2025 CPT code 28153

Resection of condyle(s) at the distal end of a phalanx, per toe.

Follow current CPT guidelines for surgical procedures and proper anatomical location coding.Carefully document all aspects of the procedure and any additional services rendered. Adhere to payer-specific guidelines and policies for proper billing and reimbursement.

Modifiers may be appropriate in certain circumstances, such as modifier 51 (multiple procedures), 76 (repeat procedure by the same physician), or other modifiers indicating specific procedural modifications. Consult official CPT guidelines and payer policies for acceptable modifier use.

The procedure should be medically necessary to alleviate pain, restore function, correct deformity, or address infection or significant trauma. Documentation should clearly justify the procedure based on the patient's clinical presentation, diagnostic findings, and the failure of conservative treatment options.

The surgeon is responsible for all aspects of the procedure, including appropriate patient preparation, anesthesia, surgical technique, wound closure, and postoperative care.

IMPORTANT May be used in conjunction with other codes depending on the extent of the procedure and any additional services performed.Consider 28126 (Resection, partial or complete, phalangeal base, each toe) for resection at the base of the phalanx or 28160 (Hemiphalangectomy or interphalangeal joint excision, toe, proximal end of phalanx, each) for hemiphalangectomy at the proximal end.

In simple words: The doctor surgically removes part of the bone at the tip of a toe. This often means part or all of the toe is removed.

This CPT code, 28153, describes the surgical resection (removal) of one or more condyles from the distal end of a phalanx bone in a toe.The procedure involves removing a portion of the bone at the end of the toe's phalanx. This often results in partial or complete toe amputation. The technique may involve creating skin flaps, using a bone saw, and closing the wound in layers.A drain may be used, and a compression dressing is applied.Appreciable vessel exploration or neuroplasty should be reported separately.

Example 1: A patient presents with a severely fractured distal phalanx of the great toe, with significant bone comminution and soft tissue damage. The surgeon performs a partial phalangectomy using code 28153 to remove the damaged portion of the bone and achieve stable healing. , A patient has a painful exostosis (bone spur) on the distal phalanx of the second toe, causing significant discomfort and deformity. The surgeon performs a condylectomy (removal of the bone spur) utilizing code 28153 to alleviate pain and restore function. , A patient presents with a severely infected distal phalanx of the fifth toe, unresponsive to conservative management. Surgical debridement and partial phalangectomy are required, using code 28153 to remove infected and necrotic tissue to promote healing.

* Preoperative diagnosis and rationale for procedure.* Operative report detailing the surgical technique, including bone resection specifics (e.g., amount of bone removed, location), wound closure details, and any complications.* Postoperative imaging (if applicable) and progress notes demonstrating healing.* Any pathology reports confirming the diagnosis (e.g., biopsy results).

** This code is typically reported once per toe. If multiple toes are affected, the code should be reported separately for each toe.Precise anatomical location within the toe should be documented in the operative report.Be mindful of other codes that might be applicable depending on the precise nature of the surgical procedure. Always refer to the most recent CPT codebook for the latest updates and coding guidelines.

  • Revenue Code: P3D (Major Procedure, Orthopedic - Other)
  • RVU: Information not available in source.Refer to CMS fee schedules and local payer information for RVU values and reimbursement rates.
  • Global Days : The global surgical period is not specified for this code. Consult the payer's specific guidelines for postoperative care and the allowed reporting of additional services.
  • Payment Status: Active
  • Modifier TC rule: A technical component (TC) modifier does not typically apply to this code, as it usually represents the entire surgical procedure.
  • Fee Schedule : Historical fee schedule data is not provided in the source.Consult historical CPT fee schedules and payer data for information on historical reimbursement rates.
  • Specialties:Podiatry, Orthopedic Surgery
  • Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center
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