You're right.......this is a doozey!! I wouldn't use modifier 58 for the revision since that's for a staged procedure. The CPT book I have says for tx of a problem that requires a return to the OR (eg, unanticipated clinical condition) use modifier 78. BUT, since it's done on the same day, not sure how that would pay out and if it's acceptable. Possibly 100% on the revision and then the 50% on the 27130...............??? Ultimately you may only get paid for the revision.
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