Modifier 50
CPT modifier indicating a bilateral procedure performed at the same operative session.
1 min read · Last reviewed May 23, 2026
At a glance
- Category
- Billing
- Primary sources
- 2
- Workspace handoff
- denial workbench →
Where this comes up
This shows up in revenue-cycle work — claim scrubbing, charge entry, posting, A/R follow-up, and month-end close. Billers and practice managers hit this term when reconciling a payment, working a denial queue, or auditing why a claim aged past 60 days.
Full definition
What it is in practice
CMS recognizes modifier 50 for procedures that are not inherently bilateral. The PFS Bilateral Surgery indicator (column in the PFS relative value file) determines whether modifier 50 is appropriate and how it is paid.
How it shows up in your practice
Check the bilateral indicator in the CMS RVU file before billing modifier 50. Mis-billing inherently bilateral codes is a common denial.
Sources
- CMS — Physician Fee Schedule (PFS)https://www.cms.gov/medicare/payment/fee-schedules/physician
- CMS — PFS Relative Value Fileshttps://www.cms.gov/medicare/payment/fee-schedules/physician/pfs-relative-value-files
Resolve modifier-50 denials in the Denial Workbench
Open denial workbench →Related terms
- BillingModifier RT / LTHCPCS modifiers identifying procedures performed on the right (RT) or left (LT) side of the body.
- BillingGlobal PeriodThe period of time during which the payer considers most related preoperative and postoperative services bundled into the surgical fee.
- BillingNCCI EditsThe CMS National Correct Coding Initiative edits that prevent improper payment when incorrect code combinations are reported.
D3rx is a healthcare-billing and compliance research aid maintained by D3rx Inc. Articles are drafted by an LLM (Anthropic Claude) against primary HHS, OCR, CMS, eCFR, NIST, and state-regulator publications, and reviewed for restraint and source fidelity by the D3rx team.
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Related across the archive
- GlossaryGlobal PeriodThe period of time during which the payer considers most related preoperative and postoperative services bundled into the surgical fee.
- GlossaryModifier RT / LTHCPCS modifiers identifying procedures performed on the right (RT) or left (LT) side of the body.
- GlossaryNCCI EditsThe CMS National Correct Coding Initiative edits that prevent improper payment when incorrect code combinations are reported.
- GlossaryModifier 22CPT modifier indicating increased procedural services requiring substantially greater work than usually required.
- GlossaryModifier 24CPT modifier indicating an unrelated E/M service performed by the same provider during a postoperative global period.
- GlossaryModifier 26CPT modifier indicating the professional component of a procedure.
- GlossaryModifier 51CPT modifier indicating multiple procedures performed at the same session by the same provider.
- BillingAWV + Problem Visit Same Day: How to Bill CorrectlyYes, you can bill AWV and a problem visit the same day. Here's how to do it correctly with modifier -25.
This glossary entry is a research aid for billing and compliance staff. It does not provide legal, medical, or financial advice and does not replace counsel. References cited link to primary sources at HHS, OCR, CMS, eCFR, NIST, and the relevant payer or industry body.