What the values mean Copy link
Indicator 2 means co-surgeons are payable without documentation, as long as the two surgeons are in different specialties. Indicator 1 means co-surgeons can be paid, but only with documentation establishing that the procedure needed two surgeons. Indicator 0 means Medicare does not permit co-surgeons for the procedure. Indicator 9 means the concept does not apply. When co-surgery is paid, each surgeon receives 62.5% of the procedure's global surgery fee schedule amount.
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; no documentation required if the surgeons are in different specialties |
| 9 | Concept does not apply |
What each surgical modifier pays for a code Copy link
Enter a code to see its five surgery indicators and what a line with each modifier pays, on the national amount in the setting you choose.
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27447 · Facility · Q4 2026 release
The national facility amount for 27447 is $1,159.35. Each modifier pays from it.
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Co-surgeons · indicator 1: Payable with documentation
Co-surgeons may be paid, but only with supporting documentation establishing the medical necessity of two surgeons.
- 27447-62 · Each co-surgeon
- $724.59 (Only with documentation)
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Bilateral surgery · indicator 1: 150% bilateral adjustment applies
Billed bilaterally (modifier 50, or on both sides), Medicare pays 150% of the single-side fee schedule amount.
- 27447-50 · Bilateral
- $1,739.02
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Assistant at surgery · indicator 2: Payable
An assistant at surgery may be separately paid for this procedure, typically as a percentage of the fee schedule amount.
- 27447-80/81/82 · Physician assistant at surgery
- $185.50
- 27447-AS · PA, NP or CNS assisting
- $157.67
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Team surgery · indicator 0: Not permitted
Medicare does not recognize a surgical team (modifier 66) for this procedure.
- 27447-66 · Team surgery
- Team surgery is not permitted for this code.
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Multiple procedures · indicator 2: Standard reduction applies
When billed with other procedures on the same date, the highest-valued one is paid at 100% and the next four at 50% each.
27447 code page has these amounts in each locality.
National amounts (GPCI 1.000) before sequestration. A modifier amount is what one line with that modifier pays; whether the modifier applies to a claim depends on the procedure performed.
Frequently asked Copy link
How much does each co-surgeon get paid?
62.5% of the procedure's global surgery fee schedule amount, so the two surgeons together receive 125%.
Is co-surgery the same as an assistant surgeon?
No. Co-surgeons (modifier 62) each perform a distinct part of the same procedure. An assistant at surgery (modifiers 80, 81, 82, or AS) helps the primary surgeon rather than performing a separate part. CMS states that co-surgeons are not acting as assistants at surgery, and it does not generally pay an assistant on top of a paid co-surgeon claim.
Does documentation matter for indicator 2?
CMS requires no documentation of medical necessity for indicator 2, as long as the two surgeons are in different specialties. Indicator 1 procedures need documentation establishing that two surgeons were medically necessary before they are paid.
Sources Copy link
- CMS Medicare Physician Fee Schedule Relative Value Files
- CMS Medicare Claims Processing Manual (Pub. 100-04)
Written from primary CMS sources—see how we source, compute, and verify everything on this site.
- The co-surgeon indicator identifies services for which two surgeons, each in a different specialty, may be paid: 1 means co-surgeons could be paid with documentation establishing medical necessity, and 2 means co-surgeons are permitted with no documentation required if the two-specialty requirement is met. —CMS Medicare Physician Fee Schedule Relative Value Files
- Each co-surgeon's fee schedule amount is 62.5 percent of the global surgery fee schedule amount. —CMS Medicare Claims Processing Manual (Pub. 100-04)
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