CPT® Code 28112

The procedure described by CPT® Code 28112 refers to the complete excision of the metatarsal head, specifically for the second, third, or fourth metatarsals. This surgical intervention is typically indicated for the treatment of bony overgrowths that occur at the metatarsal heads, which can lead to pain and functional impairment. The procedure involves making a longitudinal or lazy-S incision on the dorsal aspect of the affected metatarsal head to access the underlying structures. During the surgery, care is taken to dissect the soft tissues while protecting the superficial blood vessels to minimize complications. The long extensor tendons are identified, detached, and may be transferred as necessary to ensure proper joint function post-surgery. The joint capsule is incised, allowing for the creation of a capsular flap, which facilitates the complete exposure and excision of the metatarsal head while preserving the phalangeal base. To stabilize the joint after excision, a Kirschner wire is inserted through the proximal phalanx into the metatarsal medullary canal. Finally, any excess joint capsule is either excised or plicated, and the overlying soft tissues are meticulously closed in layers to promote optimal healing. This procedure is distinct from similar codes, such as CPT® 28111, which pertains to the complete excision of the first metatarsal head, and CPT® 28113, which is for the fifth metatarsal head.