45172

Exc rect tum transanal full

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

Whole-Procedure Pricing

Line
Qty
Global fee
Pro fee
Primary45172Exc rect tum transanal full
1
$794.94
$794.94

RVU Breakdown

Component
Office
Facility
Work
11.83
11.83
Practice expense
9.81
9.81
Malpractice
2.16
2.16
Total RVU
23.80
23.80

Payment Policy & Modifiers

Allowed adjustments
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.
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, 81% to the procedure itself, and 10% to post-operative visits.