Modifier 76: Repeat Procedure by the Same Physician
Modifier 76 reports a procedure repeated the same day by the same practitioner. How to bill the lines, how Medicare pays, and when 77, 91 or 59 fits instead.
Modifier 76 is a billing modifier that reports a procedure or service repeated later on the same day by the same physician or other qualified practitioner who did it the first time. It keeps the second claim line from being denied as a duplicate. Medicare doesn't adjust the fee for it: each repeat is paid at the normal fee schedule amount.
Key takeaways
- Put 76 on the repeated line only. The first service is billed with no modifier.
- Typical uses are repeat X-rays, ECGs and injections, and repeated surgical procedures on the same day.
- A different practitioner repeating the service uses 77; a repeated lab test uses 91.
- Never on an E/M visit, and not for a service redone because the equipment failed.
- Medicare makes no fee adjustment for 76.
Modifier 76 · payment effect
With and without the modifier
71045 without 76 · national office
$25.38
Chest X-ray
71045-76 · No change to the rate
$25.38
Repeat procedure by the same physician: paid at the full rate when medically necessary.
What modifier 76 means
Payers' duplicate-claim edits deny a second line with the same code, patient, provider and date. Sometimes the second service is real: a patient's condition changes and the test has to be run again, or a procedure has to be redone later in the day. Modifier 76 says "this was a separate, later performance of the same service by the same person."
The repeat must be medically necessary on its own. The record should show the time of each service and why the second one was needed.
When to use modifier 76
- Repeat imaging after an intervention. A single-view chest X-ray (71045) in the morning, then another after a central line placement in the afternoon. Bill line 1 as 71045 and line 2 as 71045-76.
- Serial ECGs read by the same physician as a patient's chest pain evolves (93010 for the interpretation).
- A repeated procedure the same day, such as a second injection or a procedure redone in a later session.
Noridian's billing format: with two services, bill the code on one line with no modifier and the repeat on a second line with 76. With three or more, bill one line with the total units.
When not to use modifier 76
Also skip 76:
- On E/M visits. A second same-day visit isn't a "repeat procedure."
- When a different practitioner repeats the service. That's modifier 77.
- For both sides or different sites. Use RT and LT, 50, the digit modifiers (FA–F9, TA–T9) or eyelid modifiers (E1–E4). Noridian says 76 doesn't replace them.
- For a return to the operating room for a complication in the postoperative period. That's 78, even if the same code is repeated.
- On both lines. Only the repeat carries 76; putting it on every line can create duplicate denials.
How modifier 76 affects payment
CMS lists modifier 76 among those for which contractors make no adjustment to fee schedule amounts (Pub. 100-04, ch. 12, §20.5). The repeated service is paid at the same amount as the first, subject to the usual rules: diagnostic imaging in the same session may take the technical component reduction, surgical procedures can be ranked under the multiple procedure rule, and medically unlikely edits still cap units per day.
Modifier 76 vs 77, 91 and 59
FAQ
What is modifier 76 used for?
To bill a procedure or service that the same practitioner repeated later on the same day, so the second line isn't denied as a duplicate.
What is the difference between modifier 76 and 77?
76 is for a repeat by the same practitioner; 77 is for a repeat by a different practitioner. Both are for the same day and the same code.
Does modifier 76 reduce payment?
No. Medicare makes no adjustment for 76; the repeat is paid like the original, subject to normal imaging, multiple procedure and unit limits.
Can modifier 76 be used for lab tests?
No. Repeat clinical lab tests use modifier 91.
Should modifier 76 go on the first or second line?
The second. The first service is billed without a modifier, and only the repeat carries 76.
Keep reading
- Modifier 77 and modifier 91 for other repeats.
- Modifier 26 for interpretation-only billing of repeat studies.
- Modifier 78 for returns to the operating room.
- Codes on this page: 71045 71046 93010 93000
Sources: Medicare Claims Processing Manual, Pub. 100-04, ch. 12, §20.5 and §40.2.A.5; Noridian JE Part B, Modifier 76 (updated May 9, 2025). Verified October 6, 2026.
