Fee Navigator

    Health Service Code 03.21A

    Upper urinary tract flow studies

    NOTE:
    1. Includes interpretation.
    2. Includes cystoscopy.
    Category:M+ Designated Minor Procedure
    Base rate:$164.33

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    BMIBMIANEYesIncrease By25%
    BMIBMIANTYesIncrease By25%
    ROLEANEYesReplace Base$131.04
    ROLEANESTYesReplace Base$18.39
    ANEUANEU1For Each Call Pay Base At100%
    ANEUANEU2 - 2For Each Call Pay Base At75%
    ANUANU1For Each Call Pay Base At100%
    ANUANU2 - 150For Each Call Increase By$18.39
    CALLNBRSER1For Each Call Pay Base At100%
    CALLNBRSER2 - 2For Each Call Pay Base At50%
    LVPLVP75YesReduce Base To75%

    Governing Rules: