Glossary · Updated Jul 28, 2026
Co-Surgeon Indicator
The co-surgeon indicator tells you whether two surgeons of different skills can each be separately paid for jointly performing distinct parts of the same procedure, billed with modifier 62.
What the values mean Copy link
Indicator 2 means co-surgeons are payable, each typically at a percentage of the procedure's fee schedule amount. Indicator 1 means co-surgeons are payable, but only when supporting documentation establishes the medical necessity of using two surgeons rather than one. Indicator 0 means Medicare does not recognize co-surgeons for that procedure at all. Indicator 9 means the concept does not apply.
Co-surgeon indicator values Copy link
All four values, in one table:
| Value | Meaning |
|---|---|
| 0 | Co-surgeons not permitted |
| 1 | Payable only with documentation of medical necessity |
| 2 | Payable |
| 9 | Concept does not apply |
Frequently asked Copy link
Is co-surgery the same as an assistant surgeon?
No. A co-surgeon (modifier 62) performs a distinct part of the same procedure as a primary surgeon of comparable skill; an assistant at surgery (modifiers 80, 81, 82, or AS) helps a single primary surgeon rather than performing a separate part independently. CMS states that surgeons billing as co-surgeons are not acting as assistants at surgery, and does not generally pay an assistant on top of a paid co-surgeon claim.
Does documentation matter for indicator 2?
Less so than for indicator 1—indicator 2 procedures are payable by default, while indicator 1 procedures require documentation establishing medical necessity before they're paid.
Sources Copy link
- CMS Medicare Physician Fee Schedule Relative Value Files
- CMS Physician Fee Schedule overview (cms.gov)
Written from primary CMS sources—see how we source, compute, and verify everything on this site.
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