Modifier 76
CPT modifier indicating a repeat procedure or service by the same physician or other qualified health care professional.
1 min read · Last reviewed May 23, 2026
At a glance
- Category
- Billing
- Primary sources
- 1
- Workspace handoff
- ask d3 →
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 recognizes modifier 76 to indicate the second procedure is a repeat of the first on the same date. The repeat must be medically necessary.
How it shows up in your practice
Document the indication for the repeat. Use modifier 76 when the same provider repeats the procedure (e.g., second EKG for chest pain).
Sources
- CMS — Modifiershttps://www.cms.gov/medicare/coding-billing/modifiers
Verify modifier 76 use in Ask D3
Open ask d3 →Related terms
- BillingModifier 77CPT modifier indicating a repeat procedure or service by a different physician or other qualified health care professional.
- CodingMedical NecessityThe standard requiring that services be reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member.
D3rx is a healthcare-billing and compliance research aid maintained by D3rx Inc. Articles are drafted by an LLM (Anthropic Claude) against primary HHS, OCR, CMS, eCFR, NIST, and state-regulator publications, and reviewed for restraint and source fidelity by the D3rx team.
Reviewer status: a named credentialed reviewer (CHC, CHPC, or healthcare attorney) is being engaged. Until that engagement is finalized, this page does not claim credentialed review.
Related across the archive
- GlossaryModifier 77CPT modifier indicating a repeat procedure or service by a different physician or other qualified health care professional.
- GlossaryMedical NecessityThe standard requiring that services be reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member.
- GlossaryModifier 22CPT modifier indicating increased procedural services requiring substantially greater work than usually required.
- GlossaryModifier 24CPT modifier indicating an unrelated E/M service performed by the same provider during a postoperative global period.
- GlossaryModifier 26CPT modifier indicating the professional component of a procedure.
- GlossaryModifier 50CPT modifier indicating a bilateral procedure performed at the same operative session.
- GlossaryModifier 51CPT modifier indicating multiple procedures performed at the same session by the same provider.
- BillingAWV + Problem Visit Same Day: How to Bill CorrectlyYes, you can bill AWV and a problem visit the same day. Here's how to do it correctly with modifier -25.
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.