When using bilateral procedure modifier, do I always submit "1" in the units field?

Answer: No. The number indicated in the units field depends on the CPT code submitted. It’s best to refer to the Medicare Physician Fee Schedule Database (MPFSDB) to determine, first of all, if CPT modifier 50 is applicable to a CPT code. Once in the MPFSDB, check the bilateral indicator assigned to the code to determine the number of units to submit. The following chart provides a definition of each indicator: 

Indicator
Description
0
150 percent payment adjustment for bilateral procedures does not apply. Do not use CPT modifier 50.
1
150 percent payment adjustment for bilateral procedures applies. Submit CPT modifier 50 with a quantity of "1."
2
150 percent payment adjustment for bilateral procedure does not apply, as RVUs are already based on the procedure being performed as a bilateral procedure.
3
The usual payment adjustment for bilateral procedures does not apply. Services in this category are generally radiology procedures or other diagnostic tests. Submit CPT modifier 50 with a quantity of "2."
9
Concept does not apply.

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