The same surgeon performs several distinct surgical procedures through separate incisions during one operative session. Which modifier identifies the second and subsequent procedures so the payer can apply the multiple-procedure fee reduction?

Modifier -51 (Multiple procedures)

Modifier -59 (Distinct procedural service)

Modifier -22 (Increased procedural services)

Modifier -50 (Bilateral procedure)

A surgeon excises two separate benign lesions at two different anatomic sites during one operative session. How is this reported?

A separate excision code for each lesion, sized individually, with an appropriate distinct-service modifier when required

A single code representing the combined diameter of both lesions; when two lesions are excised at different sites their greatest diameters are added together and reported under one excision code sized to that total, rather than coding each lesion on its own line

One code for the largest lesion only, with the smaller lesion considered incidental to the same operative field and not separately reportable

One excision code with modifier -50

Surgical pathology codes (organized into ascending service levels) are leveled primarily by:

The type of specimen and the level of physician work/complexity required to examine it

The number of days the specimen is stored before examination

Whether the specimen was submitted by a surgeon or a primary-care provider

The global obstetric (maternity) package for routine care typically bundles:

Antepartum care, the delivery, and postpartum care combined into one global service

Only the delivery itself, with all antepartum and postpartum visits reported separately as individual services

Only the prenatal (antepartum) visits, with the delivery and postpartum care billed separately each time

The delivery plus newborn care rendered to the infant after birth, excluding the mother's prenatal visits

Under the Medicare RBRVS, a procedure's relative value units (RVUs) are composed of:

Physician work, practice expense, and malpractice (professional liability) RVUs — adjusted by geographic indices and multiplied by a conversion factor

Base, time, and modifying units; under RBRVS every procedure's relative value is built from an anesthesia-style formula of base units plus elapsed time units plus modifying units, which are then scaled by locality and a conversion factor to reach the allowed fee

Technical and professional components only

Facility and non-facility charges only

The HCPCS Level II modifier -KX is generally appended to indicate that:

Documentation on file supports that the medical-necessity/coverage requirements in the policy have been met

The item was rented rather than purchased

The patient signed an advance beneficiary notice accepting financial responsibility, which is the specific circumstance the -KX modifier was created to report

The service was reduced at the provider's discretion

When an adjacent tissue transfer or rearrangement (e.g., a flap such as a Z-plasty) is performed to close a defect, excision of the lesion that created the defect is:

Included in the adjacent tissue transfer code and not separately reported

Reported only if the lesion was malignant

Reported as a separate benign excision code

Always reported separately with modifier -59 to unbundle the lesion excision from the adjacent tissue transfer

Modifier -57 (decision for surgery) differs from modifier -25 in that -57 is appended to an E/M when the decision made is for:

A major surgery (90-day global) performed the day of or the day before the procedure

A minor procedure with a 0- or 10-day global period

A complete echocardiography study, versus a limited/follow-up study, generally requires:

Documentation supporting evaluation of all the required anatomic structures/components defined for the complete examination

A minimum of two hours of continuous cardiac monitoring together with at least one contrast-enhanced acquisition documented in the report

Only a single view of the heart

AAPC Certified Professional Coder (CPC) Practice Test

Test your knowledge with questions from all 7 exam topics.

AAPC Certified Professional Coder (CPC) Practice Test

Studying in order?

Practice stays free. The full AAPC CPC (Medical Coding) study guide is the material itself, taught start to finish — a downloadable PDF + EPUB you keep.

Get the book — $14.99

Certified Professional Coder (CPC®) Exam — Exam facts
Administering body	AAPC Source: AAPC — Taking the CPC Exam
Questions	100 questions Source: AAPC — Taking the CPC Exam
Time limit	240 minutes Source: AAPC — Taking the CPC Exam
Passing score	70% Source: AAPC — Taking the CPC Exam
Fees	$425 — CPC exam voucher, one attempt (AAPC, one-time) $499 — CPC exam voucher, two attempts (AAPC, one-time) $400 — Student exam pricing, one attempt (AAPC, one-time) $475 — Student exam pricing, two attempts (AAPC, one-time) Source: AAPC — Taking the CPC Exam
Languages offered	Not published by AAPC What we read and found nothing in: AAPC — Taking the CPC Exam

Exam facts, with a source for every line

Frequently asked questions

How many AAPC Certified Professional Coder (CPC) practice questions are here?+

A full bank of original AAPC Certified Professional Coder (CPC) practice questions across the official content areas, weighted like the real exam, with explanations. Free, no signup.

What is the AAPC Certified Professional Coder (CPC) exam like?+

About 100 questions, 240 minutes, and you need 70% to pass. Practice by topic here, then take the full timed mock exam to gauge readiness.

Are these the real exam questions?+

No. Every question is 100% original, written from public primary sources with explanations. We never copy real exam questions or paid prep material.

Can I study in Chinese or Spanish?+

PrepPass practice is in English, 中文 and Español. The official exam is in English — switch the question language to English any time to rehearse the exact terminology you'll see on test day.

Is there a study guide for the AAPC Certified Professional Coder (CPC)?+

Yes. PrepPass sells CPC — Medical Coding Concepts & Guidelines Study Guide (2026), a PDF + EPUB download, $14.99 one-time; the practice on this page stays free without it. See the study guide →

Sample practice questions

A few real questions from this free bank, with full explanations. Use the practice tool above for the whole set.

1. Surgery & Anatomy (CPT 10000-60000)
The same surgeon performs several distinct surgical procedures through separate incisions during one operative session. Which modifier identifies the second and subsequent procedures so the payer can apply the multiple-procedure fee reduction?
- a.Modifier -59 (Distinct procedural service)
- b.Modifier -22 (Increased procedural services)
- c.Modifier -51 (Multiple procedures)
- d.Modifier -50 (Bilateral procedure)
Answer: c
Explanation: Modifier -51 tells the payer that more than one procedure was performed in the same session by the same provider, so payment ranking (100% for the highest-valued, reduced for the rest) can be applied. -50 is only for mirror-image bilateral procedures, -59 unbundles services that are normally packaged together, and -22 signals substantially greater work than usual. Do not confuse the multiple-procedure concept (-51) with unbundling (-59).
2. Surgery & Anatomy (CPT 10000-60000)
A surgeon excises two separate benign lesions at two different anatomic sites during one operative session. How is this reported?
- a.A separate excision code for each lesion, sized individually, with an appropriate distinct-service modifier when required
- b.A single code representing the combined diameter of both lesions; when two lesions are excised at different sites their greatest diameters are added together and reported under one excision code sized to that total, rather than coding each lesion on its own line
- c.One code for the largest lesion only, with the smaller lesion considered incidental to the same operative field and not separately reportable
- d.One excision code with modifier -50
Answer: a
Explanation: Lesion excisions are reported per lesion — each excision is sized by its own greatest clinical diameter plus narrowest margins and coded individually. You never add two lesions' diameters together, and -50 (bilateral) applies only to mirror-image paired structures, not to two unrelated lesions. Modifier -59 or an anatomic modifier may be needed to show the lesions are distinct.
3. Pathology & Laboratory
Surgical pathology codes (organized into ascending service levels) are leveled primarily by:
- a.The type of specimen and the level of physician work/complexity required to examine it
- b.The number of days the specimen is stored before examination
- c.Whether the specimen was submitted by a surgeon or a primary-care provider
- d.The patient's age
Answer: a
Explanation: Surgical pathology levels ascend with the complexity of the specimen and the physician work needed to evaluate it — each level lists the specimens assigned to it. Coding is driven by matching the actual specimen to its designated level, not by storage time, patient age, or who submitted it. Each specimen is generally reported at its own appropriate level.
4. Medical Terminology, ICD-10-CM, HCPCS, Compliance
The combining form 'hepat/o' refers to which organ?
- a.Stomach
- b.Gallbladder
- c.Pancreas
- d.Liver
Answer: d
Explanation: Hepat/o = liver (hepatitis, hepatomegaly). Compare gastr/o (stomach), cholecyst/o (gallbladder), and pancreat/o (pancreas). The trap is confusing hepat/o (liver) with cholecyst/o (gallbladder), two neighboring digestive-system organs with different combining forms.
5. Surgery & Anatomy (CPT 10000-60000)
The global obstetric (maternity) package for routine care typically bundles:
- a.Antepartum care, the delivery, and postpartum care combined into one global service
- b.Only the delivery itself, with all antepartum and postpartum visits reported separately as individual services
- c.Only the prenatal (antepartum) visits, with the delivery and postpartum care billed separately each time
- d.The delivery plus newborn care rendered to the infant after birth, excluding the mother's prenatal visits
Answer: a
Explanation: The routine maternity global package includes antepartum care, the delivery itself, and postpartum care. Complications or unrelated problems are reported separately, and newborn care is a separate service to the infant. The trap is coding delivery-only when the same provider furnished the full spectrum of routine maternity care.
6. Medical Terminology, ICD-10-CM, HCPCS, Compliance
Under the Medicare RBRVS, a procedure's relative value units (RVUs) are composed of:
- a.Base, time, and modifying units; under RBRVS every procedure's relative value is built from an anesthesia-style formula of base units plus elapsed time units plus modifying units, which are then scaled by locality and a conversion factor to reach the allowed fee
- b.Technical and professional components only
- c.Facility and non-facility charges only
- d.Physician work, practice expense, and malpractice (professional liability) RVUs — adjusted by geographic indices and multiplied by a conversion factor
Answer: d
Explanation: The Resource-Based Relative Value Scale (RBRVS) builds each service's value from three RVU components — physician work, practice expense, and malpractice (professional liability) — each adjusted by geographic practice cost indices (GPCIs) and then multiplied by the annual conversion factor to yield payment. The trap is confusing RVUs with the anesthesia formula (base + time + modifying units), which is a separate payment method.
7. Medical Terminology, ICD-10-CM, HCPCS, Compliance
The HCPCS Level II modifier -KX is generally appended to indicate that:
- a.The item was rented rather than purchased
- b.The patient signed an advance beneficiary notice accepting financial responsibility, which is the specific circumstance the -KX modifier was created to report
- c.Documentation on file supports that the medical-necessity/coverage requirements in the policy have been met
- d.The service was reduced at the provider's discretion
Answer: c
Explanation: Modifier -KX attests that specific documentation and coverage-policy (often LCD) requirements for an item or service are met and available on request. It is not a reduced-service modifier and is distinct from ABN-related modifiers (-GA/-GX/-GZ).
8. Surgery & Anatomy (CPT 10000-60000)
When an adjacent tissue transfer or rearrangement (e.g., a flap such as a Z-plasty) is performed to close a defect, excision of the lesion that created the defect is:
- a.Reported only if the lesion was malignant
- b.Reported as a separate benign excision code
- c.Included in the adjacent tissue transfer code and not separately reported
- d.Always reported separately with modifier -59 to unbundle the lesion excision from the adjacent tissue transfer
Answer: c
Explanation: Per CPT integumentary guidelines, the excision (of a lesion or scar) that creates the defect is bundled into the adjacent tissue transfer/rearrangement code; it is not reported separately. These codes are selected by the anatomic site and the square-centimeter size of the defect (primary plus secondary).
9. E/M Services
Modifier -57 (decision for surgery) differs from modifier -25 in that -57 is appended to an E/M when the decision made is for:
- a.A minor procedure with a 0- or 10-day global period
- b.A diagnostic laboratory test
- c.A major surgery (90-day global) performed the day of or the day before the procedure
- d.A preventive-medicine service
Answer: c
Explanation: Modifier -57 flags the E/M at which the decision to perform a MAJOR (90-day global) surgery was made, on the day of or day before surgery. Modifier -25 is used for a significant, separate E/M on the same day as a MINOR procedure (0-/10-day global). Matching the modifier to the global period is essential.
10. Medicine
A complete echocardiography study, versus a limited/follow-up study, generally requires:
- a.A minimum of two hours of continuous cardiac monitoring together with at least one contrast-enhanced acquisition documented in the report
- b.Use of contrast in every case
- c.Only a single view of the heart
- d.Documentation supporting evaluation of all the required anatomic structures/components defined for the complete examination
Answer: d
Explanation: As with 'complete' ultrasound studies elsewhere, a complete echocardiogram requires documentation of the specified structures/elements; a limited or follow-up study evaluates fewer components. Add-on services such as Doppler/color-flow or contrast are reported separately when performed and supported.

Own the complete AAPC CPC (Medical Coding) guide — PDF + EPUB, $14.99 →