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Current Procedural Terminology (CPT) coding permits inclusion of a two-digit modifier code to denote specifically tough processes necessitating additional reimbursement, labeled as the Modifier 22. The utilization of Modifier 22 with regards to pancreatic surgery and results, particularly pancreaticoduodenectomy (PD), has not been investigated. All PDs carried out from 2010-2019 at a quaternary medical system were reviewed for variations in preoperative attributes, out