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%