Modifier Coding Alert
Calculate Your Pay
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Using the previously mentioned example of a PA assisting in the open repair of a patient’s sternum (21825), here is the math behind the payments:
The MPFS assigns a total relative value unit (RVU) of $15.70 to code 21825.
When you multiply the RVUs by the 2014 unadjusted national conversion factor of 35.8228, you get the national allowable fee: $562.42. (Keep in mind that the conversion factor changes each year.)
The payment amount for a physician assisting at surgery is calculated as follows:
*The payment amount for a PA, NP, or CNS assisting at surgery is calculated as follows:
*Co-insurance or patient is responsible for the other 20 percent and any applicable deductible amounts.
Modifier Coding Alert
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