Fee Navigator®

    Health Service Code 27.5 A

    Pediatric cataract extraction

    May only be claimed for children 6 years of age and under

    Category:14 Major Procedure (pre-operative period: 30 days, post-operative period: 14 days)
    Base rate:$1024.75

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    BMIBMIANEYesIncrease By25%
    BMIBMIANTYesIncrease By25%
    ROLEANEYesReplace Base$276.32
    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
    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: