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Official Description

Arthrotomy, including exploration, drainage, or removal of loose or foreign body; metatarsophalangeal joint

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 28022 refers to an arthrotomy of the metatarsophalangeal joint, which involves surgical intervention to explore, drain, or remove loose or foreign bodies from this specific joint. The metatarsophalangeal joint is the articulation between the metatarsal bones of the foot and the proximal phalanges of the toes. This joint plays a crucial role in foot movement and stability. The procedure is typically indicated when there is a need to address conditions such as joint effusion, infection, or the presence of foreign materials that may be causing pain or dysfunction. During the arthrotomy, the surgeon makes an incision to access the joint capsule, allowing for direct examination and treatment of the underlying issues. The approach taken during the procedure is determined by the specific condition being treated, whether it involves fluid accumulation, infection, or foreign body removal. The goal of the procedure is to restore normal function to the joint and alleviate symptoms associated with the underlying condition.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 28022 is indicated for various conditions affecting the metatarsophalangeal joint. These indications include:

  • Joint Effusion - Accumulation of fluid within the joint space, which may cause swelling and discomfort.
  • Infection - Presence of infection within the joint, often characterized by pain, redness, and swelling, requiring drainage of purulent material.
  • Foreign Body Presence - The existence of loose or foreign materials within the joint that may lead to pain or impaired function.

2. Procedure

The procedure for CPT® Code 28022 involves several critical steps to ensure effective treatment of the metatarsophalangeal joint. These steps include:

  • Incision and Exposure - The surgeon begins by making an incision over the metatarsophalangeal joint to access the joint capsule. The surrounding tissues are carefully dissected to expose the joint, ensuring minimal damage to adjacent structures.
  • Joint Capsule Opening - Once the joint capsule is exposed, it is opened to allow for exploration of the joint interior. This step is crucial for assessing the condition of the joint and identifying any underlying issues.
  • Exploration and Drainage - The surgeon explores the joint for signs of infection or foreign bodies. If an infection is present, any fluid, including blood and purulent matter, is drained from the joint space. This helps to alleviate pressure and reduce the risk of further complications.
  • Culture Collection - Cultures are obtained from the joint fluid and sent for laboratory analysis. This step is essential for identifying the specific pathogens involved in an infection, guiding appropriate treatment.
  • Joint Flushing - The joint is flushed with saline solution to remove any remaining debris or contaminants. This step helps to clean the joint and promote healing.
  • Foreign Body Removal - Any identified foreign bodies within the joint are located and removed during the procedure. This is critical for restoring normal joint function and alleviating pain.
  • Final Flushing and Drain Placement - After the removal of foreign bodies, the joint is flushed again with saline solution. Drains may be placed as needed to facilitate further drainage of fluid and prevent accumulation.
  • Closure - The incision is closed in layers around the drain, ensuring proper healing and minimizing the risk of infection. A dressing is then applied to protect the surgical site.

3. Post-Procedure

Post-procedure care following an arthrotomy of the metatarsophalangeal joint includes monitoring for signs of infection, managing pain, and ensuring proper wound care. Patients may be advised to keep the surgical site clean and dry, and to follow specific instructions regarding activity levels to promote healing. The presence of drains may require additional care to prevent complications. Follow-up appointments are typically scheduled to assess the healing process and to remove any drains if applicable. Rehabilitation exercises may also be recommended to restore mobility and strength to the joint as it heals.

Short Descr EXPLORATION OF FOOT JOINT
Medium Descr ARTHRT W/EXPL DRG/RMVL LOOSE/FB MTTARPHLNGL JT
Long Descr Arthrotomy, including exploration, drainage, or removal of loose or foreign body; metatarsophalangeal joint
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P3D - Major procedure, orthopedic - other
MUE 3
CCS Clinical Classification 162 - Other OR therapeutic procedures on joints
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
82 Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s).
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
CR Catastrophe/disaster related
F1 Left hand, second digit
F2 Left hand, third digit
F4 Left hand, fifth digit
GC This service has been performed in part by a resident under the direction of a teaching physician
GW Service not related to the hospice patient's terminal condition
LT Left side (used to identify procedures performed on the left side of the body)
RT Right side (used to identify procedures performed on the right side of the body)
SG Ambulatory surgical center (asc) facility service
T1 Left foot, second digit
T2 Left foot, third digit
T3 Left foot, fourth digit
T4 Left foot, fifth digit
T5 Right foot, great toe
T6 Right foot, second digit
T7 Right foot, third digit
T8 Right foot, fourth digit
T9 Right foot, fifth digit
TA Left foot, great toe
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
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