CPT Modifier Cheat Sheet
Last reviewed: May 30, 2026
Modifiers provide additional information about a service or procedure. Use the correct modifier to support accurate coding, cleaner documentation, and fewer preventable denials.
Common CPT Modifiers
| Modifier | Definition | Example use |
|---|---|---|
| -25 | Significant, separately identifiable E/M service by the same physician on the same day as a procedure. | 99214-25 with 11301 Office visit and skin biopsy performed during the same encounter. |
| -59 | Distinct procedural service. Used to identify procedures that are not normally reported together. | 20610-59 with 20605 Shoulder injection and elbow injection performed at different sites. |
| -51 | Multiple procedures. Used when multiple procedures are performed in the same operative session, payer rules permitting. | 29881-51 Arthroscopic meniscectomy and chondroplasty performed through the same portal. |
| -RT | Right side. Indicates the service was performed on the patient's right side. | 73030-RT X-ray of the right shoulder. |
| -LT | Left side. Indicates the service was performed on the patient's left side. | 73030-LT X-ray of the left shoulder. |
| -50 | Bilateral procedure. Indicates the procedure was performed on both sides. | 93970-50 Bilateral lower extremity venous duplex ultrasound. |
| -TC | Technical component. Used when only the technical portion of a diagnostic test is performed. | 80048-TC Laboratory test, technical component only. |
| -26 | Professional component. Used when only the professional portion of a diagnostic test is performed. | 80048-26 Laboratory test, professional component only. |
| -22 | Increased procedural services. Indicates a procedure was more complex than usual and required significantly more time or effort. | 62323-22 Epidural injection requiring significantly more time and effort due to complex anatomy. |
| -24 | Unrelated E/M service during a postoperative period. | 99214-24 with 45378 Office visit for unrelated issue during the global period after colonoscopy. |
| -27 | Multiple outpatient hospital E/M encounters on the same date. | 99213-27 Two separate outpatient E/M visits on the same day for different issues. |
| -58 | Staged or related procedure/service by the same physician during the postoperative period. | 29881-58 Planned second-look arthroscopy during the global period. |
| -78 | Unplanned return to the operating room by the same physician during the postoperative period. | 10140-78 Evacuation of hematoma as an unplanned return to the OR. |
Abdominal Wall Reconstruction Pearl
In bilateral component separation/TAR, many surgeons report CPT 15734 for the first side of the abdominal wall advancement flap and CPT 15734-59 or 15734-XS, payer dependent, for the contralateral flap.
- Documentation should clearly describe the independent myofascial advancement performed on each side of the abdominal wall.
- Specifically note that the midline could not be approximated after completion of the first side, therefore the contralateral myofascial release was necessary.
- The posterior component separation, including retrorectus and TAR, is considered the same myofascial release. Bill only 15734 and 15734-59 when supported.
- Billing 15734 four times for right rectus, left rectus, right TAR, and left TAR will likely be denied.
Decision for Surgery: Modifier -57
Modifier -57, decision for surgery, can be used when the E/M service results in the decision to proceed with a major surgery, subject to payer rules and documentation support.
Example Documentation
I discussed the patient's exam, clinical findings, and images with the patient/family. I informed them that surgery was indicated. Their questions were sought and thoroughly answered. They made the decision to proceed with surgery. Informed consent was obtained.
This is a way to support reimbursement for time and medical decision-making spent with the patient. Document the discussion, the decision-making, and that the patient made the decision to proceed.
Important Verification Note
Modifier rules vary by payer, NCCI edits, global period status, place of service, and documentation. Treat this as a practical reference, then verify final billing against current AMA CPT, CMS, NCCI, payer, and institutional guidance.