Fee Navigator®

    Health Service Code 01.24B

    Flexible proctosigmoidoscopy, diagnostic only

    1. HSCs 13.99AE, 57.13A, 57.13B, 57.21A, 57.21B, 57.21C, 58.99C, and 58.99D may be claimed in addition.
    2. Benefit includes biopsies.
    3. Benefit includes the removal of diminutive polyps that are 5mm or less in size.
    Category:M+ Designated Minor Procedure
    Base rate:$74.92

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    BMIBMIANEYesIncrease By25%
    BMIBMIANTYesIncrease By25%
    BMIBMIPROYesIncrease By25%
    ROLEANEYesReplace Base$110.43
    ROLEANESTYesReplace Base$18.39
    VANEL30ANIncrease By$108.34
    VANEL30ATIncrease By$108.34
    ANUANU1For Each Call Pay Base At100%
    ANUANU2 - 150For Each Call Increase By$18.39
    UGAUGAYesReplace Base$134.85
    TRAYMAJTIncrease By$38.78
    SURCEVYesIncrease By$48.70
    SURCNTAMYesIncrease By$116.83
    SURCNTPMYesIncrease By$116.83
    SURCWKYesIncrease By$48.70
    LMTSL44ANEYesIncrease Base By$108.34
    LVPLVP75YesReduce Base To75%

    Governing Rules: