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Q:

As a non-par provider, do I have to follow the multiple surgery reduction rule?

A:

"Relative values for physicians" indicates that a surgery performed at the same operative session as a primary surgical procedure should be valued at 50% of its total relative value unit.

In this regard, the multiple surgery rule applies whether or not you are a participating provider with Medicare. Most payors will also follow this rule with some valuing the third and subsequent procedures at only 25% rather than 50%.

 

Mary Beth Black, CPC
Senior Associate

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