I work mainly as a coder and auditor, so it’s been quite a while since I’ve dealt with the reimbursement side, but I’ve been asked a question that I can’t find an answer for. When performing multiple procedures, the primary procedure is paid at 100% of the fee schedule and each subsequent procedure is paid at 50% of the fee schedule per the MPFS. Is there an additional reduction with Valve replacements and CABG done at the same time? I seem to remember an additional reduction to the CABG codes was also done, but I can’t find any documentation from Medicare (or any other payer) that explains reimbursement for these combined procedure situations.

Any help will be greatly appreciated!