55874
Tprnl plmt biodegrdabl matrl
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