55840

Extensive prostate surgery

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Code typePrimary
Payment statusActive (A)
Global period90-day

Whole-Procedure Pricing

Line
Qty
Global fee
Pro fee
Primary55840Extensive prostate surgery
1
$1,045.11
$1,045.11

RVU Breakdown

Component
Office
Facility
Work
20.83
20.83
Practice expense
7.74
7.74
Malpractice
2.72
2.72
Total RVU
31.29
31.29

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, 10% is attributed to pre-operative care, 80% to the procedure itself, and 10% to post-operative visits.