REFERENCE

Modifier Quick Reference

Common CPT and HCPCS modifiers with usage rules, payer-specific notes, and audit risk indicators.

Modifier	Name	When to Use	Audit Risk
25	Significant E/M, same day	E/M with procedure	High
59	Distinct procedural service	Bundled codes that should be paid separately	High
76	Repeat procedure, same physician	Same procedure, same day	Low
77	Repeat procedure, different physician	Same procedure, different provider	Low
GA	Waiver of liability on file	ABN issued for likely non-coverage	Medium
GZ	Item or service expected to be denied	No ABN, expected denial	Medium
XE	Separate encounter	Subset of modifier 59	Medium
XS	Separate structure	Subset of modifier 59	Medium

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