25675
Cltx dstl rad/uln dislc mnpj
Code typePrimary
Payment statusActive (A)
Global period90-day
Whole-Procedure Pricing
Line
Qty
Global fee
Pro fee
Primary25675Cltx dstl rad/uln dislc mnpj
1
$579.84
$489.32
RVU Breakdown
Component
Office
Facility
Work
4.77
4.77
Practice expense
11.46
8.75
Malpractice
1.13
1.13
Total RVU
17.36
14.65
Payment Policy & Modifiers
Allowed adjustments
Bilateral -50150%
With modifier 50 (both sides), payment is 150% of the single-side amount. → $869.76 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