40843
Reconstruction of mouth
Code typePrimary
Payment statusRestricted coverage (R)
Global period90-day
Restricted coverage: Covered only in unusual circumstances; special instructions apply.
Whole-Procedure Pricing
Line
Qty
Global fee
Pro fee
Primary40843Reconstruction of mouth
1
$1,294.28
$778.57
RVU Breakdown
Component
Office
Facility
Work
12.47
12.47
Practice expense
23.96
8.52
Malpractice
2.32
2.32
Total RVU
38.75
23.31
Payment Policy & Modifiers
Allowed adjustments
Bilateral -50Built in
The fee already assumes a bilateral service — modifier 50 doesn't change payment.
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