{"id":163595,"date":"2026-07-24T11:10:33","date_gmt":"2026-07-24T11:10:33","guid":{"rendered":"https:\/\/pabau.com\/?p=163595"},"modified":"2026-08-17T11:36:46","modified_gmt":"2026-08-17T11:36:46","slug":"cpt-code-28760","status":"publish","type":"post","link":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-28760\/","title":{"rendered":"CPT Code 28760: Jones-Type Arthrodesis Billing Guide"},"content":{"rendered":"\n<script type=\"application\/ld+json\">{\"@context\":\"https:\/\/schema.org\",\"@type\":\"MedicalWebPage\",\"headline\":\"CPT Code 28760: Jones-Type Arthrodesis Billing Guide (2026)\",\"description\":\"Complete reference for CPT Code 28760 (arthrodesis with extensor hallucis longus transfer, great toe IP joint, Jones-type procedure). Covers 2026 fee schedule, RVUs, modifiers, ICD-10 pairings, and documentation.\",\"url\":\"https:\/\/pabau.com\/procedure-codes\/cpt-code-28760\/\",\"audience\":{\"@type\":\"MedicalAudience\",\"audienceType\":\"Clinician\"},\"reviewedBy\":{\"@type\":\"Person\",\"name\":\"Dr Vanja Kitanova\",\"jobTitle\":\"Medical Reviewer\",\"affiliation\":{\"@type\":\"Organization\",\"name\":\"Pabau\"},\"knowsAbout\":[\"Medical Coding\",\"Clinical Documentation\",\"Healthcare Billing\",\"Clinical Safety\"],\"sameAs\":\"https:\/\/pabau.com\/blog\/author\/vanja\/\"},\"datePublished\":\"2026-07-25\",\"dateModified\":\"2026-07-25\"}<\/script>\n\n\n        <div id=\"key_takeaways\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/12\/Key-Takeaways-Icon.svg\" alt=\"Key Takeaways\" height=\"42\" width=\"42\">\n                                <h3>Key Takeaways<\/h3>\n            <\/div>\n            <div class=\"list\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>CPT Code 28760 describes arthrodesis with extensor hallucis longus (EHL) transfer to the first metatarsal neck and fusion of the great toe interphalangeal joint, known as the Jones-type procedure.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Missing the laterality modifier (LT or RT) is the leading cause of claim denials for CPT 28760. Every claim must specify the operative foot.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>The 2026 Medicare Physician Fee Schedule lists CPT 28760 with a work RVU of 8.91. Verify current rates using the CMS MPFS Look-Up Tool, since geographic modifiers affect final allowables.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Pabau&rsquo;s claims management software links operative documentation directly to claim submission, reducing modifier errors and ICD-10 mismatches for podiatry and orthopedic billing teams.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<p class=\"wp-block-paragraph\">CPT Code 28760 is a billable code for arthrodesis of the great toe interphalangeal (IP) joint combined with an extensor hallucis longus (EHL) tendon transfer to the first metatarsal neck, the Jones-type procedure. Payers auditing these claims routinely find operative reports that confirm the joint fusion but omit the tendon transfer, the defining element of the code. When the transfer isn&rsquo;t documented, the claim downcodes or denies entirely. This guide covers the official descriptor, 2026 Medicare rates, RVU breakdown, applicable modifiers, ICD-10 pairings, and the documentation elements auditors look for.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">CPT 28760 sits at the top of the arthrodesis range for the foot and toes (28705-28760). It combines two distinct surgical components: joint fusion and tendon transfer. Documentation that addresses only one component leads to denials. Podiatrists, orthopedic surgeons, and their billing staff need to understand both the clinical procedure and the payer requirements before submitting claims. Practices using claims management software that links operative notes to claim fields catch these errors before submission rather than after.<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe title=\"CPT Coding Pitfalls Every Medical Practice Faces\" width=\"800\" height=\"450\" src=\"https:\/\/www.youtube.com\/embed\/vbvV5okdXKg?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<h2 id=\"h-cpt-code-28760-official-description-and-procedure-overview\" class=\"wp-block-heading\">CPT Code 28760: Official description and procedure overview<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The <a href=\"https:\/\/www.ama-assn.org\/practice-management\/cpt\/cpt-code-set-overview\" target=\"_blank\" rel=\"nofollow noopener\">American Medical Association&rsquo;s CPT code set<\/a> assigns the following official descriptor to CPT Code 28760: <strong>Arthrodesis with extensor hallucis longus transfer to first metatarsal neck, great toe, interphalangeal joint (e.g., Jones-type procedure).<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Three anatomical elements define this code. All three must be present in the operative report for the claim to stand up to audit.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Arthrodesis of the great toe interphalangeal (IP) joint:<\/strong> the proximal and distal phalanges of the hallux are surgically fused, eliminating motion at the IP joint.<\/li>\n\n\n\n<li><strong>Extensor hallucis longus (EHL) tendon transfer:<\/strong> the EHL tendon is released distally and re-routed, typically to the dorsal aspect of the first metatarsal neck, redirecting its pull.<\/li>\n\n\n\n<li><strong>First metatarsal neck attachment:<\/strong> the transferred EHL is anchored to the first metatarsal neck, correcting the dynamic deformity causing toe clawing.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">CPT 28760 is categorized under <strong>Musculoskeletal System: Foot and Toes &#8211; Arthrodesis<\/strong> in the CPT codebook. The full arthrodesis range for the foot runs from 28705 (arthrodesis, pantalar) through 28760. Coders selecting the wrong code in this range will undercode the claim. For example, 28755 (arthrodesis, great toe IP joint, includes any internal fixation) does not include the EHL tendon transfer component that 28760 requires.<\/p>\n\n\n\n<h2 id=\"h-the-jones-type-procedure-clinical-context-and-indications\" class=\"wp-block-heading\">The Jones-type procedure: Clinical context and indications<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The Jones procedure was first described for claw toe deformity of the hallux caused by weakness in the intrinsic foot muscles. This weakness is most commonly seen in patients with Charcot-Marie-Tooth disease, poliomyelitis sequelae, or other neuromuscular conditions. Today, orthopedic and podiatric surgeons also perform Jones-type arthrodesis for hallux rigidus that has progressed to IP joint instability, and for fixed claw toe deformity unresponsive to conservative treatment.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Understanding the indications matters for coding because medical necessity documentation must match the ICD-10 diagnosis code submitted with the claim. A mismatch between the clinical indication in the operative note and the diagnosis code on the claim is a common denial trigger for CPT 28760.<\/p>\n\n\n\n<h3 id=\"h-primary-clinical-indications\" class=\"wp-block-heading\">Primary clinical indications<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Claw toe deformity of the great toe:<\/strong> dynamic deformity caused by EHL overactivity or intrinsic muscle weakness, creating hyperextension at the MTP joint and flexion at the IP joint.<\/li>\n\n\n\n<li><strong>Hallux rigidus with IP joint involvement:<\/strong> end-stage arthritis of the great toe IP joint requiring fusion to restore function and eliminate pain.<\/li>\n\n\n\n<li><strong>Neuromuscular foot deformity:<\/strong> Charcot-Marie-Tooth, polio, and cerebral palsy cases where tendon imbalance drives structural foot deformity.<\/li>\n\n\n\n<li><strong>Failed conservative management:<\/strong> orthotics, physical therapy, and injections that have not resolved the deformity after an adequate treatment period.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Practices treating neuromuscular conditions alongside standard podiatry procedures may find that physical therapy and musculoskeletal care documentation tools help structure pre-operative conservative treatment records. These records are critical for establishing the failure-of-conservative-care requirement many payers enforce before approving surgical claims.<\/p>\n\n\n\n<h2 id=\"h-icd-10-diagnosis-codes-that-support-cpt-code-28760\" class=\"wp-block-heading\">ICD-10 diagnosis codes that support CPT Code 28760<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Medical necessity for CPT 28760 must be established by the diagnosis code(s) on the claim. The <a href=\"https:\/\/www.aapc.com\/codify\/icd-10-crosswalk.aspx\" target=\"_blank\" rel=\"nofollow noopener\">AAPC CPT-to-ICD-10 crosswalk<\/a> identifies the most commonly accepted pairings. Local Coverage Determinations (LCDs) issued by Medicare Administrative Contractors (MACs) specify which ICD-10 codes they accept for foot arthrodesis procedures. Severe complications such as gangrene. Always verify against the applicable LCD for your MAC jurisdiction.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4;min-width:140px\">ICD-10 Code<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Description<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Notes<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">M20.21<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Hallux rigidus, right foot<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Use with modifier RT; laterality must match across claim<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">M20.22<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Hallux rigidus, left foot<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Use with modifier LT; laterality must match across claim<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">M20.10<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Hallux valgus (acquired), unspecified foot<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Use only when documentation supports hallux valgus with IP joint pathology<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">M20.11<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Hallux valgus (acquired), right foot<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Specify laterality when documentation supports it<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">M20.12<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Hallux valgus (acquired), left foot<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Specify laterality when documentation supports it<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Q66.89<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Other specified congenital deformities of feet<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Neuromuscular\/congenital indications; verify LCD acceptance<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">G60.0<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Hereditary motor and sensory neuropathy (Charcot-Marie-Tooth)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Secondary diagnosis establishing neuromuscular etiology<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">M77.31<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Calcaneal spur, right foot<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Secondary only; not sufficient alone for 28760 medical necessity<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Always verify ICD-10 pairings against your MAC&rsquo;s LCD. Medical necessity determinations are payer-specific and subject to annual updates. Diagnosis codes that one payer accepts may trigger a medical necessity review under another payer&rsquo;s policy. Coders cross-checking musculoskeletal diagnosis codes such as M72.8 against payer LCDs benefit from a centralized coding workflow that flags non-compliant pairings before submission.<\/p>\n\n\n\n<h2 id=\"h-cpt-code-28760-reimbursement-and-2026-fee-schedule\" class=\"wp-block-heading\">CPT Code 28760 reimbursement and 2026 fee schedule<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Reimbursement for CPT Code 28760 under the Medicare Physician Fee Schedule varies by geographic locality because the GPCI (Geographic Practice Cost Index) adjusts the base national rate for each Medicare Administrative Contractor region. The figures below reflect 2026 national average rates. Always verify current allowables using the <a href=\"https:\/\/www.cms.gov\/medicare\/physician-fee-schedule\/search\/overview\" target=\"_blank\" rel=\"nofollow noopener\">CMS Physician Fee Schedule Look-Up Tool<\/a>, which provides locality-specific rates updated annually.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4;min-width:180px\">Rate Component<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Facility Setting<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Non-Facility Setting<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">National Average Allowable<\/td>\n<td style=\"padding:12px 16px;color:#374151\">~$536.75<\/td>\n<td style=\"padding:12px 16px;color:#374151\">~$783.92<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Work RVU (wRVU)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">~8.91<\/td>\n<td style=\"padding:12px 16px;color:#374151\">~8.91<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Practice Expense RVU<\/td>\n<td style=\"padding:12px 16px;color:#374151\">~6.11<\/td>\n<td style=\"padding:12px 16px;color:#374151\">~13.51<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Malpractice RVU<\/td>\n<td style=\"padding:12px 16px;color:#374151\">~1.05<\/td>\n<td style=\"padding:12px 16px;color:#374151\">~1.05<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Total RVU<\/td>\n<td style=\"padding:12px 16px;color:#374151\">~16.07<\/td>\n<td style=\"padding:12px 16px;color:#374151\">~23.47<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Global Period<\/td>\n<td style=\"padding:12px 16px;color:#374151\">090 days<\/td>\n<td style=\"padding:12px 16px;color:#374151\">090 days<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">The non-facility rate is higher because practice expense RVUs reflect the overhead costs the surgeon&rsquo;s office absorbs when the procedure is performed in an office-based setting rather than a hospital or ASC. For most Jones-type procedures, the facility setting (hospital or ASC) is standard due to the complexity of the arthrodesis and tendon transfer. Use the <a href=\"https:\/\/fastrvu.com\/tools\/rvu-lookup\" target=\"_blank\" rel=\"nofollow noopener\">FastRVU 2026 RVU lookup tool<\/a> to verify exact values for your practice location.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The 90-day global period means Medicare will not separately reimburse evaluation and management visits, routine post-operative dressing changes, or suture removal within 90 days of the procedure. Services unrelated to the procedure can still be billed during the global period with appropriate modifiers.<\/p>\n\n\n        <div id=\"pro_tip\">\n            <div class=\"img\">\n                <svg width=\"42\" height=\"42\" viewBox=\"0 0 42 42\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M12.6383 19.5238C12.6632 21.2071 12.8734 22.9926 12.0685 24.5523C11.0341 26.8917 8.45076 28.169 7.56292 30.5918C6.63082 33.1061 7.19505 36.185 9.31371 37.9786C10.929 39.5678 13.4183 39.9873 15.6061 39.5463C17.4592 39.073 19.1049 37.8388 19.9706 36.1608C20.781 34.7141 20.7866 32.9904 20.5293 31.3985C20.1006 29.3092 18.3775 27.8705 16.9807 26.362C14.8814 24.1005 14.6684 20.6854 15.595 17.8915C16.4331 15.4768 19.0026 14.2344 20.0425 11.9461C20.7202 10.6769 20.7506 9.20327 20.6068 7.81304C20.1864 5.40098 18.3139 3.23631 15.8716 2.56674C13.9742 2.03969 11.8224 2.30052 10.1739 3.37614C8.70522 4.34688 7.5878 5.86618 7.28356 7.58178C6.76081 9.82981 7.53525 12.2822 9.20307 13.9118C10.7658 15.4741 12.4806 17.2273 12.6383 19.5238Z\"\n                        fill=\"#2BADD4\" \/>\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M22.7048 19.8387C22.6822 22.3279 24.4507 24.6234 26.7493 25.4682C28.0531 25.961 29.4725 25.9183 30.7989 25.5487C32.0575 24.9955 33.301 24.2237 34.0069 23.0092C34.8384 21.5811 35.2982 19.8286 34.7832 18.2094C34.3611 16.2507 32.8739 14.6541 31.0275 13.9426C28.6736 12.9595 25.8073 13.7942 24.1719 15.7001C23.2022 16.8366 22.6143 18.3326 22.7048 19.8387Z\"\n                        fill=\"#2BADD4\" \/>\n                <\/svg>\n            <\/div>\n            <div class=\"text\">\n                <h3>Pro Tip<\/h3>\n                <p>Run the CMS Physician Fee Schedule Look-Up Tool for your specific MAC locality before quoting reimbursement estimates to your surgical team. National averages can differ from local rates by 15-20% in high-cost regions like New York or California. Use the locality code for your practice&rsquo;s zip code, not the national average.<\/p>\n            <\/div>\n        <\/div>\n    \n\n\n<h2 id=\"h-applicable-modifiers-for-cpt-code-28760\" class=\"wp-block-heading\">Applicable modifiers for CPT Code 28760<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Modifier selection for CPT 28760 is where billing errors concentrate. Podiatry and orthopedic procedures are inherently unilateral and require laterality modifiers on every claim. Submitting without one is the single most common reason this code denies on first submission.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4;min-width:100px\">Modifier<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Description<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">When to use<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Audit risk<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">RT<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Right side<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Procedure performed on right foot<\/td>\n<td style=\"padding:12px 16px;color:#374151\">High &#8211; missing laterality triggers automatic denial<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">LT<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Left side<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Procedure performed on left foot<\/td>\n<td style=\"padding:12px 16px;color:#374151\">High &#8211; missing laterality triggers automatic denial<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">50<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Bilateral procedure<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Same procedure performed on both feet in the same session<\/td>\n<td style=\"padding:12px 16px;color:#374151\">High &#8211; bilateral Jones procedures are rare; expect medical necessity review<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">22<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Increased procedural services<\/td>\n<td style=\"padding:12px 16px;color:#374151\">When the procedure required substantially more work than typical &#8211; document in detail<\/td>\n<td style=\"padding:12px 16px;color:#374151\">High &#8211; requires detailed operative note narrative explaining increased complexity<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">59<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Distinct procedural service<\/td>\n<td style=\"padding:12px 16px;color:#374151\">When 28760 is billed alongside another foot procedure in the same session that would otherwise bundle<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Moderate &#8211; must document distinct anatomical site or separate indication<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">79<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Unrelated procedure during global period<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Billing an unrelated surgery during the 90-day global period<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Moderate &#8211; must clearly document unrelated indication<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Modifier 50 (bilateral) requires particular care for CPT 28760. Bilateral Jones-type procedures in a single session are clinically uncommon, though bilateral neuromuscular deformity treated simultaneously does occur. Payers will likely request operative documentation before paying both sides. Never append modifier 50 speculatively. Only use it when the operative report explicitly confirms bilateral procedures performed in the same operative session. Modifier 59 draws similar scrutiny in other procedure families.<\/p>\n\n\n\n<h2 id=\"h-documentation-requirements-for-cpt-code-28760-reimbursement\" class=\"wp-block-heading\">Documentation requirements for CPT Code 28760 reimbursement<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The operative report for CPT 28760 must confirm all three procedure components to withstand audit. Practices using digital forms and structured clinical documentation can build procedure-specific operative note templates that prompt surgeons to capture each required element. If a wound healing complication requires a skin graft, such as one billed under CPT code 15101, report it separately from the original arthrodesis claim.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/cpt-code-28760\/digital-forms.webp\" alt=\"Digital forms\"\/><figcaption class=\"wp-element-caption\"><em>Digital forms<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p class=\"wp-block-paragraph\">Auditors reviewing CPT 28760 claims look for these specific documentation elements:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Preoperative diagnosis:<\/strong> clearly states the clinical indication (e.g., hallux rigidus with IP joint deformity, claw toe deformity secondary to Charcot-Marie-Tooth) matching the ICD-10 code on the claim.<\/li>\n\n\n\n<li><strong>Procedure narrative confirming EHL transfer:<\/strong> explicitly describes the EHL tendon being released, mobilized, and re-routed to the first metatarsal neck &#8211; not just \u00ab\u00a0tendon transfer\u00a0\u00bb or \u00ab\u00a0soft tissue procedure.\u00a0\u00bb<\/li>\n\n\n\n<li><strong>IP joint fusion confirmation:<\/strong> documents the joint preparation (cartilage removal, bony surfaces prepared), fixation method used (K-wire, screw, or staple), and the position of fusion (typically 5-10 degrees of plantar flexion).<\/li>\n\n\n\n<li><strong>Laterality confirmed in operative note:<\/strong> the note must state \u00ab\u00a0right foot\u00a0\u00bb or \u00ab\u00a0left foot\u00a0\u00bb &#8211; matching the modifier on the claim.<\/li>\n\n\n\n<li><strong>Intraoperative imaging reference:<\/strong> fluoroscopy or X-ray confirmation of fixation position, if used &#8211; supports medical necessity and documents the completed fusion.<\/li>\n\n\n\n<li><strong>Post-operative plan:<\/strong> weight-bearing status, immobilization device, DVT prophylaxis documented per a DVT nursing care plan, and follow-up schedule. Required for global period management.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Operative documentation for CPT 28760 must be retained in line with state medical record retention laws and CMS requirements (commonly 7 years, longer for Medicare Advantage and Part D plans at 10 years), and stored in a HIPAA-compliant manner. Practices that maintain HIPAA-compliant documentation for medical offices can build retention schedules that meet both state and payer requirements without manual tracking.<\/p>\n\n\n        <div id=\"book_a_demo\">\n            <div class=\"left-side\">\n                <div class=\"logo\">\n                    <img decoding=\"async\"\n                        src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Logo.svg\"\n                        alt=\"Logo\"\n                        loading=\"lazy\"\n                    \/>\n                <\/div>\n\n                <h3 class=\"heading\">\n                    Streamline podiatry billing with Pabau                <\/h3>\n\n                <p class=\"description\">\n                    Pabau links structured clinical documentation directly to claim submission workflows. Reduce modifier errors, ICD-10 mismatches, and missing operative report elements before claims leave your practice, not after they deny.                <\/p>\n\n                <div class=\"button-group\">\n                    <a href=\"\/book-demo\/\" class=\"btn btn-scale-effect btn-cta-color btn-md\">\n                        <span class=\"btn-text\">Book a demo<\/span>\n                        <div class=\"btn-icon btn-icon-right\" aria-hidden=\"true\">\n                            <svg\n                                width=\"14\"\n                                height=\"12\"\n                                viewBox=\"0 0 14 12\"\n                                fill=\"none\"\n                                xmlns=\"http:\/\/www.w3.org\/2000\/svg\"\n                            >\n                                <path\n                                    d=\"M0.75 4.77295C0.335786 4.77295 0 5.10874 0 5.52295C0 5.93716 0.335786 6.27295 0.75 6.27295V5.52295V4.77295ZM13.2803 6.05328C13.5732 5.76039 13.5732 5.28551 13.2803 4.99262L8.50736 0.219648C8.21447 -0.073245 7.73959 -0.073245 7.4467 0.219648C7.15381 0.512542 7.15381 0.987415 7.4467 1.28031L11.6893 5.52295L7.4467 9.76559C7.15381 10.0585 7.15381 10.5334 7.4467 10.8263C7.73959 11.1191 8.21447 11.1191 8.50736 10.8263L13.2803 6.05328ZM0.75 5.52295V6.27295L12.75 6.27295V5.52295V4.77295L0.75 4.77295V5.52295Z\"\n                                    fill=\"currentColor\"\n                                ><\/path>\n                            <\/svg>\n                        <\/div>\n                    <\/a>\n                <\/div>\n            <\/div>\n\n            <div class=\"right-side\">\n                <img decoding=\"async\"\n                    src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Home-Page-Concept-4.webp\"\n                    alt=\"Pabau claims management dashboard for podiatry billing\"\n                    loading=\"lazy\"\n                \/>\n            <\/div>\n        <\/div>\n        \n\n\n<h2 id=\"h-common-billing-errors-and-denial-reasons-for-cpt-code-28760\" class=\"wp-block-heading\">Common billing errors and denial reasons for CPT Code 28760<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Denials for CPT 28760 cluster around a small number of recurring issues. Understanding each one helps billing staff correct claims faster and reduce the denial rate over time. Practices billing other complex surgical codes.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4;min-width:200px\">Denial Reason<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Root Cause<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Corrective Action<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Missing laterality modifier<\/td>\n<td style=\"padding:12px 16px;color:#374151\">RT or LT not appended to claim line<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Add correct modifier and resubmit; correct operative note if laterality is ambiguous<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">ICD-10 mismatch<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Diagnosis code not accepted by payer&rsquo;s LCD for arthrodesis<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Review applicable MAC LCD; recode to an accepted diagnosis if clinically supported<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">EHL transfer not documented<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Operative report describes IP joint fusion only; tendon transfer omitted<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Amend operative note to include explicit EHL transfer narrative; appeal with corrected documentation<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Bundling with 28755<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Payer bundles 28760 with 28755 (IP joint fusion without transfer) submitted same session same foot<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Do not bill 28755 and 28760 for the same foot in the same session &#8211; 28760 includes the IP fusion component<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Lack of conservative care documentation<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Payer requires evidence of failed conservative treatment before approving arthrodesis<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Include prior treatment records (orthotics, PT, injections) with appeal; build pre-auth template to capture these prospectively<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Global period billing conflict<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Post-op visit billed without recognizing it falls within 90-day global period<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Track global period dates; bill related post-op visits only after global period closes or use modifier 24 for unrelated E&#038;M<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Practices that bill CPT 28760 alongside other foot and ankle procedures. A 90-day denial pattern review often reveals systematic issues like a single coder consistently omitting laterality modifiers or a surgeon whose operative note template doesn&rsquo;t capture the tendon transfer component.<\/p>\n\n\n\n<h2 id=\"h-related-cpt-codes-in-the-arthrodesis-range-28705-28760\" class=\"wp-block-heading\">Related CPT codes in the arthrodesis range (28705-28760)<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Selecting the right arthrodesis code requires understanding the anatomical scope of each code in the 28705-28760 range. The following table helps coders distinguish CPT 28760 from adjacent codes. This distinction matters most when multiple arthrodesis procedures are performed in the same session on different joints of the same foot. Practices that also supply post-operative mobility aids.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4;min-width:100px\">CPT Code<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Short Description<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Anatomical Site<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">28705<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Arthrodesis, pantalar<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Ankle + subtalar + talonavicular joints (all)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">28715<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Arthrodesis, triple<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Subtalar + talonavicular + calcaneocuboid joints<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">28725<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Arthrodesis, subtalar<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Subtalar joint only<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">28730<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Multiple midfoot joints<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">28740<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Arthrodesis, midtarsal or tarsometatarsal, single joint<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Single midfoot joint<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">28750<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Arthrodesis, great toe; metatarsophalangeal joint<\/td>\n<td style=\"padding:12px 16px;color:#374151\">1st MTP joint &#8211; different from 28760&rsquo;s IP joint<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">28755<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Arthrodesis, great toe; interphalangeal joint<\/td>\n<td style=\"padding:12px 16px;color:#374151\">IP joint fusion only &#8211; no tendon transfer component<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">28760<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Arthrodesis with EHL transfer to 1st metatarsal neck, IP joint (Jones-type)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">IP joint fusion + EHL tendon transfer to 1st metatarsal neck<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">The critical distinction is between 28755 and 28760. Both involve arthrodesis of the great toe IP joint. Only 28760 includes the EHL tendon transfer to the first metatarsal neck. If the surgeon performed only the IP joint fusion without the tendon transfer, 28755 is the correct code. Upcoding to 28760 without a documented EHL transfer in the operative report is a billing error with audit risk. Practices providing <a href=\"https:\/\/pabau.com\/industry\/sports-medicine-software\/\">sports medicine and orthopedic care<\/a> see this distinction frequently when reviewing intraoperative reports.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Related CPT codes<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-22840\/\">CPT code 22840 \u2014 Posterior Non-Segmental Instrumentation<\/a><\/li>\n\n\n<li><a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-29515\/\">CPT code 29515 \u2014 Application of Short Leg Splint<\/a><\/li>\n\n\n<li><a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-29881\/\">CPT code 29881 \u2014 Knee Arthroscopy with Meniscectomy<\/a><\/li>\n\n\n<li><a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-21268\/\">CPT code 21268 \u2014 Orbital repositioning with bone grafts, multiple craniotomies<\/a><\/li>\n<\/ul>\n\n\n\n<h2 id=\"h-how-pabau-supports-podiatry-and-orthopedic-billing-workflows\" class=\"wp-block-heading\">How Pabau supports podiatry and orthopedic billing workflows<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Billing for surgical CPT codes like 28760 requires consistent documentation that connects the operative note to the claim fields. A missing modifier, an undocumented procedure component, or the wrong ICD-10 code anywhere in that chain costs the practice revenue and triggers rework. Pabau&rsquo;s claims management software connects clinical documentation to claim submission in one workflow, so podiatry and orthopedic billing teams can validate documentation completeness before claims are submitted rather than after they deny.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/cpt-code-28760\/automate-claims-through-healthcode.webp\" alt=\"Automate claims and billing with Pabau\"\/><figcaption class=\"wp-element-caption\"><em>Automate claims and billing with Pabau<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p class=\"wp-block-paragraph\">Practices handling structured medical forms and documentation workflows benefit from templates built around specific CPT codes: pre-operatively capturing the conservative care history that payers require, intraoperatively prompting surgeons to document both the EHL transfer and the IP joint fusion, and post-operatively tracking the 90-day global period to prevent billing conflicts. Pabau&rsquo;s platform also supports the practice management workflows that high-volume surgical practices need: multi-provider scheduling, team-based documentation, and integrated billing review.<\/p>\n\n\n        <div id=\"pro_tip\">\n            <div class=\"img\">\n                <svg width=\"42\" height=\"42\" viewBox=\"0 0 42 42\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M12.6383 19.5238C12.6632 21.2071 12.8734 22.9926 12.0685 24.5523C11.0341 26.8917 8.45076 28.169 7.56292 30.5918C6.63082 33.1061 7.19505 36.185 9.31371 37.9786C10.929 39.5678 13.4183 39.9873 15.6061 39.5463C17.4592 39.073 19.1049 37.8388 19.9706 36.1608C20.781 34.7141 20.7866 32.9904 20.5293 31.3985C20.1006 29.3092 18.3775 27.8705 16.9807 26.362C14.8814 24.1005 14.6684 20.6854 15.595 17.8915C16.4331 15.4768 19.0026 14.2344 20.0425 11.9461C20.7202 10.6769 20.7506 9.20327 20.6068 7.81304C20.1864 5.40098 18.3139 3.23631 15.8716 2.56674C13.9742 2.03969 11.8224 2.30052 10.1739 3.37614C8.70522 4.34688 7.5878 5.86618 7.28356 7.58178C6.76081 9.82981 7.53525 12.2822 9.20307 13.9118C10.7658 15.4741 12.4806 17.2273 12.6383 19.5238Z\"\n                        fill=\"#2BADD4\" \/>\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M22.7048 19.8387C22.6822 22.3279 24.4507 24.6234 26.7493 25.4682C28.0531 25.961 29.4725 25.9183 30.7989 25.5487C32.0575 24.9955 33.301 24.2237 34.0069 23.0092C34.8384 21.5811 35.2982 19.8286 34.7832 18.2094C34.3611 16.2507 32.8739 14.6541 31.0275 13.9426C28.6736 12.9595 25.8073 13.7942 24.1719 15.7001C23.2022 16.8366 22.6143 18.3326 22.7048 19.8387Z\"\n                        fill=\"#2BADD4\" \/>\n                <\/svg>\n            <\/div>\n            <div class=\"text\">\n                <h3>Pro Tip<\/h3>\n                <p>Build a CPT 28760 operative note template with checkboxes for: (1) laterality confirmed, (2) EHL transfer described with anatomical detail, (3) IP joint preparation and fixation documented, (4) intraoperative imaging referenced. A surgeon who completes all four fields produces a claim-ready operative report on the first submission.<\/p>\n            <\/div>\n        <\/div>\n    \n\n\n<h2 id=\"h-conclusion\" class=\"wp-block-heading\">Conclusion<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">CPT Code 28760 denials are almost always preventable. The code has a clear two-component requirement: IP joint arthrodesis plus EHL tendon transfer. Every denial pattern traces back to one of those components being absent from the operative report, the ICD-10 selection, or the modifier. Fix the documentation template, and the denials stop.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Pabau&rsquo;s claims management tools give podiatry and orthopedic practices a structured path from operative documentation to clean claim submission, catching modifier omissions and ICD-10 mismatches at the source. To see how Pabau handles surgical billing workflows for foot and ankle procedures, <a href=\"https:\/\/pabau.com\/book-demo\/\">book a demo<\/a>.<\/p>\n\n\n        <div id=\"expert_picks\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/11\/Expert-Picks.svg\" alt=\"Continue your research\" height=\"42\" width=\"42\">\n                                <h3>Continue your research<\/h3>\n            <\/div>\n            <div class=\"content\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Billing another distinct-site procedure in the same session?<\/strong> Pilonidal cyst excision under CPT codes <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-codes-11770-11772\/\">11770-11772<\/a> follows the same modifier 59 distinct-procedure documentation standard.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Coding a post-operative wound complication?<\/strong> A skin graft billed under CPT code <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-15101\/\">15101<\/a> needs its own documentation, separate from the original arthrodesis claim.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Ruling out a severe vascular complication?<\/strong> Gangrene reported under ICD-10 code <a href=\"https:\/\/pabau.com\/diagnostic-codes\/icd-10-code-i96\/\">I96<\/a> points to a different surgical pathway than elective arthrodesis.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<h2 id=\"h-frequently-asked-questions\" class=\"wp-block-heading\">Frequently Asked Questions<\/h2>\n\n\n\n<div class=\"schema-faq wp-block-yoast-faq-block\"><div class=\"schema-faq-section\" id=\"faq-question-1784878376876\"><h3 class=\"schema-faq-question\">What is CPT Code 28760 used for?<\/h3> <p class=\"schema-faq-answer\">CPT Code 28760 is used to bill arthrodesis with extensor hallucis longus (EHL) tendon transfer to the first metatarsal neck combined with fusion of the great toe interphalangeal joint, the Jones-type procedure. It is reported by podiatrists and orthopedic surgeons treating claw toe deformity of the hallux, hallux rigidus with IP joint involvement, and neuromuscular foot deformities such as those seen in Charcot-Marie-Tooth disease.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1784878376877\"><h3 class=\"schema-faq-question\">What is the difference between CPT 28760 and CPT 28755?<\/h3> <p class=\"schema-faq-answer\">CPT 28755 describes arthrodesis of the great toe interphalangeal joint only, with no tendon transfer. CPT 28760 describes the same IP joint fusion plus the extensor hallucis longus tendon transfer to the first metatarsal neck. If the surgeon performed both the IP fusion and the EHL transfer, report 28760. If only the IP fusion was performed without any tendon transfer, report 28755. Billing 28760 without a documented EHL transfer in the operative report is a coding error that creates audit risk.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1784878376878\"><h3 class=\"schema-faq-question\">What modifiers apply to CPT Code 28760?<\/h3> <p class=\"schema-faq-answer\">Modifier RT (right side) or LT (left side) is required on every claim for CPT 28760. Missing laterality is the most common denial reason. Modifier 50 applies when the procedure is performed bilaterally in the same session. Modifier 22 applies when the procedure required substantially more work than typical, supported by detailed operative documentation. Modifier 59 applies when 28760 is billed alongside another foot procedure that would otherwise bundle with it.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1784878376879\"><h3 class=\"schema-faq-question\">What is the Medicare reimbursement rate for CPT 28760?<\/h3> <p class=\"schema-faq-answer\">The 2026 Medicare national average allowable for CPT 28760 is approximately $536.75 in a facility setting and $783.92 in a non-facility setting, based on a work RVU of 8.91 and a 90-day global period. Rates vary by geographic locality (GPCI). Always verify current allowables using the CMS Physician Fee Schedule Look-Up Tool at cms.gov for your specific MAC jurisdiction.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1784878376880\"><h3 class=\"schema-faq-question\">What ICD-10 codes are commonly paired with CPT 28760?<\/h3> <p class=\"schema-faq-answer\">The most commonly accepted ICD-10 pairings for CPT 28760 are M20.21 (hallux rigidus, right foot) and M20.22 (hallux rigidus, left foot). M20.10-M20.12 (hallux valgus) may support medical necessity when IP joint pathology is documented. G60.0 (Charcot-Marie-Tooth disease) and Q66.89 (congenital foot deformity) apply for neuromuscular indications. Always verify accepted diagnosis codes against your MAC&rsquo;s LCD for foot arthrodesis procedures.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1784878376881\"><h3 class=\"schema-faq-question\">Is CPT 28760 covered by Medicare?<\/h3> <p class=\"schema-faq-answer\">Yes, CPT 28760 is a covered Medicare procedure when medical necessity is established through accepted ICD-10 diagnosis codes and the claim meets the documentation requirements of the applicable MAC&rsquo;s Local Coverage Determination. Coverage requires documentation of the complete procedure (both the EHL transfer and IP joint fusion), appropriate laterality modifier, and evidence that conservative treatment was attempted and failed when required by the LCD. Medicaid coverage varies by state; verify with your state Medicaid program.<\/p> <\/div> <\/div>\n","protected":false},"excerpt":{"rendered":"<p>CPT Code 28760 is a billable code for arthrodesis of the great toe interphalangeal (IP) joint combined with an extensor hallucis longus (EHL) tendon transfer to the first metatarsal neck, the Jones-type procedure. Payers auditing these claims routinely find operative reports that confirm the joint fusion but omit the tendon transfer, the defining element of [&hellip;]<\/p>\n","protected":false},"author":77,"featured_media":163594,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_yoast_wpseo_linkdex":"91","_yoast_wpseo_content_score":"30","_yoast_wpseo_is_cornerstone":"","_yoast_wpseo_keywordsynonyms":"[\"\",\"\",\"\",\"\",\"\"]","_yoast_wpseo_focuskw_text_input":"","_seo_original_html":"","footnotes":""},"categories":[1433,1546],"tags":[4300,4301,1162,4302,1163,1666,4156,3372],"class_list":["post-163595","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-billing-codes","category-cpt-codes","tag-28760-cpt-code","tag-arthrodesis-cpt-code","tag-cpt-codes","tag-foot-and-toe-cpt-codes","tag-medical-billing","tag-orthopedic-billing","tag-podiatry","tag-podiatry-billing"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.2 (Yoast SEO v28.2) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>CPT Code 28760: Jones-Type Arthrodesis Billing Guide (2026)<\/title>\n<meta name=\"description\" content=\"CPT Code 28760 covers Jones-type arthrodesis with EHL tendon transfer. 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It combines scheduling, electronic health records, clinical forms, payments, marketing automation, reporting, and patient engagement tools into one secure cloud system to help practices streamline operations and grow their business.\",\"foundingDate\":\"2011-10-20\",\"numberOfEmployees\":{\"@type\":\"QuantitativeValue\",\"minValue\":\"201\",\"maxValue\":\"500\"}},{\"@type\":\"Person\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/#\\\/schema\\\/person\\\/5de22f4ff3ec59b1925ef02dce956d7d\",\"name\":\"Katy Piper\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@id\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/03\\\/cropped-Snip20260306_177-96x96.png\",\"url\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/03\\\/cropped-Snip20260306_177-96x96.png\",\"contentUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/03\\\/cropped-Snip20260306_177-96x96.png\",\"caption\":\"Katy Piper\"},\"description\":\"Katy Piper is a content writer covering aesthetics, dermatology, and clinic operations, with a knack for making clinical detail feel approachable. Outside of work, she's usually chasing her border collie around muddy fields or hunting down the best flat white in town.\",\"url\":\"https:\\\/\\\/pabau.com\\\/fr\\\/blog\\\/author\\\/katy-piper\\\/\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-28760\\\/#faq-question-1784878376876\",\"position\":1,\"url\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-28760\\\/#faq-question-1784878376876\",\"name\":\"What is CPT Code 28760 used for?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"CPT Code 28760 is used to bill arthrodesis with extensor hallucis longus (EHL) tendon transfer to the first metatarsal neck combined with fusion of the great toe interphalangeal joint, the Jones-type procedure. It is reported by podiatrists and orthopedic surgeons treating claw toe deformity of the hallux, hallux rigidus with IP joint involvement, and neuromuscular foot deformities such as those seen in Charcot-Marie-Tooth disease.\",\"inLanguage\":\"fr-FR\"},\"inLanguage\":\"fr-FR\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-28760\\\/#faq-question-1784878376877\",\"position\":2,\"url\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-28760\\\/#faq-question-1784878376877\",\"name\":\"What is the difference between CPT 28760 and CPT 28755?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"CPT 28755 describes arthrodesis of the great toe interphalangeal joint only, with no tendon transfer. CPT 28760 describes the same IP joint fusion plus the extensor hallucis longus tendon transfer to the first metatarsal neck. If the surgeon performed both the IP fusion and the EHL transfer, report 28760. 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Always verify accepted diagnosis codes against your MAC's LCD for foot arthrodesis procedures.","inLanguage":"fr-FR"},"inLanguage":"fr-FR"},{"@type":"Question","@id":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-28760\/#faq-question-1784878376881","position":6,"url":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-28760\/#faq-question-1784878376881","name":"Is CPT 28760 covered by Medicare?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Yes, CPT 28760 is a covered Medicare procedure when medical necessity is established through accepted ICD-10 diagnosis codes and the claim meets the documentation requirements of the applicable MAC's Local Coverage Determination. Coverage requires documentation of the complete procedure (both the EHL transfer and IP joint fusion), appropriate laterality modifier, and evidence that conservative treatment was attempted and failed when required by the LCD. 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