Standard ranking and reduction Copy link
For codes with indicator 2, Medicare ranks the same-day procedures by fee schedule amount. It pays the highest at 100% and the next four at 50% each; a sixth or later procedure is priced by report. Indicator 0 means no reduction applies: each procedure is paid as if performed alone. Indicator 1 is a legacy rule that no current code carries. Indicators 3 through 7 apply specialized reductions to particular families of services, and indicator 9 means the concept does not apply.
Multiple procedure indicator values Copy link
All nine values, in one table:
| Value | Meaning |
|---|---|
| 0 | No multiple-procedure reduction |
| 1 | Legacy pre-1996 rule; no current code carries it |
| 2 | Standard reduction: 100% for the highest-ranked procedure, 50% for the next four, by report after that |
| 3 | Endoscopy family: related endoscopies sharing a base procedure are priced together, then ranked with other procedures |
| 4 | Diagnostic imaging: in the same session, each additional procedure's technical component is reduced 50% and its professional component 5% |
| 5 | Therapy: the practice expense of each additional unit or service is reduced 50% |
| 6 | Diagnostic cardiovascular: the technical component of each additional procedure is reduced 25% |
| 7 | Diagnostic ophthalmology: the technical component of each additional procedure is reduced 20% |
| 9 | Concept does not apply |
Why a code page can't show a single -51 amount Copy link
The reduction depends on every other procedure billed that day, because the ranking changes from claim to claim. That makes it a per-claim fact, not a per-code one, so code pages such as CPT 99213 leave it out of the modifier-amounts table. Use the rate calculator with the claim's full set of codes instead.
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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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.
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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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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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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.
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
Is the multiple-procedure reduction the same as modifier 51?
Modifier 51 flags a claim line as an additional procedure. The multiple procedure indicator is the rule that decides whether that line is reduced, and by how much.
Do indicators 1 and 2 pay differently?
On paper, yes: indicator 1 was the older rule, which cut the third and later procedures to 25% instead of 50%. In practice no current code carries indicator 1, so the standard reduction today follows indicator 2.
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.
- For multiple procedure indicator 2, same-day procedures are ranked by fee schedule amount and paid at 100%, 50%, 50%, 50%, 50%, and by report, each on the lower of the actual charge or the reduced fee schedule amount. —CMS Medicare Physician Fee Schedule Relative Value Files
- For multiple procedure indicator 4, the technical component of each subsequent diagnostic imaging procedure in the same session is reduced 50%, and since January 1, 2017 the professional component is reduced 5%. —CMS Medicare Physician Fee Schedule Relative Value Files
- Indicator 5 applies a 50% reduction to the practice expense of certain therapy services; indicator 6 a 25% reduction to the technical component of the second and subsequent diagnostic cardiovascular procedures; and indicator 7 a 20% reduction to the technical component of the second and subsequent diagnostic ophthalmology procedures. —CMS Medicare Physician Fee Schedule Relative Value Files
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