33935

Transplantation heart/lung

Add to my model
Code typePrimary
Payment statusRestricted coverage (R)
Global period90-day
Restricted coverage: Covered only in unusual circumstances; special instructions apply.

Pricing with Related Codes

Line
Qty
Global fee
Pro fee
Primary33935Transplantation heart/lung
1
$4,605.98
$4,605.98
Add-on33924Remove pulmonary shunt
0
$258.52/ unit
$258.52/ 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 · 89.49 wRVU credited
$4,605.98
$4,605.98

RVU Breakdown

Component
Office
Facility
Work
89.49
89.49
Practice expense
26.95
26.95
Malpractice
21.46
21.46
Total RVU
137.90
137.90

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.
Team surgery -66By report
Team surgery is priced 'by report' — the contractor sets the amount; no standard percentage.
Not applicable to this code
Bilateral -50Prof / 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.