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    Health Service Code 53.34

    Total splenectomy of a normal sized spleen

    NOTE:
    1. A normal sized spleen is defined as 20 cms or less for patients 12 years of age and older and less than 12 cms for patients younger than 12 years of age.
    2. Benefits may not be claimed for incidential splenectomies.
    Category:14 Major Procedure (pre-operative period: 30 days, post-operative period: 14 days)
    Base rate:$839.88

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    BMIBMIANEYesIncrease By25%
    BMIBMIPROYesIncrease By25%
    BMIBMI2ANYesIncrease By25%
    ROLEANEYesReplace Base$354.21
    ROLESAYesReplace Base$148.05
    ROLESAQSYesReplace Base$50.97
    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%
    SURCEVYesIncrease By$48.70
    SURCNTAMYesIncrease By$116.83
    SURCNTPMYesIncrease By$116.83
    SURCWKYesIncrease By$48.70
    LMTSL44ANEYesIncrease Base By$108.34
    LVPLVP75YesReduce Base To75%

    Governing Rules: