Triple arthrodesis is a surgical procedure designed to fuse three critical joints in the hindfoot:  the CPT code 28715 is assigned to triple arthrodesis.

• Subtalar joint
• Talonavicular joint
• Calcaneocuboid joint

Why Triple Arthrodesis?

This procedure is most often performed to:

• Alleviate pain: Patients suffering from severe arthritis or post-traumatic degeneration in these joints often experience significant pain.
• Correct deformities: Structural deformities or misalignments can be addressed by fusing the joints, thereby stabilizing the foot.
• Improve function: By eliminating painful motion between the joints, patients can achieve a more stable and, in many cases, a more functional foot.

Given the complexity and the extensive nature of this surgery, the CPT code 28715 is assigned to triple arthrodesis. The value associated with this code (13.42 in some fee schedules) reflects both the technical demand and the time required to perform the procedure.

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Related Arthrodesis Procedures

Understanding the nuances between different arthrodesis procedures is important for both clinicians and billing professionals. Below are two other common procedures in the realm of foot arthrodesis:

1. Pantalar Arthrodesis (CPT Code 28705)

Pantalar arthrodesis is a more extensive fusion procedure compared to triple arthrodesis. Here’s what sets it apart:

• Scope of Fusion: This procedure typically involves the fusion of the entire hindfoot and may include the ankle (tibiotalar) joint. Essentially, it’s a fusion of the “pan” (all) tarsal joints.
• Indications: It is often reserved for patients with widespread joint degeneration or severe deformities that affect not just the hindfoot but also the ankle. Conditions such as advanced arthritis or complex post-traumatic cases may necessitate this broader approach.
• CPT Code: The corresponding code for pantalar arthrodesis is 28705, with an associated relative value (e.g., 20.33) that indicates a higher complexity and operative time compared to triple arthrodesis.

2. Subtalar Arthrodesis (CPT Code 28725)

Subtalar arthrodesis is a more focused procedure:

• Scope of Fusion: Unlike triple arthrodesis, subtalar arthrodesis involves the fusion of only the subtalar joint. This joint, located below the ankle, plays a key role in foot inversion and eversion.
• Indications: This procedure is typically indicated when pain or instability is isolated to the subtalar joint, often due to arthritis, trauma, or inflammatory conditions.
• CPT Code: The specific CPT code for subtalar arthrodesis is 28725, and it generally carries a lower relative value (for example, 11.22) compared to both triple and pantalar arthrodesis, reflecting its narrower scope.

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How These CPT Codes Affect Billing and Reimbursement

CPT codes are not just numbers—they guide the billing process and help determine reimbursement rates for surgical procedures. The relative value units (RVUs) or similar metrics (such as the values shown: 20.33 for pantalar, 13.42 for triple, and 11.22 for subtalar arthrodesis) provide a benchmark for the complexity and time investment required by each procedure. Healthcare providers and billing professionals must use these codes correctly to ensure accurate documentation and proper compensation.

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Conclusion

To summarize:

• Triple arthrodesis is a fusion of the subtalar, talonavicular, and calcaneocuboid joints, used to relieve pain and correct deformities in the hindfoot. Its corresponding CPT code is 28715.
• Pantalar arthrodesis (CPT code 28705) involves a more extensive fusion that may include the ankle joint, addressing more widespread pathology.
• Subtalar arthrodesis (CPT code 28725) targets only the subtalar joint, making it the least extensive of the three procedures.

Understanding these distinctions is crucial for both clinical decision-making and accurate medical billing. Always ensure that you consult with both clinical experts and billing professionals to verify that you are using the most up-to-date codes and guidelines for your practice.