23040

Arthrt gh jt expl/drg/rmv fb

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

Pricing with Related Codes

Line
Qty
Global fee
Pro fee
Primary23040Arthrt gh jt expl/drg/rmv fb
1
$673.03
$673.03
Add-on20700Mnl prep&insj dp rx dlvr dev
0
$84.84/ unit
$70.81/ unit
Add-on20704Mnl prep&insj i-artic rx dev
0
$155.65/ unit
$128.59/ unit
Add-on20705Rmvl i-artic rx delivery dev
0
$128.26/ unit
$106.21/ unit
Whole procedure · 9.51 wRVU credited
$673.03
$673.03

RVU Breakdown

Component
Office
Facility
Work
9.51
9.51
Practice expense
8.68
8.68
Malpractice
1.96
1.96
Total RVU
20.15
20.15

Payment Policy & Modifiers

Allowed adjustments
Bilateral -50150%
With modifier 50 (both sides), payment is 150% of the single-side amount. $1,009.55 office.
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
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, 69% to the procedure itself, and 21% to post-operative visits.