CurrentBlue Cross Blue Shield - WisconsinPolicy C-21005

Modifier 62 (Co-surgeon) - Professional, Commercial Reimbursement Policy

Governs reimbursement rules for procedures billed with modifier 62 (co-surgeons) for Blue Cross Blue Shield - Wisconsin commercial products; identifies eligible procedure indicators and payment calculation and billing expectations for participating and nonparticipating professional providers.

Policy Summary

PayerBlue Cross Blue Shield - Wisconsin

PolicyModifier 62 (Co-surgeon) - Professional, Commercial Reimbursement Policy

Policy CodePolicy C-21005

Change TypeTitle clarifiedindicator language updated (no material coverage change)

Effective Date11/17/2023

Next Review Date

Key ActionEach surgeon must bill the same procedure code(s) with modifier 62; co-surgeons must be from different specialties and performing surgical services during the same operative session.

SourceLink

POLICY UPDATE CHANGES

Review approved: no changes on 12/02/2025.

11/17/2023 review approved and effective: removed 'Co-Surgeon Services' from policy title; added clarifying language to indicators.

Policy created by splitting prior Co-Surgeon/Team Surgeon Services policy into two new policies (C-21005 and C-21006).

63%payment percentage to each co-surgeon

2MPFS Co-Surgery reimbursable indicator

0,1,9MPFS Co-Surgery non-reimbursable indicators

Co-surgeon Reimbursement Criteria

Policy Summary

PayerBlue Cross Blue Shield - Wisconsin

PolicyModifier 62 (Co-surgeon) - Professional, Commercial Reimbursement Policy

Policy CodePolicy C-21005

Change TypeTitle clarifiedindicator language updated (no material coverage change)

Effective Date11/17/2023

Next Review Date

Key ActionEach surgeon must bill the same procedure code(s) with modifier 62; co-surgeons must be from different specialties and performing surgical services during the same operative session.

SourceLink

On This Page

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Co-surgeon reimbursement criteria

Covered when ALL of the following are met:

ALL of the following

ONE of
- Procedure has MPFS CoSurgery payment indicator '2' (reimbursable)MPFS indicator = '2'
- Procedure does NOT have MPFS CoSurgery payment indicators '0','1', or '9' (these indicators are nonreimbursable)MPFS indicator ∉ {'0','1','9'}

Both surgeons bill the same procedure code(s) and each appends modifier 62 to the code(s)

If one or both surgeons fail to bill modifier 62 appropriately, one surgeon may receive 100% of the fee schedule and the other may be denied or pended as a duplicate or suspected duplicate service.

Each co-surgeon is from a different specialty and both perform surgical services during the same operative session

Reimbursement to each co-surgeon is 63% of the applicable fee schedule or contracted/negotiated rate

Payment split applies when billed correctly with modifier 62.

It is NOT considered co-surgery when two surgeons perform separate procedures during the same operative session; such services are not reimbursable under the co-surgeon rules

If a co-surgeon acts as an assistant for additional procedures during the same surgical session, assistant surgeon and multiple procedure rules and fee reductions apply

Assistant surgeon rules do not apply to procedures appropriately billed with modifier 62.

Billing and Reimbursement Requirements for Co-surgeons

Billing Rule

Billing and reimbursement requirements when using modifier 62

Each surgeon must bill the same procedure code(s) with modifier 62; co-surgeons must be from different specialties and performing surgical services during the same operative session. Reimbursement to each surgeon is 63% of the applicable fee schedule or contracted/negotiated rate. If one or both surgeons fail to use modifier 62 appropriately, one surgeon may receive 100% of the fee schedule or contracted/negotiated rate and the other surgeon's claim may be denied or pended as a duplicate or suspected duplicate service.

Both co-surgeons must report the identical procedure code(s) and append modifier 62.
Co-surgeons must be from different specialties and perform surgical services during the same operative session.
Failure to append modifier 62 appropriately may result in one surgeon receiving full payment and the other claim being denied or pended.

Modifier Definitions

Modifier 62 (Co-surgeon)

DefinitionModifier 62: used when two surgeons work together as primary surgeons performing distinct parts of a procedure; each reports distinct operative work by adding modifier 62 to the procedure code and any associated add-on codes.

ReportingEach surgeon should report the co-surgery once using the same procedure code; if additional procedures are performed during the same session, separate codes may be reported with modifier 62 as appropriate.

Assistant roleIf a co-surgeon acts as an assistant for additional procedures during the same session, those services may be reported with modifier 80 or 82 as appropriate (not under modifier 62).

MPFS Indicator 0	Not reimbursable as co-surgery—do not reimburse under modifier 62.
MPFS Indicator 1	Not reimbursable as co-surgery—do not reimburse under modifier 62.
MPFS Indicator 9	Not reimbursable as co-surgery—do not reimburse under modifier 62.

OpenPayer

Modifier 62 (Co-surgeon) - Professional, Commercial Reimbursement Policy

Co-surgeon Reimbursement Criteria

Coding Indicators and Payment Split

Billing and Reimbursement Requirements for Co-surgeons

Modifier Definitions

Policy Changes and History