CPT code 29891: Ankle arthroscopy, talus or tibia lesion2026 Medicare rate & RVUs in Missouri
Reports arthroscopic removal and drilling of an osteochondral defect in the ankle when the surgeon treats a focal lesion of the talus or tibia.
CMS doesn’t publish an office rate for 29891 in Missouri.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 29891 covers
An orthopedic surgeon typically performs this ankle arthroscopy for a focal osteochondral defect, such as a lesion on the talar dome or tibial plafond. The surgeon removes unstable or damaged tissue at the defect and drills the underlying bone to stimulate healing. The procedure is commonly performed in a hospital outpatient department or ambulatory surgery center.
Report 29891 when the operative work addresses the osteochondral defect by excision and drilling, rather than repair or fixation of a lesion. The operative report should identify the site and describe the lesion treatment, including drilling. CMS assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeons and team surgery are not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 29891 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $616.48 |
| Metropolitan St. Louis, MO | Unavailable | $621.26 |
| Rest of Missouri | Unavailable | $595.80 |
How the 29891 rate is calculated
Each of 29891’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 29891
RVUs × geographic indexes × conversion factor
Work9.43
9.43 RVUs× 1.000 GPCI
Practice expense7.98
7.98 RVUs× 1.000 GPCI
Malpractice1.57
1.57 RVUs× 1.000 GPCI
Adjusted RVUs
18.9800
Conversion factor
$33.4009
Medicare rate
$633.95
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 29891
29891 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 29891
Ankle arthroscopy, talus or tibia lesion
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 29891
Ankle arthroscopy, talus or tibia lesion
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
29891 without 50 · national facility
$633.95
Ankle arthroscopy, talus or tibia lesion
29891-50 · Bilateral: 150%
$950.93
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
29891 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 29892Talar lesion repairLarge talar dome lesion
- 29891 treats the defect by excision and drilling. Choose 29892 when the surgeon arthroscopically repairs the osteochondral lesion.
- 29894Ankle arthroscopyLoose or foreign body removal
- 29894 is for arthroscopic removal of a loose body. It does not describe excision and drilling of an osteochondral defect.
- 29897Ankle arthroscopyLimited debridement
- 29897 describes limited ankle arthroscopic debridement. Use 29891 when the operative work specifically excises and drills an osteochondral defect.
- 29898Ankle arthroscopyExtensive debridement
- 29898 describes extensive ankle arthroscopic debridement; 29891 is selected for excision and drilling of an osteochondral defect.
29891 billing questions
When is 29891 preferred over 29892?
Use 29891 for arthroscopic excision and drilling of the defect. Code 29892 is for arthroscopically aided repair of an osteochondral lesion, such as when the surgeon repairs or fixes the lesion.
Are lesion preparation and drilling separately billable?
No. Removing the defect tissue and drilling the underlying bone are part of 29891, not separate services. Separately performed work on another condition must be distinct and supported by the operative report.
What documentation supports 29891?
Document the ankle, the lesion's location on the talus or tibia, arthroscopic findings, and the excision and drilling performed.
How is bilateral 29891 reported?
CMS identifies this as a bilateral procedure; reporting modifier 50 is paid at 150%.
What global period applies?
The major-surgery 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be paid?
Assistant-at-surgery payment may be made. CMS does not permit co-surgeons or team surgery for this code.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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