27286

Arthrd hip jt sbtrchc osteot

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

Pricing with Related Codes

Line
Qty
Global fee
Pro fee
Primary27286Arthrd hip jt sbtrchc osteot
1
$1,480.66
$1,480.66
Add-on20705Rmvl i-artic rx delivery dev
0
$128.26/ unit
$106.21/ unit
Whole procedure · 24.54 wRVU credited
$1,480.66
$1,480.66

RVU Breakdown

Component
Office
Facility
Work
24.54
24.54
Practice expense
14.57
14.57
Malpractice
5.22
5.22
Total RVU
44.33
44.33

Payment Policy & Modifiers

Allowed adjustments
Bilateral -50150%
With modifier 50 (both sides), payment is 150% of the single-side amount. $2,220.99 office.
Multiple procedure MPPRApplies
When billed with other procedures the same day: highest-valued paid 100%, the rest 50%. Add-on codes are exempt.
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 paid (62.5% each) if medical necessity is documented.
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.