December 1, 2016

Question:
What is the reimbursement for co-surgery using modifier 62? Is it different for the primary and co-surgeon?

Answer:
For Medicare, co-surgery requires two different specialties performing separate parts of a single CPT code. Private payers may have different policies regarding the specialties involved. For both surgeons, a 62 modifier is appended to the appropriate CPT code(s). Medicare multiples the allowable fee by 125% and splits the reimbursement exactly in half, resulting in a payment of 62.5% to each surgeon. Both surgeons dictate an operative note describing their work and both have post-operative responsibilities.

*This response is based on the best information available as of 12/01/16.