Fee Navigator®

    Health Service Code 55.2 A

    Surgical gastrostomy

    NOTE:
    1. Benefit will be paid at 100% when only procedure performed.
    2. When performed with other abdominal or gastrointestinal procedures, benefit will be paid as ADD or ADD2. Refer to Price List.
    Category:14 Major Procedure (pre-operative period: 30 days, post-operative period: 14 days)
    Base rate:$531.29

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    BMIBMIANEYesIncrease By25%
    BMIBMIANTYesIncrease By25%
    BMIBMIPROYesIncrease By25%
    ROLEANEYesReplace Base$206.05
    ROLEANESTYesReplace Base$18.70
    ROLESAYesReplace Base$148.42
    ROLESAQSYesReplace Base$51.10
    ROLESSSTYesReplace Base$325.09
    VANEL30ANIncrease By$110.16
    VANEL30ATIncrease By$110.16
    ANUANU1For Each Call Pay Base At100%
    ANUANU2 - 150For Each Call Increase By$18.70
    SAUSAU1For Each Call Pay Base At100%
    SAUSAU2 - 33For Each Call Increase By$37.13
    SAQUSAQU1 - 36For Each Call Pay Base At100%
    SURCEVYesIncrease By$48.82
    SURCNTAMYesIncrease By$117.12
    SURCNTPMYesIncrease By$117.12
    SURCWKYesIncrease By$48.82
    LMTSL40YesIncrease Base To150%
    LMTSL40ANEYesIncrease Base To150%
    LMTSL44ANEYesIncrease Base By$110.16
    CAGECAANEYesIncrease Base To125%
    CAGECAANTYesIncrease Base To125%
    CAGECASRGYesIncrease Base To125%
    LVPADDYesReplace$48.82
    LVPADD2YesReplace$252.33
    LVPLVP75YesReduce Base To75%

    Governing Rules: