Modifiers 73 & 74, outpatient procedure discontinued
These modifiers indicate a procedure in an outpatient hospital/ambulatory surgery center (ASC) setting that was cancelled after the patient's surgical preparation.
- Modifier 73 indicates the cancellation happened before the administration of anesthesia.
- Modifier 74 indicates the cancellation happened after the administration of anesthesia and/or the initiation of the procedure.
- Priority Health may request notes to determine the extent of services rendered.
For physician reporting of a discontinued procedure, see modifier 53.
Please reference the CPT Manual for additional instruction.
Acceptable reasons for cancellation
Cancellation must be due to extenuating circumstances, or those that threaten the life of the patient.
Do not use these modifiers,to report an elective cancellation of the procedure.
Effective 04/01/2013, reimbursement for Modifier 73 for all products will be 50% of the base fee schedule. There will be no reduction to reimbursement for Modifier 74.
- 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
- 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