Fee Navigator®

    Health Service Code 01.14

    Other nonoperative gastroscopy

    Esophagogastroscopy

    NOTE:
    1. HSCs 11.02, 12.12B, 12.13A, 13.99AF, 54.21C, 54.21D, 54.21E, 54.91A, 54.91C, 54.92E, 54.99A, 55.1 B, 55.41A, 55.41B, 56.34A, 56.99A and 58.39B may be claimed in addition.
    2. Benefit includes biopsies.
    Category:M+ Designated Minor Procedure
    Base rate:$113.99

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    BMIBMIANEYesIncrease By25%
    BMIBMIPROYesIncrease By25%
    BMIBMI2ANYesIncrease By25%
    ROLEANEYesReplace Base$134.74
    ROLE2ANESYesReplace Base$22.44
    VANEL30ANIncrease By$110.16
    VANEL30AT2Increase By$110.16
    2ANU2ANU1For Each Call Pay Base At100%
    2ANU2ANU2 - 150For Each Call Increase By$22.44
    SURCEVYesIncrease By$48.82
    SURCNTAMYesIncrease By$117.12
    SURCNTPMYesIncrease By$117.12
    SURCWKYesIncrease By$48.82
    LMTSL44ANEYesIncrease Base By$110.16
    LVPLVP75YesReduce Base To75%

    Governing Rules: