CPT® & HCPCS Level II Modifiers Reference
Complete directory of procedural, evaluation and management (E/M), anatomical, and NCCI edit modifiers. Use the quick search bar to filter modifiers by code or billing application.
Essential & High-Volume CPT® Modifiers
Critical payment and NCCI unbundling modifiers used routinely in physician fee schedule billing.
| Modifier | Official Description | Type / Application |
|---|---|---|
| 25 | Significant, separately identifiable evaluation and management (E/M) service by the same physician on the same day of the procedure or other service. | Payment / E&M |
| 26 | Professional component. Certain procedures are a combination of a professional and technical component; append 26 for professional service only. | Component |
| TC | Technical component. Identifies facility/equipment costs when billed separately from physician interpretation. | Component |
| 59 | Distinct procedural service. Indicates that a procedure or service was distinct or independent from other non-E/M services performed on the same day. | NCCI Edit |
| 50 | Bilateral procedure. Identifies surgical or diagnostic procedures performed on both sides of the body during the same session. | Payment / Surgical |
| 22 | Increased procedural services. Work required to perform a service was substantially greater than typically required. Requires supporting documentation. | Pricing Override |
| 24 | Unrelated evaluation and management service by the same physician during a postoperative global period. | Global Surgery |
| 51 | Multiple procedures. Identifies additional procedures performed at the same operative session (subject to multiple procedure reduction). | Payment / Surgical |
| 52 | Reduced services. Indicates a service or procedure was partially reduced or eliminated at the physician's discretion. | Payment / Surgical |
| 53 | Discontinued procedure. Indicates surgical or diagnostic procedure terminated due to extenuating circumstances or patient safety. | Payment / Discontinued |
| 57 | Decision for surgery. E/M service resulted in the initial decision to perform major surgery (090-day global period). | Global Surgery |
| 58 | Staged or related procedure by the same physician during the postoperative period (planned prospectively). | Global Surgery |
| 76 | Repeat procedure or service by the same physician or other qualified health care professional. | Repeat Service |
| 77 | Repeat procedure by another physician or other qualified health care professional. | Repeat Service |
| 78 | Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period. | Global Surgery |
| 79 | Unrelated procedure or service by the same physician during the postoperative period. | Global Surgery |
CMS Subsets (X{EPSU}) & Anatomic Modifiers
Specific HCPCS Level II and Medicare subsets used to define precise anatomical sites and override NCCI bundling edits.
| Modifier | Description & Usage | Category |
|---|---|---|
| XE | Separate Encounter: A service that is distinct because it occurred during a separate encounter. | CMS NCCI Subset |
| XP | Separate Practitioner: A service that is distinct because it was performed by a different practitioner. | CMS NCCI Subset |
| XS | Separate Structure: A service that is distinct because it was performed on a separate organ/structure. | CMS NCCI Subset |
| XU | Unusual Non-Overlapping Service: The use of a service that is distinct because it does not overlap usual components. | CMS NCCI Subset |
| LT | Left side (used to identify procedures performed on the left side of the body). | Anatomic Site |
| RT | Right side (used to identify procedures performed on the right side of the body). | Anatomic Site |
| E1–E4 | Upper / Lower Left & Right Eyelids. | Anatomic Site |
| FA, F1–F9 | Left / Right Hand Fingers and Thumbs. | Anatomic Site |
| TA, T1–T9 | Left / Right Foot Toes. | Anatomic Site |