You would assign one line, one unit, modifier 50, double fee = we did this CPT twice, once RT, once LT.
In the CPT book, the parenthetical below 61154 indicates, "(For bilateral procedure, report 61154 with modifier 50).
Modifier 50 means bilateral procedure (same CPT done on both sides in the same session)
The 50 means twice.
You would not assign two units, that would be four times or bilateral procedure two times.
There could be some random payer which wants two units
and a 50 (makes no sense). There could be a payer that wants bilateral procedures on two lines, one unit, RT & LT. Some have even wanted a 50 on the second line with the laterality mod either RT or LT (this was a long time ago, have not seen lately). You would have to look up the payer's bilateral surgery policy, however most follow CMS at this point.
If you look up the code in the CMS PFS, it has a bilateral surgery indicator of "1".
Bilateral Surgery Indicator (CPT Modifier 50)
1 = 150% payment adjustment for bilateral procedures applies. If you bill a code with the bilateral modifier, Medicare bases payment for these codes (when reported as bilateral procedures) on the lower of: ● The total actual charge for both sides ● 150% of the fee schedule amount for a single code
If you report a code as a bilateral procedure with other procedure codes on the same day, Medicare applies the bilateral adjustment before applying any applicable multiple procedure rules.
Examples:
https://www.uhcprovider.com/content...ursement/COMM-Bilateral-Procedures-Policy.pdf
https://www.humana.com/provider/medical-resources/claims-payments/claims-payment-policies "When using modifier 50 to report a bilateral procedure, report a single claim line with a unit of 1. When using modifiers LT and RT to report a bilateral procedure, report two claim lines, each with a unit of 1."