Summary & Overview
CPT 28715: Triple Arthrodesis (Hindfoot Fusion)
CPT code 28715 denotes a triple arthrodesis — fusion of the subtalar, talonavicular and calcaneocuboid joints — performed for degenerative arthritis or traumatic injury to stabilize the hindfoot and restore function. Nationally, this code captures a specialized orthopedic surgical intervention with implications for surgical utilization, hospital resource use, and post-operative rehabilitation pathways.
Key payers in the coverage and reimbursement landscape include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. These payers collectively shape prior authorization, coverage criteria, and payment policies that affect access and site-of-service decisions for patients requiring hindfoot fusion.
Readers will find clinical context about when a triple arthrodesis is performed, an overview of typical settings of care, and benchmarking information relevant to utilization and policy. The publication also summarizes common modifiers and coding considerations, outlines where claim complexity often arises, and highlights policy updates or payer practices that influence authorization and payment. This summary is intended to inform coding professionals, orthopedic providers, and policy analysts about the clinical and administrative contours of CPT code 28715 at a national level.
Billing Code Overview
CPT code 28715 describes a triple arthrodesis, a surgical procedure in which the provider fuses three joints of the hindfoot — the subtalar, talonavicular, and calcaneocuboid joints — to address severe degenerative arthritis or trauma and to stabilize and mobilize the ankle complex. The procedure is classified as an orthopedic surgical service focused on hindfoot fusion.
Service Type: Surgical — Orthopedic/Hindfoot Fusion
Typical Site of Service: Hospital inpatient or outpatient surgical center, depending on clinical complexity and post-operative needs.
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with long-standing post-traumatic and degenerative collapse of the hindfoot presents with progressive ankle and hindfoot pain, deformity, and impaired ambulation despite conservative care including bracing and corticosteroid injections. Imaging demonstrates severe arthritic destruction with instability involving the subtalar, talonavicular, and calcaneocuboid joints. The orthopedic foot and ankle surgeon schedules a triple arthrodesis to fuse these three joints to restore a plantigrade, stable hindfoot and reduce pain.
Preoperative workflow includes history and physical, medical optimization, informed consent, preoperative weight-bearing and advanced imaging, and anesthesia evaluation. Intraoperative steps include exposure of the subtalar, talonavicular, and calcaneocuboid joints, cartilaginous debridement, alignment correction, bone grafting as indicated, and rigid internal fixation (plates, screws, or staples). Postoperative care includes immobilization in a cast or boot, non-weight-bearing for a period per surgeon protocol, serial radiographs to document fusion, and progressive rehabilitation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
52 | Reduced services | Use when the triple arthrodesis is partially reduced in scope compared with the full procedure. |