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.

• Don't use modifier 53 for an elective cancellation of the procedure.
• Inappropriate with E/M or anesthesia codes
• This modifier can be used with both diagnostic or surgical CPT codes.
• Facilities reporting a discontinued outpatient procedure should use modifier 73 or 74.
• Inappropriate to use for Ambulatory Surgery Center (ASC) or hospital facility claims. Use facility modifiers 73 or 74

Please reference the CPT Manual for additional instruction.

Modifier 53 reimbursement

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.