58760
Fimbrioplasty
Code typePrimary
Payment statusActive (A)
Global period90-day
Whole-Procedure Pricing
Line
Qty
Global fee
Pro fee
Primary58760Fimbrioplasty
1
$724.47
$724.47
RVU Breakdown
Component
Office
Facility
Work
13.58
13.58
Practice expense
5.73
5.73
Malpractice
2.38
2.38
Total RVU
21.69
21.69
Payment Policy & Modifiers
Allowed adjustments
Bilateral -50150%
With modifier 50 (both sides), payment is 150% of the single-side amount. → $1,086.71 office.
Multiple procedure MPPRApplies
When billed with other procedures the same day: highest-valued paid 100%, the rest 50%.
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