Billing code 28116: Coalition resectionMedicare rate & RVUs in Oklahoma
Resection of a tarsal coalition is reported when a surgeon removes an abnormal connection between foot bones, such as a calcaneonavicular or talocalcaneal coalition.
Medicare pays $628.12 for 28116 in the office in Oklahoma (Oklahoma). Which amount applies depends on the service address.
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 28116 covers
A foot and ankle orthopedic surgeon or podiatric surgeon uses this service to remove a bridge connecting tarsal bones, often for a symptomatic coalition that restricts hindfoot motion or causes pain. Common examples include calcaneonavicular and talocalcaneal coalitions. The procedure may include interposition of tissue or another material between the bones, or be performed without interposition.
Report the code for the coalition resection, whether or not interposition is used. The operative report should identify the coalition, the bones involved, the resection performed, and whether interposition was used. Medicare includes the day-before preoperative visit and 90 days of related postoperative care in the 90-day global period. 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%. Medicare does not pay an assistant at surgery; 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.
28116 in Oklahoma
| Payment locality | Office | Facility |
|---|---|---|
| Oklahoma | $628.12 | $462.58 |
How the 28116 rate is calculated
Each of 28116’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 · 28116
RVUs × geographic indexes × conversion factor
Work8.91
8.91 RVUs× 1.000 GPCI
Practice expense10.42
10.42 RVUs× 1.000 GPCI
Malpractice0.76
0.76 RVUs× 1.000 GPCI
Adjusted RVUs
20.0900
Conversion factor
$33.4009
Medicare rate
$671.02
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 28116
28116 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 28116
Coalition resection
| 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) | 1 | Not paid (statutory restriction). |
| 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 · 28116
Coalition resection
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
28116 without 50 · national office
$671.02
Coalition resection
28116-50 · Bilateral: 150%
$1,006.53
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).
28116 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 28120Bone excision
- 28120 describes partial excision of the talus or calcaneus. Use 28116 when removing a tarsal coalition, rather than excising bone for another indication.
- 28122Tarsal bone excision
- 28122 describes partial excision of a tarsal or metatarsal bone other than the talus or calcaneus. It is not the specific code for coalition resection.
- 28725Subtalar fusion
- 28725 describes subtalar arthrodesis, which fuses the joint. Code 28116 describes resection of a coalition rather than joint fusion.
28116 billing questions
Does this code include interposition?
Yes. The code covers coalition resection with or without interposition; document whether an interposition material was used.
How is this different from partial excision of a tarsal bone?
Use this code when the target is a coalition connecting tarsal bones. Partial-excision codes describe bone removal for other indications, rather than resection of a coalition.
Is related postoperative care separately reported?
The 90-day global period includes related postoperative care for 90 days and the day-before preoperative visit.
How does Medicare handle bilateral procedures?
When the service is performed bilaterally, report modifier 50; Medicare pays it at 150%.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
What happens when another procedure is performed in the same session?
Under the standard multiple procedure reduction, Medicare pays the highest-valued procedure in full and other procedures 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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