Reimbursement: Co-Surgery

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September 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. For both surgeons, modifier 62 is appended to the appropriate CPT code(s). Medicare multiples the allowable by 125% and splits the reimbursement exactly in half, resulting in a payment of 62.5% to each surgeon. For example, when plastic surgery and neurosurgery do a craniosynostosis procedure together using 61559 then each surgeon reports 61559-62. So to answer your question, the payment is the same for both surgeons. Both surgeons dictate an operative note describing their work and both have post-operative responsibilities. For private payers, coding guidelines and payment may vary.

*This response is based on the best information available as of 09/01/16.

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