16.89A

Base Rate – $95.24
Name – Injection for discogram

Category – M+ Designated Minor Procedure

Fee Modifiers

Type Code # of calls Explicit Action Amount
CALL
CALL
SURC
SURC
SURC
SURC
LVP
NBRSER
NBRSER
EV
NTAM
NTPM
WK
LVP75

 2 – 3 
  
  
  
  
 
 
  
 Yes 
 Yes 
 Yes 
 Yes 
 Yes
For Each Call Pay Base At
For Each Call Pay Base At
Increase By
Increase By
Increase By
Increase By
Reduce Base To
100%
75%
$48.70
$116.83
$116.83
$48.70
75%

II – Operations On The Nervous System

/ 16 Operations On Spinal Cord And Spinal Canal Structures

// 16.8 Invasive diagnostic procedures on spinal cord and spinal canal structures

/// 16.89 Other invasive diagnostic procedures on spinal cord and spinal canal structures

//// 16.89A


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