28296

Cor hlx vlgs dstl mtar osteo

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

Pricing with Related Codes

Line
Qty
Global fee
Pro fee
Primary28296Cor hlx vlgs dstl mtar osteo
1
$883.45
$484.31
Add-on20705Rmvl i-artic rx delivery dev
0
$128.26/ unit
$106.21/ unit
Whole procedure · 8.04 wRVU credited
$883.45
$484.31

RVU Breakdown

Component
Office
Facility
Work
8.04
8.04
Practice expense
17.59
5.64
Malpractice
0.82
0.82
Total RVU
26.45
14.50

Payment Policy & Modifiers

Allowed adjustments
Bilateral -50150%
With modifier 50 (both sides), payment is 150% of the single-side amount. $1,325.18 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.