Podiatry CPT Codes 2026: A Guide for Providers and Patients
Podiatry CPT codes · Updated Oct 13, 2026
46 working9920299203992049920599212992139921499215117191172011721117301173211750110551105611057G0127L30209776011042110431104411045110461104797597975982055020551206102828528292282962829728298282992811028510281192874028450–2849528805288102882028825
This updated guide to podiatry CPT codes gives providers and patients a clear, current reference for foot and ankle billing. Every code below was verified against the 2026 CPT code set, and all core podiatry codes are unchanged in 2026. The billing facts that matter this year: routine foot care remains statutorily excluded by Medicare under Section 1862(a)(13) unless a covered systemic diagnosis is paired with class-finding modifiers Q7, Q8, or Q9, and at-risk foot care is generally payable no more often than every 60 days. Use it as a billing checklist for providers or a plain-language reference for patients.
In this refreshed October 2026 edition, we break down the sections of the podiatry CPT codes guidance that matter most: authorization requirements, covered and routine foot care services, and a complete code list for foot and ankle care. Use it as a billing checklist for providers or a plain-language reference for patients.
Authorization Requirements and Frequency of Covered Podiatric CPT Codes Services
Podiatrists must obtain prior authorization for certain services by contacting the Centers Plan for Healthy Living Utilization Management team at 1-844-292-4211 (Option 1) or by faxing requests to 1-718-581-5522. Note that authorization does not guarantee payment—claims must still be submitted correctly.
Member Eligibility
Providers are responsible for verifying member eligibility. This can be done by calling Member Services at (855) 270-1600 or via the online Provider Portal available 24/7.
Medically Necessary Podiatry
| Plan | Authorization Requirement |
|---|---|
| MLTC | No Authorization Required |
| MAPD | No auth for first 4 visits/year; auth required thereafter |
| DSNP | No auth for first 4 visits/year; auth required thereafter |
| ISNP | No Authorization Required |
| MAP | No auth for first 4 visits/year; auth required thereafter |
Not Medically Necessary (Routine) Podiatry
| Plan | Authorization Requirement |
|---|---|
| MLTC | Not covered unless it prevents medical complications* |
| MAPD | Not covered unless it prevents medical complications* |
| DSNP | No auth required; limited to 4 visits per year |
| ISNP | No auth required; limited to 1 visit every 3 months |
| MAP | Not covered unless it prevents medical complications* |
Complications include diabetes, arthritis, vascular disease, and common foot issues like ingrown toenails, plantar fasciitis, ulcers, corns, calluses, and minor Achilles tendon tears. Prior authorization is required for routine care that prevents further complications.
Full List of Podiatry CPT Codes [2026]
Below is the complete 2026 table of foot and ankle CPT and HCPCS codes, verified against current billing sources.
Full codes table (tap to open)
| CPT Code | Common service |
|---|---|
| 99202 | New patient office visit, straightforward MDM |
| 99203 | New patient office visit, low MDM |
| 99204 | New patient office visit, moderate MDM |
| 99205 | New patient office visit, high MDM |
| 99212 | Established patient visit, straightforward MDM |
| 99213 | Established patient visit, low MDM |
| 99214 | Established patient visit, moderate MDM |
| 99215 | Established patient visit, high MDM |
| 11719 | Trimming of nondystrophic nails, any number |
| 11720 | Debridement of 1 to 5 nails |
| 11721 | Debridement of 6 or more nails |
| 11730 | Avulsion of nail plate, single |
| 11732 | Each additional nail plate avulsion |
| 11750 | Excision of nail and nail matrix, permanent removal |
| 11055 | Callus or corn paring, single lesion |
| 11056 | Callus or corn paring, 2 to 4 lesions |
| 11057 | Callus or corn paring, more than 4 lesions |
| G0127 | Trimming of dystrophic nails, any number |
| L3020 | Materials for custom orthotics |
| 97760 | Orthotic management and training |
| 11042 | Surgical debridement, epidermis and dermis, first 20 sq cm |
| 11043 | Surgical debridement, subcutaneous tissue, first 20 sq cm |
| 11044 | Surgical debridement, muscle and fascia, first 20 sq cm |
| 11045 | Surgical debridement, each additional 20 sq cm, epidermis and dermis |
| 11046 | Surgical debridement, each additional 20 sq cm, subcutaneous tissue |
| 11047 | Surgical debridement, each additional 20 sq cm, muscle and fascia |
| 97597 | Active wound-care debridement, first 20 sq cm |
| 97598 | Active wound-care debridement, each additional 20 sq cm |
| 20550 | Injection, tendon sheath or ligament |
| 20551 | Injection, tendon origin |
| 20610 | Injection, major joint or bursa |
| 28285 | Hammertoe correction, one toe |
| 28292 | Bunion correction, other variant |
| 28296 | Bunionectomy with distal metatarsal osteotomy |
| 28297 | Bunion correction, Lapidus-type procedure |
| 28298 | Bunion correction, other variant |
| 28299 | Bunion correction, other variant |
| 28110 | Bunionette ostectomy, 5th metatarsal head |
| 28510 | Closed phalangeal fracture treatment, other than great toe |
| 28119 | Calcaneal ostectomy |
| 28740 | Midfoot arthrodesis |
| 28450–28495 | Tarsal and metatarsal fracture care |
| 28805 | Transmetatarsal amputation |
| 28810 | Amputation, metatarsal |
| 28820 | Metatarsophalangeal joint disarticulation |
| 28825 | Interphalangeal joint disarticulation |
Podiatry CPT Codes 2026 Update: Injections, Surgical Debridement, HCPCS Codes, and Modifiers
October 2026 update: the table above lists the verified 2026 podiatry code set, and every code there is unchanged in 2026. These additions complete the guide. Injections: 20550 (tendon sheath or ligament injection), 20551 (tendon origin or insertion), and 20610 (major joint or bursa aspiration and injection). Surgical wound debridement: 11042 through 11047, chosen by wound depth and area. HCPCS codes: G0127 (trimming of dystrophic nails, any number), L3020 (materials for custom foot orthotics), and 97760 (orthotic management and training).
Modifiers decide whether these codes get paid. Append modifier 25 when a same-day evaluation and management visit is separately identifiable from a procedure. Use class-finding modifiers Q7, Q8, or Q9 to support coverage of routine foot care when a covered systemic diagnosis is present, and add toe modifiers TA through T9 plus RT or LT for laterality. Routine foot care remains statutorily excluded by Medicare under Section 1862(a)(13) unless a covered systemic diagnosis and a Q7, Q8, or Q9 modifier are present, and at-risk foot care is generally payable no more often than every 60 days.
Browse more Podiatry CPT Codes articles
More billing references: browse our Codes guides and the Podiatry CPT Codes tag archive.
Bookmark the Podiatry CPT Codes archive to check for future updates.
Official reference: American Medical Association CPT code set.
FAQs: Podiatric CPT Codes
What are podiatry CPT codes?
CPT codes used for medical and surgical procedures performed on the foot and ankle by a podiatrist.
What is CPT code 27301 used for?
Injection of a therapeutic substance into the knee joint.
What is CPT code 28020?
A code for the surgical removal of a lesion on the foot, such as a corn or callus.
What is CPT code 99242 used for?
An outpatient consultation service with a detailed history and examination.
What is CPT 78813?
A nuclear medicine imaging procedure that combines PET and CT scans to track tumor metabolism.
What is CPT code 11720?
Debridement of a single nail, involving the removal of damaged tissue.
What is the CPT code 27310?
Arthrocentesis, the aspiration and/or injection of a major joint, like the knee.
What is CPT code 26991?
Amputation of a finger at the metacarpal bone level.
What is CPT code 27824?
Open treatment of a dislocated ankle, often including a fracture repair.
What is CPT code 28002?
Excision of a lesion on the foot’s fascia.
What is CPT 78012?
A thyroid uptake imaging study to evaluate thyroid gland function.
What is CPT 00790?
Anesthesia for shoulder cast application or removal.
What is CPT 99024 used for?
A code for a routine post-operative follow-up visit within the global surgery period.
Is 66984 a CPT code?
Yes, it is the CPT code for cataract surgery with an intraocular lens implant.
What is CPT 99202?
An office visit for a new patient requiring a straightforward medical decision.
What is CPT 95180?
Rapid desensitization procedure for allergies, such as to antibiotics like penicillin.
What is CPT 58970?
A salpingo-oophorectomy, the removal of an ovary and its fallopian tube.
What is CPT P9040?
This is an HCPCS Level II code, not a CPT code, for a unit of leukocyte-rich red blood cells.
What is CPT code 25500?
Closed treatment of a radial shaft fracture in the forearm without manipulation.
What is CPT 93246?
External mobile cardiovascular telemetry for monitoring heart rhythms over 24-48 hours.
What is CPT code 27712?
Open treatment of a tibial shaft fracture.
What is the CPT code 76820?
A Doppler ultrasound of a pregnant uterus.
What is the CPT code 27750?
Closed treatment of an ankle dislocation without a fracture.
What is CPT code 24470?
A code for the repair of a dislocated elbow.
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