Modifier 78
CPT modifier indicating an unplanned return to the operating room by the same physician for a related procedure during the postoperative period.
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 Global Surgery recognizes modifier 78 for related, unplanned returns. Unlike 79, it does not start a new global period.
How it shows up in your practice
Document the unplanned nature and the relationship to the original procedure. Reimbursement is reduced to the intraoperative portion of the procedure RVUs.
Sources
- CMS MLN — Global Surgery Booklethttps://www.cms.gov/outreach-and-education/medicare-learning-network-mln/mlnproducts/downloads/globallsurgery-icn907166.pdf
Defend modifier-78 denials in the Denial Workbench
Open denial workbench →Related terms
- BillingModifier 79CPT modifier indicating an unrelated procedure or service by the same physician during the postoperative period.
- 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.
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 24CPT modifier indicating an unrelated E/M service performed by the same provider during a postoperative global period.
- GlossaryModifier 79CPT modifier indicating an unrelated procedure or service by the same physician during the postoperative period.
- GlossaryGlobal PeriodThe period of time during which the payer considers most related preoperative and postoperative services bundled into the surgical fee.
- GlossaryModifier 57CPT modifier indicating an E/M service that resulted in the initial decision to perform major surgery.
- 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.
- 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.
- GlossaryModifier 22CPT modifier indicating increased procedural services requiring substantially greater work than usually required.
- 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.
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.