Modifier 62
Modifier 62 = Two Surgeons / Co-Surgeons. Learn when Modifier 62 is appropriate, how co-surgery differs from assistant surgery and team surgery, how Medicare determines eligibility, what documentation is required, how claims are billed, and how AR callers should handle denials.
Modifier 62 at a Glance
The most important concepts to understand before billing co-surgery.
Two Surgeons
Modifier 62 identifies services performed by two surgeons acting as primary surgeons on the same reportable procedure.
Co-Surgery
The surgeons perform distinct parts of a single reportable procedure.
Different Specialties
Medicare’s co-surgeon policy generally involves two surgeons from different specialties.
Documentation
Certain procedures require supporting documentation establishing the medical necessity for two surgeons.
What Is Modifier 62?
Start with the basic definition.
Simple Definition
Modifier 62 means Two Surgeons.
It is used when two surgeons work together as primary surgeons to perform distinct parts of a single reportable procedure.
Each surgeon reports the same procedure code with Modifier 62 when the payer’s requirements for co-surgery are met.
The surgeons are not simply assisting one another. Each surgeon has a primary role in the procedure.
Easy Way to Remember Modifier 62
Ask:
“Did two surgeons, generally from different specialties, work together as primary surgeons on distinct parts of one reportable procedure?”
If yes, Modifier 62 may be appropriate — but the specific procedure must be eligible and payer requirements must be satisfied.
Official CMS Concept
CMS describes co-surgery as circumstances in which the skills of two surgeons, generally in different specialties, are required to perform a procedure because of the complexity of the procedure or the patient’s condition.
When two surgeons work together as primary surgeons performing distinct parts of a single reportable procedure, each surgeon reports the same surgical procedure code with Modifier 62.
CMS also distinguishes co-surgery from situations where two physicians simply perform different procedures on the same patient during the same operative session.
When May Modifier 62 Be Appropriate?
Two Surgeons
Two surgeons participate in the same reportable surgical procedure.
Primary Surgeons
Both physicians act as primary surgeons rather than one acting only as an assistant.
Distinct Parts
Each surgeon performs a distinct part of the same reportable procedure.
Different Specialties
Medicare’s co-surgeon payment policy generally requires the two surgeons to be from different specialties.
Eligible Procedure
The specific procedure must be eligible for co-surgeon payment under the applicable payment policy.
Medical Necessity
When required, documentation must establish why two surgeons were medically necessary.
Important: Two Surgeons Does Not Automatically Mean Modifier 62
This is one of the most common billing mistakes.
Same Patient
Two surgeons seeing or treating the same patient does not automatically establish co-surgery.
Different Procedures
If each surgeon performs a different procedure represented by a different CPT code, Modifier 62 may not apply.
Assistant Surgeon
A surgeon who assists the primary surgeon is not automatically a co-surgeon.
Same Specialty
Medicare co-surgeon rules generally require two surgeons from different specialties.
Team Surgery
More than two surgeons working as a surgical team may involve Modifier 66 rather than Modifier 62.
Separate Services
Different procedures performed during the same session may simply be separately reportable procedures when supported.
Modifier 62 vs 66 vs 80 vs 81 vs 82
Understand the difference before working a denial.
| Modifier | Meaning | Basic Concept |
|---|---|---|
| 62 | Two Surgeons / Co-Surgeons | Two primary surgeons perform distinct parts of one reportable procedure. |
| 66 | Surgical Team | More than two surgeons work as a team when team surgery rules apply. |
| 80 | Assistant Surgeon | A physician assists the primary surgeon. |
| 81 | Minimum Assistant Surgeon | A physician provides minimum assistant-at-surgery services when applicable. |
| 82 | Assistant Surgeon When Qualified Resident Unavailable | Used under specific Medicare assistant-at-surgery circumstances. |
Modifier 62 — Co-Surgeons
- Two surgeons.
- Both act as primary surgeons.
- Each performs distinct parts.
- Same reportable procedure.
- Generally different specialties under Medicare.
Modifier 66 — Team Surgeons
- More than two surgeons.
- Team approach.
- Procedure must qualify for team-surgeon payment.
- Supporting documentation may be required.
- Payment is generally subject to team-surgery rules.
Medicare Co-Surgeon Indicators
Always verify the applicable Medicare fee schedule information for the procedure.
Not Allowed
Co-surgeons are not allowed for the procedure.
Documentation Required
Co-surgeons could be paid, but supporting documentation is required to establish medical necessity for two surgeons.
Allowed
Co-surgeons are allowed when the applicable two-specialty requirements are met.
Not Applicable
The co-surgeon concept does not apply to the procedure.
Why the Co-Surgeon Indicator Matters
Before appealing a Modifier 62 denial, verify the procedure’s Medicare co-surgeon indicator.
An indicator of 0 means co-surgeons are not permitted for that procedure. An indicator of 1 means the service may allow co-surgeons but requires supporting documentation to establish medical necessity. An indicator of 2 means co-surgeons are allowed when the applicable specialty requirements are met.
Therefore, simply proving that two physicians participated in a surgery does not guarantee Medicare payment.
How to Bill Modifier 62
General professional claim workflow.
Modifier 62 Claim Example
Surgeon A and Surgeon B work together as primary surgeons on the same reportable surgical procedure. Each surgeon performs a distinct part of the procedure.
If the procedure is eligible for co-surgeon payment and all applicable requirements are met, each surgeon may report the same procedure code with Modifier 62.
This is an educational example. The actual CPT code, procedure eligibility, payment indicator, specialty requirements and documentation requirements must be verified.
Situations That May Not Support Modifier 62
Assistant Surgeon
One surgeon is simply assisting the primary surgeon.
Different Procedures
Each physician performs a different procedure represented by a different CPT code.
Same Specialty
Medicare’s two-specialty co-surgeon requirement is not met.
Procedure Not Eligible
The procedure’s payment indicator does not permit co-surgeon payment.
No Medical Necessity
Required documentation does not establish why two surgeons were necessary.
Team Surgery
More than two surgeons are involved and the circumstances support team-surgery rules instead.
Modifier 62 Documentation Requirements
Strong documentation is critical for co-surgery claims.
Operative Report
The operative documentation should identify the procedure performed.
Two Surgeons
Documentation should identify the participation of both surgeons.
Distinct Work
Each surgeon’s distinct operative role should be supported.
Medical Necessity
When required, the record should establish why two surgeons were medically necessary.
Specialty Information
The applicable specialties should meet payer requirements.
Signatures
Maintain complete and legible documentation with appropriate provider identification and signatures when required.
Common Modifier 62 Denials
Blue-only denial cards for consistent website styling.
Co-Surgeon Not Allowed
The procedure does not permit payment for two co-surgeons.
Medical Necessity Not Established
Documentation does not establish why two surgeons were required.
Specialty Requirement
The payer determines that the required two-specialty conditions were not met.
Missing Modifier
The procedure was billed without the required Modifier 62.
Assistant Surgery Conflict
The payer determines that one physician functioned as an assistant rather than a co-surgeon.
Duplicate Billing
The payer may process the second surgeon’s claim as duplicate when co-surgeon requirements are not correctly reported.
Documentation Missing
Required operative reports or supporting records were not submitted.
Wrong Modifier
The claim may have been billed with an assistant or team surgery modifier when co-surgery requirements apply, or vice versa.
Procedure Not Eligible
The applicable Medicare fee schedule or payer policy does not support Modifier 62 for the procedure.
How an AR Caller Should Work a Modifier 62 Denial
Practical denial-management workflow.
Review the EOB / ERA
Identify the exact denial reason, CARC, RARC and affected claim line.
Identify the CPT Code
Determine which procedure was billed with Modifier 62.
Verify Co-Surgeon Indicator
Check the applicable Medicare Physician Fee Schedule or payer-specific co-surgeon indicator.
Verify Specialty
Confirm whether the two surgeons satisfy the applicable specialty requirements.
Review Operative Report
Confirm both surgeons participated as primary surgeons and performed distinct parts of the procedure.
Check Medical Necessity
Determine whether the documentation supports the need for two surgeons.
Compare 62 vs 66 vs 80
Determine whether the actual service represents co-surgery, team surgery or assistant surgery.
Verify Payer Policy
Review Medicare MAC, Medicaid, Medicare Advantage or commercial payer requirements.
Correct or Appeal
Determine whether a corrected claim or appeal with documentation is appropriate.
Document the Follow-Up
Record payer representative, reference number, action taken and next follow-up date.
AR Caller Script for Modifier 62
“I’m calling regarding a surgical claim that was denied for the co-surgeon services.”
“Could you please provide the exact denial reason and the applicable claim adjustment reason code?”
“Can you confirm whether CPT [CODE] is eligible for co-surgeon reimbursement under your policy?”
“Can you confirm the co-surgeon indicator or payment criteria applicable to this procedure?”
“The procedure was performed by two surgeons who acted as primary surgeons and performed distinct portions of the same procedure. Can you confirm whether Modifier 62 is appropriate for this claim?”
“Does your policy require the operative report or additional documentation to establish medical necessity for the two surgeons?”
“If documentation is required, may we submit the operative report for reconsideration?”
“Could you please provide the call reference number and the appropriate submission method?”
Modifier 62 Appeal Strategy
Identify the Denial
Clearly identify the denied procedure and denial reason.
Establish Eligibility
Demonstrate that the procedure allows co-surgeon reporting.
Establish Two Surgeons
Identify both physicians and their specialties.
Explain Distinct Work
Explain each surgeon’s primary role and distinct operative contribution.
Prove Medical Necessity
Include supporting documentation when the payment indicator requires it.
Request Reprocessing
Request reconsideration or reprocessing when the documentation supports Modifier 62.
Modifier 62 Examples
Educational examples. Always verify the actual CPT code and payer requirements.
Two surgeons from different specialties are required to perform different portions of one complex surgical procedure.
Surgeon A — CPT XXXXX-62 Surgeon B — CPT XXXXX-62If the procedure is eligible for co-surgeon payment and all requirements are met, Modifier 62 may be appropriate for both surgeons.
Surgeon A performs one procedure while Surgeon B performs a separate procedure during the same operative session.
CPT A CPT BThe fact that two surgeons were present does not automatically make this co-surgery.
Surgeon A performs the primary procedure and Surgeon B provides assistance.
Primary Surgeon Assistant SurgeonThis situation should be evaluated under assistant-at-surgery rules rather than automatically reporting Modifier 62.
More than two surgeons from different specialties are required to perform a complex surgical procedure as a team.
Surgical Team Modifier 66Team-surgery rules may apply rather than Modifier 62.
A procedure has a Medicare co-surgeon indicator of 1.
CO-SURG = 1Co-surgeon payment may be possible, but supporting documentation is required to establish medical necessity for two surgeons.
A procedure has a Medicare co-surgeon indicator of 0.
CO-SURG = 0Medicare does not allow co-surgeon payment for that procedure under the indicator.
Modifier 62 on the CMS-1500
General professional claim-line example.
| Claim Field | Example |
|---|---|
| CPT / HCPCS | Applicable surgical procedure |
| Modifier | 62 |
| Diagnosis Pointer | Applicable ICD-10-CM diagnosis |
| Units | Applicable units |
| Charge | Provider’s billed amount |
Important
The exact claim submission and pricing methodology depends on the payer, procedure, co-surgeon indicator and applicable billing rules.
Modifier 62 and Medicare
Medicare Checklist
- Verify the CPT/HCPCS procedure.
- Check the Medicare co-surgeon indicator.
- Confirm the two-specialty requirement.
- Confirm both surgeons acted as primary surgeons.
- Confirm distinct portions of the procedure.
- Review medical necessity requirements.
- Submit supporting documentation when required.
Medicare Documentation
Medicare’s payment rules distinguish procedures where co-surgeons may be paid with and without additional documentation.
For procedures with a co-surgeon indicator of 1, supporting documentation is required to establish the medical necessity of two surgeons.
Always verify the current Medicare fee schedule and applicable MAC guidance for the specific procedure.
Modifier 62 and Medicaid
Medicaid Review
- Check the state Medicaid program.
- Verify whether co-surgeon services are covered.
- Review the state fee schedule.
- Verify procedure-specific restrictions.
- Check MCO-specific requirements when applicable.
Do Not Assume Medicare Rules Apply
Medicaid programs and managed-care organizations may have their own reimbursement and documentation requirements.
Always verify the applicable state Medicaid or MCO policy before correcting or appealing a claim.
Modifier 62 and Commercial Insurance
Check Payer Policy
Commercial payers may use their own co-surgeon policies and reimbursement rules.
Verify Procedure Eligibility
Confirm that the payer allows two-surgeon reimbursement for the specific procedure.
Review Contract Rules
Contractual reimbursement rules may affect how co-surgeon services are processed.
Root Causes of Modifier 62 Denials
Procedure Ineligible
The procedure does not allow co-surgeon payment.
Wrong Specialty
The payer’s specialty requirements were not satisfied.
Weak Documentation
The record does not establish medical necessity for two surgeons.
Wrong Modifier
The service may actually represent assistant surgery or team surgery.
How to Prevent Modifier 62 Denials
Verify Before Billing
Confirm co-surgeon eligibility before the claim is submitted.
Verify Specialties
Confirm the providers meet the applicable specialty requirements.
Capture Documentation
Ensure operative reports clearly support both surgeons’ participation.
Check Fee Schedule
Verify the current co-surgeon indicator for Medicare claims.
Educate Providers
Explain the difference between co-surgery, assistant surgery and team surgery.
Track Denials
Trend Modifier 62 denials by CPT code, provider and payer.
Modifier 62 Decision Workflow
Use this checklist before billing or appealing.
Modifier 62 Quick Cheat Sheet
- Modifier 62 = Two Surgeons / Co-Surgeons.
- Two surgeons generally act as primary surgeons.
- Each surgeon performs a distinct part of one reportable procedure.
- Medicare generally requires the two surgeons to be from different specialties.
- Check the Medicare co-surgeon indicator.
- Indicator 0 = co-surgeons not allowed.
- Indicator 1 = potentially payable with supporting documentation.
- Indicator 2 = co-surgeons allowed when applicable specialty requirements are met.
- Indicator 9 = concept does not apply.
- Do not confuse co-surgery with assistant surgery.
- Do not confuse co-surgery with team surgery.
- Modifier 66 generally relates to team surgeons.
- Modifier 80 relates to assistant surgeon services.
- Modifier 81 relates to minimum assistant surgery.
- Modifier 82 has specific assistant-at-surgery circumstances.
- Review operative documentation.
- Verify medical necessity when required.
- Always verify payer-specific requirements.
Medicare Claim Review Checklist
| Question | What to Verify |
|---|---|
| Procedure eligible? | Check the Medicare co-surgeon indicator. |
| Two surgeons? | Confirm both physicians participated. |
| Primary surgeons? | Confirm neither physician was simply an assistant. |
| Different specialties? | Verify the applicable Medicare specialty requirement. |
| Distinct work? | Review operative documentation. |
| Medical necessity? | Confirm supporting documentation when required. |
| Modifier? | Confirm Modifier 62 is appropriate. |
Modifier 62 FAQs
What is Modifier 62?
Modifier 62 is the two-surgeon or co-surgeon modifier. It is used when two surgeons work together as primary surgeons performing distinct parts of a single reportable procedure, when the procedure and payer requirements allow it.
Does Modifier 62 mean two surgeons performed surgery?
Not automatically. Two surgeons participating in a patient’s surgery does not by itself establish co-surgery. The surgeons must meet the applicable co-surgeon requirements.
Do both surgeons bill the same CPT code?
When the requirements for co-surgery are met, each surgeon generally reports the same definitive procedure code with Modifier 62.
Do both surgeons have to be from different specialties?
For Medicare, the co-surgeon payment indicator is based on two surgeons from different specialties. Always verify the current Medicare and payer requirements for the procedure.
What is the difference between Modifier 62 and 66?
Modifier 62 is for two co-surgeons. Modifier 66 is for team-surgeon circumstances involving more than two surgeons when the procedure qualifies for team-surgery payment.
What is the difference between Modifier 62 and 80?
Modifier 62 identifies co-surgeons who each act as primary surgeons on distinct portions of one procedure. Modifier 80 identifies an assistant surgeon.
What does Medicare co-surgeon indicator 0 mean?
Indicator 0 means co-surgeons are not allowed for that procedure under the Medicare payment indicator.
What does Medicare co-surgeon indicator 1 mean?
Indicator 1 means co-surgeons could be paid, but supporting documentation is required to establish the medical necessity of two surgeons.
What does Medicare co-surgeon indicator 2 mean?
Indicator 2 means co-surgeons are allowed when the applicable two-specialty requirements are met.
What does Medicare co-surgeon indicator 9 mean?
Indicator 9 means the co-surgeon concept does not apply to that procedure.
Is documentation always required for Modifier 62?
Documentation requirements vary by procedure and payer. Medicare’s indicator 1 specifically identifies procedures where supporting documentation is required to establish the medical necessity of two surgeons.
Can two surgeons bill different CPT codes and use Modifier 62?
Modifier 62 is generally associated with two surgeons performing distinct portions of the same reportable procedure. If two physicians perform different procedures represented by different CPT codes, the circumstances should be evaluated under the applicable separate-procedure rules rather than automatically using Modifier 62.
Can Modifier 62 be used with an assistant surgeon?
Modifier 62 and assistant-surgery modifiers describe different roles. A physician acting only as an assistant should not automatically be treated as a co-surgeon.
Why was my Modifier 62 claim denied as duplicate?
The payer may not have recognized the claim as an eligible co-surgeon service, the second claim may not have been reported correctly, or the procedure may not qualify for Modifier 62. Review the denial reason, procedure eligibility, specialty requirements and documentation.
How should an AR caller work a Modifier 62 denial?
Review the EOB or ERA, verify the CPT code, check the co-surgeon indicator, confirm the specialties, review the operative report, verify medical necessity, check payer policy and then determine whether correction or appeal is appropriate.
2026 CMS Guidance
CMS’s current resources continue to identify Modifier 62 as the co-surgeon modifier. Medicare’s co-surgeon indicator identifies whether two surgeons may be paid for the procedure and whether supporting documentation is required.
CMS also distinguishes co-surgery from team surgery. Modifier 62 applies to two surgeons, while Modifier 66 applies to qualifying team-surgery circumstances.
When working Medicare AR, verify the current Physician Fee Schedule information and applicable MAC requirements rather than relying on an old procedure list.
Before You Bill Modifier 62
- Confirm the surgical procedure.
- Confirm two surgeons participated.
- Confirm both surgeons acted as primary surgeons.
- Confirm each surgeon performed a distinct part.
- Confirm the procedure is eligible for co-surgeon payment.
- Check the Medicare co-surgeon indicator when applicable.
- Confirm specialty requirements.
- Confirm medical necessity for two surgeons when required.
- Review the operative report.
- Determine whether 62, 66 or an assistant modifier is actually appropriate.
- Verify payer-specific requirements.
Official CMS References
Use current official resources when validating Modifier 62.
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