Fee Navigator®

    Health Service Code 50.99E

    Peripheral embolectomy or endarterectomy, additional benefit

    NOTE:
    1. May only be claimed in association with other vascular surgery through the same arteriotomy.
    2. A single call applies regardless of the number of embolectomies or endarterectomies provided in the same vessel.
    3. Multiple calls may only be claimed when multiple vessels are treated.
    Category:14 Major Procedure (pre-operative period: 30 days, post-operative period: 14 days)
    Base rate:$205.71

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    BMIBMIANEYesIncrease By25%
    BMIBMIPROYesIncrease By25%
    ROLEANEYesReplace Base$111.05
    CALLNBRSER1For Each Call Pay Base At100%
    CALLNBRSER2 - 3For Each Call Pay Base At75%

    Governing Rules:

    • 6.8.1

      HSCs with a designated category code of 1 and 15 include related post-operative services and those with a designated category code of 3, 4, 6 and 14 include both related pre-operative and post-operative services.

      1. a consultation benefit may be claimed up to and including the day of surgery.
      2. pre-operative hospital care may be claimed by the physician who performs the surgery if information is submitted to show that conservative treatment was attempted before surgery was performed.
      3. benefits may be claimed as applicable for complications occurring during or following post-operative time periods.
      4. Deleted
      5. HSC 03.04R may be claimed in the pre-operative time frame when all conditions in the notes have been met.

      The following chart gives the pre-operative and post-operative periods.

      CategoryPre-operativePost-operative
      10 - Days14 - Days
      37 - Days7 - Days
      47 - Days14 - Days
      614 - Days14 - Days
      1430 - Days14 - Days
      150 - Days7 - Days