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Modifier 57

Modifier 57 Description and Billing Use

Plain-language description

Identifies an E/M service that resulted in the initial decision for major surgery under applicable global-surgery rules.

How modifier 57 is used

Modifier 57 identifies an evaluation and management service that resulted in the initial decision for major surgery. Confirm the global-surgery context, timing, and that the note supports a genuine decision for surgery rather than routine preoperative work.

Before reporting this modifier

  1. 1. Confirm the current official or licensed definition and payer acceptance.
  2. 2. Identify the exact claim circumstance the modifier communicates.
  3. 3. Make the code, setting, related services, and medical record consistent.
  4. 4. Check NCCI, global surgery, component, DME, ABN, or drug rules that apply.
  5. 5. Do not append a modifier only to force an edit override.
LessonStudy the related billing ruleOfficial sourceReview current CMS guidance

This is a workflow summary, not a licensed CPT definition or claim-specific coding instruction. Verify the code set and payer rule effective for the date of service.