33542

Removal of heart lesion

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

Pricing with Related Codes

Line
Qty
Global fee
Pro fee
Primary33542Removal of heart lesion
1
$2,455.63
$2,455.63
Add-on33141Heart tmr w/other procedure
0
$119.58/ unit
$119.58/ unit
Add-on33257Ablate atria lmtd add-on
0
$569.15/ unit
$569.15/ unit
Add-on33259Ablate atria w/bypass add-on
0
$820.99/ unit
$820.99/ unit
Add-on34714Opn fem art expos cndt crtj
0
$245.16/ unit
$245.16/ unit
Add-on34716Opn ax/subcla art expos cndt
0
$338.35/ unit
$338.35/ unit
Add-on34833Opn ilac art expos cndt crtj
0
$355.05/ unit
$355.05/ unit
Whole procedure · 47.00 wRVU credited
$2,455.63
$2,455.63

RVU Breakdown

Component
Office
Facility
Work
47.00
47.00
Practice expense
14.90
14.90
Malpractice
11.62
11.62
Total RVU
73.52
73.52

Payment Policy & Modifiers

Allowed adjustments
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
Bilateral -50Team 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, 9% is attributed to pre-operative care, 84% to the procedure itself, and 7% to post-operative visits.