Medicare AdvantageBilling CodesMedium impact
MA03.017c, Modifiers for Shared or Split Surgical Services (Modifiers 54, 55, 56)
Independence Blue Cross·Orthopedics, General Surgery, Cardiothoracic Surgery +8 more·Medical Policy
Effective date
Apr 16, 2025
We identified it
Jun 19, 2026
Summary
Medicare Advantage policy MA03.017c regarding modifiers 54, 55, and 56 for shared or split surgical services has been reissued. This policy governs how to bill when surgical care is divided between multiple providers (preoperative, postoperative, and surgical care only).
Action Required
By April 16, 2025: Billing team should review the updated MA03.017c policy for any changes to modifier 54, 55, and 56 usage guidelines for Medicare Advantage plans. Update billing procedures and staff training materials to reflect any new requirements for shared or split surgical services billing.