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    v1.0.30
    OpenPayerPolicy UpdatesPodiatryCigna Subtalar Arthroereisis Coverage | OpenPayer
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    CurrentCignaPolicy 0486

    Subtalar Joint Implantation (Subtalar Arthroereisis)

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    This policy addresses coverage of subtalar joint implantation, also called subtalar arthroereisis or extraosseous talotarsal stabilization, including use for pes planus, posterior tibial tendon dysfunction, and talotarsal joint subluxation or dislocation.

    Policy Summary
    PayerCigna
    PolicySubtalar Joint Implantation (Subtalar Arthroereisis)
    Policy CodePolicy 0486
    Change TypeAnnual reviewno clinical policy statement changes
    Effective DateOct 15, 2026
    Next Review DateOct 15, 2027
    Key ActionUse the most appropriate billing codes in effect on the submission or service date.
    SourceLink
    POLICY UPDATE CHANGES

    No material clinical or coverage changes in this revision.

    UnprovenCoverage status
    3Specifically identified indications
    9.2%Overall complication rate
    46%Reported implant removal in adults

    Coverage Criteria

    OpenPayer is powered by Trek Health's payer performance platform. Trek continuously ingests, validates, and normalizes Transparency in Coverage data alongside payer policies and other commercial payer data to create a structured payer intelligence foundation. OpenPayer uses this foundation to deliver personalized search results, dynamically generated policy pages, and tailored policy monitoring based on each user's payers, specialties, billing codes, and areas of interest. The same intelligence powers broader payer performance workflows, including reimbursement benchmarking, contract evaluation, payer negotiations, and financial decision-making.

    Experimental, investigational, or unproven

    Subtalar joint implantation is considered experimental, investigational, or unproven for any indication.

    Experimental, investigational, or unproven procedure: Subtalar joint implantation, subtalar arthroereisis, or extraosseous talotarsal stabilization is considered experimental, investigational, or unproven regardless of the indication.

    This includes rigid or flexible pes planus (flatfoot), posterior tibial tendon dysfunction, and talotarsal joint subluxation or dislocation.

    Coverage is not provided for subtalar joint implantation, also called subtalar arthroereisis or extraosseous talotarsal stabilization, because it is considered experimental, investigational, or unproven for any indication. This includes treatment of rigid or flexible pes planus (flatfoot), posterior tibial tendon dysfunction, and talotarsal joint subluxation or dislocation.

    Coding Information

    CPT Codes — Considered Experimental/Investigational/UnprovenCPTExperimental
    28899Unlisted procedure, foot or toes
    0335TInsertion of sinus tarsi implant
    0511TRemoval and reinsertion of sinus tarsi implant
    HCPCS — Considered Experimental/Investigational/UnprovenHCPCSExperimental
    S2117Arthroereisis, subtalar

    Provider and Billing Guidance

    Documentation Required

    Submit current and appropriate codes

    When billing, use the most appropriate codes in effect as of the submission or service date. The policy code list may not be all-inclusive because AMA and CMS code updates may occur more frequently than policy updates.

    Denial Risk

    Procedure is unproven for any indication

    Requests for subtalar joint implantation, subtalar arthroereisis, or extraosseous talotarsal stabilization are denied as experimental, investigational, or unproven for any indication, including rigid or flexible pes planus, posterior tibial tendon dysfunction, and talotarsal joint subluxation or dislocation.

    Note

    Benefit plan terms control

    Coverage determinations are subject to the applicable benefit plan document, applicable laws and regulations, and the specific facts of the case. If the customer's benefit plan document conflicts with the Coverage Policy, the benefit plan document controls.

    Billing Rule

    Use valid applicable billing codes

    Claims submitted with codes that are not covered under the applicable Coverage Policy, or with deleted or ineffective codes at the time of service, may be denied as not covered or may not be eligible for reimbursement.

    Clinical Background

    Subtalar arthroereisis is a surgical procedure in which an implant is inserted into the sinus tarsi to decrease subtalar range of motion, improve the weight-bearing position during gait, and limit calcaneal eversion. The procedure has been investigated for pes planus, posterior tibial tendon dysfunction, and talotarsal joint dislocation.

    Terminology

    Subtalar joint implantation
    ProcedureA surgical procedure involving insertion of an implant into the sinus tarsi.
    Joint addressedThe subtalar joint.
    PurposeTo stabilize or limit motion of the subtalar joint.
    Subtalar arthroereisis
    Alternate termSubtalar arthroereisis is another name for subtalar joint implantation.
    TechniqueThe procedure uses an implant to stabilize the joint.
    Joint relationshipIt involves stabilization of the subtalar or talotarsal joint.
    Extraosseous talotarsal stabilization
    TermExtraosseous talotarsal stabilization is a term used for subtalar arthroereisis.
    Implant placementAn implant is inserted into the sinus tarsi.
    Intended effectThe procedure stabilizes the talotarsal relationship.
    Pes planus
    DefinitionPes planus, also called flatfoot or pes planovalgus, is loss of the normal medial longitudinal arch.
    Flexible presentationA normal arch is present during non-weight bearing but flattens when weight bearing.
    Rigid presentationAn acceptable medial longitudinal arch does not appear during non-weight bearing.
    Policy Summary
    PayerCigna
    PolicySubtalar Joint Implantation (Subtalar Arthroereisis)
    Policy CodePolicy 0486
    Change TypeAnnual reviewno clinical policy statement changes
    Effective DateOct 15, 2026
    Next Review DateOct 15, 2027
    Key ActionUse the most appropriate billing codes in effect on the submission or service date.
    SourceLink
    On This Page
    Coverage CriteriaCoding InformationProvider and Billing GuidanceClinical BackgroundTerminology