76.89A

Base Rate – $37.35
Name – Injection of contrast media for corpus cavernosogram

Category – M Minor Procedure

Fee Modifiers

Type Code # of calls Explicit Action Amount
BMI
ROLE
ANU
ANU
SURC
SURC
SURC
SURC
LVP
BMIANT
ANEST
ANU
ANU
EV
NTAM
NTPM
WK
LVP75
 
  
 1 
 2 – 150 
  
  
  
  
 
Yes 
 Yes 
  
  
 Yes 
 Yes 
 Yes 
 Yes 
 Yes
Increase By
Replace Base
For Each Call Pay Base At
For Each Call Increase By
Increase By
Increase By
Increase By
Increase By
Reduce Base To
25%
$18.29
100%
$18.29
$48.70
$116.83
$116.83
$48.70
75%

XII – Operations On The Male Genital Organs

/ 76 Operations On Penis

// 76.8 Invasive diagnostic procedures on penis

/// 76.89 Other invasive diagnostic procedures on penis

//// 76.89A


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