Modifier Advisor

Look up any CPT modifier — definition, when to use it, when not to, documentation requirements, and payer notes. Or use the Scenario Guide to get modifier recommendations for common billing situations.

39 of 39 modifiers

Select a modifier to see the full reference

Use, documentation requirements, payer notes & related modifiers

Modifier quick reference

E&M modifiers

25 — E&M same day as procedure
57 — Decision for major surgery
24 — Unrelated E&M in global period

NCCI modifiers

59 — Distinct procedural service
XE — Separate encounter
XS — Separate structure
XP — Separate practitioner
XU — Unusual non-overlapping

Surgical modifiers

50 — Bilateral procedure
51 — Multiple procedures
58 — Staged procedure
78 — Return to OR (complication)
79 — Unrelated procedure in global

Billing modifiers

26 — Professional component
TC — Technical component
54/55/56 — Split global package

Lab & telehealth

91 — Repeat clinical lab test
GT — Medicare telehealth
95 — Commercial telehealth

Documentation tip

Every modifier must be supported by the medical record
Modifiers 22, 59, and XU are common OIG audit targets
Hard NCCI bundles (modifier indicator 0) cannot be overridden by any modifier