If you have procedure with an RVU of 51.9 and price calculations is 8,950.00 and then another RVU of 38.5 and the price calculations is 10,800.00 would you bill the higher RVU with less reimbursement first or lower. also does it matter in what order you bill the procedures? if a phsyican does a laminectomy and discetomy would you bill the laminectomy primary and the disectomy as a distinct and seperate procedure by appending the 59 modifer