CommercialBilling CodesMedium impact
03.00.31g, Modifiers for Split or Shared Surgical Services (Modifiers 54, 55, and 56)
Independence Blue Cross·Medical Policy
Effective date
Apr 16, 2025
We identified it
Jun 19, 2026
Summary
Policy 03.00.31g provides guidance on the correct use of surgical modifiers 54, 55, and 56 for split or shared surgical services. This reissue (effective 04/16/2025) clarifies modifier application rules to ensure accurate billing when multiple providers participate in a single surgical procedure or when surgical care is divided between preoperative, intraoperative, and postoperative phases.
Action Required
By 04/16/2025: Billing team and providers must review and implement the updated modifier guidance in policy 03.00.31g. Verify that all surgical claims using modifiers 54 (surgical care only), 55 (postoperative management only), or 56 (preoperative evaluation and postoperative management only) comply with the reissued policy requirements. Update billing software rules and provider training materials to reflect correct modifier application. Claims submitted with incorrect modifier usage may be denied or subject to recoupment.