Wiki CPT 44137 - Fee/RVU

[maryv22]

Hello,

Does anyone know why CPT 44137 (Removal of transplanted intestinal allograft, complete) does not have a RVU or fee?
Is there a specific fee your organization would use for this procedure?

 

[cgaston]

It appears that Medicare has strict guidelines for intestinal transplants. They will only be reimbursed if performed at approved facilities:

https://www.cms.gov/medicare-covera...WordSearchType=Exact&kq=true&bc=IAAAABAACAAA&

and page 17 here:
https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R1341CP.pdf

ETA: it also states that payment for grafts will be included in the DRG payment. That explains why there are no prices for codes 44135-44137

 

[CodingKing]

RBRVS status C. Some MAC's post the rates for some Carrier Priced codes, other codes are reviewed on a case by case basis.