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Frequently Asked Questions

What Is the 53 Column in the Fee Schedule Tool?

 

SuperCoder’s fee schedule tool includes a column with the header “53.” This column lets you see the RVUs assigned in the Medicare Physician Fee Schedule for certain colonoscopy codes reported with modifier 53 (Discontinued procedure). The tool also shows you the local and national Medicare fees for those codes with modifier 53 appended.

 

The codes with RVUs assigned by Medicare for modifier 53 include:

  • 44388-53, Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)
  • 45378-53, Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)
  • G0105-53, Colorectal cancer screening; colonoscopy on individual at high risk
  • G0121-53, Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk.

 

Important: The modifier 53 column is shown in the fee schedule tool for every code. An entry of $0.00 or a blank space in the 53 column means only that Medicare does not assign specific RVUs for that code with modifier 53 appended. You may still append modifier 53 to that code if documentation and coding guidelines indicate appending modifier 53 is appropriate for the case. The payer will review the claim and determine payment.