Fee Navigator®

    Health Service Code 01.22

    Other nonoperative colonoscopy

    NOTE:
    1. HSCs 13.99AE, 57.13A, 57.13B, 57.21A, 57.21B, 57.21C and 58.99C may be claimed in addition.
    2. Benefit includes biopsies.
    3. Benefit includes the removal of diminutive polyps that are 5mm or less in size.
    4. Refer to HSCs 01.22A, 01.22B and 01.22C for screening.
    Category:M+ Designated Minor Procedure
    Base rate:$185.86

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    BMIBMIANEYesIncrease By25%
    BMIBMIANTYesIncrease By25%
    BMIBMIPROYesIncrease By25%
    ROLEANEYesReplace Base$112.39
    ROLEANESTYesReplace Base$18.70
    VANEL30ANIncrease By$110.16
    VANEL30ATIncrease By$110.16
    ANUANU1For Each Call Pay Base At100%
    ANUANU2 - 150For Each Call Increase By$18.70
    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: