Choose pantalar fusion when the ankle is included along with the hindfoot joints. Triple arthrodesis covers the hindfoot fusion without the ankle.
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CMS RVU26D · Effective 2026-10-01
28705 Pantalar fusion Medicare reimbursement rates in Texas
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 Texas.
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 Texas?
Texas has 8 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 8 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
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.
Where 28705 pays more and less in Texas
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 Texas, from the same CMS release.
This code is for fusion limited to the subtalar joint; pantalar fusion covers the ankle and broader hindfoot complex.
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.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Office Unavailable | Facility $1115.81 |
| Beaumont | Office Unavailable | Facility $1068.53 |
| Brazoria | Office Unavailable | Facility $1085.95 |
| Dallas | Office Unavailable | Facility $1096.42 |
| Fort Worth | Office Unavailable | Facility $1094.36 |
| Galveston | Office Unavailable | Facility $1091.62 |
| Houston | Office Unavailable | Facility $1148.54 |
| Rest Of Texas | Office Unavailable | Facility $1079.12 |
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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.
