CPT® Code 28171

Radical resection of a tumor in the tarsal region, excluding the talus or calcaneus, is a surgical procedure primarily indicated for the removal of malignant neoplasms. However, it may also be necessary for benign tumors or those of indeterminate nature. The procedure begins with the creation of a skin incision directly over the tumor site, or alternatively, a skin flap may be elevated to provide access. Once the incision is made, the surgeon meticulously dissects the overlying tissue to expose the tumor. The radical resection involves the complete removal of all bone and cartilage that is affected by the tumor, ensuring that the tumor is excised en bloc, which means the tumor is taken out in one piece along with a generous margin of healthy surrounding tissue. This approach is critical to minimize the risk of residual tumor cells remaining in the body. The resection of bone also necessitates the excision of all involved soft tissues, which can include muscles, tendons, fat, blood vessels, lymph vessels, nerves, and any tissues that are adjacent to the joints. To confirm that the surgical margins are free of tumor cells, a separately reportable frozen section may be performed during the procedure. If any margins are found to contain malignancy, further tissue removal is conducted until all margins are confirmed to be clear of tumor cells. After the tumor and surrounding tissues are removed, drains may be placed as necessary to prevent fluid accumulation. The surgical wound is typically closed in layers, and if required, additional reconstructive procedures may be performed to restore the area’s function and appearance. For coding purposes, the appropriate CPT® code for this procedure is 28171, while other codes are designated for metatarsal and phalanx of the toe procedures.