Modifier 54- Surgical Care Only

Modifier 54 is used when a physician provides only the surgical portion of a patient's care and another provider manages the preoperative or postoperative care.

What is Modifier 54?

Modifier 54 tells insurance payers that the provider performed only the surgical procedure and is not responsible for the entire global surgical package.

When to Use Modifier 54

• The provider performs only the surgery
• Another provider manages follow-up care
• The global package is split between providers
• Documentation supports shared care

Billing Example

A surgeon performs a procedure, but postoperative management is transferred to another physician. Modifier 54 may be appended to the surgical claim.

Documentation Tips

• Document transfer of care arrangements
• Include operative reports
• Identify all providers involved
• Maintain complete patient records

Common Denial Reasons

• Missing transfer of care documentation
• Incorrect global billing
• Incomplete operative notes
• Modifier applied incorrectly

Related Modifiers

Modifier 55

Modifier 56

Modifier 58

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