28540
Treat foot dislocation
Code typePrimary
Payment statusActive (A)
Global period90-day
Whole-Procedure Pricing
Line
Qty
Global fee
Pro fee
Primary28540Treat foot dislocation
1
$199.07
$171.01
RVU Breakdown
Component
Office
Facility
Work
2.14
2.14
Practice expense
3.64
2.80
Malpractice
0.18
0.18
Total RVU
5.96
5.12
Payment Policy & Modifiers
Allowed adjustments
Bilateral -50150%
With modifier 50 (both sides), payment is 150% of the single-side amount. → $298.61 office.
Multiple procedure MPPRApplies
When billed with other procedures the same day: highest-valued paid 100%, the rest 50%.
Assistant surgeon -80/81/8216% · documented
Assistant at surgery (mod 80/81/82) paid at 16% if medical necessity is documented.
Not applicable to this code
Co-surgeon -62Team surgeon -66Prof / tech split