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The math here is important

it is (mainly anaerobes) or archaebacteria in the presence of cobalt

CPT 90471 Modifier Rules: When to Use Them and How to Avoid CO-97 Denials The Complete Modifier Guide for CPT 90471 The 90471 CPT code typically doesn't require a modifier

Response: The defined topped-out measure benchmark policy seeks to provide scoring relief for clinicians whose MIPS performances are most impacted by limited measure choice and who would otherwise be unable to avoid a negative payment adjustment due to limited measure choice and the topped-out measure scoring cap

That's a realistic and sustainable rate of weight loss