Fee Navigator®

    Health Service Code 25.39D

    Phototherapeutic keratectomy - for corneal scar, epithelial irregularity or amblyogenic refractive error

    NOTE:

    May not be claimed for routine refractive purposes.

    Category:14 Major Procedure (pre-operative period: 30 days, post-operative period: 14 days)
    Base rate:$463.93

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    BMIBMIANTYesIncrease By25%
    ROLEANESTYesReplace Base$18.70
    ROLESAYesReplace Base$148.42
    ROLESAQSYesReplace Base$51.10
    ROLESSSTYesReplace Base$325.09
    ANUANU1For Each Call Pay Base At100%
    ANUANU2 - 150For Each Call Increase By$18.70
    SAUSAU1For Each Call Pay Base At100%
    SAUSAU2 - 33For Each Call Increase By$37.13
    SAQUSAQU1 - 36For Each Call Pay Base At100%
    TRAYMAJTIncrease By$38.88
    NBTRNBTRYes
    SURCEVYesIncrease By$48.82
    SURCNTAMYesIncrease By$117.12
    SURCNTPMYesIncrease By$117.12
    SURCWKYesIncrease By$48.82
    LVPLVP75YesReduce Base To75%

    Governing Rules: