Podiatry CPT Codes: Complete Billing and Coding Guide

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Podiatry billing requires prior authorization approval and eligibility checks to submit claims on time, pass first-claim acceptance rates, and avoid denials. It’s only one side of billing; the other depends heavily on coding. Without it, insurers can’t process your claims.

Podiatry CPT codes can change your claims entirely; one minor error can lead to denial. From nail debridement to foot care, ankle, and other surgical treatments, you need to add the most appropriate CPT codes to avoid denials. But challenges come up when CPT coding guidelines change; one payer accepts CPT 11721, and another doesn’t—that’s where things get messed up. In today’s guide, we provide a list of common podiatry CPT codes with detailed explanations, billing guidelines, and errors to avoid for clean claim submission.

Understanding Podiatry CPT Codes

The American Medical Association (AMA) introduced podiatry CPT codes and updates them annually to improve healthcare records and reimbursement accuracy.

These Current Procedural Terminology (CPT) codes indicate what procedure or treatment is delivered to the patient and help insurers release reimbursements based on the captured codes.

List of Common Podiatry CPT Codes

Here’s an overview of common podiatry CPT codes used to bill podiatry services.

CPT code	Description
11719	Trimming of one or more developed nails (fingers or toes).
11720	Removal or debridement of 1 to 5 abnormal, diseased, or infected nails.
11721	Removal or debridement of 6 or more abnormal, diseased, or infected nails.
11730	Removal of part or all of a single nail plate by avulsion method.
11732	Removal of part or all of an additional nail plate after the first use of avulsion method.
11740	Evacuation of a nail hematoma.
11750	Removal of part or all of a fingernail or toenail, including nail plate and matrix.
11755	Biopsies of nail plate, bed, hyponychium, proximal nail folds, or lateral nail folds.
11760	Repair of nail bed.
11762	Repair of nail bed using a graft.
11765	Wedge excision of lateral margin og nail.
11055	Single benign hyperkeratotic lesion.
11056	2 to 4 benign hyperkeratotic lesions.
11057	More than 4 benign hyperkeratotic lesions.
97597	Excision of dead tissue from an open wound, area measures 20 cm² or less.
97598	Additional excision of open wound care.
97602	Removal of dead tissue from wound without viable and non-viable tissues.
97605	Subatmospheric pressure around the wound to remove fluids and infectious materials of area less than or equal to 50 cm².
97606	Subatmospheric pressure around the wound to remove fluids and infectious materials of area more than 50 cm².
97610	Wound healing improvement by using a low-frequency ultrasound device.
11000	Debridement of dead tissue in skin for up to 10% of the body surface.
11001	Additional 10% of dead tissue debridement from the skin.
11042	Dead tissue skin removal of subcutaneous layer for the first 20 cm².
11045	Additional 20 cm² debridement of subcutaneous layer.
11043	Debridement of muscle or fascia for the first 20 cm².
11046	Debridement of muscle or fascia and subcutaneous layer for the additional 20 cm².
11044	Debridement of infected tissue in bone, covers the first or only 20 cm² or less.
11047	Debridement of infected tissue in bone, covers additional 20 cm².
20550	Reduction of aponeurosis formation through therapeutic medical procedure.
20551	Injection of tendon origin or insertion.
20600	Injection into a small joint, without ultrasound guidance.
20604	Injection into a small joint, with ultrasound guidance.
20605	Injection into an intermediate joint without ultrasound guidance.
20606	Injection into an intermediate joint with ultrasound guidance.
20610	Injection into a major joint or bursa to remove fluid, without using ultrasound guidance.
20611	Injection into a major joint or bursa to remove fluid, using ultrasound guidance.
28001	Drainage of bursa of the foot.
28005	Incision of the bone cortex.
28008	Incision of the foot or toe.
28010	Percutaneous tenotomy of a single tendon.
28011	Percutaneous tenotomy of multiple tendons.
28024	Incision of a toe joint.
28043	Excision of abnormal mass from foot or toe less than 1.5 cm.
28110	Incision of fifth bone of the foot.
28111	Removal of first metatarsal head.
28112	Removal of second, third, or fourth metatarsal head.
28122	Removal of infected portion of tarsal or metatarsal bone.
28285	Repairs a hammertoe deformity.
28292	Correction of hallux valgus (bunion).
28296	Correction of hallux valgus (bunion) with metatarsal osteotomy.
28750	Arthrodesis of great toe metatarsophalangeal joint.
28755	Arthrodesis of interphalangeal joint.
28470	Metatarsal fracture treatment without manipulation or skin incision.
28475	Closed treatment of metatarsal fracture with manipulation or adjustment.
28490	Correction of great toe or phalanx fracture without surgery or manipulation.
28495	Closed treatment of a phalanx or phalanges fracture in the great toe with manipulation.
28510	Closed treatment of a phalanx or phalanges fracture without manipulation.
28515	Closed treatment of a phalanx or phalanges fracture in a toe other than the great toe with manipulation or adjustment.
28600	Closed treatment of a tarsometatarsal joint dislocation, without using anesthesia.
28605	Closed treatment of a tarsometatarsal joint dislocation, with anesthesia.
99202	E/M service for a new patient for 15 or more minutes, or straightforward medical decision making.
99203	E/M service for a new patient for 30 or more minutes, or low-level medical decision making.
99204	E/M service for a new patient for 45 or more minutes, or moderate-level medical decision making.
99205	E/M service for a new patient for 60 or more minutes, or high-level medical decision making.
99212	E/M service for an established patient for 10 or more minutes, or straightforward level of medical decision making.
99213	E/M service for an established patient for 20 or more minutes, or low level of medical decision making.
99214	E/M service for an established patient for 30 or more minutes, or moderate level of medical decision making.
99215	E/M service for an established patient for 40 or more minutes, or high level of medical decision making.
73600	X-ray of ankle, 2 views.
73610	X-ray of ankle, 3 or more views.
73620	X-ray of foot, 2 views.
73630	X-ray of foot, 3 views.
73650	X-ray of calcaneus (heel bone), 2 views.
73660	X-ray of one or multiple toes, 2 views.
73718	MRI of lower extremity without contrast.
73719	MRI of lower extremity with contrast.
73720	MRI of lower extremity without and with contrast.

Podiatry CPT Codes by Procedure Type

Let’s discuss common podiatry CPT codes used for billing by their procedure type in detail.

Evaluation & Management (E/M) CPT Codes

When podiatrists perform evaluation and management (E/M) services to diagnose symptoms or diseases and document the findings, use the following codes based on the patient type (new/established).

CPT Code	Patient Type	Description
99202	New	15 minutes, straightforward MDM.
99203	New	30 minutes, low-level MDM.
99204	New	45 minutes, moderate-level MDM.
99205	New	60 minutes, high level of MDM.
99212	Old	10 minutes, straightforward MDM.
99213	Old	20 minutes, low-level MDM.
99214	Old	30 minutes, moderate-level MDM.
99215	Old	40 minutes, high level of MDM.

Routine Foot Care CPT Code

When the provider performs routine foot care services, which involve basic hygiene, maintenance, and preventive treatments for the foot and toenails, use the following CPT codes.

CPT Code	Description
11055	Single benign hyperkeratotic lesion using surgical instruments like a scalpel or curette.
11056	2 to 4 benign hyperkeratotic lesions removed using a scalpel or curette.
11057	More than 4 benign hyperkeratotic lesions removed using a scalpel or curette.

Nail Procedure CPT Codes

A nail procedure is the process of trimming or removing the infectious, damaged, or tumorous nails from the fingernails or toenails.

CPT Code	Description
11719	Trimming of one or more normally developed nails.
11720	Debridement of 1 to 5 abnormal, diseased, or infected nails.
11721	Debridement of 6 or more abnormal, diseased, or infected nails.
11730	Single nail plate removal of some part or all using simple avulsion technique.
11732	Additional nail plate removal of some part or all after using the first simple avulsion technique.
11740	Nail hematoma evacuation, means draining blood from under the nail.
11750	Removal of some part or all of a fingernail or toenail, including the nail plate, matrix, and lunula, if the excision is complete.
11755	Biopsies of nail plate, bed, hyponychium, proximal nail folds, or lateral nail folds.
11760	Repair of damage to the nail bed due to laceration, crush, or avulsion.
11762	Repair of damage to the nail bed by using a graft due to laceration, crush, or avulsion.
11765	Wedge excision of the nail fold at the lateral margin (groove) of a nail, such as ingrown toenail.

Wound Care & Debridement CPT Codes

Wound care and debridement CPT codes report procedures performed to clean, manage, and remove damaged tissue from wounds. In podiatry, these codes commonly apply to diabetic foot ulcers, pressure wounds, and chronic foot injuries.

CPT Code	Description
97597	Selective debridement of wounds, first 20 sq. cm or less.
97598	Each additional 20 sq. cm of selective debridement.
11042	Debridement of subcutaneous tissue, first 20 sq. cm or less.
11043	Debridement of muscle and/or fascia, first 20 sq. cm or less.
11044	Debridement of bone, first 20 sq. cm or less.
11045	Each additional 20 sq. cm of subcutaneous tissue debridement.
11046	Each additional 20 sq. cm of muscle and/or fascia debridement.
11047	Each additional 20 sq. cm of bone debridement.
97602	Non-selective wound debridement, without anesthesia.
97605	Negative pressure wound therapy (NPWT), wound area 50 sq. cm or less.
97606	Negative pressure wound therapy (NPWT), wound area greater than 50 sq. cm.

Skin Lesion & Callus Treatment CPT Codes

These CPT codes report procedures involving the removal, excision, or treatment of skin lesions, corns, and calluses on the feet and toes.

CPT Code	Description
17110	Destruction of 1–14 benign skin lesions, such as plantar warts.
17111	Destruction of 15 or more benign skin lesions.
11420	Excision of benign skin lesion on scalp, neck, hands, feet, or genitalia; excised diameter 0.5 cm or less.
11421	Excision of benign skin lesion, same anatomical areas; 0.6–1.0 cm.
11422	Excision of benign skin lesion; 1.1–2.0 cm.
11423	Excision of benign skin lesion; 2.1–3.0 cm.
11424	Excision of benign skin lesion; 3.1–4.0 cm.
11426	Excision of benign skin lesion; over 4.0 cm.

Injection Procedure CPT Codes

Injection procedure CPT codes report injections administered to treat foot and ankle conditions, including plantar fasciitis, tendon inflammation, joint pain, and ligament disorders.

CPT Code	Description
20550	Injection into a tendon sheath, ligament, or aponeurosis.
20551	Injection into a tendon origin or insertion.
20600	Aspiration and/or injection of a small joint or bursa.
20604	Small joint aspiration/injection with ultrasound guidance.
20605	Aspiration and/or injection of an intermediate joint or bursa.
20606	Intermediate joint aspiration/injection with ultrasound guidance.
20610	Aspiration and/or injection of a major joint or bursa.
20611	Major joint aspiration/injection with ultrasound guidance.

Foot & Ankle Surgery CPT Codes

Foot and ankle surgery CPT codes report surgical procedures performed to treat bone deformities, joint disorders, soft tissue conditions, and other foot and ankle problems.

CPT Code	Description
28001	Incision and drainage of bursa, foot.
28008	Tenotomy of foot tendon, subcutaneous.
28010	Percutaneous tenotomy of a single toe.
28011	Percutaneous tenotomy of multiple toes.
28043	Excision of soft tissue tumor, foot or toe, subcutaneous.
28110	Partial excision of the fifth metatarsal head.
28112	Partial excision of the second, third, or fourth metatarsal head.
28122	Partial excision of bone in the foot.

Hammertoe Repair

Hammer toe repair CPT codes are used when the provider performs surgical treatment of a hammertoe deformity (or related lesser toe deformities like claw toe or mallet toe) on toes two through five.

CPT Code	Description
28285	Hammertoe deformity repair.
28286	Correction of hammertoe deformity with volar plastic closure.

Bunion Surgery

Bunion surgery CPT codes report the bunionectomy, which corrects the bone and tissue misalignment of a bunion (hallux valgus).

CPT Code	Description
28292	Bone removal from a bunion.
28296	Bone removal from a bunion, with distal metatarsal osteotomy.
28295	Bone removal from a bunion, with a proximal metatarsal osteotomy.
28297	Bone removal from a bunion, with fusion of joint between foot’s first metatarsal bone and the medial cuneiform bone.
28298	Bone removal from a bunion, with proximal phalanx osteotomy.
28299	Bone removal from a bunion, with double osteotomy.

Tendon and Bone Procedures

Tendon and bone procedure CPT codes report surgical treatments for foot and ankle conditions, including tendon injuries, bone deformities, fractures, and joint disorders.

CPT Code	Description
27650	Primary repair of a ruptured Achilles tendon.
27652	Primary Achilles tendon repair with graft augmentation.
27654	Secondary repair of a ruptured Achilles tendon.
27658	Repair of a flexor tendon in the leg, primary.
27659	Repair of a flexor tendon in the leg, with graft.
27685	Lengthening or shortening of a leg or ankle tendon, single tendon.
27686	Lengthening or shortening of multiple leg or ankle tendons.
28118	Partial excision of the heel bone (calcaneus).
28119	Partial excision of the heel bone with plantar fascial release.
28120	Partial excision of bone in the talus or calcaneus.
28122	Partial excision of bone in the foot.
28200	Repair of a flexor tendon in the foot, primary.
28202	Repair of a flexor tendon in the foot, with graft.
28208	Repair of an extensor tendon in the foot, primary.
28210	Repair of an extensor tendon in the foot, with graft.
28308	Osteotomy of a metatarsal bone, other than the first metatarsal.
28306	Osteotomy of the first metatarsal.
28740	Fusion of a single midtarsal or tarsometatarsal joint.
28730	Fusion of multiple midtarsal or tarsometatarsal joints.

Osteotomy Procedures

Osteotomy CPT codes report surgical procedures that cut, reshape, or reposition bones to correct deformities, improve alignment, and relieve pressure or pain. In podiatry, osteotomies commonly treat bunions, metatarsal deformities, and other foot alignment problems.

CPT Code	Description
28304	Osteotomy of a tarsal bone, other than the calcaneus.
28305	Osteotomy of the calcaneus.
28306	Osteotomy of the first metatarsal.
28307	Osteotomy of the first metatarsal with autogenous or other graft.
28308	Osteotomy of a metatarsal, other than the first metatarsal.
28309	Osteotomy of multiple metatarsals.
28310	Osteotomy of a toe phalanx.

Common Modifiers Used in Podiatry Billing

In podiatry medical billing, modifiers play an important role, as they add context to the service/treatment delivered to the patient. They help insurers understand whether a service should receive extra payment, reduced payment, or be unbundled from standard edits to ensure accurate reimbursement.

Here’s the list of common modifiers and their descriptions to help you choose the one that fits your context.

Modifier	Description
Q7	One Class A finding; non-traumatic amputation of the foot.
Q8	Two Class B findings; absent posterior tibial or dorsalis pedis pulse, advanced trophic changes.
Q9	One Class B and two Class C findings (e.g., claudication, temperature changes, edema, paresthesia).
LT/RT	Left foot/right foot.
TA	Left foot, great toe (hallux).
T1 – T4	Left foot, digits 2 through 5.
T5	Right foot, great toe (hallux).
T6 – T9	Right foot, digits 2 through 5.
25	E/M service by same physician on the same date.
59	Distinct procedural service.

Podiatry CPT Codes Billing Guidelines For Maximum Reimbursement

Podiatry CPT coding and billing guidelines help foot and ankle practices report procedures accurately, avoid claim denials, and receive appropriate reimbursement for covered services.

To maximize reimbursement, podiatry practices should follow these key billing practices:

Select the most appropriate and updated CPT code that accurately represents the services performed.
Ensure medical records support the billed service, including patient symptoms, medical history, examination findings, wound measurements, tissue depth, and anatomical site.
Use the modifiers where required.
Before submitting a claim, verify Medicare coverage requirements, as it doesn’t cover all routine foot care services. Coverage may depend on the patient’s underlying systemic condition, qualifying clinical findings, and medical necessity.
Always link the appropriate diagnosis code with the CPT code to establish medical necessity.
Before providing treatment, you must verify the patient’s insurance eligibility, prior authorization requirements, and frequency limitations for routine foot care.

Common Podiatry Coding Errors That Trigger Claim Denials

Here are some common podiatry coding mistakes that practices should avoid:

Incorrect CPT code selection.
Missing or incorrect use of modifiers.
Incomplete medical necessity or documentation.
Incorrect wound debridement coding.
Billing bundled services by unbundling them.
Failure to verify insurance coverage.
Forgetting to obtain a prior authorization number.
Incomplete or missing clinical documentation.
Missing or incorrect patient demographics.
Linking the wrong ICD-10 diagnosis code to a CPT code.

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Frequently Asked Questions

Why is podiatry billing different from general medical billing?

Podiatry billing is different from general medical billing due to it’s requirements, such as wound care debridement depth/area, Q-modifiers, routine foot care restrictions, and surgical frequency limitations and guidelines. These factors make podiatry billing differ from most other specialties.

What are the most commonly used CPT codes in podiatry?

Common podiatry CPT codes include 11720 and 11721 for nail debridement, 11055–11057 for callus removal, 97597 for selective wound debridement, 28285 for hammertoe correction, and 28296 for bunion surgery. Other codes cover foot injections, fracture treatment, and evaluation and management (E/M) services.

What CPT codes are used for routine foot care and nail debridement?

Common CPT codes for routine foot care and nail treatment include:

11055–11057: Paring or cutting of corns and calluses.
11719: Trimming of nondystrophic nails.
11720: Debridement of 1–5 nails.
11721: Debridement of 6 or more nails.
G0127: Trimming of dystrophic nails.

Does Medicare cover routine podiatry services?

Medicare Part B generally does not cover routine foot care, such as nail trimming and callus removal, unless specific coverage exceptions apply. However, Medicare may cover certain foot care services for patients with qualifying systemic conditions, associated clinical findings, or medically necessary treatment needs. Coverage depends on Medicare guidelines, documentation, and applicable billing requirements.

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