No office rate
Choose pantalar fusion when the ankle is included along with the hindfoot joints. Triple arthrodesis covers the hindfoot fusion without the ankle.
On this page
CMS RVU26D · Effective 2026-10-01
28705 Pantalar fusion Medicare reimbursement rates in Hawaii
Reports surgical fusion of the ankle and hindfoot joints for extensive painful arthritis, deformity, or instability involving the pantalar complex. Compare 28705 office and facility rates across CMS payment localities in Hawaii.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 28705 in Hawaii?
Hawaii has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1109.51
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Orthopedic surgery
About 28705: Pantalar foot and ankle fusion
Reports surgical fusion of the ankle and hindfoot joints for extensive painful arthritis, deformity, or instability involving the pantalar complex.
Pantalar arthrodesis fuses the ankle and hindfoot joints—the tibiotalar, subtalar, talonavicular, and calcaneocuboid articulations—into a stable construct. A foot-and-ankle orthopedic surgeon typically performs this extensive operation for severe painful arthritis, deformity, or instability involving the joint complex, including selected post-traumatic or neuromuscular cases.
Report the service when the operative documentation supports fusion of the ankle and the hindfoot articulations, rather than a more limited fusion. Document the treated joints, indication, and laterality. The procedure has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. For multiple procedures in one session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 28705
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU19.82 · 60%
- Practice expense (office) RVU10.20 · 31%
- Malpractice RVU3.11 · 9%
290
Medicare services in 2024 · #4019 by national volume
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.
28705 compared with similar codes
Office rates for Hawaii, from the same CMS release.
No office rate
This code is for fusion limited to the subtalar joint; pantalar fusion covers the ankle and broader hindfoot complex.
No office rate
This code concerns multiple midtarsal or tarsometatarsal joints, not the ankle-and-hindfoot fusion addressed by pantalar arthrodesis.
Compare 28705 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Hawaii, Guam →
Office / nonfacility
Unavailable
Facility
$1109.51
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 28705 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
3,245
- Code
- 28705
- Physician work
- 19.82
- Practice expense
- 10.20
- Malpractice
- 3.11
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 19.82 | × 1.000 | 19.8200 |
| Practice expense | 10.20 | × 1.137 | 11.5974 |
| Malpractice | 3.11 | × 0.579 | 1.8007 |
| Total RVUs | 33.2181 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$1109.51
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 19.82 | 1 |
| Practice expense | 10.2 | 1.137 |
| Malpractice | 3.11 | 0.579 |
(19.82 × 1 + 10.2 × 1.137 + 3.11 × 0.579) × $33.4009 = $1109.51
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
28705 billing questions
How does pantalar fusion differ from triple arthrodesis?
Pantalar fusion includes the ankle joint as well as the hindfoot joints. Triple arthrodesis is the more limited choice when the ankle is not included in the fusion.
Can the individual hindfoot fusions be reported separately?
When the operative service is a pantalar fusion, the included ankle and hindfoot joints are part of that fusion service. The operative report should identify the joints fused.
How is bilateral pantalar fusion reported?
Use modifier 50 for a bilateral procedure. CMS payment for bilateral reporting is 150%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
3,24228665,,Treat toe dislocation,A,,1.92,2.53,,1.48,,0.19,4.64,3.59,0,010,0.10,0.80,0.10,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,24328666,,Treat toe dislocation,A,,2.59,2.11,NA,2.11,,0.21,4.91,4.91,0,010,0.10,0.80,0.10,2,0,1,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,24428675,,Repair of toe dislocation,A,,5.48,11.42,,5.62,,0.70,17.60,11.80,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,24528705,,Arthrodesis pantalar,A,,19.82,10.20,NA,10.20,,3.11,33.13,33.13,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,24628715,,Arthrodesis triple,A,,13.08,11.02,NA,11.02,,2.36,26.46,26.46,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,24728725,,Arthrodesis subtalar,A,,10.94,9.04,NA,9.04,,1.85,21.83,21.83,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,24828730,,Fusion of foot bones,A,,10.43,8.26,NA,8.26,,1.62,20.31,20.31,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014