11952
Subq njx fil matrl 5.1-10cc
Code typePrimary
Payment statusRestricted coverage (R)
Global period0-day
Restricted coverage: Covered only in unusual circumstances; special instructions apply.
Whole-Procedure Pricing
Line
Qty
Global fee
Pro fee
Primary11952Subq njx fil matrl 5.1-10cc
1
$156.65
$87.51
RVU Breakdown
Component
Office
Facility
Work
1.65
1.65
Practice expense
2.74
0.67
Malpractice
0.30
0.30
Total RVU
4.69
2.62
Payment Policy & Modifiers
Allowed adjustments
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
Bilateral -50Co-surgeon -62Team surgeon -66Prof / tech split