OPERATIVE NOTE SURGICAL CENTER WEST VALLEY CITY , UTAH PATIENT : Age : 55 This is a Commercial Payer ( Follow Medicare rules . External causes are NOT required ) Use a HCPCS Level Il code for moderate sedation for Medicare for the first 15 minutes Follow instructions . DOS : 1 / 1 / 20XX PHYSICIAN : MD OPERATIVE PROCEDURE : Colonoscopy and 1st degree internal hemorrhoids and External Hemorrhoids . SURGEON : MD ANESTHESIA Conscious Sedation : 33 mins