If the doctor is appending the 26 modifier, what that means is that he is only doing the professional component of the procedure/test/diagnostic service. And what that means is that he is the one receiving and interpreting the results, and that someone else actually performed the procedure/test/diagnostic service, and they billed for it with a TC modifier, meaning they did the technical component.
If he is in fact performing the procedure, and then reading/interpreting the results, he should not use the 26 modifier. He would just bill the procedure with no 26 or TC modifier.