15937

Exc sac pr ulc prep mus ostc

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Code typePrimary
Payment statusActive (A)
Global period90-day

Whole-Procedure Pricing

Line
Qty
Global fee
Pro fee
Primary15937Exc sac pr ulc prep mus ostc
1
$919.53
$919.53

RVU Breakdown

Component
Office
Facility
Work
14.76
14.76
Practice expense
10.05
10.05
Malpractice
2.72
2.72
Total RVU
27.53
27.53

Payment Policy & Modifiers

Allowed adjustments
Multiple procedure MPPRApplies
When billed with other procedures the same day: highest-valued paid 100%, the rest 50%.
Co-surgeons -6262.5% each
Co-surgeons paid (62.5% each) if medical necessity is documented.
Not applicable to this code
Bilateral -50Assistant surgeon Team surgeon -66Prof / tech split

Global surgery package

Major surgery: payment covers the day before, the day of, and 90 days after. Of the total payment, 10% is attributed to pre-operative care, 71% to the procedure itself, and 19% to post-operative visits.