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List Of All CPT Modifiers (2023) | Descriptions & Modifier Explanation

Below, you can find a list of all the CPT modifiers. A modifier ‘modifies’ a procedure or item and adds information or changes a description based on the documentation provided by the physician. First, we’ll explain what modifiers are before providing the CPT modifiers list.

CPT modifiers are added to CPT or HCPCS codes to provide additional information to the claim for the insurance payer and aim to clarify the procedure.

For example, additional information is required if a provider performed multiple procedures, if the medical necessity of a procedure needs to be explained, or if a procedure was performed on the right or left side of the body.

The CPT modifiers have two numeric digits, are copyrighted by the American Medical Association, and are updated annually.

The following examples from the CPT book explain appropriate scenarios for appending CPT modifiers to a claim:

  • For procedures provided more than once (to the same patient).
  • For billing bilateral (two-sided) procedure(s).
  • For reduced or increased procedures
  • For procedures performed in more than one location.
  • For procedures provided by more than one provider.
  • For professional and technical components.

Simply put, CPT modifiers add information to a CPT code about why, where, and how the procedure was performed.

TIP: Are you looking for a list with the HCPCS modifiers instead of the CPT modifiers? You can find the complete list of HCPCS modifiers here.

The CPT modifiers are divided into three categories. The first category of modifiers ranges from 22 to 99 and is called ‘Provider Services and Ambulatory Service Center Modifiers.’

The second category of CPT modifiers is also known as ‘performance measure modifiers’ or ‘category II modifiers.’ They may be used to indicate that a procedure was considered but not performed due to;

  • medical reasons;
  • patient reasons;
  • system reasons; or
  • system circumstances.

The third category of CPT modifiers may be used to describe anesthesia services, known as ‘anesthesia physical status’ modifiers.

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CPT Modifiers Category I

1. Modifier 21 (Deleted)

This modifier was deleted on 01-01-2009 and was used for prolonged evaluation and management services. Instead, you can use CPT 99354, CPT 99355, CPT 99356, CPT 99357, CPT 99358, or CPT 99359.

Learn more about the 21 modifier.

2. Modifier 22

Use this modifier for increased procedural services. The circumstances of the surgery need to be unusual and require more mental and/or physical work from the surgeon than usual.

Learn more about the 22 modifier.

3. Modifier 23

This modifier may be used in procedures with unusual anesthesia. Append this modifier when the provider uses anesthesia for a procedure that usually doesn’t require it.

Learn more about the 23 modifier.

4. Modifier 24

Append this modifier to an E/M service if a provider performed it during the global surgery period. The E/M must be unrelated to the patient’s surgery.

Learn more about the 24 modifier.

5. Modifier 25

This modifier may be used when a provider performs an E/M service on a patient on the same day as another procedure or service.

Learn more about the 25 modifier.

6. Modifier 26

This modifier identifies the professional component of a service and shows that a physician provides the interpretation and supervision of a procedure.

Learn more about the 26 modifier.

7. Modifier 27

Append this modifier to a subsequent, separate, and distinct E/M service for patients who received multiple E/M services with different providers on the same day and in the same hospital.

Learn more about the 27 modifier.

8. Modifier 32

This modifier can be appended for mandated services. Third parties, such as a legislative, governmental, or regulatory requirement, mandate that a provider performs a service.

Learn more about the 32 modifier.

9. Modifier 33

Append this modifier for preventive services. The primary function of a preventive service is to screen for specific diseases. Do not append this modifier to services with the word ‘screening’ in the description (for example, screening mammogram).

Learn more about the 33 modifier.

10. Modifier 47

Append this modifier to a service or procedure when the performing surgeon also administered general or local anesthesia.

Learn more about the 47 modifier.

11. Modifier 50

This modifier may be used for bilateral radiology, diagnostic, or surgical procedures. A bilateral procedure is performed on both sides of the patient’s body during the same session.

Learn more about the 50 modifier.

12. Modifier 51

Append this modifier to multiple subsequent procedures if performed by the same provider, on the same patient, and during the same encounter.

Learn more about the 51 modifier.

13. Modifier 52

Append this modifier to reduced services. Use this modifier if a provider did not completely perform the procedure described by the code descriptor.

Learn more about the 52 modifier.

14. Modifier 53

Use this modifier for discontinued procedures. Report this modifier if a surgical or diagnostic procedure is terminated because it threatens the patient’s health.

Learn more about the 53 modifier.

15. Modifier 54

Report this modifier when a provider performs a procedure but does not provide postoperative or preoperative management.

Learn more about the 54 modifier.

16. Modifier 55

This modifier may be used when a provider performs postoperative management but they do not provide intraoperative or preoperative services.

Learn more about the 55 modifier.

17. Modifier 56

This modifier can be appended to a procedure if a provider performs preoperative management only and does not provide postoperative or intraoperative services.

Learn more about the 56 modifier.

18. Modifier 57

Append this modifier to a code if a provider decides to perform the surgery on the day or the day before the E/M service.

Learn more about the 57 modifier.

19. Modifier 58

This modifier may be appended to procedures performed during the postoperative period when a procedure is staged or planned.

Learn more about the 58 modifier.

20. Modifier 59

This is one of the common modifiers and identifies a distinct or independent procedural service from other non–E/M services performed on the same day by the same provider.

Learn more about the 59 modifier.

21. Modifier 62

Append this modifier for procedures performed by two primary surgeons, performing a distinct part of the procedure.

Learn more about the 62 modifier.

22. Modifier 63

This modifier can be appended to procedures performed on infants weighing less than four kilograms.

Learn more about the 63 modifier.

23. Modifier 66

Use this modifier when the provider who performed it was part of a surgical team because the procedure was difficult or highly complex.

Learn more about the 66 modifier.

24. Modifier 73

Append this modifier for discontinued ambulatory surgery centers or outpatient hospital procedures terminated before anesthesia was provided to the patient.

Learn more about the 73 modifier.

25. Modifier 74

This modifier can be used for discontinued ambulatory surgery centers or outpatient hospital-terminated procedures after the administration of anesthesia.

Learn more about the 74 modifier.

26. Modifier 76

You can use this modifier if the same provider repeats a procedure after they performed the initial procedure.

Learn more about the 76 modifier.

27. Modifier 77

Append this modifier to a code if a different provider repeats a procedure because the initial same procedure was not successful and was performed by another provider.

Learn more about the 77 modifier.

28. Modifier 78

Use this modifier when you bill a procedure provided by the same provider but unrelated to the initial procedure and performed during the postoperative period.

Learn more about the 78 modifier.

29. Modifier 79

Append this modifier if an unrelated procedure is performed during the postoperative period, the original procedure by the same provider.

Learn more about the 79 modifier.

30. Modifier 80

This modifier indicates that an assistant surgeon was present during the procedure and assisted a principal or operating surgeon.

Learn more about the 80 modifier.

31. Modifier 81

Append this modifier if an assistant surgeon was present during a part of the procedure and assisted a principal or operating surgeon.

Learn more about the 81 modifier.

32. Modifier 82

Use this modifier if an assistant surgeon was present during the entire procedure and assisted the operating or principal surgeon because a medical resident was unavailable.

Learn more about the 82 modifier.

33. Modifier 90

This modifier can be used when an outside or reference laboratory performs a pathology or laboratory test instead of the reporting or treating provider.

Learn more about the 90 modifier.

34. Modifier 91

You can use this modifier for repeated lab tests for the same patient and on the same day.

Learn more about the 91 modifier.

35. Modifier 92

This modifier identifies a disposable, single-use, transportable lab test or kit with an analytical chamber.

Learn more about the 92 modifier.

36. Modifier 93

Use this modifier for audio–only technology services that allow synchronous real-time interaction between patient and provider.

Learn more about the 93 modifier.

37. Modifier 95

Append this modifier for synchronous or real–time audiovisual conference services that allow the provider to provide healthcare from a different location than the patient.

Learn more about the 95 modifier.

38. Modifier 96

Habilitative services can be identified with this modifier. These services improve, maintain, and develop their skills to perform instrumental activities of daily living (IADLs) or activities of daily living (ADLs).

Read more about the 96 modifier.

39. Modifier 97

Rehabilitative services are indicated with this modifier. These services help patients restore or improve functions or skills lost due to disease or illness.

Read more about the 97 modifier.

40. Modifier 99

Report modifier 99 as the first modifier on a claim when the service or procedure requires more than one modifier.

Read more about the 99 modifier.

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CPT Modifiers Category II

41. Modifier 1P

Use this modifier for a quality reporting code if a patient’s medical status prevents the provider from action.

42. Modifier 2P

This modifier indicates that a provider couldn’t act for patient reasons, such as refusal.

43. Modifier 3P

This modifier indicates that the provider did not act due to the healthcare delivery system.

44. Modifier 8P

Report this modifier if a provider could not act but did not specify the reason for not providing the action for a patient.

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CPT Modifier List – Category III

45. Modifier P1

Report this physical status modifier to identify anesthesia services provided by a physician to a normal and healthy patient.

46. Modifier P2

Report this physical status modifier to identify anesthesia services provided by a physician to a patient with mild systemic disease.

47. Modifier P3

Report this physical status modifier to identify anesthesia services provided by a physician to a patient with severe systemic disease.

48. Modifier P4

Report this physical status modifier to identify anesthesia services a physician provides to a patient suffering from a severe systemic disease that constantly threatens their life.

49. Modifier P5

Report this physical status modifier to identify anesthesia services provided by a physician to a dying patient who is not expected to survive without an operation.

50. Modifier P6

Report this physical status modifier to identify anesthesia services provided by a physician to a dead declared patient whose organs are removed to be donated.

Tip: You can find the HCPCS Level II Modifiers list here.

51. References

CPT Professional 2022

https://www.cms.gov/files/document/chapter1generalcorrectcodingpoliciesfinal11.pdf

CPT Professional 2022

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