21497
Interdental wirg oth/thn fx
Code typePrimary
Payment statusActive (A)
Global period90-day
Whole-Procedure Pricing
Line
Qty
Global fee
Pro fee
Primary21497Interdental wirg oth/thn fx
1
$717.12
$561.80
RVU Breakdown
Component
Office
Facility
Work
4.52
4.52
Practice expense
16.45
11.80
Malpractice
0.50
0.50
Total RVU
21.47
16.82
Payment Policy & Modifiers
Allowed adjustments
Multiple procedure MPPRApplies
When billed with other procedures the same day: highest-valued paid 100%, the rest 50%.
Assistant surgeon -80/81/8216% · documented
Assistant at surgery (mod 80/81/82) paid at 16% if medical necessity is documented.
Not applicable to this code
Bilateral -50Co-surgeon -62Team surgeon -66Prof / tech split