RESIDENCY REVIEW COMMITTEE
COUNCIL ON PODIATRIC MEDICAL EDUCATION
9312 Old Georgetown Road
Bethesda, Maryland 20814-1621
301-581-9200
APPLICATION FOR INCREASE IN POSITIONS
Increases in residency positions are considered and authorized by the Residency Review
Committee. The application must be submitted prior to activation of the residency position(s),
preferably at least six months before the anticipated starting date. The effective date of
granting an authorization of increased residency positions by the Residency Review
Committee will be no earlier than the date on which the program has both authorization of
the increase and the additional resident(s) in place. A program on probationary approval
may not request an increase in positions.
It is requested that two flash drives of this form and of the documentation in response to items
7-11 and permission for members of the Committee to review the logs online be submitted to the
Council office. Hand-written responses and hard copy documentation will not be accepted.
A $500 application fee, made payable to the Council on Podiatric Medical Education, must
accompany the application. The application will not be processed until the sponsoring institution
submits all required materials, including the application fee.
1. Sponsoring institution: _______________________________________________________
2. Address: __________________________________________________________________
3. City, State, Zip: _____________________________________________________________
4. Current number of positions per program (please provide the number of approved positions
for each program sponsored by the institution):
PMSR (per year) ____/____/____/____
PMSR/RRA (per year) ____/____/____/____
5. Proposed number of positions per program (please provide the number of proposed positions
for each program sponsored by the institution):
PMSR (per year) ____/____/____/____
PMSR/RRA (per year) ____/____/____/____
6. Anticipated effective date for the increase: _______________________________________
1
7. List any increases in active podiatric staff and/or non-podiatric medical staff with the
educational and professional qualifications of each (i.e., for each staff member list name,
degree, and affiliations with certifying and professional organizations, as well as the type of
training provided), 12 months of categorical volume, and the anticipated increase in volume
(percentage of cases each new staff member is bringing to the institution).
8. Describe the development or expansion of facilities including new affiliations. If training is
offered for the first time in another institution(s), provide documentation of affiliation.
(When training is provided at a secondary institution, the participating institutions indicate
their respective training commitments through a memorandum of understanding or contract.
This document acknowledges the affiliation and delineates financial support [including
resident liability] and educational contributions of each training site. The document is signed
by the chief administrative officer of each participating institution.)
9. For programs that cannot document adequate surgical volume for the proposed increase in
positions through web-based logs only, the chart at the end of the application must be
completed to identify all surgical procedures available at the sponsoring institution(s) and all
affiliated training sites.
2
10. List any increase or decrease in training resources through the sponsoring institution or other
affiliated facilities. If the program has either developed new training resources or revised
existing training resources, provide an updated copy of one resident’s comprehensive
schedule for the entire training year and specific competencies and resident assessments
associated with the new or revised training resource(s).
11. Use the following space to clarify additional training experiences that are available to justify
the increase in positions. The sponsoring institution is invited to append to this application
any additional statement or information that may provide further evidence of the institution’s
ability to train the proposed number of residents.
Chief administrative officer (sign and print name)
Date
Program director (sign and print name)
Date
NOTE:
The Residency Review Committee reserves the right to request further information
for use in determining authorization of increased residency positions.
CPME/RRC: 345
March 2012
3
9. For programs that cannot document adequate surgical volume for the proposed increase in
positions through web-based logs only, this chart must be completed to identify all surgical
procedures available at the sponsoring institution(s) and all affiliated training sites. For
secondary institutions or facilities utilized, appropriately executed affiliation agreements must
exist to be included in the number of procedures column.
CATEGORY 1 DIGITAL SURGERY
RANGE OF CPT DESCRIPTION
CODES
28108, 28124,
Partial ostectomy/exostectomy
28126, 28153
28150
Phalangectomy
28024, 28160,
Arthroplasty (interphalangeal joint [IPJ])
28285, 28286
Implant (IPJ)
28160
Diaphysectomy
28310, 28312
Phalangeal osteotomy
28285, 28755
Fusion (IPJ)
28820, 28825
Amputation
28108, 28175
Management of osseous tumor/neoplasm
28005, 28124
Management of bone/joint infection
28505, 28525
Open management of digital
fracture/dislocation
Revision/repair of surgical outcome
28280, 28531
Other osseous digital procedure not listed
above
TOTAL NUMBER OF PROCEDURES
4
CODE
NUMBER OF
NUMBER PROCEDURES
1.1
1.2
1.3
1.4
1.5
1.6
1.7
1.8
1.9
1.10
1.11
1.12
1.13
0
CATEGORY 2 FIRST RAY SURGERY, Hallux Valgus
RANGE OF CPT DESCRIPTION
CODES
28290
Bunionectomy (partial ostectomy/Silver
procedure)
28292
Bunionectomy with capsulotendon
balancing procedure
28298-99
Bunionectomy with phalangeal
osteotomy
28296, 28299,
Bunionectomy with distal first metatarsal
28306
osteotomy
28296, 28299,
Bunionectomy with first metatarsal base
28306
or shaft osteotomy
28297, 28299
Bunionectomy with first
metatarsocuneiform fusion
28750
Metatarsophalangeal joint (MPJ) fusion
28293
MPJ implant
28270
MPJ arthroplasty
TOTAL NUMBER OF PROCEDURES
CATEGORY 2 FIRST RAY SURGERY, Hallux Limitus
RANGE OF CPT DESCRIPTION
CODES
28289
Cheilectomy
28310
Joint salvage with phalangeal osteotomy
(Kessel-Bonney, enclavement)
28296, 28306
Joint salvage with distal metatarsal
osteotomy
28296, 28306
Joint salvage with first metatarsal shaft
or base osteotomy
28297
Joint salvage with first
metatarsocuneiform fusion
28750
MPJ fusion
28293
MPJ implant
28292
MPJ arthroplasty
TOTAL NUMBER OF PROCEDURES
5
CODE
NUMBER OF
NUMBER PROCEDURES
2.1.1
2.1.2
2.1.3
2.1.4
2.1.5
2.1.6
2.1.7
2.1.8
2.1.9
0
CODE
NUMBER
2.2.1
2.2.2
NUMBER OF
PROCEDURES
2.2.3
2.2.4
2.2.5
2.2.6
2.2.7
2.2.8
0
CATEGORY 2 FIRST RAY SURGERY, Other First Ray
RANGE OF CPT DESCRIPTION
CODES
28294
Tendon
transfer/lengthening/capsulotendon
balancing procedure
28306-7
Osteotomy (e.g., dorsiflexory)
28615, 28740
Metatarsocuneiform fusion (other than
for hallux valgus or hallux limitus)
28810, 28820
Amputation
28104-6,
Management of osseous tumor/neoplasm
(with or without bone graft)
28002-5, 28122
Management of bone/joint infection (with
or without bone graft)
28485, 28645
Open management of fracture or MPJ
dislocation
28306-7
Corticotomy/callus distraction
28322
Revision/repair of surgical outcome (e.g.,
non-union, hallux varus)
28111, 28760,
Other first ray procedure not listed above
28899
TOTAL NUMBER OF PROCEDURES
6
CODE
NUMBER
2.3.1
NUMBER OF
PROCEDURES
2.3.2
2.3.3
2.3.4
2.3.5
2.3.6
2.3.7
2.3.8
2.3.9
2.3.10
0
CATEGORY 3 OTHER SOFT TISSUE FOOT SURGERY
RANGE OF CPT DESCRIPTION
CODES
28315
Excision of ossicle/sesamoid
28080, 64776
Excision of neuroma
10121, 11011-12, Removal of deep foreign body (excluding
28020-4, 28192hardware removal)
93
28008, 28060,
Plantar fasciotomy
28062, 29893
28270
Lesser MPJ capsulotendon balancing
28200-34
Tendon repair, lengthening, or transfer
involving the forefoot (including digital
flexor digitorum longus transfer)
28615
Open management of dislocation
(MPJ/tarsometatarsal)
10180, 11043-44, Incision and drainage/wide debridement
20000, 20005,
of soft tissue infection (including plantar
20103, 28001-3
space)
28060-2
Plantar fasciectomy
11400-426,
Excision of soft tissue tumor/mass of the
11600-646,
foot (without reconstructive surgery)
28039-47, 2805054, 28092
Procedure code number no longer used
14020-21, 14040- Plastic surgery techniques (including skin
41, 14300, 14350, graft, skin plasty, flaps, syndactylization,
15050, 15240-41, desyndactylization, and debulking
15738, 15740,
procedures limited to the forefoot)
15750, 15756-58,
20969-73, 28280,
28286, 28313,
28340-45, 28360
28020-24, 28050, Microscopic nerve/vascular repair
64727
(forefoot only)
Other soft tissue procedures not listed
above (limited to the foot)
27615-16, 27618- Excision of soft-tissue tumor/mass of the
19, 27632, 27634
ankle (without reconstructive surgery)
28035, 28055,
External neurolysis/decompression
64702, 64704,
(including tarsal tunnel)
64722, 64726
TOTAL NUMBER OF PROCEDURES
7
CODE
NUMBER
3.1
3.2
3.3
NUMBER OF
PROCEDURES
3.4
3.5
3.6
3.7
3.8
3.9
3.10
3.11
3.12
3.13
3.14
3.15
3.16
0
CATEGORY 4 OTHER OSSEOUS FOOT SURGERY
RANGE OF
DESCRIPTION
CPT CODES
27640-41, 28116, Partial ostectomy (distal to and including
28118-20, 28122, the talus)
28288
28052, 28234,
Lesser MPJ arthroplasty
28645
28110
Bunionectomy of the fifth metatarsal
without osteotomy
28112-14
Metatarsal head resection (single or
multiple)
28899
Lesser MPJ implant
28308-9
Central metatarsal osteotomy
28308
Bunionectomy of the fifth metatarsal with
osteotomy
28485
Open management of lesser metatarsal
fractures
20900, 20902
Harvesting of bone graft distal to the
ankle
28805, 28810
Amputation (lesser ray, transmetatarsal
amputation)
20005, 28005
Management of bone/joint infection distal
to the tarsometatarsal joints (with or
without bone graft)
28171, 28173
Management of bone tumor/neoplasm
distal to the tarsometatarsal joints (with or
without bone graft)
28615
Open management of tarsometatarsal
fracture/dislocation
28308-9
Multiple osteotomy management of
metatarsus adductus
27840, 28730,
Tarsometatarsal fusion
28735
28899
Corticotomy/callus distraction of lesser
metatarsal
28320, 28322
Revision/repair of surgical outcome in the
forefoot
28130, 28140
Other osseous procedures not listed above
(distal to the tarsometatarsal joint)
28118
Detachment/reattachment of Achilles
tendon with partial ostectomy
TOTAL NUMBER OF PROCEDURES
8
CODE
NUMBER
4.1
NUMBER OF
PROCEDURES
4.2
4.3
4.4
4.5
4.6
4.7
4.8
4.9
4.10
4.11
4.12
4.13
4.14
4.15
4.16
4.17
4.18
4.19
0
CATEGORY 5 RECONSTRUCTIVE REARFOOT AND ANKLE SURGERY, Elective –
Soft Tissue
RANGE OF CPT DESCRIPTION
CODE
NUMBER OF
CODES
NUMBER PROCEDURES
14020-21, 14040- Plastic surgery techniques involving the
5.1.1
41, 14300, 14350 midfoot, rearfoot, or ankle
27690-92
Tendon transfer involving the midfoot,
5.1.2
rearfoot, ankle, or leg
27685-87, 28240
Tendon lengthening involving the
5.1.3
midfoot, rearfoot, ankle, or leg
28260-4
Soft tissue repair of complex congenital
5.1.4
foot/ankle deformity (clubfoot, vertical
talus)
27698
Delayed repair of ligamentous structures
5.1.5
27654, 27659,
Ligament or tendon augmentation/
5.1.6
27665, 27675-6,
supplementation/restoration
27685-86, 27698,
28238
27625-6
Open synovectomy of the rearfoot/ankle
5.1.7
28035
Procedure code number no longer used
5.1.8
27630
Other elective rearfoot
5.1.9
reconstructive/ankle soft tissue surgery
not listed above
TOTAL NUMBER OF PROCEDURES
0
9
CATEGORY 5 RECONSTRUCTIVE REARFOOT AND ANKLE SURGERY, Elective –
Osseous
RANGE OF
DESCRIPTION
CODE
NUMBER OF
CPT CODES
NUMBER PROCEDURES
29891-92, 29894- Operative arthroscopy
5.2.1
95, 29897-8,
29904-7
28118
Procedure code number no longer used
5.2.2
28899
Subtalar arthroeresis
5.2.3
27870-71, 28705, Midfoot, rearfoot, or ankle fusion
5.2.4
28715, 28725,
28730, 28735,
28737, 28740,
29899, 29907
27705-9, 27712,
Midfoot, rearfoot, or tibial osteotomy
5.2.5
27715, 28300,
28302, 28304-5
28116
Coalition resection
5.2.6
28446
Open management of talar dome lesion
5.2.7
(with or without osteotomy)
27610, 27612,
Ankle arthrotomy with removal of loose
5.2.8
27620, 27625-26 body or other osteochondral debridement
27702-3
Ankle implant
5.2.9
27705, 27707,
Corticotomy or osteotomy with callus
5.2.10
27709, 27715,
distraction/correction of complex
28899
deformity of the midfoot, rearfoot, ankle,
or tibia
27700, 27720,
Other elective rearfoot
5.2.11
27722, 27724-6,
reconstructive/ankle osseous surgery not
27745
listed above
TOTAL NUMBER OF PROCEDURES
0
10
CATEGORY 5 RECONSTRUCTIVE REARFOOT AND ANKLE SURGERY, NonElective – Soft Tissue
RANGE OF
DESCRIPTION
CODE
NUMBER OF
CPT CODES
NUMBER PROCEDURES
27650, 27652,
Repair of acute tendon injury
5.3.1
27658, 27664
27695-96
Repair of acute ligament injury
5.3.2
64727
Microscopic nerve/vascular repair of the
5.3.3
midfoot, rearfoot, or ankle
28043, 28045-46 Excision of soft tissue tumor/mass of the
5.3.4
foot (with reconstructive surgery)
Procedure code number no longer used
5.3.5
27846, 27848,
Open repair of dislocation (proximal to
5.3.6
28555, 28585
tarsometatarsal joints)
27600, 27892-4
Other non-elective rearfoot
5.3.7
reconstructive/ankle soft tissue surgery
not listed above
27615-16, 27618- Excision of soft tissue tumor/mass of the
5.3.8
19, 27632, 27634 ankle (with reconstructive surgery)
TOTAL NUMBER OF PROCEDURES
0
11
CATEGORY 5 RECONSTRUCTIVE REARFOOT AND ANKLE SURGERY, NonElective – Osseous
RANGE OF
DESCRIPTION
CODE
NUMBER OF
CPT CODES
NUMBER PROCEDURES
28465, 28555
Open repair of adult midfoot fracture
5.4.1
28415, 28420,
Open repair of adult rearfoot fracture
5.4.2
28445, 28465
27758-9, 27766,
Open repair of adult ankle fracture
5.4.3
27769, 27784,
27792, 27814,
27822-23, 2782629, 27832
27758-9, 27766,
Open repair of pediatric rearfoot/ankle
5.4.4
27769, 27784,
fractures or dislocations
27792, 27814,
27822-23, 2782629, 27832
27635, 27637-38, Management of bone tumor/neoplasm
5.4.5
27645-7, 28100-4, (with or without bone graft)
28106-7
20005, 27603-4,
Management of bone/joint infection (with 5.4.6
27607, 27610
or without bone graft)
27888, 28800
Amputation proximal to the
5.4.7
tarsometatarsal joints
27889, 28585
Other non-elective rearfoot
5.4.8
reconstructive/ankle osseous surgery not
listed above
TOTAL NUMBER OF PROCEDURES
0
12