The CPT 22-Modifier at a Single Private-Practice Orthopaedic Institution: Success, Reimbursement, and Financial Burden

This study investigates the effectiveness and financial implications of using the CPT 22-modifier in surgical billing at a private orthopaedic practice, focusing on its success rates, reimbursement amounts, and associated delays across various subspecialties. The findings reveal that while the modifier is more frequently approved by government payers and results in a modest increase in reimbursement, it also leads to significant delays and higher rebilling rates, suggesting that the administrative burden may outweigh the financial benefits in certain cases.