23220

Radical rescj tumor prox hum

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Code typePrimary
Payment statusActive (A)
Global period90-day

Pricing with Related Codes

Line
Qty
Global fee
Pro fee
Primary23220Radical rescj tumor prox hum
1
$1,737.51
$1,737.51
Add-on20932Osteoart algrft w/surf & b1
0
$648.65/ unit
$648.65/ unit
Add-on20933Hemicrt intrclry algrft prtl
0
$595.54/ unit
$595.54/ unit
Add-on20934Intercalary algrft compl
0
$648.65/ unit
$648.65/ unit
Whole procedure · 29.45 wRVU credited
$1,737.51
$1,737.51

RVU Breakdown

Component
Office
Facility
Work
29.45
29.45
Practice expense
16.31
16.31
Malpractice
6.26
6.26
Total RVU
52.02
52.02

Payment Policy & Modifiers

Allowed adjustments
Bilateral -50150%
With modifier 50 (both sides), payment is 150% of the single-side amount. $2,606.27 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.