Surgical arthrodesis of multiple midtarsal or tarsometatarsal joints, performed as a single procedure regardless of how many joints are fused.

Verified May 8, 2026 · 8 sources ↓

Medicare: $678.37
Total RVUs: 20.31
Global, days: 90
Region: Foot & ankle

Drawn from AAPCPodiatrymMdclarityFindacodeAacpm

Documentation requirements

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

Source · Editorial brief grounded in 8 cited references ↓

Identify each joint fused by name (e.g., talonavicular, naviculocuneiform, first TMT, second TMT) — 'multiple midfoot joints' alone is insufficient for audit purposes.
Specify fixation method used (screws, staples, plates) and confirm hardware placement in the operative note.
Document bone graft type and harvest site; if ipsilateral, note it is not separately billable; if from a distant site, support the add-on graft code.
Record the clinical indication (e.g., Lisfranc arthritis, acquired flatfoot deformity, post-traumatic arthritis) with a corresponding ICD-10-CM code linking directly to each fused joint.
Note the surgical approach by name and confirm the operative note does not default to 'standard approach' language.
If an osteotomy was performed concurrently for flatfoot correction, document that separately to justify use of 28735 instead of 28730.

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 58 Staged or related 59 Distinct service LT Left side RT Right side 76 Repeat, same physician 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon

What this code covers

Source · Editorial summary grounded in 8 cited references ↓

28730 covers open arthrodesis of multiple midtarsal or tarsometatarsal (Lisfranc) joints in a single operative session. The midtarsal joints include the talonavicular and calcaneocuboid articulations; the tarsometatarsal joints (Lisfranc complex) include the articulations of the cuneiforms and cuboid with the bases of the metatarsals. Internal fixation is typically used to achieve and maintain alignment during fusion.

The code descriptor includes the word 'multiple,' so you report 28730 once even when three or more joints are fused in the same foot during the same session — do not stack it with modifier 51 across separate line items for individual joints. For a single-joint midtarsal or TMT fusion, use 28740 instead. For fusion with a concomitant osteotomy for flatfoot correction, step up to 28735.

Bone graft sourced from a distant donor site (e.g., contralateral foot, iliac crest) can be separately reported with 20900 or 20902. Graft harvested from the ipsilateral foot is bundled into 28730 and cannot be billed separately. The 90-day global period means all routine post-op visits, hardware checks, and wound care through day 90 are included. Use modifier 78 for an unplanned return to the OR for a related complication within the global, and modifier 79 for an unrelated procedure in the same window.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	10.43
Practice expense RVU	8.26
Malpractice RVU	1.62
Total RVU	20.31
Medicare national rate	$678.37
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	$678.37
HOPD (APC 5115) Hospital outpatient department	$13,116.76
ASC (PI J8) Ambulatory surgical center (freestanding)	$10,044.89

Common denial reasons

The recurring reasons claims for CPT 28730 get rejected.

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

Upcoding or downcoding between 28730 and 28740 when the number of joints fused is not explicitly documented in the operative report.
Duplicate billing — submitting 28730 multiple times or stacking it with 28740 for joints in the same foot during the same session.
Separate billing of ipsilateral bone graft harvest, which is bundled into 28730 and not payable as an additional line.
Missing or vague ICD-10-CM diagnosis that does not support medical necessity for multi-joint arthrodesis (e.g., unspecified foot pain without imaging or conservative treatment documentation).
Global period violations — billing routine post-op visits or hardware checks within the 90-day global without modifier 24.

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 8 cited references ↓

01Can I bill 28730 more than once if three TMT joints were fused?

No. The descriptor includes 'multiple,' so 28730 is reported once per foot per session regardless of how many midtarsal or TMT joints are fused. Do not stack it with modifier 51 across multiple line items for individual joints.

02What is the difference between 28730 and 28740?

28740 is for a single midtarsal or tarsometatarsal joint. 28730 is for multiple joints or a transverse (panmidfoot) fusion. If the operative report documents only one joint, use 28740. Two or more joints in the same foot in the same session triggers 28730.

03When should I use 28735 instead of 28730?

Use 28735 when the surgeon performs multiple midtarsal or TMT arthrodesis combined with an osteotomy specifically for flatfoot correction. 28730 does not capture the additional osteotomy work; the operative note must explicitly document the osteotomy and its purpose.

04Can the bone graft be billed separately with 28730?

Only if the graft was harvested from a distant donor site. Use 20900 for a minor graft or 20902 for a major graft from a separate site. Graft taken from the ipsilateral foot is bundled into 28730 and cannot generate a separate charge.

05What modifier applies if the patient returns to the OR within the 90-day global for a hardware complication?

Modifier 78 applies for an unplanned return to the OR for a complication related to the original 28730 procedure. Modifier 79 applies if the return is for an entirely unrelated procedure. Do not use 78 for an elective staged procedure — that requires modifier 58.

06Is 28730 appropriate for hallux valgus or hallux rigidus correction?

No. Per podiatric coding guidance, 28730 should not be used for hallux valgus or hallux rigidus correction. Those procedures have dedicated codes (e.g., 28750 for first MTP arthrodesis). Using 28730 for hallux correction is a known audit flag.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira AI Scribe

Mira's AI scribe captures each joint fused by anatomic name, the fixation construct used, graft source and site, and the named surgical approach from dictation — the four elements audit teams most commonly flag as missing or vague in 28730 operative notes. That documentation directly prevents downcoding to 28740, bundling disputes over graft add-ons, and medical necessity denials tied to unsupported ICD-10-CM codes.

See how Mira captures CPT 28730 documentation