Anesthesia Code Modifiers
| AA | Anesthesia services personally performed by anesthesiologist – Distinct fee schedule amount. Affects payment. |
| AD | Medical supervision by a physician: More than 4 concurrent anesthesia procedures. – Distinct fee schedule amount. Affects payment. |
| QK | Medical direction of 2, 3 or 4 concurrent anesthesia procedures involving qualified individuals – 1999 services limits the payment to 50% of the amount that would have been allowed if personally performed by a physician or non-supervised CRNA. |
| QS | Monitored anesthesia care – No effect on payment. For informational purposes only. Must be used in conjunction with a pricing anesthesia modifier. |
| QX | CRNA service with medical direction by physician – Payment is limited to 50% of the amount that would have been allowed if personally performed by physician or non-supervised CRNA. |
| QY | Medical direction of one certified registered nurse anesthetist (CRNA) by an anesthesiologist. |
| QZ | CRNA service without medical direction by a physician – No effect on payment. Payment is equal to the amount that would have been allowed if personally performed by a physician. |
| 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. Coverage /payment will be determined on a “by-report” basis. |
| 47 | Anesthesia by surgeon – Used to report regional or general anesthesia provided by the surgeon (Not covered by Medicare). |
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