55874

Tprnl plmt biodegrdabl matrl

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Code typePrimary
Payment statusActive (A)
Global period0-day

Whole-Procedure Pricing

Line
Qty
Global fee
Pro fee
Primary55874Tprnl plmt biodegrdabl matrl
1
$3,704.49
$142.62

RVU Breakdown

Component
Office
Facility
Work
2.95
2.95
Practice expense
107.63
0.99
Malpractice
0.33
0.33
Total RVU
110.91
4.27

Payment Policy & Modifiers

Allowed adjustments
Multiple procedure MPPRApplies
When billed with other procedures the same day: highest-valued paid 100%, the rest 50%.
Co-surgeons -6262.5% each
Co-surgeons paid (62.5% each) if medical necessity is documented.
Team surgery -66By report
Team surgery may be paid case by case with supporting documentation.
Not applicable to this code
Bilateral -50Assistant surgeon Prof / tech split