Fee Navigator®

    Health Service Code 16.99A

    Epidural injection of steroids

    Additional notes:
    • Listed under 16 - OPERATIONS ON SPINAL CORD AND SPINAL CANAL STRUCTURES:

      The listed benefits are payable irrespective of the number of vertebrae involved if one incision utilized, unless otherwise stated.

    Category:M Minor Procedure
    Base rate:$111.11

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    BMIBMIPROYesIncrease By25%
    SURCEVYesIncrease By$48.70
    SURCNTAMYesIncrease By$116.83
    SURCNTPMYesIncrease By$116.83
    SURCWKYesIncrease By$48.70
    LVPLVP75YesReduce Base To75%

    Governing Rules:

    • 6.1

      If a physician performs a minor procedure and provides a service warranting a claim for an office visit or a home visit on the same day, benefits for both may be claimed only if the services and diagnoses are unrelated.

    • 6.2

      If a service is provided in a hospital emergency department, AACC or UCC, only the minor procedure or the visit benefit, whichever is the greater, may be claimed, unless the problems are emergencies and the diagnoses are unrelated.

    • 6.7.1

      If a minor procedure (M or M+) is provided with a hospital visit on the same day, only the greater benefit HSC may be claimed.