Fee Navigator

    Health Service Code 22.51A

    Functional blepharoplasty - upper eyelid - without cosmetic intent

    NOTE:

    May only be claimed for patients where at least half the pupil is covered by the skin of the upper eyelids. Sufficient evidence to support this must be documented in the patient record.

    Category:14 Major Procedure (pre-operative period: 30 days, post-operative period: 14 days)
    Base rate:$392.26

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    BMIBMIANEYesIncrease By25%
    BMIBMIANTYesIncrease By25%
    ROLEANEYesReplace Base$150.17
    ROLEANESTYesReplace Base$18.39
    ROLESAYesReplace Base$148.05
    ROLESAQSYesReplace Base$50.97
    ROLESSSTYesReplace Base$280.58
    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
    SAUSAU1For Each Call Pay Base At100%
    SAUSAU2 - 33For Each Call Increase By$37.04
    SAQUSAQU1 - 36For Each Call Pay Base At100%
    CALLNBRSER1For Each Call Pay Base At100%
    CALLNBRSER2 - 2For Each Call Pay Base At75%
    TRAYMAJTIncrease By$38.78
    NBTRNBTRYes
    REDOREANEYesIncrease Base To125%
    REDOREOPYesIncrease Base To125%
    SURCEVYesIncrease By$48.70
    SURCNTAMYesIncrease By$116.83
    SURCNTPMYesIncrease By$116.83
    SURCWKYesIncrease By$48.70
    LVPLVP75YesReduce Base To75%

    Governing Rules: