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Wiki Modifier 26/TC reimbursement splits - How to calculate?

Prada

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Prosper, TX
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For CPT code 72275 billed with modifier 26 (POS 11) and Mod -TC (POS 24) -
I checked the indicator is "1" so the code is eligible for the modifiers.

what is the percentage of reimbursement split - how is it calculated?
 
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