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Co-Surgeons and Team Surgeons
Specific surgical procedures requiring the skills of two or more surgeons include:
Co-Surgeons:
- Surgical procedure allows for co-surgeons (as indicated by the Co-Surgeon indicator on CMS RVU file).
- Surgical procedures requiring two surgeons of different specialties (this includes surgical procedures involving two surgeons performing parts of the procedure simultaneously).
- Both surgeons should bill the same procedure code with Modifier 62.
- Each provider will be reimbursed 75% of the fee allowance.
- If multiple surgeries are performed by one of the surgeons, multiple procedure rules will apply.
Team Surgeons:
- Surgical procedure allows for team surgeons (as indicated by the Team Surgeon indicator on CMS RVU file).
- Surgical procedures requiring a team of surgeons (more than two surgeons of different specialties).
- Each surgeon should bill the procedure code with Modifier 66.
- Each surgeon will be reimbursed 100% of the fee allowance.
- If multiple surgeries are performed by one of the surgeons, multiple procedure rules will apply.
Note: Advanced Practice Providers are not eligible to bill as a co-surgeon or team surgeon.
For more information, refer to the Medicare National Correct Coding Initiative (NCCI) webpage.
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