To report services of an assistant surgeon, the following surgical modifiers should be appended: 80 Assistant Surgeon: This modifier pertains to physicians services only.
Assistant at Surgery Modifiers Fact Sheet - Novitas Solutions 20692 $396.90 Up Next. %PDF-1.4
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!op pO:y[5SabbzOAn` 9 Not applicable concept (e.g., service is not surgery). <>stream
Actual payment will be based on Health Options policies, procedures, and Customer Benefit Plans. 20605 $50.31
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CDT is a trademark of the ADA. 0000069701 00000 n
You must log in or register to reply here. (Examples: Obstetrical Billing & Multiple Birth Guidelines Quick Reference Guide . Chicago, IL 60611. 0000031389 00000 n
3. Revisions
CPT Codes and Fees: Surgery Guide 1 = Statutory payment restriction for assistants at surgery applies to this procedure. 21295 $164.32 CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CDT.
Coding Corner: How to report a consult service when your - cmadocs Fargo (Headquarters) These codes describe patient-initiated digital communications provided by physician or other qualified health care professional (99421, 99422, 99423), or a non-physician health care professional (98970, 98971, 98972). Assistant surgeons should bill the same CPT surgical procedure codes as the primary surgeon with either modifier "80" or "82." Assistant surgeons are reimbursed at a percentage of the allowed amount for primary surgeons. It may not display this or other websites correctly. 20664 $581.00 You acknowledge that the ADA holds all copyright, trademark and other rights in CDT. 21335 $686.65 A physician, nurse practitioner, physician assistant or clinical nurse specialist who is authorized to provide such services under state law can serve as an assistant at surgery. Tagged as: AMA Current Procedural Terminology, CPT codes, Physicians as Assistants at Surgery, specialty surgical organizations, Bulletin of the American College of Surgeons 0000003025 00000 n
If this is your first visit, be sure to check out the. 118. 1 0 obj
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All procedures with a global period of ZZZ are related to another procedure, and the applicable global period for the ZZZ code is determined by the related procedure. <>/Metadata 280 0 R/ViewerPreferences 281 0 R>>
1. We maintain and annually update a List of Current Procedural Terminology (CPT)/Healthcare Common Procedure Coding System (HCPCS) Codes (the Code List), which identifies all the items and services included within certain designated health services (DHS) categories or that may qualify for certain exceptions. Updated cross references and policy format. This type of unbundling is incorrect coding. Department of Health & Human .
Provider Reimbursement Policies | Anthem.com Surgeon who performed surgery (s) with two or more other surgeons; all surgeons must add CPT Modifier 66 to the surgical procedure Procedure codes that have a TEAM 1 or 2 indicator on the MPFSDB must be submitted with supporting documentation CPT Modifier 80 Assistant Surgeon (Physician).
AMA Releases 2020 CPT code set | American Medical Association CMS takes big steps to fix prior authorization in Medicare Advantage and more in the latest Advocacy Update spotlight. Up Next. Because in the coding world, you know add-on codes should only be paid if the parent code is paid. If this is a U.S. Government information system, CMS maintains ownership and responsibility for its computer systems. 21044 $817.33 0000007696 00000 n
21210 $861.00 A licensed physician assistant 3. 2 = Payment restriction for assistants at surgery does not apply to this procedure. To license the electronic data file of UB-04 Data Specifications, contact AHA at (312) 893-6816. Assistant 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. A: . 80 NoridianAssistant surgeon may be paid.
Services Not Covered by Medicare | AAFP 21110 $459.00 0000067715 00000 n
1 = Statutory payment restriction for assistants at surgery applies to this procedure. stream
The ADA does not directly or indirectly practice medicine or dispense dental services. 21195 $1,240.00 2020 CPT CODE ADDITIONS 2 92202 One of the following ICD-10-CM diagnosis codes is required on the claim: B39.4, B39.5, B39.9, B58.01, . 522 0 obj
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The Current Procedural Terminology (CPT) code set helps spur and integrate care innovation. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material. x]1n0^
3(/`q 8RZA^H+#mZ__m>uDy}iwo=^h_{;"^Om,WxR'j*gC. 21184 $2,245.05 21230 $724.83 endstream 32 0 obj Jz/SZ5 Visit the AMA Store for coding resources from the authoritative source on the CPT code set. Article. 0000004728 00000 n
2 The assistant surgeon may be paid. The 2018 report adds 93 codes that the CPT Editorial Panel has approved since the last report was issued in 2016. License to use CPT for any use not authorized here in must be obtained through the AMA, CPT Intellectual Property Services, 515 N. State Street, Chicago, IL 60610. Up Next. Learn about the latest changes for CPT Category III Codes for emerging technologies, services and procedures. 20693 $430.00 21172 $1,619.39 0000013889 00000 n
The MPFSDB is a file layout that carriers and A/B MACs use to display the total fee schedule amount, related component parts, and payment policy indicators. Check Medicare Physician Fee Schedule (MPFS) Indicator/Descriptor Lists. 21050 $800.65 You shall not remove, alter, or obscure any ADA copyright notices or other proprietary rights notices included in the materials. This modifier is not intended for use by non-physician providers. The list consists of procedures that Medicare has determined required a first-assistant-at-surgery in fewer than 5% . `[ELd}CGa= F(!V: =Q 0VB5 W5*WuU}8-cPZ99%t/50 Confidential 2 0 obj
For example: If a general surgeon bills as co-surgeon on CPT code 22558, then he is paid to assist in the entire procedure not just the laparotomy portion. 21330 $488.00 FOURTH EDITION. The surgeon typically pays the co-surgeon/assistant out of the revenue . These rates are provided for informational purposes only and are not to be considered a guarantee of payment. <>stream
21047 $1,153.00 0000004776 00000 n
Current Procedural Terminology (CPT) codes provide a uniform nomenclature for coding medical procedures and services. 20900 $373.00 Receive Medicare's "Latest Updates" each week. <<4920F65ACFB5B2110A0060FF8C42FF7F>]/Prev 129922>> Physicians should not bill CPT code 99417 with the following CPT codes: 99354, 99355, 99358, 99359, 99415, or 99416. 109. The scope of this license is determined by the AMA, the copyright holder. CPT Code Reimbursement CPT 91311, 0111A, 0112A Covid Vaccine for children, 5 Important points to improve claim submission success rate. 20550 $55.36 21345 $705.00 20838 $2,281.94 21154 $2,034.89 An assistant at surgery is a provider who actively assists the physician in charge of a case in performing a surgical procedure. Pre-exposure prophylaxis is one of the Affordable Care Act (ACA) preventive services at risk in federal court, says Stephen Parodi, MD. Assistant Surgeon Policy EmblemHealth1. Current Procedural Terminology (CPT) codes provide a uniform nomenclature for coding medical procedures and services. 21235 $653.00 21155 $2,248.96 474 49
You are using an out of date browser. All Rights Reserved to AMA. Assistant surgeon CPT codes Medical Billing CPT ModifiersAssistant surgeon CPT codes not covered list 3000 39400 30000 procedure codes that are "Nevers" for assistant surgeon. THE LICENSES GRANTED HEREIN ARE EXPRESSLY CONDITIONED UPON YOUR ACCEPTANCE OF ALL TERMS AND CONDITIONS CONTAINED IN THESE AGREEMENTS. CMS DISCLAIMER. When a provider reports an eligible procedure with modifier 62 appended, reimbursement will be 125% of the allowed amount, divided equally between the co-surgeons. startxref If an entity wishes to utilize any AHA materials, please contact the AHA at 312-893-6816. 20555 $269.83 The Internet-Only Manuals (IOM), Medicare Claims Processing Manual, Publication 100-04, Chapter 12, Section 20.4.5 (Allowable Adjustments) limits the reporting of use of an operating microscope (CPT code 69990) to procedures described by CPT codes 61304-61546, 61550-61711, 62010-62100, 63081-63308, 63704-63710, 64831, 64834-64836, 64840-64858, Assistant Surgeon Policy: Reimbursement Policy (Effective 01/11/2016) CPT/HCPCS codes allowed for assistant surgeon reimbursement) to reflect annual code edits: o Added 54437 and 54438 o Removed 21810, 33332, 33472, 33960, 42508, 43350, MODIFIERS Professional Claims Effective 8/27/07 Blue Cross and Blue Shield of Texas/HMO Blue Texas accept all valid CPT and HCPCS Assistant Surgeon Modifiers Modifier 80, 81, 82: Denote assistant surgeons. Several general guidelines are repeated in this Chapter.
PDF MODIFIERS RECOGNIZED IN PROCESSING SERVICE CLAIMS iLLINOIS HEALTHCARE 21137 $679.31 The revenue codes and UB-04 codes are the IP of the American Hospital Association. 21325 $333.00 0000071003 00000 n
A physicians surgical assistant services may be identified by adding the modifier 80 to the usual procedure code.
Coding for Evaluation and Management Services | AAFP Keep in mind that determination of coverage under a member's plan does not necessarily ensure reimbursement . the assistant surgeon indicator in the Professional Services Fee Schedule to determine if assistant surgeon fees are payable. One assistant surgeon is allowed per procedure code/surgery. All Rights Reserved.
CPT Codes and Fees: Assistant Surgery Guide - NC By continuing beyond this notice, users consent to being monitored, recorded, and audited by company personnel. 21365 $1,028.43 21034 $1,048.00 The report is available on the ACS website. There are times in which the various content contributor primary resources are not synchronized or updated on the same time interval. Should be submitted on those surgical procedures where an assistant surgeon is warranted. The Medicaid rates for ambulance services are calculated in accordance with 1 TAC 355.8600. The ADA is a third-party beneficiary to this Agreement. 0000006219 00000 n
20665 $95.00
Assistant at Surgery: All You Need to Know | daisyBill No, the large language model cannot deliver medical care. In this episode of Making the Rounds, learn about one resident's experience of not matching, offering insight on coping and how unmatched applicants can find a position. 20808 $4,002.10 21179 $1,388.01 Find information about CPT Category I Vaccine Codes. 20553 $29.00 %%EOF
Learn more. registered for member area and forum access, https://www.cms.gov/apps/physician-fee-schedule/search/search-results.aspx?Y=0&T=1&HT=0&H1=69990&M=5, https://www.cms.gov/apps/physician-fee-schedule/search/search-criteria.aspx, http://www.cms.gov/Medicare/Coding/ect=/NationalCorrectCodInitEd/NCCIEP/list.asp, http://www.cms.gov/Outreach-and-Edus/downloads/How_to_MPFS_Booklet_ICN901344.pdf, https://www.novitas-solutions.com/partb/reimbursement/mfsdbhelp.html, https://www.noridianmedicare.com/partb/fees/docs/2013/2013_mpfs_indicator_descriptors.pdf. Medical CPT codes are critical to streamlining reporting and increasing accuracy and efficiency, as well as for administrative purposes such as claims processing and developing guid .Read More Related Topic: CPT Catalog of Topics 17% of the fee schedule (Fee Schedule Amount x 85%) x 20%. 0000030598 00000 n
AS USED HEREIN, "YOU" AND "YOUR" REFER TO YOU AND ANY ORGANIZATION ON BEHALF OF WHICH YOU ARE ACTING. 20982 $3,772.65 20245 $428.00 Should be submitted on those surgical, Procedure 1206- Assistant Surgeon Purpose: ProcedureProcedure 1206- Assistant Surgeon Lines of Business: All Purpose: This Network Health guideline describes services provided by assistant surgeons that Global cesarean section CPT codes submitted by an assistant surgeon will be reimbursed using the. 0000034523 00000 n
Up Next. Psychological and Neuropsychological Testing 20957 $2,307.53 <> Officials and members gather to elect officers and address policy at the 2023 AMA Annual Meeting being held in Chicago, June 9-14, 2023. All our content are education purpose only. Actual payment will be based on Health Options policies, procedures, and Customer Benefit Plans, Reimbursement by Procedure Codes 20000 29999Effective Jan. 1, 2015.
20660 $182.49 Confidential Each surgeon will be reimbursed 62.5% of the allowed amount. Note: Multiple procedure reductions may apply if an assistant at surgery submits multiple procedure codes. At any time, and for any lawful Government purpose, the government may monitor, record, and audit your system usage and/or intercept, search and seize any communication or data transiting or stored on this system. What Patients Can Learn From Current CPT Codes. Procedures with a global period of MMM are maternity procedures. 0000000016 00000 n
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Reimbursement by Procedure Codes 20000 29999 Effective Jan. 1, 2015 AMA members get discounts on prep courses and practice questions. 21060 $745.26 4/2022. 21159 $2,543.33 When reporting services provided by non-physician practitioners acting as assistants at surgery, append modifier AS to the procedure code used to report the surgeons service. Pathology and Laboratory. <>
20680 $389.00 The assistant at surgery payment indicator describes when assistant at surgery may be paid or not. All codes in the NPFS with the status code indicator "1" for "Assistant Surgeons" are considered by UnitedHealthcare Medicare Advantage to not be reimbursable for Assistant Surgeon services, as indicated by an Assistant Surgeon or surgical assistant modifier (80, 81, 82, or AS), and will not be allowed for payment. Assistant Surgeon (when qualified resident surgeon not available), Physician Assistant (PA), Nurse Practitioner (NP), Clinical Nurse Specialist (CNS) services for Assistant at Surgery. These include preventive examinations represented by CPT codes 99381-99397. Policy. 28 0 obj Please click here to see all U.S. Government Rights Provisions. This includes items such as CPT codes, CDT codes, ICD-10 and other UB-04 codes. 43846 80 . You should report inpatient consultation services using an Initial Hospital Care code (99221-99223) for the initial evaluation, and a Subsequent Hospital Care code (99231-99233) for subsequent visits.
CHCP - Resources - Policy Updates April 2021 - Cigna Need coding resources? | American Medical Association Assistant surgeons' Fees Should Be Paid For Almost All Assistant surgeons' fees should be paid for surgeon for these procedures has been found so indisputably necessary that Medicare and Medicaid pay nation-wide for an assistant surgeon for procedure codes: 28289 which lists all of the surgical CPT codes and indicates whether there is a , Assistant At Surgery (Modifiers 80/81/82/AS) Providers Subject: Assistant at Surgery (Modifiers 80/81/82/AS) Effective Date: Services should be billed with CPT codes, reductions to the assistant surgeon in accordance with Louisiana Department of Health and Hospitals . 0000020908 00000 n
Medicare does not recognize a registered nurse first assistant (RNFA) as a qualified Medicare provider. Assistant Surgeon and Cesarean Sections Only a non-global cesarean section delivery code (CPT codes 59514 or 59620) is a reimbursable service when submitted with an appropriate assistant surgeon modifier. endobj 21080 $1,854.59 Note: The information obtained from this Noridian website application is as current as possible. Applicable Federal Acquisition Regulation Clauses (FARS)\Department of Defense Federal Acquisition Regulation Supplement (DFARS) Restrictions Apply to Government use. Additions and deletions to the 2023 AMA Current Procedural Terminology (CPT) code set describe myriad methods for delivering behavioral health care. Any questions pertaining to the license or use of the CPT must be addressed to the AMA. Ua:Te'vIBcjxD?8hX`h:P0B#::\F!%4 ?cX4bk* ?21j3$ y]~3htrrppC oa\;33. Note: Non Physician Practitioner (NPP) or mid-level practitioner (PA, NP, CNS): Allowed equals 85% of surgical assist or 16% allowable, Inappropriate to bill AS modifier for physician surgical services, Inappropriate to append modifier 58 (staging) with assistant surgery. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material. 21010 $675.99 Therefore, you have no reasonable expectation of privacy. 20206 $109.00 Ambulance. Complete Global Service Data for Orthopaedic Surgery 2020 Cpt 1999 OrthopedicCptCodeCheatSheet Downloaded from sdslife.mindspacetech.com by guest KYLEE YADIRA CPT 2021 Express Reference Coding Card: Dermatology Amer Assn of Neurological Surgeons For a better understanding of the latest revisions to the CPT code set, rely on the best-selling .
Physician Coverage Guidelines | Executive Office of Health and Human Assistant surgeon may be paid.
Modifier 62 - two surgeons or cosurgeons - Regence Removed CMS Assistant at Surgery status indicator table. 21249 $1,450.00 For assistant-at-surgery services performed by physicians, the fee schedule amount equals 16 percent of the amount otherwise applicable for the surgical payment. 2. Procedure codes with a CMS assistant surgeon indicator of "2" are eligible for assistant surgeon reimbursement. 0000069315 00000 n
Appropriate use of assistant at surgery modifiers and payment indicators. If multiple services are submitted with modifiers indicating assistants at surgery, each service is independently reviewed (based on the above-listed indicators) to determine payment. 20526 $66.00 All the articles are getting from various resources. Correct Use Physician: Assist-at-surgery allowed with appended modifiers 80, 81, or 82 Allowed = 16% of surgery fee schedule allowable Note: Non Physician Practitioner (NPP) or mid-level practitioner (PA, NP, CNS): Append AS modifier only Allowed equals 85% of surgical assist or 16% allowable Incorrect Use 5/1/2020: N/A: Co-Surgeon/Team Surgeon Modifiers: CPCP009: 10/27/2022: View: Drug Testing Clinical Payment and Coding Policy: CPCP020: 12/29/2021: . Procedures with a global period of MMM are maternity procedures. Reimbursement is not allowed for more than one assistant surgeon. CPT code 37217 (transcatheter placement of intravascular stent[s], intrathoracic common Please reach out and we would do the investigation and remove the article. This section summarizes some of the rules. 0
0000009465 00000 n
These rates are provided for informational purposes only and are not to be considered a guarantee of payment. 474 0 obj
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21240 $1,061.22 Treatment Description. Medicare Fee for Office Visit CPT Codes - CPT Code 99213, 99214, 99203; Medicare Fee Schedule, Payment and Reimbursement Benefit Guideline, . While reimbursement is considered, payment determination is subject to, but not limited to: In instances where the provider is participating, based on member benefits, co-payment, coinsurance, and/or deductible shall apply. Drive in style with preferred savings when you buy, lease or rent a car. 21182 $1,905.99 The use of the information system establishes user's consent to any and all monitoring and recording of their activities. Treatment Description. 21343 $922.00 BY CLICKING ABOVE ON THE LINK LABELED "I Accept", YOU HEREBY ACKNOWLEDGE THAT YOU HAVE READ, UNDERSTOOD AND AGREED TO ALL TERMS AND CONDITIONS SET FORTH IN THESE AGREEMENTS. endobj
First Coast Service Options Inc. (First Coast) would like to remind providers within jurisdiction N (JN) of the appropriate use of assistant at surgery modifiers and payment under the Medicare physician fee schedule (MPFS). NOTE: Physicians acting as assistants cannot bill as co-surgeons. 20225 $112.94 0000067999 00000 n
Actual payment will be based on Health Options policies, procedures, and Customer Benefit Plans. CPT Codes, Descriptors, , Surgery: Cardiovascular System (surg Cardio), Reimbursable for a second assistant surgeon. In general, represented by concurrent CPT codes with indicator 2 designation. CDT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. 20973 $2,680.73 21208 $884.00 21215 $941.22 CPT Code Reimbursement Medicare only covers three immunizations (influenza, pneumonia, and hepatitis B) as prophylactic physician services. 81 Minimum Assistant Surgeon No fee schedules, basic unit, relative values or related listings are included in CDT. Refer to the Multiple Procedures Payment Reduction for Medical and Surgical Services Reimbursement Policy for additional information. xref
If he only performs the laparotomy . <> All procedures on the Medicare Physician Fee Schedule are assigned a global period of 000, 010, 090, XXX, YYY, ZZZ, or MMM. 0000031829 00000 n
Assistant at surgery may be paid.
List of CPT/HCPCS Codes | CMS - Home - Centers for Medicare & Medicaid Up Next. Added a note that codes are updated quarterly. 21346 $844.00 0000005235 00000 n
Surgery: Cardiovascular System 1. This Agreement will terminate upon notice to you if you violate the terms of this Agreement. Revenue Codes Requiring CPT or HCPCS Codes: CPCP018: 10/27/2022: View: Paravertebral Facet Injection Procedure Coding & Billing Policy: CPCP036: 12/22/2022: View: Pneumatic Compression Devices . The assistant at surgery procedure code eligible list is developed based on The Center for Medicare & Medicaid Services (CMS) Physician Fee Schedule (PFS) Relative Value Unit (RVU) File status indicators. Modifier 90; Reference (Outside) Laboratory . What Patients Can Learn From Current CPT Codes. 26 0 obj The AMA promotes the art and science of medicine and the betterment of public health. 21125 $780.00 On June 30, 2009, within the post-op period of the cataract removal surgery, a YAG laser capsulotomy (CPT code 66821) was performed on the right eye. Providers must list this code separately in addition to the code for the primary procedure. The reimbursement amount is dependent upon the assistant surgeon modifier appended to the surgical code submitted. Medical CPT codes are critical to streamlining reporting and increasing accuracy and efficiency, as well as for administrative purposes such as claims processing and developing guid. In fact, Medicare does not. November 2006 CPT Assistant, the Add-on code should be reported on same claim as the primary Mohs procedure even though the dates of service may differ. 21116 $24.83 21194 $1,319.83 B. Procedures billed with the assistant-at-surgery physician modifiers -80, -81, -82, or the AS modifier for physician assistants, nurse practitioners and clinical nurse specialists, are.
Cpt Codes For Assistant Surgeon - Surgical Tech Classes %%EOF AS Non-physician provider as assistant at surgery: This modifier applies when the assistant at surgery services are provided by a PA, ARNP, or CNS. Before you can enter the Noridian Medicare site, please read and accept an agreement to abide by the copyright rules regarding the information you find within this site. 20662 $441.73 Assistant Special Edition: December Update (2020) in which vaccine product code 91302 (AstraZeneca, two dose vaccine) was established with its corre-sponding administration codes (0021A, 0022A). 0000012547 00000 n
a. 0000001301 00000 n
CMS Disclaimer Please note, the terms of a customer's particular benefit plan document [Group Service Agreement, Evidence of Coverage, Certificate of Coverage, Summary Plan Description (SPD) or similar plan document] may differ significantly from the standard benefit plans upon which these policies are based. Medicare's policies on billing patients in excess of the Medicare allowed amount apply to assistant-at-surgery services. The below table identified procedure codes that are not eligible for reimbursement when reported by an Assistant Surgeon. Physicians should report the HCPCS/CPT code that describes the procedure performed to the greatest specificity possible.
Assistant at Surgery | BCBSND 0000069053 00000 n
3 surg cardio. Modifier 80 is appended to the surgical code when another surgeon is assisting at surgery. If you find anything not as per policy. 0000031621 00000 n
First Assistant Not Payable Under Medicare for 2017 Page 2. Benefits will be derived based on CMS designation for Assistant Surgeon. 0000068429 00000 n
21121 $603.00 CPT has responded by adding six new codes to report online digital evaluation services, or e-visits. It also provides guidance on the . 20974 $53.00 20690 $241.26 20910 $378.00 The unavailability of a qualified resident surgeon is a prerequisite for use of this modifier and the service must have been performed in a teaching facility. 1.
Correct coding for assistant surgeons | Blue Cross & Blue Shield of 20250 $349.47 All Rights Reserved to AMA. 21282 $322.17 0000018245 00000 n
Evaluation and Management (E&M) Services Medicare Global Surgery Rules define the rules for reporting evaluation and management (E&M) services with procedures covered by these rules. Issue briefs summarize key health policy issues by providing concise and digestible content for both relevant stakeholders and those who may know little about the topic. 21145 $1,415.00 xb```b````c``mgd@ AV( G(00YYR.((W: Services rendered for assistant at surgery by non-physician providers are reimbursed at 85 percent of 16 percent (i.e., 13.6 percent) of the MPFS amount. The American Medical Association (AMA) has several resources to help accurately bill procedures and services with the Current Procedural Terminology (CPT) code set and Healthcare Common Procedure Coding System (HCPCS) codes. 21077 $2,403.71 21245 $1,000.00 2023 Blue Cross Blue Shield of North Dakota, Please wait while your form is being submitted, Directory Validation Instructions (No Surprises Act), Recredentialing & Credentialing Applications, Multiple Procedures Payment Reduction for Medical and Surgical Services Reimbursement Policy, CPT (Current Procedural Terminology) | AMA, Routine claim editing logic, including but not limited to incidental or mutually exclusive logic, and medical necessity. A second assistant surgeon will be considered only on a written appeal when documentation of medical necessity for the second assistant surgeon is submitted. When a surgeon is unavailable to serve as an assistant, a qualified surgical resident or other qualified health care professional, such as a nurse practitioner or physician assistant with experience in assisting, may participate in operations, according to the ACSStatements on Principles. This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60610. Continue Reading. Per fee schedule indicator, descriptor 2 = payment restriction for assistants at surgery does not apply to this procedure. 21127 $829.00 25 Significant, separately identifiable E&M service same practitioner same day May allow E&M payment separate from another service; requires supporting documentation : 26 Professional component: Pays professional component only (*refer to practitioner fee schedule, Notes A, B, C) 50 Bilateral procedure: Bill procedure code one time with modifier and quantity "1" to indicate bilaterals .