Co-surgeon indicators 1 and 2: 62.5 percent each.

The field

The Co-Surgeons (Modifier 62) field is at position 38 of the payment policy indicator file (Chapter 23, section 50.6); Chapter 12 calls it Field 24. It identifies services for which two surgeons, each in a different specialty, may be paid.

The values

• 0: co-surgeons not permitted.
• 1: co-surgeons could be paid; supporting documentation is required to establish the medical necessity of two surgeons.
• 2: co-surgeons permitted; no documentation required if the two-specialty requirement is met.
• 9: the concept does not apply.

How payment works

Each surgeon bills the procedure with modifier 62. The fee schedule amount for each co-surgeon is 62.5 percent of the global surgery fee schedule amount, so two co-surgeons together are paid 125 percent (Chapter 12, section 40.8). With indicator 1 the claim is suspended and the documentation is reviewed; if it supports two surgeons, each is paid the lower of the billed amount or 62.5 percent. With indicator 2 payment rules for two surgeons apply directly. With indicator 0, the first bill is paid at 100 percent and later bills from other physicians are denied.

What counts as co-surgery

Co-surgery includes two surgeons each in a different specialty performing a specific procedure, and two surgeons performing parts of a procedure simultaneously, such as a heart transplant or bilateral knee replacements. Surgeons of different specialties who each perform a different procedure are not co-surgeons. Some procedures need modifier 62; if both surgeons do not use it, CMS says the claims are returned unpaid (MLN booklet).

Worked example (hypothetical)

For a procedure with a $3,000 fee schedule amount and indicator 2, each surgeon is paid up to $1,875, a combined $3,750. The same procedure with indicator 0 would pay $3,000 to the first claim only.

Related

For three or more surgeons see team surgery; for an assistant instead of a second surgeon see assistant-at-surgery pay. The row wording also asked about "indicator 1 2"; the page covers all four values so the two can be compared.

FAQ

How much does each co-surgeon get paid?

Each is paid 62.5 percent of the global surgery fee schedule amount when modifier 62 is billed and the rules for two surgeons apply.

What is the difference between co-surgeon indicators 1 and 2?

Indicator 1 means co-surgeons could be paid but supporting documentation of medical necessity is required. Indicator 2 means they are permitted with no documentation if the two-specialty requirement is met.

What does co-surgeon indicator 0 mean?

Co-surgeons are not permitted. The first bill submitted is paid and later bills from other physicians are denied.

Do both surgeons use modifier 62?

Yes. Each surgeon bills the procedure with modifier 62, and CMS says claims are returned unpaid when both surgeons do not use it where it is required.

Does the global period apply to co-surgeons?

Yes. The global surgical package rules apply to each physician participating in co- or team surgery.

Sources

Retrieved 2026-11-02 from the CMS documents below. Indicator meanings are paraphrased from the CMS definitions; no AMA CPT descriptors are reproduced. CMS revises the fee schedule and its manuals, so check the current text.

• CMS: Medicare Claims Processing Manual, Chapter 23, Fee Schedule Administration and Coding Requirements (Rev. 13701, issued 06-16-26): section 50.6, Co-Surgeons field (retrieved 2026-11-02).
• CMS: Medicare Claims Processing Manual, Chapter 12, Physicians/Nonphysician Practitioners (Rev. 13753, issued 05-07-26): section 40.8, billing instructions and claims processing requirements (retrieved 2026-11-02).
• CMS: MLN907166, Global Surgery booklet (December 2025): Co-Surgeons and Team Surgeons (retrieved 2026-11-02).