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Thread: Please help on surgery codes

  1. #1

    Default Please help on surgery codes

    AAPC: Back to School
    I have a question? If I am billing out a surgery in NY state does the CPT codes get paid according to RVU factor or what that insurance company finds to be there primary code? I thought in NY it is the RVU? I would love some help on this. Because I am billing surgeries according to RVU and major commercial insurance companies are changing my codes around. What should I do?
    My septo codes are as follows
    31276 50
    30140 50
    31255 50
    31267 50
    The insurance company is taking the 31276 as primary code. Why?

    thanks Colleen

  2. #2


    Because the RVU for 31276 is doubled when you add modifier 50 and therefore greater than the RVU for 30520.

    ENT CT

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