27228

Treat hip fracture(s)

Add to my model
Code typePrimary
Payment statusActive (A)
Global period90-day

Whole-Procedure Pricing

Line
Qty
Global fee
Pro fee
Primary27228Treat hip fracture(s)
1
$1,685.74
$1,685.74

RVU Breakdown

Component
Office
Facility
Work
28.60
28.60
Practice expense
15.76
15.76
Malpractice
6.11
6.11
Total RVU
50.47
50.47

Payment Policy & Modifiers

Allowed adjustments
Bilateral -50150%
With modifier 50 (both sides), payment is 150% of the single-side amount. $2,528.61 office.
Multiple procedure MPPRApplies
When billed with other procedures the same day: highest-valued paid 100%, the rest 50%.
Assistant surgeon -80/81/8216%
Assistant at surgery (mod 80/81/82) is paid at 16% of the fee schedule amount.
Co-surgeons -6262.5% each
Co-surgeons (mod 62) are paid 62.5% of the fee each (125% total, split).
Not applicable to this code
Team surgeon -66Prof / tech split

Global surgery package

Major surgery: payment covers the day before, the day of, and 90 days after. Of the total payment, 10% is attributed to pre-operative care, 69% to the procedure itself, and 21% to post-operative visits.