Modifier 57
CPT modifier indicating an E/M service that resulted in the initial decision to perform major surgery.
1 min read · Last reviewed May 23, 2026
At a glance
- Category
- Billing
- Primary sources
- 1
- Workspace handoff
- denial workbench →
Where this comes up
This shows up in revenue-cycle work — claim scrubbing, charge entry, posting, A/R follow-up, and month-end close. Billers and practice managers hit this term when reconciling a payment, working a denial queue, or auditing why a claim aged past 60 days.
Full definition
What it is in practice
CMS allows modifier 57 on the E/M furnished the day before or the day of major surgery (90-day global). For minor surgeries, modifier 25 is the right choice.
How it shows up in your practice
Document the decision-for-surgery clearly in the E/M note. Pair with the surgery procedure code on the claim.
Sources
- CMS MLN — Global Surgery Booklethttps://www.cms.gov/outreach-and-education/medicare-learning-network-mln/mlnproducts/downloads/globallsurgery-icn907166.pdf
Defend modifier-57 denials in the Denial Workbench
Open denial workbench →Related terms
- BillingModifier 25CPT modifier indicating that a significant, separately identifiable E/M service was performed by the same provider on the same day as another procedure or service.
- BillingModifier 24CPT modifier indicating an unrelated E/M service performed by the same provider during a postoperative global period.
- BillingGlobal PeriodThe period of time during which the payer considers most related preoperative and postoperative services bundled into the surgical fee.
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Related across the archive
- GlossaryModifier 24CPT modifier indicating an unrelated E/M service performed by the same provider during a postoperative global period.
- GlossaryGlobal PeriodThe period of time during which the payer considers most related preoperative and postoperative services bundled into the surgical fee.
- GlossaryModifier 25CPT modifier indicating that a significant, separately identifiable E/M service was performed by the same provider on the same day as another procedure or service.
- BillingModifier 25: When to Use It and Common MistakesWhen to use modifier -25, when to skip it, and the common mistakes that trigger audits and denials.
- GlossaryModifier 22CPT modifier indicating increased procedural services requiring substantially greater work than usually required.
- GlossaryModifier 26CPT modifier indicating the professional component of a procedure.
- GlossaryModifier 50CPT modifier indicating a bilateral procedure performed at the same operative session.
- RegulationNCCI Global Surgical Package PolicyMedicare's global surgical package bundles preoperative, intraoperative, and routine postoperative care into a single payment for the surgical CPT code, with global periods of 0, 10, or 90 days.
This glossary entry is a research aid for billing and compliance staff. It does not provide legal, medical, or financial advice and does not replace counsel. References cited link to primary sources at HHS, OCR, CMS, eCFR, NIST, and the relevant payer or industry body.