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    Health Service Code 49.7 JA

    Single chamber (right ventricular) implantable cardioverter defibrillator, insertion and testing

    1. May only be claimed by cardiologists or thoracic surgeons.
    2. May not be claimed in addition to electrophysiology studies (HSCs 49.98AA through 49.98Y).
    Category:14 Major Procedure (pre-operative period: 30 days, post-operative period: 14 days)
    Base rate:$1039.50

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    BMIBMIANEYesIncrease By25%
    BMIBMIPROYesIncrease By25%
    BMIBMI2ANYesIncrease By25%
    AGEL30Increase Base To150%
    ROLEANEYesReplace Base$783.36
    ROLESAYesReplace Base$148.05
    ROLESAQSYesReplace Base$50.97
    ROLESSCVTYesReplace Base$310.38
    ROLESSSTYesReplace Base$280.58
    ROLE2ANESYesReplace Base$22.07
    VANEL30ANIncrease By$108.34
    VANEL30AT2Increase By$108.34
    2ANU2ANU1For Each Call Pay Base At100%
    2ANU2ANU2 - 150For Each Call Increase By$22.07
    SAUSAU1For Each Call Pay Base At100%
    SAUSAU2 - 33For Each Call Increase By$37.04
    SAQUSAQU1 - 36For Each Call Pay Base At100%
    REDOCOMPLTYesIncrease Base To150%
    REDOPARTYesIncrease Base To125%
    REDOREDO1YesIncrease Base To175%
    REDOREDO2YesIncrease Base To225%
    REDOREDO3YesIncrease Base To275%
    REDOREDO4YesIncrease Base To325%
    REDOREDO5YesIncrease Base To375%
    SURCEVYesIncrease By$48.70
    SURCNTAMYesIncrease By$116.83
    SURCNTPMYesIncrease By$116.83
    SURCWKYesIncrease By$48.70
    LMTSL44YesIncrease Base To150%
    LMTSL44ANEYesIncrease Base By$108.34
    LVPLVP75YesReduce Base To75%

    Governing Rules: