Live kidney donor surgery and related services.

Submit this modifier on services provided to a live kidney donor to indicate that the services are related to a kidney transplant.
  • All donor services must be submitted using the beneficiary's name (kidney recipient) and Medicare number 
  • It's very important to submit this modifier so recipient and kidney donor services can be distinguished from each other
  • For services rendered on/after October 1, 2015, we also suggest submitting ICD-10-CM code Z52.4 as a primary diagnosis


  • CMS IOM 100-04, Chapter 3, Section 90.1.1 F, 90.1.3 (PDF, 2.16 MB)
  • CMS IOM 100-02, Chapter 11, Section 140 (PDF, 455 KB)

Contact Palmetto GBA JJ Part B Medicare

Provider Contact Center: 877-567-7271

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