Fee Navigator®

    Health Service Code 65.7 A

    Repair of diaphragmatic hernia, abdominal approach, acquired

    NOTE:

    When performed with HSCs 56.93A or 56.93C, the benefit will be paid as ADD. Refer to the Price List.

    Category:14 Major Procedure (pre-operative period: 30 days, post-operative period: 14 days)
    Base rate:$685.37

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    BMIBMIANEYesIncrease By25%
    BMIBMIPROYesIncrease By25%
    BMIBMI2ANYesIncrease By25%
    ROLEANEYesReplace Base$262.24
    ROLESAYesReplace Base$148.42
    ROLESAQSYesReplace Base$51.10
    ROLESSSTYesReplace Base$325.09
    ROLE2ANESYesReplace Base$22.44
    VANEADDAReplace$254.64
    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%
    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%
    CAGECASRGYesIncrease Base To125%
    CAGECA2ANYesIncrease Base To125%
    LVPADDYesReplace$155.76
    LVPLVP75YesReduce Base To75%

    Governing Rules: