57423
Active90-day globalRepair paravag defect lap
2026 Medicare payment
Estimated allowed amounts. Pick a locality or enter a ZIP; toggle modifiers to see how the payment rules change the number; add the add-on codes to price the whole procedure.
| Line | Qty | Non-facility (office) | Facility (hospital/ASC) |
|---|---|---|---|
| 57423 | 1 | $820.99 | $820.99 |
| add-on49327 | 0 | $116.57/ unit | $116.57/ unit |
RVU breakdown (national)
Relative value units before geographic adjustment. Payment = (work×GPCIw + PE×GPCIpe + MP×GPCImp) × CF
| Row | Work RVU | PE RVU (office) | PE RVU (facility) | MP RVU | Total (office) |
|---|---|---|---|---|---|
| 57423 | 15.68 | 6.23 | 6.23 | 2.67 | 24.58 |
Payment policy for 57423
CMS's indicator fields, translated. These control which modifiers are payable and how.
Professional/technical (PC/TC)
pctc=0Physician service
Cannot be split into professional/technical components — modifiers 26 and TC don't apply.
Multiple procedures
mult_surg=2Standard MPPR
When billed with other procedures the same day: highest-valued paid 100%, the rest 50%.
Bilateral (modifier 50)
bilt_surg=0150% rule doesn't apply
Bilateral adjustment does not apply (e.g., the code is unilateral by definition or physiology).
Assistant surgeon (80/81/82)
asst_surg=2Payable
Assistant at surgery (mod 80/81/82) is paid at 16% of the fee schedule amount.
Co-surgeons (modifier 62)
co_surg=2Payable
Co-surgeons (mod 62) are paid 62.5% of the fee each (125% total, split).
Team surgery (modifier 66)
team_surg=0Not permitted
Team surgery (mod 66) may not be paid for this procedure.
Global surgery package
Major surgery: payment covers the day before, the day of, and 90 days after. Of the total payment, 8% is attributed to pre-operative care, 83% to the procedure itself, and 9% to post-operative visits.
Source: pfs.data.cms.gov "Indicators for 2026", retrieved 2026-07-16; conversion factors $33.4009 / $33.5675 (QP) per CMS-1832-F. Estimated amounts — not billing or coding advice.