CPT Code 0628TComplete Billing & Coding Guide (2026)Perq njx algc fluor lmbr ea
About CPT 0628T
CPT 0628T is a Current Procedural Terminology code in the Other category maintained by the American Medical Association. The CMS short descriptor reads "Perq njx algc fluor lmbr ea". For the full AMA long descriptor and clinical guidance, refer to the current CPT code manual.
Add-on codes cannot be billed alone and inherit their global period from the primary procedure. Payer scrubbers will reject add-on codes submitted without a valid base code on the same claim.
0628T has 10 NCCI bundling edit pairs documented. Run your scrubber against the NCCI quarterly update before submission. When clinically warranted, use modifier 59 or the X-modifiers (XE, XS, XP, XU) to bypass an indicator-1 edit, with chart documentation supporting the distinct service.
Code Properties
RVU Breakdown
Every CPT code’s Medicare payment is calculated from three Relative Value Unit components: physician work, practice expense, and malpractice. Together they multiply by the conversion factor to produce the payment amount.
Payment = Total RVU × Conversion Factor ($33.4009) × Geographic Adjustment (GPCI). National averages shown. Actual payment varies by locality.
NCCI Bundling Edits
10 pairsThese codes trigger National Correct Coding Initiative edits when billed with 0628T. An indicator of 0 means the pair cannot be unbundled. Indicator 1 means modifier 59 or X-modifiers may allow separate billing with supporting documentation.
Billing 0628T alongside a bundled code without the correct modifier generates CARC 97 denials. Payers often flag these as audit risks. Document medical necessity for the separate service and apply modifier 59 or the appropriate X-modifier (XE, XS, XP, XU) only when clinically justified.
Anesthesia service included in surgical procedure
Anesthesia service included in surgical procedure
Anesthesia service included in surgical procedure
Anesthesia service included in surgical procedure
Anesthesia service included in surgical procedure
Anesthesia service included in surgical procedure
Misuse of Column Two code with Column One code
Misuse of Column Two code with Column One code
Misuse of Column Two code with Column One code
Misuse of Column Two code with Column One code
Bundling denials on 0628T are recoverable when the edit indicator is 1 and the chart documents a distinct, separately identifiable service. Our coders verify the indicator and pick the precise X-modifier (XE, XS, XP, XU) instead of defaulting to modifier 59.
Applicable Modifiers
Modifiers commonly paired with 0628T based on its category. Apply only when the clinical circumstance warrants. Incorrect modifier use is a top audit target.
Modifier audits catch what scrubbers miss. Our AAPC-certified team reviews every modifier choice on 0628T against the chart documentation before submission, surfacing missed and misapplied modifiers across the practice.
Find the revenue leakage in your 0628T claims.
Wrong modifier, missing documentation, bundling without justification, stale ICD-10 linkage: these are the silent revenue killers on Other claims. Our AAPC-certified team audits your last 90 days of 0628T claims, surfaces the recoverable dollars, and appeals them. Free, no obligation.
Losing revenue on CPT 0628T? We’ll find it.
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Everything about CPT 0628T
What does CPT code 0628T cover?
CPT 0628T is a Current Procedural Terminology code in the Other category maintained by the American Medical Association. The CMS short descriptor reads "Perq njx algc fluor lmbr ea". For the full AMA long descriptor and clinical guidance, refer to the current CPT code manual.
What is the Medicare payment for CPT 0628T?
The national average Medicare payment for CPT 0628T is approximately $0 in a non-facility setting and $0 in a facility setting. Actual payment varies by locality based on GPCI adjustments. Total RVU is 0 with a conversion factor of $33.4009.
What is the global period for CPT 0628T?
CPT 0628T is an add-on code (indicator ZZZ). Its global period matches the base procedure it's billed with. Cannot be billed alone. Must be paired with a primary code per CPT guidelines.
What codes bundle with CPT 0628T?
CPT 0628T has NCCI Procedure-to-Procedure edits with 10+ codes including 01937, 01938, 01939. Modifier indicator 0 means the edit cannot be bypassed. Indicator 1 means modifier 59 or X-modifiers may allow separate billing with documentation.
CPT codes and descriptions are copyright of the American Medical Association. RVU values reflect current CMS publications. Actual payment varies by locality. Commercial payer rates vary by contract.
Free 90-Day AR Recovery Audit
We audit your last 90 days of claims and surface the revenue leakage: wrong modifiers, missed bundling appeals, ICD-10 specificity gaps. AAPC-certified coders. 2.49% of collections. No setup fees.