Key CPT Codes
| CPT | Descriptor | wRVU | Medicare estimate | Global |
|---|---|---|---|---|
| 44140 | Colectomy, partial; with anastomosis | 22.03 | $1,250.20 | 90 |
| 44204 | Laparoscopic colectomy, partial | 25.76 | $1,413.19 | 90 |
| 47562 | Laparoscopy, surgical; cholecystectomy | 10.21 | $631.95 | 90 |
| 44970 | Laparoscopy, surgical, appendectomy | 9.21 | $578.17 | 90 |
| 49020 | Drainage abdom abscess open | 26.0 | $1,488.01 | 90 |
| 43775 | Laparoscopic longitudinal gastrectomy / sleeve gastrectomy | 19.87 | $1,000.02 | 90 |
Coding Decision Points
- Modifier 22 needs objective extra work, not a routine difficult case.
- Document why the work was substantially greater, how much extra time was required, and what anatomic or clinical factors drove it.
- Do not use modifier 22 to compensate for poor code selection.
Common Documentation Gaps
Use concrete details: additional time, adhesions, inflammation, distorted anatomy, reoperative field, hemorrhage, obesity/body habitus, contamination, or complexity beyond the descriptor.
FAQ
Does modifier 22 automatically increase payment?
No. It flags increased services and usually requires payer review and documentation.
Should modifier 22 go on add-on codes?
Usually avoid reflexive modifier 22 on add-on codes; verify payer policy and document why the add-on work itself was increased.