Fee Navigator®

    Health Service Code 49.0

    Pericardiocentesis

    NOTE:

    If a repeat service occurs within 14 days, benefit will be modified, refer to Price List.

    Category:M+ Designated Minor Procedure
    Base rate:$332.51

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    BMIBMIANEYesIncrease By25%
    BMIBMIANTYesIncrease By25%
    REPTREPTYesReplace Base$192.47
    ROLEANEYesReplace Base$112.39
    ROLEANESTYesReplace Base$18.70
    ANUANU1For Each Call Pay Base At100%
    ANUANU2 - 150For Each Call Increase By$18.70
    UGAUGAYesReplace Base$134.85
    SURCEVYesIncrease By$48.82
    SURCNTAMYesIncrease By$117.12
    SURCNTPMYesIncrease By$117.12
    SURCWKYesIncrease By$48.82
    LVPLVP75YesReduce Base To75%

    Governing Rules: