Modifier 80

Assistant Surgeon

Instructions

Modifier 80 is appended to the surgical code when another surgeon is assisting at surgery. Check Medicare Physician Fee Schedule (MPFS) Indicator/Descriptor Lists. See Column A indicates if assistant at surgery allowed/not allowed.

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

  • Inappropriate to bill AS modifier for physician surgical services
  • Inappropriate to append modifier 58 (staging) with assistant surgery

Claim Coding Example

  • Per fee schedule indicator, descriptor 2 = payment restriction for assistants at surgery does not apply to this procedure. Assistant surgeon may be paid.
Treatment Description CPT/Modifier
Gastric Bypass for Morbid Obesity 43846 80

 

Resource

 

Last Updated Dec 09 , 2023