Medicare Part B Payments to Physicians for Co-Surgery Procedures
Under Medicare Part B, when the individual skills of two surgeons are necessary to perform a specific surgical procedure or distinct parts of a surgical procedure (or procedures) simultaneously on the same patient during the same operative session (co-surgery), each surgeon should report the specific procedure(s) by billing the same procedure code(s) with a modifier "62." By appending modifier "62" to the procedure code(s), the fee schedule amount applicable to the payment for each co-surgeon is 62.5 percent of the global surgery fee schedule amount. We plan to audit a sample of claim line items - specifically where different physicians billed for the same co-surgery procedure code, for the same beneficiary, on the same date of service. Our objective is to determine whether Medicare Part B payments to physicians for co-surgery procedures were properly made.
|Announced or Revised||Agency||Title||Component||Report Number(s)||Expected Issue Date (FY)|
|Revised||Centers for Medicare and Medicaid Services||Medicare Part B Payments to Physicians for Co-Surgery Procedures||Office of Audit Services||W-00-20-35844; W-00-22-35844||2023|