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#SURGEON FIRST ASSISTANT CODE#

The Medicare Physician Fee Schedule RVU table is a dense and expansive spreadsheet bursting with data that many will find difficult to navigate.

#SURGEON FIRST ASSISTANT CODE#

To determine whether a surgical CPT code qualifies for an assistant requires you to reference the Medicare Physician Fee Schedule RVU information for the specific surgical CPT code. Not all surgeries qualify for an assistant at surgery. When is an Assistant at Surgery Warranted? Non-Physician Practitioner (modifier -AS) reimbursement is 13.6% of the surgical reimbursement rate, per 8 CCR §9789.15.1.

Physician (modifiers -80, -81, or -82) reimbursement is 16% of the global surgery fee schedule amount per 8 CCR §9789.16.8.

Service performed by a physician assistant, nurse practitioner, or clinical nurse specialist use modifier -AS.

Performed by an MD when no qualified resident available use modifier -82.

Minimal surgical assistant services by a medical doctor (MD) use modifier -81.

Service performed by a medical doctor (MD) use modifier -80.

The following is a summary of the role assistant at surgery plays and what qualifies:Īssistant at surgery - Though not explicitly defined in 8 CCR §9789.16.8, an assistant at surgery is a physician or non-physician practitioner who actively assists the surgeon and goes beyond providing ancillary services. physician assistants, nurse practitioners, or clinical nurse specialists), acting as an assistant at surgery, this amount is further reduced to 13.6% of the surgical reimbursement.

A physician (MD) assistant surgeon is paid 16% of the reimbursement for the applicable surgical CPT code. Under some circumstances, when a procedure doesn’t require the skill of a second surgeon, but either the patient’s condition or surgical complexity requires an assistant, the services of the assistant at surgery are reimbursable. To qualify for reimbursement, the California regulations are more ambiguous and require more documentation than required for co-surgeons and team surgery. Typically this arises when physicians or non-physician practitioners assist during a procedure, but don’t perform any surgery.

Notably left in the box was a discussion on assistant(s) at surgery. Last week, we opened Pandora’s box on co-surgeons and team surgery.