Modifier 53, discontinued procedure
Use modifier 53 when a service is terminated due to circumstances beyond the physician or health care provider's control. This may include conditions that threaten the patient's health.
- Do not use modifier 53 for an elective cancellation of the procedure.
- This modifier can be used with both diagnostic or surgical CPT codes.
- Facilities reporting a discontinued outpatient procedure should use modifier 73 or 74.
Please reference the CPT Manual for additional instruction.
Modifier 53 reimbursement
Effective 04/01/2013, reimbursement under all plans will be 50% of the base fee schedule. This does not include MSD reduction, bilateral pricing, etc., that may also be applied.
- AI modifier
- Anatomic modifiers
- Anesthesia modifiers
- AT: Active treatment
- GA and GY: Medicare non-coverage notification
- GN, GO & GP: Therapy type
- UD and UA: Treated and released or admitted/transferred (Medicaid only)
- XE, XS, XP, XU: Distinct services
- 22: Unusual procedural services
- 25: Significant service separate from E&M service
- 26 and TC: Professional and technical components
- 33: Preventive service
- 50 & 51: Bilateral and multiple procedures
- 52: Reduced services
- 53: Discontinued procedure
- 54 & 55: Surgical care and post-op care
- 56: Pre-operative management only
- 57: E&M service same day or before major surgery
- 59: Distinct procedural service
- 62: Two surgeons
- 73 & 74: Discontinued outpatient surgery
- 76 & 77: Repeated procedures, same day
- 78: Unplanned return to operating room
- 80, 81, 82: Assistant at surgery