Fee Navigator®

    Health Service Code 98.22B

    Laceration, face, over 2.5 cms (1 unit) and/or body, over 5 cms (1 unit)

    For each layer or unit, refer to Price List


    The following applies to HSCs 98.22A and 98.22B.

    1. Benefit includes primary closure of wound by any method excluding adhesive tape skin closure or simple bandaging, normal wound care follow-up and suture removal.
    2. Where the laceration is treated with the use of adhesive tape skin closure or simple bandaging, a visit should be claimed.
    3. Where multiple lacerations are repaired, use the combined length.
    4. May only be claimed when the laceration is a result of a trauma either minor or major.
    5. May not be claimed in addition to an elective procedure.
    Category:1 Major Procedure (pre-operative period: 0 days, post-operative period: 14 days)
    Base rate:$61.77

    AMA billing tips:

    • Remember the 3 L's: Length, location, layers.

      Length and Location For total lengths that are over any unit by any amount, round up to the next unit. Facial lacerations = 2.5 cm per unit (ears, under jaw bone and hair line forward is considered the face). Body lacerations = 5.0 cm per unit (remainder of body including scalp)

      Layers For multiple layered lacerations, measure and count each layer separately

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    BMIBMIANEYesIncrease By25%
    BMIBMIANTYesIncrease By25%
    BMIBMIPROYesIncrease By25%
    AGEL10Increase Base To130%
    ROLEANEYesReplace Base$112.29
    ROLEANESTYesReplace Base$18.70
    ANUANU1For Each Call Pay Base At100%
    ANUANU2 - 150For Each Call Increase By$18.70
    CALLF2.5B51For Each Call Pay Base At100%
    CALLF2.5B52 - 12For Each Call Increase By$30.91
    TRAYMAJTIncrease By$38.88
    SURCEVYesIncrease By$48.82
    SURCNTAMYesIncrease By$117.12
    SURCNTPMYesIncrease By$117.12
    SURCWKYesIncrease By$48.82
    LVPLVP75YesReduce Base To75%

    Governing Rules: