Original Effective Date:
04/01/1999
Current Effective Date:
09/01/2016
An "assistant surgeon" is a physician who assists the physician during a surgical procedure. The services of an assistant surgeon are payable when the following guidelines are met:
- The complexity of the surgery requires an assistant. Surgical procedures that generally do not require the services of an assistant surgeon include endoscopies, angiograms, and minor surgeries such as incision and drainage of abscesses and most cataract extractions; and
- The facility does not have a resident or training program; or
- The facility has a resident or training program, but a resident or intern on staff is not available to assist the surgeon. In this case, modifier -82 should be used to indicate no resident was available.
Claims Filing Information
Procedure codes describing the surgical procedures performed should be indicated on the claim. In addition, if the surgery does not usually require the services of an assistant surgeon, please include a copy of the operative report or other narrative explaining the complexity of the surgery and why the assistant surgeon services were needed.
Claims for any sterilization procedure must be accompanied by a copy of a properly executed and signed Sterilization Required Consent Form 1146. Claims for any hysterectomy procedure must be accompanied by the Hysterectomy Acknowledgement Form 1145. Claims without these required forms will be denied for not meeting the federal requirements regarding informed consent. Please refer to QUEST Integration - Sterilizations and QUEST Integration - Hysterectomy for details about the requirements and the forms.
Coordination with the primary surgeon
The assistant surgeon's charges should be filed separately from the primary surgeon's services. When filing a claim for assistant surgeon charges, be sure the surgical procedure code and diagnosis code match those on the primary surgeon's claim. You may also wish to coordinate the submission of your claim with the primary surgeon. If your claim is received before the surgeon’s claim, the processing of your claim may be delayed.
Modifier Codes
Please use one of the following modifier codes as appropriate:
| Modifier Code | Description |
|---|---|
| -80 | Assistant Surgeon: Surgical assistant services may be identified by adding the modifier -80 to the usual procedure code(s) |
| -81 | Minimum Assistant Surgeon: Minimum surgical assistant services are identified by adding the modifier -81 to the usual procedure number. |
| -82 | Assistant Surgeon (when qualified resident surgeon not available): The unavailability of a qualified resident surgeon is a prerequisite for use of modifier -82 appended to the usual procedure code(s). |
Physician's Assistant (PA) or Nurse Practitioner Acting as Assistant Surgeon
When an appropriately licensed physician's assistant (PA) acts as an assistant surgeon, the claims should be filed using the surgical procedure code and modifier code -AS.
Revision History
| Date | Nature of Revision |
|---|---|
| 08/03/2026 | Migrated to new platform. |