61564

Excision of skull tumor

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

Pricing with Related Codes

Line
Qty
Global fee
Pro fee
Primary61564Excision of skull tumor
1
$2,333.05
$2,333.05
Add-on69990Microsurgery add-on
0
$198.07/ unit
$198.07/ unit
Whole procedure · 33.87 wRVU credited
$2,333.05
$2,333.05

RVU Breakdown

Component
Office
Facility
Work
33.87
33.87
Practice expense
21.68
21.68
Malpractice
14.30
14.30
Total RVU
69.85
69.85

Payment Policy & Modifiers

Allowed adjustments
Bilateral -50150%
With modifier 50 (both sides), payment is 150% of the single-side amount. $3,499.58 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, 11% is attributed to pre-operative care, 76% to the procedure itself, and 13% to post-operative visits.