68720

Create tear sac drain

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

Whole-Procedure Pricing

Line
Qty
Global fee
Pro fee
Primary68720Create tear sac drain
1
$702.75
$702.75

RVU Breakdown

Component
Office
Facility
Work
9.71
9.71
Practice expense
10.51
10.51
Malpractice
0.82
0.82
Total RVU
21.04
21.04

Payment Policy & Modifiers

Allowed adjustments
Bilateral -50150%
With modifier 50 (both sides), payment is 150% of the single-side amount. $1,054.13 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

Global surgery package

Major surgery: payment covers the day before, the day of, and 90 days after. Of the total payment, 10% is attributed to pre-operative care, 70% to the procedure itself, and 20% to post-operative visits.