25676

Optx rad/uln dislc aqt/chrnc

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Code typePrimary
Payment statusActive (A)
Global period90-day

Whole-Procedure Pricing

Line
Qty
Global fee
Pro fee
Primary25676Optx rad/uln dislc aqt/chrnc
1
$595.20
$595.20

RVU Breakdown

Component
Office
Facility
Work
8.08
8.08
Practice expense
8.13
8.13
Malpractice
1.61
1.61
Total RVU
17.82
17.82

Payment Policy & Modifiers

Allowed adjustments
Bilateral -50150%
With modifier 50 (both sides), payment is 150% of the single-side amount. $892.80 office.
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.
Not applicable to this code
Co-surgeon -62Team 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.