56640

Vlvctmy rad comp w/lymphadec

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

Pricing with Related Codes

Line
Qty
Global fee
Pro fee
Primary56640Vlvctmy rad comp w/lymphadec
1
$1,432.23
$1,432.23
Add-on38900Io map of sent lymph node
0
$144.96/ unit
$122.92/ unit
Whole procedure · 24.16 wRVU credited
$1,432.23
$1,432.23

RVU Breakdown

Component
Office
Facility
Work
24.16
24.16
Practice expense
13.13
13.13
Malpractice
5.59
5.59
Total RVU
42.88
42.88

Payment Policy & Modifiers

Allowed adjustments
Bilateral -50150%
With modifier 50 (both sides), payment is 150% of the single-side amount. $2,148.35 office.
Multiple procedure MPPRApplies
When billed with other procedures the same day: highest-valued paid 100%, the rest 50%. Add-on codes are exempt.
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
Team 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, 12% is attributed to pre-operative care, 74% to the procedure itself, and 14% to post-operative visits.