11954
Subq njx fil matrl>10.0 cc
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
Primary11954Subq njx fil matrl>10.0 cc
1
$173.35
$96.19
RVU Breakdown
Component
Office
Facility
Work
1.80
1.80
Practice expense
3.04
0.73
Malpractice
0.35
0.35
Total RVU
5.19
2.88
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