# Additional fee for Modifier 22?



## dearobinson (Jul 10, 2009)

I need some guidance on what additional fee to charge when appending with -22.  Would it be reasonable to charge half of the procedure fee?

Thanks!

Dea Robinson, MA, CPC


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## Erica1217 (Jul 10, 2009)

It depends on the circumstances.  Why are you using the modifier -22?  Did the surgery take and extra hour?  Twice as long as normal?  If you and the provider feel the extra work & effort is worth an extra 20%, charge that... if you feel it's worth double your usual reimbursement, then charge that.  It just all depends.  There is not one answer for this question. 

 Erica


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## dearobinson (Jul 10, 2009)

In this instance, a hysterectomy, the uterus was pathologically large and took extra time to remove.  Sounds like I could get an idea of how much longer it took and do some kind of percentage off the original procedure code when I append it.

Thanks!


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## Erica1217 (Jul 10, 2009)

I've had luck getting about an additional 20 - 25% for each extra hour of work (depending on payor).  Your doc should be documenting the nature and time of this extra / unusal work or your appeals will most-likely not be successful.  

Good luck!

 Erica


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## FTessaBartels (Jul 14, 2009)

*Usually 25%*

When we use the -22 modifier for an exceptionally difficult or long case, we typically increase our fee for that procedure by 25%.  (Sometimes a bit more, sometimes a bit less.)  

F Tessa Bartels, CPC, CEMC


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