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53452

Carrier-priced10-day global

Tprnl balo cntnc dev uni

Carrier-priced: Your Medicare contractor sets the price case by case (often after reviewing documentation).

2026 Medicare payment

Estimated allowed amounts. Pick a locality or enter a ZIP; toggle modifiers to see how the payment rules change the number.

Show values as
Modifiers
LineQtyNon-facility (office)Facility (hospital/ASC)
534521$0.00$0.00
Conversion factor: Locality: national average GPCIs

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 (national)

Relative value units before geographic adjustment. Payment = (work×GPCIw + PE×GPCIpe + MP×GPCImp) × CF

RowWork RVUPE RVU (office)PE RVU (facility)MP RVUTotal (office)
534520.000.000.000.000.00

Payment policy for 53452

CMS's indicator fields, translated. These control which modifiers are payable and how.

Professional/technical (PC/TC)

pctc=0

Physician service

Cannot be split into professional/technical components — modifiers 26 and TC don't apply.

Multiple procedures

mult_surg=0

No reduction

No multiple-procedure payment adjustment applies (typical for add-on codes).

Bilateral (modifier 50)

bilt_surg=0

150% rule doesn't apply

Bilateral adjustment does not apply (e.g., the code is unilateral by definition or physiology).

Assistant surgeon (80/81/82)

asst_surg=0

Payable with documentation

Assistant at surgery (mod 80/81/82) paid at 16% if medical necessity is documented.

Co-surgeons (modifier 62)

co_surg=0

Not permitted

Co-surgeons (mod 62) may not be paid for this procedure.

Team surgery (modifier 66)

team_surg=0

Not permitted

Team surgery (mod 66) may not be paid for this procedure.

Global surgery package

Payment covers the procedure plus related care for 10 days after. Of the total payment, 10% is attributed to pre-operative care, 80% to the procedure itself, and 10% to post-operative visits.

Source: pfs.data.cms.gov "Indicators for 2026", retrieved 2026-07-16; conversion factors $33.4009 / $33.5675 (QP) per CMS-1832-F. Estimated amounts — not billing or coding advice.

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