How are providers supposed to bill for bilateral knee replacements?
Bilateral knee replacement surgery during the same encounter is considered a procedure subject to bilateral pricing per CMS. Many times the bilateral knee replacements are accomplished by two surgeons who each replace a distinct knee. Even though each surgeon is doing a separate knee, the two surgeons are actually operating as co-surgeons for bilateral knee replacement and should each bill their part with CPT code 27447 with modifiers 50 and 62. Additionally, according to the Medicare Physicians’ Fee Schedule Database, co-surgery for bilateral knee replacement is covered if medically necessary. It is expected the medical records will support the medical necessity for bilateral knee replacement.
