X333

Base Rate – $126.22
Name – Ultrasound, venous, peripheral

Category – T Test

Fee Modifiers

Type Code # of calls Explicit Action Amount
AGE
CALL
CALL
CALL
CALL
L13
CALL13
CALL13
NBRSER
NBRSER
 
 1 
 2 – 4 
 1 
 2 – 4
 
  
  
  
 
Increase Base To
For Each Call Pay Base At
For Each Call Pay Base At
For Each Call Pay Base At
For Each Call Pay Base At
130%
130%
117%
100%
90%

Diagnostic Radiology

/ Diagnostic Ultrasound

// Peripheral Vascular System

/// –

//// X333


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