Anesthesia Modifiers Including Physical Status Modifiers:
All anesthesia services are reported by use of the anesthesia five-digit procedure code (00100-01999) plus
the addition of a physical status modifier. The use of other optional modifiers may be appropriate.
Physical Status Modifiers
Physical Status modifiers are represented by the initial letter ‘P’ followed by a single digit from 1 to 6
defined below:
P1 – A normal healthy patient.
P2 – A patient with mild systemic disease.
P3 – A patient with severe systemic disease.
P4 – A patient with severe systemic disease that is a constant threat to life.
P5 – A moribund patient who is not expected to survive without the operation.
P6 – A declared brain-dead patient whose organs are being removed for donor purposes.
The above six levels are consistent with the American Society of Anesthesiologists (ASA) ranking of patient physical status. Physical status is included in CPT to distinguish between various levels of
complexity of the anesthesia service provided.
Example: 00100-P1
Other Modifiers (Optional)
Under certain circumstances, medical services and procedures may need to be further modified. Other
modifiers commonly used in Anesthesia are included below. A complete list of modifiers and their
respective codes are listed in Appendix A.
-22 Unusual Procedural Services: When the service(s) provided is greater than that usually
required for the listed procedure, it may be identified by adding modifier ‘-22’ to the usual procedure
number or by use of the separate five digit modifier code 09922. A report may also be appropriate.
-23 Unusual Anesthesia: Occasionally, a procedure which usually requires either no anesthesia or
local anesthesia, because of unusual circumstances must be done under general anesthesia. This
circumstance may be reported by adding the modifier ‘-23’ to the procedure code of the basic service
or by use of the separate five digit modifier code 09923. Note: Modifier ‘-47’, Anesthesia by
Surgeon, (see modifier section) would not be used as a modifier for the anesthesia procedures 00100-
01999.
-32 Mandated Services: Services related to mandated consultation and/or related services (eg,
PRO, 3rd party payer) may be identified by adding the modifier ‘-32’ to the basic procedure, or the
service may be reported by use of the five digit modifier 09932.
