20692

Appl mltpln uni ext fixj sys

Add to my model
Code typePrimary
Payment statusActive (A)
Global period90-day

Pricing with Related Codes

Line
Qty
Global fee
Pro fee
Primary20692Appl mltpln uni ext fixj sys
1
$1,047.12
$1,047.12
Add-on20702Mnl prep&insj imed rx dev
0
$147.97/ unit
$122.92/ unit
Whole procedure · 15.86 wRVU credited
$1,047.12
$1,047.12

RVU Breakdown

Component
Office
Facility
Work
15.86
15.86
Practice expense
12.56
12.56
Malpractice
2.93
2.93
Total RVU
31.35
31.35

Payment Policy & Modifiers

Allowed adjustments
Multiple procedure MPPRApplies
When billed with other procedures the same day: highest-valued paid 100%, the rest 50%. Add-on codes are exempt.
Assistant surgeon -80/81/8216%
Assistant at surgery (mod 80/81/82) is paid at 16% of the fee schedule amount.
Co-surgeons -6262.5% each
Co-surgeons paid (62.5% each) if medical necessity is documented.
Not applicable to this code
Bilateral -50Team 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, 69% to the procedure itself, and 21% to post-operative visits.