Department of Veterans' Affairs Fee Schedules for Medical Services

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Item 100% MBS Item 100% MBS Item 100% MBS Item 100% MBS 55812 109.10 55851 76.45 56230 177.45 57007 567.75 55813 54.55 55852 109.10 56231 177.45 57041 233.40 55814 37.85 55853 54.55 56232 177.45 57047 283.90 55815 18.95 55854 37.85 56233 240.00 57201 155.20 55816 109.10 55855 18.95 56234 351.40 57247 77.55 55817 54.55 56001 195.05 56235 122.45 57341 470.00 55818 37.85 56007 250.00 56236 177.45 57345 241.60 55819 18.95 56010 252.10 56237 240.00 57350 510.00 55820 109.10 56013 250.00 56238 351.40 57351 510.00 55821 54.55 56016 290.00 56239 122.45 57355 264.15 55822 37.85 56022 225.00 56240 177.45 57356 264.15 55823 18.95 56025 113.15 56259 164.80 57360 700.00 55824 109.10 56026 56.60 56301 295.00 57361 350.00 55825 54.55 56028 336.80 56307 400.00 57506 29.75 55826 37.85 56030 225.00 56341 149.45 57509 39.75 55827 18.95 56036 336.80 56347 202.00 57512 40.50 55828 109.10 56041 98.75 56401 250.00 57515 54.00 55829 54.55 56047 126.10 56407 360.00 57518 32.50 55830 37.85 56050 128.20 56409 250.00 57521 43.40 55831 18.95 56053 128.20 56412 360.00 57524 49.40 55832 109.10 56056 155.45 56441 126.80 57527 65.75 55833 54.55 56062 113.15 56447 181.50 57529 14.90 55834 37.85 56068 168.40 56449 126.80 57530 19.90 55835 18.95 56070 113.15 56452 181.50 57532 20.25 55836 109.10 56076 168.40 56501 385.00 57533 27.00 55837 54.55 56101 230.00 56507 480.05 57535 16.25 55838 37.85 56107 340.00 56541 193.15 57536 21.70 55839 18.95 56141 116.45 56547 243.75 57538 24.70 55840 109.10 56147 171.60 56552 600.00 57539 32.90 55841 54.55 56219 326.20 56554 600.00 57700 40.50 55842 37.85 56220 240.00 56619 220.00 57702 20.25 55843 18.95 56221 240.00 56625 334.65 57703 54.00 55844 87.35 56223 240.00 56659 112.10 57705 27.00 55845 43.70 56224 351.40 56665 167.40 57706 32.50 55846 37.85 56225 351.40 56801 466.55 57708 16.25 55847 18.95 56226 351.40 56807 560.00 57709 43.40 55848 109.10 56227 122.50 56841 233.35 57711 21.70 55849 54.55 56228 122.50 56847 283.85 57712 47.15 55850 152.85 56229 122.50 57001 466.65 57714 23.60 66 1 NOVEMBER 2011 – 31 OCTOBER 2012
Item 100% MBS Item 100% MBS Item 100% MBS Item 100% MBS 57715 60.90 57963 47.40 58527 69.40 59301 44.75 57717 30.45 57965 23.70 58529 34.70 59303 53.95 57721 99.25 57966 47.40 58700 46.05 59304 27.00 57723 49.65 57968 23.70 58702 23.05 59306 100.30 57901 64.50 57969 47.40 58706 157.90 59307 50.15 57902 64.50 58100 67.15 58708 78.95 59309 200.60 57903 47.30 58102 33.60 58715 151.55 59310 100.30 57906 64.50 58103 55.10 58717 75.80 59312 87.00 57909 64.50 58105 27.55 58718 126.10 59313 43.50 57911 32.25 58106 77.00 58720 63.05 59314 52.50 57912 47.15 58108 110.00 58721 138.25 59315 26.25 57914 32.25 58109 47.00 58723 69.15 59318 47.05 57915 47.15 58111 38.50 58900 35.70 59319 23.55 57917 23.65 58112 97.25 58902 17.85 59503 89.40 57918 47.15 58114 55.00 58903 47.60 59504 44.70 57920 32.25 58115 110.00 58905 23.80 59700 96.55 57921 47.15 58117 23.50 58909 89.95 59701 48.30 57923 32.25 58120 110.00 58911 45.00 59703 75.90 57924 47.15 58121 110.00 58912 110.25 59704 37.95 57926 23.60 58123 48.65 58914 55.15 59712 113.70 57927 49.65 58124 55.00 58915 78.95 59713 56.85 57929 23.60 58126 55.00 58916 138.50 59715 143.55 57930 32.90 58127 55.00 58917 39.50 59716 71.80 57932 23.60 58300 40.10 58920 69.25 59718 134.65 57933 78.25 58302 20.05 58921 135.25 59719 67.35 57935 23.60 58306 89.40 58923 67.65 59724 226.45 57938 23.60 58308 44.70 58924 84.05 59725 113.25 57939 64.50 58500 35.35 58926 42.05 59733 107.70 57941 24.85 58502 17.70 58927 76.45 59734 53.85 57942 49.65 58503 47.15 58929 38.25 59736 62.00 57944 16.45 58505 23.60 58933 205.60 59737 31.00 57945 43.40 58506 60.75 58935 102.80 59739 73.75 57947 39.15 58508 30.40 58936 195.95 59740 36.90 57950 32.25 58509 39.75 58938 98.00 59751 139.15 57953 24.85 58511 19.90 58939 139.30 59752 69.60 57956 21.70 58521 43.40 58941 69.65 59754 219.35 57959 23.70 58523 21.70 59103 21.30 59755 109.70 57960 47.40 58524 56.50 59104 10.65 59760 115.15 57962 23.70 58526 28.25 59300 89.50 59761 57.60 1 NOVEMBER 2011 – 31 OCTOBER 2012 67
Page 1 and 2:
Department of Veterans’ Affairs F
Page 3 and 4:
DEPARTMENT OF VETERANS’ AFFAIRS M
Page 5 and 6:
LOCAL MEDICAL OFFICER FEE SCHEDULE
Page 7 and 8:
LOCAL MEDICAL OFFICER FEE SCHEDULE
Page 9 and 10:
DERIVED FEES - READY RECKONER FOR L
Page 11 and 12:
Item Nos. Patients LMO Fee 2631 1 $
Page 13 and 14:
REPATRIATION MEDICAL FEE SCHEDULE R
Page 15 and 16:
Item RMFS In Hospital % 359 439.20
Page 17 and 18: Item RMFS In Hospital % 11240 104.0
Page 29 and 30: Item 32168 169.80 32171 111.10 RMFS
Page 33 and 34: Item 35687 526.00 35688 526.00 3569
Page 35 and 36: Item 37221 676.75 37223 299.35 RMFS
Page 37 and 38: Item 38464 470.05 38466 1,295.60 38
Page 39 and 40: Item 39656 4,554.80 39658 5,214.20
Page 43 and 44: Item 42683 175.85 RMFS In Hospital
Page 49 and 50: Item 46315 1,374.70 46318 1,896.25
Page 51 and 52: Item 47432 669.70 RMFS In Hospital
Page 53 and 54: Item 48215 1,011.65 48218 963.75 48
Page 55 and 56: Item 49563 1,279.25 49564 1,525.10
Page 59 and 60: Item RMFS In Hospital % 52460 1,094
Page 61 and 62: RELATIVE VALUE GUIDE RELATIVE VALUE
Page 63 and 64: Item Relative Value Guide Item Rela
Page 65 and 66: Item Relative Value Guide Item Rela
Page 67: DIAGNOSTIC IMAGING SERVICES Item 10
Page 71 and 72: Item 100% MBS Item 100% MBS Item 10
Page 73 and 74: PATHOLOGY SERVICES PATHOLOGY FEE SC
Page 75 and 76: Item 100% MBS Item 100% MBS Item 10
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Department of Veterans' Affairs Fee Schedules for Medical Services

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