Modifier 77: Repeat Procedure by Another Physician
Modifier 77 reports the same procedure repeated on the same day by a different physician. When to use it, 77 vs 76 and 91, and why it does not bypass NCCI.
Modifier 77 is a billing modifier that tells the payer a procedure or service was repeated, usually on the same day, by a different physician or qualified professional than the one who did it first. It keeps the second service from being rejected as a duplicate of the first. The most common uses are repeat X-rays and repeat ECG interpretations read by another physician later in the day.
Key takeaways
- 77 means a different physician repeated the service. The same physician repeating it uses modifier 76.
- The record must show why the repeat was needed, for example a new finding or a change in the patient's condition.
- 77 doesn't change payment. Each service is paid at its normal fee schedule amount.
- 77 is not an NCCI-associated modifier. It doesn't bypass procedure-to-procedure edits.
- Repeat clinical lab tests use 91, not 77.
Modifier 77 · payment effect
With and without the modifier
71046 without 77 · national office
$33.07
Chest X-ray
71046-77 · No change to the rate
$33.07
Repeat procedure by another physician: paid at the full rate when medically necessary.
When to use modifier 77
Use 77 when all of these are true:
- The same procedure code is billed twice for the patient on the same date of service.
- A different physician or qualified professional performed or interpreted the repeat, not the one who billed the first.
- The repeat was medically necessary. Noridian's example of acceptable documentation is a note of suspicious findings on the original X-ray.
Examples.
- A patient has a chest X-ray (71046) in the morning, read by one radiologist. After a central line is placed that afternoon, a second chest X-ray is read by a different radiologist. The second claim is 71046-77, or 71046-26-77 if only the interpretation is billed.
- A patient has an ECG in the emergency department, interpreted by one physician, and a repeat ECG after chest pain recurs, interpreted by a cardiologist. The cardiologist bills 93010-77.
When not to use modifier 77
- The same physician repeated the service. Use 76.
- A repeat clinical laboratory test. Use 91, which applies to tests paid under the clinical laboratory fee schedule.
- The service was repeated because the first attempt failed or the image was unreadable. That's part of doing the service once.
- A procedure in another surgery's global period. Use the global-surgery modifiers: 58, 78 or 79.
- Separate units of a code that allows multiple units per day. Bill the units on one line, within the code's unit limits.
How modifier 77 affects payment
Modifier 77 has no payment percentage. The repeated service is paid at its normal fee schedule amount; if only the professional component is billed, add 26 and the professional-component rate applies. Without 77, a second identical line for the same patient and date is likely to be rejected as a duplicate. Because a repeat is easy to question, MACs may ask for the record showing why it was needed.
Modifier 77 vs 76, 91 and 59
| Modifier | Use it when | Bypasses NCCI edits? |
|---|---|---|
| 77 | Same procedure repeated by a different physician | No |
| 76 | Same procedure repeated by the same physician | No |
| 91 | Repeat clinical lab test for a new result, paid under the clinical lab fee schedule | Yes |
| 59 | Two different, normally bundled procedures that were separate | Yes |
FAQ
What is the difference between modifier 77 and 76?
Who repeated the service. 76 is a repeat by the same physician; 77 is a repeat by a different physician. Both report the same code twice on the same day and neither changes payment.
When should modifier 77 be used?
When a different physician repeats a procedure or service that was already performed and billed for the patient that day, and the repeat was medically necessary.
What is the difference between modifiers 78 and 77?
77 is a repeat of the same service by another physician. 78 is a related return to the operating room during a surgery's postoperative period, paid only the intraoperative share.
Can modifiers 76 and 77 be used together?
Not on the same line. Each repeat is either by the same physician (76) or a different one (77). If a service is repeated more than once in a day by different physicians, each line carries the modifier that describes it.
Does modifier 77 bypass NCCI edits?
No. CMS's NCCI Policy Manual says 76 and 77 are not NCCI-associated modifiers.
Keep reading
- Modifier 76 for repeats by the same physician.
- Modifier 91 for repeat lab tests.
- Modifier 26 and TC for split professional and technical billing.
- Codes on this page: 71046 93010 93000
Sources: Medicare NCCI Policy Manual, ch. 1 (2026); Noridian JF Part B, Modifier 77 (updated May 9, 2025). Verified October 6, 2026.
