Surgical fusion of the three hindfoot joints — subtalar, talonavicular, and calcaneocuboid — performed as a single operative procedure.

Verified May 8, 2026 · 5 sources ↓

Medicare: $883.79
Total RVUs: 26.46
Global, days: 90
Region: Foot & ankle

Drawn from CMSAAPCZimmerbiometMdclarity

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 5 cited references ↓

Operative note must name all three joints fused: subtalar, talonavicular, and calcaneocuboid — generic language like 'hindfoot fusion' is an audit flag.
Document the indication by name (e.g., stage IV PTTD, post-traumatic arthritis, Charcot-Marie-Tooth) and confirm failure of conservative treatment.
Record fixation method and implant details including manufacturer, lot number, and size for each joint.
Note the surgical approach used for each joint — auditors flag operative notes that describe access without specifying approach per joint.
Preoperative imaging (weight-bearing X-rays, CT, or MRI) confirming arthritic changes or deformity at all three joints must be in the chart.
If bone graft is used, document source (autograft vs. allograft) and harvesting site, as separate graft codes may apply.

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 50 Bilateral procedure 51 Multiple procedures 58 Staged or related 78 Unplanned return — related 79 Unrelated during global LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

28715 covers open triple arthrodesis of the hindfoot: simultaneous fusion of the subtalar, talonavicular, and calcaneocuboid joints. The procedure eliminates motion across all three joints to correct deformity, relieve arthritic pain, or stabilize a foot that has failed conservative management. Common indications include end-stage posterior tibial tendon dysfunction (adult-acquired flatfoot), post-traumatic arthritis, rheumatoid arthritis, and neuromuscular conditions such as Charcot-Marie-Tooth disease.

The 90-day global period covers the day-before visit, the surgery itself, and all routine post-op care through day 90. Complications requiring a return to the OR for a related issue bill with modifier 78. An unrelated procedure in the same global window gets modifier 79. E/M visits during the global that address a new or unrelated problem need modifier 24.

Triple arthrodesis sits adjacent to 28705 (pantalar arthrodesis) and 28725 (subtalar arthrodesis alone). Don't upcode to 28705 unless the tibiotalar joint is also fused. Don't downcode to 28725 if all three hindfoot joints are addressed — the operative note must explicitly document work at each of the three joints to defend 28715.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	13.08
Practice expense RVU	11.02
Malpractice RVU	2.36
Total RVU	26.46
Medicare national rate	$883.79
Global period	90 days

Payment by site of service

Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.

Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026

Setting	Medicare rate (national)
Office (PFS non-facility) Procedure performed in physician's office	$883.79
HOPD (APC 5115) Hospital outpatient department	$13,116.76
ASC (PI J8) Ambulatory surgical center (freestanding)	$9,510.96

Common denial reasons

The recurring reasons claims for CPT 28715 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

Operative note documents only one or two hindfoot joints, triggering downcoding to 28725 or 28730.
Missing or inadequate conservative treatment history — payers require documented failure of non-surgical management before approving elective hindfoot fusion.
Preoperative imaging not linked to the claim or absent from the medical record, causing medical necessity denial.
Upcoding flag when billing 28715 on the same claim as 28725 or 28705 for the same foot on the same date — these are mutually exclusive.
Global period violation: post-op E/M visits billed without modifier 24 when the visit is unrelated to the fusion.

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 5 cited references ↓

01What is the difference between 28715 and 28705?

28715 fuses the three hindfoot joints (subtalar, talonavicular, calcaneocuboid). 28705 (pantalar) adds the tibiotalar (ankle) joint. Use 28705 only if the ankle joint is explicitly fused in the same operative session.

02Can I bill 28715 and 28725 together for the same foot?

No. 28725 covers subtalar arthrodesis alone. If all three hindfoot joints are fused, 28715 is the correct code and subsumes 28725. Billing both for the same foot on the same date will trigger an NCCI bundling edit.

03Is modifier 50 appropriate if triple arthrodesis is performed bilaterally?

Yes. If both feet undergo triple arthrodesis in the same operative session, append modifier 50 to 28715. Some payers require LT and RT on separate line items instead — verify payer preference before submitting.

04What global period applies to 28715 and what does it include?

28715 carries a 90-day global period. It includes the day-before visit, the procedure itself, and all routine post-op visits, dressing changes, and suture or staple removal through day 90. Unrelated E/M services in that window need modifier 24.

05When is modifier 22 appropriate for 28715?

Use modifier 22 when documented circumstances substantially increase operative work — for example, severe deformity requiring osteotomies, revision after prior failed fusion, or significant hardware removal. The operative note must quantify the additional time and complexity; modifier 22 without supporting documentation is routinely denied.

06Can bone graft codes be billed separately with 28715?

It depends on graft source and payer. Autograft harvested through a separate incision (e.g., iliac crest) may support an additional graft harvest code. Allograft and local autograft taken through the primary incision are generally considered bundled. Document graft type and harvest method explicitly to support any separate billing.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira AI Scribe

Mira's AI scribe captures the specific joints addressed (subtalar, talonavicular, calcaneocuboid), the surgical approach at each joint, fixation construct, bone graft source if used, and the named clinical indication from dictation. That prevents the single most common 28715 denial: an operative note that says 'hindfoot fusion' without confirming all three joint sites — giving auditors grounds to downcode to 28725.

See how Mira captures CPT 28715 documentation