With the exception of the HSCs specified under GR 6.15.4, benefits that may be claimed for redo cardiac, vascular and thoracic surgery are as follows:

1. 150% of the listed benefit if the procedure is performed entirely through a previous incision;
2. 125% if part of the procedure is performed through a previous incision.

HSCs 46.03B, 47.92C, 50.75A and 51.98A are defined as having a reoperative component and therefore are not eligible for redo modifiers. HSCs 51.61A and 51.61B are also not eligible for redo modifiers.

A claim for a redo modifier may not be submitted unless the patient has left the operating room and post anesthetic recovery room.

Benefits that may be claimed for redos for one of the following HSCs vary depending on how many redos have been performed in the past, (whether partly or wholly), through that incision. The first redo may be claimed at 175% of the listed benefit, the second at 225%, the third at 275%, the fourth at 325%, and the fifth at 375%.

In cases where multiple redos are performed at the same encounter through the previous incision, the lesser procedures will be paid at 75% of the redo modifier benefits.