21143
Rcnstj mdface lefort i 3/>pc
Code typePrimary
Payment statusActive (A)
Global period90-day
Whole-Procedure Pricing
Line
Qty
Global fee
Pro fee
Primary21143Rcnstj mdface lefort i 3/>pc
1
$1,273.58
$1,273.58
RVU Breakdown
Component
Office
Facility
Work
20.52
20.52
Practice expense
14.63
14.63
Malpractice
2.98
2.98
Total RVU
38.13
38.13
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%
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