Scalpel & Heart · for surgical PAs

The Surgical PA Revenue Estimator

By Karen Calcano, MMSc, PA-C

Your OR work, made visible. Tell us your case load and we'll show your first-assist revenue, how it stacks against your salary, and the post-op work the global package quietly hides.

1 Your OR week

Cases where you first-assist in a typical week. Ballpark it.

Cases you first-assist per week

2 Your specialty

Tap your specialty to set a conservative average surgeon fee per case. Nudge it if you know yours.

$ Average surgeon fee per case (Medicare). Commercial pays more, so this is a floor.

3 Your salary

Your gross annual base.

Optional. Pre-op and post-op visits outside a global period, and new consults, are separately billable. Add a rough weekly clinic count and we'll fold it in at a conservative blended rate.

Clinic visits per week Avg per visit $

Add your weekly cases, a surgeon fee, and your salary.

You generate in first-assist revenue, conservatively

per year, across 48 working weeks. And this is only the part that gets billed.

First-assist revenue vs. your salary

Up to your salary

Beyond your salary

What this number leaves out

Every post-op round, wound check, and follow-up you do inside the global window (90 days after major surgery, 10 after minor) is bundled into the surgeon's fee that was already paid. It generates zero additional revenue, even though it is real work only you are doing. That labor is value the practice keeps for free. Your true contribution is this number plus all of that.

Money is step one. Freedom is the point.

You now know your billable floor. The next number tells you what it would take to walk away, scale back, or stop saying yes out of fear. Get your Freedom Number.

Enter a valid email.

You're in.

Next up: your Freedom Number. Open the calculator →

How this is estimated. When a PA first-assists, Medicare pays the assistant 13.6% of the surgeon's fee for the procedure (85% of the 16% assistant-at-surgery rate), billed with modifier AS. Average surgeon fee per case is an illustrative 2026 Medicare blend for common assistant-eligible procedures in each specialty: cardiothoracic around $1,800 (single-arterial CABG, code 33533, is about $1,758), general surgery around $850 (a blend of cholecystectomy, appendectomy, hernia, and larger cases), orthopedics around $1,400 (a blend of joint replacement near $1,600 and lower-fee cases). Per-case fees vary widely by procedure, only assistant-eligible procedures qualify, and commercial payers often pay more.

About the global package. Care delivered within the surgical global period (90 days for major surgery, 10 for minor) is bundled into the surgeon's fee and is not separately billable, so this tool does not count it. It is, however, real work a surgical PA performs.

This is a directional, educational estimate, not billing, coding, financial, or legal advice. Verify exact figures with the CMS Physician Fee Schedule Look-Up Tool. Sources: CMS Physician Fee Schedule (2026) and Medicare Claims Processing Manual, Chapter 12; AAPA.

Karen Calcano, MMSc, PA-C · scalpelandheart.com · Happier in Healthcare