Fee Navigator

    Health Service Code 49.0

    Pericardiocentesis

    NOTE:

    If a repeat service occurs within 14 days, benefit will be modified, refer to Price List.

    Category:M+ Designated Minor Procedure
    Base rate:$218.04

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    BMIBMIANEYesIncrease By25%
    BMIBMIANTYesIncrease By25%
    REPTREPTYesReplace Base$126.21
    ROLEANEYesReplace Base$110.53
    ROLEANESTYesReplace Base$18.39
    ANUANU1For Each Call Pay Base At100%
    ANUANU2 - 150For Each Call Increase By$18.39
    UGAUGAYesReplace Base$134.85
    SURCEVYesIncrease By$48.70
    SURCNTAMYesIncrease By$116.83
    SURCNTPMYesIncrease By$116.83
    SURCWKYesIncrease By$48.70
    LVPLVP75YesReduce Base To75%

    Governing Rules: