Fee Navigator®

    Health Service Code 03.22B

    Multi-channel cystometrogram

    NOTE:
    1. Includes utilization of rectal and bladder pressures, electromyography as well as interpretation.
    2. Includes cystoscopy.
    Category:M+ Designated Minor Procedure
    Base rate:$86.67

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    BMIBMIANEYesIncrease By25%
    BMIBMIANTYesIncrease By25%
    ROLEANEYesReplace Base$111.05
    ROLEANESTYesReplace Base$18.70
    ANUANU1For Each Call Pay Base At100%
    ANUANU2 - 150For Each Call Increase By$18.70
    UGAUGAYesReplace Base$134.85
    TRAYMAJTIncrease By$38.88
    NBTRNBTRYes
    LVPLVP75YesReduce Base To75%

    Governing Rules: