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Billing code 29891: Ankle arthroscopyMedicare rate & RVUs

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 RVU26DEffective Oct 1, 2026109 payment localities1.2K Medicare services in 2024

Medicare pays $633.95 for 29891 nationally in a facility.

Medicare rate · 29891

Ankle arthroscopy

Work RVUs
9.43
Total RVUs
18.98
Global days
090

National rate · 2026

$633.95

Facility setting, before claim adjustments.

See every locality for 29891 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

On this page 10 sections
  1. Medicare rate
  2. What 29891 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

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

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

29891 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$577.87
Alaska*Unavailable$785.21
ArizonaUnavailable$618.14
ArkansasUnavailable$570.93
AtlantaUnavailable$649.70
AustinUnavailable$644.06
BakersfieldUnavailable$645.02
Baltimore/Surr. CntysUnavailable$670.87
BeaumontUnavailable$606.24
BrazoriaUnavailable$622.53

29891 rates by state

Office rate range in each state. Select a state to see its payment localities.

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
29891 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

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

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 29891

Ankle arthroscopy

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

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

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).

When to use modifier 50

29891 compared with similar codes

Compare codes · National

5 codes, side by side

  • 29891

    Ankle arthroscopy9.43 wRVU

    Not priced

  • 29892

    Talar lesion repair10.01 wRVU

    Not priced

  • 29894

    Ankle arthroscopy7.17 wRVU

    Not priced

  • 29897

    Ankle arthroscopy7.14 wRVU

    Not priced

  • 29898

    Ankle arthroscopy8.28 wRVU

    Not priced

How to choose

29892Talar lesion repair
29891 treats the defect by excision and drilling. Choose 29892 when the surgeon arthroscopically repairs the osteochondral lesion.
29894Ankle arthroscopy
29894 is for arthroscopic removal of a loose body. It does not describe excision and drilling of an osteochondral defect.
29897Ankle arthroscopy
29897 describes limited ankle arthroscopic debridement. Use 29891 when the operative work specifically excises and drills an osteochondral defect.
29898Ankle arthroscopy
29898 describes extensive ankle arthroscopic debridement; 29891 is selected for excision and drilling of an osteochondral defect.

Codes related to 29891

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 29891
CodeHow it relatesNational office range
Used instead
29892Talar lesion repairUsed for arthroscopically aided repair of an osteochondral lesion rather than excision and drilling.No office rate
29894Ankle arthroscopyCovers arthroscopic loose-body removal when the service is removal rather than treatment of a defect.No office rate
29897Ankle arthroscopyLimited ankle arthroscopic debridement for joint pathology without the focal defect treatment described by 29891.No office rate
29898Ankle arthroscopyExtensive ankle arthroscopic debridement when that is the principal work rather than defect excision and drilling.No office rate

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
RVUs for 29891PPRRVU2026_Oct_nonQPP.csv, line 3,371 (RVU26D)

Open CMS sourceHow we calculate rates

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