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Assistant Surgeon Question

  1. Default Assistant Surgeon Question
    Medical Coding Books
    Can anyone tell me if an assistant surgeon (modifier 80) will be paid for an implantable penile prosthesis (CPT 54400, 54401 or 54405)? I am researching this for a client and thought I would start here.

  2. #2
    54405 accepts it

  3. #3
    I believe that Medicare allows payment for an assistant surgeon for 54405. Codes 54000 and 54004 do not allow payment for an assistant surgeon.

    If this is not a Medicare patient, then the third party payer for the patient would need to be contacted to see what their guidelines are for paying assistants at surgery.

  4. Default implantable penile prosthesis
    Medicare allows coverage for eligible claims. Some commercial carriers have excluded coverage for this procedure (check benefits for sure).

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