Q4319
Sanograft, per sq cm
Code typeAdd-on
Paid withContractor-defined
Payment statusActive (A)
Global periodAdd-on code
Add-On Payment Increment
What Q4319 adds per unit to the primary it is billed with — not a total, since this code is never payable on its own.
Line
Qty
Global fee
Pro fee
Add-onQ4319Sanograft, per sq cm
1
$127.26
$127.26
RVU Breakdown
Component
Office
Facility
Work
0.00
0.00
Practice expense
3.81
3.81
Malpractice
0.00
0.00
Total RVU
3.81
3.81
Payment Policy & Modifiers
Allowed adjustments
Assistant surgeon -80/81/8216% · documented
Assistant at surgery (mod 80/81/82) paid at 16% if medical necessity is documented.
Not applicable to this code
Bilateral -50Multiple procedure Co-surgeon -62Team surgeon -66Prof / tech split