21077

Impres&prep orbital prosth

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Code typePrimary
Payment statusActive (A)
Global period90-day

Whole-Procedure Pricing

Line
Qty
Global fee
Pro fee
Primary21077Impres&prep orbital prosth
1
$2,193.77
$1,528.43

RVU Breakdown

Component
Office
Facility
Work
32.86
32.86
Practice expense
29.07
9.15
Malpractice
3.75
3.75
Total RVU
65.68
45.76

Payment Policy & Modifiers

Allowed adjustments
Bilateral -50150%
With modifier 50 (both sides), payment is 150% of the single-side amount. $3,290.65 office.
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
Co-surgeon -62Team 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.