Fee Navigator®

    Health Service Code 35.0 A

    Dental extraction/treatment

    NOTE:

    May be claimed when performed by a physician on an emergency basis or when required as part of surgical repair of fractured mandible.

    Category:M Minor Procedure
    Base rate:$55.22

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    BMIBMIANTYesIncrease By25%
    ROLEANESTYesReplace Base$18.39
    ANUANU1For Each Call Pay Base At100%
    ANUANU2 - 150For Each Call Increase By$18.39
    UGAUGAYesReplace Base$134.85
    TRAYMINTIncrease By$13.11
    NBTRNBTRYes
    SURCEVYesIncrease By$48.70
    SURCNTAMYesIncrease By$116.83
    SURCNTPMYesIncrease By$116.83
    SURCWKYesIncrease By$48.70
    LVPLVP75YesReduce Base To75%

    Governing Rules: