Fee Navigator®

    Health Service Code 16.43D

    Repair of spine fracture/dislocation, posterior (cervical, thoracic, lumbar)

    Open reduction internal fixation, instrumentation and graft

    Additional notes:
    • Listed under 16 - OPERATIONS ON SPINAL CORD AND SPINAL CANAL STRUCTURES:

      The listed benefits are payable irrespective of the number of vertebrae involved if one incision utilized, unless otherwise stated.

    Category:14 Major Procedure (pre-operative period: 30 days, post-operative period: 14 days)
    Base rate:$1582.24

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    BMIBMIANEYesIncrease By25%
    BMIBMIPROYesIncrease By25%
    BMIBMI2ANYesIncrease By25%
    ROLEANEYesReplace Base$543.23
    ROLESAYesReplace Base$148.42
    ROLESAQSYesReplace Base$51.10
    ROLESSOSYesReplace Base$281.29
    ROLE2ANESYesReplace Base$22.44
    2ANU2ANU1For Each Call Pay Base At100%
    2ANU2ANU2 - 150For Each Call Increase By$22.44
    SAUSAU1For Each Call Pay Base At100%
    SAUSAU2 - 33For Each Call Increase By$37.13
    SSOUSSOU1For Each Call Pay Base At100%
    SSOUSSOU2 - 33For Each Call Increase By$93.76
    SAQUSAQU1 - 36For Each Call Pay Base At100%
    REDONUFRACYesIncrease Base To150%
    SURCEVYesIncrease By$48.82
    SURCNTAMYesIncrease By$117.12
    SURCNTPMYesIncrease By$117.12
    SURCWKYesIncrease By$48.82

    Governing Rules: