CPT modifiers - Assistan physician

Assistant at Surgery (CPT Modifiers 80 81 82 and AS) 


We will continue to pay assistants at surgery at 16 percent of the surgical allowance, with the exception of Physician Assistants (PA) and Nurse Practitioners (NP), which are further reduced because these specialties are allowed 85% of the fee schedule allowed amounts. The NP and PA receive an allowed amount of 85% of the 16% for acting as the assistant surgeon. The NP or PA must have a provider identification number (PIN) to bill such services, as they can not bill surgery services under the incident to rules.

Example: Here is an example of the pricing difference for a surgeon and the NP specialty. Procedure code
12018 allows an assistant at surgery. A physician filing 1201880 would be allowed 16% of the fee schedule allowance of $289.62, which is $46.34. The NP files as 12018AS and is allowed $39.39 (85% of the $46.34).


CPT surgery Modifiers

CPT modifier 62 and 66

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