- 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).
