57250

Repair rectum & vagina

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

Pricing with Related Codes

Line
Qty
Global fee
Pro fee
Primary57250Repair rectum & vagina
1
$545.44
$545.44
Add-on57267Insert mesh/pelvic flr addon
0
$219.11/ unit
$219.11/ unit
Whole procedure · 9.83 wRVU credited
$545.44
$545.44

RVU Breakdown

Component
Office
Facility
Work
9.83
9.83
Practice expense
4.85
4.85
Malpractice
1.65
1.65
Total RVU
16.33
16.33

Payment Policy & Modifiers

Allowed adjustments
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
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, 12% is attributed to pre-operative care, 74% to the procedure itself, and 14% to post-operative visits.