additional procedures were performed at the same session (e.g., osteotomy, synovectomy), each must be independently documented with separate descriptions of distinct work
• Pre-operative conservative treatment attempts documented to support medical necessity — failed non-operative management supports surgical indication

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

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

Common denial reasons

The recurring reasons claims for CPT 28289 get rejected.

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

• Operative note bundled with an implant arthroplasty code (28293) without modifier when both procedures involve the same joint on the same date
• Missing laterality on claim or mismatch between laterality in the op note and the claim form
• Lack of radiographic or clinical documentation confirming hallux rigidus diagnosis — payers distinguish this from hallux limitus and may deny without supporting imaging
• Global period conflict — E/M or follow-up visit billed within the 90-day global without modifier 24 indicating an unrelated diagnosis
• Multiple-procedure reduction applied without modifier 51 when billed alongside other foot procedure codes in the same session