CPT Modifier 73
Discontinued outpatient hospital/ambulatory surgical center (ASC) procedure prior to the administration of anesthesia.
Guidelines and Instructions
- Submit CPT modifier 73 for ambulatory surgery center (ASC) facility charges when the surgical procedure is discontinued before anesthesia is administered
- This modifier may not be submitted by the operating surgeon. Only ASCs should submit this modifier. Surgeons may refer to CPT modifier 53.
- ASC claims that involve a terminated surgery must be accompanied by an operative report that specifies the following:
- Reason for termination of surgery
- Description of services actually performed
- Description of supplies actually provided
- Services not performed that would have been if surgery had not been terminated
- Supplies that would have been provided if the surgery had not been terminated
- Time actually spent in each stage (e.g., pre-op, operative and post-op)
- Time that would have been spent in each of these stages if the surgery had not been terminated
- Surgical procedures scheduled to be performed in an ASC that are terminated are subject to specific reimbursement:
- Procedure terminated before administration of anesthesia — 50 percent of fee schedule
- Procedure terminated after administration of anesthesia — 100 percent of fee schedule
- Procedures terminated before the ASC has expended substantial reference will not be covered
- If intraocular lens (IOL) insertion is terminated, the allowance for the unused IOL will be deducted prior to payment
Reference: Internet Only Manual (IOM), Publication 100-04, Chapter 14 (PDF, 182 KB).