Fee Navigator®

    Health Service Code 49.7 MA

    Cardiac resynchronization defibrillator insertion and testing

    NOTE:
    1. May only be claimed by cardiologists or thoracic surgeons.
    2. May not be claimed in addition to electrophysiology studies (HSCs 49.98AA through 49.98Y).
    Category:14 Major Procedure (pre-operative period: 30 days, post-operative period: 14 days)
    Base rate:$1995.05

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    BMIBMIANEYesIncrease By25%
    BMIBMIPROYesIncrease By25%
    BMIBMI2ANYesIncrease By25%
    AGEL30Increase Base To150%
    ROLEANEYesReplace Base$1475.35
    ROLESAYesReplace Base$148.42
    ROLESAQSYesReplace Base$51.10
    ROLESSCVTYesReplace Base$312.56
    ROLESSSTYesReplace Base$325.09
    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
    SAUSAU1For Each Call Pay Base At100%
    SAUSAU2 - 33For Each Call Increase By$37.13
    SAQUSAQU1 - 36For Each Call Pay Base At100%
    REDOCOMPLTYesIncrease Base To150%
    REDOPARTYesIncrease Base To125%
    REDOREDO1YesIncrease Base To175%
    REDOREDO2YesIncrease Base To225%
    REDOREDO3YesIncrease Base To275%
    REDOREDO4YesIncrease Base To325%
    REDOREDO5YesIncrease Base To375%
    SURCEVYesIncrease By$48.82
    SURCNTAMYesIncrease By$117.12
    SURCNTPMYesIncrease By$117.12
    SURCWKYesIncrease By$48.82
    LMTSL44YesIncrease Base To150%
    LMTSL44ANEYesIncrease Base By$110.16
    LVPLVP75YesReduce Base To75%

    Governing Rules: