CPT® Code 28035

The procedure described by CPT® Code 28035 refers to the surgical release of the tarsal tunnel, specifically targeting the posterior tibial nerve to alleviate compression. The tarsal tunnel is an anatomical structure located at the posterior aspect of the ankle, formed by the flexor retinaculum, tibia, talus, and calcaneus. Within this tunnel, several important anatomical components are housed, including the posterior tibialis tendon, flexor digitorum tendon, flexor hallucis longus tendon, as well as the posterior tibial artery and vein, and the posterior tibial nerve itself. Tarsal tunnel syndrome arises when the posterior tibial nerve is compressed or entrapped within this fibro-osseous tunnel, leading to pain, numbness, or weakness in the foot. The surgical procedure involves making an incision on the posteromedial side of the ankle to access the flexor retinaculum, which is then released from the lateral malleolus to the sustentaculum tali. The surgeon carefully follows the tarsal tunnel distally, releasing the fascial arcade surrounding the medial and lateral plantar nerve branches up to the abductor hallucis. The goal of this procedure is to completely free the posterior tibial nerve from any adhesions or scar tissue, thereby relieving the symptoms associated with tarsal tunnel syndrome. After the nerve has been adequately decompressed, the soft tissue is meticulously closed in layers to promote optimal healing.