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    Health Service Code 21.31B

    Probing and irrigation of nasolacrimal duct for patients 18 years of age and under

    1. May only be claimed when performed in an operating room, day surgery or non hospital surgical facility.
    2. Benefit rate includes both eyes.
    Common terms:
    • 18 years of age
    Category:M Minor Procedure
    Base rate:$261.45

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    BMIBMIANEYesIncrease By25%
    BMIBMIANTYesIncrease By25%
    ROLEANEYesReplace Base$110.53
    ROLEANESTYesReplace Base$18.39
    VANEL30ANIncrease By$108.34
    VANEL30ATIncrease By$108.34
    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
    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: