Pricing vs Informational Modifier Order

Orders CPT/HCPCS modifiers on the claim line: pricing (payment-affecting) modifiers first, then informational/statistical, flagging conflicts and unrecognized modifiers.

Open the tool → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.

Example

Modifier 1: 59
Modifier 2: 26
Modifier 3: RT

Result: Claim order: 26 59 RT -- 26 (pricing) leads; 59 and RT follow as informational.

The tool opens with these values already filled in. Replace them with your own.

What you enter

Modifier 1
Modifier 2
Modifier 3
Modifier 4

How this is calculated

CMS Pub. 100-04 Ch. 12 / 23 modifier-reporting guidance and payer claim-editing convention: pricing (payment-affecting) modifiers are reported before informational/statistical modifiers; the wrong order can mis-price or reject the line. Read the source ↗

A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.