Surgery Modifier Payment Table

Modifiers as defined by CPT are reimbursed according to the following Modifier Payment Table:

Modifier Description Reimbursement %
of normal allowable amount
22 Unusual procedural service 120% with review
50 Bilateral Procedures 150%
52 Reduced Services 50%
53 Discontinued Procedure 50%
54 Surgical care only 70%
55 Post-operative care only 20%
56 Pre-operative care only 10%
62 Two surgeons 62.5%
63 Procedure performed on infant 120% with review
66 Surgical team 62.5%
73 Discontinued outpatient procedure before anesthesia administered 20%
74 Discontinued outpatient procedure after anesthesia administered 50%
78 Return to operating room for a related procedure during the postoperative period 80%
80 Assistant Surgeon 20%
81 Minimum Assistant Surgeon 16%
82 Assistant Surgeon 20%
AS Physician Assistant – assistant at surgery 16%