37215

Transcath stent cca w/eps

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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
Primary37215Transcath stent cca w/eps
1
$889.47
$889.47
Add-on0984TIv img xtrc cere vsl oct 1st
0
$0.00/ unit
$0.00/ unit
Add-on37252Intrvasc us noncoronary 1st
0
$895.48/ unit
$79.16/ unit
Add-on37253Intrvasc us noncoronary addl
0
$169.68/ unit
$62.46/ unit
Whole procedure · 17.31 wRVU credited
$889.47
$889.47
How these numbers were computed
  • status=CThis code is not separately payable under the Physician Fee Schedule (status C) — amounts shown are $0.

RVU Breakdown

Component
Office
Facility
Work
17.31
17.31
Practice expense
4.70
4.70
Malpractice
4.62
4.62
Total RVU
26.63
26.63

Payment Policy & Modifiers

Allowed adjustments
Bilateral -50150%
With modifier 50 (both sides), payment is 150% of the single-side amount. $1,334.21 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% · documented
Assistant at surgery (mod 80/81/82) paid at 16% if medical necessity is documented.
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, 9% is attributed to pre-operative care, 84% to the procedure itself, and 7% to post-operative visits.