Fee Navigator®

    Health Service Code 78.99B

    Other tubal sterilization, any method

    NOTE:

    May not be claimed if sterilization is subsequent to a previous reversal. If a repeat procedure is required due to a previously failed attempt, supporting documentation must be provided.

    Category:14 Major Procedure (pre-operative period: 30 days, post-operative period: 14 days)
    Base rate:$226.83

    AMA billing tips:

    • If a patient previously had an insured tubal sterilization followed by a reversal, the second tubal sterilization is not considered to be an insured service and should be billed to the patient.

    Fee modifiers:

    TypeCode# of callsExplicitActionAmount
    BMIBMIANEYesIncrease By25%
    BMIBMIANTYesIncrease By25%
    BMIBMIPROYesIncrease By25%
    ROLEANEYesReplace Base$149.85
    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
    INCSDIFFYesIncrease Base By
    LVPLVP75YesReduce Base To75%

    Governing Rules: