Billing modifier · CMS claims manual
Modifier 58: a planned follow-on procedure in the global period.
Modifier 58 reports a staged or related surgical procedure performed during the postoperative period of the first procedure when it was planned at the time, more extensive than the original, or therapy following a diagnostic surgical procedure. It is not used for a problem that needs a return to the operating room. A new postoperative period begins with the next procedure.
Modifier 58 at a glance
- Modifier
- 58: Staged or Related Procedure
- Used on
- Staged or related procedure in the postoperative period
- Medicare rule
- Not for a return to the OR; a new postoperative period begins with the next procedure
- Primary source
- CMS Ch. 12 s.40.2.A.6
What CMS says
CMS chapter 12, section 40.2.A.6: modifier 58 was established to facilitate billing of staged or related surgical procedures done during the postoperative period of the first procedure. It is not used to report treatment of a problem that requires a return to the operating room.
The three circumstances CMS lists are a procedure or service that was (a) planned prospectively or at the time of the original procedure, (b) more extensive than the original procedure, or (c) for therapy following a diagnostic surgical procedure. A new postoperative period begins when the next procedure in the series is billed.
Compare the global-period modifiers
Return trip to the OR for complications: modifier 78 (section 40.2.A.5). Unrelated procedure: modifier 79 (A.7), which also starts a new postoperative period. Unrelated E/M: modifier 24. Section 40.1.B separately says procedures staged prospectively, or clearly distinct procedures during the postoperative period that are not reoperations or complications treatment, are outside the global package.
Limits
CMS has a section for procedures billed with two or more surgical modifiers (40.9), so check it when 58 sits next to 51, 62 or others. The CPT descriptor is not reproduced here. Confirm payer-specific rules; some commercial payers handle staged procedures with their own policies.
Look-alike modifiers
- Modifier 54: Surgical care only.
- Modifier 57: Decision for surgery visit.
- Modifier 51: Multiple procedures at one session.
The full modifier descriptions are in the AMA CPT code book and the HCPCS Level II code set; this page covers only what the CMS claims manuals say about modifier 58.
Sources
- CMS: Medicare Claims Processing Manual, Chapter 12 (Rev. 13753, issued 05-07-26) — sections 40.1, 40.2.A.5 to A.7 and 40.9, global package and related modifiers (retrieved 2026-11-02)
Every rule above was read from these CMS pages on November 2, 2026. Payers revise policies and contracts, so confirm anything that affects a claim with the payer or your Medicare Administrative Contractor.
Frequently asked questions
When does a new global period start after modifier 58?
CMS says a new postoperative period begins when the next procedure in the series is billed.
Is modifier 58 for treating a complication that needs the OR?
No. CMS says it is not used for a problem requiring a return to the operating room; that is reported with modifier 78.
What three situations does CMS list for modifier 58?
A procedure planned at the time of the original, one more extensive than the original, or therapy following a diagnostic surgical procedure.
Not legal, billing or medical advice
This page explains published CMS manual text. It cannot see your claim, your contract or any payer’s policy. Confirm with the payer or your Medicare Administrative Contractor (MAC) before you bill, resubmit or appeal.