Fee Navigator®

    Health Service Code 71.4 B

    Vaginal portion, combined sub-urethral sling procedure, when performed by two surgeons

    NOTE:
    1. HSC 82.64A may not be claimed in addition.
    2. When performed as a second or subsequent procedure through the same incision, the procedural rate should be claimed at 50% using modifier LVP50. Anesthetic claims using ANE for second and subsequent procedures should use the LVP75 modifier.
    3. An additional benefit of 100% may be claimed for a repeat by using modifier REPT.
    Category:14 Major Procedure (pre-operative period: 30 days, post-operative period: 14 days)
    Base rate:$335.46

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    BMIBMIANEYesIncrease By25%
    BMIBMIANTYesIncrease By25%
    BMIBMIPROYesIncrease By25%
    REPTREPTYesIncrease Base To200%
    ROLEANEYesReplace Base$355.90
    ROLEANESTYesReplace Base$18.70
    ROLESAYesReplace Base$148.42
    ROLESAQSYesReplace Base$51.10
    ROLESSSTYesReplace Base$325.09
    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
    LVPLVP50YesReduce Base To50%
    LVPLVP75YesReduce Base To75%

    Governing Rules:

    • 6.8.1

      HSCs with a designated category code of 1 and 15 include related post-operative services and those with a designated category code of 3, 4, 6 and 14 include both related pre-operative and post-operative services.

      1. a consultation benefit may be claimed up to and including the day of surgery.
      2. pre-operative hospital care may be claimed by the physician who performs the surgery if information is submitted to show that conservative treatment was attempted before surgery was performed.
      3. benefits may be claimed as applicable for complications occurring during or following post-operative time periods.
      4. Deleted
      5. HSC 03.04R may be claimed in the pre-operative time frame when all conditions in the notes have been met.

      The following chart gives the pre-operative and post-operative periods.

      CategoryPre-operativePost-operative
      10 - Days14 - Days
      37 - Days7 - Days
      47 - Days14 - Days
      614 - Days14 - Days
      1430 - Days14 - Days
      150 - Days7 - Days