CPT® Code 28113

The procedure described by CPT® Code 28113 refers to the complete excision of the fifth metatarsal head, which is a surgical intervention aimed at addressing bony overgrowth in this area. The fifth metatarsal is located on the outer side of the foot and is crucial for weight-bearing and balance. When there is excessive bone growth, it can lead to pain, discomfort, and functional limitations. The surgical approach involves making a longitudinal or lazy-S incision on the dorsal aspect of the affected metatarsal head, allowing the surgeon to access the underlying structures. Careful dissection of the soft tissues is performed to protect the superficial blood vessels, ensuring that blood supply to the area is maintained. The procedure also involves identifying and detaching the long extensor tendons, which may need to be transferred to facilitate proper healing and function post-surgery. The joint capsule is incised to create a capsular flap, providing access to the metatarsal head, which is then completely excised 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 specifically indicated for the fifth metatarsal head, distinguishing it from similar procedures for the first, second, third, or fourth metatarsal heads, which are coded differently (CPT® Codes 28111 and 28112).