CPT modifier used for surgical team. Under some circumstances, highly complex procedures (requiring the concomitant services of several physicians, often of different specialties, plus other highly skilled, specially trained personnel and various types of complex equipment) are carried out under the “surgical team” concept. Such circumstances may be identified by each participating physician with the addition of the modifier -66 to the basic procedure number used for reporting services. This modifier may affect reimbursement.

CPT modifier used for discontinued outpatient hospital/ambulatory surgery center (ASC) procedure before the administration of anesthesia. Because of extenuating circumstances or those that threaten the well-being of the patient, the physician may cancel a surgical or diagnostic procedure subsequent to the patient’s surgical preparation (including sedation when provided, and being taken to the room where the procedure is to be performed), but before the administration of anesthesia (local, regional block[s], or general). Under these circumstances, the intended service that is prepared for but canceled can be reported by its usual procedure number and the addition of modifier -73. The elective cancellation of a service before the administration of anesthesia and/or surgical preparation of the patient should not be reported. For physician reporting of a discontinued procedure, see modifier -53 .

CPT modifier used for discontinued outpatient hospital/ambulatory surgery center (ASC) procedure after administration of anesthesia. Because of extenuating circumstances or those that threaten the well-being of the patient, the physician may terminate a surgical or diagnostic procedure after the administration of anesthesia (local, regional block[s], or general) or after the procedure was started (incision made, intubation started, scope inserted). Under these circumstances, the procedure started but terminated can be reported by its usual procedure number and the addition of modifier -74. The elective cancellation of a service before the administration of anesthesia and/or surgical preparation of the patient should not be reported. For physician reporting of a discontinued procedure, see modifier -53 .

CPT modifier used for repeat procedure by same physician. The physician may need to indicate that a procedure or service was repeated subsequent to the original service. This circumstance may be reported by adding modifier -76 to the repeated service. This modifier may affect reimbursement.

CPT modifier used for repeat procedure by another physician. The physician may need to indicate that a basic procedure performed by another physician had to be repeated. This situation may be reported by adding modifier -77 to the repeated service. This modifier may affect reimbursement, depending on the payer.

CPT modifier used for return to the operating room for a related procedure during the postoperative period. The physician may need to indicate that another procedure was performed during the postoperative period of the initial procedure. When this subsequent procedure is related to the first and requires the use of the operating room, it may be reported by adding the modifier -78 to the related procedure. (For repeat procedures on the same day, see modifier -76 .) This modifier may affect reimbursement, depending on the payer.

CPT modifier used for unrelated procedure or service by the same physician during the postoperative period. The physician may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. This circumstance may be reported by using the modifier -79. (For repeat procedures on the same day, see modifier -76 .) This modifier may affect reimbursement, depending on the payer.

CPT modifier used for assistant surgeon. Surgical assistant services may be identified by adding the modifier -80 to the usual procedure number(s). This modifier may affect reimbursement. Some insurance policies do not include payment for assistant surgeons such as for 1-day surgery but do pay for major or complex surgical assistance. In some instances, prior approval may be indicated due to the patient’s physiologic condition. Medicare will not pay assistant surgeons for operations that are not life threatening. Therefore Medigap insurance will not pay on this service because the service is nonallowable. Assisting surgeons usually charge 16% to 30% of the primary surgeon’s fee.