Fee Navigator®

    Health Service Code 51.61C

    Percutaneous cardiopulmonary bypass

    NOTE:
    1. May be claimed in addition to concomitant procedure fees.
    2. Benefit includes care, removal and hemostasis.
    Category:M Minor Procedure
    Base rate:$461.80

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    BMIBMIANEYesIncrease By25%
    BMIBMIANTYesIncrease By25%
    BMIBMIPROYesIncrease By25%
    ROLEANEYesReplace Base$111.05
    ROLEANESTYesReplace Base$18.70
    VANEADDAReplace$111.04
    VANEL30ANIncrease By$110.16
    VANEL30ATIncrease By$110.16
    ANUANU1For Each Call Pay Base At100%
    ANUANU2 - 150For Each Call Increase By$18.70
    LMTSL44ANEYesIncrease Base By$110.16
    LVPADDYesReplace Base100%

    Governing Rules:

    • 6.1

      If a physician performs a minor procedure and provides a service warranting a claim for an office visit or a home visit on the same day, benefits for both may be claimed only if the services and diagnoses are unrelated.

    • 6.2

      If a service is provided in a hospital emergency department, AACC or UCC, only the minor procedure or the visit benefit, whichever is the greater, may be claimed, unless the problems are emergencies and the diagnoses are unrelated.

    • 6.7.1

      If a minor procedure (M or M+) is provided with a hospital visit on the same day, only the greater benefit HSC may be claimed.