List of Possible Combinations for Procedures With More Than One Surgical Modifier

CMS provides the following list of possible combinations for procedures with more than one surgical modifier (modifiers in parentheses):

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  • Bilateral surgery (-50) and multiple surgery (-51)
  • Bilateral surgery (-50) and surgical care only (-54)
  • Bilateral surgery (-50) and postoperative care only (-55)
  • Bilateral surgery (-50) and two surgeons (-62)
  • Bilateral surgery (-50) and surgical team (-66)
  • Bilateral surgery (-50) and assistant surgeon (-80)
  • Bilateral surgery (-50), two surgeons (-62) and surgical care only (-54)
  • Bilateral surgery (-50), team surgery (-66) and surgical care only (-54)
  • Multiple surgery (-51) and surgical care only (-54)
  • Multiple surgery (-51) and postoperative care only (-55)
  • Multiple surgery (-51) and two surgeons (-62)
  • Multiple surgery (-51) and surgical team (-66)
  • Multiple surgery (-51) and assistant surgeon (-80)
  • Multiple surgery (-51), two surgeons (-62) and surgical care only (-54)
  • Multiple surgery (-51), team surgery (-66) and surgical care only (-54)
  • Two surgeons (-62) and surgical care only (-54)
  • Two surgeons (-62) and postoperative care only (-55)
  • Surgical team (-66) and surgical care only (-54)
  • Surgical team (-66) and postoperative care only (-55)

Note: Carriers must price all claims for surgical teams “by report.”

CMS notes that payment is not generally allowed for an assistant surgeon when payment for either two surgeons (modifier -62) or team surgeons (modifier -66) is appropriate. If carriers receive a bill for an assistant surgeon following payment for co-surgeons or team surgeons, they pay for the assistant only if a review of the claim verifies medical necessity.

Source: CMS, Medicare Claims Processing Manual: Chapter 12 — Physicians/Nonphysician Practitioners (pdf).

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