21084
Impres&prep sp aid prosth
Code typePrimary
Payment statusActive (A)
Global period90-day
Whole-Procedure Pricing
Line
Qty
Global fee
Pro fee
Primary21084Impres&prep sp aid prosth
1
$1,610.59
$1,056.80
RVU Breakdown
Component
Office
Facility
Work
21.92
21.92
Practice expense
23.80
7.22
Malpractice
2.50
2.50
Total RVU
48.22
31.64
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