28750
HCPCS/CPT
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Medicare Pricing
Work RVU
8.53
Facility
$536.42
Non-Facility
$1040.10
2 Active Policies
CARELON-small-joint-surgery-2025-11-15 — General Requirements and Documentation
CARELON-level-of-care-for-surgical-procedures-2025-11-15 — Level of Care for Surgical Procedures
Related Codes
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