Remember that certain procedures, and this would be mainly surgical procedures (10000-69999 CPT codes), are subjected to discounting. The first procedure pays at the full fee and the second and subsequent discount. Now the way it should work is the higher RVU should be the one that pays at the 100% rate, however in practice most payers have the system set to pay 100% of the one listed first and discount the second and subsequent. For this reason we do teach to code the higher RVU codes first ( but we really mean the higher RVU surgical CPT codes), and the subsequent in descending RVU order. This can be confusing when it comes to modifiers. Some teach to use the modifier on the second CPT code(s). In reality you want the modifier to do its job, and if you append it to the incorrect code it cannot do what you need. So the modifier needs to append to the code that would be considered bundled, and sometimes due to the very weird way they assign RVU values the modifier will be on the first listed code as that is the one with the higher RVU, but it is also the one that would be bundled. Sometimes you cannot find the logic, you just have to roll with.