CPT® Code 28307

Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; first metatarsal with autograft (other than first toe)

An osteotomy of the first metatarsal, as described by CPT® Code 28307, involves surgical intervention aimed at correcting angular deformities of the foot. This procedure can be performed with or without additional techniques such as lengthening, shortening, or angular correction. The first metatarsal is a critical bone in the foot, and its alignment is essential for proper foot function. Conditions that may necessitate this procedure include acquired or congenital deformities such as hallux valgus (commonly known as bunions), metatarsus primus varus, hallux varus, and dorsal bunions. During the procedure, the surgeon exposes the first metatarsal, and depending on the specific deformity and the location of the osteotomy, the surgical excision may extend to involve adjacent structures, including the proximal phalanx and/or the medial cuneiform bones. The metatarsophalangeal (MTP) joint capsule may be incised, and tendons may be divided as necessary to facilitate the correction. The technique employed can vary; for instance, a closing wedge osteotomy involves cutting the metatarsal and removing a wedge of bone, while an opening wedge osteotomy entails cutting the bone and using a laminar spreader to create space for alignment. In both cases, bone autograft may be utilized, particularly if harvested from a site other than the first toe, to support the healing process and maintain the structural integrity of the metatarsal post-surgery.