43287

Esphg dstl 2/3 w/laps moblj

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

Pricing with Related Codes

Line
Qty
Global fee
Pro fee
Primary43287Esphg dstl 2/3 w/laps moblj
1
$3,294.00
$3,294.00
Add-on32674Thoracoscopy lymph node exc
0
$195.40/ unit
$195.40/ unit
Whole procedure · 61.43 wRVU credited
$3,294.00
$3,294.00

RVU Breakdown

Component
Office
Facility
Work
61.43
61.43
Practice expense
21.65
21.65
Malpractice
15.54
15.54
Total RVU
98.62
98.62

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 (mod 62) are paid 62.5% of the fee each (125% total, split).
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, 81% to the procedure itself, and 10% to post-operative visits.