Modifiers · CPT modifier

Two surgeons

Modifier 62 signals that two surgeons, each acting as a primary surgeon, divided the operative work on a single procedure because the complexity of the case or the patient's condition demanded distinct skill sets simultaneously or in coordinated sequence. Neither surgeon is functioning as an assistant. Both bill the identical procedure code with modifier 62 appended, and each is reimbursed at roughly 62.5% of the standard fee schedule allowable.

Verified May 8, 2026 · 10 sources ↓

Type: CPT
CPT codes use it: 581
Top regions: Spine, Other, Foot & ankle

Drawn from AMACMSNovitas SolutionsPremera BlueWellpoint/Anthem Modifier

When to use modifier 62

Source · Editorial brief grounded in 10 cited references ↓

Append modifier 62 when two surgeons from different disciplines each perform a distinct, primary portion of one procedure during the same operative session. The classic orthopedic trigger is anterior lumbar interbody fusion (ALIF): a spine surgeon performs the definitive vertebral work while a vascular or general surgeon manages the anterior approach and vessel retraction. Both surgeons share responsibility for the same CPT code—not two separate codes—and each independently documents the segment of work they personally performed. Before submitting, confirm the procedure code carries a CMS co-surgery indicator of 1 or 2 in the Medicare Physician Fee Schedule Relative Value File; indicator 0 means co-surgery payment is not permitted at all.

Modifier 62 also applies when two surgeons operate simultaneously rather than sequentially. Bilateral simultaneous total knee arthroplasty (TKA) performed by two orthopedic surgeons—one on each knee—is a clear example: both surgeons bill the same TKA code (27447) with modifier 62 appended, and if the same specialty is involved, modifier 50 is added as well. For the modifier to function correctly, both surgeons must independently agree to append it, must link the same diagnosis code to the claim, and must submit their claims within the same time window to prevent one claim from processing at 100% while the other denies or is slashed by multiple-surgery reduction rules.

Orthopedic scenarios

Concrete situations in orthopedic practice that warrant modifier 62.

Source · Editorial brief grounded in AAOS coding guidance and cited references ↓

Anterior lumbar interbody fusion (ALIF) at L4-L5 (CPT 22558): spine surgeon performs discectomy and cage placement while a vascular surgeon manages the retroperitoneal approach and retracts the iliac vessels; both bill 22558-62 with the same lumbar diagnosis code.
Simultaneous bilateral total knee arthroplasty (TKA, CPT 27447): two orthopedic surgeons each perform a primary TKA on opposite knees during a single anesthetic session; both bill 27447-62-50, and each receives approximately 62.5% of the allowed amount.
Complex cervical arthrodesis below C2, anterior interbody technique (CPT 22554): a spine surgeon and a head-and-neck surgeon co-operate, with the second surgeon managing vascular and soft-tissue exposure through the anterior cervical corridor while the spine surgeon performs the interbody fusion; each bills 22554-62.
Open reduction and internal fixation (ORIF) of a complex acetabular fracture requiring both an anterior ilioinguinal and a posterior Kocher-Langenbeck approach simultaneously: two orthopedic trauma surgeons each control one approach, stabilize their respective columns, and both bill the appropriate acetabular ORIF code with modifier 62.
Pelvic ring reconstruction with sacroiliac joint fixation (CPT 27216) performed by a pelvic trauma surgeon anteriorly and a spine-trained surgeon managing posterior iliosacral screw placement concurrently; each surgeon documents their column of work and bills 27216-62.

Common mistakes

Where coders most often go wrong with modifier 62.

Source · Editorial brief grounded in CMS NCCI Policy Manual and cited references ↓

Only one of the two surgeons appends modifier 62: the claim without the modifier pays at 100% while the claim with modifier 62 may deny or underpay, creating an overpayment liability for the surgeon who omitted it.
Using modifier 62 when the second surgeon is actually acting as an assistant throughout the procedure—correct modifier in that scenario is 80, 81, or 82, not 62; conflating the two roles triggers medical necessity denials and payer audits.
Appending modifier 62 to instrumentation-only or bone-graft-harvest add-on codes (e.g., iliac crest graft codes): AMA CPT rules explicitly prohibit modifier 62 on standalone instrumentation or grafting codes.
Billing different CPT codes for each surgeon instead of the same procedure code: modifier 62 requires both surgeons to report the identical primary code; using separate codes turns it into two independent primary surgeries and kills the co-surgery payment logic.
Failing to verify the CMS co-surgery indicator before submitting: a procedure with indicator 0 will never pay under modifier 62 regardless of how the operative notes are written, wasting appeal cycles.
Skipping individual operative notes: each surgeon must write a separate op report describing their specific portion of the work; a single shared note is insufficient for payers requiring documentation of distinct operative contributions.
Applying modifier 62 to sequential 'tag-team' surgeries where two same-specialty surgeons perform completely separate procedures back-to-back under one anesthetic—those claims require different coding treatment, not modifier 62.

CPT codes that use modifier 62

581 orthopedic CPT codes in our reference list this modifier as applicable. Sorted by total RVU.

Source · Derived from per-code modifier guidance in our CPT reference

Showing top 12 of 581 by total RVU.

Where modifier 62 shows up

Body regions where this modifier most commonly appears in our orthopedic reference.

Spine 113 codes
Other 101 codes
Foot & ankle 64 codes
Hip 57 codes

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 10 cited references ↓

01How much does each surgeon get paid when modifier 62 is billed correctly?

Each surgeon is reimbursed at approximately 62.5% of the standard Medicare Physician Fee Schedule allowable for the procedure code. The logic is that the combined payout equals 125% of the fee, split evenly between two primary surgeons, regardless of which surgeon performed the larger share of the work.

02Can two surgeons from the same specialty use modifier 62?

Yes, same-specialty co-surgery is permitted—simultaneous bilateral TKA is the textbook example—but when both surgeons share the same specialty and are operating bilaterally, modifier 50 must also be appended alongside modifier 62 per payer guidelines.

03What happens if only one surgeon appends modifier 62?

The surgeon who omitted modifier 62 typically has their claim processed at 100% of the fee schedule, while the surgeon who correctly appended it receives only 62.5%; the result is an overpayment to one provider and a potential underpayment or denial for the other, often triggering a corrected-claim demand.

04Is modifier 62 appropriate when the second surgeon only provides exposure or approach work?

It depends on payer policy and the specific procedure code. For ALIF procedures, CMS and many payers recognize the approach surgeon as a co-surgeon because approach and closure are integral components of the single bundled code; however, if the approach is billed under a separate CPT code distinct from the definitive procedure, modifier 62 does not apply to those separate codes.

05How do I know whether a CPT code is eligible for modifier 62?

Check the 'Co-Surg' indicator column in the CMS National Physician Fee Schedule Relative Value File: indicator 2 means co-surgery is permitted without additional documentation, indicator 1 means it is permitted but medical-necessity documentation must accompany the claim, and indicator 0 means co-surgery payment is not allowed for that code.

06Can modifier 62 and modifier 80 appear together on the same line?

No. Modifiers 62 and 80 are mutually exclusive on a single procedure line. Modifier 62 establishes that both surgeons are primary surgeons; modifier 80 establishes that one surgeon is assisting another. If one surgeon transitions from co-surgeon to assistant for an additional procedure in the same session, they bill the additional code with modifier 80 on a separate line.

07What documentation does each co-surgeon need to write?

Each co-surgeon must produce an individual operative note that describes the specific steps they personally performed, the time involved, and the medical rationale for requiring two primary surgeons. Sharing a single operative note between both surgeons is generally insufficient and will trigger a documentation deficiency on audit.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

01AMA CPT Professional Edition – Modifier 62 guidelines and CPT Assistant (February 2002) anterior spine co-surgery example
02CMS National Physician Fee Schedule Relative Value File – Co-Surgery indicator column (indicators 0, 1, 2, 9)
03CMS NCCI Policy Manual for Medicare Services – Chapter on physician co-surgery billing rules
04Novitas Solutions Medicare Jurisdiction H – Modifier 62 Fact Sheet: https://www.novitas-solutions.com/webcenter/portal/MedicareJH/pagebyid?contentId=00144538
05Premera Blue Cross Payment Policy CP.PP.009 – Modifier 62 Two Surgeons: https://www.premera.com/portals/provider/paymentpolicies/cmi_051723.pdf
06Wellpoint/Anthem Modifier 62 Commercial Reimbursement Policy C-21005: https://www.wellpoint.com/content/dam/digital/wellpoint/documents/gic/mass/provider/C21005_WLPMA_Modifier62.pdf
07Moda Health Reimbursement Policy RPM035 – Modifiers 62 & 66: https://www.modahealth.com/-/media/modahealth/shared/Provider/Policies/RPM035.pdf
08Priority Health Provider Manual – Modifiers 62 and 66: https://www.priorityhealth.com/provider/manual/billing/modifiers/62-66
09AAPC Knowledge Center – Observe Documentation Requirements for Proper Modifier 62 Reimbursement: https://www.aapc.com/blog/26378-observe-documentation-requirements-for-proper-modifier-62-reimbursement/
10AAPC Orthopedic Coding Alert – Not All Team Work Qualifies for Modifier 62: https://www.aapc.com/codes/coding-newsletters/my-orthopedic-coding-alert/reader-question-not-all-team-work-qualifies-for-modifier-62-141886-article

Mira AI Scribe

When two surgeons each serve as a primary surgeon on distinct portions of one procedure, modifier 62 must be appended by both on the same CPT code. Document the exact operative steps you personally performed, name your co-surgeon in your note, and confirm your colleague is submitting the same CPT and diagnosis codes with modifier 62 on their own claim. Neither surgeon should label the other as 'assistant'—that would require modifier 80 instead. Reimbursement to each surgeon is typically 62.5% of the standard fee schedule rate. Check the CMS co-surgery indicator for the procedure code before submitting: indicator 1 requires supporting medical-necessity documentation; indicator 2 pays without additional documentation; indicator 0 means modifier 62 is not payable for that code.

See how Mira flags modifier 62 in dictation