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February 27, 2026JAMA Surgery0 citations

Beyond Modifier 22—A Path to Recognizing Surgical Complexity

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CCChristopher P. ChildersBTBrett M. TracyCSChristopher K. Senkowski

Key Points

  • To explore alternatives to modifier 22 for recognizing surgical complexity and surgeon effort.
  • Discussion of the limitations of modifier 22
  • Exploration of potential coding alternatives
  • Analysis of reimbursement impact on surgical procedures
  • Identified limitations of current reimbursement practices
  • Outlined possible new pathways for coder recognition of effort
  • Highlighted need for improved measures of surgical complexity

Abstract

This Viewpoint discusses modifier 22, a coding tool created to increase reimbursement for surgical procedures requiring more effort, and alternative pathways for quantifying surgeon work and recognizing surgical complexity.

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Cite This Study

Childers et al. (2026) studied this question.

synapsesocial.com/papers/69a1355fed1d949a99abf312https://doi.org/10.1001/jamasurg.2025.6831
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Estimated Financial Impact of 2021 Office-Visit Work Relative Unit Updates on Surgical Global Periods2024 · 5 citations
  2. 2Longitudinal Trends in Efficiency and Complexity of Surgical Procedures: Analysis of 1.7 Million Operations Between 2019 and 20232025 · 7 citations
  3. 3Are Urologists Fairly Reimbursed for Complex Procedures: Failure of 22 Modifier?2008 · 20 citations
  4. 4Is the 22 Modifier Worth It?2012 · 18 citations
  5. 5Modifier 22 Use in Fee-for-Service Medicare2024 · 15 citations