Team surgery indicator: paid by report, or not at all.

Where the indicator lives

The Team Surgeons (Modifier 66) field is at position 39 of the Physician Fee Schedule payment policy indicator file (Chapter 23, section 50.6); Chapter 12 refers to it as Field 25 of the Medicare Fee Schedule Data Base. It is one of the few indicators with a payment result of "by report" rather than a percentage.

The four values

• 0: team surgeons not permitted for this procedure.
• 1: team surgeons could be paid; supporting documentation is required to show a team was medically necessary; pay by report.
• 2: team surgeons permitted; pay by report.
• 9: the concept does not apply.

What counts as a team

A team is more than two surgeons of different specialties required for a specific procedure. Each bills the procedure with modifier 66, and every claim must carry enough information to allow pricing by report (Chapter 12, section 40.8). Surgeons of different specialties who each perform a different procedure are neither a team nor co-surgeons, and the multiple surgery rules apply to any one surgeon who performs several procedures.

How a team is paid

There is no fixed percentage. Where a Medicare fee exists for a procedure billed with modifier 66, all physicians on the team must agree on the percentage of the Medicare amount each receives. If a bill with modifier 66 arrives after one surgeon has already been paid the full amount on a bill without the modifier, the later claim is denied. With indicator 0 the contractor pays the first bill and denies bills from other physicians as not medically necessary.

Team versus co-surgeons

See the co-surgeon indicator page. The global surgery rules apply to each physician in either arrangement.

Denials

Where payment may not be made for a co- or team surgeon, the remittance carries group code CO and CARC 54 (Chapter 12, section 40.8.D).

FAQ

What does team surgery indicator 2 mean?

Team surgeons are permitted for the procedure and are paid by report.

What is the difference between indicators 1 and 2 for team surgery?

Indicator 1 means a team could be paid but supporting documentation is required to establish medical necessity. Indicator 2 permits a team without that documentation requirement. Both are priced by report.

Which modifier does each team surgeon bill?

Each surgeon bills the procedure with modifier 66, and the claims must contain enough information to allow pricing by report.

Is team surgery paid at a percentage like co-surgery?

No. Co-surgeons with modifier 62 are paid 62.5 percent of the fee schedule amount each; team surgery with modifier 66 is paid by report.

What happens with indicator 0?

Team surgeons are not permitted. The contractor pays the first bill submitted at no more than the fee schedule amount and denies bills from other physicians.

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, Team 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, co-surgeons and team surgeons (retrieved 2026-11-02).
• CMS: MLN907166, Global Surgery booklet (December 2025): Co-Surgeons and Team Surgeons (retrieved 2026-11-02).