Bilateral Surgery

50 Modifier Bilateral Procedure. Modifier 50 represents that the procedure was performed bilaterally. To report bilateral services, bill the procedure with the 50 modifier and a unit of one in the days/units field or electronic equivalent.

Example: 29870-50 $1,000 Units = 1

The billed charge should reflect a bilateral procedure amount if the procedure was performed bilaterally.
Note: Please refer to your current MPFSDB to determine whether a 50 modifier may be added on the procedure code being used.

Example: The following example demonstrates pricing of bilateral services billed.

Code Allowed Bilaterally on MPFSDB (50 Modifier)Unilateral Allowed Amount $ Final Allowance$
29870-50                             Yes                     365.31 x 150% = 547.96 (bilateral)       547.96 x 80%

Example: The following example demonstrates multiple surgery pricing logic as it is applies to bilateral surgeries.

Code            Indicator 50 Modifier Unilateral Allowed Amount $  Ranking   Final Allowance $

29870-50    2           Yes   365.31 x 150% = 547.96 (bilateral) 100%             547.96 x 80%
29345-50    2           Yes    115.04 x 150% = 172.56 (bilateral) 50%             86.28 x 80%