Multiple-Procedure Payment Reduction (MPPR)

Applies the multiple-procedure payment reduction to a set of surgical or endoscopic lines.

Open the tool → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.

Inputs and output

What you enter: The reduction policy and the percentage applied to each subsequent line.
What you get: Total expected allowed $1300.00; the multiple-procedure reduction withholds $300.00.

The tool opens pre-filled with that example. Replace the values with your own.

What this is

Enter each line's fee and it re-ranks them, pays 100% of the highest and the cited percentage on every subsequent line, and returns the expected allowed total. Supports the surgical 100/50/50 rule, the endoscopy base-code rule, and a custom subsequent percentage.

When to use it

Use it to estimate expected payment on a multi-procedure claim, or to check a remittance that reduced lines you did not expect. The reduction is arithmetic only: it does not decide whether a line is separately reportable, which is an NCCI and documentation question.

How this is calculated

CMS Pub. 100-04 Claims Processing Manual, Ch. 12 40.6 (multiple surgery: 100% highest, 50% each subsequent) and 40.7 (endoscopy base-code rule). MPFS MULT PROC indicator gates the policy. Read the source ↗

A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.