Billing code 28725: Subtalar fusionMedicare rate & RVUs in Ohio
Reports surgical fusion of the subtalar joint, commonly performed for painful hindfoot arthritis or deformity when the talocalcaneal joint is treated.
CMS doesn’t publish an office rate for 28725 in Ohio.
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 9 sections
What 28725 covers
An orthopedic foot and ankle surgeon fuses the joint between the talus and calcaneus, typically to address painful subtalar arthritis, post-traumatic joint damage, or hindfoot deformity. The operation involves preparing the joint surfaces and stabilizing the bones in the intended alignment; it is commonly performed in a hospital or ambulatory surgical setting. The operative report should identify the subtalar joint and describe the fusion performed.
Choose this code when the subtalar joint is fused, rather than a broader construct that includes other hindfoot joints. The 90-day global period includes the day-before preoperative visit and related postoperative care during the global period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons are paid only with supporting documentation, and team surgery is 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.
28725 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $703.37 |
How the 28725 rate is calculated
Each of 28725’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 · 28725
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 10.94Practice expense 9.04Malpractice 1.85
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 28725
28725 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28725
Subtalar fusion
| 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) | 1 | Permitted with supporting documentation. |
| 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 · 28725
Subtalar fusion
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
28725 without 50 · national facility
$729.14
Subtalar fusion
28725-50 · Bilateral: 150%
$1,093.71
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).
28725 compared with similar codes
Compare codes
28725 vs 28715 vs 28705 vs 28740: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 28715Hindfoot fusion
- Choose 28725 when the subtalar joint alone is fused. Choose 28715 when the operative fusion includes the additional joints of a triple arthrodesis.
- 28705Pantalar fusion
- This code represents a more extensive hindfoot fusion. Base selection on the joints fused, not simply on the diagnosis or the presence of hindfoot deformity.
- 28740Foot fusion
- 28740 concerns fusion of a single midtarsal or tarsometatarsal joint. 28725 is for fusion of the subtalar joint.
28725 billing questions
When is 28725 appropriate instead of a triple arthrodesis code?
Use 28725 when the subtalar joint is fused. A triple arthrodesis includes additional hindfoot joints, so select the code that reflects the joints actually fused.
Does the 90-day global period include routine postoperative care?
Yes. The global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral subtalar fusion reported?
CMS identifies this as a bilateral procedure reported with modifier 50 and paid at 150%.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons are paid only when supporting documentation is provided; team surgery is not permitted.
What documentation supports selecting this code?
Document the subtalar joint treated, the clinical reason for fusion, and the operative work performed. The note should make clear whether the fusion was limited to that joint or included other hindfoot joints.
What happens when another procedure is performed in the same session?
Under the standard multiple-procedure rule, the highest-valued procedure is paid in full and other procedures are paid at 50%.
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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