Osteotomy of the calcaneus (heel bone) to correct foot alignment, with or without internal fixation — encompasses Dwyer, Chambers, and sliding-type procedures.

Verified May 8, 2026 · 5 sources ↓

Medicare: $611.24
Total RVUs: 18.3
Global, days: 90
Region: Foot & ankle

Drawn from CMSTldsystemsCgsmedicare

Documentation requirements

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

Source · Editorial brief grounded in 5 cited references ↓

Name the specific osteotomy technique performed (e.g., Dwyer lateral closing-wedge, Evans lateral column lengthening, medializing slide) — 'calcaneal osteotomy' alone is insufficient for audit purposes.
Document the pre-op diagnosis with supporting imaging: ICD-10 code for pes planus, cavus, or specific heel deformity must match the operative indication.
Specify whether internal fixation was placed (screw size, type, and number) or explicitly state none was used; this affects implant billing and post-op instructions.
Record the laterality (left or right foot) in both the pre-op diagnosis and operative note to support LT/RT modifiers on the claim.
If performed concurrently with another foot procedure (e.g., 28740 or 28310), the operative note must document distinct anatomic sites or separate incisions to support modifier 59.
Document failed conservative treatment (orthotics, PT, activity modification) to establish medical necessity for surgical intervention.

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 50 Bilateral procedure 51 Multiple procedures 59 Distinct service 62 Co-surgeons 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon AS PA/NP/CNS assistant LT Left side RT Right side XS Separate structure

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

28300 covers a surgical osteotomy of the calcaneus performed to correct heel alignment problems, including pes planus (flatfoot), cavus foot, and valgus or varus heel deformity. The surgeon creates a controlled bone cut through the calcaneus and repositions the fragment — lateralizing, medializing, or angulating — then stabilizes the construct with or without screws, staples, or other internal fixation hardware. Common named techniques include the Dwyer (lateral closing-wedge), Chambers, and Evans (lateral column lengthening) osteotomies; 28300 captures all of them.

The 90-day global period means all routine post-op management through day 90 is bundled. Hardware removal (20680) is not separately billable if it's an integral step of a revision at the same site. Wound closure is included per NCCI global surgery rules — don't bill 12001–13153 for incision closure.

When 28300 is performed alongside other foot procedures — for example, a midtarsal arthrodesis (28740) or proximal phalanx osteotomy (28310) — NCCI bundles 28300 as a column 2 code under 28740. If distinct anatomic structures justify separate reporting, append modifier 59 to 28300. Laterality modifiers (LT/RT) are required; bilateral calcaneal osteotomy is unusual but would use modifier 50 with payer-specific 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	9.49
Practice expense RVU	7.2
Malpractice RVU	1.61
Total RVU	18.3
Medicare national rate	$611.24
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	$611.24
HOPD (APC 5114) Hospital outpatient department	$7,413.38
ASC (PI J8) Ambulatory surgical center (freestanding)	$4,682.29

Common denial reasons

The recurring reasons claims for CPT 28300 get rejected.

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

Missing or vague osteotomy technique: operative notes that say 'calcaneal osteotomy performed' without naming the approach or describing the cut direction trigger medical necessity reviews.
NCCI bundle conflict with 28740 (midtarsal arthrodesis): 28300 is a column 2 code to 28740; claims submitted without modifier 59 on 28300 are automatically denied when both codes appear on the same date.
Laterality omitted: claims lacking LT or RT are rejected by most Medicare MACs and many commercial payers for unilateral foot surgery codes.
Post-op E&M billed without modifier 24: routine follow-up visits within the 90-day global are bundled; billing them separately without modifier 24 (unrelated condition) results in denial.
Hardware removal (20680) billed with 28300 revision when removal was integral to the operative approach — NCCI policy prohibits separate reporting in that scenario.

Frequently asked questions

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

01Does 28300 include internal fixation, or is there a separate add-on code for hardware?

Internal fixation is included in 28300 — the code descriptor explicitly covers 'with or without internal fixation.' There is no separate CPT add-on for screws or staples used to stabilize the calcaneal osteotomy.

02Can I bill 28300 and 28740 together on the same date?

NCCI lists 28300 as a column 2 code to 28740. You can bill both only if the procedures were performed through separate incisions or on clearly distinct structures, and you append modifier 59 to 28300. Document the distinct anatomy explicitly in the operative note.

03What ICD-10 codes typically support medical necessity for 28300?

Common supporting diagnoses include M21.4x (flatfoot), M21.51–M21.52 (acquired cavus foot), Q66.5x (congenital pes planus), and M89.87x (other disorders of bone, ankle and foot). The diagnosis must reflect a structural deformity unresponsive to conservative care.

04How do I bill for hardware removal if the calcaneal hardware needs to come out after healing?

If removal occurs during the 90-day global, it's bundled unless a separate unrelated procedure applies. After the global, bill 20680 for deep implant removal with appropriate diagnosis. If hardware removal is integral to a revision osteotomy at the same site, 20680 is not separately reportable per NCCI policy.

05Is fluoroscopic guidance separately billable with 28300?

Generally no. NCCI policy treats fluoroscopy as integral to musculoskeletal osteotomy procedures. Unless a MAC or payer has an explicit exception, CPT 76000 should not be reported alongside 28300.

06What modifier applies if the surgeon returns the patient to the OR for bleeding control related to the original calcaneal osteotomy?

Use modifier 78 — unplanned return to the OR for a complication related to the original procedure during the global period. Modifier 79 is for unrelated procedures and would be incorrect here.

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 osteotomy technique by name (Dwyer, Evans, medializing slide), the direction and level of the bone cut, fixation hardware used (or explicitly none), and the laterality — all from the surgeon's dictation. That prevents the two most common audit flags: vague approach documentation and missing laterality. If a concurrent foot procedure is dictated, the scribe flags the NCCI bundle with 28740 and prompts for distinct-site documentation to support modifier 59.

See how Mira captures CPT 28300 documentation