US · guidance
CMS Pub. 100-04, ch. 4, § 10.5
Discounting
• Fifty percent of the full OPPS amount is paid if a procedure for which anesthesia is
planned is discontinued after the patient is prepared and taken to the room where the
procedure is to be performed but before anesthesia is provided.
• Fifty percent of the full OPPS amount is paid if a procedure for which anesthesia is
not planned is discontinued after the patient is prepared and taken to the room where
the procedure is to be performed.
• Multiple surgical procedures furnished during the same operative session are
discounted.
• The full amount is paid for the surgical procedure with the highest weight;
• Fifty percent is paid for any other surgical procedure(s) performed at the same
time;
• Similar discounting occurs now under the physician fee schedule and the
payment system for ASCs;
• When multiple surgical procedures are performed during the same operative
session, beneficiary coinsurance is discounted in proportion to the APC payment.
History
(Rev. 1445, Issued: 02-08-08; Effective: 01-01-08; Implementation: 03-10-08)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
2ada6224133a33b8ba101de18bb940e931fcf0ee3345d93e08343ae7efc8891f
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