[Federal Register Volume 66, Number 212 (Thursday, November 1, 2001)]
[Rules and Regulations]
[Pages 55246-55503]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 01-27275]
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Part II
Department of Health and Human Services
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Centers for Medicare & Medicaid Services
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42 CFR Part 405 et al.
Medicare Program; Revisions to Payment Policies and Five-Year Review of
and Adjustments to the Relative Value Units Under the Physician Fee
Schedule for Calendar Year 2002; Final Rule
Federal Register / Vol. 66, No. 212 / Thursday, November 1, 2001 /
Rules and Regulations
[[Page 55246]]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Parts 405, 410, 411, 414, and 415
[CMS-1169-FC]
RIN 0938-AK57
Medicare Program; Revisions to Payment Policies and Five-Year
Review of and Adjustments to the Relative Value Units Under the
Physician Fee Schedule for Calendar Year 2002
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Final rule with comment period.
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SUMMARY: This final rule with comment period makes several changes
affecting Medicare Part B payment. The changes affect: refinement of
resource-based practice expense relative value units (RVUs); services
and supplies incident to a physician's professional service; anesthesia
base unit variations; recognition of CPT tracking codes; and nurse
practitioners, physician assistants, and clinical nurse specialists
performing screening sigmoidoscopies. It also addresses comments
received on the June 8, 2001 proposed notice for the 5-year review of
work RVUs and finalizes these work RVUs. In addition, we acknowledge
comments received on our request for information on our policy for CPT
modifier 62 that is used to report the work of co-surgeons. The rule
also updates the list of certain services subject to the physician
self-referral prohibitions to reflect changes to CPT codes and
Healthcare Common Procedure Coding System codes effective January 1,
2002. These refinements and changes will ensure that our payment
systems are updated to reflect changes in medical practice and the
relative value of services.
The Medicare, Medicaid, and SCHIP Benefits Improvement and
Protection Act of 2000 modernizes the mammography screening benefit and
authorizes payment under the physician fee schedule effective January
1, 2002; provides for biennial screening pelvic examinations for
certain beneficiaries effective July 1, 2001; provides for annual
glaucoma screenings for high-risk beneficiaries effective January 1,
2002; expands coverage for screening colonoscopies to all beneficiaries
effective July 1, 2001; establishes coverage for medical nutrition
therapy services for certain beneficiaries effective January 1, 2002;
expands payment for telehealth services effective October 1, 2001;
requires certain Indian Health Service providers to be paid for some
services under the physician fee schedule effective July 1, 2001; and
revises the payment for certain physician pathology services effective
January 1, 2001. This final rule will conform our regulations to
reflect these statutory provisions.
In addition, we are finalizing the calendar year (CY) 2001 interim
RVUs and are issuing interim RVUs for new and revised procedure codes
for calendar year (CY) 2002. As required by the statute, we are
announcing that the physician fee schedule update for CY 2002 is -4.8
percent, the initial estimate of the Sustainable Growth Rate (SGR) for
CY 2002 is 5.6 percent, and the conversion factor for CY 2002 is
$36.1992.
DATES: Effective date: This rule is effective January 1, 2002.
Comment date: We will consider comments on the Clinical Practice
Expert Panel data, the physician self-referral designated health
services identified in Table 8, and the interim RVUs for selected
procedure codes identified in Addendum C if we receive them at the
appropriate address, as provided below, no later than 5 p.m. on
December 31, 2001.
ADDRESSES: Mail written comments (1 original and 2 copies) to the
following address: Centers for Medicare & Medicaid Services, Department
of Health and Human Services, Attention: CMS-1169-FC, P.O. Box 8013,
Baltimore, MD 21244-8013.
To insure that mailed comments are received in time for us to
consider them, please allow for possible delays in delivering them. If
you prefer, you may deliver your written comments (1 original and 2
copies) by courier to one of the following addresses: Room C5-14-03,
7500 Security Boulevard, Baltimore, MD 21244-8013 or Room 443-G, Hubert
H. Humphrey Building, 200 Independence Avenue, SW., Washington, DC
20201.
Comments mailed to the two above addresses may be delayed and
received too late for us to consider them.
Because of staff and resource limitations, we cannot accept
comments by facsimile (FAX) transmission. In commenting, please refer
to file code CMS-1169-FC.
For information on viewing public comments, please see the
beginning of the Supplementary Information section below.
FOR FURTHER INFORMATION CONTACT: Carolyn Mullen, (410) 786-4589 or Marc
Hartstein, (410) 786-4539 (for issues related to resource-based
practice expense relative value units).
Carlos Cano, (410) 786-0245 (for issues related to screening
sigmoidoscopies).
Paul W. Kim, (410) 786-7410 (for issues related to incident to
services).
Rick Ensor, (410) 786-5617 (for issues related to screening
mammography).
Bill Larson, (410) 786-4639 (for issues related to screening pelvic
examinations, screening for glaucoma, and coverage for screening
colonoscopies).
Bob Ulikowski, (410) 786-5721 (for issues related to the payment
for screening colonoscopies).
Mary Stojak, (410) 786-6939 (for issues related to medical
nutrition therapy).
Joan Mitchell, (410) 786-4508 (for issues related to the payment
for medical nutrition therapy).
Craig Dobyski, (410) 786-4584 (for issues related to telehealth).
Terri Harris, (410) 786-6830 (for issues related to Indian Health
Service providers).
Jim Menas, (410) 786-4507 (for issues related to anesthesia and
pathology services).
Joanne Sinsheimer (410) 786-4620 (for issues related to updates to
the list of certain services subject to the physician self-referral
prohibitions).
Diane Milstead, (410) 786-3355 (for all other issues).
SUPPLEMENTARY INFORMATION:
Inspection of Public Comments
Comments received timely will be available for public inspection as
they are received, generally beginning approximately 3 weeks after
publication of a document, at 7500 Security Blvd, Baltimore, Maryland
21244, Monday through Friday of each week from 8:30 a.m. to 5 p.m.
Please call (410) 786-7197 to make an appointment to view the public
comments.
Copies
To order copies of the Federal Register containing this document,
send your request to: New Orders, Superintendent of Documents, P.O. Box
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requested and enclose a check or money order payable to the
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cost for each copy is $9. As an alternative, you can view and photocopy
the Federal Register
[[Page 55247]]
document at most libraries designated as Federal Depository Libraries
and at many other public and academic libraries throughout the country
that receive the Federal Register.
To order the disks containing this document, send your request to:
Superintendent of Documents, Attention: Electronic Products, P.O. Box
37082, Washington, DC 20013-7082. Please specify, ``Medicare Program;
Revisions to Payment Policies Under the Physician Fee Schedule for
Calendar Year 2001,'' and enclose a check or money order payable to the
Superintendent of Documents, or enclose your VISA, Discover, or
MasterCard number and expiration date. Credit card orders can be placed
by calling the order clerk at (202) 512-1530 (or toll free at 1-888-
293-6498) or by faxing to (202) 512-1262.
This Federal Register document is also available from the Federal
Register online database through GPO Access, a service of the U.S.
Government Printing Office. The Website address is: http://www.access.gpo.gov/nara/index.html.
Information on the physician fee schedule can be found on our
homepage. You can access these data by using the following directions:
1. Go to the CMS homepage (http://www.cms.hhs.gov).
2. Click on ``Professionals.''
3. Under the heading ``Physicians and Health Care Professionals,''
click on ``Medicare Coding and Payment Systems.''
4. Select Physician Fee Schedule.
Or, you can go directly to the Physician Fee Schedule page by
typing the following: http://www.hcfa.gov/medicare/pfsmain.htm.
To assist readers in referencing sections contained in this
preamble, we are providing the following table of contents. Some of the
issues discussed in this preamble affect the payment policies but do
not require changes to the regulations in the Code of Federal
Regulations. Information on the regulation's impact appears throughout
the preamble and is not exclusively in section XIII.
Table of Contents
I. Background
A. Legislative History
B. Published Changes to the Fee Schedule
C. Components of the Fee Schedule Payment Amounts
D. Development of the Relative Value Units
II. Specific Provisions for Calendar Year 2002
A. Resource-Based Practice Expense Relative Value Units
B. Nurse Practitioners, Physician Assistants, and Clinical Nurse
Specialists Performing Screening Sigmoidoscopies
C. Services and Supplies Incident to a Physician's Professional
Services: Conditions
D. Anesthesia Services
E. Performance Measurement and Emerging Technology Codes
F. Payment Policy for CPT Modifier 62 (Co-Surgery)
III. Implementation of Medicare, Medicaid, and SCHIP Benefits
Improvement and Protection Act of 2000
A. Screening Mammography
B. Screening Pelvic Examinations
C. Screening for Glaucoma
D. Screening Colonoscopy
E. Medical Nutrition Therapy
F. Telehealth Services
G. Indian Health Service
H. Pathology Services
IV. Five-Year Review of Work Relative Value Units Under the
Physician Fee Schedule; Responses to Public Comments on the Five-
Year Review of Work Relative Value Units
V. Refinement of Relative Value Units for Calendar Year 2002 and
Response to Public Comments on Interim Relative Value Units for 2001
(Including the Interim Relative Value Units Contained in the August
2001 Proposed Rule)
A. Summary of Issues Discussed Related to the Adjustment of
Relative Value Units
B. Process for Establishing Work Relative Value Units for the
2002 Physician Fee Schedule
VI. Physician Self-Referral Prohibitions
VII. Physician Fee Schedule Update for Calendar Year 2002
VIII. Allowed Expenditures for Physicians' Services and the
Sustainable Growth Rate for Calendar Year 2002
A. Medicare Sustainable Growth Rate
B. Physicians' Services
C. Provisions Related to the SGR
D. Preliminary Estimate of the SGR for 2002
E. Sustainable Growth Rate for CY 2001
F. Sustainable Growth Rate for FY 2001
G. Calculation of the FY 2001, CY 2001, and CY 2002 Sustainable
Growth Rates
IX. Anesthesia and Physician Fee Schedule Conversion Factors for CY
2002
X. Provisions of the Final Rule
XI. Collection of Information Requirements
XII. Response to Comments
XIII. Regulatory Impact Analysis
Addendum A--Explanation and Use of Addendum B
Addendum B--2002 Relative Value Units and Related Information Used
in Determining Medicare Payments for 2002
Addendum C--Codes with Interim RVUs
Addendum D--2002 Geographic Practice Cost Indices by Medicare
Carrier and Locality
Addendum E--Updated List of CPT/HCPCS Codes Used to Describe Certain
Designated Health Services Under the Physician Self-Referral
Provision
In addition, because of the many organizations and terms to
which we refer by acronym in this final rule, we are listing these
acronyms and their corresponding terms in alphabetical order below:
AMA American Medical Association
BBA Balanced Budget Act of 1997
BBRA Balanced Budget Refinement Act of 1999
CF Conversion factor
CFR Code of Federal Regulations
CPT [Physicians'] Current Procedural Terminology [4th Edition,
1997, copyrighted by the American Medical Association]
CPEP Clinical Practice Expert Panel
CRNA Certified Registered Nurse Anesthetist
E/M Evaluation and management
EB Electrical bioimpedance
FMR Fair market rental
GAF Geographic adjustment factor
GPCI Geographic practice cost index
GDP Gross Domestic Product
CMS Centers for Medicare & Medicaid Services
HCPCS Healthcare Common Procedure Coding System
HHA Home health agency
HHS [Department of] Health and Human Services
IDTFs Independent Diagnostic Testing Facilities
MCM Medicare Carrier Manual
MedPAC Medicare Payment Advisory Commission
MEI Medicare Economic Index
MGMA Medical Group Management Association
MSA Metropolitan Statistical Area
NAMCS National Ambulatory Medical Care Survey
NCD National coverage determination
PC Professional component
PEAC Practice Expense Advisory Committee
PPAC Practicing Physicians Advisory Council
PPS Prospective payment system
RUC [AMA's Specialty Society] Relative [Value] Update Committee
RVU Relative value unit
SGR Sustainable growth rate
SMS [AMA's] Socioeconomic Monitoring System
TC Technical component
I. Background
A. Legislative History
Since January 1, 1992, Medicare has paid for physicians' services
under section 1848 of the Social Security Act (the Act), ``Payment for
Physicians' Services.'' This section provides for three major elements:
(1) a fee schedule for the payment of physicians' services; (2) a
sustainable growth rate for the rates of increase in Medicare
expenditures for physicians' services; and (3) limits on the amounts
that nonparticipating physicians can charge beneficiaries. The Act
requires that payments under the fee schedule be based on national
uniform relative value units (RVUs) based on the resources used in
furnishing a service. Section 1848(c) of the Act requires that national
RVUs be established for physician work, practice expense, and
malpractice expense.
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Section 1848(c)(2)(B)(ii)(II) of the Act provides that adjustments in
RVUs may not cause total physician fee schedule payments to differ by
more than $20 million from what they would have been had the
adjustments not been made. If adjustments to RVUs cause expenditures to
change by more than $20 million, we must make adjustments to preserve
budget neutrality.
B. Published Changes to the Fee Schedule
In the July 17, 2000 proposed rule (65 FR 44177), we listed all of
the final rules published through November 1999 relating to the updates
to the RVUs and revisions to payment policies under the physician fee
schedule.
In the June 8, 2001 Federal Register (66 FR 31028), we published a
proposed notice concerning the 5-year review of work RVUs.
In the August 2, 2001 proposed rule (66 FR 40373) we discussed
revisions contained in the November 1, 2000 final rule with comment
period and the following issues affecting Medicare payment under the
physician fee schedule:
We listed the revisions to payment policies under the
physician fee schedule that were made in the November 2000 final rule
with comment period (65 FR 65376).
We discussed policy issues affecting Medicare payment for
physicians' services, including--
--refinement of the resource-based practice expense relative value
units;
--services and supplies incident to a physician's professional service;
--anesthesia base unit variations;
--recognition of CPT tracking codes; and
--nurse practitioners, physician assistants, and clinical nurse
specialists performing screening sigmoidoscopies.
We also solicited comments on the payment policy for CPT modifier 62
used to report the work of co-surgeons.
In addition, the August 2, 2001 proposed rule addressed the
following provisions of the Medicare, Medicaid, and SCHIP Benefits
Improvement and Protection Act of 2000 (BIPA):
Payment for the screening mammography benefit under the
physician fee schedule effective January 1, 2002.
Biennial screening pelvic examinations for certain
beneficiaries effective July 1, 2001.
Annual glaucoma screenings for high-risk beneficiaries
effective January 1, 2002.
Expansion of coverage for screening colonoscopies to all
beneficiaries effective July 1, 2001.
Coverage for medical nutrition therapy services for
certain beneficiaries effective January 1, 2002.
Expansion of payment for telehealth services effective
October 1, 2001.
Payment for some services of certain Indian Health Service
providers under the physician fee schedule effective July 1, 2001.
Revision to the payment for certain physician pathology
services effective January 1, 2001.
This final rule affects the regulations set forth at Part 405,
Federal health insurance for the aged and disabled; Part 410,
Supplementary medical insurance (SMI) benefits; Part 411, Exclusions
from Medicare and limitations on Medicare payment; Part 414, Payment
for Part B medical and other health services; and Part 415, Services
furnished by physicians in providers, supervising physicians in
teaching settings, and residents in certain settings.
The information in this final rule finalizes information in the
June 8, 2001 proposed notice and the August 2, 2001 proposed rule.
C. Components of the Fee Schedule Payment Amounts
Under the formula set forth in section 1848(b)(1) of the Act, the
payment amount for each service paid under the physician fee schedule
is the product of three factors--(1) a nationally uniform relative
value for the service; (2) a geographic adjustment factor (GAF) for
each physician fee schedule area; and (3) a nationally uniform
conversion factor (CF) for the service. The CF converts the relative
values into payment amounts.
For each physician fee schedule service, there are three relative
values--(1) an RVU for physician work; (2) an RVU for practice expense;
and (3) an RVU for malpractice expense. For each of these components of
the fee schedule, there is a geographic practice cost index (GPCI) for
each fee schedule area. The GPCIs reflect the relative costs of
practice expenses, malpractice insurance, and physician work in an area
compared to the national average for each component.
The general formula for calculating the Medicare fee schedule
amount for a given service in a given fee schedule area can be
expressed as:
Payment = [(RVU work x GPCI work) + (RVU practice expense x GPCI
practice expense) + (RVU malpractice x GPCI malpractice)] x CF
The CF for calendar year (CY) 2002 appears in section XIII. The
RVUs for CY 2002 are in Addendum B. The GPCIs for CY 2002 can be found
in Addendum D.
Section 1848(e) of the Act requires us to develop GAFs for all
physician fee schedule areas. The total GAF for a fee schedule area is
equal to a weighted average of the individual GPCIs for each of the
three components of the service. In accordance with the statute,
however, the GAF for the physician's work reflects one-quarter of the
relative cost of physician's work compared to the national average.
D. Development of the Relative Value System
1. Work Relative Value Units
Approximately 7,500 codes represent services included in the
physician fee schedule. The work RVUs established for the
implementation of the fee schedule in January 1992 were developed with
extensive input from the physician community. A research team at the
Harvard School of Public Health developed the original work RVUs for
most codes in a cooperative agreement with us. In constructing the
vignettes for the original RVUs, Harvard worked with expert panels of
physicians and obtained input from physicians from numerous
specialties.
The RVUs for radiology services were based on the American College
of Radiology (ACR) relative value scale, which we integrated into the
overall physician fee schedule. The RVUs for anesthesia services were
based on RVUs from a uniform relative value guide. We established a
separate CF for anesthesia services, and we continue to recognize time
as a factor in determining payment for these services. As a result,
there is a separate payment system for anesthesia services.
II. Specific Proposals for Calendar Year 2002
In response to the publication of the August 2001 proposed rule, we
received approximately 2,000 comments. We received comments from
individual physicians, health care workers, and professional
associations and societies. The majority of comments addressed the
proposals related to medical nutrition therapy and the practice expense
refinement.
The proposed rule discussed policies that affected the number of
RVUs on which payment for certain services would be based. Certain
changes implemented through this final rule are subject to the $20
million limitation on
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annual adjustments contained in section 1848(c)(2)(B)(ii)(II) of the
Act.
After reviewing the comments and determining the policies we would
implement, we have estimated the costs and savings of these policies
and added those costs and savings to the estimated costs associated
with any other changes in RVUs for 2002. We discuss in detail the
effects of these changes in the Regulatory Impact Analysis in section
XIII.
For the convenience of the reader, the headings for the policy
issues correspond to the headings used in the August 2001 proposed
rule. More detailed background information for each issue can be found
in the June 2001 proposed notice with comment period and the August
2001 proposed rule.
A. Resource-Based Practice Expense Relative Value Units
1. Resource-Based Practice Expense Legislation
Section 121 of the Social Security Act Amendments of 1994 (Public
Law 103-432), enacted on October 31, 1994, required us to develop a
methodology for a resource-based system for determining practice
expense RVUs for each physician's service beginning in 1998. In
developing the methodology, we were to consider the staff, equipment,
and supplies used in providing medical and surgical services in various
settings. The legislation specifically required that, in implementing
the new system of practice expense RVUs, we apply the same budget-
neutrality provisions that we apply to other adjustments under the
physician fee schedule.
Section 4505(a) of the BBA amended section 1848(c)(2)(ii) of the
Act and delayed the effective date of the resource-based practice
expense RVU system until January 1, 1999. In addition, section 4505(b)
of the BBA provided for a 4-year transition period from charge-based
practice expense RVUs to resource-based RVUs. The practice expense RVUs
for CY 1999 were the product of 75 percent of charge-based RVUs and 25
percent of the resource-based RVUs. For CY 2000, the RVUs were 50
percent charge-based RVUs and 50 percent resource-based RVUs. For CY
2001, the RVUs are 25 percent charge-based and 75 percent resource-
based. After CY 2001, the RVUs will be totally resource-based.
Section 4505(e) of the BBA amended section 1848(c)(2) of the Act by
providing that 1998 practice expense RVUs be adjusted for certain
services in anticipation of implementation of resource-based practice
expenses beginning in 1999. As a result, the statute required us to
increase practice expense RVUs for office visits. For other services in
which practice expense RVUs exceeded 110 percent of the work RVUs and
were furnished less than 75 percent of the time in an office setting,
the statute required us to reduce the 1998 practice expense RVUs to a
number equal to 110 percent of the work RVUs. This reduction did not
apply to services that had proposed resource-based practice expense
RVUs that increased from their 1997 practice expense RVUs as reflected
in the June 18, 1997 proposed rule (62 FR 33196). The services affected
and the final RVUs for 1998 were published in the October 1997 final
rule (62 FR 59103).
Further legislation affecting resource-based practice expense RVUs
was included in the Balanced Budget Refinement Act of 1999 (BBRA)
(Public Law 106-113). Section 212 of the BBRA amended section
1848(c)(2)(ii) of the Act by directing us to establish a process under
which we accept and use, to the maximum extent practicable and
consistent with sound data practices, data collected or developed by
entities and organizations. These data would supplement the data we
normally collect in determining the practice expense component of the
physician fee schedule for payments in CY 2001 and CY 2002.
2. Current Methodology for Computing the Practice Expense Relative
Value Unit System
Effective with services furnished on or after January 1, 1999, we
established a new methodology for computing resource-based practice
expense RVUs that used the two significant sources of actual practice
expense data we have available--the Clinical Practice Expert Panel
(CPEP) data and the American Medical Association's (AMA) Socioeconomic
Monitoring System (SMS) data. The methodology was based on an
assumption that current aggregate specialty practice costs are a
reasonable way to establish initial estimates of relative resource
costs for physicians' services across specialties. The methodology
allocated these aggregate specialty practice costs to specific
procedures and, thus, can be seen as a ``top-down'' approach.
Discussion of the various elements of the methodology and their
application follows.
a. Practice Expense Cost Pools
We used actual practice expense data by specialty, derived from the
1995 through 1998 SMS survey data, to create six cost pools--
administrative labor, clinical labor, medical supplies, medical
equipment, office supplies, and all other expenses. There were three
steps in the creation of the cost pools. (Please note that the 1999 SMS
data are being incorporated for CY 2002.)
Step (1) We used the AMA's SMS survey of actual cost data
to determine practice expenses per hour by cost category. The practice
expenses per hour for each physician respondent's practice were
calculated as the practice expenses for the practice divided by the
total number of hours spent in patient care activities. The practice
expenses per hour for the specialty were an average of the practice
expenses per hour for the respondent physicians in that specialty. For
the CY 2000 physician fee schedule, we also used data from a survey
submitted by the Society of Thoracic Surgeons (STS) in calculating
thoracic and cardiac surgeons' practice expenses per hour. (Please see
the November 1999 final rule (64 FR 59391) for additional information
concerning acceptance of these data.) For CY 2001, we used these STS
data, as well as survey data submitted by the American Society of
Vascular Surgery and the Society of Vascular Surgery. (Please see the
November 2000 final rule (65 FR 65385) for additional information on
the acceptance of these data.)
Step (2) We determined the total number of physician hours
(by specialty) spent treating Medicare patients. This was calculated
from physician time data for each procedure code and from Medicare
claims data.
Step (3) We calculated the practice expense pools by
specialty and by cost category by multiplying the specialty practice
expenses per hour for each category by the total physician hours.
For services with work RVUs equal to zero (including the technical
component (TC) of services with a TC and a professional component
(PC)), we created a separate practice expense pool using the average
clinical staff time from the Clinical Practice Expert Panel (CPEP) data
(since these codes, by definition, do not have physician time) and the
``all physicians'' practice expense per hour.
b. Cost Allocation Methodology
For each specialty, we divided the six practice expense pools into
two groups, based on whether direct or indirect costs were involved,
and we used a different allocation basis for each group. The first
group included clinical labor, medical supplies, and medical equipment.
The second group included administrative labor, office expenses, and
all other expenses.
[[Page 55250]]
(i) Direct Costs
For direct costs (including clinical labor, medical supplies, and
medical equipment), we used the CPEP data as the allocation basis. The
CPEP data for clinical labor, medical supplies, and medical equipment
were used to allocate the costs for each of the respective cost pools.
For the separate practice expense pool for services with work RVUs
equal to zero, we used adjusted 1998 practice expense RVUs as an
interim measure to allocate the direct cost pools. (Please see the
November 1998 final rule (63 FR 58891) for further information related
to this adjustment.) Also, for all radiology services that are assigned
work RVUs, we used the adjusted 1998 practice expense RVUs for
radiology services as an interim measure to allocate the direct
practice expense cost pool for radiology. For all other specialties
that perform radiology services, we used the CPEP data for radiology
services in the allocation of that specialty's direct practice expense
cost pools.
(ii) Indirect Costs
To allocate the cost pools for indirect costs, including
administrative labor, office expenses, and all other expenses, we used
the total direct costs, as described above, in combination with the
physician fee schedule work RVUs. We converted the work RVUs to dollars
using the Medicare CF (expressed in 1995 dollars for consistency with
the SMS survey years).
The SMS pool was divided by the CPEP pool for each specialty to
produce a scaling factor that was applied to the CPEP direct cost
inputs. This was intended to match costs counted as practice expenses
in the SMS survey with items counted as practice expenses in the CPEP
process. When the specialty-specific scaling factor exceeded the
average scaling factor by more than 3 standard deviations, we used the
average scaling factor. (Please see the November 1999 final rule (64 FR
59390) for further discussion of this issue.)
For procedures performed by more than one specialty, the final
procedure code allocation was a weighted average of allocations for the
specialties that perform the procedure, with the weights being the
frequency with which each specialty performs the procedure on Medicare
patients.
c. Other Methodological Issues
(i) Global Practice Expense Relative Value Units
For services with the PC and TC paid under the physician fee
schedule, the global practice expense RVUs were set equal to the sum of
the PC and TC.
(ii) Practice Expenses per Hour Adjustments and Specialty Crosswalks
Since many specialties identified in our claims data did not
correspond exactly to the specialties included in the practice expense
tables from the SMS survey data, it was necessary to crosswalk these
specialties to the most appropriate SMS specialty category. We also
made the following adjustments to the practice expense per hour data.
(For the rationale for these adjustments to the practice expense per
hour, see the November 1998 final rule (63 FR 58841)).
We set the medical materials and supplies practice
expenses per hour for the specialty of ``oncology'' equal to the ``all
physician'' medical materials and supplies practice expenses per hour.
We based the administrative payroll, office, and other
practice expenses per hour for the specialties of ``physical therapy''
and ``occupational therapy'' on data used to develop the salary
equivalency guidelines for these specialties. We set the remaining
practice expense per hour categories equal to the ``all physician''
practice expenses per hour from the SMS survey data. (Note that in the
November 2000 final rule (65 FR 65403), we increased the space
allotment for therapy services to 750 square feet.)
Due to uncertainty concerning the appropriate crosswalk
and time data for the nonphysician specialty ``audiologist,'' we
derived the resource-based practice expense RVUs for codes performed by
audiologists from the practice expenses per hour of the other
specialties that perform these services.
For the specialty of ``emergency medicine,'' we used the
``all physician'' practice expense per hour to create practice expense
cost pools for the categories ``clerical payroll'' and ``other
expenses.''
For the specialty of ``podiatry,'' we used the ``all
physician'' practice expense per hour to create the practice expense
pool.
For the specialty of ``pathology,'' we removed the
supervision and autopsy hours reimbursed through Part A of the Medicare
program from the practice expense per hour calculation.
For the specialty ``maxillofacial prosthetics,'' we used
the ``all physician'' practice expense per hour to create practice
expense cost pools and, as an interim measure, allocated these pools
using the adjusted 1998 practice expense RVUs.
We split the practice expenses per hour for the specialty
``radiology'' into ``radiation oncology'' and ``radiology other than
radiation oncology'' and used this split practice expense per hour to
create practice expense cost pools for these specialties.
(iii) Time Associated With the Work RVUs
The time data resulting from the refinement of the work RVUs have
been, on average, 25 percent greater than the time data obtained by the
Harvard study for the same services. We adjusted the Harvard study's
time data to ensure consistency between these data sources.
For services with no assigned physician time, such as dialysis,
physical therapy, psychology, and many radiology and other diagnostic
services, we calculated estimated total physician time based on work
RVUs, maximum clinical staff time for each service as shown in the CPEP
data, or the judgment of our clinical staff.
We calculated the time for CPT codes (hereafter referred to as
``codes'') 00100 through 01996 using the base and time units from the
anesthesia fee schedule and the Medicare allowed claims data.
3. Refinement
a. Background
Section 4505(d)(1)(C) of the BBA directed us to develop a
refinement process to be used during each of the 4 years of the
transition period. We did not propose a specific long-term refinement
process in the June 1998 proposed rule (63 FR 30835). Rather, we set
out the parameters for an acceptable refinement process for practice
expense RVUs and solicited comments on our proposal. We received a
variety of comments about broad methodology issues, practice expense
per-hour data, and detailed code-level data. We made adjustments to our
proposal based on the comments we received. We also indicated that we
would consider other comments for possible refinement and that the RVUs
for all codes would be considered interim for 1999 and for future years
during the transition period.
We outlined in the November 1998 final rule (63 FR 58832) the steps
we were undertaking as part of the initial refinement process. These
steps included the following:
Establishment of a mechanism to receive independent advice
for dealing with broad practice expense RVU technical and
methodological issues.
Evaluation of any additional recommendations from the
General Accounting Office, the Medicare Payment Advisory Commission
(MedPAC), and the Practicing Physicians Advisory Council (PPAC).
[[Page 55251]]
Consultation with physician and other groups about these
issues.
We also discussed a proposal submitted by the AMA's Specialty
Society Relative Value Update Committee (RUC) for development of a new
advisory committee, the Practice Expense Advisory Committee (PEAC), to
review comments and recommendations on the code-specific CPEP data
during the refinement period. In addition, we solicited comments and
suggestions about our practice expense methodology from organizations
that have a broad range of interests and expertise in practice expense
and survey issues.
b. Current Status of Refinement Activities
In the 1999 and 2000 final rules and the 2001 proposed rule, we
provided further information on refinement activities underway,
including the AMA's formation of the PEAC and the support contract that
we awarded to the Lewin Group to focus on methodologic issues. In
addition, in these rules, we announced actions taken and decisions made
in response to the hundreds of comments received on our resource-based
physician practice expense initiative. Because the transition will be
completed in CY 2002 and the practice expense RVUs will then be totally
resource-based, it is appropriate to recap the specific achievements
reached and decisions implemented during this refinement effort to
date.
(i) Use of the Top-Down Approach
Most of the physician organizations commenting agreed that this
methodology was preferred for computing resource-based practice expense
RVUs and that it was in accordance with the requirements of the BBA.
KPMG Peat Marwick, under contract to us, reviewed the top-down
methodology in which aggregate specialty costs are applied to specific
procedures and concluded that it followed reasonable cost accounting
principles. A 1999 GAO report concludes, ``HCFA's new approach
represents a reasonable starting point for creating resource-based
practice expense RVUs. It uses the best available data for this purpose
and explicitly recognizes specialty differences in practice expense.''
Based on these comments and assessments, we made the decision to
continue to use the top-down methodology to calculate the resource-
based practice expense RVUs.
(ii) Use of the SMS Survey
The supplemental non-SMS survey data submitted by several
specialties in response to the 1998 proposed rule, with the exception
of the survey data from the thoracic surgeons, were not compatible with
the format or methodology of the SMS. We awarded a contract to the
Lewin Group to recommend criteria for the acceptance of specialty-
specific practice expense data so that we could supplement the SMS data
as appropriate. These recommended criteria are contained in the final
report, ``An Evaluation of the Health Care Financing Administration's
Resource-Based Practice Expense Methodology.'' This report is available
on our web page under the same title. (Access to our web site is
discussed in the Supplementary Information section above.)
The report also contains recommendations for revisions to the SMS
or other surveys to efficiently meet the needs of our practice expense
methodology. We augmented these recommendations and forwarded our
suggestions for revisions to any future surveys to the AMA. For
example, we developed supplementary survey questions that would allow
us to distinguish both costs and direct patient care hours for all
midlevel practitioners. We also suggested revisions that would capture
the necessary information on separately billable supplies and services
so that we could eliminate these costs from the specialty-specific
practice expense per-hour calculations.
To obtain supplementary specialty-specific practice expense data
that could be used in computing practice expense RVUs beginning January
1, 2001, we published an interim final rule on May 3, 2000 (65 FR
25664) that set forth the criteria applicable to supplemental survey
data submitted to us by August 1, 2000.
We also provided a 60-day period for submission of public comments
on our criteria for survey data submitted between August 2, 2000 and
August 1, 2001 for use in computing the practice expense RVUs for the
CY 2002 physician fee schedule.
In the November 1, 2000 final rule (65 FR 65385), we responded to
comments received on the interim final rule and made modifications to
the criteria for supplemental survey data that will be considered in
computing practice expense RVUs for the CY 2002 physician fee schedule.
These data can then be used to supplement the SMS survey data currently
used to estimate each specialty's aggregate practice costs or to
replace the crosswalks used for specialties not represented in the SMS.
In our November 1999 final rule, we accepted supplementary data
submitted by the thoracic surgeons and, in our November 2000 final
rule, we accepted survey data from the vascular surgeons that replaced
the previously crosswalked practice expense per hour data for that
specialty. In the November 2000 final rule, we also stated that if we
received additional specialty-specific survey data before August 1,
2001 that met the criteria outlined in that rule, we would use these
supplementary data in calculating the CY 2002 practice expense RVUs.
We accepted our contractor's recommendation to incorporate the
latest SMS data into our practice expense per hour calculations. For CY
2001, we incorporated the 1998 SMS data into a 4-year average, and we
are incorporating the 1999 SMS data into a 5-year average to calculate
the CY 2002 practice expense RVUs.
We also accepted the contractor's recommendation to standardize the
survey practice expense data to a common year. We adjusted the data to
reflect a 1995 cost year.
We received comments that urged us to use the median SMS specialty-
specific data instead of the mean, as well as comments supporting our
use of the mean values. We made a decision to continue to use the mean
in calculating the specialty-specific practice expense per hour. We
believe that, in a small sample, using the median could eliminate
outlying data from the calculation that represent real costs and thus
should be considered.
(iii) CPEP Data
The AMA has formed a multispecialty sub-committee of their Relative
Value Update Committee (RUC), the Practice Expense Advisory Committee
(PEAC), to review the CPEP clinical staff, equipment, and supply data
for all physicians' services. This multispecialty committee, which
includes representatives from all major specialty societies, will then
make recommendations on suggested refinements to these data. We
indicated in our November 1998 final rule (63 FR 58833) that we would
work with the PEAC and RUC to refine the practice expense direct cost
inputs. This refinement process was supported in comments we received
from almost every major physician specialty society.
In our November 1999 physician fee schedule final rule, we
implemented most clinical staff time, supply and equipment refinements
recommended by the RUC. For the November 2000 final rule, the RUC
forwarded to us significant additional refinement recommendations that
reflected multispecialty agreement on the typical resources for many
important services, including visit codes, which account for
[[Page 55252]]
approximately 24 percent of Medicare spending for physicians' services.
Again we accepted almost all of these RUC recommendations. In addition,
at its October 2000, February 2001, and April 2001 meetings, the PEAC
focused on refining high-volume services and on standardizing inputs
across wide ranges of services. The RUC and PEAC forwarded to us
recommendation on refinements for over 1,100 services. We anticipate
that the pace of refinement of the CPEP inputs will continue to
accelerate.
In addition to implementing most of the RUC-recommended
refinements, we responded to comments on errors and anomalies in the
CPEP data in both the November 1999 and November 2000 final rules. For
example, we removed separately billable casting supplies and drugs from
all services; we adjusted the prices of certain supplies that were
clearly in error; we removed duplicated equipment from the direct
inputs of the nuclear medicine codes; we added clearly essential
equipment that was missing from the lithotripsy and photochemotherapy
codes; we corrected anomalies in inputs within several families of
codes; and we changed the crosswalks for the CPEP inputs of several
codes not valued by the CPEP panels when a commenter suggested more
appropriate crosswalks.
We simplified the refinement of equipment inputs by combining both
the procedure-specific and overhead equipment into a single equipment
category. We also deleted stand-by equipment and equipment used for
multiple services at one time from the direct cost inputs because of
the difficulty of allocating these costs at the code-specific level.
We are resolving issues related to averaging input costs for codes
that were valued by more than one CPEP panel. While we have received
comments agreeing and disagreeing with our use of mean costs, the issue
is moot because we are substituting refined data for the data
previously produced by multiple CPEPs.
(iv) Physician Time Data
In the November 1999 rule (64 FR 59404), we stated that, in
general, requests for revisions for the procedure-specific physician
times should be deferred to either the RUC process or the 5-year review
process. However, we did adopt the newer data to correct the physician
time for the pediatric surgery codes and made the requested revisions
to correct anomalies in the times of certain psychotherapy codes.
In response to comments on the times associated with physical and
occupational therapy services, we added preservice and postservice
times to all of these codes.
(v) Crosswalk Issues
In response to concerns expressed by specialty societies
representing emergency medicine that the SMS data did not capture the
costs of uncompensated care, we crosswalked emergency medicine's cost
pools for administrative labor and other expenses to the practice
expense per hour for ``all physicians.''
We resolved issues related to the specialty crosswalk for nursing
specialties by eliminating the separate practice expense pools for
midlevel practitioners.
(vi) Calculation of Practice Expense Pools--Other Issues
We addressed concerns that potential errors in our specialty
utilization data will have an effect on the calculation of practice
expense RVUs. In the July 2000 proposed rule (65 FR 44178), we
discussed our simulations that demonstrated that the small percentage
of potential errors in our very large database have no adverse effect
on specialty-specific practice expense RVUs.
We have created the zero-work pool for services with no physician
work to ensure that these services are not inappropriately
disadvantaged by our methodology. We have also agreed with the request
of all the specialty societies that commented that their services
should be moved out of the zero-work pool and into the specialty-
specific pool. The specialties whose services remain in the zero-work
pool have indicated that they wish their services to remain there. We
plan to eliminate this separate pool for services with no physician
work only when we have determined what revisions to our methodology are
required so that we can value these services appropriately outside of
the zero-work pool.
(vii) Calculation of Indirect Cost
We requested that our contractor evaluate various options for
calculating indirect costs. The final report, referenced above,
contains an analysis of the impacts of six alternative allocation
methodologies. In confirming the suitability of our allocation
methodology, the report concludes that ``HCFA's approach is broadly
consistent with most of the alternative methods. This consistency
suggests that, from a broad perspective, no other allocation
methodology offers a compelling reason to abandon the current HCFA
approach.''
(viii) Site-of-Service
The practice expense RVUs would be expected to be higher in the
nonfacility setting, where the practitioner bears the costs of the
necessary staff, supplies, and equipment, than in the facility setting.
To prevent potential anomalies in our calculations due to the different
mix of specialties performing a given service in different settings, we
capped the practice expense RVUs for a physician service in facilities
at the nonfacility practice expense level for each specific service.
In the November 1999 final rule (64 FR 59407), in response to a
comment from the Renal Physicians Association, we agreed that the
monthly capitated service codes should always be reported using the
nonfacility designation. The site-of-service designations are not
meaningful for a monthly service that may be provided in different
settings for the same patient during a given month.
Although we are continuing our refinement of all practice expense
RVUs, we believe that the above description of our actions to date
illustrates that much has been accomplished. We also believe that it
demonstrates that we have been responsive to comments from the medical
community and have established a process that enables this community to
participate fully in the refinement of both the specialty-specific
practice expense per hour and the CPEP code-specific inputs.
4. Practice Expense Provisions for Calendar Year 2002
a. SMS Data
(i) Use of 1999 SMS Survey Data
We are currently using data from the 1995 through the 1998 SMS
surveys (1994 through 1997 practice expense data) in order to calculate
the specialty-specific practice expense per hour. The 1999 SMS survey
data are now available. Because we want to incorporate the most recent
survey data into our methodology during the transition period, we
proposed in our August 2001 rule (66 FR 40377) to add this 1999 data to
the 4 years of data we are currently using.
We proposed to use these 5 years of data in addition to any
supplemental specialty-specific data that meet our criteria as the
basis of the practice expense per hour calculations until the first 5-
year review of practice expense RVUs in 2007. At that time, we
anticipate that newer practice expense survey data might be available.
Comment: Specialty societies representing internal medicine, family
[[Page 55253]]
practice and a number of their subspecialties were opposed to using the
1999 SMS data in the calculation of the practice expense RVUs. While
many of these commenters were generally supportive of incorporating the
most current SMS data, they are concerned that the sample size and
results from the 1999 SMS data may not warrant their inclusion. Several
of these commenters indicated that the American Medical Association is
on record stating that ``it normally would not provide or publish data
with so few responses for some specialties.''
A number of these commenters suggested that the practice expense
information from the 1999 SMS would be less reliable because the data
were collected after CMS announced the new resource-based practice
expense methodology in the Federal Register. These commenters suggested
that the opportunity for ``gaming'' now exists because the public was
aware that the SMS data were used to calculate Medicare payments.
One commenter noted that the practice expense per hour for
cardiology dropped by 15 percent in one year and doubted that the
actual change in practice expense of this magnitude could have
occurred. Another commenter indicated that the cardiac subspecialty of
electrophysiology is very likely not represented at all in this flawed
data set.
One association that represents eye surgeons commented that the
1999 SMS survey included about half as many usable responses as the
1995 through 1997 surveys. This commenter questioned our decision to
disregard responses received by mail and indicated that an already poor
response rate to the survey has become even lower. Another commenter
that represents ophthalmology indicated that use of 1999 data with such
low response rates violates good statistical practice. The 1999
responses included only 23 ophthalmologists, while over 200 offered
responses to the survey in years before 1999. Another commenter that
represents gastroenterology indicated that the SMS is perhaps the best
available source of data on multispecialty practice costs. However,
this comment indicated that it is by no means a perfect data source for
the manner in which it has been used by CMS and is even less reliable
for certain specialties, such as gastroenterology. This commenter
appreciates our willingness to accept supplementary data from
specialties, but believes that it is our responsibility to overcome
data deficiencies. We were encouraged to develop a uniform and fair
process to overcome data deficiencies, without relying on individual
medical specialties to provide such data.
In light of AMA's suspension of the SMS survey, this commenter
urged us to discuss in the final rule our plans for updating practice
expense RVUs in future years beginning with 2003, and, if need be, for
replacing the SMS survey with an alternative data source. Another
commenter expressed concern that the newer data from the SMS surveys
will not be incorporated until the first 5-year review of practice
expense RVUs in 2007; by that time, some of the practice expense data
will have been in existence for 13 years.
Similarly, another commenter expressed concern that using the SMS
data set from 1995 through 1999 until 2007 will mean that the data will
not accurately reflect the changes in technology that will increase
costs, particularly for specialties with rapid changes in technology.
Response: In response to the comment that the SMS data are not a
perfect data source for developing practice expense RVUs, as we have
said previously, we believe the SMS survey is the best available source
of data on multispecialty practice costs. This comment was echoed by
one of the same commenters that objected to including the 1999 SMS data
in the practice expense methodology for determining 2002 RVUs. While we
have previously acknowledged that the data have potential limitations
for determining practice expense RVUs, there are no alternative data
sources that are better for this purpose.
Since there are no other data on aggregate multispecialty practice
costs that are better than the SMS, our only alternative would be to
eliminate the SMS data from the methodology and rely solely on
estimates of practice expense inputs for individual codes. We believe a
better approach would be to continue using the SMS data in the practice
expense methodology and to work with the physician community to develop
even better data for establishing practice expense RVUs in the future.
One commenter noted that we only included telephone survey
responses and not mail responses from the 1999 SMS and suggested that
this decision further reduces an already low response rate. Our
understanding is that the AMA, as a result of concerns about a
declining number of responses to the SMS survey, used several
approaches to obtain more surveys in the 1999 SMS. As part of this
effort, some survey respondents received a mail survey instead of the
normal telephone survey. Our review of information from the AMA
suggested that there were significant differences between the mail and
telephone surveys on questions related to practice expense. Since our
objective has been to use a consistent approach to obtaining practice
expense data for use in our methodology, we felt that it would be
better to incorporate only the traditional telephone survey responses
in the methodology consistent with how the data were obtained in
earlier years.
While a few commenters indicated that the SMS data are not
representative of a particular specialty's costs, they provided no
information to support the contention. One commenter suggested that
electrophysiology, a subspecialty of cardiology, was unlikely to be
included in the SMS survey. Since the SMS survey draws a random sample
from the AMA's Physician Masterfile, we believe all physicians are
equally likely to be selected for participation in the survey. We would
further note that the SMS weights response information based on known
characteristics of the population to make the final figures as
representative of the self-employed population as possible. As we have
stated previously, we believe the SMS survey is the best source of data
for specialty practice expenses. If a specialty believes that the SMS
is unrepresentative of their actual practice expenses, we have
established a process by which additional data can be submitted to us.
To date, we have used two specialty practice expense surveys in
addition to or in place of the SMS survey. We encourage specialties to
use this process to provide us with additional practice expense data
that improve the representativeness of the data that we are using to
determine the practice expense RVUs.
One commenter doubted that cardiology practice expense could have
declined as much as suggested by the 1999 SMS data. We would note that
the practice expense per hour in any given year can show more
variability than the change in practice expense per hour over time.
While the specialty of cardiology shows some level of variability in
practice expense per hour, with some years showing a higher value than
the average and other years a lower value, the change in practice
expense per hour including the 1999 SMS data is far more modest than
that suggested by the commenter. There is a -2.0 percent change in
practice expense per hour as a result of including the 1999 SMS data.
As indicated below, use of the 1999 SMS data changed average specialty
level payments to cardiologists by less than 0.5 percent.
[[Page 55254]]
We acknowledge that response rates and the number of usable
responses from the 1999 SMS are lower than in prior years.
Nevertheless, as we have stated previously, it is unclear to us why
this alone indicates that we should reject incorporating the data. To
the extent that there are few responses to the latest SMS survey, there
will be less impact on a given specialty because the practice expense
per hour calculation is weighted by the number of respondents from each
respective year. Further, we believe inclusion of more survey data will
improve the data's representativeness and lead to more stability in the
practice expense per hour. The use of the 1999 SMS data appears to have
little effect on the practice expense RVUs. In our August 2, 2001
proposed rule (66 FR 40397), we simulated the impact of including the
1999 SMS data on average specialty level payments. The increase or
decrease in average specialty level payment was less than 0.5 percent
for 29 of the 35 specialties listed, including nearly all of the
specialties that expressed concern about including the latest SMS data.
For 4 of the remaining 6 specialties, the increase or decrease in
payments was between 0.5 and 1.0 percent. Payments for the remaining
two specialties (pathology and suppliers) increased by more than 2
percent.
We are doubtful that respondents ``gamed'' responses in the 1999
SMS because of an awareness that reporting higher practice expenses
would lead to increased payments from Medicare. We observed no
noticeable increase in practice expense per hour from the 1999 SMS
survey than from earlier years. In fact, the inflation-adjusted all-
physician practice expense per hour from the 1999 SMS data is lower
than the same figure from the 1998 SMS data. Further, if the concern is
that physicians were aware of how the data would be used and would
``game'' responses to obtain higher payments from Medicare, our
expectation would be that the number of responses in the 1999 SMS would
be higher, not lower, than in prior years. For these reasons, we are
doubtful that there is any reason to assume that the 1999 SMS survey
would show more bias than surveys from previous years.
We welcome the comments that suggest that we develop a long-term
strategy for using aggregate specialty practice expense data to make
refinements to RVUs. As noted by some commenters, the AMA is no longer
conducting the SMS survey in its current form. We would like to engage
physician specialty societies, as well as other practitioner groups and
representatives of organizations affected by Medicare physician fee
schedule payments, in discussions of how to best obtain practice
expense data that will be useful in updating our methodology for
determining practice expense RVUs. Although it has been beneficial to
use 5 years of SMS data to develop practice expense RVUs, we believe
that it may not be necessary to make annual updates to aggregate
specialty practice cost data if relative practice expenses do not
change significantly from year to year. However, it may be beneficial
to periodically review aggregate practice expenses and make changes
when necessary. For instance, one commenter suggested that
technological innovation may change relative expenses among services.
For this reason, we believe a review of aggregate practice costs at
least every 5 years is necessary. In fact, the statute requires that we
review RVUs at least every 5 years. At this time, we have incorporated
all of the data from the SMS surveys into the practice expense
methodology. We will consider public input on the best way to obtain
practice expense data for use in future practice expense calculations.
(ii) Supplemental Practice Expense Survey Data
To ensure the maximum opportunity for specialties to submit
supplementary practice expense data, we proposed to accept survey data
that meet the criteria set forth in the November 2000 final rule for an
additional 2 years. The deadlines for submission of such supplemental
data to be considered in CY 2003 and CY 2004 are August 1, 2002 and
August 1, 2003, respectively.
Comment: Several commenters expressed their strong support for our
decision to accept specialty-specific practice expense surveys for an
additional 2 years. Specialty societies representing podiatry,
pediatrics, internal medicine, rheumatology and surgery, as well as the
American Medical Association (AMA) stated their agreement with this
decision.
An organization representing medical colleges commented that this
will send an important message to the physician community about our
willingness to consider all legitimate data sources in analyses of this
critical portion of payments, and one that has been a subject of
controversy within the community. A specialty society representing
dermatology stated that the additional time will allow specialties to
collect specialty-specific data that should be useful as we determine
practice expense RVUs.
The AMA and a commenter representing podiatry expressed some
concern about the criteria for the acceptance of survey data and the
AMA also expressed hope that we would be flexible concerning any data
submitted. The commenter representing emergency medicine argued that
collecting specialty-specific data would be fruitless, due to a number
of stringent criteria for submitting supplemental practice expense
survey data.
On the other hand, three commenters indicated that we should accept
only survey data that meet our criteria. The commenter representing
rheumatology stated that it is critically important that any data
accepted must meet the criteria in the November 2000 final rule.
Response: We received only comments supporting this proposal, and
we will be extending the period of acceptance of supplemental survey
data for another 2 years, as proposed. We hope to demonstrate
flexibility in helping those specialties that conduct a survey to do so
successfully, and we understand that for some specialties some revision
to the survey format may be necessary. For example, questions regarding
uncompensated care for emergency physicians or separately billable
drugs for oncologists might need to be added to a survey to determine
the appropriate practice expense for these specialties. However, like
several of the commenters, we believe that fairness to all can only be
achieved if we consistently apply the rules for determining validity to
any survey that is submitted.
Comment: A specialty society representing geriatrics expressed
concern regarding the use of SMS data in formulating practice expense
costs because the sample size for geriatricians is not large enough to
yield reliable data. The commenter stated that smaller specialty
societies will be unable to provide supplementary survey data because
of expense limitations and recommended that we continue to review
alternative data sources that recognize the greater resources spent in
caring for frail elderly persons. The society further recommended that
we consider the use of ``non-compliant'' survey data for smaller
specialty groups that do not meet our stringent and costly criteria.
Response: We could not justify accepting ``non-compliant'' surveys
from some specialties, due solely to the specialty's size, while
holding others to a more rigorous standard. However, though we would
welcome survey data from any specialty that submits a survey that meets
our criteria, we do recognize that performing a survey can be costly.
We, therefore, suggest that the specialty society consider in advance
the extent to which any possible survey result
[[Page 55255]]
might actually alter the practice expense RVUs for their services. Note
that we have only one payment amount for each service on the fee
schedule. We have no authority to pay more to one specialty than to
another for performing the same service. If a small specialty provides
only a small percentage of a given service, a change in the practice
expense per hour for that small specialty could have very little effect
on the payment for the service. For example, if geriatricians perform
mainly evaluation and management (E/M) services, even a survey that
shows increased practice costs for geriatricians would not necessarily
have any effect on the practice expense RVUs for E/M services because
geriatricians' services would represent only a small part of the
universe of E/M services. However, it is incumbent upon each specialty
society to weigh both the costs and benefits to their specialty to
determine whether conducting a practice expense survey would be
worthwhile.
(iii) Submission of Supplemental Surveys
Three organizations submitted supplemental survey data for
consideration for CY 2002. Survey data were submitted by the American
Physical Therapy Association (APTA), the American Optometric
Association (AOA), and the American Academy of Pediatrics (AAP). Our
contractor, The Lewin Group, has evaluated the data submitted by each
organization. They have recommended that we use the data submitted by
APTA and AOA and reject the data submitted by AAP. The full
recommendation and discussion will be made available on the CMS web
site. (See the Supplementary Information section of this rule for
directions on accessing our web site.)
We have decided not to use the data submitted by APTA, AOA, or AAP
because none of the surveys met all of our stated criteria. In our May
3, 2000 interim final rule (65 FR 25666), we indicated that, based on
our review of existing physician practice expense surveys, we believe
that an achievable level of precision is a coefficient of variation
(that is, the ratio of the standard error of the mean to the mean
expressed as a percent) not greater than 10 percent for overall
practice expenses or practice expenses per hour. For existing surveys,
the standard deviation is frequently the same magnitude as the mean. We
indicated in the May 2000 interim final rule that we would consider
practice expenses for which the precision of practice expenses is equal
to or better than this level of precision and that meet the other
survey criteria. None of the surveys submitted for 2002 met the level
of precision criteria; therefore, we have decided not to use the survey
data.
b. CPEP Data
(i) 2000 RUC Recommendations on CPEP Inputs
In the November 2000 final rule (65 FR 65393), we responded to the
RUC recommendations for the refinement of the direct inputs for 49 CPT
codes and for the supply and equipment inputs for four additional
services. These recommendations reflected multispecialty agreement on
the typical resources for many important services, including visit
codes, which account for approximately 24 percent of Medicare spending
for physicians' services. We accepted almost all of these
recommendations. We received the following comments on our responses to
the RUC recommendations and on the PEAC/RUC refinement process:
Comment: Several specialty societies representing osteopaths,
rheumatologists, neurologists, ophthalmologists, obstetricians, and
gynecologists commended us for implementing the refinements submitted
by the PEAC and RUC as part of the on-going refinement process. One
specialty society stated that it was encouraged by the direction
pursued with the physician fee schedule for 2001, because it
demonstrated the ability to achieve refinement within the parameters of
the fee schedule comment process. Another commenter expressed
appreciation for our support of the PEAC and RUC refinement process
because this relationship is critical to establishing fair and balanced
payment policies.
In addition, other commenters praised our staff for being helpful
in responding to the PEAC members' questions during meetings, as well
as for the willingness to work with physician specialty societies
toward establishing fair and appropriate reimbursement values. The RUC
commented that it agreed that the PEAC has made significant progress in
its ability to review and refine direct practice expense inputs for
individual CPT codes.
Response: We appreciate the above comments and are also encouraged
by the progress that the PEAC and RUC have made in refining the
practice expense inputs.
Comment: The RUC agreed that the PEAC should continue to meet and
refine the direct practice expense data. Therefore, it hopes that we
will state that the practice expense RVUs will continue to be interim
and subject to refinement as the PEAC continues its review. A specialty
society representing ophthalmology echoed this request stating that,
because the PEAC is continuing the refinement process, the interim
status of the practice expense RVUs should be reaffirmed in the rule.
The commenter requested that the RVUs remain interim and subject to
change until 2007, that is, until the first update of the five-year
review of practice expense RVUs.
Response: We are pleased that the RUC and PEAC are willing to
continue the task of helping us to refine the practice expense inputs
for the approximately 7,000 services in the physician fee schedule. We
intend to keep the practice expense RVUs as interim as long as this
refinement process is necessary. Also, as noted above, we will accept,
for another 2 years, supplemental survey data that meet our criteria.
During this period, we will also continue to make improvements to our
practice expense methodology.
Comment: A commenter representing three ophthalmology sub-
specialties, though appreciative of our implementation of the PEAC
recommendations, expressed disappointment that we have not made the
non-controversial revisions to correct additional errors in the CPEP
database. The commenter encouraged us to explore alternative ways to
improve the quality of the CPEP data without waiting for the PEAC to
consider each of the thousands of alleged errors.
Response: We have made changes to the CPEP data in those instances
when there was a clear anomaly in the data and when the more
appropriate revision would be obvious, without the benefit of a
multispecialty recommendation. However, we have found that the input
and recommendations of a multispecialty group, such as the PEAC, have
played a crucial role for the vast majority of suggested revisions when
clinical judgment is involved.
Comment: An organization representing diagnostic imaging centers
stated that it would be inappropriate for the PEAC to constitute the
review body for direct cost data for technical component services,
because the PEAC does not include any representatives of diagnostic
imaging centers. The commenter requested that, if any of the CPEP
direct cost data form the basis for future payment for technical
component services, the accuracy of these data should be reviewed by
representatives of centers that actually provide the services involved.
Response: We do not agree that it is inappropriate for the PEAC to
review
[[Page 55256]]
the direct cost inputs for imaging services. The presentations for each
service discussed at the PEAC are based either on surveys or panels of
individuals who are familiar with the procedure in question. In
addition, any of the recommendations of the PEAC that we accept are
subject to review and comment by any interested party.
Comment: Societies representing surgeons, urologists,
ophthalmologists, pediatrics, internists, and family physicians
strongly support our acceptance of the revisions of CPEP inputs for
office-based E/M services. One specialty society commented that the
refined inputs for these services reflect the work of a
multidisciplinary workgroup and demonstrate a major positive step
toward streamlining practice expense inputs. One surgical specialty
society did not fully agree that it is appropriate to use these E/M
inputs to refine postsurgical visits because the direct costs
associated with these visits are not necessarily comparable to the
typical E/M visit. On the other hand, a primary care specialty society
commented that the ``rolling'' implementation of CPEP refinement
creates an anomaly because the surgical global services have not yet
had these lower PEAC estimates for the E/M visits applied.
Response: We also saw the refinement of the practice expense inputs
for the E/M codes as a significant milestone in the whole refinement
process. These codes not only represent a sizeable portion of Medicare
payments, but they also are used by most medical specialties, and,
thus, most members of the PEAC had a stake in the outcome of this
issue. We believe that, as a result of the extensive multispecialty
discussion held by the PEAC on this issue, the recommendations on the
E/M codes represent the best available estimates of the direct inputs
needed for performing these services. With respect to the issue of
applying these E/M inputs to the surgical global services, we will not
be taking separate action now, but will be responding to the specific
PEAC recommendations. We understand that it is expected that all the
90-day global surgical services will be refined by the PEAC by next
year.
Comment: A specialty society representing internal medicine
commented that the registered nurse (RN) and licensed practical nurse
(LPN) staff mix should be used for the E/M codes rather than the RN,
LPN, and medical assistant staff mix, which is less typical. The
commenter also stated that we should increase the postservice clinical
staff work for these services by 20 percent.
Response: We do not agree with changing the staff mix at this time,
particularly because the PEAC recommendations have used this staff mix
across the majority of refined services. We also have seen no evidence
to suggest that the post-times for these services were undervalued.
(ii) 2001 RUC Recommendations on CPEP Inputs
We have received recommendations from the PEAC on the refinement to
the CPEP inputs for over 1,100 codes. These include refinements of
large numbers of orthopedic, dermatology, pathology, physical medicine,
and ophthalmology services. In addition, the PEAC confirmed that there
were no inputs for over 150 ZZZ-global procedures that are performed
only in the facility and no supply or equipment inputs for almost 700
facility-only services with an XXX or 0-day global period. We believe
this large increase in the number of CPT codes that have been refined
demonstrates that the PEAC refinement process is working due to the
valiant efforts of the AMA staff and the specialty societies
participating in this mammoth undertaking. There is also reason to
believe that the pace of refinement will continue to increase because
of the steps that the PEAC is taking to create standardized packages of
clinical staff time, supplies, or equipment that can be applied over a
wide range of services.
We have reviewed the submitted PEAC recommendations and have
accepted most of them with only minor revisions. The complete PEAC
recommendations and the revised CPEP database can be found on our web
site. (See the Supplementary Information section of this rule for
directions on accessing our web site.)The following is a list of the
only revisions we made to the PEAC recommendations:
We substituted the multispecialty minimum visit supply
package or the ophthalmology supply package for the list of individual
supplies, when appropriate.
We deleted separately billable supplies, for example,
drugs, fluids, and casting supplies, when listed in the recommended
supply list.
We rounded fractions of minutes of clinical staff time to
the nearest minute.
For CPT code 52281, cystoscopy and treatment, we deleted
the bougie a boule from the equipment list. The specialty society
supplied us with the price of $105 for this item, which does not meet
the minimum cost of $500 for an item to be included in the equipment
list.
For several ophthalmology services that did not involve
dilation of the pupil, we consulted with the specialty society and
deleted the ophthalmology visit supply package that was listed for the
post-procedure visit. This package is intended for those services where
dilation is necessary. The society confirmed that no supplies are
needed for the post-procedure visit for these services.
The recommendation did not specify the number of EEG
electrodes for CPT code 92585, auditory evoked potential,
comprehensive. We added seven electrodes, which is the same number
assigned to the visual evoked potential code.
The PEAC/RUC recommendations included time for the
clinical staff type, ``Physical Therapy Assistant (PTA),'' which
currently is not included in our CPEP input database. We are pricing
the PTAs by using the Bureau of Labor Statistics wage estimates for
physical therapy assistants. The base annual salary we are using will
be $33,690. After factoring in benefits and adjusting this to 2001
dollars, the per minute rate will be $0.386.
We have two concerns about the PEAC recommendations for
therapy services. First, we believe that some of the duties ascribed to
the physical therapy assistant are actually therapist services that are
already captured in the work RVUs. Therefore, we are deleting from all
the therapy codes the clinical staff time for obtaining vital signs and
measurements, patient education, and phone calls. Because we believe
that the resulting clinical staff times may be too low for the physical
therapy and occupational therapy evaluation and reevaluation services,
we are adding 7 additional minutes for the therapy aide in each of
these codes. In addition, some of the occupational therapy codes
contain several pieces of very expensive equipment called environmental
modules. Because it is unclear how many of these modules would
typically be used for each service, we are only including one module
for each code that might use this equipment. We note that for three
services, CPT codes 97530, 97535, and 97537, the PEAC did not submit a
recommendation for equipment, presumably because of the difficulty of
determining what would be typically used. In those cases, as in those
with a PEAC recommendation, we are allowing for one module and some
smaller equipment that was suggested by the specialty. We would hope to
work with the specialty societies to obtain more precise information on
the appropriate equipment for all of these therapy services.
[[Page 55257]]
We note that one of the services for which we received
recommendations, the casting/strapping procedure CPT code 29799, is
carrier-priced. In addition, we received recommendations for two fine
needle aspiration services, CPT codes 88170 and 88171, which are now
deleted.
(iii) Other Comments on Refinement of CPEP Inputs
Comment: Several commenters were pleased that we finalized certain
proposals regarding CPEP inputs, such as the following:
The reinstatement of the pre-procedure clinical staff time
in the facility setting for certain 0-day global services as well as
pre-service time for the vitrectomy codes.
Our decision to uphold the proposed refinements regarding
inpatient dialysis CPT codes 90935 and 90945.
The clarification of Medicare payment policy for cast
supplies when used for non-fracture/dislocation procedures.
The decision to retain Unna boot in the supplies for CPT
code 29580.
The correction of the supply list for CPT code 88104 and
the establishment of a separate nonfacility practice expense RVU for
CPT code 85607 in the 2001 fee schedule.
The extension of the code-specific refinement beyond 2002.
Response: We appreciate the above comments and will strive to
continue refining the practice expense RVUs in a manner that is fair
and beneficial to the medical community.
Comment: An allergy clinic commented that because of our definition
of a dose for CPT code 95165, Allergy Immunotherapy, doctors will be
forced to use a dosage that could be harmful to certain patients.
Response: The definition of a dose will be used only for pricing
the practice expense inputs for this service. Physicians should use
their clinical judgment in determining what dose to use for any
particular patient.
Comment: A commenter noted that the two codes for anal balloon
sphincterplasty (CPT codes 49505 and 49510) did not have the balloon
listed in the supply inputs.
Response: We agree that this was an omission and have added the
balloon to the supply list for both services.
Comment: A commenter stated that there are no practice expense
inputs assigned to CPT code 36533, insertion of implantable venous
access port, with or without subcutaneous reservoir, in the nonfacility
setting, because the CPEP panels priced it only in the facility. In
particular, the supply inputs do not contain the cost of the catheter
that is an integral part of the procedure.
Response: It is true that the original CPEP panel did not price
this in the nonfacility setting; however, we subsequently crosswalked
the inputs from the facility to the nonfacility setting for supplies,
equipment, and clinical staff, adding clinical staff time for the
intraservice period in the office. However, we agree that the catheter
is an appropriate supply and have added it to the supply list for this
code.
Comment: A specialty society representing podiatrists questioned
why the practice expense RVUs for the nail trimming codes G0127 and CPT
code 11719 are not the same. The commenter stated that they should have
the same CPEP inputs since both were refined by the PEAC this year with
identical inputs.
Response: The CPEP inputs are now identical for both codes, except
that the supplies recommendation for CPT code 11719 does not include a
surgical mask. However, none of this year's PEAC recommendations were
reflected in the August 2001 proposed rule. In addition, even codes
with identical CPEP inputs can have different practice expense RVUs if
a different mix of specialties performs each service.
Comment: Two specialty societies representing cardiologists and
electrophysiologists commented that we have allowed 60 minutes of
clinical staff time to arrange for surgical procedures with a 90-day
global period, but we have not yet allowed the same for 0-day global
period procedures in facilities. The commenters stated that they may
present specific codes to the PEAC with the recommendation that this
time be recognized for these services, and they hope that we will be
receptive to these recommendations.
Response: We will be glad to review any PEAC recommendations on
clinical staff pre-service time for 0-day global period services in the
facility setting if and when we receive them.
(iv) Repricing of Clinical Staff Wage Rates
In the August 2, 2001 proposed rule (66 FR 40378), we proposed
modifications of wage rates for the clinical staff types contained in
the CPEP database. Our contractor, Abt Associates, assigned the costs
of the original CPEP inputs for staff, supplies, and equipment based
primarily on 1994 and 1995 pricing data.
The original Abt Associates' estimates of clinical staff wage rates
relied primarily on the Bureau of Labor Statistics (BLS) data. Abt's
report on the CPEP cost estimation stated that, ``* * * the BLS data
were considered to be the preferred data set. The BLS'' reputation for
publishing valid estimates that are nationally representative led to
the choice of the BLS data as the main source. If more than one data
set provided an exact mapping for a receptionist, then the BLS wage was
chosen over any other mapping.''
We agreed with this assessment and have used the most current BLS
survey (1999) as the main source of wage data.
It should be noted that the BLS discontinued the Occupational
Compensation Survey used by Abt in 1995 and now conducts the National
Compensation Survey that has a breakdown of staff types different from
the earlier survey. Also, this survey does not cover all the staff
types contained in the CPEP data. Therefore, it was necessary for us to
crosswalk or extrapolate the wages for several staff types using
supplementary data sources for verification whenever possible.
We used three other data sources to price wages of staff types that
were not referenced in the BLS data:
The American Society of Clinical Pathologists' survey of
laboratory staff salaries (found at www.ascp.org).
The survey performed by the American Academy of Health
Physics and the American Board of Health Physics (found at
www.hps1.org).
The national salary data from the Salary Expert, an
Internet site that develops national and local salary ranges and
averages for thousands of job titles using mainly government sources.
(A detailed explanation of the methodology used to determine the
specific job salaries can be found at www.salaryexpert.com).
We also solicited any valid survey data that commenters might be able
to submit to us.
The proposed cost per minute for each staff type was derived by
dividing the proposed annual salary (converted to 2001 dollars using
the Medicare Economic Index) by 2080 to arrive at the hourly wage rate
and then again by 60 to arrive at the per minute cost. To account for
the employers' cost of providing fringe benefits, such as sick leave,
we used the same benefits multiplier of 1.366 used by Abt Associates.
Comment: We received several supportive comments on our efforts to
update the clinical staff salaries used in calculating the practice
expense RVUs. Specialty societies representing family physicians and
surgeons supported the proposal to reprice clinical staff salaries to
approximate current practice
[[Page 55258]]
expenses. A specialty society representing rheumatology stated that the
repricing of clinical staff salary data represents an overdue positive
step toward more accurate refinement of practice expense inputs. A
specialty society representing dermatology agreed with the
appropriateness of bundling similar clinical staff types into more
easily identified and easily tracked clinical labor blended categories.
Response: We agree that using current wage data to price the
clinical staff CPEP inputs is one step in ensuring that the practice
expense RVUs are based on the resources needed to perform each service.
We also would like to express our appreciation to the groups that
included salary survey data on various staff types as part of their
comments. These additional data have helped us to make appropriate
revisions to our original proposals.
The following is a discussion of the specific proposals we made on
the pricing of clinical staff types.
We received no comments on the following proposals.
Therefore, they will be implemented as proposed.
We will price as proposed the staff types physical therapy
aide, LPN, RN, certified surgical technician, laboratory technician,
cytotechnologist, cardiovascular technician, nuclear medicine
technician, optician, respiratory therapist, speech pathologist,
audiologist, and counselor.
We will collapse the medical assistant, technical aide,
medical technician, EKG technician, anesthesia technician, technician,
and cast technician staff types into a new staff type, ``medical or
technical assistant (MTA),'' that will be priced at the medical
assistant wage rate of $0.26 per minute.
+ We will bundle the staff type ``RN-cardiology'' into the staff
type ``RN.''
+ We will adjust the wage rate for the oncology-certified nurse to
be 18 percent higher than the RN.
+ We will bundle the staff type ``surgery assistant'' into the
staff type ``certified surgical technician (CST).''
+ We will use the average hourly rate of $15.60 for histologic
technologists from the 1998 American Society of Clinical Pathologists'
survey to price the histotechnologist staff type.
+ We will use the BLS salary data for electroneurodiagnostic
technologists contained in the BLS Occupational Outlook Handbook to
price the electrodiagnostic technologist staff type.
+ We will price the wage rate for the EEG technician using survey
data from the Salary Expert.
+ We will merge the nuclear cardiology technician in with the
nuclear medicine technician staff type.
We were unable to find any national salary data for the
electron microscopy technician and, in the absence of such data,
proposed crosswalking the salary from the wage rate for the
histotechnologist. Though this represented an increase in the per
minute cost for this staff type, we stated that we would welcome
reliable national survey data from the specialty that we could use in
pricing electron microscopy technicians.
Comment: The specialty society representing pathologists
recommended that the wage rate for electron microscopy (EM) technician,
which we proposed crosswalking from that of the histologic
technologist, should more accurately be priced at the same wage rate as
the cytotechnologist. The commenter stated that histologic
technologists are generally bachelor degree level personnel, whereas EM
technicians generally have post-baccalaureate education, parallel to
that of a cytotechnologist. In addition, they receive salaries that are
higher than general histotechnologists. The commenter also recommended
that the title of the EM technician category be changed to EM
technologist.
Response: We are persuaded that the commenter has proposed a more
suitable crosswalk for this staff type. Therefore, we will crosswalk
the wage rate for the EM technologist from that of the
cytotechnologist. We will also change the title as suggested by the
specialty society.
We were unable to find any national salary data for
registered electroencephalograph technologists (REEGTs) and proposed to
maintain the current rate, since the speciality society had recently
recommended this rate of pay. However, we also requested reliable
national survey data from the specialty that we could use in pricing
these three levels of neurodiagnostic staff.
Comment: The American Academy of Neurology (AAN), on behalf of
seven related organizations, submitted an abbreviated version of the
2000 American Society of Electroneurodiagnostic Technologists (ASET)
Salary Survey. The commenter stated that this national salary survey
has been collected triennially by ASET, the main national body
representing this allied health professional field, and was not
collected for any purpose connected with the physician fee schedule.
For office-based registered electroencephalograph technologists, there
were 31 responses and a mean salary per hour of $20.11. For all REEGTs,
there were 559 responses and a mean salary of $20.53 per hour. The
commenters recommend that we substitute either of these salary rates to
determine the costs for the REEGT staff type. The specialty society
representing sleep medicine requested that we consider the updated
salary data that AAN included in its comments on the proposed rule.
Response: We have reviewed this survey and believe that it provides
a more appropriate estimate of the wage rate of REEGTs than did our
crosswalk to a staff type used in a different specialty. We will use
the data for the office-based REEGTS, which results in a wage rate of
$0.47 per minute, which we note is not significantly different from our
proposed rate for the REEGT staff type.
We proposed to bundle the vascular technician with the
cardiovascular technologist staff type. Currently both are priced at
the same rate.
Comment: The American Association for Vascular Surgery, American
Society of Neuroimaging, Society of Diagnostic Medical Sonography,
Society for Vascular Surgery, and Society of Vascular Technology
submitted a joint comment as ``The Coalition.'' The Coalition argued
that the BLS was wrong to classify vascular technologists with
cardiovascular technologists and technicians because the BLS
description of duties for this classification does not include any of
the duties performed by a vascular technologist. In addition, the
commenters contended that, unlike most cardiovascular technicians, a
vascular technologist functions as a direct and largely independent
health care practitioner. A skilled vascular technologist undergoes
between 2 and 4 years of didactic and clinical post-secondary education
as evidenced by the presence of a baccalaureate degree program in
vascular technology.
The Coalition recommended that we base the salaries for vascular
technologists on data from a survey conducted earlier this year by
nVision Research that surveyed by mail 406 randomly selected vascular
technologists from a variety of settings. The response rate for this
survey was 55 percent. Based on the survey, nVision Research determined
that the median annual salary of a vascular technologist is $49,758. A
copy of the survey was included with the comment. The commenters also
recommended that we change the description of the ``vascular
technician'' to ``vascular technologist.'' A specialty society
representing echocardiography urged that we adopt the classification of
``vascular
[[Page 55259]]
technologist'' as proposed by the above groups.
Response: We agree that the nomenclature of the staff type should
be changed to ``vascular technologist.'' We have studied the data
provided by the Coalition and have consulted with our medical advisors
and now also agree that the salary shown in the submitted survey better
represents the current wage rate for vascular technologists. Therefore,
we will assign the vascular technologist staff type the recommended
yearly salary of $49,758 which results in a per minute wage rate of
$0.54.
We proposed to merge the x-ray technician and radiation
technologist staff types, which are currently priced at the same rate,
into a staff type called ``Radiologic Technologist.''
Comment: The American Society of Radiologic Technologists (ASRT)
submitted with their comment the 2001 ``Radiologic Technologist Wage
and Salary Survey'' commissioned by the organization. The comment
disagreed with our proposal to merge the x-ray technician and radiation
technologist staff types. The society stated that the radiation
technologist has completed a formal educational program and has
successfully passed a nationally recognized credentialing examination;
an x-ray technician denotes a person who is most likely informally
trained and who is often employed to perform only very limited x-ray
examinations. On the other hand, a society representing therapeutic
radiology and oncology recommended that we not crosswalk radiation
technologists to ``radiologic technologists and technicians,'' but,
instead, change the crosswalk and the name to ``radiation therapist.''
Response: We can understand why the original nomenclature assigned
by the CPEP panels to these staff types would be confusing to the
commenters. However, it is clear from the imaging services to which the
radiation technologist is assigned that this staff type was not
considered to be a radiation therapist. In addition, we do not disagree
with the distinction made by ASRT between an x-ray technician and a
radiation technologist. However, the CPEP panel did not appear to make
this same distinction. In fact, the x-ray technician is often assigned
to more complex services than the radiation therapist and Abt
Associates priced the two staff types at the same wage rate. Therefore,
we have made the decision to consider both staff types to be at the
same level and to change the title of both to ``radiologic
technologist.'' If it is necessary to make a distinction between
different levels of radiologic staff, this can be done as part of the
refinement process.
Comment: A commenter representing imaging centers recommended that
we substitute the ``more accurate and recent salary information''
obtained by the ASRT for the pricing of radiologic technologists. The
commenter stated that these data indicate that the mean salary of full-
time radiologic technologists is $53,919.
Response: We have reviewed the survey submitted to us by ASRT and
have found it to be both comprehensive and useful. We would note that
the $53,919 referenced in the comment is the mean salary for all
radiologic personnel and includes the salaries of staff level personnel
as well as chief technologists and of radiography staff as well as
dosimetrists. Therefore, this is not salary information that can be
used to price the specific radiology staff types in our database.
However, as discussed below, we have used other ASRT data to price
certain staff types for which we had no other pricing information. It
is interesting to note that the mean salary in the ASRT survey for
radiography staff is $36,862, while the 2001 salary rate for the
equivalent staff based on the BLS is $37,126; the use of either figure
would result in an almost identical per-minute wage rate. This
information gives us extra confidence in our proposed wage rate of
$0.41 per minute for radiologic technologists, and we will be
implementing this salary rate as proposed.
Because we were unable to find any national survey data
regarding the salaries for CAT scan technician, MRI technician, or
angiographic technician, we proposed crosswalking these staff types to
the BLS radiologic technologist pay scale. We also stated that we would
welcome any reliable national survey data that would allow us to
separately price these staff types.
Comment: The American Society of Radiologic Technologists (ASRT)
recommended that we use the 2001 ASRT survey submitted with its comment
to price the MRI, CAT scan and angiographic technologists, rather than
crosswalking their wage rate from the radiologic technologist. The ASRT
data show an annual salary of $42,143 for a CAT scan technologist and
$43,118 for an MRI technologist.
Response: We have reviewed the ASRT data for MRI and CAT scan
technologists and will use that data for MRI and CT staff to price
these staff types. There is a close congruence between the ASRT and the
BLS salaries for those radiologic staff for whom we have data from both
sources. Therefore, we have confidence that the wage rate we will use
for the CAT scan and MRI technologists will be relatively correct. The
wage rate for the CAT scan technologist will be $0.46 per minute and
for the MRI technologist $0.47 per minute. We could not find data in
the ASRT survey corresponding to the angiographic technician.
Therefore, until some reliable national data are available, we will
continue to crosswalk this wage rate from that of the radiologic
technologist.
We proposed merging the cardiac sonographer and the
ultrasound technician into the sonographer staff type. Currently, all
three are priced at the same rate.
Comment: The group of specialty societies commenting as the
``Coalition'' recommended that we maintain the description, ``cardiac
sonographer,'' eliminate the description, ``ultrasound technician,''
and change the description ``sonographer'' to ``diagnostic medical
sonographer.'' A specialty society representing echocardiography
strongly urged that we adopt the above classifications proposed by the
Coalition. This commenter also contended that crosswalking the salary
for cardiac sonographers from that of diagnostic medical sonographers
does not adequately reflect the salaries currently paid to cardiac
sonographers. The society is currently seeking a reliable source of
current survey information so that we can price cardiac sonographers
separately.
Response: We have already proposed eliminating the description
``ultrasound technician'' and will accept the description of
``diagnostic medical sonographer.'' We proposed merging the cardiac
sonographer into the sonographer classification because the two staff
types were currently priced the same and we did not have any other
salary data for the cardiac sonographers. However, we will accept the
recommendation to keep the category ``cardiac sonographer'' and would
be willing to reconsider the pricing if valid salary data are
submitted.
Because we were unable to find salary information for the
staff type ``dosimetrist,'' we proposed crosswalking their salary from
that of radiation therapists.
Comment: The American Society of Radiologic Technologists (ASRT)
recommended that we review our proposed equal wages rates for radiation
therapists and dosimetrists. The commenter reported that the annual
salary of $57,330 for staff dosimetrists shown in the submitted 2001
ASRT survey is considerably higher than that for radiation therapists,
which reflects their additional educational
[[Page 55260]]
requirements. The specialty society representing radiology also opposed
combining dosimetrists and radiation therapists in the same group
because these two staff types provide very different services for
radiation oncology procedures and are paid on different pay scales.
This commenter agreed with the proposed increased wage rate for
radiation therapists, but believed that the dosimetrists would be paid
approximately 20 percent more than their proposed rate. Two other
societies, one representing therapeutic radiology and oncology and one
representing radiation oncology centers, also supported an increase for
dosimetrists and one commenter suggested that we substitute the title
``medical dosimetrist.'' In addition, these two commenters recommended
that we use the ASRT data for radiation therapists as well.
Response: We appreciate receiving the ASRT data for dosimetrists
and agree that the annual salary suggested by the ASRT survey more
accurately reflects the appropriate wage rate for this staff type. The
wage rate will be $0.63 per minute. We will also change the title for
this staff type to ``medical dosimetrist.'' We will continue to use the
BLS data to determine the wage rate for radiation therapists since
there has been no evidence presented to show that the BLS survey was in
any way not representative.
We proposed using the average salary data for all
certified health physicists from the 1999 survey conducted by the
American Academy of Health Physics and the American Board of Health
Physics to price the ``physicist'' staff type.
Comment: Three specialty societies representing radiology,
therapeutic radiology and oncology, and radiation oncology centers
recommended that we use the Professional Information Survey data from
The American Association of Physicists in Medicine (AAPM) rather than
from the American Academy of Health Physics (AAHP). One commenter
pointed out that the AAHP survey does not include physicists working in
radiation oncology. The AAPM survey for CY 2000 had an overall response
rate of 58 percent and demonstrated an average annual salary of
$107,900. One commenter suggested that we also change the title to
``medical physicist.''
Response: No copy of the AAPM survey was included with any of the
comments, and we have been unable to review it at this time. However,
we would not question the commenters' assertion that the AAPM survey
was more relevant to physicists working in radiation oncology than the
survey we used to determine our proposed wage rate. Therefore, we are
using the AAPM survey salary of $107,900 on an interim basis to price
the physicist wage rate and will endeavor to obtain and review this
survey to finalize this issue. The wage rate for 2002 will be $1.21 per
minute. For clarity, we will also accept the recommendation to change
the title to ``medical physicist.''
We were unable to obtain representative national salary
data for the certified ophthalmic technician (COT), the certified
ophthalmic medical technologist (COMT), or the orthoptist staff types.
We proposed to crosswalk the COT and COMT to the laboratory technician
and histotechnician, respectively, since we believe that the skill and
responsibility of these staff types would generally correspond. In the
absence of any national salary data for the orthoptist, we proposed to
crosswalk the salary from that of the COMT, the highest level of
ophthalmic medical personnel. We also proposed crosswalking the salary
data for the certified retinal angiographer from the data listed for
ophthalmic photographers in the Salary Expert. We stated that we would
welcome reliable and representative national salary data for these
staff types.
Comment: The specialty society representing ophthalmologists
commented that they would be pleased to offer additional assistance to
validate the salaries for ophthalmic medical technicians and other
ophthalmic clinical staff. At this time, the commenter agreed that the
proposed crosswalks for these staff types are acceptable.
Response: We will be implementing these crosswalks as proposed.
We proposed to crosswalk the wage rate for the staff type
``dietitian'' from the BLS salary data for dietitians and
nutritionists.
Comment: The American Dietetic Association (ADA) commented that it
believed that the BLS database includes salaries for non-credentialed
dietitians and nutritionists and that we should reference ADA data from
its membership surveys that estimates 2001 adjusted median annual
income for dietitians to be $51,006.
Response: We would be willing to look at the ADA survey data if
they were submitted to us. We would, of course, have to review and
analyze these alternative survey data before we could substitute them
for the BLS data that we have proposed to use. However, until we are
convinced that the ADA data were equally or more representative of
dietitians who serve as clinical staff for services on the fee
schedule, we will continue to use the BLS data as our source of salary
data for dietitians.
We proposed to delete those clinical staff that can bill
separately from the list of CPEP staff types. Therefore, we proposed
substituting physical therapy aide for physical therapist, registered
nurse for physician assistant, nurse practitioner and psychologist, and
counselor for social worker.
Comment: Two specialty societies representing internal medicine and
family practice expressed support for this proposal because these staff
types, for example, nurse practitioners, are used as physician
extenders and their salaries should not be considered as practice
expense. A society representing geriatrics argued that we should not
delete the clinical staff that can bill separately from the list of
CPEP staff types because not all of these individuals bill separately,
resulting in a negative impact on geriatrics.
Response: We will implement our proposal to delete clinical staff
that can bill independently from our practice expense input database,
with the two exceptions noted below. We believe that the costs of these
staff types are not practice expenses and should be captured in the
work RVUs. This revision to our clinical staff list should not have a
negative impact on geriatrics because none of the deleted staff types
were assigned to any of the E/M services that would make up a large
percentage of geriatricians' case loads.
Comment: A society representing social workers commented that it
was not opposed to the deletion from the practice expense inputs of
staff types that can bill directly. However, the commenter pointed out
that only clinical social workers are able to bill directly, while
other social workers cannot. Therefore, the society is opposed to the
deletion of the staff type, ``social worker,'' from the CPEP inputs and
the substitution of the staff type, ``counselor.'' In addition, the
society would at least want the BLS data for ``social worker'' to be
used for pricing, though it believes that the BLS data does not
differentiate enough between the various types of practice within
social work.
Response: The commenter is correct in stating that not all social
workers can bill directly. Therefore, we will keep the social worker
staff type in our database and will use the BLS data for ``social
worker'' to determine the appropriate wage rate. In addition, we will
not delete the staff type, ``psychologist,'' which is listed as the
clinical staff for the psychological testing services. Because these
services have no
[[Page 55261]]
physician work RVUs, the work of the psychologist can only be captured
through the practice expense RVUs. We can find no appropriate national
salary at this time for this staff type. Therefore, we will use the
current wage rate of $0.82 per minute.
We proposed to delete, as redundant, the ophthalmic
medical personnel (OMP) staff type and to substitute the COMT/COT/RN/
CST blend that was suggested by the American Academy of Ophthalmology
and recommended by the PEAC.
Comment: The specialty society representing optometrists agrees
with our proposal to delete, as redundant, the ophthalmic medical
personnel (OMP) staff type and substitute the COMT/COT/RN/CST staff
blend.
Response: We will implement this as proposed. Table 1 lists each
staff type remaining in our practice expense input database, the source
of the data, the staff type crosswalk used, the proposed annual salary
in 2001 dollars, the 2002 wage rate per minute (including benefits) and
the current cost per minute (including benefits).
Table 1.--Revised Wage Rates for CPEP Staff Types
--------------------------------------------------------------------------------------------------------------------------------------------------------
Revised Current
Description Source Crosswalk Mean yrly Hrly + per per
2001 benefits minute minute
--------------------------------------------------------------------------------------------------------------------------------------------------------
Physical Therapy Aide.................... BLS Physical Therapist Aides........ 21,077 13.84 0.23 0.23
Physical Therapy Assistant............... BLS Physical Therapist Assistants... 35,223 23.13 0.39 N/A
Medical or Technical Assistant........... BLS Medical Assistants.............. 23,681 15.55 0.26 0.16
LPN...................................... BLS Licensed Practical Nurses....... 30,341 19.93 0.33 0.27
RN....................................... BLS Registered Nurses............... 46,494 30.53 0.51 0.42
RN Oncology.............................. BLS Registered Nurses plus 54,862 36.03 0.60 0.50
adjustment.
Certified Surgical Technician............ BLS Surgical Technologists.......... 28,814 18.92 0.32 0.26
Lab Technician........................... BLS Medical and Clinical Laboratory 29,724 19.52 0.33 0.29
Technicians.
Histotechnologist........................ ASCP Histologic Technologist......... 33,925 22.28 0.37 0.31
Electron Microscopy Technologist......... X-WALK Cytotechnologist................ 41,099 26.99 0.45 0.31
Cytotechnologist......................... BLS Medical and Clinical Laboratory 41,099 26.99 0.45 0.42
Technologists.
EEG Technician........................... Salary Expert Electroencephalographic 29,151 19.14 0.32 0.28
Technician.
Electrodiagnostic Technologist........... BLS Electroneurodiagnostic 33,529 22.02 0.37 0.30
Technologists.
Registered EEG Technologist.............. ASET Registered EEG Technologist..... 42,707 28.05 0.47 0.40
Vascular Technologist.................... nVision Survey Vascular Technologist........... 49,758 32.68 0.54 0.35
Cardiovascular Technician................ BLS Cardiovascular Technologists and 34,794 22.85 0.38 0.35
Technicians.
Radiologic Technologist.................. BLS Radiologic Technologists and 37,126 24.38 0.41 0.32
Technicians.
Mammography Technologist................. ASRT Mammography Technologist........ 39,212 25.75 0.43 N/A
Angiographic Technician.................. BLS Radiologic Technologists and 37,126 24.38 0.41 0.35
Technicians.
CAT Scan Technologist.................... ASRT Computed Tomography Technologist 42,143 27.68 0.46 0.32
MRI Technologist......................... ASRT Magnetic Resonance Imaging 43,118 28.32 0.47 0.32
Technologist.
Nuclear Medicine Technician.............. BLS Nuclear Medicine Technologists.. 44,361 29.13 0.49 0.39
Diagnostic Medical Sonographer........... BLS Diagnostic Medical Sonographers. 45,751 30.05 0.50 0.39
Cardiac Sonographer...................... BLS Diagnostic Medical Sonographers. 45,751 30.05 0.50 0.39
Radiation Technical Therapist............ BLS Radiation Therapists............ 45,333 29.77 0.50 0.40
Medical Dosimetrist...................... ASRT Medical Dosimetrist............. 57,330 37.65 0.63 0.50
Medical Physicist........................ AAPM Medical Physicist............... 110,166 72.35 1.21 0.97
COT...................................... X-WALK Lab Technician.................. 29,724 19.52 0.33 0.26
COMT..................................... X-WALK Histotechnician................. 33,925 22.28 0.37 0.28
Optician................................. BLS Opticians, Dispensing........... 26,336 17.30 0.29 0.28
Certified Retinal Angiographer........... Salary Expert Ophthalmic Photographer......... 35,453 23.28 0.39 0.35
Orthoptist............................... X-WALK COMT............................ 33,925 22.28 0.37 0.32
Respiratory Therapist.................... BLS Respiratory Therapists.......... 38,537 25.31 0.42 0.42
Speech Pathologist....................... BLS Speech-Language Pathologists.... 49,996 32.83 0.55 0.42
Audiologist.............................. BLS Audiologists.................... 47,748 31.36 0.52 0.41
Registered Dietician..................... BLS Dieticians and Nutritionists.... 39,050 25.65 0.43 0.37
Counselor................................ BLS Mental Health Counselors........ 30,769 20.21 0.34 0.42
Social Worker............................ BLS Medical and Public Health Social 37,011 24.31 0.41 0.33
Workers.
--------------------------------------------------------------------------------------------------------------------------------------------------------
The CPEP clinical staff inputs also include blends of staff types
that are used for those services when more than one type of clinical
staff may be used in the performance of the service. We will establish
the payment rates for these blends by calculating a simple average of
the wage rates of the staff types included. Table 2 shows the blended
staff types, the 2002 cost per minute and the current cost per minute.
Note: We received no comments on the proposed cost per minute
for the staff blends, so these rates will be implemented as
proposed.
Table 2.--Revised Wage Rates for CPEP Blended Clinical Staff Types
------------------------------------------------------------------------
Revised Current
Description per per
minute minute
------------------------------------------------------------------------
COMT/COT/RN/CST..................................... 0.38 0.307
[[Page 55262]]
Lab Tech/Histotech.................................. 0.35 0.297
Lab Tech/MTA........................................ 0.30 0.257
Optician/COMT....................................... 0.33 0.278
RN/LPN.............................................. 0.42 0.389
RN/LPN/MTA.......................................... 0.37 0.317
RN/OCN.............................................. 0.56 0.497
RN/Respiratory Therapist............................ 0.47 0.421
RN/Sonographer...................................... 0.51 0.405
Dosimetrist/Physicist............................... 0.920 N/A
------------------------------------------------------------------------
(v) Revision of the Ophthalmology Visit Supply Package
In its May 2000 submission to us, the RUC recommended the use of an
ophthalmology visit supply package that would contain the routine
supplies typically used in each 90-day global postsurgical visit for
ophthalmology services. We accepted this recommendation. However, upon
further review, we noted that two of the supplies, rev eyes and post
myd spectacles, were not used in many of the postsurgical office
visits. Therefore, after consulting with the ophthalmology specialty
society, we proposed to remove these two items from the ophthalmology
visit package. Instead, we proposed including these items as
appropriate on a code-by-code basis.
Note: Since we received no comments on this issue, we will
implement this revision on the supply package as proposed.
(vi) Deletion of Contrast Agents from the Practice Expense Inputs
Section 430(b) of BIPA amends section 1861(t)(1) of the Act to
include contrast agents in the definition of drugs and biologicals.
Previously, contrast agents were defined as supplies and were included
in the list of CPEP supplies for the appropriate services. Therefore,
we proposed to delete the costs of the following contrast agents from
our CPEP data: hypaque, methylene blue, high-density barium, polibar,
telopaque tablets, barium paste contrast, effervescent sparkies
(fizzies), and renographin-60 iodinated contrast.
Comment: The specialty society representing radiology had no
comment on the suggested list of deletions from the CPEP supplies.
However, the society expressed concern that there are no HCPCS codes
established for these deleted items and wanted information on how to
bill for these supplies.
Response: As stated above, we proposed to delete contrast agents
from the practice expense inputs in response to legislation that
included contrast agents in the definition of drugs. This proposal was
made to ensure that we did not include in the practice expense the
costs of items that could also be billed separately. However, section
1842(o)(1) of the Act makes clear that the payment of 95 percent of the
average wholesale price (AWP) can be made only if the drug is not paid
on a cost or prospective payment basis. We believe that if we do
include payment for any contrast agent in the practice expense RVUs, no
other payment should be made for this item. After further consideration
of this issue, however, we will continue to include the contrast agents
listed in our proposal in our practice expense inputs at this time.
Therefore, we are withdrawing the proposal.
c. Physician Time
RUC Time Database
The primary sources for the physician time data used in creating
the specialty-specific practice expense pools are the surveys performed
for the initial establishment of the work RVUs and the surveys
submitted to the AMA RUC. The AMA informed us that some of the times
used for the November 1998 final rule (63 FR 58823) differed from the
official RUC database, and we agreed to use the RUC-verified physician
time database when we received it from the AMA. Subsequently, the AMA
notified us that there were gaps in its own database for certain global
surgery codes and that a revised time database would be sent to us once
all the times were verified. We have now received this revised database
and proposed to use it in the calculation of the specialty-specific
practice expense pools. It should be noted that the RUC database
reflects the physician times for those codes that were surveyed as part
of the second 5-year review of physician work.
Comment: We received a number of comments that supported using the
physician time data. One commenter indicated that the new time database
is expected to provide greater accuracy and consistency in the practice
expense calculations. While commenters representing family physicians,
internists, and rheumatologists supported use of the new time data,
they also indicated that improvement is still needed. Specifically,
these commenters suggested that the number and level of postoperative
visits and the corresponding physician time included in the global
surgical period may be overstated. The commenters noted that we
previously indicated that we would study length of stay data relative
to the number of postoperative visits and included in the surgical
period, and they encouraged us to use this information to further
refine the physician time data. One commenter indicated that surgeons
rarely meet the criteria for billing critical care services in the
postoperative period even though the time and value of critical care
services are proposed for inclusion in the global period of some
surgical codes.
Organizations representing thoracic surgeons indicated that we
should not incorporate the new time data that will result in additional
practice expense reductions for thoracic and cardiac surgery. These
commenters said that no further reductions in the practice expense RVUs
for cardiac surgery should be made until new studies of practice
expense related issues by the Office of Inspector General and the
General Accounting Office are completed. This commenter indicated that
the new physician time data covers only 585 of the 7,928 codes in the
physician fee schedule but directly affects cardiothoracic surgery
because there are revised times for many high volume heart and chest
procedures. The commenter suggested that the new time information needs
to be put in the context of changes in physician time that may have
occurred in the last five to ten years on the remaining 7,343 procedure
codes where there are no new physician times. Another commenter
representing a cardiology subspecialty indicated that we incorporated
RUC time data for only 1,900 of the more than 7,000 procedure codes.
This commenter suggested that we should continue using available time
from a single source until a consistent source that includes
information on all CPT codes is available.
Response: As indicated in the proposed rule, the RUC submitted
physician time data for nearly 2,000 CPT codes in May 2001 and
recommended that we use these new physician times in the practice
expense methodology. The RUC recently sent new time for use in the
final rule that reflected refinements for a few codes. We note that the
source of the RUC times are actually the physician specialty societies
themselves, including those associations that have objected to our use
of the data. The data largely come from the specialty society surveys
that were forwarded to the RUC to support requests for physician work
RVUs for new and revised codes or services that were part of the 5-year
review. The RUC made a comprehensive effort to validate these times
before forwarding them to us. The RUC indicated to us that, over a
period of 2
[[Page 55263]]
years, specialties had been provided with an opportunity to review the
data and determine that they were accurately recorded.
While the new times forwarded by the RUC represent a minority of
CPT procedure codes, we note that they account for over 60 percent of
the allowed services that are paid under the physician fee schedule. In
response to the comment that we should make changes only when we have a
single source of time data for all codes, we note that there has never
been a single source of time for all codes. While time for some codes
is based on the original work of Harvard University, there are many
codes that came into existence since the Harvard survey was completed.
The only data source for these codes is the RUC.
We acknowledge that the Office of Inspector General is studying
issues related to physicians bringing clinical staff to the hospital
and the General Accounting Office is reviewing our use of supplemental
practice expense survey data. Since these studies are unrelated to
physician time, we do not believe they constitute a reason to suspend
incorporation of the new time data into the practice expense
methodology.
In response to the comments that suggest that the physician times
in the postoperative period may be overstated, the RUC indicated to us
that ``a number of improvements were made to the specifications
regarding the level of postoperative visits to more accurately capture
each element of physician time.'' While the total times we received
from the RUC reflect the number, types, and level of E/M services
furnished in the postoperative surgical period, these services are not
separately paid when furnished as part of a global surgical service.
Since these services are not paid separately, it is difficult to find
objective information that indicates how E/M services are provided in
the postoperative period. Currently, the only source of information we
can use is information that the RUC has supplied and data that
previously existed in our files. While we have undertaken research that
combines information on inpatient hospital stays with claims for
physicians' services, these data have limitations for determining the
level or type of visit being furnished in the postoperative period. We
would consider any further evaluation by the RUC on this issue.
d. Calculation of Practice Expense--Other Issues
Comment: Several commenters requested additional clarification and
information concerning the cause of reductions of 9 to 13 percent in
the practice expense RVUs for electrophysiology services. One commenter
indicated that there was no explanation of the proposed reduction in
practice expense for CPT codes 33207, 33208, 33249, and 93651. The
commenter suggested that we should provide a more complete explanation
of the proposed reductions or rescind them.
Response: Our observation is that there is no more than a 9 percent
reduction in practice expense RVUs for any of these codes. We also note
that the change in total payment for these codes as a result of the
change in practice expense RVUs is less than half of this amount. We
modeled five different changes to the practice expense methodology in
our August 2, 2001 proposed rule (66 FR 40397). Of these changes, the
change to physician time has the greatest effect on these codes. Since
the change in the practice expense RVUs results from new information
that affects payments for all procedure codes, we are continuing to
implement the reduction in practice expense RVUs that were proposed for
these codes.
Comment: We received one comment expressing concern that the
separate professional interpretation and technical components for CPT
code 95824 (cerebral death evaluation) have been eliminated. The
commenter requested that we restore the professional and technical
components of this service and crosswalk the technical component value
from a similar code, CPT code 95822 (EEG, sleep only). The commenter
also suggested that the work RVUs should be 1.08 RVUs, the same as
similar EEG codes.
Response: We have restored the separate professional and technical
components of this service. This service will likely be exclusively
furnished for patients who are in an institutional setting. Thus, we
will pay under the physician fee schedule only for the professional
interpretation. Payment for the technical component of the service will
be made through our payment to the institution for facility services.
Since the technical component of this service is never provided outside
of a hospital, we do not have enough information under the resource-
based methodology to establish nonfacility pricing. In the unlikely
event that this service is provided in the nonfacility setting, we are
making the global and technical component of this service subject to
carrier pricing. This change will apply to several other services that
are not furnished in nonfacility settings. We are not making changes to
the physician work RVUs for cerebral death evaluation in this final
rule. There were no requests to revise the work RVUs for this code as
part of the 5-year review of physician work.
Comment: An organization representing vascular surgeons stated that
the methodology used to incorporate the supplemental practice expense
survey data has failed. This commenter indicated that the practice
expense per hour for vascular surgeons increased by 9 percent from
using supplemental data; however, payments actually declined between
the November 2000 final rule and the August 2001 proposed rule. The
commenter provided potential explanations for the change to practice
expense RVUs. The commenter suggested that the results are inconsistent
with the statute that requires payments to recognize all costs and
violates the Administrative Procedure Act that rulemaking cannot be
arbitrary and capricious.
The commenter suggested an option that would result in a total
increase in vascular surgery payments of 9 percent, consistent with the
results of the supplemental survey. This option would involve
identifying vascular surgery procedure codes that decreased in payment
and reallocating RVUs such that aggregate payments to vascular surgeons
would increase by 9 percent.
Response: While the commenter is correct in stating that the
practice RVUs for several high-volume vascular surgery procedures
declined in our proposed rule, it is important to note that the changes
occurred independent of the use of supplemental practice expense survey
data. The supplemental practice expense survey data were incorporated
into the methodology in the November 1, 2000 final rule (65 FR 65385).
The changes that occurred between the November 2000 final rule and
the August 2001 proposed rule were the result of the five changes to
the methodology that we modeled and described in the August 2, 2001 (66
FR 40397) proposed rule. The additional reductions in practice expense
payments for vascular surgery codes that concern this commenter are
attributed to the changes we made to physician time. As we have stated
previously, the explanation of how time affects specific codes is
complex and requires extensive data analysis. We would be willing to
meet with interested parties to discuss the effects of the practice
expense methodology further.
The commenter suggests that we make decisions about an appropriate
increase
[[Page 55264]]
in value for specific services and reallocate RVUs consistent with
these decisions. We do not believe that such a policy would be
appropriate. We have established a methodology for determining practice
expenses and have valued all services using that process with the
exception of services that have no physician work RVUs. For these
services, we have established RVUs using an alternative methodology. It
is not possible to deviate from those methodologies and reallocate RVUs
to achieve particular results that may be more desirable to some
individuals than to others. Such decisions about ``appropriateness''
would become highly subjective and would, in our view, be more likely
to be criticized as arbitrary and capricious.
Comment: We received comments from specialty societies representing
technical component providers regarding the status of the zero-work
pool. Commenters representing radiology, cardiology, echocardiography
and radiation oncology centers strongly supported our position of
maintaining the status of the zero-work pool until an appropriate
alternative methodology can be determined. Two commenters argued that
none of the direct or indirect cost information resulting from the CPEP
process should be utilized to establish payment amounts for technical
component services unless and until we further consider the entire
methodology to be applied for technical component services. All
commenters urged us to consult closely with associations representing
the zero-work pool providers before making any changes in this regard.
One commenter emphasized that no changes should be made without further
research and discussion.
Response: We agree that the status of the zero-work pool should not
be changed until an alternate approach that values technical component
services appropriately can be developed. Over the next several months,
we will be analyzing the options for such an alternative approach
contained in the report, ``The Resource-Based Practice Expense
Methodology: An Analysis of Selected Topics,'' prepared by our
contractor, The Lewin Group. This report can be found on our web site,
and we would welcome comments on these options from all interested
parties. (See the Supplementary Information section of this rule for
directions on accessing our web site.) We also agree with the
commenters that we should consult with the affected specialties as we
proceed, and we will seek to maintain an open dialogue with the medical
community on this issue.
Comment: A commenter representing speech, language, and hearing
professionals recommended that the zero-work pool be modified to accept
the clinical staff wage increases. Seventy percent of the procedure
codes used by audiologists that are covered by Medicare are in that
pool and, thus, even though the proposed wage rate for audiologist has
increased by 24 percent, this increase will not be reflected for those
non-work services.
Response: The commenter is correct in stating that, because the
CPEP data are not used as allocators in the zero-work pool, the
increases in the clinical staff wage rates will not affect the payments
for audiology services at this time. However, as we mentioned above, we
are seeking to develop an appropriate alternative for the zero-work
pool and, when such an alternative is implemented, the revised wage
rates will be applied to audiology services. In addition, we allow
specialties to withdraw their services from the zero-work pool if the
specialty believes that their services will be more appropriately
valued outside that pool.
Comment: An organization representing diagnostic imaging centers
stated that, if we adopt the suggestion in the report of The Lewin
Group to establish specialty-specific zero-work pools, it has already
conducted a survey that establishes the costs per hour of providing
diagnostic imaging technical component services. The commenter added
that, regardless of the approach that we choose, the organization
welcomes the opportunity to work with us with respect to any changes
that may be contemplated in the zero-work pool methodology.
Response: As we have noted above in our discussion on specialty-
specific supplementary surveys, all of these surveys must meet the
criteria stated in our November 2000 final rule. We would be willing to
review the survey to see if the data can be used to develop a
specialty-specific practice expense per hour. In addition, we, too,
would welcome the opportunity to work with the organization as we
develop an alternative to the zero-work methodology.
e. Site-of-Service
Comments on Site-of-Service Clarification of Payment Policy
In the November 2, 1998 final rule (63 FR 58830) and the November
2, 1999 final rule (64 FR 59407), we indicated the circumstances under
which either the facility or the nonfacility RVUs are used to calculate
payment for a service. Specifically, we indicated that the lower
facility practice expense RVUs apply when the service is performed in
an Ambulatory Surgical Center (ASC) and the procedure is on the ASC-
approved procedures list. The higher nonfacility practice expense RVUs
apply to procedures performed in an ASC that are not on the ASC-
approved list because there will be no separate facility payment for
these services. As explained in the August 2001 proposed rule, we have
received a number of inquiries about the place-of-service that should
be used on the Medicare claim when a service that is not on the ASC-
approved procedures list is furnished in an ASC. In these
circumstances, we stated that physicians should indicate ASC as the
place-of-service on the Medicare claim. Other questions have arisen as
to whether a beneficiary can be billed for the ASC facility fee when
Medicare does not pay a facility fee because a procedure not on the ASC
list is performed in a certified ASC. In this situation, Medicare pays
the physician the higher nonfacility practice expense RVUs because the
ASC is effectively serving as a physician's office, and Medicare's
payment for the physician's service includes payment for all practice
expenses incurred in furnishing the service. The ASC benefit is not
implicated since the services do not meet the provisions of section
1833(i) of the Act. The services are covered as physicians' services
and paid under the physician fee schedule. Therefore, payment to the
physician reflects payment for the whole service, and the beneficiary
cannot be charged in excess of the limiting charge for the physician
fee schedule service.
Comment: Two commenters indicated that conditions of participation
and/or survey and certification guidelines limit physicians in an ASC
to furnishing only surgical procedures on the ASC approved list of
procedures. They stated that such restrictions interfere with providing
medical care that is in the patient's interest. The commenters request
that we revise the regulations to allow physicians to furnish surgical
and other medical procedures that are not on the approved ASC list in
an ASC.
Response: Because our proposal relates only to payment policy, we
are finalizing it as proposed. The payment policy will apply to
services furnished in an ASC that are not on the ASC-approved list to
the extent that such services are permitted under the conditions of
participation developed by our Office of Clinical Standards and Quality
(OCSQ) and by the survey rules developed by our Center for Medicaid and
State Operations (CMSO). It is our understanding that current
regulations
[[Page 55265]]
that restrict ASCs to furnishing surgical services does not limit them
to surgical services on the ASC-approved list, but rather, includes all
surgical services. However, questions about rules that limit services
that can be furnished in an ASC are beyond the scope of this final
rule.
B. Nurse Practitioners, Physician Assistants, and Clinical Nurse
Specialists Performing Screening Sigmoidoscopies
Based on our review of current medical literature, we believe that
nurse practitioners (NPs), clinical nurse specialists (CNSs), and
physician assistants (PAs) whose services are covered under Medicare
and who have been trained are qualified to perform screening
sigmoidoscopies safely and accurately. Therefore, in the August 2, 2001
proposed rule, we proposed revising Sec. 410.37(d) to provide that, in
order for screening sigmoidoscopies to be covered, they must be
performed by medical doctors, doctors of osteopathy, PAs, NPs, and
CNSs, if they meet the applicable Medicare qualification requirements
in Secs. 410.74, 410.75, and 410.76, and if they are authorized to
perform these services under State law.
Comment: Fifteen commenters addressed the issue of whether to allow
non-physician health care professionals to perform screening flexible
sigmoidoscopies for Medicare coverage and payment purposes. Four of the
commenters representing national non-physician health care professional
organizations and a health care consultant group enthusiastically
supported the proposal. Ten commenters, all national medical
associations or medical specialty groups, expressed various concerns
about the proposal but agreed that it was appropriate for NPs, PAs, and
CNSs to perform these services. These commenters suggested
clarification and revision of the rule in a number of different areas,
such as the need for physician supervision and appropriate training and
experience standards, to ensure quality of care in the non-physician
performance of these examinations. Two of these ten commenters that
suggested the need for additional requirements were national
gastroenterological physician groups which were divided in their
enthusiasm for the proposal. The American Gastroenterological
Association indicated that properly trained physician assistants, nurse
practitioners and clinical nurse specialists are capable and qualified
to perform screening flexible sigmoidoscopies. However, the Association
insisted that in no case should such practitioners be permitted to do
so without being directly supervised by an appropriately trained and
qualified onsite physician. In addition, the Association urged that
these non-physician providers should never be allowed to perform these
examinations without some assurance that they have been properly
educated and trained to perform them. These comments were echoed by
several other physician groups. On the other hand, the American College
of Gastroenterologists supported the proposal without specifically
mentioning the need for physician supervision and education and
experience requirements. The College emphasized that there is a great
need for sigmoidoscopy screening to be performed in the Medicare age
group. Moreover, they observed that there may not be sufficient numbers
of physicians available to perform the procedure, posing an access
problem for our beneficiaries. The College stated that, if we proceed
with the proposal, non-physician practitioners should be required to
provide certain specific information to beneficiaries stating who had
performed the examination and its impact on available benefits in
future years.
Another organization representing family physicians also noted
conditions which should be met if these practitioners provide this
service as proposed, but indicated that the existing Medicare
regulations for these practitioners suggested that these conditions are
met. For example, existing Medicare regulations require general (not
onsite) rather than direct (onsite) supervision of PAs. Several other
physician organizations in their recommendations also appear to support
a requirement less strict than direct physician supervision.
One other commenter--a national medical association--opposed the
proposal because of concerns as to whether non-physician health care
professionals could respond appropriately to problems or complications
that might possibly occur during the performance of the screening
procedure when a physician (with a higher level of medical skills) is
not present at the facility. None of the commenters who suggested
revisions to the proposed rule to specify requirements for physician
supervision and/or formal training and experience, or who opposed it,
produced scientific evidence in support of their views.
Response: As we indicated in the proposed rule, a growing body of
evidence from the medical literature has shown that certain properly
trained non-physician health care professionals can carry out screening
by flexible sigmoidoscopy as accurately and safely as physicians.
(Scheon et al. Archives of Internal Medicine 2000) This procedure
requires fewer supervised examinations to attain objective measures of
technical competency than other endoscopic procedures, does not require
sedation, and has a low rate of related complications. In the studies
reviewed, physician and non-physician endoscopists achieved similar
polyp detection rates and depth of insertion in screening performed
independently. No significant complications from sigmoidoscopy were
reported in any of these studies. The level of satisfaction with the
procedure was similar for all practitioners.
This demonstration of the ability of non-physician practitioners to
perform flexible sigmoidoscopy screening safely and accurately is a
very significant development. As the American College of
Gastroenterology noted in its comments, there is a physician
availability and a related beneficiary access problem of concern to
CMS. The Balanced Budget Act of 1997, effective January 1, 1998,
expanded Medicare coverage of non-physician practitioner services to
address concerns about access to services, especially in rural and
other areas of the United States where there is a lack of availability
of physicians for performing certain services such as screening
flexible sigmoidoscopies. The law and related regulations also outline
the level of supervision or medical direction for these non-physician
practitioners.
Flexible sigmoidoscopy is one of the promising modalities available
for decreasing mortality from colorectal cancer. The American Cancer
Society estimates that more than 56,000 Americans will die of
colorectal cancer this year. Studies have found that the use of
screening flexible sigmoidoscopy could lead to a 30 percent reduction
in total colorectal cancer mortality. (Selby et al. New England Journal
of Medicine 1992.) In view of limited Medicare beneficiary access in
certain areas, because screening flexible sigmoidoscopy remains an
underused cancer-prevention procedure, and, in the absence of any
submitted scientific literature that contradicts the underlying medical
evidence supporting the proposal, we do not believe that commenters
have presented us with a basis for revising the proposal as they have
suggested. However, we have found that a number of commenters have
offered us interesting suggestions for implementing the proposal and
clarifying the agency's intent in this
[[Page 55266]]
regard, which we explain in our response to the more specific comments
summarized below.
Comment: Several commenters referenced a recent OIG report entitled
``Medicare Coverage of Non-Physician Practitioner Services'' (OEI-02-
00-00290), which they believe makes clear that CMS does not have
systems in place to ensure that non-physician practitioners who provide
beneficiaries with medical services and who bill Medicare directly, are
performing their services in accordance with State law. One commenter
states that the report implies that it is not possible for Medicare to
ensure that a State law allows non-physician practitioners to provide
flexible sigmoidoscopies or that the services are provided in an
integrated practice arrangement with appropriate physician supervision.
For example, the commenter pointed out that 16 carrier medical
directors interviewed by the OIG reported that they do not verify that
non-physician practitioners are performing services within their State
scope of practice, and at least 22 carriers do not check the
collaborative agreement required for nurse practitioners and clinical
nurse specialists. The commenter indicated that the OIG concluded that
services performed and billed by non-physician practitioners create
potential payment and quality of care vulnerabilities since, (1) ``non-
physician practitioner billings are rising rapidly, but controls, which
are based on scopes of practice, are limited'', and (2) carriers ``do
not have sufficient guidance to distinguish which non-physician
practitioner services should be reimbursed by the program and which
should not.'' In light of these OIG findings, the commenter urges CMS
to review whether and how the agency and its carriers can ensure that
the above-mentioned concerns are resolved successfully when non-
physician practitioners perform screening flexible sigmoidoscopies. The
commenter says that ``it is vital that CMS takes steps to ensure the
fulfillment of these requirements to minimize any risk of experiencing
the vulnerabilities referenced in the OIG report with respect to
quality and payment issues.''
Response: We agree with OIG's conclusion identifying program
vulnerabilities when non-physician practitioners bill Medicare directly
for their services. We also respect beneficiaries' choices and their
need for access to medical services. While appreciative of OIG's
suggestion that it may be appropriate to consider additional controls
for Medicare payments to non-physician practitioners, we are sensitive
to issues that might arise from different treatment of different
classes of practitioners. As appropriate, we will monitor non-physician
practitioner services for both overall trends and for complex services.
Medicare currently defers to State licensing boards for regulating
and enforcing scope of practice laws. Before issuing a Medicare billing
number to a nurse practitioner or a nurse clinical specialist,
contractors first determine whether the applicant has a valid license
within the State. If a licensing board subsequently acts to suspend a
practitioner's license to practice, then Medicare suspends payments
under the practitioner's Medicare billing number. This practice is the
same for physician and non-physician practitioners.
To protect the integrity of the Medicare program, all claims
submitted are subject to data analysis that may lead to a focused or a
random review by a Medicare contractor. If Medicare is to begin
monitoring practitioners for compliance with State laws and
regulations, the program will have to develop additional regulations
and policies and impose additional workloads on contractors and perhaps
for all practitioners as well. In deciding whether such a process is
necessary and appropriate, we will carefully consider these comments in
this regard.
Comment: One commenter asked CMS, in implementing the proposal, to
ensure that non-physician practitioners are required to tender a
standard notification to Medicare beneficiaries providing them with a
clear statement that the screening flexible sigmoidoscopy is being
furnished by a non-physician practitioner. In addition, the commenter
suggests that the beneficiary be notified that under the new colorectal
cancer screening benefit, effective July 1, 2001, any average-risk
individual receiving a covered screening flexible sigmoidoscopy will be
precluded by law from receiving Medicare payment for a screening
colonoscopy (which under Medicare regulations (Sec. 410.37(f) must be
furnished by a physician)) for four years.
Response: We believe that our Medicare beneficiaries generally are
knowledgeable about the identity of the Medicare practitioner that is
furnishing them with a flexible sigmoidoscopy screening examination.
Accordingly, we believe that there is no need for non-physician
practitioners to provide beneficiaries with any formal notification
statement in this regard. As for the suggestion that a non-physician
practitioner should notify an average-risk beneficiary that providing
him/her with a screening flexible sigmoidoscopy will preclude Medicare
from paying for a screening colonoscopy (which must be performed by a
physician) for four years, we believe that all Medicare practitioners
should help to inform beneficiaries with respect to this limitation.
However, we do not believe that any practitioner should be required to
formally notify beneficiaries to this effect. While we believe that our
Medicare contractors, and all our practitioners have an important role
to play in educating our beneficiaries about the various conditions of
coverage and payment limitations that apply to different colorectal
cancer screening options that are available to them, we will not use
these regulations as a mechanism for implementing the requested
educational efforts.
Comment: One commenter suggested that we allow registered nurses to
perform these as well, as a delegated act, under a physician's
direction with the physician billing Medicare for the procedure.
Response: The regulation proposal to allow nurse practitioners,
physician assistants, and clinical nurse specialists to perform
screening flexible sigmoidoscopies for Medicare purposes was designed
to increase beneficiary access to these screening services, especially
in rural and other areas where there is a shortage or a lack of
availability of physicians who are trained and qualified to perform
these examinations. These non-physician practitioners are typically
licensed independent practitioners who are recognized under the
Medicare law and regulations for coverage and payment purposes. Under
Medicare, these non-physician practitioners may be paid under the
physician fee schedule for their tests (and treatments) that would be
physicians' services if furnished by a physician when they are
authorized by the State to perform such services. Registered nurses are
not licensed independent practitioners who are recognized under
Medicare law for coverage and payment purposes.
Comment: One commenter suggested that we should monitor beneficiary
health outcomes that result from the performance of sigmoidoscopy
examinations by non-physician practitioners to ensure that they are
done safely and accurately.
Response: We had not planned to monitor beneficiary outcomes that
might be related to implementation of the proposal to allow non-
physician practitioners to perform flexible sigmoidoscopy screening
because of the available evidence that they can provide these services
safely and effectively. If we were to consider doing this,
[[Page 55267]]
however, we would probably want to consider doing a comparative study
of health outcomes of beneficiaries who have been screened by both
physician and non-physician practitioners who have performed these
examinations.
Such a study would mean that a number of physician and non-
physician practitioners would have to collect and report data to us on
their Medicare patients for a certain period of time, which could be
burdensome for them. We may be interested in doing a study in this area
in the future if we had any credible evidence of a serious problem in
this area, but, at this time, we do not believe a study is necessary.
Result of Evaluation of Comments
We are adopting our proposal to allow certain non-physician
practitioners to perform screening flexible sigmoidoscopies.
C. Services and Supplies Incident to a Physician's Professional
Services: Conditions
Section 1861(s)(2)(A) of the Act authorizes coverage of services
and supplies (including drugs and biologicals that are not usually
self-administered by the patient) furnished incident to a physician's
service. These drugs and biologicals are commonly furnished in
physicians' offices without charge or included in the physicians'
bills. This statutory ``incident to'' benefit differs from the
``incident to'' benefit in the hospital setting as set forth in section
1861(s)(2)(B) of the Act, which authorizes coverage of hospital
services (including drugs and biologicals which are not usually self-
administered by the patient) incident to a physician's service
furnished to outpatients and partial hospitalization services furnished
to outpatients incident to a physician's service. This provision only
addresses coverage of ``incident to'' services under section
1861(s)(2)(A) of the Act. In addition, the statute provides Medicare
coverage of services incident to practitioners other than physicians.
The Medicare Carriers Manual currently requires that the physician
(or other practitioner) be either the employer of the auxiliary
personnel or be an employee of the same entity that employs the
auxiliary personnel. In the August 2, 2001 rule, we proposed to revise
Sec. 410.26 to codify our existing policy outlined in section 2050 of
the manual. Specifically, we proposed to codify the definitions of
auxiliary personnel, direct supervision, independent contractor, leased
employment, non-institutional setting, practitioner, and services and
supplies for purposes of services provided incident to a physician's
service.
In addition, we proposed to allow auxiliary personnel to provide
services incident to the services of physicians (or other
practitioners) who supervise them, regardless of the employment
relationship of the physician (or other practitioner) to the entity
that employed the auxiliary personnel.
All commenters supported the proposal. Their specific comments are
addressed below.
Comment: Commenters noted three errors in the proposed text of the
regulation. First, in the definition of auxiliary personnel set forth
in Sec. 410.26(a)(1), after the phrase ``under the supervision of a
physician,'' the term ``(or other practitioner)'' was omitted. Second,
in the definition of services and supplies set forth in
Sec. 410.26(a)(7), the phrase ``(including drugs and biologicals that,
as determined in accordance with regulations, cannot be self-
administered)'' should be changed to ``(including drugs and biologicals
which are not usually self-administered by the patient)'' in accordance
with section 112 of the BIPA, which amended sections 1861(s)(2)(A) and
(B) of the Act. Third, in the supervision requirement set forth in
Sec. 410.26(b)(5), the word ``direct'' was omitted.
Response: We agree with these comments, and we have corrected these
errors.
Comment: One commenter requested that independent contractor
physicians also be recognized as employees under the reassignment
policy set forth in section 3060 of the Medicare Carrier Manual.
Response: As stated in the August 2, 2001 rule, this proposal only
applies to the incident to policy. Furthermore, we are not defining or
re-defining the term employment. Instead, we proposed to permit
physicians (or other practitioners) to directly supervise auxiliary
personnel regardless of the employment relationship of the physicians
(or other practitioners) with the entity that hired the auxiliary
personnel. In order to bill and receive payment from Medicare under
this policy, all other applicable requirements must also be met. For
example, the service must be medically reasonable and necessary, and
appropriate reassignment must be executed.
Comment: One commenter suggested using in Sec. 410.26(b) all of the
terms defined in Sec. 410.26(a) or deleting the terms not used in
Sec. 410.26(b).
Response: We found one term--leased employment--that was not used
in Sec. 410.26(b). However, we will not eliminate this term because it
is used to define the term auxiliary personnel.
Comment: Several commenters requested that we clarify and
distinguish between the physician (or other practitioner) ordering the
incident to service and the physician (or other practitioner)
supervising the auxiliary personnel who perform the incident to
service. They stated that confusion exists as to whose Medicare Part B
billing number should be used on the claim form.
Response: Inherent in the definition of an incident to service is
the requirement that the incident to service be furnished incident to a
professional service of a physician (or other practitioner). When a
claim is submitted to Medicare under the billing number of a physician
(or other practitioner) for an incident to service, the physician is
stating that he or she either performed the service or directly
supervised the auxiliary personnel performing the service. Accordingly,
the Medicare billing number of the ordering physician (or other
practitioner) should not be used if that person did not directly
supervise the auxiliary personnel. We added language to the supervision
requirement set forth in Sec. 410.26(b)(5) to reflect this
clarification.
Comment: One commenter pointed out that the claim form currently
requires the physician (or other practitioner) to certify that he or
she personally supervised the employee. Therefore, the commenter
requested that we update the claim form to reflect the proposed
regulations.
Response: We plan to update not only the claim form but also
section 2050 of the Medicare Carriers Manual to reflect the new
regulations.
Comment: A few commenters noted that the individual does not always
receive an IRS-1099 form under an independent contractor arrangement.
Instead, when a clinic, for example, contracts with an entity that has
hired individuals to be furnished to the clinic, then the entity (and
not the individual) receives the IRS-1099 form.
Response: We agree with these commenters. Therefore, we have added
language to the definition of an independent contractor set forth in
Sec. 410.26(a)(3) to reflect this practice. However, we again emphasize
that the applicable reassignment rules must also be met and that this
incident to policy does not in any way alter the current requirements
for valid reassignment.
Comment: One commenter encouraged us to specify in the regulations
the acceptability of forms (other than the IRS W-2 form) that the
Internal Revenue Service recognizes as
[[Page 55268]]
proof of employment, such as the Payroll Agent arrangement where IRS
forms 2678 and 1997C are used instead.
Response: Under our proposal, the employment relationship is
irrelevant to whether a physician (or other practitioner) can
effectively furnish direct supervision of the auxiliary staff.
Therefore, we decline to include language that may define or re-define
the term employment.
Comment: One commenter suggested that we also include Ambulatory
Surgical Centers (ASCs) and Community Mental Health Clinics (CMHCs) in
the definition of a non-institutional setting because Medicare Part B
payments for services provided in these settings are paid through the
facility relative value units (RVUs) rather than the non-facility RVUs.
Response: The definition of a non-institutional setting is not
derived from the definition of a facility used to determine the site of
service and the application of the facility or non-facility RVUs.
Because section 1861(s)(2)(B) of the Act authorizes payment for
hospital incident to services, section 1861(s)(2)(A) of the Act cannot
authorize payment for hospital incident to services. This provision is
reiterated in Sec. 411.15(m)(2). Similarly, Sec. 411.15(p)(2)(ii)
specifically excludes payment for incident to services in skilled
nursing facilities (SNFs). Consequently, we defined non-institutional
settings as all settings except hospitals and SNFs, and we do not plan
to define ASCs and CMHCs as institutional settings.
Comment: Many commenters wanted us to restrict the definition of
auxiliary personnel so that only certain individuals may perform a
given incident to service. For example, they want us to mandate that
only audiologists may perform cochlear implant rehabilitation services
as incident to services. Likewise, they want us to permit only physical
or occupational therapists to perform physical or occupational therapy
as incident to services. In support, they noted that section 4541(b) of
the BBA amended section 1862(a)(20) of the Act and required that
physical or occupational therapy furnished as an incident to service
meet the same requirements outlined in the physical or occupational
therapy benefit set forth in sections 1861(g) and (p) of the Act.
Response: We have not further clarified who may serve as auxiliary
personnel for a particular incident to service because the scope of
practice of the auxiliary personnel and the supervising physician (or
other practitioner) is determined by State law. We deliberately used
the term any individual so that the physician (or other practitioner),
under his or her discretion and license, may use the service of anyone
ranging from another physician to a medical assistant. In addition, it
is impossible to exhaustively list all incident to services and those
specific auxiliary personnel who may perform each service.
Comment: Many commenters wanted us to re-emphasize that incident to
services set forth in section 1861(s)(2)(A) of the Act do not include
Medicare benefits separately and independently listed in the Act, such
as diagnostic services set forth in section 1861(s)(3). Some even
requested that we not permit these separately and independently listed
services to be rendered as incident to services.
Response: We realize, as did the Congress with the enactment of
section 4541(b) of the BBA, that many services--even those that are
separately and independently listed--can be furnished as incident to
services. However, this fact of medical practice is not inconsistent
with our policy. We maintain that a separately and independently listed
service can be furnished as an incident to service but is not required
to be furnished as an incident to service. Furthermore, even if a
separately and independently listed service is provided as an incident
to service, the specific requirements of that separately and
independently listed service must be met. For instance, a diagnostic
test under section 1861(s)(3) may be furnished as an incident to
service. Nevertheless, it must also meet the requirements of the
diagnostic test benefit set forth in Sec. 410.32. Namely, the test must
be ordered by the treating practitioner, and it must be supervised by a
physician. Thus, if a test requires a higher level of physician
supervision than direct supervision, then that higher level of
supervision must exist even if the test is furnished as an incident to
service. Accordingly, we decline to prohibit a separately and
independently listed service from being rendered as an incident to
service. Instead, we reiterate that a separately and independently
listed service need not meet the requirements of an incident to
service.
Comment: Recognizing that this proposal affords flexibility in the
way physicians (or other practitioners) are hired by an office or
clinic, one commenter requested that non-physician practitioners be
permitted to stand as locum tenens (taking the place of) for other non-
physician practitioners as well.
Response: This proposed rule does not alter in any way the current
locum tenens policy.
Result of Evaluation of Comments
We are finalizing our proposed revisions to Sec. 410.26 with the
corrections noted above.
D. Anesthesia Services
We generally use the 1988 American Society of Anesthesiologists'
(ASA) Relative Value Guide as the basis for the uniform relative value
guide. This guide is used in all carrier localities to determine
payment for anesthesia services furnished by physicians under Medicare
Part B. We proposed using the ASA base unit values from the 1999 guide
beginning in CY 2002 for eight codes with ASA base unit values that
were different from CMS's values (specifically, CPT codes 00810; 00902;
01150; 01214; 01432; 01440; 01770; and 01921). These are older codes
and, while we accepted the ASA base unit value initially, the ASA has
changed this base unit subsequently and no additional adjustment was
made by us to the base unit. For CPT codes 00142 and 00147, we proposed
maintaining the current base unit values although they differed from
the ASA values because values for these two codes were established
under the ``inherent reasonableness'' process in 1987.
Comment: The ASA identified additional CPT codes 00548, 00700,
00800, and 01916 with different base unit values in the most current
ASA guide from our base unit values.
Response: We are accepting the ASA's comments subject to the
following clarification. In all, 12 codes were presented where the ASA
base unit differs from our base unit. Of these, code 01921, which
appeared on the list in the August 2, 2001 proposed rule, will be
deleted in 2002. Since this code has been deleted and will no longer be
used, we will not assign base units to it and, as a result, only 11
codes will be considered.
These additional four codes were added to CPT before CY 2000. New
and revised codes starting in CY 2000 and for subsequent years are
evaluated on a code-specific basis under our usual process after we
receive recommendations from the RUC. Thus, because we review the RUC
recommendations and may make changes based on them, there could be
differences between the ASA guide and our base unit values beginning in
2000. If the RUC or other commenters recommend and we agree to a base
unit different from what ASA recommends, we will use that value and not
the ASA
[[Page 55269]]
value, even though it may be published in the ASA's guide.
Result of Evaluation of Comments
The complete list of 11 CPT codes for which we will assign the ASA
base unit values instead of the current CMS base unit values are as
follows:
------------------------------------------------------------------------
Code CMS ASA
------------------------------------------------------------------------
00548..................................................... 15 17
00700..................................................... 3 4
00800..................................................... 3 4
00810..................................................... 6 5
00902..................................................... 4 5
01150..................................................... 8 10
01214..................................................... 10 8
01432..................................................... 5 6
01440..................................................... 5 8
01770..................................................... 8 6
01916..................................................... 5 6
------------------------------------------------------------------------
A related issue is the treatment of base unit values for new codes
for 2002 as discussed in section V. The RUC reviewed the work values
for 19 new anesthesia codes for 2002. We agree with the RUC on 17 of
these codes but recommend lower values for 2 codes. The RUC recommended
9 units for CPT code 00797 (anesthesia for gastric restrictive
procedure for morbid obesity) and we proposed 8 units. The RUC
recommended 3 units for CPT code 01968 (cesarean delivery following
neuraxial labor analgesia/anesthesia--list separately in addition to
the code for primary procedure), and we proposed 2 units. (See section
V for additional information on the valuing of these new anesthesia
services.)
Result of Evaluation of Comments
We are implementing the base units for the 11 existing codes where
there are differences between the ASA's guide and our base units and
for which we received comments. In addition, we are implementing the
base units which the RUC recommended for 17 new codes and the base
units which we recommended and which are lower than the RUC's
recommendation for 2 new codes.
E. Performance Measurement and Emerging Technology Codes
In the August 2, 2001 proposed rule (66 FR 40383) we included a
discussion of the two new categories of CPT codes: Performance Measure
codes, referred to as Category II CPT codes, which are intended to
facilitate data collection; and, Emerging Technology codes, referred to
as Category III CPT codes, which are intended to track new and emerging
technologies.
For the Performance Measure codes, which have a syntax of four
digits followed by the letter ``F,'' we stated that no values would be
placed on the Performance Measure codes and no additional payment would
be made for the use of these codes. Practitioners would, however, be
able to report them on their Medicare bills to enable us to track these
services.
For the Emerging Technology Codes, which have a syntax of four
digits followed by the letter ``T,'' we stated that we would pay, on a
case-by-case basis in specific situations, when we determine that the
codes represent services that are not, in fact, experimental, but have
been shown to be safe and effective. If the coverage policy is not
consistent with the existing tracking codes, a Medicare-specific code
may need to be developed to allow payment for the service. Thus, only
specific emerging technology codes would be recognized for Medicare
payment.
Comment: Commenters expressed appreciation for our recognition of
these new categories of CPT codes. However, one commenter believed that
we should refrain from categorically denying payment for category III
(emerging technology) CPT codes, because these CPT codes may sometimes
warrant payment. Another commenter believed that we were proposing not
to pay for these codes at all. The commenter recommended that we
clarify in the final rule that carriers may determine if payment should
be made for a particular emerging technology code.
Response: We believe that these codes will serve a useful purpose.
We regret that some commenters believed that the discussion in the
proposed rule implied that these services should not be covered. We
only intended to indicate that by publishing these codes we are not
indicating that we would pay for these services in all instances. As
the commenter indicates, coverage of emerging technologies and payment
for these services is at the discretion of the carriers. We also want
to clarify that our carriers will be able to incorporate these codes
only after they are entered into our system during our regularly
scheduled updates and not as soon as the AMA posts them on the CPT web
site.
Result of Evaluation of Comments
We would like to clarify the intent of our proposal regarding
emerging technology CPT codes. The emerging technology CPT codes will
be published in the physician fee schedule with a status indicator of
``C'' to indicate that coverage and payment of these services is at the
discretion of the carrier. The only exceptions will be for those
emerging technology CPT codes that describe services for which Medicare
has issued an NCD. In these situations, coverage will be based on the
NCD, and we may establish national payment or may leave payment to the
discretion of the carriers. It is also possible that an NCD or an
established payment policy may foreclose coverage and/or payment for an
emerging technology CPT code. In summary, we will finalize our proposal
to allow both the CPT Performance Measure Codes (that is, codes with
four digits followed by the letter ``F'') and Emerging Technology Codes
(that is, codes with four digits followed by the letter ``T'') to be
listed on Medicare bills and provide payment for the emerging
technology codes as determined by the carrier.
F. Payment Policy for CPT Modifier 62 (Co-Surgery)
The CPT modifier code 62 is used to report the work of co-surgeons.
Currently, if we pay for co-surgery, we pay a total of 125 percent of
the fee schedule amount to the co-surgeons who each receive half of
this total payment. In the August 2, 2001 proposed rule (66 FR 40383),
we stated that we would be examining our payment policies for co-
surgery to consider possible ways to ensure that they reflect current
clinical practices and properly reflect the relative resources and work
effort required to perform these services. We outlined several issues
under consideration and specifically solicited information to assist us
in deciding whether to make a future proposal affecting payments for
co-surgery.
Result of Evaluation of Comments
Commenters responded to the specific questions in the proposed
rule. Many commenters believe that the current payment policy is
reasonable and that the focus should be on education efforts to ensure
the appropriate use of the modifier. We will review carefully the
information the commenters have provided. If we determine that we need
to proceed with a change in payment policy for co-surgery, the change
would be proposed as part of future rulemaking.
III. Implementation of Medicare, Medicaid, and SCHIP Benefits
Improvement and Protection Act of 2000
The Medicare, Medicaid, and SCHIP Benefits Improvement and
Protection Act of 2000 (BIPA) (Public Law 106-554), enacted on December
21, 2000, provides for revisions to policies applicable to the
physician fee
[[Page 55270]]
schedule. These revisions are presented below.
A. Screening Mammography
Medicare has paid for screening mammography since January 1, 1991.
Section 1834(c) of the Act governing these screenings did not include
screening mammography under the physician fee schedule; it provided for
payment under a separate statutory methodology. Section 104 of BIPA
amends section 1848(j)(3) of the Act to include screening mammography
as a physician's service for which payment is made under the physician
fee schedule beginning January 1, 2002. In the August 2001 proposed
rule, we proposed amending Secs. 405.534 and 405.535 to reflect the
inclusion of screening mammography as a physician's service which will
be payable under the physician fee schedule. In addition, we proposed
amending Sec. 414.2 to include screening mammography under the
definition for physicians' services. In accordance with part 414,
payments for screening mammography will be resource-based and will have
geographic adjustments that reflect cost differences among areas as do
all other services under the physician fee schedule, including
diagnostic mammography.
The following is a summary of the RVUs proposed for the
professional and technical components (PC and TC) of a screening
mammography, CPT code 76092, under the physician fee schedule.
Professional Component
A screening mammography service typically requires the same number
of views as a unilateral diagnostic mammography. Therefore, for
screening mammography, we proposed a physician work RVU of 0.70 based
on the physician work established for a unilateral diagnostic
mammography. This value is equal to the proposed work RVUs from the 5-
year review of physician work for CPT code 76090, unilateral diagnostic
mammogram (see June 8, 2001 proposed notice, ``Five-Year Review of Work
Relative Value Units Under the Physician Fee Schedule''). Since we
believe that the practice expense and malpractice expense for the
professional component of screening mammography is similar to the
professional component of unilateral diagnostic mammography, we
proposed establishing 0.25 practice expense RVUs and 0.03 malpractice
RVUs for the PC of screening mammography.
Technical Component
We proposed valuing the technical component of screening
mammography using a methodology that updates the original statutory
limit for the technical component of screening mammography of $37.40,
by the cumulative increase in physician fee schedule rates between 1992
and 2001 (see the August 2, 2001 proposed rule (66 FR 40384) for
specific information on methodology). This resulted in proposed
practice expense and malpractice RVUs for the technical component of
screening mammography of 1.27 and 0.06, respectively.
Overall, the total proposed RVUs associated with the combined PC
and TC of CPT code 76092 were 2.31 (0.70 work RVUs, 1.52 practice
expense RVUs, and 0.09 malpractice expense RVUs).
New Technology Mammography
The BIPA also required us to determine whether the assignment of
new HCPCS codes is appropriate for both screening and diagnostic
mammography performed using new digital technologies.
We determined that new HCPCS codes are appropriate for the new
digital technology mammography beginning January 1, 2002. We proposed
three separate codes for directly taking a digital image (one for
screening and one each for unilateral and bilateral diagnostic). We
also proposed a single add-on code for computer-aided diagnosis with
conversion of standard film images to digital images, since, at the
time of the development of the proposed rule, the FDA approved
computer-aided diagnosis only for screening mammography. Following is a
summary of our proposed coding and payment methodologies for digital
mammography.
Screening Mammography, Direct Digital Image (Gxxx1)
We proposed HCPCS code Gxxx1 to report screening mammography
performed using direct digital images as opposed to mammography that is
performed using the standard film images associated with CPT code
76092, or conversion of a standard film image to a digital image. For
the PC of HCPCS code Gxxx1, we proposed 0.70 work RVUs, 0.28 practice
expense RVUs, and 0.03 malpractice expense RVUs. For the TC of HCPCS
code Gxxx1, for which there is no physician work associated, we
proposed 2.50 practice expense RVUs and 0.06 malpractice RVUs.
Diagnostic Mammography, Unilateral, Direct Digital Image (Gxxx2)
We proposed HCPCS code Gxxx2 to report unilateral diagnostic
mammography performed using direct digital images as opposed to
mammography performed using the standard film images associated with
CPT code 76090, or conversion of a standard film image to a digital
image.
For the professional component of HCPCS code Gxxx2, we proposed
0.70 work RVUs, 0.28 practice expense RVUs, and 0.03 malpractice
expense RVUs. For the TC of HCPCS code Gxxx2, with which there is no
physician work associated, we proposed 1.99 practice expense RVUs and
0.05 malpractice expense RVUs.
Diagnostic Mammography, Bilateral, Direct Digital Image (Gxxx3)
We proposed HCPCS code Gxxx3 to report bilateral diagnostic
mammography that is performed using direct digital images as opposed to
mammography performed using the standard film images associated with
CPT code 76091, or conversion of a standard film image to a digital
image.
For the PC of HCPCS code Gxxx3, we proposed 0.87 work RVUs, 0.34
practice expense RVUs, and 0.03 malpractice expense RVUs. For the TC of
HCPCS code Gxxx3, with which there is no physician work associated, we
proposed 2.47 practice expense RVUs and 0.06 malpractice expense RVUs.
Computer-Aided Detection, With Either Direct Digital Image or
Conversion of Standard Film Images to Digital Images (HCPCS Code Gxxx4)
We proposed HCPCS code Gxxx4 to report conversion of standard film
images to digital images when used in conjunction with computer-aided
diagnosis software. This code was proposed as an add-on code that can
be billed only in conjunction with the primary service, CPT code 76092,
based on our understanding that the only FDA-approved use of the
computer-aided diagnosis mammography software is with screening film
images. If there are other FDA-approved uses of computer-aided
diagnosis, we stated we would allow for use of Gxxx4 as an add-on to
other mammography services.
For the PC of code Gxxx4, we proposed 0.06 work RVUs, 0.02 practice
expense RVUs, and 0.01 malpractice expense RVUs. For the TC of HCPCS
code Gxxx4, with which there is no physician work associated, we
proposed 0.41 practice expense RVUs and 0.01 malpractice expense RVUs.
Since publication of the proposed rule, the FDA has also approved
the use
[[Page 55271]]
of computer-aided diagnosis with diagnostic mammography.
Comment: The majority of comments received from manufacturers,
specialty organizations, individuals, and representatives of the
Congress were supportive of our proposed payment of mammography
services beginning January 1, 2002. The general consensus from
commenters was that the proposed 21 and 26 percent increase,
respectively, in payments for unilateral and bilateral diagnostic
mammography, as a result of the 5-year review of work (see section IV),
the new resource-based payment for screening mammography, the new
resource-based payments for both digital screening and digital
diagnostic mammography, and the payments for computer-aided diagnosis
reflect the relative resources associated with each individual service.
However, two commenters still believe that the 21 percent and 26
percent increase in payments for unilateral and bilateral diagnostic
mammography, respectively, was still inadequate to cover the costs of
these services.
Response: In agreement with the majority of comments received, we
continue to believe that our proposed relative values are an accurate
reflection of the resources associated with the provision of these
services.
Comment: We received comments that suggested that Medicare payment
is inadequate to cover the cost of screening mammography. One commenter
stated that, due to the Federally-mandated Mammography Quality
Standards Act (MQSA) requirements intrinsic to mammography (both
screening and diagnostic), it is difficult to use the current
methodology to account for all practice expenses. This commenter did
indicate support for our proposal to develop practice expense RVUs for
screening mammography using a comparison to unilateral diagnostic
mammography.
Response: We are currently using the ``no work'' methodology to
price the technical component of diagnostic mammography and a special
method for the technical component of screening mammography. We believe
that most costs associated with mammography services are likely to be
associated with the technical component. At this time, we plan to
continue using these methods to establish the practice expense relative
value units for the technical component of mammography services.
However, if we propose a change to the methodology for no-work services
in the future, we agree that it is important to consider whether MQSA
costs are incorporated in the data sources we are using to develop
RVUs.
Comment: We received two comments that suggested Medicare should
not pay for screening mammography using the physician fee schedule
until payment is set at an appropriate level so as not to require
reduction in payments for other services. The commenters were concerned
about the reduction in payment for other services that would result
from the increase in payment for screening mammography using the
methodology we proposed. These commenters acknowledged that the statute
requires us to pay for screening mammography using the physician fee
schedule. One commenter appreciated the significant effort that CMS put
forth to comply with the mandate.
Response: As indicated by the comments, section 104(a) of the BIPA
requires us to pay for screening mammography using the Medicare
physician fee schedule beginning January 1, 2002. We estimate that
payment in 2002 for screening mammography under the statutory
methodology would have been about $71, which is less than the $81 that
Medicare will pay under the physician fee schedule. Since screening
mammography is paid under the physician fee schedule, the increase in
payment will be subject to the budget neutrality calculations under
section 1848(c) of the Act. The increase in payment, although large,
will have little effect on payment for other physician fee schedule
services. The required adjustment to other physician fee schedule
payments is less than -0.1 percent.
Comment: We received comments about coding for new technology
screening mammograms. These comments indicated support for our proposed
coding but noted that two developments have since occurred that we
could not have taken into account in our proposed rule. First, CPT
created a new code for computer-aided detection (CAD) as an add-on for
screening mammography. Second, the Food and Drug Administration
approved use of CAD for diagnostic mammography. The commenters
requested that we use the CPT code for CAD as an add-on to screening
mammography and create a slightly modified HCPCS alphanumeric code as
an add-on for diagnostic mammography. The modification would specify
that the alphanumeric code is to be used as an add-on for diagnostic
mammography. Commenters also suggested that we accommodate potential
future FDA approved uses of CAD as an add-on to digital mammography
through necessary coding and payment changes as soon as possible
without having to await the next rulemaking cycle.
Response: We agree with the comments about coding of CAD. Medicare
will recognize CPT code 76085 for CAD as an add-on to screening
mammography and procedure code G0236 as an add-on to diagnostic
mammography. The code descriptors make clear that the CPT code is for
use as an add-on to screening mammography and the alphanumeric code is
an add-on to diagnostic mammography. Payment for the revised codes
follows the proposed rule approach for physician work, practice expense
and malpractice for all mammography services. There may be slight
changes to the RVUs for practice expenses as a result of updated
information included in this final rule that affect all physician fee
schedule services.
In response to the comment about potential future FDA approved uses
of CAD as add-on to digital mammography, it is possible that additional
coding changes will be necessary or that editorial revisions to
existing codes will allow for CAD to be paid as an add-on for digital
mammography. We would like to coordinate our efforts with those of the
CPT to minimize the need for alphanumeric codes and additional CPT
codes.
Comment: One commenter expressed concern about the payment
associated with the Outpatient Prospective Payment System for all forms
of mammography.
Response: Any issues related to the Outpatient Prospective Payment
System are outside the scope of this regulation and will be addressed
by a separate regulation.
Comment: One commenter asked for clarification on Federally
Qualified Health Centers (FQHC) reimbursement for screening mammography
and other new services.
Response: Any issues related to FQHC reimbursement are outside the
scope of this regulation.
Comment: One commenter expressed concern that CMS did not work more
closely with the CPT codes in the establishment of coding for digital
mammography.
Response: Whenever possible, CMS works with the American Medical
Association's CPT Editorial Panel to establish coding for new
technologies. The AMA CPT Editorial Panel has not established codes for
digital mammography; therefore, CMS proactively established temporary
G-codes for the digital mammography and
[[Page 55272]]
computer-aided detection for diagnostic mammograms.
Comment: One commenter indicated that the malpractice expense for
screening mammography should be higher than the unilateral diagnostic
value of 0.03 since most mammography malpractice claims arise from
allegations of cancers not detected or inappropriate follow-up of
screening mammograms, not diagnostic studies. In addition, the
screening mammography malpractice apportionment should be reversed for
the PC and TC portions as the malpractice expense and risk is primarily
with the interpreter of the screening mammogram, not the facility
producing the technical component.
Response: We will consider the malpractice RVUs for these services
interim for 2002 and will examine this issue with respect to the
methodology used to establish malpractice RVUs.
Result of Evaluation of Comments
We will finalize our proposed relative values, because we believe
they are an accurate reflection of the cost associated with the
provision of these services. Additionally, we will also establish a
temporary G-code (G0236) for the recent FDA approval of computer-aided
detection used in conjunction with diagnostic mammography.
Table 3.--2002 Mammography Payments
----------------------------------------------------------------------------------------------------------------
Practice Malpractice
CPT \1\ HCPCS MOD Descriptor Work RVU Expense RVU RVU Total
----------------------------------------------------------------------------------------------------------------
76090......................... ..... Mammogram, one breast 0.70 1.25 0.08 2.03
76090......................... 26 Mammogram, one breast 0.70 0.25 0.03 0.98
76090......................... TC Mammogram, one breast 0.00 1.00 0.05 1.05
76091......................... ..... Mammogram, both 0.87 1.54 0.09 2.50
breast.
76091......................... 26 Mammogram, both 0.87 0.30 0.03 1.20
breast.
76091......................... TC Mammogram, both 0.00 1.24 0.06 1.30
breast.
76092......................... ..... Mammogram, screening. 0.70 1.44 0.09 2.23
76092......................... 26 Mammogram, screening. 0.70 0.25 0.03 0.98
76092......................... TC Mammogram, screening. 0.00 1.19 0.06 1.25
G0202......................... ..... Mammogram, screen, 0.70 2.52 0.09 3.31
dir dig.
G0202......................... 26 Mammogram, screen, 0.70 0.30 0.03 1.03
dir dig.
G0202......................... TC Mammogram, screen, 0.00 2.42 0.06 2.48
dir dig.
G0204......................... ..... Diag mammo, bilat, 0.87 2.73 0.09 3.69
dir dig.
G0204......................... 26 Diag mammo, bilat, 0.87 0.35 0.03 1.25
dir dig.
G0204......................... TC Diag mammo, bilat, 0.00 2.38 0.06 2.44
dir dig.
G0206......................... ..... Diag mammo, unilat, 0.70 2.20 0.08 2.98
dir dig.
G0206......................... 26 Diag mammo, unilat, 0.70 0.28 0.03 1.01
dir dig.
G0206......................... TC Diag mammo, unilat, 0.00 1.92 0.05 1.97
dir dig.
G0236......................... ..... Computer aided 0.06 0.31 0.02 0.39
detect, diag.
G0236......................... 26 Computer aided 0.06 0.02 0.01 0.09
detect, diag.
G0236......................... TC Computer aided 0.00 0.29 0.01 0.30
detect, diag.
76085......................... ..... Computer aided 0.06 0.31 0.02 0.39
detection.
76085......................... 26 Computer aided 0.06 0.02 0.01 0.09
detection.
76085......................... TC Computer aided 0.00 0.29 0.01 0.30
detection.
----------------------------------------------------------------------------------------------------------------
\1\ CPT codes and descriptions only are copyright 2002 American Medical Association. All Rights Reserved.
Applicable FARS/DFARS Apply.
B. Screening Pelvic Examinations
Section 101 of the BIPA amends section 1861(nn)(2) of the Act
(effective July 1, 2001) to provide that a woman who does not qualify
for annual coverage of a screening pelvic examination under one of the
statutory exceptions, qualifies for coverage of a screening pelvic
examination (including a clinical breast examination) once every 2
years rather than once every 3 years.
In the August 2, 2001 proposed rule, we made conforming changes to
Sec. 410.56 (Screening Pelvic Examinations) of the regulations to
reflect this statutory provision that has been implemented through
sections 4603, 3628.1 and 4731 of the Medicare Carrier Manual, the
Medicare Intermediary Manual, and the Medicare Hospital Manual,
respectively.We received only one specific comment on the new screening
pelvic examination proposal. That comment supported our proposed rule
and recognized that the regulations are consistent with the Medicare
law.
Result of Evaluation of Comments
We are adopting our proposal to conform the regulations to the law
to provide coverage for biennial screening pelvic examination for women
not at high risk for cervical or vaginal cancer, effective July 1,
2001.
C. Screening for Glaucoma
Section 102 of the BIPA provides for Medicare coverage under Part B
for screening for glaucoma for individuals with diabetes, a family
history of glaucoma, or others determined to be at ``high risk'' for
glaucoma effective for services furnished on or after January 1, 2002.
The statute provides for coverage of glaucoma screening, including (1)
a dilated eye examination with an intraocular pressure measurement, and
(2) a direct ophthalmoscopy or a slit-lamp biomicroscopic examination,
subject to certain frequency and other limitations.
In the August 2, 2001 rule, we proposed a new Sec. 410.23
(Screening for Glaucoma: Conditions for and Limitations on Coverage),
to provide for coverage of the various types of glaucoma screening
examinations specified in the statute. As provided in the statute, this
new coverage allows payment for one glaucoma screening examination
every year. To implement the statutory provisions, we proposed
definitions for the following terms--screening for glaucoma, eligible
beneficiaries, and direct supervision.
In keeping with the language of section 102(b) of the BIPA we
proposed defining the term ``screening for glaucoma'' to mean a dilated
eye examination with an intraocular pressure measurement and a direct
ophthalmoscopy or a slit-lamp biomicroscopic examination for the
[[Page 55273]]
early detection of glaucoma. This section also provides that the
screening examinations that are to be covered under Medicare are to be
furnished by or under the direct supervision of an optometrist or
ophthalmologist who is legally authorized to furnish these services
under State law (or the State regulatory mechanism provided by State
law) of the State in which the services are furnished. These are
services that would otherwise be covered if furnished by a physician or
as incident to a physician's professional service. We also proposed
incorporating this language in Sec. 410.23.
We used the term ``eligible beneficiaries'' to indicate who may
qualify for the new screening glaucoma benefit, and we proposed
defining that term to include--individuals with diabetes mellitus,
individuals with a family history of glaucoma, and African-Americans
age 50 and over. As explained in the August 2 proposed rule, based on
our review of the medical literature, and consultation with staff of
the National Eye Institute and representatives of the American Academy
of Ophthalmology and the American Optometric Association, we
interpreted the statutory language, ``individuals determined to be at
high risk for glaucoma'' to include Medicare beneficiaries who are
African-Americans age 50 and over.
We felt that the medical evidence available at this time was only
sufficient to support inclusion of African-Americans age 50 and over in
the statutory ``high risk'' category, in addition to individuals with
diabetes and those with a family history of glaucoma who are covered
separately under the new screening benefit. However, we specifically
solicited public comment on the appropriateness of including other
individuals in the statutory definition of ``high risk'' for glaucoma,
with supporting documentation from medical literature.
Section 102(b) of the BIPA provides that the glaucoma screening
examination is to be furnished by or under the direct supervision of an
ophthalmologist or optometrist who is legally authorized to furnish
such services under State law or regulation in which the services are
furnished. We proposed defining the term ``direct supervision'' as that
term is defined in Sec. 410.32(b)(3)(ii) for purposes of the oversight
of covered diagnostic laboratory services as they are performed in the
office setting. Specifically, for purposes of screening glaucoma we
proposed defining the term ``direct supervision'' to mean that the
ophthalmologist or optometrist must be present in the office suite and
immediately available to furnish assistance and direction throughout
the performance of the procedure. The definition states that the term
``direct supervision'' does not mean the physician must be present in
the room when the procedure is performed.
We also proposed conforming changes to specify an exception to the
list of examples of routine physical checkups excluded from coverage in
Secs. 411.15(a)(1) and 411.15(k)(9) for glaucoma screening examinations
that meet the frequency limitation and the conditions for coverage that
we are specifying under new Sec. 410.23.
We received six comments that generally supported the proposal to
implement section 102 of BIPA that provides for Medicare coverage of
screening for glaucoma. Four of these comments were submitted by
national medical associations, one was submitted by a pharmaceutical
company, and another was provided by a consulting group. Only one
commenter had a suggestion for revising the specific coverage
provisions of the proposal.
Comment: One commenter responded to our invitation to the public in
the proposed rule to submit comments on the question of whether it
might be appropriate to include other individuals (and not just
African-Americans over age 50) in the statutory definition of those at
``high risk'' for glaucoma. First, the commenter cites an article from
the medical literature that notes that ``one of the clearest factors
relating to increased glaucoma prevalence is age.'' (Gilchrist.
Ophthalmic Physiol Opt 2000) Second, the commenter refers to other eye
experts in the research of the epidemiology of glaucoma who have
suggested that ``the appropriate age at which screening might be most
effective is 6 to 10 years younger among those of African descent
because of the earlier onset of disease.'' (Quigley and Vitale. Invest
Ophthalmol Vis Sci 1997) Third, the commenter states that the latter
conclusion is supported by data showing that in African-Americans who
eventually develop glaucoma, the disease is present in 25 percent by
age 54, 50 percent by age 65, and 75 percent by age 75. The commenter
cites from the same Quigley article that comparable ages for these
percentages of disease development in non-African-Americans are 64, 72,
and 81 years, respectively. Finally, the commenter concludes that this
literature supports a policy that would provide the glaucoma screening
benefit for non-African Americans at an age 6 to 10 years older than
for African-Americans (for example, 50 years of age), or beginning at
age 56 to 60 years of age.
Response: We believe that the commenter has not interpreted the
results of the Quigley and Vitale studies correctly. The article by
Quigley and Vitale reported the results of a meta-analysis and
statistical modeling to estimate the prevalence and incidence of
glaucoma. In general, results from meta-analysis and remodeling are
often limited by the quality and comparability of the original source
data. In the proposed rule, we used data reported directly from the
Baltimore Eye Study (Tielsch, et al. JAMA 1991) and the Beaver Dam Eye
Study (Klein, et al. JAMA 1992), two of the largest published studies
on glaucoma. These studies indicated that the prevalence of glaucoma in
non-African-Americans starts to increase after the age of 65 to 70
years, whereas the prevalence increases much earlier in African-
Americans. Our decision to include African-Americans in the statutory
category of those at ``high risk'' for glaucoma was based on these
studies and the increased prevalence of glaucoma in African-Americans.
Although we have decided not to add new populations to the
definition of high risk at this time, the comment does raise the issue
of how we should revise the definition in the future, if there is
evidence to do so. We have decided to revise the proposed language in
Sec. 410.23(a)(2) so that it specifically refers to ``individuals in
the following high risk categories'' to make it more consistent with
the statute. This new structure for the regulation language will permit
CMS to more easily add high risk groups to the glaucoma screening
benefit through the rulemaking process should the evidence in the
medical literature warrant it.
Payment for Glaucoma Screening
We believe that services provided as part of glaucoma screening
will often overlap with services a physician provides during a patient
encounter for ophthalmological services without requiring any
additional work or practice expense. Therefore, we proposed bundling
payment for glaucoma screening when it is provided on the same day as
an evaluation and management (E/M) service or when it is provided as
part of any ophthalmology service. In instances when glaucoma screening
is the only service provided or when it is provided as part of an
otherwise non-covered service (for example, CPT code 99397, preventive
services visit,) we proposed the following HCPCS codes and payments:
[[Page 55274]]
Gxxx5, Glaucoma Screening Furnished by a Physician for High Risk
Patients.
For physician work and for malpractice, we proposed work and
malpractice RVUs of 0.45 and 0.02, respectively, by crosswalking these
values from CPT code 99212. Gxxx6, Glaucoma Screening Furnished Under
the Direct Supervision of a Physician for High Risk Patients.
For physician work and for malpractice, we believe this new HCPCS
code represents a level of work comparable to other E/M services
performed ``incident to'' a physician's service and therefore proposed
to crosswalk the work and malpractice RVUs from CPT code 99211 (E/M
service that may not require the presence of a physician) which are
0.17 and 0.01, respectively.
For non-facility settings, we proposed the following practice
expense inputs for both of the above HCPCS Codes-- clinical staff time-
certified ophthalmic medical technologist/certified ophthalmic
technician/registered nurse: five minutes; equipment: screening lane;
and supplies: ophthalmology visit supply package.
Comment: We received a comment from the American Academy of
Ophthalmology (AAO) agreeing with our decision to bundle glaucoma
screening with other E/M services and with our decision to create two
levels of glaucoma screening services based on whether or not the
physician performed the evaluation. The AAO also agreed with our
proposal regarding RVUs for glaucoma screening performed ``incident
to'' but commented that the level of payment for glaucoma screening
performed by a physician was too low. They believe that payment rate
should be a blend between CPT codes 99202 (Office or other outpatient
visit for evaluation and management of a new patient) and 99213 (Office
or other outpatient visit for evaluation and management of an
established patient). This is based on the expectation that some
patients receiving the service will be ``new'' patients to the
ophthalmologist while others will have previously seen the
ophthalmologist and therefore be ``established'' patients.
The AAO proposes that for 2002, payment be equivalent to CPT code
99202 for both physician work and practice expense, that for 2003,
payment be equivalent to a 4.4 percent/95.6 percent blend of CPT codes
99202 and 99213 for both physician work and practice expense, that for
2004, payment be equivalent to a blend of 4.5 percent/95.5 percent
blend of CPT codes 99202/99213, and that for 2005 and thereafter,
payment be equivalent to a blend of 4.6 percent/95.4 percent of CPT
codes 99202/99213. The AAO believes that the amount of history,
physical examination, and medical decision making required for glaucoma
screening approximates the amount of history, physical examination and
medical decision making required for CPT code 99202 at the time of the
first glaucoma screening and approximates the amount of history,
physical examination, and medical decision making required for 99213 at
the time of subsequent glaucoma screenings.
The American Optometric Association (AOA) echoed the AAO's comments
concerning the crosswalk for physician work. They also noted that the
practice expense inputs should be crosswalked to the intermediate
ophthalmologic codes.
Response: We are finalizing our proposal to assign 0.45 work RVUs
and .02 malpractice RVUs to Gxxx5, glaucoma screening performed by a
physician (now G0117). This service is a screening service and
therefore cannot be easily compared to the key components of a level
III evaluation and management service (CPT code 99213). We also believe
that the vast majority of beneficiaries receiving this service will be
patients who have been previously seen by the ophthalmologist
performing the service and, therefore, CPT code 99202 would not be an
appropriate crosswalk for this service. We believe the work required
for this service is similar whether or not the patient is ``new'' or
``established''. Patients undergoing a screening service have no chief
complaint or history of present illness. To perform this service, the
only historical information required is a determination as to whether
the beneficiary meets the criteria in the law, (for example, is at high
risk for glaucoma). Therefore, the requirements for taking a history
are actually less than the requirements of CPT code 99212.
Additionally, the physical examination requirements are specified in
the statute and are similar to the requirements of CPT code 99212.
Furthermore, the vast majority of patients undergoing screening will
not have glaucoma, so the typical screening service will require
routine medical decision making. For those few patients with glaucoma
who will need to schedule a return visit, the medical decision making
is straightforward. Therefore, the glaucoma screening requirements are
similar to CPT code 99212. Our decision to assign 0.45 work RVUs to
this service is also consistent with the time required to perform the
service and places it in correct rank order with regard to other
screening services payable under Medicare. We have decided to accept
the recommendation of AOA on practice expense inputs and will crosswalk
the inputs from CPT code 92012, brief ophthalmic exam performed on an
established patient, rather than using the practice expense inputs from
CPT codes 99202 and 99213 as suggested by AAO.
Because we received no comments on the RVUs for the Gxxx6 code,
Glaucoma Screening Furnished Under the Direct Supervision of a
Physician for High Risk Patients (now G0118), we will implement this as
proposed and will assign .17 work RVUs and .01 malpractice RVUs. For
practice expense, we will also crosswalk this code to CPT 92012.
Comment: Several commenters noted that medical technicians do not
have the education or training to provide screening glaucoma services.
One commenter noted that ophthalmic medical personnel (OMP) are not
licensed by State regulatory agencies and are precluded from ordering
medications, including eyedrops. The commenter states that, according
to the Joint Commission on Allied Health Personnel in Ophthalmology and
the Association of Technical Personnel in Ophthalmology, OMPs cannot be
independent practitioners, cannot diagnose or treat eye disorders and
cannot prescribe medications. Since a dilated eye exam requires
medication, the OMP cannot perform the exam without the patient first
being seen by an ophthalmologist or optometrist.
Response: The regulation is drafted based on the statutory
provision; however, it does not supersede any State laws or licensing
requirements.
Result of Evaluation of Comments
We are adopting our proposal to include only African-Americans age
50 and over in the statutory category of those at ``high risk'' for
glaucoma. We are revising the regulation in Sec. 410.23(a)(2) to read
``Eligible beneficiary means individuals in the following high risk
categories.'' This should allow CMS to more easily add high risk groups
by rulemaking should the medical evidence warrant it.
For G0117 Glaucoma Screening for High Risk Patients Furnished by
an Optometrist or Ophthalmologist--we will assign 0.45 work RVUs, .02
malpractice RVUs and we will crosswalk practice expense inputs from CPT
code 92012.
For G0118 Glaucoma Screening for High Risk Patients Furnished
Under the Direct Supervision of an Optometrist or Ophthalmologist--we
will assign .17 work RVUs and .01 malpractice RVUs.
[[Page 55275]]
For practice expense we will also crosswalk this code to CPT code
92012.
D. Screening Colonoscopy
Before the enactment of the BIPA, sections 1861(pp)(1)(C) and
1834(d)(3)(E) of the Act authorized Medicare coverage of screening
colonoscopies once every 2 years for individuals at high risk for
colorectal cancer. Individuals not at high risk for colorectal cancer
did not qualify for coverage of screening colonoscopies under the
colorectal cancer screening benefit, but they did qualify for coverage
of other colorectal cancer screening examinations specified in the
statute. These other examinations that were covered for individuals not
at high risk for colorectal cancer included screening fecal-occult
blood tests, screening flexible sigmoidoscopies, and screening barium
enema examinations at certain frequency intervals specified in the
statute and the regulations at Sec. 410.37 (Colorectal cancer screening
tests).
Section 103 of the BIPA amended sections 1861(pp)(1)(C),
1834(d)(2)(E)(ii), and 1834(d)(3)(F) of the Act to add coverage of
screening colonoscopies once every 10 years for individuals not at high
risk for colorectal cancer. However, in the case of an individual who
is not at high risk for colorectal cancer, but who has had a screening
flexible sigmoidoscopy within the last 4 years, the statute provides
that payment may be made for a screening colonoscopy only after at
least 47 months have passed following the month in which the last
screening flexible sigmoidoscopy was performed. In addition, the
statute provides that, in the case of an individual who is not at high
risk for colorectal cancer but who does have a screening colonoscopy
performed on or after July 1, 2001, payment may be made for a screening
flexible sigmoidoscopy only after at least 119 months have passed
following the month in which the last screening colonoscopy was
performed.
In view of the statutory changes, we are conforming Secs. 410.37(e)
and 410.37(g) (related to limitations on coverage of screening
colonoscopies and screening flexible sigmoidoscopies) to make them
consistent with the new provisions of the statute that have been
implemented through manual provisions of the Medicare Carriers Manual,
the Medicare Intermediary Manual Part III, and the Medicare Hospital
Manual in transmittal numbers 6097, 1824, and 7069, respectively, in
February 2001.
Payment for Screening Colonoscopy
Payment for screening colonoscopy will be made under HCPCS code
G0121: colorectal screening; colonoscopy for an individual not meeting
criteria for high risk. As with current code G0105, screening
colonoscopy for an individual at high risk, payment will be made at the
level for a diagnostic colonoscopy, CPT code 45378, because the work is
the same whether a procedure is screening or diagnostic. As the statute
requires that, for both individuals who are or are not at high risk,
if, during the course of the screening colonoscopy, a lesion or growth
is detected that results in a biopsy or removal of the growth, the
appropriate diagnostic procedure classified as colonoscopy with biopsy
or removal should be billed and paid rather than HCPCS code G0105 or
G0121.
We received four comments in support of the proposal to conform the
regulations to the Medicare law implementing the new screening
colonoscopy provision (section 103 of the BIPA) for individuals not at
high risk for colorectal cancer. One of the commenters, however, did
have a suggestion for how we could improve the manual instructions that
we issue to our carriers on this subject.
Comment: The commenter suggests that we instruct our Medicare
carriers to identify which International Classification of Diseases--
Volume Nine (ICD-9) codes are acceptable to use in conjunction with the
interim GO121 code that has been proposed for billing for covered
screening colonoscopies performed for individuals not at high risk for
colorectal cancer. The commenter stated that our failure to do this for
screening flexible sigmoidoscopy code G0104 in the billing instructions
we issued to our carriers in 1998 created problems for everyone
concerned because individual carriers adopted a variety of acceptable
ICD-9 codes, but did not inform the public under what circumstances the
examinations were covered and when they were not.
Response: We are not aware of the problems stated above with
respect to the Medicare billing codes for screening flexible
sigmoidoscopies in 1998. In addition, we have not received any
complaints about the new billing instructions that we released to our
carriers in February of this year in conjunction with the interim G0121
code that was issued (effective July 1, 2001) for use in billing for
screening colonoscopies for individuals not at high risk for colorectal
cancer. Since individuals who might qualify for coverage under this new
screening benefit are those who would not be at ``high risk'' for
colorectal cancer, it is not clear to us why the physician billing for
the service would need to provide any ICD-9 code for the examination to
the carrier for Medicare payment to be made. We do not require that
such information be submitted to the carrier at the present time in
these circumstances.
Result of Evaluation of Comments
We are implementing our proposal as stated above. In view of the
comment, we will review the matter, and we will take any necessary
action that might be deemed appropriate.
E. Medical Nutrition Therapy
Section 105 of the BIPA amended section 1861(s)(2) of the Act to
authorize Medicare Part B coverage of medical nutrition therapy (MNT)
for certain beneficiaries who have diabetes or a renal disease,
effective for services furnished on or after January 1, 2002. This new
benefit is similar to a benefit initially established by section 4105
of the BBA as a component of the diabetes outpatient self-management
training (DSMT) benefit. The DSMT benefit, described at section
1861(qq) of the Act, is a comprehensive diabetes training program, of
which nutrition training is only one component.
Consistent with section 105(a)(3) of the BIPA, we considered the
protocols of the American Dietetic Association (ADA) and the National
Kidney Foundation (NKF) regarding medical nutrition therapy training
for both diabetes and renal disease in order to establish criteria for
coverage of these services. Because the protocols were inconclusive
with respect to duration and frequency issues, we proposed to determine
the duration and frequency of the benefit through the NCD process
rather than through the rulemaking process.
We proposed to set forth the provisions regarding medical nutrition
therapy at Part 410, subpart G and at Sec. 414.64. The MNT provisions
of the final rule follow.
Definitions (Sec. 410.130)
We defined ``renal disease'' for the purpose of this benefit as
only chronic renal insufficiency and post-transplant care provided
after discharge from the hospital. We proposed to limit post-transplant
care to care furnished within 6 months after discharge from the
hospital, if the transplant is viable and effective, because, under
such conditions, we believe the beneficiary would no longer have renal
disease and
[[Page 55276]]
would not be eligible to receive the benefit under the statutory
provision. We specifically solicited comments on this proposed time
period, and requested that the commenters support their comments with
articles from medical journals. We also established definitions of
``diabetes'', ``renal disease'', and ``chronic renal insufficiency''
for the purpose of this benefit using definitions from the Institute of
Medicine report, ``The Role of Nutrition in Maintaining Health in the
Nation's Elderly,'' published in 2000.
We proposed defining ``episode of care'' as a time period not to
exceed 12 months, starting with the assessment (based on a referral
from a physician), and including all covered interventions. Finally, in
accordance with the statute, we defined MNT services as nutritional
diagnostic, therapy, and counseling services provided by a registered
dietitian or nutrition professional for the purpose of managing
disease.
Medical Nutrition Therapy (Sec. 410.132)
At Sec. 410.132(a), we proposed the conditions for coverage of MNT
services. Specifically, we proposed that Medicare Part B pay for MNT
services furnished by a registered dietitian or nutrition professional
as defined in Sec. 410.134 when the beneficiary is referred for the
service by the beneficiary's treating physician. We proposed to limit
the definition of physician to ``treating physician'' to ensure that
the physician establishing the need for MNT is actually treating the
beneficiary for a covered chronic disease and that the therapy is
coordinated with the care being provided by the treating physician.
We proposed that the services covered consist of nutritional
assessment, interventions, reassessment, and follow-up interventions.
We chose not to define the specific components of the benefit in more
detail because we anticipated that registered dietitians and
nutritionists would use nationally recognized protocols, such as those
developed by the ADA, as they normally would in their practice. As
previously mentioned, we also proposed to use the NCD process to
develop duration and frequency limits.
At Sec. 410.132(b), we set forth the coverage limitations for MNT
services. In accordance with section 1861(s)(2)(V)(ii) of the Act, we
provided that MNT services would not be covered for beneficiaries on
dialysis for end-stage renal disease. We did not exclude all
beneficiaries who are diagnosed with end-stage renal disease because a
few individuals with end-stage renal disease do not receive maintenance
dialysis, and the statute specifically excludes beneficiaries receiving
maintenance dialysis under section 1881 of the Act. The other
provisions of this section outlined the coordination of referrals for
MNT for diabetes and renal disease, and coordination of MNT and DSMT
services.
Eligibility for MNT services will be dependent upon diagnoses and
referrals made by the treating physician. At Sec. 410.132(c), we
proposed that referral only be made by the treating physician when the
beneficiary has been diagnosed with diabetes or a renal disease, with
documentation maintained by the referring physician in the
beneficiary's medical record. Referrals must be made for each episode
of care.
At Sec. 410.132(d), we discussed requirements regarding
reassessment and follow-up interventions. Specifically, we proposed
that reassessments and follow-up interventions would only be covered
when the referring physician determined that there was a change of
diagnosis or medical condition within an episode of care that made a
change in diet necessary.
Provider Qualifications (Sec. 410.134)
The BIPA specifies how we must define ``registered dietitian or
nutrition professional'' for the purposes of this benefit, and allows
for the grandfathering of nutrition professionals licensed or certified
by States at the time of its enactment. The proposed qualifications for
a registered dietitian or nutrition professional are set forth at
Sec. 410.134, and include alternative criteria for recognition of
registered dietitians in States that do not provide for licensure or
certification of these individuals.
We received nearly 1,000 comments on the MNT portion of the
proposed rule. The most frequently received comments concerned: the
definitions of diabetes, renal disease, and treating physician; the
coordination of the diabetes self-management training and MNT benefits;
and proposed reimbursement. We also received comments about provider
qualifications.
Comment: We received a large number of comments that stated we had
defined diabetes and renal disease too narrowly and asked for further
clarification of the definitions.
Response: Our definition of diabetes does not specifically state
how physicians should perform lab tests to determine if a beneficiary
should be diagnosed with diabetes. However, as with the national
protocols for medical nutrition therapy, we assume that physicians will
conduct tests in accordance with nationally accepted clinical
guidelines, which require testing on multiple occasions to determine a
diagnosis of diabetes. We are clarifying our definition of diabetes by
adding a sentence to further explain the etiology of the disease. We
also have extended coverage to include gestational diabetes for the few
Medicare beneficiaries who would need such coverage. We believe that we
do not have the statutory authority to extend coverage to beneficiaries
who have not yet been diagnosed with diabetes.
We also expand the definition of renal disease in this final rule.
First, we clarify that beneficiaries with end-stage renal disease who
are not receiving dialysis are eligible for the service. In addition,
we have expanded the time period in which we will cover MNT for
beneficiaries who have received a renal transplant to 36 months, to
bring the coverage into conformance with the Medicare eligibility
period for individuals under age 65.
Comment: A few commenters requested that we change our definition
for renal disease to encompass all patients with glomerular filtration
rates (GFR) below 60. The GFR is the measurement of renal function and
has a range in normal adult males of 98 to 150 ml/min/1.7m2
and in normal adult females of 106 to 132 ml/min/1.72. The
commenters believe that we did not fulfill the intent of the Congress.
Response: We disagree with the comment. Neither the BIPA nor its
legislative history indicates any specific intention regarding how to
define renal disease for purposes of eligibility for this benefit.
Section 4108 of the BBA required the Department of Health and Human
Services to contract with the National Academy of Sciences (NAS) to
examine the benefits and costs associated with extending Medicare
coverage for certain services, including medical nutrition therapy. We
believe the NAS Institute of Medicine (IOM) report, ``The Role of
Nutrition in Maintaining Health in the Nation's Elderly,'' published in
2000, provides a reasonable definition for determining the scope of the
benefit. In that report, ``renal disease'' is defined as chronic renal
insufficiency, end-stage renal disease, and the beneficiary's condition
following renal transplant. The GFR rate for chronic renal
insufficiency (GFR of 13 to 50 ml/min/1.73m2) used in the
proposed rule was also in the IOM report.
The IOM report did not cover the period of time MNT should be
available to beneficiaries following a renal
[[Page 55277]]
transplant. The Congress has authorized us to provide a reasonable
interpretation of how much coverage will be provided for beneficiaries
after renal transplant.
The suggested eligibility criterion of a GFR under 60 suggested by
commentators appears to be too expansive, because typically the GFR for
beneficiaries after they receive a transplant never goes above 60. We
also received comments recommending that we match our coverage to the
length of time an under-65 beneficiary is entitled to post-transplant
coverage. We agree that this is a reasonable criterion for our coverage
of MNT services for post-renal-transplant beneficiaries.
Comment: We received a large number of comments expressing concern
about our use of the term ``treating physician''. Most commenters
believe that the term does not include both primary care physicians and
specialists. One commenter believes we exceeded our statutory
authority. Also, some commenters believe that we should allow any
physician to provide a referral for the service.
Response: We did not intend to exclude primary care physicians from
the term ``treating physician''. In this final rule, we now define the
term ``treating physician'' to mean the primary care physician or
specialist coordinating care for the beneficiary with diabetes or renal
disease.
Regarding our statutory authority, the statute, as amended at
section 1861(s)(2)(V)(iii) of the Act, clearly states that the
Secretary has authority to impose other criteria, after considering
protocols established by dietetic or nutrition professional
organizations. Requiring referral by the treating physician is within
this statutory authority. We continue to believe that we must assure
the quality of services received by Medicare beneficiaries. Therefore,
our coverage guidelines must require coordination of care for
beneficiaries with chronic diseases in order to assure that quality. We
have not changed the final rule to allow any physician to make the
referral for MNT.
Comment: We also received comments concerning the definition of the
benefit and episode of care.
Response: As stated in the proposed rule, we relied on the national
dietetic therapy protocols of major organizations to define the basic
benefit. In seeking to understand the reason for these comments, we
discovered that the use of the term ``reassessment and follow-up
interventions'' in Secs. 410.132(a) and (d) was confusing to many
commenters. In the national protocols, reassessments and follow-up
interventions are always considered part of the basic service. In the
proposed rule, we had used the terms to define a special circumstance
that happens only when a beneficiary has a change in medical condition
or diagnosis.
In this final rule, we clarify our policy by eliminating the use of
the terms ``reassessment'' and ``follow-up interventions''. We also
have changed the language slightly in several other parts of the final
rule to help clarify our intent, such as adding, ``treatment regimen''
as another reason why we would allow additional coverage in special
circumstances. Our definition of ``episode of care'' (except in the
case of coordination of services with initial DSMT and gestational
diabetes) is based on our intent to pay providers of the service more
efficiently by conforming the definition to our claims processing
requirements. Our intent continues to be that dietitians and
nutritionists should follow national MNT protocols.
Comment: Some commenters stated that the DSMT and MNT benefits for
beneficiaries with diabetes should only be coordinated to the extent of
reducing the total of number of MNT hours by one hour.
Response: In the proposed rule, we assumed that all of the MNT
benefit for diabetes would be provided as part of the initial DSMT
benefit and that follow-up DSMT and MNT for diabetes should be fully
coordinated. In our discussions with interested organizations
concerning the amount of services that should be covered for the NCD
process, great concern was expressed about the coordination of the DSMT
and MNT benefits. Therefore, we have spent a great deal of time
researching this issue. We have found no evidence to date to suggest
that the language of the proposed rule should be changed for this
requirement. However, because we are still developing our NCD
concerning the duration and frequency of the MNT benefit, we will
continue to consider any evidence that might lead to the conclusion
that additional hours should be covered when both benefits are provided
during the same time period.
Until such time as an NCD alters this requirement, if initial DSMT
and MNT benefits for diabetes are provided in the same 12 month episode
of care, only 10 total hours of services will be covered, regardless of
whether the hours are covered as MNT, DSMT, or a combination of both.
In situations where follow-up DSMT and MNT for diabetes is provided,
only the total amount of hours allowed under the MNT benefit will be
covered. (The MNT cap will be applied to any DSMT services provided to
a beneficiary during the follow-up period, until such time as an NCD
alters this requirement.)
Comment: We received comments that MNT for a diagnosis of renal
disease and MNT for a diagnosis of diabetes should not be fully
coordinated.
Response: In this final rule, we are not changing this requirement
because the provision at Sec. 410.132(d) (in this final rule
Sec. 410.132(b)(5)) already provides for additional coverage in this
situation and we believe that additional coverage is not necessary.
However, we are clarifying that beneficiaries receiving initial DSMT
can receive the full initial DSMT benefit.
Comment: One commenter was concerned that providers that had
completed a full course of study of dietetics or nutrition after
completion of a bachelor's degree would be excluded. We also received
comments asking us to clarify the requirements further.
Response: We agree that individuals that complete the full course
of study of an accredited dietetics or nutrition program after
completion of a bachelor's degree would still meet the intent of the
legislation. Therefore, we have altered the regulatory language to
include these individuals. However, we will require our contractors to
require the practitioner to provide proof of completion of the course
of study in addition to proof of receiving the degree.
In situations where the individual is credentialed as a registered
dietitian by an organization appropriate for this purpose, we will
recognize that credential as proof that the individual meets both the
education and experience required in the regulation. We have added
language at Secs. 410.134(a) and (d) to change the final rule.
Comment: A commenter noted that State licensure requirements vary
considerably; providers will need to obtain multiple licenses when they
perform services in more than one State; and providers will have to
meet different requirements if State licensure provisions change.
Response: The statutory intent to recognize State licensure and
State licensure requirements is clear. We cannot require States to have
similar licensure requirements, recognize licensure by other States, or
to provide for grandfathering of providers when State licensure laws
change. Therefore, we have not changed the final rule to reflect these
comments.
[[Page 55278]]
Payment for Medical Nutrition Therapy (Sec. 414.64)
Section 105(c) of the BIPA requires that we pay for medical
nutrition therapy services at 80 percent of the lesser of the actual
charge for the services or 85 percent of the amount determined under
the physician fee schedule for the same services if the services had
been furnished by a physician. Based upon consultation with the
American Dietetic Association (ADA) to assess the types of resource
inputs used to furnish a 15-minute medical nutrition therapy session by
a registered dietitian or professional nutritionist, we proposed the
following:
For CPT code 97802--Medical nutrition therapy; initial assessment
and intervention, individual, face-to-face with the patient, each 15
minutes, we did not propose physician work RVUs for this service, based
on the statutory provision that specifically provides that medical
nutrition therapy services may only be furnished by registered
dietitians or nutrition professionals. For practice expense, we
proposed 0.47 RVUs and, for malpractice, we proposed 0.01 RVUs for a
total of 0.48 RVUs.
For CPT code 97803--Reassessments and intervention, individual,
face-to-face with the patient, each 15 minutes, we proposed 0.0 work
RVUs, 0.34 practice expense RVUs and 0.01 malpractice RVUs for a total
of 0.35 RVUs.
For CPT code 97804--Group, 2 or more individuals, each 30 minutes,
we proposed 0.0 work RVUs, 0.14 practice expense RVUs and 0.01
malpractice RVUs for a total of 0.15 RVUs. To determine payment, the
RVUs shown above would need to be multiplied by the physician fee
schedule conversion factor and 0.85 (to reflect the statutory
requirement that payment be 85 percent of the amount determined under
the physician fee schedule).
We also stated that, consistent with the definition in the CPT's
Physical Medicine Rehabilitation codes, a group is considered to be 2
or more individuals and that Medicare co-payments and deductibles would
apply for medical nutritional therapy services.
Comment: The American Dietetic Association (ADA) and many
individuals submitted comments concerning the proposed reimbursement
rate for medical nutrition therapy services. They stated that the
proposed reimbursement rate for these services is too low and would
result in limited beneficiary access to these services since private
practice dietitians will choose not to participate. Some commenters
referenced reimbursement rates currently paid by private insurers of
$85 to $125 for 1 to 1\1/2\ hours for an initial visit and $85 per hour
for follow-up. They believe that the proposed rate for Medicare is far
short of what was envisioned by the Congress. Commenters indicated that
the statute clearly states that medical nutrition therapy payment
should be 80 percent of the lesser of the actual charge or 85 percent
of the amount determined under the physician fee schedule for the same
service, provided by a physician. According to commenters, physicians
who are also registered dietitians, use E/M codes 99213 through 99215
and 99244 when providing medical nutrition therapy services. The
commenters stated that E/M codes 99203 through 99205 are appropriate
reference points for determining medical nutrition therapy payment. The
commenters also stated that any refinement of medical nutrition therapy
values should be based on the underlying E/M codes that they believe
are the statutory basis for medical nutrition therapy payment. While
commenters acknowledge that physicians may perform other tasks besides
nutritional assessment, therapy and counseling during an office visit,
they believe those additional services are the basis for the Congress'
instruction to reimburse non-physician providers of medical nutrition
therapy at 85 percent of the amount physicians receive. The AMA's
Health Care Professionals Advisory Committee (HCPAC) submitted a
comment that suggested there should be physician work for medical
nutrition therapy. This group provides recommendations on valuing
services for codes used by non-physician providers. The HCPAC indicated
that it evaluated each of the medical nutrition therapy codes and
compared them to services that are available to other providers but not
nutritionists (for example, physical therapy services). The comment
further stated that the 15 percent reduction should not apply because
the HCPAC took this into account when developing the recommendations.
The HCPAC further added that there should be work values for medical
nutrition therapy just as there are for physical and occupational
therapy.
Response: We have reviewed the statute and legislative history.
There is no indication that Congress envisioned a particular payment
amount or expected us to use an E/M service to determine the value of
medical nutrition therapy. Section 105(c) of the BIPA states that ``the
amount paid shall be 80 percent of the lesser of the actual charge for
the services or 85 percent of the amount determined under the fee
schedule established under section 1848(b) of the Act for the same
services if furnished by a physician.'' The BIPA Conference Report
indicates that payment will equal ``the lesser of the actual charge for
the service or 85 percent of the amount that would be paid under the
physician fee schedule if such services were provided by a physician.''
The statute and Conference Report direct us to establish the physician
fee schedule amount for nutrition therapy services. The Medicare
allowed charge would equal 100 percent of the physician fee schedule
amount if the services are performed by a physician and 85 percent of
the physician fee schedule amount if the services are performed by a
registered dietitian or nutrition professional. The commenters suggest
that physicians currently bill for an E/M service when they provide
nutrition services. We do not believe that it is appropriate to compare
medical nutrition therapy provided by a registered dietitian to an E/M
service provided by a physician. Registered dietitians do not take
medical histories, they are not trained to and do not perform physical
examinations, nor do they make medical decisions. Furthermore, when
physicians use an E/M code to report the provision of counseling or
coordination of care, they typically have also performed a medical
history, physical examination, and engaged in medical decision making
as part of that service. If such an individual performed a service that
met the requirements of an E/M service, then it would be be appropriate
for him or her to report an E/M service. Further, we note that the E/M
services include not only an amount attributable to physician work, but
also payment for physician practice expenses. For instance, a level 3
new patient office visit (CPT code 99203) includes payment for 50
minutes of nurse time. A level 3 established patient office visit (CPT
code 99213) includes 36 minutes of nurse time. Both of these codes
include additional compensation for medical equipment and supplies that
are typically used in an office visit but are not used as part of a
medical nutrition therapy service. If we were to adopt the commenters'
view and crosswalk values for medical nutrition therapy to an E/M
service, we would be including payment not only for the counseling
service of the practitioner, but also, inappropriately for the costs of
clinical personnel that are not involved in the nutrition therapy
service.
[[Page 55279]]
Commenters indicated that the statute established the 85 percent
adjustment to account for activities that are typically performed by a
physician during an E/M service are not performed by a nutritionist.
The statute and legislative history do not indicate that the 85 percent
adjustment is intended to serve this purpose. In fact, the commenters
themselves note that ``consistent with other non-physician providers,
reimbursement is set at a percentage of the physician's fee schedule.''
Under the physician fee schedule, we will pay a physician 80 percent of
100 percent of the physician fee schedule amount, and, if a non-
physician practitioner provides an identical service, Medicare pays 80
percent of 85 percent of the physician fee schedule amount. For
instance, under CPT code 99213, a level 3 established patient office
visit is one of the most common services provided by physicians,
physician assistants and nurse practitioners. Even though the service
is considered to be identical, we can by law pay a physician assistant
and nurse practitioner only 85 percent of what we pay a physician to do
the same service. Thus, in the case of other practitioners, the
percentage does not reflect that a non-physician practitioner provides
fewer services than a physician. Because there is no indication in the
statute that the 85 percent adjustment should apply differently in the
context of medical nutrition therapy than for other services performed
by non-physician practitioners, we believe it is appropriate to pay 80
percent of 100 percent of the physician fee schedule amount when
medical nutrition therapy is provided by a physician and 80 percent of
85 percent of the physician fee schedule amount when the service is
provided by a registered dietitian or nutrition professional.
In response to the comment about payment rates of private insurers
for medical nutrition therapy, we cannot use such information in a
relative value system to establish payment. Section 1848(c) of the Act
requires us to establish RVUs that recognize the relative resources
involved in furnishing different physician fee schedule services. Thus,
our role is to establish the appropriate relative payment amounts. The
total payment amount is determined under a formula prescribed in
section 1848(d) of the Act. We have no authority to change the formula.
In response to the HCPAC recommendation, we reiterate that it is
inappropriate to compare medical nutrition therapy services to E/M
services performed by physicians. While medical nutrition therapy may
be performed by a physician who is also a registered dietitian, this
does not make it a physician's service that requires a work RVU.
Physicians may occasionally perform other services that have no
physician work, such as chemotherapy administration or the technical
component of a diagnostic x-ray test. When such services with no
physician work are performed by a physician, we do not establish a
physician work RVU just because the service was performed by a
physician in that instance. Physicians will occasionally meet the
statutory qualifications to be considered a registered dietitian or
nutrition professional who can bill Medicare for medical nutrition
therapy services. In these circumstances, we will pay the physician 80
percent of 100 percent of the physician fee schedule amount. In this
unusual circumstance, we are paying for a medical nutrition therapy
service provided by a physician under section 1861(s)(2)(V) and not a
physician's service under section 1861(s)(1) of the Act.
Comment: One comment indicated that the 85 percent adjustment
should not apply because the RVUs we used are not based on physician
work or physician practice expenses to deliver the service. This
commenter indicated that we proposed an inadequate payment by not
following the statutory scheme and proceeded to apply a 15 percent
discount that is neither fair nor reasonable.
Response: The statute requires us to establish a physician fee
schedule amount for the service and pay 80 percent of 100 percent of
the amount if the service is provided by a physician and 80 percent of
85 percent if the service is provided by a registered dietitian or
nutrition professional. We initially anticipated that physicians would
never bill Medicare for medical nutrition therapy services because they
generally would not meet the statutory requirements to be considered
registered dietitians or nutrition professionals. In this circumstance,
we agree that it seems unusual to apply a reduction for a service that
seldom would be furnished by a physician. However, we believe that the
statute requires that Medicare payment be based on the 85 percent
level. We understand that, although not common, there are physicians
who do meet the statutory requirements to be considered registered
dietitians or nutrition professionals. In these circumstances, our
payment to the physician will be based on 100 percent of the physician
fee schedule amount, not the 85 percent that we will pay to a
registered dietitian or nutrition professional. We believe the statute
would not allow a physician who does not meet the statutory
requirements for a registered dietitian or nutrition professional to be
paid for a medical nutrition therapy service. If a physician provides
medical nutrition counseling as part of a patient encounter that meets
the requirements for an E/M service, the physician can bill Medicare
for a physician's service.
Comment: We received one comment requesting that we clarify that
Medicare will pay qualified providers in private practice settings or
physician offices where they may be independent contractors. The
commenter also asked how we intend to pay for medical nutrition therapy
in the hospital outpatient department. The commenter also asked for
clarification on reassignment of payment if a registered dietitian is
an employee of physicians or hospital outpatient facilities.
Response: Medicare will pay qualified dietitians and nutrition
professionals who enroll in the Medicare program regardless of whether
they provide medical nutrition therapy services in an independent
practice setting, hospital outpatient department or any other setting,
with the exception of services provided to patients in an inpatient
stay in a hospital or skilled nursing facility. In these circumstances,
our payment to the hospital or skilled nursing facility includes
payment for medical nutrition therapy. If a qualified practitioner
provides medical nutrition therapy in any other setting, including a
private practice setting, section 1833(a)(1)(T) of the Act requires
that Medicare payment equal 80 percent of the lesser of actual charges
or 80 percent of 85 percent of the amount determined under the
physician fee schedule. Payment in the hospital outpatient department
will be made under the physician fee schedule, not under the hospital
outpatient prospective payment system.
Current rules regarding reassignment of benefits would apply to
medical nutrition therapy. We want to emphasize that medical nutrition
therapy cannot be provided incident to a physician's service unless the
physician also meets the qualifications to bill Medicare as a
registered dietitian or nutrition professional.
Comment: Commenters objected to the methodology used to establish
the proposed RVUs for this service. They believe it is inappropriate to
use the top-down or no-work pool methodology to determine medical
nutrition therapy payment. They believe that medical nutrition therapy
payment should not be based on comparison to a preventive medicine code
(CPT code 99401) in the zero-work pool methodology. The
[[Page 55280]]
commenters indicated that preventive medicine services omit the
problem-oriented components of the comprehensive history, as well as
other essential assessment points, such as the patient's chief
complaint and history of present illness. They disagree with our
assertion in the proposed rule that physicians do not perform nutrition
services and assert that it is inappropriate to use the top-down or
zero-work methodology to establish the RVU for medical nutrition
therapy.
Response: We use the top-down methodology or no-work pool
methodology to price the practice expense RVUs for all services priced
under the Medicare physician fee schedule. Given that the statute
indicates that medical nutrition therapy should be paid using the
physician fee schedule, we believe it is reasonable and appropriate to
use the same methodologies that we use to develop RVUs for other
physician fee schedule services. With respect to use of the preventive
medicine service, we used a service that we felt had similar practice
expenses to medical nutrition therapy. It is not clear why practice
expenses for a counseling service would differ based on the health
status of the patient.
Comment: A commenter representing dietitians asked us to review the
relativity of payment across the three medical nutrition CPT codes. The
commenter indicated that payment for CPT code 97803 was set at 72.9
percent of proposed RVUs for CPT code 97802 and 97804 was set at 31
percent of CPT code 97802. The commenter argues that, because
reassessments are shorter than initial assessments, the proposed RVUs
are actually discounted twice (that is, less payment per 15 minutes of
time as well as less total time). They believe that the value of CPT
codes 97802 and 97803 should be identical. The commenters indicated
that E/M services provided by physicians do not receive the same
discount. The commenter also stated that the payment for CPT code 97804
was less than for other group services and gave the example of a nurse
or pharmacist providing nutrition instruction under the diabetes self-
management training benefit.
Response: We have reviewed the payments for CPT codes 97802 and
97803 and agree with the commenter that these two codes should have the
same values. The essential difference between an initial and follow up
medical nutrition therapy service is the time spent performing the
service. Initial visits will be longer than follow-up visits and will
likely involve Medicare payment for more increments of service. We will
pay less for follow up visits because they will typically involve fewer
15 minute increments of time than an initial visit. The payment rate we
are establishing in this final rule for CPT code 97803 will be the same
as the proposed rate for CPT code 97802. We have also changed the
payment rate for CPT code 97804 assuming that the code will normally be
billed for 4 to 6 patients with the average of 5. Using the revised
values, the payment rate for group medical nutrition therapy would
approximate the hourly rate paid for other medical nutrition therapy
services. (We note that the RVU units between the proposed and final
rule show some marginal change because of changes made in the practice
expense methodology that affect all physician fee schedule services).
We do not agree with the comment that ``evaluation and management
services provided by physicians do not receive the same discount.'' E/M
service are not time based services and, as stated above, for many
reasons are inappropriate comparisons to medical nutrition therapy
service codes.
Comment: Many commenters stated that co-payments must be structured
so that they are not barriers to the medical nutrition therapy benefit.
Response: Section 105(c) of the BIPA modifies section 1833(a)(1) of
the Act to add subparagraph (T) that requires that Medicare payment
equal 80 percent of the lesser of the actual charge for the services or
85 percent of the amount determined under physician fee schedule. The
statute requires the same coinsurance for medical nutrition therapy
services that applies to other Part B services.
Comment: Commenters suggested that initial medical nutrition
therapy sessions for treatment of diabetes or renal disease should be
billed under CPT code 97802 and subsequent medical nutrition therapy
sessions should be billed under CPT code 97803. New diagnoses due to a
change in medical condition or unanticipated complications should be
billed under CPT code 97802 and subsequent medical nutrition therapy
sessions should be billed under CPT code 97803.
Response: At the present time, we are requiring that medical
nutrition therapy be reported by using CPT codes 97802, 97803, and
97804. We will revisit our coding requirements when we publish the NCD
for medical nutrition therapy. The NCD will set forth the structure of
the medical nutrition therapy benefit in detail. We will make a
decision concerning creation or modification of codes and creation of
modifiers for reporting medical nutrition therapy once the NCD has been
published. Until the NCD is published, creation or modification of
codes and creation of modifiers would be premature. Therefore, we are
requiring that the initial individual medical nutrition therapy visit
be reported as CPT code 97802 and all follow up visits (for
interventions and reassessments) for individual medical nutrition
therapy be reported as CPT code 97803. All group medical nutrition
therapy visits should be reported as CPT code 97804 whether they are
initial or follow up visits.
Comment: Commenters urged us to define medical nutrition therapy
descriptors consistently. They stated that the descriptors in Table 5
of the proposed rule should agree with the descriptors in Sec. 414.132.
Response: We agree. We will make the descriptors for medical
nutrition therapy consistent with the nomenclature in CPT and our
regulations.
Comment: We received a comment that recommended that we consider
including additional items in the practice expense inputs for medical
nutrition therapy. The commenter indicated that inputs should include
staff costs for training on billing procedures, Health Insurance
Portability and Accountability Act training, audit expenses, and other
costs resulting from Medicare policies and procedures. The commenter
indicated that expenses of registered dietitians in private practice
differ little from other practitioners.
Response: There are two major data sources used in the practice
expense methodology--estimates of direct inputs and aggregate practice
expense per hour information from the AMA's Socioeconomic Monitoring
Survey. At this time, we are using the practice expense per hour for
all physicians to establish the practice expense RVUs for medical
nutrition therapy. We are not currently using the estimates of direct
expenses for medical nutrition therapy because the services are valued
in the no-work pool. However, we are researching alternatives to the
no-work pool that would allow all no-work services to be priced under
the top-down methodology. If we develop such an alternative, the
estimates of direct expenses will be important in determining the RVUs
for medical nutrition therapy. Indirect expenses are based on physician
work and direct inputs. We believe that many of the costs identified by
this commenter are indirect costs that would likely be included in
practice expenses reported through the SMS survey. Since the commenter
has suggested that practice expenses for private practice registered
dietitians differ little from other
[[Page 55281]]
practitioners, we believe the average practice expense per hour for all
physicians is sufficient to use in the practice expense methodology.
Result of Evaluation of Comments
The payment rate we are establishing in this final rule for CPT
code 97803 will be the same as the rate for CPT code 97802. We are also
changing the payment rate for CPT code 97804 using the assumption that
the code will normally be billed for 4 to 6 patients with the average
of 5. Using these revised values, the payment rate for group medical
nutrition therapy will approximate the hourly rate paid for other
medical nutrition therapy services.
F. Telehealth Services
Beginning October 1, 2001, the BIPA amended section 1834 of the Act
to specify that we pay a physician (as defined in section 1861(r) of
the Act) or a practitioner (described in section 1842(b)(18)(C) of the
Act) for telehealth services that are furnished via a
telecommunications system to an eligible telehealth individual.
The BIPA defined Medicare telehealth services as professional
consultations, office or other outpatient visits, and office psychiatry
services identified as of July 1, 2000, by CPT codes 99241 through
99275; 99201 through 99215, 90804 through 90809 and 90862 (and as we
may subsequently modify) and any additional service we specify. The
BIPA defines an eligible telehealth individual as an individual
enrolled under Part B who receives a telehealth service furnished at an
originating site.
Section 1834(m) of the Act, as added by the BIPA, limited an
originating site to a physician's or practitioner's office, hospital,
critical access hospital, rural health clinic, or Federally qualified
health center. Additionally, the BIPA specified that the originating
site must be located in one of the following geographic areas:
In an area that is designated as a rural health
professional shortage area (HPSA) under section 332(a)(1)(A) of the
Public Health Service Act.
In a county that is not included in a Metropolitan
Statistical Area (MSA).
However, an entity participating in a Federal telemedicine
demonstration project that has been approved by, or receives funding
from us as of December 31, 2000 would not be required to be in a rural
HPSA or non-MSA.
The BIPA also required that we pay a physician or practitioner
located at a distant site that furnishes a telehealth service to an
eligible telehealth beneficiary an amount equal to the amount that the
physician or practitioner would have been paid under Medicare had the
service been furnished without the use of a telecommunications system.
This section also provided for a facility fee payment for the
period beginning October 1, 2001 through December 31, 2002, to the
originating site of $20. For each subsequent year, the facility fee for
the preceding year is increased by the percentage increase in the MEI
as defined in section 1842(i)(3) of the Act. The BIPA also amended
section 1833(a)(1) of the Act to specify that the amount paid must be
80 percent of the lesser of the actual charge or the amounts specified
in new section 1834(m)(2) of the Act.
In order for us to have this benefit expansion implemented timely,
we have used a program memorandum. The program memorandum was effective
October 1, 2001. This final rule will be effective January 1, 2002.
The rule published on August 2, 2001 proposed to establish policies
for implementing the provisions of section 1834(m) of the Act, as added
by the BIPA, that change Medicare payment for telehealth services.
We proposed to revise Sec. 410.78 to specify that Medicare
beneficiaries are eligible for telehealth services only if they receive
services from an originating site located in either a rural HPSA as
defined by section 332(a)(1)(A) of the Public Health Services Act or in
a county outside of a MSA as defined by section 1886(d)(2)(D) of the
Act.
1. Definitions
Section 1834(m)(4)(F) of the Act, which was added by the BIPA and
became effective for services beginning October 1, 2001, defined
telehealth services as professional consultations, office and other
outpatient visits, individual psychotherapy, pharmacologic management,
and any additional service we specify. Additionally, this provision
identified covered services by HCPCS codes identified as of July 1,
2000. We proposed to revise Sec. 410.78 to implement this coverage
expansion to include the following services (and corresponding CPT
codes):
Consultations (codes 99241 through 99275).
Office and other outpatient visits (codes 99201 through
99215).
Individual psychotherapy (codes 90804 through 90809).
Pharmacologic management (code 90862).
We solicited comments regarding the guidelines that we should use
to make additions or deletions of services. We also solicited comments
about specific services that may be appropriate to be covered under the
Medicare telehealth benefit.
In this final rule, we are specifying at Sec. 410.78 that, except
for the use of store and forward technology in the demonstration
programs conducted in Alaska or Hawaii, an interactive
telecommunications system must be used and the medical examination of
the patient must be at the control of the physician or practitioner at
the distant site. We are defining interactive telecommunications system
as multimedia communications equipment that includes, at a minimum,
audio and video equipment permitting two-way, real-time interactive
communication between the patient and physician or practitioner at the
distant site. We are also specifying that telephones, facsimile
machines, and electronic mail systems do not meet the definition of an
interactive telecommunications system.
A patient need not be present for a Federal telemedicine
demonstration program conducted in Alaska or Hawaii. We are specifying
that for Federal telemedicine demonstration programs conducted in
Alaska or Hawaii, Medicare payment is permitted for telehealth when
asynchronous store and forward technologies, in single or multimedia
formats, are used as a substitute for an interactive telecommunications
system. Additionally, we are specifying that the physician or
practitioner at the distant site must be affiliated with the
demonstration program.
We are defining asynchronous, store and forward technologies, as
the transmission of the patient's medical information from an
originating site to the physician or practitioner at the distant site.
The physician or practitioner at the distant site can review the
medical case without the patient being present. An asynchronous
telecommunications system in single media format does not include
telephone calls, images transmitted via facsimile machines, and text
messages without visualization of the patient (electronic mail).
Photographs must be specific to the patient's medical condition and
adequate for rendering or confirming a diagnosis or treatment plan.
Finally, we are defining the originating site as the location of an
eligible telehealth individual at the time the service being furnished
via a telecommunications system occurs.
2. Conditions of Payment
The BIPA changed the telepresenter requirements. In accordance with
section 1834(m)(2)(C) of the Act, a
[[Page 55282]]
telepresenter is not required to be present. Therefore, we would not
require a telepresenter as a condition of Medicare payment.
Section 1834(m)(1) of the Act requires that Medicare make payments
for telehealth services furnished via a telecommunications system by a
physician or a practitioner (described in section 1842(b)(18)(C) of the
Act). Non-physician practitioners described in this section of the Act
include nurse practitioners, physician assistants, clinical nurse
specialists, certified nurse midwives, clinical psychologists, clinical
social workers, and certified registered nurse anesthetists or
anesthesiologists' assistants. Section 1834(m)(2) of the Act specifies
that we pay the physician or practitioner at the distant site who
furnishes a telehealth service an amount equal to the amount that the
physician or practitioner would have been paid under Medicare had the
service been furnished without the use of a telecommunications system.
Certified registered nurse anesthetists and anesthesiologists'
assistants would not be permitted to bill for and receive payment for a
telehealth service under this provision. Under the Medicare program,
these practitioners do not receive payment for office visits,
consultation, individual psychotherapy, or pharmacologic management
when these services are furnished without the use of a
telecommunications system. Section 1834(m)(2) of the Act specifies that
we pay to the distant site physician or practitioner an amount equal to
what would have been paid for the service without the use of a
telecommunications system. Therefore, certified registered nurse
anesthetists and anesthesiologists' assistants would not receive
payment for telehealth services.
We proposed at Sec. 410.78 that, as a condition of Part B payment
for telehealth services, the physician or practitioner at the distant
site must be licensed to provide the service under State law.
Section 1834(m)(2)(A) of the Act specifies that the payment amount
for the professional service is equal to the amount that would have
been paid without the use of a telecommunications system. Medicare
payment for physicians' services is generally based, under section 1848
of the Act, on the resource-based physician fee schedule. Payment to
other health care practitioners listed earlier, authorized under
section 1833 of the Act, is based on a percentage of the physician fee
schedule payment amount. Therefore, we will pay for office or other
outpatient visits, consultation, individual psychotherapy, and
pharmacologic management services furnished by physicians at 80 percent
of the lower of the actual charge or the fee schedule amount for
physicians' services. We will also pay for services furnished by other
practitioners at 80 percent of the lower of the actual charge or that
practitioner's respective percentage of the physician fee schedule.
Section 1834(m)(2) of the Act provides for a professional fee for
the physician or practitioner at the distant site (equal to the
applicable Part B fee schedule amount) and a $20 facility fee for the
originating site. Telepresenters are not required, unless one is deemed
medically necessary by the physician or practitioner at the distant
site. The BIPA does not address the issue of payment for the
telepresenter. The Office of the Inspector General has advised us that
permitting the physician or practitioner at the distant site to pay the
telepresenter creates a significant risk under the anti-kickback
statute. Therefore, we establish in Sec. 414.65 that payments made to
the distant site physician or practitioner for professional fees,
including deductible and coinsurance (for the professional service),
are not to be shared with the referring practitioner or telepresenter.
However, the telepresenter could bill and receive payment for
services that are not telehealth services that a telepresenter would
otherwise be allowed to provide under the Medicare statute, including
services furnished on the same day as the telehealth service.
The BBA prohibited any payment for line charges or facility fees
associated with a professional consultation via a telecommunications
system. Section 1834(m)(2)(B) of the Act, as added by the BIPA,
provides for a facility fee payment to the originating site, specifying
that the amount of payment is 80 percent of the lesser of the actual
charge or a facility fee of $20.00. The BIPA further specifies that,
beginning January 1, 2003, the originating facility fee be increased
annually by the Medicare Economic Index (MEI) as defined in section
1842(i)(3) of the Act. Additionally, we clarify that the Geographic
Practice Cost Index (GPCI) would not apply to the facility fee for the
originating site. This fee is statutorily set and is not subject to the
geographic payment adjustments authorized under the physician's fee
schedule. The beneficiary is responsible for any unmet deductible
amount and Medicare coinsurance. We would revise Sec. 414.65 to provide
for payment of a facility fee to the originating site.
Section 1834(m)(3) of the Act specifies that sections
1842(b)(18)(A) and (B) apply to physicians and practitioners receiving
payment for telehealth services and to originating sites receiving a
facility fee, in the same manner as they apply to practitioners. This
section requires that payment for such services may only be made on an
assignment-related basis. We did not reflect this provision in the
proposed rule. Because this requirement is specified in the BIPA and we
have no discretion, we are implementing it in this final rule in new
Sec. 414.65(d).
Comment: One commenter believed that requiring an originating site
to be located in a rural HPSA or non-MSA county would not permit
medical practitioners located in urban and suburban areas to offer
telehealth services.
Response: We clarify that, as a condition of payment under
Medicare, the originating site must be located in a rural HPSA or non-
MSA county. The physician or practitioner at the distant site, who
provides the telehealth service, is not subject to these limitations.
For example, a psychologist in Salt Lake City, Utah would be able to
provide a mental health visit to a beneficiary at a physician's office
located in a non-MSA county.
Comment: We received various comments on the definition of an
originating site. Many commenters believe that the list of facilities
eligible to be a telehealth originating site should be expanded beyond
those specified in the statute. Specific suggestions were received to
include the patient's residence, skilled nursing facilities, nursing
homes, and community mental health centers as originating site
facilities within this provision. Another commenter suggested that we
recommend legislative changes to remove the requirement that an
originating site facility be located in a HPSA or non-MSA county.
Moreover, one organization requested that all locations included
within the Alaska Native Tribal Health Consortium, including but not
limited to outpatient health facilities recognized by the Indian Health
Service as tribal health facilities be included as an originating site.
The commenter requested that these sites be defined as an originating
site regardless of whether they are certified as a Medicare Federally
qualified health center or not.
Response: Section 1834(m) of the Act defines an originating site
facility to include only a physician's or practitioner's office,
hospital, critical access hospital, rural health clinic or Federally
qualified health center.
[[Page 55283]]
Further, the Act specifies that the originating site must be located in
a rural HPSA or non-MSA county. We do not have the legislative
authority to expand the definition of a telehealth originating site
beyond this provision. However, we will be studying this issue as part
of a report to the Congress as authorized by section 223(d) of the
BIPA.
Comment: One specialty college requested confirmation that the
patient's medical information provided via store and forward telehealth
is furnished to the physician or practitioner at the distant site in
order to recommend or confirm a diagnosis and or treatment plan and not
to provide a formal interpretation of imaging exams.
Response: The commenter is correct. Payment for services via store
and forward technology under this provision does not include formal
interpretation of an imaging exam. Medicare currently allows coverage
and payment for medical services delivered via a telecommunications
system that do not require a face-to-face ``hands on'' encounter.
Section 2020(A) of the Medicare Carriers Manual addresses this issue
and lists radiology, electrocardiogram, and electroencephalogram
interpretations as examples of such services.
Comment: In the proposed rule, we requested comments on the
guidelines that we should use to make additions or deletions to covered
Medicare telehealth services. We also requested suggestions and
comments about specific services that may be appropriate for payment
under the Medicare telehealth benefit. In response to our solicitation,
we received one comment regarding the guidelines we should use to make
changes to the scope of Medicare telehealth coverage. Ten commenters
provided specific suggestions regarding additional services that may be
appropriate for the Medicare telehealth benefit.
Several commenters indicated that a psychiatric diagnostic
interview, CPT code 90801, would be appropriate for Medicare telehealth
payment. One association stated that the elements of this service are
directly comparable to a new patient office visit, which the law
defines as a telehealth service. Given that the law permits us to add
additional services as appropriate, this commenter suggested that we
include a psychiatric diagnostic interview within the definition of a
telehealth service. Another association suggested that interactive
psychotherapy, CPT codes 90810, 90812 and 90814, should be covered
Medicare telehealth services. Interactive psychotherapy uses play
equipment, physical devices and other mechanisms of non-verbal
communication in an office or outpatient facility.
Several commenters suggested that telerehabilitation interventions
that provide education, mentoring and consultation be included within
the scope of Medicare telehealth coverage. The commenters specifically
note that speech therapy and physical and occupational therapy should
be included as telehealth services.
One consortium requested that all services provided under the
Federal telehealth project in Alaska be included as covered telehealth
services within this provision. The commenter believes that virtually
all evaluation & management and psychiatry services should be included
as Medicare telehealth services. Additionally, the commenter notes that
many respiratory, digestive, ophthalmology and otorhinolaryngology
services are appropriate for telehealth coverage.
One organization suggested that we consider guidelines similar to
those currently in place for non-telehealth services. For instance, the
commenter stated the service should be reasonable and necessary, safe
and effective, medically appropriate, and provided within the purview
of accepted standards of medical practice. The commenter stresses that
the type of technology used to deliver the service should be secondary
to the reasonable and necessary criteria.
Response: We will use these comments and suggestions to assist us
in establishing guidelines for a telehealth coverage process and the
addition of specific telehealth services that may be appropriate for
Medicare beneficiaries. However, we do not believe it would be
appropriate to expand the scope of telehealth services beyond the
services explicitly listed in the Act until we have a process in place
for adding new telehealth services.
Comment: With regard to the definition of a ``telecommunications
system'', one organization encouraged us to permit store and forward
technologies in other circumstances beyond federal telemedicine
demonstration projects conducted in Alaska or Hawaii. The commenter
believes that emphasis should be given to whether a particular service
is reasonable and necessary rather than specific technology
requirements. Moreover, the commenter stated that the face-to-face
requirement is outdated for telehealth as well as other areas of the
Medicare fee schedule and suggested that current technology, such as
electronic mail, permits physicians to care for their patients even
when the patient is not present.
Response: Section 1834(m) of the Act defines a telehealth service
as office and other outpatient visits (99201 through 99215),
professional consultations (99241 through 99275), individual
psychotherapy (90804 through 90809), and pharmacologic management
(90862). Further, the law specifies that payment must be equal to what
would have been paid without the use of a telecommunications system.
As a condition of payment under Medicare, these services require a
face-to-face patient encounter. We believe that the patient's presence
and use of an interactive audio and video telecommunications system
permitting the distant site practitioner to interact with the patient
provides a reasonable substitute for a face-to-face encounter. The law
provides for the use of asynchronous, store and forward technologies
for delivering telehealth services only for telemedicine demonstration
projects conducted in Alaska or Hawaii. We do not have the authority to
expand the use of store and forward technology in delivering telehealth
services.
Comment: One organization in a remote region requested that a
definition of a telepresenter be added to Sec. 410.78. The commenter
suggested we permit a certified community health aid to present a
patient when the aide is the only medical professional available to act
as a telepresenter.
Response: The physician or practitioner at the distant site has the
authority to determine whether it is medically necessary to require a
telepresenter and, if necessary, the appropriate medical professional
needed to present the patient. We do not believe it is appropriate for
us to specify the type of medical professionals that are necessary to
act as a telepresenter.
Comment: We received conflicting comments concerning interstate
telehealth services. One organization requested that we require the
physician or practitioner at the distant site to be licensed in the
State where the originating site is located. On the other hand, an
association requested clarification that the physician or practitioner
at the distant site only needs to be licensed in the State where he or
she is located and does not need to be licensed in the State where the
originating site is located. Another commenter requested that we
clarify that the service is considered rendered where the distant site
physician or practitioner is located.
Response: We defer to State law regarding licensure issues. When
the
[[Page 55284]]
State law for the originating site permits an out-of-State practitioner
to provide a telehealth service, without being licensed in the State in
which the originating site is located, Medicare would make payment for
the telehealth service. However, when State law precludes an out-of-
State practitioner from delivering a telehealth service, Medicare would
not pay for that service.
We clarify that for payment purposes, the site of service for the
telehealth service is the location of the physician or practitioner at
the distant site. Given that section 1834(m) of the Act specifies that
payment to the physician or practitioner at the distant site must be
equal to the amount that would have been paid without the use of
telehealth, it is appropriate to use the Geographic Practice Cost Index
(GPCI) relevant to the distant site. However, our determination of the
distant site physician's or practitioner's location as the site of
service for Medicare payment is not intended to make a comment
regarding the scope of medical practice.
Comment: One consortium believes that the proposed rule would not
permit the physician or practitioner at the distant site to bill for a
telehealth service when State or Federal law exempts a physician or
practitioner from being licensed in the State in which he or she is
currently employed. The consortium is a Federal telemedicine
demonstration project that would be permitted to use store and forward
telecommunications technologies in delivering telehealth services. The
commenter notes that the State of Alaska exempts physicians or
practitioners who are part of the military or Public Health Service
that provide health care services in Alaska from its licensure
requirements. Further, the commenter stated that Federal law authorizes
health care professionals who are members of the military providing
services for the Department of Defense to practice in any State
provided the professionals are licensed in a State, the District of
Columbia or other specific locations. The commenter also noted that
current Medicare manual instructions specify that when a physician in a
Federal hospital provides services to the public generally as a
community institution, he or she may be considered as meeting the
statutory definition of a physician even though he or she may not have
a license to practice in the State in which he or she is employed.
Response: The telehealth provision does not affect State or Federal
legislation providing certain physicians or practitioners an exemption
from State licensure. When Federal or State law exempts a physician or
practitioner from State licensure, then the physician or practitioner
at the distant site is permitted to provide a telehealth service
regardless of whether he or she is licensed within the State where he
or she is employed.
Comment: One organization requested that Sec. 414.65(a)(2) be
revised to specify for what services the physician or practitioner who
presents the patient could bill. The commenter believes that when the
physician at the distant site determines that it is medically necessary
for another practitioner to assist in providing the telehealth service,
the telepresenter should be compensated. The commenter suggested that a
telepresenter be permitted to bill for a consultation or confirmatory
consultation.
Response: On the day the telehealth service occurs, the
telepresenter may bill and receive payment for services that are not
telehealth services that he or she would otherwise be allowed to
provide under Medicare. A telepresenter, for example, a nurse
practitioner, could bill for and be paid for a medically necessary
office, outpatient or inpatient visit preceding or subsequent to a
telehealth service. Additionally, the telepresenter could be paid for
other medically necessary services requested by the physician or
practitioner at the distant site. However, the physician at the distant
site may not share any portion of the telehealth payment with the
telepresenter or referring practitioner. We do not agree that
Sec. 414.65(a)(2) should be changed to specify the services for which a
telepresenter can and cannot bill. This section implements payment for
telehealth services only, and the Act does not provide for a payment to
the telepresenter for telehealth services.
Comment: Many organizations and individual commenters expressed
overall support for the revision of Medicare payment for telehealth.
Specifically, commenters mentioned removal of the fee sharing
requirement, relaxed conditions of payment, and the addition of non-MSA
counties to the geographic areas eligible for telehealth under
Medicare. The commenters noted that these changes will have a positive
effect on health care delivery and will help provide services to areas
where specialty care is sparse.
Response: We agree that the proposed revisions to Medicare
telehealth coverage and payment policies, as authorized by the BIPA,
remove significant barriers for physicians and practitioners wishing to
provide telehealth services.
Comment: One commenter indicated that the cost of collecting the
coinsurance for the originating site facility fee could easily exceed
the amount the facility would collect from the beneficiary. The
commenter encouraged us to permit originating sites to waive the
coinsurance in those situations where the telehealth facility charge is
the only amount to be billed to the beneficiary.
Response: We do not have the authority to eliminate the coinsurance
requirement outright for telehealth originating sites. However,
Medicare permits the waiver of coinsurance for limited situations.
Section 5220 of the Medicare Carriers Manual specifies that physicians
and suppliers may waive billing for or collection of coinsurance or
deductibles for indigent patients or when the physicians' or suppliers'
cost of billing or collecting exceeds or is disproportionate to the
amounts to be collected. Documentation must be sufficient to support
that costs for billing the beneficiary exceed or are disproportionate
to the amount collected from the beneficiary. In this instance, the
amount collected refers to 20 percent of the originating site
telehealth facility fee.
We clarify that when the patient owes additional coinsurance to the
originating site for other Medicare services, billing for the
telehealth facility fee coinsurance amount may be consolidated with the
coinsurance amount owed for those services. We believe that this would
resolve the commenter's concern that the cost for billing and or
collecting the coinsurance for a single facility fee could exceed or be
disproportionate to the amount collected from the beneficiary.
Comment: One association submitted a number of comments that have
payment implications for the Federally qualified health center benefit.
Response: These issues involve specific aspects of the Federally
qualified health center payment methodology and are beyond the scope of
this provision. We will take these comments into consideration in
formulating future instructions for payment implications on FQHCs.
Result of Evaluation of Comments
We are implementing this provision as stated above.
G. Indian Health Service
The Indian health care system provides primary health care to many
American Indian and Alaska Native Medicare beneficiaries. This system
consists of programs operated by a Federal agency, the Indian Health
[[Page 55285]]
Service (IHS), and Federally funded programs operated by Indian tribes,
tribal organizations, and urban Indian organizations (as those terms
are defined in section 4 of the Indian Health Care Improvement Act).
These programs deliver a range of clinical and preventive health
services to their beneficiaries through a network of facilities
including hospitals and outpatient clinics. Programs operated in IHS-
owned or leased facilities, by IHS or by tribes or tribal
organizations, are considered ``Federal providers'' by Medicare.
Sections 1814(c) and 1835(d) of the Act generally prohibit payment to
Federal providers, subject to exceptions contained in section 1880 of
the Act for these IHS facilities. Before enactment of the BIPA, the
exception in section 1880 of the Act was applicable only to IHS owned
or leased hospitals, provider-based clinics, and skilled nursing
facilities (regardless of whether the entity is tribally operated). The
exception did not permit Medicare to pay for services furnished by IHS
owned or leased free-standing outpatient clinics or to pay any IHS
owned or leased facilities for services by physicians and other
practitioners paid under a fee schedule.
Effective July 1, 2001, section 432 of the BIPA extends the
exception in section 1880 of the Act to permit Medicare payments to
hospitals and outpatient clinics (provider-based or free-standing),
operated by the IHS or by a tribe or tribal organization, for services
furnished by physicians and specified non-physician practitioners in or
at the direction of the hospital or outpatient clinic. Payments for
these services are made to the hospital or outpatient clinic, not to
the physician or other practitioner. These payments are subject to the
same situations, terms, and conditions as would apply if the services
were furnished in, or at the direction of, a hospital or outpatient
clinic that is not operated by the IHS or by a tribe or tribal
organization. The payments include incentive payments for physicians
furnishing covered physicians' services in rural or urban health
professional shortage areas (HPSAs) if the usual HPSA criteria are met.
(For further information see section 1833 of the Act and Sec. 414.42 of
our regulations.) Payments will not be made under these provisions to
the extent that Medicare is otherwise paying for the same services
under other provisions (for example, as part of a bundled payment, or
if a tribal outpatient clinic continues to bill as a Federally
qualified health center (FQHC)).
We have added a new Sec. 410.46 to our regulations to reflect this
new statutory provision. Due to the statutory effective date of July 1,
2001, we implemented this BIPA provision through program memorandum
instructions.
Result of Evaluation of Comments
We received no comments on the statutory requirement to pay Indian
Health Service and tribal hospitals and clinics for the services of
physicians and other practitioners under Medicare fee schedules.
H. Pathology Services
The November 2, 1999 final rule (64 FR 59380) provided that, for
services furnished on or after January 1, 2001, carriers would no
longer pay claims to independent laboratories under the physician fee
schedule for the technical component (TC) of physician pathology
services for hospital inpatients. Before that rule, independent
laboratories could bill the carrier under the physician fee schedule
for the TC of a physician pathology service furnished to a hospital
inpatient. Also, under that rule, independent laboratories would still
have been able to bill and receive payment for the TC of physician
pathology services furnished to patients who are not hospital
inpatients.
Section 542 of the BIPA requires the Medicare carrier to continue
to pay for the TC of physician pathology services when an independent
laboratory furnishes these services to an inpatient or outpatient of a
covered hospital. The BIPA provisions apply to TC services furnished
during the 2-year period beginning January 1, 2001 and continuing
through December 31, 2002. We informed the carriers and the
intermediaries of this provision through program memorandum AB-01-47,
which was issued in March 2001. This program memorandum requested the
carriers to notify independent laboratories of this provision in their
next regularly scheduled bulletin and to place this bulletin on their
Internet web site. In the absence of further legislation, the policy of
the November 1999 final rule will take effect for the TC of physician
pathology services furnished to hospital patients after December 31,
2002. We have revised Sec. 415.130 to conform to the statutory change
in section 542 of BIPA concerning the payment for the TC of physician
pathology services.
Result of Evaluation of Comments
We have received no comments on this issue.
IV. Five-Year Review of Work Relative Value Units Under the
Physician Fee Schedule; Responses to Public Comments on the Five-
Year Review of Work Relative Value Units
A. Scope of Five-Year Review
This final rule includes the culmination of the 5-year review of
work RVUs required by statute. The work RVUs affected by this review
will be effective for services furnished beginning January 1, 2002.
In our June 8, 2001 proposed notice (66 FR 31028), we explained the
process used to conduct the 5-year review of work RVUs. During the
comment period we received approximately 35 public comments on
approximately 900 codes. After review by our medical staff, we
forwarded all of the comments we received concerning potentially
misvalued services to the AMA's Specialty Society Relative Value Update
Committee (RUC).
The RUC submitted work RVU recommendations for all of the codes we
forwarded with the exception of the anesthesia codes and conscious
sedation codes. We analyzed all of the RUC recommendations and
evaluated both the recommended work RVUs and the rationale for the
recommendations. If we had concerns about the application of a
particular methodology, but thought the recommended work RVUs were
reasonable, we verified that the recommended work RVUs were appropriate
by using alternative methodologies. (For additional information on the
review process, please see the proposed notice published June 8, 2001.)
B. Review of Comments (Includes Table 4 Work RVU Refinements of 5-Year
Review Codes Commented on in Response to the June 8, 2001 Proposed
Notice)
During the comment period for our June 8, 2001 proposed notice,
commenters generally supported our proposed changes. We received more
than 125 comments on approximately 39 specific codes plus all the
anesthesia services. The majority of these comments addressed the
gastrointestinal endoscopy codes and anesthesia services.
We convened a multispecialty panel of physicians to assist us in
the review of the comments. The comments we did not submit for panel
review are discussed at the end of this section. The panel was
moderated by our medical staff and consisted of:
Clinicians representing the commenting specialties, based
on our determination of those specialties which
[[Page 55286]]
are most identified with the services in question. Although commenting
specialties were welcomed to observe the entire refinement process,
they were only involved in the discussion of those services for which
they were invited to participate.
Primary care clinicians nominated by the American Academy
of Family Physicians and the American College of Physicians and
American Society of Internal Medicine.
Four carrier medical directors.
Four clinicians with practices in related specialties who
had knowledge of the services under review.
We submitted 6 codes for evaluation by the panel. The panel
discussed the work RVUs involved in each procedure under review in
comparison to the work RVUs associated with other services on the fee
schedule. We assembled a set of reference services and asked each panel
member to compare the clinical aspects for the services they believed
were incorrectly valued to one or more of the reference services. In
compiling the reference set, we attempted to include--(1) services that
are commonly performed whose work RVUs are not controversial; (2)
services that span the entire work spectrum from the easiest to the
most difficult; and (3) at least three services performed by each of
the major specialties so that each specialty would be represented. The
reference set listed over 300 services. Group members were encouraged
to make comparisons to these reference services. The intent of the
panel process was to capture each participant's independent judgement
based on the discussion and his or her clinical experience. Following
each discussion, each participant rated the work for the procedure.
Ratings were individual and confidential; there was no attempt to
achieve consensus among the panel members.
We then analyzed the ratings based on a presumption that the RVUs
in the proposed notice were correct. To overcome this presumption, the
inaccuracy of the proposed RVUs had to be apparent to the broad range
of physicians participating in each panel.
Ratings of work were analyzed for consistency among the groups
represented on each panel. We used statistical tests to determine
whether there was enough agreement among the groups on the panel, and
whether the agreed-upon RVUs were significantly different from the
proposed RVUs published in the June 8, 2001 proposed notice. We did not
modify the RVUs unless there was a clear indication for a change. If
there was agreement across groups for change, but the groups did not
agree on what the new RVUs should be, we eliminated the outlier group,
and looked for agreement among the remaining groups as the basis for
new RVUs. We used the same methodology in analyzing the ratings that we
first used in the refinement process for the 1993 fee schedule. The
statistical tests we used are described in detail in the November 25,
1992 final rule (57 FR 55938).
Our decision to convene a multispecialty refinement panel of
physicians and to apply the statistical tests referred to above was
based on our need to balance the interests of those who commented on
the work RVUs against the redistributive effects that would occur in
other specialties. Of the 6 codes reviewed by the multispecialty panel,
all were the subject of requests for increased values.
We also received comments that we did not submit to the panels for
a variety of reasons. These comments are discussed later in this
section. Of the proposed codes that were reviewed, 3 increased, and 3
were not changed.
Table 4.--Work Relative Value Unit Refinements of Five-Year Review
Codes Commented on in Response to the June 8, 2001 Proposed Notice
Table 4 lists the codes reviewed during the 5-year review on which
we received comments. This table includes the following information:
CPT/HCPCS Code. This is the CPT or alphanumeric HCPCS code
for a service.
Modifier. A modifier-26 is shown if the work RVUs
represent the professional component of the service.
Description. This is an abbreviated version of the
narrative description of the code.
Proposed Work RVUs. This column includes the work RVUs
proposed in the June 8, 2001 proposed notice for each reviewed code.
Requested Work RVUs. This column identifies the work RVUs
requested by the commenters. If the commenters requested different
RVUs, the table lists the highest requested RVUs. For some codes we
received recommendations for an increase but no specific RVUs were
recommended.
RUC Recommendation. This column identifies the work RVUs
recommended by the RUC if the RUC made a specific work value
recommendation as part of its comments on the June 8, 2001 proposed
notice.
2002 Work RVUs. This column contains the 2002 work RVUs.
Basis for Decision. This column indicates whether:
+ The recommendations of the multispecialty refinement panel were
the basis upon which we determined that the proposed work RVUs
published June 8, 2001 should be retained (indicator 1).
+ A new value emerged from our analysis of the refinement panel
ratings (indicator 2).
+ A new or retained value came from review of the comment(s)
received (indicator 3).
+ A new value came from the need to make a rank-order change to
maintain or correct existing relationships among services (indicator
4).
+ A value is retained and the code has been referred to the RUC
(indicator 5).
+ There is no change in value but we have adjusted the global
period (indicator 6).
Table 4.--Work RVU Refinements of the Five-Year Review Codes Commented on in Response to June 8, 2001 Proposed Notice
--------------------------------------------------------------------------------------------------------------------------------------------------------
Proposed Requested 2002 Work Basis for
CPT/HCPCS Code \1\ Mod Descriptor Work RVU Work RVU RUC REC RVU decision
--------------------------------------------------------------------------------------------------------------------------------------------------------
00100-01999........................ ........................... Anesthesia services.. (\2\) (\3\) ........... (\2\) #5
11055.............................. ........................... Trim skin lesion..... 0.27 0.43 ........... 0.43 #3
11056.............................. ........................... Trim skin lesion, 2 0.39 0.61 ........... 0.61 #3
to 4.
11057.............................. ........................... Trim skin lesions, 0.50 0.79 ........... 0.79 #3
over 4.
11719.............................. ........................... Trim nail(s)......... 0.11 0.17 ........... 0.17 #3
27286.............................. ........................... Fusion of hip joint.. 23.45 ........... ........... 23.45 #4
[[Page 55287]]
36400.............................. ........................... Drawing blood........ 0.18 0.38 ........... 0.38 #2
36405.............................. ........................... Drawing blood........ 0.18 0.32 ........... 0.31 #2
38510.............................. ........................... Biopsy/removal, lymph 6.43 ........... ........... 6.43 #6
nodes.
38571.............................. ........................... Laparoscopy, 12.38 19.84 ........... 14.68 #2
lymphadenectomy.
38740.............................. ........................... Remove armpit lymph 10.02 10.03 ........... 10.03 #3
nodes.
38745.............................. ........................... Remove armpit lymph 13.00 13.10 ........... 13.10 #3
nodes.
38760.............................. ........................... Remove groin lymph 12.94 12.95 ........... 12.95 #3
nodes.
39503.............................. ........................... Repair of diaphragm 34.85 95.00 ........... 95.00 #3
hernia.
43219.............................. ........................... Esophagus endoscopy.. 2.80 3.18 ........... 2.80 #3
43239.............................. ........................... Upper GI endoscopy, 2.69 2.87 ........... \1\ 2.87 #3
biopsy.
43244.............................. ........................... Upper GI endoscopy/ 4.59 5.05 ........... 5.05 #3
ligation.
43247.............................. ........................... Operative upper GI 3.39 3.40 ........... 3.39 #3
endoscopy.
43249.............................. ........................... Esoph endoscopy, 2.90 3.25 ........... 2.90 #3
dilation.
43255.............................. ........................... Operative upper GI 4.40 4.82 ........... 4.82 #3
endoscopy.
43259.............................. ........................... Endoscopic ultrasound 4.89 6.53 ........... 4.89 #3
exam.
43263.............................. ........................... Endo 6.19 7.29 ........... 7.29 #3
cholangiopancreatogr
aph.
43265.............................. ........................... Endo 8.90 10.02 ........... 10.02 #3
cholangiopancreatogr
aph.
43269.............................. ........................... Endo 6.04 8.21 ........... 8.21 #3
cholangiopancreatogr
aph.
44388.............................. ........................... Colon endoscopy...... 2.82 3.24 ........... 2.82 #3
44389.............................. ........................... Colonoscopy with 3.13 3.54 ........... 3.13 #3
biopsy.
44390.............................. ........................... Colonoscopy for 3.83 4.25 ........... 3.83 #3
foreign body.
44391.............................. ........................... Colonoscopy for 4.32 5.25 ........... 4.32 #3
bleeding.
44392.............................. ........................... Colonoscopy and 3.82 4.23 ........... 3.82 #3
polypectomy.
44393.............................. ........................... Colonoscopy, lesion 4.84 5.79 ........... 4.84 #3
removal.
45380.............................. ........................... Colonoscopy and 4.01 4.44 ........... \1\ 4.44 #3
biopsy.
49605.............................. ........................... Repair umbilical 22.66 76.00 ........... 76.00 #3
lesion.
56515.............................. ........................... Destruction, vulva 2.76 3.63 ........... 2.76 #1
lesion(s).
56605.............................. ........................... Biopsy of vulva/ 1.10 ........... 1.10 \4\ 1.10 #3
perineum.
56810.............................. ........................... Repair of perineum... 4.13 ........... 4.13 \4\ 4.13 #3
57500.............................. ........................... Biopsy of cervix..... 0.97 ........... ........... 0.97 #5
58100.............................. ........................... Biopsy of uterus 0.71 ........... 1.53 \4\ 1.53 #3
lining.
76090.............................. ........................... Mammogram, one breast 0.70 0.93 ........... 0.70 #1
76091.............................. ........................... Mammogram, both 0.87 1.10 ........... 0.87 #1
breasts.
G0127.............................. ........................... Trim nail(s)......... 0.11 ........... ........... 0.17 #3
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ All CPT codes and descriptors copyright 2000 American Medical Association.
[[Page 55288]]
\2\ No change.
\3\ 26% incr.
\4\ RVUS to remain interim for 2002.
C. Discussion of Comments by Clinical Area
In this section, we discuss the comments we received on the 39
codes of the more than 900 codes for which we sought public comment.
For the codes for which we did not receive any comments, our proposed
RVUs are being made final. We have categorized the comments into the
same clinical areas we used in the June 8, 2001 notice. Within each
clinical area, listed below, we discuss the comments received in CPT
code order.
1. Vascular Surgery
Comment: The American Association for Vascular Surgery and the
Society for Vascular Surgery expressed appreciation that we agreed with
the RUC recommendations for work RVUs for the vascular surgery codes
reviewed under the second 5-year review. However, it indicated that
some of these services may still be undervalued. It will be reviewing
these services as well as a small number of vascular surgery services
that were not submitted this year and possibly submit these under the
next 5-year review.
Response and final decision: We will finalize the RVUs for the
vascular surgery codes as proposed.
2. General Surgery and Colon and Rectal Surgery
Family 2 Lymphadenectomy
Comment: The American College of Surgery (ACS) was supportive of
the work performed by CMS medical officers to ensure that rank order
anomalies were eliminated from 6 families of codes where acceptance of
the RUC recommendations would create distortions in family work value
relativity and the rest of the physician fee schedule.
The ACS pointed out a typographical error in the proposed notice.
For Family 2 Lymphadenectomy, CMS disagreed with the RUC, and stated
that the median survey result of 13 is appropriate for CPT code 38745.
The ACS commented that the survey median is actually 13.10. The
correction of this error would lead to increases for related family
codes 38740 (from 10.02 to 10.03) and 38760 (from 12.94 to 12.95).
Response and final decision: We agree with the commenter's response
and will adjust the work values for CPT code 38740 to 10.03; for CPT
code 38745 to 13.10; and for CPT code 38760 to 12.95.
Family 3 Lymph Nodes and Lymphatic Channels--Incision/Excision
Comment: The American Academy of Otolaryngology recommended that
CMS change the global surgical period of CPT code 38510 from 90 days to
10 days following the RUC survey data for this CPT code. It alleges
that there were no postoperative visits beyond 10 days associated with
this procedure for the relative work established.
Response: The RUC valued this service based on the fact that it is
typically furnished to an outpatient. The value of a hospital discharge
day was subtracted from the median survey value. The median survey
value is based on one followup office visit. We believe there is merit
to the group's point and will change the global period from 90 days to
10 days.
3. Thoracic Surgery
Comment: The Society of Thoracic Surgeons expressed appreciation
that we had accepted the RUC recommendations for corrections to work
values of many thoracic and cardiac procedures.
Response and final decision: We will finalize the RVUs for these
codes as proposed.
4. Orthopedic Surgery
We received no comments on these codes. Therefore, we will finalize
all of the proposed work RVUs for the orthopedic surgery codes. We
would also note that, in the June rule, we proposed to correct a rank
order anomaly by increasing values for CPT code 27286. This code,
however, was inadvertently omitted from the table and addendum; it is
included in Table 4 and Addendum A of this final rule.
5. Ophthalmology
We received no comments on these codes. Therefore, we will finalize
all of the proposed work RVUs for the ophthalmology codes.
6. Urology
We received no comments on these codes. Therefore, we will finalize
all of the proposed work RVUs for the urology codes.
7. Obstetrics/Gynecology
CPT Code 38571, Laparoscopy, Surgical; With Bilateral Total Pelvic
Lympadenectomy
Comment: The Society of Gynecologic Oncologists (SGO) stated that,
while we had proposed an increase for CPT code 38572, an increase was
not proposed for CPT code 38571. The SGO believes that both of these
codes are undervalued based on insufficient work RVUs being assigned
for the laparoscopy with bilateral total pelvic lymphadenectomy
procedure, which is common to both codes. It requested that a
proportional increase in work RVUs be made for CPT 38571 as well.
Response: We accepted the RUC recommendation that no increase be
made in the work RVU for this service based on the lack of compelling
evidence to support an increase, and we had proposed retaining the
current work RVU for this service. However, based on the comments
received, we referred this code to a multispecialty refinement panel
for review.
Final decision: As a result of our analysis of the multispecialty
refinement panel ratings, we are increasing the work RVUs for CPT code
38571 to 14.68 work RVUs.
CPT Code 56515, Destruction of Lesion(s), Vulva; Extensive, Any Method
Comment: For CPT code 56515, SGO disagreed with the rationale that
CPT codes 56515 and 46924 have comparable physician and intraservice
work time. It indicated that CPT code 56515 involves lasering a much
larger area; therefore, the amount of intraservice time and the number
of postoperative visits can be significantly higher.
Response: We had accepted the RUC recommendation of 2.76 work RVUs
for this code which was lower than the 3.625 which had been requested
by the specialty. Based on the comments received, we referred this code
to a multispecialty refinement panel for review.
Final decision: As a result of our analysis of the refinement panel
ratings, we are retaining the work RVU of 2.76.
CPT Code 57500, Biopsy, Single or Multiple, or Excision of Lesion, With
or Without Fulguration (Separate Procedure)
Comment: In addition to comments on the 2 codes referenced above,
SGO also recommended that, while CPT code 57500 was not considered part
of the 5-year review, this gender-specific code be forwarded to the RUC
for evaluation. It believes the amount of physician time and level of
pre- and postoperative work for this procedure is similar to that for
the male-specific procedures of CPT
[[Page 55289]]
code 54100 (Biopsy of penis (separate procedure)), and CPT code 54505
(Biopsy of testis, incisional (separate procedure)), and thus the
physician work for CPT code 57500 should be increased.
Response and final decision: We will refer this code to the RUC for
review.
Comment: In our June 8, 2001 proposed notice, we also stated that
we referred three female-specific procedure codes that appeared to be
misvalued to the RUC for review. As part of its comments on the
proposed notice, and in response to our request to review these
services, the RUC has provided recommendations on work RVUs for the
three codes as follows:
CPT code 56605, Biopsy of vulva or perineum (separate
procedure); one lesion.
The RUC stated that this code was reviewed during the first 5-year
review and was increased at that time to double the original work RVU
for CPT code 56605. While the current work RVU for this code is less
than CPT code 54100, Biopsy of penis (WRVU 1.90), the structure of CPT
code 56605 allows additional reporting when more than one lesion is
biopsied, while the penile code (54100) may be only reported once,
regardless of the number of biopsies. The RUC recommended that the
current work RVU of 1.10 be maintained for CPT code 56605.
CPT code 56810, Perineoplasty, repair of perineum,
nonobsterical (separate procedure).
The RUC indicated that the specialty stated that this service may
be undervalued; however, perineoplasty is performed so rarely as a
separate procedure that it would be difficult to obtain valid survey
data to appropriately value this service. In addition, the specialty is
currently considering CPT revisions to this family of codes and will
review this issue at that time. The RUC recommended that the current
work RVU of 4.13 be maintained for the service.
CPT code 58100, Endometrial sampling (biopsy) with or
without endocervical sampling (biopsy), without cervical dilation, any
method (separate procedure).
The RUC indicated that, based on a review of survey data, CPT code
58100 is undervalued. The RUC compared this code to CPT code 55700 and
determined that these 2 services are similar in time and intensity. The
RUC also agreed that 58100 is more work than the reference procedure,
CPT code 57505, and recommended an increase in the work RVU for CPT
code 58100 to 1.53. The RUC also provided refinements to the practice
expense inputs for this code.
Response and final decision: We agree with the RUC recommendations
for these three codes and will maintain the current work RVUs of 1.10
for CPT code 56605 and 4.13 for CPT code 56810 and increase the work
RVUs for CPT code 58100 to 1.53. Because the public has not had a
chance to comment on these work RVUs, we will consider them to be
interim and will accept comments on values for these 3 codes.
8. Gastroenterology
In the June 8, 2001 proposed notice, we explained that, for the
selected series of gastrointestinal endoscopy codes for the 5-year
review, the RUC recommended increases in work RVUs for some of the
codes and no change in work for other codes. While some of these
endoscopy codes may be misvalued, we proposed to keep all work RVUs for
gastrointestinal endoscopy codes unchanged. We also requested that the
RUC perform a comprehensive review of all gastrointestinal endoscopy
codes to ensure that all codes are properly valued and that no rank-
order anomalies within and across specialties are created or
exacerbated.
With respect to the RUC recommendation concerning permitting
separate reporting and payment of conscious sedation codes 90141 and
90142, we stated we would be reviewing data concerning this issue. Any
proposal we would have concerning payment and reporting of conscious
sedation codes would be the subject of future rulemaking.
Comment: Many physicians and several medical organizations
expressed concern about our decision to propose no changes for the 17
endoscopy codes for which the RUC had recommended increases. The
American Society for Gastrointestinal Endoscopy, the American College
of Gastroenterology, and the American Gastroenterological Association
provided an extensive discussion on each of the codes which we will
summarize and respond to below.
CPT Code 43219, Esophagoscopy, Rigid or Flexible; With Insertion of
Plastic Tube or Stent
The RUC recommended an increase in work RVUs from 2.8 to 3.18 for
CPT code 43219 based upon the increased complexity of the condition of
the patients receiving these stents. We proposed to maintain the
current work RVUs due to our concerns about creating rank order
anomalies in the fee schedule.
Comment: We received comments regarding this code from several
societies representing gastroenterologists who said that the
incremental work involved with esophageal stent placement, presently
valued at 1.21 RVUs, should be increased to 1.59 RVUs. The commenters
agreed with CMS that several other stent codes were recently reviewed
by the RUC and valued using the incremental work value of 1.21 RVUs.
Increasing the incremental work value for CPT code 43219 to 1.59 RVUs
would result in rank order anomalies for several codes. The commenters
acknowledged that these anomalies resulted from the timing of the 5-
year review and the valuation of new stent placement codes. In spite of
this, the commenters felt the RUC-recommended value was appropriate.
Response: We feel the current work increment of 1.21 RVUs for
placement of a stent over the base code 43200 is the appropriate value
when assessing incremental work. We do not agree that the incremental
work for stent placement should be increased to 1.59 RVUs. The upper GI
endoscopy base CPT code 43235 has RVUs of 2.39 and CPT code 43256,
upper GI endoscopy with stent placement (including predilation) has
work RVUs of 4.35. This results in an incremental value of 1.96 RVUs
which includes placement of the stent (1.21 RVUs) and predilation (0.75
RVUs).
Furthermore, diagnostic bronchoscopy, CPT code 31622, has work RVUs
of 2.78, and bronchoscopy with tracheal dilation and placement of a
tracheal stent (CPT code 31631) has an RVU of 4.37. This means that the
incremental work value for tracheal dilation and stent placement is
1.59 RVUs which is significantly less than the work increment of 1.96
listed for CPT code 43256. We also note that CPT code 43219 will be
billed with CPT code 43226 (dilation of the esophagus over a guidewire)
which has an incremental value of 0.75 work RVUs. This means that when
an esophageal stent is placed, the total work value is 1.59 (base code)
plus 1.21 (stent placement) plus 0.75 (dilation) for a total of 3.55
RVUs.
More important, the incremental work of placing the stent is 1.96
RVUs which is similar to the incremental work of placing a stent
elsewhere in the GI tract and more than the incremental work of placing
a stent in the trachea. Increasing the incremental work of placing an
esophageal stent to 1.59 RVUs from 1.21 would create a significant rank
order anomaly in the physician fee schedule because esophageal stent
placement would be valued more than stent placement elsewhere.
[[Page 55290]]
Lastly, we note that less work is required to place a plastic stent
than to place a wire stent. Both, however, are coded using CPT code
43219 and are valued similarly. For these reasons, we have decided to
maintain the current RVUs of 2.80 for this code, and we would like the
RUC to review all of the GI endoscopic stent placement codes and all of
the GI endoscopic dilation codes simultaneously. Because these services
are performed by gastroenterologists and various surgical specialties
(general surgery, thoracic surgery, otolaryngology, and colorectal
surgery), the RUC should obtain input from all specialties performing
these services.
CPT Code 43239, Upper Gastrointestinal Endoscopy Including Esophagus,
Stomach, and Either the Duodenum and/or Jejunum as Appropriate, With
Biopsy, Single or Multiple
The RUC recommended an increase in work RVUs from 2.69 to 2.87
based on an increase in the number of biopsies obtained during each
procedure. The RUC also stated that technological advances allowing for
greater precision and detail in finding abnormalities have increased
the complexity of this service. The RUC also stated that technological
advances have allowed results to be reported more quickly which
increases the postservice work because biopsy information and treatment
guidance are conveyed to the patient the same day as the procedure. We
disagreed, and in the June rule we proposed to maintain the current
work RVUs.
Comment: We received comments from several societies representing
gastroenterologists and the following concerns were expressed: First,
they did not feel that the work of performing biopsy procedures at
different sites in the GI tract was the same. They commented that
biopsy of lesions in different anatomic sites required different
amounts of work. Second, they felt that even though CPT code 43239 was
used to report both single and multiple biopsies, the typical patient
requires multiple biopsies.
Response: We reviewed these comments and compared the intraservice
time for this procedure to other endoscopic biopsy procedures and we
have decided to accept the RUC recommendations for this code. However,
we are making this value interim. Please see the discussion under CPT
code 45380 regarding this issue.
CPT Code 43244, Upper Gastrointestinal Endoscopy Including Esophagus,
Stomach, and Either the Duodenum and/or Jejunum as Appropriate; With
Band Ligation of Esophageal and or Gastric Varices; CPT Code 43255,
Upper Gastrointestinal Endoscopy Including Esophagus, Stomach, and
Either the Duodenum and/or Jejunum as Appropriate; With Control of
Bleeding, Any Method
The RUC recommended an increase in work RVUs for CPT code 43255
from 4.4 to 4.82 work RVUs, based on the use of new technology, such as
lasers, to control bleeding. The RUC also recommended an increase in
work RVUs for CPT code 43244 from 4.59 to 5.05 RVUs, based on the
increased number of bands typically used to treat esophageal varices.
We disagreed and proposed to maintain the current work RVUs.
Comment: We received comments from several societies representing
gastroenterologists and the following concerns were expressed: First,
they felt that we had incorrectly determined that these two services
should be valued identically because the RUC stated that they were
``similar'' in terms of work. Second, although they acknowledged that
the use of cautery to control bleeding is not new, they said that the
service is undervalued irrespective of which method is used to control
bleeding.
Response: We reviewed these comments and compared the intraservice
time to other similar procedures and have decided to accept the RUC
recommendations for the above CPT codes.
CPT Code 43247, Upper Gastrointestinal Endoscopy Including Esophagus,
Stomach, and Either the Duodenum and/or Jejunum as Appropriate; With
Removal of Foreign Body
The RUC recommended an increase in work RVUs for this CPT code from
3.39 to 3.59 work RVUs, based on increased complexity of patients
undergoing this procedure with a concomitant increase in risk of
morbidity. We disagreed and proposed to maintain the current work RVUs.
Comment: We received comments from several societies representing
gastroenterologists with the following concerns: First, they felt the
increase in the work RVU for this procedure was justified because the
procedure is usually performed under emergent conditions. Second, they
did not favor uniform incremental work values for removal of foreign
bodies from different sites in the gastrointestinal tract.
Response: The RUC used a building-block approach to validate its
acceptance of the median work RVUs from the survey. We do not believe
the approach used by the RUC is valid for this CPT code. We compared
this service to other similar services and continue to believe that the
RUC recommendation does not represent the appropriate work increments
for foreign body removal from various gastrointestinal sites.
Furthermore, it would create a clear rank-order anomaly with CPT code
43215 that should have an identical work increment. Therefore, we will
maintain the current work RVUs for this procedure. If the RUC reviews
this service again, we ask that all GI endoscopic services for removal
of foreign bodies be included in the review.
CPT Code 43249, Upper Gastrointestinal Endoscopy Including Esophagus,
Stomach, and Either the Duodenum and/or Jejunum as Appropriate; With
Balloon Dilation
The RUC recommended an increase from 2.9 to 3.35 work RVUs for this
CPT code based on increased complexity of the condition of patients
undergoing this procedure. We disagreed and proposed to maintain the
current work RVUs.
Comment: We received comments from several organizations
representing gastroenterologists who felt the increase in incremental
work value was justified based on their survey. However, they admitted
that revaluing CPT code 43249 would create a rank order anomaly with
CPT code 43220, an identical procedure. They stated that CPT code 43220
is also undervalued.
Response: The current work increment for ``balloon dilation of
esophagus (less than 30mm diameter)'' is 0.51 RVUs for both the
esophagus and upper gastrointestinal endoscopy families. Since this is
the same procedure in both families, it is unclear why the work should
be increased for the upper gastrointestinal family only. This would
create a rank-order anomaly. We have decided to maintain the current
work RVUs for CPT code 43249. We plan to ask the RUC to review the
incremental work RVUs for both CPT code 43249 and CPT code 43220.
CPT Code 43259, Upper Gastrointestinal Endoscopy Including Esophagus,
Stomach, and Either the Duodenum and/or Jejunum as Appropriate; With
Endoscopic Ultrasound Examination
The RUC recommended an increase in work RVUs from 4.59 to 8.59
based on the complexity of the equipment and the skill and judgement
required. The
[[Page 55291]]
RUC also noted that the survey results supported this procedure as
requiring more work than CPT code 43260--diagnostic endoscopic
retrograde cholangio-pancreatography (ERCP)--which has 5.96 work RVUs.
Comment: We received comments from several societies representing
gastroenterologists who agreed with us that the RUC values for the new
endoscopic ultrasound codes (EUS) were inconsistent with the value
recommended by the RUC for CPT code 43259. They felt that new survey
data should have been used by the RUC when valuing CPT code 43259
instead of the current incremental work values used by the RUC for the
5-year review.
Response: The RUC used the following building-block methodology to
arrive at its recommendation for 43259--1) The RUC added 1.5 work RVUs,
which is approximately 75 percent of the difference between the RUC
recommendation from the last 5-year review (6.11 work RVUs) and the
work RVUs that we assigned (4.0 work RVUs); (2) the RUC then added 2.2
work RVUs, which are the work RVUs of CPT code
93312 (Echocardiography, Transesophageal, Real Time With Image
Documentation (2D) (With or Without M-Mode Recording); Including Probe
Placement, Image Acquisition, Interpretation and report)
Not only do we disagree with the RUC methodology for this
recommendation, but we also note that the RUC has used the current work
RVUs for CPT code 43259 to value not only other gastrointestinal
transendoscopic ultrasound procedures but also many transendoscopic
ultrasound guided biopsy codes. We also note that the RUC has recently
re-evaluated CPT code 43231, Esophagoscopy, rigid or flexible; with
endoscopic ultrasound examination, and recommended much lower RVUs for
the incremental work of the ultrasound examination. Therefore,
accepting the RUC recommendation for this code would be inconsistent
with the RUC's reevaluation of CPT code 43231, would invalidate the
work valuation of many other gastrointestinal endoscopy codes, and
would create numerous rank-order anomalies. Therefore, we recommend
that the RUC review CPT code 43259 along with all the other endoscopic
ultrasound examination codes and all the transendoscopic ultrasound
guided biopsy codes.
CPT Code 43263, Endoscopic Retrograde Cholangio-pancreatography (ERCP);
With Pressure Measurement of Sphincter of Oddi (Pancreatic Duct or
Common Bile Duct)
CPT Code 43265, Endoscopic Retrograde Cholangio-pancreatography (ERCP)
With Endoscopic Retrograde Destruction, Lithotripsy of Stone(s), Any
Method
CPT Code 43269, Endoscopic Retrograde Cholangio-pancreatography (ERCP);
With Endoscopic Retrograde Removal of Foreign Body and/or Change of
Tube or Stent
The RUC recommended an increase in work RVUs from 6.19 to 7.29 for
CPT code 43263 based on the need to measure pressures in both the
biliary and pancreatic sphincters, as well as the need for prolonged
postoperative monitoring.
The RUC recommended an increase in work RVUs from 8.9 to 10.02 for
CPT code 43265 based on a rank-order anomaly with code 43264 because
this procedure is considered to be more time-consuming and complex than
CPT code 43264.
The RUC recommended an increase in work RVUs from 6.04 to 8.21 for
CPT code 43269 based on a rank-order anomaly between this code and CPT
code 43268.
Comment: We received comments on these three codes from several
organizations representing gastroenterologists. It was their position
that these codes were commonly performed, undervalued procedures and
that the survey data the organizations provided justify the increase in
RVUs. We disagreed and proposed to maintain the current work RVUs for
these three codes.
Response: We have reviewed the codes and compared their
intraservice times to other similar procedures and have decided to
accept the RUC recommendations.
CPT Code 44388, Colonoscopy Through Stoma; Diagnostic With or Without
Collection of Specimen(s) by Brushing or Washing (Separate Procedure)
CPT Code 44389, Colonoscopy Through Stoma; With Biopsy, Single or
Multiple
CPT Code 44390, Colonoscopy Through Stoma; With Removal of Foreign Body
CPT Code 44391, Colonoscopy Through Stoma; With Control of Bleeding,
any Method
CPT Code 44392, Colonoscopy Through Stoma; With Removal of Tumor(s),
Polyp(s), or Other Lesion(s) by Hot Biopsy Forceps or Bipolar Cautery
CPT Code 44393, Colonoscopy Through Stoma: With Ablation of Tumor(s),
Polyp(s), or Other Lesion(s) Not Amenable to Removal by Hot Biopsy
Forceps, Bipolar Cautery or Snare Technique
These 6 codes are in the same family, and the RUC recommended an
increase for each code in this family primarily because it felt that
the base CPT code, 44388, should be valued the same as CPT code 45378,
diagnostic colonoscopy, at 3.7 work RVUs. The RUC also recommended that
the values for the other codes in this family be increased to maintain
their relativity to CPT code 44388. We disagreed and proposed to
maintain the current work RVUs for all codes in this family.
Comment: We received comments from several societies representing
gastroenterologists who commented that, although performing a
colonoscopy through a stoma involves less physician work than
performing a standard colonoscopy, they believed that performing a
colonoscopy through a stoma is more technically challenging than
performing a standard colonoscopy.
Response: We disagree with valuing the performance of a colonoscopy
through a stoma identically to performing a standard colonoscopy. We
feel the proposed valuation creates a series of rank-order anomalies.
Consequently, we will finalize our proposal to maintain the current
RVUs for this family of codes. In addition to determining that the RUC
recommendation for the base code 44388 was incorrect, we note that the
RUC recommendations create increments of work for performance of
``biopsy, single or multiple,'' ``control of bleeding, any method,''
``removal of tumors,'' and ``ablation of tumors'' during a colonoscopy
through a stoma, which are inconsistent with the same increments for
the complete colonoscopy family of codes that begins
[[Page 55292]]
with code 45378. We note that, in addition to gastroenterologists,
general surgeons and colorectal surgeons perform these procedures.
Therefore, if the RUC reconsiders the work values of these codes, we
believe that information should be obtained from all physicians who
perform these services.
CPT Code 45380, Colonoscopy, Flexible Proximal to Splenic Flexure; With
Biopsy, Single or Multiple
The RUC recommended an increase in work RVUs from 3.98 to 4.44 for
this CPT code, based on the increased number of biopsies generally
taken during this procedure and the increased difficulty in removing
these polyps. We disagreed and proposed to maintain the current work
RVUs for this service.
Comment: We received comments from several societies representing
gastroenterologists who commented that work increments for performing
biopsies at different sites within the gastrointestinal tract are
different. Furthermore, the societies believe that the incremental work
of biopsy procedures performed by different specialties (for example,
gastrointestinal endoscopic biopsies and tracheobronchial endoscopic
biopsies) need not be valued identically. They also note that even
though this code is reported for both single and multiple biopsies, the
``typical'' patient usually has multiple biopsies performed.
Response: We have reviewed these comments and compared the
intraservice time of this code to the intraservice time of other
similar procedures. We have decided to accept the RUC recommendation.
However, CMS believes the best approach to accurately value
gastrointestinal endoscopy biopsy procedures is to evaluate all the
biopsy procedures in the gastrointestinal tract. This would provide the
opportunity to establish the correct incremental work RVUs and avoid
creating rank-order anomalies. Therefore, we will make the work values
for CPT code 43239 (as indicated earlier) and 45380, interim until we
receive further recommendations from the RUC regarding the entire
spectrum of gastrointestinal biopsy procedures.
9. Conscious Sedation
Comment: The American Academy of Family Physicians indicated that
the RUC has appointed an ad hoc workgroup to review the issue of
conscious sedation, including identifying codes where conscious
sedation is not inherently included as a component of the physician
work. It recommended that, when the workgroup and RUC complete this
review, we allow separate reporting and payment for CPT codes 90141 and
90142 in conjunction with the identified codes. The AMA and the RUC
also referred to the newly formed workgroup in their comments, and the
AMA urged us to work with the RUC and the CPT to reach a solution on
the coding and payment issues surrounding conscious sedation.
Response and Final Decision: We welcome suggestions on this issue
from both the coding and payment perspective. When the workgroup review
of these issues is complete, we will evaluate any recommendations we
receive for the development of any future proposals.
10. Pulmonary Medicine/Critical Care
We received no comments on these codes. Therefore, we will finalize
the proposed work RVUs for the pulmonary medicine and critical care
codes.
11. Cardiology
CPT Code 93350, Transthoracic Echocardiography
Comment: The American College of Cardiology expressed appreciation
of our acceptance of the RUC recommendation to increase the work RVUs
for this code.
Response and Final Decision: We are finalizing the proposed RVUs
for CPT code 93350 and maintaining the work values for the other 2 CPT
codes, 32234 and 32235, as discussed in the proposed notice.
12. Pediatrics
CPT Code 36400 (Venipuncture Under Age 3 Years; Femoral, Jugular or
Sagittal Sinus) and CPT Code 36405 (Venipuncture, Under Age 3 Years,
Scalp Vein)
Comment: The American Academy of Pediatrics (AAP) disagreed with
our recommendations for CPT codes 36400 and 36405. The RUC recommended
work RVUs of .38 and .32, respectively. We proposed that the work RVUs
remain unchanged at .18 for each code. We do not believe it is
appropriate to compare the work RVUs of a venipuncture to the work of
an evaluation and management service. The AAP pointed out that the work
involved in providing a venipuncture to a patient under age 3 is more
intense than it has been in the past.
Response: Based on the comments received, we referred this code to
a multispecialty refinement panel for review.
Final decision: As a result of our analysis of the multispecialty
refinement panel ratings, we are increasing the work RVUs for CPT code
36400 to 0.38 and also increasing the work RVUs for CPT code 36405 to
0.31.
13. Pediatric Surgery
CPT Code 39503 (Repair, Neonatal Diaphragmatic Hernia, With or Without
Chest Tube Insertion and With or Without Creation of Ventral Hernia)
and CPT Code 49605 (Repair of Large Omphalacele or Gastroschisis; With
or Without Prosthesis)
Comment: The AAP and the American Pediatric Surgical Association
(ASPA) recommend that codes 39503 (Repair, neonatal diaphragmatic
hernia, with or without chest tube insertion and with or without
creation of ventral hernia), and 49605 (Repair of large omphalacele or
gastroschisis; with or without prosthesis) receive interim values of 95
and 76, respectively, until the issue of critical care in the
postoperative period is resolved. We had proposed to maintain the
current work RVUs of 37.54 and 24.94, respectively, as interim 2002
work values and asked the RUC to resubmit recommendations for work RVUs
for CPT codes 39503 and 49605 with either a 000 or 010 global period.
As an option, pending resolution of the critical care issue, the APSA
recommended that the interim work values for CPT codes 39503 and 49605
be 46.35 and 30.14, respectively.
The RUC agreed that the physician work in the postoperative period
caring for these seriously ill neonates was significant and required
the services of both surgeon and the neonatologist. The RUC requests
that CMS treat these codes in the same manner as the other 90-day
global codes that include extensive postoperative care.
Response: Upon further review, we agree with the RUC's
recommendation and will establish the work values for CPT codes 39503
and 49605 at 95 and 76 units, respectively.
14. Radiology
CPT Code 76090, Mammography; Unilateral and CPT Code 76091 Mammography;
Bilateral
Comment: The American College of Radiology (ACR) requested that CMS
increase the work RVUs for unilateral mammography, that is, CPT code
76090, from the proposed .70, to .93 and for bilateral mammography,
that is, code 76091, from the proposed .87, to 1.10. The ACR believes
these values, which are the median survey values, more accurately
reflect the work involved with these two procedures. The ACR points out
that there is a significant amount of physician time associated
[[Page 55293]]
with reviewing the results with these anxious patients and complying
with the mandatory Mammography Quality Standards Act requirements.
The ACR commented that the chart at 66 FR 31045 of the June 8, 2001
proposed rule indicates that CPT code 76005 had a RUC recommendation of
10.60. However, that column should read .60.
The ACR also took exception to the requested work RVUs reported in
the chart at 66 FR 31045 for codes 76065, 76090 and 76091. The chart
displayed requested work RVUs of .60 for 76065, .64 for 76090, and .76
for code 76091. The ACR asked that the chart be corrected to reflect
the actual requested work RVUs for each code. These corrected values,
based on the median survey values, are .70 for CPT code 76065, .93 for
76090, and 1.10 for CPT code 76091.
Response: Based on the comments received, we referred these codes
to a refinement panel for review. We regret the error in the chart
concerning the requested work RVUs.
Final decision: As a result of our analysis of the multispecialty
panel ratings, we are retaining the work RVU of 0.70 for CPT code 76090
and 0.87 for CPT code 76091, the work RVUs we proposed in the June 8
proposed rule.
CPT Code 76092, Screening Mammography, Bilateral Two View Film Study of
Each Breast
In addition, we had requested the RUC to review the work RVUs for
code 76092 (Screening mammography, bilateral two view film study of
each breast). In its comments on the June 8, 2001 proposed rule, the
RUC indicated it had placed this issue on the September 2001 meeting
agenda and would provide recommendations to us following that meeting.
The September meeting had to be cancelled and the issues to be
addressed at that meeting will be discussed at the first meeting early
next year. Therefore, we are finalizing the current RVUs for this code.
15. Plastic Surgery
We received no comments on these codes. Therefore, we will finalize
the proposed work RVUs for the plastic surgery codes.
B. Other Comments
1. Anesthesia Services
In our June 8, 2001 proposed rule (66 FR 31065), we stated that the
American Society of Anesthesiologists (ASA) contended that the work of
anesthesia services is undervalued and, based on discussions with the
RUC, the ASA requested a 24 percent increase in anesthesia work.
However, the RUC furnished no recommendation on anesthesia services;
instead, it assigned to a newly created workgroup the responsibility
for reviewing anesthesia services in the context of the physician fee
schedule. We indicated that the ASA will be working with this workgroup
on clinical issues, such as induction and postinduction intensity, and
did not propose any changes to the anesthesia CF at this time to
reflect the 5-year review of physician work for anesthesia services.
However, we did indicate that we might make changes in response to
recommendations the RUC may provide.
Comment: Many individual anesthesiologists commented that their
services are undervalued. The American Society of Anesthesiologists
also commented that its services are undervalued and asked that we
accept the results of the first RUC workgroup (weighted average
increase of 26 percent on representative codes) and extrapolate this to
all anesthesia codes. We also received letters from individuals
indicating that anesthesia services are undervalued.
In its comments, the RUC stated that it had not come to an
agreement on extrapolating the results of the work of the 19 studied
anesthesia codes to all anesthesia codes. The RUC agreed that the five
quintiles for postinduction anesthesia and the examples associated with
each quintile were appropriate. The RUC also examined the intensity
values assigned to each quintile and made adjustments to the intensity
values based on comparisons to evaluation and management codes and
critical care services. It agreed to the following values--.224 for
Level 1; .031 for Level 2; .051 for Level 3; .070 for Level 4; and .085
for Level 5.
The RUC approved the following intensity factors for the induction
period--.067 for induction of general anesthesia; .067 for induction of
spinal and epidural anesthesia; and .051 for induction of regional
anesthesia.
Although the RUC recommended acceptance of the building block work
values for the 19 codes studied, it did not resolve issues related to
how often anesthesiologists provide the retrobulbar bloc for code 00142
and agreed that the distribution of postinduction time among the
quintiles should be reviewed in more detail after it receives more
input from surgical specialties.
Response and final decision: The RUC has informed us that it will
continue to look at anesthesia work beginning at its first meeting in
CY 2002. We will review the RUC recommendation and address anesthesia
work in next year's proposed physician fee schedule rule.
2. Spine Injection Procedures
We received no comments on these codes. Therefore we will finalize
the proposed work RVUs for the spine injection procedure codes.
3. Biofeedback
We received no comments on these codes. Therefore, we will finalize
the proposed work RVUs for the biofeedback codes.
4. Surgical Management of Burn Wounds
We received no comments on these codes. Therefore, we will finalize
the proposed work RVUs for the codes involving surgical management of
burn wounds.
5. Transplantation
We received no comments on these codes. Therefore, we will finalize
the proposed work RVUs for the transplantation codes.
6. Arthroscopy Services
We received no comments on these codes. Therefore, we will finalize
the proposed work RVUs for the arthroscopy service codes.
7. Wheelchair Management
We received no comments on these codes. Therefore, we will finalize
the proposed work RVUs for the wheelchair management codes.
8. Psychological Testing
We received no comments on these codes. Therefore, we will finalize
the proposed work RVUs for the psychological testing codes.
9. Podiatric Services
In our June 8, 2001 proposed notice (66 FR 31067), we stated the
American Podiatric Medical Association (APMA) submitted 5 codes (trim
skin lesions/trim nails) for review (11719, 11055, 11056, 11057, and
G0127) and that the HCPAC requested we review our current utilization
data to ensure that the original utilization assumptions were correct.
The HCPAC recommended that the current review of data should be based
on actual 1999 utilization data since these codes were not fully
implemented until April 1, 1998. We stated that we would review the
utilization data associated with the aforementioned codes to ensure the
original assumptions are still correct and that we would publish our
decision in the final rule.
[[Page 55294]]
Comment: The APMA was pleased that we would review the utilization
data; however, it indicated that the work RVUs should not be revised
based on current utilization. It recommended that we accept the
original RUC recommendations since these values were based on the
results of surveys of practicing podiatrists that were considered and
approved by the RUC.
Response and final decision: Based on our review of the data and
the APMA recommendation that we accept the original RUC recommended
values, we are increasing the work values for these services as
follows:
CPT code 11719, Trimming of nondystrophic nails, any
number, a work RVU of 0.17.
CPT code 11055, Paring or cutting of benign hyperkeratotic
lesion (for example, corn or callus) single lesion, a work RVU of 0.43.
CPT code 11056, two to four lesions, a work RVU of 0.61.
CPT code 11057, more than four lesions, a work RVU of 0.79 .
For HCPCS code G0127, Trim nails, while we did not receive a RUC
recommendation on this code (since we created the code), we are
increasing the work RVU to 0.17 to be consistent with the increase made
to CPT code 11719.
D. Other Issues
1. Critical Care Services in a Global Period
The June 8, 2001 proposed rule included a discussion on critical
care services (66 FR 31067-68). We stated that current Medicare policy
allows separate payment to the surgeon for postoperative critical care
services during the surgical global period only when the patient has
suffered trauma or burns. If the surgeon provides critical care
services during the global period, for reasons unrelated to the
surgery, that is separately payable as well. However, the approach the
RUC used for the 5-year review had previously been used to validate
postoperative work. That approach compared the work of a postoperative
intensive care unit visit by the surgeon to code 99291, Critical care,
evaluation and management of the critically ill or critically injured
patient, first 30-74 minutes, which is valued at 4.00 work RVUs, rather
than comparing a level three subsequent hospital visit (code 99233),
which is valued at 1.51 work RVUs).
We indicated that valuing the surgeon's postoperative intensive
care unit visits as critical care services had raised a number of
issues that could require a change in payment policy to ensure that
postoperative critical care is appropriately paid. In order to ensure
that we make appropriate payments to physicians furnishing
postoperative critical care services to Medicare beneficiaries, we
specifically solicited information and comments on several questions
and issues. We also proposed that the work RVUs for those surgical
codes where any postoperative intensive care unit visits were valued as
critical care remain interim, until we address the issues discussed
above.
Many individual physicians, specialty societies, and health benefit
programs provided comments and addressed the points we had outlined in
the proposed notice. We appreciate their responses and will carefully
review this information as we determine whether to make a future
proposal.
2. Budget Neutrality
As explained in the proposed rule published June 8, 2001 (66 FR
31068-69), section 1848(c)(2)(B)(ii)(II) of the Act requires that
increases or decreases in RVUs may not cause the amount of expenditures
for the year to differ by more than $20 million from what expenditures
would have been in the absence of these changes. If this threshold is
exceeded, we make across-the-board adjustments to preserve budget
neutrality. Based on the proposed changes in work RVUs, we indicated
that budget-neutrality adjustments would be required. We proposed to
reduce the conversion factor to meet the budget neutrality requirement,
rather than applying a reduction to all work RVUs. We also indicated
that revisions in payment policies, including the establishment of
interim and final RVUs for coding changes contained in a separate
proposed rule, might result in additional budget-neutrality
adjustments.
Comment: The American Academy of Family Physicians, American
College of Radiology, American College of Physicians, American Society
for Internal Medicine, and the American Medical Association Specialty
Society RVUs Update Committee indicated that they supported our
proposal to maintain budget neutrality by adjusting the conversion
factor.
Response and final decision: We will proceed with our proposal to
maintain budget neutrality by adjusting the conversion factor.
V. Refinement of Relative Value Units for Calendar Year 2002 and
Responses to Public Comments on Interim Relative Value Units for
2001
A. Summary of Issues Discussed Related to the Adjustment of Relative
Value Units
Section V.B of this final rule describes the methodology used to
review the comments received on the RVUs for physician work and the
process used to establish RVUs for new and revised CPT codes. Changes
to codes on the physician fee schedule (Addendum B) are effective for
services furnished beginning January 1, 2002.
B. Process for Establishing Work Relative Value Units for the 2002 Fee
Schedule and Clarification of CPT Definitions
Our November 1, 2000 final rule on the 2001 physician fee schedule
(65 FR 65376) announced the final work RVUs for Medicare payment for
existing procedure codes under the physician fee schedule and interim
RVUs for new and revised codes. The RVUs contained in the rule applied
to physician services furnished beginning January 1, 2001. We announced
that we considered the RVUs for the interim codes to be subject to
public comment under the annual refinement process. In this section, we
summarize the refinements to the interim work RVUs that have occurred
since publication of the November 2000 final rule and our establishment
of the interim work RVUs for new and revised codes for the 2002 fee
schedule.
1. Work Relative Value Unit Refinements of Interim and Related Relative
Value Units
a. Methodology (Includes Table 5, Refinements of the 2001 Interim Work
Relative Value Units)
Although the RVUs in the November 2000 final rule were used to
calculate 2001 payment amounts, we considered the RVUs for the new or
revised codes to be interim. We accepted comments for a period of 60
days. We received substantive comments from many individual physicians
and several specialty societies on 52 CPT codes with interim work RVUs.
Only comments on codes listed in Addendum C of the November 2000 final
rule were considered.
We used a process similar to the process used in 1997 to address
substantive comments. (See the October 31, 1997 final rule on the
physician fee schedule (62 FR 59084) for the discussion of refinement
of CPT codes with interim work RVUs.) We convened
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a multispecialty refinement panel of physicians to assist us in the
review of the comments. The comments that we did not submit to panel
review are discussed at the end of this section, as well as those
comments that were reviewed by the panel. We invited representatives
from each of the specialty societies from which substantive comments
were received to attend a panel for discussion of the codes on which
they had commented. The panel was moderated by our medical staff and
consisted of the following voting members:
One to two clinicians representing the commenting
specialty or specialties, based upon our determination of those
specialties which are most identified with the service(s) in question.
Although commenting specialties were welcome to observe the entire
refinement process, they were only involved in the discussion of those
services for which they were invited to participate.
Two primary care clinicians nominated by the American
Academy of Family Physicians and the American Society of Internal
Medicine.
Four carrier medical directors.
Four clinicians with practices in related specialties, who
were expected to have knowledge of the services under review.
The panel discussed the work involved in each procedure under
review in comparison to the work associated with other services on the
fee schedule. We assembled a set of reference services and asked the
panel members to compare the clinical aspects of the work of services
they believed were incorrectly valued to one or more of the reference
services. In compiling the set, we attempted to include--(1) services
that are commonly performed whose work RVUs are not controversial; (2)
services that span the entire spectrum from the easiest to the most
difficult; and (3) at least three services performed by each of the
major specialties so that each specialty would be represented. The set
contained approximately 300 services. Group members were encouraged to
make comparisons to reference services. The intent of the panel process
was to capture each participant's independent judgement based on the
discussion and his or her clinical experience. Following each
discussion, each participant rated the work for the procedure. Ratings
were individual and confidential, and there was no attempt to achieve
consensus among the panel members.
We then analyzed the ratings based on a presumption that the
interim RVUs were correct. To overcome this presumption, the inaccuracy
of the interim RVUs had to be apparent to a broad range of physicians
participating in the panel.
Ratings of work were analyzed for consistency among the groups
represented on the panel. In general, we used statistical tests to
determine whether there was enough agreement among the groups of the
panel, and whether the agreed-upon RVUs were significantly different
from the interim RVUs published in Addendum C of the November 2000
final rule. We did not modify the RVUs unless there was a clear
indication for a change. If there was agreement across groups for
change, but the groups did not agree on what the new RVUs should be, we
eliminated the outlier group and looked for agreement among the
remaining groups as the basis for new RVUs. We used the same
methodology in analyzing the ratings that we first used in the
refinement process for the 1993 fee schedule. The statistical tests
were described in detail in the November 25, 1992 final rule (57 FR
55938).
Our decision to convene a multispecialty refinement panel of
physicians and to apply the statistical tests described above was based
on our need to balance the interests of those who commented on the work
RVUs against the redistributive effects that would occur in other
specialties. Of the 3 codes reviewed by the multispecialty panel, all
were the subject of requests for increased values. Of the 3 interim
work RVUs that were reviewed, 2 were increased and 1 was unchanged.
We also received comments on RVUs that were interim for 2001, but
which we did not submit to the panel for review for a variety of
reasons. These comments and our decisions on those comments are
discussed in further detail below.
Table 5 lists the interim and related codes reviewed during the
refinement process described in this section. This table includes the
following information:
CPT Code. This is the CPT code for a service.
Descriptor. This is an abbreviated version of the
narrative description of the code.
2001 Work RVU. The work RVUs that appeared in the November
2000 rule are shown for each reviewed code.
Requested Work RVU. This column identifies the work RVUs
requested by commenters.
2002 Work RVU. This column contains the final RVUs for
physician work.
Table 5.--Refinement of 2001 Interim Work Relative Value Units
----------------------------------------------------------------------------------------------------------------
2001 work Requested 2002 work
\1\ CPT code Descriptor RVU work RVU RVU
----------------------------------------------------------------------------------------------------------------
19102............................... Bx breast percut w/image........... 2.00 2.73 2.00
19103............................... Bx breast percut w/device.......... 2.37 5.55 3.70
22522............................... Percutaneous vertebroplasty, addl.. 3.00 4.31 4.31
----------------------------------------------------------------------------------------------------------------
\1\ All CPT codes and descriptions copyright 2002 American Medical Association.
2. Interim 2001 Codes
Stenting Procedures--(CPT Codes 43256, 44370, 44379, 44383, 44397,
45345, 45387, and 45342)
We accepted the RUC recommended increase over the base code of 1.96
work RVUs. Commenters suggested that this increment should be increased
to 2.59 work RVUs to reflect the work increase the RUC had recommended
for CPT code 43219 (one of the codes used to arrive at this increase)
as part of the 5-year review. Additionally, they also commented that
the increment for the pre-dilation service should be from the dilation
of gastric outlet in connection with an upper GI as opposed to the
esophagoscopy code. Finally, commenters did not believe that these
services should be subject to ``within family work neutrality
adjustments'' (see Final Decision below) and instead believed that any
increase in total RVUs should be addressed through the SGR or
conversion factor. They felt that these stent placements are new
technology and should not be viewed as code splitting/unbundling of
services. They stated that stent placements have only been performed
over the last 4-5 years and any work associated with them is
[[Page 55296]]
not reflected in current work values for endoscopic codes.
Final decision: ``Within family work neutrality adjustments'' are
used for new or revised services that are not considered new
technologies. To achieve work neutrality within families of services,
we compare the new or revised work RVUs (weighted by projected
frequency) to the old work RVUs (weighted by actual frequency) to
ensure that additional RVUs have not been added based on fragmentation
of existing codes. We agree with the commenter that these services are
new technologies and thus should not be subject to within family work
neutrality adjustments. With regard to the final work value for CPT
code 43219 and the use of dilation and stent placement codes in
assigning a work value to 43219, please see our discussion elsewhere in
this rule.
Cryosurgical Ablation of the Prostate--CPT Code 55873
We agreed with the RUC recommended work RVU for CPT code 55873 as
we felt that the comparison to CPT code 55801, Prostatectomy, perineal,
subtotal, was appropriate to aid in setting the work RVU of CPT code
55873. One commenter did not agree that this comparison was
appropriate. The commenter indicated that the RUC was being requested
to review this service again at its February meeting.
Final decision: The RUC provided comments on interim valued CPT
code 55873 that re-visited the appropriate comparison service. Based
upon comments received, the final work RVUs for CPT code 55873 will be
increased to 19.47.
Percutaneous Vertebroplasty--CPT Code 22522
We disagreed with the RUC-recommended work RVUs of 4.31 for this
service. CPT code 22522 is an add-on code that should have no
associated pre- or postservice work. We removed the pre- and
postservice work from the weighted average of CPT codes 22520 and
22521, which are the base services with which add-on CPT code 22522
should be billed in conjunction, and recalculated the value. Thus, we
assigned interim work RVUs of 3.00 for CPT code 22522. Several
commenters disagreed and do not believe that our methodology has
appropriately valued this add-on service. Commenters felt we should sum
the work RVUs of CPT codes 22520 and 22521 and then take 50 percent of
this value. They believe that this is how we historically have
calculated work RVUs for add-on services. Based on these comments, we
referred this code to a multispecialty refinement panel for review.
Final decision: As a result of the statistical analysis of the
refinement panel ratings, the final work RVUs are 4.31 for CPT code
22522.
Fetal Biophysical Stress Testing--CPT Codes 76818 and 76819
Although we agreed with the relativity presented by the RUC, we
reduced the RVUs for these aforementioned services due to within family
work neutrality adjustments. As previously discussed, within family
work neutrality adjustments are used to ensure that additional relative
values are not added based on fragmentation of existing codes. One
specialty organization felt that we inappropriately determined that the
work associated with the original CPT code 76818 (CPT code 76819 was
added for January 1, 2001), included the average work of both with and
without non-stress test. It believes that the survey data presented to
the RUC suggest that this assumption is invalid and that the
inappropriate within family neutralization of these services creates a
rank-order anomaly in this family of codes.
The survey data indicated that CPT code 76818 required more time
and greater mental effort than CPT code 76805 (Complete OB ultrasound),
which has 0.99 work RVUs, since the ultrasound portion of CPT code
76818, while less extensive, is typically performed in a high-risk
situation. In addition, CPT code 76818 also includes CPT code 59025
(Fetal non-stress test) with work RVUs of 0.53. The specialty
organization also reported that CPT code 76819 requires more work than
CPT code 76815 (Limited obstetric ultrasound) with work RVUs of 0.65.
The assignment of 0.86 RVUs to CPT code 76818 and 0.63 RVUs to 76819
creates a rank-order anomaly with this family of obstetric ultrasound
procedures.
Final Decision: We agree with the commenter that the within family
neutrality adjustment we made for 2001 was not appropriate and created
a rank-order anomaly within this family of services. We will remove the
neutrality adjustments for January 1, 2002.
Cognitive Skills and Sensory Integrative Techniques--CPT Codes 97532
and 97533
We did not agree with the HCPAC recommendation for CPT codes 97532
and 97533 (work RVUs of 0.51 and 0.48, respectively). These two new
services were created to replace deleted CPT code 97770. We believed
that the work associated with these new services is analogous to
deleted CPT code 97770 and therefore, we assigned work RVUs of 0.44
(the value assigned to the deleted code) to these new replacement
codes. Commenters felt that assignment of this work value was arbitrary
on our part, particularly since the HCPAC information had been based on
information from a survey completed by the practitioners who provide
these services.
Final Decision: We disagree with the commenters and are finalizing
the interim work values. This is an example of replacing one CPT code
with two new CPT codes that describe identical work. Because there is
no new technology involved, we will finalize the interim work RVUs.
Wound Care CPT Codes
Absent a HCPAC recommendation for either of the aforementioned CPT
codes, we valued the work of CPT code 97601 as 0.50 RVUs, the same as
deleted service G0169 that described the work in the new code. We
considered CPT code 97602 to be bundled into CPT code 97601 and
therefore did not establish work RVUs for this service. Commenters
believed that we inappropriately bundled CPT code 97602 into 97601
since they represent distinct services. The commenters requested that
we reconsider bundling CPT code 97602.
Final Decision: We have re-examined our determination but have not
changed our decision. CPT code 97602 describes services that typically
involve placement of a wound covering, for example, wet-to-dry gauze or
enzyme-treated dressing. It also includes nonspecific removal of
devitalized tissue that is an inherent part of changing a dressing.
This service is already included in the work and practice expenses of
CPT code 97601. In the typical service described by 97601, the patient
has a dressing placed over the wound. We would add that the services
described by 97602 are also included in the work and practice expenses
of the whirlpool code, CPT 97022. For this reason, we consider this a
bundled service that is not paid separately.
Percutaneous Breast Biopsy--CPT Codes 19102 and 19103
We agreed with the RUC recommended work RVUs of CPT codes 19102
(RVU = 2.00) and 19103 (RVU = 2.37). Commenters believed that the work
RVUs assigned to these codes were inappropriately low and did not
accurately reflect the time and intensity of the work involved.
Commenters supplied information to support their request for increasing
the work RVUs for
[[Page 55297]]
these services. Based on these comments, we referred this code to a
multispecialty refinement panel for review.
Final decision: As a result of the statistical analysis of the
multispecialty refinement panel ratings, the final work RVUs for CPT
code 19102 are 2.00, and the final work RVUs for CPT code 19103 are
3.70.
Magnetic Resonance Imaging Procedures--CPT codes 70540, 70542, 70543,
71550, 71551, 71552, 72195, 72196, 72197, 73218, 73219, 73220, 73221,
73222, 73223, 73718, 73719, 73720, 73721, 73722, 73723, 74181, 74182,
and 74183
We received a RUC recommendation for only 3 of these codes (70540,
70542, 70543) for January 1, 2001. However, this recommendation did not
reflect the required within family work neutrality adjustment. The work
RVUs of 0.98, 1.17, and 1.56 were assigned to these services to ensure
that there would not be additional work RVUs introduced into the
system. We did not receive work recommendations or utilization data for
any of the other new MRI codes and assigned work RVUs for these other
codes based on the methodology outlined in the November 2000 final
rule.
Commenters expressed concern about the within family work
neutrality adjustment applied to the RUC-recommended work RVUs, and the
methodology that was used to establish work values for the other MRI
procedures. Commenters requested that we re-evaluate the within family
work neutrality adjustment based upon updated information supplied in
their respective comments.
Final decision: We are accepting the work values for these services
which were submitted by the RUC in its comment on the interim work
values we assigned in last year's final rule. We note that these work
values are virtually identical to the work values that we assigned as
interim last year. Based upon comments received, we have re-evaluated
the utilization crosswalks upon which our within family work neutrality
adjustments were based.
Since 2001 is the first year for which actual data is available for
these services, we used available data (first two quarters of 2001) to
capture the actual utilization of these new services. This utilization
was then subjected to a standard analysis of reporting trends to
estimate the completion percentage of 2001 utilization data. The
available utilization was then ``aged'' to represent one full year of
data for 2001. After determining the utilization for 2001, we applied
this revised within family work neutrality adjustment across the entire
family of MRI procedures rather than applying this adjustment to
subsets. We are finalizing these within family work neutral values and
note that the re-calculation of this neutrality adjustment results in
increases to the work RVUs of the MRI services referenced above.
Computed Tomographic Angiography (CTA)--CPT Codes 70496, 70498, 71275,
72191, 73206, 73706, 74175 and 75635
We agreed with the RUC recommendation of 1.75 for CPT codes 70496
and 70498 for January 1, 2001. However, the RUC did not submit work
recommendations for the other CTA codes. We assigned work RVUs for
these other codes based on the methodology outlined in the November
2000 rule. Commenters disagreed with the interim values we had proposed
for CTA codes and provided additional information for valuing these
services. The commenter felt that our decisions created rank-order
anomalies between anatomic sites.
Final decision: We are accepting the work values for these services
which were submitted by the RUC in its comment on the interim work
values we assigned in last year's final rule. We will implement them as
final values for 2002.
Practice Expense Refinements of 2001 Interim and Revised RVUs
Percutaneous Breast Biopsy--CPT Codes 19102 and 19103
Comment: A specialty organization representing breast surgeons
submitted its suggested direct cost inputs for these two services and
had several comments on their practice expenses. The commenter
indicated that the price in the database for the biopsy driver was too
low, that the clinical staff type should be a registered nurse rather
than a technician and that there should be pre- and postservice
clinical staff time when the procedure is performed in the facility
setting. In addition, the commenter questioned whether the 50 percent
utilization rate used to price equipment was realistic for new
technology and recommended that device-specific utilization rates be
determined. The society also questioned the lack of direct cost inputs
for equipment and supplies for CPT 76095, the associated procedure for
image guidance. A manufacturer commented that the equipment inputs for
CPT 19102 were erroneously dropped from the CPEP database.
Response: We had accepted the RUC recommendations on these two
services, making only the following technical changes to the supplies
and equipment: we did not include the cost of the crash cart, because
we consider this an indirect expense, nor the cost of the biopsy gun
handle, because this was less than the $500 required for an item to be
on the equipment list. We also did not include separately billable
fluids, the formalin that would be supplied by the lab, or the
biohazard bag and skin marking pen that could be used for more than one
procedure.
If the specialty that was involved in the presentation of these
codes to the RUC now believes that the direct inputs do not adequately
represent the costs of performing these services, one option would be
to have these codes refined by the PEAC. In the meantime, we are
prepared to make certain changes to the CPEP data in response to the
recommendations made by the commenters. We will add the power table and
surgical lamp to both codes and will increase the price associated with
the biopsy device driver, subject to verification when we undertake our
repricing of the CPEP equipment inputs. Because the specialties
presenting the codes to the RUC, and the RUC itself, recommended using
radiologic staff for these services, we will not change the staff type
to registered nurse at this time. However, we will substitute the
higher-paid mammography technologist, which we have just added to our
staff type list, for the current x-ray technician staff type.
We have in the past solicited information from the specialties
regarding equipment-specific utilization rates, but we have never
received sufficient information to propose any changes in our policy.
Additionally, for most services, changing the utilization rate would
have very little effect.
The commenter is correct that the associated procedure for image
guidance, CPT 76095, currently does not have CPEP inputs assigned to
the non-facility setting. However, at this time, it is priced as a part
of the ``zero work'' pool, and the CPEP inputs are not used to
calculate the practice expense RVUs for this service. We would hope
that this code could be refined in the near future and given the
appropriate inputs for the office setting.
CPT Codes 34812, 34820, 34830, 34831 and 34832 for Repair of Aortic
Aneurysm
Comment: A specialty organization representing vascular surgery
stated that CPT codes 34812 and 34820 should have clinical staff
preservice time added and that CPT codes 34830, 34831 and
[[Page 55298]]
34832 were assigned inappropriately low postservice clinical staff
times.
Response: We accepted the RUC recommendations for all of these
services. There was no preservice time included in the RUC
recommendation for CPT codes 34812 and 34820. In addition, we have
assigned 99 minutes of clinical staff postservice time to CPT codes
34830, 34831 and 34832, as recommended by the RUC. These codes can be
refined by the PEAC which now has a standard package for 90-day global
pre- and postservice times for clinical staff and is also discussing
the coordination of care clinical staff times for 0-day global
services.
We received the following comments on HCPCS codes established in
the November 1, 2000 final rule.
G0169 Removal of Devitalized tissue, without use of
anesthesia.
Comment: The American Podiatric Medical Association recognized
that, effective January 1, 2001, this code was eliminated and we have
adopted CPT code 97601, which is sufficiently similar to the services
described by G0169. However, it requested we address a policy issue
related to the discussion of this service. In the November 2, 1999
Federal Register (64 FR 59426), we stated that G0169 was created
because CPT codes 11040 through 11044 for debridement were created to
describe ``complex surgical services requiring the use of general
anesthesia.'' APMA indicates that there had never been a policy
requiring the use of any anesthesia, much less general anesthesia, when
performing surgical debridement that is reported with CPT codes 11040
through 11044. However, as a result of the statement in the November 2
Federal Register, some carriers developed policies denying payment for
these codes if anesthesia was not used. The APMA urged us to clarify
that anesthesia, whether general or local, is not required when billing
CPT codes 11040 through 11044.
Response: We acknowledge that the use of ``general anesthesia'' in
the preamble to the November 2, 1999 rule was an error, and we believe
all our contractors are aware of our misstatement. As the commenter
stated, the code G0169 has been deleted and replaced by CPT code 97601,
Removal of devitalized tissue from wound(s); selective debridement,
without anesthesia (e.g., high pressure waterjet, shape selective
debridement with scissors, scalpel, and tweezers) including topical
application(s), wound assessment, and instruction(s) for ongoing care,
one session. We expect that our contractors will develop policies to
distinguish this service from the debridement codes, 11040 through
11044. We anticipate that they may consider a variety of factors,
including the extent of the debridement and the amount of medical skill
required to perform the service, and not simply whether a local
anesthetic was used in the procedure.
Comment: The American College of Surgeons urged us to issue
instructions to carriers specifying that the use of CPT code 97061 is
limited to physical therapists and other non-physician practitioners
and that the debridement of wounds by surgeons is properly reported
with a code from the CPT debridement codes 11040-11044.
Response: As we stated in the response to the previous comment, we
believe that our contractors are likely to make this distinction in
their local policies. If we determine that relying on local carrier
policies is unsatisfactory, then we will consider whether national
guidance is needed.
G0181 and G0182, Care plan Oversight.
Comment: A few organizations expressed disappointment that we
finalized our proposal to establish two new G codes for care plan
oversight services, rather than continue to recognize the CPT codes
related to these services.
Response: The CPT codes for care plan oversight were modified so
that they included services that extend beyond the limits of our
current payment policy. As a result, we will continue to use the G-
codes that are consistent with our payment policies.
G0180 and G0179 Certification and Recertification of
Medicare Covered Home Health Services.
Comment: Several specialty organizations expressed appreciation for
our willingness to recognize and compensate physicians for these
services and supported our decision to pursue this coding and
reimbursement issue through the CPT and RUC processes. The American
College of Surgeons expressed concern that claims submitted by surgeons
for physician certification or recertification would be denied
inappropriately due to longstanding rules that preclude payment for
services that are provided during the global period.
Response: As was stated in the November 1, 2000 final rule (66 FR
65408), surgeons performing these services could be paid for G0179 and
G0180 during the global period. We have heard no specific complaints
that this policy has not been implemented appropriately.
G Codes Related to Swallowing Function
Comment: The American College of Surgeons objected to the creation
of these G codes and requested that we discontinue their use and work
with the otolaryngologists to submit a coding request on these services
to the CPT Editorial Panel. The American Academy of Otolaryngology--
Head and Neck Surgery, Inc. (AAO-HNS) also expressed concern about
creation of these codes. It felt that our description of the codes was
incomplete and inaccurate.
In the November 1, 2000 final rule we proposed 4 new G codes and
stated that these would replace the more general CPT code 92525,
Evaluation of swallowing and oral function for feeding. AAO-HNS
believes that this incorrectly implies that the single code 92525
includes 4 unique services and, therefore, we have significantly
understated the work and practice expenses required for these
procedures.
For G0193, Endoscopy study of swallowing function, and GO194
Sensory testing during endoscoping study of swallowing, we stated that
coverage of these services remains at the discretion of the carrier and
that they would be carrier priced. AAO-HNS expressed concern that
carriers might misinterpret this statement to mean the codes should not
be covered and, if covered, the payment might be inappropriately low.
AAO-HNS requested we clarify that these services should be covered and
recommended that pricing for GO193 should equal to the sum of the RVUs
for CPT code 31575, Laryngoscopy, flexible fiberoptic; diagnostic, and
CPT code 92525.
AAO-HNS also did not agree with our decision to treat G0194 as an
``add-on'' code as this group felt this would create confusion. Rather,
AAO-HNS suggested that GO194 be treated as a stand-alone code with RVUs
equal to CPT codes 31575, 92525 and 92520 (Laryngeal function studies).
In addition, AAO-HNS was concerned about our statement that CPT
code 31575 and CPT code 31579 (Laryngoscopy, flexible or rigid
fiberoptic, with stroboscopy) should not be used for evaluations of
swallowing and urged that we clarify that these codes could still be
used to report flexible fiberoptic laryngosopies for patients with
swallowing problems.
Response: These G codes related to swallowing function were created
because of the ambiguity of the CPT code, 92525. The CPT editorial
panel will be reviewing codes designed to substitute for the G-codes
created. The specialty advisors, including AAO-
[[Page 55299]]
HNS, will have the opportunity to comment on these proposals and to
create codes that they believe will describe the services more
accurately. If the CPT editorial panel adopts these revised codes, they
could be in the 2003 CPT book.
Comment: The American Occupational Therapy Association stated that
in the specific discussion of code GO195, and by implication the
related codes, we stated these services are performed typically by a
speech and language pathologist. While AOTA does not disagree with this
characterization, it requested that we clarify that other
professionals, specifically occupational therapists, also may be
trained in these procedures. It noted that in some areas of the country
occupational therapists typically perform swallowing evaluations,
particularly in conjunction with feeding and eating deficits.
Response: These G codes did not specify which professionals could
perform these services. The description of the new G codes only stated
that these services would be most commonly performed by speech and
language pathologists. Our contractors, who have the capacity to be
responsive to local differences in practice patterns, will be aware of
whether occupational therapists have the qualifications to perform
these evaluations and will make the decisions about whether the service
performed matches the services described by the code.
Comment: The American College of Radiology requested clarification
on the specialties we anticipate using G0196; they asked if this G code
would be used by the speech pathologist while the radiologist would use
CPT code 74230. ACR expressed concern that provision of such a G code
would promote performance of fluoroscopy by non-trained individuals.
Response: We do not believe that the development of these G codes
should lead to non-trained individuals performing fluoroscopy. Prior to
the development of the G codes, we were asked by speech and language
pathologists if they could bill 74230 to describe the work they did in
conjunction with a fluoroscopic or video evaluation of swallowing. We
did not think that the speech and language pathologists should bill the
code 74230 and created this G code to describe the portion of the
examination that they typically performed.
We were also asked whether the services of a speech and language
pathologist should have remained bundled into the technical portion of
the 74230 examination, because this may have been the method of billing
these services prior to the development of the G code. Because this new
G code separates the services of the speech and language pathologists
in this examination, we may need to clarify which services are included
in the technical portion of 74230. None of these concerns would lead a
non-skilled practitioner to perform either of these services.
G Codes Related to Speech Generating Devices and Voice Prostheses
G0197-G0201
Comment: AAO-HNS expressed concern about the establishment of G
codes related to speech generating devices and voice prostheses. It
continues to believe that the creation of codes used to describe
services that are already described in CPT makes compliance with
Medicare policy difficult and confusing.
Response: The current CPT codes, 92597 and 92598, identify two
distinct services--evaluation or modification of voice prosthetics and
augmentative or alternative communicative devices. Since different
types of patients require either voice prosthetics (for example, an
artificial larynx) or augmentative or alternative communicative
devices, we believe that separating these two services through the use
of G-codes actually should make compliance with Medicare policies
easier, since the services being delivered are more accurately
described.
Revisions to Malpractice RVUs for New and Revised CPT Codes for
2001
Malpractice RVUs are calculated using the methodology described in
detail at Addendum G of our November 1, 2000 final rule (65 FR 65589).
Because of the timing of the release of new and revised CPT codes each
year, the malpractice RVUs for the first year of these codes are
extrapolated from existing similar codes, based on the advice of our
medical consultants, and are considered interim subject to public
comment and revision. The following year these codes are given values
based on our malpractice RVU methodology and a review of comments
received.
The malpractice RVUs for 2001 new and revised codes published in
Addendum B of the November 1, 2000 final rule were thus extrapolated
from (RVUs for existing similar codes). The malpractice RVUs for these
codes in this year's Addendum B were calculated by our consultant,
KPMG, using the same methodology used for all other codes. Likewise,
the malpractice RVUs for new and revised 2002 codes are being
extrapolated from existing similar codes and will be calculated using
the malpractice RVU methodology next year.
Comment: One commenter stated that malpractice premiums are rapidly
increasing all over the country and that we should ensure that the
physician fee schedule reflect these increases.
Response: We agree that changes in malpractice premiums should, to
the extent possible, be reflected in the physician fee schedule. The
most recent malpractice data available were used in constructing the
2001 malpractice RVUs and the revised 2001 GPCIs. In addition, the
relative weights of the component cost shares (work, practice expense,
malpractice) in the physician fee schedule and in the MEI are
periodically adjusted when the most recent AMA SMS data indicate
significant shifts among physician practice cost components. However,
because of the time needed to collect the data and propose changes
through the rulemaking process, there is a time lag in making these
changes.
Establishment of Interim Work Relative Value Units for New and Revised
Physician's Current Procedural Terminology (CPT) Codes and New
Healthcare Common Procedure Coding System Codes (HCPCS) for 2002
(Includes Table 6, AMA RUC and HCPAC Work RVU Recommendations and CMS
Decisions for New and Revised 2002 CPT Codes)
One aspect of establishing RVUs for 2002 was related to the
assignment of interim work RVUs for all new and revised CPT codes. As
described in our November 25, 1992 notice in the 1993 fee schedule (57
FR 55983), and in section III.B. of our November 22, 1996 final rule
(61 FR 59505-59506), we established a process, based on recommendations
received from the AMA's RUC, for establishing interim work RVUs for new
and revised codes.
This year we received RUC work RVU recommendations for
approximately 314 new and revised CPT codes. Our staff and medical
officers reviewed the RUC recommendations by comparing them to our
reference set or to other comparable services for which work RVUs had
been previously established, or to both of these criteria. We also
considered the relationships among the new and revised codes for which
we received RUC recommendations. We agreed with the majority of these
relationships reflected in the RUC values. In some instances, when we
agreed with the relationships, we revised the work RVUs to achieve work
neutrality within families of codes, that is, the work RVUs have been
adjusted so that the sum of the new or revised work RVUs
[[Page 55300]]
(weighted by projected frequency of use) for a family will be the same
as the sum of the current work RVUs (weighted by projected frequency of
use for that family of codes). For approximately 93 percent of the RUC
recommendations, proposed work RVUs were accepted, and for
approximately 7 percent, we disagreed with the RUC recommendation. In a
majority of instances, we agreed with the relativity proposed by the
RUC, but needed to decrease work RVUs to retain budget neutrality.
There were also 10 CPT codes for which we did not receive a RUC
recommendation. After a review of these CPT codes by our staff and
medical officers, we established interim work RVUs for the majority of
these services. For those services for which we could not arrive at
interim work RVUs, we have assigned a carrier-priced status until such
time as the RUC provides work RVU recommendations.
We received 18 recommendations from the Health Care Professionals
Advisory Committee (HCPAC). We accepted 12, or 67 percent, of the HCPAC
recommendations.
Table 6, AMA RUC and HCPAC Work RVU Recommendations and CMS
Decisions for New and Revised 2002 CPT Codes, lists the new or revised
CPT codes, and their associated work RVUs, that will be interim in
2002. This table includes the following information:
A ``#'' identifies a new code for 2002.
CPT code. This is the CPT code for a service.
Modifier. A ``26'' in this column indicates that the work
RVUs are for the professional component of the code.
Description. This is an abbreviated version of the
narrative description of the code.
RUC recommendations. This column identifies the work RVUs
recommended by the RUC.
HCPAC recommendations. This column identifies the work
RVUs recommended by the HCPAC.
CMS decision. This column indicates whether we agreed with
the RUC recommendation (``agree'') or we disagreed with the RUC
recommendation (``disagree''). Codes for which we did not accept the
RUC recommendation are discussed in greater detail following this
table. An ``(a)'' indicates that no RUC recommendation was provided. A
discussion follows the table.
2002 Work RVUs. This column establishes the 2002 work RVUs
for physician work.
Table 6.--AMA RUC and HCPAC Work RVU Recommendations and CMS Decisions for New and Revised 2002 CPT Codes
--------------------------------------------------------------------------------------------------------------------------------------------------------
RUC HCPAC 2002 work
* CPT CODE Mod Description recommendation recommendation CMS decision RVU
--------------------------------------------------------------------------------------------------------------------------------------------------------
10021 #............................... 26 FNA W/O IMAGE........... 1.27 .............. Agree.................... 1.27
10022 #............................... 26 FNA W/IMAGE............. 1.27 .............. Agree.................... 1.27
11755................................. .............. BIOPSY, NAIL UNIT....... 1.31 .............. Agree.................... 1.31
11981 #............................... .............. INSERT DRUG IMPLANT 1.48 .............. Agree.................... 1.48
DEVICE.
11982 #............................... .............. REMOVE DRUG IMPLANT 1.78 .............. Agree.................... 1.78
DEVICE.
11983 #............................... .............. REMOVE/INSERT DRUG 3.30 .............. Agree.................... 3.30
IMPLANT.
17000................................. .............. DESTROY BENIGN/PREMAL 0.60 .............. Agree.................... 0.60
LESION.
17003................................. .............. DESTROY LESIONS, 2-14... 0.15 .............. Agree.................... 0.15
17004................................. .............. DESTROY LESIONS, 15 OR 2.79 .............. Agree.................... 2.79
MORE.
17110................................. .............. DESTRUCT LESION, 1-14... 0.65 .............. Agree.................... 0.65
17111................................. .............. DESTRUCT LESION, 15 OR 0.92 .............. Agree.................... 0.92
MORE.
17260................................. .............. DESTRUCTION OF SKIN 0.91 .............. Agree.................... 0.91
LESIONS.
17261................................. .............. DESTRUCTION OF SKIN 1.71 .............. Agree.................... 1.71
LESIONS.
17262................................. .............. DESTRUCTION OF SKIN 1.58 .............. Agree.................... 1.58
LESIONS.
17263................................. .............. DESTRUCTION OF SKIN 1.79 .............. Agree.................... 1.79
LESIONS.
17264................................. .............. DESTRUCTION OF SKIN 1.94 .............. Agree.................... 1.94
LESIONS.
17266................................. .............. DESTRUCTION OF SKIN 2.34 .............. Agree.................... 2.34
LESIONS.
17270................................. .............. DESTRUCTION OF SKIN 1.32 .............. Agree.................... 1.32
LESIONS.
17271................................. .............. DESTRUCTION OF SKIN 1.49 .............. Agree.................... 1.49
LESIONS.
17272................................. .............. DESTRUCTION OF SKIN 1.77 .............. Agree.................... 1.77
LESIONS.
17273................................. .............. DESTRUCTION OF SKIN 2.05 .............. Agree.................... 2.05
LESIONS.
17274................................. .............. DESTRUCTION OF SKIN 2.59 .............. Agree.................... 2.59
LESIONS.
17276................................. .............. DESTRUCTION OF SKIN 3.20 .............. Agree.................... 3.20
LESIONS.
17280................................. .............. DESTRUCTION OF SKIN 1.17 .............. Agree.................... 1.17
LESIONS.
17281................................. .............. DESTRUCTION OF SKIN 1.72 .............. Agree.................... 1.72
LESIONS.
17282................................. .............. DESTRUCTION OF SKIN 2.04 .............. Agree.................... 2.04
LESIONS.
17283................................. .............. DESTRUCTION OF SKIN 2.64 .............. Agree.................... 2.64
LESIONS.
17284................................. .............. DESTRUCTION OF SKIN 3.21 .............. Agree.................... 3.21
LESIONS.
17286................................. .............. DESTRUCTION OF SKIN 4.44 .............. Agree.................... 4.44
LESIONS.
20225................................. .............. BONE BIOPSY, TROCAR/ 1.87 .............. Agree.................... 1.87
NEEDLE.
20526 #............................... .............. THER INJECTION, CARPAL 0.86 .............. Agree.................... 0.86
TUNNEL.
20550................................. .............. INJECT TENDON/LIGAMENT/ 0.86 .............. Agree.................... 0.86
CYST.
20551 #............................... .............. INJECT TENDON ORIGIN/ 0.86 .............. Agree.................... 0.86
INSERT.
20552 #............................... .............. INJECT TRIGGER POINT, 1 0.86 .............. Agree.................... 0.86
OR 2.
20553 #............................... .............. INJECT TRIGGER POINTS, 3 0.86 .............. Agree.................... 0.86
23000................................. .............. REMOVAL OF CALCIUM 4.36 .............. Agree.................... 4.36
DEPOSITS.
23350................................. .............. INJECTION FOR SHOULDER X- 1.00 .............. Agree.................... 1.00
RAY.
24075................................. .............. REMOVE ARM/ELBOW LESION. 3.92 .............. Agree.................... 3.92
24076................................. .............. REMOVE ARM/ELBOW LESION. 6.30 .............. Agree.................... 6.30
24300 #............................... .............. MANIPULATE ELBOW W/ 3.75 .............. Agree.................... 3.75
ANESTH.
24332 #............................... .............. TENOLYSIS, TRICEPS...... 7.45 .............. Agree.................... 7.45
24343 #............................... .............. REPR ELBOW LAT LIGMNT W/ 8.65 .............. Agree.................... 8.65
TISS.
24344 #............................... .............. RECONSTRUCT ELBOW LAT 14.00 .............. Agree.................... 14.00
LIGMNT.
[[Page 55301]]
24345 #............................... .............. REPR ELBW MED LIGMNT W/ 8.65 .............. Agree.................... 8.65
TISS.
24346 #............................... .............. RECONSTRUCT ELBOW MED 14.00 .............. Agree.................... 14.00
LIGMNT.
25001 #............................... .............. INCISE FLEXOR CARPI 3.38 .............. Agree.................... 3.38
RADIALIS.
25020................................. .............. DECOMPRESS FOREARM 1 5.92 .............. Agree.................... 5.92
SPACE.
25023................................. .............. DECOMPRESS FOREARM 1 12.96 .............. Agree.................... 12.96
SPACE.
25024 #............................... .............. DECOMPRESS FOREARM 2 9.50 .............. Agree.................... 9.50
SPACES.
25025 #............................... DECOMPRESS FORAM 2 16.54 .............. Agree.................... 16.54
SPACES.
25075................................. .............. REMOVE FOREARM LESION 3.74 .............. Agree.................... 3.74
SUBCUT.
25076................................. REMOVE FOREARM LESION 4.92 .............. Agree.................... 4.92
DEEP.
25259 #............................... .............. MANIPULATE WRIST W/ 3.75 .............. Agree.................... 3.75
ANESTHES.
25274................................. .............. REPAIR FOREARM TENDON/ 8.75 .............. Agree.................... 8.75
MUSCLE.
25275 #............................... .............. REPAIR FOREARM TENDON 8.50 .............. Agree.................... 8.50
SHEATH.
25394 #............................... .............. REPAIR CARPAL BONE, 10.40 .............. Agree.................... 10.40
SHORTEN.
25405................................. .............. REPAIR/GRAFT RADIUS OR 14.38 .............. Agree.................... 14.38
ULNA.
25420................................. .............. REPAIR/GRAFT RADIUS & 16.33 .............. Agree.................... 16.33
ULNA.
25430 #............................... .............. VASC GRAFT INTO CARPAL 9.25 .............. Agree.................... 9.25
BONE.
25431 #............................... .............. REPAIR NONUNION CARPAL 10.44 .............. Agree.................... 10.44
BONE.
25440................................. .............. REPAIR/GRAFT WRIST BONE. 10.44 .............. Agree.................... 10.44
25520................................. .............. TREAT FRACTURE OR RADIUS 6.26 .............. Agree.................... 6.26
25526................................. .............. TREAT FRACTURE OF RADIUS 12.98 .............. Agree.................... 12.98
25645................................. .............. TREAT WRITST BONE 7.25 .............. Agree.................... 7.25
FRACTURE.
25651 #............................... .............. PIN ULNAR STYLOID 5.36 .............. Agree.................... 5.36
FRACTURE.
25652 #............................... .............. TREAT FRACTURE ULNAR 7.60 .............. Agree.................... 7.60
STYLOID.
25671 #............................... .............. PIN RADIOULNAR 6.00 .............. Agree.................... 6.00
DISLOCATION.
26115................................. .............. REMOVE HAND LESION 3.86 .............. Agree.................... 3.86
SUBCUT.
26116................................. .............. REMOVE HAND LESION, DEEP 5.53 .............. Agree.................... 5.53
26160................................. .............. REMOVE TENDON SHEATH 3.15 .............. Agree.................... 3.15
LESION.
26250................................. .............. EXTENSIVE HAND SURGERY.. 7.55 .............. Agree.................... 7.55
26255................................. .............. EXTENSIVE HAND SURGERY.. 12.43 .............. Agree.................... 12.43
26340 #............................... .............. MANIPULATE FINGER W/ 2.50 .............. Agree.................... 2.50
ANESTH.
26350................................. .............. REPAIR FINGER/HAND 5.99 .............. Agree.................... 5.99
TENDON.
26352................................. .............. REPAIR/GRAFT HAND TENDON 7.68 .............. Agree.................... 7.68
26356................................. .............. REPAIR FINGER/HAND 8.07 .............. Agree.................... 8.07
TENDON.
26357................................. .............. REPAIR FINGER/HAND 8.58 .............. Agree.................... 8.58
TENDON.
26358................................. .............. REPAIR/GRAFT HAND TENDON 9.14 .............. Agree.................... 9.14
26390................................. .............. REVISE HAND/FINGER 9.19 .............. Agree.................... 9.19
TENDON.
26392................................. .............. REPAIR/GRAFT HAND TENDON 10.26 .............. Agree.................... 10.26
26415................................. .............. EXCISION, HAND/FINGER 8.34 .............. Agree.................... 8.34
TENDON.
26416................................. .............. GRAFT HAND OR FINGER 9.37 .............. Agree.................... 9.37
TENDON.
26426................................. .............. REPAIR FINGER/HAND 6.15 .............. Agree.................... 6.15
TENDON.
26428................................. .............. REPAIR/GRAFT FINGER 7.21 .............. Agree.................... 7.21
TENDON.
26445................................. .............. RELEASE HAND/FINGER 4.31 .............. Agree.................... 4.31
TENDON.
26510................................. .............. THUMB TENDON TRANSFER... 5.43 .............. Agree.................... 5.43
26587................................. .............. RECONSTRUCT EXTRA FINGER 14.05 .............. Agree.................... 14.05
26590................................. .............. REPAIR FINGER DEFORMITY. 17.96 .............. Agree.................... 17.96
26607................................. .............. TREAT METACARPAL 5.36 .............. Agree.................... 5.36
FRACTURE.
26608................................. .............. TREAT METACARPAL 5.36 .............. Agree.................... 5.36
FRACTURE.
26670................................. .............. TREAT HAND DISLOCATION.. 3.69 .............. Agree.................... 3.69
26675................................. .............. TREAT HAND DISLOCATION.. 4.54 .............. Agree.................... 4.54
26676................................. .............. PINE HAND DISLOCATION... 5.52 .............. Agree.................... 5.52
26685................................. .............. TREAT HAND DISLOCATION.. 6.98 .............. Agree.................... 6.98
26843................................. .............. FUSION OF HAND JOINT.... 7.61 .............. Agree.................... 7.61
26844................................. .............. FUSION/GRAFT OF HAND 8.73 .............. Agree.................... 8.73
JOINT.
27096................................. .............. INJECT SACROILIAC JOINT. 1.40 .............. Agree.................... 1.40
28299................................. .............. CORRECTION OF BUNION.... 10.58 .............. Agree.................... 10.58
29086 #............................... .............. APPLY FINGER CAST....... 0.62 .............. Agree.................... 0.62
29805 #............................... .............. SHOULDER ARTHROSCOPY, DX 5.89 .............. Agree.................... 5.89
29806 #............................... .............. SHOULDER ARTHROSCOPY/ 14.37 .............. Agree.................... 14.37
SURGERY.
29807 #............................... .............. SHOULDER ARTHROSCOPY/ 13.90 .............. Agree.................... 13.90
SURGERY.
29819................................. .............. SHOULDER ARTHROSCOPY/ 7.62 .............. Agree.................... 7.62
SURGERY.
29820................................. .............. SHOULDER ARTHROSCOPY/ 7.07 .............. Agree.................... 7.07
SURGERY.
29821................................. .............. SHOULDER ARTHROSCOPY/ 7.72 .............. Agree.................... 7.72
SURGERY.
29822................................. .............. SHOULDER ARTHROSCOPY/ 7.43 .............. Agree.................... 7.43
SURGERY.
[[Page 55302]]
29823................................. .............. SHOULDER ARTHROSCOPY/ 8.17 .............. Agree.................... 8.17
SURGERY.
29824 #............................... .............. SHOULDER ARTHROSCOPY/ 8.25 .............. Agree.................... 8.25
SURGERY.
29900 #............................... .............. MCP JOINT ARTHROSCOPY, 5.42 .............. Agree.................... 5.42
DX.
29901 #............................... .............. MCP JOINT ARTHROSCOPY, 6.13 .............. Agree.................... 6.13
SURG.
29902 #............................... .............. MCP JOINT ARTHROSCOPY, 6.70 .............. Agree.................... 6.70
SURG.
30117................................. .............. REMOVAL OF INTRANASAL 3.16 .............. Agree.................... 3.16
LESION.
30118................................. .............. REMOVAL OF INTRANASAL 9.69 .............. Agree.................... 9.69
LESION.
31641................................. .............. BRONCHOSCOPY, TREAT 5.03 .............. Agree.................... 5.03
BLOCKAGE.
32650................................. .............. THORACOSCOPY, SURGICAL.. 10.75 .............. Agree.................... 10.75
33967 #............................... .............. INSERT IA PERCUT DEVICE. 4.85 .............. Agree.................... 4.85
33975................................. .............. IMPLANT VENTRICULAR 21.00 .............. Agree.................... 21.00
DEVICE.
33976................................. .............. IMPLANT VENTRICULAR 23.00 .............. Agree.................... 23.00
DEVICE.
33977................................. .............. REMOVE VENTRICULAR 19.29 .............. Agree.................... 19.29
DEVICE.
33978................................. .............. REMOVE VENTRICULAR 21.73 .............. Agree.................... 21.73
DEVICE.
33979 #............................... .............. INSERT INTRACORPOREAL carrier .............. Agree.................... carrier
DEVICE.
33980 #............................... .............. REMOVE INTRACORPOREAL carrier .............. Agree.................... carrier
DEVICE.
35646................................. .............. ARTERY BYPASS GRAFT..... 31.00 .............. Agree.................... 31.00
35647 #............................... .............. ARTERY BYPASS GRAFT..... 28.00 .............. Agree.................... 28.00
35685................................. .............. BYPASS GRAFT PATENCY/ 4.05 .............. Agree.................... 4.05
PATCH.
35686 #............................... .............. BYPASS GRAFT/AV FIST 3.35 .............. Agree.................... 3.35
PATENCY.
36002 #............................... .............. PSEUDOANEURYSM INJECTION 1.96 .............. Agree.................... 1.96
TRT.
36005................................. .............. INJECTION EXT VENOGRAPHY 0.95 .............. Agree.................... 0.95
36400................................. .............. DRAWING BLOOD........... 0.38 .............. Agree.................... 0.38
36819................................. .............. AV FUSION/UPPR ARM VEIN. 14.00 .............. Agree.................... 14.00
36820 #............................... .............. AV FUSION/FOREARM VEIN.. 14.00 .............. Agree.................... 14.00
36823................................. .............. INSERTION OF CANNULA(S). 21.00 .............. Agree.................... 21.00
38220 #............................... .............. BONE MARROW ASPIRATION.. 1.08 .............. Agree.................... 1.08
38221 #............................... .............. BONE MARROW BIOPSY...... 1.37 .............. Agree.................... 1.37
43200................................. .............. ESOPHAGUS ENDOSCOPY..... 1.59 .............. Agree.................... 1.59
43227................................. .............. ESOPH ENDOSCOPY, REPAIR. 3.60 .............. Agree.................... 3.60
43245................................. .............. OPERATIVE UPPER GI 3.39 .............. Agree.................... 3.39
ENDOSCOPY.
43310................................. .............. REPAIR OF ESOPHAGUS..... 27.47 .............. Agree.................... 27.47
43312................................. .............. REPAIR ESOPHAGUS AND 30.50 .............. Agree.................... 30.50
FISTULA.
43313 #............................... .............. ESOPHAGOPLASTY 45.28 .............. Agree.................... 45.28
CONGENITAL.
43314 #............................... .............. TRACHEO-ESOPHAGOPLASTY 50.27 .............. Agree.................... 50.27
CONG.
44120................................. .............. REMOVAL OF SMALL 17.00 .............. Agree.................... 17.00
INTESTINE.
44121................................. .............. REMOVAL OF SMALL 4.45 .............. Agree.................... 4.45
INTESTINE.
44126 #............................... .............. ENTERECTOMY W/TAPER, 35.50 .............. Agree.................... 35.50
CONG.
44127 #............................... .............. ENTERECTOMY W/O TAPER, 41.00 .............. Agree.................... 41.00
CONG.
44128 #............................... .............. ENTERECTOMY CONG, ADD-ON 4.45 .............. Agree.................... 4.45
44140................................. .............. PARTIAL REMOVAL OF COLON 18.35 .............. Agree.................... 18.35
44160................................. REMOVAL OF COLON........ 18.62 .............. Agree.................... 18.62
44202................................. .............. LAP RESPECT S/INTESTINE 22.04 .............. Agree.................... 22.04
SINGL.
44203 #............................... .............. LAP RESECT S/INTESTINE, 4.45 .............. Agree.................... 4.45
ADDL.
44204 #............................... .............. LAPARO PARTIAL COLECTOMY 22.00 .............. Disagree................. 25.08
44205 #............................... .............. LAP COLECTOMY PART W/ 19.50 .............. Disagree................. 22.23
ILEUM.
44366................................. .............. SMALL BOWEL ENDOSCOPY... 4.41 .............. Agree.................... 4.41
44378................................. .............. SMALL BOWEL ENDOSCOPY... 5.26 .............. Agree.................... 5.26
44391................................. .............. COLONOSCOPY FOR BLEEDING 3.82 .............. Agree.................... 3.82
45136 #............................... .............. EXCISE ILEOANAL 27.30 .............. Agree.................... 27.30
RESERVOIR.
45190................................. .............. DESTRUCTION, RECTAL 8.28 .............. Agree.................... 8.28
TUMOR.
45303................................. .............. PROCTOSIGMOIDOSCOPY 0.44 .............. Agree.................... 0.44
DILATE.
45317................................. .............. PROTOSIGMOIDOSCOPY BLEED 1.50 .............. Agree.................... 1.50
45334................................. .............. SIGMOIDOSCOPY FOR 2.73 .............. Agree.................... 2.73
BLEEDING.
45382................................. .............. COLONOSCOPY/CONTROL 5.69 .............. Agree.................... 5.69
BLEEDING.
46020 #............................... .............. PLACEMENT OF SETON...... 2.90 .............. Agree.................... 2.90
46604................................. .............. ANOSCOPY AND DILATION... 1.31 .............. Agree.................... 1.31
46614................................. .............. ANOSCOPY/CONTROL 2.01 .............. Agree.................... 2.01
BLEEDING.
46924................................. .............. DESTRUCTION, ANAL 2.76 .............. Agree.................... 2.76
LESION(S).
47370 #............................... .............. LAPARO ABLATE LIVER (a) .............. (a)...................... 18.00
TUMORE RF.
47371 #............................... .............. LAPARO ABLATE LIVER (a) .............. (a)...................... 16.94
CRYOSUG.
47380 #............................... .............. OPEN ABLATE LIVER TUMOR (a) .............. (a)...................... 21.25
RF.
47381 #............................... .............. OPEN ABLATE LIVER TUMOR (a) .............. (a)...................... 21.00
CRYO.
47382 #............................... .............. PERCUT ABLATE LIVER RF.. (a) .............. (a)...................... 12.00
48100................................. .............. BIOPSY OF PANCREAS, OPEN 11.08 .............. Agree.................... 11.08
49424................................. .............. ASSESS CYST, CONTRAST 0.76 .............. Agree.................... 0.76
INJECT.
49491 #............................... .............. REPAIRING HERN PREMIE 11.13 .............. Agree.................... 11.13
REDUC.
[[Page 55303]]
49492 #............................... .............. RPR ING HERN PREMIE, 14.03 .............. Agree.................... 14.03
BLOCKED.
49495................................. .............. RPR ING HERNIA BABY, 5.89 .............. Agree.................... 5.89
REDUC.
49496................................. .............. RPR ING HERNIA BABY, 8.79 .............. Agree.................... 8.79
BLOCKED.
50220................................. .............. REMOVE KIDNEY, OPEN..... 17.15 .............. Agree.................... 17.15
50225................................. .............. REMOVAL KIDNEY OPEN, 20.23 .............. Agree.................... 20.23
COMPLEX.
50230................................. .............. REMOVAL KIDNEY OPEN, 22.07 .............. Agree.................... 22.07
RADICAL.
51596................................. .............. REMOVE BLADDER/CREATE 39.52 .............. Agree.................... 39.52
POUCH.
52001 #............................... .............. CYSTOSCOPY, REMOVAL OF 5.45 .............. Disagree................. 2.37
CLOTS.
52347 #............................... .............. CYSTOSCOPY, RESECT DUCTS 5.28 .............. Agree.................... 5.28
52510................................. .............. DILATIONPROSTATIC 6.72 .............. Agree.................... 6.72
URETHRA.
53431 #............................... .............. RECONSTRUCT URETHRA/ 19.89 .............. Agree.................... 19.89
BLADDER.
53444 #............................... .............. INSERT TANDEM CUFF...... 13.40 .............. Agree.................... 13.40
53445................................. .............. INSERT URO./VES NCK 14.06 .............. Agree.................... 14.06
SPHINCTER.
53446 #............................... .............. REMOVE URO SPHINCTER.... 10.23 .............. Agree.................... 10.23
53447................................. .............. REMOVE/REPLACE UR 13.49 .............. Agree.................... 13.49
SPHINCTER.
53448 #............................... .............. REMOVE/REPLC UR SPHINCTR 21.15 .............. Agree.................... 21.15
COMP.
53449................................. .............. REPAIR URO SPHINCTER.... 9.70 .............. Agree.................... 9.70
53853 #............................... .............. PROSTATIC WATER 6.41 .............. Disagree................. 4.14
THERMOTHER.
54065................................. .............. DESTRUCTION, PENIS 2.42 .............. Agree.................... 2.42
LESION(S).
54162 #............................... .............. LYSIS PENIL CIRCUMCIS 3.00 .............. Agree.................... 3.00
LESION.
54163 #............................... .............. REPAIR OF CIRCUMSION.... 3.00 .............. Agree.................... 3.00
54164 #............................... .............. FRENULOTOMY OF PENIS.... 2.50 .............. Agree.................... 2.50
54400................................. .............. INSERT SEMI-RIGID 8.99 .............. Agree.................... 8.99
PROSTHESIS.
54401................................. .............. INSERT SELF-CONTD 10.28 .............. Agree.................... 10.28
PROSTHESIS.
54405................................. .............. INSERT MULTI-COMP PENIS 13.43 .............. Agree.................... 13.43
PROS.
54406 #............................... .............. REMOVE MULTI-COMP PENIS 12.10 .............. Agree.................... 12.10
PROS.
54408 #............................... .............. REPAIR MUTLI-COMP PENIS 12.75 .............. Agree.................... 12.75
PROS.
54410 #............................... .............. REMOVE/REPLACE PENIS 15.50 .............. Agree.................... 15.50
PROSTH.
54411 #............................... .............. REMV/REPLC PENIS PROS, 16.00 .............. Agree.................... 16.00
COMP.
54415 #............................... .............. REMOVE SELF-CONTD PENIS 8.20 .............. Agree.................... 8.20
PROS.
54416 #............................... .............. REMV/REPL PENIS CONTAIN 10.87 .............. Agree.................... 10.87
PROS.
54417 #............................... .............. REMV/REPLC PENIS PROS, 14.19 .............. Agree.................... 14.19
COMPL.
54512................................. .............. EXCISE LESION TESTIS.... 8.58 .............. Agree.................... 8.58
56501................................. .............. DESTROY, VULVA LESIONS, 1.53 .............. Agree.................... 1.53
SIMP.
56515................................. .............. DESTROY VULVA LESION/S 1.88 .............. Agree.................... 1.88
COMPL.
56605................................. .............. BIOPSY OF VULVA/PERINEUM 1.10 .............. Agree.................... 1.10
56810................................. .............. REPAIR OF PERINEUM...... 4.13 .............. Agree.................... 4.13
57022................................. .............. I & D VAGINAL HEMATOMA, 2.56 .............. Agree.................... 2.56
PP.
57061................................. .............. DESTROY VAG LESIONS, 1.25 .............. Agree.................... 1.25
SIMPLE.
57065................................. .............. DESTROY VAG LESIONS, 2.61 .............. Agree.................... 2.61
COMPLEX.
57155 #............................... .............. INSERT UTERI TANDEMNS/ 6.27 .............. Agree.................... 6.27
OVOIDS.
58100................................. .............. BIOPSY OF UTERUS LINING. 1.53 .............. Agree.................... 1.53
58346 #............................... .............. INSERT HEYMAN UTERI 6.75 .............. Agree.................... 6.75
CAPSULE.
58563................................. .............. HYSTEROSCOPY, ABLATION.. 6.17 .............. Agree.................... 6.17
58953 #............................... .............. TAH, RAD DISSECT FOR 32.00 .............. Agree.................... 32.00
DEBULK.
58954 #............................... .............. TAH RAD DEBULK/LYMPH 35.00 .............. Agree.................... 35.00
REMOVE.
59000................................. .............. AMNIOCENTESIS, 1.30 .............. Agree.................... 1.30
DIAGNOSTIC.
59001 #............................... .............. AMINOCENTESIS, 3.00 .............. Agree.................... 3.00
THERAPEUTIC.
64555................................. .............. IMPLANT NEUROELECTRODES. 2.27 .............. Agree.................... 2.27
64561 #............................... .............. IMPLANT NEUROELECTRODES. 6.74 .............. Agree.................... 6.74
64575................................. .............. IMPLANT NEUROELECTRODES. 4.53 .............. Agree.................... 4.53
64581 #............................... .............. IMPLANT NEUROELECTRODES. 13.50 .............. Agree.................... 13.50
64820................................. .............. REMOVE SYMPATHETIC 10.37 .............. Agree.................... 10.37
NERVES.
64821 #............................... .............. REMOVE SYMPATHETIC 8.75 .............. Agree.................... 8.75
NERVES.
64822 #............................... .............. REMOVE SYMPATHETIC 8.75 .............. Agree.................... 8.75
NERVES.
64823 #............................... .............. REMOVE SYMPATHETIC 10.37 .............. Agree.................... 10.37
NERVES.
66982................................. .............. CATARACT SURGERY, 13.50 .............. Agree.................... 13.50
COMPLEX.
67225 #............................... .............. EYE PHOTODYNAMIC THER (\a\) .............. (\a\).................... 0.47
ADD-ON.
69990................................. .............. MICROSURGERY ADD-ON..... 3.47 .............. Agree.................... 3.47
74230................................. 26 CINE/VIDEO X-RAY, THROAT/ 0.53 .............. Agree.................... 0.53
ESO.
74305................................. 26 X-RAY BILE DUCTS/ 0.42 .............. Agree.................... 0.42
PANCREAS.
76066................................. 26 JOINT SURVEY, SINGLE 0.31 .............. Agree.................... 0.31
VIEW.
76078................................. 26 RADIOGRAPHIC 0.20 .............. Agree.................... 0.20
ABSORPTIONMETRY.
76085 #............................... 26 COMPUTER MAMMOGRAM ADD- (\a\) .............. (\a\).................... 0.06
ON.
76120................................. 26 CINE/VIDEO X-RAYS....... 0.38 .............. Agree.................... 0.38
76125................................. 26 CINE/VIDEO X-RAYS ADD-ON 0.27 .............. Agree.................... 0.27
76362 #............................... 26 CAT SCAN FOR TISSUE (\a\) .............. (\a\).................... 4.00
ABLATION.
76394 #............................... 26 MRI FOR TISSUE ABLATION. (\a\) .............. (\a\).................... 4.25
76490 #............................... 26 US FOR TISSUE ABLATION.. (\a\) .............. (\a\).................... 2.00
[[Page 55304]]
76819................................. 26 FETAL BIOPHYS PROFIL W/O 0.63 .............. Disagree................. 0.77
NST.
76885................................. 26 US EXAM INFANT HIPS, 0.74 .............. Agree.................... 0.74
DYNAMIC.
76886................................. 26 US EXAM INFANT HIPS, 0.62 .............. Agree.................... 0.62
STATIC.
77300................................. 26 RADIATION THERAPY DOSE 0.62 .............. Agree.................... 0.62
PLAN.
77301 #............................... 26 RADIOL THERAPY DOSE 8.00 .............. Agree.................... 8.00
PLAN, IMRT.
77418 #............................... RADIATION TX DELIVERY, 0.00 .............. Agree.................... 0.00
IMRT.
85097................................. BONE MARROW 0.94 .............. Agree.................... 0.94
INTERPRETATION.
88380 #............................... 26 MICRODISSECTION......... carrier .............. Agree.................... carrier
90471................................. IMMUNIZATION ADMIN...... 0.17 .............. Disagree................. 0.00
90472................................. IMMUNIZATION ADMIN, EACH 0.15 .............. Disagree................. 0.00
ADD.
90473 #............................... IMMUNE ADMIN ORAL/NASAL. 0.17 .............. Disagree................. 0.00
90939 #............................... HEMODIALYSIS STUDY, 0.00 .............. Agree.................... 0.00
TRANSCUT.
91123 #............................... IRRIGATE FECAL IMPACTION 0.00 .............. Agree.................... 0.00
92136 #............................... 26 OPHTHALMIC BIOMETRY..... 0.54 .............. Agree.................... 0.54
92973 #............................... PERCUT CORONARY 3.28 .............. Agree.................... 3.28
THROMBECTOMY.
92974 #............................... CATH PLACE, CARDIO 3.00 .............. Agree.................... 3.00
BRACHYTX.
93025 #............................... MICROVOLT T-WAVE ASSESS. 0.75 .............. Agree.................... 0.75
93609................................. 26 MAP TACHYCARDIA, ADD-ON. (\a\) .............. Disagree................. 4.81
93612................................. 26 INTRAVENTRICULAR PACING. 3.02 .............. Agree.................... 3.02
93613 #............................... 26 ELECTROPHYS MAP, 3D, ADD- carrier .............. Disagree................. 7.00
ON.
93619................................. 26 ELECTROPHYSIOLOGY 7.32 .............. Agree.................... 7.32
EVALUATION.
93620................................. 2 ELECTROPHYSIOLOGY 11.59 .............. Agree.................... 11.59
EVALUATION.
93621................................. 26 ELECTROPHYSIOLOGY 2.10 .............. Agree.................... 2.10
EVALUATION.
93622................................. 26 ELECTROPHYSIOLOGY 3.10 .............. Agree.................... 3.10
EVALUATION.
93701 #............................... 26 BIOIMPEDANCE, THORACIC.. 0.00 .............. Disagree................. 0.17
94720................................. 26 MONOXIDE DIFFUSING 0.26 .............. Agree.................... 0.26
CAPACITY.
94750................................. 26 PULMONARY COMPLIANCE 0.23 .............. Agree.................... 0.23
STUDY.
95144................................. ANTIGEN THERAPY SERVICES 0.06 .............. Agree.................... 0.06
95145................................. ANTIGEN THERAPY SERVICES 0.06 .............. Agree.................... 0.06
95165................................. ANTIGEN THERAPY SERVICES 0.06 .............. Agree.................... 0.06
95170................................. ANTIGEN THERAPY SERVICES 0.06 .............. Agree.................... 0.06
95250 #............................... GLUCOSE MONITORING, CONT 0.00 .............. Agree.................... 0.00
95875................................. 26 LIMB EXERCISE TEST...... 1.10 .............. Agree.................... 1.10
95904................................. 26 SENSE NERVE CONDUCTION 0.34 .............. Agree.................... 0.34
TEST.
95965 #............................... 26 MEG, SPONTANEOUS........ 8.00 .............. Agree.................... 8.00
95966 #............................... 26 MEG, EVOKED, SINGLE..... 4.00 .............. Agree.................... 4.00
95967 #............................... 26 MEG, EVOKED, EACH ADDL.. 3.50 .............. Agree.................... 3.50
96000 #............................... MOTION ANALYSIS, VIDEO/ .............. carrier Disagree................. 1.80
3D.
96001 #............................... MOTION TEST W/FT PRESS .............. carrier Disagree................. 2.15
MEAS.
96002 #............................... DYNAMIC SURFACE EMG..... .............. carrier Disagree................. 0.41
96003 #............................... DYNAMIC FINE WIRE EMG... .............. carrier Disagree................. 0.37
96004 #............................... PHYS REVIEW OF MOTION .............. carrier Disagree................. 1.80
TESTS.
96150 #............................... ASSESS HLTH/BEHAVE, INIT .............. 0.50 Agree.................... 0.50
96151 #............................... ASSESS HLTH/BEHAVE, .............. 0.48 Agree.................... 0.48
SUBSEQ.
96152 #............................... INTERVENE HLTH/BEHAVE, .............. 0.46 Agree.................... 0.46
INDIV.
96153 #............................... INTERVENE HLTH/BEHAVE, .............. 0.10 Agree.................... 0.10
GROUP.
96154 #............................... INTERV HLTH/BEHAV, FAM W/ .............. 0.45 Agree.................... 0.45
PT.
96155 #............................... INTERV HLTH/BEHAV FAM NO .............. 0.44 Agree.................... 0.44
PT.
96567 #............................... PHOTODYNAMIC TX, SKIN... 0.00 .............. Agree.................... 0.00
97005 #............................... ATHLETIC TRAIN EVAL..... .............. (a) Agree.................... 0.00
97006 #............................... ATHLETIC TRAIN REEVAL... .............. (a) Agree.................... 0.00
97112................................. NEUROMUSCULAR .............. 0.45 Agree.................... 0.45
REEDUCATION.
97504................................. ORTHOTIC TRAINING....... .............. 0.45 Agree.................... 0.45
97535................................. SELF CARE MNGMENT .............. 0.45 Agree.................... 0.45
TRAINING.
97601................................. WOUND CARE SELECTIVE.... .............. 0.50 Agree.................... 0.50
97602................................. WOUND CARE NON-SELECTIVE .............. 0.32 Disagree................. 0.00
99090................................. COMPUTER DATA ANALYSIS.. 0.00 .............. Agree.................... 0.00
99091 #............................... COLLECT/REVIEW DATA FROM 1.10 .............. Disagree................. 0.00
PT.
99289 #............................... PT TRANSPORT, 30-74 MIN. 4.80 .............. Disagree................. 0.00
99290 #............................... PT TRANSPORT, ADDL 30 2.40 .............. Disagree................. 0.00
MIN.
99374................................. HOME HEALTH CARE 1.10 .............. Agree.................... 1.10
SUPERVISION.
99375................................. HOME HEALTH CARE 1.73 .............. Agree.................... 1.73
SUPERVISION.
99377................................. HOSPICE CARE SUPERVISION 1.10 .............. Agree.................... 1.10
99378................................. HOSPICE CARE SUPERVISION 1.73 .............. Agree.................... 1.73
99379................................. NURSING FAC CARE 1.10 .............. Agree.................... 1.10
SUPERVISION.
99380................................. NURSING FAC CARE 1.73 .............. Agree.................... 1.73
SUPERVISION.
99381................................. PREV VISIT, NEW, INFANT. 1.19 .............. Agree.................... 1.19
99382................................. PREV VISIT, NEW, AGE 1-4 1.36 .............. Agree.................... 1.36
[[Page 55305]]
99383................................. PREV VISIT, NEW, AGE 5- 1.36 .............. Agree.................... 1.36
11.
99384................................. PREV VISIT, NEW, AGE 12- 1.53 .............. Agree.................... 1.53
17.
99385................................. PREV VISIT, NEW, AGE 18- 1.53 .............. Agree.................... 1.53
39.
99386................................. PREV VISIT, NEW, AGE 40- 1.88 .............. Agree.................... 1.88
64.
99387................................. PREV VISIT, NEW, 65 & 2.06 .............. Agree.................... 2.06
OVER.
99391................................. PREV VISIT, EST, INFANT. 1.02 .............. Agree.................... 1.02
99392................................. PREV VISIT, EST, AGE 1-4 1.19 .............. Agree.................... 1.19
99393................................. PREV VISIT, EST, AGE 5- 1.19 .............. Agree.................... 1.19
11.
99394................................. PREV VISIT, EST, AGE 12- 1.36 .............. Agree.................... 1.36
17.
99395................................. PREV VISIT, EST, AGE 18- 1.36 .............. Agree.................... 1.36
39.
99396................................. PREV VISIT, EST, AGE 40- 1.53 .............. Agree.................... 1.53
64.
99397................................. PREV VISIT, EST, 65 & 1.71 .............. Agree.................... 1.71
OVER.
--------------------------------------------------------------------------------------------------------------------------------------------------------
(a) No RUC recommendation provided.
# New CPT codes.
* All CPT codes copyright 2002 American Medical Association.
Table 7, AMA RUC Anesthesia Recommendations and CMS Decisions for
New and Revised 2002 CPT Codes, lists the new or revised CPT codes for
anesthesia and their base units that will be interim in 2002. This
table includes the following information:
CPT code. This is the CPT code for a service.
Description. This is an abbreviated version of the
narrative description of the code.
RUC recommendations. This column identifies the base units
recommended by the RUC.
CMS decision. This column indicates whether we agreed with
the RUC recommendation (``agree'') or we disagreed with the RUC
recommendation (``disagree''). Codes for which we did not accept the
RUC recommendation are discussed in greater detail following this
table.
2002 Base Units. This column establishes the 2002 base
units for these services.
Table 7.--AMA RUC Anesthesia Recommendations and CMS Decisions for New and Revised 2002 CPT Codes
----------------------------------------------------------------------------------------------------------------
RUC 2002 Base
*CPT code Description recommendation CMS decision units
----------------------------------------------------------------------------------------------------------------
00797........................ ANESTH, SURGERY FOR OBESITY... 9 Disagree............. 8
00851........................ ANESTH, TUBAL LIGATION........ 6 Agree................ 6
00869........................ ANESTH, VASECTOMY............. 3 Agree................ 3
01905........................ ANES, SPINE INJECT, X-RAY/RE.. 5 Agree................ 5
01916........................ ANESTH, DX ARTERIOGRAPHY...... 5 Agree................ 5
01924........................ ANES, THER INTERVEN RAD, ART.. 5 Agree................ 5
01925........................ ANES, THER INTERVEN RAD, CAR.. 7 Agree................ 7
01926........................ ANES, TX INTERV RAD HRT/CRAN.. 8 Agree................ 8
01930........................ ANES, THER INTERVEN RAD, VEI.. 5 Agree................ 5
01931........................ ANES, THER INTERVEN RAD, TIP.. 7 Agree................ 7
01932........................ ANES, TX INTERV RAD, TH VEIN.. 6 Agree................ 6
01933........................ ANES, TX INTERV RAD, CRAN V... 7 Agree................ 7
01951........................ ANESTH, BURN, LESS 4 PERCENT.. 3 Agree................ 3
01952........................ ANESTH, BURN, 4-9 PERCENT..... 5 Agree................ 5
01960........................ ANESTH, VAGINAL DELIVERY...... 5 Agree................ 5
01961........................ ANESTH, CS DELIVERY........... 7 Agree................ 7
01962........................ ANESTH, EMER HYSTERECTOMY..... 8 Agree................ 8
01963........................ ANESTH, CS HYSTERECTOMY....... 8 Agree................ 8
01964........................ ANESTH, ABORTION PROCEDURES... 4 Agree................ 4
01967........................ ANESTH/ANALG, VAG DELIVERY.... 5 Agree................ 5
01968........................ ANES/ANALG CS DELIVER ADD-ON.. 3 Disagree............. 2
01969........................ ANESTH/ANALG CS HYST ADD-ON... 5 Agree................ 5
----------------------------------------------------------------------------------------------------------------
* All CPT codes copyright 2002 American Medical Association.
Discussion of Codes for Which There Were No RUC Recommendations or for
which the RUC Recommendations Were Not Accepted
The following is a summary of our rationale for not accepting
particular RUC work RVU or base unit recommendations. It is arranged by
type of service in CPT code order. Additionally, we also discuss those
CPT codes for which we received no RUC recommendations for physician
work RVUs. This summary refers only to work RVUs.
Anesthesia for Intraperitoneal Procedures in Upper Abdomen Including
Laparoscopy; Gastric Restrictive Procedure for Morbid Obesity (CPT Code
00797).
The RUC recommended that 9 base units be assigned to this procedure
[[Page 55306]]
based on a comparison to CPT code 00790 (Anesthesia for intraperitoneal
procedures in the upper abdomen including laparoscopy; not otherwise
specified). We disagree. We believe that assigning 9 base units to
00797 creates a rank order anomaly with CPT code 00794 (Anesthesia for
intraperitoneal procedures in the upper abdomen including laparoscopy;
pancreatectomy, partial or total (for example, Whipple procedure))
which is assigned 8 base units.
While obese patients do make the work of an anesthesiologist more
difficult, we believe that the vignette used in the RUC survey was
atypical and exaggerated the required work because the patient in the
vignette was described as having asthma. We believe the work of an
anesthesiologist is greater for patients undergoing Whipple procedures
because, typically, these patients are sicker and require longer
operative time and more intense anesthesia care than patients
undergoing gastric restrictive procedures. Therefore, we are assigning
8 base units to 00797.
Cesarean Delivery Following Neuraxial Labor Analgesia/Anesthesia (List
Separately in Addition to Code for Primary Procedure (CPT Code 01968))
The RUC recommended 3 base units for this add-on procedure. This
procedure is reported in addition to CPT code 01967 (Neuraxial labor
analgesia/anesthesia for planned vaginal delivery (this includes any
repeat subarachnoid needle placement and drug injection and/or any
necessary replacement of an epidural catheter during labor)), when a
patient who has been given neuraxial anesthesia for a planned vaginal
delivery requires conversion to a cesarian delivery and must be given
anesthesia for the cesarian delivery. The RUC recommended 7 base units
for CPT code 01961 (Anesthesia for, cesarian delivery only), a
recommendation with which we agree. We note the following:
The base units of 01961, anesthesia for cesarian delivery,
are the same as the base units of 01967 plus 01968.
The survey respondents valued the add-on code 01968 as if
it were a stand-alone code with a median base unit of 7 and an
intraservice time of 75 minutes. Both the median base units and the
intraservice time are identical to the survey results for 01961.
CPT code 01968 is currently reported (per the American
Society of Anesthesiologists) as 00857 (Neuraxial analgesia/anesthesia
for labor ending in a cesarian delivery (this includes any repeat
subarachnoid needle placement and drug injection and/or any necessary
replacement of an epidural catheter during labor), which is valued at 7
base units. Moreover, the work of CPT code 01967 plus CPT code 01968 is
completely described by CPT code 00857 so it is unclear why the sum of
the base units assigned to 01967 and 01968 should not be identical to
the base units currently assigned to CPT code 00857.
In view of these concerns, we are assigning 2 base units to CPT
code 01968. We are also making a neutrality adjustment to the
anesthesia conversion factor based on our analysis of the estimated
difference in base units between previously repeated anesthesia codes
and the new codes.
Injection, Therapeutic (Eg, Local Anesthetic, Corticosteroid); Carpal
Canal, (CPT Code 20526) Injection; Tendon Sheath, Ligament, Ganglion
Cyst, (CPT Code 20550)
Injection; Tendon Origin/Insertion, (CPT Code 20551)
Injection; Single or Multiple Trigger Point(s), One or Two Muscle
Group(s) (CPT Code 20552), and
Injection; Single or Multiple Trigger Point(s), Three or More Muscle
Groups (CPT Code 20553)
CPT codes 20526, 20551, 20552, and 20553 are new codes, while 20550
is being revised from its current descriptor ``Injection, tendon
sheath, ligament; ganglion cyst, or trigger points'' to the descriptor
above. We received an interim recommendation of 0.86 work RVUs for
these codes, from the RUC, based on the fact that all these procedures
are currently reported as 20550 which is valued at 0.86 RVUs.
CPT code 20550 comprises several procedures with varying amounts of
physician work that will now be reported separately. We are assigning
0.86 RVUs to all these codes on an interim basis, and will review this
further for 2002 if we receive recommendations from the RUC. At that
time we will also have utilization data on these services to assist us
in making work neutrality adjustments should any adjustments be
required.
Laparoscopy, Surgical; Colectomy, Partial With Anastomosis (CPT Code
44204) and Laparoscopy, Surgical; Colectomy, Partial, With Removal of
Terminal Ileum With Ileocecostomy (CPT Code 44205)
The RUC recommended 22.00 RVUs for CPT code 44204 and 19.50 RVUs
for CPT Code 44205 based on the reference code 44140 (Colectomy,
partial; with anastomosis) which, at the time of the recommendation,
had a work RVU of 18.35. We increased the work RVU of CPT Code 44140 to
21 as part of the 5-year review of physician work. In order to prevent
rank order anomalies we are assigning work RVUs of 25.08 and 22.23 to
CPT Codes 44204 and 44205, respectively. These work RVUs represent a 14
percent increase over the RUC recommendation and are consistent with
our valuation of CPT Code 44140.
Laparoscopy, Surgical, Ablation of One or More Liver Tumor(s);
Radiofrequency (CPT Code 47370), Laparoscopy, Surgical, Ablation of One
or More Liver Tumor(s); Cryosurgical (CPT Code 47371), Ablation, Open,
of One or More Liver Tumor(s); Radiofrequency (CPT Code 47380),
Ablation, Open, of One or More Liver Tumor(s); Cryosurgical (CPT Code
47381), Ablation, One or More Liver Tumor(s), Percutaneous,
Radiofrequency (CPT Code 47382), Computerized Axial Tomography Guidance
for, and Monitoring of, Tissue Ablation (CPT Code 76362), Magnetic
Resonance Guidance for, and Monitoring of, Tissue Ablation (CPT Code
76394); and Ultrasound Guidance for, and Monitoring of, Tissue Ablation
(CPT Code 76490)
We have not received recommendations from the RUC for these
procedures. We have assigned work RVUs as follows:
47370--18 work RVUs
47371--16.94 work RVUs
47380--21.25 work RVUs
47381--21.00 work RVUs
47382--12.00 work RVUs
To arrive at the values listed above, we compared the time and
intensity of these services to other open and laparoscopic liver,
colon, and renal procedures. We believe that the RVUs assigned place
them in the correct rank order with these other services and with
respect to each other.
76362--4.00 work RVUs
76394--4.25 work RVUs
76490--2.00 work RVUs
To arrive at the values above, we compared the time and intensity
of these procedures to other radiologic guidance codes and to
radiologic supervision and interpretation codes. We believe that the
assigned RVUs place them in correct rank order to other radiologic
guidance services and to each other.
Cystourethroscopy with irrigation and evacuation of clots, (CPT Code
52001)
The RUC recommended 5.45 work RVUs based on a comparison to the
reference procedures CPT code 52315 (Cystourethroscopy, with removal of
[[Page 55307]]
foreign body, calculus, or ureteral stent from urethra or bladder
(separate procedure); complicated), and CPT Code 52235
(Cystourethroscopy, with fulguration (including cryosurgery or laser
surgery) and/or resection of; medium bladder tumor(s) (2.0 to 5.0 cm)).
We are concerned that 52001, with its current descriptor, will be
reported whenever a cystoscopy is performed and blood is present during
the examination. As written, the code may be reported whenever any
blood clots are present. The RUC recommendation is based upon the
urologists' response to a scenario where the bladder outlet was
obstructed due to large blood clots and removal of the blood clots
required a resectoscope. Unfortunately, the code descriptor does not
require the presence of bladder obstruction due to blood clots, nor
does it require the use of a resectoscope. Therefore, until the
descriptor of this code is clarified by the AMA CPT editorial panel, we
are assigning 2.37 RVUs to this procedure. As the CPT code is now
written, the time and intensity of the physician work for this
procedure are comparable to CPT Code 52005. (Cystourethroscopy, with
ureteral catheterization, with or without irrigation, instillation, or
ureteropyelography, exclusive of radiologic service).
Transurethral Destruction of Prostatic Tissue; By Water Induced
Thermotherapy (CPT Code 53853)
The RUC recommended 6.41 work RVUs for this procedure based on a
comparison to CPT Code 54670 (Suture or repair of testicular injury)
which has a similar work value and similar pre-, intra-, and
postservice times to the median times in the survey for 53853. The RUC
also noted that CPT Code 53850 (Transurethral destruction of prostate;
by microwave thermotherapy) has 90 minutes of intraservice time as
compared to 60 minutes for CPT code 53853 and that the recommended work
value for CPT code 53853 was approximately \2/3\ of the work value for
CPT code 53850.
We note that although the intraservice time for CPT code 53853 is
60 minutes, most of that time is spent monitoring the flow of hot water
through a catheter and balloon and checking the water's temperature. We
estimate that the maximum amount of time spent on activities other than
monitoring is 20 minutes. This means that the work intensity for the
intraservice portion of this procedure is significantly less than it is
for most other surgical procedures and, specifically, the reference
codes examined by the RUC. Therefore, we believe it is more appropriate
to compare CPT code 53853 to 90-day global procedures with less than 30
minutes of intraservice time. For these reasons we compared CPT code
58350 to the following procedures:
----------------------------------------------------------------------------------------------------------------
Intraservice Pre/post
CPT code Work RVU time service
(minutes) time
----------------------------------------------------------------------------------------------------------------
53853 Transurethral destruction of prostate RUC Recommendation--6.41............ 60 *113
tissue; by water-induced thermotherapy.
CMS assigned RVU 4.14...............
30130 Excision turbinate, partial or complete, 3.38................................ 27 78
any method.
42826 Tonsillectomy, primary or secondary; age 3.38................................ 28 82
12 or over.
46045 Incision and drainage of intramural, 4.32................................ 25 206
intramuscular, or submucosal abscess,
transanal, under anesthesia.
46946 Ligation of internal hemorrhoids; 3.0................................. 25 75
multiple procedures.
58800 Drainage of ovarian cyst(s), unilateral 4.14................................ 23 100
or bilateral, (separate procedure); vaginal
approach.
61105 Twist burr hole for subdural or 5.14................................ 27 97
ventricular puncture.
65810 Paracentesis of anterior chamber of eye 4.87................................ 28 104
(separate procedure); with removal of vitreous
and/or discission of anterior hyaloid
membrane, with or without air injection.
67031 Severing of vitreous strands, vitreous 3.67................................ 26 79
face adhesions, sheets, membranes, or
opacities, laser surgery (one or more stages).
----------------------------------------------------------------------------------------------------------------
* see below.
The RUC sent us a postservice time of 131 minutes, which we believe
is incorrect. The RUC assigned 3 postservice visits to this procedure
which have a combined time of 35 minutes, not 53 minutes as recommended
by the RUC. Therefore, the correct postservice time is 118 minutes.
With respect to the services listed above, we note that all of them
carry significant risks to the patient and have intraservice work of
high intensity. In fact, we believe the intraservice work of all the
above procedures is of greater intensity than any portion of the
intraservice work of CPT code 53853. After review of the procedures
considered by the RUC and the above procedures, we believe that the
time and intensity of CPT code 53853 is most comparable to CPT code
58800 and are assigning 4.14 work RVUs to CPT code 53853. This places
CPT code 53853 in the correct rank order with respect not only to the
procedures listed above but also to the prostate ablation,
cystourethroscopy, and testicular procedures considered by the RUC.
Destruction of Localized Lesion of Choroids (eg, Choroidal
Neovascularization); Photodynamic Therapy, Second Eye, at Single
Session (List Separately in Addition To Code for Primary Eye Treatment)
CPT Code 67225
We did not receive a RUC recommendation on this code. We are
assigning work RVUs of 0.47, which is the work value for G0184, the
code previously used for reporting this service.
Immunization Administration (Includes Percutaneous, Intradermal,
Subcutaneous, Intramuscular and Jet Injections); One Vaccine (Single or
Combination Vaccine/Toxoid) (CPT Code 90471), Immunization
Administration (Includes Percutaneous, Intradermal, Subcutaneous,
Intramuscular and Jet Injections); Each Additional Vaccine/Toxoid (List
Separately in Addition To Code for Primary Procedure) One Vaccine (CPT
Code 90472)
The RUC recommended a work RVU of .17 for CPT code 90471 and .15
work RVUs for CPT code 90472. These
[[Page 55308]]
services are analogous to CPT code 90872 (Therapeutic, prophylactic or
diagnostic injection (specify material injected); subcutaneous or
intramuscular) which has no physician work RVUs. They are services
performed by a nurse and have no physician work. If the physician
performs any counseling related to this service, it is considered part
of the work of the preventive medicine visit during which the
immunization was administered. If the vaccine is administered during a
visit other than a preventive medicine service, any physician
counseling should be billed separately as an E/M service. For these
reasons we are not assigning work RVUs to these codes.
Immunization Administration by Intranasal or Oral Route; One Vaccine
(Single or Combination Vaccine/Toxoid) (CPT Code 90473); and,
Immunization Administration by Intranasal or Oral Route Each Additional
Vaccine/Toxoid (List Separately in Addition To Code for Primary
Procedure) CPT Code 90474
The RUC recommended a work RVU of .17 for CPT code 90473 and .15
work RVUs for CPT code 90474. These are noncovered services. Medicare
does not cover self-administered vaccines, and, therefore, we are not
assigning work RVUs to these services.
Intraventricular and/or Intra-Atrial Mapping of Tachycardia Site(s)
With Catheter Manipulation to Record From Multiple Sites to Identify
Origin of Tachycardia (CPT Code 93609)
We have not received a recommendation from the RUC for this
service. The descriptor for this service has not changed but the AMA
CPT editorial panel changed the global period for this service from a
zero day global to a ZZZ global. This means that it is now an ``add
on'' code and the physician work RVUs will no longer include any pre-
or postservice work. It currently has a work RVU of 10.07. In order to
appropriately value this add on service, we compared it to several
other electrophysiology services, including CPT code 93619,
(Comprehensive electrophyisologic evaluation with right atrial pacing
and recording, right ventricular pacing and recording, His bundle
recording, including insertion and repositioning of multiple electrode
catheters; without induction or attempted induction of arrhythmia) with
a work RVU of 7.32, and CPT code 93618, Induction of arrhythmia by
electrical pacing (work RVU 4.26), and CPT code 93624,
(Electrophysiologic follow up study with pacing and recording to test
effectiveness of therapy, including induction of attempted induction of
arrhythmia), with a work RVU of 4.81. After reviewing these services,
we believe that the time and intensity of physician work for CPT code
93609 as an add-on code is most similar to CPT code 93624 and are
assigning a work RVU of 4.81 to CPT code 93609.
Intracardiac Electrophysiologic 3-Dimensional Mapping (CPT Code 93613)
This is a new add-on code for which we have not received a
recommendation from the RUC. As an add-on code, this service does not
include and pre- or postservice work. We compared this service to CPT
code 93619 (Comprehensive electrophysiologic evaluation with right
atrial pacing and recording, right ventricular pacing and recording,
His bundle recording, including insertion and repositioning of multiple
electrode catheters; without induction or attempted induction of
arrhythmia) with work RVUs of 7.32 and to CPT code 93651 (Intracardiac
catheter ablation of arrhythmogenic focus; for treatment of
supraventricular tachycardia by ablation of fast or slow
atrioventricular pathways, accessory atrioventricular connections or
other atrial foci, singly or in combination) with work RVUs of 16.25.
We also wanted to ensure that the work value for this service was
placed in correct rank order to CPT code 93609 (see above). We believe
that the intraservice time and intensity of this service is slightly
less than that of CPT code 93619 and are assigning 7.00 work RVUs to
CPT code 93613.
Bioimpedence, Thoracic, Electrical CPT Code 93701
We received a RUC recommendation that this service has no physician
work. We currently cover this service under the HCPCS code M0302. We
assigned 0.17 physician work RVUs to this service in the November 2000
final rule after conducting a notice and comment period. We will
consider the RUC recommendation. If we considered changing the work
RVUs for this service, we would discuss any proposed change in a future
notice of proposed rule making. However, we are going to discontinue
HCPCS code M0302 and will recognize CPT Code 93701 for this service.
Comprehensive Computer-Based Motion Analysis by Video-Taping And 3-D
Kinematics (CPT Code 96000), Comprehensive Computer-Based Motion
Analysis by Video-Taping and 3-D Kinematics; With Dynamic Plantar
Pressure Measurements During Walking (CPT Code 96001), Dynamic Surface
Electromyography, During Walking or Other Functional Activities, 1-12
Muscles (CPT Code 96002), Dynamic Fine Wire Electromyography, During
Walking or Other Functional Activities, 1 Muscle (CPT Code 96003), and
Physician Review and Interpretation of Comprehensive Computer Based
Motion Analysis, Dynamic Plantar Pressure Measurements, Dynamic Surface
Electromyography During Walking or Other Functional Activities, and
Dynamic Fine Wire Electromyography, With Written Report (CPT Code
96004)
HCPAC recommended that these services be carrier priced. We
disagree and are assigning work RVUs to these services as follows:
CPT code 96000--1.8 work RVUs
CPT code 96001--2.15 work RVUs
CPT code 96002--.41 work RVUs
CPT code 96003--.37 work RVUs
CPT code 96004--1.8 work RVUs
To arrive at these values, we compared the time and intensity of
CPT codes 96000 and 96001 to other physical therapy services. We
believe that the assigned RVUs place these services in the correct rank
order with other physical therapy services. We compared the time and
intensity of CPT codes 96002 and 96003 to other electromyography
services and believe that the assigned RVUs place these services in the
correct rank order with other electromyography services. We compared
the time and intensity of CPT code 96004 with other physical therapy
services and physician consultation services and believe the assigned
RVUs place CPT code 96004 in the correct rank order with these other
services.
Removal of Devitalized Tissue From Wound(s); Non-Selective Debridement,
Without Anesthesia (eg, Wet-To-Moist Dressings, Enzymatic, Abrasion),
Including Topical Applications(s), Wound Assessment and Instruction(s)
for Ongoing Care, Per Session, CPT 97602
The HCPAC recommended a work RVU of .32 for this service. We
disagree with this recommendation as we continue to believe that this
code is bundled into 97602 for the reasons discussed earlier in this
section. Therefore, we are not establishing work RVUs for this service.
[[Page 55309]]
Collection and Interpretation of Physiologic Data (eg, ECG, Blood
Pressure, Glucose Monitoring) Digitally Stored and/or Transmitted by
the Patient and/or Caregiver to the Physician or Other Qualified Health
Care Professional, Requiring a Minimum of 30 Minutes of Time CPT CODE
99091
The RUC recommended work RVUs of 1.10 for this code. We disagree as
this work is considered part of the pre and postservice work of an E/M
service and propose to bundle payment for this code. (Note that payment
for similar CPT code, 99090, Analysis of clinical data in computers
(eg, ECGs, blood pressures, hematologic data, is also currently
bundled.)
CPT Codes 99289, Physician Constant Attention of the Critically Ill or
Injured Patient During an Interfacility Transport; First 30-74 Minutes,
and 99290 Each Additional 30 Minutes (List Separately in Addition To
Code for Primary Service)
These two new codes were created for CPT 2002 that describe
services provided during patient transport. The RUC recommended that
CPT code 99289 be valued at 4.8 work RVUs and CPT code 99290 be valued
at 2.4 work RVUs. The CPT explanatory notes accompanying these two new
codes state:
The following codes 99289 and 99290 are used to report the
physical attendance and direct face-to-face care by a physician
during the interfacility transport of a critically ill or injured
patient. For the purposes of reporting codes 99289 and 99290, face-
to-face care begins when the physician assumes the primary
responsibility of the patient at the referring hospital or facility,
and ends when the receiving hospital or facility accepts
responsibility for the patient's care. Only the time the physician
spends in direct face-to-face contact the patient during the
transport should be reported. Patient transport services involving
less than 30 minutes of face-to-face physician care should not be
reported using 99289, 99290.
Procedure(s) or service(s) performed by other members of the
transporting team may not be reported by the supervising physician.
Any procedure(s) or service(s) performed by the physician before or
during transport that are identified in CPT may be reported
separately with the exception of routine monitoring evaluations (eg,
heart rate, respiratory rate, blood pressure, and pulse oximetry)
and the initiation of mechanical ventilation.
The time spent by the physician performing separately reportable
services or procedures should not be included in the face-to-face
time reported by codes 99289, 99290. The direction of emergency care
to transporting staff by a physician located in a hospital or other
facility by two-way communication is not considered direct face-to-
face care and should not be reported with codes 99289, 99290.
The CPT explanatory notes go on to state that physicians should
report emergency department services codes, initial hospital care
codes, and critical care codes only after the patient has been admitted
to the emergency department, the inpatient floor, or the critical care
unit of the receiving facility.
Decision: We would like to note that, currently, physician services
provided to patients during interfacility transport are reported, and
paid, using the appropriate E/M service codes (for example, outpatient
visits, emergency visits, prolonged services, critical care).
We have several significant concerns about the new CPT codes, 99289
and 99290. First, other than requiring face-to-face contact with the
patient, there is no requirement for delivery of any specific physician
service. This is in contrast to requirements for reporting critical
care services under CPT codes 99291, 99292, 99295, 99296, 99297, and
99298. When reporting CPT codes 99291 and 99292 the CPT requires that,
in addition to the patient being critically ill or critically injured,
and the physician devoting his or her full attention to the patient,
``high complexity decision making to assess, manipulate, and support
vital system function(s) to treat single or multiple vital organ system
failure and/or to prevent further life-threatening deterioration of the
patient's condition.'' These codes are valued at 4.0 work RVUs and 2.0
work RVUs, respectively.
The CPT goes on to state that--
``Although critical care typically requires interpretation of
multiple physiologic parameters and/or application of advanced
technology(s), critical care may be provided in life threatening
situations when those elements are not present.''
`` * * * Providing medical care to a critically ill, injured, or
postoperative patient qualifies as a critical care service only if both
the illness or injury and the treatment being provided, meet the above
requirements.''
As the code descriptors are written, the care described by the new
CPT patient transport codes 99289 and 99290 do not meet the
requirements for critical care. In fact, some services that will be
reported as 99289 and 99290 would also be more appropriately reported
as a new or established outpatient visit, an emergency visit, or as
prolonged services, depending on the type of care that was delivered.
We believe that the descriptors for CPT codes 99289 and 99290 will make
it difficult for physicians to know when to report 99289 and 99290
appropriately.
Second, the beginning and ending times for 99289 and 99290 are
unclear. We do not believe time spent in the referring and receiving
facility should be counted towards this service. Time spent in the
facility prior to and after transfer may not require any physician
services even though the physician is face-to-face with the patient.
Furthermore, if services are provided at the referring or receiving
facility they should be billed as the appropriate E/M service (for
example, new patient visit, emergency visit).
Third, we note that the descriptors for 99289 and 99290 include the
phrase `` * * * critically ill or injured patient'' while the
descriptors for 99291 and 99292 include the phrase `` * * * critically
ill or critically injured patient.'' We realize that CPT descriptors
are carefully developed, so we are concerned about this discrepancy and
believe it needs to be clarified.
Fourth, we note that although CPT specifically includes (or
bundles) certain services into critical care, it does not include those
same services in the payment for 99289 and 99290 (for example, gastric
intubation, temporary transcutaneous pacing).
Therefore, after careful review of the descriptors and explanatory
notes for CPT codes 99289 and 99290, we have decided to not recognize
these codes for Medicare purposes. Instead, we have created two HCPCS
Level II codes to describe critical care services provided to patients
during inter-facility transport. These codes are:
G0240--Critical Care Service delivered by a physician; face-to-
face, during inter-facility transport of a critically ill or critically
injured patient: first 30-74 minutes of active transport.
G0240 will be valued at 4.0 work RVUs.
G0241--each additional 30 minutes (list separately in addition to
G0240)
G0241 will be valued at 2.0 work RVUs.
We believe that these two G codes carry out the intent of 99289 and
99290 with less ambiguity and thus will facilitate accurate reporting
of these services by physicians. We have decided to value these
services at the present value for 99291 (4.0 work RVUs) and 99292 (2.0
work RVUs). Although critical care is the most intense E/M service
delivered by physicians, there is considerable variation in the
intensity range of the services provided under the umbrella of critical
care. We value all critical care services uniformly and do not believe
there is a need to develop a
[[Page 55310]]
tiered approach to valuing critical care services.
We will apply all the requirements for critical care services (CPT
codes 99291 and 99292) to G0240 and G0241 with the following two
exceptions: (1) All time counted towards patient transport time must be
face-to-face time with the patient; (2) We will only allow face-to-face
time spent in actual transport to be counted towards G0240 and G0241;
E/M services delivered in the referring and receiving facilities may be
reported under other appropriate E/M codes (for example, outpatient,
emergency, or critical care services).
If the actual transportation time is less than 30 minutes and/or
the service does not meet the requirements of G0240 and G0241, then the
physician may report his or her services under the appropriate E/M code
(for example, outpatient visit, emergency visit, prolonged services).
In order for G0240 and G0241 to be payable, the medical record must
document the time spent in actual patient transport, the nature of the
patient's critical illness or critical injury, and the critical care
services delivered to the patient. Consistent with the teaching
physician policies in section 15016 of the Medicare Carriers Manual,
residents who provide this service are paid through graduate medical
education payments. Therefore, their services are not payable through
Medicare Part B.
Any services delivered, or face-to-face time spent with the
patient, by a resident, nurse, emergency medical technician, or other
non-physician may not be billed using G0240 or G0241. Nor may any
services performed by any physician or non-physician who is not
physically present with the patient during interfacility transport be
billed. Time spent in the referring facility, the receiving facility,
and time spent prior to transport are not countable towards G0240 and
G0241. Additionally, any time spent performing separately billable
procedures may not be counted towards G0240 and G0241 (for example,
insertion of chest tubes, insertion of intravenous lines and
pacemakers, and cardiopulmonary resuscitation). All services bundled
into 99291 and 99292 will also be bundled into G0240 and G0241.
Establishment of Interim Practice Expense Relative Value Units for New
and Revised Physician's Current Procedural Terminology (CPT) Codes and
New HCFA Common Procedure Coding System Codes for 2002
We have developed a process for establishing interim practice
expense RVUs (PERVUs) for new and revised codes that is similar to that
used for work RVUs. Under this process, the RUC recommends the practice
expense direct inputs, that is, the staff time, supplies and equipment
associated with each new code. We then review the recommendations in a
manner similar to our evaluation of the recommended work RVUs.
The RUC recommendations on the practice expense inputs for the new
and revised 2002 codes were submitted to us as interim recommendations.
We, therefore, consider that these recommendations are still subject to
further refinement by the PEAC, or by us, if it is determined that such
future review is needed. We may also revisit these inputs in light of
future decisions of the PEAC regarding supply and equipment packages
and standardized approaches to pre- and postservice clinical staff
times.
We have accepted, at least in the interim, almost all of the
practice expense recommendations submitted by the RUC for the codes
listed in table 6, AMA RUC and HCPAC Work RVU Recommendations and CMS
Decisions for New and Revised 2002 CPT Codes.'' We made the following
minor changes to the inputs where relevant:
We substituted the RUC agreed-upon multispecialty minimum
visit supply package for the list of individual supplies where
appropriate.
We deleted separately billable supplies, for example,
drugs, fluids, casting supplies, when listed in the recommended supply
list.
We rounded fractions of minutes of clinical staff time to
the nearest minute.
The RUC agreed with the specialty society representing
neurology that the magnetoencephalography codes, CPT 95965, 95966,
95967, are only performed in the facility setting and that they
therefore had no direct practice expense inputs. However, we have
subsequently heard from the specialty society that it has determined
that a small number of practitioners do perform these services in the
office setting and that there would be costs in that setting that
should be reflected. We have accepted the suggestion that the TC of
these codes be carrier-priced, at least until we can ascertain what
direct cost inputs should be included when these services are performed
in the non-facility setting.
We are accepting the practice expense inputs recommended
for CPT code 77418 (Intensity modulated treatment delivery, single or
multiple fields/arcs, via narrow spatially and temporally modulated
beams (binary, dynamic, MLC, etc.), per treatment session, with the
exception of the time for the radiation therapist which we are reducing
from the recommended 123 minutes to 60 minutes. We are concerned that
there may be overlap in the staff time for other codes billed in
conjunction with CPT code 77418, such as CPT code 76950 (Ultrasound
guidance for placement of radiation therapy fields) and CPT code 77417
(Therapeutic radiology port film(s)).
Further, we understand that the code was valued assuming the
typical time for the service was 60 minutes and included the time of
two radiation therapists. We believe that the service commonly takes
less than the recommended 123 minutes and it may involve only one
therapist. As a result of these concerns, we are valuing the service
using 60 minutes of radiation technician time. This valuation is
considered interim during the refinement of practice expense RVUs. We
also note that the practice expense RVUs for 77418 are being determined
under the resource-based methodology even though the service has no
physician work. We believe that the service will have a more
appropriate relative payment amount if the practice expense RVUs are
determined outside of the no work methodology.
We did not receive a RUC recommendation for CPT code
93613, Intracardiac electrophysiology, or CPT 96004, Gait and motion
studies. We have assumed that these services are performed only in the
facility setting and have no direct inputs.
For the following CPT codes we did not receive practice expense
recommendations. Therefore, we are providing practice expense inputs
through crosswalking to an existing code as indicated below:
----------------------------------------------------------------------------------------------------------------
New/revised CPT code Existing CPT/HCPCS code
----------------------------------------------------------------------------------------------------------------
20553 Therapeutic Injections............ 20550 Therapeutic Injections.
47370 Ablation of Hepatic Tumors........ 47562 Laparoscopic cholecystectomy.
47371 Ablation of Hepatic Tumors........ 47562 Laparoscopic cholecystectomy.
47380 Ablation of Hepatic Tumors........ 47350 Repair liver wound.
[[Page 55311]]
47381 Ablation of Hepatic Tumors........ 47350 Repair liver wound.
47382 Ablation of Hepatic Tumors........ 47525 Change bile duct catheter.
67225 Ocular Photodynamic Therapy....... G0184 Ocular photodynamic tx, 2nd.
76362 Ablation of Hepatic Tumors........ 76360 CAT scan for needle biopsy.
76394 Ablation of Hepatic Tumors........ 76393 Mr guidance for needle place.
76490 Ablation of Hepatic Tumors........ 76942 Echo guide for biopsy.
----------------------------------------------------------------------------------------------------------------
C. Other Changes to the 2002 Physician Fee Schedule and Clarification
of CPT Definitions
For the 2002 physician fee schedule, we are establishing or
revising several alpha-numeric HCPCS codes for reporting certain
services that are not clearly described by existing CPT codes.
In addition to the two new HCPCS codes for patient transport we
have discussed in section IV.B., ``Establishment of Interim Work
Relative Value Units for New and Revised Physician's Current Procedural
Terminology (CPT) Codes and New Healthcare Common Procedure Coding
System Codes (HCPCS) for 2002'' above; we are also establishing the
HCPCS codes for the respiratory therapy services below.
Respiratory Therapy Codes
Respiratory therapists can deliver services incident to a
physician's service or in a provider setting such as an outpatient
hospital or a comprehensive outpatient rehabilitation facility. In the
past, services delivered by respiratory therapists or other health
professionals often have not been clearly described by the existing CPT
codes. In order to clarify coding of these services, typically
delivered by respiratory therapists, but at times delivered by other
specially trained health professionals, we are instituting new G codes
to describe these services.
We developed three codes for use to describe services to improve
respiratory function:
G0237 Therapeutic Procedures To Increase Strength or Endurance of
Respiratory Muscles, Face-to-Face, One-on-One, Each 15 Minutes
(Includes Monitoring).
This service is to be billed when the therapist works with the
patient to perform specific exercises aimed at strengthening the main
and accessory muscles of respiration.
We have provided a specific value for this code based upon the time
that a respiratory therapist, who we believe will be the typical
professional providing this service, will spend performing this service
and practice expenses crosswalked from other similar services. This
code will have no physician work.
G0238 Therapeutic Procedures To Improve Respiratory Function, Other
Than Ones Described by G0237, One-on-One, Face-to-Face, per 15 Minutes
(Includes Monitoring)
G0239 Therapeutic Procedures To Improve Respiratory Function, Two or
More Patients Treated During the Same Period, Face-to-Face (Includes
Monitoring)
Codes G0237 and G0238 are billed in 15-minute increments. The
method for ``counting'' the 15 minutes will be consistent with the
method for counting minutes in many of the 97000 series CPT codes (see
PM-01-68 for details). These codes would describe activities, such as
monitored exercise, that improve respiratory function. Both G0238 and
G0239 would be carrier-priced. The carriers have the authority to
request information about the specific nature of the services
delivered. CPT codes G0237-G0239 may not be billed with codes G0110 and
G0111, which are restricted to services in the National Emphysema
Treatment Trial (NETT), since they represent the same services.
These codes are designed to provide more specific information about
the services being delivered. The availability of codes for services to
improve respiratory function will make billing of CPT codes 97000-97799
inappropriate for professionals involved in treating respiratory
conditions, unless these services are delivered by physical and
occupational therapists and meet the other requirements for physical
and occupational therapy services. We recognize that speech and
language pathologists also occasionally treat patients to improve
respiratory function as part of their treatment of speech and language
disorders. Because the primary goal of these services is not to improve
respiratory function, but to restore speech and communication, these
services should be coded with 92507, ``treatment of speech, language,
voice, communication, and/or auditory processing disorder (includes
aural rehabilitation, individual).''
VI. Update of the Codes for the Physician Self-Referral Prohibition
On January 4, 2001 we published in the Federal Register a final
rule with comment period, ``Medicare and Medicaid Programs; Physicians'
Referrals to Health Care Entities With Which They Have Financial
Relationships'' (66 FR 856). That final rule incorporated into
regulations the provisions in paragraphs (a), (b) and (h) of section
1877 of the Social Security Act (the Act). Section 1877 of the Act
prohibits a physician from referring a Medicare patient for certain
``designated health services'' to a health care entity with which the
physician (or a member of the physician's immediate family) has a
financial relationship, unless an exception applies. In the final rule,
we published an attachment listing all of the CPT and HCPCS codes that
defined the entire scope of the following designated health services
for purposes of section 1877 of the Act: clinical laboratory services;
physical therapy services (including speech-language pathology
services); occupational therapy services; radiology and certain other
imaging services; and radiation therapy services and supplies.
In the January 4, 2001 final rule, we stated that we would update
the list of codes used to define these designated health services in an
addendum to the annual final rule concerning physician fee schedule
payment policies. Thus, we are now publishing an updated all-inclusive
list of codes at Addendum E. We also will provide that update on our
website at www.hcfa.gov/medlearn/refphys.htm. The purpose of this
update is to conform the code list to the most recent publication of
CPT and HCPCS codes. The list of codes will become effective on January
4, 2002. We are using the January 4, 2002 date because that is the
effective date for all but one provision of the January 4, 2001
physician self-referral final rule (changes made to 42 CFR 424.22 in
the final rule became effective on April 6, 2001). In future years, we
intend to use a January 1 effective date to coincide with the effective
date of the new CPT and HCPCS codes.
Table 8, below, identifies the CPT and HCPCS codes that have been
added to
[[Page 55312]]
or deleted from the list of codes published as an attachment to the
January 4, 2001 physician self-referral final rule. In that final rule,
we stated that we would consider timely comments regarding the updated
code list. Accordingly, we will consider comments with respect to the
codes listed in Table 8, below, if we receive them by the date
specified in the date section of this final rule.
Table 8.--Additions and Deletions to the Physician Self-Referral Codes
------------------------------------------------------------------------
CPT\1\ or HCPCS code
-------------------------------------------------------------------------
Additions
------------------------------------------------------------------------
76085 Computer mammogram add-on.
77301 Radioltherapy dos plan, imrt.
77418 Radiation tx delivery, imrt.
92974 Cath place, cardio brachytx.
96000 Motion analysis, video/3d.
96001 Motion test w/ft press meas.
96002 Dynamic surface emg.
96003 Dynamic fine wire emg.
G0202 Screening mammography digital.
G0204 Diagnostic mammography digital.
G0206 Diagnostic mammography digital.
G0236 Digital film convert diag ma.
J1270 Injection, doxercalciferol.
J1755 Iron sucrose injection.
Q3018 Hepatitis B vaccine.
------------------------------------------------------------------------
Deletions
------------------------------------------------------------------------
90744 Hepb vacc ped/adol 3 dose im.
90746 Hep B vaccine, adult, im.
90747 Hepb vacc, ill pat 4 dose im.
------------------------------------------------------------------------
\1\ CPT codes, descriptions and other data only are copyright 2001
American Medical Association. All Rights Reserved. Applicable FARS/
DFARS Clauses Apply.
Table 8 includes 2 codes (J1270 and J1755) that we have identified
as dialysis-related outpatient prescription drugs. The physician self-
referral prohibition will not apply to these services if they meet the
conditions set forth in Sec. 411.355(g) concerning the exception to the
physician self-referral rule for EPO and other dialysis-related
outpatient prescription drugs furnished in or by an ESRD facility.
Table 8 also includes codes (G0202, 76085 and Q3018) that we have
identified as screening tests and a vaccine. The physician self-
referral prohibition will not apply to these services if they meet the
conditions at Sec. 411.355(h) concerning the exception for preventive
screening tests, immunizations, and vaccines.
We note that, in response to our January 4, 2001 final rule with
comment, we received a number of comments regarding designated health
services. We intend to address those comments in a second final rule
regarding the physician self-referral prohibition.
VII. Physician Fee Schedule Update for Calendar Year 2002
A. Physician Fee Schedule Update
The physician fee schedule update for 2002 is -4.8 percent. Under
section 1848(d)(3) of the Act, the update is equal to 1 plus the
product of the Medicare Economic Index (MEI) (divided by 100) and 1
plus the update adjustment factor. For 2002, the MEI is equal to 2.6
percent (1.026). A more detailed description of the MEI and its
calculation follows. The update adjustment factor is equal to -7.0
percent (0.930). Section 1848(d)(4)(F) of the Act requires an
additional -0.2 percent (0.998) reduction to the update for 2002. Thus,
the product of the MEI (1.026), the update adjustment factor (0.930),
and the statutory adjustment factor (0.998) equals the 2002 update of -
4.8 percent (0.9523). The MEI and the update adjustment factor are
described below.
B. The Percentage Change in the Medicare Economic Index
The MEI measures the weighted-average annual price change for
various inputs needed to produce physicians' services. The MEI is a
fixed-weight input price index, with an adjustment for the change in
economy-wide labor productivity. This index, which has 1996 base
weights, is comprised of two broad categories--physician's own time and
physician's practice expense.
The physician's own time component represents the net income
portion of business receipts and primarily reflects the input of the
physician's own time into the production of physicians' services in
physicians' offices. This category consists of two subcomponents--wages
and salaries, and fringe benefits. These components are adjusted by the
10-year moving average annual percent change in output per man-hour for
the nonfarm business sector to reflect productivity growth in
physicians' offices.
The physician's practice expense category represents the rate of
price growth in nonphysician inputs to the production of services in
physicians' offices. This category consists of wages and salaries and
fringe benefits for nonphysician staff and other nonlabor inputs. Like
physician's own time, the nonphysician staff categories are adjusted
for productivity using the 10-year moving average annual percent change
in output per man-hour for the nonfarm business sector. The physician's
practice expense component also includes the following categories of
nonlabor inputs--office expense, medical materials and supplies,
professional liability insurance, medical equipment, professional car,
and other expense. Table 9 presents a listing of the MEI cost
categories with associated weights and percent changes for price
proxies for the 2002 update. The calendar year 2002 MEI is 2.6 percent.
Table 9.--Increase in the Medicare Economic Index Update for Calendar
Year 2002 \1\
------------------------------------------------------------------------
CY 2002
Cost categories and price measures 1996 Weights percent
\2\ changes
------------------------------------------------------------------------
Medicare Economic Index Total........... 100.0 2.6
1. Physician's Own Time \3\ \4\..... 54.5 2.1
[[Page 55313]]
a. Wages and Salaries: Average 44.2 2.0
hourly earnings private
nonfarm, net of productivity...
b. Fringe Benefits: Employment 10.3 3.2
Cost Index, benefits, private
nonfarm, net of productivity...
2. Physician's Practice Expense \3\ 45.5 3.0
\4\................................
a. Nonphysician Employee 16.8 2.5
Compensation...................
1. Wages and Salaries: 12.4 2.3
Employment Cost Index,
wages and salaries,
weighted by occupation, net
of productivity............
2. Fringe Benefits: 4.4 3.7
Employment Cost Index,
fringe benefits, white
collar, net of productivity
b. Office Expense: Consumer 11.6 4.2
Price Index forUrban Consumers
(CPI-U), housing...............
c. Medical Materials and 4.5 1.8
Supplies: Producer Price Index
(PPI), ethical drugs/PPI,
surgical appliances and
supplies/CPI-U, medical
equipment and supplies (equally
weighted)......................
d. Professional Liability 3.2 4.0
Insurance: HCFA professional
liability insurance survey \5\.
e. Medical Equipment: PPI, 1.9 0.6
medical instruments and
equipment......................
f. Other Professional Expense... 7.6 2.8
1. Professional Car: CP-U, 1.3 3.9
private transportation.....
Other: CPI-U, all items less 6.3 2.6
food and energy............
Addendum:
Productivity: 10-year moving average n/a 2.0
of output per man-hour, nonfarm
business sector....................
Physician's Own Time, not 54.5 4.3
productivity adjusted..............
Wages and salaries, not 44.2 4.1
productivity adjusted..........
Fringe benefits, not 10.3 5.3
productivity adjusted..........
Nonphysician Employee Compensation, 16.8 4.7
not productivity adjusted..........
Wages and salaries, not 12.4 4.3
productivity adjusted..........
Fringe benefits, not 4.4 5.9
productivity adjusted..........
------------------------------------------------------------------------
\1\ The rates of historical change are for the 12-month period
endingJune 30, 2001, which is the period used for computing the
calendar year 2002 update. The price proxy values are based upon the
latest available Bureau of Labor Statistics data as of September 18,
2001.
\2\ The weights shown for the MEI components are the 1996 base-year
weights, which may not sum to subtotals or totals because of rounding.
The MEI is a fixed-weight, Laspeyres-type input price index whose
category weights indicate the distribution of expenditures among the
inputs to physicians' services for calendar year 1996. To determine
the MEI level for a given year, the price proxy level for each
component is multiplied by its 1996 weight. The sum of these products
(weights multiplied by the price index levels) over all cost
categories yields the composite MEI level for a given year. The annual
percent change in the MEI levels is an estimate of price change over
time for a fixed market basket of inputs to physicians' services.
\3\ The Physician's Own Time and Nonphysician Employee Compensation
category price measures include an adjustment for productivity. The
price measure for each category is divided by the 10-year moving
average of output per man-hour in the nonfarm business sector. For
example, the fringe benefits component of the Physician's Own Time
category is calculated by dividing the rate of growth in the
employment cost index-benefits for private, nonfarm workers by the 10-
year moving average rate of growth of output per man-hour for the
nonfarm business sector. Dividing one plus the decimal form of the
percent change in the employment cost index-benefits (1+.053=1.053) by
one plus the decimal form of the percent change in the 10-year moving
average of labor productivity(1+.020=1.020) equals one plus the change
in the employment cost index-benefits for white collar workers net of
the change in output per manhour (1.053/1.020=1.032). All Physician's
Own Time and Nonphysician Employee Compensation categories are
adjusted in this way. Due to a higher level of precision the computer
calculated quotient may differ from the quotient calculated from
rounded individual percent changes.
\4\ The measures of productivity, average hourly earnings, Employment
Cost Indexes, as well as the various Producer and Consumer Price
Indexes can be found on the Bureau of Labor Statistics website--http://stats.bls.gov.
\5\ Derived from a CMS survey of several major insurers (the latest
available historical percent change data are for the period ending
second quarter of 2001).
\n/a\ Productivity is factored into the MEI compensation categories as
an adjustment to the price variables; therefore, no explicit weight
exists for productivity in the MEI.
C. The Update Adjustment Factor
Paragraphs (3) and (4) of section 1848(d)(3) of the Act indicate
that the physician fee schedule update is equal to the product of the
Medicare Economic Index and an ``update adjustment factor.'' The update
adjustment factor is applied to the inflation update to reflect success
or failure in meeting the expenditure target that the law refers to as
``allowed expenditures.'' Allowed expenditures are equal to actual
expenditures in a base period updated each year by the sustainable
growth rate (SGR). The SGR is a percentage increase that is determined
by a formula specified in section 1848(f) of the Act. The next section
of this final rule describes the SGR and its calculation in detail. The
update adjustment factor is determined based on a comparison of actual
and allowed expenditures. For years beginning with 1999, the BBA
required that the update adjustment factor be determined under section
1848(d)(3) of the Act to equal--
The difference between (1) the sum of the allowed
expenditures for physicians' services (as determined under subparagraph
(C)) for the period beginning April 1, 1997, and ending on March 31 of
the year involved, and (2) the amount of actual expenditures for
physicians' services furnished during the period beginning April 1,
1997, and ending on March 31 of the preceding year; divided by--
The actual expenditures for physicians' services for the
12-month period ending on March 31 of the preceding year, increased by
the sustainable growth rate under subsection (f) for the fiscal year
which begins during such 12-month period.
The BBRA made changes to the methodology for determining the
physician fee schedule update beginning in 2001. In particular, it
established that the methodology in section 1848(d)(3) of the Act would
only be used for determining the physician fee schedule update for 1999
and 2000; the physician fee schedule update for 2001 and subsequent
years is determined under section 1848(d)(4) of the Act. While the
general principle of adjusting the inflation update (the MEI) based on
a comparison of actual and target expenditures (the update adjustment
factor) is continuing, the BBRA made fundamental changes to the
calculation of the update adjustment factor. These changes do two
things. First, the measurement of actual
[[Page 55314]]
expenditures will occur on the basis of a calendar year rather than a
April 1 to March 31 year. This essentially conforms the measurement of
actual expenditures with other aspects of the SGR system that are also
occurring on the basis of a calendar year as a result of BBRA
amendments. As explained in our April 10, 2000 SGR notice (65 FR
19000), the BBRA essentially changed the SGR system from one that
spanned 3 different time periods (1--Measurement of actual expenditures
on the basis of a April 1 to March 31 period; 2--calculation of the SGR
rate of increase on a Federal fiscal year basis; and 3--application of
the update on a calendar year basis) to one that spans only one time
period (all three elements are computed on the basis of a calendar
year). Second, it ensures that any deviation between cumulative actual
expenditures and cumulative allowed expenditures will be corrected over
several years rather than in a single year. This will result in less
year-to-year volatility in the physician fee schedule update than will
occur if adjustments to the update are made to bring expenditures in
line with the target in one year.
Under section 1848(d)(4)(A) of the Act, the physician fee schedule
update for a year is equal to the product of--(1) 1 plus the
Secretary's estimate of the percentage increase in the MEI for the
year, and (2) 1 plus the Secretary's estimate of the update adjustment
factor for the year. Under section 1848(d)(4)(B) of the Act, the update
adjustment factor for a year beginning with 2001 is equal to the sum of
the following--
Prior Year Adjustment Component. An amount determined by--
+ Computing the difference (which may be positive or negative)
between the amount of the allowed expenditures for physicians' services
for the prior year (the year prior to the year for which the update is
being determined) and the amount of the actual expenditures for such
services for that year;
+ Dividing that difference by the amount of the actual expenditures
for such services for that year; and
+ Multiplying that quotient by 0.75.
Cumulative Adjustment Component. An amount determined by--
+ Computing the difference (which may be positive or negative)
between the amount of the allowed expenditures for physicians' services
from April 1, 1996 through the end of the prior year and the amount of
the actual expenditures for such services during that period;
+ Dividing that difference by actual expenditures for such services
for the prior year as increased by the sustainable growth rate for the
year for which the update adjustment factor is to be determined; and
+ Multiplying that quotient by 0.33.
Section 1848(d)(4)(D) of the Act indicates that the update
adjustment factor determined under section 1848(d)(4)(B) for a year may
not be less than -0.07 or greater than 0.03. At this time, we estimate
that the sum of the prior year and cumulative adjustment components
will be less than -0.07 limit. In a letter to the Medicare Payment
Advisory Commission and in data we made available to the public on the
CMS website in March, we indicated that the estimated update adjustment
factor for 2002 would be -1.5 percent. However, we also indicated that
a number of factors could change our estimate of the update adjustment
factor. Since our March estimate, a number of factors have changed that
lower our estimate of allowed expenditures and increase our estimate of
actual expenditures. Allowed expenditures have declined because real
per capita gross domestic product (GDP) growth for 2000 is lower than
the estimates in March. This occurs because of changes to economic
figures for 2000 made at the Bureau of Economic Analysis. Further,
current estimates of real GDP per capita growth for 2001 and 2002 are
lower than in March. We provide a more detailed explanation of factors
that affect our estimate of allowed expenditures in the next section of
this final regulation on the SGR. An explanation of changes to actual
expenditures follows.
As indicated above, we are currently estimating higher 2001 actual
expenditures than we did in March. We did not have any Medicare claims
data to develop our March estimates of actual expenditures for 2001. At
this time, we are using claims received through June 30 to estimate
actual expenditures for all of 2001. Based on the claims received in
the first half of the year, our current estimates of actual
expenditures for 2001 are higher than earlier estimates. We will be
revising the measurement of actual expenditures for CY 2001 based on
claims received through June 30, 2002. These revised figures will be
determined no later than November 1, 2002. If the revised figures are
different than current estimates, the difference will be reflected in
the update adjustment factor used in determining the 2003 physician fee
schedule update.
After taking into account the factors described above that affect
allowed and actual expenditures, we originally estimated that the
update adjustment factor for 2002 would be -5.4 percent or 1.6
percentage points more than the -7.0 percent limit on the update
adjustment factor. However, in making updates to the list of codes that
are included in the SGR, we discovered that a number of new procedure
codes were inadvertently not included in the measurement of actual
expenditures beginning in 1998. Therefore, the measurement of actual
expenditures for 1998, 1999, and 2000 was lower than it should have
been. As a result, the physician fee schedule update was higher in 2000
and 2001 than if we had included these codes. Including these codes in
the measurement of actual expenditures results in a lower update
adjustment factor than we earlier estimated. We will be making no
changes to physician fee schedule payments made for services furnished
in 2000 and 2001. However, under section 1848(d) of the Act, we must
include these codes in the measurement of actual expenditures for
historical, current, and future periods. While we do not currently know
the precise effect of not measuring expenditures for all codes included
in the SGR on the update adjustment factor for 2002, we are certain
that it is in excess of 1.6 percentage points and is of sufficient
magnitude to result in the update adjustment factor being less than the
-7.0 percent statutory limit. In the near future, we expect to complete
this analysis and update information that we make available on the CMS
website. We plan to provide complete data that show quarterly allowed
and actual expenditures for all procedure codes included in the SGR, as
well as a list of the codes themselves.
Section 1848(d)(4)(A)(ii) of the Act indicates that 1 should be
added to the update adjustment factor determined under section
1848(d)(4)(B) of the Act. Thus, adding 1 to -0.070 makes the update
adjustment factor equal to 0.930.
(As indicated in the SGR discussion below, allowed expenditures
through the end of CY 2001 will be revised one more time, not later
than November 1, 2002. We will also be revising the measurement of
actual expenditures for CY 2001 based on claims received through June
30, 2002, not later than November 1, 2002. The SGR for 2001 will also
be revised one more time, and the SGR for 2002 will be revised two more
times. The resulting effect from revisions of estimates will be
reflected in the update adjustment factor determined for 2003.)
[[Page 55315]]
VIII. Allowed Expenditures for Physicians' Services and the
Sustainable Growth Rate
A. Medicare Sustainable Growth Rate
Section 1848(f) of the Act, as amended by section 4503 of the BBA,
replaced the Medicare Volume Performance Standard (MVPS) with a
Sustainable Growth Rate (SGR). Section 1848(f)(2) of the Act specifies
the formula for establishing yearly SGR targets for physicians'
services under Medicare. The use of SGR targets is intended to control
the actual growth in aggregate Medicare expenditures for physicians'
services.
The SGR targets are not limits on expenditures. Payments for
services are not withheld if the SGR target is exceeded by actual
expenditures. Rather, the appropriate fee schedule update, as specified
in section 1848(d)(3) of the Act, is adjusted to reflect the success or
failure in meeting the SGR target. If expenditures exceed the target,
the update is reduced. If expenditures are less than the target, the
update is increased.
As with the MVPS, the statute specifies a formula to calculate the
SGR based on our estimate of the change in each of four factors. The
four factors for calculating the SGR are as follows--
(1) The estimated change in fees for physicians' services.
(2) The estimated change in the average number of Medicare fee-for-
service beneficiaries.
(3) The estimated projected growth in real GDP per capita.
(4) The estimated change in expenditures due to changes in law or
regulations.
Section 211 of the BBRA amended sections 1848(d) and 1848(f) of the
Act with respect to the physician fee schedule update and the SGR.
Section 211(b) of the BBRA maintains the formula for calculating the
SGR, but amends section 1848(f)(2) of the Act to apply the SGR on a
calendar year (CY) basis beginning with 2000 while maintaining the SGR
on a fiscal year (FY) basis for FY 1998 through FY 2000. Specifically,
section 1848(f)(2) of the Act, as amended by section 211(b) of the
BBRA, states that ``* * * [t]he sustainable growth rate for all
physicians' services for a fiscal year (beginning with fiscal year 1998
and ending with fiscal year 2000) and a year beginning with 2000 shall
be equal to the product of--
(1) 1 plus the Secretary's estimate of the weighted average
percentage increase (divided by 100) in the fees for all physicians'
services in the applicable period involved,
(2) 1 plus the Secretary's estimate of the percentage change
(divided by 100) in the average number of individuals enrolled under
this part (other than Medicare+Choice plan enrollees) from the previous
applicable period to the applicable period involved,
(3) 1 plus the Secretary's estimate of the projected percentage
growth in real gross domestic product per capita (divided by 100) from
the previous applicable period to the applicable period involved; and
(4) 1 plus the Secretary's estimate of the percentage change
(divided by 100) in expenditures for all physicians' services in the
applicable period (compared with the previous applicable period) which
will result from changes in law and regulations, determined without
taking into account estimated changes in expenditures resulting from
the update adjustment factor determined under section 1848 (d)(3)(B) or
(d)(4)(B) of the Act, as the case may be, minus 1 and multiplied by
100.''
Under section 1848(f)(4)(C) of the Act, the term ``applicable
period'' means--(1) a FY, in the case of FY 1998, FY 1999 and FY 2000,
and (2) a CY with respect to a year beginning with 2000.
Section 1848(d)(4)(C) of the Act requires us to make the transition
from a FY SGR to a CY SGR in 1999 by using the FY 1999 SGR for the
first 3 months of 1999 and the FY 2000 SGR for the 9-month period
beginning April 1, 1999. Allowed expenditures for the year are equal to
the sum of allowed expenditures for each respective period. The SGR for
CY 2000 is then applied to allowed expenditures for CY 1999.
As stated in the April 10, 2000 final notice (65 FR 19000), the
BBRA requires the estimates of the FY 2000 and CY 2000 SGRs to be
revised based on more recent data, but, as explained below, the BBRA
does not provide for revision of either the FY 1998 or the FY 1999 SGR.
This means that, for the transition to a calendar year SGR system,
allowed expenditures for the period April 1, 1999 through December 31,
1999 (determined by applying the FY 2000 SGR to allowed expenditures
for the 12-month period ending March 31, 1999) are subject to change
based on revision of the FY 2000 SGR; allowed expenditures for the
period January 1, 1999 through March 31, 1999 (determined using the FY
1999 SGR) are not subject to revision.
In general, the BBRA requires us to publish SGRs for 3 different
time periods, no later than November 1 of each year, using the best
data available as of September 1 of each year. Under section
1848(f)(3)(C)(i) of the Act, as added by section 211(b)(5) of the BBRA,
the SGR is estimated and subsequently revised twice (beginning with the
FY and CY 2000 SGRs) based on later data. Under section
1848(f)(3)(C)(ii) of the Act, there are no further revisions to the SGR
once it has been estimated and subsequently revised in each of the 2
years following the initial estimate.
The requirement of revisions to the SGR based on later data means
that we will estimate and publish an SGR for the upcoming year, the
contemporaneous year, and the preceding year by no later than November
1 of each year. For example, by no later than November 1, 2002, we will
publish an estimate of the SGR for CY 2003, a revision of the CY 2002
SGR that is first being estimated in this notice, and a revision of the
CY 2001 SGR first estimated in the final rule published on November 2,
2000 (65 FR 65429) and revised in this final rule. Under section
1848(f)(3)(C)(ii) of the Act, the final revision to the CY 2001 SGR
will be announced in the Federal Register no later than November 1,
2002.
Subparagraphs (A) and (B) of section 1848(f)(3) of the Act, specify
special rules with respect to the SGR and the CY 2001 and CY 2002
updates. Section 1848(f)(3)(A) of the Act required us, no later than
November 1, 2000, to revise the SGRs for FY 2000 and CY 2000 and to
establish the SGR for CY 2001, based on the best data available, as of
September 1, 2000. We published our first estimate of the SGRs for FY
2000 and CY 2000 in a Federal Register notice on April 10, 2000 (65 FR
19000). Revised estimates of the SGRs for FY 2000 and CY 2000 and our
original estimate of the SGR for CY 2001 appeared in the Federal
Register on November 1, 2000 (65 FR 65429). We used each of the SGRs
published in the November 1, 2000 Federal Register to determine the
physician fee schedule update for 2001. Section 1848(f)(3)(B) of the
Act requires us, by no later than November 1, 2001, to revise the SGRs
for FY 2000 and CYs 2000 and 2001 and establish the SGR for CY 2002,
based on the best data available as of September 1, 2001 and to use
each of these SGRs to determine the physician fee schedule update for
2002. We are using each of the SGRs established in this notice to
determine the 2002 physician fee schedule update. In accordance with
section 1848(f)(3)(C)(ii) of the Act, there will be no further
revisions to the FY 2000 and CY 2000 SGRs after the revisions we are
making in this final rule.
B. Physicians' Services
Section 1848(f)(4)(A) of the Act defines the scope of physicians'
services
[[Page 55316]]
covered by the SGR. The statute indicates that the term ``physicians'
services'' includes other items and services (such as clinical
diagnostic laboratory tests and radiology services), specified by the
Secretary, that are commonly performed or furnished by a physician or
in a physician's office, but does not include services furnished to a
Medicare+Choice plan enrollee. The BBA and BBRA made no changes to this
definition which was also used for the MVPS. We published a definition
of physicians' services for use in the MVPS and subsequent SGR in the
Federal Register (61 FR 59717) on November 22, 1996. We defined
``physicians' services'' to include many of the medical and other
health services listed in section 1861(s) of the Act. Since the statute
has made a number of changes to the definition of medical and other
health services included in section 1861(s), we are updating our
definition of physicians' services consistent with the statutory
changes. Our practice has been to make adjustments to the SGR for
medical and other health services added to the statute that meet the
criterion of being ``commonly performed by a physician or a physicians'
office.'' For instance, the BBA and the BIPA amended section 1861(s) of
the Act to add new preventive benefits to the Medicare statute. Since
these preventive services are generally provided by physicians or in
physicians' offices, we made adjustments to the SGR to reflect
additional Medicare expenditures for the newly-added Medicare benefits.
Physicians' services for the SGR include the following medical and
other health services if bills for the items and services are processed
and paid by Medicare carriers:
Physicians' services.
Services and supplies furnished incident to physicians'
services.
Outpatient physical therapy services and outpatient
occupational therapy services.
Antigens prepared by or under the direct supervision of a
physician.
Services of physician assistants, certified registered
nurse anesthetists, certified nurse midwives, clinical psychologists,
clinical social workers, nurse practitioners, and clinical nurse
specialists.
Screening tests for prostate cancer, colorectal cancer,
glaucoma.
Screening mammography, screening pap smears and screening
pelvic exams.
Diabetes outpatient self-management training services.
Medical nutrition therapy services.
Diagnostic x-ray tests, diagnostic laboratory tests and
other diagnostic tests.
X-ray, radium, and radioactive isotope therapy.
Surgical dressings, splints, casts, and other devices used
for the reduction of fractures and dislocations.
Bone mass measurements.
C. Provisions Related to the SGR
Section 211(b)(1) of the BBRA amends section 1848(f)(1) of the Act
to require that SGR estimates be published in the Federal Register not
later than November 1 of every year. In this notice, we are publishing
our initial estimate of the SGR for 2002, a revised estimate of the SGR
for 2001 and final estimates of the SGRs for FY and CY 2000.
In general, the update for a year is based on the Medicare Economic
Index (MEI) as adjusted, within bounds, by the amount of actual
expenditures for physicians' services compared to target (referred to
as ``allowed'' in the statute) expenditures. A key difference between
the MVPS and the SGR is that the comparison of actual and allowed
expenditures is made on a cumulative basis under the SGR, while it was
made on an annual basis under the MVPS. The ``update adjustment
factor'' in section 1848(d)(4)(B) of the Act is an adjustment to the
MEI that reflects the difference between actual expenditures and target
expenditures.
Section 1848(d)(3)(C) of the Act, as modified by the BBA, defines
allowed expenditures for the 12-month period ending March 31, 1997 to
be equal to actual expenditures for physicians' services during that
period (that is, April 1, 1996 through March 31, 1997), as we have
estimated. Section 1848(d)(3)(C) of the Act defines allowed
expenditures for subsequent 12-month periods to be equal to allowed
expenditures for physicians' services for the previous year increased
by the SGR for the FY which begins during the 12-month period. For
example, allowed expenditures for the 12-month period April 1, 1997
through March 31, 1998 are equal to allowed expenditures for the 12
months ending March 31, 1997, increased by the SGR for FY 1998. The
BBRA subsequently provided for a transition to a calendar year SGR
system in 1999. Allowed expenditures for the first quarter of 1999 are
determined using the FY 1999 SGR and allowed expenditures for the April
1, 1999 to December 31, 1999 period are determined using the FY 2000
SGR. Allowed expenditures in 2000 are equal to 1999 allowed
expenditures increased by the 2000 SGR. Allowed expenditures for each
subsequent year will equal expenditures from the prior year updated by
the SGR.
Table 10 shows annual and cumulative allowed expenditures for
physicians' services for each of the 12-month periods between April 1,
1996 and March 31, 2000, for 1999 and 2000.
Table 10
----------------------------------------------------------------------------------------------------------------
Cumulative
Annual allowed allowed
Period expenditures expenditures FY or CY SGR
(in billions) (in billions)
----------------------------------------------------------------------------------------------------------------
4/1/96-3/31/97........................... $48.9 $48.9 N/A
4/1/97-3/31/98........................... 49.6 98.5 FY 1998=1.5%
4/1/98-3/31/99........................... 49.4 47.9 FY 1998=-0.3%
1/1/99-3/31/99........................... 12.5 \(1)\ FY 1999=-0.3%
4/1/99-12/31/99.......................... 39.6 \(2)\ FY 2000=6.9%
1/1/99-12/31/99.......................... 52.1 187.6 FY 1999/FY 2000
1/1/00-12/31/00.......................... 55.9 243.5 CY 2000=7.3%
1/1/01-12/31/01.......................... 59.3 302.7 CY 2001=6.1%
1/1/02-12/31/02.......................... 62.6 365.3 CY 2002=5.6%
----------------------------------------------------------------------------------------------------------------
\1\ Included in $147.9 above.
\2\ Included in $187.6 below.
[[Page 55317]]
Note: Allowed Expenditures for the first quarter of 1999 are
based on the FY 1999 SGR and allowed expenditures for the last three
quarters of 1999 are based on the FY 2000 SGR.
Allowed Expenditures in the First Year
(April 1, 1996-March 31, 1997) are equal to actual expenditures.
All subsequent figures are equal to quarterly allowed expenditure
figures increased by the applicable SGR. Cumulative allowed
expenditures are equal to the sum of annual allowed expenditures. We
provide more detailed quarterly allowed and actual expenditure data on
the CMS website under the Medicare Actuary's publications at the
following address: http://www.hcfa.gov/pubforms/actuary/. We expect to
update this information in November.
Allowed expenditures for the April 1, 1999 through the December 31,
1999 period are based on the FY 2000 SGR. As previously discussed,
section 1848(f)(3) of the Act requires two revisions to the FY and CY
2000 SGR. We made the first revision to the FY and CY 2000 SGR in the
physician fee schedule final rule published in the Federal Register on
November 1, 2000 (65 FR 65427). We are making the second and final
revision in this final rule. Consistent with section 1848(f)(3)(B) of
the Act, the revised FY and CY 2000 SGR uses the best data available to
us as of September 1, 2001.
D. Preliminary Estimate of the SGR for 2002
According to subparagraphs (A) through (D) of section 1848(f)(2) of
the Act, as amended by section 211(b) of the BBRA, we have determined
the preliminary estimate of the CY 2002 SGR to be 5.6 percent. We first
estimated the CY 2002 SGR in March and made the estimate available to
the Medicare Payment Advisory Commission and our website. Our March and
current estimates of the four statutory factors are indicated in table
11:
Table 11
------------------------------------------------------------------------
March Current
Statutory factors estimate estimate
------------------------------------------------------------------------
Fees.............................................. 1.6 2.3
Enrollment........................................ 0.4 0.7
Real Per Capita GDP............................... 2.4 1.7
Law and Regulation................................ 1.5 0.8
---------------------
Total......................................... 6.0 5.6
------------------------------------------------------------------------
Note: Consistent with section 1848(f)(2) of the Act, the
statutory factors are multiplied, not added, to produce the total
(that is, 1.023 x 1.007 x 1.017 x 1.008 = 1.056.) A more
detailed explanation of each figure is provided below in section
H.1.
E. Sustainable Growth Rate for CY 2001
According to subparagraphs (A) through (D) of section 1848(f)(2) of
the Act, as amended by section 211(b) of the BBRA, our current estimate
of the CY 2001 SGR is 6.1 percent. Table 12 shows our original estimate
of the CY 2001 SGR published in the Federal Register on November 1,
2000 (65 FR 65433) and current estimates of the four statutory factors
that determine the CY 2001 SGR:
Table 12
------------------------------------------------------------------------
11/1/00 Current
Statutory factors estimate estimate
------------------------------------------------------------------------
Fees.............................................. 1.9 1.9
Enrollment........................................ 0.9 3.0
Real Per Capita GDP............................... 2.7 0.7
Law and Regulation................................ 0.0 0.4
---------------------
Total......................................... 5.6 6.1
------------------------------------------------------------------------
A more detailed explanation of each figure is provided below in
section H.2.
F. Sustainable Growth Rate for CY 2000
According to subparagraphs (A) through (D) of section 1848(f)(2) of
the Act, as amended by section 211(b) of the BBRA, our current estimate
of the CY 2000 SGR is 7.3 percent. Table 13 shows estimates included in
the November 1, 2000 Federal Register (65 FR 65433) and current
estimates of the four statutory factors that determine the CY 2000 SGR:
Table 13
------------------------------------------------------------------------
11/1/00 Current
Statutory factors estimate estimate
------------------------------------------------------------------------
Fees.............................................. 2.1 2.1
Enrollment........................................ 1.0 1.0
Real Per Capita GDP............................... 4.3 3.2
Law and Regulation................................ 0.5 0.8
---------------------
Total......................................... 8.1 7.3
------------------------------------------------------------------------
A more detailed explanation of each figure is provided below in
section H.3.
G. Sustainable Growth Rate for FY 2000
According to subparagraphs (A) through (D) of section 1848(f)(2) of
the Act, as amended by section 211(b) of the BBRA, our current estimate
of the FY 2000 SGR is 6.9 percent. Table 14 shows estimates included in
the November 1, 2000 Federal Register (65 FR 65433) and current
estimates of the four statutory factors that determine the FY 2000 SGR:
Table 14
------------------------------------------------------------------------
11/1/00 Current
Statutory factors estimate estimate
------------------------------------------------------------------------
Fees.............................................. 2.1 2.1
Enrollment........................................ 0.8 0.5
Real Per Capita GDP............................... 4.5 3.6
Law and Regulation................................ 0.3 0.6
---------------------
Total......................................... 7.9 6.9
------------------------------------------------------------------------
A more detailed explanation of each figure is provided below in
section H.3.
H. Calculation of the FY 2000, CY 2000, CY 2001, and CY 2002
Sustainable Growth Rates
1. Detail on the CY 2002 SGR
A more detailed discussion of our preliminary estimates of the four
elements of the 2002 SGR follows.
Factor 1--Changes in Fees for Physicians' Services (Before Applying
Legislative Adjustments) for CY 2002
This factor was calculated as a weighted average of the CY 2002 fee
increases that apply for the different types of services included in
the definition of physicians' services for the SGR.
Physicians' services as defined in sections 1861(s)(1) and (2) of
the Act represent approximately 89 percent of allowed charges for
physicians' services under the SGR and are updated by the Medicare
Economic Index (MEI). Our current estimate of the MEI for 2002 is 2.6
percent. Diagnostic laboratory tests represent approximately 11 percent
of the Medicare allowed charges for physicians' services under the SGR.
The BBA provided for a 0.0 percent update for CY 2002 for laboratory
services. Table 15 shows both the physicians' and laboratory service
updates that were used to determine the percentage increase in
physicians' fees for CY 2002.
Table 15
------------------------------------------------------------------------
Weight Update
------------------------------------------------------------------------
Physician........................................ 0.89 2.6
Laboratory....................................... 0.11 0.0
Weighted Average................................. 1.0 2.3
------------------------------------------------------------------------
After taking into account the elements described in the table, we
estimate that the weighted-average increase in fees for CY 2002 for
physicians' services under the SGR (before applying any legislative
adjustments) will be 2.3 percent.
Factor 2--The Percentage Change in the Average Number of Part B
Enrollees From CY 2001 to CY 2002
This factor is our estimate of the percent change in the average
number of
[[Page 55318]]
fee-for-service enrollees for CY 2002 as compared to CY 2001
Medicare+Choice (M+C) plan enrollees, whose Medicare-covered medical
care is outside the scope of the SGR, and who are excluded from this
estimate. Our actuaries estimate that the average number of Medicare
Part B fee-for-service enrollees (excluding beneficiaries enrolled in
M+C plans) will increase by 0.7 percent in calendar year 2002. This
estimate was derived by subtracting estimated M+C enrollment from
estimated overall Medicare enrollment as illustrated in table 16.
Table 16
[In millions]
------------------------------------------------------------------------
2001 2002
------------------------------------------------------------------------
Overall........................................... 37.828 38.149
Medicare+Choice................................... 5.662 5.761
Net............................................... 32.166 32.388
Percent Increase:................................. ......... 0.7
------------------------------------------------------------------------
Since 2002 has yet to begin, we currently only have estimates of
this figure for 2002. An important factor affecting fee-for-service
enrollment is beneficiary enrollment in Medicare+Choice plans. At this
time, we do not know how actual enrollment in Medicare+Choice plans
will compare to current estimates. While we do receive information on
whether a Medicare+Choice plan will continue to participate or withdraw
from the program, it remains difficult to estimate the number of
beneficiaries who will select a Medicare+Choice plan or fee-for-service
before the start of the calendar year. While some plans will no longer
offer a Medicare+Choice plan, other plans are available as an option to
most beneficiaries in areas where there have been plan withdrawals. It
is difficult to estimate the size of the Medicare+Choice enrollee
population before the start of a calendar year. Because we determine
the fee-for-service enrollment figure net of the change in
Medicare+Choice enrollment, early estimates of this factor are
difficult to make. Our estimate of this factor is preliminary and only
has minimal effect on the physician fee schedule update for CY 2002.
The CY 2002 SGR will also be used in the calculation of the 2003
physician fee schedule update in a final rule to be published no later
than November 1, 2002. By that time, we will have information on actual
enrollment in Medicare+Choice plans for the first 8 months of CY 2002
and will be better able to predict the change in fee-for-service
enrollment for the year.
Factor 3--Estimated Real Gross Domestic Product Per Capita Growth in CY
2002
Section 1848(f)(2)(C) of the Act, as amended by section 211 of the
BBRA, requires us to estimate growth in real GDP per capita. This
factor is applied on a CY basis beginning with the CY 2000 SGR. We
estimate that the growth in real per capita GDP will be 1.7 percent in
CY 2002. Our past experience indicates that there have also been large
changes in estimates of real per capita GDP growth and the actual
change in this factor. It is likely that this figure will change
further as actual information on economic performance becomes available
to us in 2002. Again, we note that we will use revised estimates of
real per capita GDP growth in setting future year updates.
Factor 4--Percentage Change in Expenditures for Physicians' Services
Resulting From Changes in Law or Regulations in CY 2002 Compared With
CY 2001
Sections 101 through 104 of BIPA added Medicare coverage for
screening glaucoma, authorized Medicare to pay for specific new
technology mammography services, and changed coverage for screening pap
smears, screening pelvic exams, and screening colonoscopy for average-
risk individuals. In addition, section 105 of the BIPA also establishes
a new benefit for medical nutrition therapy and expands access to
telehealth services in section 223. Section 432 of the BIPA also
requires that Medicare make payment to Indian Health Service hospitals
and ambulatory clinics for physicians' and practitioners' services as
well as outpatient physical and occupational therapy services that are
included in the definition of physicians' services for purposes of the
SGR. Since these provisions will increase Medicare expenditures for
services that are included in the SGR, we are making an upward
adjustment to reflect additional Medicare expenditures in 2002. Our
estimates of the cost of these provisions for the period FY 2002-FY
2006 are included in our Notice of Proposed Rulemaking published in the
Federal Register on August 2, 2001 (66 FR 40400).
We are making an adjustment to the SGR for one additional factor.
In section VI.B. of this final rule, we provided a definition of
physicians' services for purposes of the SGR. Historically, we have not
measured expenditures for screening mammography under the SGR. However,
section 1848(f)(4) of the Act indicates that ``physicians'' services
includes other items and services (such as clinical diagnostic
laboratory tests and radiology services), specified by the Secretary,
that are commonly performed or furnished by a physician or in a
physician's office.'' Screening mammography services are ``radiology
services'' that are performed by ``physicians or in a physician's
office.'' As a result, we are using this rule to add screening
mammography to the list of services that are part of the SGR
definition. Since we have not previously measured expenditures for
screening mammography services under the SGR, it is appropriate to make
an adjustment to this factor for the change to the definition of
physicians' services. We are making an adjustment that reflects
estimated payments for screening mammography services in CY 2002. We
will make a subsequent revision based on actual expenditures for
screening mammography.
After taking these provisions into account, the percentage change
in expenditures for physicians' services resulting from changes in law
or regulations is estimated to be 0.8 percent for 2002. In March, we
estimated that this figure would be 1.5 percent. The 0.7 percentage
point difference is due to a change in our estimate of the BIPA
provisions. In March, we had no information about implementation of
these provisions. We used updated assumptions about pricing and
utilization based on proposed policies published in the August 2, 2001
proposed rule (66 FR 40400).
2. Detail on the CY 2001 SGR
A more detailed discussion of our current estimates of the four
elements of the 2001 SGR follows.
Factor 1--Changes in Fees for Physicians' Services (Before Applying
Legislative Adjustments) for CY 2001
We are continuing to use 1.9 percent for this element of the SGR
for the CY 2001 SGR. This factor is unchanged from earlier estimates
previously described for CY 2001 in the November 1, 2000 Federal
Register (65 FR 65433).
Factor 2--The Percentage Change in the Average Number of Fee-for-
Service Part B Enrollees From CY 2000 to CY 2001
This factor is our estimate of the percent change in the average
number of fee-for-service enrollees for CY 2001 as compared to CY 2000.
As we indicated above, this factor is difficult to estimate prior to
the beginning of the period for which the estimates are being made
because of the interaction of the fee-for-service and Medicare+Choice
program and the lack of availability of actual data
[[Page 55319]]
on beneficiary selection of Medicare+Choice enrollment. We currently
have information on actual enrollment in the Medicare+Choice program
for CY 2001 and CY 2000 that permits estimates of the change in fee-
for-service enrollment for these years that will be more reflective of
the final actual enrollment and percent year-to-year change. The
estimates for CY 2000 and CY 2001 were derived by subtracting estimated
M+C enrollment from estimated overall Medicare enrollment as
illustrated in table 17.
Table 17
[In millions]
------------------------------------------------------------------------
2000 2001
------------------------------------------------------------------------
Overall........................................... 37.453 37.828
Medicare+Choice................................... 6.233 5.662
Net............................................... 31.221 32.166
Percent Increase.................................. ......... 3.0
------------------------------------------------------------------------
Our actuaries estimate of the percent change in the average number
of fee-for-service enrollees net of Medicare+Choice enrollment for 2001
compared to 2000 of 3.0 percent is more than our early estimate of this
factor (0.9 percent for CY 2001 from the November 1, 2000 Federal
Register (65 FR 65433)) because the historical base from which our
actuarial estimate is made has changed. We currently have complete
information on Medicare fee-for-service enrollment for 2000 that is
lower than the figure we used one year ago. Further, we now have
information on actual fee-for-service enrollment for the first 8 months
of 2001. This figure is slightly higher than the figure used in the
November 1, 2000 Federal Register (65 FR 65433). We would caution that
our estimate of fee-for-service enrollment for 2001 may change once we
have complete information for the entire year.
Factor 3--Estimated Real Gross Domestic Product Per Capita Growth in CY
2001
Section 1848(f)(2)(C) of the Act, as amended by section 211 of the
BBRA, requires us to estimate growth in real GDP per capita. We
estimate that the growth in real per capita GDP will be 0.7 percent in
CY 2001. There have also been large changes in initial estimates of
real per capita GDP growth and the actual change in this factor. There
could be further changes in this factor once we have complete
information on economic performance for the entire year. Again, we note
that we will use revised estimates of real per capita GDP growth in
setting future year updates.
Factor 4--Percentage Change in Expenditures for Physicians' Services
Resulting From Changes in Law or Regulations in CY 2001 Compared With
CY 2000
As described above, the BIPA makes changes to the Act that affect
Medicare expenditures for services that are included in the SGR. Some
of these provisions have no effect on Medicare expenditures in 2001
because they do not go into effect until 2002. Other provisions are
effective at some time during 2001. Provisions that become effective in
2001 relate to new technology mammography and coverage changes for
screening pap smears, screening pelvic exams and screening colonoscopy,
expanded access to telehealth services and Medicare payment for
services provided in Indian Health Service hospitals and clinics. After
taking these provisions into account, the percentage change in
expenditures for physicians' services resulting from changes in law or
regulations is estimated to be 0.4 percent for 2001.
3. Detail on Calculation of the FY 2000 and CY 2000 SGRs
A more detailed discussion of our revised estimates of the four
elements of the FY 2000 and CY 2000 SGRs follows.
Factor 1--Changes in Fees for Physicians' Services (Before Applying
Legislative Adjustments) for FY 2000 SGR and CY 2000 SGR
We are continuing to use 2.1 percent for this element of the SGR
for the FY 2000 SGR and the CY 2000 SGR. This factor is unchanged from
earlier estimates previously described respectively for FY 2000 and CY
2000 in the October 1, 1999 Federal Register (64 FR 53395), the April
10, 2000 Federal Register (65 FR 19003) and the August 2, 2001 Federal
Register (66 FR 40397).
Factor 2--The Percentage Change in the Average Number of Fee-for-
Service Part B Enrollees for the FY 2000 SGR and CY 2000 SGR
This factor is our estimate of the percent change in the average
number of fee-for-service enrollees for FY 2000 as compared to FY 1999
and CY 2000 as compared to CY 1999. We currently have complete
information on actual enrollment in the Medicare+Choice program for FY
2000 and CY 2000 that permits a measure of change in fee-for-service
enrollment for these years that reflects the actual change. The
estimates for CY 2000 were derived by subtracting estimated M+C
enrollment from estimated overall Medicare enrollment as illustrated in
table 18.
Table 18
[In millions]
------------------------------------------------------------------------
1999 2000
------------------------------------------------------------------------
Overall........................................... 37.115 37.453
Medicare+Choice................................... 6.191 6.233
Net............................................... 30.923 31.221
Percent Increase.................................. ......... 1.0
------------------------------------------------------------------------
Our actuaries' estimate of the percent change in the average number
of fee-for-service enrollees net of Medicare+Choice enrollment for 2000
compared to 1999 of 1.0 percent is the same as our estimate of this
factor at this time last year (1.0 percent). However, the current
estimate of 0.5 percent for FY 2000 is lower than the 0.8 percent
estimate of this factor at this time last year.
Factor 3--Estimated Real Gross Domestic Product Per Capita Growth in FY
2000 and CY 2000
We estimate that real GDP per capita growth will be 3.6 percent for
FY 2000 and 3.2 percent for CY 2000. In the FY 2000 SGR notice
published on October 1, 1999 (64 FR 53396), we estimated that real GDP
per capita growth for FY 2000 would be 1.8 percent. In our April 10,
2000 SGR notice, we estimated that real GDP per capita growth for CY
2000 would be 2.5 percent. In our November 1, 2000 final rule (65 FR
65433), we estimated that real GDP per capita growth would be 4.5
percent for FY 2000 and 4.3 percent CY 2000. The final figures that we
will use for this factor are 3.6 percent for FY 2000 and 3.2 percent
for CY 2000. The latest figures on real GDP per capita growth are
approximately one percentage point less than estimated last year. The
lower estimates are due to annual revisions of the National Income and
Product Accounts (NIPA) by the Bureau of Economic Analysis. Usually, in
annual revisions of the NIPA, new estimates incorporate source data
that are more complete, more detailed, and otherwise more appropriate
than those that were previously incorporated. In addition, several
methodological changes have been made. (For detailed description of the
NIPA revisions, see Brent R. Moulton, Eugene P. Seskin, and David F.
Sullivan, ``Annual Revision of the National Income and Product
Accounts: Annual Estimates, 1998-2000, Quarterly Estimates, 1998: 1-
2000: I, Survey of Current Business'' (August, 2001): 7-32.)
[[Page 55320]]
Factor 4--Percentage Change in Expenditures for Physicians' Services
Resulting From Changes in Law or Regulations in FY 2000 Compared with
FY 1999, and CY 2000, Compared With CY 1999
As we explained in our October 1, 1999 and April 10, 2000 SGR
notices, legislative changes contained in the BBA and the BBRA will
have an impact on expenditures for physicians' services under the SGR
in FY 2000 and CY 2000. Section 4103 of the BBA mandates a new prostate
screening benefit effective January 1, 2000. Additionally, effective
January 1, 2000, section 4513 of the BBA removes the requirement that a
subluxation of the spine be demonstrated by an x-ray before Medicare
payment can be made for chiropractic services furnished to a
beneficiary. This provision will also result in a small increase in
expenditures in FY 2000 and CY 2000. The impact of BBA Medicare
Secondary Payer provisions will have small marginal impact on reducing
expenditures in FY 2000 and CY 2000.
Certain BBRA provisions also have a small impact on expenditures in
FY 2000 and CY 2000. Section 224 of the BBRA increases payments for pap
smears and is slightly increasing expenditures. Section 221 of the BBRA
postponed the implementation of payment caps on physical and
occupational therapy and speech-language pathology services. The effect
of this provision on physicians and independent practitioners is a
small increase in expenditures for these years. Medicare expenditures
for outpatient physical and occupational therapy services by therapists
in independent practice are growing rapidly as a result of provisions
of section 4541 of the BBA that require Medicare to make payments for
facility-based therapy services under the physician fee schedule.
Physical and occupational therapy services previously paid on the basis
of a cost report through the Medicare fiscal intermediaries are more
likely to be billed by therapists in independent practice because these
services are no longer being paid on a cost basis. We analyzed growth
in Medicare expenditures for physical and occupational therapy and
believe that the larger rate of increase in Medicare expenditures for
these services billed to carriers is likely a result of the statutory
provisions that require the services to be paid under the Medicare
physician fee schedule. We are making an upward adjustment to the SGR
for this factor.
After taking into account these provisions, the percentage change
in expenditures for physicians' services resulting from changes in law
or regulations is estimated to be 0.6 percent for FY 2000 and 0.8
percent for CY 2000.
IX. Calculation of the 2002 Physician Fee Schedule and Anesthesia
Conversion Factor
The 2002 physician fee schedule conversion factor is $36.1992. The
separate 2002 national average anesthesia conversion factor is $16.60.
The specific calculations to determine the physician fee schedule
and anesthesia conversion factor for calendar year 2002 are explained
below.
Detail on Calculation of the Calendar Year 2002 Physician Fee Schedule
Conversion Factor
Physician Fee Schedule Conversion Factor
Under section 1848(d)(1)(A) of the Act, the physician fee schedule
conversion factor is equal to the conversion factor for the previous
year multiplied by the update determined under section 1848(d)(4) of
the Act. In addition, section 1848(c)(2)(B)(ii)(II) of the Act requires
that changes to relative value units (RVUs) cannot cause expenditures
to increase or decrease by more than $20 million from the amount of
expenditures that would have been made if such adjustments had not been
made. We implement this requirement through a uniform budget neutrality
adjustment to the conversion factor. There are two changes that will
require us to make an adjustment to the conversion factor to comply
with the budget neutrality requirement in section 1848(c)(2)(B)(ii)(II)
of the Act. We are making a 0.460 percent reduction (0.9954) in the
conversion factor to account for the increase in work RVUs resulting
from the 5-year review. We are also making a 0.18 percent (0.9982)
reduction in the conversion factor to account for an anticipated
increase in the volume and intensity of services in response to the
final year of the implementation of resource-based practice expense
RVUs. As a result of the 5-year review of RVUs and additional budget-
neutrality adjustments required by law, the conversion factor is 5.4
percent lower than last year's conversion factor.
The two budget neutrality factors are applied after the update is
applied to the 2001 conversion factor:
Table 19
------------------------------------------------------------------------
------------------------------------------------------------------------
2001 Conversion Factor..................................... $38.2581
2002 Update................................................ 0.9523
Budget-Neutrality Adjustment: 5 Year Review................. 0.9954
Budget-Neutrality Adjustment: Practice Expense Transition... 0.9982
2002 Conversion Factor..................................... $36.1992
------------------------------------------------------------------------
Anesthesia Fee Schedule Conversion Factor
Section 1848(b)(2)(B) of the Act indicates that, to the extent
practicable, the Secretary will use the anesthesia relative value guide
with appropriate adjustment of the conversion factor, in a manner to
assure that the fee schedule amounts for anesthesia services are
consistent with the fee schedule amounts for other services. The
statute also requires the Secretary to adjust the conversion factor by
geographic adjustment factors in the same manner as for other physician
fee schedule services. Unlike other physician fee schedule services,
anesthesia services are paid using a system of base and time units. The
base and time units are summed and multiplied by a conversion factor.
The base unit is fixed depending upon the type of anesthesia procedure
performed, and the time units will vary based on the length of the
anesthesia time associated with the surgical procedure. Thus,
Medicare's payment will increase as anesthesia time lengthens. The same
anesthesia service provided in two different surgeries will be paid
different amounts if the associated anesthesia time is different. This
system differs from other physician fee schedule services where payment
is determined based on the product of RVUs and a conversion factor;
payment for a given procedure will not vary based on the length of time
it takes to perform the procedure in a specific instance.
Since anesthesia services do not have RVUs like other physician fee
schedule services, we have had to make appropriate adjustments to the
anesthesia fee schedule conversion factor to simulate changes to RVUs.
We modeled the resource-based practice expense methodology using
imputed anesthesia RVUs that were made comparable to other physician
fee schedule services. As a result of modeling these changes, we are
incorporating a 1.89 percent reduction (0.9811) to the anesthesia fee
schedule conversion factor. We are incorporating an additional increase
of 0.2 percent (1.002) to account for base unit revisions for 2002,
both for the five-year review and for the alignment of CMS base units
with ASA base units. All other adjustments (physician fee schedule
update, adjustment for 5-year review of
[[Page 55321]]
physician work, adjustment for volume and intensity changes) made to
the anesthesia fee schedule conversion factor are the same as those
applied to the physician fee schedule. To determine the anesthesia fee
schedule conversion factor for 2002, we used the following figures:
Table 20
------------------------------------------------------------------------
------------------------------------------------------------------------
2001 Anesthesia Conversion Factor.......................... $17.83
2002 Update................................................ 0.9523
Practice Expense RVU Adjustment for 2002.................... 0.9823
Adjustment for Base Unit Alignment.......................... 1.0020
5-Year Review............................................... 0.9954
Volume and Intensity Adjustment............................. 0.9982
2003 Conversion Factor..................................... $16.60
------------------------------------------------------------------------
X. Provisions of the Final Rule
The provisions of this final rule restate the provisions of the
August 2001 proposed rule, except as noted elsewhere in the preamble.
Following is a highlight of the changes made from the proposed rule:
For screening glaucoma, we are revising the regulation in
Sec. 410.23(a)(2) to read ``Eligible beneficiary means individuals in
the following high risk categories.'' This should allow us to more
easily add high-risk groups by rulemaking should the medical evidence
warrant it.
For G0117 Glaucoma Screening for High Risk Patients Furnished by an
Optometrist or Ophthalmologist, we will assign 0.45 work RVUs, .02
malpractice RVUs, and we will crosswalk practice expense inputs from
CPT code 92012.
For G0118 Glaucoma Screening for High Risk Patients Furnished Under
the Direct Supervision of an Optometrist or Ophthalmologist, we will
assign 0.17 work RVUs and 0.01 malpractice RVUs. For practice expense,
we will also crosswalk this code to CPT code 92012.
For medical nutrition therapy, we made various changes in response
to comments received. For detailed information, see section III.G.
For telehealth services section 1834(m)(3) of the Act specifies
that sections 1842(b)(18)(A) and (B) apply to physicians and
practitioners receiving payment for telehealth services and to
originating sites receiving a facility fee, in the same manner as they
apply to practitioners. This section requires that payment for these
services may only be made on an assignment-related basis. We did not
reflect this provision in the proposed rule. Nonetheless, because this
requirement is required by the plain language of the law and because we
are without discretion with respect to its application, we are
implementing it in this final rule in new Sec. 414.65(d).
Other Issues
Included in the comments we received were issues and topics that
were not specifically included as proposals in the August 2, 2001
proposed rule such as coding issues on specific services, the need to
expand dissemination of information on Medicare benefits and a variety
of other topics. While we do not address these specifically in this
rule, we will ensure that the appropriate CMS components are aware of
the concerns expressed and would hope that these concerns can be
addressed through appropriate channels.
XI. Collection of Information Requirements
Under the Paperwork Reduction Act (PRA) of 1995, we are required to
provide 30-day notice in the Federal Register and solicit public
comment before a collection of information requirement is submitted to
the Office of Management and Budget (OMB) for review and approval. In
order to fairly evaluate whether an information collection should be
approved by OMB, section 3506(c)(2)(A) of the Paperwork Reduction Act
of 1995 requires that we solicit comment on the following issues:
The need for the information collection and its usefulness
in carrying out the proper functions of our agency.
The accuracy of our estimate of the information collection
burden.
The quality, utility, and clarity of the information to be
collected.
Recommendations to minimize the information collection
burden on the affected public, including automated collection
techniques.
We are soliciting public comment on each of these issues for
Sec. 410.132 in this document, which contains information collection
requirements.
Paragraph (c) of this section requires a referring physician or
practitioner to maintain referral documentation in the beneficiary's
medical record for each referral.
We believe the burden associated with these provisions is exempt in
accordance with 5 CFR 1320.3(b)(2) because the time, effort, and
financial resources necessary to comply with these requirements would
be incurred by referring physicians and practitioners in the normal
course of business activities.
If you comment on these information collection and recordkeeping
requirements, please mail copies directly to the following:
Centers for Medicare & Medicaid Services, Office of Information
Services, Information Technology Investment Management Group, Attn.:
John Burke, CMS-1169-FC, Room N2-14-26, 7500 Security Boulevard,
Baltimore, MD 21244-1850.
Office of Information and Regulatory Affairs, Office of Management and
Budget, Room 10235, New Executive Office Building, Washington, DC
20503, Attn: Allison Eydt, CMS Desk Officer.
XII. Response to Comments
Because of the large number of items of correspondence we normally
receive on Federal Register documents published for comment, we are not
able to acknowledge or respond to them individually. We will consider
all comments we receive by the date and time specified in the DATES
section of this preamble, and, if we proceed with a subsequent
document, we will respond to the comments in the preamble to that
document.
XIII. Regulatory Impact Analysis
We have examined the impact of this final rule as required by
Executive Order 12866, the Unfunded Mandates Reform Act of 1995 (UMRA)
(Pub. L. 104-4), the Regulatory Flexibility Act of 1980 (RFA) (Pub. L.
96-354), and Executive Order 13132 of August 4, 1999 (Federalism).
EO 12866 directs agencies to assess costs and benefits of available
regulatory alternatives and, when regulation is necessary, to select
regulatory approaches that maximize net benefits (including potential
economic, environmental, public health and safety effects, distributive
impacts, and equity). A regulatory impact analysis (RIA) must be
prepared for major rules with economically significant effects ($100
million or more annually). While the changes in the Medicare physician
fee schedule are, for the most part, budget neutral, they do involve
redistribution of Medicare spending among procedures and physician
specialties. The redistributive effect of this rule on any particular
specialty is in our estimate likely to exceed $100 million for at least
one specialty group. For this reason we are considering this a major
economic rule.
However, it is important to note, as indicated in section VII of
this preamble, the physician fee update for 2002 under section 1848(d)
of the Act is -4.8 percent of an estimated $41.2 billion in physician
expenditures for 2001. Even though the physician fee schedule update is
-4.8 percent, we project that the total Medicare
[[Page 55322]]
expenditures for physicians' services will increase from $41.2 billion
to $41.7 billion in 2002.
The UMRA also requires (in section 202) that agencies prepare an
assessment of anticipated costs and benefits before developing any rule
that may result in expenditure in any one year by State, local, or
tribal governments, in the aggregate, or by the private sector, of $110
million or more. We have determined that this rule has no consequential
effect on State, local, or tribal governments. We believe the private
sector cost of this rule falls below the above-stated threshold as
well.
The RFA requires that we analyze regulatory options for small
businesses and other small entities. We prepare a Regulatory
Flexibility Analysis unless we certify that a rule would not have a
significant economic impact on a substantial number of small entities.
The analysis must include a justification concerning the reason action
is being taken, the kinds and number of small entities the rule
affects, and an explanation of any meaningful options that achieve the
objectives and lessen significant adverse economic impact on the small
entities.
In addition, section 1102(b) of the Act requires us to prepare a
regulatory impact analysis if a rule may have a significant impact on
the operations of a substantial number of small rural hospitals. This
analysis must conform to the provisions of section 604 of the RFA. For
purposes of section 1102(b) of the Act, we define a small rural
hospital as a hospital that is located outside of a Metropolitan
Statistical Area and has fewer than 100 beds.
For purposes of the RFA, all physicians are considered to be small
entities. There are about 700,000 physicians and other practitioners
who receive Medicare payment under the physician fee schedule.
For the purpose of EO 12866 and the RFA we have prepared the
following analysis, which, together with the rest of this preamble,
meets all four assessment requirements. It explains the rationale for
and purpose of the rule, details the costs and benefits of the rule,
analyzes alternatives, and presents the measures we considered to
minimize the burden on small entities.
A. 5 Year Review of Physician Work and Resource-Based Practice Expense
Relative Value Units
Revisions in physician work and resource-based practice expense
RVUs for physicians' services are required by law to be budget neutral.
We calculate total payments from the revisions to work and practice
expense relative value units such that total payments do not change
more than $20 million as a result of the revisions. Increases in
payments for some services are necessarily offset by decreases in
payments for other services. For revisions to physician work values
that are occuring as part of the 5-year review, we are making a budget
neutrality adjustment to the physician fee schedule conversion factor.
For practice expense, we adjust all the practice expense RVUs upwards
or downwards to meet the budget neutrality requirement in the statute.
This means that increases in practice expense RVUs for some services
will be offset by corresponding decreases in values for other services.
We showed the impact of proposed changes in physician work and practice
expense RVUs in our Notice of Proposed Rulemaking in the Federal
Register on August 2, 2001 (65 FR 40397). Table 21 shows the impact on
total allowed charges by specialty of this final rule's physician work
and practice expense RVU changes. We are showing the impact of the
proposed rule changes as well additional changes that are occurring as
a result of this final rule. There are five changes we are adopting in
this final rule that result in changes to the impacts displayed in the
proposed rule. Table 21 incorporates additional impacts that result
from using 2000 utilization data to determine the resource-based
practice expense RVUs. This change has a very modest effect on payment
for nearly all specialties. Based on public comments to our notice of
proposed rulemaking, we have also made changes to physician work RVUs
that were part of the 5-year review. These changes will increase
payments to Gastronterology, General Surgery, Obstetrics and Gynecology
and Podiatry. We also incorporated revised physician time data supplied
to us by the Relative Value Update Committee (RUC). Relative to the
physician times used in our proposed rule, there were slight
refinements to some codes. With the exception of Nephrology, the new
times have virtually no impact on specialty level payments. Nephrology
payments will go up as a result of using new physician times supplied
to us by the RUC. The RUC supplied us with a time of 186 minutes for
the highest volume nephrology procedure code, 90921. This compared to a
physician time of 153 minutes that was previously used. Finally, we
also incorporated refinements to the practice expense inputs that are
being recommended by the Practice Expense Advisory Committee (PEAC) and
the RUC. These changes will result in a reduction in average payments
to rheumatology of about 6 percent. This occurs primarily as a result
of refinements to 4 codes that are frequently performed by
rheumatologists (20610, 20550, 20605 and 20600). Based on the PEAC and
RUC comments, we made changes to the practice expense inputs that
result in a reduction in relative payments for these procedure codes.
Other specialties that will experience a smaller reduction in payments
as a result of the practice expense refinements for 2002 are Orthopedic
Surgery, Podiatry and Urology. Since the changes are budget neutral,
the reductions in practice expense RVUs will be offset by increases in
practice expense payments that will be broadly distributed among other
physician specialties.
Table 21 shows the impact of this final rule compared to the
proposed rule that was published on August 2, 2001. We note that the
table shows the impact of this rule only and does not incorporate
practice expense changes from three other final rules, November 2, 1998
(63 FR 58895), November 2, 1999 (64 FR 59433) and November 1, 2000 (65
FR 65377). The table shows the average specialty change in payments in
CY 2002 that are occurring as a result of this final rule relative to
what would have occurred in 2002 had this rule not been published. The
rule shows the redistributive (or relative) change in payments among
specialties. It does not show the absolute average change in specialty
level payments from 2001 to 2002 that are also affected by the final
year of the transition to resource-based practice expense RVUs and the
physician fee schedule update. The transition to resource-based RVUs is
complete in CY 2002 and has no effect when comparing the impact on CY
2002 payments before and after changes made in this final rule. The
physician fee schedule update and change to the conversion factor are
discussed in sections VII and IX, respectively.
[[Page 55323]]
Table 21.--Impact of Physician Work and Practice Expense Relative Value Unit Changes--Final Rule Compared to
Proposed Rule
----------------------------------------------------------------------------------------------------------------
Allowed Proposed rule Final rule
Specialty charges impact impact
(billions) (percent) (percent)
----------------------------------------------------------------------------------------------------------------
Anesthesiology.................................................. $1.5 1 1
Cardiac Surgery................................................. 0.3 0 0
Cardiology...................................................... 4.2 0 -1
Chiropractor.................................................... 0.4 0 0
Clinics......................................................... 1.6 0 0
Dermatology..................................................... 1.4 1 2
Emergency Medicine.............................................. 1.0 0 0
Family Practice................................................. 3.3 0 0
Gastroenterology................................................ 1.2 1 3
General Practice................................................ 1.0 0 0
General Surgery................................................. 2.0 4 4
Hematology Oncology............................................. 0.6 0 1
Internal Medicine............................................... 7.1 0 1
Nephrology...................................................... 1.0 0 2
Neurology....................................................... 0.9 0 0
Neurosurgery.................................................... 0.4 0 0
Nonphysician Practitioner....................................... 1.2 0 1
Obstetrics/Gynecology........................................... 0.4 1 2
Ophthalmology................................................... 3.9 -1 -1
Optometrist..................................................... 0.5 0 -3
Orthopedic Surgery.............................................. 2.3 0 -1
Other Physician................................................. 1.4 1 0
Otolaryngology.................................................. 0.6 0 1
Pathology....................................................... 0.6 3 3
Plastic Surgery................................................. 0.2 0 1
Podiatry........................................................ 1.1 1 0
Psychiatry...................................................... 1.1 0 0
Pulmonary....................................................... 1.1 0 1
Radiation Oncology.............................................. 0.7 0 -2
Radiology....................................................... 3.3 0 -1
Rheumatology.................................................... 0.3 0 -6
Suppliers....................................................... 0.7 2 0
Thoracic Surgery................................................ 0.5 1 0
Urology......................................................... 1.3 1 1
Vascular Surgery................................................ 0.3 2 1
----------------------------------------------------------------------------------------------------------------
Table 22, titled Impact of 5-Year Review and Proposed Rule on
Medicare Payments for Selected Procedures, shows the percentage change
in total payment (in CY 2002 physician fee schedule dollars) for
selected high-volume procedures that result from changes to the
physician work, practice expense and malpractice announced in this
final rule. These tables reflect the impact of this final rule only on
the fully implemented fee schedule amount. The payments in these
columns are determined using a conversion factor $36.1992. The RVUs
used for calculating payment in the ``old'' columns are from the
November 1, 2000 final rule. The RVUs used in calculating payments in
the ``new'' columns are from this final rule. By using the same
conversion factor of $36.1992 to calculate payments in both the ``old''
and ``new'' columns, the impact of changes to the RVUs that are
included in this final rule are illustrated. These tables do not show
the actual impact on payment from 2001 to 2002 that are also affected
by the final year of the practice expense transition and physician fee
schedule update.
Table 22.--Impact of 5 Year Review and Proposed Rule on Medicare Payment for Selected Procedures
--------------------------------------------------------------------------------------------------------------------------------------------------------
Old non- New non- Percent Old New Percent
HCPCS MOD DESC facility facility change facility facility change
--------------------------------------------------------------------------------------------------------------------------------------------------------
11721.................................... ........... Debride nail, 6 or more......... $40.18 $36.92 -8 $28.96 $28.96 0
17000.................................... ........... Destroy benign/premal lesion.... 60.45 62.62 4 32.58 32.94 1
27130.................................... ........... Total hip replacement........... NA NA NA 1,419.01 1,452.31 2
27236.................................... ........... Treat thigh fracture............ NA NA NA 1,088.87 1,113.85 2
27244.................................... ........... Treat thigh fracture............ NA NA NA 1,111.68 1,137.38 2
27447.................................... ........... Total knee replacement.......... NA NA NA 1,483.08 1,514.21 2
33533.................................... ........... CABG, arterial, single.......... NA NA NA 1,756.02 1,827.34 4
35301.................................... ........... Rechanneling of artery.......... NA NA NA 1,107.33 1,061.36 -4
43239.................................... ........... Upper GI endoscopy, biopsy...... 281.99 354.75 26 148.78 154.93 4
45385.................................... ........... Lesion removal colonoscopy...... 474.93 571.22 20 283.44 287.78 2
66821.................................... ........... After cataract laser surgery.... 217.56 229.50 6 203.44 213.94 5
66984.................................... ........... Cataract surg w/iol, i stage.... NA NA NA 660.27 669.32 1
67210.................................... ........... Treatment of retinal lesion..... 594.03 603.08 2 544.44 546.61 0
[[Page 55324]]
71010.................................... 26 Chest x-ray..................... 9.05 9.05 0 9.05 9.05 0
71020.................................... 26 Chest x-ray..................... 11.22 11.22 0 11.22 11.22 0
76091.................................... ........... Mammogram, both breasts......... 84.34 90.50 7 NA NA NA
76091.................................... 26 Mammogram, both breasts......... 35.11 43.44 24 35.11 43.44 24
76092.................................... ........... Mammogram, screening............ 71.03 80.72 14 71.03 80.72 14
76092.................................... 26 Mammogram, screening............ 22.73 35.48 56 22.73 35.48 56
77427.................................... ........... Radiation tx management, x5..... 167.24 167.96 0 167.24 167.96 0
78465.................................... 26 Heart image (3d), multiple...... 75.29 74.93 -1 75.29 74.93 -1
88305.................................... 26 Tissue exam by pathologist...... 39.82 40.54 2 39.82 40.54 2
90801.................................... ........... Psy dx interview................ 145.52 144.80 -1 137.19 137.19 0
90806.................................... ........... Psytx, off, 45-50 min........... 96.65 95.93 -1 91.22 91.22 0
90807.................................... ........... Psytx, off, 45-50 min w/e&m..... 103.89 103.53 0 98.82 98.82 0
90862.................................... ........... Medication management........... 51.04 51.04 0 46.33 46.33 0
90921.................................... ........... ESRD related services, month.... 263.89 273.30 4 263.89 273.30 4
90935.................................... ........... Hemodialysis, one evaluation.... NA NA NA 73.48 76.38 4
92004.................................... ........... Eye exam, new patient........... 124.16 123.44 -1 87.60 87.96 0
92012.................................... ........... Eye exam established pat........ 62.62 61.18 -2 35.84 35.84 0
92014.................................... ........... Eye exam & treatment............ 89.77 91.22 2 59.00 58.64 -1
92980.................................... ........... Insert intracoronary stent...... NA NA NA 799.64 790.59 -1
92982.................................... ........... Coronary artery dilation........ NA NA NA 592.22 584.26 -1
93000.................................... ........... Electrocardiogram, complete..... 26.06 25.34 -3 NA NA NA
93010.................................... ........... Electrocardiogram report........ 9.05 9.05 0 9.05 9.05 0
93015.................................... ........... Cardiovascular stress test...... 102.81 99.91 -3 NA NA NA
93307.................................... 26 Echo exam of heart.............. 48.51 48.14 -1 48.51 48.14 -1
93510.................................... 26 Left heart catheterization...... 232.76 230.59 -1 232.76 230.59 -1
98941.................................... ........... Chiropractic manipulation....... 35.48 35.48 0 30.77 31.13 1
99202.................................... ........... Office/outpatient visit, new.... 60.45 61.54 2 45.61 45.61 0
99203.................................... ........... Office/outpatient visit, new.... 90.50 91.95 2 69.50 69.50 0
99204.................................... ........... Office/outpatient visit, new.... 130.32 130.68 0 102.81 102.81 0
99205.................................... ........... Office/outpatient visit, new.... 165.07 166.15 1 136.11 136.47 0
99211.................................... ........... Office/outpatient visit, est.... 19.91 20.27 2 8.69 8.69 0
99212.................................... ........... Office/outpatient visit, est.... 35.48 36.20 2 23.17 23.17 0
99213.................................... ........... Office/outpatient visit, est.... 49.59 50.32 2 34.03 34.03 0
99214.................................... ........... Office/outpatient visit, est.... 78.19 78.91 1 55.75 56.11 1
99215.................................... ........... Office/outpatient visit, est.... 114.39 115.84 1 90.14 90.50 0
99221.................................... ........... Initial hospital care........... NA NA NA 65.16 65.16 0
99222.................................... ........... Initial hospital care........... NA NA NA 107.87 108.24 0
99223.................................... ........... Initial hospital care........... NA NA NA 150.59 150.95 0
99231.................................... ........... Subsequent hospital care........ NA NA NA 32.58 32.58 0
99232.................................... ........... Subsequent hospital care........ NA NA NA 53.21 53.57 1
99233.................................... ........... Subsequent hospital care........ NA NA NA 76.02 76.38 1
99236.................................... ........... Observ/hosp same date........... NA NA NA 213.58 214.66 1
99238.................................... ........... Hospital discharge day.......... NA NA NA 64.07 66.24 3
99239.................................... ........... Hospital discharge day.......... NA NA NA 87.60 90.86 4
99241.................................... ........... Office consultation............. 46.33 47.06 2 32.94 33.30 1
99242.................................... ........... Office consultation............. 86.15 87.24 1 67.69 68.05 1
99243.................................... ........... Office consultation............. 114.39 115.84 1 90.14 90.14 0
99244.................................... ........... Office consultation............. 162.53 164.34 1 133.21 133.58 0
99245.................................... ........... Office consultation............. 211.04 212.85 1 176.65 177.01 0
99251.................................... ........... Initial inpatient consult....... NA NA NA 36.20 34.75 -4
99252.................................... ........... Initial inpatient consult....... NA NA NA 71.31 69.86 -2
99253.................................... ........... Initial inpatient consult....... NA NA NA 96.65 95.20 -2
99254.................................... ........... Initial inpatient consult....... NA NA NA 138.28 136.83 -1
99255.................................... ........... Initial inpatient consult....... NA NA NA 189.68 188.60 -1
99261.................................... ........... Follow-up inpatient consult..... NA NA NA 23.53 21.72 -8
99262.................................... ........... Follow-up inpatient consult..... NA NA NA 45.25 43.44 -4
99263.................................... ........... Follow-up inpatient consult..... NA NA NA 66.24 64.80 -2
99282.................................... ........... Emergency dept visit............ NA NA NA 26.43 26.43 0
99283.................................... ........... Emergency dept visit............ NA NA NA 59.37 59.37 0
99284.................................... ........... Emergency dept visit............ NA NA NA 92.67 92.67 0
99285.................................... ........... Emergency dept visit............ NA NA NA 144.43 144.80 0
99291.................................... ........... Critical care, first hour....... NA NA NA 197.65 198.37 0
99292.................................... ........... Critical care, addl 30 min...... NA NA NA 98.46 98.82 0
99301.................................... ........... Nursing facility care........... 60.09 70.23 17 60.09 60.09 0
99302.................................... ........... Nursing facility care........... 80.36 95.57 19 80.36 80.72 0
99303.................................... ........... Nursing facility care........... 99.91 118.73 19 99.91 100.27 0
99311.................................... ........... Nursing fac care, subseq........ 30.05 40.18 34 30.05 30.05 0
99312.................................... ........... Nursing fac care, subseq........ 49.59 61.90 25 49.59 49.95 1
99313.................................... ........... Nursing fac care, subseq........ 70.59 84.34 20 70.59 70.95 1
[[Page 55325]]
99348.................................... ........... Home visit, est patient......... 73.12 73.85 1 NA NA NA
99350.................................... ........... Home visit, est patient......... 166.88 166.52 0 NA NA NA
--------------------------------------------------------------------------------------------------------------------------------------------------------
(In two different places above, we indicate that the tables do not
include the effect of the ``final'' year of the practice expense
transition. While we note that resource-based practice expense will be
fully implemented in 2002, our expectation is that we would continue to
make refinements that improve the practice expense relative value
units. We acknowledge that the efforts of the PEAC and RUC to make
useful comments on practice expense inputs have resulted in significant
improvements to the data we are using to determine practice expense
relative value units. The refinements we have made to date have
affected hundreds of procedure codes accounting for a high percentage
of Medicare expenditures paid under the physician fee schedule. Our
expectation is that this work will continue and we continue, to welcome
comments and input from all members of the public interested in these
issues).
B. Nurse Practitioners, Physician Assistants, and Clinical Nurse
Specialists Performing Screening Sigmoidoscopies
As discussed in section II.B. of the preamble, this regulation will
expand the list of practitioners for whose services Medicare may make
payment for screening flexible sigmoidoscopies to include nurse
practitioners, physician assistants, and clinical nurse specialists, as
long as those practitioners meet applicable Medicare qualification
requirements, and they are authorized to perform those screening
services under State law. At present, the Medicare condition of
coverage for screening flexible sigmoidoscopies limits coverage of
those services to those that are performed by either a doctor of
medicine or osteopathy (as defined in section 1861(r)(1) of the Act)
who is authorized under State law to perform the examination.
We estimate that this expansion in the scope of practitioners who
can receive Medicare payment for screening flexible sigmoidoscopies
will increase beneficiary access to these screening services and will
result in an increase in the number of covered exams that are
performed. At the same time, we estimate that this final rule will
result in a decrease in payments that are made for certain screening
flexible sigmoidoscopies because they will be performed by nurse
practitioners, physician assistants, and clinical nurse specialists,
since services they provide are paid at 85 percent of the amount of
payment that is made to physicians for the same screening service.
Taking these factors into account, we estimate that this provision will
result in negligible additional Medicare program costs. For a more
detailed discussion of this provision see section II.B. of this
preamble.
C. Services and Supplies Incident to a Physician's Professional
Services--Conditions
Under this rule auxiliary personnel may provide services incident
to the services of physicians (or other practitioners) who supervise
them, regardless of the employment relationship. There are no costs or
savings to the Medicare program associated with this provision. This
provision could result in increased beneficiary access to the auxiliary
personnel. For a more detailed discussion of this provision see section
II.C. of this preamble.
D. Anesthesia Services--Anesthesia Base Units
As previously discussed in section II.D. of the preamble, with the
exception of codes 00142 and 00147, we are using the same anesthesia
base unit per anesthesia code as the ASA provides in its uniform
relative value guide. There are eleven codes where our base unit value
for an anesthesia code differed from the corresponding ASA base unit.
Using the ASA base units resulted in an increase for 8 codes and a
decrease for 3 codes. New and revised codes starting in CY 2000 and for
subsequent years are evaluated on a code-specific basis under our usual
process after we receive recommendations from the RUC. Thus, because of
our review of the RUC recommendations, there could be differences
between the ASA's guide and our base units beginning in CY 2000.
We have determined the budget neutrality impact on the anesthesia
CF for the 11 codes for which CMS's base units are equal to the ASA's
base units as well as the addition of 19 new anesthesia codes in CY
2002. The impact was determined by estimating the increase or decrease
in base units between our base units and the ASA's base units for
existing codes as well as the increase and decrease in base units
between the new 2002 codes and the previous codes by which the services
would have been reported. This results in an increase of approximately
.2 percent in the 2002 anesthesia CF. For a more detailed discussion of
this provision see section II.D. of this preamble.
E. Performance Measurement and Emerging Technology Codes
As previously discussed in section II.E. of the preamble, the AMA
has developed two new categories of codes--performance codes and
emerging technology. Allowing the performance measurement code to be
recorded on Medicare billing forms will have no budgetary impact since
we are not proposing payment for these codes. We are allowing for
carrier pricing of the emerging technology codes.
We expect that the emerging technology codes will be used
infrequently and may be used in place of ``unlisted'' procedure codes
that are also carrier-priced. There would be few, if any, Medicare
program costs associated with this proposal. For a more detailed
discussion of this provision see section II.E. of this preamble.
F. BIPA Provisions Included in This Final Rule
The following provisions of the BIPA are discussed in detail in
section III of this preamble. This final rule conforms the regulations
text to the BIPA provisions. We showed the anticipated costs associated
with the BIPA provisions in our August 2, 2001 proposed rule (66 FR
40400). We are showing that same table again in table 23 below.
[[Page 55326]]
Table 23.--Medicare Cost Estimates for BIPA 2000 Provisions
[In millions]
----------------------------------------------------------------------------------------------------------------
BIPA provisions FY 2002 FY 2003 FY 2004 FY 2005 FY 2006
----------------------------------------------------------------------------------------------------------------
Sec. 101 Biennial Pelvic 10 20 20 20 20
Examinations...................
Sec. 102 Screening Glaucoma.... 30 50 50 60 60
Sec. 103 Screening Colonoscopy. 40 40 30 10 10
Sec. 104 Screening Mammography. 30 40 40 40 50
Sec. 105 Medical Nutrition..... 20 50 60 70 70
Sec. 223 Telehealth Services... 20 30 40 50 60
Sec. 432 Indian Health......... 60 70 80 80 90
----------------------------------------------------------------------------------------------------------------
1. Screening Mammography
As discussed in section III.A. of the preamble, the BIPA eliminates
the statutorily prescribed payment rate for screening mammography and
specifies that it will be paid under the physician fee schedule
beginning January 1, 2002. To pay for the professional component of the
screening mammography, we are using the work and malpractice RVUs that
have been established for unilateral diagnostic mammography. We are
establishing the practice expense RVUs for the professional component
under the resource-based methodology. The process we used to establish
the practice expense RVU for the TC is described in detail in section
III.A. Currently, we pay for screening mammography under section
1834(c) of the Act. Payment for screening mammography under that
section is not subject to the budget neutrality requirements that apply
to physician fee schedule services under section 1848(c)(2)(B)(ii)(II)
of the Act. However, effective January 1, 2002, screening mammography
will be paid under the physician fee schedule and, thus, subject to the
budget neutrality requirements that apply to physician fee schedule
services. We will include the current payment amounts for screening
mammography in aggregate physician fee schedule payments subject to the
budget neutrality requirements. As a result, the BIPA requirement that
we pay for screening mammography under the physician fee schedule will
not result in an increase in Medicare program expenditures. However,
the increase in payment for screening mammography under the physician
fee schedule will be included in the budget neutrality adjustments that
apply to physician fee schedule services. The BIPA also establishes a
methodology for determining payment for certain types of new technology
that are used in providing both diagnostic and screening mammography
services. The statutory provisions are in effect from April 1, 2001 to
December 31, 2001. The statute gives us the authority to determine
whether separate codes and payment amounts are appropriate for
screening and diagnostic mammography services that involve use of a new
technology on or after January 1, 2002. We are establishing several new
codes and fee schedule amounts for screening and diagnostic mammography
services that involve use of a new technology. We believe this will
help ensure that all Medicare beneficiaries have access to the benefits
of mammography, including recent advances that further enhance the
clinical capability of this vital health service for women. The BIPA
provisions related to new technology mammography will result in the
Medicare program costs shown in Table 23. The BIPA makes no changes to
provisions for Medicare coverage of screening mammography.
2. Screening Pelvic Examinations
As discussed in section III.B. of the preamble, section 101 of the
BIPA provides for expanded coverage for screening pelvic examinations
(including a clinical breast examination) furnished on or after July 1,
2001. Specifically, the revised benefit will allow for biennial
coverage of screening pelvic examination for all women who do not
qualify under the law for annual coverage of such tests. We estimate
that this change in the frequency of coverage for certain beneficiaries
will result in an increase in Medicare payments. These payments will be
made to a large number of physicians and other practitioners who
provide these tests and for any medically necessary follow-up tests, or
treatment that may be required as a result of the increased frequency
of coverage of these tests. Medicare program expenditures associated
with screening pelvic examinations have been included in the
President's budget for Medicare expenditures. The impact of this
provision is shown in Table 23.
3. Screening for Glaucoma
As discussed in section III.C. of the preamble, section 102 of the
BIPA authorizes coverage of glaucoma screening examinations effective
January 1, 2002, subject to certain frequency and other limitations. We
believe services provided as part of glaucoma screening will often
overlap with other services a physician provides during a patient
encounter that is associated with a higher payment amount. We believe
that physicians will more commonly provide glaucoma tests in
conjunction with other services and will rarely provide only glaucoma
screening to Medicare patients. Based on the projected utilization of
these screening services and related medically necessary follow-up
tests and treatment that may be required for the beneficiaries
screened, we estimate that this new benefit will result in an increase
in Medicare payments. These payments will be made to ophthalmologists
or optometrists who will provide these screening tests and for any
related follow-up tests and treatment that may be required. Medicare
program expenditures associated with the BIPA provision that
establishes coverage for screening glaucoma are shown in Table 23. The
addition of the screening glaucoma benefit will allow a greater number
of beneficiaries access to a preventive service.
4. Screening Colonoscopy
As discussed in section III.D. of the preamble, section 103 of the
BIPA amended the Act to add coverage of screening colonoscopies once
every 10 years for individuals not at high risk for colorectal cancer.
We estimate that this new benefit will result in an increase in
Medicare payments. These payments will be made to practitioners who
will provide these screening tests and related follow-up tests and
treatment that may be required. The addition of the screening
colonoscopy benefit will allow beneficiaries who are not at high risk
for colorectal cancer greater access to preventive services. The impact
of this provision is shown in Table 23.
5. Medical Nutrition Therapy
As discussed in section III.E. of the preamble, section 105 of the
BIPA
[[Page 55327]]
amended the Act to authorize Medicare coverage under Part B of medical
nutrition therapy (MNT) for beneficiaries who have diabetes or renal
disease, effective for services furnished on or after January 1, 2002.
We are implementing this provision in 42 CFR at part 410, in subpart G.
Specifically, the final rule discusses the education, experience, and
licensing requirements for dietitians or nutritionists furnishing the
service. In addition, the final rule discusses a referral requirement
and the manner by which the medical nutrition therapy and diabetes
outpatient self-management training benefits will be coordinated to
avoid duplicate payment. We are also establishing payment amounts for
these services under the physician fee schedule.
We estimate that this new benefit will result in an increase in
Medicare payments. These payments will be made to dietitians and
nutrition professionals who will provide these diagnostic therapy and
counseling services. Costs to the Medicare program associated with this
provision are shown in Table 23.
6. Telehealth
We estimate that the cost of providing office or other outpatient
visits, consultation services, individual psychotherapy, and
pharmacologic management in accordance with section 223 of the BIPA
will be approximately $20 million in FY 2002 and approximately $60
million by FY 2006, as indicated above in Table 23.
This final rule does not mandate that entities provide
consultation, office or other outpatient visits, individual
psychotherapy or pharmacological management services via a
telecommunications system. Thus, this final rule will not require
entities to purchase telehealth equipment or to acquire the
telecommunications infrastructure necessary to deliver these services
via a telecommunications system. Therefore, this final rule does not
impose costs associated with starting and operating a telehealth
network.
7. Indian Health Services
As discussed in section III.G. of the preamble, section 432 of the
BIPA authorizes payment under the physician fee schedule to physicians
and certain practitioners for services furnished in a hospital and an
ambulatory care clinic, whether provider-based or free-standing, of the
Indian Health Service effective for services furnished on or after July
1, 2001. We are adding a new Sec. 410.46 to conform our regulations to
the statute. Costs to the Medicare program for this BIPA provision are
shown in Table 23.
8. Pathology Services
As discussed in section III.H. of the preamble, in the November 2,
1999 physician fee schedule final rule (64 FR 59381), we stated that we
would implement a policy to pay only hospitals for the TC of physician
pathology services furnished to hospital inpatients. Before the
effective date of this proposal, any independent laboratory could bill
the carrier under the physician fee schedule for the TC of physician
pathology to a hospital inpatient. That regulation provided that for
services furnished on or after January 1, 2001, the carriers would no
longer pay claims to an independent laboratory under the physician fee
schedule for the TC of physician pathology services furnished for
hospital inpatients. Similar treatment was provided under the hospital
outpatient prospective payment system for the TC of physician pathology
services to hospital outpatients. We delayed implementation of this
provision for one year; it was to take effect for services furnished on
or after January 1, 2001. The delay was intended to allow independent
laboratories and hospitals sufficient time to negotiate arrangements.
Section 542 of the BIPA requires Medicare to continue to pay for
the TC of physician pathology services when an independent laboratory
furnishes this service to an inpatient or outpatient of a covered
hospital. This provision applies to TC services furnished during the 2-
year period beginning on January 1, 2001.
In the November 2, 1999 final rule, we estimated that payment under
the physician fee schedule for TC billings by independent laboratories
would decrease by $6 million per year if the original proposal had been
implemented on January 1, 2001. As a result of the BIPA, these savings
are not realized for two years.
G. Update of the Codes for the Physician Self-Referral Prohibition
As discussed in section VI of this preamble, we are updating the
list of codes used to define certain designated health services for the
purposes of section 1877 of the Act. We are not making any substantive
change to the description of any designated health service as set forth
in the January 4, 2001 physician self-referral final rule (66 FR 856).
Instead, we are merely updating our list of codes to conform to coding
changes in the most recent publication of CPT and HCPCS codes. For this
reason, we certify that the changes we are making will not have a
significant economic effect on a substantial number of small entities
or on the operations of a substantial number of small rural hospitals.
For an in-depth discussion of the anticipated effects of the recent
physician self-referral final rule, refer to the regulatory impact
statement in that rule as published in the January 4, 2001 Federal
Register (66 FR 856).
H. Budget-Neutrality
The increase in physician work RVUs will necessitate an adjustment
to meet the statute's budget neutrality requirements. We are reducing
the physician fee schedule CF by -0.46 percent (CF X 0.9954) to ensure
that the increase in physician work RVUs remains budget neutral across
all physician fee schedule services. Each year since the fee schedule
has been implemented, our actuaries have determined any adjustments
needed to meet the budget-neutrality requirement of the statute. A
component of the actuarial determination of budget-neutrality involves
estimating the impact of changes in the volume and intensity of
physicians' services provided to Medicare beneficiaries as a result of
the proposed changes to relative value units. Consistent with the
provision in the November 1998 final rule, the actuaries would use a
model that assumes a 30 percent volume-and-intensity response to price
reductions. Based on the practice expense changes that will occur in
2002, the actuaries estimate that a -0.18 (CF X 0.9982) percent
adjustment to the conversion factor is necessary to meet the budget
neutrality requirements in the statute. If the assumed volume and
intensity offset does not occur, the offset applied to the RVUs will
be, in essence, returned because there will be a future year adjustment
to the physician fee schedule update.
I. Impact on Beneficiaries
Although changes in physicians' payments when the physician fee
schedule was implemented in 1992 were large, we detected no problems
with beneficiary access to care. Furthermore, since beginning our
transition to a resource-based practice expense system in 1999, we have
not found that there are problems with beneficiary access to care.
J. Federalism
We have reviewed this proposed rule under the threshold criteria of
EO 13132, Federalism, and we have determined that the proposed rule
does
[[Page 55328]]
not significantly affect the rights, roles, and responsibilities of
States.
List of Subjects
42 CFR Part 405
Administrative practice and procedure, Health facilities, Health
professions, Kidney diseases, Medicare, Reporting and recordkeeping
requirements, Rural areas, X-rays.
42 CFR Part 410
Health facilities, Health professions, Kidney diseases,
Laboratories, Medicare, Rural areas, X-rays.
42 CFR Part 411
Kidney diseases, Medicare, Reporting and recordkeeping
requirements.
42 CFR Part 414
Administrative practice and procedure, Health facilities, Health
professions, Kidney diseases, Medicare, Reporting and recordkeeping
requirements, Rural areas, X-rays.
42 CFR Part 415
Health facilities, Health professions, Medicare, Reporting and
recordkeeping requirements.
For the reasons set forth in the preamble, the Centers for Medicare
and Medicaid amends 42 CFR chapter IV as follows:
PART 405--FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED
1. The authority citation for part 405 continues to read as
follows:
Authority: Secs. 1102 and 1871 of the Social Security Act (42
U.S.C. 1302 and 1395hh).
2. In Sec. 405.534, an introductory paragraph is added to read as
follows:
Sec. 405.534 Limitation on payment for screening mammography services.
The provisions in paragraphs (a), (b), and (c) of this section
apply for services provided from January 1, 1991 until December 31,
2001. Screening mammography services provided after December 31, 2001
are paid under the physician fee schedule in accordance with Sec. 414.2
of this chapter.
* * * * *
3. In Sec. 405.535, the section heading is revised and the
introductory text is amended by adding two sentences to the beginning
to read as follows:
Sec. 405.535 Special rule for nonparticipating physicians and
suppliers furnishing screening mammography services before January 1,
2002.
The provisions in this section apply for screening mammography
services provided from January 1, 1991 until December 31, 2001.
Screening mammography services provided after December 31, 2001 are
physician services pursuant to Sec. 414.2 of this chapter paid under
the physician fee schedule. * * *
* * * * *
PART 410--SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS
1. The authority citation for part 410 continues to read as
follows:
Authority: Secs. 1102 and 1871 of the Social Security Act (42
U.S.C. 1302 and 1395hh).
2. Section 410.3 is amended by revising paragraph (a)(1) to read as
follows:
Sec. 410.3 Scope of benefits.
(a) * * *
(1) Medical and other health services such as physicians' services,
outpatient services furnished by a hospital or a CAH, diagnostic tests,
outpatient physical therapy and speech pathology services, rural health
clinic services, Federally qualified health center services, IHS,
Indian tribe, or tribal organization facility services, and outpatient
renal dialysis services.
* * * * *
3. Section 410.10 is amended by adding paragraph (x) to read as
follows:
Sec. 410.10 Medical and other health services: Included services.
* * * * *
(x) Services of physicians and other practitioners furnished in or
at the direction of an IHS or Indian tribal hospital or clinic.
4. Section 410.22 is redesignated as Sec. 410.21, Sec. 410.23 is
redesignated as Sec. 410.22, and a new Sec. 410.23 is added to read as
follows:
Sec. 410.23 Screening for glaucoma: Conditions for and limitations on
coverage.
(a) Definitions: As used in this section, the following definitions
apply:
(1) Direct supervision in the office setting means the optometrist
or the ophthalmologist must be present in the office suite and be
immediately available to furnish assistance and direction throughout
the performance of the procedure. It does not mean the physician must
be present in the room when the procedure is performed.
(2) Eligible beneficiary means individuals in the following high
risk categories:
(i) Individual with diabetes mellitus;
(ii) Individual with a family history of glaucoma; or
(iii) African-Americans age 50 and over.
(3) Screening for glaucoma means the following procedures furnished
to an individual for the early detection of glaucoma:
(i) A dilated eye examination with an intraocular pressure
measurement.
(ii) A direct ophthalmoscopy examination, or a slit-lamp
biomicroscopic examination.
(b) Condition for coverage of screening for glaucoma.
Medicare Part B pays for glaucoma screening examinations provided
to eligible beneficiaries as described in paragraph (a)(2) of this
section if they are furnished by or under the direct supervision in the
office setting of an optometrist or ophthalmologist who is legally
authorized to perform these services under State law (or the State
regulatory mechanism provided by State law) of the State in which the
services are furnished, as would otherwise be covered if furnished by a
physician or incident to a physician's professional service.
(c) Limitations on coverage of glaucoma screening examinations.
(1) Payment may not be made for a glaucoma screening examination
that is performed for an individual who is not an eligible beneficiary
as described in paragraph (a)(2) of this section.
(2) Payment may be made for a glaucoma screening examination that
is performed on an individual who is an eligible beneficiary as
described in paragraph (a)(2) of this section, after at least 11 months
have passed following the month in which the last glaucoma screening
examination was performed.
5. In Sec. 410.26, paragraph (b) is redesignated as paragraph (c),
paragraph (a) is redesignated as paragraph (b) and revised, a new
paragraph (a) is added, and newly designated paragraph (c) is amended
by adding a paragraph heading:
Sec. 410.26 Services and supplies incident to a physician's
professional service: Conditions.
(a) Definitions. For purposes of this section, the following
definitions apply:
(1) Auxiliary personnel means any individual who is acting under
the supervision of a physician (or other practitioner), regardless of
whether the individual is an employee, leased employee, or independent
contractor of the physician (or other practitioner) or of the same
entity that employs or contracts with the physician (or other
practitioner).
(2) Direct supervision means the level of supervision by the
physician (or other practitioner) of auxiliary personnel as defined in
Sec. 410.32(b)(3)(ii).
[[Page 55329]]
(3) Independent contractor means an individual who performs part-
time or full-time work for which the individual receives an IRS-1099
form.
(4) Leased employment means an employment relationship that is
recognized by applicable State law and that is established by two
employers by a contract such that one employer hires the services of an
employee of the other employer.
(5) Noninstitutional setting means all settings other than a
hospital or skilled nursing facility.
(6) Practitioner means a non-physician practitioner who is
authorized by the Act to receive payment for services incident to his
or her own services.
(7) Services and supplies means any services or supplies (including
drugs or biologicals that are not usually self-administered) that are
included in section 1861(s)(2)(A) of the Act and are not specifically
listed in the Act as a separate benefit included in the Medicare
program.
(b) Medicare Part B pays for services and supplies incident to the
service of a physician (or other practitioner).
(1) Services and supplies must be furnished in a noninstitutional
setting to noninstitutional patients.
(2) Services and supplies must be an integral, though incidental,
part of the service of a physician (or other practitioner) in the
course of diagnosis or treatment of an injury or illness.
(3) Services and supplies must be commonly furnished without charge
or included in the bill of a physician (or other practitioner).
(4) Services and supplies must be of a type that are commonly
furnished in the office or clinic of a physician (or other
practitioner).
(5) Services and supplies must be furnished under the direct
supervision of the physician (or other practitioner). The physician (or
other practitioner) directly supervising the auxiliary personnel need
not be the same physician (or other practitioner) upon whose
professional service the incident to service is based.
(6) Services and supplies must be furnished by the physician,
practitioner with an incident to benefit, or auxiliary personnel.
(7) A physician (or other practitioner) may be an employee or an
independent contractor.
(c) Limitation. * * *
6. In Sec. 410.37, paragraphs (d), (e)(2), and (g) are revised and
paragraph (e)(3) is added to read as follows:
Sec. 410.37 Colorectal cancer screening tests: Conditions for and
limitations on coverage.
* * * * *
(d) Condition for coverage of flexible sigmoidoscopy screening.
Medicare Part B pays for a flexible sigmoidoscopy screening service if
it is performed by a doctor of medicine or osteopathy (as defined in
section 1861(r)(1) of the Act), or by a physician assistant, nurse
practitioner, or clinical nurse specialist (as defined in section
1861(aa)(5) of the Act and Secs. 410.74, 410.75, and 410.76) who is
authorized under State law to perform the examination.
(e) Limitations on coverage of screening flexible sigmoidoscopies.
* * *
(2) For an individual 50 years of age or over, except as described
in paragraph (e)(3) of this section, payment may be made for screening
flexible sigmoidoscopy after at least 47 months have passed following
the month in which the last screening flexible sigmoidoscopy or, as
provided in paragraphs (h) and (i) of this section, the last screening
barium enema was performed.
(3) In the case of an individual who is not at high risk for
colorectal cancer as described in paragraph (a)(3) of this section but
who has had a screening colonoscopy performed, payment may be made for
a screening flexible sigmoidosocopy only after at least 119 months have
passed following the month in which the last screening colonoscopy was
performed.
* * * * *
(g) Limitations on coverage of screening colonoscopies. (1)
Effective for services furnished on or after January 1, 1998 through
June 30, 2001, payment may not be made for a screening colonoscopy for
an individual who is not at high risk for colorectal cancer as
described in paragraph (a)(3) of this section.
(2) Effective for services furnished on or after July 1, 2001,
except as described in paragraph (g)(4) of this section, payment may be
made for a screening colonoscopy performed for an individual who is not
at high risk for colorectal cancer as described in paragraph (a)(3) of
this section, after at least 119 months have passed following the month
in which the last screening colonoscopy was performed.
(3) Payment may be made for a screening colonoscopy performed for
an individual who is at high risk for colorectal cancer as described in
paragraph (a)(3) of this section, after at least 23 months have passed
following the month in which the last screening colonoscopy was
performed, or, as provided in paragraphs (h) and (i) of this section,
the last screening barium enema was performed.
(4) In the case of an individual who is not at high risk for
colorectal cancer as described in paragraph (a)(3) of this section but
who has had a screening flexible sigmoidoscopy performed, payment may
be made for a screening colonoscopy only after at least 47 months have
passed following the month in which the last screening flexible
sigmoidoscopy was performed.
* * * * *
7. Section 410.46 is added to read as follows:
Sec. 410.46 Physician and other practitioner services furnished in or
at the direction of an IHS or Indian tribal hospital or clinic: Scope
and conditions.
(a) Medicare Part B pays, in accordance with the physician fee
schedule, for services furnished in or at the direction of a hospital
or outpatient clinic (provider-based or free-standing) that is operated
by the Indian Health Service (IHS) or by an Indian tribe or tribal
organization (as those terms are defined in section 4 of the Indian
Health Care Improvement Act). These services are subject to the same
situations, terms, and conditions that would apply if the services were
furnished in or at the direction of a hospital or clinic that is not
operated by IHS or by an Indian tribe or tribal organization. Payments
include health professional shortage areas incentive payments when the
requirements for these incentive payments in Sec. 414.42 of this
chapter are met.
(b) Payment is not made under this section to the extent that
Medicare otherwise pays for the same services under other provisions.
(c) Payment is made under these provisions for the following
services:
(1) Services for which payment is made under the physician fee
schedule in accordance with part 414 of this chapter.
(2) Services furnished by non-physician practitioners for which
payment under Part B is made under the physician fee schedule.
(3) Services furnished by a physical therapist or occupational
therapist, for which payment under Part B is made under the physician
fee schedule.
(d) Payments under these provisions will be paid to the IHS or
tribal hospital or clinic.
8. In Sec. 410.56, paragraphs (b)(1), the introductory text of
(b)(2), and (b)(3) are revised to read as follows:
Sec. 410.56 Screening pelvic examinations.
* * * * *
[[Page 55330]]
(b) * * *
(1) General rule. Except as specified in paragraphs (b)(2) and
(b)(3) of this section, payment may be made for a pelvic examination
performed on an asymptomatic woman only if the individual has not had a
pelvic examination paid for by Medicare during the preceding 23 months
following the month in which her last Medicare-covered screening pelvic
examination was performed.
(2) More frequent screening based on high-risk factors. Subject to
the limitation as specified in paragraph (b)(4) of this section,
payment may be made for a screening pelvic examination performed more
frequently than once every 24 months if the test is performed by a
physician or other practitioner specified in paragraph (a) of this
section, and there is evidence that the woman is at high risk (on the
basis of her medical history or other findings) of developing cervical
cancer or vaginal cancer, as determined in accordance with the
following risk factors:
* * * * *
(3) More frequent screening for women of childbearing age. Subject
to the limitation as specified in paragraph (b)(4) of this section,
payment may be made for a screening pelvic examination performed more
frequently than once every 24 months if the test is performed by a
physician or other practitioner as specified in paragraph (a) of this
section for a woman of childbearing age who has had an examination that
indicated the presence of cervical or vaginal cancer or other
abnormality during any of the preceding 3 years. The term ``woman of
childbearing age'' means a woman who is premenopausal, and has been
determined by a physician, or a qualified practitioner, as specified in
paragraph (a) of this section, to be of childbearing age, based on her
medical history or other findings.
* * * * *
9. Section 410.78 is revised to read as follows:
Sec. 410.78 Office and other outpatient visits, consultation,
individual psychotherapy and pharmacologic management via an
interactive telecommunications system.
(a) Definitions. For the purposes of this section the following
definitions apply:
(1) Asynchronous store and forward technologies means the
transmission of a patient's medical information from an originating
site to the physician or practitioner at the distant site. The
physician or practitioner at the distant site can review the medical
case without the patient being present. An asynchronous
telecommunications system in single media format does not include
telephone calls, images transmitted via facsimile machines and text
messages without visualization of the patient (electronic mail).
Photographs visualized by a telecommunications system must be specific
to the patient's medical condition and adequate for furnishing or
confirming a diagnosis and or treatment plan. Dermatological
photographs, for example, a photograph of a skin lesion, may be
considered to meet the requirement of a single media format under this
provision.
(2) Distant site means the site at which the physician or
practitioner delivering the service is located at the time the service
is provided via a telecommunications system.
(3) Interactive telecommunications system means multimedia
communications equipment that includes, at a minimum, audio and video
equipment permitting two-way, real-time interactive communication
between the patient and distant site physician or practitioner.
Telephones, facsimile machines, and electronic mail systems do not meet
the definition of an interactive telecommunications system.
(4) Originating site means, for purposes of a consultation, office
or other outpatient visit, individual psychotherapy, or pharmacologic
management via an interactive telecommunications system, the location
of an eligible Medicare beneficiary at the time the service being
furnished via a telecommunications system occurs. For asynchronous
store and forward telecommunications technologies, the only originating
sites are Federal telemedicine demonstration programs conducted in
Alaska or Hawaii.
(b) General rule. Medicare Part B pays for office and other
outpatient visits, professional consultation, individual psychotherapy,
and pharmacologic management furnished by means of an interactive
telecommunications system if the following conditions are met:
(1) The physician or practitioner at the distant site must be
licensed to provide the service under State law. When the physician or
practitioner at the distant site is licensed under State law to provide
a covered telehealth service (that is, professional consultations,
office and other outpatient visits, individual psychotherapy, and
pharmacologic management), he or she may bill for, and receive payment
for, this service when delivered via a telecommunications system.
(2) The practitioner at the distant site is one of the following:
(i) A physician as described in Sec. 410.20.
(ii) A physician assistant as described Sec. 410.74.
(iii) A nurse practitioner as described in Sec. 410.75.
(iv) A clinical nurse specialist as described in Sec. 410.76.
(v) A nurse-midwife as described in Sec. 410.77.
(vi) A clinical psychologist as described in Sec. 410.71.
(vii) A clinical social worker as described in Sec. 410.73.
(3) The services are furnished to a beneficiary at an originating
site, which is one of the following:
(i) The office of a physician or practitioner.
(ii) A critical access hospital (as described in section
1861(mm)(1) of the Act).
(iii) A rural health clinic (as described in section 1861(aa)(2) of
the Act).
(iv) A Federally qualified health center (as defined in section
1861(aa)(4) of the Act).
(v) A hospital (as defined in section 1861(e) of the Act).
(4) Originating sites must be located in either a rural health
professional shortage area as defined under section 332(a)(1)(A) of the
Public Health Service Act (42 U.S.C. 254e(a)(1)(A)) or in a county that
is not included in a Metropolitan Statistical Area as defined in
section 1886(d)(2)(D) of the Act. Entities participating in a Federal
telemedicine demonstration project that have been approved by, or
receive funding from, the Secretary as of December 31, 2000 qualify as
an eligible originating site regardless of geographic location.
(5) The medical examination of the patient is under the control of
the physician or practitioner at the distant site.
(c) Telepresenter not required. A telepresenter is not required as
a condition of payment unless a telepresenter is medically necessary as
determined by the physician or practitioner at the distant site.
(d) Exception to the interactive telecommunications system
requirement. For Federal telemedicine demonstration programs conducted
in Alaska or Hawaii only, Medicare payment is permitted for telehealth
when asynchronous store and forward technologies, in single or
multimedia formats, are used as a substitute for an interactive
telecommunications system.
(e) Limitation. A clinical psychologist and a clinical social
worker may bill and receive payment for individual psychotherapy via a
telecommunications system, but may
[[Page 55331]]
not seek payment for medical evaluation and management services.
10. A new subpart G is added to read as follows:
Subpart G--Medical Nutrition Therapy
Sec.
410.130 Definitions.
410.132 Medical nutrition therapy.
410.134 Provider qualifications.
Subpart G--Medical Nutrition Therapy
Sec. 410.130 Definitions.
For the purposes of this subpart, the following definitions apply:
Chronic renal insufficiency means the stage of renal disease
associated with a reduction in renal function not severe enough to
require dialysis or transplantation (glomerular filtration rate [GFR]
13-50 ml/min/1.73m\2\).
Diabetes means diabetes mellitus consisting of two types. Type 1 is
an autoimmune disease that destroys the beta cells of the pancreas,
leading to insulin deficiency. Type 2 is familial hyperglycemia that
occurs primarily in adults but can also occur in children and
adolescents. It is caused by an insulin resistance whose etiology is
multiple and not totally understood. Gestational diabetes is any degree
of glucose intolerance with onset or first recognition during
pregnancy. The diagnostic criterion for a diagnosis of diabetes for a
fasting glucose tolerance test is greater than or equal to 126 mg/dL.
Episode of care means services covered in a 12-month time period
when coordinated with initial diabetes self-management training (DSMT)
and one calendar year for each year thereafter, starting with the
assessment and including all covered interventions based on referral(s)
from a physician as specified in Sec. 410.132(c). The time period
covered for gestational diabetes extends only until the pregnancy ends.
Medical nutrition therapy services means nutritional diagnostic,
therapeutic, and counseling services provided by a registered dietitian
or nutrition professional for the purpose of managing diabetes or a
renal disease.
Physician means a doctor of medicine or osteopathy legally
authorized to practice medicine and surgery by the State in which he or
she performs such function or action (including a physician within the
meaning of section of 1101(a)(7) of the Act).
Renal disease means chronic renal insufficiency, end-stage renal
disease when dialysis is not received, or the medical condition of a
beneficiary for 36 months after kidney transplant.
Treating physician means the primary care physician or specialist
coordinating care for the beneficiary with diabetes or renal disease.
Sec. 410.132 Medical nutrition therapy.
(a) Conditions for coverage of MNT services. Medicare Part B pays
for MNT services provided by a registered dietitian or nutrition
professional as defined in Sec. 410.134 when the beneficiary is
referred for the service by the treating physician. Services covered
consist of face-to-face nutritional assessments and interventions in
accordance with nationally accepted dietary or nutritional protocols.
(b) Limitations on coverage of MNT services.
(1) MNT services based on a diagnosis of renal disease as described
in this subpart are not covered for beneficiaries receiving maintenance
dialysis for which payment is made under section 1881 of the Act.
(2) A beneficiary may only receive the maximum number of hours
covered under the DSMT benefit for both DSMT and MNT during the initial
DSMT training period unless additional hours are determined to be
medically necessary under the national coverage determination process.
(3) In years when the beneficiary is eligible for MNT and follow-up
DSMT, the beneficiary may only receive the maximum number of hours
covered under MNT unless additional hours are determined to be
medically necessary under the national coverage determination process.
(4) If a beneficiary has both diabetes and renal disease, the
beneficiary may only receive the maximum number of hours covered under
the renal MNT benefit in one episode of care unless he or she is
receiving initial DSMT services, in which case the beneficiary would
receive whichever is greater.
(5) An exception to the maximum number of hours in (b)(2), (3), and
(4) of this section may be made when the treating physician determines
that there is a change of diagnosis, medical condition, or treatment
regimen related to diabetes or renal disease that requires a change in
MNT during an episode of care.
(c) Referrals. Referral may only be made by the treating physician
when the beneficiary has been diagnosed with diabetes or renal disease
as defined in this subpart with documentation maintained by the
referring physician in the beneficiary's medical record. Referrals must
be made for each episode of care and any additional assessments or
interventions required by a change of diagnosis, medical condition, or
treatment regimen during an episode of care.
Sec. 410.134 Provider qualifications.
For Medicare Part B coverage of MNT, only a registered dietitian or
nutrition professional may provide the services. ``Registered dietitian
or nutrition professional'' means an individual who, on or after
December 22, 2000:
(a) Holds a bachelor's or higher degree granted by a regionally
accredited college or university in the United States (or an equivalent
foreign degree) with completion of the academic requirements of a
program in nutrition or dietetics accredited by an appropriate national
accreditation organization recognized for this purpose.
(b) Has completed at least 900 hours of supervised dietetics
practice under the supervision of a registered dietitian or nutrition
professional.
(c) Is licensed or certified as a dietitian or nutrition
professional by the State in which the services are performed. In a
State that does not provide for licensure or certification, the
individual will be deemed to have met this requirement if he or she is
recognized as a ``registered dietitian'' by the Commission on Dietetic
Registration or its successor organization, or meets the requirements
of paragraphs (a) and (b) of this section.
(d) Exceptions.
(i) A dietitian or nutritionist licensed or certified in a State as
of December 21, 2000 is not required to meet the requirements of (a)
and (b) of this section.
(ii) A ``registered dietician'' in good standing, as recognized by
the Commission of Dietetic Registration or its successor organization,
is deemed to have met the requirements of (a) and (b) of this section.
PART 411--EXCLUSIONS FROM MEDICARE AND LIMITATIONS ON MEDICARE
PAYMENT
1. The authority citation for part 411 continues to read as
follows:
Authority: Secs. 1102 and 1871 of the Social Security Act (42
U.S.C. 1302 and 1395hh).
2. In Sec. 411.15, paragraph (a)(1) is revised, and a new paragraph
(k)(10) is added to read as follows:
Sec. 411.15 Particular services excluded from coverage.
* * * * *
(a) * * *
(1) Examinations performed for a purpose other than treatment or
diagnosis of a specific illness, symptoms, complaint, or injury, except
for screening mammography, colorectal cancer screening tests, screening
pelvic examinations, prostate cancer screening
[[Page 55332]]
tests, or glaucoma screening exams that meet the criteria specified in
paragraphs (k)(6) through (k)(10) of this section.
* * * * *
(k) * * *
(10) In the case of screening exams for glaucoma, for the purpose
of early detection of glaucoma, subject to the conditions and
limitations specified in Sec. 410.23 of this chapter.
* * * * *
PART 414--PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES
1. The authority citation for part 414 continues to read as
follows:
Authority: Secs. 1102, 1871, and 1881(b)(1) of the Social
Security Act (42 U.S.C. 1302, 1395hh, and 1395rr(b)(1)).
2. In 414.2, the definition of ``Physician services'' is amended by
adding a new paragraph (8) to read as follows:
Sec. 414.2 Definitions.
* * * * *
Physician Services * * *
(8) Screening mammography services.
* * * * *
3. A new Sec. 414.64 is added to read as follows:
Sec. 414.64 Payment for medical nutrition therapy.
(a) Payment under the physician fee schedule. Medicare payment for
medical nutrition therapy is made under the physician fee schedule in
accordance with subpart B of this part. Payment to non-physician
professionals, as specified in paragraph (b) of this section, is the
lesser of the actual charges or 80 percent of 85 percent of the
physician fee schedule amount.
(b) To whom payment may be made. Payment may be made to a
registered dietician or nutrition professional qualified to furnish
medical nutrition therapy in accordance with part 410, subpart G of
this chapter.
(c) Effective date of payment. Medicare pays suppliers of medical
nutrition therapy on or after the effective date of enrollment of the
supplier at the carrier.
(d) Limitation on payment. Payment is made only for documented
nutritional therapy sessions actually attended by the beneficiary.
(e) Other conditions for fee-for-service payment. Payment is made
only if the beneficiary:
(1) Is not an inpatient of a hospital, SNF, nursing home, or
hospice.
(2) Is not receiving services in an RHC, FQHC or ESRD dialysis
facility.
4. Section 414.65 is revised to read as follows:
Sec. 414.65 Payment for office or other outpatient visits,
consultation, individual psychotherapy, and pharmacologic management
via interactive telecommunications systems.
(a) Professional service. Medicare payment for the professional
service via an interactive telecommunications system is made according
to the following limitations:
(1) The Medicare payment amount for office or other outpatient
visits, consultation, individual psychotherapy, and pharmacologic
management via an interactive telecommunications system is equal to the
current fee schedule amount applicable to services of the physician or
practitioner.
(2) Only the physician or practitioner at the distant site may bill
and receive payment for the professional service via an interactive
telecommunications system.
(3) Payments made to the physician or practitioner at the distant
site, including deductible and coinsurance, for the professional
service may not be shared with the referring practitioner or
telepresenter.
(b) Originating site facility fee. For office or other outpatient
visits, consultation, individual psychotherapy, or pharmacologic
management services delivered via an interactive telecommunications
system furnished on or after October 1, 2001:
(1) For services furnished on or after October 1, 2001 through
December 31, 2002, the payment amount to the originating site is the
lesser of the actual charge or the originating site facility fee of
$20. For services furnished on or after January 1 of each subsequent
year, the facility fee for the originating site will be updated by the
Medicare Economic Index (MEI) as defined in section 1842(i)(3) of the
Act.
(2) Only the originating site may bill for the originating site
facility fee and only on an assignment-related basis. The distant site
physician or practitioner may not bill for or receive payment for
facility fees associated with the professional service furnished via an
interactive telecommunications system.
(c) Deductible and coinsurance apply. The payment for the
professional service and originating site facility fee is subject to
the coinsurance and deductible requirements of sections 1833(a)(1) and
(b) of the Act.
(d) Assignment required for physicians, practitioners, and
originating sites. Payment to physicians, practitioners, and
originating sites is made only on an assignment-related basis.
(e) Sanctions. A distant site practitioner or originating site
facility may be subject to the applicable sanctions provided for in
chapter IV, part 402 and chapter V, parts 1001, 1002, and 1003 of this
title if he or she does any of the following:
(1) Knowingly and willfully bills or collects for services in
violation of the limitation of this section.
(2) Fails to timely correct excess charges by reducing the actual
charge billed for the service in an amount that does not exceed the
limiting charge for the service or fails to timely refund excess
collections.
(3) Fails to submit a claim on a standard form for services
provided for which payment is made on a fee schedule basis.
(4) Imposes a charge for completing and submitting the standard
claims form.
PART 415--SERVICES FURNISHED BY PHYSICIANS IN PROVIDERS,
SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN
CERTAIN SETTINGS
1. The authority citation for part 415 continues to read as
follows:
Authority: Secs. 1102 and 1871 of the Social Security Act (42
U.S.C. 1302 and 1395hh).
2. Section 415.130 is amended by:
A. Redesignating paragraphs (a), (b), and (c) as paragraphs (b),
(c), and (d).
B. Adding a new paragraph (a).
C. Amending newly designated paragraph (b)(3) by removing the
reference ``paragraph (b)'' and adding ``paragraph (c)'' in its place.
D. Amending newly designated paragraph (b)(4) by removing the
reference ``paragraphs (b)(1), (b)(3), and (b)(4)'' and adding
``paragraphs (c)(1), (c)(3), and (c)(4)'' in their place.
E. Revising newly designated paragraph (d).
Sec. 415.130 Conditions for payment: Physician pathology services.
(a) Definitions. The following definitions are used in this
section.
(1) Covered hospital means, with respect to an inpatient or an
outpatient, a hospital that had an arrangement with an independent
laboratory that was in effect as of July 22, 1999, under which a
laboratory furnished the technical component of physician pathology
services to fee-for-service Medicare beneficiaries who were hospital
inpatients or outpatients, and submitted claims for payment for this
technical component directly to a Medicare carrier.
(2) Fee-for-service Medicare beneficiaries means those
beneficiaries who are entitled to benefits under Part
[[Page 55333]]
A or are enrolled under Part B of Title XVIII of the Act or both and
are not enrolled in any of the following:
(i) A Medicare+Choice plan under Part C of Title XVIII of the Act.
(ii) A plan offered by an eligible organization under section 1876
of the Act;
(iii) A program of all-inclusive care for the elderly (PACE) under
1894 of the Act; or
(iv) A social health maintenance organization (SHMO) demonstration
project established under section 4018(b) of the Omnibus Budget
Reconciliation Act of 1987.
* * * * *
(d) Physician pathology services furnished by an independent
laboratory. The technical component of physician pathology services
furnished by an independent laboratory to a hospital inpatient or
outpatient before January 1, 2001 may be paid to the laboratory on a
fee schedule basis. After December 31, 2000 but before January 1, 2003,
if an independent laboratory furnishes the technical component of a
physician pathology service to a fee-for-service Medicare beneficiary
who is an inpatient or outpatient of a covered hospital, the carrier
will treat the technical component as a service for which payment will
be made to the laboratory under the physician fee schedule. For these
two years the service will not be treated as an inpatient hospital
service for which payment is made to the hospital under section 1886(d)
of the Act or as an outpatient hospital service for which payment is
made to the hospital under section 1833(t) of the Act. After December
31, 2002, the technical component for physician pathology services
furnished by an independent laboratory to a hospital inpatient or
outpatient is paid only to the hospital.
(Catalog of Federal Domestic Assistance Program No. 93.774,
Medicare--Supplementary Medical Insurance Program)
Dated: October 22, 2001.
Thomas A. Scully,
Administrator, Centers for Medicare & Medicaid Services.
Approved: October 24, 2001.
Tommy G. Thompson,
Secretary.
Note: These addenda will not appear in the Code of Federal
Regulations.
Addendum A--Explanation and Use of Addenda B
The addenda on the following pages provide various data pertaining
to the Medicare fee schedule for physicians' services furnished in
2002. Addendum B contains the RVUs for work, non-facility practice
expense, facility practice expense, and malpractice expense, and other
information for all services included in the physician fee schedule.
Addendum B--2002 Relative Value Units and Related Information Used
in Determining Medicare Payments for 2002
This addendum contains the following information for each CPT code
and alphanumeric HCPCS code, except for alphanumeric codes beginning
with B (enteral and parenteral therapy), E (durable medical equipment),
K (temporary codes for nonphysicians' services or items), or L
(orthotics), and codes for anesthesiology.
1. CPT/HCPCS code. This is the CPT or alphanumeric HCPCS number for
the service. Alphanumeric HCPCS codes are included at the end of this
addendum.
2. Modifier. A modifier is shown if there is a technical component
(modifier TC) and a professional component (PC) (modifier -26) for the
service. If there is a PC and a TC for the service, Addendum B contains
three entries for the code: One for the global values (both
professional and technical); one for modifier -26 (PC); and one for
modifier TC. The global service is not designated by a modifier, and
physicians must bill using the code without a modifier if the physician
furnishes both the PC and the TC of the service.
Modifier -53 is shown for a discontinued procedure. There will be
RVUs for the code (CPT code 45378) with this modifier.
3. Status indicator. This indicator shows whether the CPT/HCPCS
code is in the physician fee schedule and whether it is separately
payable if the service is covered.
A = Active code. These codes are separately payable under the fee
schedule if covered. There will be RVUs for codes with this status. The
presence of an ``A'' indicator does not mean that Medicare has made a
national decision regarding the coverage of the service. Carriers
remain responsible for coverage decisions in the absence of a national
Medicare policy.
B = Bundled code. Payment for covered services is always bundled
into payment for other services not specified. If RVUs are shown, they
are not used for Medicare payment. If these services are covered,
payment for them is subsumed by the payment for the services to which
they are incident. (An example is a telephone call from a hospital
nurse regarding care of a patient.)
C = Carrier-priced code. Carriers will establish RVUs and payment
amounts for these services, generally on a case-by-case basis following
review of documentation, such as an operative report.
D = Deleted code. These codes are deleted effective with the
beginning of the calendar year.
E = Excluded from physician fee schedule by regulation. These codes
are for items or services that we chose to exclude from the physician
fee schedule payment by regulation. No RVUs are shown, and no payment
may be made under the physician fee schedule for these codes. Payment
for them, if they are covered, continues under reasonable charge or
other payment procedures.
G = Code not valid for Medicare purposes. Medicare does not
recognize codes assigned this status. Medicare uses another code for
reporting of, and payment for, these services.
H = Deleted modifier (code used to have modifier of TC and PC).
I = Code not valid for Medicare purposes. Medicare does not
recognize codes assigned this status. Medicare uses another code for
the reporting of, and payment for, these services. This indicator is
treated in the same manner as status indicator ``G''. It's use allows
for more efficient processing of Medicare claims.
N = Noncovered service. These codes are noncovered services.
Medicare payment may not be made for these codes. If RVUs are shown,
they are not used for Medicare payment.
P = Bundled or excluded code. There are no RVUs for these services.
No separate payment should be made for them under the physician fee
schedule.
--If the item or service is covered as incident to a physician's
service and is furnished on the same day as a physician's service,
payment for it is bundled into the payment for the physician's service
to which it is incident (an example is an elastic bandage furnished by
a physician incident to a physician's service).
--If the item or service is covered as other than incident to a
physician's service, it is excluded from the physician fee schedule
(for example, colostomy supplies) and is paid under the other payment
provisions of the Act.
R = Restricted coverage. Special coverage instructions apply. If
the service is covered and no RVUs are shown, it is carrier-priced.
T = There are RVUs for these services, but they are only paid if
there are no other services payable under the physician fee schedule
billed on the same date by the same provider. If any other services
payable under the physician fee schedule are billed on the same date by
the same provider, these
[[Page 55334]]
services are bundled into the service(s) for which payment is made.
X = Exclusion by law. These codes represent an item or service that
is not within the definition of ``physicians' services'' for physician
fee schedule payment purposes. No RVUs are shown for these codes, and
no payment may be made under the physician fee schedule. (Examples are
ambulance services and clinical diagnostic laboratory services.)
4. Description of code. This is an abbreviated version of the
narrative description of the code.
5. Physician work RVUs. These are the RVUs for the physician work
for this service in 2000. Codes that are not used for Medicare payment
are identified with a ``+.''
6. Facility practice expense RVUs. These are the fully implemented
resource-based practice expense RVUs for facility settings.
7. Non-facility practice expense RVUs. These are the fully
implemented resource-based practice expense RVUs for non-facility
settings.
8. Malpractice expense RVUs. These are the RVUs for the malpractice
expense for the service for 2000.
9. Facility total. This is the sum of the work, fully implemented
facility practice expense, and malpractice expense RVUs.
10. Non-facility total. This is the sum of the work, fully
implemented non-facility practice expense, and malpractice expense
RVUs.
11. Global period. This indicator shows the number of days in the
global period for the code (0, 10, or 90 days). An explanation of the
alpha codes follows:
MMM = The code describes a service furnished in uncomplicated
maternity cases including antepartum care, delivery, and postpartum
care. The usual global surgical concept does not apply. See the 1999
Physicians' Current Procedural Terminology for specific definitions.
XXX = The global concept does not apply.
YYY = The global period is to be set by the carrier (for example,
unlisted surgery codes).
ZZZ = The code is part of another service and falls within the
global period for the other service.
--------------------
\1\ CPT codes and descriptions only are copyright 2001 American Medical
Association. All Rights Reserved. Applicable FARS/DFARS Apply.
\2\ Copyright 1994 American Dental Association. All rights reserved.
\3\ +Indicates RVUs are not used for Medicare payment.
[[Page 55334]]
Addendum B.--Relative Value Units (RVUs) and Related Information
--------------------------------------------------------------------------------------------------------------------------------------------------------
Fully Fully
Physician implemented Fully Mal- implemented Fully
CPT \1\/ MOD Status Description work RVUs non- implemented practice non- implemented Global
HCPCS \3\ facility PE facility PE RVUs facility facility
\2\ RVUs RVUs total total
--------------------------------------------------------------------------------------------------------------------------------------------------------
0001T ................ C Endovas repr abdo ao 0.00 0.00 0.00 0.00 0.00 0.00 XXX
aneurys.
0002T ................ C Endovas repr abdo ao 0.00 0.00 0.00 0.00 0.00 0.00 XXX
aneurys.
0003T ................ C Cervicography......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
0005T ................ C Perc cath stent/brain 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cv art.
0006T ................ C Perc cath stent/brain 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cv art.
0007T ................ C Perc cath stent/brain 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cv art.
0008T ................ C Upper gi endoscopy w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
suture.
0009T ................ C Endometrial 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cryoablation.
0010T ................ C Tb test, gamma 0.00 0.00 0.00 0.00 0.00 0.00 XXX
interferon.
0012T ................ C Osteochondral knee 0.00 0.00 0.00 0.00 0.00 0.00 XXX
autograft.
0013T ................ C Osteochondral knee 0.00 0.00 0.00 0.00 0.00 0.00 XXX
allograft.
0014T ................ C Meniscal transplant, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
knee.
0016T ................ C Thermotx choroid vasc 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lesion.
0017T ................ C Photocoagulat macular 0.00 0.00 0.00 0.00 0.00 0.00 XXX
drusen.
0018T ................ C Transcranial magnetic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
stimul.
0019T ................ C Extracorp shock wave 0.00 0.00 0.00 0.00 0.00 0.00 XXX
tx, ms.
0020T ................ C Extracorp shock wave 0.00 0.00 0.00 0.00 0.00 0.00 XXX
tx, ft.
0021T ................ C Fetal oximetry, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
trnsvag/cerv.
0023T ................ C Phenotype drug test, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hiv 1.
0024T ................ C Transcath cardiac 0.00 0.00 0.00 0.00 0.00 0.00 XXX
reduction.
0025T ................ C Ultrasonic pachymetry. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
0026T ................ C Measure remnant 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lipoproteins.
10021 ................ A Fna w/o image......... 1.27 1.02 NA 0.10 2.39 NA XXX
10021 26 A Fna w/o image......... 1.27 0.55 0.55 0.07 1.89 1.89 XXX
10021 TC A Fna w/o image......... 0.00 0.47 NA 0.03 0.50 NA XXX
10022 ................ A Fna w/image........... 1.27 1.11 NA 0.08 2.46 NA XXX
10022 26 A Fna w/image........... 1.27 0.48 0.48 0.05 1.80 1.80 XXX
10022 TC A Fna w/image........... 0.00 0.63 NA 0.03 0.66 NA XXX
10040 ................ A Acne surgery.......... 1.18 1.00 0.54 0.05 2.23 1.77 010
10060 ................ A Drainage of skin 1.17 1.51 0.70 0.08 2.76 1.95 010
abscess.
10061 ................ A Drainage of skin 2.40 1.88 1.48 0.17 4.45 4.05 010
abscess.
10080 ................ A Drainage of pilonidal 1.17 2.18 0.75 0.09 3.44 2.01 010
cyst.
10081 ................ A Drainage of pilonidal 2.45 3.02 1.61 0.19 5.66 4.25 010
cyst.
10120 ................ A Remove foreign body... 1.22 1.52 0.36 0.10 2.84 1.68 010
10121 ................ A Remove foreign body... 2.69 2.99 1.83 0.25 5.93 4.77 010
10140 ................ A Drainage of hematoma/ 1.53 1.54 0.90 0.15 3.22 2.58 010
fluid.
10160 ................ A Puncture drainage of 1.20 0.74 0.43 0.11 2.05 1.74 010
lesion.
10180 ................ A Complex drainage, 2.25 1.51 1.33 0.25 4.01 3.83 010
wound.
11000 ................ A Debride infected skin. 0.60 0.66 0.24 0.05 1.31 0.89 000
11001 ................ A Debride infected skin 0.30 0.37 0.11 0.02 0.69 0.43 ZZZ
add-on.
11010 ................ A Debride skin, fx...... 4.20 2.53 2.10 0.45 7.18 6.75 010
11011 ................ A Debride skin/muscle, 4.95 3.90 2.69 0.53 9.38 8.17 000
fx.
11012 ................ A Debride skin/muscle/ 6.88 5.52 4.35 0.89 13.29 12.12 000
bone, fx.
11040 ................ A Debride skin, partial. 0.50 0.55 0.22 0.05 1.10 0.77 000
11041 ................ A Debride skin, full.... 0.82 0.69 0.34 0.08 1.59 1.24 000
11042 ................ A Debride skin/tissue... 1.12 1.04 0.47 0.11 2.27 1.70 000
[[Page 55335]]
11043 ................ A Debride tissue/muscle. 2.38 2.72 1.42 0.24 5.34 4.04 010
11044 ................ A Debride tissue/muscle/ 3.06 3.30 1.86 0.34 6.70 5.26 010
bone.
11055 ................ R Trim skin lesion...... 0.43 0.52 0.19 0.02 0.97 0.64 000
11056 ................ R Trim skin lesions, 2 0.61 0.59 0.26 0.03 1.23 0.90 000
to 4.
11057 ................ R Trim skin lesions, 0.79 0.66 0.34 0.04 1.49 1.17 000
over 4.
11100 ................ A Biopsy of skin lesion. 0.81 1.49 0.38 0.04 2.34 1.23 000
11101 ................ A Biopsy, skin add-on... 0.41 0.71 0.20 0.02 1.14 0.63 ZZZ
11200 ................ A Removal of skin tags.. 0.77 1.20 0.32 0.04 2.01 1.13 010
11201 ................ A Remove skin tags add- 0.29 0.53 0.12 0.02 0.84 0.43 ZZZ
on.
11300 ................ A Shave skin lesion..... 0.51 1.05 0.22 0.03 1.59 0.76 000
11301 ................ A Shave skin lesion..... 0.85 1.12 0.39 0.04 2.01 1.28 000
11302 ................ A Shave skin lesion..... 1.05 1.21 0.49 0.05 2.31 1.59 000
11303 ................ A Shave skin lesion..... 1.24 1.36 0.55 0.06 2.66 1.85 000
11305 ................ A Shave skin lesion..... 0.67 0.77 0.29 0.04 1.48 1.00 000
11306 ................ A Shave skin lesion..... 0.99 1.02 0.44 0.05 2.06 1.48 000
11307 ................ A Shave skin lesion..... 1.14 1.15 0.51 0.05 2.34 1.70 000
11308 ................ A Shave skin lesion..... 1.41 1.29 0.62 0.07 2.77 2.10 000
11310 ................ A Shave skin lesion..... 0.73 1.15 0.34 0.04 1.92 1.11 000
11311 ................ A Shave skin lesion..... 1.05 1.24 0.51 0.05 2.34 1.61 000
11312 ................ A Shave skin lesion..... 1.20 1.32 0.58 0.06 2.58 1.84 000
11313 ................ A Shave skin lesion..... 1.62 1.63 0.74 0.09 3.34 2.45 000
11400 ................ A Removal of skin lesion 0.91 1.68 0.36 0.06 2.65 1.33 010
11401 ................ A Removal of skin lesion 1.32 1.83 0.53 0.09 3.24 1.94 010
11402 ................ A Removal of skin lesion 1.61 2.61 0.98 0.12 4.34 2.71 010
11403 ................ A Removal of skin lesion 1.92 2.84 1.12 0.16 4.92 3.20 010
11404 ................ A Removal of skin lesion 2.20 3.02 1.19 0.18 5.40 3.57 010
11406 ................ A Removal of skin lesion 2.76 3.33 1.41 0.25 6.34 4.42 010
11420 ................ A Removal of skin lesion 1.06 1.52 0.44 0.08 2.66 1.58 010
11421 ................ A Removal of skin lesion 1.53 1.84 0.64 0.11 3.48 2.28 010
11422 ................ A Removal of skin lesion 1.76 2.60 1.08 0.14 4.50 2.98 010
11423 ................ A Removal of skin lesion 2.17 3.02 1.26 0.17 5.36 3.60 010
11424 ................ A Removal of skin lesion 2.62 3.20 1.43 0.21 6.03 4.26 010
11426 ................ A Removal of skin lesion 3.78 3.81 1.89 0.34 7.93 6.01 010
11440 ................ A Removal of skin lesion 1.15 2.26 0.53 0.08 3.49 1.76 010
11441 ................ A Removal of skin lesion 1.61 2.48 0.74 0.11 4.20 2.46 010
11442 ................ A Removal of skin lesion 1.87 2.91 1.30 0.14 4.92 3.31 010
11443 ................ A Removal of skin lesion 2.49 3.41 1.64 0.18 6.08 4.31 010
11444 ................ A Removal of skin lesion 3.42 3.92 2.08 0.25 7.59 5.75 010
11446 ................ A Removal of skin lesion 4.49 4.37 2.58 0.30 9.16 7.37 010
11450 ................ A Removal, sweat gland 2.73 4.20 1.03 0.26 7.19 4.02 090
lesion.
11451 ................ A Removal, sweat gland 3.95 5.23 1.33 0.39 9.57 5.67 090
lesion.
11462 ................ A Removal, sweat gland 2.51 4.32 0.98 0.23 7.06 3.72 090
lesion.
11463 ................ A Removal, sweat gland 3.95 5.67 1.67 0.40 10.02 6.02 090
lesion.
11470 ................ A Removal, sweat gland 3.25 4.97 1.26 0.30 8.52 4.81 090
lesion.
11471 ................ A Removal, sweat gland 4.41 5.54 1.74 0.40 10.35 6.55 090
lesion.
11600 ................ A Removal of skin lesion 1.41 2.48 1.08 0.09 3.98 2.58 010
11601 ................ A Removal of skin lesion 1.93 2.52 1.36 0.12 4.57 3.41 010
11602 ................ A Removal of skin lesion 2.09 2.66 1.40 0.13 4.88 3.62 010
11603 ................ A Removal of skin lesion 2.35 2.93 1.49 0.16 5.44 4.00 010
11604 ................ A Removal of skin lesion 2.58 3.27 1.56 0.18 6.03 4.32 010
11606 ................ A Removal of skin lesion 3.43 3.88 1.85 0.28 7.59 5.56 010
11620 ................ A Removal of skin lesion 1.34 2.47 1.09 0.09 3.90 2.52 010
11621 ................ A Removal of skin lesion 1.97 2.56 1.41 0.12 4.65 3.50 010
11622 ................ A Removal of skin lesion 2.34 2.87 1.60 0.15 5.36 4.09 010
11623 ................ A Removal of skin lesion 2.93 3.30 1.86 0.20 6.43 4.99 010
11624 ................ A Removal of skin lesion 3.43 3.72 2.08 0.25 7.40 5.76 010
11626 ................ A Removal of skin lesion 4.30 4.48 2.57 0.35 9.13 7.22 010
11640 ................ A Removal of skin lesion 1.53 2.51 1.29 0.10 4.14 2.92 010
11641 ................ A Removal of skin lesion 2.44 2.94 1.78 0.15 5.53 4.37 010
11642 ................ A Removal of skin lesion 2.93 3.37 2.03 0.18 6.48 5.14 010
11643 ................ A Removal of skin lesion 3.50 3.83 2.32 0.24 7.57 6.06 010
11644 ................ A Removal of skin lesion 4.55 4.81 2.95 0.33 9.69 7.83 010
11646 ................ A Removal of skin lesion 5.95 5.68 3.77 0.46 12.09 10.18 010
11719 ................ R Trim nail(s).......... 0.17 0.25 0.07 0.01 0.43 0.25 000
11720 ................ A Debride nail, 1-5..... 0.32 0.34 0.13 0.02 0.68 0.47 000
11721 ................ A Debride nail, 6 or 0.54 0.44 0.22 0.04 1.02 0.80 000
more.
11730 ................ A Removal of nail plate. 1.13 0.83 0.46 0.09 2.05 1.68 000
11732 ................ A Remove nail plate, add- 0.57 0.30 0.24 0.05 0.92 0.86 ZZZ
on.
11740 ................ A Drain blood from under 0.37 0.81 0.14 0.03 1.21 0.54 000
nail.
11750 ................ A Removal of nail bed... 1.86 1.75 0.78 0.16 3.77 2.80 010
11752 ................ A Remove nail bed/finger 2.67 2.20 1.77 0.33 5.20 4.77 010
tip.
11755 ................ A Biopsy, nail unit..... 1.31 1.10 0.60 0.06 2.47 1.97 000
11760 ................ A Repair of nail bed.... 1.58 1.80 1.28 0.17 3.55 3.03 010
[[Page 55336]]
11762 ................ A Reconstruction of nail 2.89 2.28 1.95 0.32 5.49 5.16 010
bed.
11765 ................ A Excision of nail fold, 0.69 1.14 0.51 0.05 1.88 1.25 010
toe.
11770 ................ A Removal of pilonidal 2.61 3.11 1.26 0.24 5.96 4.11 010
lesion.
11771 ................ A Removal of pilonidal 5.74 5.80 4.01 0.56 12.10 10.31 090
lesion.
11772 ................ A Removal of pilonidal 6.98 6.95 4.44 0.68 14.61 12.10 090
lesion.
11900 ................ A Injection into skin 0.52 0.77 0.23 0.02 1.31 0.77 000
lesions.
11901 ................ A Added skin lesions 0.80 0.89 0.38 0.03 1.72 1.21 000
injection.
11920 ................ R Correct skin color 1.61 2.25 0.81 0.17 4.03 2.59 000
defects.
11921 ................ R Correct skin color 1.93 2.78 1.02 0.21 4.92 3.16 000
defects.
11922 ................ R Correct skin color 0.49 0.40 0.26 0.05 0.94 0.80 ZZZ
defects.
11950 ................ R Therapy for contour 0.84 1.23 0.47 0.06 2.13 1.37 000
defects.
11951 ................ R Therapy for contour 1.19 1.47 0.49 0.10 2.76 1.78 000
defects.
11952 ................ R Therapy for contour 1.69 1.65 0.64 0.17 3.51 2.50 000
defects.
11954 ................ R Therapy for contour 1.85 2.62 0.97 0.19 4.66 3.01 000
defects.
11960 ................ A Insert tissue 9.08 NA 11.54 0.88 NA 21.50 090
expander(s).
11970 ................ A Replace tissue 7.06 NA 5.15 0.77 NA 12.98 090
expander.
11971 ................ A Remove tissue 2.13 6.10 4.07 0.21 8.44 6.41 090
expander(s).
11975 ................ N Insert contraceptive +1.48 1.58 0.59 0.14 3.20 2.21 XXX
cap.
11976 ................ R Removal of 1.78 1.72 0.69 0.17 3.67 2.64 000
contraceptive cap.
11977 ................ N Removal/reinsert +3.30 2.31 1.32 0.31 5.92 4.93 XXX
contra cap.
11980 ................ A Implant hormone 1.48 1.14 0.58 0.10 2.72 2.16 000
pellet(s).
11981 ................ A Insert drug implant 1.48 1.58 0.59 0.14 3.20 2.21 XXX
device.
11982 ................ A Remove drug implant 1.78 1.70 0.71 0.17 3.65 2.66 XXX
device.
11983 ................ A Remove/insert drug 3.30 2.31 1.32 0.31 5.92 4.93 XXX
implant.
12001 ................ A Repair superficial 1.70 2.13 0.44 0.13 3.96 2.27 010
wound(s).
12002 ................ A Repair superficial 1.86 2.21 0.95 0.15 4.22 2.96 010
wound(s).
12004 ................ A Repair superficial 2.24 2.47 1.07 0.17 4.88 3.48 010
wound(s).
12005 ................ A Repair superficial 2.86 3.04 1.25 0.23 6.13 4.34 010
wound(s).
12006 ................ A Repair superficial 3.67 3.59 1.59 0.31 7.57 5.57 010
wound(s).
12007 ................ A Repair superficial 4.12 4.26 1.85 0.37 8.75 6.34 010
wound(s).
12011 ................ A Repair superficial 1.76 2.30 0.45 0.14 4.20 2.35 010
wound(s).
12013 ................ A Repair superficial 1.99 2.45 0.99 0.16 4.60 3.14 010
wound(s).
12014 ................ A Repair superficial 2.46 2.72 1.11 0.18 5.36 3.75 010
wound(s).
12015 ................ A Repair superficial 3.19 3.38 1.31 0.24 6.81 4.74 010
wound(s).
12016 ................ A Repair superficial 3.93 3.89 1.58 0.32 8.14 5.83 010
wound(s).
12017 ................ A Repair superficial 4.71 NA 1.93 0.39 NA 7.03 010
wound(s).
12018 ................ A Repair superficial 5.53 NA 2.18 0.46 NA 8.17 010
wound(s).
12020 ................ A Closure of split wound 2.62 2.51 1.44 0.24 5.37 4.30 010
12021 ................ A Closure of split wound 1.84 1.65 1.02 0.19 3.68 3.05 010
12031 ................ A Layer closure of 2.15 2.21 0.81 0.15 4.51 3.11 010
wound(s).
12032 ................ A Layer closure of 2.47 2.84 1.36 0.15 5.46 3.98 010
wound(s).
12034 ................ A Layer closure of 2.92 3.12 1.51 0.21 6.25 4.64 010
wound(s).
12035 ................ A Layer closure of 3.43 3.20 1.73 0.30 6.93 5.46 010
wound(s).
12036 ................ A Layer closure of 4.05 5.33 2.50 0.41 9.79 6.96 010
wound(s).
12037 ................ A Layer closure of 4.67 5.57 2.86 0.49 10.73 8.02 010
wound(s).
12041 ................ A Layer closure of 2.37 2.41 0.87 0.17 4.95 3.41 010
wound(s).
12042 ................ A Layer closure of 2.74 3.03 1.49 0.17 5.94 4.40 010
wound(s).
12044 ................ A Layer closure of 3.14 3.22 1.67 0.24 6.60 5.05 010
wound(s).
12045 ................ A Layer closure of 3.64 3.54 1.93 0.34 7.52 5.91 010
wound(s).
12046 ................ A Layer closure of 4.25 6.24 2.62 0.40 10.89 7.27 010
wound(s).
12047 ................ A Layer closure of 4.65 7.21 2.86 0.41 12.27 7.92 010
wound(s).
12051 ................ A Layer closure of 2.47 3.11 1.49 0.16 5.74 4.12 010
wound(s).
12052 ................ A Layer closure of 2.77 3.00 1.47 0.17 5.94 4.41 010
wound(s).
12053 ................ A Layer closure of 3.12 3.20 1.63 0.20 6.52 4.95 010
wound(s).
12054 ................ A Layer closure of 3.46 3.52 1.72 0.25 7.23 5.43 010
wound(s).
12055 ................ A Layer closure of 4.43 4.49 2.27 0.35 9.27 7.05 010
wound(s).
12056 ................ A Layer closure of 5.24 7.31 3.26 0.43 12.98 8.93 010
wound(s).
12057 ................ A Layer closure of 5.96 6.31 3.66 0.50 12.77 10.12 010
wound(s).
13100 ................ A Repair of wound or 3.12 3.39 1.93 0.21 6.72 5.26 010
lesion.
13101 ................ A Repair of wound or 3.92 3.59 2.39 0.22 7.73 6.53 010
lesion.
13102 ................ A Repair wound/lesion 1.24 0.75 0.60 0.10 2.09 1.94 ZZZ
add-on.
13120 ................ A Repair of wound or 3.30 3.48 1.95 0.23 7.01 5.48 010
lesion.
13121 ................ A Repair of wound or 4.33 3.84 2.52 0.25 8.42 7.10 010
lesion.
13122 ................ A Repair wound/lesion 1.44 0.89 0.67 0.12 2.45 2.23 ZZZ
add-on.
13131 ................ A Repair of wound or 3.79 3.75 2.30 0.25 7.79 6.34 010
lesion.
13132 ................ A Repair of wound or 5.95 4.57 3.38 0.32 10.84 9.65 010
lesion.
13133 ................ A Repair wound/lesion 2.19 1.23 1.08 0.17 3.59 3.44 ZZZ
add-on.
13150 ................ A Repair of wound or 3.81 5.19 2.75 0.29 9.29 6.85 010
lesion.
13151 ................ A Repair of wound or 4.45 5.07 3.19 0.28 9.80 7.92 010
lesion.
13152 ................ A Repair of wound or 6.33 5.78 4.14 0.38 12.49 10.85 010
lesion.
13153 ................ A Repair wound/lesion 2.38 1.38 1.20 0.18 3.94 3.76 ZZZ
add-on.
13160 ................ A Late closure of wound. 10.48 NA 6.47 1.19 NA 18.14 090
14000 ................ A Skin tissue 5.89 7.58 4.83 0.46 13.93 11.18 090
rearrangement.
[[Page 55337]]
14001 ................ A Skin tissue 8.47 8.72 6.18 0.65 17.84 15.30 090
rearrangement.
14020 ................ A Skin tissue 6.59 8.05 5.56 0.50 15.14 12.65 090
rearrangement.
14021 ................ A Skin tissue 10.06 9.29 7.38 0.69 20.04 18.13 090
rearrangement.
14040 ................ A Skin tissue 7.87 8.19 6.27 0.53 16.59 14.67 090
rearrangement.
14041 ................ A Skin tissue 11.49 9.90 8.17 0.68 22.07 20.34 090
rearrangement.
14060 ................ A Skin tissue 8.50 8.64 7.13 0.59 17.73 16.22 090
rearrangement.
14061 ................ A Skin tissue 12.29 10.85 9.08 0.75 23.89 22.12 090
rearrangement.
14300 ................ A Skin tissue 11.76 10.11 8.68 0.88 22.75 21.32 090
rearrangement.
14350 ................ A Skin tissue 9.61 NA 6.48 1.09 NA 17.18 090
rearrangement.
15000 ................ A Skin graft............ 4.00 2.51 1.91 0.37 6.88 6.28 000
15001 ................ A Skin graft add-on..... 1.00 0.64 0.43 0.11 1.75 1.54 ZZZ
15050 ................ A Skin pinch graft...... 4.30 4.98 4.12 0.46 9.74 8.88 090
15100 ................ A Skin split graft...... 9.05 6.27 6.26 0.94 16.26 16.25 090
15101 ................ A Skin split graft add- 1.72 1.40 0.76 0.18 3.30 2.66 ZZZ
on.
15120 ................ A Skin split graft...... 9.83 8.62 6.97 0.87 19.32 17.67 090
15121 ................ A Skin split graft add- 2.67 1.83 1.23 0.27 4.77 4.17 ZZZ
on.
15200 ................ A Skin full graft....... 8.03 9.90 5.64 0.73 18.66 14.40 090
15201 ................ A Skin full graft add-on 1.32 1.00 0.68 0.14 2.46 2.14 ZZZ
15220 ................ A Skin full graft....... 7.87 9.38 6.47 0.68 17.93 15.02 090
15221 ................ A Skin full graft add-on 1.19 0.92 0.60 0.12 2.23 1.91 ZZZ
15240 ................ A Skin full graft....... 9.04 9.01 7.27 0.77 18.82 17.08 090
15241 ................ A Skin full graft add-on 1.86 1.47 0.95 0.17 3.50 2.98 ZZZ
15260 ................ A Skin full graft....... 10.06 9.01 7.74 0.63 19.70 18.43 090
15261 ................ A Skin full graft add-on 2.23 1.59 1.16 0.17 3.99 3.56 ZZZ
15342 ................ A Cultured skin graft, 1.00 2.18 1.04 0.09 3.27 2.13 010
25 cm.
15343 ................ A Cultured skin graft 0.25 0.42 0.10 0.02 0.69 0.37 ZZZ
addl 25 cm.
15350 ................ A Skin homograft........ 4.00 7.78 4.23 0.42 12.20 8.65 090
15351 ................ A Skin homograft add-on. 1.00 0.85 0.42 0.11 1.96 1.53 ZZZ
15400 ................ A Skin heterograft...... 4.00 4.89 4.89 0.40 9.29 9.29 090
15401 ................ A Skin heterograft add- 1.00 1.59 0.47 0.11 2.70 1.58 ZZZ
on.
15570 ................ A Form skin pedicle flap 9.21 7.80 6.37 0.96 17.97 16.54 090
15572 ................ A Form skin pedicle flap 9.27 8.08 6.34 0.93 18.28 16.54 090
15574 ................ A Form skin pedicle flap 9.88 8.61 7.14 0.92 19.41 17.94 090
15576 ................ A Form skin pedicle flap 8.69 8.89 6.55 0.72 18.30 15.96 090
15600 ................ A Skin graft............ 1.91 6.66 2.51 0.19 8.76 4.61 090
15610 ................ A Skin graft............ 2.42 5.90 2.67 0.25 8.57 5.34 090
15620 ................ A Skin graft............ 2.94 7.04 3.54 0.28 10.26 6.76 090
15630 ................ A Skin graft............ 3.27 6.09 3.83 0.28 9.64 7.38 090
15650 ................ A Transfer skin pedicle 3.97 5.69 3.99 0.36 10.02 8.32 090
flap.
15732 ................ A Muscle-skin graft, 17.84 NA 11.63 1.50 NA 30.97 090
head/neck.
15734 ................ A Muscle-skin graft, 17.79 NA 11.49 1.91 NA 31.19 090
trunk.
15736 ................ A Muscle-skin graft, arm 16.27 NA 11.14 1.78 NA 29.19 090
15738 ................ A Muscle-skin graft, leg 17.92 NA 11.47 1.95 NA 31.34 090
15740 ................ A Island pedicle flap 10.25 8.74 7.20 0.62 19.61 18.07 090
graft.
15750 ................ A Neurovascular pedicle 11.41 NA 8.45 1.12 NA 20.98 090
graft.
15756 ................ A Free muscle flap, 35.23 NA 22.50 3.11 NA 60.84 090
microvasc.
15757 ................ A Free skin flap, 35.23 NA 22.54 3.37 NA 61.14 090
microvasc.
15758 ................ A Free fascial flap, 35.10 NA 22.75 3.52 NA 61.37 090
microvasc.
15760 ................ A Composite skin graft.. 8.74 9.27 6.93 0.72 18.73 16.39 090
15770 ................ A Derma-fat-fascia graft 7.52 NA 6.14 0.78 NA 14.44 090
15775 ................ R Hair transplant punch 3.96 3.12 1.60 0.43 7.51 5.99 000
grafts.
15776 ................ R Hair transplant punch 5.54 3.97 2.97 0.60 10.11 9.11 000
grafts.
15780 ................ A Abrasion treatment of 7.29 6.41 6.13 0.41 14.11 13.83 090
skin.
15781 ................ A Abrasion treatment of 4.85 5.17 4.83 0.27 10.29 9.95 090
skin.
15782 ................ A Abrasion treatment of 4.32 4.37 4.09 0.21 8.90 8.62 090
skin.
15783 ................ A Abrasion treatment of 4.29 5.02 3.51 0.26 9.57 8.06 090
skin.
15786 ................ A Abrasion, lesion, 2.03 1.73 1.29 0.11 3.87 3.43 010
single.
15787 ................ A Abrasion, lesions, add- 0.33 0.39 0.18 0.02 0.74 0.53 ZZZ
on.
15788 ................ R Chemical peel, face, 2.09 3.15 1.07 0.11 5.35 3.27 090
epiderm.
15789 ................ R Chemical peel, face, 4.92 5.65 3.32 0.27 10.84 8.51 090
dermal.
15792 ................ R Chemical peel, 1.86 2.87 1.63 0.10 4.83 3.59 090
nonfacial.
15793 ................ A Chemical peel, 3.74 NA 3.81 0.17 NA 7.72 090
nonfacial.
15810 ................ A Salabrasion........... 4.74 4.04 4.04 0.42 9.20 9.20 090
15811 ................ A Salabrasion........... 5.39 5.85 5.06 0.52 11.76 10.97 090
15819 ................ A Plastic surgery, neck. 9.38 NA 6.24 0.77 NA 16.39 090
15820 ................ A Revision of lower 5.15 10.34 7.13 0.30 15.79 12.58 090
eyelid.
15821 ................ A Revision of lower 5.72 11.87 7.34 0.31 17.90 13.37 090
eyelid.
15822 ................ A Revision of upper 4.45 10.58 6.58 0.22 15.25 11.25 090
eyelid.
15823 ................ A Revision of upper 7.05 11.38 7.60 0.32 18.75 14.97 090
eyelid.
15824 ................ R Removal of forehead 0.00 0.00 0.00 0.00 0.00 0.00 000
wrinkles.
15825 ................ R Removal of neck 0.00 0.00 0.00 0.00 0.00 0.00 000
wrinkles.
15826 ................ R Removal of brow 0.00 0.00 0.00 0.00 0.00 0.00 000
wrinkles.
15828 ................ R Removal of face 0.00 0.00 0.00 0.00 0.00 0.00 000
wrinkles.
[[Page 55338]]
15829 ................ R Removal of skin 0.00 0.00 0.00 0.00 0.00 0.00 000
wrinkles.
15831 ................ A Excise excessive skin 12.40 NA 8.14 1.30 NA 21.84 090
tissue.
15832 ................ A Excise excessive skin 11.59 NA 8.04 1.21 NA 20.84 090
tissue.
15833 ................ A Excise excessive skin 10.64 NA 7.34 1.17 NA 19.15 090
tissue.
15834 ................ A Excise excessive skin 10.85 NA 7.59 1.18 NA 19.62 090
tissue.
15835 ................ A Excise excessive skin 11.67 NA 7.94 1.13 NA 20.74 090
tissue.
15836 ................ A Excise excessive skin 9.34 NA 6.51 0.95 NA 16.80 090
tissue.
15837 ................ A Excise excessive skin 8.43 7.30 6.38 0.78 16.51 15.59 090
tissue.
15838 ................ A Excise excessive skin 7.13 NA 5.70 0.58 NA 13.41 090
tissue.
15839 ................ A Excise excessive skin 9.38 7.64 5.97 0.88 17.90 16.23 090
tissue.
15840 ................ A Graft for face nerve 13.26 NA 10.10 1.15 NA 24.51 090
palsy.
15841 ................ A Graft for face nerve 23.26 NA 14.68 2.65 NA 40.59 090
palsy.
15842 ................ A Flap for face nerve 37.96 NA 22.81 3.99 NA 64.76 090
palsy.
15845 ................ A Skin and muscle 12.57 NA 8.81 0.80 NA 22.18 090
repair, face.
15850 ................ B Removal of sutures.... +0.78 1.43 0.31 0.04 2.25 1.13 XXX
15851 ................ A Removal of sutures.... 0.86 1.64 0.35 0.05 2.55 1.26 000
15852 ................ A Dressing change, not 0.86 1.93 0.36 0.07 2.86 1.29 000
for burn.
15860 ................ A Test for blood flow in 1.95 1.35 0.84 0.13 3.43 2.92 000
graft.
15876 ................ R Suction assisted 0.00 0.00 0.00 0.00 0.00 0.00 000
lipectomy.
15877 ................ R Suction assisted 0.00 0.00 0.00 0.00 0.00 0.00 000
lipectomy.
15878 ................ R Suction assisted 0.00 0.00 0.00 0.00 0.00 0.00 000
lipectomy.
15879 ................ R Suction assisted 0.00 0.00 0.00 0.00 0.00 0.00 000
lipectomy.
15920 ................ A Removal of tail bone 7.95 NA 5.90 0.83 NA 14.68 090
ulcer.
15922 ................ A Removal of tail bone 9.90 NA 7.78 1.06 NA 18.74 090
ulcer.
15931 ................ A Remove sacrum pressure 9.24 NA 5.89 0.95 NA 16.08 090
sore.
15933 ................ A Remove sacrum pressure 10.85 NA 8.32 1.14 NA 20.31 090
sore.
15934 ................ A Remove sacrum pressure 12.69 NA 8.48 1.35 NA 22.52 090
sore.
15935 ................ A Remove sacrum pressure 14.57 NA 10.12 1.56 NA 26.25 090
sore.
15936 ................ A Remove sacrum pressure 12.38 NA 8.81 1.32 NA 22.51 090
sore.
15937 ................ A Remove sacrum pressure 14.21 NA 10.75 1.51 NA 26.47 090
sore.
15940 ................ A Remove hip pressure 9.34 NA 6.17 0.98 NA 16.49 090
sore.
15941 ................ A Remove hip pressure 11.43 NA 10.44 1.23 NA 23.10 090
sore.
15944 ................ A Remove hip pressure 11.46 NA 8.77 1.21 NA 21.44 090
sore.
15945 ................ A Remove hip pressure 12.69 NA 9.73 1.38 NA 23.80 090
sore.
15946 ................ A Remove hip pressure 21.57 NA 14.65 2.32 NA 38.54 090
sore.
15950 ................ A Remove thigh pressure 7.54 NA 5.43 0.80 NA 13.77 090
sore.
15951 ................ A Remove thigh pressure 10.72 NA 8.07 1.14 NA 19.93 090
sore.
15952 ................ A Remove thigh pressure 11.39 NA 7.86 1.19 NA 20.44 090
sore.
15953 ................ A Remove thigh pressure 12.63 NA 9.24 1.38 NA 23.25 090
sore.
15956 ................ A Remove thigh pressure 15.52 NA 10.71 1.64 NA 27.87 090
sore.
15958 ................ A Remove thigh pressure 15.48 NA 11.20 1.66 NA 28.34 090
sore.
15999 ................ C Removal of pressure 0.00 0.00 0.00 0.00 0.00 0.00 YYY
sore.
16000 ................ A Initial treatment of 0.89 1.09 0.27 0.06 2.04 1.22 000
burn(s).
16010 ................ A Treatment of burn(s).. 0.87 1.21 0.37 0.07 2.15 1.31 000
16015 ................ A Treatment of burn(s).. 2.35 2.01 1.03 0.22 4.58 3.60 000
16020 ................ A Treatment of burn(s).. 0.80 1.20 0.27 0.06 2.06 1.13 000
16025 ................ A Treatment of burn(s).. 1.85 1.94 0.69 0.16 3.95 2.70 000
16030 ................ A Treatment of burn(s).. 2.08 3.36 0.97 0.18 5.62 3.23 000
16035 ................ A Incision of burn scab, 3.75 NA 1.56 0.36 NA 5.67 090
initi.
16036 ................ A Incise burn scab, addl 1.50 NA 0.62 0.11 NA 2.23 ZZZ
incis.
17000 ................ A Detroy benign/premal 0.60 1.10 0.28 0.03 1.73 0.91 010
lesion.
17003 ................ A Destroy lesions, 2-14. 0.15 0.24 0.07 0.01 0.40 0.23 ZZZ
17004 ................ A Destroy lesions, 15 or 2.79 2.56 1.30 0.12 5.47 4.21 010
more.
17106 ................ A Destruction of skin 4.59 4.88 2.88 0.28 9.75 7.75 090
lesions.
17107 ................ A Destruction of skin 9.16 6.92 5.28 0.53 16.61 14.97 090
lesions.
17108 ................ A Destruction of skin 13.20 8.87 7.26 0.89 22.96 21.35 090
lesions.
17110 ................ A Destruct lesion, 1-14. 0.65 1.11 0.26 0.04 1.80 0.95 010
17111 ................ A Destruct lesion, 15 or 0.92 1.13 0.41 0.04 2.09 1.37 010
more.
17250 ................ A Chemical cautery, 0.50 0.76 0.21 0.04 1.30 0.75 000
tissue.
17260 ................ A Destruction of skin 0.91 1.37 0.39 0.04 2.32 1.34 010
lesions.
17261 ................ A Destruction of skin 1.17 1.48 0.56 0.05 2.70 1.78 010
lesions.
17262 ................ A Destruction of skin 1.58 1.69 0.76 0.07 3.34 2.41 010
lesions.
17263 ................ A Destruction of skin 1.79 1.80 0.83 0.08 3.67 2.70 010
lesions.
17264 ................ A Destruction of skin 1.94 1.87 0.87 0.08 3.89 2.89 010
lesions.
17266 ................ A Destruction of skin 2.34 2.08 1.05 0.11 4.53 3.50 010
lesions.
17270 ................ A Destruction of skin 1.32 1.57 0.60 0.06 2.95 1.98 010
lesions.
17271 ................ A Destruction of skin 1.49 1.65 0.72 0.06 3.20 2.27 010
lesions.
17272 ................ A Destruction of skin 1.77 1.79 0.86 0.07 3.63 2.70 010
lesions.
17273 ................ A Destruction of skin 2.05 1.93 0.97 0.09 4.07 3.11 010
lesions.
17274 ................ A Destruction of skin 2.59 2.21 1.20 0.11 4.91 3.90 010
lesions.
17276 ................ A Destruction of skin 3.20 2.52 1.84 0.15 5.87 5.19 010
lesions.
17280 ................ A Destruction of skin 1.17 1.41 0.54 0.05 2.63 1.76 010
lesions.
17281 ................ A Destruction of skin 1.72 1.77 0.83 0.07 3.56 2.62 010
lesions.
[[Page 55339]]
17282 ................ A Destruction of skin 2.04 1.93 0.99 0.09 4.06 3.12 010
lesions.
17283 ................ A Destruction of skin 2.64 2.23 1.24 0.11 4.98 3.99 010
lesions.
17284 ................ A Destruction of skin 3.21 2.52 1.51 0.14 5.87 4.86 010
lesions.
17286 ................ A Destruction of skin 4.44 3.23 2.52 0.22 7.89 7.18 010
lesions.
17304 ................ A Chemosurgery of skin 7.60 7.76 3.74 0.31 15.67 11.65 000
lesion.
17305 ................ A 2nd stage chemosurgery 2.85 3.60 1.40 0.12 6.57 4.37 000
17306 ................ A 3rd stage chemosurgery 2.85 3.64 1.41 0.12 6.61 4.38 000
17307 ................ A Followup skin lesion 2.85 3.62 1.43 0.12 6.59 4.40 000
therapy.
17310 ................ A Extensive skin 0.95 1.54 0.48 0.05 2.54 1.48 000
chemosurgery.
17340 ................ A Cryotherapy of skin... 0.76 0.39 0.27 0.04 1.19 1.07 010
17360 ................ A Skin peel therapy..... 1.43 1.46 0.73 0.06 2.95 2.22 010
17380 ................ R Hair removal by 0.00 0.00 0.00 0.00 0.00 0.00 000
electrolysis.
17999 ................ C Skin tissue procedure. 0.00 0.00 0.00 0.00 0.00 0.00 YYY
19000 ................ A Drainage of breast 0.84 1.27 0.30 0.07 2.18 1.21 000
lesion.
19001 ................ A Drain breast lesion 0.42 0.86 0.15 0.03 1.31 0.60 ZZZ
add-on.
19020 ................ A Incision of breast 3.57 7.13 3.51 0.35 11.05 7.43 090
lesion.
19030 ................ A Injection for breast x- 1.53 3.70 0.54 0.07 5.30 2.14 000
ray.
19100 ................ A Bx breast percut w/o 1.27 1.50 0.45 0.10 2.87 1.82 000
image.
19101 ................ A Biopsy of breast, open 3.18 5.27 1.97 0.20 8.65 5.35 010
19102 ................ A Bx breast percut w/ 2.00 5.13 0.71 0.13 7.26 2.84 000
image.
19103 ................ A Bx breast percut w/ 3.70 12.73 1.31 0.16 16.59 5.17 000
device.
19110 ................ A Nipple exploration.... 4.30 9.79 4.56 0.44 14.53 9.30 090
19112 ................ A Excise breast duct 3.67 10.91 3.19 0.38 14.96 7.24 090
fistula.
19120 ................ A Removal of breast 5.56 5.18 3.20 0.56 11.30 9.32 090
lesion.
19125 ................ A Excision, breast 6.06 5.36 3.36 0.61 12.03 10.03 090
lesion.
19126 ................ A Excision, addl breast 2.93 NA 1.06 0.30 NA 4.29 ZZZ
lesion.
19140 ................ A Removal of breast 5.14 10.26 3.79 0.52 15.92 9.45 090
tissue.
19160 ................ A Removal of breast 5.99 NA 4.62 0.61 NA 11.22 090
tissue.
19162 ................ A Remove breast tissue, 13.53 NA 8.07 1.38 NA 22.98 090
nodes.
19180 ................ A Removal of breast..... 8.80 NA 6.08 0.88 NA 15.76 090
19182 ................ A Removal of breast..... 7.73 NA 5.06 0.79 NA 13.58 090
19200 ................ A Removal of breast..... 15.49 NA 9.33 1.51 NA 26.33 090
19220 ................ A Removal of breast..... 15.72 NA 9.52 1.56 NA 26.80 090
19240 ................ A Removal of breast..... 16.00 NA 8.94 1.62 NA 26.56 090
19260 ................ A Removal of chest wall 15.44 NA 9.12 1.64 NA 26.20 090
lesion.
19271 ................ A Revision of chest wall 18.90 NA 11.13 2.27 NA 32.30 090
19272 ................ A Extensive chest wall 21.55 NA 12.36 2.54 NA 36.45 090
surgery.
19290 ................ A Place needle wire, 1.27 2.95 0.45 0.06 4.28 1.78 000
breast.
19291 ................ A Place needle wire, 0.63 1.74 0.22 0.03 2.40 0.88 ZZZ
breast.
19295 ................ A Place breast clip, 0.00 2.83 NA 0.01 2.84 NA ZZZ
percut.
19316 ................ A Suspension of breast.. 10.69 NA 8.00 1.15 NA 19.84 090
19318 ................ A Reduction of large 15.62 NA 10.64 1.69 NA 27.95 090
breast.
19324 ................ A Enlarge breast........ 5.85 NA 4.41 0.63 NA 10.89 090
19325 ................ A Enlarge breast with 8.45 NA 7.00 0.90 NA 16.35 090
implant.
19328 ................ A Removal of breast 5.68 NA 4.73 0.61 NA 11.02 090
implant.
19330 ................ A Removal of implant 7.59 NA 5.41 0.81 NA 13.81 090
material.
19340 ................ A Immediate breast 6.33 NA 3.30 0.68 NA 10.31 ZZZ
prosthesis.
19342 ................ A Delayed breast 11.20 NA 8.15 1.21 NA 20.56 090
prosthesis.
19350 ................ A Breast reconstruction. 8.92 14.55 7.09 0.95 24.42 16.96 090
19355 ................ A Correct inverted 7.57 12.42 5.93 0.80 20.79 14.30 090
nipple(s).
19357 ................ A Breast reconstruction. 18.16 NA 14.40 1.96 NA 34.52 090
19361 ................ A Breast reconstruction. 19.26 NA 12.45 2.08 NA 33.79 090
19364 ................ A Breast reconstruction. 41.00 NA 25.45 3.91 NA 70.36 090
19366 ................ A Breast reconstruction. 21.28 NA 12.02 2.27 NA 35.57 090
19367 ................ A Breast reconstruction. 25.73 NA 15.77 2.78 NA 44.28 090
19368 ................ A Breast reconstruction. 32.42 NA 19.04 3.51 NA 54.97 090
19369 ................ A Breast reconstruction. 29.82 NA 18.29 3.24 NA 51.35 090
19370 ................ A Surgery of breast 8.05 NA 6.39 0.86 NA 15.30 090
capsule.
19371 ................ A Removal of breast 9.35 NA 7.46 1.01 NA 17.82 090
capsule.
19380 ................ A Revise breast 9.14 NA 7.35 0.98 NA 17.47 090
reconstruction.
19396 ................ A Design custom breast 2.17 7.08 0.87 0.23 9.48 3.27 000
implant.
19499 ................ C Breast surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
20000 ................ A Incision of abscess... 2.12 2.23 1.20 0.17 4.52 3.49 010
20005 ................ A Incision of deep 3.42 3.07 2.22 0.34 6.83 5.98 010
abscess.
20100 ................ A Explore wound, neck... 10.08 6.49 4.12 0.99 17.56 15.19 010
20101 ................ A Explore wound, chest.. 3.22 3.03 1.64 0.24 6.49 5.10 010
20102 ................ A Explore wound, abdomen 3.94 3.43 1.85 0.35 7.72 6.14 010
20103 ................ A Explore wound, 5.30 4.41 3.01 0.57 10.28 8.88 010
extremity.
20150 ................ A Excise epiphyseal bar. 13.69 NA 9.72 0.96 NA 24.37 090
20200 ................ A Muscle biopsy......... 1.46 1.72 0.62 0.17 3.35 2.25 000
20205 ................ A Deep muscle biopsy.... 2.35 4.04 0.98 0.23 6.62 3.56 000
20206 ................ A Needle biopsy, muscle. 0.99 3.27 0.36 0.06 4.32 1.41 000
20220 ................ A Bone biopsy, trocar/ 1.27 4.96 2.98 0.06 6.29 4.31 000
needle.
[[Page 55340]]
20225 ................ A Bone biopsy, trocar/ 1.87 4.47 3.06 0.11 6.45 5.04 000
needle.
20240 ................ A Bone biopsy, 3.23 NA 4.15 0.33 NA 7.71 010
excisional.
20245 ................ A Bone biopsy, 7.78 NA 6.91 0.44 NA 15.13 010
excisional.
20250 ................ A Open bone biopsy...... 5.03 NA 4.37 0.50 NA 9.90 010
20251 ................ A Open bone biopsy...... 5.56 NA 4.86 0.79 NA 11.21 010
20500 ................ A Injection of sinus 1.23 5.34 3.91 0.10 6.67 5.24 010
tract.
20501 ................ A Inject sinus tract for 0.76 3.32 0.27 0.03 4.11 1.06 000
x-ray.
20520 ................ A Removal of foreign 1.85 5.62 3.62 0.17 7.64 5.64 010
body.
20525 ................ A Removal of foreign 3.50 7.26 4.40 0.40 11.16 8.30 010
body.
20526 ................ A Ther injection carpal 0.86 0.78 0.39 0.06 1.70 1.31 000
tunnel.
20550 ................ A Inject tendon/ligament/ 0.86 0.85 0.28 0.06 1.77 1.20 000
cyst.
20551 ................ A Inject tendon origin/ 0.86 0.78 0.39 0.06 1.70 1.31 000
insert.
20552 ................ A Inject trigger point, 0.86 0.78 0.39 0.06 1.70 1.31 000
1 or 2.
20553 ................ A Inject trigger points, 0.86 0.78 0.39 0.06 1.70 1.31 000
> 3.
20600 ................ A Drain/inject, joint/ 0.66 0.67 0.37 0.06 1.39 1.09 000
bursa.
20605 ................ A Drain/inject, joint/ 0.68 0.78 0.38 0.06 1.52 1.12 000
bursa.
20610 ................ A Drain/inject, joint/ 0.79 0.96 0.44 0.08 1.83 1.31 000
bursa.
20615 ................ A Treatment of bone cyst 2.28 4.89 2.52 0.19 7.36 4.99 010
20650 ................ A Insert and remove bone 2.23 5.06 3.19 0.28 7.57 5.70 010
pin.
20660 ................ A Apply, remove fixation 2.51 NA 1.49 0.48 NA 4.48 000
device.
20661 ................ A Application of head 4.89 NA 6.74 0.92 NA 12.55 090
brace.
20662 ................ A Application of pelvis 6.07 NA 5.12 0.81 NA 12.00 090
brace.
20663 ................ A Application of thigh 5.43 NA 4.94 0.77 NA 11.14 090
brace.
20664 ................ A Halo brace application 8.06 NA 8.55 1.49 NA 18.10 090
20665 ................ A Removal of fixation 1.31 2.33 1.25 0.17 3.81 2.73 010
device.
20670 ................ A Removal of support 1.74 5.73 3.42 0.23 7.70 5.39 010
implant.
20680 ................ A Removal of support 3.35 5.04 5.04 0.46 8.85 8.85 090
implant.
20690 ................ A Apply bone fixation 3.52 NA 1.91 0.47 NA 5.90 090
device.
20692 ................ A Apply bone fixation 6.41 NA 3.57 0.60 NA 10.58 090
device.
20693 ................ A Adjust bone fixation 5.86 NA 12.98 0.85 NA 19.69 090
device.
20694 ................ A Remove bone fixation 4.16 8.96 6.30 0.57 13.69 11.03 090
device.
20802 ................ A Replantation, arm, 41.15 NA 28.95 5.81 NA 75.91 090
complete.
20805 ................ A Replant, forearm, 50.00 NA 38.72 3.95 NA 92.67 090
complete.
20808 ................ A Replantation hand, 61.65 NA 56.41 6.49 NA 124.55 090
complete.
20816 ................ A Replantation digit, 30.94 NA 49.50 3.01 NA 83.45 090
complete.
20822 ................ A Replantation digit, 25.59 NA 45.97 3.07 NA 74.63 090
complete.
20824 ................ A Replantation thumb, 30.94 NA 49.10 3.48 NA 83.52 090
complete.
20827 ................ A Replantation thumb, 26.41 NA 45.65 3.21 NA 75.27 090
complete.
20838 ................ A Replantation foot, 41.41 NA 25.82 5.85 NA 73.08 090
complete.
20900 ................ A Removal of bone for 5.58 5.97 5.97 0.77 12.32 12.32 090
graft.
20902 ................ A Removal of bone for 7.55 NA 8.91 1.06 NA 17.52 090
graft.
20910 ................ A Remove cartilage for 5.34 9.09 6.94 0.50 14.93 12.78 090
graft.
20912 ................ A Remove cartilage for 6.35 NA 7.68 0.55 NA 14.58 090
graft.
20920 ................ A Removal of fascia for 5.31 NA 5.44 0.54 NA 11.29 090
graft.
20922 ................ A Removal of fascia for 6.61 8.50 6.28 0.88 15.99 13.77 090
graft.
20924 ................ A Removal of tendon for 6.48 NA 7.03 0.82 NA 14.33 090
graft.
20926 ................ A Removal of tissue for 5.53 NA 6.54 0.73 NA 12.80 090
graft.
20930 ................ B Spinal bone allograft. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
20931 ................ A Spinal bone allograft. 1.81 NA 0.98 0.34 NA 3.13 ZZZ
20936 ................ B Spinal bone autograft. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
20937 ................ A Spinal bone autograft. 2.79 NA 1.54 0.43 NA 4.76 ZZZ
20938 ................ A Spinal bone autograft. 3.02 NA 1.64 0.52 NA 5.18 ZZZ
20950 ................ A Fluid pressure, muscle 1.26 NA 2.15 0.16 NA 3.57 000
20955 ................ A Fibula bone graft, 39.21 NA 30.52 4.35 NA 74.08 090
microvasc.
20956 ................ A Iliac bone graft, 39.27 NA 28.18 5.77 NA 73.22 090
microvasc.
20957 ................ A Mt bone graft, 40.65 NA 21.71 5.74 NA 68.10 090
microvasc.
20962 ................ A Other bone graft, 39.27 NA 28.54 5.19 NA 73.00 090
microvasc.
20969 ................ A Bone/skin graft, 43.92 NA 33.31 4.34 NA 81.57 090
microvasc.
20970 ................ A Bone/skin graft, iliac 43.06 NA 30.08 4.64 NA 77.78 090
crest.
20972 ................ A Bone/skin graft, 42.99 NA 18.23 6.07 NA 67.29 090
metatarsal.
20973 ................ A Bone/skin graft, great 45.76 NA 30.52 4.65 NA 80.93 090
toe.
20974 ................ A Electrical bone 0.62 0.47 0.34 0.09 1.18 1.05 000
stimulation.
20975 ................ A Electrical bone 2.60 NA 1.42 0.42 NA 4.44 000
stimulation.
20979 ................ A Us bone stimulation... 0.62 0.58 0.25 0.04 1.24 0.91 000
20999 ................ C Musculoskeletal 0.00 0.00 0.00 0.00 0.00 0.00 YYY
surgery.
21010 ................ A Incision of jaw joint. 10.14 NA 7.24 0.54 NA 17.92 090
21015 ................ A Resection of facial 5.29 NA 7.38 0.52 NA 13.19 090
tumor.
21025 ................ A Excision of bone, 10.06 7.40 7.00 0.79 18.25 17.85 090
lower jaw.
21026 ................ A Excision of facial 4.85 5.23 5.12 0.40 10.48 10.37 090
bone(s).
21029 ................ A Contour of face bone 7.71 7.18 6.73 0.74 15.63 15.18 090
lesion.
21030 ................ A Removal of face bone 6.46 5.47 4.94 0.60 12.53 12.00 090
lesion.
21031 ................ A Remove exostosis, 3.24 3.39 2.19 0.28 6.91 5.71 090
mandible.
21032 ................ A Remove exostosis, 3.24 3.38 2.47 0.27 6.89 5.98 090
maxilla.
[[Page 55341]]
21034 ................ A Removal of face bone 16.17 10.59 10.59 1.37 28.13 28.13 090
lesion.
21040 ................ A Removal of jaw bone 2.11 3.03 1.81 0.19 5.33 4.11 090
lesion.
21041 ................ A Removal of jaw bone 6.71 5.68 4.46 0.56 12.95 11.73 090
lesion.
21044 ................ A Removal of jaw bone 11.86 NA 8.33 0.87 NA 21.06 090
lesion.
21045 ................ A Extensive jaw surgery. 16.17 NA 10.63 1.20 NA 28.00 090
21050 ................ A Removal of jaw joint.. 10.77 NA 11.93 0.84 NA 23.54 090
21060 ................ A Remove jaw joint 10.23 NA 10.59 1.16 NA 21.98 090
cartilage.
21070 ................ A Remove coronoid 8.20 NA 6.36 0.67 NA 15.23 090
process.
21076 ................ A Prepare face/oral 13.42 9.87 7.41 1.36 24.65 22.19 010
prosthesis.
21077 ................ A Prepare face/oral 33.75 24.83 18.64 3.43 62.01 55.82 090
prosthesis.
21079 ................ A Prepare face/oral 22.34 17.55 12.90 1.59 41.48 36.83 090
prosthesis.
21080 ................ A Prepare face/oral 25.10 19.72 14.49 2.55 47.37 42.14 090
prosthesis.
21081 ................ A Prepare face/oral 22.88 17.97 13.21 1.87 42.72 37.96 090
prosthesis.
21082 ................ A Prepare face/oral 20.87 15.35 11.53 1.46 37.68 33.86 090
prosthesis.
21083 ................ A Prepare face/oral 19.30 15.16 11.14 1.96 36.42 32.40 090
prosthesis.
21084 ................ A Prepare face/oral 22.51 17.68 12.99 1.57 41.76 37.07 090
prosthesis.
21085 ................ A Prepare face/oral 9.00 6.62 4.97 0.65 16.27 14.62 010
prosthesis.
21086 ................ A Prepare face/oral 24.92 19.58 14.39 1.86 46.36 41.17 090
prosthesis.
21087 ................ A Prepare face/oral 24.92 18.33 13.76 2.22 45.47 40.90 090
prosthesis.
21088 ................ C Prepare face/oral 0.00 0.00 0.00 0.00 0.00 0.00 090
prosthesis.
21089 ................ C Prepare face/oral 0.00 0.00 0.00 0.00 0.00 0.00 090
prosthesis.
21100 ................ A Maxillofacial fixation 4.22 5.66 3.70 0.18 10.06 8.10 090
21110 ................ A Interdental fixation.. 5.21 5.25 4.48 0.28 10.74 9.97 090
21116 ................ A Injection, jaw joint x- 0.81 7.88 0.30 0.05 8.74 1.16 000
ray.
21120 ................ A Reconstruction of chin 4.93 7.96 4.98 0.29 13.18 10.20 090
21121 ................ A Reconstruction of chin 7.64 7.68 6.65 0.56 15.88 14.85 090
21122 ................ A Reconstruction of chin 8.52 NA 7.95 0.59 NA 17.06 090
21123 ................ A Reconstruction of chin 11.16 NA 7.68 1.16 NA 20.00 090
21125 ................ A Augmentation, lower 10.62 9.56 7.84 0.72 20.90 19.18 090
jaw bone.
21127 ................ A Augmentation, lower 11.12 10.66 7.33 0.76 22.54 19.21 090
jaw bone.
21137 ................ A Reduction of forehead. 9.82 NA 8.20 0.53 NA 18.55 090
21138 ................ A Reduction of forehead. 12.19 NA 8.82 1.47 NA 22.48 090
21139 ................ A Reduction of forehead. 14.61 NA 8.23 1.02 NA 23.86 090
21141 ................ A Reconstruct midface, 18.10 NA 10.69 1.63 NA 30.42 090
lefort.
21142 ................ A Reconstruct midface, 18.81 NA 13.80 1.16 NA 33.77 090
lefort.
21143 ................ A Reconstruct midface, 19.58 NA 11.21 0.90 NA 31.69 090
lefort.
21145 ................ A Reconstruct midface, 19.94 NA 11.69 2.09 NA 33.72 090
lefort.
21146 ................ A Reconstruct midface, 20.71 NA 11.61 2.13 NA 34.45 090
lefort.
21147 ................ A Reconstruct midface, 21.77 NA 12.07 1.52 NA 35.36 090
lefort.
21150 ................ A Reconstruct midface, 25.24 NA 17.20 1.09 NA 43.53 090
lefort.
21151 ................ A Reconstruct midface, 28.30 NA 21.35 1.98 NA 51.63 090
lefort.
21154 ................ A Reconstruct midface, 30.52 NA 21.03 4.86 NA 56.41 090
lefort.
21155 ................ A Reconstruct midface, 34.45 NA 23.20 5.48 NA 63.13 090
lefort.
21159 ................ A Reconstruct midface, 42.38 NA 21.72 6.74 NA 70.84 090
lefort.
21160 ................ A Reconstruct midface, 46.44 NA 30.39 4.39 NA 81.22 090
lefort.
21172 ................ A Reconstruct orbit/ 27.80 NA 16.39 1.91 NA 46.10 090
forehead.
21175 ................ A Reconstruct orbit/ 33.17 NA 19.79 5.16 NA 58.12 090
forehead.
21179 ................ A Reconstruct entire 22.25 NA 18.94 2.48 NA 43.67 090
forehead.
21180 ................ A Reconstruct entire 25.19 NA 18.33 2.15 NA 45.67 090
forehead.
21181 ................ A Contour cranial bone 9.90 NA 8.46 0.97 NA 19.33 090
lesion.
21182 ................ A Reconstruct cranial 32.19 NA 21.97 2.53 NA 56.69 090
bone.
21183 ................ A Reconstruct cranial 35.31 NA 22.93 2.75 NA 60.99 090
bone.
21184 ................ A Reconstruct cranial 38.24 NA 19.54 4.12 NA 61.90 090
bone.
21188 ................ A Reconstruction of 22.46 NA 15.86 1.85 NA 40.17 090
midface.
21193 ................ A Reconst lwr jaw w/o 17.15 NA 10.77 1.53 NA 29.45 090
graft.
21194 ................ A Reconst lwr jaw w/ 19.84 NA 12.44 1.39 NA 33.67 090
graft.
21195 ................ A Reconst lwr jaw w/o 17.24 NA 12.36 1.20 NA 30.80 090
fixation.
21196 ................ A Reconst lwr jaw w/ 18.91 NA 12.83 1.62 NA 33.36 090
fixation.
21198 ................ A Reconstr lwr jaw 14.16 NA 12.30 1.05 NA 27.51 090
segment.
21199 ................ A Reconstr lwr jaw w/ 16.00 NA 10.85 1.26 NA 28.11 090
advance.
21206 ................ A Reconstruct upper jaw 14.10 NA 9.39 1.01 NA 24.50 090
bone.
21208 ................ A Augmentation of facial 10.23 8.95 8.62 0.92 20.10 19.77 090
bones.
21209 ................ A Reduction of facial 6.72 8.05 6.54 0.60 15.37 13.86 090
bones.
21210 ................ A Face bone graft....... 10.23 8.82 8.28 0.88 19.93 19.39 090
21215 ................ A Lower jaw bone graft.. 10.77 8.95 7.48 1.04 20.76 19.29 090
21230 ................ A Rib cartilage graft... 10.77 NA 10.85 0.96 NA 22.58 090
21235 ................ A Ear cartilage graft... 6.72 11.90 8.36 0.52 19.14 15.60 090
21240 ................ A Reconstruction of jaw 14.05 NA 11.79 1.15 NA 26.99 090
joint.
21242 ................ A Reconstruction of jaw 12.95 NA 10.85 1.40 NA 25.20 090
joint.
21243 ................ A Reconstruction of jaw 20.79 NA 13.97 1.85 NA 36.61 090
joint.
21244 ................ A Reconstruction of 11.86 NA 9.56 0.95 NA 22.37 090
lower jaw.
21245 ................ A Reconstruction of jaw. 11.86 24.85 10.25 0.88 37.59 22.99 090
21246 ................ A Reconstruction of jaw. 12.47 10.20 10.20 1.21 23.88 23.88 090
[[Page 55342]]
21247 ................ A Reconstruct lower jaw 22.63 NA 20.17 2.21 NA 45.01 090
bone.
21248 ................ A Reconstruction of jaw. 11.48 8.91 7.86 1.01 21.40 20.35 090
21249 ................ A Reconstruction of jaw. 17.52 11.44 10.35 1.39 30.35 29.26 090
21255 ................ A Reconstruct lower jaw 16.72 NA 13.16 1.13 NA 31.01 090
bone.
21256 ................ A Reconstruction of 16.19 NA 13.87 1.04 NA 31.10 090
orbit.
21260 ................ A Revise eye sockets.... 16.52 NA 13.54 1.25 NA 31.31 090
21261 ................ A Revise eye sockets.... 31.49 NA 20.04 2.20 NA 53.73 090
21263 ................ A Revise eye sockets.... 28.42 NA 15.09 2.16 NA 45.67 090
21267 ................ A Revise eye sockets.... 18.90 NA 14.75 1.35 NA 35.00 090
21268 ................ A Revise eye sockets.... 24.48 NA 15.15 0.79 NA 40.42 090
21270 ................ A Augmentation, cheek 10.23 10.39 9.99 0.73 21.35 20.95 090
bone.
21275 ................ A Revision, orbitofacial 11.24 NA 11.02 1.03 NA 23.29 090
bones.
21280 ................ A Revision of eyelid.... 6.03 NA 6.27 0.27 NA 12.57 090
21282 ................ A Revision of eyelid.... 3.49 NA 5.38 0.21 NA 9.08 090
21295 ................ A Revision of jaw muscle/ 1.53 NA 4.34 0.13 NA 6.00 090
bone.
21296 ................ A Revision of jaw muscle/ 4.25 NA 4.09 0.30 NA 8.64 090
bone.
21299 ................ C Cranio/maxillofacial 0.00 0.00 0.00 0.00 0.00 0.00 YYY
surgery.
21300 ................ A Treatment of skull 0.72 2.77 0.30 0.09 3.58 1.11 000
fracture.
21310 ................ A Treatment of nose 0.58 2.70 0.15 0.05 3.33 0.78 000
fracture.
21315 ................ A Treatment of nose 1.51 3.49 1.27 0.12 5.12 2.90 010
fracture.
21320 ................ A Treatment of nose 1.85 4.96 2.10 0.15 6.96 4.10 010
fracture.
21325 ................ A Treatment of nose 3.77 NA 3.73 0.31 NA 7.81 090
fracture.
21330 ................ A Treatment of nose 5.38 NA 5.67 0.48 NA 11.53 090
fracture.
21335 ................ A Treatment of nose 8.61 NA 7.34 0.64 NA 16.59 090
fracture.
21336 ................ A Treat nasal septal 5.72 NA 5.74 0.45 NA 11.91 090
fracture.
21337 ................ A Treat nasal septal 2.70 5.24 3.42 0.22 8.16 6.34 090
fracture.
21338 ................ A Treat nasoethmoid 6.46 NA 5.75 0.53 NA 12.74 090
fracture.
21339 ................ A Treat nasoethmoid 8.09 NA 6.97 0.76 NA 15.82 090
fracture.
21340 ................ A Treatment of nose 10.77 NA 8.78 0.85 NA 20.40 090
fracture.
21343 ................ A Treatment of sinus 12.95 NA 9.48 1.06 NA 23.49 090
fracture.
21344 ................ A Treatment of sinus 19.72 NA 13.82 1.72 NA 35.26 090
fracture.
21345 ................ A Treat nose/jaw 8.16 10.36 7.91 0.60 19.12 16.67 090
fracture.
21346 ................ A Treat nose/jaw 10.61 NA 10.12 0.85 NA 21.58 090
fracture.
21347 ................ A Treat nose/jaw 12.69 NA 9.68 1.14 NA 23.51 090
fracture.
21348 ................ A Treat nose/jaw 16.69 NA 11.57 1.50 NA 29.76 090
fracture.
21355 ................ A Treat cheek bone 3.77 3.89 2.54 0.29 7.95 6.60 010
fracture.
21356 ................ A Treat cheek bone 4.15 NA 3.31 0.36 NA 7.82 010
fracture.
21360 ................ A Treat cheek bone 6.46 NA 5.74 0.52 NA 12.72 090
fracture.
21365 ................ A Treat cheek bone 14.95 NA 11.72 1.30 NA 27.97 090
fracture.
21366 ................ A Treat cheek bone 17.77 NA 14.28 1.41 NA 33.46 090
fracture.
21385 ................ A Treat eye socket 9.16 NA 8.04 0.64 NA 17.84 090
fracture.
21386 ................ A Treat eye socket 9.16 NA 8.43 0.76 NA 18.35 090
fracture.
21387 ................ A Treat eye socket 9.70 NA 8.55 0.78 NA 19.03 090
fracture.
21390 ................ A Treat eye socket 10.13 NA 8.73 0.70 NA 19.56 090
fracture.
21395 ................ A Treat eye socket 12.68 NA 9.24 1.09 NA 23.01 090
fracture.
21400 ................ A Treat eye socket 1.40 3.29 1.05 0.12 4.81 2.57 090
fracture.
21401 ................ A Treat eye socket 3.26 4.34 3.65 0.34 7.94 7.25 090
fracture.
21406 ................ A Treat eye socket 7.01 NA 7.20 0.59 NA 14.80 090
fracture.
21407 ................ A Treat eye socket 8.61 NA 7.99 0.67 NA 17.27 090
fracture.
21408 ................ A Treat eye socket 12.38 NA 10.29 1.24 NA 23.91 090
fracture.
21421 ................ A Treat mouth roof 5.14 7.23 6.84 0.42 12.79 12.40 090
fracture.
21422 ................ A Treat mouth roof 8.32 NA 7.93 0.69 NA 16.94 090
fracture.
21423 ................ A Treat mouth roof 10.40 NA 8.63 0.95 NA 19.98 090
fracture.
21431 ................ A Treat craniofacial 7.05 NA 8.44 0.58 NA 16.07 090
fracture.
21432 ................ A Treat craniofacial 8.61 NA 8.06 0.55 NA 17.22 090
fracture.
21433 ................ A Treat craniofacial 25.35 NA 17.29 2.46 NA 45.10 090
fracture.
21435 ................ A Treat craniofacial 17.25 NA 12.97 1.66 NA 31.88 090
fracture.
21436 ................ A Treat craniofacial 28.04 NA 16.02 2.32 NA 46.38 090
fracture.
21440 ................ A Treat dental ridge 2.70 5.44 3.73 0.22 8.36 6.65 090
fracture.
21445 ................ A Treat dental ridge 5.38 7.14 5.04 0.55 13.07 10.97 090
fracture.
21450 ................ A Treat lower jaw 2.97 6.45 2.90 0.23 9.65 6.10 090
fracture.
21451 ................ A Treat lower jaw 4.87 6.46 6.11 0.39 11.72 11.37 090
fracture.
21452 ................ A Treat lower jaw 1.98 13.44 4.35 0.14 15.56 6.47 090
fracture.
21453 ................ A Treat lower jaw 5.54 7.32 6.69 0.49 13.35 12.72 090
fracture.
21454 ................ A Treat lower jaw 6.46 NA 5.72 0.55 NA 12.73 090
fracture.
21461 ................ A Treat lower jaw 8.09 8.40 8.26 0.73 17.22 17.08 090
fracture.
21462 ................ A Treat lower jaw 9.79 10.06 8.18 0.80 20.65 18.77 090
fracture.
21465 ................ A Treat lower jaw 11.91 NA 8.42 0.84 NA 21.17 090
fracture.
21470 ................ A Treat lower jaw 15.34 NA 10.31 1.36 NA 27.01 090
fracture.
21480 ................ A Reset dislocated jaw.. 0.61 1.62 0.18 0.05 2.28 0.84 000
21485 ................ A Reset dislocated jaw.. 3.99 3.82 3.34 0.31 8.12 7.64 090
21490 ................ A Repair dislocated jaw. 11.86 NA 7.69 1.31 NA 20.86 090
21493 ................ A Treat hyoid bone 1.27 NA 3.68 0.10 NA 5.05 090
fracture.
[[Page 55343]]
21494 ................ A Treat hyoid bone 6.28 NA 4.21 0.44 NA 10.93 090
fracture.
21495 ................ A Treat hyoid bone 5.69 NA 5.28 0.41 NA 11.38 090
fracture.
21497 ................ A Interdental wiring.... 3.86 4.68 3.81 0.31 8.85 7.98 090
21499 ................ C Head surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY
21501 ................ A Drain neck/chest 3.81 4.50 3.64 0.36 8.67 7.81 090
lesion.
21502 ................ A Drain chest lesion.... 7.12 NA 7.05 0.79 NA 14.96 090
21510 ................ A Drainage of bone 5.74 NA 7.47 0.67 NA 13.88 090
lesion.
21550 ................ A Biopsy of neck/chest.. 2.06 2.32 1.25 0.13 4.51 3.44 010
21555 ................ A Remove lesion, neck/ 4.35 4.25 2.43 0.41 9.01 7.19 090
chest.
21556 ................ A Remove lesion, neck/ 5.57 NA 3.29 0.51 NA 9.37 090
chest.
21557 ................ A Remove tumor, neck/ 8.88 NA 7.87 0.85 NA 17.60 090
chest.
21600 ................ A Partial removal of rib 6.89 NA 7.80 0.81 NA 15.50 090
21610 ................ A Partial removal of rib 14.61 NA 11.26 1.85 NA 27.72 090
21615 ................ A Removal of rib........ 9.87 NA 7.90 1.20 NA 18.97 090
21616 ................ A Removal of rib and 12.04 NA 8.94 1.31 NA 22.29 090
nerves.
21620 ................ A Partial removal of 6.79 NA 8.13 0.77 NA 15.69 090
sternum.
21627 ................ A Sternal debridement... 6.81 NA 12.16 0.82 NA 19.79 090
21630 ................ A Extensive sternum 17.38 NA 14.03 1.95 NA 33.36 090
surgery.
21632 ................ A Extensive sternum 18.14 NA 12.35 2.16 NA 32.65 090
surgery.
21700 ................ A Revision of neck 6.19 8.63 7.19 0.31 15.13 13.69 090
muscle.
21705 ................ A Revision of neck 9.60 NA 7.87 0.92 NA 18.39 090
muscle/rib.
21720 ................ A Revision of neck 5.68 8.71 5.93 0.80 15.19 12.41 090
muscle.
21725 ................ A Revision of neck 6.99 NA 7.28 0.90 NA 15.17 090
muscle.
21740 ................ A Reconstruction of 16.50 NA 12.85 2.03 NA 31.38 090
sternum.
21750 ................ A Repair of sternum 10.77 NA 9.41 1.35 NA 21.53 090
separation.
21800 ................ A Treatment of rib 0.96 2.31 1.11 0.09 3.36 2.16 090
fracture.
21805 ................ A Treatment of rib 2.75 NA 4.08 0.29 NA 7.12 090
fracture.
21810 ................ A Treatment of rib 6.86 NA 7.49 0.60 NA 14.95 090
fracture(s).
21820 ................ A Treat sternum fracture 1.28 2.80 1.58 0.15 4.23 3.01 090
21825 ................ A Treat sternum fracture 7.41 NA 9.90 0.84 NA 18.15 090
21899 ................ C Neck/chest surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
21920 ................ A Biopsy soft tissue of 2.06 2.40 0.77 0.12 4.58 2.95 010
back.
21925 ................ A Biopsy soft tissue of 4.49 10.19 4.79 0.44 15.12 9.72 090
back.
21930 ................ A Remove lesion, back or 5.00 4.55 2.66 0.49 10.04 8.15 090
flank.
21935 ................ A Remove tumor, back.... 17.96 NA 13.53 1.87 NA 33.36 090
22100 ................ A Remove part of neck 9.73 NA 8.36 1.55 NA 19.64 090
vertebra.
22101 ................ A Remove part, thorax 9.81 NA 9.04 1.51 NA 20.36 090
vertebra.
22102 ................ A Remove part, lumbar 9.81 NA 9.18 1.46 NA 20.45 090
vertebra.
22103 ................ A Remove extra spine 2.34 NA 1.27 0.37 NA 3.98 ZZZ
segment.
22110 ................ A Remove part of neck 12.74 NA 11.06 2.20 NA 26.00 090
vertebra.
22112 ................ A Remove part, thorax 12.81 NA 10.95 1.96 NA 25.72 090
vertebra.
22114 ................ A Remove part, lumbar 12.81 NA 10.71 1.98 NA 25.50 090
vertebra.
22116 ................ A Remove extra spine 2.32 NA 1.26 0.40 NA 3.98 ZZZ
segment.
22210 ................ A Revision of neck spine 23.82 NA 17.42 4.23 NA 45.47 090
22212 ................ A Revision of thorax 19.42 NA 14.60 2.78 NA 36.80 090
spine.
22214 ................ A Revision of lumbar 19.45 NA 15.32 2.78 NA 37.55 090
spine.
22216 ................ A Revise, extra spine 6.04 NA 3.31 0.98 NA 10.33 ZZZ
segment.
22220 ................ A Revision of neck spine 21.37 NA 15.61 3.65 NA 40.63 090
22222 ................ A Revision of thorax 21.52 NA 15.08 3.08 NA 39.68 090
spine.
22224 ................ A Revision of lumbar 21.52 NA 15.70 3.20 NA 40.42 090
spine.
22226 ................ A Revise, extra spine 6.04 NA 3.22 1.01 NA 10.27 ZZZ
segment.
22305 ................ A Treat spine process 2.05 3.25 2.01 0.29 5.59 4.35 090
fracture.
22310 ................ A Treat spine fracture.. 2.61 4.77 3.54 0.37 7.75 6.52 090
22315 ................ A Treat spine fracture.. 8.84 NA 9.32 1.37 NA 19.53 090
22318 ................ A Treat odontoid fx w/o 21.50 NA 15.02 4.26 NA 40.78 090
graft.
22319 ................ A Treat odontoid fx w/ 24.00 NA 17.42 4.76 NA 46.18 090
graft.
22325 ................ A Treat spine fracture.. 18.30 NA 14.94 2.61 NA 35.85 090
22326 ................ A Treat neck spine 19.59 NA 15.67 3.54 NA 38.80 090
fracture.
22327 ................ A Treat thorax spine 19.20 NA 15.43 2.75 NA 37.38 090
fracture.
22328 ................ A Treat each add spine 4.61 NA 2.43 0.66 NA 7.70 ZZZ
fx.
22505 ................ A Manipulation of spine. 1.87 4.58 3.20 0.27 6.72 5.34 010
22520 ................ A Percut vertebroplasty 8.91 NA 4.15 0.99 NA 14.05 010
thor.
22521 ................ A Percut vertebroplasty 8.34 NA 3.92 0.93 NA 13.19 010
lumb.
22522 ................ A Percut vertebroplasty 4.31 NA 1.75 0.33 NA 6.39 ZZZ
addl.
22548 ................ A Neck spine fusion..... 25.82 NA 18.08 4.98 NA 48.88 090
22554 ................ A Neck spine fusion..... 18.62 NA 13.94 3.51 NA 36.07 090
22556 ................ A Thorax spine fusion... 23.46 NA 16.80 3.78 NA 44.04 090
22558 ................ A Lumbar spine fusion... 22.28 NA 15.27 3.18 NA 40.73 090
22585 ................ A Additional spinal 5.53 NA 2.94 0.98 NA 9.45 ZZZ
fusion.
22590 ................ A Spine & skull spinal 20.51 NA 15.56 3.81 NA 39.88 090
fusion.
22595 ................ A Neck spinal fusion.... 19.39 NA 14.58 3.62 NA 37.59 090
22600 ................ A Neck spine fusion..... 16.14 NA 12.66 2.89 NA 31.69 090
22610 ................ A Thorax spine fusion... 16.02 NA 12.98 2.66 NA 31.66 090
[[Page 55344]]
22612 ................ A Lumbar spine fusion... 21.00 NA 15.75 3.28 NA 40.03 090
22614 ................ A Spine fusion, extra 6.44 NA 3.54 1.04 NA 11.02 ZZZ
segment.
22630 ................ A Lumbar spine fusion... 20.84 NA 16.01 3.79 NA 40.64 090
22632 ................ A Spine fusion, extra 5.23 NA 2.75 0.90 NA 8.88 ZZZ
segment.
22800 ................ A Fusion of spine....... 18.25 NA 14.30 2.71 NA 35.26 090
22802 ................ A Fusion of spine....... 30.88 NA 21.88 4.42 NA 57.18 090
22804 ................ A Fusion of spine....... 36.27 NA 24.48 5.23 NA 65.98 090
22808 ................ A Fusion of spine....... 26.27 NA 18.27 4.36 NA 48.90 090
22810 ................ A Fusion of spine....... 30.27 NA 19.63 4.49 NA 54.39 090
22812 ................ A Fusion of spine....... 32.70 NA 21.89 4.67 NA 59.26 090
22818 ................ A Kyphectomy, 1-2 31.83 NA 21.69 5.01 NA 58.53 090
segments.
22819 ................ A Kyphectomy, 3 or more. 36.44 NA 22.19 5.20 NA 63.83 090
22830 ................ A Exploration of spinal 10.85 NA 10.05 1.73 NA 22.63 090
fusion.
22840 ................ A Insert spine fixation 12.54 NA 6.84 2.03 NA 21.41 ZZZ
device.
22841 ................ B Insert spine fixation 0.00 0.00 0.00 0.00 0.00 0.00 XXX
device.
22842 ................ A Insert spine fixation 12.58 NA 6.83 2.04 NA 21.45 ZZZ
device.
22843 ................ A Insert spine fixation 13.46 NA 7.39 2.10 NA 22.95 ZZZ
device.
22844 ................ A Insert spine fixation 16.44 NA 9.26 2.42 NA 28.12 ZZZ
device.
22845 ................ A Insert spine fixation 11.96 NA 6.38 2.22 NA 20.56 ZZZ
device.
22846 ................ A Insert spine fixation 12.42 NA 6.70 2.26 NA 21.38 ZZZ
device.
22847 ................ A Insert spine fixation 13.80 NA 7.08 2.36 NA 23.24 ZZZ
device.
22848 ................ A Insert pelv fixation 6.00 NA 3.38 0.88 NA 10.26 ZZZ
device.
22849 ................ A Reinsert spinal 18.51 NA 14.22 2.87 NA 35.60 090
fixation.
22850 ................ A Remove spine fixation 9.52 NA 8.89 1.51 NA 19.92 090
device.
22851 ................ A Apply spine prosth 6.71 NA 3.54 1.11 NA 11.36 ZZZ
device.
22852 ................ A Remove spine fixation 9.01 NA 8.60 1.40 NA 19.01 090
device.
22855 ................ A Remove spine fixation 15.13 NA 11.67 2.74 NA 29.54 090
device.
22899 ................ C Spine surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
22900 ................ A Remove abdominal wall 5.80 NA 4.42 0.58 NA 10.80 090
lesion.
22999 ................ C Abdomen surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
23000 ................ A Removal of calcium 4.36 9.04 6.97 0.50 13.90 11.83 090
deposits.
23020 ................ A Release shoulder joint 8.93 NA 10.53 1.23 NA 20.69 090
23030 ................ A Drain shoulder lesion. 3.43 6.40 4.44 0.42 10.25 8.29 010
23031 ................ A Drain shoulder bursa.. 2.74 5.80 4.16 0.33 8.87 7.23 010
23035 ................ A Drain shoulder bone 8.61 NA 16.13 1.19 NA 25.93 090
lesion.
23040 ................ A Exploratory shoulder 9.20 NA 11.71 1.28 NA 22.19 090
surgery.
23044 ................ A Exploratory shoulder 7.12 NA 10.73 0.97 NA 18.82 090
surgery.
23065 ................ A Biopsy shoulder 2.27 2.61 1.34 0.14 5.02 3.75 010
tissues.
23066 ................ A Biopsy shoulder 4.16 8.34 6.16 0.50 13.00 10.82 090
tissues.
23075 ................ A Removal of shoulder 2.39 5.40 3.17 0.25 8.04 5.81 010
lesion.
23076 ................ A Removal of shoulder 7.63 NA 8.36 0.87 NA 16.86 090
lesion.
23077 ................ A Remove tumor of 16.09 NA 14.41 1.81 NA 32.31 090
shoulder.
23100 ................ A Biopsy of shoulder 6.03 NA 8.73 0.81 NA 15.57 090
joint.
23101 ................ A Shoulder joint surgery 5.58 NA 8.63 0.77 NA 14.98 090
23105 ................ A Remove shoulder joint 8.23 NA 10.18 1.13 NA 19.54 090
lining.
23106 ................ A Incision of collarbone 5.96 NA 9.27 0.82 NA 16.05 090
joint.
23107 ................ A Explore treat shoulder 8.62 NA 10.41 1.19 NA 20.22 090
joint.
23120 ................ A Partial removal, 7.11 NA 9.55 0.99 NA 17.65 090
collar bone.
23125 ................ A Removal of collar bone 9.39 NA 10.78 1.27 NA 21.44 090
23130 ................ A Remove shoulder bone, 7.55 NA 9.82 1.06 NA 18.43 090
part.
23140 ................ A Removal of bone lesion 6.89 NA 8.31 0.82 NA 16.02 090
23145 ................ A Removal of bone lesion 9.09 NA 10.87 1.24 NA 21.20 090
23146 ................ A Removal of bone lesion 7.83 NA 10.70 1.11 NA 19.64 090
23150 ................ A Removal of humerus 8.48 NA 10.14 1.14 NA 19.76 090
lesion.
23155 ................ A Removal of humerus 10.35 NA 12.33 1.20 NA 23.88 090
lesion.
23156 ................ A Removal of humerus 8.68 NA 10.45 1.18 NA 20.31 090
lesion.
23170 ................ A Remove collar bone 6.86 NA 11.33 0.84 NA 19.03 090
lesion.
23172 ................ A Remove shoulder blade 6.90 NA 9.59 0.95 NA 17.44 090
lesion.
23174 ................ A Remove humerus lesion. 9.51 NA 11.74 1.30 NA 22.55 090
23180 ................ A Remove collar bone 8.53 NA 16.16 1.18 NA 25.87 090
lesion.
23182 ................ A Remove shoulder blade 8.15 NA 16.18 1.08 NA 25.41 090
lesion.
23184 ................ A Remove humerus lesion. 9.38 NA 16.43 1.24 NA 27.05 090
23190 ................ A Partial removal of 7.24 NA 8.74 0.97 NA 16.95 090
scapula.
23195 ................ A Removal of head of 9.81 NA 10.03 1.38 NA 21.22 090
humerus.
23200 ................ A Removal of collar bone 12.08 NA 14.39 1.48 NA 27.95 090
23210 ................ A Removal of shoulder 12.49 NA 13.96 1.61 NA 28.06 090
blade.
23220 ................ A Partial removal of 14.56 NA 15.57 2.03 NA 32.16 090
humerus.
23221 ................ A Partial removal of 17.74 NA 16.93 2.51 NA 37.18 090
humerus.
23222 ................ A Partial removal of 23.92 NA 20.66 3.37 NA 47.95 090
humerus.
23330 ................ A Remove shoulder 1.85 6.15 3.49 0.18 8.18 5.52 010
foreign body.
23331 ................ A Remove shoulder 7.38 NA 9.70 1.02 NA 18.10 090
foreign body.
23332 ................ A Remove shoulder 11.62 NA 12.12 1.62 NA 25.36 090
foreign body.
23350 ................ A Injection for shoulder 1.00 7.22 0.35 0.05 8.27 1.40 000
x-ray.
[[Page 55345]]
23395 ................ A Muscle transfer, 16.85 NA 14.09 2.29 NA 33.23 090
shoulder/arm.
23397 ................ A Muscle transfers...... 16.13 NA 13.86 2.24 NA 32.23 090
23400 ................ A Fixation of shoulder 13.54 NA 14.52 1.91 NA 29.97 090
blade.
23405 ................ A Incision of tendon & 8.37 NA 9.66 1.12 NA 19.15 090
muscle.
23406 ................ A Incise tendon(s) & 10.79 NA 11.55 1.48 NA 23.82 090
muscle(s).
23410 ................ A Repair of tendon(s)... 12.45 NA 12.55 1.72 NA 26.72 090
23412 ................ A Repair of tendon(s)... 13.31 NA 13.05 1.86 NA 28.22 090
23415 ................ A Release of shoulder 9.97 NA 10.22 1.39 NA 21.58 090
ligament.
23420 ................ A Repair of shoulder.... 13.30 NA 13.94 1.86 NA 29.10 090
23430 ................ A Repair biceps tendon.. 9.98 NA 11.15 1.40 NA 22.53 090
23440 ................ A Remove/transplant 10.48 NA 11.54 1.47 NA 23.49 090
tendon.
23450 ................ A Repair shoulder 13.40 NA 13.02 1.86 NA 28.28 090
capsule.
23455 ................ A Repair shoulder 14.37 NA 13.62 2.01 NA 30.00 090
capsule.
23460 ................ A Repair shoulder 15.37 NA 14.21 2.17 NA 31.75 090
capsule.
23462 ................ A Repair shoulder 15.30 NA 13.68 2.16 NA 31.14 090
capsule.
23465 ................ A Repair shoulder 15.85 NA 14.47 1.61 NA 31.93 090
capsule.
23466 ................ A Repair shoulder 14.22 NA 13.63 2.00 NA 29.85 090
capsule.
23470 ................ A Reconstruct shoulder 17.15 NA 15.16 2.40 NA 34.71 090
joint.
23472 ................ A Reconstruct shoulder 21.10 NA 17.40 2.37 NA 40.87 090
joint.
23480 ................ A Revision of collar 11.18 NA 11.94 1.56 NA 24.68 090
bone.
23485 ................ A Revision of collar 13.43 NA 13.10 1.84 NA 28.37 090
bone.
23490 ................ A Reinforce clavicle.... 11.86 NA 13.74 1.11 NA 26.71 090
23491 ................ A Reinforce shoulder 14.21 NA 13.54 2.00 NA 29.75 090
bones.
23500 ................ A Treat clavicle 2.08 3.87 2.60 0.26 6.21 4.94 090
fracture.
23505 ................ A Treat clavicle 3.69 5.98 4.02 0.50 10.17 8.21 090
fracture.
23515 ................ A Treat clavicle 7.41 NA 8.24 1.03 NA 16.68 090
fracture.
23520 ................ A Treat clavicle 2.16 3.91 2.67 0.26 6.33 5.09 090
dislocation.
23525 ................ A Treat clavicle 3.60 7.16 4.08 0.44 11.20 8.12 090
dislocation.
23530 ................ A Treat clavicle 7.31 NA 7.94 0.85 NA 16.10 090
dislocation.
23532 ................ A Treat clavicle 8.01 NA 8.67 1.13 NA 17.81 090
dislocation.
23540 ................ A Treat clavicle 2.23 4.56 2.63 0.24 7.03 5.10 090
dislocation.
23545 ................ A Treat clavicle 3.25 4.99 3.65 0.39 8.63 7.29 090
dislocation.
23550 ................ A Treat clavicle 7.24 NA 8.29 0.94 NA 16.47 090
dislocation.
23552 ................ A Treat clavicle 8.45 NA 8.82 1.18 NA 18.45 090
dislocation.
23570 ................ A Treat shoulder blade 2.23 3.84 2.70 0.29 6.36 5.22 090
fx.
23575 ................ A Treat shoulder blade 4.06 6.22 4.18 0.53 10.81 8.77 090
fx.
23585 ................ A Treat scapula fracture 8.96 NA 9.31 1.25 NA 19.52 090
23600 ................ A Treat humerus fracture 2.93 5.65 3.71 0.39 8.97 7.03 090
23605 ................ A Treat humerus fracture 4.87 8.32 6.55 0.67 13.86 12.09 090
23615 ................ A Treat humerus fracture 9.35 NA 10.19 1.31 NA 20.85 090
23616 ................ A Treat humerus fracture 21.27 NA 16.26 2.98 NA 40.51 090
23620 ................ A Treat humerus fracture 2.40 5.35 3.43 0.32 8.07 6.15 090
23625 ................ A Treat humerus fracture 3.93 7.35 5.57 0.53 11.81 10.03 090
23630 ................ A Treat humerus fracture 7.35 NA 8.20 1.03 NA 16.58 090
23650 ................ A Treat shoulder 3.39 5.58 3.67 0.31 9.28 7.37 090
dislocation.
23655 ................ A Treat shoulder 4.57 NA 4.39 0.52 NA 9.48 090
dislocation.
23660 ................ A Treat shoulder 7.49 NA 8.27 1.01 NA 16.77 090
dislocation.
23665 ................ A Treat dislocation/ 4.47 7.68 5.81 0.60 12.75 10.88 090
fracture.
23670 ................ A Treat dislocation/ 7.90 NA 8.72 1.10 NA 17.72 090
fracture.
23675 ................ A Treat dislocation/ 6.05 8.22 6.71 0.83 15.10 13.59 090
fracture.
23680 ................ A Treat dislocation/ 10.06 NA 9.89 1.39 NA 21.34 090
fracture.
23700 ................ A Fixation of shoulder.. 2.52 NA 3.48 0.35 NA 6.35 010
23800 ................ A Fusion of shoulder 14.16 NA 14.28 1.97 NA 30.41 090
joint.
23802 ................ A Fusion of shoulder 16.60 NA 15.83 2.34 NA 34.77 090
joint.
23900 ................ A Amputation of arm & 19.72 NA 16.35 2.47 NA 38.54 090
girdle.
23920 ................ A Amputation at shoulder 14.61 NA 13.70 1.92 NA 30.23 090
joint.
23921 ................ A Amputation follow-up 5.49 NA 6.67 0.78 NA 12.94 090
surgery.
23929 ................ C Shoulder surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
23930 ................ A Drainage of arm lesion 2.94 6.10 4.01 0.32 9.36 7.27 010
23931 ................ A Drainage of arm bursa. 1.79 5.76 3.74 0.21 7.76 5.74 010
23935 ................ A Drain arm/elbow bone 6.09 NA 12.90 0.84 NA 19.83 090
lesion.
24000 ................ A Exploratory elbow 5.82 NA 6.06 0.77 NA 12.65 090
surgery.
24006 ................ A Release elbow joint... 9.31 NA 8.64 1.27 NA 19.22 090
24065 ................ A Biopsy arm/elbow soft 2.08 5.50 3.25 0.14 7.72 5.47 010
tissue.
24066 ................ A Biopsy arm/elbow soft 5.21 8.48 6.40 0.61 14.30 12.22 090
tissue.
24075 ................ A Remove arm/elbow 3.92 7.80 5.91 0.43 12.15 10.26 090
lesion.
24076 ................ A Remove arm/elbow 6.30 NA 7.39 0.70 NA 14.39 090
lesion.
24077 ................ A Remove tumor of arm/ 11.76 NA 14.23 1.32 NA 27.31 090
elbow.
24100 ................ A Biopsy elbow joint 4.93 NA 5.83 0.62 NA 11.38 090
lining.
24101 ................ A Explore/treat elbow 6.13 NA 6.82 0.84 NA 13.79 090
joint.
24102 ................ A Remove elbow joint 8.03 NA 7.81 1.09 NA 16.93 090
lining.
24105 ................ A Removal of elbow bursa 3.61 NA 5.26 0.49 NA 9.36 090
24110 ................ A Remove humerus lesion. 7.39 NA 9.75 0.99 NA 18.13 090
[[Page 55346]]
24115 ................ A Remove/graft bone 9.63 NA 10.80 1.15 NA 21.58 090
lesion.
24116 ................ A Remove/graft bone 11.81 NA 12.20 1.66 NA 25.67 090
lesion.
24120 ................ A Remove elbow lesion... 6.65 NA 6.96 0.87 NA 14.48 090
24125 ................ A Remove/graft bone 7.89 NA 6.67 0.88 NA 15.44 090
lesion.
24126 ................ A Remove/graft bone 8.31 NA 7.79 0.90 NA 17.00 090
lesion.
24130 ................ A Removal of head of 6.25 NA 6.91 0.87 NA 14.03 090
radius.
24134 ................ A Removal of arm bone 9.73 NA 16.50 1.31 NA 27.54 090
lesion.
24136 ................ A Remove radius bone 7.99 NA 7.09 0.85 NA 15.93 090
lesion.
24138 ................ A Remove elbow bone 8.05 NA 8.06 1.12 NA 17.23 090
lesion.
24140 ................ A Partial removal of arm 9.18 NA 16.67 1.23 NA 27.08 090
bone.
24145 ................ A Partial removal of 7.58 NA 11.43 1.01 NA 20.02 090
radius.
24147 ................ A Partial removal of 7.54 NA 11.40 1.04 NA 19.98 090
elbow.
24149 ................ A Radical resection of 14.20 NA 11.28 1.90 NA 27.38 090
elbow.
24150 ................ A Extensive humerus 13.27 NA 14.92 1.81 NA 30.00 090
surgery.
24151 ................ A Extensive humerus 15.58 NA 16.64 2.19 NA 34.41 090
surgery.
24152 ................ A Extensive radius 10.06 NA 9.96 1.19 NA 21.21 090
surgery.
24153 ................ A Extensive radius 11.54 NA 7.55 0.64 NA 19.73 090
surgery.
24155 ................ A Removal of elbow joint 11.73 NA 9.66 1.42 NA 22.81 090
24160 ................ A Remove elbow joint 7.83 NA 7.77 1.07 NA 16.67 090
implant.
24164 ................ A Remove radius head 6.23 NA 6.93 0.84 NA 14.00 090
implant.
24200 ................ A Removal of arm foreign 1.76 5.80 3.25 0.15 7.71 5.16 010
body.
24201 ................ A Removal of arm foreign 4.56 8.42 6.97 0.56 13.54 12.09 090
body.
24220 ................ A Injection for elbow x- 1.31 11.16 0.47 0.07 12.54 1.85 000
ray.
24300 ................ A Manipulate elbow w/ 3.75 NA 5.46 0.52 NA 9.73 090
anesth.
24301 ................ A Muscle/tendon transfer 10.20 NA 9.11 1.30 NA 20.61 090
24305 ................ A Arm tendon lengthening 7.45 NA 7.70 0.98 NA 16.13 090
24310 ................ A Revision of arm tendon 5.98 NA 8.43 0.74 NA 15.15 090
24320 ................ A Repair of arm tendon.. 10.56 NA 11.29 1.00 NA 22.85 090
24330 ................ A Revision of arm 9.60 NA 8.79 1.21 NA 19.60 090
muscles.
24331 ................ A Revision of arm 10.65 NA 9.25 1.41 NA 21.31 090
muscles.
24332 ................ A Tenolysis, triceps.... 7.45 NA 5.23 0.77 NA 13.45 090
24340 ................ A Repair of biceps 7.89 NA 7.74 1.08 NA 16.71 090
tendon.
24341 ................ A Repair arm tendon/ 7.90 NA 7.85 1.08 NA 16.83 090
muscle.
24342 ................ A Repair of ruptured 10.62 NA 9.37 1.48 NA 21.47 090
tendon.
24343 ................ A Repr elbow lat ligmnt 8.65 NA 7.91 1.21 NA 17.77 090
w/tiss.
24344 ................ A Reconstruct elbow lat 14.00 NA 10.87 1.95 NA 26.82 090
ligmnt.
24345 ................ A Repr elbw med ligmnt w/ 8.65 NA 7.91 1.21 NA 17.77 090
tiss.
24346 ................ A Reconstruct elbow med 14.00 NA 10.87 1.95 NA 26.82 090
ligmnt.
24350 ................ A Repair of tennis elbow 5.25 NA 6.25 0.72 NA 12.22 090
24351 ................ A Repair of tennis elbow 5.91 NA 6.72 0.82 NA 13.45 090
24352 ................ A Repair of tennis elbow 6.43 NA 7.01 0.90 NA 14.34 090
24354 ................ A Repair of tennis elbow 6.48 NA 6.85 0.88 NA 14.21 090
24356 ................ A Revision of tennis 6.68 NA 7.21 0.90 NA 14.79 090
elbow.
24360 ................ A Reconstruct elbow 12.34 NA 10.26 1.69 NA 24.29 090
joint.
24361 ................ A Reconstruct elbow 14.08 NA 11.30 1.95 NA 27.33 090
joint.
24362 ................ A Reconstruct elbow 14.99 NA 11.30 1.92 NA 28.21 090
joint.
24363 ................ A Replace elbow joint... 18.49 NA 13.80 2.52 NA 34.81 090
24365 ................ A Reconstruct head of 8.39 NA 7.96 1.11 NA 17.46 090
radius.
24366 ................ A Reconstruct head of 9.13 NA 8.48 1.28 NA 18.89 090
radius.
24400 ................ A Revision of humerus... 11.06 NA 12.48 1.53 NA 25.07 090
24410 ................ A Revision of humerus... 14.82 NA 13.75 1.89 NA 30.46 090
24420 ................ A Revision of humerus... 13.44 NA 16.08 1.82 NA 31.34 090
24430 ................ A Repair of humerus..... 12.81 NA 12.88 1.80 NA 27.49 090
24435 ................ A Repair humerus with 13.17 NA 13.98 1.84 NA 28.99 090
graft.
24470 ................ A Revision of elbow 8.74 NA 6.59 1.23 NA 16.56 090
joint.
24495 ................ A Decompression of 8.12 NA 10.33 0.92 NA 19.37 090
forearm.
24498 ................ A Reinforce humerus..... 11.92 NA 12.31 1.67 NA 25.90 090
24500 ................ A Treat humerus fracture 3.21 5.09 3.38 0.41 8.71 7.00 090
24505 ................ A Treat humerus fracture 5.17 8.88 6.81 0.72 14.77 12.70 090
24515 ................ A Treat humerus fracture 11.65 NA 11.40 1.63 NA 24.68 090
24516 ................ A Treat humerus fracture 11.65 NA 11.85 1.63 NA 25.13 090
24530 ................ A Treat humerus fracture 3.50 6.19 4.86 0.47 10.16 8.83 090
24535 ................ A Treat humerus fracture 6.87 8.81 6.72 0.96 16.64 14.55 090
24538 ................ A Treat humerus fracture 9.43 NA 10.61 1.25 NA 21.29 090
24545 ................ A Treat humerus fracture 10.46 NA 10.18 1.47 NA 22.11 090
24546 ................ A Treat humerus fracture 15.69 NA 13.69 2.18 NA 31.56 090
24560 ................ A Treat humerus fracture 2.80 4.87 3.23 0.35 8.02 6.38 090
24565 ................ A Treat humerus fracture 5.56 8.09 5.82 0.74 14.39 12.12 090
24566 ................ A Treat humerus fracture 7.79 NA 9.96 1.10 NA 18.85 090
24575 ................ A Treat humerus fracture 10.66 NA 8.49 1.44 NA 20.59 090
24576 ................ A Treat humerus fracture 2.86 4.62 3.26 0.38 7.86 6.50 090
24577 ................ A Treat humerus fracture 5.79 8.22 6.13 0.81 14.82 12.73 090
24579 ................ A Treat humerus fracture 11.60 NA 11.32 1.62 NA 24.54 090
[[Page 55347]]
24582 ................ A Treat humerus fracture 8.55 NA 10.46 1.20 NA 20.21 090
24586 ................ A Treat elbow fracture.. 15.21 NA 11.23 2.12 NA 28.56 090
24587 ................ A Treat elbow fracture.. 15.16 NA 11.13 2.14 NA 28.43 090
24600 ................ A Treat elbow 4.23 6.82 5.12 0.49 11.54 9.84 090
dislocation.
24605 ................ A Treat elbow 5.42 NA 5.02 0.72 NA 11.16 090
dislocation.
24615 ................ A Treat elbow 9.42 NA 7.94 1.31 NA 18.67 090
dislocation.
24620 ................ A Treat elbow fracture.. 6.98 NA 6.63 0.90 NA 14.51 090
24635 ................ A Treat elbow fracture.. 13.19 NA 16.55 1.84 NA 31.58 090
24640 ................ A Treat elbow 1.20 3.35 1.88 0.11 4.66 3.19 010
dislocation.
24650 ................ A Treat radius fracture. 2.16 4.55 2.92 0.28 6.99 5.36 090
24655 ................ A Treat radius fracture. 4.40 7.33 5.22 0.58 12.31 10.20 090
24665 ................ A Treat radius fracture. 8.14 NA 9.40 1.13 NA 18.67 090
24666 ................ A Treat radius fracture. 9.49 NA 10.18 1.32 NA 20.99 090
24670 ................ A Treat ulnar fracture.. 2.54 4.49 3.10 0.33 7.36 5.97 090
24675 ................ A Treat ulnar fracture.. 4.72 7.55 5.49 0.65 12.92 10.86 090
24685 ................ A Treat ulnar fracture.. 8.80 NA 9.79 1.23 NA 19.82 090
24800 ................ A Fusion of elbow joint. 11.20 NA 9.90 1.41 NA 22.51 090
24802 ................ A Fusion/graft of elbow 13.69 NA 11.50 1.89 NA 27.08 090
joint.
24900 ................ A Amputation of upper 9.60 NA 11.37 1.18 NA 22.15 090
arm.
24920 ................ A Amputation of upper 9.54 NA 13.96 1.22 NA 24.72 090
arm.
24925 ................ A Amputation follow-up 7.07 NA 9.64 0.95 NA 17.66 090
surgery.
24930 ................ A Amputation follow-up 10.25 NA 10.86 1.23 NA 22.34 090
surgery.
24931 ................ A Amputate upper arm & 12.72 NA 11.63 1.56 NA 25.91 090
implant.
24935 ................ A Revision of amputation 15.56 NA 13.22 1.58 NA 30.36 090
24940 ................ C Revision of upper arm. 0.00 0.00 0.00 0.00 0.00 0.00 090
24999 ................ C Upper arm/elbow 0.00 0.00 0.00 0.00 0.00 0.00 YYY
surgery.
25000 ................ A Incision of tendon 3.38 NA 7.49 0.45 NA 11.32 090
sheath.
25001 ................ A Incise flexor carpi 3.38 NA 4.30 0.45 NA 8.13 090
radialis.
25020 ................ A Decompress forearm 1 5.92 NA 11.49 0.75 NA 18.16 090
space.
25023 ................ A Decompress forearm 1 12.96 NA 17.50 1.50 NA 31.96 090
space.
25024 ................ A Decompress forearm 2 9.50 NA 8.17 1.20 NA 18.87 090
spaces.
25025 ................ A Decompress forearm 2 16.54 NA 12.05 1.91 NA 30.50 090
spaces.
25028 ................ A Drainage of forearm 5.25 NA 10.20 0.61 NA 16.06 090
lesion.
25031 ................ A Drainage of forearm 4.14 NA 10.24 0.50 NA 14.88 090
bursa.
25035 ................ A Treat forearm bone 7.36 NA 16.18 0.98 NA 24.52 090
lesion.
25040 ................ A Explore/treat wrist 7.18 NA 9.40 0.96 NA 17.54 090
joint.
25065 ................ A Biopsy forearm soft 1.99 2.53 2.53 0.12 4.64 4.64 010
tissues.
25066 ................ A Biopsy forearm soft 4.13 NA 8.40 0.49 NA 13.02 090
tissues.
25075 ................ A Remove forearm lesion 3.74 NA 7.13 0.40 NA 11.27 090
subcut.
25076 ................ A Remove forearm lesion 4.92 NA 12.68 0.59 NA 18.19 090
deep.
25077 ................ A Remove tumor, forearm/ 9.76 NA 15.66 1.10 NA 26.52 090
wrist.
25085 ................ A Incision of wrist 5.50 NA 11.29 0.71 NA 17.50 090
capsule.
25100 ................ A Biopsy of wrist joint. 3.90 NA 7.99 0.50 NA 12.39 090
25101 ................ A Explore/treat wrist 4.69 NA 7.75 0.60 NA 13.04 090
joint.
25105 ................ A Remove wrist joint 5.85 NA 11.22 0.77 NA 17.84 090
lining.
25107 ................ A Remove wrist joint 6.43 NA 11.41 0.82 NA 18.66 090
cartilage.
25110 ................ A Remove wrist tendon 3.92 NA 8.94 0.48 NA 13.34 090
lesion.
25111 ................ A Remove wrist tendon 3.39 NA 6.70 0.42 NA 10.51 090
lesion.
25112 ................ A Reremove wrist tendon 4.53 NA 7.43 0.54 NA 12.50 090
lesion.
25115 ................ A Remove wrist/forearm 8.82 NA 17.19 1.11 NA 27.12 090
lesion.
25116 ................ A Remove wrist/forearm 7.11 NA 16.20 0.90 NA 24.21 090
lesion.
25118 ................ A Excise wrist tendon 4.37 NA 7.93 0.55 NA 12.85 090
sheath.
25119 ................ A Partial removal of 6.04 NA 11.45 0.80 NA 18.29 090
ulna.
25120 ................ A Removal of forearm 6.10 NA 14.87 0.81 NA 21.78 090
lesion.
25125 ................ A Remove/graft forearm 7.48 NA 16.11 1.02 NA 24.61 090
lesion.
25126 ................ A Remove/graft forearm 7.55 NA 15.76 1.00 NA 24.31 090
lesion.
25130 ................ A Removal of wrist 5.26 NA 8.33 0.66 NA 14.25 090
lesion.
25135 ................ A Remove & graft wrist 6.89 NA 9.00 0.89 NA 16.78 090
lesion.
25136 ................ A Remove & graft wrist 5.97 NA 9.26 0.58 NA 15.81 090
lesion.
25145 ................ A Remove forearm bone 6.37 NA 15.43 0.82 NA 22.62 090
lesion.
25150 ................ A Partial removal of 7.09 NA 12.00 0.96 NA 20.05 090
ulna.
25151 ................ A Partial removal of 7.39 NA 16.22 0.93 NA 24.54 090
radius.
25170 ................ A Extensive forearm 11.09 NA 17.56 1.52 NA 30.17 090
surgery.
25210 ................ A Removal of wrist bone. 5.95 NA 8.71 0.73 NA 15.39 090
25215 ................ A Removal of wrist bones 7.89 NA 12.27 1.02 NA 21.18 090
25230 ................ A Partial removal of 5.23 NA 8.23 0.66 NA 14.12 090
radius.
25240 ................ A Partial removal of 5.17 NA 10.78 0.69 NA 16.64 090
ulna.
25246 ................ A Injection for wrist x- 1.45 10.20 0.52 0.07 11.72 2.04 000
ray.
25248 ................ A Remove forearm foreign 5.14 NA 10.66 0.54 NA 16.34 090
body.
25250 ................ A Removal of wrist 6.60 NA 8.91 0.84 NA 16.35 090
prosthesis.
25251 ................ A Removal of wrist 9.57 NA 12.52 1.15 NA 23.24 090
prosthesis.
25259 ................ A Manipulate wrist w/ 3.75 NA 5.35 0.52 NA 9.62 090
anesthes.
25260 ................ A Repair forearm tendon/ 7.80 NA 17.11 0.97 NA 25.88 090
muscle.
[[Page 55348]]
25263 ................ A Repair forearm tendon/ 7.82 NA 15.65 0.94 NA 24.41 090
muscle.
25265 ................ A Repair forearm tendon/ 9.88 NA 17.11 1.19 NA 28.18 090
muscle.
25270 ................ A Repair forearm tendon/ 6.00 NA 16.04 0.76 NA 22.80 090
muscle.
25272 ................ A Repair forearm tendon/ 7.04 NA 16.50 0.89 NA 24.43 090
muscle.
25274 ................ A Repair forearm tendon/ 8.75 NA 17.36 1.11 NA 27.22 090
muscle.
25275 ................ A Repair forearm tendon 8.50 NA 7.53 1.11 NA 17.14 090
sheath.
25280 ................ A Revise wrist/forearm 7.22 NA 15.80 0.91 NA 23.93 090
tendon.
25290 ................ A Incise wrist/forearm 5.29 NA 18.17 0.66 NA 24.12 090
tendon.
25295 ................ A Release wrist/forearm 6.55 NA 15.16 0.84 NA 22.55 090
tendon.
25300 ................ A Fusion of tendons at 8.80 NA 10.02 1.07 NA 19.89 090
wrist.
25301 ................ A Fusion of tendons at 8.40 NA 10.15 1.08 NA 19.63 090
wrist.
25310 ................ A Transplant forearm 8.14 NA 16.47 1.01 NA 25.62 090
tendon.
25312 ................ A Transplant forearm 9.57 NA 17.24 1.22 NA 28.03 090
tendon.
25315 ................ A Revise palsy hand 10.20 NA 18.59 1.26 NA 30.05 090
tendon(s).
25316 ................ A Revise palsy hand 12.33 NA 18.40 1.74 NA 32.47 090
tendon(s).
25320 ................ A Repair/revise wrist 10.77 NA 11.53 1.32 NA 23.62 090
joint.
25332 ................ A Revise wrist joint.... 11.41 NA 11.89 1.46 NA 24.76 090
25335 ................ A Realignment of hand... 12.88 NA 13.60 1.66 NA 28.14 090
25337 ................ A Reconstruct ulna/ 10.17 NA 13.80 1.31 NA 25.28 090
radioulnar.
25350 ................ A Revision of radius.... 8.78 NA 16.68 1.17 NA 26.63 090
25355 ................ A Revision of radius.... 10.17 NA 17.17 1.44 NA 28.78 090
25360 ................ A Revision of ulna...... 8.43 NA 16.86 1.17 NA 26.46 090
25365 ................ A Revise radius & ulna.. 12.40 NA 18.74 1.67 NA 32.81 090
25370 ................ A Revise radius or ulna. 13.36 NA 17.84 1.88 NA 33.08 090
25375 ................ A Revise radius & ulna.. 13.04 NA 16.44 1.84 NA 31.32 090
25390 ................ A Shorten radius or ulna 10.40 NA 17.38 1.38 NA 29.16 090
25391 ................ A Lengthen radius or 13.65 NA 19.01 1.73 NA 34.39 090
ulna.
25392 ................ A Shorten radius & ulna. 13.95 NA 15.59 1.73 NA 31.27 090
25393 ................ A Lengthen radius & ulna 15.87 NA 21.72 1.87 NA 39.46 090
25394 ................ A Repair carpal bone, 10.40 NA 8.43 1.15 NA 19.98 090
shorten.
25400 ................ A Repair radius or ulna. 10.92 NA 17.98 1.50 NA 30.40 090
25405 ................ A Repair/graft radius or 14.38 NA 20.38 1.95 NA 36.71 090
ulna.
25415 ................ A Repair radius & ulna.. 13.35 NA 19.14 1.87 NA 34.36 090
25420 ................ A Repair/graft radius & 16.33 NA 21.72 2.20 NA 40.25 090
ulna.
25425 ................ A Repair/graft radius or 13.21 NA 24.75 1.61 NA 39.57 090
ulna.
25426 ................ A Repair/graft radius & 15.82 NA 18.15 2.23 NA 36.20 090
ulna.
25430 ................ A Vasc graft into carpal 9.25 NA 7.82 0.56 NA 17.63 090
bone.
25431 ................ A Repair nonunion carpal 10.44 NA 6.42 0.56 NA 17.42 090
bone.
25440 ................ A Repair/graft wrist 10.44 NA 11.05 1.41 NA 22.90 090
bone.
25441 ................ A Reconstruct wrist 12.90 NA 12.24 1.83 NA 26.97 090
joint.
25442 ................ A Reconstruct wrist 10.85 NA 11.46 1.24 NA 23.55 090
joint.
25443 ................ A Reconstruct wrist 10.39 NA 13.29 1.30 NA 24.98 090
joint.
25444 ................ A Reconstruct wrist 11.15 NA 14.29 1.43 NA 26.87 090
joint.
25445 ................ A Reconstruct wrist 9.69 NA 13.50 1.26 NA 24.45 090
joint.
25446 ................ A Wrist replacement..... 16.55 NA 14.45 2.20 NA 33.20 090
25447 ................ A Repair wrist joint(s). 10.37 NA 11.27 1.34 NA 22.98 090
25449 ................ A Remove wrist joint 14.49 NA 16.20 1.77 NA 32.46 090
implant.
25450 ................ A Revision of wrist 7.87 NA 13.91 0.88 NA 22.66 090
joint.
25455 ................ A Revision of wrist 9.49 NA 15.22 1.07 NA 25.78 090
joint.
25490 ................ A Reinforce radius...... 9.54 NA 16.70 1.19 NA 27.43 090
25491 ................ A Reinforce ulna........ 9.96 NA 16.98 1.41 NA 28.35 090
25492 ................ A Reinforce radius and 12.33 NA 16.09 1.62 NA 30.04 090
ulna.
25500 ................ A Treat fracture of 2.45 4.27 2.94 0.28 7.00 5.67 090
radius.
25505 ................ A Treat fracture of 5.21 7.87 5.65 0.69 13.77 11.55 090
radius.
25515 ................ A Treat fracture of 9.18 NA 10.00 1.22 NA 20.40 090
radius.
25520 ................ A Treat fracture of 6.26 8.00 6.28 0.85 15.11 13.39 090
radius.
25525 ................ A Treat fracture of 12.24 NA 11.65 1.68 NA 25.57 090
radius.
25526 ................ A Treat fracture of 12.98 NA 15.01 1.80 NA 29.79 090
radius.
25530 ................ A Treat fracture of ulna 2.09 4.21 2.87 0.27 6.57 5.23 090
25535 ................ A Treat fracture of ulna 5.14 7.74 5.72 0.68 13.56 11.54 090
25545 ................ A Treat fracture of ulna 8.90 NA 9.88 1.23 NA 20.01 090
25560 ................ A Treat fracture radius 2.44 4.28 2.93 0.27 6.99 5.64 090
& ulna.
25565 ................ A Treat fracture radius 5.63 8.02 5.94 0.76 14.41 12.33 090
& ulna.
25574 ................ A Treat fracture radius 7.01 NA 8.72 0.96 NA 16.69 090
& ulna.
25575 ................ A Treat fracture radius/ 10.45 NA 10.74 1.46 NA 22.65 090
ulna.
25600 ................ A Treat fracture radius/ 2.63 4.53 3.10 0.34 7.50 6.07 090
ulna.
25605 ................ A Treat fracture radius/ 5.81 8.18 6.11 0.81 14.80 12.73 090
ulna.
25611 ................ A Treat fracture radius/ 7.77 NA 10.04 1.08 NA 18.89 090
ulna.
25620 ................ A Treat fracture radius/ 8.55 NA 9.67 1.17 NA 19.39 090
ulna.
25622 ................ A Treat wrist bone 2.61 4.48 3.10 0.33 7.42 6.04 090
fracture.
25624 ................ A Treat wrist bone 4.53 7.40 5.34 0.61 12.54 10.48 090
fracture.
25628 ................ A Treat wrist bone 8.43 NA 9.68 1.14 NA 19.25 090
fracture.
25630 ................ A Treat wrist bone 2.88 4.66 3.20 0.37 7.91 6.45 090
fracture.
[[Page 55349]]
25635 ................ A Treat wrist bone 4.39 7.45 5.11 0.39 12.23 9.89 090
fracture.
25645 ................ A Treat wrist bone 7.25 NA 9.56 0.93 NA 17.74 090
fracture.
25650 ................ A Treat wrist bone 3.05 4.75 3.24 0.37 8.17 6.66 090
fracture.
25651 ................ A Pin ulnar styloid 5.36 NA 4.39 0.73 NA 10.48 090
fracture.
25652 ................ A Treat fracture ulnar 7.60 NA 6.90 0.97 NA 15.47 090
styloid.
25660 ................ A Treat wrist 4.76 NA 5.45 0.59 NA 10.80 090
dislocation.
25670 ................ A Treat wrist 7.92 NA 9.54 1.07 NA 18.53 090
dislocation.
25671 ................ A Pin radioulnar 6.00 NA 6.02 0.75 NA 12.77 090
dislocation.
25675 ................ A Treat wrist 4.67 7.57 5.39 0.57 12.81 10.63 090
dislocation.
25676 ................ A Treat wrist 8.04 NA 9.52 1.10 NA 18.66 090
dislocation.
25680 ................ A Treat wrist fracture.. 5.99 NA 6.45 0.61 NA 13.05 090
25685 ................ A Treat wrist fracture.. 9.78 NA 10.20 1.25 NA 21.23 090
25690 ................ A Treat wrist 5.50 NA 7.00 0.78 NA 13.28 090
dislocation.
25695 ................ A Treat wrist 8.34 NA 9.68 1.07 NA 19.09 090
dislocation.
25800 ................ A Fusion of wrist joint. 9.76 NA 10.87 1.30 NA 21.93 090
25805 ................ A Fusion/graft of wrist 11.28 NA 11.61 1.51 NA 24.40 090
joint.
25810 ................ A Fusion/graft of wrist 10.57 NA 11.33 1.37 NA 23.27 090
joint.
25820 ................ A Fusion of hand bones.. 7.45 NA 9.54 0.96 NA 17.95 090
25825 ................ A Fuse hand bones with 9.27 NA 10.51 1.20 NA 20.98 090
graft.
25830 ................ A Fusion, radioulnar jnt/ 10.06 NA 16.99 1.27 NA 28.32 090
ulna.
25900 ................ A Amputation of forearm. 9.01 NA 15.04 1.08 NA 25.13 090
25905 ................ A Amputation of forearm. 9.12 NA 14.25 1.06 NA 24.43 090
25907 ................ A Amputation follow-up 7.80 NA 15.26 1.01 NA 24.07 090
surgery.
25909 ................ A Amputation follow-up 8.96 NA 14.51 1.07 NA 24.54 090
surgery.
25915 ................ A Amputation of forearm. 17.08 NA 15.11 2.41 NA 34.60 090
25920 ................ A Amputate hand at wrist 8.68 NA 10.12 1.06 NA 19.86 090
25922 ................ A Amputate hand at wrist 7.42 NA 7.58 0.93 NA 15.93 090
25924 ................ A Amputation follow-up 8.46 NA 10.19 1.07 NA 19.72 090
surgery.
25927 ................ A Amputation of hand.... 8.80 NA 14.11 1.02 NA 23.93 090
25929 ................ A Amputation follow-up 7.59 NA 7.42 0.89 NA 15.90 090
surgery.
25931 ................ A Amputation follow-up 7.81 NA 15.79 0.88 NA 24.48 090
surgery.
25999 ................ C Forearm or wrist 0.00 0.00 0.00 0.00 0.00 0.00 YYY
surgery.
26010 ................ A Drainage of finger 1.54 5.24 3.94 0.14 6.92 5.62 010
abscess.
26011 ................ A Drainage of finger 2.19 7.48 6.50 0.25 9.92 8.94 010
abscess.
26020 ................ A Drain hand tendon 4.67 NA 13.10 0.59 NA 18.36 090
sheath.
26025 ................ A Drainage of palm bursa 4.82 NA 13.26 0.60 NA 18.68 090
26030 ................ A Drainage of palm 5.93 NA 14.02 0.72 NA 20.67 090
bursa(s).
26034 ................ A Treat hand bone lesion 6.23 NA 14.84 0.79 NA 21.86 090
26035 ................ A Decompress fingers/ 9.51 NA 15.17 1.12 NA 25.80 090
hand.
26037 ................ A Decompress fingers/ 7.25 NA 12.67 0.87 NA 20.79 090
hand.
26040 ................ A Release palm 3.33 NA 12.87 0.45 NA 16.65 090
contracture.
26045 ................ A Release palm 5.56 NA 14.17 0.74 NA 20.47 090
contracture.
26055 ................ A Incise finger tendon 2.69 8.12 7.69 0.36 11.17 10.74 090
sheath.
26060 ................ A Incision of finger 2.81 NA 7.57 0.35 NA 10.73 090
tendon.
26070 ................ A Explore/treat hand 3.69 NA 11.69 0.35 NA 15.73 090
joint.
26075 ................ A Explore/treat finger 3.79 NA 12.47 0.40 NA 16.66 090
joint.
26080 ................ A Explore/treat finger 4.24 NA 13.09 0.52 NA 17.85 090
joint.
26100 ................ A Biopsy hand joint 3.67 NA 8.43 0.45 NA 12.55 090
lining.
26105 ................ A Biopsy finger joint 3.71 NA 12.95 0.45 NA 17.11 090
lining.
26110 ................ A Biopsy finger joint 3.53 NA 12.46 0.44 NA 16.43 090
lining.
26115 ................ A Remove hand lesion 3.86 7.66 7.66 0.48 12.00 12.00 090
subcut.
26116 ................ A Remove hand lesion, 5.53 NA 13.91 0.69 NA 20.13 090
deep.
26117 ................ A Remove tumor, hand/ 8.55 NA 15.41 1.01 NA 24.97 090
finger.
26121 ................ A Release palm 7.54 NA 15.80 0.94 NA 24.28 090
contracture.
26123 ................ A Release palm 9.29 NA 16.73 1.17 NA 27.19 090
contracture.
26125 ................ A Release palm 4.61 NA 2.60 0.57 NA 7.78 ZZZ
contracture.
26130 ................ A Remove wrist joint 5.42 NA 15.62 0.65 NA 21.69 090
lining.
26135 ................ A Revise finger joint, 6.96 NA 17.04 0.87 NA 24.87 090
each.
26140 ................ A Revise finger joint, 6.17 NA 16.33 0.76 NA 23.26 090
each.
26145 ................ A Tendon excision, palm/ 6.32 NA 16.86 0.77 NA 23.95 090
finger.
26160 ................ A Remove tendon sheath 3.15 7.93 7.88 0.39 11.47 11.42 090
lesion.
26170 ................ A Removal of palm 4.77 NA 8.53 0.60 NA 13.90 090
tendon, each.
26180 ................ A Removal of finger 5.18 NA 9.19 0.64 NA 15.01 090
tendon.
26185 ................ A Remove finger bone.... 5.25 NA 8.76 0.67 NA 14.68 090
26200 ................ A Remove hand bone 5.51 NA 13.97 0.71 NA 20.19 090
lesion.
26205 ................ A Remove/graft bone 7.70 NA 15.35 0.95 NA 24.00 090
lesion.
26210 ................ A Removal of finger 5.15 NA 14.32 0.64 NA 20.11 090
lesion.
26215 ................ A Remove/graft finger 7.10 NA 14.89 0.77 NA 22.76 090
lesion.
26230 ................ A Partial removal of 6.33 NA 12.87 0.84 NA 20.04 090
hand bone.
26235 ................ A Partial removal, 6.19 NA 12.56 0.78 NA 19.53 090
finger bone.
26236 ................ A Partial removal, 5.32 NA 12.62 0.66 NA 18.60 090
finger bone.
26250 ................ A Extensive hand surgery 7.55 NA 17.33 0.92 NA 25.80 090
26255 ................ A Extensive hand surgery 12.43 NA 18.74 1.05 NA 32.22 090
[[Page 55350]]
26260 ................ A Extensive finger 7.03 NA 16.39 0.83 NA 24.25 090
surgery.
26261 ................ A Extensive finger 9.09 NA 16.10 0.84 NA 26.03 090
surgery.
26262 ................ A Partial removal of 5.67 NA 14.81 0.70 NA 21.18 090
finger.
26320 ................ A Removal of implant 3.98 NA 13.08 0.49 NA 17.55 090
from hand.
26340 ................ A Manipulate finger w/ 2.50 NA 4.53 0.32 NA 7.35 090
anesth.
26350 ................ A Repair finger/hand 5.99 NA 20.24 0.73 NA 26.96 090
tendon.
26352 ................ A Repair/graft hand 7.68 NA 19.74 0.93 NA 28.35 090
tendon.
26356 ................ A Repair finger/hand 8.07 NA 21.55 0.99 NA 30.61 090
tendon.
26357 ................ A Repair finger/hand 8.58 NA 21.30 1.02 NA 30.90 090
tendon.
26358 ................ A Repair/graft hand 9.14 NA 22.43 1.07 NA 32.64 090
tendon.
26370 ................ A Repair finger/hand 7.11 NA 20.61 0.90 NA 28.62 090
tendon.
26372 ................ A Repair/graft hand 8.76 NA 20.46 1.06 NA 30.28 090
tendon.
26373 ................ A Repair finger/hand 8.16 NA 22.61 0.98 NA 31.75 090
tendon.
26390 ................ A Revise hand/finger 9.19 NA 16.93 1.09 NA 27.21 090
tendon.
26392 ................ A Repair/graft hand 10.26 NA 23.05 1.26 NA 34.57 090
tendon.
26410 ................ A Repair hand tendon.... 4.63 NA 16.26 0.57 NA 21.46 090
26412 ................ A Repair/graft hand 6.31 NA 16.83 0.80 NA 23.94 090
tendon.
26415 ................ A Excision, hand/finger 8.34 NA 18.14 0.77 NA 27.25 090
tendon.
26416 ................ A Graft hand or finger 9.37 NA 18.95 1.20 NA 29.52 090
tendon.
26418 ................ A Repair finger tendon.. 4.25 NA 16.34 0.50 NA 21.09 090
26420 ................ A Repair/graft finger 6.77 NA 17.92 0.83 NA 25.52 090
tendon.
26426 ................ A Repair finger/hand 6.15 NA 17.05 0.77 NA 23.97 090
tendon.
26428 ................ A Repair/graft finger 7.21 NA 16.05 0.84 NA 24.10 090
tendon.
26432 ................ A Repair finger tendon.. 4.02 NA 13.49 0.48 NA 17.99 090
26433 ................ A Repair finger tendon.. 4.56 NA 14.42 0.56 NA 19.54 090
26434 ................ A Repair/graft finger 6.09 NA 15.34 0.71 NA 22.14 090
tendon.
26437 ................ A Realignment of tendons 5.82 NA 14.16 0.74 NA 20.72 090
26440 ................ A Release palm/finger 5.02 NA 18.48 0.62 NA 24.12 090
tendon.
26442 ................ A Release palm & finger 8.16 NA 19.40 0.94 NA 28.50 090
tendon.
26445 ................ A Release hand/finger 4.31 NA 18.27 0.54 NA 23.12 090
tendon.
26449 ................ A Release forearm/hand 7.00 NA 20.16 0.84 NA 28.00 090
tendon.
26450 ................ A Incision of palm 3.67 NA 8.71 0.46 NA 12.84 090
tendon.
26455 ................ A Incision of finger 3.64 NA 8.38 0.47 NA 12.49 090
tendon.
26460 ................ A Incise hand/finger 3.46 NA 8.06 0.44 NA 11.96 090
tendon.
26471 ................ A Fusion of finger 5.73 NA 13.93 0.73 NA 20.39 090
tendons.
26474 ................ A Fusion of finger 5.32 NA 13.30 0.69 NA 19.31 090
tendons.
26476 ................ A Tendon lengthening.... 5.18 NA 12.72 0.62 NA 18.52 090
26477 ................ A Tendon shortening..... 5.15 NA 13.73 0.60 NA 19.48 090
26478 ................ A Lengthening of hand 5.80 NA 14.73 0.77 NA 21.30 090
tendon.
26479 ................ A Shortening of hand 5.74 NA 13.71 0.76 NA 20.21 090
tendon.
26480 ................ A Transplant hand tendon 6.69 NA 19.63 0.84 NA 27.16 090
26483 ................ A Transplant/graft hand 8.29 NA 19.79 1.03 NA 29.11 090
tendon.
26485 ................ A Transplant palm tendon 7.70 NA 20.08 0.94 NA 28.72 090
26489 ................ A Transplant/graft palm 9.55 NA 17.34 0.98 NA 27.87 090
tendon.
26490 ................ A Revise thumb tendon... 8.41 NA 14.87 1.05 NA 24.33 090
26492 ................ A Tendon transfer with 9.62 NA 15.84 1.19 NA 26.65 090
graft.
26494 ................ A Hand tendon/muscle 8.47 NA 13.52 1.13 NA 23.12 090
transfer.
26496 ................ A Revise thumb tendon... 9.59 NA 15.53 1.17 NA 26.29 090
26497 ................ A Finger tendon transfer 9.57 NA 16.42 1.17 NA 27.16 090
26498 ................ A Finger tendon transfer 14.00 NA 18.19 1.74 NA 33.93 090
26499 ................ A Revision of finger.... 8.98 NA 14.61 0.94 NA 24.53 090
26500 ................ A Hand tendon 5.96 NA 15.16 0.66 NA 21.78 090
reconstruction.
26502 ................ A Hand tendon 7.14 NA 15.14 0.87 NA 23.15 090
reconstruction.
26504 ................ A Hand tendon 7.47 NA 14.31 0.84 NA 22.62 090
reconstruction.
26508 ................ A Release thumb 6.01 NA 14.11 0.76 NA 20.88 090
contracture.
26510 ................ A Thumb tendon transfer. 5.43 NA 14.18 0.71 NA 20.32 090
26516 ................ A Fusion of knuckle 7.15 NA 15.06 0.90 NA 23.11 090
joint.
26517 ................ A Fusion of knuckle 8.83 NA 15.89 0.96 NA 25.68 090
joints.
26518 ................ A Fusion of knuckle 9.02 NA 15.91 1.13 NA 26.06 090
joints.
26520 ................ A Release knuckle 5.30 NA 18.59 0.65 NA 24.54 090
contracture.
26525 ................ A Release finger 5.33 NA 18.67 0.66 NA 24.66 090
contracture.
26530 ................ A Revise knuckle joint.. 6.69 NA 19.35 0.86 NA 26.90 090
26531 ................ A Revise knuckle with 7.91 NA 19.41 1.01 NA 28.33 090
implant.
26535 ................ A Revise finger joint... 5.24 NA 11.10 0.66 NA 17.00 090
26536 ................ A Revise/implant finger 6.37 NA 17.97 0.80 NA 25.14 090
joint.
26540 ................ A Repair hand joint..... 6.43 NA 14.54 0.81 NA 21.78 090
26541 ................ A Repair hand joint with 8.62 NA 16.36 1.12 NA 26.10 090
graft.
26542 ................ A Repair hand joint with 6.78 NA 14.51 0.87 NA 22.16 090
graft.
26545 ................ A Reconstruct finger 6.92 NA 16.16 0.79 NA 23.87 090
joint.
26546 ................ A Repair nonunion hand.. 8.92 NA 15.95 1.14 NA 26.01 090
26548 ................ A Reconstruct finger 8.03 NA 16.13 0.98 NA 25.14 090
joint.
26550 ................ A Construct thumb 21.24 NA 30.36 1.80 NA 53.40 090
replacement.
26551 ................ A Great toe-hand 46.58 NA 29.35 6.57 NA 82.50 090
transfer.
[[Page 55351]]
26553 ................ A Single transfer, toe- 46.27 NA 29.23 1.99 NA 77.49 090
hand.
26554 ................ A Double transfer, toe- 54.95 NA 32.69 7.76 NA 95.40 090
hand.
26555 ................ A Positional change of 16.63 NA 24.00 2.13 NA 42.76 090
finger.
26556 ................ A Toe joint transfer.... 47.26 NA 29.62 6.67 NA 83.55 090
26560 ................ A Repair of web finger.. 5.38 NA 12.55 0.60 NA 18.53 090
26561 ................ A Repair of web finger.. 10.92 NA 18.61 0.69 NA 30.22 090
26562 ................ A Repair of web finger.. 15.00 NA 13.44 0.98 NA 29.42 090
26565 ................ A Correct metacarpal 6.74 NA 14.77 0.84 NA 22.35 090
flaw.
26567 ................ A Correct finger 6.82 NA 15.10 0.84 NA 22.76 090
deformity.
26568 ................ A Lengthen metacarpal/ 9.08 NA 19.48 1.10 NA 29.66 090
finger.
26580 ................ A Repair hand deformity. 18.18 NA 17.22 1.46 NA 36.86 090
26585 ................ D Repair finger 0.00 NA 0.00 0.00 NA 0.00 090
deformity.
26587 ................ A Reconstruct extra 14.05 4.67 NA 1.08 19.80 NA 090
finger.
26590 ................ A Repair finger 17.96 NA 14.62 1.32 NA 33.90 090
deformity.
26591 ................ A Repair muscles of hand 3.25 NA 14.22 0.37 NA 17.84 090
26593 ................ A Release muscles of 5.31 NA 13.33 0.64 NA 19.28 090
hand.
26596 ................ A Excision constricting 8.95 NA 10.26 0.87 NA 20.08 090
tissue.
26597 ................ D Release of scar 0.00 NA 0.00 0.00 NA 0.00 090
contracture.
26600 ................ A Treat metacarpal 1.96 4.15 2.83 0.25 6.36 5.04 090
fracture.
26605 ................ A Treat metacarpal 2.85 6.05 4.29 0.38 9.28 7.52 090
fracture.
26607 ................ A Treat metacarpal 5.36 NA 8.33 0.70 NA 14.39 090
fracture.
26608 ................ A Treat metacarpal 5.36 NA 8.85 0.73 NA 14.94 090
fracture.
26615 ................ A Treat metacarpal 5.33 NA 8.43 0.70 NA 14.46 090
fracture.
26641 ................ A Treat thumb 3.94 6.58 4.99 0.42 10.94 9.35 090
dislocation.
26645 ................ A Treat thumb fracture.. 4.41 7.33 5.30 0.54 12.28 10.25 090
26650 ................ A Treat thumb fracture.. 5.72 NA 9.02 0.77 NA 15.51 090
26665 ................ A Treat thumb fracture.. 7.60 NA 9.24 0.97 NA 17.81 090
26670 ................ A Treat hand dislocation 3.69 6.46 4.93 0.36 10.51 8.98 090
26675 ................ A Treat hand dislocation 4.64 6.82 4.71 0.56 12.02 9.91 090
26676 ................ A Pin hand dislocation.. 5.52 NA 9.36 0.76 NA 15.64 090
26685 ................ A Treat hand dislocation 6.98 NA 8.88 0.95 NA 16.81 090
26686 ................ A Treat hand dislocation 7.94 NA 9.84 1.05 NA 18.83 090
26700 ................ A Treat knuckle 3.69 5.01 3.02 0.35 9.05 7.06 090
dislocation.
26705 ................ A Treat knuckle 4.19 6.26 4.33 0.50 10.95 9.02 090
dislocation.
26706 ................ A Pin knuckle 5.12 NA 5.87 0.64 NA 11.63 090
dislocation.
26715 ................ A Treat knuckle 5.74 NA 8.62 0.75 NA 15.11 090
dislocation.
26720 ................ A Treat finger fracture, 1.66 3.06 1.72 0.20 4.92 3.58 090
each.
26725 ................ A Treat finger fracture, 3.33 5.27 3.26 0.43 9.03 7.02 090
each.
26727 ................ A Treat finger fracture, 5.23 NA 8.88 0.69 NA 14.80 090
each.
26735 ................ A Treat finger fracture, 5.98 NA 8.99 0.77 NA 15.74 090
each.
26740 ................ A Treat finger fracture, 1.94 3.86 2.67 0.24 6.04 4.85 090
each.
26742 ................ A Treat finger fracture, 3.85 7.21 5.13 0.49 11.55 9.47 090
each.
26746 ................ A Treat finger fracture, 5.81 NA 8.93 0.74 NA 15.48 090
each.
26750 ................ A Treat finger fracture, 1.70 3.66 2.47 0.19 5.55 4.36 090
each.
26755 ................ A Treat finger fracture, 3.10 5.08 3.27 0.37 8.55 6.74 090
each.
26756 ................ A Pin finger fracture, 4.39 NA 8.74 0.56 NA 13.69 090
each.
26765 ................ A Treat finger fracture, 4.17 NA 8.02 0.51 NA 12.70 090
each.
26770 ................ A Treat finger 3.02 4.87 2.80 0.27 8.16 6.09 090
dislocation.
26775 ................ A Treat finger 3.71 6.07 4.09 0.43 10.21 8.23 090
dislocation.
26776 ................ A Pin finger dislocation 4.80 NA 8.61 0.63 NA 14.04 090
26785 ................ A Treat finger 4.21 NA 7.95 0.54 NA 12.70 090
dislocation.
26820 ................ A Thumb fusion with 8.26 NA 15.80 1.11 NA 25.17 090
graft.
26841 ................ A Fusion of thumb....... 7.13 NA 15.37 0.97 NA 23.47 090
26842 ................ A Thumb fusion with 8.24 NA 15.49 1.10 NA 24.83 090
graft.
26843 ................ A Fusion of hand joint.. 7.61 NA 13.91 0.99 NA 22.51 090
26844 ................ A Fusion/graft of hand 8.73 NA 15.63 1.12 NA 25.48 090
joint.
26850 ................ A Fusion of knuckle..... 6.97 NA 14.63 0.89 NA 22.49 090
26852 ................ A Fusion of knuckle with 8.46 NA 15.19 1.05 NA 24.70 090
graft.
26860 ................ A Fusion of finger joint 4.69 NA 13.45 0.60 NA 18.74 090
26861 ................ A Fusion of finger jnt, 1.74 NA 0.99 0.22 NA 2.95 ZZZ
add-on.
26862 ................ A Fusion/graft of finger 7.37 NA 15.18 0.92 NA 23.47 090
joint.
26863 ................ A Fuse/graft added joint 3.90 NA 2.25 0.51 NA 6.66 ZZZ
26910 ................ A Amputate metacarpal 7.60 NA 13.98 0.90 NA 22.48 090
bone.
26951 ................ A Amputation of finger/ 4.59 NA 13.06 0.56 NA 18.21 090
thumb.
26952 ................ A Amputation of finger/ 6.31 NA 14.47 0.74 NA 21.52 090
thumb.
26989 ................ C Hand/finger surgery... 0.00 0.00 0.00 0.00 0.00 0.00 YYY
26990 ................ A Drainage of pelvis 7.48 NA 15.92 0.92 NA 24.32 090
lesion.
26991 ................ A Drainage of pelvis 6.68 11.32 9.39 0.85 18.85 16.92 090
bursa.
26992 ................ A Drainage of bone 13.02 NA 19.95 1.75 NA 34.72 090
lesion.
27000 ................ A Incision of hip tendon 5.62 NA 7.48 0.76 NA 13.86 090
27001 ................ A Incision of hip tendon 6.94 NA 8.42 0.95 NA 16.31 090
27003 ................ A Incision of hip tendon 7.34 NA 9.01 0.93 NA 17.28 090
27005 ................ A Incision of hip tendon 9.66 NA 10.50 1.36 NA 21.52 090
[[Page 55352]]
27006 ................ A Incision of hip 9.68 NA 10.59 1.33 NA 21.60 090
tendons.
27025 ................ A Incision of hip/thigh 11.16 NA 10.53 1.38 NA 23.07 090
fascia.
27030 ................ A Drainage of hip joint. 13.01 NA 12.45 1.81 NA 27.27 090
27033 ................ A Exploration of hip 13.39 NA 12.62 1.87 NA 27.88 090
joint.
27035 ................ A Denervation of hip 16.69 NA 19.67 1.70 NA 38.06 090
joint.
27036 ................ A Excision of hip joint/ 12.88 NA 14.03 1.80 NA 28.71 090
muscle.
27040 ................ A Biopsy of soft tissues 2.87 6.23 4.00 0.21 9.31 7.08 010
27041 ................ A Biopsy of soft tissues 9.89 NA 8.60 1.01 NA 19.50 090
27047 ................ A Remove hip/pelvis 7.45 9.26 7.03 0.79 17.50 15.27 090
lesion.
27048 ................ A Remove hip/pelvis 6.25 NA 7.94 0.73 NA 14.92 090
lesion.
27049 ................ A Remove tumor, hip/ 13.66 NA 13.77 1.60 NA 29.03 090
pelvis.
27050 ................ A Biopsy of sacroiliac 4.36 NA 7.52 0.53 NA 12.41 090
joint.
27052 ................ A Biopsy of hip joint... 6.23 NA 8.24 0.85 NA 15.32 090
27054 ................ A Removal of hip joint 8.54 NA 10.67 1.17 NA 20.38 090
lining.
27060 ................ A Removal of ischial 5.43 NA 7.21 0.60 NA 13.24 090
bursa.
27062 ................ A Remove femur lesion/ 5.37 NA 7.32 0.74 NA 13.43 090
bursa.
27065 ................ A Removal of hip bone 5.90 NA 8.65 0.76 NA 15.31 090
lesion.
27066 ................ A Removal of hip bone 10.33 NA 12.53 1.42 NA 24.28 090
lesion.
27067 ................ A Remove/graft hip bone 13.83 NA 14.54 1.95 NA 30.32 090
lesion.
27070 ................ A Partial removal of hip 10.72 NA 17.71 1.36 NA 29.79 090
bone.
27071 ................ A Partial removal of hip 11.46 NA 18.67 1.51 NA 31.64 090
bone.
27075 ................ A Extensive hip surgery. 35.00 NA 25.75 2.22 NA 62.97 090
27076 ................ A Extensive hip surgery. 22.12 NA 20.08 2.86 NA 45.06 090
27077 ................ A Extensive hip surgery. 40.00 NA 30.55 3.18 NA 73.73 090
27078 ................ A Extensive hip surgery. 13.44 NA 16.30 1.67 NA 31.41 090
27079 ................ A Extensive hip surgery. 13.75 NA 13.43 1.86 NA 29.04 090
27080 ................ A Removal of tail bone.. 6.39 NA 7.64 0.80 NA 14.83 090
27086 ................ A Remove hip foreign 1.87 5.85 3.70 0.17 7.89 5.74 010
body.
27087 ................ A Remove hip foreign 8.54 NA 9.04 1.09 NA 18.67 090
body.
27090 ................ A Removal of hip 11.15 NA 11.37 1.55 NA 24.07 090
prosthesis.
27091 ................ A Removal of hip 22.14 NA 15.14 3.11 NA 40.39 090
prosthesis.
27093 ................ A Injection for hip x- 1.30 13.59 0.53 0.09 14.98 1.92 000
ray.
27095 ................ A Injection for hip x- 1.50 11.00 0.60 0.10 12.60 2.20 000
ray.
27096 ................ A Inject sacroiliac 1.40 8.86 0.35 0.08 10.34 1.83 000
joint.
27097 ................ A Revision of hip tendon 8.80 NA 8.13 1.22 NA 18.15 090
27098 ................ A Transfer tendon to 8.83 NA 9.18 1.24 NA 19.25 090
pelvis.
27100 ................ A Transfer of abdominal 11.08 NA 13.03 1.57 NA 25.68 090
muscle.
27105 ................ A Transfer of spinal 11.77 NA 12.14 1.66 NA 25.57 090
muscle.
27110 ................ A Transfer of iliopsoas 13.26 NA 12.99 1.38 NA 27.63 090
muscle.
27111 ................ A Transfer of iliopsoas 12.15 NA 11.77 1.48 NA 25.40 090
muscle.
27120 ................ A Reconstruction of hip 18.01 NA 14.28 2.45 NA 34.74 090
socket.
27122 ................ A Reconstruction of hip 14.98 NA 14.48 2.08 NA 31.54 090
socket.
27125 ................ A Partial hip 14.69 NA 14.02 2.05 NA 30.76 090
replacement.
27130 ................ A Total hip arthroplasty 20.12 NA 17.18 2.82 NA 40.12 090
27132 ................ A Total hip arthroplasty 23.30 NA 19.00 3.26 NA 45.56 090
27134 ................ A Revise hip joint 28.52 NA 21.82 3.97 NA 54.31 090
replacement.
27137 ................ A Revise hip joint 21.17 NA 17.54 2.97 NA 41.68 090
replacement.
27138 ................ A Revise hip joint 22.17 NA 17.94 3.11 NA 43.22 090
replacement.
27140 ................ A Transplant femur ridge 12.24 NA 11.98 1.67 NA 25.89 090
27146 ................ A Incision of hip bone.. 17.43 NA 15.87 2.27 NA 35.57 090
27147 ................ A Revision of hip bone.. 20.58 NA 17.87 2.61 NA 41.06 090
27151 ................ A Incision of hip bones. 22.51 NA 18.97 3.12 NA 44.60 090
27156 ................ A Revision of hip bones. 24.63 NA 19.84 3.48 NA 47.95 090
27158 ................ A Revision of pelvis.... 19.74 NA 15.58 2.60 NA 37.92 090
27161 ................ A Incision of neck of 16.71 NA 14.47 2.32 NA 33.50 090
femur.
27165 ................ A Incision/fixation of 17.91 NA 14.92 2.51 NA 35.34 090
femur.
27170 ................ A Repair/graft femur 16.07 NA 14.16 2.20 NA 32.43 090
head/neck.
27175 ................ A Treat slipped 8.46 NA 7.26 1.19 NA 16.91 090
epiphysis.
27176 ................ A Treat slipped 12.05 NA 10.23 1.68 NA 23.96 090
epiphysis.
27177 ................ A Treat slipped 15.08 NA 12.22 2.11 NA 29.41 090
epiphysis.
27178 ................ A Treat slipped 11.99 NA 10.13 1.68 NA 23.80 090
epiphysis.
27179 ................ A Revise head/neck of 12.98 NA 10.90 1.84 NA 25.72 090
femur.
27181 ................ A Treat slipped 14.68 NA 11.92 1.74 NA 28.34 090
epiphysis.
27185 ................ A Revision of femur 9.18 NA 10.04 1.29 NA 20.51 090
epiphysis.
27187 ................ A Reinforce hip bones... 13.54 NA 13.53 1.89 NA 28.96 090
27193 ................ A Treat pelvic ring 5.56 7.14 5.36 0.77 13.47 11.69 090
fracture.
27194 ................ A Treat pelvic ring 9.65 9.20 7.69 1.32 20.17 18.66 090
fracture.
27200 ................ A Treat tail bone 1.84 3.13 1.84 0.22 5.19 3.90 090
fracture.
27202 ................ A Treat tail bone 7.04 NA 21.62 0.69 NA 29.35 090
fracture.
27215 ................ A Treat pelvic 10.05 NA 10.60 1.37 NA 22.02 090
fracture(s).
27216 ................ A Treat pelvic ring 15.19 NA 15.51 2.15 NA 32.85 090
fracture.
27217 ................ A Treat pelvic ring 14.11 NA 12.83 1.95 NA 28.89 090
fracture.
27218 ................ A Treat pelvic ring 20.15 NA 16.68 2.85 NA 39.68 090
fracture.
[[Page 55353]]
27220 ................ A Treat hip socket 6.18 7.48 5.72 0.85 14.51 12.75 090
fracture.
27222 ................ A Treat hip socket 12.70 NA 10.37 1.77 NA 24.84 090
fracture.
27226 ................ A Treat hip wall 14.91 NA 10.36 2.07 NA 27.34 090
fracture.
27227 ................ A Treat hip fracture(s). 23.45 NA 17.22 3.24 NA 43.91 090
27228 ................ A Treat hip fracture(s). 27.16 NA 19.67 3.77 NA 50.60 090
27230 ................ A Treat thigh fracture.. 5.50 7.62 6.30 0.73 13.85 12.53 090
27232 ................ A Treat thigh fracture.. 10.68 NA 9.31 1.45 NA 21.44 090
27235 ................ A Treat thigh fracture.. 12.16 NA 11.24 1.71 NA 25.11 090
27236 ................ A Treat thigh fracture.. 15.60 NA 12.99 2.18 NA 30.77 090
27238 ................ A Treat thigh fracture.. 5.52 NA 6.36 0.76 NA 12.64 090
27240 ................ A Treat thigh fracture.. 12.50 NA 10.38 1.69 NA 24.57 090
27244 ................ A Treat thigh fracture.. 15.94 NA 13.25 2.23 NA 31.42 090
27245 ................ A Treat thigh fracture.. 20.31 NA 15.61 2.85 NA 38.77 090
27246 ................ A Treat thigh fracture.. 4.71 7.31 5.93 0.66 12.68 11.30 090
27248 ................ A Treat thigh fracture.. 10.45 NA 10.20 1.45 NA 22.10 090
27250 ................ A Treat hip dislocation. 6.95 NA 6.55 0.68 NA 14.18 090
27252 ................ A Treat hip dislocation. 10.39 NA 8.31 1.37 NA 20.07 090
27253 ................ A Treat hip dislocation. 12.92 NA 11.10 1.81 NA 25.83 090
27254 ................ A Treat hip dislocation. 18.26 NA 14.29 2.52 NA 35.07 090
27256 ................ A Treat hip dislocation. 4.12 NA 4.31 0.49 NA 8.92 010
27257 ................ A Treat hip dislocation. 5.22 NA 4.59 0.56 NA 10.37 010
27258 ................ A Treat hip dislocation. 15.43 NA 13.93 2.06 NA 31.42 090
27259 ................ A Treat hip dislocation. 21.55 NA 18.02 2.99 NA 42.56 090
27265 ................ A Treat hip dislocation. 5.05 NA 6.09 0.65 NA 11.79 090
27266 ................ A Treat hip dislocation. 7.49 NA 7.50 1.04 NA 16.03 090
27275 ................ A Manipulation of hip 2.27 NA 3.62 0.31 NA 6.20 010
joint.
27280 ................ A Fusion of sacroiliac 13.39 NA 13.95 1.98 NA 29.32 090
joint.
27282 ................ A Fusion of pubic bones. 11.34 NA 12.33 1.14 NA 24.81 090
27284 ................ A Fusion of hip joint... 23.45 NA 18.86 2.36 NA 44.67 090
27286 ................ A Fusion of hip joint... 23.45 NA 19.13 2.37 NA 44.95 090
27290 ................ A Amputation of leg at 23.28 NA 17.37 2.94 NA 43.59 090
hip.
27295 ................ A Amputation of leg at 18.65 NA 14.65 2.35 NA 35.65 090
hip.
27299 ................ C Pelvis/hip joint 0.00 0.00 0.00 0.00 0.00 0.00 YYY
surgery.
27301 ................ A Drain thigh/knee 6.49 15.30 14.04 0.80 22.59 21.33 090
lesion.
27303 ................ A Drainage of bone 8.28 NA 14.63 1.14 NA 24.05 090
lesion.
27305 ................ A Incise thigh tendon & 5.92 NA 8.88 0.77 NA 15.57 090
fascia.
27306 ................ A Incision of thigh 4.62 NA 7.54 0.62 NA 12.78 090
tendon.
27307 ................ A Incision of thigh 5.80 NA 8.15 0.78 NA 14.73 090
tendons.
27310 ................ A Exploration of knee 9.27 NA 10.14 1.29 NA 20.70 090
joint.
27315 ................ A Partial removal, thigh 6.97 NA 4.04 0.79 NA 11.80 090
nerve.
27320 ................ A Partial removal, thigh 6.30 NA 5.07 0.78 NA 12.15 090
nerve.
27323 ................ A Biopsy, thigh soft 2.28 5.57 3.49 0.17 8.02 5.94 010
tissues.
27324 ................ A Biopsy, thigh soft 4.90 NA 6.79 0.59 NA 12.28 090
tissues.
27327 ................ A Removal of thigh 4.47 8.47 6.35 0.50 13.44 11.32 090
lesion.
27328 ................ A Removal of thigh 5.57 NA 7.19 0.66 NA 13.42 090
lesion.
27329 ................ A Remove tumor, thigh/ 14.14 NA 15.02 1.68 NA 30.84 090
knee.
27330 ................ A Biopsy, knee joint 4.97 NA 6.42 0.66 NA 12.05 090
lining.
27331 ................ A Explore/treat knee 5.88 NA 7.56 0.81 NA 14.25 090
joint.
27332 ................ A Removal of knee 8.27 NA 8.84 1.15 NA 18.26 090
cartilage.
27333 ................ A Removal of knee 7.30 NA 8.49 1.03 NA 16.82 090
cartilage.
27334 ................ A Remove knee joint 8.70 NA 9.80 1.21 NA 19.71 090
lining.
27335 ................ A Remove knee joint 10.00 NA 10.58 1.41 NA 21.99 090
lining.
27340 ................ A Removal of kneecap 4.18 NA 6.03 0.58 NA 10.79 090
bursa.
27345 ................ A Removal of knee cyst.. 5.92 NA 7.49 0.81 NA 14.22 090
27347 ................ A Remove knee cyst...... 5.78 2.64 2.64 0.76 9.18 9.18 090
27350 ................ A Removal of kneecap.... 8.17 NA 8.95 1.15 NA 18.27 090
27355 ................ A Remove femur lesion... 7.65 NA 10.36 1.07 NA 19.08 090
27356 ................ A Remove femur lesion/ 9.48 NA 11.32 1.29 NA 22.09 090
graft.
27357 ................ A Remove femur lesion/ 10.53 NA 11.75 1.48 NA 23.76 090
graft.
27358 ................ A Remove femur lesion/ 4.74 NA 2.69 0.67 NA 8.10 ZZZ
fixation.
27360 ................ A Partial removal, leg 10.50 NA 18.43 1.42 NA 30.35 090
bone(s).
27365 ................ A Extensive leg surgery. 16.27 NA 14.69 2.26 NA 33.22 090
27370 ................ A Injection for knee x- 0.96 11.10 0.35 0.06 12.12 1.37 000
ray.
27372 ................ A Removal of foreign 5.07 8.66 6.28 0.62 14.35 11.97 090
body.
27380 ................ A Repair of kneecap 7.16 NA 8.57 1.00 NA 16.73 090
tendon.
27381 ................ A Repair/graft kneecap 10.34 NA 10.34 1.44 NA 22.12 090
tendon.
27385 ................ A Repair of thigh muscle 7.76 NA 8.93 1.09 NA 17.78 090
27386 ................ A Repair/graft of thigh 10.56 NA 11.12 1.49 NA 23.17 090
muscle.
27390 ................ A Incision of thigh 5.33 NA 8.22 0.69 NA 14.24 090
tendon.
27391 ................ A Incision of thigh 7.20 NA 9.08 0.99 NA 17.27 090
tendons.
27392 ................ A Incision of thigh 9.20 NA 11.15 1.23 NA 21.58 090
tendons.
27393 ................ A Lengthening of thigh 6.39 NA 8.45 0.90 NA 15.74 090
tendon.
27394 ................ A Lengthening of thigh 8.50 NA 10.51 1.17 NA 20.18 090
tendons.
[[Page 55354]]
27395 ................ A Lengthening of thigh 11.73 NA 13.19 1.63 NA 26.55 090
tendons.
27396 ................ A Transplant of thigh 7.86 NA 9.65 1.11 NA 18.62 090
tendon.
27397 ................ A Transplants of thigh 11.28 NA 11.71 1.58 NA 24.57 090
tendons.
27400 ................ A Revise thigh muscles/ 9.02 NA 10.67 1.18 NA 20.87 090
tendons.
27403 ................ A Repair of knee 8.33 NA 8.88 1.16 NA 18.37 090
cartilage.
27405 ................ A Repair of knee 8.65 NA 9.81 1.21 NA 19.67 090
ligament.
27407 ................ A Repair of knee 10.28 NA 10.67 1.38 NA 22.33 090
ligament.
27409 ................ A Repair of knee 12.90 NA 12.11 1.75 NA 26.76 090
ligaments.
27418 ................ A Repair degenerated 10.85 NA 10.99 1.51 NA 23.35 090
kneecap.
27420 ................ A Revision of unstable 9.83 NA 9.87 1.38 NA 21.08 090
kneecap.
27422 ................ A Revision of unstable 9.78 NA 9.83 1.37 NA 20.98 090
kneecap.
27424 ................ A Revision/removal of 9.81 NA 9.75 1.38 NA 20.94 090
kneecap.
27425 ................ A Lateral retinacular 5.22 NA 7.29 0.73 NA 13.24 090
release.
27427 ................ A Reconstruction, knee.. 9.36 NA 9.57 1.29 NA 20.22 090
27428 ................ A Reconstruction, knee.. 14.00 NA 12.85 1.95 NA 28.80 090
27429 ................ A Reconstruction, knee.. 15.52 NA 13.69 2.18 NA 31.39 090
27430 ................ A Revision of thigh 9.67 NA 9.90 1.35 NA 20.92 090
muscles.
27435 ................ A Incision of knee joint 9.49 NA 9.68 1.33 NA 20.50 090
27437 ................ A Revise kneecap........ 8.46 NA 10.06 1.18 NA 19.70 090
27438 ................ A Revise kneecap with 11.23 NA 11.34 1.56 NA 24.13 090
implant.
27440 ................ A Revision of knee joint 10.43 NA 10.92 1.42 NA 22.77 090
27441 ................ A Revision of knee joint 10.82 NA 11.24 1.49 NA 23.55 090
27442 ................ A Revision of knee joint 11.89 NA 11.77 1.68 NA 25.34 090
27443 ................ A Revision of knee joint 10.93 NA 11.56 1.52 NA 24.01 090
27445 ................ A Revision of knee joint 17.68 NA 14.98 2.49 NA 35.15 090
27446 ................ A Revision of knee joint 15.84 NA 14.26 2.22 NA 32.32 090
27447 ................ A Total knee 21.48 NA 17.35 3.00 NA 41.83 090
arthroplasty.
27448 ................ A Incision of thigh..... 11.06 NA 11.98 1.51 NA 24.55 090
27450 ................ A Incision of thigh..... 13.98 NA 13.83 1.96 NA 29.77 090
27454 ................ A Realignment of thigh 17.56 NA 15.83 2.46 NA 35.85 090
bone.
27455 ................ A Realignment of knee... 12.82 NA 12.57 1.78 NA 27.17 090
27457 ................ A Realignment of knee... 13.45 NA 11.73 1.88 NA 27.06 090
27465 ................ A Shortening of thigh 13.87 NA 14.09 1.86 NA 29.82 090
bone.
27466 ................ A Lengthening of thigh 16.33 NA 16.19 1.92 NA 34.44 090
bone.
27468 ................ A Shorten/lengthen 18.97 NA 14.57 2.68 NA 36.22 090
thighs.
27470 ................ A Repair of thigh....... 16.07 NA 16.07 2.24 NA 34.38 090
27472 ................ A Repair/graft of thigh. 17.72 NA 16.98 2.49 NA 37.19 090
27475 ................ A Surgery to stop leg 8.64 NA 9.51 1.13 NA 19.28 090
growth.
27477 ................ A Surgery to stop leg 9.85 NA 10.10 1.31 NA 21.26 090
growth.
27479 ................ A Surgery to stop leg 12.80 NA 12.09 1.81 NA 26.70 090
growth.
27485 ................ A Surgery to stop leg 8.84 NA 9.40 1.24 NA 19.48 090
growth.
27486 ................ A Revise/replace knee 19.27 NA 16.13 2.70 NA 38.10 090
joint.
27487 ................ A Revise/replace knee 25.27 NA 19.26 3.54 NA 48.07 090
joint.
27488 ................ A Removal of knee 15.74 NA 14.21 2.21 NA 32.16 090
prosthesis.
27495 ................ A Reinforce thigh....... 15.55 NA 15.78 2.18 NA 33.51 090
27496 ................ A Decompression of thigh/ 6.11 NA 7.96 0.77 NA 14.84 090
knee.
27497 ................ A Decompression of thigh/ 7.17 NA 8.16 0.84 NA 16.17 090
knee.
27498 ................ A Decompression of thigh/ 7.99 NA 8.37 0.97 NA 17.33 090
knee.
27499 ................ A Decompression of thigh/ 9.00 NA 9.42 1.18 NA 19.60 090
knee.
27500 ................ A Treatment of thigh 5.92 9.84 7.57 0.80 16.56 14.29 090
fracture.
27501 ................ A Treatment of thigh 5.92 10.92 8.62 0.83 17.67 15.37 090
fracture.
27502 ................ A Treatment of thigh 10.58 NA 11.27 1.49 NA 23.34 090
fracture.
27503 ................ A Treatment of thigh 10.58 NA 11.26 1.49 NA 23.33 090
fracture.
27506 ................ A Treatment of thigh 17.45 NA 14.57 2.33 NA 34.35 090
fracture.
27507 ................ A Treatment of thigh 13.99 NA 12.58 1.95 NA 28.52 090
fracture.
27508 ................ A Treatment of thigh 5.83 7.17 5.43 0.80 13.80 12.06 090
fracture.
27509 ................ A Treatment of thigh 7.71 NA 9.44 1.08 NA 18.23 090
fracture.
27510 ................ A Treatment of thigh 9.13 NA 7.37 1.26 NA 17.76 090
fracture.
27511 ................ A Treatment of thigh 13.64 NA 13.38 1.91 NA 28.93 090
fracture.
27513 ................ A Treatment of thigh 17.92 NA 15.80 2.51 NA 36.23 090
fracture.
27514 ................ A Treatment of thigh 17.30 NA 14.55 2.41 NA 34.26 090
fracture.
27516 ................ A Treat thigh fx growth 5.37 7.98 5.85 0.74 14.09 11.96 090
plate.
27517 ................ A Treat thigh fx growth 8.78 9.94 7.90 1.22 19.94 17.90 090
plate.
27519 ................ A Treat thigh fx growth 15.02 NA 13.11 2.09 NA 30.22 090
plate.
27520 ................ A Treat kneecap fracture 2.86 5.48 3.82 0.38 8.72 7.06 090
27524 ................ A Treat kneecap fracture 10.00 NA 8.98 1.40 NA 20.38 090
27530 ................ A Treat knee fracture... 3.78 6.00 4.33 0.51 10.29 8.62 090
27532 ................ A Treat knee fracture... 7.30 7.65 5.84 1.02 15.97 14.16 090
27535 ................ A Treat knee fracture... 11.50 NA 12.15 1.61 NA 25.26 090
27536 ................ A Treat knee fracture... 15.65 NA 12.16 2.19 NA 30.00 090
27538 ................ A Treat knee fracture(s) 4.87 7.64 5.60 0.67 13.18 11.14 090
27540 ................ A Treat knee fracture... 13.10 NA 10.75 1.80 NA 25.65 090
27550 ................ A Treat knee dislocation 5.76 7.60 5.79 0.68 14.04 12.23 090
[[Page 55355]]
27552 ................ A Treat knee dislocation 7.90 NA 8.04 1.10 NA 17.04 090
27556 ................ A Treat knee dislocation 14.41 NA 14.45 2.01 NA 30.87 090
27557 ................ A Treat knee dislocation 16.77 NA 15.78 2.37 NA 34.92 090
27558 ................ A Treat knee dislocation 17.72 NA 15.91 2.51 NA 36.14 090
27560 ................ A Treat kneecap 3.82 5.89 4.04 0.40 10.11 8.26 090
dislocation.
27562 ................ A Treat kneecap 5.79 NA 5.67 0.69 NA 12.15 090
dislocation.
27566 ................ A Treat kneecap 12.23 NA 10.09 1.73 NA 24.05 090
dislocation.
27570 ................ A Fixation of knee joint 1.74 NA 3.24 0.24 NA 5.22 010
27580 ................ A Fusion of knee........ 19.37 NA 16.63 2.70 NA 38.70 090
27590 ................ A Amputate leg at thigh. 12.03 NA 12.67 1.35 NA 26.05 090
27591 ................ A Amputate leg at thigh. 12.68 NA 14.01 1.63 NA 28.32 090
27592 ................ A Amputate leg at thigh. 10.02 NA 12.55 1.17 NA 23.74 090
27594 ................ A Amputation follow-up 6.92 NA 9.05 0.82 NA 16.79 090
surgery.
27596 ................ A Amputation follow-up 10.60 NA 12.64 1.24 NA 24.48 090
surgery.
27598 ................ A Amputate lower leg at 10.53 NA 11.69 1.24 NA 23.46 090
knee.
27599 ................ C Leg surgery procedure. 0.00 0.00 0.00 0.00 0.00 0.00 YYY
27600 ................ A Decompression of lower 5.65 NA 7.67 0.68 NA 14.00 090
leg.
27601 ................ A Decompression of lower 5.64 NA 7.68 0.69 NA 14.01 090
leg.
27602 ................ A Decompression of lower 7.35 NA 8.08 0.85 NA 16.28 090
leg.
27603 ................ A Drain lower leg lesion 4.94 16.03 10.54 0.56 21.53 16.04 090
27604 ................ A Drain lower leg bursa. 4.47 11.01 8.47 0.54 16.02 13.48 090
27605 ................ A Incision of achilles 2.87 9.81 3.67 0.38 13.06 6.92 010
tendon.
27606 ................ A Incision of achilles 4.14 13.19 5.08 0.57 17.90 9.79 010
tendon.
27607 ................ A Treat lower leg bone 7.97 NA 12.78 1.08 NA 21.83 090
lesion.
27610 ................ A Explore/treat ankle 8.34 NA 10.43 1.15 NA 19.92 090
joint.
27612 ................ A Exploration of ankle 7.33 NA 8.32 1.01 NA 16.66 090
joint.
27613 ................ A Biopsy lower leg soft 2.17 5.38 2.96 0.16 7.71 5.29 010
tissue.
27614 ................ A Biopsy lower leg soft 5.66 10.88 7.17 0.62 17.16 13.45 090
tissue.
27615 ................ A Remove tumor, lower 12.56 NA 17.07 1.39 NA 31.02 090
leg.
27618 ................ A Remove lower leg 5.09 11.72 6.72 0.54 17.35 12.35 090
lesion.
27619 ................ A Remove lower leg 8.40 12.63 9.55 1.01 22.04 18.96 090
lesion.
27620 ................ A Explore/treat ankle 5.98 NA 8.20 0.83 NA 15.01 090
joint.
27625 ................ A Remove ankle joint 8.30 NA 9.57 1.16 NA 19.03 090
lining.
27626 ................ A Remove ankle joint 8.91 NA 10.39 1.23 NA 20.53 090
lining.
27630 ................ A Removal of tendon 4.80 10.70 6.87 0.60 16.10 12.27 090
lesion.
27635 ................ A Remove lower leg bone 7.78 NA 11.13 1.06 NA 19.97 090
lesion.
27637 ................ A Remove/graft leg bone 9.85 NA 12.36 1.38 NA 23.59 090
lesion.
27638 ................ A Remove/graft leg bone 10.57 NA 12.55 1.47 NA 24.59 090
lesion.
27640 ................ A Partial removal of 11.37 NA 18.46 1.54 NA 31.37 090
tibia.
27641 ................ A Partial removal of 9.24 NA 16.52 1.22 NA 26.98 090
fibula.
27645 ................ A Extensive lower leg 14.17 NA 18.78 1.98 NA 34.93 090
surgery.
27646 ................ A Extensive lower leg 12.66 NA 18.50 1.55 NA 32.71 090
surgery.
27647 ................ A Extensive ankle/heel 12.24 NA 11.31 1.64 NA 25.19 090
surgery.
27648 ................ A Injection for ankle x- 0.96 9.49 0.36 0.05 10.50 1.37 000
ray.
27650 ................ A Repair achilles tendon 9.69 NA 9.60 1.35 NA 20.64 090
27652 ................ A Repair/graft achilles 10.33 NA 9.90 1.45 NA 21.68 090
tendon.
27654 ................ A Repair of achilles 10.02 NA 10.34 1.41 NA 21.77 090
tendon.
27656 ................ A Repair leg fascia 4.57 11.38 7.06 0.48 16.43 12.11 090
defect.
27658 ................ A Repair of leg tendon, 4.98 10.63 9.14 0.68 16.29 14.80 090
each.
27659 ................ A Repair of leg tendon, 6.81 12.77 9.97 0.96 20.54 17.74 090
each.
27664 ................ A Repair of leg tendon, 4.59 17.85 9.17 0.63 23.07 14.39 090
each.
27665 ................ A Repair of leg tendon, 5.40 8.95 8.95 0.75 15.10 15.10 090
each.
27675 ................ A Repair lower leg 7.18 NA 8.48 1.01 NA 16.67 090
tendons.
27676 ................ A Repair lower leg 8.42 NA 9.72 1.15 NA 19.29 090
tendons.
27680 ................ A Release of lower leg 5.74 NA 8.27 0.80 NA 14.81 090
tendon.
27681 ................ A Release of lower leg 6.82 NA 8.88 0.92 NA 16.62 090
tendons.
27685 ................ A Revision of lower leg 6.50 10.37 8.45 0.91 17.78 15.86 090
tendon.
27686 ................ A Revise lower leg 7.46 15.30 9.89 1.05 23.81 18.40 090
tendons.
27687 ................ A Revision of calf 6.24 NA 8.70 0.88 NA 15.82 090
tendon.
27690 ................ A Revise lower leg 8.71 NA 9.61 1.22 NA 19.54 090
tendon.
27691 ................ A Revise lower leg 9.96 NA 11.10 1.40 NA 22.46 090
tendon.
27692 ................ A Revise additional leg 1.87 NA 0.99 0.26 NA 3.12 ZZZ
tendon.
27695 ................ A Repair of ankle 6.51 NA 9.20 0.90 NA 16.61 090
ligament.
27696 ................ A Repair of ankle 8.27 NA 9.54 1.16 NA 18.97 090
ligaments.
27698 ................ A Repair of ankle 9.36 NA 9.72 1.31 NA 20.39 090
ligament.
27700 ................ A Revision of ankle 9.29 NA 7.95 1.24 NA 18.48 090
joint.
27702 ................ A Reconstruct ankle 13.67 NA 13.02 1.92 NA 28.61 090
joint.
27703 ................ A Reconstruction, ankle 15.87 NA 13.31 2.24 NA 31.42 090
joint.
27704 ................ A Removal of ankle 7.62 NA 9.40 0.61 NA 17.63 090
implant.
27705 ................ A Incision of tibia..... 10.38 NA 11.55 1.44 NA 23.37 090
27707 ................ A Incision of fibula.... 4.37 NA 8.48 0.60 NA 13.45 090
27709 ................ A Incision of tibia & 9.95 NA 11.48 1.39 NA 22.82 090
fibula.
27712 ................ A Realignment of lower 14.25 NA 13.92 2.00 NA 30.17 090
leg.
[[Page 55356]]
27715 ................ A Revision of lower leg. 14.39 NA 15.22 2.00 NA 31.61 090
27720 ................ A Repair of tibia....... 11.79 NA 13.67 1.66 NA 27.12 090
27722 ................ A Repair/graft of tibia. 11.82 NA 13.46 1.65 NA 26.93 090
27724 ................ A Repair/graft of tibia. 18.20 NA 17.28 2.10 NA 37.58 090
27725 ................ A Repair of lower leg... 15.59 NA 15.62 2.20 NA 33.41 090
27727 ................ A Repair of lower leg... 14.01 NA 14.43 1.84 NA 30.28 090
27730 ................ A Repair of tibia 7.41 21.54 10.22 0.75 29.70 18.38 090
epiphysis.
27732 ................ A Repair of fibula 5.32 14.45 7.22 0.63 20.40 13.17 090
epiphysis.
27734 ................ A Repair lower leg 8.48 NA 10.84 0.85 NA 20.17 090
epiphyses.
27740 ................ A Repair of leg 9.30 16.04 9.72 1.31 26.65 20.33 090
epiphyses.
27742 ................ A Repair of leg 10.30 16.44 9.27 1.55 28.29 21.12 090
epiphyses.
27745 ................ A Reinforce tibia....... 10.07 NA 11.60 1.38 NA 23.05 090
27750 ................ A Treatment of tibia 3.19 5.65 4.00 0.43 9.27 7.62 090
fracture.
27752 ................ A Treatment of tibia 5.84 8.20 6.17 0.82 14.86 12.83 090
fracture.
27756 ................ A Treatment of tibia 6.78 NA 10.84 0.94 NA 18.56 090
fracture.
27758 ................ A Treatment of tibia 11.67 NA 12.22 1.52 NA 25.41 090
fracture.
27759 ................ A Treatment of tibia 13.76 NA 13.46 1.93 NA 29.15 090
fracture.
27760 ................ A Treatment of ankle 3.01 5.42 3.87 0.39 8.82 7.27 090
fracture.
27762 ................ A Treatment of ankle 5.25 7.57 5.75 0.71 13.53 11.71 090
fracture.
27766 ................ A Treatment of ankle 8.36 NA 8.26 1.17 NA 17.79 090
fracture.
27780 ................ A Treatment of fibula 2.65 5.37 3.69 0.33 8.35 6.67 090
fracture.
27781 ................ A Treatment of fibula 4.40 6.38 4.62 0.57 11.35 9.59 090
fracture.
27784 ................ A Treatment of fibula 7.11 NA 8.63 0.98 NA 16.72 090
fracture.
27786 ................ A Treatment of ankle 2.84 5.38 3.78 0.37 8.59 6.99 090
fracture.
27788 ................ A Treatment of ankle 4.45 6.65 4.62 0.61 11.71 9.68 090
fracture.
27792 ................ A Treatment of ankle 7.66 NA 8.18 1.07 NA 16.91 090
fracture.
27808 ................ A Treatment of ankle 2.83 6.44 4.50 0.38 9.65 7.71 090
fracture.
27810 ................ A Treatment of ankle 5.13 7.77 5.71 0.71 13.61 11.55 090
fracture.
27814 ................ A Treatment of ankle 10.68 NA 10.93 1.50 NA 23.11 090
fracture.
27816 ................ A Treatment of ankle 2.89 5.97 4.55 0.37 9.23 7.81 090
fracture.
27818 ................ A Treatment of ankle 5.50 7.89 5.88 0.74 14.13 12.12 090
fracture.
27822 ................ A Treatment of ankle 11.00 NA 13.18 1.29 NA 25.47 090
fracture.
27823 ................ A Treatment of ankle 13.00 NA 14.39 1.65 NA 29.04 090
fracture.
27824 ................ A Treat lower leg 2.89 6.43 4.50 0.39 9.71 7.78 090
fracture.
27825 ................ A Treat lower leg 6.19 8.30 6.32 0.85 15.34 13.36 090
fracture.
27826 ................ A Treat lower leg 8.54 NA 11.88 1.19 NA 21.61 090
fracture.
27827 ................ A Treat lower leg 14.06 NA 15.00 1.96 NA 31.02 090
fracture.
27828 ................ A Treat lower leg 16.23 NA 15.03 2.27 NA 33.53 090
fracture.
27829 ................ A Treat lower leg joint. 5.49 NA 8.67 0.77 NA 14.93 090
27830 ................ A Treat lower leg 3.79 5.82 4.36 0.44 10.05 8.59 090
dislocation.
27831 ................ A Treat lower leg 4.56 NA 4.94 0.61 NA 10.11 090
dislocation.
27832 ................ A Treat lower leg 6.49 NA 8.06 0.91 NA 15.46 090
dislocation.
27840 ................ A Treat ankle 4.58 NA 6.21 0.47 NA 11.26 090
dislocation.
27842 ................ A Treat ankle 6.21 NA 5.25 0.76 NA 12.22 090
dislocation.
27846 ................ A Treat ankle 9.79 NA 10.46 1.36 NA 21.61 090
dislocation.
27848 ................ A Treat ankle 11.20 NA 11.70 1.55 NA 24.45 090
dislocation.
27860 ................ A Fixation of ankle 2.34 NA 3.78 0.31 NA 6.43 010
joint.
27870 ................ A Fusion of ankle joint. 13.91 NA 13.76 1.95 NA 29.62 090
27871 ................ A Fusion of tibiofibular 9.17 NA 11.03 1.29 NA 21.49 090
joint.
27880 ................ A Amputation of lower 11.85 NA 11.95 1.38 NA 25.18 090
leg.
27881 ................ A Amputation of lower 12.34 NA 13.44 1.59 NA 27.37 090
leg.
27882 ................ A Amputation of lower 8.94 NA 13.13 1.03 NA 23.10 090
leg.
27884 ................ A Amputation follow-up 8.21 NA 10.78 0.95 NA 19.94 090
surgery.
27886 ................ A Amputation follow-up 9.32 NA 11.26 1.13 NA 21.71 090
surgery.
27888 ................ A Amputation of foot at 9.67 NA 11.11 1.26 NA 22.04 090
ankle.
27889 ................ A Amputation of foot at 9.98 NA 10.45 1.19 NA 21.62 090
ankle.
27892 ................ A Decompression of leg.. 7.39 NA 8.41 0.86 NA 16.66 090
27893 ................ A Decompression of leg.. 7.35 NA 8.58 0.90 NA 16.83 090
27894 ................ A Decompression of leg.. 10.49 NA 10.09 1.25 NA 21.83 090
27899 ................ C Leg/ankle surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
28001 ................ A Drainage of bursa of 2.73 5.62 3.09 0.31 8.66 6.13 010
foot.
28002 ................ A Treatment of foot 4.62 6.78 4.22 0.56 11.96 9.40 010
infection.
28003 ................ A Treatment of foot 8.41 11.40 10.63 1.03 20.84 20.07 090
infection.
28005 ................ A Treat foot bone lesion 8.68 NA 10.26 1.14 NA 20.08 090
28008 ................ A Incision of foot 4.45 8.17 6.38 0.56 13.18 11.39 090
fascia.
28010 ................ A Incision of toe tendon 2.84 7.64 5.37 0.39 10.87 8.60 090
28011 ................ A Incision of toe 4.14 9.36 6.79 0.58 14.08 11.51 090
tendons.
28020 ................ A Exploration of foot 5.01 8.12 6.81 0.64 13.77 12.46 090
joint.
28022 ................ A Exploration of foot 4.67 7.90 6.26 0.62 13.19 11.55 090
joint.
28024 ................ A Exploration of toe 4.38 8.55 6.64 0.50 13.43 11.52 090
joint.
28030 ................ A Removal of foot nerve. 6.15 NA 3.50 0.85 NA 10.50 090
28035 ................ A Decompression of tibia 5.09 8.80 5.35 0.71 14.60 11.15 090
nerve.
28043 ................ A Excision of foot 3.54 7.47 4.96 0.45 11.46 8.95 090
lesion.
[[Page 55357]]
28045 ................ A Excision of foot 4.72 8.18 5.81 0.62 13.52 11.15 090
lesion.
28046 ................ A Resection of tumor, 10.18 13.58 11.38 1.13 24.89 22.69 090
foot.
28050 ................ A Biopsy of foot joint 4.25 9.52 6.11 0.55 14.32 10.91 090
lining.
28052 ................ A Biopsy of foot joint 3.94 8.01 5.76 0.51 12.46 10.21 090
lining.
28054 ................ A Biopsy of toe joint 3.45 7.70 5.50 0.45 11.60 9.40 090
lining.
28060 ................ A Partial removal, foot 5.23 8.72 6.51 0.69 14.64 12.43 090
fascia.
28062 ................ A Removal of foot fascia 6.52 9.27 6.87 0.85 16.64 14.24 090
28070 ................ A Removal of foot joint 5.10 7.98 6.12 0.68 13.76 11.90 090
lining.
28072 ................ A Removal of foot joint 4.58 8.84 6.67 0.64 14.06 11.89 090
lining.
28080 ................ A Removal of foot lesion 3.58 7.82 5.51 0.50 11.90 9.59 090
28086 ................ A Excise foot tendon 4.78 11.87 7.11 0.66 17.31 12.55 090
sheath.
28088 ................ A Excise foot tendon 3.86 9.97 6.62 0.52 14.35 11.00 090
sheath.
28090 ................ A Removal of foot lesion 4.41 8.12 5.64 0.57 13.10 10.62 090
28092 ................ A Removal of toe lesions 3.64 8.17 6.08 0.46 12.27 10.18 090
28100 ................ A Removal of ankle/heel 5.66 13.07 7.70 0.76 19.49 14.12 090
lesion.
28102 ................ A Remove/graft foot 7.73 NA 9.00 0.97 NA 17.70 090
lesion.
28103 ................ A Remove/graft foot 6.50 8.76 6.93 0.89 16.15 14.32 090
lesion.
28104 ................ A Removal of foot lesion 5.12 8.49 6.76 0.69 14.30 12.57 090
28106 ................ A Remove/graft foot 7.16 NA 6.97 1.01 NA 15.14 090
lesion.
28107 ................ A Remove/graft foot 5.56 9.96 7.13 0.74 16.26 13.43 090
lesion.
28108 ................ A Removal of toe lesions 4.16 7.49 5.36 0.52 12.17 10.04 090
28110 ................ A Part removal of 4.08 8.80 6.87 0.49 13.37 11.44 090
metatarsal.
28111 ................ A Part removal of 5.01 9.09 7.69 0.63 14.73 13.33 090
metatarsal.
28112 ................ A Part removal of 4.49 8.89 7.47 0.60 13.98 12.56 090
metatarsal.
28113 ................ A Part removal of 4.79 8.92 7.13 0.63 14.34 12.55 090
metatarsal.
28114 ................ A Removal of metatarsal 9.79 12.36 10.85 1.36 23.51 22.00 090
heads.
28116 ................ A Revision of foot...... 7.75 9.27 6.38 1.03 18.05 15.16 090
28118 ................ A Removal of heel bone.. 5.96 9.37 7.24 0.79 16.12 13.99 090
28119 ................ A Removal of heel spur.. 5.39 8.58 6.15 0.74 14.71 12.28 090
28120 ................ A Part removal of ankle/ 5.40 11.28 9.83 0.69 17.37 15.92 090
heel.
28122 ................ A Partial removal of 7.29 10.94 9.50 0.96 19.19 17.75 090
foot bone.
28124 ................ A Partial removal of toe 4.81 9.61 7.61 0.65 15.07 13.07 090
28126 ................ A Partial removal of toe 3.52 8.37 6.76 0.49 12.38 10.77 090
28130 ................ A Removal of ankle bone. 8.11 NA 8.77 1.11 NA 17.99 090
28140 ................ A Removal of metatarsal. 6.91 10.40 7.92 0.84 18.15 15.67 090
28150 ................ A Removal of toe........ 4.09 8.75 7.07 0.52 13.36 11.68 090
28153 ................ A Partial removal of toe 3.66 8.39 6.22 0.49 12.54 10.37 090
28160 ................ A Partial removal of toe 3.74 8.55 7.22 0.51 12.80 11.47 090
28171 ................ A Extensive foot surgery 9.60 NA 8.27 1.13 NA 19.00 090
28173 ................ A Extensive foot surgery 8.80 10.83 8.88 1.04 20.67 18.72 090
28175 ................ A Extensive foot surgery 6.05 9.54 6.99 0.75 16.34 13.79 090
28190 ................ A Removal of foot 1.96 6.54 3.53 0.16 8.66 5.65 010
foreign body.
28192 ................ A Removal of foot 4.64 8.20 5.44 0.52 13.36 10.60 090
foreign body.
28193 ................ A Removal of foot 5.73 8.94 6.67 0.63 15.30 13.03 090
foreign body.
28200 ................ A Repair of foot tendon. 4.60 8.47 6.32 0.59 13.66 11.51 090
28202 ................ A Repair/graft of foot 6.84 12.63 6.83 0.86 20.33 14.53 090
tendon.
28208 ................ A Repair of foot tendon. 4.37 8.17 6.03 0.59 13.13 10.99 090
28210 ................ A Repair/graft of foot 6.35 9.83 6.38 0.77 16.95 13.50 090
tendon.
28220 ................ A Release of foot tendon 4.53 8.12 6.41 0.63 13.28 11.57 090
28222 ................ A Release of foot 5.62 8.40 6.77 0.77 14.79 13.16 090
tendons.
28225 ................ A Release of foot tendon 3.66 7.76 5.57 0.50 11.92 9.73 090
28226 ................ A Release of foot 4.53 8.30 6.66 0.62 13.45 11.81 090
tendons.
28230 ................ A Incision of foot 4.24 8.26 6.83 0.59 13.09 11.66 090
tendon(s).
28232 ................ A Incision of toe tendon 3.39 8.12 6.53 0.48 11.99 10.40 090
28234 ................ A Incision of foot 3.37 7.98 6.11 0.46 11.81 9.94 090
tendon.
28238 ................ A Revision of foot 7.73 9.77 7.60 1.08 18.58 16.41 090
tendon.
28240 ................ A Release of big toe.... 4.36 8.17 6.40 0.61 13.14 11.37 090
28250 ................ A Revision of foot 5.92 9.05 7.12 0.81 15.78 13.85 090
fascia.
28260 ................ A Release of midfoot 7.96 11.04 8.08 1.08 20.08 17.12 090
joint.
28261 ................ A Revision of foot 11.73 11.16 9.64 1.66 24.55 23.03 090
tendon.
28262 ................ A Revision of foot and 15.83 15.66 15.09 2.22 33.71 33.14 090
ankle.
28264 ................ A Release of midfoot 10.35 10.98 10.98 1.46 22.79 22.79 090
joint.
28270 ................ A Release of foot 4.76 8.75 7.43 0.67 14.18 12.86 090
contracture.
28272 ................ A Release of toe joint, 3.80 7.70 5.50 0.52 12.02 9.82 090
each.
28280 ................ A Fusion of toes........ 5.19 8.39 6.77 0.72 14.30 12.68 090
28285 ................ A Repair of hammertoe... 4.59 8.79 6.76 0.64 14.02 11.99 090
28286 ................ A Repair of hammertoe... 4.56 8.78 6.75 0.64 13.98 11.95 090
28288 ................ A Partial removal of 4.74 9.00 8.02 0.65 14.39 13.41 090
foot bone.
28289 ................ A Repair hallux rigidus. 7.04 10.54 9.75 0.96 18.54 17.75 090
28290 ................ A Correction of bunion.. 5.66 9.55 8.81 0.79 16.00 15.26 090
28292 ................ A Correction of bunion.. 7.04 9.82 7.69 0.98 17.84 15.71 090
28293 ................ A Correction of bunion.. 9.15 10.67 8.02 1.28 21.10 18.45 090
28294 ................ A Correction of bunion.. 8.56 10.52 8.30 1.16 20.24 18.02 090
[[Page 55358]]
28296 ................ A Correction of bunion.. 9.18 10.84 8.65 1.28 21.30 19.11 090
28297 ................ A Correction of bunion.. 9.18 12.80 10.25 1.31 23.29 20.74 090
28298 ................ A Correction of bunion.. 7.94 10.10 8.48 1.12 19.16 17.54 090
28299 ................ A Correction of bunion.. 10.58 11.55 9.21 1.24 23.37 21.03 090
28300 ................ A Incision of heel bone. 9.54 14.15 9.43 1.31 25.00 20.28 090
28302 ................ A Incision of ankle bone 9.55 9.55 9.22 1.15 20.25 19.92 090
28304 ................ A Incision of midfoot 9.16 9.53 7.88 1.00 19.69 18.04 090
bones.
28305 ................ A Incise/graft midfoot 10.50 14.52 10.07 0.55 25.57 21.12 090
bones.
28306 ................ A Incision of metatarsal 5.86 8.84 6.51 0.81 15.51 13.18 090
28307 ................ A Incision of metatarsal 6.33 13.70 7.74 0.71 20.74 14.78 090
28308 ................ A Incision of metatarsal 5.29 7.97 5.60 0.74 14.00 11.63 090
28309 ................ A Incision of 12.78 NA 11.08 1.64 NA 25.50 090
metatarsals.
28310 ................ A Revision of big toe... 5.43 9.00 6.93 0.76 15.19 13.12 090
28312 ................ A Revision of toe....... 4.55 8.66 7.87 0.62 13.83 13.04 090
28313 ................ A Repair deformity of 5.01 9.06 9.06 0.68 14.75 14.75 090
toe.
28315 ................ A Removal of sesamoid 4.86 7.95 5.82 0.66 13.47 11.34 090
bone.
28320 ................ A Repair of foot bones.. 9.18 NA 9.02 1.27 NA 19.47 090
28322 ................ A Repair of metatarsals. 8.34 11.71 8.38 1.17 21.22 17.89 090
28340 ................ A Resect enlarged toe 6.98 8.96 6.28 0.98 16.92 14.24 090
tissue.
28341 ................ A Resect enlarged toe... 8.41 9.55 6.88 1.18 19.14 16.47 090
28344 ................ A Repair extra toe(s)... 4.26 7.38 4.86 0.60 12.24 9.72 090
28345 ................ A Repair webbed toe(s).. 5.92 9.48 7.58 0.84 16.24 14.34 090
28360 ................ A Reconstruct cleft foot 13.34 NA 12.22 1.88 NA 27.44 090
28400 ................ A Treatment of heel 2.16 5.76 4.74 0.29 8.21 7.19 090
fracture.
28405 ................ A Treatment of heel 4.57 6.66 5.87 0.63 11.86 11.07 090
fracture.
28406 ................ A Treatment of heel 6.31 NA 8.69 0.87 NA 15.87 090
fracture.
28415 ................ A Treat heel fracture... 15.97 NA 15.72 2.24 NA 33.93 090
28420 ................ A Treat/graft heel 16.64 NA 15.95 2.29 NA 34.88 090
fracture.
28430 ................ A Treatment of ankle 2.09 5.25 4.26 0.27 7.61 6.62 090
fracture.
28435 ................ A Treatment of ankle 3.40 5.41 4.57 0.47 9.28 8.44 090
fracture.
28436 ................ A Treatment of ankle 4.71 NA 7.86 0.66 NA 13.23 090
fracture.
28445 ................ A Treat ankle fracture.. 15.62 NA 13.94 1.29 NA 30.85 090
28450 ................ A Treat midfoot 1.90 5.28 4.07 0.25 7.43 6.22 090
fracture, each.
28455 ................ A Treat midfoot 3.09 5.51 4.94 0.43 9.03 8.46 090
fracture, each.
28456 ................ A Treat midfoot fracture 2.68 NA 6.27 0.36 NA 9.31 090
28465 ................ A Treat midfoot 7.01 NA 8.25 0.87 NA 16.13 090
fracture, each.
28470 ................ A Treat metatarsal 1.99 4.52 3.41 0.26 6.77 5.66 090
fracture.
28475 ................ A Treat metatarsal 2.97 5.18 4.38 0.41 8.56 7.76 090
fracture.
28476 ................ A Treat metatarsal 3.38 NA 6.71 0.46 NA 10.55 090
fracture.
28485 ................ A Treat metatarsal 5.71 NA 8.16 0.80 NA 14.67 090
fracture.
28490 ................ A Treat big toe fracture 1.09 2.76 2.21 0.13 3.98 3.43 090
28495 ................ A Treat big toe fracture 1.58 2.82 2.31 0.19 4.59 4.08 090
28496 ................ A Treat big toe fracture 2.33 11.10 4.58 0.32 13.75 7.23 090
28505 ................ A Treat big toe fracture 3.81 11.46 6.74 0.50 15.77 11.05 090
28510 ................ A Treatment of toe 1.09 2.51 2.23 0.13 3.73 3.45 090
fracture.
28515 ................ A Treatment of toe 1.46 2.83 2.30 0.17 4.46 3.93 090
fracture.
28525 ................ A Treat toe fracture.... 3.32 10.82 6.16 0.44 14.58 9.92 090
28530 ................ A Treat sesamoid bone 1.06 2.91 2.91 0.13 4.10 4.10 090
fracture.
28531 ................ A Treat sesamoid bone 2.35 11.91 4.73 0.33 14.59 7.41 090
fracture.
28540 ................ A Treat foot dislocation 2.04 3.75 3.75 0.24 6.03 6.03 090
28545 ................ A Treat foot dislocation 2.45 4.76 4.76 0.33 7.54 7.54 090
28546 ................ A Treat foot dislocation 3.20 12.55 6.31 0.46 16.21 9.97 090
28555 ................ A Repair foot 6.30 13.49 8.36 0.88 20.67 15.54 090
dislocation.
28570 ................ A Treat foot dislocation 1.66 3.67 3.67 0.22 5.55 5.55 090
28575 ................ A Treat foot dislocation 3.31 5.19 5.19 0.45 8.95 8.95 090
28576 ................ A Treat foot dislocation 4.17 12.06 6.85 0.56 16.79 11.58 090
28585 ................ A Repair foot 7.99 8.75 8.32 1.13 17.87 17.44 090
dislocation.
28600 ................ A Treat foot dislocation 1.89 4.32 3.89 0.24 6.45 6.02 090
28605 ................ A Treat foot dislocation 2.71 4.40 4.40 0.35 7.46 7.46 090
28606 ................ A Treat foot dislocation 4.90 16.14 7.09 0.68 21.72 12.67 090
28615 ................ A Repair foot 7.77 NA 9.45 1.09 NA 18.31 090
dislocation.
28630 ................ A Treat toe dislocation. 1.70 2.35 2.35 0.17 4.22 4.22 010
28635 ................ A Treat toe dislocation. 1.91 2.49 2.49 0.24 4.64 4.64 010
28636 ................ A Treat toe dislocation. 2.77 4.81 3.22 0.39 7.97 6.38 010
28645 ................ A Repair toe dislocation 4.22 6.69 4.34 0.58 11.49 9.14 090
28660 ................ A Treat toe dislocation. 1.23 3.11 2.60 0.11 4.45 3.94 010
28665 ................ A Treat toe dislocation. 1.92 2.47 2.47 0.24 4.63 4.63 010
28666 ................ A Treat toe dislocation. 2.66 13.30 3.00 0.38 16.34 6.04 010
28675 ................ A Repair of toe 2.92 9.48 4.90 0.41 12.81 8.23 090
dislocation.
28705 ................ A Fusion of foot bones.. 18.80 NA 15.67 2.13 NA 36.60 090
28715 ................ A Fusion of foot bones.. 13.10 NA 12.57 1.84 NA 27.51 090
28725 ................ A Fusion of foot bones.. 11.61 NA 11.48 1.63 NA 24.72 090
28730 ................ A Fusion of foot bones.. 10.76 NA 10.76 1.51 NA 23.03 090
[[Page 55359]]
28735 ................ A Fusion of foot bones.. 10.85 NA 10.45 1.51 NA 22.81 090
28737 ................ A Revision of foot bones 9.64 NA 9.04 1.36 NA 20.04 090
28740 ................ A Fusion of foot bones.. 8.02 13.03 8.94 1.13 22.18 18.09 090
28750 ................ A Fusion of big toe 7.30 12.48 9.13 1.03 20.81 17.46 090
joint.
28755 ................ A Fusion of big toe 4.74 8.52 6.42 0.66 13.92 11.82 090
joint.
28760 ................ A Fusion of big toe 7.75 10.39 7.82 1.07 19.21 16.64 090
joint.
28800 ................ A Amputation of midfoot. 8.21 NA 8.90 0.98 NA 18.09 090
28805 ................ A Amputation thru 8.39 NA 9.00 0.97 NA 18.36 090
metatarsal.
28810 ................ A Amputation toe & 6.21 NA 7.97 0.70 NA 14.88 090
metatarsal.
28820 ................ A Amputation of toe..... 4.41 9.91 7.16 0.51 14.83 12.08 090
28825 ................ A Partial amputation of 3.59 10.12 6.95 0.43 14.14 10.97 090
toe.
28899 ................ C Foot/toes surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
29000 ................ A Application of body 2.25 2.71 1.67 0.30 5.26 4.22 000
cast.
29010 ................ A Application of body 2.06 2.98 1.72 0.27 5.31 4.05 000
cast.
29015 ................ A Application of body 2.41 3.17 1.93 0.21 5.79 4.55 000
cast.
29020 ................ A Application of body 2.11 3.33 1.47 0.16 5.60 3.74 000
cast.
29025 ................ A Application of body 2.40 3.32 1.86 0.26 5.98 4.52 000
cast.
29035 ................ A Application of body 1.77 3.05 1.56 0.24 5.06 3.57 000
cast.
29040 ................ A Application of body 2.22 2.54 1.49 0.35 5.11 4.06 000
cast.
29044 ................ A Application of body 2.12 3.20 1.81 0.29 5.61 4.22 000
cast.
29046 ................ A Application of body 2.41 3.31 2.04 0.34 6.06 4.79 000
cast.
29049 ................ A Application of figure 0.89 1.07 0.57 0.12 2.08 1.58 000
eight.
29055 ................ A Application of 1.78 2.40 1.42 0.24 4.42 3.44 000
shoulder cast.
29058 ................ A Application of 1.31 1.33 0.73 0.14 2.78 2.18 000
shoulder cast.
29065 ................ A Application of long 0.87 1.10 0.69 0.12 2.09 1.68 000
arm cast.
29075 ................ A Application of forearm 0.77 1.05 0.63 0.11 1.93 1.51 000
cast.
29085 ................ A Apply hand/wrist cast. 0.87 1.10 0.62 0.11 2.08 1.60 000
29086 ................ A Apply finger cast..... 0.62 0.81 0.50 0.07 1.50 1.19 000
29105 ................ A Apply long arm splint. 0.87 1.05 0.52 0.11 2.03 1.50 000
29125 ................ A Apply forearm splint.. 0.59 0.88 0.41 0.06 1.53 1.06 000
29126 ................ A Apply forearm splint.. 0.77 1.21 0.47 0.06 2.04 1.30 000
29130 ................ A Application of finger 0.50 0.44 0.18 0.05 0.99 0.73 000
splint.
29131 ................ A Application of finger 0.55 0.71 0.23 0.03 1.29 0.81 000
splint.
29200 ................ A Strapping of chest.... 0.65 0.85 0.37 0.04 1.54 1.06 000
29220 ................ A Strapping of low back. 0.64 0.96 0.41 0.07 1.67 1.12 000
29240 ................ A Strapping of shoulder. 0.71 0.92 0.39 0.05 1.68 1.15 000
29260 ................ A Strapping of elbow or 0.55 0.85 0.35 0.04 1.44 0.94 000
wrist.
29280 ................ A Strapping of hand or 0.51 0.91 0.39 0.04 1.46 0.94 000
finger.
29305 ................ A Application of hip 2.03 2.74 1.60 0.29 5.06 3.92 000
cast.
29325 ................ A Application of hip 2.32 3.05 1.79 0.31 5.68 4.42 000
casts.
29345 ................ A Application of long 1.40 1.51 1.02 0.19 3.10 2.61 000
leg cast.
29355 ................ A Application of long 1.53 1.47 1.11 0.20 3.20 2.84 000
leg cast.
29358 ................ A Apply long leg cast 1.43 1.72 1.07 0.19 3.34 2.69 000
brace.
29365 ................ A Application of long 1.18 1.38 0.90 0.17 2.73 2.25 000
leg cast.
29405 ................ A Apply short leg cast.. 0.86 1.03 0.66 0.12 2.01 1.64 000
29425 ................ A Apply short leg cast.. 1.01 1.05 0.68 0.14 2.20 1.83 000
29435 ................ A Apply short leg cast.. 1.18 1.35 0.88 0.17 2.70 2.23 000
29440 ................ A Addition of walker to 0.57 0.61 0.26 0.07 1.25 0.90 000
cast.
29445 ................ A Apply rigid leg cast.. 1.78 1.58 0.96 0.24 3.60 2.98 000
29450 ................ A Application of leg 2.08 1.40 1.11 0.13 3.61 3.32 000
cast.
29505 ................ A Application, long leg 0.69 1.10 0.48 0.06 1.85 1.23 000
splint.
29515 ................ A Application lower leg 0.73 0.78 0.48 0.07 1.58 1.28 000
splint.
29520 ................ A Strapping of hip...... 0.54 0.93 0.44 0.02 1.49 1.00 000
29530 ................ A Strapping of knee..... 0.57 0.83 0.36 0.04 1.44 0.97 000
29540 ................ A Strapping of ankle.... 0.51 0.40 0.32 0.04 0.95 0.87 000
29550 ................ A Strapping of toes..... 0.47 0.40 0.29 0.05 0.92 0.81 000
29580 ................ A Application of paste 0.57 0.61 0.36 0.05 1.23 0.98 000
boot.
29590 ................ A Application of foot 0.76 0.50 0.30 0.06 1.32 1.12 000
splint.
29700 ................ A Removal/revision of 0.57 0.81 0.28 0.07 1.45 0.92 000
cast.
29705 ................ A Removal/revision of 0.76 0.73 0.39 0.10 1.59 1.25 000
cast.
29710 ................ A Removal/revision of 1.34 1.50 0.66 0.17 3.01 2.17 000
cast.
29715 ................ A Removal/revision of 0.94 0.98 0.29 0.08 2.00 1.31 000
cast.
29720 ................ A Repair of body cast... 0.68 0.95 0.36 0.10 1.73 1.14 000
29730 ................ A Windowing of cast..... 0.75 0.71 0.36 0.10 1.56 1.21 000
29740 ................ A Wedging of cast....... 1.12 1.02 0.46 0.15 2.29 1.73 000
29750 ................ A Wedging of clubfoot 1.26 1.13 0.62 0.16 2.55 2.04 000
cast.
29799 ................ C Casting/strapping 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
29800 ................ A Jaw arthroscopy/ 6.43 NA 9.15 0.84 NA 16.42 090
surgery.
29804 ................ A Jaw arthroscopy/ 8.14 NA 8.73 0.66 NA 17.53 090
surgery.
29805 ................ A Shoulder arthroscopy, 5.89 3.23 3.23 0.83 9.95 9.95 090
dx.
29806 ................ A Shoulder arthroscopy/ 14.37 NA 11.33 2.01 NA 27.71 090
surgery.
29807 ................ A Shoulder arthroscopy/ 13.90 NA 11.06 2.01 NA 26.97 090
surgery.
29815 ................ D Shoulder arthroscopy.. 0.00 NA 0.00 0.00 NA 0.00 090
[[Page 55360]]
29819 ................ A Shoulder arthroscopy/ 7.62 NA 9.82 1.07 NA 18.51 090
surgery.
29820 ................ A Shoulder arthroscopy/ 7.07 NA 9.55 0.99 NA 17.61 090
surgery.
29821 ................ A Shoulder arthroscopy/ 7.72 NA 9.84 1.08 NA 18.64 090
surgery.
29822 ................ A Shoulder arthroscopy/ 7.43 NA 9.75 1.04 NA 18.22 090
surgery.
29823 ................ A Shoulder arthroscopy/ 8.17 NA 10.14 1.15 NA 19.46 090
surgery.
29824 ................ A Shoulder arthroscopy/ 8.25 NA 7.48 1.16 NA 16.89 090
surgery.
29825 ................ A Shoulder arthroscopy/ 7.62 NA 9.80 1.06 NA 18.48 090
surgery.
29826 ................ A Shoulder arthroscopy/ 8.99 NA 10.65 1.26 NA 20.90 090
surgery.
29830 ................ A Elbow arthroscopy..... 5.76 NA 6.14 0.79 NA 12.69 090
29834 ................ A Elbow arthroscopy/ 6.28 NA 6.94 0.86 NA 14.08 090
surgery.
29835 ................ A Elbow arthroscopy/ 6.48 NA 6.95 0.88 NA 14.31 090
surgery.
29836 ................ A Elbow arthroscopy/ 7.55 NA 7.62 1.06 NA 16.23 090
surgery.
29837 ................ A Elbow arthroscopy/ 6.87 NA 7.30 0.96 NA 15.13 090
surgery.
29838 ................ A Elbow arthroscopy/ 7.71 NA 7.73 1.07 NA 16.51 090
surgery.
29840 ................ A Wrist arthroscopy..... 5.54 NA 8.38 0.69 NA 14.61 090
29843 ................ A Wrist arthroscopy/ 6.01 NA 8.70 0.82 NA 15.53 090
surgery.
29844 ................ A Wrist arthroscopy/ 6.37 NA 8.96 0.86 NA 16.19 090
surgery.
29845 ................ A Wrist arthroscopy/ 7.52 NA 9.56 0.84 NA 17.92 090
surgery.
29846 ................ A Wrist arthroscopy/ 6.75 NA 11.67 0.89 NA 19.31 090
surgery.
29847 ................ A Wrist arthroscopy/ 7.08 NA 11.85 0.91 NA 19.84 090
surgery.
29848 ................ A Wrist endoscopy/ 5.44 NA 8.46 0.72 NA 14.62 090
surgery.
29850 ................ A Knee arthroscopy/ 8.19 NA 7.49 0.74 NA 16.42 090
surgery.
29851 ................ A Knee arthroscopy/ 13.10 NA 12.00 1.81 NA 26.91 090
surgery.
29855 ................ A Tibial arthroscopy/ 10.62 NA 10.55 1.50 NA 22.67 090
surgery.
29856 ................ A Tibial arthroscopy/ 14.14 NA 12.49 2.00 NA 28.63 090
surgery.
29860 ................ A Hip arthroscopy, dx... 8.05 NA 8.05 1.14 NA 17.24 090
29861 ................ A Hip arthroscopy/ 9.15 NA 8.71 1.29 NA 19.15 090
surgery.
29862 ................ A Hip arthroscopy/ 9.90 NA 9.75 1.39 NA 21.04 090
surgery.
29863 ................ A Hip arthroscopy/ 9.90 NA 10.31 1.40 NA 21.61 090
surgery.
29870 ................ A Knee arthroscopy, dx.. 5.07 NA 6.27 0.67 NA 12.01 090
29871 ................ A Knee arthroscopy/ 6.55 NA 8.38 0.88 NA 15.81 090
drainage.
29874 ................ A Knee arthroscopy/ 7.05 NA 8.15 0.87 NA 16.07 090
surgery.
29875 ................ A Knee arthroscopy/ 6.31 NA 7.69 0.88 NA 14.88 090
surgery.
29876 ................ A Knee arthroscopy/ 7.92 NA 9.19 1.11 NA 18.22 090
surgery.
29877 ................ A Knee arthroscopy/ 7.35 NA 8.29 1.03 NA 16.67 090
surgery.
29879 ................ A Knee arthroscopy/ 8.04 NA 8.68 1.13 NA 17.85 090
surgery.
29880 ................ A Knee arthroscopy/ 8.50 NA 8.95 1.19 NA 18.64 090
surgery.
29881 ................ A Knee arthroscopy/ 7.76 NA 8.53 1.09 NA 17.38 090
surgery.
29882 ................ A Knee arthroscopy/ 8.65 NA 9.01 1.09 NA 18.75 090
surgery.
29883 ................ A Knee arthroscopy/ 11.05 NA 10.41 1.33 NA 22.79 090
surgery.
29884 ................ A Knee arthroscopy/ 7.33 NA 8.87 1.03 NA 17.23 090
surgery.
29885 ................ A Knee arthroscopy/ 9.09 NA 9.85 1.27 NA 20.21 090
surgery.
29886 ................ A Knee arthroscopy/ 7.54 NA 8.99 1.06 NA 17.59 090
surgery.
29887 ................ A Knee arthroscopy/ 9.04 NA 9.83 1.27 NA 20.14 090
surgery.
29888 ................ A Knee arthroscopy/ 13.90 NA 12.50 1.95 NA 28.35 090
surgery.
29889 ................ A Knee arthroscopy/ 16.00 NA 13.71 2.11 NA 31.82 090
surgery.
29891 ................ A Ankle arthroscopy/ 8.40 NA 8.92 1.17 NA 18.49 090
surgery.
29892 ................ A Ankle arthroscopy/ 9.00 NA 9.04 1.26 NA 19.30 090
surgery.
29893 ................ A Scope, plantar 5.22 NA 5.56 0.74 NA 11.52 090
fasciotomy.
29894 ................ A Ankle arthroscopy/ 7.21 NA 8.04 1.01 NA 16.26 090
surgery.
29895 ................ A Ankle arthroscopy/ 6.99 NA 8.01 0.97 NA 15.97 090
surgery.
29897 ................ A Ankle arthroscopy/ 7.18 NA 8.73 1.01 NA 16.92 090
surgery.
29898 ................ A Ankle arthroscopy/ 8.32 NA 8.79 1.14 NA 18.25 090
surgery.
29900 ................ A Mcp joint arthroscopy, 5.42 NA 5.88 0.69 NA 11.99 090
dx.
29901 ................ A Mcp joint arthroscopy, 6.13 NA 6.28 0.81 NA 13.22 090
surg.
29902 ................ A Mcp joint arthroscopy, 6.70 NA 6.60 0.89 NA 14.19 090
surg.
29909 ................ D Arthroscopy of joint.. 0.00 0.00 0.00 0.00 0.00 0.00 YYY
29999 ................ C Arthroscopy of joint.. 0.00 0.00 0.00 0.00 0.00 0.00 YYY
30000 ................ A Drainage of nose 1.43 2.53 1.51 0.10 4.06 3.04 010
lesion.
30020 ................ A Drainage of nose 1.43 2.64 1.57 0.08 4.15 3.08 010
lesion.
30100 ................ A Intranasal biopsy..... 0.94 1.34 0.53 0.06 2.34 1.53 000
30110 ................ A Removal of nose 1.63 2.80 0.88 0.12 4.55 2.63 010
polyp(s).
30115 ................ A Removal of nose 4.35 NA 4.54 0.31 NA 9.20 090
polyp(s).
30117 ................ A Removal of intranasal 3.16 4.95 3.20 0.22 8.33 6.58 090
lesion.
30118 ................ A Removal of intranasal 9.69 NA 8.55 0.66 NA 18.90 090
lesion.
30120 ................ A Revision of nose...... 5.27 5.71 5.71 0.41 11.39 11.39 090
30124 ................ A Removal of nose lesion 3.10 NA 3.31 0.20 NA 6.61 090
30125 ................ A Removal of nose lesion 7.16 NA 6.61 0.54 NA 14.31 090
30130 ................ A Removal of turbinate 3.38 NA 3.99 0.22 NA 7.59 090
bones.
30140 ................ A Removal of turbinate 3.43 NA 4.61 0.24 NA 8.28 090
bones.
30150 ................ A Partial removal of 9.14 NA 8.83 0.76 NA 18.73 090
nose.
30160 ................ A Removal of nose....... 9.58 NA 8.79 0.78 NA 19.15 090
30200 ................ A Injection treatment of 0.78 1.23 0.46 0.06 2.07 1.30 000
nose.
[[Page 55361]]
30210 ................ A Nasal sinus therapy... 1.08 2.15 0.61 0.08 3.31 1.77 010
30220 ................ A Insert nasal septal 1.54 2.52 0.84 0.11 4.17 2.49 010
button.
30300 ................ A Remove nasal foreign 1.04 2.62 0.37 0.07 3.73 1.48 010
body.
30310 ................ A Remove nasal foreign 1.96 NA 1.92 0.14 NA 4.02 010
body.
30320 ................ A Remove nasal foreign 4.52 NA 5.26 0.36 NA 10.14 090
body.
30400 ................ R Reconstruction of nose 9.83 NA 8.95 0.80 NA 19.58 090
30410 ................ R Reconstruction of nose 12.98 NA 10.45 1.08 NA 24.51 090
30420 ................ R Reconstruction of nose 15.88 NA 12.50 1.24 NA 29.62 090
30430 ................ R Revision of nose...... 7.21 NA 7.40 0.62 NA 15.23 090
30435 ................ R Revision of nose...... 11.71 NA 10.68 1.10 NA 23.49 090
30450 ................ R Revision of nose...... 18.65 NA 14.37 1.53 NA 34.55 090
30460 ................ A Revision of nose...... 9.96 NA 9.16 0.85 NA 19.97 090
30462 ................ A Revision of nose...... 19.57 NA 14.30 1.92 NA 35.79 090
30465 ................ A Repair nasal stenosis. 11.64 NA 9.58 0.97 NA 22.19 090
30520 ................ A Repair of nasal septum 5.70 NA 5.93 0.41 NA 12.04 090
30540 ................ A Repair nasal defect... 7.75 NA 6.71 0.53 NA 14.99 090
30545 ................ A Repair nasal defect... 11.38 NA 9.19 0.80 NA 21.37 090
30560 ................ A Release of nasal 1.26 2.37 1.52 0.09 3.72 2.87 010
adhesions.
30580 ................ A Repair upper jaw 6.69 5.00 5.00 0.50 12.19 12.19 090
fistula.
30600 ................ A Repair mouth/nose 6.02 4.90 4.90 0.70 11.62 11.62 090
fistula.
30620 ................ A Intranasal 5.97 NA 6.69 0.45 NA 13.11 090
reconstruction.
30630 ................ A Repair nasal septum 7.12 NA 7.23 0.51 NA 14.86 090
defect.
30801 ................ A Cauterization, inner 1.09 2.57 2.31 0.08 3.74 3.48 010
nose.
30802 ................ A Cauterization, inner 2.03 3.14 2.87 0.15 5.32 5.05 010
nose.
30901 ................ A Control of nosebleed.. 1.21 1.43 0.34 0.09 2.73 1.64 000
30903 ................ A Control of nosebleed.. 1.54 3.20 0.53 0.12 4.86 2.19 000
30905 ................ A Control of nosebleed.. 1.97 3.85 0.80 0.15 5.97 2.92 000
30906 ................ A Repeat control of 2.45 4.27 1.27 0.17 6.89 3.89 000
nosebleed.
30915 ................ A Ligation, nasal sinus 7.20 NA 7.13 0.50 NA 14.83 090
artery.
30920 ................ A Ligation, upper jaw 9.83 NA 8.64 0.69 NA 19.16 090
artery.
30930 ................ A Therapy, fracture of 1.26 NA 2.17 0.09 NA 3.52 010
nose.
30999 ................ C Nasal surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
31000 ................ A Irrigation, maxillary 1.15 2.43 0.66 0.08 3.66 1.89 010
sinus.
31002 ................ A Irrigation, sphenoid 1.91 NA 2.07 0.14 NA 4.12 010
sinus.
31020 ................ A Exploration, maxillary 2.94 4.20 3.68 0.20 7.34 6.82 090
sinus.
31030 ................ A Exploration, maxillary 5.92 4.85 4.68 0.42 11.19 11.02 090
sinus.
31032 ................ A Explore sinus,remove 6.57 NA 6.16 0.47 NA 13.20 090
polyps.
31040 ................ A Exploration behind 9.42 NA 7.34 0.71 NA 17.47 090
upper jaw.
31050 ................ A Exploration, sphenoid 5.28 NA 5.12 0.39 NA 10.79 090
sinus.
31051 ................ A Sphenoid sinus surgery 7.11 NA 6.66 0.55 NA 14.32 090
31070 ................ A Exploration of frontal 4.28 NA 5.04 0.30 NA 9.62 090
sinus.
31075 ................ A Exploration of frontal 9.16 NA 8.38 0.64 NA 18.18 090
sinus.
31080 ................ A Removal of frontal 11.42 NA 9.13 0.78 NA 21.33 090
sinus.
31081 ................ A Removal of frontal 12.75 NA 9.97 1.84 NA 24.56 090
sinus.
31084 ................ A Removal of frontal 13.51 NA 10.76 0.96 NA 25.23 090
sinus.
31085 ................ A Removal of frontal 14.20 NA 11.12 1.18 NA 26.50 090
sinus.
31086 ................ A Removal of frontal 12.86 NA 10.50 0.90 NA 24.26 090
sinus.
31087 ................ A Removal of frontal 13.10 NA 10.32 1.15 NA 24.57 090
sinus.
31090 ................ A Exploration of sinuses 9.53 NA 9.05 0.66 NA 19.24 090
31200 ................ A Removal of ethmoid 4.97 NA 5.86 0.25 NA 11.08 090
sinus.
31201 ................ A Removal of ethmoid 8.37 NA 7.91 0.58 NA 16.86 090
sinus.
31205 ................ A Removal of ethmoid 10.24 NA 8.66 0.58 NA 19.48 090
sinus.
31225 ................ A Removal of upper jaw.. 19.23 NA 15.42 1.38 NA 36.03 090
31230 ................ A Removal of upper jaw.. 21.94 NA 17.21 1.57 NA 40.72 090
31231 ................ A Nasal endoscopy, dx... 1.10 2.01 0.61 0.08 3.19 1.79 000
31233 ................ A Nasal/sinus endoscopy, 2.18 2.66 1.24 0.16 5.00 3.58 000
dx.
31235 ................ A Nasal/sinus endoscopy, 2.64 2.93 1.49 0.18 5.75 4.31 000
dx.
31237 ................ A Nasal/sinus endoscopy, 2.98 3.22 1.66 0.21 6.41 4.85 000
surg.
31238 ................ A Nasal/sinus endoscopy, 3.26 3.75 1.89 0.23 7.24 5.38 000
surg.
31239 ................ A Nasal/sinus endoscopy, 8.70 NA 6.72 0.46 NA 15.88 010
surg.
31240 ................ A Nasal/sinus endoscopy, 2.61 NA 1.62 0.18 NA 4.41 000
surg.
31254 ................ A Revision of ethmoid 4.65 NA 2.79 0.32 NA 7.76 000
sinus.
31255 ................ A Removal of ethmoid 6.96 NA 4.14 0.49 NA 11.59 000
sinus.
31256 ................ A Exploration maxillary 3.29 NA 2.01 0.23 NA 5.53 000
sinus.
31267 ................ A Endoscopy, maxillary 5.46 NA 3.27 0.38 NA 9.11 000
sinus.
31276 ................ A Sinus endoscopy, 8.85 NA 5.24 0.62 NA 14.71 000
surgical.
31287 ................ A Nasal/sinus endoscopy, 3.92 NA 2.37 0.27 NA 6.56 000
surg.
31288 ................ A Nasal/sinus endoscopy, 4.58 NA 2.75 0.32 NA 7.65 000
surg.
31290 ................ A Nasal/sinus endoscopy, 17.24 NA 11.86 1.20 NA 30.30 010
surg.
31291 ................ A Nasal/sinus endoscopy, 18.19 NA 12.28 1.73 NA 32.20 010
surg.
31292 ................ A Nasal/sinus endoscopy, 14.76 NA 10.36 0.99 NA 26.11 010
surg.
31293 ................ A Nasal/sinus endoscopy, 16.21 NA 11.16 0.97 NA 28.34 010
surg.
31294 ................ A Nasal/sinus endoscopy, 19.06 NA 12.46 1.04 NA 32.56 010
surg.
[[Page 55362]]
31299 ................ C Sinus surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
31300 ................ A Removal of larynx 14.29 NA 17.46 0.99 NA 32.74 090
lesion.
31320 ................ A Diagnostic incision, 5.26 NA 12.54 0.40 NA 18.20 090
larynx.
31360 ................ A Removal of larynx..... 17.08 NA 19.24 1.20 NA 37.52 090
31365 ................ A Removal of larynx..... 24.16 NA 23.20 1.72 NA 49.08 090
31367 ................ A Partial removal of 21.86 NA 23.92 1.57 NA 47.35 090
larynx.
31368 ................ A Partial removal of 27.09 NA 28.64 1.90 NA 57.63 090
larynx.
31370 ................ A Partial removal of 21.38 NA 23.46 1.51 NA 46.35 090
larynx.
31375 ................ A Partial removal of 20.21 NA 21.16 1.43 NA 42.80 090
larynx.
31380 ................ A Partial removal of 20.21 NA 21.41 1.40 NA 43.02 090
larynx.
31382 ................ A Partial removal of 20.52 NA 23.06 1.44 NA 45.02 090
larynx.
31390 ................ A Removal of larynx & 27.53 NA 28.90 1.95 NA 58.38 090
pharynx.
31395 ................ A Reconstruct larynx & 31.09 NA 35.02 2.27 NA 68.38 090
pharynx.
31400 ................ A Revision of larynx.... 10.31 NA 15.75 0.72 NA 26.78 090
31420 ................ A Removal of epiglottis. 10.22 NA 15.60 0.71 NA 26.53 090
31500 ................ A Insert emergency 2.33 NA 0.69 0.15 NA 3.17 000
airway.
31502 ................ A Change of windpipe 0.65 1.97 0.27 0.04 2.66 0.96 000
airway.
31505 ................ A Diagnostic 0.61 1.85 0.35 0.04 2.50 1.00 000
laryngoscopy.
31510 ................ A Laryngoscopy with 1.92 2.86 1.04 0.15 4.93 3.11 000
biopsy.
31511 ................ A Remove foreign body, 2.16 3.15 0.75 0.16 5.47 3.07 000
larynx.
31512 ................ A Removal of larynx 2.07 3.00 1.10 0.16 5.23 3.33 000
lesion.
31513 ................ A Injection into vocal 2.10 NA 1.32 0.15 NA 3.57 000
cord.
31515 ................ A Laryngoscopy for 1.80 2.30 0.90 0.12 4.22 2.82 000
aspiration.
31520 ................ A Diagnostic 2.56 NA 1.41 0.17 NA 4.14 000
laryngoscopy.
31525 ................ A Diagnostic 2.63 2.94 1.53 0.18 5.75 4.34 000
laryngoscopy.
31526 ................ A Diagnostic 2.57 NA 1.59 0.18 NA 4.34 000
laryngoscopy.
31527 ................ A Laryngoscopy for 3.27 NA 1.77 0.21 NA 5.25 000
treatment.
31528 ................ A Laryngoscopy and 2.37 NA 1.24 0.16 NA 3.77 000
dilation.
31529 ................ A Laryngoscopy and 2.68 NA 1.62 0.18 NA 4.48 000
dilation.
31530 ................ A Operative laryngoscopy 3.39 NA 1.89 0.24 NA 5.52 000
31531 ................ A Operative laryngoscopy 3.59 NA 2.18 0.25 NA 6.02 000
31535 ................ A Operative laryngoscopy 3.16 NA 1.88 0.22 NA 5.26 000
31536 ................ A Operative laryngoscopy 3.56 NA 2.16 0.25 NA 5.97 000
31540 ................ A Operative laryngoscopy 4.13 NA 2.48 0.29 NA 6.90 000
31541 ................ A Operative laryngoscopy 4.53 NA 2.72 0.32 NA 7.57 000
31560 ................ A Operative laryngoscopy 5.46 NA 3.11 0.38 NA 8.95 000
31561 ................ A Operative laryngoscopy 6.00 NA 2.96 0.42 NA 9.38 000
31570 ................ A Laryngoscopy with 3.87 3.97 2.31 0.24 8.08 6.42 000
injection.
31571 ................ A Laryngoscopy with 4.27 NA 2.46 0.30 NA 7.03 000
injection.
31575 ................ A Diagnostic 1.10 2.08 0.59 0.08 3.26 1.77 000
laryngoscopy.
31576 ................ A Laryngoscopy with 1.97 2.26 1.08 0.13 4.36 3.18 000
biopsy.
31577 ................ A Remove foreign body, 2.47 2.90 1.31 0.17 5.54 3.95 000
larynx.
31578 ................ A Removal of larynx 2.84 3.13 1.62 0.20 6.17 4.66 000
lesion.
31579 ................ A Diagnostic 2.26 2.97 1.27 0.16 5.39 3.69 000
laryngoscopy.
31580 ................ A Revision of larynx.... 12.38 NA 16.85 0.87 NA 30.10 090
31582 ................ A Revision of larynx.... 21.62 NA 22.06 1.52 NA 45.20 090
31584 ................ A Treat larynx fracture. 19.64 NA 19.05 1.42 NA 40.11 090
31585 ................ A Treat larynx fracture. 4.64 NA 8.92 0.30 NA 13.86 090
31586 ................ A Treat larynx fracture. 8.03 NA 12.71 0.56 NA 21.30 090
31587 ................ A Revision of larynx.... 11.99 NA 14.77 0.88 NA 27.64 090
31588 ................ A Revision of larynx.... 13.11 NA 17.21 0.92 NA 31.24 090
31590 ................ A Reinnervate larynx.... 6.97 NA 12.63 0.50 NA 20.10 090
31595 ................ A Larynx nerve surgery.. 8.34 NA 11.90 0.62 NA 20.86 090
31599 ................ C Larynx surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
31600 ................ A Incision of windpipe.. 7.18 NA 3.15 0.34 NA 10.67 000
31601 ................ A Incision of windpipe.. 4.45 NA 2.20 0.39 NA 7.04 000
31603 ................ A Incision of windpipe.. 4.15 NA 1.88 0.35 NA 6.38 000
31605 ................ A Incision of windpipe.. 3.58 NA 1.24 0.33 NA 5.15 000
31610 ................ A Incision of windpipe.. 8.76 NA 10.98 0.69 NA 20.43 090
31611 ................ A Surgery/speech 5.64 NA 10.28 0.40 NA 16.32 090
prosthesis.
31612 ................ A Puncture/clear 0.91 1.53 0.48 0.06 2.50 1.45 000
windpipe.
31613 ................ A Repair windpipe 4.59 NA 8.94 0.37 NA 13.90 090
opening.
31614 ................ A Repair windpipe 7.12 NA 12.47 0.51 NA 20.10 090
opening.
31615 ................ A Visualization of 2.09 3.76 1.20 0.14 5.99 3.43 000
windpipe.
31622 ................ A Dx bronchoscope/wash.. 2.78 3.69 1.20 0.14 6.61 4.12 000
31623 ................ A Dx bronchoscope/brush. 2.88 2.97 1.17 0.14 5.99 4.19 000
31624 ................ A Dx bronchoscope/lavage 2.88 2.75 1.17 0.13 5.76 4.18 000
31625 ................ A Bronchoscopy with 3.37 2.96 1.34 0.16 6.49 4.87 000
biopsy.
31628 ................ A Bronchoscopy with 3.81 3.38 1.45 0.14 7.33 5.40 000
biopsy.
31629 ................ A Bronchoscopy with 3.37 NA 1.32 0.13 NA 4.82 000
biopsy.
31630 ................ A Bronchoscopy with 3.82 NA 1.99 0.30 NA 6.11 000
repair.
31631 ................ A Bronchoscopy with 4.37 NA 2.04 0.31 NA 6.72 000
dilation.
31635 ................ A Remove foreign body, 3.68 NA 1.70 0.21 NA 5.59 000
airway.
[[Page 55363]]
31640 ................ A Bronchoscopy & remove 4.94 NA 2.36 0.37 NA 7.67 000
lesion.
31641 ................ A Bronchoscopy, treat 5.03 NA 2.20 0.30 NA 7.53 000
blockage.
31643 ................ A Diag bronchoscope/ 3.50 1.17 1.17 0.15 4.82 4.82 000
catheter.
31645 ................ A Bronchoscopy, clear 3.16 NA 1.27 0.13 NA 4.56 000
airways.
31646 ................ A Bronchoscopy, reclear 2.72 NA 1.12 0.12 NA 3.96 000
airway.
31656 ................ A Bronchoscopy, inj for 2.17 NA 1.05 0.10 NA 3.32 000
xray.
31700 ................ A Insertion of airway 1.34 3.44 0.68 0.07 4.85 2.09 000
catheter.
31708 ................ A Instill airway 1.41 NA 0.64 0.06 NA 2.11 000
contrast dye.
31710 ................ A Insertion of airway 1.30 NA 0.75 0.06 NA 2.11 000
catheter.
31715 ................ A Injection for bronchus 1.11 NA 0.73 0.06 NA 1.90 000
x-ray.
31717 ................ A Bronchial brush biopsy 2.12 3.25 0.89 0.09 5.46 3.10 000
31720 ................ A Clearance of airways.. 1.06 1.90 0.35 0.06 3.02 1.47 000
31725 ................ A Clearance of airways.. 1.96 NA 0.61 0.10 NA 2.67 000
31730 ................ A Intro, windpipe wire/ 2.85 2.54 1.13 0.15 5.54 4.13 000
tube.
31750 ................ A Repair of windpipe.... 13.02 NA 16.22 1.02 NA 30.26 090
31755 ................ A Repair of windpipe.... 15.93 NA 19.27 1.15 NA 36.35 090
31760 ................ A Repair of windpipe.... 22.35 NA 12.79 1.48 NA 36.62 090
31766 ................ A Reconstruction of 30.43 NA 15.03 3.16 NA 48.62 090
windpipe.
31770 ................ A Repair/graft of 22.51 NA 15.67 2.27 NA 40.45 090
bronchus.
31775 ................ A Reconstruct bronchus.. 23.54 NA 15.14 2.91 NA 41.59 090
31780 ................ A Reconstruct windpipe.. 17.72 NA 12.97 1.55 NA 32.24 090
31781 ................ A Reconstruct windpipe.. 23.53 NA 15.49 2.04 NA 41.06 090
31785 ................ A Remove windpipe lesion 17.23 NA 13.05 1.36 NA 31.64 090
31786 ................ A Remove windpipe lesion 23.98 NA 14.41 2.20 NA 40.59 090
31800 ................ A Repair of windpipe 7.43 NA 6.81 0.67 NA 14.91 090
injury.
31805 ................ A Repair of windpipe 13.13 NA 10.72 1.45 NA 25.30 090
injury.
31820 ................ A Closure of windpipe 4.49 8.24 8.07 0.35 13.08 12.91 090
lesion.
31825 ................ A Repair of windpipe 6.81 10.86 10.86 0.50 18.17 18.17 090
defect.
31830 ................ A Revise windpipe scar.. 4.50 7.82 7.82 0.36 12.68 12.68 090
31899 ................ C Airways surgical 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
32000 ................ A Drainage of chest..... 1.54 3.10 0.51 0.07 4.71 2.12 000
32002 ................ A Treatment of collapsed 2.19 NA 0.87 0.11 NA 3.17 000
lung.
32005 ................ A Treat lung lining 2.19 NA 0.88 0.17 NA 3.24 000
chemically.
32020 ................ A Insertion of chest 3.98 NA 1.48 0.36 NA 5.82 000
tube.
32035 ................ A Exploration of chest.. 8.67 NA 7.83 1.02 NA 17.52 090
32036 ................ A Exploration of chest.. 9.68 NA 8.39 1.20 NA 19.27 090
32095 ................ A Biopsy through chest 8.36 NA 8.05 0.99 NA 17.40 090
wall.
32100 ................ A Exploration/biopsy of 15.24 NA 10.30 1.45 NA 26.99 090
chest.
32110 ................ A Explore/repair chest.. 23.00 NA 12.72 1.63 NA 37.35 090
32120 ................ A Re-exploration of 11.54 NA 9.34 1.42 NA 22.30 090
chest.
32124 ................ A Explore chest free 12.72 NA 9.53 1.51 NA 23.76 090
adhesions.
32140 ................ A Removal of lung 13.93 NA 9.79 1.68 NA 25.40 090
lesion(s).
32141 ................ A Remove/treat lung 14.00 NA 9.98 1.72 NA 25.70 090
lesions.
32150 ................ A Removal of lung 14.15 NA 9.70 1.60 NA 25.45 090
lesion(s).
32151 ................ A Remove lung foreign 14.21 NA 10.20 1.49 NA 25.90 090
body.
32160 ................ A Open chest heart 9.30 NA 6.34 1.01 NA 16.65 090
massage.
32200 ................ A Drain, open, lung 15.29 NA 10.08 1.46 NA 26.83 090
lesion.
32201 ................ A Drain, percut, lung 4.00 NA 5.67 0.18 NA 9.85 000
lesion.
32215 ................ A Treat chest lining.... 11.33 NA 9.16 1.34 NA 21.83 090
32220 ................ A Release of lung....... 24.00 NA 13.56 2.39 NA 39.95 090
32225 ................ A Partial release of 13.96 NA 9.95 1.70 NA 25.61 090
lung.
32310 ................ A Removal of chest 13.44 NA 9.86 1.65 NA 24.95 090
lining.
32320 ................ A Free/remove chest 24.00 NA 13.21 2.50 NA 39.71 090
lining.
32400 ................ A Needle biopsy chest 1.76 1.89 0.59 0.07 3.72 2.42 000
lining.
32402 ................ A Open biopsy chest 7.56 NA 7.76 0.91 NA 16.23 090
lining.
32405 ................ A Biopsy, lung or 1.93 2.33 0.67 0.09 4.35 2.69 000
mediastinum.
32420 ................ A Puncture/clear lung... 2.18 NA 0.88 0.11 NA 3.17 000
32440 ................ A Removal of lung....... 25.00 NA 13.57 2.56 NA 41.13 090
32442 ................ A Sleeve pneumonectomy.. 26.24 NA 14.35 3.12 NA 43.71 090
32445 ................ A Removal of lung....... 25.09 NA 13.83 3.11 NA 42.03 090
32480 ................ A Partial removal of 23.75 NA 12.78 2.24 NA 38.77 090
lung.
32482 ................ A Bilobectomy........... 25.00 NA 13.39 2.35 NA 40.74 090
32484 ................ A Segmentectomy......... 20.69 NA 11.97 2.54 NA 35.20 090
32486 ................ A Sleeve lobectomy...... 23.92 NA 13.32 3.00 NA 40.24 090
32488 ................ A Completion 25.71 NA 13.89 3.18 NA 42.78 090
pneumonectomy.
32491 ................ R Lung volume reduction. 21.25 NA 12.67 2.66 NA 36.58 090
32500 ................ A Partial removal of 22.00 NA 12.70 1.77 NA 36.47 090
lung.
32501 ................ A Repair bronchus add-on 4.69 NA 1.59 0.56 NA 6.84 ZZZ
32520 ................ A Remove lung & revise 21.68 NA 12.56 2.71 NA 36.95 090
chest.
32522 ................ A Remove lung & revise 24.20 NA 13.63 2.84 NA 40.67 090
chest.
32525 ................ A Remove lung & revise 26.50 NA 14.22 3.25 NA 43.97 090
chest.
32540 ................ A Removal of lung lesion 14.64 NA 9.99 1.84 NA 26.47 090
32601 ................ A Thoracoscopy, 5.46 NA 3.60 0.63 NA 9.69 000
diagnostic.
[[Page 55364]]
32602 ................ A Thoracoscopy, 5.96 NA 3.72 0.70 NA 10.38 000
diagnostic.
32603 ................ A Thoracoscopy, 7.81 NA 4.33 0.76 NA 12.90 000
diagnostic.
32604 ................ A Thoracoscopy, 8.78 NA 4.79 0.97 NA 14.54 000
diagnostic.
32605 ................ A Thoracoscopy, 6.93 NA 4.19 0.86 NA 11.98 000
diagnostic.
32606 ................ A Thoracoscopy, 8.40 NA 4.55 0.99 NA 13.94 000
diagnostic.
32650 ................ A Thoracoscopy, surgical 10.75 NA 8.47 1.25 NA 20.47 090
32651 ................ A Thoracoscopy, surgical 12.91 NA 8.84 1.50 NA 23.25 090
32652 ................ A Thoracoscopy, surgical 18.66 NA 11.16 2.30 NA 32.12 090
32653 ................ A Thoracoscopy, surgical 12.87 NA 9.15 1.55 NA 23.57 090
32654 ................ A Thoracoscopy, surgical 12.44 NA 7.53 1.51 NA 21.48 090
32655 ................ A Thoracoscopy, surgical 13.10 NA 8.86 1.53 NA 23.49 090
32656 ................ A Thoracoscopy, surgical 12.91 NA 9.53 1.61 NA 24.05 090
32657 ................ A Thoracoscopy, surgical 13.65 NA 9.36 1.64 NA 24.65 090
32658 ................ A Thoracoscopy, surgical 11.63 NA 9.05 1.47 NA 22.15 090
32659 ................ A Thoracoscopy, surgical 11.59 NA 9.10 1.39 NA 22.08 090
32660 ................ A Thoracoscopy, surgical 17.43 NA 10.53 2.09 NA 30.05 090
32661 ................ A Thoracoscopy, surgical 13.25 NA 9.15 1.66 NA 24.06 090
32662 ................ A Thoracoscopy, surgical 16.44 NA 10.59 2.01 NA 29.04 090
32663 ................ A Thoracoscopy, surgical 18.47 NA 11.22 2.28 NA 31.97 090
32664 ................ A Thoracoscopy, surgical 14.20 NA 9.43 1.70 NA 25.33 090
32665 ................ A Thoracoscopy, surgical 15.54 NA 9.18 1.79 NA 26.51 090
32800 ................ A Repair lung hernia.... 13.69 NA 10.05 1.51 NA 25.25 090
32810 ................ A Close chest after 13.05 NA 10.05 1.55 NA 24.65 090
drainage.
32815 ................ A Close bronchial 23.15 NA 13.32 2.84 NA 39.31 090
fistula.
32820 ................ A Reconstruct injured 21.48 NA 13.99 2.31 NA 37.78 090
chest.
32850 ................ X Donor pneumonectomy... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
32851 ................ A Lung transplant, 38.63 NA 19.94 4.90 NA 63.47 090
single.
32852 ................ A Lung transplant with 41.80 NA 21.40 5.17 NA 68.37 090
bypass.
32853 ................ A Lung transplant, 47.81 NA 23.49 6.13 NA 77.43 090
double.
32854 ................ A Lung transplant with 50.98 NA 24.35 6.41 NA 81.74 090
bypass.
32900 ................ A Removal of rib(s)..... 20.27 NA 12.27 2.42 NA 34.96 090
32905 ................ A Revise & repair chest 20.75 NA 12.77 2.54 NA 36.06 090
wall.
32906 ................ A Revise & repair chest 26.77 NA 14.12 3.30 NA 44.19 090
wall.
32940 ................ A Revision of lung...... 19.43 NA 11.96 2.47 NA 33.86 090
32960 ................ A Therapeutic 1.84 2.16 0.70 0.12 4.12 2.66 000
pneumothorax.
32997 ................ A Total lung lavage..... 6.00 NA 2.00 0.55 NA 8.55 000
32999 ................ C Chest surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
33010 ................ A Drainage of heart sac. 2.24 NA 1.01 0.13 NA 3.38 000
33011 ................ A Repeat drainage of 2.24 NA 1.05 0.13 NA 3.42 000
heart sac.
33015 ................ A Incision of heart sac. 6.80 NA 4.41 0.64 NA 11.85 090
33020 ................ A Incision of heart sac. 12.61 NA 7.91 1.50 NA 22.02 090
33025 ................ A Incision of heart sac. 12.09 NA 7.77 1.50 NA 21.36 090
33030 ................ A Partial removal of 18.71 NA 12.12 2.40 NA 33.23 090
heart sac.
33031 ................ A Partial removal of 21.79 NA 13.20 2.78 NA 37.77 090
heart sac.
33050 ................ A Removal of heart sac 14.36 NA 10.24 1.73 NA 26.33 090
lesion.
33120 ................ A Removal of heart 24.56 NA 15.68 3.06 NA 43.30 090
lesion.
33130 ................ A Removal of heart 21.39 NA 12.40 2.51 NA 36.30 090
lesion.
33140 ................ A Heart revascularize 20.00 NA 10.57 2.27 NA 32.84 090
(tmr).
33141 ................ A Heart tmr w/other 4.84 NA 1.63 0.55 NA 7.02 ZZZ
procedure.
33200 ................ A Insertion of heart 12.48 NA 9.59 1.17 NA 23.24 090
pacemaker.
33201 ................ A Insertion of heart 10.18 NA 9.39 1.21 NA 20.78 090
pacemaker.
33206 ................ A Insertion of heart 6.67 NA 5.35 0.50 NA 12.52 090
pacemaker.
33207 ................ A Insertion of heart 8.04 NA 6.00 0.57 NA 14.61 090
pacemaker.
33208 ................ A Insertion of heart 8.13 NA 6.14 0.54 NA 14.81 090
pacemaker.
33210 ................ A Insertion of heart 3.30 NA 1.34 0.17 NA 4.81 000
electrode.
33211 ................ A Insertion of heart 3.40 NA 1.41 0.17 NA 4.98 000
electrode.
33212 ................ A Insertion of pulse 5.52 NA 4.44 0.44 NA 10.40 090
generator.
33213 ................ A Insertion of pulse 6.37 NA 4.85 0.46 NA 11.68 090
generator.
33214 ................ A Upgrade of pacemaker 7.75 NA 5.95 0.52 NA 14.22 090
system.
33216 ................ A Revise eltrd pacing- 5.39 NA 4.95 0.36 NA 10.70 090
defib.
33217 ................ A Revise eltrd pacing- 5.75 NA 5.26 0.36 NA 11.37 090
defib.
33218 ................ A Revise eltrd pacing- 5.44 NA 4.51 0.40 NA 10.35 090
defib.
33220 ................ A Revise eltrd pacing- 5.52 NA 4.45 0.39 NA 10.36 090
defib.
33222 ................ A Revise pocket, 4.96 NA 3.93 0.39 NA 9.28 090
pacemaker.
33223 ................ A Revise pocket, pacing- 6.46 NA 5.06 0.44 NA 11.96 090
defib.
33233 ................ A Removal of pacemaker 3.29 NA 3.80 0.22 NA 7.31 090
system.
33234 ................ A Removal of pacemaker 7.82 NA 5.03 0.56 NA 13.41 090
system.
33235 ................ A Removal pacemaker 9.40 NA 6.26 0.68 NA 16.34 090
electrode.
33236 ................ A Remove electrode/ 12.60 NA 9.35 1.49 NA 23.44 090
thoracotomy.
33237 ................ A Remove electrode/ 13.71 NA 9.51 1.57 NA 24.79 090
thoracotomy.
33238 ................ A Remove electrode/ 15.22 NA 9.24 1.56 NA 26.02 090
thoracotomy.
33240 ................ A Insert pulse generator 7.60 NA 5.49 0.53 NA 13.62 090
33241 ................ A Remove pulse generator 3.24 NA 3.39 0.21 NA 6.84 090
[[Page 55365]]
33243 ................ A Remove eltrd/ 22.64 NA 10.88 2.53 NA 36.05 090
thoracotomy.
33244 ................ A Remove eltrd, transven 13.76 NA 8.22 1.05 NA 23.03 090
33245 ................ A Insert epic eltrd pace- 14.30 NA 10.79 1.28 NA 26.37 090
defib.
33246 ................ A Insert epic eltrd/ 20.71 NA 14.16 2.22 NA 37.09 090
generator.
33249 ................ A Eltrd/insert pace- 14.23 NA 8.98 0.80 NA 24.01 090
defib.
33250 ................ A Ablate heart dysrhythm 21.85 NA 13.65 1.01 NA 36.51 090
focus.
33251 ................ A Ablate heart dysrhythm 24.88 NA 14.06 2.41 NA 41.35 090
focus.
33253 ................ A Reconstruct atria..... 31.06 NA 16.58 3.68 NA 51.32 090
33261 ................ A Ablate heart dysrhythm 24.88 NA 14.47 2.82 NA 42.17 090
focus.
33282 ................ A Implant pat-active ht 4.17 NA 4.42 0.39 NA 8.98 090
record.
33284 ................ A Remove pat-active ht 2.50 NA 3.94 0.23 NA 6.67 090
record.
33300 ................ A Repair of heart wound. 17.92 NA 11.56 1.91 NA 31.39 090
33305 ................ A Repair of heart wound. 21.44 NA 13.24 2.68 NA 37.36 090
33310 ................ A Exploratory heart 18.51 NA 11.85 2.26 NA 32.62 090
surgery.
33315 ................ A Exploratory heart 22.37 NA 13.43 2.90 NA 38.70 090
surgery.
33320 ................ A Repair major blood 16.79 NA 11.06 1.66 NA 29.51 090
vessel(s).
33321 ................ A Repair major vessel... 20.20 NA 13.15 2.70 NA 36.05 090
33322 ................ A Repair major blood 20.62 NA 13.02 2.51 NA 36.15 090
vessel(s).
33330 ................ A Insert major vessel 21.43 NA 12.35 2.49 NA 36.27 090
graft.
33332 ................ A Insert major vessel 23.96 NA 12.94 2.45 NA 39.35 090
graft.
33335 ................ A Insert major vessel 30.01 NA 16.15 3.79 NA 49.95 090
graft.
33400 ................ A Repair of aortic valve 28.50 NA 17.04 3.09 NA 48.63 090
33401 ................ A Valvuloplasty, open... 23.91 NA 14.85 2.71 NA 41.47 090
33403 ................ A Valvuloplasty, w/cp 24.89 NA 15.99 2.48 NA 43.36 090
bypass.
33404 ................ A Prepare heart-aorta 28.54 NA 17.22 3.31 NA 49.07 090
conduit.
33405 ................ A Replacement of aortic 35.00 NA 17.69 3.86 NA 56.55 090
valve.
33406 ................ A Replacement of aortic 37.50 NA 18.53 4.07 NA 60.10 090
valve.
33410 ................ A Replacement of aortic 32.46 NA 16.93 4.11 NA 53.50 090
valve.
33411 ................ A Replacement of aortic 36.25 NA 18.07 4.16 NA 58.48 090
valve.
33412 ................ A Replacement of aortic 42.00 NA 21.90 4.66 NA 68.56 090
valve.
33413 ................ A Replacement of aortic 43.50 NA 23.05 4.26 NA 70.81 090
valve.
33414 ................ A Repair of aortic valve 30.35 NA 17.67 3.79 NA 51.81 090
33415 ................ A Revision, subvalvular 27.15 NA 16.53 3.25 NA 46.93 090
tissue.
33416 ................ A Revise ventricle 30.35 NA 16.06 3.85 NA 50.26 090
muscle.
33417 ................ A Repair of aortic valve 28.53 NA 17.09 3.58 NA 49.20 090
33420 ................ A Revision of mitral 22.70 NA 11.77 1.48 NA 35.95 090
valve.
33422 ................ A Revision of mitral 25.94 NA 14.74 3.30 NA 43.98 090
valve.
33425 ................ A Repair of mitral valve 27.00 NA 14.98 3.00 NA 44.98 090
33426 ................ A Repair of mitral valve 33.00 NA 17.14 3.87 NA 54.01 090
33427 ................ A Repair of mitral valve 40.00 NA 19.42 4.30 NA 63.72 090
33430 ................ A Replacement of mitral 33.50 NA 17.26 3.95 NA 54.71 090
valve.
33460 ................ A Revision of tricuspid 23.60 NA 13.83 3.02 NA 40.45 090
valve.
33463 ................ A Valvuloplasty, 25.62 NA 14.60 3.17 NA 43.39 090
tricuspid.
33464 ................ A Valvuloplasty, 27.33 NA 15.22 3.47 NA 46.02 090
tricuspid.
33465 ................ A Replace tricuspid 28.79 NA 15.67 3.61 NA 48.07 090
valve.
33468 ................ A Revision of tricuspid 30.12 NA 19.06 4.00 NA 53.18 090
valve.
33470 ................ A Revision of pulmonary 20.81 NA 14.20 2.81 NA 37.82 090
valve.
33471 ................ A Valvotomy, pulmonary 22.25 NA 13.13 3.00 NA 38.38 090
valve.
33472 ................ A Revision of pulmonary 22.25 NA 13.13 2.92 NA 38.30 090
valve.
33474 ................ A Revision of pulmonary 23.04 NA 13.45 2.84 NA 39.33 090
valve.
33475 ................ A Replacement, pulmonary 33.00 NA 18.28 2.64 NA 53.92 090
valve.
33476 ................ A Revision of heart 25.77 NA 14.23 2.40 NA 42.40 090
chamber.
33478 ................ A Revision of heart 26.74 NA 14.43 3.56 NA 44.73 090
chamber.
33496 ................ A Repair, prosth valve 27.25 NA 16.84 3.44 NA 47.53 090
clot.
33500 ................ A Repair heart vessel 25.55 NA 13.99 2.80 NA 42.34 090
fistula.
33501 ................ A Repair heart vessel 17.78 NA 10.24 2.05 NA 30.07 090
fistula.
33502 ................ A Coronary artery 21.04 NA 16.64 2.51 NA 40.19 090
correction.
33503 ................ A Coronary artery graft. 21.78 NA 13.90 1.42 NA 37.10 090
33504 ................ A Coronary artery graft. 24.66 NA 16.55 3.04 NA 44.25 090
33505 ................ A Repair artery w/tunnel 26.84 NA 18.16 1.52 NA 46.52 090
33506 ................ A Repair artery, 35.50 NA 19.27 3.19 NA 57.96 090
translocation.
33510 ................ A CABG, vein, single.... 29.00 NA 15.53 3.13 NA 47.66 090
33511 ................ A CABG, vein, two....... 30.00 NA 16.05 3.34 NA 49.39 090
33512 ................ A CABG, vein, three..... 31.80 NA 16.65 3.70 NA 52.15 090
33513 ................ A CABG, vein, four...... 32.00 NA 16.77 3.99 NA 52.76 090
33514 ................ A CABG, vein, five...... 32.75 NA 17.00 4.37 NA 54.12 090
33516 ................ A Cabg, vein, six or 35.00 NA 17.74 4.62 NA 57.36 090
more.
33517 ................ A CABG, artery-vein, 2.57 NA 0.86 0.32 NA 3.75 ZZZ
single.
33518 ................ A CABG, artery-vein, two 4.85 NA 1.62 0.61 NA 7.08 ZZZ
33519 ................ A CABG, artery-vein, 7.12 NA 2.38 0.89 NA 10.39 ZZZ
three.
33521 ................ A CABG, artery-vein, 9.40 NA 3.15 1.18 NA 13.73 ZZZ
four.
33522 ................ A CABG, artery-vein, 11.67 NA 3.91 1.48 NA 17.06 ZZZ
five.
33523 ................ A Cabg, art-vein, six or 13.95 NA 4.63 1.78 NA 20.36 ZZZ
more.
[[Page 55366]]
33530 ................ A Coronary artery, 5.86 NA 1.96 0.73 NA 8.55 ZZZ
bypass/reop.
33533 ................ A CABG, arterial, single 30.00 NA 17.24 3.24 NA 50.48 090
33534 ................ A CABG, arterial, two... 32.20 NA 17.45 3.63 NA 53.28 090
33535 ................ A CABG, arterial, three. 34.50 NA 17.77 3.97 NA 56.24 090
33536 ................ A Cabg, arterial, four 37.50 NA 19.27 3.29 NA 60.06 090
or more.
33542 ................ A Removal of heart 28.85 NA 17.05 3.61 NA 49.51 090
lesion.
33545 ................ A Repair of heart damage 36.78 NA 19.79 4.40 NA 60.97 090
33572 ................ A Open coronary 4.45 NA 1.48 0.55 NA 6.48 ZZZ
endarterectomy.
33600 ................ A Closure of valve...... 29.51 NA 17.79 2.30 NA 49.60 090
33602 ................ A Closure of valve...... 28.54 NA 16.65 2.90 NA 48.09 090
33606 ................ A Anastomosis/artery- 30.74 NA 17.53 3.59 NA 51.86 090
aorta.
33608 ................ A Repair anomaly w/ 31.09 NA 16.38 4.17 NA 51.64 090
conduit.
33610 ................ A Repair by enlargement. 30.61 NA 18.89 4.02 NA 53.52 090
33611 ................ A Repair double 34.00 NA 19.08 3.28 NA 56.36 090
ventricle.
33612 ................ A Repair double 35.00 NA 20.17 4.44 NA 59.61 090
ventricle.
33615 ................ A Repair, modified 34.00 NA 19.33 3.15 NA 56.48 090
fontan.
33617 ................ A Repair single 37.00 NA 21.25 4.09 NA 62.34 090
ventricle.
33619 ................ A Repair single 45.00 NA 26.49 4.71 NA 76.20 090
ventricle.
33641 ................ A Repair heart septum 21.39 NA 11.82 2.67 NA 35.88 090
defect.
33645 ................ A Revision of heart 24.82 NA 13.92 3.27 NA 42.01 090
veins.
33647 ................ A Repair heart septum 28.73 NA 17.08 3.37 NA 49.18 090
defects.
33660 ................ A Repair of heart 30.00 NA 17.09 2.82 NA 49.91 090
defects.
33665 ................ A Repair of heart 28.60 NA 16.87 3.81 NA 49.28 090
defects.
33670 ................ A Repair of heart 35.00 NA 16.68 2.18 NA 53.86 090
chambers.
33681 ................ A Repair heart septum 30.61 NA 17.83 3.53 NA 51.97 090
defect.
33684 ................ A Repair heart septum 29.65 NA 17.82 3.77 NA 51.24 090
defect.
33688 ................ A Repair heart septum 30.62 NA 16.70 3.89 NA 51.21 090
defect.
33690 ................ A Reinforce pulmonary 19.55 NA 13.55 2.56 NA 35.66 090
artery.
33692 ................ A Repair of heart 30.75 NA 17.52 3.77 NA 52.04 090
defects.
33694 ................ A Repair of heart 34.00 NA 17.82 4.27 NA 56.09 090
defects.
33697 ................ A Repair of heart 36.00 NA 18.62 4.54 NA 59.16 090
defects.
33702 ................ A Repair of heart 26.54 NA 16.53 3.45 NA 46.52 090
defects.
33710 ................ A Repair of heart 29.71 NA 16.82 3.85 NA 50.38 090
defects.
33720 ................ A Repair of heart defect 26.56 NA 16.51 3.21 NA 46.28 090
33722 ................ A Repair of heart defect 28.41 NA 17.05 3.80 NA 49.26 090
33730 ................ A Repair heart-vein 34.25 NA 18.35 2.85 NA 55.45 090
defect(s).
33732 ................ A Repair heart-vein 28.16 NA 17.95 2.78 NA 48.89 090
defect.
33735 ................ A Revision of heart 21.39 NA 13.00 1.12 NA 35.51 090
chamber.
33736 ................ A Revision of heart 23.52 NA 14.06 2.70 NA 40.28 090
chamber.
33737 ................ A Revision of heart 21.76 NA 15.22 2.93 NA 39.91 090
chamber.
33750 ................ A Major vessel shunt.... 21.41 NA 12.83 1.74 NA 35.98 090
33755 ................ A Major vessel shunt.... 21.79 NA 12.94 2.93 NA 37.66 090
33762 ................ A Major vessel shunt.... 21.79 NA 13.32 1.59 NA 36.70 090
33764 ................ A Major vessel shunt & 21.79 NA 14.22 1.93 NA 37.94 090
graft.
33766 ................ A Major vessel shunt.... 22.76 NA 15.16 3.04 NA 40.96 090
33767 ................ A Major vessel shunt.... 24.50 NA 14.92 3.14 NA 42.56 090
33770 ................ A Repair great vessels 37.00 NA 19.01 4.49 NA 60.50 090
defect.
33771 ................ A Repair great vessels 34.65 NA 18.08 4.67 NA 57.40 090
defect.
33774 ................ A Repair great vessels 30.98 NA 16.61 4.18 NA 51.77 090
defect.
33775 ................ A Repair great vessels 32.20 NA 17.10 4.34 NA 53.64 090
defect.
33776 ................ A Repair great vessels 34.04 NA 17.83 4.58 NA 56.45 090
defect.
33777 ................ A Repair great vessels 33.46 NA 17.60 4.51 NA 55.57 090
defect.
33778 ................ A Repair great vessels 40.00 NA 20.21 4.83 NA 65.04 090
defect.
33779 ................ A Repair great vessels 36.21 NA 17.93 2.40 NA 56.54 090
defect.
33780 ................ A Repair great vessels 41.75 NA 20.98 5.21 NA 67.94 090
defect.
33781 ................ A Repair great vessels 36.45 NA 18.80 4.91 NA 60.16 090
defect.
33786 ................ A Repair arterial trunk. 39.00 NA 19.81 4.69 NA 63.50 090
33788 ................ A Revision of pulmonary 26.62 NA 14.87 3.32 NA 44.81 090
artery.
33800 ................ A Aortic suspension..... 16.24 NA 13.12 1.11 NA 30.47 090
33802 ................ A Repair vessel defect.. 17.66 NA 12.22 1.56 NA 31.44 090
33803 ................ A Repair vessel defect.. 19.60 NA 13.53 2.63 NA 35.76 090
33813 ................ A Repair septal defect.. 20.65 NA 14.12 2.78 NA 37.55 090
33814 ................ A Repair septal defect.. 25.77 NA 15.61 2.52 NA 43.90 090
33820 ................ A Revise major vessel... 16.29 NA 10.95 2.10 NA 29.34 090
33822 ................ A Revise major vessel... 17.32 NA 11.16 2.33 NA 30.81 090
33824 ................ A Revise major vessel... 19.52 NA 11.97 2.61 NA 34.10 090
33840 ................ A Remove aorta 20.63 NA 14.11 2.36 NA 37.10 090
constriction.
33845 ................ A Remove aorta 22.12 NA 14.85 2.90 NA 39.87 090
constriction.
33851 ................ A Remove aorta 21.27 NA 12.98 2.86 NA 37.11 090
constriction.
33852 ................ A Repair septal defect.. 23.71 NA 14.14 3.19 NA 41.04 090
33853 ................ A Repair septal defect.. 31.72 NA 18.25 4.23 NA 54.20 090
33860 ................ A Ascending aortic graft 38.00 NA 18.74 4.30 NA 61.04 090
33861 ................ A Ascending aortic graft 42.00 NA 20.15 4.24 NA 66.39 090
[[Page 55367]]
33863 ................ A Ascending aortic graft 45.00 NA 21.10 4.60 NA 70.70 090
33870 ................ A Transverse aortic arch 44.00 NA 20.69 5.09 NA 69.78 090
graft.
33875 ................ A Thoracic aortic graft. 33.06 NA 17.01 4.08 NA 54.15 090
33877 ................ A Thoracoabdominal graft 42.60 NA 19.96 5.07 NA 67.63 090
33910 ................ A Remove lung artery 24.59 NA 14.16 3.06 NA 41.81 090
emboli.
33915 ................ A Remove lung artery 21.02 NA 12.31 1.20 NA 34.53 090
emboli.
33916 ................ A Surgery of great 25.83 NA 15.49 3.04 NA 44.36 090
vessel.
33917 ................ A Repair pulmonary 24.50 NA 15.36 3.17 NA 43.03 090
artery.
33918 ................ A Repair pulmonary 26.45 NA 14.80 3.42 NA 44.67 090
atresia.
33919 ................ A Repair pulmonary 40.00 NA 21.02 3.48 NA 64.50 090
atresia.
33920 ................ A Repair pulmonary 31.95 NA 17.28 3.61 NA 52.84 090
atresia.
33922 ................ A Transect pulmonary 23.52 NA 13.79 2.30 NA 39.61 090
artery.
33924 ................ A Remove pulmonary shunt 5.50 NA 2.05 0.74 NA 8.29 ZZZ
33930 ................ X Removal of donor heart/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lung.
33935 ................ R Transplantation, heart/ 60.96 NA 27.93 8.15 NA 97.04 090
lung.
33940 ................ X Removal of donor heart 0.00 0.00 0.00 0.00 0.00 0.00 XXX
33945 ................ R Transplantation of 42.10 NA 21.67 5.42 NA 69.19 090
heart.
33960 ................ A External circulation 19.36 NA 6.06 2.14 NA 27.56 000
assist.
33961 ................ A External circulation 10.93 NA 3.79 1.47 NA 16.19 ZZZ
assist.
33967 ................ A Insert ia percut 4.85 2.01 1.96 0.27 7.13 7.08 000
device.
33968 ................ A Remove aortic assist 0.64 NA 0.24 0.07 NA 0.95 000
device.
33970 ................ A Aortic circulation 6.75 NA 2.37 0.70 NA 9.82 000
assist.
33971 ................ A Aortic circulation 9.69 NA 7.82 0.97 NA 18.48 090
assist.
33973 ................ A Insert balloon device. 9.76 NA 3.44 1.01 NA 14.21 000
33974 ................ A Remove intra-aortic 14.41 NA 10.69 1.48 NA 26.58 090
balloon.
33975 ................ A Implant ventricular 21.00 NA 7.04 1.72 NA 29.76 XXX
device.
33976 ................ A Implant ventricular 23.00 NA 7.78 2.82 NA 33.60 XXX
device.
33977 ................ A Remove ventricular 19.29 NA 10.46 2.44 NA 32.19 090
device.
33978 ................ A Remove ventricular 21.73 NA 11.27 2.66 NA 35.66 090
device.
33979 ................ C Insert intracorporeal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
device.
33980 ................ C Remove intracorporeal 0.00 0.00 0.00 0.00 0.00 0.00 090
device.
33999 ................ C Cardiac surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
34001 ................ A Removal of artery clot 12.91 NA 5.97 1.46 NA 20.34 090
34051 ................ A Removal of artery clot 15.21 NA 7.07 1.90 NA 24.18 090
34101 ................ A Removal of artery clot 10.00 NA 4.84 1.11 NA 15.95 090
34111 ................ A Removal of arm artery 10.00 NA 4.88 0.85 NA 15.73 090
clot.
34151 ................ A Removal of artery clot 25.00 NA 10.54 1.84 NA 37.38 090
34201 ................ A Removal of artery clot 10.03 NA 5.12 1.02 NA 16.17 090
34203 ................ A Removal of leg artery 16.50 NA 7.65 1.37 NA 25.52 090
clot.
34401 ................ A Removal of vein clot.. 25.00 NA 10.47 1.20 NA 36.67 090
34421 ................ A Removal of vein clot.. 12.00 NA 6.01 0.95 NA 18.96 090
34451 ................ A Removal of vein clot.. 27.00 NA 11.08 1.59 NA 39.67 090
34471 ................ A Removal of vein clot.. 10.18 NA 5.18 0.90 NA 16.26 090
34490 ................ A Removal of vein clot.. 9.86 NA 6.26 0.73 NA 16.85 090
34501 ................ A Repair valve, femoral 16.00 NA 8.98 1.37 NA 26.35 090
vein.
34502 ................ A Reconstruct vena cava. 26.95 NA 11.34 2.99 NA 41.28 090
34510 ................ A Transposition of vein 18.95 NA 10.23 1.60 NA 30.78 090
valve.
34520 ................ A Cross-over vein graft. 17.95 NA 9.59 1.41 NA 28.95 090
34530 ................ A Leg vein fusion....... 16.64 NA 8.48 2.06 NA 27.18 090
34800 ................ A Endovasc abdo repair w/ 20.75 NA 9.79 1.49 NA 32.03 090
tube.
34802 ................ A Endovasc abdo repr w/ 23.00 NA 10.69 1.65 NA 35.34 090
device.
34804 ................ A Endovasc abdo repr w/ 23.00 NA 10.69 1.65 NA 35.34 090
device.
34808 ................ A Endovasc abdo occlud 4.13 NA 1.65 0.29 NA 6.07 ZZZ
device.
34812 ................ A Xpose for endoprosth, 6.75 NA 2.69 0.49 NA 9.93 000
aortic.
34813 ................ A Xpose for endoprosth, 4.80 NA 1.92 0.34 NA 7.06 ZZZ
femorl.
34820 ................ A Xpose for endoprosth, 9.75 NA 3.89 0.70 NA 14.34 000
iliac.
34825 ................ A Endovasc extend 12.00 NA 6.30 0.86 NA 19.16 090
prosth, init.
34826 ................ A Endovasc exten prosth, 4.13 NA 1.65 0.29 NA 6.07 ZZZ
addl.
34830 ................ A Open aortic tube 32.59 NA 14.89 2.34 NA 49.82 090
prosth repr.
34831 ................ A Open aortoiliac prosth 35.34 NA 15.99 2.53 NA 53.86 090
repr.
34832 ................ A Open aortofemor prosth 35.34 NA 15.99 2.53 NA 53.86 090
repr.
35001 ................ A Repair defect of 19.64 NA 8.41 2.44 NA 30.49 090
artery.
35002 ................ A Repair artery rupture, 21.00 NA 9.12 1.82 NA 31.94 090
neck.
35005 ................ A Repair defect of 18.12 NA 8.04 1.35 NA 27.51 090
artery.
35011 ................ A Repair defect of 18.00 NA 7.59 1.30 NA 26.89 090
artery.
35013 ................ A Repair artery rupture, 22.00 NA 8.98 1.91 NA 32.89 090
arm.
35021 ................ A Repair defect of 19.65 NA 8.64 1.93 NA 30.22 090
artery.
35022 ................ A Repair artery rupture, 23.18 NA 9.57 1.99 NA 34.74 090
chest.
35045 ................ A Repair defect of arm 17.57 NA 7.99 1.25 NA 26.81 090
artery.
35081 ................ A Repair defect of 28.01 NA 11.69 3.20 NA 42.90 090
artery.
35082 ................ A Repair artery rupture, 38.50 NA 15.08 4.07 NA 57.65 090
aorta.
35091 ................ A Repair defect of 35.40 NA 14.22 4.09 NA 53.71 090
artery.
35092 ................ A Repair artery rupture, 45.00 NA 17.35 4.31 NA 66.66 090
aorta.
[[Page 55368]]
35102 ................ A Repair defect of 30.76 NA 12.67 3.44 NA 46.87 090
artery.
35103 ................ A Repair artery rupture, 40.50 NA 15.81 3.79 NA 60.10 090
groin.
35111 ................ A Repair defect of 25.00 NA 10.43 1.81 NA 37.24 090
artery.
35112 ................ A Repair artery 30.00 NA 12.06 1.95 NA 44.01 090
rupture,spleen.
35121 ................ A Repair defect of 30.00 NA 12.39 2.93 NA 45.32 090
artery.
35122 ................ A Repair artery rupture, 35.00 NA 13.73 3.54 NA 52.27 090
belly.
35131 ................ A Repair defect of 25.00 NA 10.64 2.11 NA 37.75 090
artery.
35132 ................ A Repair artery rupture, 30.00 NA 12.14 2.48 NA 44.62 090
groin.
35141 ................ A Repair defect of 20.00 NA 8.66 1.65 NA 30.31 090
artery.
35142 ................ A Repair artery rupture, 23.30 NA 9.76 1.75 NA 34.81 090
thigh.
35151 ................ A Repair defect of 22.64 NA 9.72 1.93 NA 34.29 090
artery.
35152 ................ A Repair artery rupture, 25.62 NA 10.50 1.93 NA 38.05 090
knee.
35161 ................ A Repair defect of 18.76 NA 8.96 2.21 NA 29.93 090
artery.
35162 ................ A Repair artery rupture. 19.78 NA 9.05 2.21 NA 31.04 090
35180 ................ A Repair blood vessel 13.62 NA 6.49 1.44 NA 21.55 090
lesion.
35182 ................ A Repair blood vessel 30.00 NA 12.39 1.88 NA 44.27 090
lesion.
35184 ................ A Repair blood vessel 18.00 NA 7.92 1.34 NA 27.26 090
lesion.
35188 ................ A Repair blood vessel 14.28 NA 6.70 1.53 NA 22.51 090
lesion.
35189 ................ A Repair blood vessel 28.00 NA 11.71 2.12 NA 41.83 090
lesion.
35190 ................ A Repair blood vessel 12.75 NA 6.03 1.33 NA 20.11 090
lesion.
35201 ................ A Repair blood vessel 16.14 NA 7.18 1.17 NA 24.49 090
lesion.
35206 ................ A Repair blood vessel 13.25 NA 7.60 1.04 NA 21.89 090
lesion.
35207 ................ A Repair blood vessel 10.15 NA 9.91 1.15 NA 21.21 090
lesion.
35211 ................ A Repair blood vessel 22.12 NA 13.55 2.83 NA 38.50 090
lesion.
35216 ................ A Repair blood vessel 18.75 NA 11.83 2.17 NA 32.75 090
lesion.
35221 ................ A Repair blood vessel 24.39 NA 10.31 1.79 NA 36.49 090
lesion.
35226 ................ A Repair blood vessel 14.50 NA 8.54 0.84 NA 23.88 090
lesion.
35231 ................ A Repair blood vessel 20.00 NA 9.45 1.32 NA 30.77 090
lesion.
35236 ................ A Repair blood vessel 17.11 NA 8.97 1.19 NA 27.27 090
lesion.
35241 ................ A Repair blood vessel 23.12 NA 14.09 2.90 NA 40.11 090
lesion.
35246 ................ A Repair blood vessel 26.45 NA 14.32 2.22 NA 42.99 090
lesion.
35251 ................ A Repair blood vessel 30.20 NA 12.39 1.87 NA 44.46 090
lesion.
35256 ................ A Repair blood vessel 18.36 NA 9.63 1.32 NA 29.31 090
lesion.
35261 ................ A Repair blood vessel 17.80 NA 7.56 1.34 NA 26.70 090
lesion.
35266 ................ A Repair blood vessel 14.91 NA 8.12 1.16 NA 24.19 090
lesion.
35271 ................ A Repair blood vessel 22.12 NA 13.43 2.77 NA 38.32 090
lesion.
35276 ................ A Repair blood vessel 24.25 NA 13.56 2.37 NA 40.18 090
lesion.
35281 ................ A Repair blood vessel 28.00 NA 11.66 1.82 NA 41.48 090
lesion.
35286 ................ A Repair blood vessel 16.16 NA 8.88 1.36 NA 26.40 090
lesion.
35301 ................ A Rechanneling of artery 18.70 NA 8.39 2.23 NA 29.32 090
35311 ................ A Rechanneling of artery 27.00 NA 11.10 2.75 NA 40.85 090
35321 ................ A Rechanneling of artery 16.00 NA 6.87 1.36 NA 24.23 090
35331 ................ A Rechanneling of artery 26.20 NA 11.11 2.71 NA 40.02 090
35341 ................ A Rechanneling of artery 25.11 NA 10.70 2.87 NA 38.68 090
35351 ................ A Rechanneling of artery 23.00 NA 9.84 2.29 NA 35.13 090
35355 ................ A Rechanneling of artery 18.50 NA 8.33 1.80 NA 28.63 090
35361 ................ A Rechanneling of artery 28.20 NA 11.60 2.66 NA 42.46 090
35363 ................ A Rechanneling of artery 30.20 NA 12.54 2.77 NA 45.51 090
35371 ................ A Rechanneling of artery 14.72 NA 6.75 1.32 NA 22.79 090
35372 ................ A Rechanneling of artery 18.00 NA 7.91 1.53 NA 27.44 090
35381 ................ A Rechanneling of artery 15.81 NA 7.35 1.80 NA 24.96 090
35390 ................ A Reoperation, carotid 3.19 NA 1.11 0.38 NA 4.68 ZZZ
add-on.
35400 ................ A Angioscopy............ 3.00 NA 1.05 0.34 NA 4.39 ZZZ
35450 ................ A Repair arterial 10.07 NA 4.22 0.84 NA 15.13 000
blockage.
35452 ................ A Repair arterial 6.91 NA 3.11 0.76 NA 10.78 000
blockage.
35454 ................ A Repair arterial 6.04 NA 2.83 0.67 NA 9.54 000
blockage.
35456 ................ A Repair arterial 7.35 NA 3.27 0.82 NA 11.44 000
blockage.
35458 ................ A Repair arterial 9.49 NA 4.03 1.09 NA 14.61 000
blockage.
35459 ................ A Repair arterial 8.63 NA 3.69 0.96 NA 13.28 000
blockage.
35460 ................ A Repair venous blockage 6.04 NA 2.70 0.66 NA 9.40 000
35470 ................ A Repair arterial 8.63 NA 3.98 0.50 NA 13.11 000
blockage.
35471 ................ A Repair arterial 10.07 NA 4.67 0.50 NA 15.24 000
blockage.
35472 ................ A Repair arterial 6.91 NA 3.32 0.39 NA 10.62 000
blockage.
35473 ................ A Repair arterial 6.04 NA 3.01 0.34 NA 9.39 000
blockage.
35474 ................ A Repair arterial 7.36 NA 3.52 0.40 NA 11.28 000
blockage.
35475 ................ R Repair arterial 9.49 NA 4.23 0.47 NA 14.19 000
blockage.
35476 ................ A Repair venous blockage 6.04 NA 2.94 0.27 NA 9.25 000
35480 ................ A Atherectomy, open..... 11.08 NA 4.58 1.13 NA 16.79 000
35481 ................ A Atherectomy, open..... 7.61 NA 3.54 0.84 NA 11.99 000
35482 ................ A Atherectomy, open..... 6.65 NA 3.16 0.75 NA 10.56 000
35483 ................ A Atherectomy, open..... 8.10 NA 3.52 0.81 NA 12.43 000
35484 ................ A Atherectomy, open..... 10.44 NA 4.21 1.13 NA 15.78 000
35485 ................ A Atherectomy, open..... 9.49 NA 4.05 1.06 NA 14.60 000
[[Page 55369]]
35490 ................ A Atherectomy, 11.08 NA 4.83 0.55 NA 16.46 000
percutaneous.
35491 ................ A Atherectomy, 7.61 NA 3.59 0.49 NA 11.69 000
percutaneous.
35492 ................ A Atherectomy, 6.65 NA 3.22 0.43 NA 10.30 000
percutaneous.
35493 ................ A Atherectomy, 8.10 NA 3.90 0.47 NA 12.47 000
percutaneous.
35494 ................ A Atherectomy, 10.44 NA 4.57 0.48 NA 15.49 000
percutaneous.
35495 ................ A Atherectomy, 9.49 NA 4.52 0.51 NA 14.52 000
percutaneous.
35500 ................ A Harvest vein for 6.45 NA 2.25 0.63 NA 9.33 ZZZ
bypass.
35501 ................ A Artery bypass graft... 19.19 NA 8.14 2.33 NA 29.66 090
35506 ................ A Artery bypass graft... 19.67 NA 8.32 2.33 NA 30.32 090
35507 ................ A Artery bypass graft... 19.67 NA 8.29 2.27 NA 30.23 090
35508 ................ A Artery bypass graft... 18.65 NA 7.91 2.34 NA 28.90 090
35509 ................ A Artery bypass graft... 18.07 NA 7.70 2.12 NA 27.89 090
35511 ................ A Artery bypass graft... 21.20 NA 8.80 1.74 NA 31.74 090
35515 ................ A Artery bypass graft... 18.65 NA 7.80 2.26 NA 28.71 090
35516 ................ A Artery bypass graft... 16.32 NA 4.94 1.88 NA 23.14 090
35518 ................ A Artery bypass graft... 21.20 NA 8.80 1.78 NA 31.78 090
35521 ................ A Artery bypass graft... 22.20 NA 9.53 1.82 NA 33.55 090
35526 ................ A Artery bypass graft... 29.95 NA 12.19 2.18 NA 44.32 090
35531 ................ A Artery bypass graft... 36.20 NA 14.53 2.91 NA 53.64 090
35533 ................ A Artery bypass graft... 28.00 NA 11.74 2.35 NA 42.09 090
35536 ................ A Artery bypass graft... 31.70 NA 12.85 2.62 NA 47.17 090
35541 ................ A Artery bypass graft... 25.80 NA 10.98 2.74 NA 39.52 090
35546 ................ A Artery bypass graft... 25.54 NA 10.75 2.84 NA 39.13 090
35548 ................ A Artery bypass graft... 21.57 NA 9.45 2.45 NA 33.47 090
35549 ................ A Artery bypass graft... 23.35 NA 9.88 2.77 NA 36.00 090
35551 ................ A Artery bypass graft... 26.67 NA 11.20 3.19 NA 41.06 090
35556 ................ A Artery bypass graft... 21.76 NA 9.45 2.48 NA 33.69 090
35558 ................ A Artery bypass graft... 21.20 NA 9.11 1.58 NA 31.89 090
35560 ................ A Artery bypass graft... 32.00 NA 13.12 2.73 NA 47.85 090
35563 ................ A Artery bypass graft... 24.20 NA 10.42 1.68 NA 36.30 090
35565 ................ A Artery bypass graft... 23.20 NA 9.99 1.71 NA 34.90 090
35566 ................ A Artery bypass graft... 26.92 NA 11.77 3.02 NA 41.71 090
35571 ................ A Artery bypass graft... 24.06 NA 12.13 2.14 NA 38.33 090
35582 ................ A Vein bypass graft..... 27.13 NA 11.35 3.11 NA 41.59 090
35583 ................ A Vein bypass graft..... 22.37 NA 10.62 2.53 NA 35.52 090
35585 ................ A Vein bypass graft..... 28.39 NA 14.53 3.21 NA 46.13 090
35587 ................ A Vein bypass graft..... 24.75 NA 12.79 2.17 NA 39.71 090
35600 ................ A Harvest artery for 4.95 NA 1.98 0.60 NA 7.53 ZZZ
cabg.
35601 ................ A Artery bypass graft... 17.50 NA 7.49 2.08 NA 27.07 090
35606 ................ A Artery bypass graft... 18.71 NA 7.93 2.17 NA 28.81 090
35612 ................ A Artery bypass graft... 15.76 NA 6.70 1.72 NA 24.18 090
35616 ................ A Artery bypass graft... 15.70 NA 7.05 1.84 NA 24.59 090
35621 ................ A Artery bypass graft... 20.00 NA 8.79 1.68 NA 30.47 090
35623 ................ A Bypass graft, not vein 24.00 NA 10.22 1.91 NA 36.13 090
35626 ................ A Artery bypass graft... 27.75 NA 11.08 2.89 NA 41.72 090
35631 ................ A Artery bypass graft... 34.00 NA 13.74 2.83 NA 50.57 090
35636 ................ A Artery bypass graft... 29.50 NA 12.26 2.37 NA 44.13 090
35641 ................ A Artery bypass graft... 24.57 NA 10.47 2.83 NA 37.87 090
35642 ................ A Artery bypass graft... 17.98 NA 7.92 1.84 NA 27.74 090
35645 ................ A Artery bypass graft... 17.47 NA 8.36 1.91 NA 27.74 090
35646 ................ A Artery bypass graft... 31.00 NA 13.26 2.98 NA 47.24 090
35647 ................ A Artery bypass graft... 28.00 NA 11.97 2.98 NA 42.95 090
35650 ................ A Artery bypass graft... 19.00 NA 7.93 1.64 NA 28.57 090
35651 ................ A Artery bypass graft... 25.04 NA 10.70 2.53 NA 38.27 090
35654 ................ A Artery bypass graft... 25.00 NA 10.60 2.10 NA 37.70 090
35656 ................ A Artery bypass graft... 19.53 NA 8.44 2.21 NA 30.18 090
35661 ................ A Artery bypass graft... 19.00 NA 8.26 1.50 NA 28.76 090
35663 ................ A Artery bypass graft... 22.00 NA 9.65 1.55 NA 33.20 090
35665 ................ A Artery bypass graft... 21.00 NA 9.18 1.76 NA 31.94 090
35666 ................ A Artery bypass graft... 22.19 NA 11.93 2.19 NA 36.31 090
35671 ................ A Artery bypass graft... 19.33 NA 10.53 1.68 NA 31.54 090
35681 ................ A Composite bypass graft 1.60 NA 0.56 0.18 NA 2.34 ZZZ
35682 ................ A Composite bypass graft 7.20 NA 2.51 0.83 NA 10.54 ZZZ
35683 ................ A Composite bypass graft 8.50 NA 2.99 0.98 NA 12.47 ZZZ
35685 ................ A Bypass graft patency/ 4.05 NA 1.50 0.41 NA 5.96 ZZZ
patch.
35686 ................ A Bypass graft/av fist 3.35 NA 1.24 0.34 NA 4.93 ZZZ
patency.
35691 ................ A Arterial transposition 18.05 NA 7.65 2.06 NA 27.76 090
35693 ................ A Arterial transposition 15.36 NA 6.66 1.80 NA 23.82 090
35694 ................ A Arterial transposition 19.16 NA 8.02 2.13 NA 29.31 090
35695 ................ A Arterial transposition 19.16 NA 7.92 2.19 NA 29.27 090
35700 ................ A Reoperation, bypass 3.08 NA 1.07 0.36 NA 4.51 ZZZ
graft.
35701 ................ A Exploration, carotid 8.50 NA 4.70 0.64 NA 13.84 090
artery.
35721 ................ A Exploration, femoral 7.18 NA 5.10 0.59 NA 12.87 090
artery.
[[Page 55370]]
35741 ................ A Exploration popliteal 8.00 NA 5.47 0.60 NA 14.07 090
artery.
35761 ................ A Exploration of artery/ 5.37 NA 4.47 0.60 NA 10.44 090
vein.
35800 ................ A Explore neck vessels.. 7.02 NA 3.95 0.79 NA 11.76 090
35820 ................ A Explore chest vessels. 12.88 NA 4.32 1.61 NA 18.81 090
35840 ................ A Explore abdominal 9.77 NA 5.21 1.06 NA 16.04 090
vessels.
35860 ................ A Explore limb vessels.. 5.55 NA 3.62 0.63 NA 9.80 090
35870 ................ A Repair vessel graft 22.17 NA 10.21 2.47 NA 34.85 090
defect.
35875 ................ A Removal of clot in 10.13 NA 6.63 0.97 NA 17.73 090
graft.
35876 ................ A Removal of clot in 17.00 NA 9.16 1.88 NA 28.04 090
graft.
35879 ................ A Revise graft w/vein... 16.00 NA 7.77 1.35 NA 25.12 090
35881 ................ A Revise graft w/vein... 18.00 NA 8.65 1.44 NA 28.09 090
35901 ................ A Excision, graft, neck. 8.19 NA 5.85 0.90 NA 14.94 090
35903 ................ A Excision, graft, 9.39 NA 8.20 1.03 NA 18.62 090
extremity.
35905 ................ A Excision, graft, 31.25 NA 15.39 2.15 NA 48.79 090
thorax.
35907 ................ A Excision, graft, 35.00 NA 14.97 2.17 NA 52.14 090
abdomen.
36000 ................ A Place needle in vein.. 0.18 0.65 0.05 0.01 0.84 0.24 XXX
36002 ................ A Pseudoaneurysm 1.96 2.95 1.03 0.08 4.99 3.07 000
injection trt.
36005 ................ A Injection ext 0.95 7.29 0.34 0.04 8.28 1.33 000
venography.
36010 ................ A Place catheter in vein 2.43 NA 0.84 0.16 NA 3.43 XXX
36011 ................ A Place catheter in vein 3.14 NA 1.10 0.17 NA 4.41 XXX
36012 ................ A Place catheter in vein 3.52 NA 1.23 0.17 NA 4.92 XXX
36013 ................ A Place catheter in 2.52 NA 0.61 0.17 NA 3.30 XXX
artery.
36014 ................ A Place catheter in 3.02 NA 1.06 0.14 NA 4.22 XXX
artery.
36015 ................ A Place catheter in 3.52 NA 1.24 0.16 NA 4.92 XXX
artery.
36100 ................ A Establish access to 3.02 NA 1.16 0.18 NA 4.36 XXX
artery.
36120 ................ A Establish access to 2.01 NA 0.69 0.11 NA 2.81 XXX
artery.
36140 ................ A Establish access to 2.01 NA 0.69 0.12 NA 2.82 XXX
artery.
36145 ................ A Artery to vein shunt.. 2.01 NA 0.70 0.10 NA 2.81 XXX
36160 ................ A Establish access to 2.52 NA 0.90 0.20 NA 3.62 XXX
aorta.
36200 ................ A Place catheter in 3.02 NA 1.09 0.15 NA 4.26 XXX
aorta.
36215 ................ A Place catheter in 4.68 NA 1.68 0.22 NA 6.58 XXX
artery.
36216 ................ A Place catheter in 5.28 NA 1.89 0.24 NA 7.41 XXX
artery.
36217 ................ A Place catheter in 6.30 NA 2.29 0.32 NA 8.91 XXX
artery.
36218 ................ A Place catheter in 1.01 NA 0.37 0.05 NA 1.43 ZZZ
artery.
36245 ................ A Place catheter in 4.68 NA 1.78 0.23 NA 6.69 XXX
artery.
36246 ................ A Place catheter in 5.28 NA 1.91 0.26 NA 7.45 XXX
artery.
36247 ................ A Place catheter in 6.30 NA 2.25 0.32 NA 8.87 XXX
artery.
36248 ................ A Place catheter in 1.01 NA 0.37 0.06 NA 1.44 ZZZ
artery.
36260 ................ A Insertion of infusion 9.71 NA 5.63 1.00 NA 16.34 090
pump.
36261 ................ A Revision of infusion 5.45 NA 3.47 0.50 NA 9.42 090
pump.
36262 ................ A Removal of infusion 4.02 NA 2.59 0.43 NA 7.04 090
pump.
36299 ................ C Vessel injection 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
36400 ................ A Drawing blood......... 0.38 0.72 0.10 0.01 1.11 0.49 XXX
36405 ................ A Drawing blood......... 0.31 0.58 0.09 0.01 0.90 0.41 XXX
36406 ................ A Drawing blood......... 0.18 0.94 0.06 0.01 1.13 0.25 XXX
36410 ................ A Drawing blood......... 0.18 0.50 0.05 0.01 0.69 0.24 XXX
36415 ................ I Drawing blood......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
36420 ................ A Establish access to 1.01 NA 0.33 0.09 NA 1.43 XXX
vein.
36425 ................ A Establish access to 0.76 3.44 0.17 0.05 4.25 0.98 XXX
vein.
36430 ................ A Blood transfusion 0.00 0.95 NA 0.05 1.00 NA XXX
service.
36440 ................ A Blood transfusion 1.03 NA 0.31 0.08 NA 1.42 XXX
service.
36450 ................ A Exchange transfusion 2.23 NA 0.71 0.16 NA 3.10 XXX
service.
36455 ................ A Exchange transfusion 2.43 NA 0.97 0.10 NA 3.50 XXX
service.
36460 ................ A Transfusion service, 6.59 NA 2.55 0.56 NA 9.70 XXX
fetal.
36468 ................ R Injection(s), spider 0.00 0.00 0.00 0.00 0.00 0.00 000
veins.
36469 ................ R Injection(s), spider 0.00 0.00 0.00 0.00 0.00 0.00 000
veins.
36470 ................ A Injection therapy of 1.09 2.60 0.40 0.10 3.79 1.59 010
vein.
36471 ................ A Injection therapy of 1.57 2.65 0.58 0.15 4.37 2.30 010
veins.
36481 ................ A Insertion of catheter, 6.99 NA 2.86 0.40 NA 10.25 000
vein.
36488 ................ A Insertion of catheter, 1.35 NA 0.76 0.09 NA 2.20 000
vein.
36489 ................ A Insertion of catheter, 2.50 4.70 1.08 0.08 7.28 3.66 000
vein.
36490 ................ A Insertion of catheter, 1.67 NA 0.86 0.17 NA 2.70 000
vein.
36491 ................ A Insertion of catheter, 1.43 NA 0.75 0.13 NA 2.31 000
vein.
36493 ................ A Repositioning of cvc.. 1.21 NA 0.88 0.06 NA 2.15 000
36500 ................ A Insertion of catheter, 3.52 NA 1.31 0.14 NA 4.97 000
vein.
36510 ................ A Insertion of catheter, 1.09 NA 0.73 0.06 NA 1.88 000
vein.
36520 ................ A Plasma and/or cell 1.74 NA 1.07 0.06 NA 2.87 000
exchange.
36521 ................ A Apheresis w/ adsorp/ 1.74 NA 1.07 0.06 NA 2.87 000
reinfuse.
36522 ................ A Photopheresis......... 1.67 6.03 1.16 0.07 7.77 2.90 000
36530 ................ R Insertion of infusion 6.20 NA 4.17 0.56 NA 10.93 010
pump.
36531 ................ R Revision of infusion 4.87 NA 3.32 0.44 NA 8.63 010
pump.
36532 ................ R Removal of infusion 3.30 NA 1.57 0.34 NA 5.21 010
pump.
36533 ................ A Insertion of access 5.32 4.67 3.50 0.49 10.48 9.31 010
device.
[[Page 55371]]
36534 ................ A Revision of access 2.80 NA 1.55 0.19 NA 4.54 010
device.
36535 ................ A Removal of access 2.27 2.95 1.89 0.21 5.43 4.37 010
device.
36540 ................ B Collect blood venous 0.00 0.00 0.00 0.00 0.00 0.00 XXX
device.
36550 ................ A Declot vascular device 0.00 0.38 NA 0.31 0.69 NA XXX
36600 ................ A Withdrawal of arterial 0.32 0.43 0.09 0.02 0.77 0.43 XXX
blood.
36620 ................ A Insertion catheter, 1.15 NA 0.25 0.06 NA 1.46 000
artery.
36625 ................ A Insertion catheter, 2.11 NA 0.61 0.16 NA 2.88 000
artery.
36640 ................ A Insertion catheter, 2.10 NA 0.75 0.18 NA 3.03 000
artery.
36660 ................ A Insertion catheter, 1.40 NA 0.38 0.08 NA 1.86 000
artery.
36680 ................ A Insert needle, bone 1.20 NA 0.66 0.08 NA 1.94 000
cavity.
36800 ................ A Insertion of cannula.. 2.43 NA 1.59 0.17 NA 4.19 000
36810 ................ A Insertion of cannula.. 3.97 NA 2.22 0.40 NA 6.59 000
36815 ................ A Insertion of cannula.. 2.62 NA 1.28 0.26 NA 4.16 000
36819 ................ A Av fusion/uppr arm 14.00 NA 6.56 1.53 NA 22.09 090
vein.
36820 ................ A Av fusion/forearm vein 14.00 NA 6.56 1.53 NA 22.09 090
36821 ................ A Av fusion direct any 8.93 NA 5.03 0.97 NA 14.93 090
site.
36822 ................ A Insertion of 5.42 NA 6.81 0.63 NA 12.86 090
cannula(s).
36823 ................ A Insertion of 21.00 NA 10.63 2.18 NA 33.81 090
cannula(s).
36825 ................ A Artery-vein graft..... 9.84 NA 5.58 1.09 NA 16.51 090
36830 ................ A Artery-vein graft..... 12.00 NA 6.14 1.32 NA 19.46 090
36831 ................ A Open thrombect av 8.00 NA 3.99 0.79 NA 12.78 090
fistula.
36832 ................ A Av fistula revision, 10.50 NA 5.59 1.13 NA 17.22 090
open.
36833 ................ A Av fistula revision... 11.95 NA 6.11 1.29 NA 19.35 090
36834 ................ A Repair A-V aneurysm... 9.93 NA 3.93 1.06 NA 14.92 090
36835 ................ A Artery to vein shunt.. 7.15 NA 4.50 0.80 NA 12.45 090
36860 ................ A External cannula 2.01 2.52 1.33 0.10 4.63 3.44 000
declotting.
36861 ................ A Cannula declotting.... 2.52 NA 1.50 0.14 NA 4.16 000
36870 ................ A Percut thrombect av 5.16 41.63 2.45 0.23 47.02 7.84 090
fistula.
37140 ................ A Revision of 23.60 NA 10.56 1.21 NA 35.37 090
circulation.
37145 ................ A Revision of 24.61 NA 12.97 2.48 NA 40.06 090
circulation.
37160 ................ A Revision of 21.60 NA 9.43 2.16 NA 33.19 090
circulation.
37180 ................ A Revision of 24.61 NA 10.66 2.63 NA 37.90 090
circulation.
37181 ................ A Splice spleen/kidney 26.68 NA 11.02 2.67 NA 40.37 090
veins.
37195 ................ A Thrombolytic therapy, 0.00 7.65 NA 0.38 8.03 NA XXX
stroke.
37200 ................ A Transcatheter biopsy.. 4.56 NA 1.60 0.19 NA 6.35 000
37201 ................ A Transcatheter therapy 5.00 NA 2.59 0.24 NA 7.83 000
infuse.
37202 ................ A Transcatheter therapy 5.68 NA 3.33 0.38 NA 9.39 000
infuse.
37203 ................ A Transcatheter 5.03 NA 2.62 0.23 NA 7.88 000
retrieval.
37204 ................ A Transcatheter 18.14 NA 6.36 0.85 NA 25.35 000
occlusion.
37205 ................ A Transcatheter stent... 8.28 NA 3.90 0.43 NA 12.61 000
37206 ................ A Transcatheter stent 4.13 NA 1.54 0.22 NA 5.89 ZZZ
add-on.
37207 ................ A Transcatheter stent... 8.28 NA 3.61 0.89 NA 12.78 000
37208 ................ A Transcatheter stent 4.13 NA 1.45 0.44 NA 6.02 ZZZ
add-on.
37209 ................ A Exchange arterial 2.27 NA 0.80 0.11 NA 3.18 000
catheter.
37250 ................ A Iv us first vessel add- 2.10 NA 0.79 0.17 NA 3.06 ZZZ
on.
37251 ................ A Iv us each add vessel 1.60 NA 0.58 0.14 NA 2.32 ZZZ
add-on.
37565 ................ A Ligation of neck vein. 10.88 NA 5.34 0.45 NA 16.67 090
37600 ................ A Ligation of neck 11.25 NA 6.51 0.40 NA 18.16 090
artery.
37605 ................ A Ligation of neck 13.11 NA 6.63 0.77 NA 20.51 090
artery.
37606 ................ A Ligation of neck 6.28 NA 3.85 0.79 NA 10.92 090
artery.
37607 ................ A Ligation of a-v 6.16 NA 3.71 0.67 NA 10.54 090
fistula.
37609 ................ A Temporal artery 3.00 7.25 2.58 0.21 10.46 5.79 010
procedure.
37615 ................ A Ligation of neck 5.73 NA 3.61 0.57 NA 9.91 090
artery.
37616 ................ A Ligation of chest 16.49 NA 10.54 1.93 NA 28.96 090
artery.
37617 ................ A Ligation of abdomen 22.06 NA 9.81 1.69 NA 33.56 090
artery.
37618 ................ A Ligation of extremity 4.84 NA 3.56 0.54 NA 8.94 090
artery.
37620 ................ A Revision of major vein 10.56 NA 5.53 0.75 NA 16.84 090
37650 ................ A Revision of major vein 7.80 NA 4.64 0.56 NA 13.00 090
37660 ................ A Revision of major vein 21.00 NA 9.44 1.17 NA 31.61 090
37700 ................ A Revise leg vein....... 3.73 NA 3.20 0.40 NA 7.33 090
37720 ................ A Removal of leg vein... 5.66 NA 3.72 0.61 NA 9.99 090
37730 ................ A Removal of leg veins.. 7.33 NA 4.59 0.77 NA 12.69 090
37735 ................ A Removal of leg veins/ 10.53 NA 5.94 1.17 NA 17.64 090
lesion.
37760 ................ A Revision of leg veins. 10.47 NA 5.78 1.11 NA 17.36 090
37780 ................ A Revision of leg vein.. 3.84 NA 2.89 0.41 NA 7.14 090
37785 ................ A Revise secondary 3.84 7.18 2.91 0.41 11.43 7.16 090
varicosity.
37788 ................ A Revascularization, 22.01 NA 14.08 1.35 NA 37.44 090
penis.
37790 ................ A Penile venous 8.34 NA 6.78 0.63 NA 15.75 090
occlusion.
37799 ................ C Vascular surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
38100 ................ A Removal of spleen, 14.50 NA 6.73 1.30 NA 22.53 090
total.
38101 ................ A Removal of spleen, 15.31 NA 7.27 1.38 NA 23.96 090
partial.
38102 ................ A Removal of spleen, 4.80 NA 1.73 0.49 NA 7.02 ZZZ
total.
38115 ................ A Repair of ruptured 15.82 NA 7.23 1.40 NA 24.45 090
spleen.
[[Page 55372]]
38120 ................ A Laparoscopy, 17.00 NA 7.58 1.73 NA 26.31 090
splenectomy.
38129 ................ C Laparoscope proc, 0.00 0.00 0.00 0.00 0.00 0.00 YYY
spleen.
38200 ................ A Injection for spleen x- 2.64 NA 0.93 0.12 NA 3.69 000
ray.
38220 ................ A Bone marrow aspiration 1.08 4.64 0.44 0.03 5.75 1.55 XXX
38221 ................ A Bone marrow biopsy.... 1.37 4.74 0.56 0.04 6.15 1.97 XXX
38230 ................ R Bone marrow collection 4.54 NA 2.45 0.25 NA 7.24 010
38231 ................ R Stem cell collection.. 1.50 NA 0.61 0.05 NA 2.16 000
38240 ................ R Bone marrow/stem 2.24 NA 0.88 0.08 NA 3.20 XXX
transplant.
38241 ................ R Bone marrow/stem 2.24 NA 0.86 0.08 NA 3.18 XXX
transplant.
38300 ................ A Drainage, lymph node 1.99 4.88 2.65 0.15 7.02 4.79 010
lesion.
38305 ................ A Drainage, lymph node 6.00 7.99 6.41 0.36 14.35 12.77 090
lesion.
38308 ................ A Incision of lymph 6.45 NA 5.40 0.51 NA 12.36 090
channels.
38380 ................ A Thoracic duct 7.46 NA 7.61 0.68 NA 15.75 090
procedure.
38381 ................ A Thoracic duct 12.88 NA 9.72 1.58 NA 24.18 090
procedure.
38382 ................ A Thoracic duct 10.08 NA 8.81 1.08 NA 19.97 090
procedure.
38500 ................ A Biopsy/removal, lymph 3.75 3.15 2.63 0.28 7.18 6.66 010
nodes.
38505 ................ A Needle biopsy, lymph 1.14 3.21 1.13 0.09 4.44 2.36 000
nodes.
38510 ................ A Biopsy/removal, lymph 6.43 NA 5.55 0.38 NA 12.36 010
nodes.
38520 ................ A Biopsy/removal, lymph 6.67 NA 5.67 0.52 NA 12.86 090
nodes.
38525 ................ A Biopsy/removal, lymph 6.07 NA 4.51 0.48 NA 11.06 090
nodes.
38530 ................ A Biopsy/removal, lymph 7.98 NA 5.78 0.63 NA 14.39 090
nodes.
38542 ................ A Explore deep node(s), 5.91 NA 6.09 0.50 NA 12.50 090
neck.
38550 ................ A Removal, neck/armpit 6.92 NA 5.01 0.69 NA 12.62 090
lesion.
38555 ................ A Removal, neck/armpit 14.14 NA 9.47 1.46 NA 25.07 090
lesion.
38562 ................ A Removal, pelvic lymph 10.49 NA 6.79 0.97 NA 18.25 090
nodes.
38564 ................ A Removal, abdomen lymph 10.83 NA 6.54 1.06 NA 18.43 090
nodes.
38570 ................ A Laparoscopy, lymph 9.25 NA 4.63 0.89 NA 14.77 010
node biop.
38571 ................ A Laparoscopy, 14.68 NA 6.50 0.80 NA 21.98 010
lymphadenectomy.
38572 ................ A Laparoscopy, 16.59 NA 7.71 1.32 NA 25.62 010
lymphadenectomy.
38589 ................ C Laparoscope proc, 0.00 0.00 0.00 0.00 0.00 0.00 YYY
lymphatic.
38700 ................ A Removal of lymph 8.24 NA 13.61 0.60 NA 22.45 090
nodes, neck.
38720 ................ A Removal of lymph 13.61 NA 16.25 1.03 NA 30.89 090
nodes, neck.
38724 ................ A Removal of lymph 14.54 NA 16.82 1.10 NA 32.46 090
nodes, neck.
38740 ................ A Remove armpit lymph 10.03 NA 5.89 0.69 NA 16.61 090
nodes.
38745 ................ A Remove armpit lymph 13.10 NA 8.47 0.90 NA 22.47 090
nodes.
38746 ................ A Remove thoracic lymph 4.89 NA 1.65 0.55 NA 7.09 ZZZ
nodes.
38747 ................ A Remove abdominal lymph 4.89 NA 1.75 0.50 NA 7.14 ZZZ
nodes.
38760 ................ A Remove groin lymph 12.95 NA 7.36 0.88 NA 21.19 090
nodes.
38765 ................ A Remove groin lymph 19.98 NA 11.57 1.50 NA 33.05 090
nodes.
38770 ................ A Remove pelvis lymph 13.23 NA 7.18 0.94 NA 21.35 090
nodes.
38780 ................ A Remove abdomen lymph 16.59 NA 9.67 1.60 NA 27.86 090
nodes.
38790 ................ A Inject for lymphatic x- 1.29 14.77 0.46 0.09 16.15 1.84 000
ray.
38792 ................ A Identify sentinel node 0.52 NA 0.19 0.04 NA 0.75 000
38794 ................ A Access thoracic lymph 4.45 NA 1.57 0.17 NA 6.19 090
duct.
38999 ................ C Blood/lymph system 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
39000 ................ A Exploration of chest.. 6.10 NA 7.41 0.73 NA 14.24 090
39010 ................ A Exploration of chest.. 11.79 NA 9.31 1.46 NA 22.56 090
39200 ................ A Removal chest lesion.. 13.62 NA 10.10 1.65 NA 25.37 090
39220 ................ A Removal chest lesion.. 17.42 NA 11.29 2.10 NA 30.81 090
39400 ................ A Visualization of chest 5.61 NA 7.01 0.69 NA 13.31 010
39499 ................ C Chest procedure....... 0.00 0.00 0.00 0.00 0.00 0.00 YYY
39501 ................ A Repair diaphragm 13.19 NA 7.82 1.38 NA 22.39 090
laceration.
39502 ................ A Repair paraesophageal 16.33 NA 8.41 1.68 NA 26.42 090
hernia.
39503 ................ A Repair of diaphragm 95.00 NA 37.24 3.52 NA 135.76 090
hernia.
39520 ................ A Repair of diaphragm 16.10 NA 9.59 1.83 NA 27.52 090
hernia.
39530 ................ A Repair of diaphragm 15.41 NA 8.69 1.66 NA 25.76 090
hernia.
39531 ................ A Repair of diaphragm 16.42 NA 8.45 1.83 NA 26.70 090
hernia.
39540 ................ A Repair of diaphragm 13.32 NA 7.79 1.38 NA 22.49 090
hernia.
39541 ................ A Repair of diaphragm 14.41 NA 7.97 1.52 NA 23.90 090
hernia.
39545 ................ A Revision of diaphragm. 13.37 NA 9.32 1.55 NA 24.24 090
39560 ................ A Resect diaphragm, 12.00 NA 7.62 1.35 NA 20.97 090
simple.
39561 ................ A Resect diaphragm, 17.50 NA 9.84 1.97 NA 29.31 090
complex.
39599 ................ C Diaphragm surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
40490 ................ A Biopsy of lip......... 1.22 1.63 0.63 0.06 2.91 1.91 000
40500 ................ A Partial excision of 4.28 5.72 5.72 0.31 10.31 10.31 090
lip.
40510 ................ A Partial excision of 4.70 6.75 6.52 0.38 11.83 11.60 090
lip.
40520 ................ A Partial excision of 4.67 7.97 7.15 0.42 13.06 12.24 090
lip.
40525 ................ A Reconstruct lip with 7.55 NA 8.84 0.68 NA 17.07 090
flap.
40527 ................ A Reconstruct lip with 9.13 NA 9.60 0.82 NA 19.55 090
flap.
40530 ................ A Partial removal of lip 5.40 7.35 6.56 0.47 13.22 12.43 090
40650 ................ A Repair lip............ 3.64 5.78 5.18 0.31 9.73 9.13 090
40652 ................ A Repair lip............ 4.26 7.08 7.04 0.39 11.73 11.69 090
40654 ................ A Repair lip............ 5.31 7.95 7.95 0.48 13.74 13.74 090
[[Page 55373]]
40700 ................ A Repair cleft lip/nasal 12.79 NA 10.88 0.93 NA 24.60 090
40701 ................ A Repair cleft lip/nasal 15.85 NA 14.66 1.36 NA 31.87 090
40702 ................ A Repair cleft lip/nasal 13.04 NA 8.99 1.01 NA 23.04 090
40720 ................ A Repair cleft lip/nasal 13.55 NA 12.89 1.31 NA 27.75 090
40761 ................ A Repair cleft lip/nasal 14.72 NA 12.76 1.41 NA 28.89 090
40799 ................ C Lip surgery procedure. 0.00 0.00 0.00 0.00 0.00 0.00 YYY
40800 ................ A Drainage of mouth 1.17 2.01 0.48 0.09 3.27 1.74 010
lesion.
40801 ................ A Drainage of mouth 2.53 2.52 1.98 0.18 5.23 4.69 010
lesion.
40804 ................ A Removal, foreign body, 1.24 2.59 2.03 0.09 3.92 3.36 010
mouth.
40805 ................ A Removal, foreign body, 2.69 3.27 2.85 0.17 6.13 5.71 010
mouth.
40806 ................ A Incision of lip fold.. 0.31 0.89 0.89 0.02 1.22 1.22 000
40808 ................ A Biopsy of mouth lesion 0.96 2.11 2.11 0.07 3.14 3.14 010
40810 ................ A Excision of mouth 1.31 2.70 2.47 0.09 4.10 3.87 010
lesion.
40812 ................ A Excise/repair mouth 2.31 2.95 2.93 0.17 5.43 5.41 010
lesion.
40814 ................ A Excise/repair mouth 3.42 4.08 4.08 0.26 7.76 7.76 090
lesion.
40816 ................ A Excision of mouth 3.67 4.32 4.32 0.27 8.26 8.26 090
lesion.
40818 ................ A Excise oral mucosa for 2.41 4.05 4.05 0.14 6.60 6.60 090
graft.
40819 ................ A Excise lip or cheek 2.41 3.67 3.48 0.17 6.25 6.06 090
fold.
40820 ................ A Treatment of mouth 1.28 2.38 2.30 0.08 3.74 3.66 010
lesion.
40830 ................ A Repair mouth 1.76 2.48 2.48 0.14 4.38 4.38 010
laceration.
40831 ................ A Repair mouth 2.46 2.72 2.72 0.21 5.39 5.39 010
laceration.
40840 ................ R Reconstruction of 8.73 5.93 5.93 0.79 15.45 15.45 090
mouth.
40842 ................ R Reconstruction of 8.73 5.90 5.90 0.65 15.28 15.28 090
mouth.
40843 ................ R Reconstruction of 12.10 7.35 7.35 0.84 20.29 20.29 090
mouth.
40844 ................ R Reconstruction of 16.01 9.01 9.01 1.63 26.65 26.65 090
mouth.
40845 ................ R Reconstruction of 18.58 12.25 12.25 1.47 32.30 32.30 090
mouth.
40899 ................ C Mouth surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
41000 ................ A Drainage of mouth 1.30 2.40 1.55 0.09 3.79 2.94 010
lesion.
41005 ................ A Drainage of mouth 1.26 2.33 1.62 0.09 3.68 2.97 010
lesion.
41006 ................ A Drainage of mouth 3.24 3.58 3.28 0.25 7.07 6.77 090
lesion.
41007 ................ A Drainage of mouth 3.10 3.78 3.33 0.22 7.10 6.65 090
lesion.
41008 ................ A Drainage of mouth 3.37 3.69 3.22 0.24 7.30 6.83 090
lesion.
41009 ................ A Drainage of mouth 3.59 3.65 3.42 0.25 7.49 7.26 090
lesion.
41010 ................ A Incision of tongue 1.06 3.57 3.57 0.06 4.69 4.69 010
fold.
41015 ................ A Drainage of mouth 3.96 4.05 3.39 0.29 8.30 7.64 090
lesion.
41016 ................ A Drainage of mouth 4.07 4.31 3.61 0.28 8.66 7.96 090
lesion.
41017 ................ A Drainage of mouth 4.07 4.26 3.46 0.32 8.65 7.85 090
lesion.
41018 ................ A Drainage of mouth 5.10 4.39 3.87 0.35 9.84 9.32 090
lesion.
41100 ................ A Biopsy of tongue...... 1.63 2.67 2.64 0.12 4.42 4.39 010
41105 ................ A Biopsy of tongue...... 1.42 2.42 2.42 0.10 3.94 3.94 010
41108 ................ A Biopsy of floor of 1.05 2.38 2.38 0.08 3.51 3.51 010
mouth.
41110 ................ A Excision of tongue 1.51 3.19 2.63 0.11 4.81 4.25 010
lesion.
41112 ................ A Excision of tongue 2.73 3.56 3.56 0.20 6.49 6.49 090
lesion.
41113 ................ A Excision of tongue 3.19 3.50 3.50 0.23 6.92 6.92 090
lesion.
41114 ................ A Excision of tongue 8.47 NA 6.59 0.64 NA 15.70 090
lesion.
41115 ................ A Excision of tongue 1.74 2.69 2.53 0.13 4.56 4.40 010
fold.
41116 ................ A Excision of mouth 2.44 3.37 3.37 0.17 5.98 5.98 090
lesion.
41120 ................ A Partial removal of 9.77 NA 9.12 0.70 NA 19.59 090
tongue.
41130 ................ A Partial removal of 11.15 NA 9.76 0.81 NA 21.72 090
tongue.
41135 ................ A Tongue and neck 23.09 NA 16.63 1.66 NA 41.38 090
surgery.
41140 ................ A Removal of tongue..... 25.50 NA 17.39 1.85 NA 44.74 090
41145 ................ A Tongue removal, neck 30.06 NA 21.36 2.11 NA 53.53 090
surgery.
41150 ................ A Tongue, mouth, jaw 23.04 NA 17.64 1.67 NA 42.35 090
surgery.
41153 ................ A Tongue, mouth, neck 23.77 NA 18.04 1.71 NA 43.52 090
surgery.
41155 ................ A Tongue, jaw, & neck 27.72 NA 20.44 2.02 NA 50.18 090
surgery.
41250 ................ A Repair tongue 1.91 2.98 1.77 0.15 5.04 3.83 010
laceration.
41251 ................ A Repair tongue 2.27 3.12 1.88 0.18 5.57 4.33 010
laceration.
41252 ................ A Repair tongue 2.97 3.23 2.33 0.23 6.43 5.53 010
laceration.
41500 ................ A Fixation of tongue.... 3.71 NA 4.43 0.26 NA 8.40 090
41510 ................ A Tongue to lip surgery. 3.42 NA 5.39 0.24 NA 9.05 090
41520 ................ A Reconstruction, tongue 2.73 3.06 3.06 0.19 5.98 5.98 090
fold.
41599 ................ C Tongue and mouth 0.00 0.00 0.00 0.00 0.00 0.00 YYY
surgery.
41800 ................ A Drainage of gum lesion 1.17 1.96 1.43 0.09 3.22 2.69 010
41805 ................ A Removal foreign body, 1.24 2.08 2.08 0.09 3.41 3.41 010
gum.
41806 ................ A Removal foreign body, 2.69 2.54 2.54 0.22 5.45 5.45 010
jawbone.
41820 ................ R Excision, gum, each 0.00 0.00 0.00 0.00 0.00 0.00 000
quadrant.
41821 ................ R Excision of gum flap.. 0.00 0.00 0.00 0.00 0.00 0.00 000
41822 ................ R Excision of gum lesion 2.31 2.82 0.98 0.24 5.37 3.53 010
41823 ................ R Excision of gum lesion 3.30 3.54 3.23 0.29 7.13 6.82 090
41825 ................ A Excision of gum lesion 1.31 2.43 2.41 0.10 3.84 3.82 010
41826 ................ A Excision of gum lesion 2.31 2.66 2.66 0.17 5.14 5.14 010
41827 ................ A Excision of gum lesion 3.42 3.63 3.63 0.25 7.30 7.30 090
41828 ................ R Excision of gum lesion 3.09 3.07 2.47 0.22 6.38 5.78 010
[[Page 55374]]
41830 ................ R Removal of gum tissue. 3.35 3.39 2.98 0.23 6.97 6.56 010
41850 ................ R Treatment of gum 0.00 0.00 0.00 0.00 0.00 0.00 000
lesion.
41870 ................ R Gum graft............. 0.00 0.00 0.00 0.00 0.00 0.00 000
41872 ................ R Repair gum............ 2.59 2.93 2.93 0.18 5.70 5.70 090
41874 ................ R Repair tooth socket... 3.09 2.86 2.45 0.23 6.18 5.77 090
41899 ................ C Dental surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
42000 ................ A Drainage mouth roof 1.23 2.52 1.51 0.10 3.85 2.84 010
lesion.
42100 ................ A Biopsy roof of mouth.. 1.31 2.47 2.47 0.10 3.88 3.88 010
42104 ................ A Excision lesion, mouth 1.64 2.58 2.58 0.12 4.34 4.34 010
roof.
42106 ................ A Excision lesion, mouth 2.10 2.66 2.66 0.16 4.92 4.92 010
roof.
42107 ................ A Excision lesion, mouth 4.44 4.26 4.26 0.32 9.02 9.02 090
roof.
42120 ................ A Remove palate/lesion.. 6.17 NA 6.19 0.44 NA 12.80 090
42140 ................ A Excision of uvula..... 1.62 3.91 3.36 0.12 5.65 5.10 090
42145 ................ A Repair palate, pharynx/ 8.05 NA 7.59 0.56 NA 16.20 090
uvula.
42160 ................ A Treatment mouth roof 1.80 3.25 2.72 0.13 5.18 4.65 010
lesion.
42180 ................ A Repair palate......... 2.50 3.29 2.25 0.19 5.98 4.94 010
42182 ................ A Repair palate......... 3.83 3.10 3.10 0.27 7.20 7.20 010
42200 ................ A Reconstruct cleft 12.00 NA 9.78 0.97 NA 22.75 090
palate.
42205 ................ A Reconstruct cleft 13.29 NA 9.76 0.82 NA 23.87 090
palate.
42210 ................ A Reconstruct cleft 14.50 NA 11.47 1.24 NA 27.21 090
palate.
42215 ................ A Reconstruct cleft 8.82 NA 9.72 0.96 NA 19.50 090
palate.
42220 ................ A Reconstruct cleft 7.02 NA 6.85 0.41 NA 14.28 090
palate.
42225 ................ A Reconstruct cleft 9.54 NA 9.16 0.75 NA 19.45 090
palate.
42226 ................ A Lengthening of palate. 10.01 NA 9.96 0.73 NA 20.70 090
42227 ................ A Lengthening of palate. 9.52 NA 9.09 0.70 NA 19.31 090
42235 ................ A Repair palate......... 7.87 NA 5.93 0.49 NA 14.29 090
42260 ................ A Repair nose to lip 9.80 6.43 6.43 0.85 17.08 17.08 090
fistula.
42280 ................ A Preparation, palate 1.54 1.44 0.60 0.12 3.10 2.26 010
mold.
42281 ................ A Insertion, palate 1.93 1.57 0.92 0.14 3.64 2.99 010
prosthesis.
42299 ................ C Palate/uvula surgery.. 0.00 0.00 0.00 0.00 0.00 0.00 YYY
42300 ................ A Drainage of salivary 1.93 2.65 1.98 0.15 4.73 4.06 010
gland.
42305 ................ A Drainage of salivary 6.07 NA 5.38 0.46 NA 11.91 090
gland.
42310 ................ A Drainage of salivary 1.56 2.32 1.82 0.11 3.99 3.49 010
gland.
42320 ................ A Drainage of salivary 2.35 2.79 2.15 0.17 5.31 4.67 010
gland.
42325 ................ A Create salivary cyst 2.75 3.85 1.26 0.17 6.77 4.18 090
drain.
42326 ................ A Create salivary cyst 3.78 3.33 1.51 0.34 7.45 5.63 090
drain.
42330 ................ A Removal of salivary 2.21 2.81 1.20 0.16 5.18 3.57 010
stone.
42335 ................ A Removal of salivary 3.31 3.71 3.71 0.23 7.25 7.25 090
stone.
42340 ................ A Removal of salivary 4.60 5.07 5.07 0.34 10.01 10.01 090
stone.
42400 ................ A Biopsy of salivary 0.78 2.52 0.40 0.06 3.36 1.24 000
gland.
42405 ................ A Biopsy of salivary 3.29 3.44 3.44 0.24 6.97 6.97 010
gland.
42408 ................ A Excision of salivary 4.54 4.71 4.71 0.34 9.59 9.59 090
cyst.
42409 ................ A Drainage of salivary 2.81 3.34 3.34 0.20 6.35 6.35 090
cyst.
42410 ................ A Excise parotid gland/ 9.34 NA 8.20 0.77 NA 18.31 090
lesion.
42415 ................ A Excise parotid gland/ 16.89 NA 12.82 1.26 NA 30.97 090
lesion.
42420 ................ A Excise parotid gland/ 19.59 NA 14.46 1.45 NA 35.50 090
lesion.
42425 ................ A Excise parotid gland/ 13.02 NA 10.70 0.98 NA 24.70 090
lesion.
42426 ................ A Excise parotid gland/ 21.26 NA 15.44 1.57 NA 38.27 090
lesion.
42440 ................ A Excise submaxillary 6.97 NA 6.13 0.51 NA 13.61 090
gland.
42450 ................ A Excise sublingual 4.62 4.38 4.38 0.34 9.34 9.34 090
gland.
42500 ................ A Repair salivary duct.. 4.30 5.14 5.10 0.30 9.74 9.70 090
42505 ................ A Repair salivary duct.. 6.18 6.02 6.02 0.44 12.64 12.64 090
42507 ................ A Parotid duct diversion 6.11 NA 5.44 0.66 NA 12.21 090
42508 ................ A Parotid duct diversion 9.10 NA 8.40 0.64 NA 18.14 090
42509 ................ A Parotid duct diversion 11.54 NA 9.25 1.24 NA 22.03 090
42510 ................ A Parotid duct diversion 8.15 NA 7.27 0.57 NA 15.99 090
42550 ................ A Injection for salivary 1.25 12.45 0.44 0.06 13.76 1.75 000
x-ray.
42600 ................ A Closure of salivary 4.82 7.89 5.61 0.34 13.05 10.77 090
fistula.
42650 ................ A Dilation of salivary 0.77 1.13 0.41 0.06 1.96 1.24 000
duct.
42660 ................ A Dilation of salivary 1.13 1.15 1.15 0.07 2.35 2.35 000
duct.
42665 ................ A Ligation of salivary 2.53 3.03 3.03 0.17 5.73 5.73 090
duct.
42699 ................ C Salivary surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
42700 ................ A Drainage of tonsil 1.62 3.30 1.93 0.12 5.04 3.67 010
abscess.
42720 ................ A Drainage of throat 5.42 4.77 4.77 0.39 10.58 10.58 010
abscess.
42725 ................ A Drainage of throat 10.72 NA 8.70 0.80 NA 20.22 090
abscess.
42800 ................ A Biopsy of throat...... 1.39 3.09 2.63 0.10 4.58 4.12 010
42802 ................ A Biopsy of throat...... 1.54 3.24 2.72 0.11 4.89 4.37 010
42804 ................ A Biopsy of upper nose/ 1.24 3.04 2.56 0.09 4.37 3.89 010
throat.
42806 ................ A Biopsy of upper nose/ 1.58 3.53 2.76 0.12 5.23 4.46 010
throat.
42808 ................ A Excise pharynx lesion. 2.30 5.00 3.17 0.17 7.47 5.64 010
42809 ................ A Remove pharynx foreign 1.81 3.48 1.77 0.13 5.42 3.71 010
body.
42810 ................ A Excision of neck cyst. 3.25 5.66 4.61 0.25 9.16 8.11 090
42815 ................ A Excision of neck cyst. 7.07 NA 6.67 0.53 NA 14.27 090
[[Page 55375]]
42820 ................ A Remove tonsils and 3.91 NA 4.02 0.28 NA 8.21 090
adenoids.
42821 ................ A Remove tonsils and 4.29 NA 4.30 0.30 NA 8.89 090
adenoids.
42825 ................ A Removal of tonsils.... 3.42 NA 3.74 0.24 NA 7.40 090
42826 ................ A Removal of tonsils.... 3.38 NA 3.81 0.23 NA 7.42 090
42830 ................ A Removal of adenoids... 2.57 NA 2.51 0.18 NA 5.26 090
42831 ................ A Removal of adenoids... 2.71 NA 2.59 0.19 NA 5.49 090
42835 ................ A Removal of adenoids... 2.30 NA 3.20 0.17 NA 5.67 090
42836 ................ A Removal of adenoids... 3.18 NA 3.69 0.22 NA 7.09 090
42842 ................ A Extensive surgery of 8.76 NA 7.96 0.61 NA 17.33 090
throat.
42844 ................ A Extensive surgery of 14.31 NA 11.57 1.04 NA 26.92 090
throat.
42845 ................ A Extensive surgery of 24.29 NA 18.00 1.76 NA 44.05 090
throat.
42860 ................ A Excision of tonsil 2.22 NA 3.08 0.16 NA 5.46 090
tags.
42870 ................ A Excision of lingual 5.40 NA 6.18 0.38 NA 11.96 090
tonsil.
42890 ................ A Partial removal of 12.94 NA 11.03 0.91 NA 24.88 090
pharynx.
42892 ................ A Revision of pharyngeal 15.83 NA 12.68 1.14 NA 29.65 090
walls.
42894 ................ A Revision of pharyngeal 22.88 NA 17.38 1.64 NA 41.90 090
walls.
42900 ................ A Repair throat wound... 5.25 NA 3.93 0.39 NA 9.57 010
42950 ................ A Reconstruction of 8.10 NA 7.60 0.58 NA 16.28 090
throat.
42953 ................ A Repair throat, 8.96 NA 9.14 0.73 NA 18.83 090
esophagus.
42955 ................ A Surgical opening of 7.39 NA 6.55 0.63 NA 14.57 090
throat.
42960 ................ A Control throat 2.33 NA 2.13 0.17 NA 4.63 010
bleeding.
42961 ................ A Control throat 5.59 NA 5.30 0.40 NA 11.29 090
bleeding.
42962 ................ A Control throat 7.14 NA 6.35 0.51 NA 14.00 090
bleeding.
42970 ................ A Control nose/throat 5.43 NA 3.99 0.37 NA 9.79 090
bleeding.
42971 ................ A Control nose/throat 6.21 NA 5.99 0.45 NA 12.65 090
bleeding.
42972 ................ A Control nose/throat 7.20 NA 5.73 0.54 NA 13.47 090
bleeding.
42999 ................ C Throat surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
43020 ................ A Incision of esophagus. 8.09 NA 6.77 0.70 NA 15.56 090
43030 ................ A Throat muscle surgery. 7.69 NA 7.00 0.60 NA 15.29 090
43045 ................ A Incision of esophagus. 20.12 NA 11.14 2.15 NA 33.41 090
43100 ................ A Excision of esophagus 9.19 NA 7.58 0.79 NA 17.56 090
lesion.
43101 ................ A Excision of esophagus 16.24 NA 8.84 1.81 NA 26.89 090
lesion.
43107 ................ A Removal of esophagus.. 40.00 NA 18.49 3.29 NA 61.78 090
43108 ................ A Removal of esophagus.. 34.19 NA 16.39 3.78 NA 54.36 090
43112 ................ A Removal of esophagus.. 43.50 NA 20.06 3.67 NA 67.23 090
43113 ................ A Removal of esophagus.. 35.27 NA 16.38 4.33 NA 55.98 090
43116 ................ A Partial removal of 31.22 NA 18.49 2.62 NA 52.33 090
esophagus.
43117 ................ A Partial removal of 40.00 NA 18.51 3.51 NA 62.02 090
esophagus.
43118 ................ A Partial removal of 33.20 NA 15.76 3.56 NA 52.52 090
esophagus.
43121 ................ A Partial removal of 29.19 NA 15.08 3.44 NA 47.71 090
esophagus.
43122 ................ A Parital removal of 40.00 NA 18.05 3.27 NA 61.32 090
esophagus.
43123 ................ A Partial removal of 33.20 NA 15.58 3.96 NA 52.74 090
esophagus.
43124 ................ A Removal of esophagus.. 27.32 NA 15.15 2.95 NA 45.42 090
43130 ................ A Removal of esophagus 11.75 NA 9.05 1.06 NA 21.86 090
pouch.
43135 ................ A Removal of esophagus 16.10 NA 10.09 1.85 NA 28.04 090
pouch.
43200 ................ A Esophagus endoscopy... 1.59 7.92 1.22 0.11 9.62 2.92 000
43202 ................ A Esophagus endoscopy, 1.89 6.46 1.15 0.12 8.47 3.16 000
biopsy.
43204 ................ A Esophagus endoscopy & 3.77 NA 1.71 0.18 NA 5.66 000
inject.
43205 ................ A Esophagus endoscopy/ 3.79 NA 1.71 0.17 NA 5.67 000
ligation.
43215 ................ A Esophagus endoscopy... 2.60 NA 1.26 0.17 NA 4.03 000
43216 ................ A Esophagus endoscopy/ 2.40 NA 1.20 0.15 NA 3.75 000
lesion.
43217 ................ A Esophagus endoscopy... 2.90 NA 1.35 0.17 NA 4.42 000
43219 ................ A Esophagus endoscopy... 2.80 NA 1.43 0.16 NA 4.39 000
43220 ................ A Esoph endoscopy, 2.10 NA 1.14 0.12 NA 3.36 000
dilation.
43226 ................ A Esoph endoscopy, 2.34 NA 1.21 0.12 NA 3.67 000
dilation.
43227 ................ A Esoph endoscopy, 3.60 NA 1.64 0.18 NA 5.42 000
repair.
43228 ................ A Esoph endoscopy, 3.77 NA 1.77 0.25 NA 5.79 000
ablation.
43231 ................ A Esoph endoscopy w/us 3.19 NA 1.60 0.20 NA 4.99 000
exam.
43232 ................ A Esoph endoscopy w/us 4.48 NA 2.15 0.26 NA 6.89 000
fn bx.
43234 ................ A Upper GI endoscopy, 2.01 4.58 1.06 0.13 6.72 3.20 000
exam.
43235 ................ A Uppr GI endoscopy, 2.39 6.38 1.23 0.13 8.90 3.75 000
diagnosis.
43239 ................ A Upper GI endoscopy, 2.87 6.79 1.27 0.14 9.80 4.28 000
biopsy.
43240 ................ A Esoph endoscope w/ 6.86 NA 2.97 0.36 NA 10.19 000
drain cyst.
43241 ................ A Upper GI endoscopy 2.59 NA 1.27 0.14 NA 4.00 000
with tube.
43242 ................ A Uppr GI endoscopy w/us 7.31 2.64 2.64 0.29 10.24 10.24 000
fn bx.
43243 ................ A Upper GI endoscopy & 4.57 NA 2.00 0.21 NA 6.78 000
inject.
43244 ................ A Upper GI endoscopy/ 5.05 NA 2.18 0.21 NA 7.44 000
ligation.
43245 ................ A Operative upper GI 3.39 NA 1.55 0.18 NA 5.12 000
endoscopy.
43246 ................ A Place gastrostomy tube 4.33 NA 1.84 0.24 NA 6.41 000
43247 ................ A Operative upper GI 3.39 NA 1.56 0.17 NA 5.12 000
endoscopy.
43248 ................ A Uppr GI endoscopy/ 3.15 NA 1.49 0.15 NA 4.79 000
guide wire.
43249 ................ A Esoph endoscopy, 2.90 NA 1.39 0.15 NA 4.44 000
dilation.
43250 ................ A Upper GI endoscopy/ 3.20 NA 1.48 0.17 NA 4.85 000
tumor.
[[Page 55376]]
43251 ................ A Operative upper GI 3.70 NA 1.67 0.19 NA 5.56 000
endoscopy.
43255 ................ A Operative upper GI 4.82 NA 1.97 0.20 NA 6.99 000
endoscopy.
43256 ................ A Uppr GI endoscopy w 4.60 1.66 1.66 0.23 6.49 6.49 000
stent.
43258 ................ A Operative upper GI 4.55 NA 1.99 0.22 NA 6.76 000
endoscopy.
43259 ................ A Endoscopic ultrasound 4.89 NA 2.22 0.22 NA 7.33 000
exam.
43260 ................ A Endo 5.96 NA 2.50 0.27 NA 8.73 000
cholangiopancreatogra
ph.
43261 ................ A Endo 6.27 NA 2.62 0.29 NA 9.18 000
cholangiopancreatogra
ph.
43262 ................ A Endo 7.39 NA 3.03 0.34 NA 10.76 000
cholangiopancreatogra
ph.
43263 ................ A Endo 7.29 NA 3.00 0.28 NA 10.57 000
cholangiopancreatogra
ph.
43264 ................ A Endo 8.90 NA 3.58 0.41 NA 12.89 000
cholangiopancreatogra
ph.
43265 ................ A Endo 10.02 NA 3.99 0.42 NA 14.43 000
cholangiopancreatogra
ph.
43267 ................ A Endo 7.39 NA 3.04 0.34 NA 10.77 000
cholangiopancreatogra
ph.
43268 ................ A Endo 7.39 NA 3.03 0.34 NA 10.76 000
cholangiopancreatogra
ph.
43269 ................ A Endo 8.21 NA 3.33 0.28 NA 11.82 000
cholangiopancreatogra
ph.
43271 ................ A Endo 7.39 NA 3.02 0.34 NA 10.75 000
cholangiopancreatogra
ph.
43272 ................ A Endo 7.39 NA 3.04 0.34 NA 10.77 000
cholangiopancreatogra
ph.
43280 ................ A Laparoscopy, 17.25 NA 8.43 1.76 NA 27.44 090
fundoplasty.
43289 ................ C Laparoscope proc, 0.00 0.00 0.00 0.00 0.00 0.00 YYY
esoph.
43300 ................ A Repair of esophagus... 9.14 NA 7.31 0.85 NA 17.30 090
43305 ................ A Repair esophagus and 17.39 NA 12.84 1.36 NA 31.59 090
fistula.
43310 ................ A Repair of esophagus... 25.39 NA 14.51 3.18 NA 43.08 090
43312 ................ A Repair esophagus and 28.42 NA 17.45 3.38 NA 49.25 090
fistula.
43313 ................ A Esophagoplasty 45.28 NA 22.01 5.43 NA 72.72 090
congential.
43314 ................ A Tracheo-esophagoplasty 50.27 NA 24.07 5.53 NA 79.87 090
cong.
43320 ................ A Fuse esophagus & 19.93 NA 10.67 1.59 NA 32.19 090
stomach.
43324 ................ A Revise esophagus & 20.57 NA 9.79 1.72 NA 32.08 090
stomach.
43325 ................ A Revise esophagus & 20.06 NA 10.08 1.65 NA 31.79 090
stomach.
43326 ................ A Revise esophagus & 19.74 NA 10.33 1.84 NA 31.91 090
stomach.
43330 ................ A Repair of esophagus... 19.77 NA 9.78 1.52 NA 31.07 090
43331 ................ A Repair of esophagus... 20.13 NA 11.41 1.93 NA 33.47 090
43340 ................ A Fuse esophagus & 19.61 NA 10.31 1.53 NA 31.45 090
intestine.
43341 ................ A Fuse esophagus & 20.85 NA 11.17 2.14 NA 34.16 090
intestine.
43350 ................ A Surgical opening, 15.78 NA 10.50 1.15 NA 27.43 090
esophagus.
43351 ................ A Surgical opening, 18.35 NA 10.91 1.51 NA 30.77 090
esophagus.
43352 ................ A Surgical opening, 15.26 NA 9.59 1.28 NA 26.13 090
esophagus.
43360 ................ A Gastrointestinal 35.70 NA 17.43 3.00 NA 56.13 090
repair.
43361 ................ A Gastrointestinal 40.50 NA 17.93 3.52 NA 61.95 090
repair.
43400 ................ A Ligate esophagus veins 21.20 NA 10.46 0.99 NA 32.65 090
43401 ................ A Esophagus surgery for 22.09 NA 10.34 1.73 NA 34.16 090
veins.
43405 ................ A Ligate/staple 20.01 NA 9.45 1.63 NA 31.09 090
esophagus.
43410 ................ A Repair esophagus wound 13.47 NA 9.35 1.15 NA 23.97 090
43415 ................ A Repair esophagus wound 25.00 NA 12.50 1.92 NA 39.42 090
43420 ................ A Repair esophagus 14.35 NA 9.15 0.86 NA 24.36 090
opening.
43425 ................ A Repair esophagus 21.03 NA 11.00 2.03 NA 34.06 090
opening.
43450 ................ A Dilate esophagus...... 1.38 1.47 0.63 0.07 2.92 2.08 000
43453 ................ A Dilate esophagus...... 1.51 NA 0.68 0.08 NA 2.27 000
43456 ................ A Dilate esophagus...... 2.57 NA 1.07 0.14 NA 3.78 000
43458 ................ A Dilate esophagus...... 3.06 NA 1.26 0.17 NA 4.49 000
43460 ................ A Pressure treatment 3.80 NA 1.54 0.21 NA 5.55 000
esophagus.
43496 ................ C Free jejunum flap, 0.00 0.00 0.00 0.00 0.00 0.00 090
microvasc.
43499 ................ C Esophagus surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
43500 ................ A Surgical opening of 11.05 NA 5.23 0.84 NA 17.12 090
stomach.
43501 ................ A Surgical repair of 20.04 NA 8.86 1.55 NA 30.45 090
stomach.
43502 ................ A Surgical repair of 23.13 NA 10.16 1.83 NA 35.12 090
stomach.
43510 ................ A Surgical opening of 13.08 NA 7.50 0.90 NA 21.48 090
stomach.
43520 ................ A Incision of pyloric 9.99 NA 5.73 0.84 NA 16.56 090
muscle.
43600 ................ A Biopsy of stomach..... 1.91 NA 1.05 0.11 NA 3.07 000
43605 ................ A Biopsy of stomach..... 11.98 NA 5.55 0.93 NA 18.46 090
43610 ................ A Excision of stomach 14.60 NA 6.85 1.14 NA 22.59 090
lesion.
43611 ................ A Excision of stomach 17.84 NA 8.12 1.38 NA 27.34 090
lesion.
43620 ................ A Removal of stomach.... 30.04 NA 12.89 2.29 NA 45.22 090
43621 ................ A Removal of stomach.... 30.73 NA 13.21 2.36 NA 46.30 090
43622 ................ A Removal of stomach.... 32.53 NA 13.79 2.48 NA 48.80 090
43631 ................ A Removal of stomach, 22.59 NA 9.72 1.99 NA 34.30 090
partial.
43632 ................ A Removal of stomach, 22.59 NA 9.73 2.00 NA 34.32 090
partial.
43633 ................ A Removal of stomach, 23.10 NA 9.87 2.05 NA 35.02 090
partial.
43634 ................ A Removal of stomach, 25.12 NA 10.84 2.18 NA 38.14 090
partial.
43635 ................ A Removal of stomach, 2.06 NA 0.74 0.21 NA 3.01 ZZZ
partial.
43638 ................ A Removal of stomach, 29.00 NA 12.13 2.24 NA 43.37 090
partial.
43639 ................ A Removal of stomach, 29.65 NA 12.30 2.31 NA 44.26 090
partial.
43640 ................ A Vagotomy & pylorus 17.02 NA 7.72 1.51 NA 26.25 090
repair.
43641 ................ A Vagotomy & pylorus 17.27 NA 7.82 1.53 NA 26.62 090
repair.
43651 ................ A Laparoscopy, vagus 10.15 NA 4.71 1.03 NA 15.89 090
nerve.
[[Page 55377]]
43652 ................ A Laparoscopy, vagus 12.15 NA 5.53 1.25 NA 18.93 090
nerve.
43653 ................ A Laparoscopy, 7.73 NA 4.37 0.78 NA 12.88 090
gastrostomy.
43659 ................ C Laparoscope proc, stom 0.00 0.00 0.00 0.00 0.00 0.00 YYY
43750 ................ A Place gastrostomy tube 4.49 NA 2.72 0.33 NA 7.54 010
43752 ................ B Nasal/orogastric w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
stent.
43760 ................ A Change gastrostomy 1.10 1.47 0.46 0.07 2.64 1.63 000
tube.
43761 ................ A Reposition gastrostomy 2.01 NA 0.83 0.10 NA 2.94 000
tube.
43800 ................ A Reconstruction of 13.69 NA 6.60 1.07 NA 21.36 090
pylorus.
43810 ................ A Fusion of stomach and 14.65 NA 6.94 1.10 NA 22.69 090
bowel.
43820 ................ A Fusion of stomach and 15.37 NA 7.15 1.18 NA 23.70 090
bowel.
43825 ................ A Fusion of stomach and 19.22 NA 8.56 1.50 NA 29.28 090
bowel.
43830 ................ A Place gastrostomy tube 9.53 NA 5.06 0.69 NA 15.28 090
43831 ................ A Place gastrostomy tube 7.84 NA 4.67 0.81 NA 13.32 090
43832 ................ A Place gastrostomy tube 15.60 NA 7.66 1.13 NA 24.39 090
43840 ................ A Repair of stomach 15.56 NA 7.21 1.20 NA 23.97 090
lesion.
43842 ................ A Gastroplasty for 18.47 NA 11.24 1.51 NA 31.22 090
obesity.
43843 ................ A Gastroplasty for 18.65 NA 11.25 1.53 NA 31.43 090
obesity.
43846 ................ A Gastric bypass for 24.05 NA 13.68 1.96 NA 39.69 090
obesity.
43847 ................ A Gastric bypass for 26.92 NA 15.28 2.14 NA 44.34 090
obesity.
43848 ................ A Revision gastroplasty. 29.39 NA 16.54 2.39 NA 48.32 090
43850 ................ A Revise stomach-bowel 24.72 NA 10.42 1.97 NA 37.11 090
fusion.
43855 ................ A Revise stomach-bowel 26.16 NA 11.12 2.01 NA 39.29 090
fusion.
43860 ................ A Revise stomach-bowel 25.00 NA 10.58 2.03 NA 37.61 090
fusion.
43865 ................ A Revise stomach-bowel 26.52 NA 11.21 2.15 NA 39.88 090
fusion.
43870 ................ A Repair stomach opening 9.69 NA 5.22 0.71 NA 15.62 090
43880 ................ A Repair stomach-bowel 24.65 NA 10.87 1.94 NA 37.46 090
fistula.
43999 ................ C Stomach surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
44005 ................ A Freeing of bowel 16.23 NA 7.40 1.39 NA 25.02 090
adhesion.
44010 ................ A Incision of small 12.52 NA 6.48 1.05 NA 20.05 090
bowel.
44015 ................ A Insert needle cath 2.62 NA 0.93 0.25 NA 3.80 ZZZ
bowel.
44020 ................ A Explore small 13.99 NA 6.56 1.20 NA 21.75 090
intestine.
44021 ................ A Decompress small bowel 14.08 NA 7.02 1.18 NA 22.28 090
44025 ................ A Incision of large 14.28 NA 6.65 1.21 NA 22.14 090
bowel.
44050 ................ A Reduce bowel 14.03 NA 6.60 1.15 NA 21.78 090
obstruction.
44055 ................ A Correct malrotation of 22.00 NA 9.51 1.32 NA 32.83 090
bowel.
44100 ................ A Biopsy of bowel....... 2.01 NA 1.09 0.12 NA 3.22 000
44110 ................ A Excise intestine 11.81 NA 5.84 1.00 NA 18.65 090
lesion(s).
44111 ................ A Excision of bowel 14.29 NA 7.10 1.22 NA 22.61 090
lesion(s).
44120 ................ A Removal of small 17.00 NA 7.67 1.46 NA 26.13 090
intestine.
44121 ................ A Removal of small 4.45 NA 1.60 0.45 NA 6.50 ZZZ
intestine.
44125 ................ A Removal of small 17.54 NA 7.86 1.49 NA 26.89 090
intestine.
44126 ................ A Enterectomy w/taper, 35.50 NA 18.03 0.36 NA 53.89 090
cong.
44127 ................ A Enterectomy w/o taper, 41.00 NA 20.56 0.41 NA 61.97 090
cong.
44128 ................ A Enterectomy cong, add- 4.45 NA 1.78 0.45 NA 6.68 ZZZ
on.
44130 ................ A Bowel to bowel fusion. 14.49 NA 6.78 1.23 NA 22.50 090
44132 ................ R Enterectomy, cadaver 0.00 0.00 0.00 0.00 0.00 0.00 XXX
donor.
44133 ................ R Enterectomy, live 0.00 0.00 0.00 0.00 0.00 0.00 XXX
donor.
44135 ................ R Intestine transplant, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cadaver.
44136 ................ R Intestine transplant, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
live.
44139 ................ A Mobilization of colon. 2.23 NA 0.80 0.21 NA 3.24 ZZZ
44140 ................ A Partial removal of 21.00 NA 9.53 1.83 NA 32.36 090
colon.
44141 ................ A Partial removal of 19.51 NA 11.93 1.95 NA 33.39 090
colon.
44143 ................ A Partial removal of 22.99 NA 13.14 2.02 NA 38.15 090
colon.
44144 ................ A Partial removal of 21.53 NA 11.75 1.89 NA 35.17 090
colon.
44145 ................ A Partial removal of 26.42 NA 11.90 2.22 NA 40.54 090
colon.
44146 ................ A Partial removal of 27.54 NA 15.41 2.20 NA 45.15 090
colon.
44147 ................ A Partial removal of 20.71 NA 10.15 1.74 NA 32.60 090
colon.
44150 ................ A Removal of colon...... 23.95 NA 14.08 2.05 NA 40.08 090
44151 ................ A Removal of colon/ 26.88 NA 15.74 1.97 NA 44.59 090
ileostomy.
44152 ................ A Removal of colon/ 27.83 NA 17.01 2.36 NA 47.20 090
ileostomy.
44153 ................ A Removal of colon/ 30.59 NA 16.64 2.33 NA 49.56 090
ileostomy.
44155 ................ A Removal of colon/ 27.86 NA 15.28 2.26 NA 45.40 090
ileostomy.
44156 ................ A Removal of colon/ 30.79 NA 17.86 2.19 NA 50.84 090
ileostomy.
44160 ................ A Removal of colon...... 18.62 NA 8.65 1.55 NA 28.82 090
44200 ................ A Laparoscopy, 14.44 NA 6.79 1.46 NA 22.69 090
enterolysis.
44201 ................ A Laparoscopy, 9.78 NA 5.16 0.97 NA 15.91 090
jejunostomy.
44202 ................ A Lap resect s/intestine 22.04 NA 9.82 2.16 NA 34.02 090
singl.
44203 ................ A Lap resect s/ 4.45 NA 1.60 0.45 NA 6.50 ZZZ
intestine, addl.
44204 ................ A Laparo partial 25.08 NA 10.46 1.83 NA 37.37 090
colectomy.
44205 ................ A Lap colectomy part w/ 22.23 NA 9.31 1.55 NA 33.09 090
ileum.
44209 ................ C Laparoscope proc, 0.00 0.00 0.00 0.00 0.00 0.00 YYY
intestine.
44300 ................ A Open bowel to skin.... 12.11 NA 6.79 0.88 NA 19.78 090
44310 ................ A Ileostomy/jejunostomy. 15.95 NA 10.50 1.13 NA 27.58 090
[[Page 55378]]
44312 ................ A Revision of ileostomy. 8.02 NA 5.25 0.54 NA 13.81 090
44314 ................ A Revision of ileostomy. 15.05 NA 10.37 0.99 NA 26.41 090
44316 ................ A Devise bowel pouch.... 21.09 NA 13.77 1.41 NA 36.27 090
44320 ................ A Colostomy............. 17.64 NA 12.13 1.28 NA 31.05 090
44322 ................ A Colostomy with 11.98 NA 10.41 1.18 NA 23.57 090
biopsies.
44340 ................ A Revision of colostomy. 7.72 NA 4.86 0.56 NA 13.14 090
44345 ................ A Revision of colostomy. 15.43 NA 8.34 1.11 NA 24.88 090
44346 ................ A Revision of colostomy. 16.99 NA 8.91 1.20 NA 27.10 090
44360 ................ A Small bowel endoscopy. 2.59 NA 1.39 0.14 NA 4.12 000
44361 ................ A Small bowel endoscopy/ 2.87 NA 1.50 0.15 NA 4.52 000
biopsy.
44363 ................ A Small bowel endoscopy. 3.50 NA 1.71 0.19 NA 5.40 000
44364 ................ A Small bowel endoscopy. 3.74 NA 1.80 0.21 NA 5.75 000
44365 ................ A Small bowel endoscopy. 3.31 NA 1.68 0.18 NA 5.17 000
44366 ................ A Small bowel endoscopy. 4.41 NA 2.05 0.22 NA 6.68 000
44369 ................ A Small bowel endoscopy. 4.52 NA 2.05 0.23 NA 6.80 000
44370 ................ A Small bowel endoscopy/ 4.80 1.74 1.74 0.21 6.75 6.75 000
stent.
44372 ................ A Small bowel endoscopy. 4.41 NA 2.04 0.27 NA 6.72 000
44373 ................ A Small bowel endoscopy. 3.50 NA 1.80 0.19 NA 5.49 000
44376 ................ A Small bowel endoscopy. 5.26 NA 2.36 0.29 NA 7.91 000
44377 ................ A Small bowel endoscopy/ 5.53 NA 2.47 0.28 NA 8.28 000
biopsy.
44378 ................ A Small bowel endoscopy. 7.13 NA 3.06 0.37 NA 10.56 000
44379 ................ A S bowel endoscope w/ 7.47 2.67 2.67 0.38 10.52 10.52 000
stent.
44380 ................ A Small bowel endoscopy. 1.05 NA 0.79 0.08 NA 1.92 000
44382 ................ A Small bowel endoscopy. 1.27 NA 0.90 0.09 NA 2.26 000
44383 ................ A Ileoscopy w/stent..... 3.26 1.16 1.16 0.13 4.55 4.55 000
44385 ................ A Endoscopy of bowel 1.82 5.26 0.95 0.12 7.20 2.89 000
pouch.
44386 ................ A Endoscopy, bowel pouch/ 2.12 6.98 1.09 0.15 9.25 3.36 000
biop.
44388 ................ A Colon endoscopy....... 2.82 6.91 1.42 0.18 9.91 4.42 000
44389 ................ A Colonoscopy with 3.13 7.62 1.55 0.18 10.93 4.86 000
biopsy.
44390 ................ A Colonoscopy for 3.83 6.68 1.80 0.22 10.73 5.85 000
foreign body.
44391 ................ A Colonoscopy for 4.32 6.04 1.78 0.23 10.59 6.33 000
bleeding.
44392 ................ A Colonoscopy & 3.82 8.21 1.79 0.23 12.26 5.84 000
polypectomy.
44393 ................ A Colonoscopy, lesion 4.84 8.45 2.19 0.27 13.56 7.30 000
removal.
44394 ................ A Colonoscopy w/snare... 4.43 7.71 2.04 0.26 12.40 6.73 000
44397 ................ A Colonoscopy w stent... 4.71 NA 2.10 0.28 NA 7.09 000
44500 ................ A Intro, 0.49 NA 0.37 0.02 NA 0.88 000
gastrointestinal tube.
44602 ................ A Suture, small 16.03 NA 7.34 1.07 NA 24.44 090
intestine.
44603 ................ A Suture, small 18.66 NA 8.25 1.39 NA 28.30 090
intestine.
44604 ................ A Suture, large 16.03 NA 7.35 1.42 NA 24.80 090
intestine.
44605 ................ A Repair of bowel lesion 19.53 NA 8.94 1.54 NA 30.01 090
44615 ................ A Intestinal 15.93 NA 7.32 1.39 NA 24.64 090
stricturoplasty.
44620 ................ A Repair bowel opening.. 12.20 NA 5.81 1.05 NA 19.06 090
44625 ................ A Repair bowel opening.. 15.05 NA 6.86 1.30 NA 23.21 090
44626 ................ A Repair bowel opening.. 25.36 NA 10.60 2.19 NA 38.15 090
44640 ................ A Repair bowel-skin 21.65 NA 9.70 1.46 NA 32.81 090
fistula.
44650 ................ A Repair bowel fistula.. 22.57 NA 10.01 1.49 NA 34.07 090
44660 ................ A Repair bowel-bladder 21.36 NA 9.51 1.14 NA 32.01 090
fistula.
44661 ................ A Repair bowel-bladder 24.81 NA 10.73 1.53 NA 37.07 090
fistula.
44680 ................ A Surgical revision, 15.40 NA 7.47 1.37 NA 24.24 090
intestine.
44700 ................ A Suspend bowel w/ 16.11 NA 7.57 1.21 NA 24.89 090
prosthesis.
44799 ................ C Intestine surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
44800 ................ A Excision of bowel 11.23 NA 5.61 1.11 NA 17.95 090
pouch.
44820 ................ A Excision of mesentery 12.09 NA 5.98 1.03 NA 19.10 090
lesion.
44850 ................ A Repair of mesentery... 10.74 NA 5.41 0.99 NA 17.14 090
44899 ................ C Bowel surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
44900 ................ A Drain app abscess, 10.14 NA 5.96 0.84 NA 16.94 090
open.
44901 ................ A Drain app abscess, 3.38 NA 5.01 0.17 NA 8.56 000
percut.
44950 ................ A Appendectomy.......... 10.00 NA 5.31 0.88 NA 16.19 090
44955 ................ A Appendectomy add-on... 1.53 NA 0.57 0.16 NA 2.26 ZZZ
44960 ................ A Appendectomy.......... 12.34 NA 6.50 1.09 NA 19.93 090
44970 ................ A Laparoscopy, 8.70 NA 4.21 0.88 NA 13.79 090
appendectomy.
44979 ................ C Laparoscope proc, app. 0.00 0.00 0.00 0.00 0.00 0.00 YYY
45000 ................ A Drainage of pelvic 4.52 NA 3.80 0.37 NA 8.69 090
abscess.
45005 ................ A Drainage of rectal 1.99 4.58 1.62 0.18 6.75 3.79 010
abscess.
45020 ................ A Drainage of rectal 4.72 NA 4.21 0.41 NA 9.34 090
abscess.
45100 ................ A Biopsy of rectum...... 3.68 4.86 2.12 0.33 8.87 6.13 090
45108 ................ A Removal of anorectal 4.76 6.40 2.95 0.46 11.62 8.17 090
lesion.
45110 ................ A Removal of rectum..... 28.00 NA 13.26 2.26 NA 43.52 090
45111 ................ A Partial removal of 16.48 NA 8.78 1.60 NA 26.86 090
rectum.
45112 ................ A Removal of rectum..... 30.54 NA 13.70 2.35 NA 46.59 090
45113 ................ A Partial proctectomy... 30.58 NA 13.39 2.13 NA 46.10 090
45114 ................ A Partial removal of 27.32 NA 12.61 2.28 NA 42.21 090
rectum.
45116 ................ A Partial removal of 24.58 NA 11.58 2.00 NA 38.16 090
rectum.
[[Page 55379]]
45119 ................ A Remove rectum w/ 30.84 NA 13.25 2.13 NA 46.22 090
reservoir.
45120 ................ A Removal of rectum..... 24.60 NA 11.63 2.28 NA 38.51 090
45121 ................ A Removal of rectum and 27.04 NA 12.53 2.66 NA 42.23 090
colon.
45123 ................ A Partial proctectomy... 16.71 NA 8.21 1.04 NA 25.96 090
45126 ................ A Pelvic exenteration... 45.16 NA 19.12 3.23 NA 67.51 090
45130 ................ A Excision of rectal 16.44 NA 7.80 1.12 NA 25.36 090
prolapse.
45135 ................ A Excision of rectal 19.28 NA 9.10 1.52 NA 29.90 090
prolapse.
45136 ................ A Excise ileoanal 27.30 NA 12.66 2.19 NA 42.15 090
reservoir.
45150 ................ A Excision of rectal 5.67 5.89 3.19 0.46 12.02 9.32 090
stricture.
45160 ................ A Excision of rectal 15.32 NA 7.14 1.07 NA 23.53 090
lesion.
45170 ................ A Excision of rectal 11.49 NA 5.89 0.89 NA 18.27 090
lesion.
45190 ................ A Destruction, rectal 9.74 NA 5.33 0.76 NA 15.83 090
tumor.
45300 ................ A Proctosigmoidoscopy dx 0.38 1.34 0.23 0.05 1.77 0.66 000
45303 ................ A Proctosigmoidoscopy 0.44 1.55 0.27 0.06 2.05 0.77 000
dilate.
45305 ................ A Protosigmoidoscopy w/ 1.01 1.64 0.46 0.09 2.74 1.56 000
bx.
45307 ................ A Protosigmoidoscopy fb. 0.94 2.68 0.44 0.15 3.77 1.53 000
45308 ................ A Protosigmoidoscopy 0.83 1.59 0.39 0.13 2.55 1.35 000
removal.
45309 ................ A Protosigmoidoscopy 2.01 2.43 0.81 0.17 4.61 2.99 000
removal.
45315 ................ A Protosigmoidoscopy 1.40 2.84 0.60 0.20 4.44 2.20 000
removal.
45317 ................ A Protosigmoidoscopy 1.50 1.94 0.63 0.20 3.64 2.33 000
bleed.
45320 ................ A Protosigmoidoscopy 1.58 1.88 0.68 0.20 3.66 2.46 000
ablate.
45321 ................ A Protosigmoidoscopy 1.17 NA 0.52 0.17 NA 1.86 000
volvul.
45327 ................ A Proctosigmoidoscopy w/ 1.65 NA 0.89 0.10 NA 2.64 000
stent.
45330 ................ A Diagnostic 0.96 1.92 0.53 0.05 2.93 1.54 000
sigmoidoscopy.
45331 ................ A Sigmoidoscopy and 1.15 2.38 0.54 0.07 3.60 1.76 000
biopsy.
45332 ................ A Sigmoidoscopy w/fb 1.79 4.36 0.76 0.11 6.26 2.66 000
removal.
45333 ................ A Sigmoidoscopy & 1.79 3.93 0.77 0.12 5.84 2.68 000
polypectomy.
45334 ................ A Sigmoidoscopy for 2.73 NA 1.12 0.16 NA 4.01 000
bleeding.
45337 ................ A Sigmoidoscopy & 2.36 NA 0.97 0.15 NA 3.48 000
decompress.
45338 ................ A Sigmoidoscpy w/tumr 2.34 4.75 0.97 0.15 7.24 3.46 000
remove.
45339 ................ A Sigmoidoscopy w/ablate 3.14 3.62 1.27 0.17 6.93 4.58 000
tumr.
45341 ................ A Sigmoidoscopy w/ 2.60 NA 1.40 0.20 NA 4.20 000
ultrasound.
45342 ................ A Sigmoidoscopy w/us 4.06 NA 1.85 0.23 NA 6.14 000
guide bx.
45345 ................ A Sigmodoscopy w/stent.. 2.92 NA 1.44 0.15 NA 4.51 000
45355 ................ A Surgical colonoscopy.. 3.52 NA 1.28 0.26 NA 5.06 000
45378 ................ A Diagnostic colonoscopy 3.70 8.79 1.77 0.20 12.69 5.67 000
45378 53 A Diagnostic colonoscopy 0.96 1.92 0.53 0.05 2.93 1.54 000
45379 ................ A Colonoscopy w/fb 4.69 8.25 2.13 0.25 13.19 7.07 000
removal.
45380 ................ A Colonoscopy and biopsy 4.44 9.28 2.05 0.21 13.93 6.70 000
45382 ................ A Colonoscopy/control 5.69 10.32 2.29 0.27 16.28 8.25 000
bleeding.
45383 ................ A Lesion removal 5.87 10.01 2.56 0.32 16.20 8.75 000
colonoscopy.
45384 ................ A Lesion remove 4.70 9.74 2.14 0.24 14.68 7.08 000
colonoscopy.
45385 ................ A Lesion removal 5.31 10.19 2.36 0.28 15.78 7.95 000
colonoscopy.
45387 ................ A Colonoscopy w/stent... 5.91 NA 2.57 0.33 NA 8.81 000
45500 ................ A Repair of rectum...... 7.29 NA 4.24 0.56 NA 12.09 090
45505 ................ A Repair of rectum...... 7.58 NA 3.86 0.50 NA 11.94 090
45520 ................ A Treatment of rectal 0.55 0.77 0.20 0.04 1.36 0.79 000
prolapse.
45540 ................ A Correct rectal 16.27 NA 8.18 1.17 NA 25.62 090
prolapse.
45541 ................ A Correct rectal 13.40 NA 7.03 0.88 NA 21.31 090
prolapse.
45550 ................ A Repair rectum/remove 23.00 NA 10.40 1.58 NA 34.98 090
sigmoid.
45560 ................ A Repair of rectocele... 10.58 NA 6.12 0.73 NA 17.43 090
45562 ................ A Exploration/repair of 15.38 NA 7.52 1.15 NA 24.05 090
rectum.
45563 ................ A Exploration/repair of 23.47 NA 11.34 1.84 NA 36.65 090
rectum.
45800 ................ A Repair rect/bladder 17.77 NA 8.23 1.14 NA 27.14 090
fistula.
45805 ................ A Repair fistula w/ 20.78 NA 10.72 1.47 NA 32.97 090
colostomy.
45820 ................ A Repair rectourethral 18.48 NA 8.55 1.17 NA 28.20 090
fistula.
45825 ................ A Repair fistula w/ 21.25 NA 10.57 0.97 NA 32.79 090
colostomy.
45900 ................ A Reduction of rectal 2.61 NA 1.04 0.17 NA 3.82 010
prolapse.
45905 ................ A Dilation of anal 2.30 12.19 0.96 0.14 14.63 3.40 010
sphincter.
45910 ................ A Dilation of rectal 2.80 17.62 1.15 0.14 20.56 4.09 010
narrowing.
45915 ................ A Remove rectal 3.14 4.89 1.16 0.17 8.20 4.47 010
obstruction.
45999 ................ C Rectum surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
46020 ................ A Placement of seton.... 2.90 3.09 2.36 0.22 6.21 5.48 010
46030 ................ A Removal of rectal 1.23 2.90 1.22 0.11 4.24 2.56 010
marker.
46040 ................ A Incision of rectal 4.96 5.57 3.15 0.48 11.01 8.59 090
abscess.
46045 ................ A Incision of rectal 4.32 NA 2.88 0.40 NA 7.60 090
abscess.
46050 ................ A Incision of anal 1.19 3.68 1.37 0.11 4.98 2.67 010
abscess.
46060 ................ A Incision of rectal 5.69 NA 3.83 0.52 NA 10.04 090
abscess.
46070 ................ A Incision of anal 2.71 NA 2.54 0.27 NA 5.52 090
septum.
46080 ................ A Incision of anal 2.49 3.81 1.65 0.23 6.53 4.37 010
sphincter.
46083 ................ A Incise external 1.40 4.78 1.59 0.12 6.30 3.11 010
hemorrhoid.
46200 ................ A Removal of anal 3.42 4.01 2.42 0.30 7.73 6.14 090
fissure.
46210 ................ A Removal of anal crypt. 2.67 5.12 2.17 0.26 8.05 5.10 090
[[Page 55380]]
46211 ................ A Removal of anal crypts 4.25 4.97 3.10 0.37 9.59 7.72 090
46220 ................ A Removal of anal tab... 1.56 1.32 0.56 0.14 3.02 2.26 010
46221 ................ A Ligation of 2.04 1.80 1.12 0.12 3.96 3.28 010
hemorrhoid(s).
46230 ................ A Removal of anal tabs.. 2.57 4.38 1.69 0.22 7.17 4.48 010
46250 ................ A Hemorrhoidectomy...... 3.89 5.59 2.71 0.43 9.91 7.03 090
46255 ................ A Hemorrhoidectomy...... 4.60 6.45 2.96 0.51 11.56 8.07 090
46257 ................ A Remove hemorrhoids & 5.40 NA 3.12 0.59 NA 9.11 090
fissure.
46258 ................ A Remove hemorrhoids & 5.73 NA 3.30 0.64 NA 9.67 090
fistula.
46260 ................ A Hemorrhoidectomy...... 6.37 NA 4.04 0.68 NA 11.09 090
46261 ................ A Remove hemorrhoids & 7.08 NA 4.19 0.70 NA 11.97 090
fissure.
46262 ................ A Remove hemorrhoids & 7.50 NA 4.35 0.76 NA 12.61 090
fistula.
46270 ................ A Removal of anal 3.72 5.23 2.65 0.36 9.31 6.73 090
fistula.
46275 ................ A Removal of anal 4.56 4.65 2.85 0.40 9.61 7.81 090
fistula.
46280 ................ A Removal of anal 5.98 NA 3.83 0.50 NA 10.31 090
fistula.
46285 ................ A Removal of anal 4.09 4.28 2.69 0.34 8.71 7.12 090
fistula.
46288 ................ A Repair anal fistula... 7.13 NA 4.25 0.60 NA 11.98 090
46320 ................ A Removal of hemorrhoid 1.61 4.00 1.57 0.14 5.75 3.32 010
clot.
46500 ................ A Injection into 1.61 2.89 0.58 0.12 4.62 2.31 010
hemorrhoid(s).
46600 ................ A Diagnostic anoscopy... 0.50 0.82 0.15 0.04 1.36 0.69 000
46604 ................ A Anoscopy and dilation. 1.31 0.99 0.47 0.09 2.39 1.87 000
46606 ................ A Anoscopy and biopsy... 0.81 0.87 0.29 0.07 1.75 1.17 000
46608 ................ A Anoscopy/remove for 1.51 1.81 0.49 0.13 3.45 2.13 000
body.
46610 ................ A Anoscopy/remove lesion 1.32 1.46 0.48 0.12 2.90 1.92 000
46611 ................ A Anoscopy.............. 1.81 2.07 0.65 0.15 4.03 2.61 000
46612 ................ A Anoscopy/ remove 2.34 2.65 0.85 0.18 5.17 3.37 000
lesions.
46614 ................ A Anoscopy/control 2.01 1.90 0.71 0.14 4.05 2.86 000
bleeding.
46615 ................ A Anoscopy.............. 2.68 1.76 0.96 0.23 4.67 3.87 000
46700 ................ A Repair of anal 9.13 NA 4.78 0.56 NA 14.47 090
stricture.
46705 ................ A Repair of anal 6.90 NA 4.53 0.73 NA 12.16 090
stricture.
46715 ................ A Repair of anovaginal 7.20 NA 4.46 0.76 NA 12.42 090
fistula.
46716 ................ A Repair of anovaginal 15.07 NA 8.05 1.30 NA 24.42 090
fistula.
46730 ................ A Construction of absent 26.75 NA 12.25 2.03 NA 41.03 090
anus.
46735 ................ A Construction of absent 32.17 NA 15.49 2.64 NA 50.30 090
anus.
46740 ................ A Construction of absent 30.00 NA 14.61 1.99 NA 46.60 090
anus.
46742 ................ A Repair of imperforated 35.80 NA 18.31 2.63 NA 56.74 090
anus.
46744 ................ A Repair of cloacal 52.63 NA 22.78 2.27 NA 77.68 090
anomaly.
46746 ................ A Repair of cloacal 58.22 NA 27.19 2.51 NA 87.92 090
anomaly.
46748 ................ A Repair of cloacal 64.21 NA 29.58 2.77 NA 96.56 090
anomaly.
46750 ................ A Repair of anal 10.25 NA 5.79 0.69 NA 16.73 090
sphincter.
46751 ................ A Repair of anal 8.77 NA 6.14 0.78 NA 15.69 090
sphincter.
46753 ................ A Reconstruction of anus 8.29 NA 4.13 0.58 NA 13.00 090
46754 ................ A Removal of suture from 2.20 5.36 1.43 0.12 7.68 3.75 010
anus.
46760 ................ A Repair of anal 14.43 NA 7.07 0.86 NA 22.36 090
sphincter.
46761 ................ A Repair of anal 13.84 NA 6.87 0.84 NA 21.55 090
sphincter.
46762 ................ A Implant artificial 12.71 NA 6.08 0.71 NA 19.50 090
sphincter.
46900 ................ A Destruction, anal 1.91 3.52 0.74 0.13 5.56 2.78 010
lesion(s).
46910 ................ A Destruction, anal 1.86 3.81 1.48 0.14 5.81 3.48 010
lesion(s).
46916 ................ A Cryosurgery, anal 1.86 3.24 1.68 0.09 5.19 3.63 010
lesion(s).
46917 ................ A Laser surgery, anal 1.86 5.32 1.62 0.16 7.34 3.64 010
lesions.
46922 ................ A Excision of anal 1.86 3.96 1.46 0.17 5.99 3.49 010
lesion(s).
46924 ................ A Destruction, anal 2.76 4.81 1.77 0.20 7.77 4.73 010
lesion(s).
46934 ................ A Destruction of 3.51 6.62 3.77 0.26 10.39 7.54 090
hemorrhoids.
46935 ................ A Destruction of 2.43 4.60 0.87 0.17 7.20 3.47 010
hemorrhoids.
46936 ................ A Destruction of 3.69 6.67 3.58 0.30 10.66 7.57 090
hemorrhoids.
46937 ................ A Cryotherapy of rectal 2.69 4.51 1.72 0.12 7.32 4.53 010
lesion.
46938 ................ A Cryotherapy of rectal 4.66 6.22 3.27 0.40 11.28 8.33 090
lesion.
46940 ................ A Treatment of anal 2.32 3.47 0.83 0.17 5.96 3.32 010
fissure.
46942 ................ A Treatment of anal 2.04 2.84 0.71 0.14 5.02 2.89 010
fissure.
46945 ................ A Ligation of 1.84 4.04 2.29 0.17 6.05 4.30 090
hemorrhoids.
46946 ................ A Ligation of 2.58 5.40 2.61 0.22 8.20 5.41 090
hemorrhoids.
46999 ................ C Anus surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY
47000 ................ A Needle biopsy of liver 1.90 8.36 0.67 0.09 10.35 2.66 000
47001 ................ A Needle biopsy, liver 1.90 NA 0.68 0.18 NA 2.76 ZZZ
add-on.
47010 ................ A Open drainage, liver 16.01 NA 9.60 0.65 NA 26.26 090
lesion.
47011 ................ A Percut drain, liver 3.70 NA 4.61 0.17 NA 8.48 000
lesion.
47015 ................ A Inject/aspirate liver 15.11 NA 8.23 0.86 NA 24.20 090
cyst.
47100 ................ A Wedge biopsy of liver. 11.67 NA 6.50 0.75 NA 18.92 090
47120 ................ A Partial removal of 35.50 NA 17.02 2.29 NA 54.81 090
liver.
47122 ................ A Extensive removal of 55.13 NA 24.11 3.60 NA 82.84 090
liver.
47125 ................ A Partial removal of 49.19 NA 22.12 3.18 NA 74.49 090
liver.
47130 ................ A Partial removal of 53.35 NA 23.49 3.47 NA 80.31 090
liver.
47133 ................ X Removal of donor liver 0.00 0.00 0.00 0.00 0.00 0.00 XXX
47134 ................ R Partial removal, donor 39.15 NA 13.91 3.98 NA 57.04 XXX
liver.
[[Page 55381]]
47135 ................ R Transplantation of 81.52 NA 43.28 8.13 NA 132.93 090
liver.
47136 ................ R Transplantation of 68.60 NA 47.00 6.93 NA 122.53 090
liver.
47300 ................ A Surgery for liver 15.08 NA 7.75 0.97 NA 23.80 090
lesion.
47350 ................ A Repair liver wound.... 19.56 NA 9.45 1.25 NA 30.26 090
47360 ................ A Repair liver wound.... 26.92 NA 12.96 1.71 NA 41.59 090
47361 ................ A Repair liver wound.... 47.12 NA 19.94 3.11 NA 70.17 090
47362 ................ A Repair liver wound.... 18.51 NA 9.77 1.22 NA 29.50 090
47370 ................ A Laparo ablate liver 18.00 7.19 7.19 0.85 26.04 26.04 090
tumor rf.
47371 ................ A Laparo ablate liver 16.94 6.76 6.76 0.85 24.55 24.55 090
cryosug.
47379 ................ C Laparoscope procedure, 0.00 0.00 0.00 0.00 0.00 0.00 YYY
liver.
47380 ................ A Open ablate liver 21.25 8.48 8.48 0.85 30.58 30.58 090
tumor rf.
47381 ................ A Open ablate liver 21.00 8.38 8.38 0.85 30.23 30.23 090
tumor cryo.
47382 ................ A Percut ablate liver rf 12.00 NA 5.37 0.85 NA 18.22 010
47399 ................ C Liver surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
47400 ................ A Incision of liver duct 32.49 NA 14.99 1.82 NA 49.30 090
47420 ................ A Incision of bile duct. 19.88 NA 9.46 1.70 NA 31.04 090
47425 ................ A Incision of bile duct. 19.83 NA 9.38 1.60 NA 30.81 090
47460 ................ A Incise bile duct 18.04 NA 9.26 1.24 NA 28.54 090
sphincter.
47480 ................ A Incision of 10.82 NA 6.80 0.85 NA 18.47 090
gallbladder.
47490 ................ A Incision of 7.23 NA 7.67 0.33 NA 15.23 090
gallbladder.
47500 ................ A Injection for liver x- 1.96 NA 0.68 0.09 NA 2.73 000
rays.
47505 ................ A Injection for liver x- 0.76 2.88 0.26 0.03 3.67 1.05 000
rays.
47510 ................ A Insert catheter, bile 7.83 NA 9.46 0.36 NA 17.65 090
duct.
47511 ................ A Insert bile duct drain 10.50 NA 10.57 0.47 NA 21.54 090
47525 ................ A Change bile duct 5.55 NA 3.34 0.24 NA 9.13 010
catheter.
47530 ................ A Revise/reinsert bile 5.85 NA 5.07 0.29 NA 11.21 090
tube.
47550 ................ A Bile duct endoscopy 3.02 NA 1.08 0.30 NA 4.40 ZZZ
add-on.
47552 ................ A Biliary endoscopy thru 6.04 NA 2.52 0.42 NA 8.98 000
skin.
47553 ................ A Biliary endoscopy thru 6.35 NA 2.70 0.30 NA 9.35 000
skin.
47554 ................ A Biliary endoscopy thru 9.06 NA 3.55 0.74 NA 13.35 000
skin.
47555 ................ A Biliary endoscopy thru 7.56 NA 3.15 0.35 NA 11.06 000
skin.
47556 ................ A Biliary endoscopy thru 8.56 NA 3.49 0.38 NA 12.43 000
skin.
47560 ................ A Laparoscopy w/ 4.89 NA 1.89 0.49 NA 7.27 000
cholangio.
47561 ................ A Laparo w/cholangio/ 5.18 NA 2.19 0.49 NA 7.86 000
biopsy.
47562 ................ A Laparoscopic 11.09 NA 5.15 1.13 NA 17.37 090
cholecystectomy.
47563 ................ A Laparo cholecystectomy/ 11.94 NA 5.43 1.21 NA 18.58 090
graph.
47564 ................ A Laparo cholecystectomy/ 14.23 NA 6.26 1.44 NA 21.93 090
explr.
47570 ................ A Laparo 12.58 NA 5.67 1.28 NA 19.53 090
cholecystoenterostomy.
47579 ................ C Laparoscope proc, 0.00 0.00 0.00 0.00 0.00 0.00 YYY
biliary.
47600 ................ A Removal of gallbladder 13.58 NA 6.86 1.16 NA 21.60 090
47605 ................ A Removal of gallbladder 14.69 NA 7.23 1.25 NA 23.17 090
47610 ................ A Removal of gallbladder 18.82 NA 8.80 1.61 NA 29.23 090
47612 ................ A Removal of gallbladder 18.78 NA 8.70 1.60 NA 29.08 090
47620 ................ A Removal of gallbladder 20.64 NA 9.35 1.77 NA 31.76 090
47630 ................ A Remove bile duct stone 9.11 NA 3.20 0.46 NA 12.77 090
47700 ................ A Exploration of bile 15.62 NA 8.79 1.40 NA 25.81 090
ducts.
47701 ................ A Bile duct revision.... 27.81 NA 13.60 3.00 NA 44.41 090
47711 ................ A Excision of bile duct 23.03 NA 11.34 1.98 NA 36.35 090
tumor.
47712 ................ A Excision of bile duct 30.24 NA 14.00 2.67 NA 46.91 090
tumor.
47715 ................ A Excision of bile duct 18.80 NA 8.95 1.59 NA 29.34 090
cyst.
47716 ................ A Fusion of bile duct 16.44 NA 8.19 1.41 NA 26.04 090
cyst.
47720 ................ A Fuse gallbladder & 15.91 NA 8.66 1.37 NA 25.94 090
bowel.
47721 ................ A Fuse upper gi 19.12 NA 9.90 1.63 NA 30.65 090
structures.
47740 ................ A Fuse gallbladder & 18.48 NA 9.64 1.59 NA 29.71 090
bowel.
47741 ................ A Fuse gallbladder & 21.34 NA 10.62 1.82 NA 33.78 090
bowel.
47760 ................ A Fuse bile ducts and 25.85 NA 12.28 2.21 NA 40.34 090
bowel.
47765 ................ A Fuse liver ducts & 24.88 NA 12.73 2.18 NA 39.79 090
bowel.
47780 ................ A Fuse bile ducts and 26.50 NA 12.49 2.27 NA 41.26 090
bowel.
47785 ................ A Fuse bile ducts and 31.18 NA 14.97 2.69 NA 48.84 090
bowel.
47800 ................ A Reconstruction of bile 23.30 NA 11.57 1.95 NA 36.82 090
ducts.
47801 ................ A Placement, bile duct 15.17 NA 10.21 0.69 NA 26.07 090
support.
47802 ................ A Fuse liver duct & 21.55 NA 11.60 1.84 NA 34.99 090
intestine.
47900 ................ A Suture bile duct 19.90 NA 10.25 1.65 NA 31.80 090
injury.
47999 ................ C Bile tract surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
48000 ................ A Drainage of abdomen... 28.07 NA 12.59 1.32 NA 41.98 090
48001 ................ A Placement of drain, 35.45 NA 15.04 1.90 NA 52.39 090
pancreas.
48005 ................ A Resect/debride 42.17 NA 17.39 2.26 NA 61.82 090
pancreas.
48020 ................ A Removal of pancreatic 15.70 NA 7.44 1.36 NA 24.50 090
stone.
48100 ................ A Biopsy of pancreas, 12.23 NA 7.03 1.08 NA 20.34 090
open.
48102 ................ A Needle biopsy, 4.68 8.96 2.45 0.20 13.84 7.33 010
pancreas.
48120 ................ A Removal of pancreas 15.85 NA 7.69 1.35 NA 24.89 090
lesion.
48140 ................ A Partial removal of 22.94 NA 10.78 2.12 NA 35.84 090
pancreas.
48145 ................ A Partial removal of 24.02 NA 11.48 2.25 NA 37.75 090
pancreas.
[[Page 55382]]
48146 ................ A Pancreatectomy........ 26.40 NA 13.96 2.43 NA 42.79 090
48148 ................ A Removal of pancreatic 17.34 NA 9.15 1.61 NA 28.10 090
duct.
48150 ................ A Partial removal of 48.00 NA 21.29 4.43 NA 73.72 090
pancreas.
48152 ................ A Pancreatectomy........ 43.75 NA 20.74 4.07 NA 68.56 090
48153 ................ A Pancreatectomy........ 47.89 NA 22.18 4.40 NA 74.47 090
48154 ................ A Pancreatectomy........ 44.10 NA 20.82 4.10 NA 69.02 090
48155 ................ A Removal of pancreas... 24.64 NA 13.89 2.30 NA 40.83 090
48160 ................ N Pancreas removal/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
transplant.
48180 ................ A Fuse pancreas and 24.72 NA 11.16 2.24 NA 38.12 090
bowel.
48400 ................ A Injection, intraop add- 1.95 NA 0.69 0.10 NA 2.74 ZZZ
on.
48500 ................ A Surgery of pancreatic 15.28 NA 7.74 1.35 NA 24.37 090
cyst.
48510 ................ A Drain pancreatic 14.31 NA 7.45 1.07 NA 22.83 090
pseudocyst.
48511 ................ A Drain pancreatic 4.00 NA 3.95 0.17 NA 8.12 000
pseudocyst.
48520 ................ A Fuse pancreas cyst and 15.59 NA 7.49 1.41 NA 24.49 090
bowel.
48540 ................ A Fuse pancreas cyst and 19.72 NA 8.84 1.82 NA 30.38 090
bowel.
48545 ................ A Pancreatorrhaphy...... 18.18 NA 8.88 1.61 NA 28.67 090
48547 ................ A Duodenal exclusion.... 25.83 NA 11.04 2.30 NA 39.17 090
48550 ................ X Donor pancreatectomy.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
48554 ................ R Transpl allograft 34.17 NA 12.27 3.30 NA 49.74 090
pancreas.
48556 ................ A Removal, allograft 15.71 NA 8.71 1.52 NA 25.94 090
pancreas.
48999 ................ C Pancreas surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
49000 ................ A Exploration of abdomen 11.68 NA 6.22 1.17 NA 19.07 090
49002 ................ A Reopening of abdomen.. 10.49 NA 6.10 1.06 NA 17.65 090
49010 ................ A Exploration behind 12.28 NA 7.05 1.22 NA 20.55 090
abdomen.
49020 ................ A Drain abdominal 22.84 NA 11.41 1.31 NA 35.56 090
abscess.
49021 ................ A Drain abdominal 3.38 NA 5.84 0.16 NA 9.38 000
abscess.
49040 ................ A Drain, open, abdom 13.52 NA 8.02 0.84 NA 22.38 090
abscess.
49041 ................ A Drain, percut, abdom 4.00 NA 6.07 0.18 NA 10.25 000
abscess.
49060 ................ A Drain, open, retrop 15.86 NA 9.62 0.77 NA 26.25 090
abscess.
49061 ................ A Drain, percut, 3.70 NA 5.99 0.17 NA 9.86 000
retroper absc.
49062 ................ A Drain to peritoneal 11.36 NA 7.06 1.08 NA 19.50 090
cavity.
49080 ................ A Puncture, peritoneal 1.35 4.56 0.48 0.07 5.98 1.90 000
cavity.
49081 ................ A Removal of abdominal 1.26 3.14 0.60 0.06 4.46 1.92 000
fluid.
49085 ................ A Remove abdomen foreign 12.14 NA 6.72 0.88 NA 19.74 090
body.
49180 ................ A Biopsy, abdominal mass 1.73 8.50 0.60 0.08 10.31 2.41 000
49200 ................ A Removal of abdominal 10.25 NA 6.59 0.89 NA 17.73 090
lesion.
49201 ................ A Removal of abdominal 14.84 NA 8.90 1.44 NA 25.18 090
lesion.
49215 ................ A Excise sacral spine 33.50 NA 15.52 2.48 NA 51.50 090
tumor.
49220 ................ A Multiple surgery, 14.88 NA 7.94 1.51 NA 24.33 090
abdomen.
49250 ................ A Excision of umbilicus. 8.35 NA 5.26 0.84 NA 14.45 090
49255 ................ A Removal of omentum.... 11.14 NA 6.66 1.12 NA 18.92 090
49320 ................ A Diag laparo separate 5.10 NA 3.08 0.50 NA 8.68 010
proc.
49321 ................ A Laparoscopy, biopsy... 5.40 NA 3.07 0.53 NA 9.00 010
49322 ................ A Laparoscopy, 5.70 NA 3.53 0.57 NA 9.80 010
aspiration.
49323 ................ A Laparo drain 9.48 NA 4.18 0.88 NA 14.54 090
lymphocele.
49329 ................ C Laparo proc, abdm/per/ 0.00 0.00 0.00 0.00 0.00 0.00 YYY
oment.
49400 ................ A Air injection into 1.88 NA 0.82 0.11 NA 2.81 000
abdomen.
49420 ................ A Insert abdominal drain 2.22 NA 0.98 0.13 NA 3.33 000
49421 ................ A Insert abdominal drain 5.54 NA 4.08 0.55 NA 10.17 090
49422 ................ A Remove perm cannula/ 6.25 NA 3.01 0.63 NA 9.89 010
catheter.
49423 ................ A Exchange drainage 1.46 NA 0.70 0.07 NA 2.23 000
catheter.
49424 ................ A Assess cyst, contrast 0.76 NA 0.45 0.03 NA 1.24 000
inject.
49425 ................ A Insert abdomen-venous 11.37 NA 6.79 1.21 NA 19.37 090
drain.
49426 ................ A Revise abdomen-venous 9.63 NA 6.17 0.93 NA 16.73 090
shunt.
49427 ................ A Injection, abdominal 0.89 NA 0.50 0.05 NA 1.44 000
shunt.
49428 ................ A Ligation of shunt..... 6.06 NA 3.19 0.31 NA 9.56 010
49429 ................ A Removal of shunt...... 7.40 NA 3.55 0.81 NA 11.76 010
49491 ................ A Repairing hern premie 11.13 NA 5.65 1.00 NA 17.78 090
reduc.
49492 ................ A Rpr ing hern premie, 14.03 NA 6.40 1.42 NA 21.85 090
blocked.
49495 ................ A Rpr ing hernia baby, 5.89 NA 3.72 0.55 NA 10.16 090
reduc.
49496 ................ A Rpr ing hernia baby, 8.79 NA 5.94 0.89 NA 15.62 090
blocked.
49500 ................ A Rpr ing hernia, init, 5.48 NA 3.48 0.46 NA 9.42 090
reduce.
49501 ................ A Rpr ing hernia, init 8.88 NA 4.62 0.76 NA 14.26 090
blocked.
49505 ................ A Rpr i/hern init 7.60 4.58 4.13 0.65 12.83 12.38 090
reduc>5 yr.
49507 ................ A Rpr i/hern init 9.57 NA 6.17 0.83 NA 16.57 090
block>5 yr.
49520 ................ A Rerepair ing hernia, 9.63 NA 5.49 0.84 NA 15.96 090
reduce.
49521 ................ A Rerepair ing hernia, 11.97 NA 5.85 1.04 NA 18.86 090
blocked.
49525 ................ A Repair ing hernia, 8.57 NA 4.97 0.74 NA 14.28 090
sliding.
49540 ................ A Repair lumbar hernia.. 10.39 NA 5.65 0.90 NA 16.94 090
49550 ................ A Rpr fem hernia, init, 8.63 NA 4.55 0.75 NA 13.93 090
reduce.
49553 ................ A Rpr fem hernia, init 9.44 NA 4.95 0.83 NA 15.22 090
blocked.
49555 ................ A Rerepair fem hernia, 9.03 NA 5.30 0.79 NA 15.12 090
reduce.
49557 ................ A Rerepair fem hernia, 11.15 NA 5.59 0.97 NA 17.71 090
blocked.
[[Page 55383]]
49560 ................ A Rpr ventral hern init, 11.57 NA 6.11 1.00 NA 18.68 090
reduc.
49561 ................ A Rpr ventral hern init, 14.25 NA 6.71 1.23 NA 22.19 090
block.
49565 ................ A Rerepair ventrl hern, 11.57 NA 6.27 1.00 NA 18.84 090
reduce.
49566 ................ A Rerepair ventrl hern, 14.40 NA 6.79 1.24 NA 22.43 090
block.
49568 ................ A Hernia repair w/mesh.. 4.89 NA 1.76 0.50 NA 7.15 ZZZ
49570 ................ A Rpr epigastric hern, 5.69 NA 3.54 0.50 NA 9.73 090
reduce.
49572 ................ A Rpr epigastric hern, 6.73 NA 4.00 0.58 NA 11.31 090
blocked.
49580 ................ A Rpr umbil hern, reduc 4.11 NA 3.03 0.34 NA 7.48 090
5 yr.
49582 ................ A Rpr umbil hern, block 6.65 NA 5.02 0.57 NA 12.24 090
5 yr.
49585 ................ A Rpr umbil hern, reduc 6.23 NA 4.15 0.53 NA 10.91 090
> 5 yr.
49587 ................ A Rpr umbil hern, block 7.56 NA 4.27 0.65 NA 12.48 090
> 5 yr.
49590 ................ A Repair spigelian 8.54 NA 4.96 0.74 NA 14.24 090
hernia.
49600 ................ A Repair umbilical 10.96 NA 6.30 1.13 NA 18.39 090
lesion.
49605 ................ A Repair umbilical 76.00 NA 30.79 2.57 NA 109.36 090
lesion.
49606 ................ A Repair umbilical 18.60 NA 9.61 2.22 NA 30.43 090
lesion.
49610 ................ A Repair umbilical 10.50 NA 6.87 0.77 NA 18.14 090
lesion.
49611 ................ A Repair umbilical 8.92 NA 6.56 0.65 NA 16.13 090
lesion.
49650 ................ A Laparo hernia repair 6.27 NA 3.33 0.64 NA 10.24 090
initial.
49651 ................ A Laparo hernia repair 8.24 NA 4.40 0.84 NA 13.48 090
recur.
49659 ................ C Laparo proc, hernia 0.00 0.00 0.00 0.00 0.00 0.00 YYY
repair.
49900 ................ A Repair of abdominal 12.28 NA 6.80 1.23 NA 20.31 090
wall.
49905 ................ A Omental flap.......... 6.55 NA 2.44 0.61 NA 9.60 ZZZ
49906 ................ C Free omental flap, 0.00 0.00 0.00 0.00 0.00 0.00 090
microvasc.
49999 ................ C Abdomen surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
50010 ................ A Exploration of kidney. 10.98 NA 7.07 0.79 NA 18.84 090
50020 ................ A Renal abscess, open 14.66 NA 13.72 0.80 NA 29.18 090
drain.
50021 ................ A Renal abscess, percut 3.38 NA 10.46 0.15 NA 13.99 000
drain.
50040 ................ A Drainage of kidney.... 14.94 NA 11.56 0.82 NA 27.32 090
50045 ................ A Exploration of kidney. 15.46 NA 8.55 1.06 NA 25.07 090
50060 ................ A Removal of kidney 19.30 NA 10.03 1.14 NA 30.47 090
stone.
50065 ................ A Incision of kidney.... 20.79 NA 10.56 1.13 NA 32.48 090
50070 ................ A Incision of kidney.... 20.32 NA 10.70 1.20 NA 32.22 090
50075 ................ A Removal of kidney 25.34 NA 12.65 1.51 NA 39.50 090
stone.
50080 ................ A Removal of kidney 14.71 NA 11.03 0.86 NA 26.60 090
stone.
50081 ................ A Removal of kidney 21.80 NA 13.27 1.30 NA 36.37 090
stone.
50100 ................ A Revise kidney blood 16.09 NA 9.34 1.64 NA 27.07 090
vessels.
50120 ................ A Exploration of kidney. 15.91 NA 8.93 1.04 NA 25.88 090
50125 ................ A Explore and drain 16.52 NA 9.48 1.07 NA 27.07 090
kidney.
50130 ................ A Removal of kidney 17.29 NA 9.24 1.04 NA 27.57 090
stone.
50135 ................ A Exploration of kidney. 19.18 NA 9.93 1.18 NA 30.29 090
50200 ................ A Biopsy of kidney...... 2.63 NA 0.96 0.12 NA 3.71 000
50205 ................ A Biopsy of kidney...... 11.31 NA 6.52 0.94 NA 18.77 090
50220 ................ A Remove kidney, open... 17.15 NA 9.29 1.16 NA 27.60 090
50225 ................ A Removal kidney open, 20.23 NA 10.30 1.26 NA 31.79 090
complex.
50230 ................ A Removal kidney open, 22.07 NA 10.92 1.35 NA 34.34 090
radical.
50234 ................ A Removal of kidney & 22.40 NA 11.05 1.37 NA 34.82 090
ureter.
50236 ................ A Removal of kidney & 24.86 NA 14.27 1.50 NA 40.63 090
ureter.
50240 ................ A Partial removal of 22.00 NA 13.32 1.36 NA 36.68 090
kidney.
50280 ................ A Removal of kidney 15.67 NA 8.69 0.99 NA 25.35 090
lesion.
50290 ................ A Removal of kidney 14.73 NA 8.49 1.11 NA 24.33 090
lesion.
50300 ................ X Removal of donor 0.00 0.00 0.00 0.00 0.00 0.00 XXX
kidney.
50320 ................ A Removal of donor 22.21 NA 10.98 1.78 NA 34.97 090
kidney.
50340 ................ A Removal of kidney..... 12.15 NA 9.31 1.15 NA 22.61 090
50360 ................ A Transplantation of 31.53 NA 17.87 2.97 NA 52.37 090
kidney.
50365 ................ A Transplantation of 36.81 NA 21.29 3.51 NA 61.61 090
kidney.
50370 ................ A Remove transplanted 13.72 NA 9.88 1.26 NA 24.86 090
kidney.
50380 ................ A Reimplantation of 20.76 NA 13.52 1.80 NA 36.08 090
kidney.
50390 ................ A Drainage of kidney 1.96 NA 0.68 0.09 NA 2.73 000
lesion.
50392 ................ A Insert kidney drain... 3.38 NA 1.18 0.15 NA 4.71 000
50393 ................ A Insert ureteral tube.. 4.16 NA 1.44 0.18 NA 5.78 000
50394 ................ A Injection for kidney x- 0.76 2.60 0.26 0.04 3.40 1.06 000
ray.
50395 ................ A Create passage to 3.38 NA 1.17 0.16 NA 4.71 000
kidney.
50396 ................ A Measure kidney 2.09 NA 0.89 0.10 NA 3.08 000
pressure.
50398 ................ A Change kidney tube.... 1.46 1.06 0.51 0.07 2.59 2.04 000
50400 ................ A Revision of kidney/ 19.50 NA 10.06 1.21 NA 30.77 090
ureter.
50405 ................ A Revision of kidney/ 23.93 NA 11.84 1.45 NA 37.22 090
ureter.
50500 ................ A Repair of kidney wound 19.57 NA 11.37 1.45 NA 32.39 090
50520 ................ A Close kidney-skin 17.23 NA 11.80 1.26 NA 30.29 090
fistula.
50525 ................ A Repair renal-abdomen 22.27 NA 13.30 1.51 NA 37.08 090
fistula.
50526 ................ A Repair renal-abdomen 24.02 NA 14.86 1.62 NA 40.50 090
fistula.
50540 ................ A Revision of horseshoe 19.93 NA 10.42 1.28 NA 31.63 090
kidney.
50541 ................ A Laparo ablate renal 16.00 NA 6.79 0.99 NA 23.78 090
cyst.
50544 ................ A Laparoscopy, 22.40 NA 9.04 1.41 NA 32.85 090
pyeloplasty.
[[Page 55384]]
50545 ................ A Laparo radical 24.00 NA 9.65 1.53 NA 35.18 090
nephrectomy.
50546 ................ A Laparoscopic 20.48 NA 8.40 1.37 NA 30.25 090
nephrectomy.
50547 ................ A Laparo removal donor 25.50 NA 11.27 2.04 NA 38.81 090
kidney.
50548 ................ A Laparo remove k/ureter 24.40 NA 9.70 1.49 NA 35.59 090
50549 ................ C Laparoscope proc, 0.00 0.00 0.00 0.00 0.00 0.00 YYY
renal.
50551 ................ A Kidney endoscopy...... 5.60 4.93 1.90 0.33 10.86 7.83 000
50553 ................ A Kidney endoscopy...... 5.99 16.25 2.05 0.35 22.59 8.39 000
50555 ................ A Kidney endoscopy & 6.53 20.11 2.25 0.38 27.02 9.16 000
biopsy.
50557 ................ A Kidney endoscopy & 6.62 20.23 2.25 0.39 27.24 9.26 000
treatment.
50559 ................ A Renal endoscopy/ 6.78 NA 2.42 0.27 NA 9.47 000
radiotracer.
50561 ................ A Kidney endoscopy & 7.59 18.31 2.58 0.44 26.34 10.61 000
treatment.
50570 ................ A Kidney endoscopy...... 9.54 NA 3.24 0.56 NA 13.34 000
50572 ................ A Kidney endoscopy...... 10.35 NA 3.52 0.64 NA 14.51 000
50574 ................ A Kidney endoscopy & 11.02 NA 3.87 0.65 NA 15.54 000
biopsy.
50575 ................ A Kidney endoscopy...... 13.98 NA 4.73 0.84 NA 19.55 000
50576 ................ A Kidney endoscopy & 10.99 NA 3.74 0.66 NA 15.39 000
treatment.
50578 ................ A Renal endoscopy/ 11.35 NA 4.01 0.67 NA 16.03 000
radiotracer.
50580 ................ A Kidney endoscopy & 11.86 NA 4.03 0.70 NA 16.59 000
treatment.
50590 ................ A Fragmenting of kidney 9.09 10.78 5.35 0.54 20.41 14.98 090
stone.
50600 ................ A Exploration of ureter. 15.84 NA 9.07 0.99 NA 25.90 090
50605 ................ A Insert ureteral 15.46 NA 8.88 1.13 NA 25.47 090
support.
50610 ................ A Removal of ureter 15.92 NA 9.09 1.08 NA 26.09 090
stone.
50620 ................ A Removal of ureter 15.16 NA 8.55 0.91 NA 24.62 090
stone.
50630 ................ A Removal of ureter 14.94 NA 8.48 0.90 NA 24.32 090
stone.
50650 ................ A Removal of ureter..... 17.41 NA 9.71 1.07 NA 28.19 090
50660 ................ A Removal of ureter..... 19.55 NA 10.43 1.19 NA 31.17 090
50684 ................ A Injection for ureter x- 0.76 15.02 0.26 0.04 15.82 1.06 000
ray.
50686 ................ A Measure ureter 1.51 5.08 0.65 0.09 6.68 2.25 000
pressure.
50688 ................ A Change of ureter tube. 1.17 NA 1.76 0.06 NA 2.99 010
50690 ................ A Injection for ureter x- 1.16 15.40 0.40 0.06 16.62 1.62 000
ray.
50700 ................ A Revision of ureter.... 15.21 NA 9.09 0.86 NA 25.16 090
50715 ................ A Release of ureter..... 18.90 NA 12.37 1.68 NA 32.95 090
50722 ................ A Release of ureter..... 16.35 NA 10.42 1.41 NA 28.18 090
50725 ................ A Release/revise ureter. 18.49 NA 10.61 1.44 NA 30.54 090
50727 ................ A Revise ureter......... 8.18 NA 6.54 0.51 NA 15.23 090
50728 ................ A Revise ureter......... 12.02 NA 8.18 0.88 NA 21.08 090
50740 ................ A Fusion of ureter & 18.42 NA 9.66 1.49 NA 29.57 090
kidney.
50750 ................ A Fusion of ureter & 19.51 NA 10.48 1.24 NA 31.23 090
kidney.
50760 ................ A Fusion of ureters..... 18.42 NA 10.11 1.25 NA 29.78 090
50770 ................ A Splicing of ureters... 19.51 NA 10.43 1.25 NA 31.19 090
50780 ................ A Reimplant ureter in 18.36 NA 10.01 1.20 NA 29.57 090
bladder.
50782 ................ A Reimplant ureter in 19.54 NA 11.91 1.13 NA 32.58 090
bladder.
50783 ................ A Reimplant ureter in 20.55 NA 11.22 1.35 NA 33.12 090
bladder.
50785 ................ A Reimplant ureter in 20.52 NA 10.83 1.30 NA 32.65 090
bladder.
50800 ................ A Implant ureter in 14.52 NA 10.02 0.92 NA 25.46 090
bowel.
50810 ................ A Fusion of ureter & 20.05 NA 12.23 1.78 NA 34.06 090
bowel.
50815 ................ A Urine shunt to 19.93 NA 11.71 1.31 NA 32.95 090
intestine.
50820 ................ A Construct bowel 21.89 NA 12.38 1.38 NA 35.65 090
bladder.
50825 ................ A Construct bowel 28.18 NA 15.30 1.81 NA 45.29 090
bladder.
50830 ................ A Revise urine flow..... 31.28 NA 15.96 2.20 NA 49.44 090
50840 ................ A Replace ureter by 20.00 NA 11.83 1.26 NA 33.09 090
bowel.
50845 ................ A Appendico-vesicostomy. 20.89 NA 10.20 1.26 NA 32.35 090
50860 ................ A Transplant ureter to 15.36 NA 8.93 1.01 NA 25.30 090
skin.
50900 ................ A Repair of ureter...... 13.62 NA 8.08 0.98 NA 22.68 090
50920 ................ A Closure ureter/skin 14.33 NA 8.37 0.84 NA 23.54 090
fistula.
50930 ................ A Closure ureter/bowel 18.72 NA 10.80 1.57 NA 31.09 090
fistula.
50940 ................ A Release of ureter..... 14.51 NA 8.44 1.04 NA 23.99 090
50945 ................ A Laparoscopy 17.00 NA 7.42 1.15 NA 25.57 090
ureterolithotomy.
50947 ................ A Laparo new ureter/ 24.50 NA 11.74 1.99 NA 38.23 090
bladder.
50948 ................ A Laparo new ureter/ 22.50 NA 10.61 1.83 NA 34.94 090
bladder.
50949 ................ C Laparoscope proc, 0.00 0.00 0.00 0.00 0.00 0.00 YYY
ureter.
50951 ................ A Endoscopy of ureter... 5.84 5.28 1.98 0.35 11.47 8.17 000
50953 ................ A Endoscopy of ureter... 6.24 16.55 2.12 0.37 23.16 8.73 000
50955 ................ A Ureter endoscopy & 6.75 21.11 2.38 0.38 28.24 9.51 000
biopsy.
50957 ................ A Ureter endoscopy & 6.79 19.64 2.28 0.40 26.83 9.47 000
treatment.
50959 ................ A Ureter endoscopy & 4.40 NA 1.58 0.18 NA 6.16 000
tracer.
50961 ................ A Ureter endoscopy & 6.05 23.38 2.04 0.35 29.78 8.44 000
treatment.
50970 ................ A Ureter endoscopy...... 7.14 NA 2.43 0.43 NA 10.00 000
50972 ................ A Ureter endoscopy & 6.89 NA 2.52 0.39 NA 9.80 000
catheter.
50974 ................ A Ureter endoscopy & 9.17 NA 3.16 0.53 NA 12.86 000
biopsy.
50976 ................ A Ureter endoscopy & 9.04 NA 3.09 0.53 NA 12.66 000
treatment.
50978 ................ A Ureter endoscopy & 5.10 NA 1.88 0.30 NA 7.28 000
tracer.
50980 ................ A Ureter endoscopy & 6.85 NA 2.34 0.41 NA 9.60 000
treatment.
[[Page 55385]]
51000 ................ A Drainage of bladder... 0.78 2.03 0.25 0.05 2.86 1.08 000
51005 ................ A Drainage of bladder... 1.02 3.37 0.35 0.08 4.47 1.45 000
51010 ................ A Drainage of bladder... 3.53 4.42 2.37 0.23 8.18 6.13 010
51020 ................ A Incise & treat bladder 6.71 NA 5.72 0.42 NA 12.85 090
51030 ................ A Incise & treat bladder 6.77 NA 6.01 0.42 NA 13.20 090
51040 ................ A Incise & drain bladder 4.40 NA 4.47 0.27 NA 9.14 090
51045 ................ A Incise bladder/drain 6.77 NA 6.01 0.47 NA 13.25 090
ureter.
51050 ................ A Removal of bladder 6.92 NA 5.27 0.42 NA 12.61 090
stone.
51060 ................ A Removal of ureter 8.85 NA 6.53 0.54 NA 15.92 090
stone.
51065 ................ A Remove ureter calculus 8.85 NA 6.06 0.53 NA 15.44 090
51080 ................ A Drainage of bladder 5.96 NA 5.67 0.35 NA 11.98 090
abscess.
51500 ................ A Removal of bladder 10.14 NA 6.13 0.88 NA 17.15 090
cyst.
51520 ................ A Removal of bladder 9.29 NA 6.66 0.58 NA 16.53 090
lesion.
51525 ................ A Removal of bladder 13.97 NA 8.15 0.85 NA 22.97 090
lesion.
51530 ................ A Removal of bladder 12.38 NA 7.81 0.82 NA 21.01 090
lesion.
51535 ................ A Repair of ureter 12.57 NA 8.23 0.90 NA 21.70 090
lesion.
51550 ................ A Partial removal of 15.66 NA 8.68 1.05 NA 25.39 090
bladder.
51555 ................ A Partial removal of 21.23 NA 11.00 1.37 NA 33.60 090
bladder.
51565 ................ A Revise bladder & 21.62 NA 11.62 1.40 NA 34.64 090
ureter(s).
51570 ................ A Removal of bladder.... 24.24 NA 12.60 1.59 NA 38.43 090
51575 ................ A Removal of bladder & 30.45 NA 15.35 1.88 NA 47.68 090
nodes.
51580 ................ A Remove bladder/revise 31.08 NA 16.01 1.94 NA 49.03 090
tract.
51585 ................ A Removal of bladder & 35.23 NA 17.34 2.18 NA 54.75 090
nodes.
51590 ................ A Remove bladder/revise 32.66 NA 16.01 2.01 NA 50.68 090
tract.
51595 ................ A Remove bladder/revise 37.14 NA 17.55 2.23 NA 56.92 090
tract.
51596 ................ A Remove bladder/create 39.52 NA 18.94 2.39 NA 60.85 090
pouch.
51597 ................ A Removal of pelvic 38.35 NA 18.06 2.49 NA 58.90 090
structures.
51600 ................ A Injection for bladder 0.88 5.51 0.30 0.04 6.43 1.22 000
x-ray.
51605 ................ A Preparation for 0.64 16.73 0.22 0.04 17.41 0.90 000
bladder x-ray.
51610 ................ A Injection for bladder 1.05 16.20 0.36 0.05 17.30 1.46 000
x-ray.
51700 ................ A Irrigation of bladder. 0.88 1.32 0.30 0.05 2.25 1.23 000
51705 ................ A Change of bladder tube 1.02 2.15 0.65 0.06 3.23 1.73 010
51710 ................ A Change of bladder tube 1.49 5.11 1.47 0.09 6.69 3.05 010
51715 ................ A Endoscopic injection/ 3.74 4.44 1.29 0.24 8.42 5.27 000
implant.
51720 ................ A Treatment of bladder 1.96 1.68 0.74 0.12 3.76 2.82 000
lesion.
51725 ................ A Simple cystometrogram. 1.51 5.92 NA 0.13 7.56 NA 000
51725 26 A Simple cystometrogram. 1.51 0.52 0.52 0.10 2.13 2.13 000
51725 TC A Simple cystometrogram. 0.00 5.40 NA 0.03 5.43 NA 000
51726 ................ A Complex cystometrogram 1.71 4.65 NA 0.15 6.51 NA 000
51726 26 A Complex cystometrogram 1.71 0.59 0.59 0.11 2.41 2.41 000
51726 TC A Complex cystometrogram 0.00 4.06 NA 0.04 4.10 NA 000
51736 ................ A Urine flow measurement 0.61 1.07 NA 0.05 1.73 NA 000
51736 26 A Urine flow measurement 0.61 0.21 0.21 0.04 0.86 0.86 000
51736 TC A Urine flow measurement 0.00 0.86 NA 0.01 0.87 NA 000
51741 ................ A Electro-uroflowmetry, 1.14 1.93 NA 0.09 3.16 NA 000
first.
51741 26 A Electro-uroflowmetry, 1.14 0.40 0.40 0.07 1.61 1.61 000
first.
51741 TC A Electro-uroflowmetry, 0.00 1.53 NA 0.02 1.55 NA 000
first.
51772 ................ A Urethra pressure 1.61 4.73 NA 0.16 6.50 NA 000
profile.
51772 26 A Urethra pressure 1.61 0.59 0.59 0.12 2.32 2.32 000
profile.
51772 TC A Urethra pressure 0.00 4.14 NA 0.04 4.18 NA 000
profile.
51784 ................ A Anal/urinary muscle 1.53 3.36 NA 0.13 5.02 NA 000
study.
51784 26 A Anal/urinary muscle 1.53 0.53 0.53 0.10 2.16 2.16 000
study.
51784 TC A Anal/urinary muscle 0.00 2.83 NA 0.03 2.86 NA 000
study.
51785 ................ A Anal/urinary muscle 1.53 3.46 NA 0.12 5.11 NA 000
study.
51785 26 A Anal/urinary muscle 1.53 0.53 0.53 0.09 2.15 2.15 000
study.
51785 TC A Anal/urinary muscle 0.00 2.93 NA 0.03 2.96 NA 000
study.
51792 ................ A Urinary reflex study.. 1.10 3.33 NA 0.20 4.63 NA 000
51792 26 A Urinary reflex study.. 1.10 0.43 0.43 0.09 1.62 1.62 000
51792 TC A Urinary reflex study.. 0.00 2.90 NA 0.11 3.01 NA 000
51795 ................ A Urine voiding pressure 1.53 4.84 NA 0.18 6.55 NA 000
study.
51795 26 A Urine voiding pressure 1.53 0.53 0.53 0.10 2.16 2.16 000
study.
51795 TC A Urine voiding pressure 0.00 4.31 NA 0.08 4.39 NA 000
study.
51797 ................ A Intraabdominal 1.60 4.87 NA 0.14 6.61 NA 000
pressure test.
51797 26 A Intraabdominal 1.60 0.56 0.56 0.10 2.26 2.26 000
pressure test.
51797 TC A Intraabdominal 0.00 4.31 NA 0.04 4.35 NA 000
pressure test.
51800 ................ A Revision of bladder/ 17.42 NA 9.59 1.17 NA 28.18 090
urethra.
51820 ................ A Revision of urinary 17.89 NA 10.91 1.45 NA 30.25 090
tract.
51840 ................ A Attach bladder/urethra 10.71 NA 6.88 0.87 NA 18.46 090
51841 ................ A Attach bladder/urethra 13.03 NA 8.57 1.04 NA 22.64 090
51845 ................ A Repair bladder neck... 9.73 NA 6.90 0.62 NA 17.25 090
51860 ................ A Repair of bladder 12.02 NA 7.90 0.89 NA 20.81 090
wound.
51865 ................ A Repair of bladder 15.04 NA 8.93 1.01 NA 24.98 090
wound.
51880 ................ A Repair of bladder 7.66 NA 5.98 0.54 NA 14.18 090
opening.
[[Page 55386]]
51900 ................ A Repair bladder/vagina 12.97 NA 8.29 0.87 NA 22.13 090
lesion.
51920 ................ A Close bladder-uterus 11.81 NA 7.65 0.86 NA 20.32 090
fistula.
51925 ................ A Hysterectomy/bladder 15.58 NA 9.65 1.48 NA 26.71 090
repair.
51940 ................ A Correction of bladder 28.43 NA 16.41 1.97 NA 46.81 090
defect.
51960 ................ A Revision of bladder & 23.01 NA 13.39 1.41 NA 37.81 090
bowel.
51980 ................ A Construct bladder 11.36 NA 7.30 0.74 NA 19.40 090
opening.
51990 ................ A Laparo urethral 12.50 NA 6.79 1.02 NA 20.31 090
suspension.
51992 ................ A Laparo sling operation 14.01 NA 6.81 0.93 NA 21.75 090
52000 ................ A Cystoscopy............ 2.01 3.45 0.69 0.12 5.58 2.82 000
52001 ................ A Cystoscopy, removal of 2.37 NA 0.98 0.32 NA 3.67 000
clots.
52005 ................ A Cystoscopy & ureter 2.37 13.40 0.91 0.15 15.92 3.43 000
catheter.
52007 ................ A Cystoscopy and biopsy. 3.02 NA 1.02 0.18 NA 4.22 000
52010 ................ A Cystoscopy & duct 3.02 5.91 1.02 0.18 9.11 4.22 000
catheter.
52204 ................ A Cystoscopy............ 2.37 6.17 0.80 0.15 8.69 3.32 000
52214 ................ A Cystoscopy and 3.71 6.53 1.26 0.22 10.46 5.19 000
treatment.
52224 ................ A Cystoscopy and 3.14 6.41 1.07 0.18 9.73 4.39 000
treatment.
52234 ................ A Cystoscopy and 4.63 NA 1.68 0.27 NA 6.58 000
treatment.
52235 ................ A Cystoscopy and 5.45 NA 1.97 0.32 NA 7.74 000
treatment.
52240 ................ A Cystoscopy and 9.72 NA 3.43 0.58 NA 13.73 000
treatment.
52250 ................ A Cystoscopy and 4.50 NA 1.53 0.27 NA 6.30 000
radiotracer.
52260 ................ A Cystoscopy and 3.92 NA 1.34 0.23 NA 5.49 000
treatment.
52265 ................ A Cystoscopy and 2.94 3.77 1.00 0.18 6.89 4.12 000
treatment.
52270 ................ A Cystoscopy & revise 3.37 6.88 1.14 0.20 10.45 4.71 000
urethra.
52275 ................ A Cystoscopy & revise 4.70 7.42 1.59 0.28 12.40 6.57 000
urethra.
52276 ................ A Cystoscopy and 5.00 7.55 1.70 0.30 12.85 7.00 000
treatment.
52277 ................ A Cystoscopy and 6.17 NA 2.12 0.38 NA 8.67 000
treatment.
52281 ................ A Cystoscopy and 2.80 14.54 1.08 0.17 17.51 4.05 000
treatment.
52282 ................ A Cystoscopy, implant 6.40 15.36 2.18 0.38 22.14 8.96 000
stent.
52283 ................ A Cystoscopy and 3.74 6.58 1.27 0.22 10.54 5.23 000
treatment.
52285 ................ A Cystoscopy and 3.61 7.06 1.23 0.22 10.89 5.06 000
treatment.
52290 ................ A Cystoscopy and 4.59 NA 1.56 0.27 NA 6.42 000
treatment.
52300 ................ A Cystoscopy and 5.31 NA 1.80 0.32 NA 7.43 000
treatment.
52301 ................ A Cystoscopy and 5.51 NA 1.82 0.39 NA 7.72 000
treatment.
52305 ................ A Cystoscopy and 5.31 NA 1.80 0.31 NA 7.42 000
treatment.
52310 ................ A Cystoscopy and 2.81 3.85 1.02 0.17 6.83 4.00 000
treatment.
52315 ................ A Cystoscopy and 5.21 16.43 1.76 0.31 21.95 7.28 000
treatment.
52317 ................ A Remove bladder stone.. 6.72 26.09 2.28 0.40 33.21 9.40 000
52318 ................ A Remove bladder stone.. 9.19 NA 3.11 0.54 NA 12.84 000
52320 ................ A Cystoscopy and 4.70 NA 1.59 0.28 NA 6.57 000
treatment.
52325 ................ A Cystoscopy, stone 6.16 NA 2.08 0.37 NA 8.61 000
removal.
52327 ................ A Cystoscopy, inject 5.19 NA 1.77 0.32 NA 7.28 000
material.
52330 ................ A Cystoscopy and 5.04 20.79 1.71 0.30 26.13 7.05 000
treatment.
52332 ................ A Cystoscopy and 2.83 18.84 1.07 0.17 21.84 4.07 000
treatment.
52334 ................ A Create passage to 4.83 NA 1.63 0.28 NA 6.74 000
kidney.
52341 ................ A Cysto w/ureter 6.00 NA 2.40 0.37 NA 8.77 000
stricture tx.
52342 ................ A Cysto w/up stricture 6.50 NA 2.59 0.40 NA 9.49 000
tx.
52343 ................ A Cysto w/renal 7.20 NA 2.87 0.44 NA 10.51 000
stricture tx.
52344 ................ A Cysto/uretero, stone 7.70 NA 3.07 0.47 NA 11.24 000
remove.
52345 ................ A Cysto/uretero w/up 8.20 NA 3.27 0.50 NA 11.97 000
stricture.
52346 ................ A Cystouretero w/renal 9.23 NA 3.68 0.57 NA 13.48 000
strict.
52347 ................ A Cystoscopy, resect 5.28 NA 2.14 0.33 NA 7.75 000
ducts.
52351 ................ A Cystouretro & or 5.86 NA 1.99 0.36 NA 8.21 000
pyeloscope.
52352 ................ A Cystouretro w/stone 6.88 NA 2.33 0.42 NA 9.63 000
remove.
52353 ................ A Cystouretero w/ 7.97 NA 2.69 0.49 NA 11.15 000
lithotripsy.
52354 ................ A Cystouretero w/biopsy. 7.34 NA 2.49 0.45 NA 10.28 000
52355 ................ A Cystouretero w/excise 8.82 NA 2.99 0.55 NA 12.36 000
tumor.
52400 ................ A Cystouretero w/congen 9.68 NA 5.75 0.60 NA 16.03 090
repr.
52450 ................ A Incision of prostate.. 7.64 NA 6.56 0.46 NA 14.66 090
52500 ................ A Revision of bladder 8.47 NA 6.81 0.50 NA 15.78 090
neck.
52510 ................ A Dilation prostatic 6.72 NA 5.80 0.40 NA 12.92 090
urethra.
52601 ................ A Prostatectomy (TURP).. 12.37 NA 8.16 0.74 NA 21.27 090
52606 ................ A Control postop 8.13 NA 6.27 0.49 NA 14.89 090
bleeding.
52612 ................ A Prostatectomy, first 7.98 NA 6.72 0.48 NA 15.18 090
stage.
52614 ................ A Prostatectomy, second 6.84 NA 6.30 0.41 NA 13.55 090
stage.
52620 ................ A Remove residual 6.61 NA 6.22 0.39 NA 13.22 090
prostate.
52630 ................ A Remove prostate 7.26 NA 6.44 0.43 NA 14.13 090
regrowth.
52640 ................ A Relieve bladder 6.62 NA 5.73 0.39 NA 12.74 090
contracture.
52647 ................ A Laser surgery of 10.36 59.33 4.85 0.61 70.30 15.82 090
prostate.
52648 ................ A Laser surgery of 11.21 NA 7.63 0.66 NA 19.50 090
prostate.
52700 ................ A Drainage of prostate 6.80 NA 6.32 0.41 NA 13.53 090
abscess.
53000 ................ A Incision of urethra... 2.28 7.47 2.63 0.13 9.88 5.04 010
53010 ................ A Incision of urethra... 3.64 NA 4.12 0.20 NA 7.96 090
53020 ................ A Incision of urethra... 1.77 4.43 0.67 0.11 6.31 2.55 000
[[Page 55387]]
53025 ................ A Incision of urethra... 1.13 4.81 0.45 0.07 6.01 1.65 000
53040 ................ A Drainage of urethra 6.40 14.74 8.33 0.41 21.55 15.14 090
abscess.
53060 ................ A Drainage of urethra 2.63 6.21 2.91 0.23 9.07 5.77 010
abscess.
53080 ................ A Drainage of urinary 6.29 NA 8.37 0.42 NA 15.08 090
leakage.
53085 ................ A Drainage of urinary 10.27 NA 10.29 0.67 NA 21.23 090
leakage.
53200 ................ A Biopsy of urethra..... 2.59 5.63 0.97 0.17 8.39 3.73 000
53210 ................ A Removal of urethra.... 12.57 NA 8.00 0.81 NA 21.38 090
53215 ................ A Removal of urethra.... 15.58 NA 8.81 0.93 NA 25.32 090
53220 ................ A Treatment of urethra 7.00 NA 5.71 0.44 NA 13.15 090
lesion.
53230 ................ A Removal of urethra 9.58 NA 6.36 0.60 NA 16.54 090
lesion.
53235 ................ A Removal of urethra 10.14 NA 6.49 0.60 NA 17.23 090
lesion.
53240 ................ A Surgery for urethra 6.45 NA 5.32 0.42 NA 12.19 090
pouch.
53250 ................ A Removal of urethra 5.89 NA 4.74 0.35 NA 10.98 090
gland.
53260 ................ A Treatment of urethra 2.98 6.11 2.44 0.23 9.32 5.65 010
lesion.
53265 ................ A Treatment of urethra 3.12 6.60 2.42 0.20 9.92 5.74 010
lesion.
53270 ................ A Removal of urethra 3.09 7.03 2.83 0.21 10.33 6.13 010
gland.
53275 ................ A Repair of urethra 4.53 NA 3.43 0.28 NA 8.24 010
defect.
53400 ................ A Revise urethra, stage 12.77 NA 8.31 0.85 NA 21.93 090
1.
53405 ................ A Revise urethra, stage 14.48 NA 8.61 0.91 NA 24.00 090
2.
53410 ................ A Reconstruction of 16.44 NA 9.21 0.99 NA 26.64 090
urethra.
53415 ................ A Reconstruction of 19.41 NA 10.16 1.16 NA 30.73 090
urethra.
53420 ................ A Reconstruct urethra, 14.08 NA 8.82 0.90 NA 23.80 090
stage 1.
53425 ................ A Reconstruct urethra, 15.98 NA 9.02 0.97 NA 25.97 090
stage 2.
53430 ................ A Reconstruction of 16.34 NA 9.34 1.01 NA 26.69 090
urethra.
53431 ................ A Reconstruct urethra/ 19.89 7.94 7.94 1.25 29.08 29.08 090
bladder.
53440 ................ A Correct bladder 12.34 NA 8.09 0.73 NA 21.16 090
function.
53442 ................ A Remove perineal 8.27 NA 6.08 0.55 NA 14.90 090
prosthesis.
53443 ................ D Reconstruction of 0.00 NA 0.00 0.00 NA 0.00 090
urethra.
53444 ................ A Insert tandem cuff.... 13.40 NA 6.66 0.79 NA 20.85 090
53445 ................ A Insert uro/ves nck 14.06 NA 8.72 0.84 NA 23.62 090
sphincter.
53446 ................ A Remove uro sphincter.. 10.23 NA 8.46 0.61 NA 19.30 090
53447 ................ A Remove/replace ur 13.49 NA 7.90 0.79 NA 22.18 090
sphincter.
53448 ................ A Remov/replc ur 21.15 NA 12.35 1.27 NA 34.77 090
sphinctr comp.
53449 ................ A Repair uro sphincter.. 9.70 NA 6.73 0.57 NA 17.00 090
53450 ................ A Revision of urethra... 6.14 NA 5.16 0.37 NA 11.67 090
53460 ................ A Revision of urethra... 7.12 NA 5.50 0.43 NA 13.05 090
53502 ................ A Repair of urethra 7.63 NA 5.80 0.50 NA 13.93 090
injury.
53505 ................ A Repair of urethra 7.63 NA 5.62 0.46 NA 13.71 090
injury.
53510 ................ A Repair of urethra 10.11 NA 6.58 0.60 NA 17.29 090
injury.
53515 ................ A Repair of urethra 13.31 NA 7.81 0.83 NA 21.95 090
injury.
53520 ................ A Repair of urethra 8.68 NA 6.12 0.53 NA 15.33 090
defect.
53600 ................ A Dilate urethra 1.21 1.19 0.46 0.07 2.47 1.74 000
stricture.
53601 ................ A Dilate urethra 0.98 1.31 0.40 0.06 2.35 1.44 000
stricture.
53605 ................ A Dilate urethra 1.28 NA 0.44 0.08 NA 1.80 000
stricture.
53620 ................ A Dilate urethra 1.62 1.91 0.63 0.10 3.63 2.35 000
stricture.
53621 ................ A Dilate urethra 1.35 2.00 0.52 0.08 3.43 1.95 000
stricture.
53660 ................ A Dilation of urethra... 0.71 1.22 0.33 0.04 1.97 1.08 000
53661 ................ A Dilation of urethra... 0.72 1.21 0.31 0.04 1.97 1.07 000
53665 ................ A Dilation of urethra... 0.76 NA 0.27 0.05 NA 1.08 000
53670 ................ A Insert urinary 0.50 1.74 0.18 0.03 2.27 0.71 000
catheter.
53675 ................ A Insert urinary 1.47 2.63 0.58 0.09 4.19 2.14 000
catheter.
53850 ................ A Prostatic microwave 9.45 87.54 4.50 0.56 97.55 14.51 090
thermotx.
53852 ................ A Prostatic rf thermotx. 9.88 75.53 4.68 0.58 85.99 15.14 090
53853 ................ A Prostatic water 4.14 52.75 2.55 0.38 57.27 7.07 090
thermother.
53899 ................ C Urology surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
54000 ................ A Slitting of prepuce... 1.54 5.66 1.51 0.10 7.30 3.15 010
54001 ................ A Slitting of prepuce... 2.19 6.56 2.15 0.14 8.89 4.48 010
54015 ................ A Drain penis lesion.... 5.32 7.95 3.21 0.33 13.60 8.86 010
54050 ................ A Destruction, penis 1.24 2.85 0.47 0.07 4.16 1.78 010
lesion(s).
54055 ................ A Destruction, penis 1.22 6.64 1.42 0.07 7.93 2.71 010
lesion(s).
54056 ................ A Cryosurgery, penis 1.24 2.96 0.58 0.06 4.26 1.88 010
lesion(s).
54057 ................ A Laser surg, penis 1.24 2.97 1.41 0.08 4.29 2.73 010
lesion(s).
54060 ................ A Excision of penis 1.93 5.65 1.66 0.12 7.70 3.71 010
lesion(s).
54065 ................ A Destruction, penis 2.42 5.38 2.24 0.13 7.93 4.79 010
lesion(s).
54100 ................ A Biopsy of penis....... 1.90 3.54 0.77 0.10 5.54 2.77 000
54105 ................ A Biopsy of penis....... 3.50 6.75 2.19 0.21 10.46 5.90 010
54110 ................ A Treatment of penis 10.13 NA 8.20 0.60 NA 18.93 090
lesion.
54111 ................ A Treat penis lesion, 13.57 NA 9.37 0.79 NA 23.73 090
graft.
54112 ................ A Treat penis lesion, 15.86 NA 10.08 0.94 NA 26.88 090
graft.
54115 ................ A Treatment of penis 6.15 11.63 6.77 0.39 18.17 13.31 090
lesion.
54120 ................ A Partial removal of 9.97 NA 8.14 0.60 NA 18.71 090
penis.
54125 ................ A Removal of penis...... 13.53 NA 9.37 0.81 NA 23.71 090
54130 ................ A Remove penis & nodes.. 20.14 NA 12.00 1.19 NA 33.33 090
[[Page 55388]]
54135 ................ A Remove penis & nodes.. 26.36 NA 14.68 1.58 NA 42.62 090
54150 ................ A Circumcision.......... 1.81 6.04 1.87 0.17 8.02 3.85 010
54152 ................ A Circumcision.......... 2.31 NA 1.76 0.16 NA 4.23 010
54160 ................ A Circumcision.......... 2.48 5.04 1.82 0.16 7.68 4.46 010
54161 ................ A Circumcision.......... 3.27 NA 2.10 0.20 NA 5.57 010
54162 ................ A Lysis penil circumcis 3.00 NA 2.91 0.18 NA 6.09 010
lesion.
54163 ................ A Repair of circumcision 3.00 NA 2.54 0.18 NA 5.72 010
54164 ................ A Frenulotomy of penis.. 2.50 NA 2.37 0.15 NA 5.02 010
54200 ................ A Treatment of penis 1.06 2.87 0.38 0.06 3.99 1.50 010
lesion.
54205 ................ A Treatment of penis 7.93 NA 7.50 0.47 NA 15.90 090
lesion.
54220 ................ A Treatment of penis 2.42 2.08 1.04 0.15 4.65 3.61 000
lesion.
54230 ................ A Prepare penis study... 1.34 NA 0.46 0.08 NA 1.88 000
54231 ................ A Dynamic cavernosometry 2.04 2.26 0.83 0.14 4.44 3.01 000
54235 ................ A Penile injection...... 1.19 1.19 0.41 0.07 2.45 1.67 000
54240 ................ A Penis study........... 1.31 1.59 NA 0.13 3.03 NA 000
54240 26 A Penis study........... 1.31 0.45 0.45 0.08 1.84 1.84 000
54240 TC A Penis study........... 0.00 1.14 NA 0.05 1.19 NA 000
54250 ................ A Penis study........... 2.22 2.90 NA 0.16 5.28 NA 000
54250 26 A Penis study........... 2.22 0.75 0.75 0.14 3.11 3.11 000
54250 TC A Penis study........... 0.00 2.15 NA 0.02 2.17 NA 000
54300 ................ A Revision of penis..... 10.41 NA 8.89 0.64 NA 19.94 090
54304 ................ A Revision of penis..... 12.49 NA 10.04 0.74 NA 23.27 090
54308 ................ A Reconstruction of 11.83 NA 9.94 0.70 NA 22.47 090
urethra.
54312 ................ A Reconstruction of 13.57 NA 10.73 0.81 NA 25.11 090
urethra.
54316 ................ A Reconstruction of 16.82 NA 11.67 1.00 NA 29.49 090
urethra.
54318 ................ A Reconstruction of 11.25 NA 10.06 1.15 NA 22.46 090
urethra.
54322 ................ A Reconstruction of 13.01 NA 9.56 0.77 NA 23.34 090
urethra.
54324 ................ A Reconstruction of 16.31 NA 12.02 1.03 NA 29.36 090
urethra.
54326 ................ A Reconstruction of 15.72 NA 11.17 0.93 NA 27.82 090
urethra.
54328 ................ A Revise penis/urethra.. 15.65 NA 11.59 0.92 NA 28.16 090
54332 ................ A Revise penis/urethra.. 17.08 NA 11.87 1.01 NA 29.96 090
54336 ................ A Revise penis/urethra.. 20.04 NA 13.59 1.90 NA 35.53 090
54340 ................ A Secondary urethral 8.91 NA 9.80 0.72 NA 19.43 090
surgery.
54344 ................ A Secondary urethral 15.94 NA 10.91 1.10 NA 27.95 090
surgery.
54348 ................ A Secondary urethral 17.15 NA 12.10 1.02 NA 30.27 090
surgery.
54352 ................ A Reconstruct urethra/ 24.74 NA 16.53 1.62 NA 42.89 090
penis.
54360 ................ A Penis plastic surgery. 11.93 NA 8.82 0.72 NA 21.47 090
54380 ................ A Repair penis.......... 13.18 NA 10.79 1.16 NA 25.13 090
54385 ................ A Repair penis.......... 15.39 NA 12.20 0.71 NA 28.30 090
54390 ................ A Repair penis and 21.61 NA 14.69 1.28 NA 37.58 090
bladder.
54400 ................ A Insert semi-rigid 8.99 NA 6.53 0.53 NA 16.05 090
prosthesis.
54401 ................ A Insert self-contd 10.28 NA 7.37 0.61 NA 18.26 090
prosthesis.
54402 ................ D Remove penis 0.00 NA 0.00 0.00 NA 0.00 090
prosthesis.
54405 ................ A Insert multi-comp 13.43 NA 8.45 0.80 NA 22.68 090
penis pros.
54406 ................ A Remove multi-comp 12.10 NA 6.09 0.80 NA 18.99 090
penis pros.
54407 ................ D Remove multi-comp 0.00 NA 0.00 0.00 NA 0.00 090
prosthesis.
54408 ................ A Repair multi-comp 12.75 NA 6.46 0.80 NA 20.01 090
penis pros.
54409 ................ D Revise penis 0.00 NA 0.00 0.00 NA 0.00 090
prosthesis.
54410 ................ A Remove/replace penis 15.50 NA 7.36 0.80 NA 23.66 090
prosth.
54411 ................ A Remv/replc penis pros, 16.00 NA 8.98 0.80 NA 25.78 090
comp.
54415 ................ A Remove self-contd 8.20 NA 5.35 0.55 NA 14.10 090
penis pros.
54416 ................ A Remv/repl penis 10.87 NA 6.94 0.55 NA 18.36 090
contain pros.
54417 ................ A Remv/replc penis pros, 14.19 NA 7.89 0.55 NA 22.63 090
compl.
54420 ................ A Revision of penis..... 11.42 NA 8.70 0.72 NA 20.84 090
54430 ................ A Revision of penis..... 10.15 NA 8.17 0.60 NA 18.92 090
54435 ................ A Revision of penis..... 6.12 NA 6.30 0.36 NA 12.78 090
54440 ................ C Repair of penis....... 0.00 0.00 0.00 0.00 0.00 0.00 090
54450 ................ A Preputial stretching.. 1.12 1.10 0.49 0.07 2.29 1.68 000
54500 ................ A Biopsy of testis...... 1.31 6.26 0.45 0.08 7.65 1.84 000
54505 ................ A Biopsy of testis...... 3.46 NA 2.75 0.21 NA 6.42 010
54510 ................ D Removal of testis 0.00 NA 0.00 0.00 NA 0.00 090
lesion.
54512 ................ A Excise lesion testis.. 8.58 NA 5.19 0.56 NA 14.33 090
54520 ................ A Removal of testis..... 5.23 NA 3.75 0.33 NA 9.31 090
54522 ................ A Orchiectomy, partial.. 9.50 NA 6.15 0.62 NA 16.27 090
54530 ................ A Removal of testis..... 8.58 NA 5.46 0.53 NA 14.57 090
54535 ................ A Extensive testis 12.16 NA 7.62 0.83 NA 20.61 090
surgery.
54550 ................ A Exploration for testis 7.78 NA 4.97 0.49 NA 13.24 090
54560 ................ A Exploration for testis 11.13 NA 7.10 0.79 NA 19.02 090
54600 ................ A Reduce testis torsion. 7.01 NA 4.38 0.45 NA 11.84 090
54620 ................ A Suspension of testis.. 4.90 NA 3.26 0.31 NA 8.47 010
54640 ................ A Suspension of testis.. 6.90 NA 4.40 0.49 NA 11.79 090
54650 ................ A Orchiopexy (Fowler- 11.45 NA 7.29 0.81 NA 19.55 090
Stephens).
54660 ................ A Revision of testis.... 5.11 NA 3.65 0.35 NA 9.11 090
[[Page 55389]]
54670 ................ A Repair testis injury.. 6.41 NA 4.30 0.41 NA 11.12 090
54680 ................ A Relocation of 12.65 NA 7.65 0.94 NA 21.24 090
testis(es).
54690 ................ A Laparoscopy, 10.96 NA 7.08 0.99 NA 19.03 090
orchiectomy.
54692 ................ A Laparoscopy, 12.88 NA 5.84 0.87 NA 19.59 090
orchiopexy.
54699 ................ C Laparoscope proc, 0.00 0.00 0.00 0.00 0.00 0.00 YYY
testis.
54700 ................ A Drainage of scrotum... 3.43 8.80 3.53 0.23 12.46 7.19 010
54800 ................ A Biopsy of epididymis.. 2.33 6.45 0.79 0.14 8.92 3.26 000
54820 ................ A Exploration of 5.14 NA 3.61 0.33 NA 9.08 090
epididymis.
54830 ................ A Remove epididymis 5.38 NA 3.85 0.34 NA 9.57 090
lesion.
54840 ................ A Remove epididymis 5.20 NA 3.79 0.31 NA 9.30 090
lesion.
54860 ................ A Removal of epididymis. 6.32 NA 4.40 0.38 NA 11.10 090
54861 ................ A Removal of epididymis. 8.90 NA 5.28 0.52 NA 14.70 090
54900 ................ A Fusion of spermatic 13.20 NA 6.99 1.34 NA 21.53 090
ducts.
54901 ................ A Fusion of spermatic 17.94 NA 9.27 1.83 NA 29.04 090
ducts.
55000 ................ A Drainage of hydrocele. 1.43 2.24 0.49 0.10 3.77 2.02 000
55040 ................ A Removal of hydrocele.. 5.36 NA 3.56 0.35 NA 9.27 090
55041 ................ A Removal of hydroceles. 7.74 NA 4.63 0.50 NA 12.87 090
55060 ................ A Repair of hydrocele... 5.52 NA 3.64 0.37 NA 9.53 090
55100 ................ A Drainage of scrotum 2.13 10.06 3.63 0.15 12.34 5.91 010
abscess.
55110 ................ A Explore scrotum....... 5.70 NA 3.71 0.36 NA 9.77 090
55120 ................ A Removal of scrotum 5.09 NA 3.52 0.33 NA 8.94 090
lesion.
55150 ................ A Removal of scrotum.... 7.22 NA 4.76 0.47 NA 12.45 090
55175 ................ A Revision of scrotum... 5.24 NA 3.88 0.33 NA 9.45 090
55180 ................ A Revision of scrotum... 10.72 NA 6.38 0.72 NA 17.82 090
55200 ................ A Incision of sperm duct 4.24 NA 3.10 0.25 NA 7.59 090
55250 ................ A Removal of sperm 3.29 9.72 3.28 0.21 13.22 6.78 090
duct(s).
55300 ................ A Prepare, sperm duct x- 3.51 NA 1.56 0.20 NA 5.27 000
ray.
55400 ................ A Repair of sperm duct.. 8.49 NA 5.32 0.50 NA 14.31 090
55450 ................ A Ligation of sperm duct 4.12 8.08 2.62 0.24 12.44 6.98 010
55500 ................ A Removal of hydrocele.. 5.59 NA 3.76 0.43 NA 9.78 090
55520 ................ A Removal of sperm cord 6.03 NA 3.82 0.56 NA 10.41 090
lesion.
55530 ................ A Revise spermatic cord 5.66 NA 3.92 0.36 NA 9.94 090
veins.
55535 ................ A Revise spermatic cord 6.56 NA 4.23 0.42 NA 11.21 090
veins.
55540 ................ A Revise hernia & sperm 7.67 NA 4.37 0.74 NA 12.78 090
veins.
55550 ................ A Laparo ligate 6.57 NA 3.67 0.47 NA 10.71 090
spermatic vein.
55559 ................ C Laparo proc, spermatic 0.00 0.00 0.00 0.00 0.00 0.00 YYY
cord.
55600 ................ A Incise sperm duct 6.38 NA 4.41 0.38 NA 11.17 090
pouch.
55605 ................ A Incise sperm duct 7.96 NA 5.39 0.54 NA 13.89 090
pouch.
55650 ................ A Remove sperm duct 11.80 NA 6.44 0.72 NA 18.96 090
pouch.
55680 ................ A Remove sperm pouch 5.19 NA 3.77 0.31 NA 9.27 090
lesion.
55700 ................ A Biopsy of prostate.... 1.57 4.68 0.73 0.10 6.35 2.40 000
55705 ................ A Biopsy of prostate.... 4.57 NA 3.92 0.26 NA 8.75 010
55720 ................ A Drainage of prostate 7.64 NA 5.88 0.44 NA 13.96 090
abscess.
55725 ................ A Drainage of prostate 8.68 NA 6.58 0.51 NA 15.77 090
abscess.
55801 ................ A Removal of prostate... 17.80 NA 9.78 1.08 NA 28.66 090
55810 ................ A Extensive prostate 22.58 NA 11.85 1.35 NA 35.78 090
surgery.
55812 ................ A Extensive prostate 27.51 NA 13.91 1.69 NA 43.11 090
surgery.
55815 ................ A Extensive prostate 30.46 NA 15.01 1.84 NA 47.31 090
surgery.
55821 ................ A Removal of prostate... 14.25 NA 8.20 0.85 NA 23.30 090
55831 ................ A Removal of prostate... 15.62 NA 8.67 0.94 NA 25.23 090
55840 ................ A Extensive prostate 22.69 NA 12.32 1.37 NA 36.38 090
surgery.
55842 ................ A Extensive prostate 24.38 NA 12.86 1.48 NA 38.72 090
surgery.
55845 ................ A Extensive prostate 28.55 NA 14.26 1.71 NA 44.52 090
surgery.
55859 ................ A Percut/needle insert, 12.52 NA 7.71 0.74 NA 20.97 090
pros.
55860 ................ A Surgical exposure, 14.45 NA 7.93 0.82 NA 23.20 090
prostate.
55862 ................ A Extensive prostate 18.39 NA 9.69 1.14 NA 29.22 090
surgery.
55865 ................ A Extensive prostate 22.87 NA 11.49 1.37 NA 35.73 090
surgery.
55870 ................ A Electroejaculation.... 2.58 1.96 0.98 0.14 4.68 3.70 000
55873 ................ A Cryoablate prostate... 19.47 NA 10.65 1.02 NA 31.14 090
55899 ................ C Genital surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
55970 ................ N Sex transformation, M 0.00 0.00 0.00 0.00 0.00 0.00 XXX
to F.
55980 ................ N Sex transformation, F 0.00 0.00 0.00 0.00 0.00 0.00 XXX
to M.
56405 ................ A I & D of vulva/ 1.44 2.50 1.33 0.14 4.08 2.91 010
perineum.
56420 ................ A Drainage of gland 1.39 2.48 1.33 0.13 4.00 2.85 010
abscess.
56440 ................ A Surgery for vulva 2.84 3.83 2.40 0.28 6.95 5.52 010
lesion.
56441 ................ A Lysis of labial 1.97 2.74 2.11 0.17 4.88 4.25 010
lesion(s).
56501 ................ A Destroy, vulva 1.53 2.42 1.42 0.15 4.10 3.10 010
lesions, simp.
56515 ................ A Destroy vulva lesion/s 2.76 3.20 2.46 0.18 6.14 5.40 010
compl.
56605 ................ A Biopsy of vulva/ 1.10 1.90 0.50 0.11 3.11 1.71 000
perineum.
56606 ................ A Biopsy of vulva/ 0.55 1.69 0.23 0.06 2.30 0.84 ZZZ
perineum.
56620 ................ A Partial removal of 7.47 NA 5.13 0.76 NA 13.36 090
vulva.
56625 ................ A Complete removal of 8.40 NA 6.20 0.84 NA 15.44 090
vulva.
56630 ................ A Extensive vulva 12.36 NA 7.93 1.23 NA 21.52 090
surgery.
[[Page 55390]]
56631 ................ A Extensive vulva 16.20 NA 10.80 1.63 NA 28.63 090
surgery.
56632 ................ A Extensive vulva 20.29 NA 12.42 2.03 NA 34.74 090
surgery.
56633 ................ A Extensive vulva 16.47 NA 9.70 1.66 NA 27.83 090
surgery.
56634 ................ A Extensive vulva 17.88 NA 11.25 1.78 NA 30.91 090
surgery.
56637 ................ A Extensive vulva 21.97 NA 13.16 2.18 NA 37.31 090
surgery.
56640 ................ A Extensive vulva 22.17 NA 12.58 2.26 NA 37.01 090
surgery.
56700 ................ A Partial removal of 2.52 3.18 2.16 0.24 5.94 4.92 010
hymen.
56720 ................ A Incision of hymen..... 0.68 1.79 0.57 0.07 2.54 1.32 000
56740 ................ A Remove vagina gland 4.57 4.08 3.08 0.37 9.02 8.02 010
lesion.
56800 ................ A Repair of vagina...... 3.89 NA 2.86 0.37 NA 7.12 010
56805 ................ A Repair clitoris....... 18.86 NA 9.69 1.82 NA 30.37 090
56810 ................ A Repair of perineum.... 4.13 NA 2.91 0.41 NA 7.45 010
57000 ................ A Exploration of vagina. 2.97 NA 2.49 0.28 NA 5.74 010
57010 ................ A Drainage of pelvic 6.03 NA 4.08 0.57 NA 10.68 090
abscess.
57020 ................ A Drainage of pelvic 1.50 1.63 0.66 0.15 3.28 2.31 000
fluid.
57022 ................ A I & d vaginal 2.56 NA 2.14 0.24 NA 4.94 010
hematoma, pp.
57023 ................ A I & d vag hematoma, 4.75 NA 3.01 0.24 NA 8.00 010
non-ob.
57061 ................ A Destroy vag lesions, 1.25 2.37 1.33 0.13 3.75 2.71 010
simple.
57065 ................ A Destroy vag lesions, 2.61 3.09 2.41 0.26 5.96 5.28 010
complex.
57100 ................ A Biopsy of vagina...... 1.20 1.64 0.53 0.10 2.94 1.83 000
57105 ................ A Biopsy of vagina...... 1.69 2.35 2.34 0.17 4.21 4.20 010
57106 ................ A Remove vagina wall, 6.36 2.67 2.67 0.58 9.61 9.61 090
partial.
57107 ................ A Remove vagina tissue, 23.00 NA 10.65 2.17 NA 35.82 090
part.
57109 ................ A Vaginectomy partial w/ 27.00 NA 13.89 1.97 NA 42.86 090
nodes.
57110 ................ A Remove vagina wall, 14.29 NA 7.56 1.43 NA 23.28 090
complete.
57111 ................ A Remove vagina tissue, 27.00 NA 12.85 2.71 NA 42.56 090
compl.
57112 ................ A Vaginectomy w/nodes, 29.00 NA 14.38 2.19 NA 45.57 090
compl.
57120 ................ A Closure of vagina..... 7.41 NA 4.85 0.75 NA 13.01 090
57130 ................ A Remove vagina lesion.. 2.43 NA 2.25 0.23 NA 4.91 010
57135 ................ A Remove vagina lesion.. 2.67 3.09 2.35 0.26 6.02 5.28 010
57150 ................ A Treat vagina infection 0.55 1.04 0.22 0.06 1.65 0.83 000
57155 ................ A Insert uteri tandems/ 6.27 NA 3.67 0.63 NA 10.57 090
ovoids.
57160 ................ A Insert pessary/other 0.89 1.12 0.41 0.09 2.10 1.39 000
device.
57170 ................ A Fitting of diaphragm/ 0.91 1.46 0.36 0.09 2.46 1.36 000
cap.
57180 ................ A Treat vaginal bleeding 1.58 2.37 1.55 0.16 4.11 3.29 010
57200 ................ A Repair of vagina...... 3.94 NA 3.14 0.38 NA 7.46 090
57210 ................ A Repair vagina/perineum 5.17 NA 3.69 0.50 NA 9.36 090
57220 ................ A Revision of urethra... 4.31 NA 3.52 0.42 NA 8.25 090
57230 ................ A Repair of urethral 5.64 NA 4.49 0.50 NA 10.63 090
lesion.
57240 ................ A Repair bladder & 6.07 NA 4.62 0.53 NA 11.22 090
vagina.
57250 ................ A Repair rectum & vagina 5.53 NA 4.01 0.54 NA 10.08 090
57260 ................ A Repair of vagina...... 8.27 NA 5.17 0.83 NA 14.27 090
57265 ................ A Extensive repair of 11.34 NA 7.22 1.14 NA 19.70 090
vagina.
57268 ................ A Repair of bowel bulge. 6.76 NA 4.54 0.66 NA 11.96 090
57270 ................ A Repair of bowel pouch. 12.11 NA 6.58 1.17 NA 19.86 090
57280 ................ A Suspension of vagina.. 15.04 NA 7.74 1.44 NA 24.22 090
57282 ................ A Repair of vaginal 8.86 NA 5.44 0.86 NA 15.16 090
prolapse.
57284 ................ A Repair paravaginal 12.70 NA 7.45 1.17 NA 21.32 090
defect.
57287 ................ A Revise/remove sling 10.71 NA 7.47 0.74 NA 18.92 090
repair.
57288 ................ A Repair bladder defect. 13.02 NA 7.24 0.86 NA 21.12 090
57289 ................ A Repair bladder & 11.58 NA 7.12 0.95 NA 19.65 090
vagina.
57291 ................ A Construction of vagina 7.95 NA 5.93 0.78 NA 14.66 090
57292 ................ A Construct vagina with 13.09 NA 7.20 1.29 NA 21.58 090
graft.
57300 ................ A Repair rectum-vagina 7.61 NA 4.82 0.70 NA 13.13 090
fistula.
57305 ................ A Repair rectum-vagina 13.77 NA 7.00 1.33 NA 22.10 090
fistula.
57307 ................ A Fistula repair & 15.93 NA 7.72 1.59 NA 25.24 090
colostomy.
57308 ................ A Fistula repair, 9.94 NA 5.96 0.91 NA 16.81 090
transperine.
57310 ................ A Repair urethrovaginal 6.78 NA 4.95 0.45 NA 12.18 090
lesion.
57311 ................ A Repair urethrovaginal 7.98 NA 5.45 0.51 NA 13.94 090
lesion.
57320 ................ A Repair bladder-vagina 8.01 NA 5.68 0.60 NA 14.29 090
lesion.
57330 ................ A Repair bladder-vagina 12.35 NA 6.96 0.86 NA 20.17 090
lesion.
57335 ................ A Repair vagina......... 18.73 NA 9.84 1.66 NA 30.23 090
57400 ................ A Dilation of vagina.... 2.27 NA 1.18 0.22 NA 3.67 000
57410 ................ A Pelvic examination.... 1.75 2.75 1.12 0.14 4.64 3.01 000
57415 ................ A Remove vaginal foreign 2.17 3.71 2.18 0.19 6.07 4.54 010
body.
57452 ................ A Examination of vagina. 0.99 1.69 0.46 0.10 2.78 1.55 000
57454 ................ A Vagina examination & 1.27 1.88 0.62 0.13 3.28 2.02 000
biopsy.
57460 ................ A Cervix excision....... 2.83 2.17 1.19 0.28 5.28 4.30 000
57500 ................ A Biopsy of cervix...... 0.97 2.29 0.50 0.10 3.36 1.57 000
57505 ................ A Endocervical curettage 1.14 2.05 1.36 0.12 3.31 2.62 010
57510 ................ A Cauterization of 1.90 3.39 1.66 0.18 5.47 3.74 010
cervix.
57511 ................ A Cryocautery of cervix. 1.90 2.54 0.77 0.18 4.62 2.85 010
57513 ................ A Laser surgery of 1.90 2.72 1.66 0.19 4.81 3.75 010
cervix.
[[Page 55391]]
57520 ................ A Conization of cervix.. 4.04 4.43 2.93 0.41 8.88 7.38 090
57522 ................ A Conization of cervix.. 3.36 4.02 2.68 0.34 7.72 6.38 090
57530 ................ A Removal of cervix..... 4.79 NA 3.78 0.48 NA 9.05 090
57531 ................ A Removal of cervix, 28.00 NA 14.44 2.46 NA 44.90 090
radical.
57540 ................ A Removal of residual 12.22 NA 6.49 1.21 NA 19.92 090
cervix.
57545 ................ A Remove cervix/repair 13.03 NA 6.95 1.30 NA 21.28 090
pelvis.
57550 ................ A Removal of residual 5.53 NA 3.98 0.55 NA 10.06 090
cervix.
57555 ................ A Remove cervix/repair 8.95 NA 5.90 0.89 NA 15.74 090
vagina.
57556 ................ A Remove cervix, repair 8.37 NA 5.14 0.80 NA 14.31 090
bowel.
57700 ................ A Revision of cervix.... 3.55 NA 2.71 0.33 NA 6.59 090
57720 ................ A Revision of cervix.... 4.13 NA 3.41 0.41 NA 7.95 090
57800 ................ A Dilation of cervical 0.77 1.22 0.36 0.08 2.07 1.21 000
canal.
57820 ................ A D & C of residual 1.67 2.70 2.40 0.17 4.54 4.24 010
cervix.
58100 ................ A Biopsy of uterus 1.53 1.56 0.76 0.07 3.16 2.36 000
lining.
58120 ................ A Dilation and curettage 3.27 4.01 2.55 0.33 7.61 6.15 010
58140 ................ A Removal of uterus 14.60 NA 7.38 1.46 NA 23.44 090
lesion.
58145 ................ A Removal of uterus 8.04 NA 5.11 0.80 NA 13.95 090
lesion.
58150 ................ A Total hysterectomy.... 15.24 NA 7.90 1.53 NA 24.67 090
58152 ................ A Total hysterectomy.... 20.60 NA 10.17 1.52 NA 32.29 090
58180 ................ A Partial hysterectomy.. 15.29 NA 7.90 1.54 NA 24.73 090
58200 ................ A Extensive hysterectomy 21.59 NA 11.62 2.15 NA 35.36 090
58210 ................ A Extensive hysterectomy 28.85 NA 14.67 2.91 NA 46.43 090
58240 ................ A Removal of pelvis 38.39 NA 19.71 3.76 NA 61.86 090
contents.
58260 ................ A Vaginal hysterectomy.. 12.98 NA 6.90 1.23 NA 21.11 090
58262 ................ A Vaginal hysterectomy.. 14.77 NA 7.66 1.42 NA 23.85 090
58263 ................ A Vaginal hysterectomy.. 16.06 NA 8.22 1.55 NA 25.83 090
58267 ................ A Hysterectomy & vagina 17.04 NA 8.81 1.51 NA 27.36 090
repair.
58270 ................ A Hysterectomy & vagina 14.26 NA 7.43 1.37 NA 23.06 090
repair.
58275 ................ A Hysterectomy/revise 15.76 NA 7.94 1.51 NA 25.21 090
vagina.
58280 ................ A Hysterectomy/revise 17.01 NA 8.46 1.54 NA 27.01 090
vagina.
58285 ................ A Extensive hysterectomy 22.26 NA 11.15 1.88 NA 35.29 090
58300 ................ N Insert intrauterine +1.01 1.42 0.40 0.10 2.53 1.51 XXX
device.
58301 ................ A Remove intrauterine 1.27 1.62 0.51 0.13 3.02 1.91 000
device.
58321 ................ A Artificial 0.92 1.03 0.37 0.10 2.05 1.39 000
insemination.
58322 ................ A Artificial 1.10 1.05 0.42 0.11 2.26 1.63 000
insemination.
58323 ................ A Sperm washing......... 0.23 0.53 0.10 0.02 0.78 0.35 000
58340 ................ A Catheter for 0.88 12.42 0.33 0.08 13.38 1.29 000
hysterography.
58345 ................ A Reopen fallopian tube. 4.66 NA 1.73 0.36 NA 6.75 010
58346 ................ A Insert heyman uteri 6.75 NA 3.84 0.68 NA 11.27 090
capsule.
58350 ................ A Reopen fallopian tube. 1.01 2.15 1.17 0.10 3.26 2.28 010
58353 ................ A Endometr ablate, 3.56 NA 2.28 0.37 NA 6.21 010
thermal.
58400 ................ A Suspension of uterus.. 6.36 NA 4.17 0.62 NA 11.15 090
58410 ................ A Suspension of uterus.. 12.73 NA 6.84 1.09 NA 20.66 090
58520 ................ A Repair of ruptured 11.92 NA 6.24 1.17 NA 19.33 090
uterus.
58540 ................ A Revision of uterus.... 14.64 NA 6.96 1.28 NA 22.88 090
58550 ................ A Laparo-asst vag 14.19 NA 7.11 1.44 NA 22.74 010
hysterectomy.
58551 ................ A Laparoscopy, remove 14.21 NA 7.09 1.45 NA 22.75 010
myoma.
58555 ................ A Hysteroscopy, dx, sep 3.33 2.95 1.49 0.34 6.62 5.16 000
proc.
58558 ................ A Hysteroscopy, biopsy.. 4.75 3.55 2.13 0.49 8.79 7.37 000
58559 ................ A Hysteroscopy, lysis... 6.17 2.59 2.59 0.62 9.38 9.38 000
58560 ................ A Hysteroscopy, resect 7.00 3.01 3.01 0.71 10.72 10.72 000
septum.
58561 ................ A Hysteroscopy, remove 10.00 3.78 3.78 1.02 14.80 14.80 000
myoma.
58562 ................ A Hysteroscopy, remove 5.21 NA 2.34 0.52 NA 8.07 000
fb.
58563 ................ A Hysteroscopy, ablation 6.17 2.62 2.62 0.62 9.41 9.41 000
58578 ................ C Laparo proc, uterus... 0.00 0.00 0.00 0.00 0.00 0.00 YYY
58579 ................ C Hysteroscope procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY
58600 ................ A Division of fallopian 5.60 NA 3.51 0.39 NA 9.50 090
tube.
58605 ................ A Division of fallopian 5.00 NA 3.32 0.33 NA 8.65 090
tube.
58611 ................ A Ligate oviduct(s) add- 1.45 NA 0.61 0.07 NA 2.13 ZZZ
on.
58615 ................ A Occlude fallopian 3.90 NA 3.35 0.40 NA 7.65 010
tube(s).
58660 ................ A Laparoscopy, lysis.... 11.29 NA 5.78 1.14 NA 18.21 090
58661 ................ A Laparoscopy, remove 11.05 NA 5.47 1.12 NA 17.64 010
adnexa.
58662 ................ A Laparoscopy, excise 11.79 NA 5.75 1.18 NA 18.72 090
lesions.
58670 ................ A Laparoscopy, tubal 5.60 NA 3.73 0.55 NA 9.88 090
cautery.
58671 ................ A Laparoscopy, tubal 5.60 NA 3.74 0.56 NA 9.90 090
block.
58672 ................ A Laparoscopy, 12.88 NA 6.81 1.22 NA 20.91 090
fimbrioplasty.
58673 ................ A Laparoscopy, 13.74 NA 7.16 1.40 NA 22.30 090
salpingostomy.
58679 ................ C Laparo proc, oviduct- 0.00 0.00 0.00 0.00 0.00 0.00 YYY
ovary.
58700 ................ A Removal of fallopian 12.05 NA 6.05 0.64 NA 18.74 090
tube.
58720 ................ A Removal of ovary/ 11.36 NA 6.05 1.14 NA 18.55 090
tube(s).
58740 ................ A Revise fallopian 14.00 NA 7.34 0.59 NA 21.93 090
tube(s).
58750 ................ A Repair oviduct........ 14.84 NA 7.60 1.52 NA 23.96 090
58752 ................ A Revise ovarian tube(s) 14.84 NA 7.92 1.51 NA 24.27 090
[[Page 55392]]
58760 ................ A Remove tubal 13.13 NA 7.00 1.34 NA 21.47 090
obstruction.
58770 ................ A Create new tubal 13.97 NA 7.24 1.42 NA 22.63 090
opening.
58800 ................ A Drainage of ovarian 4.14 4.43 4.36 0.36 8.93 8.86 090
cyst(s).
58805 ................ A Drainage of ovarian 5.88 NA 3.66 0.56 NA 10.10 090
cyst(s).
58820 ................ A Drain ovary abscess, 4.22 NA 3.38 0.29 NA 7.89 090
open.
58822 ................ A Drain ovary abscess, 10.13 NA 5.20 0.92 NA 16.25 090
percut.
58823 ................ A Drain pelvic abscess, 3.38 NA 2.38 0.18 NA 5.94 000
percut.
58825 ................ A Transposition, 10.98 NA 5.95 0.62 NA 17.55 090
ovary(s).
58900 ................ A Biopsy of ovary(s).... 5.99 NA 3.64 0.56 NA 10.19 090
58920 ................ A Partial removal of 11.36 NA 5.85 0.68 NA 17.89 090
ovary(s).
58925 ................ A Removal of ovarian 11.36 NA 5.79 1.14 NA 18.29 090
cyst(s).
58940 ................ A Removal of ovary(s)... 7.29 NA 4.18 0.73 NA 12.20 090
58943 ................ A Removal of ovary(s)... 18.43 NA 9.92 1.86 NA 30.21 090
58950 ................ A Resect ovarian 16.93 NA 9.41 1.55 NA 27.89 090
malignancy.
58951 ................ A Resect ovarian 22.38 NA 11.81 2.20 NA 36.39 090
malignancy.
58952 ................ A Resect ovarian 25.01 NA 12.99 2.50 NA 40.50 090
malignancy.
58953 ................ A Tah, rad dissect for 32.00 NA 15.59 3.20 NA 50.79 090
debulk.
58954 ................ A Tah rad debulk/lymph 35.00 NA 16.71 3.50 NA 55.21 090
remove.
58960 ................ A Exploration of abdomen 14.65 NA 8.52 1.47 NA 24.64 090
58970 ................ A Retrieval of oocyte... 3.53 8.56 1.92 0.36 12.45 5.81 000
58974 ................ C Transfer of embryo.... 0.00 0.00 0.00 0.00 0.00 0.00 000
58976 ................ A Transfer of embryo.... 3.83 2.30 1.53 0.39 6.52 5.75 000
58999 ................ C Genital surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
59000 ................ A Amniocentesis, 1.30 2.05 0.72 0.23 3.58 2.25 000
diagnostic.
59001 ................ A Amniocentesis, 3.00 NA 1.37 0.23 NA 4.60 000
therapeutic.
59012 ................ A Fetal cord puncture, 3.45 NA 1.71 0.62 NA 5.78 000
prenatal.
59015 ................ A Chorion biopsy........ 2.20 1.64 1.11 0.40 4.24 3.71 000
59020 ................ A Fetal contract stress 0.66 0.78 NA 0.20 1.64 NA 000
test.
59020 26 A Fetal contract stress 0.66 0.28 0.28 0.12 1.06 1.06 000
test.
59020 TC A Fetal contract stress 0.00 0.50 NA 0.08 0.58 NA 000
test.
59025 ................ A Fetal non-stress test. 0.53 0.44 NA 0.12 1.09 NA 000
59025 26 A Fetal non-stress test. 0.53 0.22 0.22 0.10 0.85 0.85 000
59025 TC A Fetal non-stress test. 0.00 0.22 NA 0.02 0.24 NA 000
59030 ................ A Fetal scalp blood 1.99 NA 1.14 0.36 NA 3.49 000
sample.
59050 ................ A Fetal monitor w/report 0.89 NA 0.38 0.16 NA 1.43 XXX
59051 ................ A Fetal monitor/ 0.74 NA 0.31 0.14 NA 1.19 XXX
interpret only.
59100 ................ A Remove uterus lesion.. 12.35 NA 6.61 2.21 NA 21.17 090
59120 ................ A Treat ectopic 11.49 NA 6.35 2.06 NA 19.90 090
pregnancy.
59121 ................ A Treat ectopic 11.67 NA 6.39 2.09 NA 20.15 090
pregnancy.
59130 ................ A Treat ectopic 14.22 NA 7.16 2.54 NA 23.92 090
pregnancy.
59135 ................ A Treat ectopic 13.88 NA 7.27 2.49 NA 23.64 090
pregnancy.
59136 ................ A Treat ectopic 13.18 NA 6.36 2.36 NA 21.90 090
pregnancy.
59140 ................ A Treat ectopic 5.46 NA 3.70 0.98 NA 10.14 090
pregnancy.
59150 ................ A Treat ectopic 11.67 NA 6.69 1.23 NA 19.59 090
pregnancy.
59151 ................ A Treat ectopic 11.49 NA 6.12 1.41 NA 19.02 090
pregnancy.
59160 ................ A D & C after delivery.. 2.71 3.73 2.29 0.49 6.93 5.49 010
59200 ................ A Insert cervical 0.79 1.41 0.32 0.15 2.35 1.26 000
dilator.
59300 ................ A Episiotomy or vaginal 2.41 2.01 1.01 0.43 4.85 3.85 000
repair.
59320 ................ A Revision of cervix.... 2.48 NA 1.31 0.45 NA 4.24 000
59325 ................ A Revision of cervix.... 4.07 NA 1.97 0.73 NA 6.77 000
59350 ................ A Repair of uterus...... 4.95 NA 2.19 0.88 NA 8.02 000
59400 ................ A Obstetrical care...... 23.06 NA 15.41 4.14 NA 42.61 MMM
59409 ................ A Obstetrical care...... 13.50 NA 5.57 2.42 NA 21.49 MMM
59410 ................ A Obstetrical care...... 14.78 NA 6.98 2.65 NA 24.41 MMM
59412 ................ A Antepartum 1.71 1.38 0.72 0.31 3.40 2.74 MMM
manipulation.
59414 ................ A Deliver placenta...... 1.61 NA 1.34 0.29 NA 3.24 MMM
59425 ................ A Antepartum care only.. 4.81 5.36 5.32 0.86 11.03 10.99 MMM
59426 ................ A Antepartum care only.. 8.28 9.14 9.14 1.49 18.91 18.91 MMM
59430 ................ A Care after delivery... 2.13 1.29 1.29 0.38 3.80 3.80 MMM
59510 ................ A Cesarean delivery..... 26.22 NA 17.61 4.70 NA 48.53 MMM
59514 ................ A Cesarean delivery only 15.97 NA 6.57 2.86 NA 25.40 MMM
59515 ................ A Cesarean delivery..... 17.37 NA 8.52 3.12 NA 29.01 MMM
59525 ................ A Remove uterus after 8.54 NA 3.52 1.53 NA 13.59 ZZZ
cesarean.
59610 ................ A Vbac delivery......... 24.62 NA 16.29 4.41 NA 45.32 MMM
59612 ................ A Vbac delivery only.... 15.06 NA 6.43 2.70 NA 24.19 MMM
59614 ................ A Vbac care after 16.34 NA 7.70 2.93 NA 26.97 MMM
delivery.
59618 ................ A Attempted vbac 27.78 NA 18.38 4.98 NA 51.14 MMM
delivery.
59620 ................ A Attempted vbac 17.53 NA 6.87 3.15 NA 27.55 MMM
delivery only.
59622 ................ A Attempted vbac after 18.93 NA 8.91 3.39 NA 31.23 MMM
care.
59812 ................ A Treatment of 4.01 3.75 2.51 0.58 8.34 7.10 090
miscarriage.
59820 ................ A Care of miscarriage... 4.01 3.79 2.85 0.72 8.52 7.58 090
59821 ................ A Treatment of 4.47 3.79 3.01 0.80 9.06 8.28 090
miscarriage.
59830 ................ A Treat uterus infection 6.11 NA 3.85 1.10 NA 11.06 090
[[Page 55393]]
59840 ................ R Abortion.............. 3.01 4.01 2.47 0.54 7.56 6.02 010
59841 ................ R Abortion.............. 5.24 5.78 3.72 0.94 11.96 9.90 010
59850 ................ R Abortion.............. 5.91 NA 2.75 1.06 NA 9.72 090
59851 ................ R Abortion.............. 5.93 NA 3.22 1.06 NA 10.21 090
59852 ................ R Abortion.............. 8.24 NA 4.58 1.48 NA 14.30 090
59855 ................ R Abortion.............. 6.12 NA 3.38 1.10 NA 10.60 090
59856 ................ R Abortion.............. 7.48 NA 3.74 1.34 NA 12.56 090
59857 ................ R Abortion.............. 9.29 NA 4.46 1.66 NA 15.41 090
59866 ................ R Abortion (mpr)........ 4.00 NA 1.60 0.72 NA 6.32 000
59870 ................ A Evacuate mole of 6.01 NA 3.83 0.77 NA 10.61 090
uterus.
59871 ................ A Remove cerclage suture 2.13 2.19 0.93 0.38 4.70 3.44 000
59898 ................ C Laparo proc, ob care/ 0.00 0.00 0.00 0.00 0.00 0.00 YYY
deliver.
59899 ................ C Maternity care 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
60000 ................ A Drain thyroid/tongue 1.76 2.40 2.22 0.14 4.30 4.12 010
cyst.
60001 ................ A Aspirate/inject 0.97 1.77 0.35 0.06 2.80 1.38 000
thyriod cyst.
60100 ................ A Biopsy of thyroid..... 1.56 2.70 0.56 0.05 4.31 2.17 000
60200 ................ A Remove thyroid lesion. 9.55 NA 6.88 0.84 NA 17.27 090
60210 ................ A Partial thyroid 10.88 NA 6.63 1.01 NA 18.52 090
excision.
60212 ................ A Parital thyroid 16.03 NA 8.62 1.51 NA 26.16 090
excision.
60220 ................ A Partial removal of 11.90 NA 7.27 0.97 NA 20.14 090
thyroid.
60225 ................ A Partial removal of 14.19 NA 8.05 1.31 NA 23.55 090
thyroid.
60240 ................ A Removal of thyroid.... 16.06 NA 9.32 1.50 NA 26.88 090
60252 ................ A Removal of thyroid.... 20.57 NA 11.64 1.63 NA 33.84 090
60254 ................ A Extensive thyroid 26.99 NA 16.39 1.96 NA 45.34 090
surgery.
60260 ................ A Repeat thyroid surgery 17.47 NA 10.66 1.39 NA 29.52 090
60270 ................ A Removal of thyroid.... 20.27 NA 11.54 1.78 NA 33.59 090
60271 ................ A Removal of thyroid.... 16.83 NA 10.20 1.35 NA 28.38 090
60280 ................ A Remove thyroid duct 5.87 NA 5.29 0.45 NA 11.61 090
lesion.
60281 ................ A Remove thyroid duct 8.53 NA 6.27 0.67 NA 15.47 090
lesion.
60500 ................ A Explore parathyroid 16.23 NA 7.99 1.61 NA 25.83 090
glands.
60502 ................ A Re-explore 20.35 NA 9.97 2.00 NA 32.32 090
parathyroids.
60505 ................ A Explore parathyroid 21.49 NA 11.53 2.14 NA 35.16 090
glands.
60512 ................ A Autotransplant 4.45 NA 1.72 0.44 NA 6.61 ZZZ
parathyroid.
60520 ................ A Removal of thymus 16.81 NA 9.55 1.84 NA 28.20 090
gland.
60521 ................ A Removal of thymus 18.87 NA 11.57 2.34 NA 32.78 090
gland.
60522 ................ A Removal of thymus 23.09 NA 12.88 2.83 NA 38.80 090
gland.
60540 ................ A Explore adrenal gland. 17.03 NA 8.09 1.42 NA 26.54 090
60545 ................ A Explore adrenal gland. 19.88 NA 9.73 1.75 NA 31.36 090
60600 ................ A Remove carotid body 17.93 NA 13.43 1.87 NA 33.23 090
lesion.
60605 ................ A Remove carotid body 20.24 NA 18.12 2.28 NA 40.64 090
lesion.
60650 ................ A Laparoscopy 20.00 NA 8.34 1.98 NA 30.32 090
adrenalectomy.
60659 ................ C Laparo proc, endocrine 0.00 0.00 0.00 0.00 0.00 0.00 YYY
60699 ................ C Endocrine surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
61000 ................ A Remove cranial cavity 1.58 1.79 1.53 0.13 3.50 3.24 000
fluid.
61001 ................ A Remove cranial cavity 1.49 2.08 1.47 0.15 3.72 3.11 000
fluid.
61020 ................ A Remove brain cavity 1.51 2.52 1.51 0.26 4.29 3.28 000
fluid.
61026 ................ A Injection into brain 1.69 2.28 1.73 0.21 4.18 3.63 000
canal.
61050 ................ A Remove brain canal 1.51 NA 1.56 0.13 NA 3.20 000
fluid.
61055 ................ A Injection into brain 2.10 NA 1.80 0.13 NA 4.03 000
canal.
61070 ................ A Brain canal shunt 0.89 7.33 1.22 0.09 8.31 2.20 000
procedure.
61105 ................ A Twist drill hole...... 5.14 NA 3.67 1.05 NA 9.86 090
61107 ................ A Drill skull for 5.00 NA 3.12 1.02 NA 9.14 000
implantation.
61108 ................ A Drill skull for 10.19 NA 7.09 2.04 NA 19.32 090
drainage.
61120 ................ A Burr hole for puncture 8.76 NA 5.88 1.81 NA 16.45 090
61140 ................ A Pierce skull for 15.90 NA 10.00 3.15 NA 29.05 090
biopsy.
61150 ................ A Pierce skull for 17.57 NA 10.74 3.52 NA 31.83 090
drainage.
61151 ................ A Pierce skull for 12.42 NA 8.16 2.45 NA 23.03 090
drainage.
61154 ................ A Pierce skull & remove 14.99 NA 9.43 3.05 NA 27.47 090
clot.
61156 ................ A Pierce skull for 16.32 NA 10.30 3.42 NA 30.04 090
drainage.
61210 ................ A Pierce skull, implant 5.84 NA 3.53 1.16 NA 10.53 000
device.
61215 ................ A Insert brain-fluid 4.89 NA 4.24 0.99 NA 10.12 090
device.
61250 ................ A Pierce skull & explore 10.42 NA 6.73 2.02 NA 19.17 090
61253 ................ A Pierce skull & explore 12.36 NA 7.65 2.26 NA 22.27 090
61304 ................ A Open skull for 21.96 NA 12.85 4.33 NA 39.14 090
exploration.
61305 ................ A Open skull for 26.61 NA 15.31 5.25 NA 47.17 090
exploration.
61312 ................ A Open skull for 24.57 NA 14.57 4.99 NA 44.13 090
drainage.
61313 ................ A Open skull for 24.93 NA 14.76 5.07 NA 44.76 090
drainage.
61314 ................ A Open skull for 24.23 NA 11.55 4.00 NA 39.78 090
drainage.
61315 ................ A Open skull for 27.68 NA 16.22 5.62 NA 49.52 090
drainage.
61320 ................ A Open skull for 25.62 NA 15.20 5.20 NA 46.02 090
drainage.
61321 ................ A Open skull for 28.50 NA 16.09 5.35 NA 49.94 090
drainage.
61330 ................ A Decompress eye socket. 23.32 NA 19.43 2.58 NA 45.33 090
61332 ................ A Explore/biopsy eye 27.28 NA 20.43 4.15 NA 51.86 090
socket.
[[Page 55394]]
61333 ................ A Explore orbit/remove 27.95 NA 16.45 2.24 NA 46.64 090
lesion.
61334 ................ A Explore orbit/remove 18.27 NA 10.08 3.02 NA 31.37 090
object.
61340 ................ A Relieve cranial 18.66 NA 11.75 3.66 NA 34.07 090
pressure.
61343 ................ A Incise skull (press 29.77 NA 17.96 6.04 NA 53.77 090
relief).
61345 ................ A Relieve cranial 27.20 NA 16.17 5.23 NA 48.60 090
pressure.
61440 ................ A Incise skull for 26.63 NA 12.14 5.57 NA 44.34 090
surgery.
61450 ................ A Incise skull for 25.95 NA 14.46 5.11 NA 45.52 090
surgery.
61458 ................ A Incise skull for brain 27.29 NA 15.89 5.28 NA 48.46 090
wound.
61460 ................ A Incise skull for 28.39 NA 16.77 5.13 NA 50.29 090
surgery.
61470 ................ A Incise skull for 26.06 NA 13.74 4.65 NA 44.45 090
surgery.
61480 ................ A Incise skull for 26.49 NA 12.34 5.54 NA 44.37 090
surgery.
61490 ................ A Incise skull for 25.66 NA 15.18 5.37 NA 46.21 090
surgery.
61500 ................ A Removal of skull 17.92 NA 11.03 3.26 NA 32.21 090
lesion.
61501 ................ A Remove infected skull 14.84 NA 9.62 2.63 NA 27.09 090
bone.
61510 ................ A Removal of brain 28.45 NA 16.60 5.77 NA 50.82 090
lesion.
61512 ................ A Remove brain lining 35.09 NA 20.18 7.14 NA 62.41 090
lesion.
61514 ................ A Removal of brain 25.26 NA 14.91 5.12 NA 45.29 090
abscess.
61516 ................ A Removal of brain 24.61 NA 15.01 4.94 NA 44.56 090
lesion.
61518 ................ A Removal of brain 37.32 NA 22.34 7.53 NA 67.19 090
lesion.
61519 ................ A Remove brain lining 41.39 NA 24.42 8.15 NA 73.96 090
lesion.
61520 ................ A Removal of brain 54.84 NA 31.93 10.10 NA 96.87 090
lesion.
61521 ................ A Removal of brain 44.48 NA 26.22 8.85 NA 79.55 090
lesion.
61522 ................ A Removal of brain 29.45 NA 17.20 5.30 NA 51.95 090
abscess.
61524 ................ A Removal of brain 27.86 NA 16.83 5.01 NA 49.70 090
lesion.
61526 ................ A Removal of brain 52.17 NA 31.55 6.72 NA 90.44 090
lesion.
61530 ................ A Removal of brain 43.86 NA 27.43 6.17 NA 77.46 090
lesion.
61531 ................ A Implant brain 14.63 NA 9.56 2.84 NA 27.03 090
electrodes.
61533 ................ A Implant brain 19.71 NA 12.21 3.80 NA 35.72 090
electrodes.
61534 ................ A Removal of brain 20.97 NA 13.30 4.15 NA 38.42 090
lesion.
61535 ................ A Remove brain 11.63 NA 8.16 2.29 NA 22.08 090
electrodes.
61536 ................ A Removal of brain 35.52 NA 21.18 6.68 NA 63.38 090
lesion.
61538 ................ A Removal of brain 26.81 NA 16.30 5.38 NA 48.49 090
tissue.
61539 ................ A Removal of brain 32.08 NA 18.91 6.62 NA 57.61 090
tissue.
61541 ................ A Incision of brain 28.85 NA 16.89 5.50 NA 51.24 090
tissue.
61542 ................ A Removal of brain 31.02 NA 18.00 6.49 NA 55.51 090
tissue.
61543 ................ A Removal of brain 29.22 NA 17.42 6.11 NA 52.75 090
tissue.
61544 ................ A Remove & treat brain 25.50 NA 15.21 4.91 NA 45.62 090
lesion.
61545 ................ A Excision of brain 43.80 NA 25.09 8.88 NA 77.77 090
tumor.
61546 ................ A Removal of pituitary 31.30 NA 18.74 6.06 NA 56.10 090
gland.
61548 ................ A Removal of pituitary 21.53 NA 13.74 3.63 NA 38.90 090
gland.
61550 ................ A Release of skull seams 14.65 NA 4.89 1.14 NA 20.68 090
61552 ................ A Release of skull seams 19.56 NA 9.87 0.88 NA 30.31 090
61556 ................ A Incise skull/sutures.. 22.26 NA 11.74 3.57 NA 37.57 090
61557 ................ A Incise skull/sutures.. 22.38 NA 13.41 4.68 NA 40.47 090
61558 ................ A Excision of skull/ 25.58 NA 12.67 2.61 NA 40.86 090
sutures.
61559 ................ A Excision of skull/ 32.79 NA 18.89 6.86 NA 58.54 090
sutures.
61563 ................ A Excision of skull 26.83 NA 16.25 4.46 NA 47.54 090
tumor.
61564 ................ A Excision of skull 33.83 NA 18.73 7.08 NA 59.64 090
tumor.
61570 ................ A Remove foreign body, 24.60 NA 13.80 4.60 NA 43.00 090
brain.
61571 ................ A Incise skull for brain 26.39 NA 15.43 5.23 NA 47.05 090
wound.
61575 ................ A Skull base/brainstem 34.36 NA 21.38 5.02 NA 60.76 090
surgery.
61576 ................ A Skull base/brainstem 52.43 NA 28.89 4.68 NA 86.00 090
surgery.
61580 ................ A Craniofacial approach, 30.35 NA 19.96 2.75 NA 53.06 090
skull.
61581 ................ A Craniofacial approach, 34.60 NA 22.57 3.37 NA 60.54 090
skull.
61582 ................ A Craniofacial approach, 31.66 NA 19.56 6.30 NA 57.52 090
skull.
61583 ................ A Craniofacial approach, 36.21 NA 22.71 6.94 NA 65.86 090
skull.
61584 ................ A Orbitocranial approach/ 34.65 NA 20.99 6.53 NA 62.17 090
skull.
61585 ................ A Orbitocranial approach/ 38.61 NA 22.21 6.19 NA 67.01 090
skull.
61586 ................ A Resect nasopharynx, 25.10 NA 16.39 3.52 NA 45.01 090
skull.
61590 ................ A Infratemporal approach/ 41.78 NA 26.12 4.28 NA 72.18 090
skull.
61591 ................ A Infratemporal approach/ 43.68 NA 26.89 5.26 NA 75.83 090
skull.
61592 ................ A Orbitocranial approach/ 39.64 NA 23.59 7.55 NA 70.78 090
skull.
61595 ................ A Transtemporal approach/ 29.57 NA 19.74 3.05 NA 52.36 090
skull.
61596 ................ A Transcochlear approach/ 35.63 NA 21.88 4.25 NA 61.76 090
skull.
61597 ................ A Transcondylar approach/ 37.96 NA 22.41 6.65 NA 67.02 090
skull.
61598 ................ A Transpetrosal approach/ 33.41 NA 20.92 4.60 NA 58.93 090
skull.
61600 ................ A Resect/excise cranial 25.85 NA 15.01 3.12 NA 43.98 090
lesion.
61601 ................ A Resect/excise cranial 27.89 NA 17.34 5.29 NA 50.52 090
lesion.
61605 ................ A Resect/excise cranial 29.33 NA 18.97 2.51 NA 50.81 090
lesion.
61606 ................ A Resect/excise cranial 38.83 NA 23.17 6.81 NA 68.81 090
lesion.
61607 ................ A Resect/excise cranial 36.27 NA 22.17 5.69 NA 64.13 090
lesion.
61608 ................ A Resect/excise cranial 42.10 NA 24.89 8.31 NA 75.30 090
lesion.
61609 ................ A Transect artery, sinus 9.89 NA 5.11 2.07 NA 17.07 ZZZ
[[Page 55395]]
61610 ................ A Transect artery, sinus 29.67 NA 14.38 3.52 NA 47.57 ZZZ
61611 ................ A Transect artery, sinus 7.42 NA 2.96 1.55 NA 11.93 ZZZ
61612 ................ A Transect artery, sinus 27.88 NA 14.30 3.55 NA 45.73 ZZZ
61613 ................ A Remove aneurysm, sinus 40.86 NA 23.34 8.32 NA 72.52 090
61615 ................ A Resect/excise lesion, 32.07 NA 20.81 4.64 NA 57.52 090
skull.
61616 ................ A Resect/excise lesion, 43.33 NA 26.97 7.02 NA 77.32 090
skull.
61618 ................ A Repair dura........... 16.99 NA 11.43 2.92 NA 31.34 090
61619 ................ A Repair dura........... 20.71 NA 13.67 3.42 NA 37.80 090
61624 ................ A Occlusion/embolization 20.15 NA 7.46 1.15 NA 28.76 000
cath.
61626 ................ A Occlusion/embolization 16.62 NA 5.88 0.84 NA 23.34 000
cath.
61680 ................ A Intracranial vessel 30.71 NA 18.38 6.04 NA 55.13 090
surgery.
61682 ................ A Intracranial vessel 61.57 NA 34.65 12.69 NA 108.91 090
surgery.
61684 ................ A Intracranial vessel 39.81 NA 22.60 7.87 NA 70.28 090
surgery.
61686 ................ A Intracranial vessel 64.49 NA 36.70 13.20 NA 114.39 090
surgery.
61690 ................ A Intracranial vessel 29.31 NA 17.64 5.51 NA 52.46 090
surgery.
61692 ................ A Intracranial vessel 51.87 NA 29.51 10.17 NA 91.55 090
surgery.
61697 ................ A Brain aneurysm repr, 50.52 NA 28.42 10.31 NA 89.25 090
complx.
61698 ................ A Brain aneurysm repr, 48.41 NA 27.31 9.99 NA 85.71 090
complx.
61700 ................ A Brain aneurysm repr , 50.52 NA 28.42 10.18 NA 89.12 090
simple.
61702 ................ A Inner skull vessel 48.41 NA 27.31 9.75 NA 85.47 090
surgery.
61703 ................ A Clamp neck artery..... 17.47 NA 11.13 3.62 NA 32.22 090
61705 ................ A Revise circulation to 36.20 NA 19.89 6.67 NA 62.76 090
head.
61708 ................ A Revise circulation to 35.30 NA 16.52 2.18 NA 54.00 090
head.
61710 ................ A Revise circulation to 29.67 NA 14.68 2.42 NA 46.77 090
head.
61711 ................ A Fusion of skull 36.33 NA 20.68 7.39 NA 64.40 090
arteries.
61720 ................ A Incise skull/brain 16.77 NA 10.90 3.51 NA 31.18 090
surgery.
61735 ................ A Incise skull/brain 20.43 NA 12.77 4.16 NA 37.36 090
surgery.
61750 ................ A Incise skull/brain 18.20 NA 11.08 3.71 NA 32.99 090
biopsy.
61751 ................ A Brain biopsy w/ ct/mr 17.62 NA 10.92 3.57 NA 32.11 090
guide.
61760 ................ A Implant brain 22.27 NA 12.85 4.59 NA 39.71 090
electrodes.
61770 ................ A Incise skull for 21.44 NA 13.26 4.09 NA 38.79 090
treatment.
61790 ................ A Treat trigeminal nerve 10.86 NA 6.92 1.82 NA 19.60 090
61791 ................ A Treat trigeminal tract 14.61 NA 9.39 3.03 NA 27.03 090
61793 ................ A Focus radiation beam.. 17.24 NA 11.07 3.51 NA 31.82 090
61795 ................ A Brain surgery using 4.04 NA 2.14 0.81 NA 6.99 ZZZ
computer.
61850 ................ A Implant 12.39 NA 8.13 2.23 NA 22.75 090
neuroelectrodes.
61860 ................ A Implant 20.87 NA 12.59 4.04 NA 37.50 090
neuroelectrodes.
61862 ................ A Implant neurostimul, 19.34 NA 12.16 3.97 NA 35.47 090
subcort.
61870 ................ A Implant 14.94 NA 9.97 1.70 NA 26.61 090
neuroelectrodes.
61875 ................ A Implant 15.06 NA 7.39 2.42 NA 24.87 090
neuroelectrodes.
61880 ................ A Revise/remove 6.29 NA 5.26 1.31 NA 12.86 090
neuroelectrode.
61885 ................ A Implant neurostim one 5.85 NA 4.36 1.22 NA 11.43 090
array.
61886 ................ A Implant neurostim 8.00 NA 6.13 1.64 NA 15.77 090
arrays.
61888 ................ A Revise/remove 5.07 NA 3.90 1.04 NA 10.01 010
neuroreceiver.
62000 ................ A Treat skull fracture.. 12.53 NA 6.19 0.87 NA 19.59 090
62005 ................ A Treat skull fracture.. 16.17 NA 9.35 2.33 NA 27.85 090
62010 ................ A Treatment of head 19.81 NA 11.83 4.05 NA 35.69 090
injury.
62100 ................ A Repair brain fluid 22.03 NA 13.97 4.07 NA 40.07 090
leakage.
62115 ................ A Reduction of skull 21.66 NA 11.03 4.53 NA 37.22 090
defect.
62116 ................ A Reduction of skull 23.59 NA 14.04 4.85 NA 42.48 090
defect.
62117 ................ A Reduction of skull 26.60 NA 12.68 5.56 NA 44.84 090
defect.
62120 ................ A Repair skull cavity 23.35 NA 15.14 3.07 NA 41.56 090
lesion.
62121 ................ A Incise skull repair... 21.58 NA 13.52 2.47 NA 37.57 090
62140 ................ A Repair of skull defect 13.51 NA 8.72 2.60 NA 24.83 090
62141 ................ A Repair of skull defect 14.91 NA 9.89 2.85 NA 27.65 090
62142 ................ A Remove skull plate/ 10.79 NA 7.31 2.10 NA 20.20 090
flap.
62143 ................ A Replace skull plate/ 13.05 NA 8.81 2.55 NA 24.41 090
flap.
62145 ................ A Repair of skull & 18.82 NA 11.77 3.81 NA 34.40 090
brain.
62146 ................ A Repair of skull with 16.12 NA 10.63 2.94 NA 29.69 090
graft.
62147 ................ A Repair of skull with 19.34 NA 12.38 3.64 NA 35.36 090
graft.
62180 ................ A Establish brain cavity 21.06 NA 13.08 4.32 NA 38.46 090
shunt.
62190 ................ A Establish brain cavity 11.07 NA 7.77 2.18 NA 21.02 090
shunt.
62192 ................ A Establish brain cavity 12.25 NA 8.25 2.46 NA 22.96 090
shunt.
62194 ................ A Replace/irrigate 5.03 NA 2.25 0.50 NA 7.78 010
catheter.
62200 ................ A Establish brain cavity 18.32 NA 11.72 3.70 NA 33.74 090
shunt.
62201 ................ A Establish brain cavity 14.86 NA 9.76 2.52 NA 27.14 090
shunt.
62220 ................ A Establish brain cavity 13.00 NA 8.60 2.53 NA 24.13 090
shunt.
62223 ................ A Establish brain cavity 12.87 NA 8.54 2.58 NA 23.99 090
shunt.
62225 ................ A Replace/irrigate 5.41 NA 4.11 1.09 NA 10.61 090
catheter.
62230 ................ A Replace/revise brain 10.54 NA 6.42 2.10 NA 19.06 090
shunt.
62252 ................ A Csf shunt reprogram... 0.74 1.35 NA 0.18 2.27 NA XXX
62252 26 A Csf shunt reprogram... 0.74 0.30 0.30 0.16 1.20 1.20 XXX
62252 TC A Csf shunt reprogram... 0.00 1.05 NA 0.02 1.07 NA XXX
[[Page 55396]]
62256 ................ A Remove brain cavity 6.60 NA 5.40 1.34 NA 13.34 090
shunt.
62258 ................ A Replace brain cavity 14.54 NA 8.82 2.91 NA 26.27 090
shunt.
62263 ................ A Lysis epidural 6.14 5.15 2.07 0.42 11.71 8.63 010
adhesions.
62268 ................ A Drain spinal cord cyst 4.74 NA 2.74 0.29 NA 7.77 000
62269 ................ A Needle biopsy, spinal 5.02 NA 2.40 0.29 NA 7.71 000
cord.
62270 ................ A Spinal fluid tap, 1.13 4.08 0.48 0.06 5.27 1.67 000
diagnostic.
62272 ................ A Drain cerebro spinal 1.35 3.38 0.62 0.13 4.86 2.10 000
fluid.
62273 ................ A Treat epidural spine 2.15 1.57 1.27 0.14 3.86 3.56 000
lesion.
62280 ................ A Treat spinal cord 2.63 3.79 0.70 0.17 6.59 3.50 010
lesion.
62281 ................ A Treat spinal cord 2.66 4.50 0.62 0.16 7.32 3.44 010
lesion.
62282 ................ A Treat spinal canal 2.33 5.57 0.62 0.14 8.04 3.09 010
lesion.
62284 ................ A Injection for 1.54 5.53 0.55 0.10 7.17 2.19 000
myelogram.
62287 ................ A Percutaneous 8.08 NA 5.05 0.66 NA 13.79 090
diskectomy.
62290 ................ A Inject for spine disk 3.00 5.68 1.30 0.20 8.88 4.50 000
x-ray.
62291 ................ A Inject for spine disk 2.91 6.24 1.20 0.17 9.32 4.28 000
x-ray.
62292 ................ A Injection into disk 7.86 NA 5.34 0.65 NA 13.85 090
lesion.
62294 ................ A Injection into spinal 11.83 NA 7.37 0.85 NA 20.05 090
artery.
62310 ................ A Inject spine c/t...... 1.91 3.71 0.43 0.11 5.73 2.45 000
62311 ................ A Inject spine l/s (cd). 1.54 4.22 0.37 0.09 5.85 2.00 000
62318 ................ A Inject spine w/cath, c/ 2.04 3.83 0.44 0.12 5.99 2.60 000
t.
62319 ................ A Inject spine w/cath l/ 1.87 3.67 0.40 0.11 5.65 2.38 000
s (cd).
62350 ................ A Implant spinal canal 6.87 NA 3.79 0.64 NA 11.30 090
cath.
62351 ................ A Implant spinal canal 10.00 NA 6.90 1.79 NA 18.69 090
cath.
62355 ................ A Remove spinal canal 5.45 NA 3.02 0.47 NA 8.94 090
catheter.
62360 ................ A Insert spine infusion 2.62 NA 2.46 0.21 NA 5.29 090
device.
62361 ................ A Implant spine infusion 5.42 NA 3.67 0.50 NA 9.59 090
pump.
62362 ................ A Implant spine infusion 7.04 NA 4.06 0.86 NA 11.96 090
pump.
62365 ................ A Remove spine infusion 5.42 NA 3.99 0.58 NA 9.99 090
device.
62367 ................ C Analyze spine infusion 0.00 0.00 0.00 0.00 0.00 0.00 XXX
pump.
62367 26 A Analyze spine infusion 0.48 0.14 0.14 0.03 0.65 0.65 XXX
pump.
62367 TC C Analyze spine infusion 0.00 0.00 0.00 0.00 0.00 0.00 XXX
pump.
62368 ................ C Analyze spine infusion 0.00 0.00 0.00 0.00 0.00 0.00 XXX
pump.
62368 26 A Analyze spine infusion 0.75 0.20 0.20 0.05 1.00 1.00 XXX
pump.
62368 TC C Analyze spine infusion 0.00 0.00 0.00 0.00 0.00 0.00 XXX
pump.
63001 ................ A Removal of spinal 15.82 NA 11.68 3.03 NA 30.53 090
lamina.
63003 ................ A Removal of spinal 15.95 NA 11.95 2.98 NA 30.88 090
lamina.
63005 ................ A Removal of spinal 14.92 NA 11.49 2.62 NA 29.03 090
lamina.
63011 ................ A Removal of spinal 14.52 NA 11.29 1.43 NA 27.24 090
lamina.
63012 ................ A Removal of spinal 15.40 NA 10.34 2.71 NA 28.45 090
lamina.
63015 ................ A Removal of spinal 19.35 NA 13.68 3.84 NA 36.87 090
lamina.
63016 ................ A Removal of spinal 19.20 NA 13.66 3.62 NA 36.48 090
lamina.
63017 ................ A Removal of spinal 15.94 NA 12.00 2.91 NA 30.85 090
lamina.
63020 ................ A Neck spine disk 14.81 NA 11.33 2.89 NA 29.03 090
surgery.
63030 ................ A Low back disk surgery. 12.00 NA 9.92 2.21 NA 24.13 090
63035 ................ A Spinal disk surgery 3.15 NA 1.67 0.57 NA 5.39 ZZZ
add-on.
63040 ................ A Laminotomy, single 18.81 NA 13.39 3.36 NA 35.56 090
cervical.
63042 ................ A Laminotomy, single 17.47 NA 12.95 3.11 NA 33.53 090
lumbar.
63043 ................ C Laminotomy, addl 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
cervical.
63044 ................ C Laminotomy, addl 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
lumbar.
63045 ................ A Removal of spinal 16.50 NA 12.22 3.19 NA 31.91 090
lamina.
63046 ................ A Removal of spinal 15.80 NA 12.02 2.89 NA 30.71 090
lamina.
63047 ................ A Removal of spinal 14.61 NA 11.42 2.61 NA 28.64 090
lamina.
63048 ................ A Remove spinal lamina 3.26 NA 1.75 0.58 NA 5.59 ZZZ
add-on.
63055 ................ A Decompress spinal cord 21.99 NA 15.11 4.09 NA 41.19 090
63056 ................ A Decompress spinal cord 20.36 NA 14.44 3.34 NA 38.14 090
63057 ................ A Decompress spine cord 5.26 NA 2.82 0.81 NA 8.89 ZZZ
add-on.
63064 ................ A Decompress spinal cord 24.61 NA 17.12 4.72 NA 46.45 090
63066 ................ A Decompress spine cord 3.26 NA 1.76 0.63 NA 5.65 ZZZ
add-on.
63075 ................ A Neck spine disk 19.41 NA 13.83 3.73 NA 36.97 090
surgery.
63076 ................ A Neck spine disk 4.05 NA 2.16 0.78 NA 6.99 ZZZ
surgery.
63077 ................ A Spine disk surgery, 21.44 NA 15.47 3.44 NA 40.35 090
thorax.
63078 ................ A Spine disk surgery, 3.28 NA 1.72 0.50 NA 5.50 ZZZ
thorax.
63081 ................ A Removal of vertebral 23.73 NA 16.68 4.46 NA 44.87 090
body.
63082 ................ A Remove vertebral body 4.37 NA 2.34 0.82 NA 7.53 ZZZ
add-on.
63085 ................ A Removal of vertebral 26.92 NA 17.89 4.70 NA 49.51 090
body.
63086 ................ A Remove vertebral body 3.19 NA 1.66 0.55 NA 5.40 ZZZ
add-on.
63087 ................ A Removal of vertebral 35.57 NA 22.45 5.87 NA 63.89 090
body.
63088 ................ A Remove vertebral body 4.33 NA 2.30 0.77 NA 7.40 ZZZ
add-on.
63090 ................ A Removal of vertebral 28.16 NA 18.12 4.27 NA 50.55 090
body.
63091 ................ A Remove vertebral body 3.03 NA 1.48 0.45 NA 4.96 ZZZ
add-on.
63170 ................ A Incise spinal cord 19.83 NA 13.54 3.89 NA 37.26 090
tract(s).
63172 ................ A Drainage of spinal 17.66 NA 13.37 3.46 NA 34.49 090
cyst.
63173 ................ A Drainage of spinal 21.99 NA 15.54 4.14 NA 41.67 090
cyst.
[[Page 55397]]
63180 ................ A Revise spinal cord 18.27 NA 13.04 3.83 NA 35.14 090
ligaments.
63182 ................ A Revise spinal cord 20.50 NA 13.61 3.48 NA 37.59 090
ligaments.
63185 ................ A Incise spinal column/ 15.04 NA 9.70 2.08 NA 26.82 090
nerves.
63190 ................ A Incise spinal column/ 17.45 NA 11.68 2.88 NA 32.01 090
nerves.
63191 ................ A Incise spinal column/ 17.54 NA 10.65 3.50 NA 31.69 090
nerves.
63194 ................ A Incise spinal column & 19.19 NA 13.48 4.01 NA 36.68 090
cord.
63195 ................ A Incise spinal column & 18.84 NA 13.02 3.44 NA 35.30 090
cord.
63196 ................ A Incise spinal column & 22.30 NA 14.03 4.66 NA 40.99 090
cord.
63197 ................ A Incise spinal column & 21.11 NA 13.49 4.42 NA 39.02 090
cord.
63198 ................ A Incise spinal column & 25.38 NA 12.70 5.31 NA 43.39 090
cord.
63199 ................ A Incise spinal column & 26.89 NA 14.38 5.62 NA 46.89 090
cord.
63200 ................ A Release of spinal cord 19.18 NA 13.42 3.61 NA 36.21 090
63250 ................ A Revise spinal cord 40.76 NA 23.15 7.65 NA 71.56 090
vessels.
63251 ................ A Revise spinal cord 41.20 NA 23.51 7.98 NA 72.69 090
vessels.
63252 ................ A Revise spinal cord 41.19 NA 23.36 7.75 NA 72.30 090
vessels.
63265 ................ A Excise intraspinal 21.56 NA 13.21 4.29 NA 39.06 090
lesion.
63266 ................ A Excise intraspinal 22.30 NA 13.70 4.47 NA 40.47 090
lesion.
63267 ................ A Excise intraspinal 17.95 NA 11.48 3.50 NA 32.93 090
lesion.
63268 ................ A Excise intraspinal 18.52 NA 10.97 3.18 NA 32.67 090
lesion.
63270 ................ A Excise intraspinal 26.80 NA 16.10 5.41 NA 48.31 090
lesion.
63271 ................ A Excise intraspinal 26.92 NA 16.17 5.56 NA 48.65 090
lesion.
63272 ................ A Excise intraspinal 25.32 NA 15.31 5.07 NA 45.70 090
lesion.
63273 ................ A Excise intraspinal 24.29 NA 14.84 5.08 NA 44.21 090
lesion.
63275 ................ A Biopsy/excise spinal 23.68 NA 14.47 4.68 NA 42.83 090
tumor.
63276 ................ A Biopsy/excise spinal 23.45 NA 14.27 4.63 NA 42.35 090
tumor.
63277 ................ A Biopsy/excise spinal 20.83 NA 12.99 4.03 NA 37.85 090
tumor.
63278 ................ A Biopsy/excise spinal 20.56 NA 13.08 4.02 NA 37.66 090
tumor.
63280 ................ A Biopsy/excise spinal 28.35 NA 16.76 5.80 NA 50.91 090
tumor.
63281 ................ A Biopsy/excise spinal 28.05 NA 16.73 5.67 NA 50.45 090
tumor.
63282 ................ A Biopsy/excise spinal 26.39 NA 15.79 5.33 NA 47.51 090
tumor.
63283 ................ A Biopsy/excise spinal 25.00 NA 15.07 5.12 NA 45.19 090
tumor.
63285 ................ A Biopsy/excise spinal 36.00 NA 20.82 7.31 NA 64.13 090
tumor.
63286 ................ A Biopsy/excise spinal 35.63 NA 20.51 7.07 NA 63.21 090
tumor.
63287 ................ A Biopsy/excise spinal 36.70 NA 21.03 7.48 NA 65.21 090
tumor.
63290 ................ A Biopsy/excise spinal 37.38 NA 21.58 7.65 NA 66.61 090
tumor.
63300 ................ A Removal of vertebral 24.43 NA 14.63 4.78 NA 43.84 090
body.
63301 ................ A Removal of vertebral 27.60 NA 15.65 5.03 NA 48.28 090
body.
63302 ................ A Removal of vertebral 27.81 NA 16.45 5.25 NA 49.51 090
body.
63303 ................ A Removal of vertebral 30.50 NA 17.71 5.21 NA 53.42 090
body.
63304 ................ A Removal of vertebral 30.33 NA 17.80 4.72 NA 52.85 090
body.
63305 ................ A Removal of vertebral 32.03 NA 19.24 5.39 NA 56.66 090
body.
63306 ................ A Removal of vertebral 32.22 NA 18.19 2.39 NA 52.80 090
body.
63307 ................ A Removal of vertebral 31.63 NA 17.29 4.23 NA 53.15 090
body.
63308 ................ A Remove vertebral body 5.25 NA 2.74 1.01 NA 9.00 ZZZ
add-on.
63600 ................ A Remove spinal cord 14.02 NA 6.38 1.22 NA 21.62 090
lesion.
63610 ................ A Stimulation of spinal 8.73 NA 3.90 0.43 NA 13.06 000
cord.
63615 ................ A Remove lesion of 16.28 NA 9.50 2.85 NA 28.63 090
spinal cord.
63650 ................ A Implant 6.74 NA 2.97 0.48 NA 10.19 090
neuroelectrodes.
63655 ................ A Implant 10.29 NA 7.26 1.85 NA 19.40 090
neuroelectrodes.
63660 ................ A Revise/remove 6.16 NA 3.67 0.65 NA 10.48 090
neuroelectrode.
63685 ................ A Implant neuroreceiver. 7.04 NA 4.15 0.96 NA 12.15 090
63688 ................ A Revise/remove 5.39 NA 3.69 0.70 NA 9.78 090
neuroreceiver.
63700 ................ A Repair of spinal 16.53 NA 10.47 2.69 NA 29.69 090
herniation.
63702 ................ A Repair of spinal 18.48 NA 9.90 1.36 NA 29.74 090
herniation.
63704 ................ A Repair of spinal 21.18 NA 12.37 3.84 NA 37.39 090
herniation.
63706 ................ A Repair of spinal 24.11 NA 13.60 4.73 NA 42.44 090
herniation.
63707 ................ A Repair spinal fluid 11.26 NA 8.06 1.96 NA 21.28 090
leakage.
63709 ................ A Repair spinal fluid 14.32 NA 9.79 2.49 NA 26.60 090
leakage.
63710 ................ A Graft repair of spine 14.07 NA 9.54 2.61 NA 26.22 090
defect.
63740 ................ A Install spinal shunt.. 11.36 NA 7.79 2.15 NA 21.30 090
63741 ................ A Install spinal shunt.. 8.25 NA 4.72 1.05 NA 14.02 090
63744 ................ A Revision of spinal 8.10 NA 5.72 1.51 NA 15.33 090
shunt.
63746 ................ A Removal of spinal 6.43 NA 4.96 1.15 NA 12.54 090
shunt.
64400 ................ A Injection for nerve 1.11 2.70 0.29 0.06 3.87 1.46 000
block.
64402 ................ A Injection for nerve 1.25 4.38 0.45 0.07 5.70 1.77 000
block.
64405 ................ A Injection for nerve 1.32 1.34 0.37 0.08 2.74 1.77 000
block.
64408 ................ A Injection for nerve 1.41 2.95 0.62 0.09 4.45 2.12 000
block.
64410 ................ A Injection for nerve 1.43 3.27 0.35 0.08 4.78 1.86 000
block.
64412 ................ A Injection for nerve 1.18 2.49 0.37 0.08 3.75 1.63 000
block.
64413 ................ A Injection for nerve 1.40 2.81 0.34 0.09 4.30 1.83 000
block.
64415 ................ A Injection for nerve 1.48 2.65 0.32 0.08 4.21 1.88 000
block.
64417 ................ A Injection for nerve 1.44 3.21 0.38 0.09 4.74 1.91 000
block.
64418 ................ A Injection for nerve 1.32 2.49 0.29 0.07 3.88 1.68 000
block.
[[Page 55398]]
64420 ................ A Injection for nerve 1.18 2.37 0.27 0.07 3.62 1.52 000
block.
64421 ................ A Injection for nerve 1.68 2.91 0.38 0.10 4.69 2.16 000
block.
64425 ................ A Injection for nerve 1.75 2.33 0.41 0.11 4.19 2.27 000
block.
64430 ................ A Injection for nerve 1.46 2.89 0.47 0.11 4.46 2.04 000
block.
64435 ................ A Injection for nerve 1.45 2.96 0.60 0.15 4.56 2.20 000
block.
64445 ................ A Injection for nerve 1.48 1.60 0.42 0.08 3.16 1.98 000
block.
64450 ................ A Injection for nerve 1.27 1.79 0.33 0.08 3.14 1.68 000
block.
64470 ................ A Inj paravertebral c/t. 1.85 4.02 0.48 0.12 5.99 2.45 000
64472 ................ A Inj paravertebral c/t 1.29 3.90 0.33 0.09 5.28 1.71 ZZZ
add-on.
64475 ................ A Inj paravertebral l/s. 1.41 3.82 0.39 0.09 5.32 1.89 000
64476 ................ A Inj paravertebral l/s 0.98 3.86 0.26 0.06 4.90 1.30 ZZZ
add-on.
64479 ................ A Inj foramen epidural c/ 2.20 4.40 0.64 0.14 6.74 2.98 000
t.
64480 ................ A Inj foramen epidural 1.54 4.07 0.50 0.09 5.70 2.13 ZZZ
add-on.
64483 ................ A Inj foramen epidural l/ 1.90 4.44 0.56 0.12 6.46 2.58 000
s.
64484 ................ A Inj foramen epidural 1.33 4.05 0.40 0.08 5.46 1.81 ZZZ
add-on.
64505 ................ A Injection for nerve 1.36 2.41 0.35 0.08 3.85 1.79 000
block.
64508 ................ A Injection for nerve 1.12 2.32 0.48 0.06 3.50 1.66 000
block.
64510 ................ A Injection for nerve 1.22 2.53 0.26 0.07 3.82 1.55 000
block.
64520 ................ A Injection for nerve 1.35 3.49 0.31 0.08 4.92 1.74 000
block.
64530 ................ A Injection for nerve 1.58 3.07 0.37 0.09 4.74 2.04 000
block.
64550 ................ A Apply neurostimulator. 0.18 0.56 0.07 0.01 0.75 0.26 000
64553 ................ A Implant 2.31 4.25 1.33 0.17 6.73 3.81 010
neuroelectrodes.
64555 ................ A Implant 2.27 2.38 0.77 0.11 4.76 3.15 010
neuroelectrodes.
64560 ................ A Implant 2.36 2.30 0.94 0.17 4.83 3.47 010
neuroelectrodes.
64561 ................ A Implant 6.74 15.28 3.83 0.11 22.13 10.68 010
neuroelectrodes.
64565 ................ A Implant 1.76 3.41 0.69 0.08 5.25 2.53 010
neuroelectrodes.
64573 ................ A Implant 7.50 NA 5.40 1.48 NA 14.38 090
neuroelectrodes.
64575 ................ A Implant 4.35 NA 3.03 0.37 NA 7.75 090
neuroelectrodes.
64577 ................ A Implant 4.62 NA 3.44 0.50 NA 8.56 090
neuroelectrodes.
64580 ................ A Implant 4.12 NA 3.94 0.21 NA 8.27 090
neuroelectrodes.
64581 ................ A Implant 13.50 NA 6.72 0.37 NA 20.59 090
neuroelectrodes.
64585 ................ A Revise/remove 2.06 2.82 2.20 0.29 5.17 4.55 010
neuroelectrode.
64590 ................ A Implant neuroreceiver. 2.40 NA 2.17 0.40 NA 4.97 010
64595 ................ A Revise/remove 1.73 NA 2.08 0.22 NA 4.03 010
neuroreceiver.
64600 ................ A Injection treatment of 3.45 2.98 2.06 0.28 6.71 5.79 010
nerve.
64605 ................ A Injection treatment of 5.61 3.62 2.90 0.53 9.76 9.04 010
nerve.
64610 ................ A Injection treatment of 7.16 NA 4.18 1.12 NA 12.46 010
nerve.
64612 ................ A Destroy nerve, face 1.96 3.00 1.65 0.09 5.05 3.70 010
muscle.
64613 ................ A Destroy nerve, spine 1.96 1.82 1.48 0.10 3.88 3.54 010
muscle.
64614 ................ A Destroy nerve, extrem 2.20 3.23 0.82 0.09 5.52 3.11 010
musc.
64620 ................ A Injection treatment of 2.84 2.98 0.67 0.17 5.99 3.68 010
nerve.
64622 ................ A Destr paravertebrl 3.00 4.77 0.74 0.17 7.94 3.91 010
nerve l/s.
64623 ................ A Destr paravertebral n 0.99 3.85 0.24 0.06 4.90 1.29 ZZZ
add-on.
64626 ................ A Destr paravertebrl 3.28 4.34 0.80 0.22 7.84 4.30 010
nerve c/t.
64627 ................ A Destr paravertebral n 1.16 3.74 0.29 0.08 4.98 1.53 ZZZ
add-on.
64630 ................ A Injection treatment of 3.00 3.66 0.88 0.16 6.82 4.04 010
nerve.
64640 ................ A Injection treatment of 2.76 3.67 1.72 0.11 6.54 4.59 010
nerve.
64680 ................ A Injection treatment of 2.62 2.89 0.76 0.15 5.66 3.53 010
nerve.
64702 ................ A Revise finger/toe 4.23 NA 4.05 0.51 NA 8.79 090
nerve.
64704 ................ A Revise hand/foot nerve 4.57 NA 3.23 0.59 NA 8.39 090
64708 ................ A Revise arm/leg nerve.. 6.12 NA 5.19 0.82 NA 12.13 090
64712 ................ A Revision of sciatic 7.75 NA 5.61 0.54 NA 13.90 090
nerve.
64713 ................ A Revision of arm 11.00 NA 6.66 1.01 NA 18.67 090
nerve(s).
64714 ................ A Revise low back 10.33 NA 4.25 0.64 NA 15.22 090
nerve(s).
64716 ................ A Revision of cranial 6.31 NA 5.18 0.59 NA 12.08 090
nerve.
64718 ................ A Revise ulnar nerve at 5.99 NA 5.29 0.87 NA 12.15 090
elbow.
64719 ................ A Revise ulnar nerve at 4.85 NA 4.78 0.63 NA 10.26 090
wrist.
64721 ................ A Carpal tunnel surgery. 4.29 6.59 6.14 0.59 11.47 11.02 090
64722 ................ A Relieve pressure on 4.70 NA 3.49 0.32 NA 8.51 090
nerve(s).
64726 ................ A Release foot/toe nerve 4.18 NA 3.14 0.57 NA 7.89 090
64727 ................ A Internal nerve 3.10 NA 1.68 0.40 NA 5.18 ZZZ
revision.
64732 ................ A Incision of brow nerve 4.41 NA 3.69 0.77 NA 8.87 090
64734 ................ A Incision of cheek 4.92 NA 3.80 0.83 NA 9.55 090
nerve.
64736 ................ A Incision of chin nerve 4.60 NA 2.98 0.71 NA 8.29 090
64738 ................ A Incision of jaw nerve. 5.73 NA 3.92 0.84 NA 10.49 090
64740 ................ A Incision of tongue 5.59 NA 4.11 0.43 NA 10.13 090
nerve.
64742 ................ A Incision of facial 6.22 NA 4.96 0.69 NA 11.87 090
nerve.
64744 ................ A Incise nerve, back of 5.24 NA 3.94 0.98 NA 10.16 090
head.
64746 ................ A Incise diaphragm nerve 5.93 NA 4.58 0.75 NA 11.26 090
64752 ................ A Incision of vagus 7.06 NA 4.96 0.83 NA 12.85 090
nerve.
64755 ................ A Incision of stomach 13.52 NA 6.40 1.16 NA 21.08 090
nerves.
64760 ................ A Incision of vagus 6.96 NA 4.05 0.51 NA 11.52 090
nerve.
64761 ................ A Incision of pelvis 6.41 NA 3.48 0.26 NA 10.15 090
nerve.
[[Page 55399]]
64763 ................ A Incise hip/thigh nerve 6.93 NA 6.21 0.77 NA 13.91 090
64766 ................ A Incise hip/thigh nerve 8.67 NA 4.73 0.99 NA 14.39 090
64771 ................ A Sever cranial nerve... 7.35 NA 5.44 1.32 NA 14.11 090
64772 ................ A Incision of spinal 7.21 NA 4.88 1.20 NA 13.29 090
nerve.
64774 ................ A Remove skin nerve 5.17 NA 3.92 0.60 NA 9.69 090
lesion.
64776 ................ A Remove digit nerve 5.12 NA 3.89 0.63 NA 9.64 090
lesion.
64778 ................ A Digit nerve surgery 3.11 NA 1.64 0.38 NA 5.13 ZZZ
add-on.
64782 ................ A Remove limb nerve 6.23 NA 3.93 0.79 NA 10.95 090
lesion.
64783 ................ A Limb nerve surgery add- 3.72 NA 1.95 0.48 NA 6.15 ZZZ
on.
64784 ................ A Remove nerve lesion... 9.82 NA 6.99 1.17 NA 17.98 090
64786 ................ A Remove sciatic nerve 15.46 NA 10.41 2.22 NA 28.09 090
lesion.
64787 ................ A Implant nerve end..... 4.30 NA 2.28 0.56 NA 7.14 ZZZ
64788 ................ A Remove skin nerve 4.61 NA 3.50 0.54 NA 8.65 090
lesion.
64790 ................ A Removal of nerve 11.31 NA 7.53 1.68 NA 20.52 090
lesion.
64792 ................ A Removal of nerve 14.92 NA 9.13 1.88 NA 25.93 090
lesion.
64795 ................ A Biopsy of nerve....... 3.01 NA 1.81 0.40 NA 5.22 000
64802 ................ A Remove sympathetic 9.15 NA 5.17 0.87 NA 15.19 090
nerves.
64804 ................ A Remove sympathetic 14.64 NA 6.83 1.79 NA 23.26 090
nerves.
64809 ................ A Remove sympathetic 13.67 NA 6.04 0.96 NA 20.67 090
nerves.
64818 ................ A Remove sympathetic 10.30 NA 5.76 1.08 NA 17.14 090
nerves.
64820 ................ A Remove sympathetic 10.37 NA 6.48 1.17 NA 18.02 090
nerves.
64821 ................ A Remove sympathetic 8.75 NA 7.09 0.99 NA 16.83 090
nerves.
64822 ................ A Remove sympathetic 8.75 NA 7.09 0.99 NA 16.83 090
nerves.
64823 ................ A Remove sympathetic 10.37 NA 7.89 1.17 NA 19.43 090
nerves.
64831 ................ A Repair of digit nerve. 9.44 NA 7.44 1.14 NA 18.02 090
64832 ................ A Repair nerve add-on... 5.66 NA 3.11 0.68 NA 9.45 ZZZ
64834 ................ A Repair of hand or foot 10.19 NA 7.40 1.23 NA 18.82 090
nerve.
64835 ................ A Repair of hand or foot 10.94 NA 8.06 1.36 NA 20.36 090
nerve.
64836 ................ A Repair of hand or foot 10.94 NA 7.94 1.32 NA 20.20 090
nerve.
64837 ................ A Repair nerve add-on... 6.26 NA 3.47 0.80 NA 10.53 ZZZ
64840 ................ A Repair of leg nerve... 13.02 NA 7.79 0.86 NA 21.67 090
64856 ................ A Repair/transpose nerve 13.80 NA 9.66 1.71 NA 25.17 090
64857 ................ A Repair arm/leg nerve.. 14.49 NA 10.21 1.76 NA 26.46 090
64858 ................ A Repair sciatic nerve.. 16.49 NA 11.04 2.78 NA 30.31 090
64859 ................ A Nerve surgery......... 4.26 NA 2.24 0.50 NA 7.00 ZZZ
64861 ................ A Repair of arm nerves.. 19.24 NA 13.02 2.45 NA 34.71 090
64862 ................ A Repair of low back 19.44 NA 12.29 2.47 NA 34.20 090
nerves.
64864 ................ A Repair of facial nerve 12.55 NA 8.63 1.13 NA 22.31 090
64865 ................ A Repair of facial nerve 15.24 NA 10.46 1.37 NA 27.07 090
64866 ................ A Fusion of facial/other 15.74 NA 9.84 1.06 NA 26.64 090
nerve.
64868 ................ A Fusion of facial/other 14.04 NA 9.57 1.40 NA 25.01 090
nerve.
64870 ................ A Fusion of facial/other 15.99 NA 9.65 1.08 NA 26.72 090
nerve.
64872 ................ A Subsequent repair of 1.99 NA 1.08 0.24 NA 3.31 ZZZ
nerve.
64874 ................ A Repair & revise nerve 2.98 NA 1.64 0.34 NA 4.96 ZZZ
add-on.
64876 ................ A Repair nerve/shorten 3.38 NA 1.35 0.39 NA 5.12 ZZZ
bone.
64885 ................ A Nerve graft, head or 17.53 NA 11.66 1.51 NA 30.70 090
neck.
64886 ................ A Nerve graft, head or 20.75 NA 13.60 1.73 NA 36.08 090
neck.
64890 ................ A Nerve graft, hand or 15.15 NA 10.27 1.74 NA 27.16 090
foot.
64891 ................ A Nerve graft, hand or 16.14 NA 5.75 1.38 NA 23.27 090
foot.
64892 ................ A Nerve graft, arm or 14.65 NA 8.96 1.65 NA 25.26 090
leg.
64893 ................ A Nerve graft, arm or 15.60 NA 10.75 1.77 NA 28.12 090
leg.
64895 ................ A Nerve graft, hand or 19.25 NA 8.62 2.04 NA 29.91 090
foot.
64896 ................ A Nerve graft, hand or 20.49 NA 11.75 1.85 NA 34.09 090
foot.
64897 ................ A Nerve graft, arm or 18.24 NA 10.92 2.64 NA 31.80 090
leg.
64898 ................ A Nerve graft, arm or 19.50 NA 10.75 2.71 NA 32.96 090
leg.
64901 ................ A Nerve graft add-on.... 10.22 NA 5.75 0.99 NA 16.96 ZZZ
64902 ................ A Nerve graft add-on.... 11.83 NA 6.32 1.10 NA 19.25 ZZZ
64905 ................ A Nerve pedicle transfer 14.02 NA 8.93 1.52 NA 24.47 090
64907 ................ A Nerve pedicle transfer 18.83 NA 12.07 1.79 NA 32.69 090
64999 ................ C Nervous system surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
65091 ................ A Revise eye............ 6.46 NA 11.59 0.26 NA 18.31 090
65093 ................ A Revise eye with 6.87 NA 11.83 0.28 NA 18.98 090
implant.
65101 ................ A Removal of eye........ 7.03 NA 12.04 0.28 NA 19.35 090
65103 ................ A Remove eye/insert 7.57 NA 12.17 0.30 NA 20.04 090
implant.
65105 ................ A Remove eye/attach 8.49 NA 12.67 0.34 NA 21.50 090
implant.
65110 ................ A Removal of eye........ 13.95 NA 15.90 0.68 NA 30.53 090
65112 ................ A Remove eye/revise 16.38 NA 17.26 0.96 NA 34.60 090
socket.
65114 ................ A Remove eye/revise 17.53 NA 18.54 0.94 NA 37.01 090
socket.
65125 ................ A Revise ocular implant. 3.12 6.23 1.48 0.15 9.50 4.75 090
65130 ................ A Insert ocular implant. 7.15 NA 11.46 0.28 NA 18.89 090
65135 ................ A Insert ocular implant. 7.33 NA 12.37 0.29 NA 19.99 090
65140 ................ A Attach ocular implant. 8.02 NA 12.36 0.31 NA 20.69 090
65150 ................ A Revise ocular implant. 6.26 NA 10.94 0.25 NA 17.45 090
[[Page 55400]]
65155 ................ A Reinsert ocular 8.66 NA 12.59 0.40 NA 21.65 090
implant.
65175 ................ A Removal of ocular 6.28 NA 11.35 0.26 NA 17.89 090
implant.
65205 ................ A Remove foreign body 0.71 0.63 0.20 0.03 1.37 0.94 000
from eye.
65210 ................ A Remove foreign body 0.84 0.78 0.32 0.03 1.65 1.19 000
from eye.
65220 ................ A Remove foreign body 0.71 8.23 0.19 0.05 8.99 0.95 000
from eye.
65222 ................ A Remove foreign body 0.93 0.80 0.29 0.04 1.77 1.26 000
from eye.
65235 ................ A Remove foreign body 7.57 NA 7.04 0.30 NA 14.91 090
from eye.
65260 ................ A Remove foreign body 10.96 NA 12.66 0.43 NA 24.05 090
from eye.
65265 ................ A Remove foreign body 12.59 NA 14.38 0.50 NA 27.47 090
from eye.
65270 ................ A Repair of eye wound... 1.90 4.07 2.44 0.08 6.05 4.42 010
65272 ................ A Repair of eye wound... 3.82 5.76 4.75 0.16 9.74 8.73 090
65273 ................ A Repair of eye wound... 4.36 NA 5.15 0.17 NA 9.68 090
65275 ................ A Repair of eye wound... 5.34 5.50 5.32 0.27 11.11 10.93 090
65280 ................ A Repair of eye wound... 7.66 NA 7.88 0.30 NA 15.84 090
65285 ................ A Repair of eye wound... 12.90 NA 13.86 0.51 NA 27.27 090
65286 ................ A Repair of eye wound... 5.51 9.12 7.85 0.21 14.84 13.57 090
65290 ................ A Repair of eye socket 5.41 NA 6.60 0.26 NA 12.27 090
wound.
65400 ................ A Removal of eye lesion. 6.06 8.61 7.13 0.24 14.91 13.43 090
65410 ................ A Biopsy of cornea...... 1.47 1.76 0.71 0.06 3.29 2.24 000
65420 ................ A Removal of eye lesion. 4.17 8.36 7.22 0.17 12.70 11.56 090
65426 ................ A Removal of eye lesion. 5.25 8.01 6.75 0.20 13.46 12.20 090
65430 ................ A Corneal smear......... 1.47 8.68 0.71 0.06 10.21 2.24 000
65435 ................ A Curette/treat cornea.. 0.92 1.37 0.41 0.04 2.33 1.37 000
65436 ................ A Curette/treat cornea.. 4.19 6.02 5.03 0.17 10.38 9.39 090
65450 ................ A Treatment of corneal 3.27 7.97 6.80 0.13 11.37 10.20 090
lesion.
65600 ................ A Revision of cornea.... 3.40 5.54 1.54 0.14 9.08 5.08 090
65710 ................ A Corneal transplant.... 12.35 NA 13.25 0.49 NA 26.09 090
65730 ................ A Corneal transplant.... 14.25 NA 12.16 0.56 NA 26.97 090
65750 ................ A Corneal transplant.... 15.00 NA 14.54 0.59 NA 30.13 090
65755 ................ A Corneal transplant.... 14.89 NA 14.48 0.58 NA 29.95 090
65760 ................ N Revision of cornea.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
65765 ................ N Revision of cornea.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
65767 ................ N Corneal tissue 0.00 0.00 0.00 0.00 0.00 0.00 XXX
transplant.
65770 ................ A Revise cornea with 17.56 NA 15.48 0.69 NA 33.73 090
implant.
65771 ................ N Radial keratotomy..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
65772 ................ A Correction of 4.29 7.51 6.47 0.17 11.97 10.93 090
astigmatism.
65775 ................ A Correction of 5.79 NA 8.63 0.22 NA 14.64 090
astigmatism.
65800 ................ A Drainage of eye....... 1.91 2.33 1.45 0.08 4.32 3.44 000
65805 ................ A Drainage of eye....... 1.91 2.34 1.46 0.08 4.33 3.45 000
65810 ................ A Drainage of eye....... 4.87 NA 8.95 0.19 NA 14.01 090
65815 ................ A Drainage of eye....... 5.05 9.40 8.16 0.20 14.65 13.41 090
65820 ................ A Relieve inner eye 8.13 NA 10.99 0.32 NA 19.44 090
pressure.
65850 ................ A Incision of eye....... 10.52 NA 10.35 0.41 NA 21.28 090
65855 ................ A Laser surgery of eye.. 3.85 5.17 3.70 0.17 9.19 7.72 010
65860 ................ A Incise inner eye 3.55 4.15 3.18 0.14 7.84 6.87 090
adhesions.
65865 ................ A Incise inner eye 5.60 NA 6.92 0.22 NA 12.74 090
adhesions.
65870 ................ A Incise inner eye 6.27 NA 7.25 0.24 NA 13.76 090
adhesions.
65875 ................ A Incise inner eye 6.54 NA 7.37 0.25 NA 14.16 090
adhesions.
65880 ................ A Incise inner eye 7.09 NA 7.64 0.28 NA 15.01 090
adhesions.
65900 ................ A Remove eye lesion..... 10.93 NA 12.75 0.46 NA 24.14 090
65920 ................ A Remove implant of eye. 8.40 NA 8.26 0.33 NA 16.99 090
65930 ................ A Remove blood clot from 7.44 NA 8.83 0.29 NA 16.56 090
eye.
66020 ................ A Injection treatment of 1.59 2.43 1.57 0.07 4.09 3.23 010
eye.
66030 ................ A Injection treatment of 1.25 2.25 1.40 0.05 3.55 2.70 010
eye.
66130 ................ A Remove eye lesion..... 7.69 7.63 6.71 0.31 15.63 14.71 090
66150 ................ A Glaucoma surgery...... 8.30 NA 10.98 0.33 NA 19.61 090
66155 ................ A Glaucoma surgery...... 8.29 NA 10.94 0.32 NA 19.55 090
66160 ................ A Glaucoma surgery...... 10.17 NA 11.84 0.41 NA 22.42 090
66165 ................ A Glaucoma surgery...... 8.01 NA 10.72 0.31 NA 19.04 090
66170 ................ A Glaucoma surgery...... 12.16 NA 17.11 0.48 NA 29.75 090
66172 ................ A Incision of eye....... 15.04 NA 15.67 0.59 NA 31.30 090
66180 ................ A Implant eye shunt..... 14.55 NA 12.44 0.57 NA 27.56 090
66185 ................ A Revise eye shunt...... 8.14 NA 8.47 0.32 NA 16.93 090
66220 ................ A Repair eye lesion..... 7.77 NA 9.99 0.32 NA 18.08 090
66225 ................ A Repair/graft eye 11.05 NA 9.65 0.44 NA 21.14 090
lesion.
66250 ................ A Follow-up surgery of 5.98 8.08 6.48 0.23 14.29 12.69 090
eye.
66500 ................ A Incision of iris...... 3.71 NA 4.82 0.15 NA 8.68 090
66505 ................ A Incision of iris...... 4.08 NA 5.01 0.17 NA 9.26 090
66600 ................ A Remove iris and lesion 8.68 NA 8.90 0.34 NA 17.92 090
66605 ................ A Removal of iris....... 12.79 NA 12.54 0.61 NA 25.94 090
66625 ................ A Removal of iris....... 5.13 7.90 6.81 0.20 13.23 12.14 090
66630 ................ A Removal of iris....... 6.16 NA 7.76 0.24 NA 14.16 090
66635 ................ A Removal of iris....... 6.25 NA 6.65 0.24 NA 13.14 090
[[Page 55401]]
66680 ................ A Repair iris & ciliary 5.44 NA 6.30 0.21 NA 11.95 090
body.
66682 ................ A Repair iris & ciliary 6.21 NA 7.75 0.24 NA 14.20 090
body.
66700 ................ A Destruction, ciliary 4.78 7.17 7.17 0.19 12.14 12.14 090
body.
66710 ................ A Destruction, ciliary 4.78 8.92 7.53 0.18 13.88 12.49 090
body.
66720 ................ A Destruction, ciliary 4.78 8.40 7.53 0.19 13.37 12.50 090
body.
66740 ................ A Destruction, ciliary 4.78 NA 6.53 0.18 NA 11.49 090
body.
66761 ................ A Revision of iris...... 4.07 5.66 4.38 0.16 9.89 8.61 090
66762 ................ A Revision of iris...... 4.58 5.65 4.45 0.18 10.41 9.21 090
66770 ................ A Removal of inner eye 5.18 5.94 4.68 0.20 11.32 10.06 090
lesion.
66820 ................ A Incision, secondary 3.89 NA 8.50 0.16 NA 12.55 090
cataract.
66821 ................ A After cataract laser 2.35 3.89 3.46 0.10 6.34 5.91 090
surgery.
66825 ................ A Reposition intraocular 8.23 NA 10.56 0.32 NA 19.11 090
lens.
66830 ................ A Removal of lens lesion 8.20 NA 7.06 0.32 NA 15.58 090
66840 ................ A Removal of lens 7.91 NA 6.92 0.31 NA 15.14 090
material.
66850 ................ A Removal of lens 9.11 NA 7.52 0.36 NA 16.99 090
material.
66852 ................ A Removal of lens 9.97 NA 7.99 0.39 NA 18.35 090
material.
66920 ................ A Extraction of lens.... 8.86 NA 7.42 0.35 NA 16.63 090
66930 ................ A Extraction of lens.... 10.18 NA 8.94 0.41 NA 19.53 090
66940 ................ A Extraction of lens.... 8.93 NA 8.39 0.35 NA 17.67 090
66982 ................ A Cataract surgery, 13.50 NA 9.31 0.56 NA 23.37 090
complex.
66983 ................ A Cataract surg w/iol, 1 8.99 NA 6.34 0.37 NA 15.70 090
stage.
66984 ................ A Cataract surg w/iol, 1 10.23 NA 7.85 0.41 NA 18.49 090
stage.
66985 ................ A Insert lens prosthesis 8.39 NA 7.05 0.33 NA 15.77 090
66986 ................ A Exchange lens 12.28 NA 8.86 0.49 NA 21.63 090
prosthesis.
66999 ................ C Eye surgery procedure. 0.00 0.00 0.00 0.00 0.00 0.00 YYY
67005 ................ A Partial removal of eye 5.70 NA 2.75 0.22 NA 8.67 090
fluid.
67010 ................ A Partial removal of eye 6.87 NA 3.32 0.27 NA 10.46 090
fluid.
67015 ................ A Release of eye fluid.. 6.92 NA 8.38 0.27 NA 15.57 090
67025 ................ A Replace eye fluid..... 6.84 18.23 7.77 0.27 25.34 14.88 090
67027 ................ A Implant eye drug 10.85 15.12 9.26 0.46 26.43 20.57 090
system.
67028 ................ A Injection eye drug.... 2.52 11.92 1.21 0.11 14.55 3.84 000
67030 ................ A Incise inner eye 4.84 NA 6.96 0.19 NA 11.99 090
strands.
67031 ................ A Laser surgery, eye 3.67 4.22 3.24 0.15 8.04 7.06 090
strands.
67036 ................ A Removal of inner eye 11.89 NA 9.30 0.47 NA 21.66 090
fluid.
67038 ................ A Strip retinal membrane 21.24 NA 16.01 0.84 NA 38.09 090
67039 ................ A Laser treatment of 14.52 NA 12.74 0.57 NA 27.83 090
retina.
67040 ................ A Laser treatment of 17.23 NA 14.08 0.68 NA 31.99 090
retina.
67101 ................ A Repair detached retina 7.53 11.29 9.12 0.29 19.11 16.94 090
67105 ................ A Repair detached retina 7.41 7.80 5.70 0.29 15.50 13.40 090
67107 ................ A Repair detached retina 14.84 NA 13.63 0.58 NA 29.05 090
67108 ................ A Repair detached retina 20.82 NA 18.30 0.82 NA 39.94 090
67110 ................ A Repair detached retina 8.81 21.74 10.56 0.35 30.90 19.72 090
67112 ................ A Rerepair detached 16.86 NA 15.66 0.66 NA 33.18 090
retina.
67115 ................ A Release encircling 4.99 NA 7.02 0.19 NA 12.20 090
material.
67120 ................ A Remove eye implant 5.98 17.57 7.36 0.23 23.78 13.57 090
material.
67121 ................ A Remove eye implant 10.67 NA 12.47 0.42 NA 23.56 090
material.
67141 ................ A Treatment of retina... 5.20 8.29 7.16 0.20 13.69 12.56 090
67145 ................ A Treatment of retina... 5.37 5.43 4.28 0.21 11.01 9.86 090
67208 ................ A Treatment of retinal 6.70 8.62 7.26 0.26 15.58 14.22 090
lesion.
67210 ................ A Treatment of retinal 8.82 7.49 5.93 0.35 16.66 15.10 090
lesion.
67218 ................ A Treatment of retinal 18.53 NA 16.36 0.53 NA 35.42 090
lesion.
67220 ................ A Treatment of choroid 13.13 11.18 9.94 0.51 24.82 23.58 090
lesion.
67221 ................ A Ocular photodynamic 4.01 4.80 1.95 0.16 8.97 6.12 000
ther.
67225 ................ A Eye photodynamic ther 0.47 0.24 0.19 0.50 1.21 1.16 ZZZ
add-on.
67227 ................ A Treatment of retinal 6.58 9.29 7.40 0.26 16.13 14.24 090
lesion.
67228 ................ A Treatment of retinal 12.74 10.17 7.47 0.50 23.41 20.71 090
lesion.
67250 ................ A Reinforce eye wall.... 8.66 NA 12.10 0.36 NA 21.12 090
67255 ................ A Reinforce/graft eye 8.90 NA 12.11 0.35 NA 21.36 090
wall.
67299 ................ C Eye surgery procedure. 0.00 0.00 0.00 0.00 0.00 0.00 YYY
67311 ................ A Revise eye muscle..... 6.65 NA 6.36 0.27 NA 13.28 090
67312 ................ A Revise two eye muscles 8.54 NA 7.46 0.35 NA 16.35 090
67314 ................ A Revise eye muscle..... 7.52 NA 6.94 0.30 NA 14.76 090
67316 ................ A Revise two eye muscles 9.66 NA 7.99 0.40 NA 18.05 090
67318 ................ A Revise eye muscle(s).. 7.85 NA 7.37 0.31 NA 15.53 090
67320 ................ A Revise eye muscle(s) 4.33 NA 2.09 0.17 NA 6.59 ZZZ
add-on.
67331 ................ A Eye surgery follow-up 4.06 NA 2.02 0.17 NA 6.25 ZZZ
add-on.
67332 ................ A Rerevise eye muscles 4.49 NA 2.16 0.18 NA 6.83 ZZZ
add-on.
67334 ................ A Revise eye muscle w/ 3.98 NA 1.90 0.16 NA 6.04 ZZZ
suture.
67335 ................ A Eye suture during 2.49 NA 1.20 0.10 NA 3.79 ZZZ
surgery.
67340 ................ A Revise eye muscle add- 4.93 NA 2.41 0.19 NA 7.53 ZZZ
on.
67343 ................ A Release eye tissue.... 7.35 NA 7.26 0.30 NA 14.91 090
67345 ................ A Destroy nerve of eye 2.96 4.46 1.36 0.13 7.55 4.45 010
muscle.
67350 ................ A Biopsy eye muscle..... 2.87 NA 1.99 0.13 NA 4.99 000
[[Page 55402]]
67399 ................ C Eye muscle surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
67400 ................ A Explore/biopsy eye 9.76 NA 13.85 0.43 NA 24.04 090
socket.
67405 ................ A Explore/drain eye 7.93 NA 12.56 0.36 NA 20.85 090
socket.
67412 ................ A Explore/treat eye 9.50 NA 16.02 0.41 NA 25.93 090
socket.
67413 ................ A Explore/treat eye 10.00 NA 13.80 0.43 NA 24.23 090
socket.
67414 ................ A Explr/decompress eye 11.13 NA 16.90 0.48 NA 28.51 090
socket.
67415 ................ A Aspiration, orbital 1.76 NA 0.80 0.09 NA 2.65 000
contents.
67420 ................ A Explore/treat eye 20.06 NA 20.79 0.84 NA 41.69 090
socket.
67430 ................ A Explore/treat eye 13.39 NA 18.38 0.97 NA 32.74 090
socket.
67440 ................ A Explore/drain eye 13.09 NA 18.43 0.58 NA 32.10 090
socket.
67445 ................ A Explr/decompress eye 14.42 NA 18.19 0.63 NA 33.24 090
socket.
67450 ................ A Explore/biopsy eye 13.51 NA 17.51 0.56 NA 31.58 090
socket.
67500 ................ A Inject/treat eye 0.79 0.95 0.20 0.04 1.78 1.03 000
socket.
67505 ................ A Inject/treat eye 0.82 0.95 0.21 0.04 1.81 1.07 000
socket.
67515 ................ A Inject/treat eye 0.61 0.86 0.29 0.02 1.49 0.92 000
socket.
67550 ................ A Insert eye socket 10.19 NA 13.57 0.50 NA 24.26 090
implant.
67560 ................ A Revise eye socket 10.60 NA 13.50 0.47 NA 24.57 090
implant.
67570 ................ A Decompress optic nerve 13.58 NA 17.66 0.69 NA 31.93 090
67599 ................ C Orbit surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
67700 ................ A Drainage of eyelid 1.35 7.80 0.60 0.06 9.21 2.01 010
abscess.
67710 ................ A Incision of eyelid.... 1.02 7.92 0.49 0.04 8.98 1.55 010
67715 ................ A Incision of eyelid 1.22 NA 0.59 0.05 NA 1.86 010
fold.
67800 ................ A Remove eyelid lesion.. 1.38 2.67 0.66 0.06 4.11 2.10 010
67801 ................ A Remove eyelid lesions. 1.88 8.23 0.91 0.08 10.19 2.87 010
67805 ................ A Remove eyelid lesions. 2.22 8.41 1.06 0.09 10.72 3.37 010
67808 ................ A Remove eyelid 3.80 NA 4.34 0.17 NA 8.31 090
lesion(s).
67810 ................ A Biopsy of eyelid...... 1.48 5.26 0.72 0.06 6.80 2.26 000
67820 ................ A Revise eyelashes...... 0.89 2.02 0.39 0.04 2.95 1.32 000
67825 ................ A Revise eyelashes...... 1.38 5.70 1.07 0.06 7.14 2.51 010
67830 ................ A Revise eyelashes...... 1.70 11.55 2.20 0.07 13.32 3.97 010
67835 ................ A Revise eyelashes...... 5.56 NA 4.90 0.22 NA 10.68 090
67840 ................ A Remove eyelid lesion.. 2.04 8.19 0.99 0.08 10.31 3.11 010
67850 ................ A Treat eyelid lesion... 1.69 8.79 2.07 0.07 10.55 3.83 010
67875 ................ A Closure of eyelid by 1.35 11.62 2.16 0.06 13.03 3.57 000
suture.
67880 ................ A Revision of eyelid.... 3.80 12.77 3.24 0.16 16.73 7.20 090
67882 ................ A Revision of eyelid.... 5.07 15.42 4.84 0.21 20.70 10.12 090
67900 ................ A Repair brow defect.... 6.14 11.29 6.69 0.30 17.73 13.13 090
67901 ................ A Repair eyelid defect.. 6.97 NA 7.22 0.32 NA 14.51 090
67902 ................ A Repair eyelid defect.. 7.03 NA 7.17 0.34 NA 14.54 090
67903 ................ A Repair eyelid defect.. 6.37 10.72 6.80 0.39 17.48 13.56 090
67904 ................ A Repair eyelid defect.. 6.26 14.97 8.57 0.26 21.49 15.09 090
67906 ................ A Repair eyelid defect.. 6.79 9.91 6.30 0.42 17.12 13.51 090
67908 ................ A Repair eyelid defect.. 5.13 9.65 6.36 0.20 14.98 11.69 090
67909 ................ A Revise eyelid defect.. 5.40 10.20 6.87 0.25 15.85 12.52 090
67911 ................ A Revise eyelid defect.. 5.27 NA 6.92 0.23 NA 12.42 090
67914 ................ A Repair eyelid defect.. 3.68 13.22 3.70 0.16 17.06 7.54 090
67915 ................ A Repair eyelid defect.. 3.18 11.73 1.52 0.13 15.04 4.83 090
67916 ................ A Repair eyelid defect.. 5.31 17.26 5.52 0.22 22.79 11.05 090
67917 ................ A Repair eyelid defect.. 6.02 10.63 6.86 0.25 16.90 13.13 090
67921 ................ A Repair eyelid defect.. 3.40 12.94 3.47 0.14 16.48 7.01 090
67922 ................ A Repair eyelid defect.. 3.06 11.73 3.31 0.13 14.92 6.50 090
67923 ................ A Repair eyelid defect.. 5.88 16.33 5.62 0.24 22.45 11.74 090
67924 ................ A Repair eyelid defect.. 5.79 9.97 6.20 0.23 15.99 12.22 090
67930 ................ A Repair eyelid wound... 3.61 12.50 3.15 0.17 16.28 6.93 010
67935 ................ A Repair eyelid wound... 6.22 16.12 5.60 0.29 22.63 12.11 090
67938 ................ A Remove eyelid foreign 1.33 9.65 0.53 0.06 11.04 1.92 010
body.
67950 ................ A Revision of eyelid.... 5.82 9.01 7.67 0.30 15.13 13.79 090
67961 ................ A Revision of eyelid.... 5.69 9.39 6.03 0.26 15.34 11.98 090
67966 ................ A Revision of eyelid.... 6.57 9.01 6.25 0.33 15.91 13.15 090
67971 ................ A Reconstruction of 9.79 NA 7.85 0.42 NA 18.06 090
eyelid.
67973 ................ A Reconstruction of 12.87 NA 9.95 0.59 NA 23.41 090
eyelid.
67974 ................ A Reconstruction of 12.84 NA 9.87 0.54 NA 23.25 090
eyelid.
67975 ................ A Reconstruction of 9.13 NA 7.51 0.38 NA 17.02 090
eyelid.
67999 ................ C Revision of eyelid.... 0.00 0.00 0.00 0.00 0.00 0.00 YYY
68020 ................ A Incise/drain eyelid 1.37 7.79 0.65 0.06 9.22 2.08 010
lining.
68040 ................ A Treatment of eyelid 0.85 7.68 0.41 0.03 8.56 1.29 000
lesions.
68100 ................ A Biopsy of eyelid 1.35 7.93 0.65 0.06 9.34 2.06 000
lining.
68110 ................ A Remove eyelid lining 1.77 8.98 1.41 0.07 10.82 3.25 010
lesion.
68115 ................ A Remove eyelid lining 2.36 8.47 1.14 0.10 10.93 3.60 010
lesion.
68130 ................ A Remove eyelid lining 4.93 NA 2.38 0.19 NA 7.50 090
lesion.
68135 ................ A Remove eyelid lining 1.84 8.23 0.89 0.07 10.14 2.80 010
lesion.
68200 ................ A Treat eyelid by 0.49 0.76 0.24 0.02 1.27 0.75 000
injection.
68320 ................ A Revise/graft eyelid 5.37 5.75 5.34 0.21 11.33 10.92 090
lining.
[[Page 55403]]
68325 ................ A Revise/graft eyelid 7.36 NA 6.33 0.30 NA 13.99 090
lining.
68326 ................ A Revise/graft eyelid 7.15 NA 6.26 0.30 NA 13.71 090
lining.
68328 ................ A Revise/graft eyelid 8.18 NA 7.07 0.40 NA 15.65 090
lining.
68330 ................ A Revise eyelid lining.. 4.83 7.34 5.82 0.19 12.36 10.84 090
68335 ................ A Revise/graft eyelid 7.19 NA 5.68 0.29 NA 13.16 090
lining.
68340 ................ A Separate eyelid 4.17 15.87 4.33 0.17 20.21 8.67 090
adhesions.
68360 ................ A Revise eyelid lining.. 4.37 6.77 5.42 0.17 11.31 9.96 090
68362 ................ A Revise eyelid lining.. 7.34 NA 8.02 0.29 NA 15.65 090
68399 ................ C Eyelid lining surgery. 0.00 0.00 0.00 0.00 0.00 0.00 YYY
68400 ................ A Incise/drain tear 1.69 11.48 2.18 0.07 13.24 3.94 010
gland.
68420 ................ A Incise/drain tear sac. 2.30 11.89 2.52 0.10 14.29 4.92 010
68440 ................ A Incise tear duct 0.94 7.86 0.45 0.04 8.84 1.43 010
opening.
68500 ................ A Removal of tear gland. 11.02 NA 9.13 0.60 NA 20.75 090
68505 ................ A Partial removal, tear 10.94 NA 10.31 0.57 NA 21.82 090
gland.
68510 ................ A Biopsy of tear gland.. 4.61 13.09 2.22 0.19 17.89 7.02 000
68520 ................ A Removal of tear sac... 7.51 NA 7.47 0.33 NA 15.31 090
68525 ................ A Biopsy of tear sac.... 4.43 NA 2.15 0.18 NA 6.76 000
68530 ................ A Clearance of tear duct 3.66 15.33 3.18 0.16 19.15 7.00 010
68540 ................ A Remove tear gland 10.60 NA 9.73 0.46 NA 20.79 090
lesion.
68550 ................ A Remove tear gland 13.26 NA 10.50 0.66 NA 24.42 090
lesion.
68700 ................ A Repair tear ducts..... 6.60 NA 6.87 0.27 NA 13.74 090
68705 ................ A Revise tear duct 2.06 8.33 1.00 0.08 10.47 3.14 010
opening.
68720 ................ A Create tear sac drain. 8.96 NA 8.04 0.38 NA 17.38 090
68745 ................ A Create tear duct drain 8.63 NA 7.82 0.38 NA 16.83 090
68750 ................ A Create tear duct drain 8.66 NA 8.46 0.37 NA 17.49 090
68760 ................ A Close tear duct 1.73 6.77 1.25 0.07 8.57 3.05 010
opening.
68761 ................ A Close tear duct 1.36 3.09 1.03 0.06 4.51 2.45 010
opening.
68770 ................ A Close tear system 7.02 17.74 6.15 0.28 25.04 13.45 090
fistula.
68801 ................ A Dilate tear duct 0.94 0.88 0.57 0.04 1.86 1.55 010
opening.
68810 ................ A Probe nasolacrimal 1.90 2.48 0.91 0.08 4.46 2.89 010
duct.
68811 ................ A Probe nasolacrimal 2.35 NA 2.46 0.10 NA 4.91 010
duct.
68815 ................ A Probe nasolacrimal 3.20 14.08 2.92 0.14 17.42 6.26 010
duct.
68840 ................ A Explore/irrigate tear 1.25 1.62 1.00 0.05 2.92 2.30 010
ducts.
68850 ................ A Injection for tear sac 0.80 15.29 0.32 0.03 16.12 1.15 000
x-ray.
68899 ................ C Tear duct system 0.00 0.00 0.00 0.00 0.00 0.00 YYY
surgery.
69000 ................ A Drain external ear 1.45 2.14 0.59 0.10 3.69 2.14 010
lesion.
69005 ................ A Drain external ear 2.11 2.55 2.11 0.16 4.82 4.38 010
lesion.
69020 ................ A Drain outer ear canal 1.48 2.25 0.71 0.11 3.84 2.30 010
lesion.
69090 ................ N Pierce earlobes....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
69100 ................ A Biopsy of external ear 0.81 1.44 0.41 0.04 2.29 1.26 000
69105 ................ A Biopsy of external ear 0.85 1.51 1.02 0.06 2.42 1.93 000
canal.
69110 ................ A Remove external ear, 3.44 3.48 2.85 0.24 7.16 6.53 090
partial.
69120 ................ A Removal of external 4.05 NA 4.68 0.31 NA 9.04 090
ear.
69140 ................ A Remove ear canal 7.97 NA 8.24 0.56 NA 16.77 090
lesion(s).
69145 ................ A Remove ear canal 2.62 3.41 2.54 0.18 6.21 5.34 090
lesion(s).
69150 ................ A Extensive ear canal 13.43 NA 11.38 1.07 NA 25.88 090
surgery.
69155 ................ A Extensive ear/neck 20.80 NA 16.26 1.51 NA 38.57 090
surgery.
69200 ................ A Clear outer ear canal. 0.77 1.45 0.77 0.05 2.27 1.59 000
69205 ................ A Clear outer ear canal. 1.20 NA 1.58 0.09 NA 2.87 010
69210 ................ A Remove impacted ear 0.61 0.59 0.25 0.04 1.24 0.90 000
wax.
69220 ................ A Clean out mastoid 0.83 1.53 0.44 0.06 2.42 1.33 000
cavity.
69222 ................ A Clean out mastoid 1.40 2.24 1.71 0.10 3.74 3.21 010
cavity.
69300 ................ R Revise external ear... 6.36 NA 4.38 0.43 NA 11.17 YYY
69310 ................ A Rebuild outer ear 10.79 NA 9.86 0.77 NA 21.42 090
canal.
69320 ................ A Rebuild outer ear 16.96 NA 13.77 1.17 NA 31.90 090
canal.
69399 ................ C Outer ear surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
69400 ................ A Inflate middle ear 0.83 1.51 0.49 0.06 2.40 1.38 000
canal.
69401 ................ A Inflate middle ear 0.63 1.41 0.34 0.04 2.08 1.01 000
canal.
69405 ................ A Catheterize middle ear 2.63 3.09 1.50 0.18 5.90 4.31 010
canal.
69410 ................ A Inset middle ear 0.33 1.39 0.17 0.02 1.74 0.52 000
(baffle).
69420 ................ A Incision of eardrum... 1.33 2.35 0.75 0.10 3.78 2.18 010
69421 ................ A Incision of eardrum... 1.73 2.58 1.92 0.13 4.44 3.78 010
69424 ................ A Remove ventilating 0.85 1.68 0.94 0.06 2.59 1.85 000
tube.
69433 ................ A Create eardrum opening 1.52 2.32 0.88 0.11 3.95 2.51 010
69436 ................ A Create eardrum opening 1.96 NA 2.05 0.14 NA 4.15 010
69440 ................ A Exploration of middle 7.57 NA 7.41 0.53 NA 15.51 090
ear.
69450 ................ A Eardrum revision...... 5.57 NA 6.18 0.39 NA 12.14 090
69501 ................ A Mastoidectomy......... 9.07 NA 8.22 0.65 NA 17.94 090
69502 ................ A Mastoidectomy......... 12.38 NA 10.80 0.86 NA 24.04 090
69505 ................ A Remove mastoid 12.99 NA 10.94 0.92 NA 24.85 090
structures.
69511 ................ A Extensive mastoid 13.52 NA 11.45 0.96 NA 25.93 090
surgery.
69530 ................ A Extensive mastoid 19.19 NA 15.06 1.32 NA 35.57 090
surgery.
69535 ................ A Remove part of 36.14 NA 25.13 2.59 NA 63.86 090
temporal bone.
[[Page 55404]]
69540 ................ A Remove ear lesion..... 1.20 2.27 1.61 0.09 3.56 2.90 010
69550 ................ A Remove ear lesion..... 10.99 NA 9.97 0.80 NA 21.76 090
69552 ................ A Remove ear lesion..... 19.46 NA 14.81 1.36 NA 35.63 090
69554 ................ A Remove ear lesion..... 33.16 NA 21.79 2.32 NA 57.27 090
69601 ................ A Mastoid surgery 13.24 NA 11.97 0.92 NA 26.13 090
revision.
69602 ................ A Mastoid surgery 13.58 NA 11.55 0.94 NA 26.07 090
revision.
69603 ................ A Mastoid surgery 14.02 NA 11.80 1.00 NA 26.82 090
revision.
69604 ................ A Mastoid surgery 14.02 NA 11.76 0.98 NA 26.76 090
revision.
69605 ................ A Mastoid surgery 18.49 NA 14.37 1.29 NA 34.15 090
revision.
69610 ................ A Repair of eardrum..... 4.43 4.27 3.47 0.31 9.01 8.21 010
69620 ................ A Repair of eardrum..... 5.89 6.90 3.40 0.40 13.19 9.69 090
69631 ................ A Repair eardrum 9.86 NA 9.38 0.69 NA 19.93 090
structures.
69632 ................ A Rebuild eardrum 12.75 NA 11.73 0.89 NA 25.37 090
structures.
69633 ................ A Rebuild eardrum 12.10 NA 11.36 0.84 NA 24.30 090
structures.
69635 ................ A Repair eardrum 13.33 NA 11.41 0.87 NA 25.61 090
structures.
69636 ................ A Rebuild eardrum 15.22 NA 13.23 1.07 NA 29.52 090
structures.
69637 ................ A Rebuild eardrum 15.11 NA 13.16 1.06 NA 29.33 090
structures.
69641 ................ A Revise middle ear & 12.71 NA 11.06 0.89 NA 24.66 090
mastoid.
69642 ................ A Revise middle ear & 16.84 NA 14.16 1.18 NA 32.18 090
mastoid.
69643 ................ A Revise middle ear & 15.32 NA 13.24 1.08 NA 29.64 090
mastoid.
69644 ................ A Revise middle ear & 16.97 NA 14.22 1.19 NA 32.38 090
mastoid.
69645 ................ A Revise middle ear & 16.38 NA 13.77 1.16 NA 31.31 090
mastoid.
69646 ................ A Revise middle ear & 17.99 NA 14.83 1.26 NA 34.08 090
mastoid.
69650 ................ A Release middle ear 9.66 NA 8.53 0.68 NA 18.87 090
bone.
69660 ................ A Revise middle ear bone 11.90 NA 9.86 0.84 NA 22.60 090
69661 ................ A Revise middle ear bone 15.74 NA 12.63 1.10 NA 29.47 090
69662 ................ A Revise middle ear bone 15.44 NA 12.56 1.08 NA 29.08 090
69666 ................ A Repair middle ear 9.75 NA 8.65 0.68 NA 19.08 090
structures.
69667 ................ A Repair middle ear 9.76 NA 8.58 0.72 NA 19.06 090
structures.
69670 ................ A Remove mastoid air 11.51 NA 10.36 0.78 NA 22.65 090
cells.
69676 ................ A Remove middle ear 9.52 NA 9.14 0.69 NA 19.35 090
nerve.
69700 ................ A Close mastoid fistula. 8.23 NA 5.77 0.55 NA 14.55 090
69710 ................ N Implant/replace 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hearing aid.
69711 ................ A Remove/repair hearing 10.44 NA 9.62 0.62 NA 20.68 090
aid.
69714 ................ A Implant temple bone w/ 14.00 NA 11.53 1.01 NA 26.54 090
stimul.
69715 ................ A Temple bone implnt w/ 18.25 NA 14.05 1.32 NA 33.62 090
stimulat.
69717 ................ A Temple bone implant 14.98 NA 11.46 1.08 NA 27.52 090
revision.
69718 ................ A Revise temple bone 18.50 NA 14.20 1.34 NA 34.04 090
implant.
69720 ................ A Release facial nerve.. 14.38 NA 12.85 1.03 NA 28.26 090
69725 ................ A Release facial nerve.. 25.38 NA 17.97 1.78 NA 45.13 090
69740 ................ A Repair facial nerve... 15.96 NA 10.90 1.13 NA 27.99 090
69745 ................ A Repair facial nerve... 16.69 NA 12.80 1.00 NA 30.49 090
69799 ................ C Middle ear surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
69801 ................ A Incise inner ear...... 8.56 NA 7.96 0.60 NA 17.12 090
69802 ................ A Incise inner ear...... 13.10 NA 11.37 0.91 NA 25.38 090
69805 ................ A Explore inner ear..... 13.82 NA 10.91 0.97 NA 25.70 090
69806 ................ A Explore inner ear..... 12.35 NA 10.82 0.86 NA 24.03 090
69820 ................ A Establish inner ear 10.34 NA 8.78 0.66 NA 19.78 090
window.
69840 ................ A Revise inner ear 10.26 NA 9.00 0.64 NA 19.90 090
window.
69905 ................ A Remove inner ear...... 11.10 NA 9.94 0.77 NA 21.81 090
69910 ................ A Remove inner ear & 13.63 NA 11.42 0.94 NA 25.99 090
mastoid.
69915 ................ A Incise inner ear nerve 21.23 NA 15.88 1.54 NA 38.65 090
69930 ................ A Implant cochlear 16.81 NA 12.94 1.19 NA 30.94 090
device.
69949 ................ C Inner ear surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedure.
69950 ................ A Incise inner ear nerve 25.64 NA 16.71 2.90 NA 45.25 090
69955 ................ A Release facial nerve.. 27.04 NA 18.39 1.89 NA 47.32 090
69960 ................ A Release inner ear 27.04 NA 18.40 2.43 NA 47.87 090
canal.
69970 ................ A Remove inner ear 30.04 NA 19.12 2.34 NA 51.50 090
lesion.
69979 ................ C Temporal bone surgery. 0.00 0.00 0.00 0.00 0.00 0.00 YYY
69990 ................ R Microsurgery add-on... 3.47 NA 1.87 0.56 NA 5.90 ZZZ
70010 ................ A Contrast x-ray of 1.19 4.53 NA 0.24 5.96 NA XXX
brain.
70010 26 A Contrast x-ray of 1.19 0.42 0.42 0.06 1.67 1.67 XXX
brain.
70010 TC A Contrast x-ray of 0.00 4.11 NA 0.18 4.29 NA XXX
brain.
70015 ................ A Contrast x-ray of 1.19 1.71 NA 0.12 3.02 NA XXX
brain.
70015 26 A Contrast x-ray of 1.19 0.42 0.42 0.05 1.66 1.66 XXX
brain.
70015 TC A Contrast x-ray of 0.00 1.29 NA 0.07 1.36 NA XXX
brain.
70030 ................ A X-ray eye for foreign 0.17 0.45 NA 0.03 0.65 NA XXX
body.
70030 26 A X-ray eye for foreign 0.17 0.06 0.06 0.01 0.24 0.24 XXX
body.
70030 TC A X-ray eye for foreign 0.00 0.39 NA 0.02 0.41 NA XXX
body.
70100 ................ A X-ray exam of jaw..... 0.18 0.56 NA 0.03 0.77 NA XXX
70100 26 A X-ray exam of jaw..... 0.18 0.06 0.06 0.01 0.25 0.25 XXX
70100 TC A X-ray exam of jaw..... 0.00 0.50 NA 0.02 0.52 NA XXX
70110 ................ A X-ray exam of jaw..... 0.25 0.68 NA 0.04 0.97 NA XXX
[[Page 55405]]
70110 26 A X-ray exam of jaw..... 0.25 0.09 0.09 0.01 0.35 0.35 XXX
70110 TC A X-ray exam of jaw..... 0.00 0.59 NA 0.03 0.62 NA XXX
70120 ................ A X-ray exam of mastoids 0.18 0.65 NA 0.04 0.87 NA XXX
70120 26 A X-ray exam of mastoids 0.18 0.06 0.06 0.01 0.25 0.25 XXX
70120 TC A X-ray exam of mastoids 0.00 0.59 NA 0.03 0.62 NA XXX
70130 ................ A X-ray exam of mastoids 0.34 0.86 NA 0.05 1.25 NA XXX
70130 26 A X-ray exam of mastoids 0.34 0.12 0.12 0.01 0.47 0.47 XXX
70130 TC A X-ray exam of mastoids 0.00 0.74 NA 0.04 0.78 NA XXX
70134 ................ A X-ray exam of middle 0.34 0.82 NA 0.05 1.21 NA XXX
ear.
70134 26 A X-ray exam of middle 0.34 0.12 0.12 0.01 0.47 0.47 XXX
ear.
70134 TC A X-ray exam of middle 0.00 0.70 NA 0.04 0.74 NA XXX
ear.
70140 ................ A X-ray exam of facial 0.19 0.66 NA 0.04 0.89 NA XXX
bones.
70140 26 A X-ray exam of facial 0.19 0.07 0.07 0.01 0.27 0.27 XXX
bones.
70140 TC A X-ray exam of facial 0.00 0.59 NA 0.03 0.62 NA XXX
bones.
70150 ................ A X-ray exam of facial 0.26 0.83 NA 0.05 1.14 NA XXX
bones.
70150 26 A X-ray exam of facial 0.26 0.09 0.09 0.01 0.36 0.36 XXX
bones.
70150 TC A X-ray exam of facial 0.00 0.74 NA 0.04 0.78 NA XXX
bones.
70160 ................ A X-ray exam of nasal 0.17 0.56 NA 0.03 0.76 NA XXX
bones.
70160 26 A X-ray exam of nasal 0.17 0.06 0.06 0.01 0.24 0.24 XXX
bones.
70160 TC A X-ray exam of nasal 0.00 0.50 NA 0.02 0.52 NA XXX
bones.
70170 ................ A X-ray exam of tear 0.30 1.01 NA 0.06 1.37 NA XXX
duct.
70170 26 A X-ray exam of tear 0.30 0.11 0.11 0.01 0.42 0.42 XXX
duct.
70170 TC A X-ray exam of tear 0.00 0.90 NA 0.05 0.95 NA XXX
duct.
70190 ................ A X-ray exam of eye 0.21 0.66 NA 0.04 0.91 NA XXX
sockets.
70190 26 A X-ray exam of eye 0.21 0.07 0.07 0.01 0.29 0.29 XXX
sockets.
70190 TC A X-ray exam of eye 0.00 0.59 NA 0.03 0.62 NA XXX
sockets.
70200 ................ A X-ray exam of eye 0.28 0.84 NA 0.05 1.17 NA XXX
sockets.
70200 26 A X-ray exam of eye 0.28 0.10 0.10 0.01 0.39 0.39 XXX
sockets.
70200 TC A X-ray exam of eye 0.00 0.74 NA 0.04 0.78 NA XXX
sockets.
70210 ................ A X-ray exam of sinuses. 0.17 0.65 NA 0.04 0.86 NA XXX
70210 26 A X-ray exam of sinuses. 0.17 0.06 0.06 0.01 0.24 0.24 XXX
70210 TC A X-ray exam of sinuses. 0.00 0.59 NA 0.03 0.62 NA XXX
70220 ................ A X-ray exam of sinuses. 0.25 0.83 NA 0.05 1.13 NA XXX
70220 26 A X-ray exam of sinuses. 0.25 0.09 0.09 0.01 0.35 0.35 XXX
70220 TC A X-ray exam of sinuses. 0.00 0.74 NA 0.04 0.78 NA XXX
70240 ................ A X-ray exam, pituitary 0.19 0.46 NA 0.03 0.68 NA XXX
saddle.
70240 26 A X-ray exam, pituitary 0.19 0.07 0.07 0.01 0.27 0.27 XXX
saddle.
70240 TC A X-ray exam, pituitary 0.00 0.39 NA 0.02 0.41 NA XXX
saddle.
70250 ................ A X-ray exam of skull... 0.24 0.67 NA 0.04 0.95 NA XXX
70250 26 A X-ray exam of skull... 0.24 0.08 0.08 0.01 0.33 0.33 XXX
70250 TC A X-ray exam of skull... 0.00 0.59 NA 0.03 0.62 NA XXX
70260 ................ A X-ray exam of skull... 0.34 0.96 NA 0.06 1.36 NA XXX
70260 26 A X-ray exam of skull... 0.34 0.12 0.12 0.01 0.47 0.47 XXX
70260 TC A X-ray exam of skull... 0.00 0.84 NA 0.05 0.89 NA XXX
70300 ................ A X-ray exam of teeth... 0.10 0.29 NA 0.03 0.42 NA XXX
70300 26 A X-ray exam of teeth... 0.10 0.04 0.04 0.01 0.15 0.15 XXX
70300 TC A X-ray exam of teeth... 0.00 0.25 NA 0.02 0.27 NA XXX
70310 ................ A X-ray exam of teeth... 0.16 0.46 NA 0.03 0.65 NA XXX
70310 26 A X-ray exam of teeth... 0.16 0.07 0.07 0.01 0.24 0.24 XXX
70310 TC A X-ray exam of teeth... 0.00 0.39 NA 0.02 0.41 NA XXX
70320 ................ A Full mouth x-ray of 0.22 0.82 NA 0.05 1.09 NA XXX
teeth.
70320 26 A Full mouth x-ray of 0.22 0.08 0.08 0.01 0.31 0.31 XXX
teeth.
70320 TC A Full mouth x-ray of 0.00 0.74 NA 0.04 0.78 NA XXX
teeth.
70328 ................ A X-ray exam of jaw 0.18 0.53 NA 0.03 0.74 NA XXX
joint.
70328 26 A X-ray exam of jaw 0.18 0.06 0.06 0.01 0.25 0.25 XXX
joint.
70328 TC A X-ray exam of jaw 0.00 0.47 NA 0.02 0.49 NA XXX
joint.
70330 ................ A X-ray exam of jaw 0.24 0.88 NA 0.05 1.17 NA XXX
joints.
70330 26 A X-ray exam of jaw 0.24 0.08 0.08 0.01 0.33 0.33 XXX
joints.
70330 TC A X-ray exam of jaw 0.00 0.80 NA 0.04 0.84 NA XXX
joints.
70332 ................ A X-ray exam of jaw 0.54 2.18 NA 0.12 2.84 NA XXX
joint.
70332 26 A X-ray exam of jaw 0.54 0.19 0.19 0.02 0.75 0.75 XXX
joint.
70332 TC A X-ray exam of jaw 0.00 1.99 NA 0.10 2.09 NA XXX
joint.
70336 ................ A Magnetic image, jaw 1.48 11.16 NA 0.56 13.20 NA XXX
joint.
70336 26 A Magnetic image, jaw 1.48 0.52 0.52 0.07 2.07 2.07 XXX
joint.
70336 TC A Magnetic image, jaw 0.00 10.64 NA 0.49 11.13 NA XXX
joint.
70350 ................ A X-ray head for 0.17 0.42 NA 0.03 0.62 NA XXX
orthodontia.
70350 26 A X-ray head for 0.17 0.06 0.06 0.01 0.24 0.24 XXX
orthodontia.
70350 TC A X-ray head for 0.00 0.36 NA 0.02 0.38 NA XXX
orthodontia.
70355 ................ A Panoramic x-ray of 0.20 0.61 NA 0.04 0.85 NA XXX
jaws.
70355 26 A Panoramic x-ray of 0.20 0.07 0.07 0.01 0.28 0.28 XXX
jaws.
70355 TC A Panoramic x-ray of 0.00 0.54 NA 0.03 0.57 NA XXX
jaws.
70360 ................ A X-ray exam of neck.... 0.17 0.45 NA 0.03 0.65 NA XXX
70360 26 A X-ray exam of neck.... 0.17 0.06 0.06 0.01 0.24 0.24 XXX
[[Page 55406]]
70360 TC A X-ray exam of neck.... 0.00 0.39 NA 0.02 0.41 NA XXX
70370 ................ A Throat x-ray & 0.32 1.35 NA 0.07 1.74 NA XXX
fluoroscopy.
70370 26 A Throat x-ray & 0.32 0.11 0.11 0.01 0.44 0.44 XXX
fluoroscopy.
70370 TC A Throat x-ray & 0.00 1.24 NA 0.06 1.30 NA XXX
fluoroscopy.
70371 ................ A Speech evaluation, 0.84 2.29 NA 0.14 3.27 NA XXX
complex.
70371 26 A Speech evaluation, 0.84 0.30 0.30 0.04 1.18 1.18 XXX
complex.
70371 TC A Speech evaluation, 0.00 1.99 NA 0.10 2.09 NA XXX
complex.
70373 ................ A Contrast x-ray of 0.44 1.84 NA 0.11 2.39 NA XXX
larynx.
70373 26 A Contrast x-ray of 0.44 0.15 0.15 0.02 0.61 0.61 XXX
larynx.
70373 TC A Contrast x-ray of 0.00 1.69 NA 0.09 1.78 NA XXX
larynx.
70380 ................ A X-ray exam of salivary 0.17 0.69 NA 0.04 0.90 NA XXX
gland.
70380 26 A X-ray exam of salivary 0.17 0.06 0.06 0.01 0.24 0.24 XXX
gland.
70380 TC A X-ray exam of salivary 0.00 0.63 NA 0.03 0.66 NA XXX
gland.
70390 ................ A X-ray exam of salivary 0.38 1.82 NA 0.11 2.31 NA XXX
duct.
70390 26 A X-ray exam of salivary 0.38 0.13 0.13 0.02 0.53 0.53 XXX
duct.
70390 TC A X-ray exam of salivary 0.00 1.69 NA 0.09 1.78 NA XXX
duct.
70450 ................ A Ct head/brain w/o dye. 0.85 4.78 NA 0.25 5.88 NA XXX
70450 26 A Ct head/brain w/o dye. 0.85 0.30 0.30 0.04 1.19 1.19 XXX
70450 TC A Ct head/brain w/o dye. 0.00 4.48 NA 0.21 4.69 NA XXX
70460 ................ A Ct head/brain w/dye... 1.13 5.77 NA 0.30 7.20 NA XXX
70460 26 A Ct head/brain w/dye... 1.13 0.40 0.40 0.05 1.58 1.58 XXX
70460 TC A Ct head/brain w/dye... 0.00 5.37 NA 0.25 5.62 NA XXX
70470 ................ A Ct head/brain w/o&w 1.27 7.16 NA 0.37 8.80 NA XXX
dye.
70470 26 A Ct head/brain w/o&w 1.27 0.45 0.45 0.06 1.78 1.78 XXX
dye.
70470 TC A Ct head/brain w/o&w 0.00 6.71 NA 0.31 7.02 NA XXX
dye.
70480 ................ A Ct orbit/ear/fossa w/o 1.28 4.93 NA 0.27 6.48 NA XXX
dye.
70480 26 A Ct orbit/ear/fossa w/o 1.28 0.45 0.45 0.06 1.79 1.79 XXX
dye.
70480 TC A Ct orbit/ear/fossa w/o 0.00 4.48 NA 0.21 4.69 NA XXX
dye.
70481 ................ A Ct orbit/ear/fossa w/ 1.38 5.85 NA 0.31 7.54 NA XXX
dye.
70481 26 A Ct orbit/ear/fossa w/ 1.38 0.48 0.48 0.06 1.92 1.92 XXX
dye.
70481 TC A Ct orbit/ear/fossa w/ 0.00 5.37 NA 0.25 5.62 NA XXX
dye.
70482 ................ A Ct orbit/ear/fossa w/ 1.45 7.22 NA 0.37 9.04 NA XXX
o&w dye.
70482 26 A Ct orbit/ear/fossa w/ 1.45 0.51 0.51 0.06 2.02 2.02 XXX
o&w dye.
70482 TC A Ct orbit/ear/fossa w/ 0.00 6.71 NA 0.31 7.02 NA XXX
o&w dye.
70486 ................ A Ct maxillofacial w/o 1.14 4.88 NA 0.26 6.28 NA XXX
dye.
70486 26 A Ct maxillofacial w/o 1.14 0.40 0.40 0.05 1.59 1.59 XXX
dye.
70486 TC A Ct maxillofacial w/o 0.00 4.48 NA 0.21 4.69 NA XXX
dye.
70487 ................ A Ct maxillofacial w/dye 1.30 5.83 NA 0.31 7.44 NA XXX
70487 26 A Ct maxillofacial w/dye 1.30 0.46 0.46 0.06 1.82 1.82 XXX
70487 TC A Ct maxillofacial w/dye 0.00 5.37 NA 0.25 5.62 NA XXX
70488 ................ A Ct maxillofacial w/o&w 1.42 7.21 NA 0.37 9.00 NA XXX
dye.
70488 26 A Ct maxillofacial w/o&w 1.42 0.50 0.50 0.06 1.98 1.98 XXX
dye.
70488 TC A Ct maxillofacial w/o&w 0.00 6.71 NA 0.31 7.02 NA XXX
dye.
70490 ................ A Ct soft tissue neck w/ 1.28 4.93 NA 0.27 6.48 NA XXX
o dye.
70490 26 A Ct soft tissue neck w/ 1.28 0.45 0.45 0.06 1.79 1.79 XXX
o dye.
70490 TC A Ct soft tissue neck w/ 0.00 4.48 NA 0.21 4.69 NA XXX
o dye.
70491 ................ A Ct soft tissue neck w/ 1.38 5.85 NA 0.31 7.54 NA XXX
dye.
70491 26 A Ct soft tissue neck w/ 1.38 0.48 0.48 0.06 1.92 1.92 XXX
dye.
70491 TC A Ct soft tissue neck w/ 0.00 5.37 NA 0.25 5.62 NA XXX
dye.
70492 ................ A Ct sft tsue nck w/o & 1.45 7.22 NA 0.37 9.04 NA XXX
w/dye.
70492 26 A Ct sft tsue nck w/o & 1.45 0.51 0.51 0.06 2.02 2.02 XXX
w/dye.
70492 TC A Ct sft tsue nck w/o & 0.00 6.71 NA 0.31 7.02 NA XXX
w/dye.
70496 ................ A Ct angiography, head.. 1.75 7.41 NA 0.56 9.72 NA XXX
70496 26 A Ct angiography, head.. 1.75 0.70 0.70 0.08 2.53 2.53 XXX
70496 TC A Ct angiography, head.. 0.00 6.71 NA 0.48 7.19 NA XXX
70498 ................ A Ct angiography, neck.. 1.75 7.41 NA 0.56 9.72 NA XXX
70498 26 A Ct angiography, neck.. 1.75 0.70 0.70 0.08 2.53 2.53 XXX
70498 TC A Ct angiography, neck.. 0.00 6.71 NA 0.48 7.19 NA XXX
70540 ................ A Mri orbit/face/neck w/ 1.35 11.11 NA 0.36 12.82 NA XXX
o dye.
70540 26 A Mri orbit/face/neck w/ 1.35 0.47 0.47 0.04 1.86 1.86 XXX
o dye.
70540 TC A Mri orbit/face/neck w/ 0.00 10.64 NA 0.32 10.96 NA XXX
o dye.
70542 ................ A Mri orbit/face/neck w/ 1.62 13.33 NA 0.44 15.39 NA XXX
dye.
70542 26 A Mri orbit/face/neck w/ 1.62 0.57 0.57 0.05 2.24 2.24 XXX
dye.
70542 TC A Mri orbit/face/neck w/ 0.00 12.76 NA 0.39 13.15 NA XXX
dye.
70543 ................ A Mri orbt/fac/nck w/o&w 2.15 24.39 NA 0.77 27.31 NA XXX
dye.
70543 26 A Mri orbt/fac/nck w/o&w 2.15 0.75 0.75 0.07 2.97 2.97 XXX
dye.
70543 TC A Mri orbt/fac/nck w/o&w 0.00 23.64 NA 0.70 24.34 NA XXX
dye.
70544 ................ A Mr angiography head w/ 1.20 11.06 NA 0.54 12.80 NA XXX
o dye.
70544 26 A Mr angiography head w/ 1.20 0.42 0.42 0.05 1.67 1.67 XXX
o dye.
70544 TC A Mr angiography head w/ 0.00 10.64 NA 0.49 11.13 NA XXX
o dye.
70545 ................ A Mr angiography head w/ 1.20 11.06 NA 0.54 12.80 NA XXX
dye.
70545 26 A Mr angiography head w/ 1.20 0.42 0.42 0.05 1.67 1.67 XXX
dye.
70545 TC A Mr angiography head w/ 0.00 10.64 NA 0.49 11.13 NA XXX
dye.
[[Page 55407]]
70546 ................ A Mr angiograph head w/ 1.80 21.92 NA 0.57 24.29 NA XXX
o&w dye.
70546 26 A Mr angiograph head w/ 1.80 0.63 0.63 0.08 2.51 2.51 XXX
o&w dye.
70546 TC A Mr angiograph head w/ 0.00 21.29 NA 0.49 21.78 NA XXX
o&w dye.
70547 ................ A Mr angiography neck w/ 1.20 11.06 NA 0.54 12.80 NA XXX
o dye.
70547 26 A Mr angiography neck w/ 1.20 0.42 0.42 0.05 1.67 1.67 XXX
o dye.
70547 TC A Mr angiography neck w/ 0.00 10.64 NA 0.49 11.13 NA XXX
o dye.
70548 ................ A Mr angiography neck w/ 1.20 11.06 NA 0.54 12.80 NA XXX
dye.
70548 26 A Mr angiography neck w/ 1.20 0.42 0.42 0.05 1.67 1.67 XXX
dye.
70548 TC A Mr angiography neck w/ 0.00 10.64 NA 0.49 11.13 NA XXX
dye.
70549 ................ A Mr angiograph neck w/ 1.80 21.92 NA 0.57 24.29 NA XXX
o&w dye.
70549 26 A Mr angiograph neck w/ 1.80 0.63 0.63 0.08 2.51 2.51 XXX
o&w dye.
70549 TC A Mr angiograph neck w/ 0.00 21.29 NA 0.49 21.78 NA XXX
o&w dye.
70551 ................ A Mri brain w/o dye..... 1.48 11.16 NA 0.56 13.20 NA XXX
70551 26 A Mri brain w/o dye..... 1.48 0.52 0.52 0.07 2.07 2.07 XXX
70551 TC A Mri brain w/o dye..... 0.00 10.64 NA 0.49 11.13 NA XXX
70552 ................ A Mri brain w/dye....... 1.78 13.40 NA 0.66 15.84 NA XXX
70552 26 A Mri brain w/dye....... 1.78 0.64 0.64 0.08 2.50 2.50 XXX
70552 TC A Mri brain w/dye....... 0.00 12.76 NA 0.58 13.34 NA XXX
70553 ................ A Mri brain w/o&w dye... 2.36 24.47 NA 1.19 28.02 NA XXX
70553 26 A Mri brain w/o&w dye... 2.36 0.83 0.83 0.10 3.29 3.29 XXX
70553 TC A Mri brain w/o&w dye... 0.00 23.64 NA 1.09 24.73 NA XXX
71010 ................ A Chest x-ray........... 0.18 0.51 NA 0.03 0.72 NA XXX
71010 26 A Chest x-ray........... 0.18 0.06 0.06 0.01 0.25 0.25 XXX
71010 TC A Chest x-ray........... 0.00 0.45 NA 0.02 0.47 NA XXX
71015 ................ A Chest x-ray........... 0.21 0.57 NA 0.03 0.81 NA XXX
71015 26 A Chest x-ray........... 0.21 0.07 0.07 0.01 0.29 0.29 XXX
71015 TC A Chest x-ray........... 0.00 0.50 NA 0.02 0.52 NA XXX
71020 ................ A Chest x-ray........... 0.22 0.67 NA 0.04 0.93 NA XXX
71020 26 A Chest x-ray........... 0.22 0.08 0.08 0.01 0.31 0.31 XXX
71020 TC A Chest x-ray........... 0.00 0.59 NA 0.03 0.62 NA XXX
71021 ................ A Chest x-ray........... 0.27 0.79 NA 0.05 1.11 NA XXX
71021 26 A Chest x-ray........... 0.27 0.09 0.09 0.01 0.37 0.37 XXX
71021 TC A Chest x-ray........... 0.00 0.70 NA 0.04 0.74 NA XXX
71022 ................ A Chest x-ray........... 0.31 0.81 NA 0.06 1.18 NA XXX
71022 26 A Chest x-ray........... 0.31 0.11 0.11 0.02 0.44 0.44 XXX
71022 TC A Chest x-ray........... 0.00 0.70 NA 0.04 0.74 NA XXX
71023 ................ A Chest x-ray and 0.38 0.88 NA 0.06 1.32 NA XXX
fluoroscopy.
71023 26 A Chest x-ray and 0.38 0.14 0.14 0.02 0.54 0.54 XXX
fluoroscopy.
71023 TC A Chest x-ray and 0.00 0.74 NA 0.04 0.78 NA XXX
fluoroscopy.
71030 ................ A Chest x-ray........... 0.31 0.85 NA 0.05 1.21 NA XXX
71030 26 A Chest x-ray........... 0.31 0.11 0.11 0.01 0.43 0.43 XXX
71030 TC A Chest x-ray........... 0.00 0.74 NA 0.04 0.78 NA XXX
71034 ................ A Chest x-ray and 0.46 1.54 NA 0.09 2.09 NA XXX
fluoroscopy.
71034 26 A Chest x-ray and 0.46 0.17 0.17 0.02 0.65 0.65 XXX
fluoroscopy.
71034 TC A Chest x-ray and 0.00 1.37 NA 0.07 1.44 NA XXX
fluoroscopy.
71035 ................ A Chest x-ray........... 0.18 0.56 NA 0.03 0.77 NA XXX
71035 26 A Chest x-ray........... 0.18 0.06 0.06 0.01 0.25 0.25 XXX
71035 TC A Chest x-ray........... 0.00 0.50 NA 0.02 0.52 NA XXX
71040 ................ A Contrast x-ray of 0.58 1.59 NA 0.10 2.27 NA XXX
bronchi.
71040 26 A Contrast x-ray of 0.58 0.20 0.20 0.03 0.81 0.81 XXX
bronchi.
71040 TC A Contrast x-ray of 0.00 1.39 NA 0.07 1.46 NA XXX
bronchi.
71060 ................ A Contrast x-ray of 0.74 2.35 NA 0.14 3.23 NA XXX
bronchi.
71060 26 A Contrast x-ray of 0.74 0.26 0.26 0.03 1.03 1.03 XXX
bronchi.
71060 TC A Contrast x-ray of 0.00 2.09 NA 0.11 2.20 NA XXX
bronchi.
71090 ................ A X-ray & pacemaker 0.54 1.82 NA 0.11 2.47 NA XXX
insertion.
71090 26 A X-ray & pacemaker 0.54 0.22 0.22 0.02 0.78 0.78 XXX
insertion.
71090 TC A X-ray & pacemaker 0.00 1.60 NA 0.09 1.69 NA XXX
insertion.
71100 ................ A X-ray exam of ribs.... 0.22 0.62 NA 0.04 0.88 NA XXX
71100 26 A X-ray exam of ribs.... 0.22 0.08 0.08 0.01 0.31 0.31 XXX
71100 TC A X-ray exam of ribs.... 0.00 0.54 NA 0.03 0.57 NA XXX
71101 ................ A X-ray exam of ribs/ 0.27 0.72 NA 0.04 1.03 NA XXX
chest.
71101 26 A X-ray exam of ribs/ 0.27 0.09 0.09 0.01 0.37 0.37 XXX
chest.
71101 TC A X-ray exam of ribs/ 0.00 0.63 NA 0.03 0.66 NA XXX
chest.
71110 ................ A X-ray exam of ribs.... 0.27 0.83 NA 0.05 1.15 NA XXX
71110 26 A X-ray exam of ribs.... 0.27 0.09 0.09 0.01 0.37 0.37 XXX
71110 TC A X-ray exam of ribs.... 0.00 0.74 NA 0.04 0.78 NA XXX
71111 ................ A X-ray exam of ribs/ 0.32 0.95 NA 0.06 1.33 NA XXX
chest.
71111 26 A X-ray exam of ribs/ 0.32 0.11 0.11 0.01 0.44 0.44 XXX
chest.
71111 TC A X-ray exam of ribs/ 0.00 0.84 NA 0.05 0.89 NA XXX
chest.
71120 ................ A X-ray exam of 0.20 0.69 NA 0.04 0.93 NA XXX
breastbone.
71120 26 A X-ray exam of 0.20 0.07 0.07 0.01 0.28 0.28 XXX
breastbone.
71120 TC A X-ray exam of 0.00 0.62 NA 0.03 0.65 NA XXX
breastbone.
71130 ................ A X-ray exam of 0.22 0.75 NA 0.04 1.01 NA XXX
breastbone.
[[Page 55408]]
71130 26 A X-ray exam of 0.22 0.08 0.08 0.01 0.31 0.31 XXX
breastbone.
71130 TC A X-ray exam of 0.00 0.67 NA 0.03 0.70 NA XXX
breastbone.
71250 ................ A Ct thorax w/o dye..... 1.16 6.02 NA 0.31 7.49 NA XXX
71250 26 A Ct thorax w/o dye..... 1.16 0.41 0.41 0.05 1.62 1.62 XXX
71250 TC A Ct thorax w/o dye..... 0.00 5.61 NA 0.26 5.87 NA XXX
71260 ................ A Ct thorax w/dye....... 1.24 7.14 NA 0.36 8.74 NA XXX
71260 26 A Ct thorax w/dye....... 1.24 0.43 0.43 0.05 1.72 1.72 XXX
71260 TC A Ct thorax w/dye....... 0.00 6.71 NA 0.31 7.02 NA XXX
71270 ................ A Ct thorax w/o&w dye... 1.38 8.88 NA 0.44 10.70 NA XXX
71270 26 A Ct thorax w/o&w dye... 1.38 0.48 0.48 0.06 1.92 1.92 XXX
71270 TC A Ct thorax w/o&w dye... 0.00 8.40 NA 0.38 8.78 NA XXX
71275 ................ A Ct angiography, chest. 1.92 9.17 NA 0.38 11.47 NA XXX
71275 26 A Ct angiography, chest. 1.92 0.77 0.77 0.06 2.75 2.75 XXX
71275 TC A Ct angiography, chest. 0.00 8.40 NA 0.32 8.72 NA XXX
71550 ................ A Mri chest w/o dye..... 1.46 11.15 NA 0.41 13.02 NA XXX
71550 26 A Mri chest w/o dye..... 1.46 0.51 0.51 0.04 2.01 2.01 XXX
71550 TC A Mri chest w/o dye..... 0.00 10.64 NA 0.37 11.01 NA XXX
71551 ................ A Mri chest w/dye....... 1.73 13.36 NA 0.49 15.58 NA XXX
71551 26 A Mri chest w/dye....... 1.73 0.60 0.60 0.06 2.39 2.39 XXX
71551 TC A Mri chest w/dye....... 0.00 12.76 NA 0.43 13.19 NA XXX
71552 ................ A Mri chest w/o&w dye... 2.26 24.43 NA 0.64 27.33 NA XXX
71552 26 A Mri chest w/o&w dye... 2.26 0.79 0.79 0.08 3.13 3.13 XXX
71552 TC A Mri chest w/o&w dye... 0.00 23.64 NA 0.56 24.20 NA XXX
71555 ................ R Mri angio chest w or w/ 1.81 11.28 NA 0.57 13.66 NA XXX
o dye.
71555 26 R Mri angio chest w or w/ 1.81 0.64 0.64 0.08 2.53 2.53 XXX
o dye.
71555 TC R Mri angio chest w or w/ 0.00 10.64 NA 0.49 11.13 NA XXX
o dye.
72010 ................ A X-ray exam of spine... 0.45 1.13 NA 0.08 1.66 NA XXX
72010 26 A X-ray exam of spine... 0.45 0.16 0.16 0.03 0.64 0.64 XXX
72010 TC A X-ray exam of spine... 0.00 0.97 NA 0.05 1.02 NA XXX
72020 ................ A X-ray exam of spine... 0.15 0.44 NA 0.03 0.62 NA XXX
72020 26 A X-ray exam of spine... 0.15 0.05 0.05 0.01 0.21 0.21 XXX
72020 TC A X-ray exam of spine... 0.00 0.39 NA 0.02 0.41 NA XXX
72040 ................ A X-ray exam of neck 0.22 0.65 NA 0.04 0.91 NA XXX
spine.
72040 26 A X-ray exam of neck 0.22 0.08 0.08 0.01 0.31 0.31 XXX
spine.
72040 TC A X-ray exam of neck 0.00 0.57 NA 0.03 0.60 NA XXX
spine.
72050 ................ A X-ray exam of neck 0.31 0.95 NA 0.07 1.33 NA XXX
spine.
72050 26 A X-ray exam of neck 0.31 0.11 0.11 0.02 0.44 0.44 XXX
spine.
72050 TC A X-ray exam of neck 0.00 0.84 NA 0.05 0.89 NA XXX
spine.
72052 ................ A X-ray exam of neck 0.36 1.20 NA 0.07 1.63 NA XXX
spine.
72052 26 A X-ray exam of neck 0.36 0.13 0.13 0.02 0.51 0.51 XXX
spine.
72052 TC A X-ray exam of neck 0.00 1.07 NA 0.05 1.12 NA XXX
spine.
72069 ................ A X-ray exam of trunk 0.22 0.56 NA 0.04 0.82 NA XXX
spine.
72069 26 A X-ray exam of trunk 0.22 0.09 0.09 0.02 0.33 0.33 XXX
spine.
72069 TC A X-ray exam of trunk 0.00 0.47 NA 0.02 0.49 NA XXX
spine.
72070 ................ A X-ray exam of thoracic 0.22 0.70 NA 0.04 0.96 NA XXX
spine.
72070 26 A X-ray exam of thoracic 0.22 0.08 0.08 0.01 0.31 0.31 XXX
spine.
72070 TC A X-ray exam of thoracic 0.00 0.62 NA 0.03 0.65 NA XXX
spine.
72072 ................ A X-ray exam of thoracic 0.22 0.78 NA 0.05 1.05 NA XXX
spine.
72072 26 A X-ray exam of thoracic 0.22 0.08 0.08 0.01 0.31 0.31 XXX
spine.
72072 TC A X-ray exam of thoracic 0.00 0.70 NA 0.04 0.74 NA XXX
spine.
72074 ................ A X-ray exam of thoracic 0.22 0.94 NA 0.06 1.22 NA XXX
spine.
72074 26 A X-ray exam of thoracic 0.22 0.08 0.08 0.01 0.31 0.31 XXX
spine.
72074 TC A X-ray exam of thoracic 0.00 0.86 NA 0.05 0.91 NA XXX
spine.
72080 ................ A X-ray exam of trunk 0.22 0.71 NA 0.05 0.98 NA XXX
spine.
72080 26 A X-ray exam of trunk 0.22 0.08 0.08 0.02 0.32 0.32 XXX
spine.
72080 TC A X-ray exam of trunk 0.00 0.63 NA 0.03 0.66 NA XXX
spine.
72090 ................ A X-ray exam of trunk 0.28 0.73 NA 0.05 1.06 NA XXX
spine.
72090 26 A X-ray exam of trunk 0.28 0.10 0.10 0.02 0.40 0.40 XXX
spine.
72090 TC A X-ray exam of trunk 0.00 0.63 NA 0.03 0.66 NA XXX
spine.
72100 ................ A X-ray exam of lower 0.22 0.71 NA 0.05 0.98 NA XXX
spine.
72100 26 A X-ray exam of lower 0.22 0.08 0.08 0.02 0.32 0.32 XXX
spine.
72100 TC A X-ray exam of lower 0.00 0.63 NA 0.03 0.66 NA XXX
spine.
72110 ................ A X-ray exam of lower 0.31 0.97 NA 0.07 1.35 NA XXX
spine.
72110 26 A X-ray exam of lower 0.31 0.11 0.11 0.02 0.44 0.44 XXX
spine.
72110 TC A X-ray exam of lower 0.00 0.86 NA 0.05 0.91 NA XXX
spine.
72114 ................ A X-ray exam of lower 0.36 1.26 NA 0.08 1.70 NA XXX
spine.
72114 26 A X-ray exam of lower 0.36 0.13 0.13 0.03 0.52 0.52 XXX
spine.
72114 TC A X-ray exam of lower 0.00 1.13 NA 0.05 1.18 NA XXX
spine.
72120 ................ A X-ray exam of lower 0.22 0.92 NA 0.07 1.21 NA XXX
spine.
72120 26 A X-ray exam of lower 0.22 0.08 0.08 0.02 0.32 0.32 XXX
spine.
72120 TC A X-ray exam of lower 0.00 0.84 NA 0.05 0.89 NA XXX
spine.
72125 ................ A Ct neck spine w/o dye. 1.16 6.02 NA 0.31 7.49 NA XXX
72125 26 A Ct neck spine w/o dye. 1.16 0.41 0.41 0.05 1.62 1.62 XXX
[[Page 55409]]
72125 TC A Ct neck spine w/o dye. 0.00 5.61 NA 0.26 5.87 NA XXX
72126 ................ A Ct neck spine w/dye... 1.22 7.14 NA 0.36 8.72 NA XXX
72126 26 A Ct neck spine w/dye... 1.22 0.43 0.43 0.05 1.70 1.70 XXX
72126 TC A Ct neck spine w/dye... 0.00 6.71 NA 0.31 7.02 NA XXX
72127 ................ A Ct neck spine w/o&w 1.27 8.85 NA 0.44 10.56 NA XXX
dye.
72127 26 A Ct neck spine w/o&w 1.27 0.45 0.45 0.06 1.78 1.78 XXX
dye.
72127 TC A Ct neck spine w/o&w 0.00 8.40 NA 0.38 8.78 NA XXX
dye.
72128 ................ A Ct chest spine w/o dye 1.16 6.02 NA 0.31 7.49 NA XXX
72128 26 A Ct chest spine w/o dye 1.16 0.41 0.41 0.05 1.62 1.62 XXX
72128 TC A Ct chest spine w/o dye 0.00 5.61 NA 0.26 5.87 NA XXX
72129 ................ A Ct chest spine w/dye.. 1.22 7.14 NA 0.36 8.72 NA XXX
72129 26 A Ct chest spine w/dye.. 1.22 0.43 0.43 0.05 1.70 1.70 XXX
72129 TC A Ct chest spine w/dye.. 0.00 6.71 NA 0.31 7.02 NA XXX
72130 ................ A Ct chest spine w/o&w 1.27 8.85 NA 0.44 10.56 NA XXX
dye.
72130 26 A Ct chest spine w/o&w 1.27 0.45 0.45 0.06 1.78 1.78 XXX
dye.
72130 TC A Ct chest spine w/o&w 0.00 8.40 NA 0.38 8.78 NA XXX
dye.
72131 ................ A Ct lumbar spine w/o 1.16 6.02 NA 0.31 7.49 NA XXX
dye.
72131 26 A Ct lumbar spine w/o 1.16 0.41 0.41 0.05 1.62 1.62 XXX
dye.
72131 TC A Ct lumbar spine w/o 0.00 5.61 NA 0.26 5.87 NA XXX
dye.
72132 ................ A Ct lumbar spine w/dye. 1.22 7.14 NA 0.37 8.73 NA XXX
72132 26 A Ct lumbar spine w/dye. 1.22 0.43 0.43 0.06 1.71 1.71 XXX
72132 TC A Ct lumbar spine w/dye. 0.00 6.71 NA 0.31 7.02 NA XXX
72133 ................ A Ct lumbar spine w/o&w 1.27 8.85 NA 0.44 10.56 NA XXX
dye.
72133 26 A Ct lumbar spine w/o&w 1.27 0.45 0.45 0.06 1.78 1.78 XXX
dye.
72133 TC A Ct lumbar spine w/o&w 0.00 8.40 NA 0.38 8.78 NA XXX
dye.
72141 ................ A Mri neck spine w/o dye 1.60 11.20 NA 0.56 13.36 NA XXX
72141 26 A Mri neck spine w/o dye 1.60 0.56 0.56 0.07 2.23 2.23 XXX
72141 TC A Mri neck spine w/o dye 0.00 10.64 NA 0.49 11.13 NA XXX
72142 ................ A Mri neck spine w/dye.. 1.92 13.45 NA 0.67 16.04 NA XXX
72142 26 A Mri neck spine w/dye.. 1.92 0.69 0.69 0.09 2.70 2.70 XXX
72142 TC A Mri neck spine w/dye.. 0.00 12.76 NA 0.58 13.34 NA XXX
72146 ................ A Mri chest spine w/o 1.60 12.38 NA 0.60 14.58 NA XXX
dye.
72146 26 A Mri chest spine w/o 1.60 0.56 0.56 0.07 2.23 2.23 XXX
dye.
72146 TC A Mri chest spine w/o 0.00 11.82 NA 0.53 12.35 NA XXX
dye.
72147 ................ A Mri chest spine w/dye. 1.92 13.44 NA 0.67 16.03 NA XXX
72147 26 A Mri chest spine w/dye. 1.92 0.68 0.68 0.09 2.69 2.69 XXX
72147 TC A Mri chest spine w/dye. 0.00 12.76 NA 0.58 13.34 NA XXX
72148 ................ A Mri lumbar spine w/o 1.48 12.34 NA 0.60 14.42 NA XXX
dye.
72148 26 A Mri lumbar spine w/o 1.48 0.52 0.52 0.07 2.07 2.07 XXX
dye.
72148 TC A Mri lumbar spine w/o 0.00 11.82 NA 0.53 12.35 NA XXX
dye.
72149 ................ A Mri lumbar spine w/dye 1.78 13.40 NA 0.67 15.85 NA XXX
72149 26 A Mri lumbar spine w/dye 1.78 0.64 0.64 0.09 2.51 2.51 XXX
72149 TC A Mri lumbar spine w/dye 0.00 12.76 NA 0.58 13.34 NA XXX
72156 ................ A Mri neck spine w/o&w 2.57 24.55 NA 1.20 28.32 NA XXX
dye.
72156 26 A Mri neck spine w/o&w 2.57 0.91 0.91 0.11 3.59 3.59 XXX
dye.
72156 TC A Mri neck spine w/o&w 0.00 23.64 NA 1.09 24.73 NA XXX
dye.
72157 ................ A Mri chest spine w/o&w 2.57 24.54 NA 1.20 28.31 NA XXX
dye.
72157 26 A Mri chest spine w/o&w 2.57 0.90 0.90 0.11 3.58 3.58 XXX
dye.
72157 TC A Mri chest spine w/o&w 0.00 23.64 NA 1.09 24.73 NA XXX
dye.
72158 ................ A Mri lumbar spine w/o&w 2.36 24.47 NA 1.20 28.03 NA XXX
dye.
72158 26 A Mri lumbar spine w/o&w 2.36 0.83 0.83 0.11 3.30 3.30 XXX
dye.
72158 TC A Mri lumbar spine w/o&w 0.00 23.64 NA 1.09 24.73 NA XXX
dye.
72159 ................ N Mr angio spine w/o&w +1.80 12.54 NA 0.61 14.95 NA XXX
dye.
72159 26 N Mr angio spine w/o&w +1.80 0.72 0.72 0.08 2.60 2.60 XXX
dye.
72159 TC N Mr angio spine w/o&w +0.00 11.82 NA 0.53 12.35 NA XXX
dye.
72170 ................ A X-ray exam of pelvis.. 0.17 0.56 NA 0.03 0.76 NA XXX
72170 26 A X-ray exam of pelvis.. 0.17 0.06 0.06 0.01 0.24 0.24 XXX
72170 TC A X-ray exam of pelvis.. 0.00 0.50 NA 0.02 0.52 NA XXX
72190 ................ A X-ray exam of pelvis.. 0.21 0.70 NA 0.04 0.95 NA XXX
72190 26 A X-ray exam of pelvis.. 0.21 0.07 0.07 0.01 0.29 0.29 XXX
72190 TC A X-ray exam of pelvis.. 0.00 0.63 NA 0.03 0.66 NA XXX
72191 ................ A Ct angiograph pelv w/ 1.81 8.78 NA 0.38 10.97 NA XXX
o&w dye.
72191 26 A Ct angiograph pelv w/ 1.81 0.72 0.72 0.06 2.59 2.59 XXX
o&w dye.
72191 TC A Ct angiograph pelv w/ 0.00 8.06 NA 0.32 8.38 NA XXX
o&w dye.
72192 ................ A Ct pelvis w/o dye..... 1.09 5.99 NA 0.31 7.39 NA XXX
72192 26 A Ct pelvis w/o dye..... 1.09 0.38 0.38 0.05 1.52 1.52 XXX
72192 TC A Ct pelvis w/o dye..... 0.00 5.61 NA 0.26 5.87 NA XXX
72193 ................ A Ct pelvis w/dye....... 1.16 6.91 NA 0.35 8.42 NA XXX
72193 26 A Ct pelvis w/dye....... 1.16 0.41 0.41 0.05 1.62 1.62 XXX
72193 TC A Ct pelvis w/dye....... 0.00 6.50 NA 0.30 6.80 NA XXX
72194 ................ A Ct pelvis w/o&w dye... 1.22 8.49 NA 0.41 10.12 NA XXX
72194 26 A Ct pelvis w/o&w dye... 1.22 0.43 0.43 0.05 1.70 1.70 XXX
72194 TC A Ct pelvis w/o&w dye... 0.00 8.06 NA 0.36 8.42 NA XXX
[[Page 55410]]
72195 ................ A Mri pelvis w/o dye.... 1.46 11.15 NA 0.42 13.03 NA XXX
72195 26 A Mri pelvis w/o dye.... 1.46 0.51 0.51 0.05 2.02 2.02 XXX
72195 TC A Mri pelvis w/o dye.... 0.00 10.64 NA 0.37 11.01 NA XXX
72196 ................ A Mri pelvis w/dye...... 1.73 13.36 NA 0.48 15.57 NA XXX
72196 26 A Mri pelvis w/dye...... 1.73 0.60 0.60 0.05 2.38 2.38 XXX
72196 TC A Mri pelvis w/dye...... 0.00 12.76 NA 0.43 13.19 NA XXX
72197 ................ A Mri pelvis w/o&w dye.. 2.26 24.43 NA 0.84 27.53 NA XXX
72197 26 A Mri pelvis w/o&w dye.. 2.26 0.79 0.79 0.08 3.13 3.13 XXX
72197 TC A Mri pelvis w/o&w dye.. 0.00 23.64 NA 0.76 24.40 NA XXX
72198 ................ N Mr angio pelvis w/o&w +1.80 11.36 NA 0.57 13.73 NA XXX
dye.
72198 26 N Mr angio pelvis w/o&w +1.80 0.72 0.72 0.08 2.60 2.60 XXX
dye.
72198 TC N Mr angio pelvis w/o&w +0.00 10.64 NA 0.49 11.13 NA XXX
dye.
72200 ................ A X-ray exam sacroiliac 0.17 0.56 NA 0.03 0.76 NA XXX
joints.
72200 26 A X-ray exam sacroiliac 0.17 0.06 0.06 0.01 0.24 0.24 XXX
joints.
72200 TC A X-ray exam sacroiliac 0.00 0.50 NA 0.02 0.52 NA XXX
joints.
72202 ................ A X-ray exam sacroiliac 0.19 0.66 NA 0.04 0.89 NA XXX
joints.
72202 26 A X-ray exam sacroiliac 0.19 0.07 0.07 0.01 0.27 0.27 XXX
joints.
72202 TC A X-ray exam sacroiliac 0.00 0.59 NA 0.03 0.62 NA XXX
joints.
72220 ................ A X-ray exam of tailbone 0.17 0.60 NA 0.04 0.81 NA XXX
72220 26 A X-ray exam of tailbone 0.17 0.06 0.06 0.01 0.24 0.24 XXX
72220 TC A X-ray exam of tailbone 0.00 0.54 NA 0.03 0.57 NA XXX
72240 ................ A Contrast x-ray of neck 0.91 4.82 NA 0.25 5.98 NA XXX
spine.
72240 26 A Contrast x-ray of neck 0.91 0.31 0.31 0.04 1.26 1.26 XXX
spine.
72240 TC A Contrast x-ray of neck 0.00 4.51 NA 0.21 4.72 NA XXX
spine.
72255 ................ A Contrast x-ray, thorax 0.91 4.41 NA 0.22 5.54 NA XXX
spine.
72255 26 A Contrast x-ray, thorax 0.91 0.30 0.30 0.04 1.25 1.25 XXX
spine.
72255 TC A Contrast x-ray, thorax 0.00 4.11 NA 0.18 4.29 NA XXX
spine.
72265 ................ A Contrast x-ray, lower 0.83 4.15 NA 0.22 5.20 NA XXX
spine.
72265 26 A Contrast x-ray, lower 0.83 0.28 0.28 0.04 1.15 1.15 XXX
spine.
72265 TC A Contrast x-ray, lower 0.00 3.87 NA 0.18 4.05 NA XXX
spine.
72270 ................ A Contrast x-ray of 1.33 6.25 NA 0.34 7.92 NA XXX
spine.
72270 26 A Contrast x-ray of 1.33 0.46 0.46 0.07 1.86 1.86 XXX
spine.
72270 TC A Contrast x-ray of 0.00 5.79 NA 0.27 6.06 NA XXX
spine.
72275 ................ A Epidurography......... 0.76 2.20 NA 0.21 3.17 NA XXX
72275 26 A Epidurography......... 0.76 0.21 0.21 0.03 1.00 1.00 XXX
72275 TC A Epidurography......... 0.00 1.99 NA 0.18 2.17 NA XXX
72285 ................ A X-ray c/t spine disk.. 1.16 8.35 NA 0.42 9.93 NA XXX
72285 26 A X-ray c/t spine disk.. 1.16 0.39 0.39 0.06 1.61 1.61 XXX
72285 TC A X-ray c/t spine disk.. 0.00 7.96 NA 0.36 8.32 NA XXX
72295 ................ A X-ray of lower spine 0.83 7.76 NA 0.37 8.96 NA XXX
disk.
72295 26 A X-ray of lower spine 0.83 0.29 0.29 0.04 1.16 1.16 XXX
disk.
72295 TC A X-ray of lower spine 0.00 7.47 NA 0.33 7.80 NA XXX
disk.
73000 ................ A X-ray exam of collar 0.16 0.56 NA 0.03 0.75 NA XXX
bone.
73000 26 A X-ray exam of collar 0.16 0.06 0.06 0.01 0.23 0.23 XXX
bone.
73000 TC A X-ray exam of collar 0.00 0.50 NA 0.02 0.52 NA XXX
bone.
73010 ................ A X-ray exam of shoulder 0.17 0.56 NA 0.03 0.76 NA XXX
blade.
73010 26 A X-ray exam of shoulder 0.17 0.06 0.06 0.01 0.24 0.24 XXX
blade.
73010 TC A X-ray exam of shoulder 0.00 0.50 NA 0.02 0.52 NA XXX
blade.
73020 ................ A X-ray exam of shoulder 0.15 0.50 NA 0.03 0.68 NA XXX
73020 26 A X-ray exam of shoulder 0.15 0.05 0.05 0.01 0.21 0.21 XXX
73020 TC A X-ray exam of shoulder 0.00 0.45 NA 0.02 0.47 NA XXX
73030 ................ A X-ray exam of shoulder 0.18 0.60 NA 0.04 0.82 NA XXX
73030 26 A X-ray exam of shoulder 0.18 0.06 0.06 0.01 0.25 0.25 XXX
73030 TC A X-ray exam of shoulder 0.00 0.54 NA 0.03 0.57 NA XXX
73040 ................ A Contrast x-ray of 0.54 2.18 NA 0.13 2.85 NA XXX
shoulder.
73040 26 A Contrast x-ray of 0.54 0.19 0.19 0.03 0.76 0.76 XXX
shoulder.
73040 TC A Contrast x-ray of 0.00 1.99 NA 0.10 2.09 NA XXX
shoulder.
73050 ................ A X-ray exam of 0.20 0.70 NA 0.05 0.95 NA XXX
shoulders.
73050 26 A X-ray exam of 0.20 0.07 0.07 0.02 0.29 0.29 XXX
shoulders.
73050 TC A X-ray exam of 0.00 0.63 NA 0.03 0.66 NA XXX
shoulders.
73060 ................ A X-ray exam of humerus. 0.17 0.60 NA 0.04 0.81 NA XXX
73060 26 A X-ray exam of humerus. 0.17 0.06 0.06 0.01 0.24 0.24 XXX
73060 TC A X-ray exam of humerus. 0.00 0.54 NA 0.03 0.57 NA XXX
73070 ................ A X-ray exam of elbow... 0.15 0.55 NA 0.03 0.73 NA XXX
73070 26 A X-ray exam of elbow... 0.15 0.05 0.05 0.01 0.21 0.21 XXX
73070 TC A X-ray exam of elbow... 0.00 0.50 NA 0.02 0.52 NA XXX
73080 ................ A X-ray exam of elbow... 0.17 0.60 NA 0.04 0.81 NA XXX
73080 26 A X-ray exam of elbow... 0.17 0.06 0.06 0.01 0.24 0.24 XXX
73080 TC A X-ray exam of elbow... 0.00 0.54 NA 0.03 0.57 NA XXX
73085 ................ A Contrast x-ray of 0.54 2.19 NA 0.13 2.86 NA XXX
elbow.
73085 26 A Contrast x-ray of 0.54 0.20 0.20 0.03 0.77 0.77 XXX
elbow.
73085 TC A Contrast x-ray of 0.00 1.99 NA 0.10 2.09 NA XXX
elbow.
73090 ................ A X-ray exam of forearm. 0.16 0.56 NA 0.03 0.75 NA XXX
[[Page 55411]]
73090 26 A X-ray exam of forearm. 0.16 0.06 0.06 0.01 0.23 0.23 XXX
73090 TC A X-ray exam of forearm. 0.00 0.50 NA 0.02 0.52 NA XXX
73092 ................ A X-ray exam of arm, 0.16 0.53 NA 0.03 0.72 NA XXX
infant.
73092 26 A X-ray exam of arm, 0.16 0.06 0.06 0.01 0.23 0.23 XXX
infant.
73092 TC A X-ray exam of arm, 0.00 0.47 NA 0.02 0.49 NA XXX
infant.
73100 ................ A X-ray exam of wrist... 0.16 0.53 NA 0.04 0.73 NA XXX
73100 26 A X-ray exam of wrist... 0.16 0.06 0.06 0.02 0.24 0.24 XXX
73100 TC A X-ray exam of wrist... 0.00 0.47 NA 0.02 0.49 NA XXX
73110 ................ A X-ray exam of wrist... 0.17 0.57 NA 0.03 0.77 NA XXX
73110 26 A X-ray exam of wrist... 0.17 0.06 0.06 0.01 0.24 0.24 XXX
73110 TC A X-ray exam of wrist... 0.00 0.51 NA 0.02 0.53 NA XXX
73115 ................ A Contrast x-ray of 0.54 1.70 NA 0.11 2.35 NA XXX
wrist.
73115 26 A Contrast x-ray of 0.54 0.20 0.20 0.03 0.77 0.77 XXX
wrist.
73115 TC A Contrast x-ray of 0.00 1.50 NA 0.08 1.58 NA XXX
wrist.
73120 ................ A X-ray exam of hand.... 0.16 0.53 NA 0.03 0.72 NA XXX
73120 26 A X-ray exam of hand.... 0.16 0.06 0.06 0.01 0.23 0.23 XXX
73120 TC A X-ray exam of hand.... 0.00 0.47 NA 0.02 0.49 NA XXX
73130 ................ A X-ray exam of hand.... 0.17 0.57 NA 0.03 0.77 NA XXX
73130 26 A X-ray exam of hand.... 0.17 0.06 0.06 0.01 0.24 0.24 XXX
73130 TC A X-ray exam of hand.... 0.00 0.51 NA 0.02 0.53 NA XXX
73140 ................ A X-ray exam of 0.13 0.44 NA 0.03 0.60 NA XXX
finger(s).
73140 26 A X-ray exam of 0.13 0.05 0.05 0.01 0.19 0.19 XXX
finger(s).
73140 TC A X-ray exam of 0.00 0.39 NA 0.02 0.41 NA XXX
finger(s).
73200 ................ A Ct upper extremity w/o 1.09 5.09 NA 0.26 6.44 NA XXX
dye.
73200 26 A Ct upper extremity w/o 1.09 0.38 0.38 0.05 1.52 1.52 XXX
dye.
73200 TC A Ct upper extremity w/o 0.00 4.71 NA 0.21 4.92 NA XXX
dye.
73201 ................ A Ct upper extremity w/ 1.16 6.02 NA 0.31 7.49 NA XXX
dye.
73201 26 A Ct upper extremity w/ 1.16 0.41 0.41 0.05 1.62 1.62 XXX
dye.
73201 TC A Ct upper extremity w/ 0.00 5.61 NA 0.26 5.87 NA XXX
dye.
73202 ................ A Ct uppr extremity w/ 1.22 7.48 NA 0.38 9.08 NA XXX
o&w dye.
73202 26 A Ct uppr extremity w/ 1.22 0.43 0.43 0.06 1.71 1.71 XXX
o&w dye.
73202 TC A Ct uppr extremity w/ 0.00 7.05 NA 0.32 7.37 NA XXX
o&w dye.
73206 ................ A Ct angio upr extrm w/ 1.81 7.77 NA 0.38 9.96 NA XXX
o&w dye.
73206 26 A Ct angio upr extrm w/ 1.81 0.72 0.72 0.06 2.59 2.59 XXX
o&w dye.
73206 TC A Ct angio upr extrm w/ 0.00 7.05 NA 0.32 7.37 NA XXX
o&w dye.
73218 ................ A Mri upper extremity w/ 1.35 11.11 NA 0.36 12.82 NA XXX
o dye.
73218 26 A Mri upper extremity w/ 1.35 0.47 0.47 0.04 1.86 1.86 XXX
o dye.
73218 TC A Mri upper extremity w/ 0.00 10.64 NA 0.32 10.96 NA XXX
o dye.
73219 ................ A Mri upper extremity w/ 1.62 13.33 NA 0.44 15.39 NA XXX
dye.
73219 26 A Mri upper extremity w/ 1.62 0.57 0.57 0.05 2.24 2.24 XXX
dye.
73219 TC A Mri upper extremity w/ 0.00 12.76 NA 0.39 13.15 NA XXX
dye.
73220 ................ A Mri uppr extremity w/ 2.15 24.39 NA 0.78 27.32 NA XXX
o&w dye.
73220 26 A Mri uppr extremity w/ 2.15 0.75 0.75 0.08 2.98 2.98 XXX
o&w dye.
73220 TC A Mri uppr extremity w/ 0.00 23.64 NA 0.70 24.34 NA XXX
o&w dye.
73221 ................ A Mri joint upr extrem w/ 1.35 11.11 NA 0.36 12.82 NA XXX
o dye.
73221 26 A Mri joint upr extrem w/ 1.35 0.47 0.47 0.04 1.86 1.86 XXX
o dye.
73221 TC A Mri joint upr extrem w/ 0.00 10.64 NA 0.32 10.96 NA XXX
o dye.
73222 ................ A Mri joint upr extrem w/ 1.62 13.33 NA 0.44 15.39 NA XXX
dye.
73222 26 A Mri joint upr extrem w/ 1.62 0.57 0.57 0.05 2.24 2.24 XXX
dye.
73222 TC A Mri joint upr extrem w/ 0.00 12.76 NA 0.39 13.15 NA XXX
dye.
73223 ................ A Mri joint upr extr w/ 2.15 24.39 NA 0.77 27.31 NA XXX
o&w dye.
73223 26 A Mri joint upr extr w/ 2.15 0.75 0.75 0.07 2.97 2.97 XXX
o&w dye.
73223 TC A Mri joint upr extr w/ 0.00 23.64 NA 0.70 24.34 NA XXX
o&w dye.
73225 ................ N Mr angio upr extr w/ +1.73 11.33 NA 0.57 13.63 NA XXX
o&w dye.
73225 26 N Mr angio upr extr w/ +1.73 0.69 0.69 0.08 2.50 2.50 XXX
o&w dye.
73225 TC N Mr angio upr extr w/ +0.00 10.64 NA 0.49 11.13 NA XXX
o&w dye.
73500 ................ A X-ray exam of hip..... 0.17 0.51 NA 0.03 0.71 NA XXX
73500 26 A X-ray exam of hip..... 0.17 0.06 0.06 0.01 0.24 0.24 XXX
73500 TC A X-ray exam of hip..... 0.00 0.45 NA 0.02 0.47 NA XXX
73510 ................ A X-ray exam of hip..... 0.21 0.61 NA 0.05 0.87 NA XXX
73510 26 A X-ray exam of hip..... 0.21 0.07 0.07 0.02 0.30 0.30 XXX
73510 TC A X-ray exam of hip..... 0.00 0.54 NA 0.03 0.57 NA XXX
73520 ................ A X-ray exam of hips.... 0.26 0.72 NA 0.05 1.03 NA XXX
73520 26 A X-ray exam of hips.... 0.26 0.09 0.09 0.02 0.37 0.37 XXX
73520 TC A X-ray exam of hips.... 0.00 0.63 NA 0.03 0.66 NA XXX
73525 ................ A Contrast x-ray of hip. 0.54 2.19 NA 0.13 2.86 NA XXX
73525 26 A Contrast x-ray of hip. 0.54 0.20 0.20 0.03 0.77 0.77 XXX
73525 TC A Contrast x-ray of hip. 0.00 1.99 NA 0.10 2.09 NA XXX
73530 ................ A X-ray exam of hip..... 0.29 0.60 NA 0.03 0.92 NA XXX
73530 26 A X-ray exam of hip..... 0.29 0.10 0.10 0.01 0.40 0.40 XXX
73530 TC A X-ray exam of hip..... 0.00 0.50 NA 0.02 0.52 NA XXX
73540 ................ A X-ray exam of pelvis & 0.20 0.61 NA 0.05 0.86 NA XXX
hips.
73540 26 A X-ray exam of pelvis & 0.20 0.07 0.07 0.02 0.29 0.29 XXX
hips.
[[Page 55412]]
73540 TC A X-ray exam of pelvis & 0.00 0.54 NA 0.03 0.57 NA XXX
hips.
73542 ................ A X-ray exam, sacroiliac 0.59 2.16 NA 0.13 2.88 NA XXX
joint.
73542 26 A X-ray exam, sacroiliac 0.59 0.17 0.17 0.03 0.79 0.79 XXX
joint.
73542 TC A X-ray exam, sacroiliac 0.00 1.99 NA 0.10 2.09 NA XXX
joint.
73550 ................ A X-ray exam of thigh... 0.17 0.60 NA 0.04 0.81 NA XXX
73550 26 A X-ray exam of thigh... 0.17 0.06 0.06 0.01 0.24 0.24 XXX
73550 TC A X-ray exam of thigh... 0.00 0.54 NA 0.03 0.57 NA XXX
73560 ................ A X-ray exam of knee, 1 0.17 0.56 NA 0.04 0.77 NA XXX
or 2.
73560 26 A X-ray exam of knee, 1 0.17 0.06 0.06 0.02 0.25 0.25 XXX
or 2.
73560 TC A X-ray exam of knee, 1 0.00 0.50 NA 0.02 0.52 NA XXX
or 2.
73562 ................ A X-ray exam of knee, 3. 0.18 0.60 NA 0.05 0.83 NA XXX
73562 26 A X-ray exam of knee, 3. 0.18 0.06 0.06 0.02 0.26 0.26 XXX
73562 TC A X-ray exam of knee, 3. 0.00 0.54 NA 0.03 0.57 NA XXX
73564 ................ A X-ray exam, knee, 4 or 0.22 0.67 NA 0.05 0.94 NA XXX
more.
73564 26 A X-ray exam, knee, 4 or 0.22 0.08 0.08 0.02 0.32 0.32 XXX
more.
73564 TC A X-ray exam, knee, 4 or 0.00 0.59 NA 0.03 0.62 NA XXX
more.
73565 ................ A X-ray exam of knees... 0.17 0.54 NA 0.04 0.75 NA XXX
73565 26 A X-ray exam of knees... 0.17 0.07 0.07 0.02 0.26 0.26 XXX
73565 TC A X-ray exam of knees... 0.00 0.47 NA 0.02 0.49 NA XXX
73580 ................ A Contrast x-ray of knee 0.54 2.68 NA 0.15 3.37 NA XXX
joint.
73580 26 A Contrast x-ray of knee 0.54 0.19 0.19 0.03 0.76 0.76 XXX
joint.
73580 TC A Contrast x-ray of knee 0.00 2.49 NA 0.12 2.61 NA XXX
joint.
73590 ................ A X-ray exam of lower 0.17 0.56 NA 0.03 0.76 NA XXX
leg.
73590 26 A X-ray exam of lower 0.17 0.06 0.06 0.01 0.24 0.24 XXX
leg.
73590 TC A X-ray exam of lower 0.00 0.50 NA 0.02 0.52 NA XXX
leg.
73592 ................ A X-ray exam of leg, 0.16 0.53 NA 0.03 0.72 NA XXX
infant.
73592 26 A X-ray exam of leg, 0.16 0.06 0.06 0.01 0.23 0.23 XXX
infant.
73592 TC A X-ray exam of leg, 0.00 0.47 NA 0.02 0.49 NA XXX
infant.
73600 ................ A X-ray exam of ankle... 0.16 0.53 NA 0.03 0.72 NA XXX
73600 26 A X-ray exam of ankle... 0.16 0.06 0.06 0.01 0.23 0.23 XXX
73600 TC A X-ray exam of ankle... 0.00 0.47 NA 0.02 0.49 NA XXX
73610 ................ A X-ray exam of ankle... 0.17 0.57 NA 0.03 0.77 NA XXX
73610 26 A X-ray exam of ankle... 0.17 0.06 0.06 0.01 0.24 0.24 XXX
73610 TC A X-ray exam of ankle... 0.00 0.51 NA 0.02 0.53 NA XXX
73615 ................ A Contrast x-ray of 0.54 2.18 NA 0.13 2.85 NA XXX
ankle.
73615 26 A Contrast x-ray of 0.54 0.19 0.19 0.03 0.76 0.76 XXX
ankle.
73615 TC A Contrast x-ray of 0.00 1.99 NA 0.10 2.09 NA XXX
ankle.
73620 ................ A X-ray exam of foot.... 0.16 0.53 NA 0.03 0.72 NA XXX
73620 26 A X-ray exam of foot.... 0.16 0.06 0.06 0.01 0.23 0.23 XXX
73620 TC A X-ray exam of foot.... 0.00 0.47 NA 0.02 0.49 NA XXX
73630 ................ A X-ray exam of foot.... 0.17 0.57 NA 0.03 0.77 NA XXX
73630 26 A X-ray exam of foot.... 0.17 0.06 0.06 0.01 0.24 0.24 XXX
73630 TC A X-ray exam of foot.... 0.00 0.51 NA 0.02 0.53 NA XXX
73650 ................ A X-ray exam of heel.... 0.16 0.51 NA 0.03 0.70 NA XXX
73650 26 A X-ray exam of heel.... 0.16 0.06 0.06 0.01 0.23 0.23 XXX
73650 TC A X-ray exam of heel.... 0.00 0.45 NA 0.02 0.47 NA XXX
73660 ................ A X-ray exam of toe(s).. 0.13 0.44 NA 0.03 0.60 NA XXX
73660 26 A X-ray exam of toe(s).. 0.13 0.05 0.05 0.01 0.19 0.19 XXX
73660 TC A X-ray exam of toe(s).. 0.00 0.39 NA 0.02 0.41 NA XXX
73700 ................ A Ct lower extremity w/o 1.09 5.09 NA 0.26 6.44 NA XXX
dye.
73700 26 A Ct lower extremity w/o 1.09 0.38 0.38 0.05 1.52 1.52 XXX
dye.
73700 TC A Ct lower extremity w/o 0.00 4.71 NA 0.21 4.92 NA XXX
dye.
73701 ................ A Ct lower extremity w/ 1.16 6.02 NA 0.31 7.49 NA XXX
dye.
73701 26 A Ct lower extremity w/ 1.16 0.41 0.41 0.05 1.62 1.62 XXX
dye.
73701 TC A Ct lower extremity w/ 0.00 5.61 NA 0.26 5.87 NA XXX
dye.
73702 ................ A Ct lwr extremity w/o&w 1.22 7.48 NA 0.37 9.07 NA XXX
dye.
73702 26 A Ct lwr extremity w/o&w 1.22 0.43 0.43 0.05 1.70 1.70 XXX
dye.
73702 TC A Ct lwr extremity w/o&w 0.00 7.05 NA 0.32 7.37 NA XXX
dye.
73706 ................ A Ct angio lwr extr w/ 1.90 7.81 NA 0.38 10.09 NA XXX
o&w dye.
73706 26 A Ct angio lwr extr w/ 1.90 0.76 0.76 0.06 2.72 2.72 XXX
o&w dye.
73706 TC A Ct angio lwr extr w/ 0.00 7.05 NA 0.32 7.37 NA XXX
o&w dye.
73718 ................ A Mri lower extremity w/ 1.35 11.11 NA 0.36 12.82 NA XXX
o dye.
73718 26 A Mri lower extremity w/ 1.35 0.47 0.47 0.04 1.86 1.86 XXX
o dye.
73718 TC A Mri lower extremity w/ 0.00 10.64 NA 0.32 10.96 NA XXX
o dye.
73719 ................ A Mri lower extremity w/ 1.62 13.32 NA 0.44 15.38 NA XXX
dye.
73719 26 A Mri lower extremity w/ 1.62 0.56 0.56 0.05 2.23 2.23 XXX
dye.
73719 TC A Mri lower extremity w/ 0.00 12.76 NA 0.39 13.15 NA XXX
dye.
73720 ................ A Mri lwr extremity w/ 2.15 24.39 NA 0.78 27.32 NA XXX
o&w dye.
73720 26 A Mri lwr extremity w/ 2.15 0.75 0.75 0.08 2.98 2.98 XXX
o&w dye.
73720 TC A Mri lwr extremity w/ 0.00 23.64 NA 0.70 24.34 NA XXX
o&w dye.
73721 ................ A Mri joint of lwr extre 1.35 11.11 NA 0.36 12.82 NA XXX
w/o d.
73721 26 A Mri joint of lwr extre 1.35 0.47 0.47 0.04 1.86 1.86 XXX
w/o d.
73721 TC A Mri joint of lwr extre 0.00 10.64 NA 0.32 10.96 NA XXX
w/o d.
[[Page 55413]]
73722 ................ A Mri joint of lwr extr 1.62 13.33 NA 0.45 15.40 NA XXX
w/dye.
73722 26 A Mri joint of lwr extr 1.62 0.57 0.57 0.06 2.25 2.25 XXX
w/dye.
73722 TC A Mri joint of lwr extr 0.00 12.76 NA 0.39 13.15 NA XXX
w/dye.
73723 ................ A Mri joint lwr extr w/ 2.15 24.39 NA 0.77 27.31 NA XXX
o&w dye.
73723 26 A Mri joint lwr extr w/ 2.15 0.75 0.75 0.07 2.97 2.97 XXX
o&w dye.
73723 TC A Mri joint lwr extr w/ 0.00 23.64 NA 0.70 24.34 NA XXX
o&w dye.
73725 ................ R Mr ang lwr ext w or w/ 1.82 11.28 NA 0.57 13.67 NA XXX
o dye.
73725 26 R Mr ang lwr ext w or w/ 1.82 0.64 0.64 0.08 2.54 2.54 XXX
o dye.
73725 TC R Mr ang lwr ext w or w/ 0.00 10.64 NA 0.49 11.13 NA XXX
o dye.
74000 ................ A X-ray exam of abdomen. 0.18 0.56 NA 0.03 0.77 NA XXX
74000 26 A X-ray exam of abdomen. 0.18 0.06 0.06 0.01 0.25 0.25 XXX
74000 TC A X-ray exam of abdomen. 0.00 0.50 NA 0.02 0.52 NA XXX
74010 ................ A X-ray exam of abdomen. 0.23 0.62 NA 0.04 0.89 NA XXX
74010 26 A X-ray exam of abdomen. 0.23 0.08 0.08 0.01 0.32 0.32 XXX
74010 TC A X-ray exam of abdomen. 0.00 0.54 NA 0.03 0.57 NA XXX
74020 ................ A X-ray exam of abdomen. 0.27 0.68 NA 0.04 0.99 NA XXX
74020 26 A X-ray exam of abdomen. 0.27 0.09 0.09 0.01 0.37 0.37 XXX
74020 TC A X-ray exam of abdomen. 0.00 0.59 NA 0.03 0.62 NA XXX
74022 ................ A X-ray exam series, 0.32 0.81 NA 0.05 1.18 NA XXX
abdomen.
74022 26 A X-ray exam series, 0.32 0.11 0.11 0.01 0.44 0.44 XXX
abdomen.
74022 TC A X-ray exam series, 0.00 0.70 NA 0.04 0.74 NA XXX
abdomen.
74150 ................ A Ct abdomen w/o dye.... 1.19 5.79 NA 0.30 7.28 NA XXX
74150 26 A Ct abdomen w/o dye.... 1.19 0.42 0.42 0.05 1.66 1.66 XXX
74150 TC A Ct abdomen w/o dye.... 0.00 5.37 NA 0.25 5.62 NA XXX
74160 ................ A Ct abdomen w/dye...... 1.27 6.94 NA 0.36 8.57 NA XXX
74160 26 A Ct abdomen w/dye...... 1.27 0.44 0.44 0.06 1.77 1.77 XXX
74160 TC A Ct abdomen w/dye...... 0.00 6.50 NA 0.30 6.80 NA XXX
74170 ................ A Ct abdomen w/o&w dye.. 1.40 8.55 NA 0.42 10.37 NA XXX
74170 26 A Ct abdomen w/o&w dye.. 1.40 0.49 0.49 0.06 1.95 1.95 XXX
74170 TC A Ct abdomen w/o&w dye.. 0.00 8.06 NA 0.36 8.42 NA XXX
74175 ................ A Ct angio abdom w/o&w 1.90 8.82 NA 0.38 11.10 NA XXX
dye.
74175 26 A Ct angio abdom w/o&w 1.90 0.76 0.76 0.06 2.72 2.72 XXX
dye.
74175 TC A Ct angio abdom w/o&w 0.00 8.06 NA 0.32 8.38 NA XXX
dye.
74181 ................ A Mri abdomen w/o dye... 1.46 11.15 NA 0.41 13.02 NA XXX
74181 26 A Mri abdomen w/o dye... 1.46 0.51 0.51 0.04 2.01 2.01 XXX
74181 TC A Mri abdomen w/o dye... 0.00 10.64 NA 0.37 11.01 NA XXX
74182 ................ A Mri abdomen w/dye..... 1.73 13.36 NA 0.49 15.58 NA XXX
74182 26 A Mri abdomen w/dye..... 1.73 0.60 0.60 0.06 2.39 2.39 XXX
74182 TC A Mri abdomen w/dye..... 0.00 12.76 NA 0.43 13.19 NA XXX
74183 ................ A Mri abdomen w/o&w dye. 2.26 24.43 NA 0.84 27.53 NA XXX
74183 26 A Mri abdomen w/o&w dye. 2.26 0.79 0.79 0.08 3.13 3.13 XXX
74183 TC A Mri abdomen w/o&w dye. 0.00 23.64 NA 0.76 24.40 NA XXX
74185 ................ R Mri angio, abdom w or 1.80 11.27 NA 0.57 13.64 NA XXX
w/o dy.
74185 26 R Mri angio, abdom w or 1.80 0.63 0.63 0.08 2.51 2.51 XXX
w/o dy.
74185 TC R Mri angio, abdom w or 0.00 10.64 NA 0.49 11.13 NA XXX
w/o dy.
74190 ................ A X-ray exam of 0.48 1.41 NA 0.08 1.97 NA XXX
peritoneum.
74190 26 A X-ray exam of 0.48 0.17 0.17 0.02 0.67 0.67 XXX
peritoneum.
74190 TC A X-ray exam of 0.00 1.24 NA 0.06 1.30 NA XXX
peritoneum.
74210 ................ A Contrst x-ray exam of 0.36 1.26 NA 0.07 1.69 NA XXX
throat.
74210 26 A Contrst x-ray exam of 0.36 0.13 0.13 0.02 0.51 0.51 XXX
throat.
74210 TC A Contrst x-ray exam of 0.00 1.13 NA 0.05 1.18 NA XXX
throat.
74220 ................ A Contrast x-ray, 0.46 1.29 NA 0.07 1.82 NA XXX
esophagus.
74220 26 A Contrast x-ray, 0.46 0.16 0.16 0.02 0.64 0.64 XXX
esophagus.
74220 TC A Contrast x-ray, 0.00 1.13 NA 0.05 1.18 NA XXX
esophagus.
74230 ................ A Cine/video x-ray, 0.53 1.43 NA 0.08 2.04 NA XXX
throat/eso.
74230 26 A Cine/video x-ray, 0.53 0.19 0.19 0.02 0.74 0.74 XXX
throat/eso.
74230 TC A Cine/video x-ray, 0.00 1.24 NA 0.06 1.30 NA XXX
throat/eso.
74235 ................ A Remove esophagus 1.19 2.90 NA 0.17 4.26 NA XXX
obstruction.
74235 26 A Remove esophagus 1.19 0.41 0.41 0.05 1.65 1.65 XXX
obstruction.
74235 TC A Remove esophagus 0.00 2.49 NA 0.12 2.61 NA XXX
obstruction.
74240 ................ A X-ray exam, upper gi 0.69 1.63 NA 0.10 2.42 NA XXX
tract.
74240 26 A X-ray exam, upper gi 0.69 0.24 0.24 0.03 0.96 0.96 XXX
tract.
74240 TC A X-ray exam, upper gi 0.00 1.39 NA 0.07 1.46 NA XXX
tract.
74241 ................ A X-ray exam, upper gi 0.69 1.65 NA 0.10 2.44 NA XXX
tract.
74241 26 A X-ray exam, upper gi 0.69 0.24 0.24 0.03 0.96 0.96 XXX
tract.
74241 TC A X-ray exam, upper gi 0.00 1.41 NA 0.07 1.48 NA XXX
tract.
74245 ................ A X-ray exam, upper gi 0.91 2.58 NA 0.15 3.64 NA XXX
tract.
74245 26 A X-ray exam, upper gi 0.91 0.32 0.32 0.04 1.27 1.27 XXX
tract.
74245 TC A X-ray exam, upper gi 0.00 2.26 NA 0.11 2.37 NA XXX
tract.
74246 ................ A Contrst x-ray uppr gi 0.69 1.80 NA 0.11 2.60 NA XXX
tract.
74246 26 A Contrst x-ray uppr gi 0.69 0.24 0.24 0.03 0.96 0.96 XXX
tract.
74246 TC A Contrst x-ray uppr gi 0.00 1.56 NA 0.08 1.64 NA XXX
tract.
74247 ................ A Contrst x-ray uppr gi 0.69 1.84 NA 0.12 2.65 NA XXX
tract.
[[Page 55414]]
74247 26 A Contrst x-ray uppr gi 0.69 0.24 0.24 0.03 0.96 0.96 XXX
tract.
74247 TC A Contrst x-ray uppr gi 0.00 1.60 NA 0.09 1.69 NA XXX
tract.
74249 ................ A Contrst x-ray uppr gi 0.91 2.76 NA 0.16 3.83 NA XXX
tract.
74249 26 A Contrst x-ray uppr gi 0.91 0.32 0.32 0.04 1.27 1.27 XXX
tract.
74249 TC A Contrst x-ray uppr gi 0.00 2.44 NA 0.12 2.56 NA XXX
tract.
74250 ................ A X-ray exam of small 0.47 1.40 NA 0.08 1.95 NA XXX
bowel.
74250 26 A X-ray exam of small 0.47 0.16 0.16 0.02 0.65 0.65 XXX
bowel.
74250 TC A X-ray exam of small 0.00 1.24 NA 0.06 1.30 NA XXX
bowel.
74251 ................ A X-ray exam of small 0.69 1.48 NA 0.09 2.26 NA XXX
bowel.
74251 26 A X-ray exam of small 0.69 0.24 0.24 0.03 0.96 0.96 XXX
bowel.
74251 TC A X-ray exam of small 0.00 1.24 NA 0.06 1.30 NA XXX
bowel.
74260 ................ A X-ray exam of small 0.50 1.58 NA 0.09 2.17 NA XXX
bowel.
74260 26 A X-ray exam of small 0.50 0.17 0.17 0.02 0.69 0.69 XXX
bowel.
74260 TC A X-ray exam of small 0.00 1.41 NA 0.07 1.48 NA XXX
bowel.
74270 ................ A Contrast x-ray exam of 0.69 1.86 NA 0.12 2.67 NA XXX
colon.
74270 26 A Contrast x-ray exam of 0.69 0.24 0.24 0.03 0.96 0.96 XXX
colon.
74270 TC A Contrast x-ray exam of 0.00 1.62 NA 0.09 1.71 NA XXX
colon.
74280 ................ A Contrast x-ray exam of 0.99 2.47 NA 0.15 3.61 NA XXX
colon.
74280 26 A Contrast x-ray exam of 0.99 0.35 0.35 0.04 1.38 1.38 XXX
colon.
74280 TC A Contrast x-ray exam of 0.00 2.12 NA 0.11 2.23 NA XXX
colon.
74283 ................ A Contrast x-ray exam of 2.02 3.14 NA 0.21 5.37 NA XXX
colon.
74283 26 A Contrast x-ray exam of 2.02 0.71 0.71 0.09 2.82 2.82 XXX
colon.
74283 TC A Contrast x-ray exam of 0.00 2.43 NA 0.12 2.55 NA XXX
colon.
74290 ................ A Contrast x-ray, 0.32 0.81 NA 0.05 1.18 NA XXX
gallbladder.
74290 26 A Contrast x-ray, 0.32 0.11 0.11 0.01 0.44 0.44 XXX
gallbladder.
74290 TC A Contrast x-ray, 0.00 0.70 NA 0.04 0.74 NA XXX
gallbladder.
74291 ................ A Contrast x-rays, 0.20 0.46 NA 0.03 0.69 NA XXX
gallbladder.
74291 26 A Contrast x-rays, 0.20 0.07 0.07 0.01 0.28 0.28 XXX
gallbladder.
74291 TC A Contrast x-rays, 0.00 0.39 NA 0.02 0.41 NA XXX
gallbladder.
74300 ................ C X-ray bile ducts/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
pancreas.
74300 26 A X-ray bile ducts/ 0.36 0.13 0.13 0.02 0.51 0.51 XXX
pancreas.
74300 TC C X-ray bile ducts/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
pancreas.
74301 ................ C X-rays at surgery add- 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
on.
74301 26 A X-rays at surgery add- 0.21 0.07 0.07 0.01 0.29 0.29 ZZZ
on.
74301 TC C X-rays at surgery add- 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
on.
74305 ................ A X-ray bile ducts/ 0.42 0.89 NA 0.06 1.37 NA XXX
pancreas.
74305 26 A X-ray bile ducts/ 0.42 0.15 0.15 0.02 0.59 0.59 XXX
pancreas.
74305 TC A X-ray bile ducts/ 0.00 0.74 NA 0.04 0.78 NA XXX
pancreas.
74320 ................ A Contrast x-ray of bile 0.54 3.18 NA 0.16 3.88 NA XXX
ducts.
74320 26 A Contrast x-ray of bile 0.54 0.19 0.19 0.02 0.75 0.75 XXX
ducts.
74320 TC A Contrast x-ray of bile 0.00 2.99 NA 0.14 3.13 NA XXX
ducts.
74327 ................ A X-ray bile stone 0.70 1.91 NA 0.12 2.73 NA XXX
removal.
74327 26 A X-ray bile stone 0.70 0.24 0.24 0.03 0.97 0.97 XXX
removal.
74327 TC A X-ray bile stone 0.00 1.67 NA 0.09 1.76 NA XXX
removal.
74328 ................ A Xray bile duct 0.70 3.24 NA 0.17 4.11 NA XXX
endoscopy.
74328 26 A Xray bile duct 0.70 0.25 0.25 0.03 0.98 0.98 XXX
endoscopy.
74328 TC A Xray bile duct 0.00 2.99 NA 0.14 3.13 NA XXX
endoscopy.
74329 ................ A X-ray for pancreas 0.70 3.24 NA 0.17 4.11 NA XXX
endoscopy.
74329 26 A X-ray for pancreas 0.70 0.25 0.25 0.03 0.98 0.98 XXX
endoscopy.
74329 TC A X-ray for pancreas 0.00 2.99 NA 0.14 3.13 NA XXX
endoscopy.
74330 ................ A X-ray bile/panc 0.90 3.31 NA 0.18 4.39 NA XXX
endoscopy.
74330 26 A X-ray bile/panc 0.90 0.32 0.32 0.04 1.26 1.26 XXX
endoscopy.
74330 TC A X-ray bile/panc 0.00 2.99 NA 0.14 3.13 NA XXX
endoscopy.
74340 ................ A X-ray guide for GI 0.54 2.68 NA 0.14 3.36 NA XXX
tube.
74340 26 A X-ray guide for GI 0.54 0.19 0.19 0.02 0.75 0.75 XXX
tube.
74340 TC A X-ray guide for GI 0.00 2.49 NA 0.12 2.61 NA XXX
tube.
74350 ................ A X-ray guide, stomach 0.76 3.26 NA 0.17 4.19 NA XXX
tube.
74350 26 A X-ray guide, stomach 0.76 0.27 0.27 0.03 1.06 1.06 XXX
tube.
74350 TC A X-ray guide, stomach 0.00 2.99 NA 0.14 3.13 NA XXX
tube.
74355 ................ A X-ray guide, 0.76 2.75 NA 0.15 3.66 NA XXX
intestinal tube.
74355 26 A X-ray guide, 0.76 0.26 0.26 0.03 1.05 1.05 XXX
intestinal tube.
74355 TC A X-ray guide, 0.00 2.49 NA 0.12 2.61 NA XXX
intestinal tube.
74360 ................ A X-ray guide, GI 0.54 3.18 NA 0.16 3.88 NA XXX
dilation.
74360 26 A X-ray guide, GI 0.54 0.19 0.19 0.02 0.75 0.75 XXX
dilation.
74360 TC A X-ray guide, GI 0.00 2.99 NA 0.14 3.13 NA XXX
dilation.
74363 ................ A X-ray, bile duct 0.88 6.10 NA 0.31 7.29 NA XXX
dilation.
74363 26 A X-ray, bile duct 0.88 0.31 0.31 0.04 1.23 1.23 XXX
dilation.
74363 TC A X-ray, bile duct 0.00 5.79 NA 0.27 6.06 NA XXX
dilation.
74400 ................ A Contrst x-ray, urinary 0.49 1.77 NA 0.11 2.37 NA XXX
tract.
74400 26 A Contrst x-ray, urinary 0.49 0.17 0.17 0.02 0.68 0.68 XXX
tract.
74400 TC A Contrst x-ray, urinary 0.00 1.60 NA 0.09 1.69 NA XXX
tract.
74410 ................ A Contrst x-ray, urinary 0.49 2.02 NA 0.11 2.62 NA XXX
tract.
74410 26 A Contrst x-ray, urinary 0.49 0.17 0.17 0.02 0.68 0.68 XXX
tract.
[[Page 55415]]
74410 TC A Contrst x-ray, urinary 0.00 1.85 NA 0.09 1.94 NA XXX
tract.
74415 ................ A Contrst x-ray, urinary 0.49 2.18 NA 0.12 2.79 NA XXX
tract.
74415 26 A Contrst x-ray, urinary 0.49 0.17 0.17 0.02 0.68 0.68 XXX
tract.
74415 TC A Contrst x-ray, urinary 0.00 2.01 NA 0.10 2.11 NA XXX
tract.
74420 ................ A Contrst x-ray, urinary 0.36 2.62 NA 0.14 3.12 NA XXX
tract.
74420 26 A Contrst x-ray, urinary 0.36 0.13 0.13 0.02 0.51 0.51 XXX
tract.
74420 TC A Contrst x-ray, urinary 0.00 2.49 NA 0.12 2.61 NA XXX
tract.
74425 ................ A Contrst x-ray, urinary 0.36 1.37 NA 0.08 1.81 NA XXX
tract.
74425 26 A Contrst x-ray, urinary 0.36 0.13 0.13 0.02 0.51 0.51 XXX
tract.
74425 TC A Contrst x-ray, urinary 0.00 1.24 NA 0.06 1.30 NA XXX
tract.
74430 ................ A Contrast x-ray, 0.32 1.11 NA 0.07 1.50 NA XXX
bladder.
74430 26 A Contrast x-ray, 0.32 0.11 0.11 0.02 0.45 0.45 XXX
bladder.
74430 TC A Contrast x-ray, 0.00 1.00 NA 0.05 1.05 NA XXX
bladder.
74440 ................ A X-ray, male genital 0.38 1.20 NA 0.07 1.65 NA XXX
tract.
74440 26 A X-ray, male genital 0.38 0.13 0.13 0.02 0.53 0.53 XXX
tract.
74440 TC A X-ray, male genital 0.00 1.07 NA 0.05 1.12 NA XXX
tract.
74445 ................ A X-ray exam of penis... 1.14 1.46 NA 0.10 2.70 NA XXX
74445 26 A X-ray exam of penis... 1.14 0.39 0.39 0.05 1.58 1.58 XXX
74445 TC A X-ray exam of penis... 0.00 1.07 NA 0.05 1.12 NA XXX
74450 ................ A X-ray, urethra/bladder 0.33 1.51 NA 0.09 1.93 NA XXX
74450 26 A X-ray, urethra/bladder 0.33 0.12 0.12 0.02 0.47 0.47 XXX
74450 TC A X-ray, urethra/bladder 0.00 1.39 NA 0.07 1.46 NA XXX
74455 ................ A X-ray, urethra/bladder 0.33 1.61 NA 0.10 2.04 NA XXX
74455 26 A X-ray, urethra/bladder 0.33 0.11 0.11 0.02 0.46 0.46 XXX
74455 TC A X-ray, urethra/bladder 0.00 1.50 NA 0.08 1.58 NA XXX
74470 ................ A X-ray exam of kidney 0.54 1.37 NA 0.08 1.99 NA XXX
lesion.
74470 26 A X-ray exam of kidney 0.54 0.19 0.19 0.02 0.75 0.75 XXX
lesion.
74470 TC A X-ray exam of kidney 0.00 1.18 NA 0.06 1.24 NA XXX
lesion.
74475 ................ A X-ray control, cath 0.54 4.06 NA 0.20 4.80 NA XXX
insert.
74475 26 A X-ray control, cath 0.54 0.19 0.19 0.02 0.75 0.75 XXX
insert.
74475 TC A X-ray control, cath 0.00 3.87 NA 0.18 4.05 NA XXX
insert.
74480 ................ A X-ray control, cath 0.54 4.06 NA 0.20 4.80 NA XXX
insert.
74480 26 A X-ray control, cath 0.54 0.19 0.19 0.02 0.75 0.75 XXX
insert.
74480 TC A X-ray control, cath 0.00 3.87 NA 0.18 4.05 NA XXX
insert.
74485 ................ A X-ray guide, GU 0.54 3.18 NA 0.17 3.89 NA XXX
dilation.
74485 26 A X-ray guide, GU 0.54 0.19 0.19 0.03 0.76 0.76 XXX
dilation.
74485 TC A X-ray guide, GU 0.00 2.99 NA 0.14 3.13 NA XXX
dilation.
74710 ................ A X-ray measurement of 0.34 1.12 NA 0.07 1.53 NA XXX
pelvis.
74710 26 A X-ray measurement of 0.34 0.12 0.12 0.02 0.48 0.48 XXX
pelvis.
74710 TC A X-ray measurement of 0.00 1.00 NA 0.05 1.05 NA XXX
pelvis.
74740 ................ A X-ray, female genital 0.38 1.37 NA 0.08 1.83 NA XXX
tract.
74740 26 A X-ray, female genital 0.38 0.13 0.13 0.02 0.53 0.53 XXX
tract.
74740 TC A X-ray, female genital 0.00 1.24 NA 0.06 1.30 NA XXX
tract.
74742 ................ A X-ray, fallopian tube. 0.61 3.23 NA 0.16 4.00 NA XXX
74742 26 A X-ray, fallopian tube. 0.61 0.24 0.24 0.02 0.87 0.87 XXX
74742 TC A X-ray, fallopian tube. 0.00 2.99 NA 0.14 3.13 NA XXX
74775 ................ A X-ray exam of perineum 0.62 1.62 NA 0.10 2.34 NA XXX
74775 26 A X-ray exam of perineum 0.62 0.23 0.23 0.03 0.88 0.88 XXX
74775 TC A X-ray exam of perineum 0.00 1.39 NA 0.07 1.46 NA XXX
75552 ................ A Heart mri for morph w/ 1.60 11.20 NA 0.56 13.36 NA XXX
o dye.
75552 26 A Heart mri for morph w/ 1.60 0.56 0.56 0.07 2.23 2.23 XXX
o dye.
75552 TC A Heart mri for morph w/ 0.00 10.64 NA 0.49 11.13 NA XXX
o dye.
75553 ................ A Heart mri for morph w/ 2.00 11.35 NA 0.58 13.93 NA XXX
dye.
75553 26 A Heart mri for morph w/ 2.00 0.71 0.71 0.09 2.80 2.80 XXX
dye.
75553 TC A Heart mri for morph w/ 0.00 10.64 NA 0.49 11.13 NA XXX
dye.
75554 ................ A Cardiac MRI/function.. 1.83 11.33 NA 0.56 13.72 NA XXX
75554 26 A Cardiac MRI/function.. 1.83 0.69 0.69 0.07 2.59 2.59 XXX
75554 TC A Cardiac MRI/function.. 0.00 10.64 NA 0.49 11.13 NA XXX
75555 ................ A Cardiac MRI/limited 1.74 11.32 NA 0.56 13.62 NA XXX
study.
75555 26 A Cardiac MRI/limited 1.74 0.68 0.68 0.07 2.49 2.49 XXX
study.
75555 TC A Cardiac MRI/limited 0.00 10.64 NA 0.49 11.13 NA XXX
study.
75556 ................ N Cardiac MRI/flow 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mapping.
75600 ................ A Contrast x-ray exam of 0.49 12.16 NA 0.56 13.21 NA XXX
aorta.
75600 26 A Contrast x-ray exam of 0.49 0.20 0.20 0.02 0.71 0.71 XXX
aorta.
75600 TC A Contrast x-ray exam of 0.00 11.96 NA 0.54 12.50 NA XXX
aorta.
75605 ................ A Contrast x-ray exam of 1.14 12.39 NA 0.59 14.12 NA XXX
aorta.
75605 26 A Contrast x-ray exam of 1.14 0.43 0.43 0.05 1.62 1.62 XXX
aorta.
75605 TC A Contrast x-ray exam of 0.00 11.96 NA 0.54 12.50 NA XXX
aorta.
75625 ................ A Contrast x-ray exam of 1.14 12.37 NA 0.59 14.10 NA XXX
aorta.
75625 26 A Contrast x-ray exam of 1.14 0.41 0.41 0.05 1.60 1.60 XXX
aorta.
75625 TC A Contrast x-ray exam of 0.00 11.96 NA 0.54 12.50 NA XXX
aorta.
75630 ................ A X-ray aorta, leg 1.79 13.14 NA 0.65 15.58 NA XXX
arteries.
75630 26 A X-ray aorta, leg 1.79 0.67 0.67 0.08 2.54 2.54 XXX
arteries.
[[Page 55416]]
75630 TC A X-ray aorta, leg 0.00 12.47 NA 0.57 13.04 NA XXX
arteries.
75635 ................ A Ct angio abdominal 2.40 9.02 NA 0.41 11.83 NA XXX
arteries.
75635 26 A Ct angio abdominal 2.40 0.96 0.96 0.09 3.45 3.45 XXX
arteries.
75635 TC A Ct angio abdominal 0.00 8.06 NA 0.32 8.38 NA XXX
arteries.
75650 ................ A Artery x-rays, head & 1.49 12.49 NA 0.61 14.59 NA XXX
neck.
75650 26 A Artery x-rays, head & 1.49 0.53 0.53 0.07 2.09 2.09 XXX
neck.
75650 TC A Artery x-rays, head & 0.00 11.96 NA 0.54 12.50 NA XXX
neck.
75658 ................ A Artery x-rays, arm.... 1.31 12.44 NA 0.60 14.35 NA XXX
75658 26 A Artery x-rays, arm.... 1.31 0.48 0.48 0.06 1.85 1.85 XXX
75658 TC A Artery x-rays, arm.... 0.00 11.96 NA 0.54 12.50 NA XXX
75660 ................ A Artery x-rays, head & 1.31 12.44 NA 0.60 14.35 NA XXX
neck.
75660 26 A Artery x-rays, head & 1.31 0.48 0.48 0.06 1.85 1.85 XXX
neck.
75660 TC A Artery x-rays, head & 0.00 11.96 NA 0.54 12.50 NA XXX
neck.
75662 ................ A Artery x-rays, head & 1.66 12.60 NA 0.62 14.88 NA XXX
neck.
75662 26 A Artery x-rays, head & 1.66 0.64 0.64 0.08 2.38 2.38 XXX
neck.
75662 TC A Artery x-rays, head & 0.00 11.96 NA 0.54 12.50 NA XXX
neck.
75665 ................ A Artery x-rays, head & 1.31 12.43 NA 0.61 14.35 NA XXX
neck.
75665 26 A Artery x-rays, head & 1.31 0.47 0.47 0.07 1.85 1.85 XXX
neck.
75665 TC A Artery x-rays, head & 0.00 11.96 NA 0.54 12.50 NA XXX
neck.
75671 ................ A Artery x-rays, head & 1.66 12.55 NA 0.62 14.83 NA XXX
neck.
75671 26 A Artery x-rays, head & 1.66 0.59 0.59 0.08 2.33 2.33 XXX
neck.
75671 TC A Artery x-rays, head & 0.00 11.96 NA 0.54 12.50 NA XXX
neck.
75676 ................ A Artery x-rays, neck... 1.31 12.43 NA 0.61 14.35 NA XXX
75676 26 A Artery x-rays, neck... 1.31 0.47 0.47 0.07 1.85 1.85 XXX
75676 TC A Artery x-rays, neck... 0.00 11.96 NA 0.54 12.50 NA XXX
75680 ................ A Artery x-rays, neck... 1.66 12.55 NA 0.62 14.83 NA XXX
75680 26 A Artery x-rays, neck... 1.66 0.59 0.59 0.08 2.33 2.33 XXX
75680 TC A Artery x-rays, neck... 0.00 11.96 NA 0.54 12.50 NA XXX
75685 ................ A Artery x-rays, spine.. 1.31 12.43 NA 0.60 14.34 NA XXX
75685 26 A Artery x-rays, spine.. 1.31 0.47 0.47 0.06 1.84 1.84 XXX
75685 TC A Artery x-rays, spine.. 0.00 11.96 NA 0.54 12.50 NA XXX
75705 ................ A Artery x-rays, spine.. 2.18 12.75 NA 0.65 15.58 NA XXX
75705 26 A Artery x-rays, spine.. 2.18 0.79 0.79 0.11 3.08 3.08 XXX
75705 TC A Artery x-rays, spine.. 0.00 11.96 NA 0.54 12.50 NA XXX
75710 ................ A Artery x-rays, arm/leg 1.14 12.38 NA 0.60 14.12 NA XXX
75710 26 A Artery x-rays, arm/leg 1.14 0.42 0.42 0.06 1.62 1.62 XXX
75710 TC A Artery x-rays, arm/leg 0.00 11.96 NA 0.54 12.50 NA XXX
75716 ................ A Artery x-rays, arms/ 1.31 12.43 NA 0.60 14.34 NA XXX
legs.
75716 26 A Artery x-rays, arms/ 1.31 0.47 0.47 0.06 1.84 1.84 XXX
legs.
75716 TC A Artery x-rays, arms/ 0.00 11.96 NA 0.54 12.50 NA XXX
legs.
75722 ................ A Artery x-rays, kidney. 1.14 12.39 NA 0.59 14.12 NA XXX
75722 26 A Artery x-rays, kidney. 1.14 0.43 0.43 0.05 1.62 1.62 XXX
75722 TC A Artery x-rays, kidney. 0.00 11.96 NA 0.54 12.50 NA XXX
75724 ................ A Artery x-rays, kidneys 1.49 12.56 NA 0.59 14.64 NA XXX
75724 26 A Artery x-rays, kidneys 1.49 0.60 0.60 0.05 2.14 2.14 XXX
75724 TC A Artery x-rays, kidneys 0.00 11.96 NA 0.54 12.50 NA XXX
75726 ................ A Artery x-rays, abdomen 1.14 12.36 NA 0.59 14.09 NA XXX
75726 26 A Artery x-rays, abdomen 1.14 0.40 0.40 0.05 1.59 1.59 XXX
75726 TC A Artery x-rays, abdomen 0.00 11.96 NA 0.54 12.50 NA XXX
75731 ................ A Artery x-rays, adrenal 1.14 12.36 NA 0.59 14.09 NA XXX
gland.
75731 26 A Artery x-rays, adrenal 1.14 0.40 0.40 0.05 1.59 1.59 XXX
gland.
75731 TC A Artery x-rays, adrenal 0.00 11.96 NA 0.54 12.50 NA XXX
gland.
75733 ................ A Artery x-rays, 1.31 12.43 NA 0.60 14.34 NA XXX
adrenals.
75733 26 A Artery x-rays, 1.31 0.47 0.47 0.06 1.84 1.84 XXX
adrenals.
75733 TC A Artery x-rays, 0.00 11.96 NA 0.54 12.50 NA XXX
adrenals.
75736 ................ A Artery x-rays, pelvis. 1.14 12.37 NA 0.59 14.10 NA XXX
75736 26 A Artery x-rays, pelvis. 1.14 0.41 0.41 0.05 1.60 1.60 XXX
75736 TC A Artery x-rays, pelvis. 0.00 11.96 NA 0.54 12.50 NA XXX
75741 ................ A Artery x-rays, lung... 1.31 12.42 NA 0.60 14.33 NA XXX
75741 26 A Artery x-rays, lung... 1.31 0.46 0.46 0.06 1.83 1.83 XXX
75741 TC A Artery x-rays, lung... 0.00 11.96 NA 0.54 12.50 NA XXX
75743 ................ A Artery x-rays, lungs.. 1.66 12.54 NA 0.61 14.81 NA XXX
75743 26 A Artery x-rays, lungs.. 1.66 0.58 0.58 0.07 2.31 2.31 XXX
75743 TC A Artery x-rays, lungs.. 0.00 11.96 NA 0.54 12.50 NA XXX
75746 ................ A Artery x-rays, lung... 1.14 12.36 NA 0.59 14.09 NA XXX
75746 26 A Artery x-rays, lung... 1.14 0.40 0.40 0.05 1.59 1.59 XXX
75746 TC A Artery x-rays, lung... 0.00 11.96 NA 0.54 12.50 NA XXX
75756 ................ A Artery x-rays, chest.. 1.14 12.44 NA 0.58 14.16 NA XXX
75756 26 A Artery x-rays, chest.. 1.14 0.48 0.48 0.04 1.66 1.66 XXX
75756 TC A Artery x-rays, chest.. 0.00 11.96 NA 0.54 12.50 NA XXX
75774 ................ A Artery x-ray, each 0.36 12.09 NA 0.56 13.01 NA ZZZ
vessel.
75774 26 A Artery x-ray, each 0.36 0.13 0.13 0.02 0.51 0.51 ZZZ
vessel.
75774 TC A Artery x-ray, each 0.00 11.96 NA 0.54 12.50 NA ZZZ
vessel.
[[Page 55417]]
75790 ................ A Visualize A-V shunt... 1.84 1.93 NA 0.16 3.93 NA XXX
75790 26 A Visualize A-V shunt... 1.84 0.64 0.64 0.09 2.57 2.57 XXX
75790 TC A Visualize A-V shunt... 0.00 1.29 NA 0.07 1.36 NA XXX
75801 ................ A Lymph vessel x-ray, 0.81 5.42 NA 0.29 6.52 NA XXX
arm/leg.
75801 26 A Lymph vessel x-ray, 0.81 0.28 0.28 0.05 1.14 1.14 XXX
arm/leg.
75801 TC A Lymph vessel x-ray, 0.00 5.14 NA 0.24 5.38 NA XXX
arm/leg.
75803 ................ A Lymph vessel x- 1.17 5.55 NA 0.29 7.01 NA XXX
ray,arms/legs.
75803 26 A Lymph vessel x- 1.17 0.41 0.41 0.05 1.63 1.63 XXX
ray,arms/legs.
75803 TC A Lymph vessel x- 0.00 5.14 NA 0.24 5.38 NA XXX
ray,arms/legs.
75805 ................ A Lymph vessel x-ray, 0.81 6.08 NA 0.31 7.20 NA XXX
trunk.
75805 26 A Lymph vessel x-ray, 0.81 0.29 0.29 0.04 1.14 1.14 XXX
trunk.
75805 TC A Lymph vessel x-ray, 0.00 5.79 NA 0.27 6.06 NA XXX
trunk.
75807 ................ A Lymph vessel x-ray, 1.17 6.20 NA 0.32 7.69 NA XXX
trunk.
75807 26 A Lymph vessel x-ray, 1.17 0.41 0.41 0.05 1.63 1.63 XXX
trunk.
75807 TC A Lymph vessel x-ray, 0.00 5.79 NA 0.27 6.06 NA XXX
trunk.
75809 ................ A Nonvascular shunt, x- 0.47 0.91 NA 0.06 1.44 NA XXX
ray.
75809 26 A Nonvascular shunt, x- 0.47 0.17 0.17 0.02 0.66 0.66 XXX
ray.
75809 TC A Nonvascular shunt, x- 0.00 0.74 NA 0.04 0.78 NA XXX
ray.
75810 ................ A Vein x-ray, spleen/ 1.14 12.36 NA 0.60 14.10 NA XXX
liver.
75810 26 A Vein x-ray, spleen/ 1.14 0.40 0.40 0.06 1.60 1.60 XXX
liver.
75810 TC A Vein x-ray, spleen/ 0.00 11.96 NA 0.54 12.50 NA XXX
liver.
75820 ................ A Vein x-ray, arm/leg... 0.70 1.15 NA 0.08 1.93 NA XXX
75820 26 A Vein x-ray, arm/leg... 0.70 0.25 0.25 0.03 0.98 0.98 XXX
75820 TC A Vein x-ray, arm/leg... 0.00 0.90 NA 0.05 0.95 NA XXX
75822 ................ A Vein x-ray, arms/legs. 1.06 1.77 NA 0.12 2.95 NA XXX
75822 26 A Vein x-ray, arms/legs. 1.06 0.37 0.37 0.05 1.48 1.48 XXX
75822 TC A Vein x-ray, arms/legs. 0.00 1.40 NA 0.07 1.47 NA XXX
75825 ................ A Vein x-ray, trunk..... 1.14 12.36 NA 0.60 14.10 NA XXX
75825 26 A Vein x-ray, trunk..... 1.14 0.40 0.40 0.06 1.60 1.60 XXX
75825 TC A Vein x-ray, trunk..... 0.00 11.96 NA 0.54 12.50 NA XXX
75827 ................ A Vein x-ray, chest..... 1.14 12.36 NA 0.59 14.09 NA XXX
75827 26 A Vein x-ray, chest..... 1.14 0.40 0.40 0.05 1.59 1.59 XXX
75827 TC A Vein x-ray, chest..... 0.00 11.96 NA 0.54 12.50 NA XXX
75831 ................ A Vein x-ray, kidney.... 1.14 12.36 NA 0.59 14.09 NA XXX
75831 26 A Vein x-ray, kidney.... 1.14 0.40 0.40 0.05 1.59 1.59 XXX
75831 TC A Vein x-ray, kidney.... 0.00 11.96 NA 0.54 12.50 NA XXX
75833 ................ A Vein x-ray, kidneys... 1.49 12.49 NA 0.61 14.59 NA XXX
75833 26 A Vein x-ray, kidneys... 1.49 0.53 0.53 0.07 2.09 2.09 XXX
75833 TC A Vein x-ray, kidneys... 0.00 11.96 NA 0.54 12.50 NA XXX
75840 ................ A Vein x-ray, adrenal 1.14 12.38 NA 0.61 14.13 NA XXX
gland.
75840 26 A Vein x-ray, adrenal 1.14 0.42 0.42 0.07 1.63 1.63 XXX
gland.
75840 TC A Vein x-ray, adrenal 0.00 11.96 NA 0.54 12.50 NA XXX
gland.
75842 ................ A Vein x-ray, adrenal 1.49 12.48 NA 0.61 14.58 NA XXX
glands.
75842 26 A Vein x-ray, adrenal 1.49 0.52 0.52 0.07 2.08 2.08 XXX
glands.
75842 TC A Vein x-ray, adrenal 0.00 11.96 NA 0.54 12.50 NA XXX
glands.
75860 ................ A Vein x-ray, neck...... 1.14 12.39 NA 0.60 14.13 NA XXX
75860 26 A Vein x-ray, neck...... 1.14 0.43 0.43 0.06 1.63 1.63 XXX
75860 TC A Vein x-ray, neck...... 0.00 11.96 NA 0.54 12.50 NA XXX
75870 ................ A Vein x-ray, skull..... 1.14 12.38 NA 0.60 14.12 NA XXX
75870 26 A Vein x-ray, skull..... 1.14 0.42 0.42 0.06 1.62 1.62 XXX
75870 TC A Vein x-ray, skull..... 0.00 11.96 NA 0.54 12.50 NA XXX
75872 ................ A Vein x-ray, skull..... 1.14 12.36 NA 0.59 14.09 NA XXX
75872 26 A Vein x-ray, skull..... 1.14 0.40 0.40 0.05 1.59 1.59 XXX
75872 TC A Vein x-ray, skull..... 0.00 11.96 NA 0.54 12.50 NA XXX
75880 ................ A Vein x-ray, eye socket 0.70 1.17 NA 0.08 1.95 NA XXX
75880 26 A Vein x-ray, eye socket 0.70 0.27 0.27 0.03 1.00 1.00 XXX
75880 TC A Vein x-ray, eye socket 0.00 0.90 NA 0.05 0.95 NA XXX
75885 ................ A Vein x-ray, liver..... 1.44 12.46 NA 0.60 14.50 NA XXX
75885 26 A Vein x-ray, liver..... 1.44 0.50 0.50 0.06 2.00 2.00 XXX
75885 TC A Vein x-ray, liver..... 0.00 11.96 NA 0.54 12.50 NA XXX
75887 ................ A Vein x-ray, liver..... 1.44 12.46 NA 0.60 14.50 NA XXX
75887 26 A Vein x-ray, liver..... 1.44 0.50 0.50 0.06 2.00 2.00 XXX
75887 TC A Vein x-ray, liver..... 0.00 11.96 NA 0.54 12.50 NA XXX
75889 ................ A Vein x-ray, liver..... 1.14 12.36 NA 0.59 14.09 NA XXX
75889 26 A Vein x-ray, liver..... 1.14 0.40 0.40 0.05 1.59 1.59 XXX
75889 TC A Vein x-ray, liver..... 0.00 11.96 NA 0.54 12.50 NA XXX
75891 ................ A Vein x-ray, liver..... 1.14 12.36 NA 0.59 14.09 NA XXX
75891 26 A Vein x-ray, liver..... 1.14 0.40 0.40 0.05 1.59 1.59 XXX
75891 TC A Vein x-ray, liver..... 0.00 11.96 NA 0.54 12.50 NA XXX
75893 ................ A Venous sampling by 0.54 12.15 NA 0.56 13.25 NA XXX
catheter.
75893 26 A Venous sampling by 0.54 0.19 0.19 0.02 0.75 0.75 XXX
catheter.
75893 TC A Venous sampling by 0.00 11.96 NA 0.54 12.50 NA XXX
catheter.
75894 ................ A X-rays, transcath 1.31 23.38 NA 1.12 25.81 NA XXX
therapy.
[[Page 55418]]
75894 26 A X-rays, transcath 1.31 0.46 0.46 0.07 1.84 1.84 XXX
therapy.
75894 TC A X-rays, transcath 0.00 22.92 NA 1.05 23.97 NA XXX
therapy.
75896 ................ A X-rays, transcath 1.31 20.42 NA 0.97 22.70 NA XXX
therapy.
75896 26 A X-rays, transcath 1.31 0.48 0.48 0.06 1.85 1.85 XXX
therapy.
75896 TC A X-rays, transcath 0.00 19.94 NA 0.91 20.85 NA XXX
therapy.
75898 ................ A Follow-up angiography. 1.65 1.60 NA 0.12 3.37 NA XXX
75898 26 A Follow-up angiography. 1.65 0.60 0.60 0.07 2.32 2.32 XXX
75898 TC A Follow-up angiography. 0.00 1.00 NA 0.05 1.05 NA XXX
75900 ................ A Arterial catheter 0.49 20.09 NA 0.94 21.52 NA XXX
exchange.
75900 26 A Arterial catheter 0.49 0.17 0.17 0.02 0.68 0.68 XXX
exchange.
75900 TC A Arterial catheter 0.00 19.92 NA 0.92 20.84 NA XXX
exchange.
75940 ................ A X-ray placement, vein 0.54 12.15 NA 0.57 13.26 NA XXX
filter.
75940 26 A X-ray placement, vein 0.54 0.19 0.19 0.03 0.76 0.76 XXX
filter.
75940 TC A X-ray placement, vein 0.00 11.96 NA 0.54 12.50 NA XXX
filter.
75945 ................ A Intravascular us...... 0.40 4.48 NA 0.23 5.11 NA XXX
75945 26 A Intravascular us...... 0.40 0.15 0.15 0.03 0.58 0.58 XXX
75945 TC A Intravascular us...... 0.00 4.33 NA 0.20 4.53 NA XXX
75946 ................ A Intravascular us add- 0.40 2.32 NA 0.14 2.86 NA ZZZ
on.
75946 26 A Intravascular us add- 0.40 0.14 0.14 0.03 0.57 0.57 ZZZ
on.
75946 TC A Intravascular us add- 0.00 2.18 NA 0.11 2.29 NA ZZZ
on.
75952 ................ C Endovasc repair abdom +0.00 0.00 0.00 0.00 0.00 0.00 XXX
aorta.
75952 26 A Endovasc repair abdom 4.50 1.80 1.80 0.68 6.98 6.98 XXX
aorta.
75952 TC C Endovasc repair abdom 0.00 0.00 0.00 0.00 0.00 0.00 XXX
aorta.
75953 ................ C Abdom aneurysm endovas +0.00 0.00 0.00 0.00 0.00 0.00 XXX
rpr.
75953 26 A Abdom aneurysm endovas 1.36 0.54 0.54 0.68 2.58 2.58 XXX
rpr.
75953 TC C Abdom aneurysm endovas 0.00 0.00 0.00 0.00 0.00 0.00 XXX
rpr.
75960 ................ A Transcatheter intro, 0.82 14.45 NA 0.68 15.95 NA XXX
stent.
75960 26 A Transcatheter intro, 0.82 0.30 0.30 0.04 1.16 1.16 XXX
stent.
75960 TC A Transcatheter intro, 0.00 14.15 NA 0.64 14.79 NA XXX
stent.
75961 ................ A Retrieval, broken 4.25 11.46 NA 0.64 16.35 NA XXX
catheter.
75961 26 A Retrieval, broken 4.25 1.49 1.49 0.18 5.92 5.92 XXX
catheter.
75961 TC A Retrieval, broken 0.00 9.97 NA 0.46 10.43 NA XXX
catheter.
75962 ................ A Repair arterial 0.54 15.15 NA 0.72 16.41 NA XXX
blockage.
75962 26 A Repair arterial 0.54 0.20 0.20 0.03 0.77 0.77 XXX
blockage.
75962 TC A Repair arterial 0.00 14.95 NA 0.69 15.64 NA XXX
blockage.
75964 ................ A Repair artery 0.36 8.10 NA 0.38 8.84 NA ZZZ
blockage, each.
75964 26 A Repair artery 0.36 0.13 0.13 0.02 0.51 0.51 ZZZ
blockage, each.
75964 TC A Repair artery 0.00 7.97 NA 0.36 8.33 NA ZZZ
blockage, each.
75966 ................ A Repair arterial 1.31 15.45 NA 0.75 17.51 NA XXX
blockage.
75966 26 A Repair arterial 1.31 0.50 0.50 0.06 1.87 1.87 XXX
blockage.
75966 TC A Repair arterial 0.00 14.95 NA 0.69 15.64 NA XXX
blockage.
75968 ................ A Repair artery 0.36 8.11 NA 0.37 8.84 NA ZZZ
blockage, each.
75968 26 A Repair artery 0.36 0.14 0.14 0.01 0.51 0.51 ZZZ
blockage, each.
75968 TC A Repair artery 0.00 7.97 NA 0.36 8.33 NA ZZZ
blockage, each.
75970 ................ A Vascular biopsy....... 0.83 11.26 NA 0.54 12.63 NA XXX
75970 26 A Vascular biopsy....... 0.83 0.30 0.30 0.04 1.17 1.17 XXX
75970 TC A Vascular biopsy....... 0.00 10.96 NA 0.50 11.46 NA XXX
75978 ................ A Repair venous blockage 0.54 15.14 NA 0.71 16.39 NA XXX
75978 26 A Repair venous blockage 0.54 0.19 0.19 0.02 0.75 0.75 XXX
75978 TC A Repair venous blockage 0.00 14.95 NA 0.69 15.64 NA XXX
75980 ................ A Contrast xray exam 1.44 5.64 NA 0.30 7.38 NA XXX
bile duct.
75980 26 A Contrast xray exam 1.44 0.50 0.50 0.06 2.00 2.00 XXX
bile duct.
75980 TC A Contrast xray exam 0.00 5.14 NA 0.24 5.38 NA XXX
bile duct.
75982 ................ A Contrast xray exam 1.44 6.29 NA 0.33 8.06 NA XXX
bile duct.
75982 26 A Contrast xray exam 1.44 0.50 0.50 0.06 2.00 2.00 XXX
bile duct.
75982 TC A Contrast xray exam 0.00 5.79 NA 0.27 6.06 NA XXX
bile duct.
75984 ................ A Xray control catheter 0.72 2.10 NA 0.12 2.94 NA XXX
change.
75984 26 A Xray control catheter 0.72 0.25 0.25 0.03 1.00 1.00 XXX
change.
75984 TC A Xray control catheter 0.00 1.85 NA 0.09 1.94 NA XXX
change.
75989 ................ A Abscess drainage under 1.19 3.41 NA 0.19 4.79 NA XXX
x-ray.
75989 26 A Abscess drainage under 1.19 0.42 0.42 0.05 1.66 1.66 XXX
x-ray.
75989 TC A Abscess drainage under 0.00 2.99 NA 0.14 3.13 NA XXX
x-ray.
75992 ................ A Atherectomy, x-ray 0.54 15.15 NA 0.71 16.40 NA XXX
exam.
75992 26 A Atherectomy, x-ray 0.54 0.20 0.20 0.02 0.76 0.76 XXX
exam.
75992 TC A Atherectomy, x-ray 0.00 14.95 NA 0.69 15.64 NA XXX
exam.
75993 ................ A Atherectomy, x-ray 0.36 8.11 NA 0.37 8.84 NA ZZZ
exam.
75993 26 A Atherectomy, x-ray 0.36 0.14 0.14 0.01 0.51 0.51 ZZZ
exam.
75993 TC A Atherectomy, x-ray 0.00 7.97 NA 0.36 8.33 NA ZZZ
exam.
75994 ................ A Atherectomy, x-ray 1.31 15.45 NA 0.75 17.51 NA XXX
exam.
75994 26 A Atherectomy, x-ray 1.31 0.50 0.50 0.06 1.87 1.87 XXX
exam.
75994 TC A Atherectomy, x-ray 0.00 14.95 NA 0.69 15.64 NA XXX
exam.
75995 ................ A Atherectomy, x-ray 1.31 15.42 NA 0.75 17.48 NA XXX
exam.
75995 26 A Atherectomy, x-ray 1.31 0.47 0.47 0.06 1.84 1.84 XXX
exam.
[[Page 55419]]
75995 TC A Atherectomy, x-ray 0.00 14.95 NA 0.69 15.64 NA XXX
exam.
75996 ................ A Atherectomy, x-ray 0.36 8.09 NA 0.37 8.82 NA ZZZ
exam.
75996 26 A Atherectomy, x-ray 0.36 0.12 0.12 0.01 0.49 0.49 ZZZ
exam.
75996 TC A Atherectomy, x-ray 0.00 7.97 NA 0.36 8.33 NA ZZZ
exam.
76000 ................ A Fluoroscope 0.17 1.31 NA 0.07 1.55 NA XXX
examination.
76000 26 A Fluoroscope 0.17 0.07 0.07 0.01 0.25 0.25 XXX
examination.
76000 TC A Fluoroscope 0.00 1.24 NA 0.06 1.30 NA XXX
examination.
76001 ................ A Fluoroscope exam, 0.67 2.73 NA 0.15 3.55 NA XXX
extensive.
76001 26 A Fluoroscope exam, 0.67 0.24 0.24 0.03 0.94 0.94 XXX
extensive.
76001 TC A Fluoroscope exam, 0.00 2.49 NA 0.12 2.61 NA XXX
extensive.
76003 ................ A Needle localization by 0.54 1.43 NA 0.09 2.06 NA XXX
x-ray.
76003 26 A Needle localization by 0.54 0.19 0.19 0.03 0.76 0.76 XXX
x-ray.
76003 TC A Needle localization by 0.00 1.24 NA 0.06 1.30 NA XXX
x-ray.
76005 ................ A Fluoroguide for spine 0.60 1.41 NA 0.09 2.10 NA XXX
inject.
76005 26 A Fluoroguide for spine 0.60 0.17 0.17 0.03 0.80 0.80 XXX
inject.
76005 TC A Fluoroguide for spine 0.00 1.24 NA 0.06 1.30 NA XXX
inject.
76006 ................ A X-ray stress view..... 0.41 0.20 0.20 0.04 0.65 0.65 XXX
76010 ................ A X-ray, nose to rectum. 0.18 0.56 NA 0.03 0.77 NA XXX
76010 26 A X-ray, nose to rectum. 0.18 0.06 0.06 0.01 0.25 0.25 XXX
76010 TC A X-ray, nose to rectum. 0.00 0.50 NA 0.02 0.52 NA XXX
76012 ................ C Percut vertebroplasty +0.00 0.00 0.00 0.00 0.00 0.00 XXX
fluor.
76012 26 A Percut vertebroplasty 1.31 0.52 0.52 0.23 2.06 2.06 XXX
fluor.
76012 TC C Percut vertebroplasty 0.00 0.00 0.00 0.00 0.00 0.00 XXX
fluor.
76013 ................ C Percut vertebroplasty, +0.00 0.00 0.00 0.00 0.00 0.00 XXX
ct.
76013 26 A Percut vertebroplasty, 1.38 0.55 0.55 0.48 2.41 2.41 XXX
ct.
76013 TC C Percut vertebroplasty, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ct.
76020 ................ A X-rays for bone age... 0.19 0.57 NA 0.03 0.79 NA XXX
76020 26 A X-rays for bone age... 0.19 0.07 0.07 0.01 0.27 0.27 XXX
76020 TC A X-rays for bone age... 0.00 0.50 NA 0.02 0.52 NA XXX
76040 ................ A X-rays, bone 0.27 0.84 NA 0.07 1.18 NA XXX
evaluation.
76040 26 A X-rays, bone 0.27 0.10 0.10 0.03 0.40 0.40 XXX
evaluation.
76040 TC A X-rays, bone 0.00 0.74 NA 0.04 0.78 NA XXX
evaluation.
76061 ................ A X-rays, bone survey... 0.45 1.11 NA 0.07 1.63 NA XXX
76061 26 A X-rays, bone survey... 0.45 0.16 0.16 0.02 0.63 0.63 XXX
76061 TC A X-rays, bone survey... 0.00 0.95 NA 0.05 1.00 NA XXX
76062 ................ A X-rays, bone survey... 0.54 1.56 NA 0.09 2.19 NA XXX
76062 26 A X-rays, bone survey... 0.54 0.19 0.19 0.02 0.75 0.75 XXX
76062 TC A X-rays, bone survey... 0.00 1.37 NA 0.07 1.44 NA XXX
76065 ................ A X-rays, bone 0.70 0.95 NA 0.05 1.70 NA XXX
evaluation.
76065 26 A X-rays, bone 0.70 0.25 0.25 0.01 0.96 0.96 XXX
evaluation.
76065 TC A X-rays, bone 0.00 0.70 NA 0.04 0.74 NA XXX
evaluation.
76066 ................ A Joint survey, single 0.31 1.17 NA 0.07 1.55 NA XXX
view.
76066 26 A Joint survey, single 0.31 0.11 0.11 0.02 0.44 0.44 XXX
view.
76066 TC A Joint survey, single 0.00 1.06 NA 0.05 1.11 NA XXX
view.
76070 ................ I CT scan, bone density +0.25 2.90 NA 0.14 3.29 NA XXX
study.
76070 26 I CT scan, bone density +0.25 0.10 0.10 0.01 0.36 0.36 XXX
study.
76070 TC I CT scan, bone density +0.00 2.80 NA 0.13 2.93 NA XXX
study.
76075 ................ A Us exam, abdom, 0.30 3.05 NA 0.15 3.50 NA XXX
limited.
76075 26 A Us exam, abdom, 0.30 0.11 0.11 0.01 0.42 0.42 XXX
limited.
76075 TC A Us exam, abdom, 0.00 2.94 NA 0.14 3.08 NA XXX
limited.
76076 ................ A Dual energy x-ray 0.22 0.80 NA 0.05 1.07 NA XXX
study.
76076 26 A Dual energy x-ray 0.22 0.08 0.08 0.01 0.31 0.31 XXX
study.
76076 TC A Dual energy x-ray 0.00 0.72 NA 0.04 0.76 NA XXX
study.
76078 ................ A Radiographic 0.20 0.80 NA 0.05 1.05 NA XXX
absorptiometry.
76078 26 A Radiographic 0.20 0.08 0.08 0.01 0.29 0.29 XXX
absorptiometry.
76078 TC A Radiographic 0.00 0.72 NA 0.04 0.76 NA XXX
absorptiometry.
76080 ................ A X-ray exam of fistula. 0.54 1.19 NA 0.07 1.80 NA XXX
76080 26 A X-ray exam of fistula. 0.54 0.19 0.19 0.02 0.75 0.75 XXX
76080 TC A X-ray exam of fistula. 0.00 1.00 NA 0.05 1.05 NA XXX
76085 ................ A Computer mammogram add- 0.06 0.31 NA 0.02 0.39 NA ZZZ
on.
76085 26 A Computer mammogram add- 0.06 0.02 0.02 0.01 0.09 0.09 ZZZ
on.
76085 TC A Computer mammogram add- 0.00 0.29 NA 0.01 0.30 NA XXX
on.
76086 ................ A X-ray of mammary duct. 0.36 2.62 NA 0.14 3.12 NA XXX
76086 26 A X-ray of mammary duct. 0.36 0.13 0.13 0.02 0.51 0.51 XXX
76086 TC A X-ray of mammary duct. 0.00 2.49 NA 0.12 2.61 NA XXX
76088 ................ A X-ray of mammary ducts 0.45 3.64 NA 0.18 4.27 NA XXX
76088 26 A X-ray of mammary ducts 0.45 0.16 0.16 0.02 0.63 0.63 XXX
76088 TC A X-ray of mammary ducts 0.00 3.48 NA 0.16 3.64 NA XXX
76090 ................ A Mammogram, one breast. 0.70 1.25 NA 0.08 2.03 NA XXX
76090 26 A Mammogram, one breast. 0.70 0.25 0.25 0.03 0.98 0.98 XXX
76090 TC A Mammogram, one breast. 0.00 1.00 NA 0.05 1.05 NA XXX
76091 ................ A Mammogram, both 0.87 1.54 NA 0.09 2.50 NA XXX
breasts.
76091 26 A Mammogram, both 0.87 0.30 0.30 0.03 1.20 1.20 XXX
breasts.
[[Page 55420]]
76091 TC A Mammogram, both 0.00 1.24 NA 0.06 1.30 NA XXX
breasts.
76092 ................ A Mammogram, screening.. 0.70 1.44 NA 0.09 2.23 NA XXX
76092 26 A Mammogram, screening.. 0.70 0.25 0.25 0.03 0.98 0.98 XXX
76092 TC A Mammogram, screening.. 0.00 1.19 NA 0.06 1.25 NA XXX
76093 ................ A Magnetic image, breast 1.63 17.31 NA 0.83 19.77 NA XXX
76093 26 A Magnetic image, breast 1.63 0.57 0.57 0.07 2.27 2.27 XXX
76093 TC A Magnetic image, breast 0.00 16.74 NA 0.76 17.50 NA XXX
76094 ................ A Magnetic image, both 1.63 23.28 NA 1.10 26.01 NA XXX
breasts.
76094 26 A Magnetic image, both 1.63 0.57 0.57 0.07 2.27 2.27 XXX
breasts.
76094 TC A Magnetic image, both 0.00 22.71 NA 1.03 23.74 NA XXX
breasts.
76095 ................ A Stereotactic breast 1.59 7.36 NA 0.40 9.35 NA XXX
biopsy.
76095 26 A Stereotactic breast 1.59 0.56 0.56 0.09 2.24 2.24 XXX
biopsy.
76095 TC A Stereotactic breast 0.00 6.80 NA 0.31 7.11 NA XXX
biopsy.
76096 ................ A X-ray of needle wire, 0.56 1.44 NA 0.09 2.09 NA XXX
breast.
76096 26 A X-ray of needle wire, 0.56 0.20 0.20 0.03 0.79 0.79 XXX
breast.
76096 TC A X-ray of needle wire, 0.00 1.24 NA 0.06 1.30 NA XXX
breast.
76098 ................ A X-ray exam, breast 0.16 0.45 NA 0.03 0.64 NA XXX
specimen.
76098 26 A X-ray exam, breast 0.16 0.06 0.06 0.01 0.23 0.23 XXX
specimen.
76098 TC A X-ray exam, breast 0.00 0.39 NA 0.02 0.41 NA XXX
specimen.
76100 ................ A X-ray exam of body 0.58 1.38 NA 0.09 2.05 NA XXX
section.
76100 26 A X-ray exam of body 0.58 0.20 0.20 0.03 0.81 0.81 XXX
section.
76100 TC A X-ray exam of body 0.00 1.18 NA 0.06 1.24 NA XXX
section.
76101 ................ A Complex body section x- 0.58 1.55 NA 0.10 2.23 NA XXX
ray.
76101 26 A Complex body section x- 0.58 0.20 0.20 0.03 0.81 0.81 XXX
ray.
76101 TC A Complex body section x- 0.00 1.35 NA 0.07 1.42 NA XXX
ray.
76102 ................ A Complex body section x- 0.58 1.84 NA 0.12 2.54 NA XXX
rays.
76102 26 A Complex body section x- 0.58 0.20 0.20 0.03 0.81 0.81 XXX
rays.
76102 TC A Complex body section x- 0.00 1.64 NA 0.09 1.73 NA XXX
rays.
76120 ................ A Cine/video x-rays..... 0.38 1.14 NA 0.07 1.59 NA XXX
76120 26 A Cine/video x-rays..... 0.38 0.14 0.14 0.02 0.54 0.54 XXX
76120 TC A Cine/video x-rays..... 0.00 1.00 NA 0.05 1.05 NA XXX
76125 ................ A Cine/ video x-rays add- 0.27 0.84 NA 0.05 1.16 NA ZZZ
on.
76125 26 A Cine/ video x-rays add- 0.27 0.10 0.10 0.01 0.38 0.38 ZZZ
on.
76125 TC A Cine/ video x-rays add- 0.00 0.74 NA 0.04 0.78 NA ZZZ
on.
76140 ................ I X-ray consultation.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
76150 ................ A X-ray exam, dry 0.00 0.39 NA 0.02 0.41 NA XXX
process.
76350 ................ C Special x-ray contrast 0.00 0.00 0.00 0.00 0.00 0.00 XXX
study.
76355 ................ A CAT scan for 1.21 8.28 NA 0.41 9.90 NA XXX
localization.
76355 26 A CAT scan for 1.21 0.44 0.44 0.06 1.71 1.71 XXX
localization.
76355 TC A CAT scan for 0.00 7.84 NA 0.35 8.19 NA XXX
localization.
76360 ................ A CAT scan for needle 1.16 8.24 NA 0.40 9.80 NA XXX
biopsy.
76360 26 A CAT scan for needle 1.16 0.40 0.40 0.05 1.61 1.61 XXX
biopsy.
76360 TC A CAT scan for needle 0.00 7.84 NA 0.35 8.19 NA XXX
biopsy.
76362 ................ A Cat scan for tissue 4.00 9.24 NA 1.38 14.62 NA XXX
ablation.
76362 26 A Cat scan for tissue 4.00 1.40 1.40 0.17 5.57 5.57 XXX
ablation.
76362 TC A Cat scan for tissue 0.00 7.84 NA 1.21 9.05 NA XXX
ablation.
76370 ................ A CAT scan for therapy 0.85 3.10 NA 0.17 4.12 NA XXX
guide.
76370 26 A CAT scan for therapy 0.85 0.30 0.30 0.04 1.19 1.19 XXX
guide.
76370 TC A CAT scan for therapy 0.00 2.80 NA 0.13 2.93 NA XXX
guide.
76375 ................ A 3d/holograph reconstr 0.16 3.42 NA 0.16 3.74 NA XXX
add-on.
76375 26 A 3d/holograph reconstr 0.16 0.06 0.06 0.01 0.23 0.23 XXX
add-on.
76375 TC A 3d/holograph reconstr 0.00 3.36 NA 0.15 3.51 NA XXX
add-on.
76380 ................ A CAT scan follow-up 0.98 3.66 NA 0.19 4.83 NA XXX
study.
76380 26 A CAT scan follow-up 0.98 0.34 0.34 0.04 1.36 1.36 XXX
study.
76380 TC A CAT scan follow-up 0.00 3.32 NA 0.15 3.47 NA XXX
study.
76390 ................ A Mr spectroscopy....... 1.40 11.14 NA 0.55 13.09 NA XXX
76390 26 A Mr spectroscopy....... 1.40 0.50 0.50 0.06 1.96 1.96 XXX
76390 TC A Mr spectroscopy....... 0.00 10.64 NA 0.49 11.13 NA XXX
76393 ................ A Mr guidance for needle 1.50 11.16 NA 0.53 13.19 NA XXX
place.
76393 26 A Mr guidance for needle 1.50 0.52 0.52 0.07 2.09 2.09 XXX
place.
76393 TC A Mr guidance for needle 0.00 10.64 NA 0.46 11.10 NA XXX
place.
76394 ................ A Mri for tissue 4.25 12.13 NA 1.43 17.81 NA XXX
ablation.
76394 26 A Mri for tissue 4.25 1.49 1.49 0.14 5.88 5.88 XXX
ablation.
76394 TC A Mri for tissue 0.00 10.64 NA 1.29 11.93 NA XXX
ablation.
76400 ................ A Magnetic image, bone 1.60 11.20 NA 0.56 13.36 NA XXX
marrow.
76400 26 A Magnetic image, bone 1.60 0.56 0.56 0.07 2.23 2.23 XXX
marrow.
76400 TC A Magnetic image, bone 0.00 10.64 NA 0.49 11.13 NA XXX
marrow.
76490 ................ A Us for tissue ablation 2.00 2.13 NA 0.36 4.49 NA XXX
76490 26 A Us for tissue ablation 2.00 0.69 0.69 0.12 2.81 2.81 XXX
76490 TC A Us for tissue ablation 0.00 1.44 NA 0.24 1.68 NA XXX
76499 ................ C Radiographic procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX
76499 26 C Radiographic procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX
76499 TC C Radiographic procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX
[[Page 55421]]
76506 ................ A Echo exam of head..... 0.63 1.61 NA 0.10 2.34 NA XXX
76506 26 A Echo exam of head..... 0.63 0.26 0.26 0.03 0.92 0.92 XXX
76506 TC A Echo exam of head..... 0.00 1.35 NA 0.07 1.42 NA XXX
76511 ................ A Echo exam of eye...... 0.94 2.37 NA 0.08 3.39 NA XXX
76511 26 A Echo exam of eye...... 0.94 0.45 0.45 0.02 1.41 1.41 XXX
76511 TC A Echo exam of eye...... 0.00 1.92 NA 0.06 1.98 NA XXX
76512 ................ A Echo exam of eye...... 0.66 2.49 NA 0.09 3.24 NA XXX
76512 26 A Echo exam of eye...... 0.66 0.31 0.31 0.01 0.98 0.98 XXX
76512 TC A Echo exam of eye...... 0.00 2.18 NA 0.08 2.26 NA XXX
76513 ................ A Echo exam of eye, 0.66 2.90 NA 0.09 3.65 NA XXX
water bath.
76513 26 A Echo exam of eye, 0.66 0.32 0.32 0.01 0.99 0.99 XXX
water bath.
76513 TC A Echo exam of eye, 0.00 2.58 NA 0.08 2.66 NA XXX
water bath.
76516 ................ A Echo exam of eye...... 0.54 2.04 NA 0.07 2.65 NA XXX
76516 26 A Echo exam of eye...... 0.54 0.26 0.26 0.01 0.81 0.81 XXX
76516 TC A Echo exam of eye...... 0.00 1.78 NA 0.06 1.84 NA XXX
76519 ................ A Echo exam of eye...... 0.54 1.91 NA 0.07 2.52 NA XXX
76519 26 A Echo exam of eye...... 0.54 0.26 0.26 0.01 0.81 0.81 XXX
76519 TC A Echo exam of eye...... 0.00 1.65 NA 0.06 1.71 NA XXX
76529 ................ A Echo exam of eye...... 0.57 2.70 NA 0.08 3.35 NA XXX
76529 26 A Echo exam of eye...... 0.57 0.27 0.27 0.01 0.85 0.85 XXX
76529 TC A Echo exam of eye...... 0.00 2.43 NA 0.07 2.50 NA XXX
76536 ................ A Us exam of head and 0.56 1.55 NA 0.09 2.20 NA XXX
neck.
76536 26 A Us exam of head and 0.56 0.20 0.20 0.02 0.78 0.78 XXX
neck.
76536 TC A Us exam of head and 0.00 1.35 NA 0.07 1.42 NA XXX
neck.
76604 ................ A Us exam, chest, b-scan 0.55 1.43 NA 0.08 2.06 NA XXX
76604 26 A Us exam, chest, b-scan 0.55 0.19 0.19 0.02 0.76 0.76 XXX
76604 TC A Us exam, chest, b-scan 0.00 1.24 NA 0.06 1.30 NA XXX
76645 ................ A Us exam, breast(s).... 0.54 1.19 NA 0.08 1.81 NA XXX
76645 26 A Us exam, breast(s).... 0.54 0.19 0.19 0.03 0.76 0.76 XXX
76645 TC A Us exam, breast(s).... 0.00 1.00 NA 0.05 1.05 NA XXX
76700 ................ A Us exam, abdom, 0.81 2.15 NA 0.13 3.09 NA XXX
complete.
76700 26 A Us exam, abdom, 0.81 0.28 0.28 0.04 1.13 1.13 XXX
complete.
76700 TC A Us exam, abdom, 0.00 1.87 NA 0.09 1.96 NA XXX
complete.
76705 ................ A Us exam, abdom, 0.59 1.56 NA 0.10 2.25 NA XXX
limited.
76705 26 A Us exam, abdom, 0.59 0.21 0.21 0.03 0.83 0.83 XXX
limited.
76705 TC A Us exam, abdom, 0.00 1.35 NA 0.07 1.42 NA XXX
limited.
76770 ................ A Us exam abdo back 0.74 2.13 NA 0.12 2.99 NA XXX
wall, comp.
76770 26 A Us exam abdo back 0.74 0.26 0.26 0.03 1.03 1.03 XXX
wall, comp.
76770 TC A Us exam abdo back 0.00 1.87 NA 0.09 1.96 NA XXX
wall, comp.
76775 ................ A Us exam abdo back 0.58 1.55 NA 0.10 2.23 NA XXX
wall, lim.
76775 26 A Us exam abdo back 0.58 0.20 0.20 0.03 0.81 0.81 XXX
wall, lim.
76775 TC A Us exam abdo back 0.00 1.35 NA 0.07 1.42 NA XXX
wall, lim.
76778 ................ A Us exam kidney 0.74 2.13 NA 0.12 2.99 NA XXX
transplant.
76778 26 A Us exam kidney 0.74 0.26 0.26 0.03 1.03 1.03 XXX
transplant.
76778 TC A Us exam kidney 0.00 1.87 NA 0.09 1.96 NA XXX
transplant.
76800 ................ A Us exam, spinal canal. 1.13 1.73 NA 0.11 2.97 NA XXX
76800 26 A Us exam, spinal canal. 1.13 0.38 0.38 0.04 1.55 1.55 XXX
76800 TC A Us exam, spinal canal. 0.00 1.35 NA 0.07 1.42 NA XXX
76805 ................ A Us exam, pg uterus, 0.99 2.35 NA 0.14 3.48 NA XXX
compl.
76805 26 A Us exam, pg uterus, 0.99 0.36 0.36 0.04 1.39 1.39 XXX
compl.
76805 TC A Us exam, pg uterus, 0.00 1.99 NA 0.10 2.09 NA XXX
compl.
76810 ................ A Us exam, pg uterus, 1.97 4.74 NA 0.25 6.96 NA XXX
mult.
76810 26 A Us exam, pg uterus, 1.97 0.75 0.75 0.07 2.79 2.79 XXX
mult.
76810 TC A Us exam, pg uterus, 0.00 3.99 NA 0.18 4.17 NA XXX
mult.
76815 ................ A Us exam, pg uterus 0.65 1.60 NA 0.09 2.34 NA XXX
limit.
76815 26 A Us exam, pg uterus 0.65 0.25 0.25 0.02 0.92 0.92 XXX
limit.
76815 TC A Us exam, pg uterus 0.00 1.35 NA 0.07 1.42 NA XXX
limit.
76816 ................ A Us exam pg uterus 0.57 1.28 NA 0.07 1.92 NA XXX
repeat.
76816 26 A Us exam pg uterus 0.57 0.22 0.22 0.02 0.81 0.81 XXX
repeat.
76816 TC A Us exam pg uterus 0.00 1.06 NA 0.05 1.11 NA XXX
repeat.
76818 ................ A Fetal biophy profile w/ 1.05 1.94 NA 0.12 3.11 NA XXX
nst.
76818 26 A Fetal biophy profile w/ 1.05 0.41 0.41 0.04 1.50 1.50 XXX
nst.
76818 TC A Fetal biophy profile w/ 0.00 1.53 NA 0.08 1.61 NA XXX
nst.
76819 ................ A Fetal biophys profil w/ 0.77 1.83 NA 0.10 2.70 NA XXX
o nst.
76819 26 A Fetal biophys profil w/ 0.77 0.30 0.30 0.02 1.09 1.09 XXX
o nst.
76819 TC A Fetal biophys profil w/ 0.00 1.53 NA 0.08 1.61 NA XXX
o nst.
76825 ................ A Echo exam of fetal 1.67 2.50 NA 0.15 4.32 NA XXX
heart.
76825 26 A Echo exam of fetal 1.67 0.63 0.63 0.06 2.36 2.36 XXX
heart.
76825 TC A Echo exam of fetal 0.00 1.87 NA 0.09 1.96 NA XXX
heart.
76826 ................ A Echo exam of fetal 0.83 0.97 NA 0.07 1.87 NA XXX
heart.
76826 26 A Echo exam of fetal 0.83 0.30 0.30 0.03 1.16 1.16 XXX
heart.
76826 TC A Echo exam of fetal 0.00 0.67 NA 0.04 0.71 NA XXX
heart.
76827 ................ A Echo exam of fetal 0.58 1.85 NA 0.12 2.55 NA XXX
heart.
[[Page 55422]]
76827 26 A Echo exam of fetal 0.58 0.22 0.22 0.02 0.82 0.82 XXX
heart.
76827 TC A Echo exam of fetal 0.00 1.63 NA 0.10 1.73 NA XXX
heart.
76828 ................ A Echo exam of fetal 0.56 1.29 NA 0.09 1.94 NA XXX
heart.
76828 26 A Echo exam of fetal 0.56 0.23 0.23 0.02 0.81 0.81 XXX
heart.
76828 TC A Echo exam of fetal 0.00 1.06 NA 0.07 1.13 NA XXX
heart.
76830 ................ A Us exam, transvaginal. 0.69 1.68 NA 0.11 2.48 NA XXX
76830 26 A Us exam, transvaginal. 0.69 0.24 0.24 0.03 0.96 0.96 XXX
76830 TC A Us exam, transvaginal. 0.00 1.44 NA 0.08 1.52 NA XXX
76831 ................ A Echo exam, uterus..... 0.72 1.71 NA 0.10 2.53 NA XXX
76831 26 A Echo exam, uterus..... 0.72 0.27 0.27 0.02 1.01 1.01 XXX
76831 TC A Echo exam, uterus..... 0.00 1.44 NA 0.08 1.52 NA XXX
76856 ................ A Us exam, pelvic, 0.69 1.68 NA 0.11 2.48 NA XXX
complete.
76856 26 A Us exam, pelvic, 0.69 0.24 0.24 0.03 0.96 0.96 XXX
complete.
76856 TC A Us exam, pelvic, 0.00 1.44 NA 0.08 1.52 NA XXX
complete.
76857 ................ A Us exam, pelvic, 0.38 1.13 NA 0.07 1.58 NA XXX
limited.
76857 26 A Us exam, pelvic, 0.38 0.13 0.13 0.02 0.53 0.53 XXX
limited.
76857 TC A Us exam, pelvic, 0.00 1.00 NA 0.05 1.05 NA XXX
limited.
76870 ................ A Us exam, scrotum...... 0.64 1.66 NA 0.11 2.41 NA XXX
76870 26 A Us exam, scrotum...... 0.64 0.22 0.22 0.03 0.89 0.89 XXX
76870 TC A Us exam, scrotum...... 0.00 1.44 NA 0.08 1.52 NA XXX
76872 ................ A Echo exam, transrectal 0.69 1.68 NA 0.12 2.49 NA XXX
76872 26 A Echo exam, transrectal 0.69 0.24 0.24 0.04 0.97 0.97 XXX
76872 TC A Echo exam, transrectal 0.00 1.44 NA 0.08 1.52 NA XXX
76873 ................ A Echograp trans r, pros 1.55 2.53 NA 0.21 4.29 NA XXX
study.
76873 26 A Echograp trans r, pros 1.55 0.54 0.54 0.08 2.17 2.17 XXX
study.
76873 TC A Echograp trans r, pros 0.00 1.99 NA 0.13 2.12 NA XXX
study.
76880 ................ A Us exam, extremity.... 0.59 1.56 NA 0.10 2.25 NA XXX
76880 26 A Us exam, extremity.... 0.59 0.21 0.21 0.03 0.83 0.83 XXX
76880 TC A Us exam, extremity.... 0.00 1.35 NA 0.07 1.42 NA XXX
76885 ................ A Us exam infant hips, 0.74 1.70 NA 0.11 2.55 NA XXX
dynamic.
6885 26 A Us exam infant hips, 0.74 0.26 0.26 0.03 1.03 1.03 XXX
dynamic.
76885 TC A Us exam infant hips, 0.00 1.44 NA 0.08 1.52 NA XXX
dynamic.
76886 ................ A Us exam infant hips, 0.62 1.57 NA 0.10 2.29 NA XXX
static.
76886 26 A Us exam infant hips, 0.62 0.22 0.22 0.03 0.87 0.87 XXX
static.
76886 TC A Us exam infant hips, 0.00 1.35 NA 0.07 1.42 NA XXX
static.
76930 ................ A Echo guide, 0.67 1.71 NA 0.10 2.48 NA XXX
cardiocentesis.
76930 26 A Echo guide, 0.67 0.27 0.27 0.02 0.96 0.96 XXX
cardiocentesis.
76930 TC A Echo guide, 0.00 1.44 NA 0.08 1.52 NA XXX
cardiocentesis.
76932 ................ A Echo guide for heart 0.67 1.71 NA 0.10 2.48 NA XXX
biopsy.
76932 26 A Echo guide for heart 0.67 0.27 0.27 0.02 0.96 0.96 XXX
biopsy.
76932 TC A Echo guide for heart 0.00 1.44 NA 0.08 1.52 NA XXX
biopsy.
76936 ................ A Echo guide for artery 1.99 6.68 NA 0.39 9.06 NA XXX
repair.
76936 26 A Echo guide for artery 1.99 0.70 0.70 0.11 2.80 2.80 XXX
repair.
76936 TC A Echo guide for artery 0.00 5.98 NA 0.28 6.26 NA XXX
repair.
76941 ................ A Echo guide for 1.34 1.98 NA 0.13 3.45 NA XXX
transfusion.
76941 26 A Echo guide for 1.34 0.53 0.53 0.06 1.93 1.93 XXX
transfusion.
76941 TC A Echo guide for 0.00 1.45 NA 0.07 1.52 NA XXX
transfusion.
76942 ................ A Echo guide for biopsy. 0.67 1.67 NA 0.12 2.46 NA XXX
76942 26 A Echo guide for biopsy. 0.67 0.23 0.23 0.04 0.94 0.94 XXX
76942 TC A Echo guide for biopsy. 0.00 1.44 NA 0.08 1.52 NA XXX
76945 ................ A Echo guide, villus 0.67 1.69 NA 0.10 2.46 NA XXX
sampling.
76945 26 A Echo guide, villus 0.67 0.24 0.24 0.03 0.94 0.94 XXX
sampling.
76945 TC A Echo guide, villus 0.00 1.45 NA 0.07 1.52 NA XXX
sampling.
76946 ................ A Echo guide for 0.38 1.59 NA 0.09 2.06 NA XXX
amniocentesis.
76946 26 A Echo guide for 0.38 0.15 0.15 0.01 0.54 0.54 XXX
amniocentesis.
76946 TC A Echo guide for 0.00 1.44 NA 0.08 1.52 NA XXX
amniocentesis.
76948 ................ A Echo guide, ova 0.38 1.57 NA 0.10 2.05 NA XXX
aspiration.
76948 26 A Echo guide, ova 0.38 0.13 0.13 0.02 0.53 0.53 XXX
aspiration.
76948 TC A Echo guide, ova 0.00 1.44 NA 0.08 1.52 NA XXX
aspiration.
76950 ................ A Echo guidance 0.58 1.45 NA 0.09 2.12 NA XXX
radiotherapy.
76950 26 A Echo guidance 0.58 0.21 0.21 0.03 0.82 0.82 XXX
radiotherapy.
76950 TC A Echo guidance 0.00 1.24 NA 0.06 1.30 NA XXX
radiotherapy.
76965 ................ A Echo guidance 1.34 5.75 NA 0.31 7.40 NA XXX
radiotherapy.
76965 26 A Echo guidance 1.34 0.46 0.46 0.07 1.87 1.87 XXX
radiotherapy.
76965 TC A Echo guidance 0.00 5.29 NA 0.24 5.53 NA XXX
radiotherapy.
76970 ................ A Ultrasound exam follow- 0.40 1.14 NA 0.07 1.61 NA XXX
up.
76970 26 A Ultrasound exam follow- 0.40 0.14 0.14 0.02 0.56 0.56 XXX
up.
76970 TC A Ultrasound exam follow- 0.00 1.00 NA 0.05 1.05 NA XXX
up.
76975 ................ A GI endoscopic 0.81 1.73 NA 0.11 2.65 NA XXX
ultrasound.
76975 26 A GI endoscopic 0.81 0.29 0.29 0.03 1.13 1.13 XXX
ultrasound.
76975 TC A GI endoscopic 0.00 1.44 NA 0.08 1.52 NA XXX
ultrasound.
76977 ................ A Us bone density 0.05 0.80 NA 0.05 0.90 NA XXX
measure.
76977 26 A Us bone density 0.05 0.02 0.02 0.01 0.08 0.08 XXX
measure.
[[Page 55423]]
76977 TC A Us bone density 0.00 0.78 NA 0.04 0.82 NA XXX
measure.
76986 ................ A Ultrasound guide 1.20 2.91 NA 0.19 4.30 NA XXX
intraoper.
76986 26 A Ultrasound guide 1.20 0.42 0.42 0.07 1.69 1.69 XXX
intraoper.
76986 TC A Ultrasound guide 0.00 2.49 NA 0.12 2.61 NA XXX
intraoper.
76999 ................ C Echo examination 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
76999 26 C Echo examination 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
76999 TC C Echo examination 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
77261 ................ A Radiation therapy 1.39 0.56 0.56 0.06 2.01 2.01 XXX
planning.
77262 ................ A Radiation therapy 2.11 0.82 0.82 0.09 3.02 3.02 XXX
planning.
77263 ................ A Radiation therapy 3.14 1.23 1.23 0.13 4.50 4.50 XXX
planning.
77280 ................ A Set radiation therapy 0.70 3.55 NA 0.18 4.43 NA XXX
field.
77280 26 A Set radiation therapy 0.70 0.25 0.25 0.03 0.98 0.98 XXX
field.
77280 TC A Set radiation therapy 0.00 3.30 NA 0.15 3.45 NA XXX
field.
77285 ................ A Set radiation therapy 1.05 5.67 NA 0.29 7.01 NA XXX
field.
77285 26 A Set radiation therapy 1.05 0.38 0.38 0.04 1.47 1.47 XXX
field.
77285 TC A Set radiation therapy 0.00 5.29 NA 0.25 5.54 NA XXX
field.
77290 ................ A Set radiation therapy 1.56 6.74 NA 0.35 8.65 NA XXX
field.
77290 26 A Set radiation therapy 1.56 0.56 0.56 0.06 2.18 2.18 XXX
field.
77290 TC A Set radiation therapy 0.00 6.18 NA 0.29 6.47 NA XXX
field.
77295 ................ A Set radiation therapy 4.57 28.18 NA 1.41 34.16 NA XXX
field.
77295 26 A Set radiation therapy 4.57 1.65 1.65 0.18 6.40 6.40 XXX
field.
77295 TC A Set radiation therapy 0.00 26.53 NA 1.23 27.76 NA XXX
field.
77299 ................ C Radiation therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX
planning.
77299 26 C Radiation therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX
planning.
77299 TC C Radiation therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX
planning.
77300 ................ A Radiation therapy dose 0.62 1.50 NA 0.09 2.21 NA XXX
plan.
77300 26 A Radiation therapy dose 0.62 0.22 0.22 0.03 0.87 0.87 XXX
plan.
77300 TC A Radiation therapy dose 0.00 1.28 NA 0.06 1.34 NA XXX
plan.
77301 ................ A Radioltherapy dos 8.00 29.72 NA 1.41 39.13 NA XXX
plan, imrt.
77301 26 A Radioltherapy dos 8.00 3.19 3.19 0.18 11.37 11.37 XXX
plan, imrt.
77301 TC A Radioltherapy dos 0.00 26.53 NA 1.23 27.76 NA XXX
plan, imrt.
77305 ................ A Radiation therapy dose 0.70 2.01 NA 0.12 2.83 NA XXX
plan.
77305 26 A Radiation therapy dose 0.70 0.25 0.25 0.03 0.98 0.98 XXX
plan.
77305 TC A Radiation therapy dose 0.00 1.76 NA 0.09 1.85 NA XXX
plan.
77310 ................ A Radiation therapy dose 1.05 2.59 NA 0.15 3.79 NA XXX
plan.
77310 26 A Radiation therapy dose 1.05 0.38 0.38 0.04 1.47 1.47 XXX
plan.
77310 TC A Radiation therapy dose 0.00 2.21 NA 0.11 2.32 NA XXX
plan.
77315 ................ A Radiation therapy dose 1.56 3.09 NA 0.18 4.83 NA XXX
plan.
77315 26 A Radiation therapy dose 1.56 0.56 0.56 0.06 2.18 2.18 XXX
plan.
77315 TC A Radiation therapy dose 0.00 2.53 NA 0.12 2.65 NA XXX
plan.
77321 ................ A Radiation therapy port 0.95 4.18 NA 0.21 5.34 NA XXX
plan.
77321 26 A Radiation therapy port 0.95 0.34 0.34 0.04 1.33 1.33 XXX
plan.
77321 TC A Radiation therapy port 0.00 3.84 NA 0.17 4.01 NA XXX
plan.
77326 ................ A Radiation therapy dose 0.93 2.58 NA 0.15 3.66 NA XXX
plan.
77326 26 A Radiation therapy dose 0.93 0.34 0.34 0.04 1.31 1.31 XXX
plan.
77326 TC A Radiation therapy dose 0.00 2.24 NA 0.11 2.35 NA XXX
plan.
77327 ................ A Radiation therapy dose 1.39 3.80 NA 0.21 5.40 NA XXX
plan.
77327 26 A Radiation therapy dose 1.39 0.50 0.50 0.06 1.95 1.95 XXX
plan.
77327 TC A Radiation therapy dose 0.00 3.30 NA 0.15 3.45 NA XXX
plan.
77328 ................ A Radiation therapy dose 2.09 5.46 NA 0.30 7.85 NA XXX
plan.
77328 26 A Radiation therapy dose 2.09 0.75 0.75 0.09 2.93 2.93 XXX
plan.
77328 TC A Radiation therapy dose 0.00 4.71 NA 0.21 4.92 NA XXX
plan.
77331 ................ A Special radiation 0.87 0.79 NA 0.06 1.72 NA XXX
dosimetry.
77331 26 A Special radiation 0.87 0.31 0.31 0.04 1.22 1.22 XXX
dosimetry.
77331 TC A Special radiation 0.00 0.48 NA 0.02 0.50 NA XXX
dosimetry.
77332 ................ A Radiation treatment 0.54 1.47 NA 0.08 2.09 NA XXX
aid(s).
77332 26 A Radiation treatment 0.54 0.19 0.19 0.02 0.75 0.75 XXX
aid(s).
77332 TC A Radiation treatment 0.00 1.28 NA 0.06 1.34 NA XXX
aid(s).
77333 ................ A Radiation treatment 0.84 2.10 NA 0.13 3.07 NA XXX
aid(s).
77333 26 A Radiation treatment 0.84 0.30 0.30 0.04 1.18 1.18 XXX
aid(s).
77333 TC A Radiation treatment 0.00 1.80 NA 0.09 1.89 NA XXX
aid(s).
77334 ................ A Radiation treatment 1.24 3.54 NA 0.19 4.97 NA XXX
aid(s).
77334 26 A Radiation treatment 1.24 0.45 0.45 0.05 1.74 1.74 XXX
aid(s).
77334 TC A Radiation treatment 0.00 3.09 NA 0.14 3.23 NA XXX
aid(s).
77336 ................ A Radiation physics 0.00 2.83 NA 0.13 2.96 NA XXX
consult.
77370 ................ A Radiation physics 0.00 3.31 NA 0.15 3.46 NA XXX
consult.
77399 ................ C External radiation 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dosimetry.
77399 26 C External radiation 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dosimetry.
77399 TC C External radiation 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dosimetry.
77401 ................ A Radiation treatment 0.00 1.68 NA 0.09 1.77 NA XXX
delivery.
77402 ................ A Radiation treatment 0.00 1.68 NA 0.09 1.77 NA XXX
delivery.
77403 ................ A Radiation treatment 0.00 1.68 NA 0.09 1.77 NA XXX
delivery.
77404 ................ A Radiation treatment 0.00 1.68 NA 0.09 1.77 NA XXX
delivery.
[[Page 55424]]
77406 ................ A Radiation treatment 0.00 1.68 NA 0.09 1.77 NA XXX
delivery.
77407 ................ A Radiation treatment 0.00 1.98 NA 0.10 2.08 NA XXX
delivery.
77408 ................ A Radiation treatment 0.00 1.98 NA 0.10 2.08 NA XXX
delivery.
77409 ................ A Radiation treatment 0.00 1.98 NA 0.10 2.08 NA XXX
delivery.
77411 ................ A Radiation treatment 0.00 1.98 NA 0.10 2.08 NA XXX
delivery.
77412 ................ A Radiation treatment 0.00 2.21 NA 0.11 2.32 NA XXX
delivery.
77413 ................ A Radiation treatment 0.00 2.21 NA 0.11 2.32 NA XXX
delivery.
77414 ................ A Radiation treatment 0.00 2.21 NA 0.11 2.32 NA XXX
delivery.
77416 ................ A Radiation treatment 0.00 2.21 NA 0.11 2.32 NA XXX
delivery.
77417 ................ A Radiology port film(s) 0.00 0.56 NA 0.03 0.59 NA XXX
77418 ................ A Radiation tx delivery, 0.00 16.07 NA 0.11 16.18 NA XXX
imrt.
77427 ................ A Radiation tx 3.31 1.19 1.19 0.14 4.64 4.64 XXX
management, x5.
77431 ................ A Radiation therapy 1.81 0.73 0.73 0.07 2.61 2.61 XXX
management.
77432 ................ A Stereotactic radiation 7.93 3.25 3.25 0.33 11.51 11.51 XXX
trmt.
77470 ................ A Special radiation 2.09 11.34 NA 0.58 14.01 NA XXX
treatment.
77470 26 A Special radiation 2.09 0.75 0.75 0.09 2.93 2.93 XXX
treatment.
77470 TC A Special radiation 0.00 10.59 NA 0.49 11.08 NA XXX
treatment.
77499 ................ C Radiation therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX
management.
77499 26 C Radiation therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX
management.
77499 TC C Radiation therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX
management.
77520 ................ C Proton trmt, simple w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
o comp.
77522 ................ C Proton trmt, simple w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
comp.
77523 ................ C Proton trmt, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
intermediate.
77525 ................ C Proton treatment, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
complex.
77600 ................ R Hyperthermia treatment 1.56 3.44 NA 0.21 5.21 NA XXX
77600 26 R Hyperthermia treatment 1.56 0.55 0.55 0.08 2.19 2.19 XXX
77600 TC R Hyperthermia treatment 0.00 2.89 NA 0.13 3.02 NA XXX
77605 ................ R Hyperthermia treatment 2.09 4.62 NA 0.31 7.02 NA XXX
77605 26 R Hyperthermia treatment 2.09 0.76 0.76 0.13 2.98 2.98 XXX
77605 TC R Hyperthermia treatment 0.00 3.86 NA 0.18 4.04 NA XXX
77610 ................ R Hyperthermia treatment 1.56 3.44 NA 0.20 5.20 NA XXX
77610 26 R Hyperthermia treatment 1.56 0.55 0.55 0.07 2.18 2.18 XXX
77610 TC R Hyperthermia treatment 0.00 2.89 NA 0.13 3.02 NA XXX
77615 ................ R Hyperthermia treatment 2.09 4.60 NA 0.27 6.96 NA XXX
77615 26 R Hyperthermia treatment 2.09 0.74 0.74 0.09 2.92 2.92 XXX
77615 TC R Hyperthermia treatment 0.00 3.86 NA 0.18 4.04 NA XXX
77620 ................ R Hyperthermia treatment 1.56 3.47 NA 0.19 5.22 NA XXX
77620 26 R Hyperthermia treatment 1.56 0.58 0.58 0.06 2.20 2.20 XXX
77620 TC R Hyperthermia treatment 0.00 2.89 NA 0.13 3.02 NA XXX
77750 ................ A Infuse radioactive 4.91 3.04 NA 0.23 8.18 NA 090
materials.
77750 26 A Infuse radioactive 4.91 1.77 1.77 0.17 6.85 6.85 090
materials.
77750 TC A Infuse radioactive 0.00 1.27 NA 0.06 1.33 NA 090
materials.
77761 ................ A Apply intrcav radiat 3.81 3.51 NA 0.28 7.60 NA 090
simple.
77761 26 A Apply intrcav radiat 3.81 1.13 1.13 0.16 5.10 5.10 090
simple.
77761 TC A Apply intrcav radiat 0.00 2.38 NA 0.12 2.50 NA 090
simple.
77762 ................ A Apply intrcav radiat 5.72 5.42 NA 0.38 11.52 NA 090
interm.
77762 26 A Apply intrcav radiat 5.72 1.99 1.99 0.22 7.93 7.93 090
interm.
77762 TC A Apply intrcav radiat 0.00 3.43 NA 0.16 3.59 NA 090
interm.
77763 ................ A Apply intrcav radiat 8.57 7.38 NA 0.53 16.48 NA 090
compl.
77763 26 A Apply intrcav radiat 8.57 3.12 3.12 0.34 12.03 12.03 090
compl.
77763 TC A Apply intrcav radiat 0.00 4.26 NA 0.19 4.45 NA 090
compl.
77776 ................ A Apply interstit radiat 4.66 3.72 NA 0.35 8.73 NA 090
simpl.
77776 26 A Apply interstit radiat 4.66 1.65 1.65 0.24 6.55 6.55 090
simpl.
77776 TC A Apply interstit radiat 0.00 2.07 NA 0.11 2.18 NA 090
simpl.
77777 ................ A Apply interstit radiat 7.48 6.37 NA 0.50 14.35 NA 090
inter.
77777 26 A Apply interstit radiat 7.48 2.35 2.35 0.32 10.15 10.15 090
inter.
77777 TC A Apply interstit radiat 0.00 4.02 NA 0.18 4.20 NA 090
inter.
77778 ................ A Apply iterstit radiat 11.19 8.90 NA 0.69 20.78 NA 090
compl.
77778 26 A Apply iterstit radiat 11.19 4.02 4.02 0.47 15.68 15.68 090
compl.
77778 TC A Apply iterstit radiat 0.00 4.88 NA 0.22 5.10 NA 090
compl.
77781 ................ A High intensity 1.66 19.88 NA 0.95 22.49 NA 090
brachytherapy.
77781 26 A High intensity 1.66 0.60 0.60 0.07 2.33 2.33 090
brachytherapy.
77781 TC A High intensity 0.00 19.28 NA 0.88 20.16 NA 090
brachytherapy.
77782 ................ A High intensity 2.49 20.18 NA 0.98 23.65 NA 090
brachytherapy.
77782 26 A High intensity 2.49 0.90 0.90 0.10 3.49 3.49 090
brachytherapy.
77782 TC A High intensity 0.00 19.28 NA 0.88 20.16 NA 090
brachytherapy.
77783 ................ A High intensity 3.73 20.62 NA 1.03 25.38 NA 090
brachytherapy.
77783 26 A High intensity 3.73 1.34 1.34 0.15 5.22 5.22 090
brachytherapy.
77783 TC A High intensity 0.00 19.28 NA 0.88 20.16 NA 090
brachytherapy.
77784 ................ A High intensity 5.61 21.30 NA 1.10 28.01 NA 090
brachytherapy.
77784 26 A High intensity 5.61 2.02 2.02 0.22 7.85 7.85 090
brachytherapy.
77784 TC A High intensity 0.00 19.28 NA 0.88 20.16 NA 090
brachytherapy.
77789 ................ A Apply surface 1.12 0.84 NA 0.05 2.01 NA 090
radiation.
[[Page 55425]]
77789 26 A Apply surface 1.12 0.41 0.41 0.03 1.56 1.56 090
radiation.
77789 TC A Apply surface 0.00 0.43 NA 0.02 0.45 NA 090
radiation.
77790 ................ A Radiation handling.... 1.05 0.86 NA 0.06 1.97 NA XXX
77790 26 A Radiation handling.... 1.05 0.38 0.38 0.04 1.47 1.47 XXX
77790 TC A Radiation handling.... 0.00 0.48 NA 0.02 0.50 NA XXX
77799 ................ C Radium/radioisotope 0.00 0.00 0.00 0.00 0.00 0.00 XXX
therapy.
77799 26 C Radium/radioisotope 0.00 0.00 0.00 0.00 0.00 0.00 XXX
therapy.
77799 TC C Radium/radioisotope 0.00 0.00 0.00 0.00 0.00 0.00 XXX
therapy.
78000 ................ A Thyroid, single uptake 0.19 0.99 NA 0.06 1.24 NA XXX
78000 26 A Thyroid, single uptake 0.19 0.07 0.07 0.01 0.27 0.27 XXX
78000 TC A Thyroid, single uptake 0.00 0.92 NA 0.05 0.97 NA XXX
78001 ................ A Thyroid, multiple 0.26 1.33 NA 0.07 1.66 NA XXX
uptakes.
78001 26 A Thyroid, multiple 0.26 0.09 0.09 0.01 0.36 0.36 XXX
uptakes.
78001 TC A Thyroid, multiple 0.00 1.24 NA 0.06 1.30 NA XXX
uptakes.
78003 ................ A Thyroid suppress/ 0.33 1.04 NA 0.06 1.43 NA XXX
stimul.
78003 26 A Thyroid suppress/ 0.33 0.12 0.12 0.01 0.46 0.46 XXX
stimul.
78003 TC A Thyroid suppress/ 0.00 0.92 NA 0.05 0.97 NA XXX
stimul.
78006 ................ A Thyroid imaging with 0.49 2.44 NA 0.13 3.06 NA XXX
uptake.
78006 26 A Thyroid imaging with 0.49 0.18 0.18 0.02 0.69 0.69 XXX
uptake.
78006 TC A Thyroid imaging with 0.00 2.26 NA 0.11 2.37 NA XXX
uptake.
78007 ................ A Thyroid image, mult 0.50 2.62 NA 0.14 3.26 NA XXX
uptakes.
78007 26 A Thyroid image, mult 0.50 0.18 0.18 0.02 0.70 0.70 XXX
uptakes.
78007 TC A Thyroid image, mult 0.00 2.44 NA 0.12 2.56 NA XXX
uptakes.
78010 ................ A Thyroid imaging....... 0.39 1.87 NA 0.11 2.37 NA XXX
78010 26 A Thyroid imaging....... 0.39 0.14 0.14 0.02 0.55 0.55 XXX
78010 TC A Thyroid imaging....... 0.00 1.73 NA 0.09 1.82 NA XXX
78011 ................ A Thyroid imaging with 0.45 2.45 NA 0.13 3.03 NA XXX
flow.
78011 26 A Thyroid imaging with 0.45 0.16 0.16 0.02 0.63 0.63 XXX
flow.
78011 TC A Thyroid imaging with 0.00 2.29 NA 0.11 2.40 NA XXX
flow.
78015 ................ A Thyroid met imaging... 0.67 2.68 NA 0.15 3.50 NA XXX
78015 26 A Thyroid met imaging... 0.67 0.24 0.24 0.03 0.94 0.94 XXX
78015 TC A Thyroid met imaging... 0.00 2.44 NA 0.12 2.56 NA XXX
78016 ................ A Thyroid met imaging/ 0.82 3.62 NA 0.18 4.62 NA XXX
studies.
78016 26 A Thyroid met imaging/ 0.82 0.31 0.31 0.03 1.16 1.16 XXX
studies.
78016 TC A Thyroid met imaging/ 0.00 3.31 NA 0.15 3.46 NA XXX
studies.
78018 ................ A Thyroid met imaging, 0.86 5.47 NA 0.27 6.60 NA XXX
body.
78018 26 A Thyroid met imaging, 0.86 0.32 0.32 0.03 1.21 1.21 XXX
body.
78018 TC A Thyroid met imaging, 0.00 5.15 NA 0.24 5.39 NA XXX
body.
78020 ................ A Thyroid met uptake.... 0.60 1.47 NA 0.14 2.21 NA ZZZ
78020 26 A Thyroid met uptake.... 0.60 0.23 0.23 0.02 0.85 0.85 ZZZ
78020 TC A Thyroid met uptake.... 0.00 1.24 NA 0.12 1.36 NA ZZZ
78070 ................ A Parathyroid nuclear 0.82 2.03 NA 0.12 2.97 NA XXX
imaging.
78070 26 A Parathyroid nuclear 0.82 0.30 0.30 0.03 1.15 1.15 XXX
imaging.
78070 TC A Parathyroid nuclear 0.00 1.73 NA 0.09 1.82 NA XXX
imaging.
78075 ................ A Adrenal nuclear 0.74 5.44 NA 0.27 6.45 NA XXX
imaging.
78075 26 A Adrenal nuclear 0.74 0.29 0.29 0.03 1.06 1.06 XXX
imaging.
78075 TC A Adrenal nuclear 0.00 5.15 NA 0.24 5.39 NA XXX
imaging.
78099 ................ C Endocrine nuclear 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
78099 26 C Endocrine nuclear 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
78099 TC C Endocrine nuclear 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
78102 ................ A Bone marrow imaging, 0.55 2.15 NA 0.12 2.82 NA XXX
ltd.
78102 26 A Bone marrow imaging, 0.55 0.21 0.21 0.02 0.78 0.78 XXX
ltd.
78102 TC A Bone marrow imaging, 0.00 1.94 NA 0.10 2.04 NA XXX
ltd.
78103 ................ A Bone marrow imaging, 0.75 3.28 NA 0.17 4.20 NA XXX
mult.
78103 26 A Bone marrow imaging, 0.75 0.27 0.27 0.03 1.05 1.05 XXX
mult.
78103 TC A Bone marrow imaging, 0.00 3.01 NA 0.14 3.15 NA XXX
mult.
78104 ................ A Bone marrow imaging, 0.80 4.16 NA 0.21 5.17 NA XXX
body.
78104 26 A Bone marrow imaging, 0.80 0.29 0.29 0.03 1.12 1.12 XXX
body.
78104 TC A Bone marrow imaging, 0.00 3.87 NA 0.18 4.05 NA XXX
body.
78110 ................ A Plasma volume, single. 0.19 0.97 NA 0.06 1.22 NA XXX
78110 26 A Plasma volume, single. 0.19 0.07 0.07 0.01 0.27 0.27 XXX
78110 TC A Plasma volume, single. 0.00 0.90 NA 0.05 0.95 NA XXX
78111 ................ A Plasma volume, 0.22 2.52 NA 0.13 2.87 NA XXX
multiple.
78111 26 A Plasma volume, 0.22 0.08 0.08 0.01 0.31 0.31 XXX
multiple.
78111 TC A Plasma volume, 0.00 2.44 NA 0.12 2.56 NA XXX
multiple.
78120 ................ A Red cell mass, single. 0.23 1.73 NA 0.10 2.06 NA XXX
78120 26 A Red cell mass, single. 0.23 0.09 0.09 0.01 0.33 0.33 XXX
78120 TC A Red cell mass, single. 0.00 1.64 NA 0.09 1.73 NA XXX
78121 ................ A Red cell mass, 0.32 2.88 NA 0.13 3.33 NA XXX
multiple.
78121 26 A Red cell mass, 0.32 0.12 0.12 0.01 0.45 0.45 XXX
multiple.
78121 TC A Red cell mass, 0.00 2.76 NA 0.12 2.88 NA XXX
multiple.
78122 ................ A Blood volume.......... 0.45 4.54 NA 0.22 5.21 NA XXX
78122 26 A Blood volume.......... 0.45 0.17 0.17 0.02 0.64 0.64 XXX
[[Page 55426]]
78122 TC A Blood volume.......... 0.00 4.37 NA 0.20 4.57 NA XXX
78130 ................ A Red cell survival 0.61 2.93 NA 0.15 3.69 NA XXX
study.
78130 26 A Red cell survival 0.61 0.22 0.22 0.03 0.86 0.86 XXX
study.
78130 TC A Red cell survival 0.00 2.71 NA 0.12 2.83 NA XXX
study.
78135 ................ A Red cell survival 0.64 4.86 NA 0.24 5.74 NA XXX
kinetics.
78135 26 A Red cell survival 0.64 0.23 0.23 0.03 0.90 0.90 XXX
kinetics.
78135 TC A Red cell survival 0.00 4.63 NA 0.21 4.84 NA XXX
kinetics.
78140 ................ A Red cell sequestration 0.61 3.95 NA 0.20 4.76 NA XXX
78140 26 A Red cell sequestration 0.61 0.21 0.21 0.03 0.85 0.85 XXX
78140 TC A Red cell sequestration 0.00 3.74 NA 0.17 3.91 NA XXX
78160 ................ A Plasma iron turnover.. 0.33 3.60 NA 0.19 4.12 NA XXX
78160 26 A Plasma iron turnover.. 0.33 0.12 0.12 0.03 0.48 0.48 XXX
78160 TC A Plasma iron turnover.. 0.00 3.48 NA 0.16 3.64 NA XXX
78162 ................ A Iron absorption exam.. 0.45 3.22 NA 0.15 3.82 NA XXX
78162 26 A Iron absorption exam.. 0.45 0.18 0.18 0.01 0.64 0.64 XXX
78162 TC A Iron absorption exam.. 0.00 3.04 NA 0.14 3.18 NA XXX
78170 ................ A Red cell iron 0.41 5.19 NA 0.27 5.87 NA XXX
utilization.
78170 26 A Red cell iron 0.41 0.15 0.15 0.04 0.60 0.60 XXX
utilization.
78170 TC A Red cell iron 0.00 5.04 NA 0.23 5.27 NA XXX
utilization.
78172 ................ C Total body iron 0.00 0.00 0.00 0.00 0.00 0.00 XXX
estimation.
78172 26 A Total body iron 0.53 0.20 0.20 0.02 0.75 0.75 XXX
estimation.
78172 TC C Total body iron 0.00 0.00 0.00 0.00 0.00 0.00 XXX
estimation.
78185 ................ A Spleen imaging........ 0.40 2.39 NA 0.13 2.92 NA XXX
78185 26 A Spleen imaging........ 0.40 0.15 0.15 0.02 0.57 0.57 XXX
78185 TC A Spleen imaging........ 0.00 2.24 NA 0.11 2.35 NA XXX
78190 ................ A Platelet survival, 1.09 5.83 NA 0.31 7.23 NA XXX
kinetics.
78190 26 A Platelet survival, 1.09 0.40 0.40 0.06 1.55 1.55 XXX
kinetics.
78190 TC A Platelet survival, 0.00 5.43 NA 0.25 5.68 NA XXX
kinetics.
78191 ................ A Platelet survival..... 0.61 7.19 NA 0.34 8.14 NA XXX
78191 26 A Platelet survival..... 0.61 0.22 0.22 0.03 0.86 0.86 XXX
78191 TC A Platelet survival..... 0.00 6.97 NA 0.31 7.28 NA XXX
78195 ................ A Lymph system imaging.. 1.20 4.31 NA 0.23 5.74 NA XXX
78195 26 A Lymph system imaging.. 1.20 0.44 0.44 0.05 1.69 1.69 XXX
78195 TC A Lymph system imaging.. 0.00 3.87 NA 0.18 4.05 NA XXX
78199 ................ C Blood/lymph nuclear 0.00 0.00 0.00 0.00 0.00 0.00 XXX
exam.
78199 26 C Blood/lymph nuclear 0.00 0.00 0.00 0.00 0.00 0.00 XXX
exam.
78199 TC C Blood/lymph nuclear 0.00 0.00 0.00 0.00 0.00 0.00 XXX
exam.
78201 ................ A Liver imaging......... 0.44 2.40 NA 0.13 2.97 NA XXX
78201 26 A Liver imaging......... 0.44 0.16 0.16 0.02 0.62 0.62 XXX
78201 TC A Liver imaging......... 0.00 2.24 NA 0.11 2.35 NA XXX
78202 ................ A Liver imaging with 0.51 2.93 NA 0.14 3.58 NA XXX
flow.
78202 26 A Liver imaging with 0.51 0.19 0.19 0.02 0.72 0.72 XXX
flow.
78202 TC A Liver imaging with 0.00 2.74 NA 0.12 2.86 NA XXX
flow.
78205 ................ A Liver imaging (3D).... 0.71 5.87 NA 0.29 6.87 NA XXX
78205 26 A Liver imaging (3D).... 0.71 0.26 0.26 0.03 1.00 1.00 XXX
78205 TC A Liver imaging (3D).... 0.00 5.61 NA 0.26 5.87 NA XXX
78206 ................ A Liver image (3d) w/ 0.96 5.96 NA 0.13 7.05 NA XXX
flow.
78206 26 A Liver image (3d) w/ 0.96 0.35 0.35 0.04 1.35 1.35 XXX
flow.
78206 TC A Liver image (3d) w/ 0.00 5.61 NA 0.09 5.70 NA XXX
flow.
78215 ................ A Liver and spleen 0.49 2.97 NA 0.14 3.60 NA XXX
imaging.
78215 26 A Liver and spleen 0.49 0.18 0.18 0.02 0.69 0.69 XXX
imaging.
78215 TC A Liver and spleen 0.00 2.79 NA 0.12 2.91 NA XXX
imaging.
78216 ................ A Liver & spleen image/ 0.57 3.52 NA 0.17 4.26 NA XXX
flow.
78216 26 A Liver & spleen image/ 0.57 0.21 0.21 0.02 0.80 0.80 XXX
flow.
78216 TC A Liver & spleen image/ 0.00 3.31 NA 0.15 3.46 NA XXX
flow.
78220 ................ A Liver function study.. 0.49 3.72 NA 0.18 4.39 NA XXX
78220 26 A Liver function study.. 0.49 0.18 0.18 0.02 0.69 0.69 XXX
78220 TC A Liver function study.. 0.00 3.54 NA 0.16 3.70 NA XXX
78223 ................ A Hepatobiliary imaging. 0.84 3.78 NA 0.20 4.82 NA XXX
78223 26 A Hepatobiliary imaging. 0.84 0.30 0.30 0.04 1.18 1.18 XXX
78223 TC A Hepatobiliary imaging. 0.00 3.48 NA 0.16 3.64 NA XXX
78230 ................ A Salivary gland imaging 0.45 2.23 NA 0.13 2.81 NA XXX
78230 26 A Salivary gland imaging 0.45 0.16 0.16 0.02 0.63 0.63 XXX
78230 TC A Salivary gland imaging 0.00 2.07 NA 0.11 2.18 NA XXX
78231 ................ A Serial salivary 0.52 3.21 NA 0.16 3.89 NA XXX
imaging.
78231 26 A Serial salivary 0.52 0.20 0.20 0.02 0.74 0.74 XXX
imaging.
78231 TC A Serial salivary 0.00 3.01 NA 0.14 3.15 NA XXX
imaging.
78232 ................ A Salivary gland 0.47 3.54 NA 0.16 4.17 NA XXX
function exam.
78232 26 A Salivary gland 0.47 0.18 0.18 0.01 0.66 0.66 XXX
function exam.
78232 TC A Salivary gland 0.00 3.36 NA 0.15 3.51 NA XXX
function exam.
78258 ................ A Esophageal motility 0.74 3.01 NA 0.15 3.90 NA XXX
study.
78258 26 A Esophageal motility 0.74 0.27 0.27 0.03 1.04 1.04 XXX
study.
78258 TC A Esophageal motility 0.00 2.74 NA 0.12 2.86 NA XXX
study.
[[Page 55427]]
78261 ................ A Gastric mucosa imaging 0.69 4.15 NA 0.21 5.05 NA XXX
78261 26 A Gastric mucosa imaging 0.69 0.26 0.26 0.03 0.98 0.98 XXX
78261 TC A Gastric mucosa imaging 0.00 3.89 NA 0.18 4.07 NA XXX
78262 ................ A Gastroesophageal 0.68 4.29 NA 0.21 5.18 NA XXX
reflux exam.
78262 26 A Gastroesophageal 0.68 0.25 0.25 0.03 0.96 0.96 XXX
reflux exam.
78262 TC A Gastroesophageal 0.00 4.04 NA 0.18 4.22 NA XXX
reflux exam.
78264 ................ A Gastric emptying study 0.78 4.20 NA 0.21 5.19 NA XXX
78264 26 A Gastric emptying study 0.78 0.28 0.28 0.03 1.09 1.09 XXX
78264 TC A Gastric emptying study 0.00 3.92 NA 0.18 4.10 NA XXX
78267 ................ X Breath tst attain/anal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
c-14.
78268 ................ X Breath test analysis, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
c-14.
78270 ................ A Vit B-12 absorption 0.20 1.54 NA 0.09 1.83 NA XXX
exam.
78270 26 A Vit B-12 absorption 0.20 0.07 0.07 0.01 0.28 0.28 XXX
exam.
78270 TC A Vit B-12 absorption 0.00 1.47 NA 0.08 1.55 NA XXX
exam.
78271 ................ A Vit B-12 absorp exam, 0.20 1.63 NA 0.09 1.92 NA XXX
IF.
78271 26 A Vit B-12 absorp exam, 0.20 0.07 0.07 0.01 0.28 0.28 XXX
IF.
78271 TC A Vit B-12 absorp exam, 0.00 1.56 NA 0.08 1.64 NA XXX
IF.
78272 ................ A Vit B-12 absorp, 0.27 2.30 NA 0.12 2.69 NA XXX
combined.
78272 26 A Vit B-12 absorp, 0.27 0.10 0.10 0.01 0.38 0.38 XXX
combined.
78272 TC A Vit B-12 absorp, 0.00 2.20 NA 0.11 2.31 NA XXX
combined.
78278 ................ A Acute GI blood loss 0.99 4.98 NA 0.25 6.22 NA XXX
imaging.
78278 26 A Acute GI blood loss 0.99 0.35 0.35 0.04 1.38 1.38 XXX
imaging.
78278 TC A Acute GI blood loss 0.00 4.63 NA 0.21 4.84 NA XXX
imaging.
78282 ................ C GI protein loss exam.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
78282 26 A GI protein loss exam.. 0.38 0.13 0.13 0.02 0.53 0.53 XXX
78282 TC C GI protein loss exam.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
78290 ................ A Meckel's divert exam.. 0.68 3.13 NA 0.16 3.97 NA XXX
78290 26 A Meckel's divert exam.. 0.68 0.24 0.24 0.03 0.95 0.95 XXX
78290 TC A Meckel's divert exam.. 0.00 2.89 NA 0.13 3.02 NA XXX
78291 ................ A Leveen/shunt patency 0.88 3.23 NA 0.17 4.28 NA XXX
exam.
78291 26 A Leveen/shunt patency 0.88 0.32 0.32 0.04 1.24 1.24 XXX
exam.
78291 TC A Leveen/shunt patency 0.00 2.91 NA 0.13 3.04 NA XXX
exam.
78299 ................ C GI nuclear procedure.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
78299 26 C GI nuclear procedure.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
78299 TC C GI nuclear procedure.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
78300 ................ A Bone imaging, limited 0.62 2.58 NA 0.15 3.35 NA XXX
area.
78300 26 A Bone imaging, limited 0.62 0.22 0.22 0.03 0.87 0.87 XXX
area.
78300 TC A Bone imaging, limited 0.00 2.36 NA 0.12 2.48 NA XXX
area.
78305 ................ A Bone imaging, multiple 0.83 3.78 NA 0.19 4.80 NA XXX
areas.
78305 26 A Bone imaging, multiple 0.83 0.30 0.30 0.03 1.16 1.16 XXX
areas.
78305 TC A Bone imaging, multiple 0.00 3.48 NA 0.16 3.64 NA XXX
areas.
78306 ................ A Bone imaging, whole 0.86 4.37 NA 0.22 5.45 NA XXX
body.
78306 26 A Bone imaging, whole 0.86 0.31 0.31 0.04 1.21 1.21 XXX
body.
78306 TC A Bone imaging, whole 0.00 4.06 NA 0.18 4.24 NA XXX
body.
78315 ................ A Bone imaging, 3 phase. 1.02 4.91 NA 0.25 6.18 NA XXX
78315 26 A Bone imaging, 3 phase. 1.02 0.37 0.37 0.04 1.43 1.43 XXX
78315 TC A Bone imaging, 3 phase. 0.00 4.54 NA 0.21 4.75 NA XXX
78320 ................ A Bone imaging (3D)..... 1.04 6.00 NA 0.30 7.34 NA XXX
78320 26 A Bone imaging (3D)..... 1.04 0.39 0.39 0.04 1.47 1.47 XXX
78320 TC A Bone imaging (3D)..... 0.00 5.61 NA 0.26 5.87 NA XXX
78350 ................ A Bone mineral, single 0.22 0.80 NA 0.05 1.07 NA XXX
photon.
78350 26 A Bone mineral, single 0.22 0.08 0.08 0.01 0.31 0.31 XXX
photon.
78350 TC A Bone mineral, single 0.00 0.72 NA 0.04 0.76 NA XXX
photon.
78351 ................ N Bone mineral, dual +0.30 1.64 0.12 0.01 1.95 0.43 XXX
photon.
78399 ................ C Musculoskeletal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
nuclear exam.
78399 26 C Musculoskeletal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
nuclear exam.
78399 TC C Musculoskeletal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
nuclear exam.
78414 ................ C Non-imaging heart 0.00 0.00 0.00 0.00 0.00 0.00 XXX
function.
78414 26 A Non-imaging heart 0.45 0.16 0.16 0.02 0.63 0.63 XXX
function.
78414 TC C Non-imaging heart 0.00 0.00 0.00 0.00 0.00 0.00 XXX
function.
78428 ................ A Cardiac shunt imaging. 0.78 2.46 NA 0.14 3.38 NA XXX
78428 26 A Cardiac shunt imaging. 0.78 0.32 0.32 0.03 1.13 1.13 XXX
78428 TC A Cardiac shunt imaging. 0.00 2.14 NA 0.11 2.25 NA XXX
78445 ................ A Vascular flow imaging. 0.49 1.94 NA 0.11 2.54 NA XXX
78445 26 A Vascular flow imaging. 0.49 0.18 0.18 0.02 0.69 0.69 XXX
78445 TC A Vascular flow imaging. 0.00 1.76 NA 0.09 1.85 NA XXX
78455 ................ A Venous thrombosis 0.73 4.04 NA 0.20 4.97 NA XXX
study.
78455 26 A Venous thrombosis 0.73 0.26 0.26 0.03 1.02 1.02 XXX
study.
78455 TC A Venous thrombosis 0.00 3.78 NA 0.17 3.95 NA XXX
study.
78456 ................ A Acute venous thrombus 1.00 4.15 NA 0.28 5.43 NA XXX
image.
78456 26 A Acute venous thrombus 1.00 0.37 0.37 0.04 1.41 1.41 XXX
image.
78456 TC A Acute venous thrombus 0.00 3.78 NA 0.24 4.02 NA XXX
image.
78457 ................ A Venous thrombosis 0.77 2.81 NA 0.15 3.73 NA XXX
imaging.
[[Page 55428]]
78457 26 A Venous thrombosis 0.77 0.28 0.28 0.03 1.08 1.08 XXX
imaging.
78457 TC A Venous thrombosis 0.00 2.53 NA 0.12 2.65 NA XXX
imaging.
78458 ................ A Ven thrombosis images, 0.90 4.17 NA 0.20 5.27 NA XXX
bilat.
78458 26 A Ven thrombosis images, 0.90 0.35 0.35 0.03 1.28 1.28 XXX
bilat.
78458 TC A Ven thrombosis images, 0.00 3.82 NA 0.17 3.99 NA XXX
bilat.
78459 ................ I Heart muscle imaging 0.00 0.00 0.00 0.00 0.00 0.00 XXX
(PET).
78459 26 I Heart muscle imaging +1.88 0.75 0.75 0.08 2.71 2.71 XXX
(PET).
78459 TC I Heart muscle imaging 0.00 0.00 0.00 0.00 0.00 0.00 XXX
(PET).
78460 ................ A Heart muscle blood, 0.86 2.55 NA 0.14 3.55 NA XXX
single.
78460 26 A Heart muscle blood, 0.86 0.31 0.31 0.03 1.20 1.20 XXX
single.
78460 TC A Heart muscle blood, 0.00 2.24 NA 0.11 2.35 NA XXX
single.
78461 ................ A Heart muscle blood, 1.23 4.94 NA 0.26 6.43 NA XXX
multiple.
78461 26 A Heart muscle blood, 1.23 0.46 0.46 0.05 1.74 1.74 XXX
multiple.
78461 TC A Heart muscle blood, 0.00 4.48 NA 0.21 4.69 NA XXX
multiple.
78464 ................ A Heart image (3d), 1.09 7.12 NA 0.35 8.56 NA XXX
single.
78464 26 A Heart image (3d), 1.09 0.41 0.41 0.04 1.54 1.54 XXX
single.
78464 TC A Heart image (3d), 0.00 6.71 NA 0.31 7.02 NA XXX
single.
78465 ................ A Heart image (3d), 1.46 11.76 NA 0.56 13.78 NA XXX
multiple.
78465 26 A Heart image (3d), 1.46 0.56 0.56 0.05 2.07 2.07 XXX
multiple.
78465 TC A Heart image (3d), 0.00 11.20 NA 0.51 11.71 NA XXX
multiple.
78466 ................ A Heart infarct image... 0.69 2.75 NA 0.15 3.59 NA XXX
78466 26 A Heart infarct image... 0.69 0.26 0.26 0.03 0.98 0.98 XXX
78466 TC A Heart infarct image... 0.00 2.49 NA 0.12 2.61 NA XXX
78468 ................ A Heart infarct image 0.80 3.78 NA 0.19 4.77 NA XXX
(ef).
78468 26 A Heart infarct image 0.80 0.30 0.30 0.03 1.13 1.13 XXX
(ef).
78468 TC A Heart infarct image 0.00 3.48 NA 0.16 3.64 NA XXX
(ef).
78469 ................ A Heart infarct image 0.92 5.31 NA 0.26 6.49 NA XXX
(3D).
78469 26 A Heart infarct image 0.92 0.35 0.35 0.03 1.30 1.30 XXX
(3D).
78469 TC A Heart infarct image 0.00 4.96 NA 0.23 5.19 NA XXX
(3D).
78472 ................ A Gated heart, planar, 0.98 5.60 NA 0.29 6.87 NA XXX
single.
78472 26 A Gated heart, planar, 0.98 0.37 0.37 0.04 1.39 1.39 XXX
single.
78472 TC A Gated heart, planar, 0.00 5.23 NA 0.25 5.48 NA XXX
single.
78473 ................ A Gated heart, multiple. 1.47 8.40 NA 0.40 10.27 NA XXX
78473 26 A Gated heart, multiple. 1.47 0.56 0.56 0.05 2.08 2.08 XXX
78473 TC A Gated heart, multiple. 0.00 7.84 NA 0.35 8.19 NA XXX
78478 ................ A Heart wall motion add- 0.62 1.72 NA 0.10 2.44 NA ZZZ
on.
78478 26 A Heart wall motion add- 0.62 0.24 0.24 0.02 0.88 0.88 ZZZ
on.
78478 TC A Heart wall motion add- 0.00 1.48 NA 0.08 1.56 NA ZZZ
on.
78480 ................ A Heart function add-on. 0.62 1.72 NA 0.10 2.44 NA ZZZ
78480 26 A Heart function add-on. 0.62 0.24 0.24 0.02 0.88 0.88 ZZZ
78480 TC A Heart function add-on. 0.00 1.48 NA 0.08 1.56 NA ZZZ
78481 ................ A Heart first pass, 0.98 5.35 NA 0.26 6.59 NA XXX
single.
78481 26 A Heart first pass, 0.98 0.39 0.39 0.03 1.40 1.40 XXX
single.
78481 TC A Heart first pass, 0.00 4.96 NA 0.23 5.19 NA XXX
single.
78483 ................ A Heart first pass, 1.47 8.05 NA 0.39 9.91 NA XXX
multiple.
78483 26 A Heart first pass, 1.47 0.58 0.58 0.05 2.10 2.10 XXX
multiple.
78483 TC A Heart first pass, 0.00 7.47 NA 0.34 7.81 NA XXX
multiple.
78491 ................ I Heart image (pet), 0.00 0.00 0.00 0.00 0.00 0.00 XXX
single.
78491 26 I Heart image (pet), +1.50 0.60 0.60 0.05 2.15 2.15 XXX
single.
78491 TC I Heart image (pet), 0.00 0.00 0.00 0.00 0.00 0.00 XXX
single.
78492 ................ I Heart image (pet), 0.00 0.00 0.00 0.00 0.00 0.00 XXX
multiple.
78492 26 I Heart image (pet), +1.87 0.75 0.75 0.06 2.68 2.68 XXX
multiple.
78492 TC I Heart image (pet), 0.00 0.00 0.00 0.00 0.00 0.00 XXX
multiple.
78494 ................ A Heart image, spect.... 1.19 7.15 NA 0.29 8.63 NA XXX
78494 26 A Heart image, spect.... 1.19 0.44 0.44 0.04 1.67 1.67 XXX
78494 TC A Heart image, spect.... 0.00 6.71 NA 0.25 6.96 NA XXX
78496 ................ A Heart first pass add- 0.50 6.91 NA 0.27 7.68 NA ZZZ
on.
78496 26 A Heart first pass add- 0.50 0.20 0.20 0.02 0.72 0.72 ZZZ
on.
78496 TC A Heart first pass add- 0.00 6.71 NA 0.25 6.96 NA ZZZ
on.
78499 ................ C Cardiovascular nuclear 0.00 0.00 0.00 0.00 0.00 0.00 XXX
exam.
78499 26 C Cardiovascular nuclear 0.00 0.00 0.00 0.00 0.00 0.00 XXX
exam.
78499 TC C Cardiovascular nuclear 0.00 0.00 0.00 0.00 0.00 0.00 XXX
exam.
78580 ................ A Lung perfusion imaging 0.74 3.53 NA 0.18 4.45 NA XXX
78580 26 A Lung perfusion imaging 0.74 0.27 0.27 0.03 1.04 1.04 XXX
78580 TC A Lung perfusion imaging 0.00 3.26 NA 0.15 3.41 NA XXX
78584 ................ A Lung V/Q image single 0.99 3.39 NA 0.18 4.56 NA XXX
breath.
78584 26 A Lung V/Q image single 0.99 0.35 0.35 0.04 1.38 1.38 XXX
breath.
78584 TC A Lung V/Q image single 0.00 3.04 NA 0.14 3.18 NA XXX
breath.
78585 ................ A Lung V/Q imaging...... 1.09 5.74 NA 0.30 7.13 NA XXX
78585 26 A Lung V/Q imaging...... 1.09 0.39 0.39 0.05 1.53 1.53 XXX
78585 TC A Lung V/Q imaging...... 0.00 5.35 NA 0.25 5.60 NA XXX
78586 ................ A Aerosol lung image, 0.40 2.60 NA 0.14 3.14 NA XXX
single.
78586 26 A Aerosol lung image, 0.40 0.14 0.14 0.02 0.56 0.56 XXX
single.
[[Page 55429]]
78586 TC A Aerosol lung image, 0.00 2.46 NA 0.12 2.58 NA XXX
single.
78587 ................ A Aerosol lung image, 0.49 2.84 NA 0.14 3.47 NA XXX
multiple.
78587 26 A Aerosol lung image, 0.49 0.18 0.18 0.02 0.69 0.69 XXX
multiple.
78587 TC A Aerosol lung image, 0.00 2.66 NA 0.12 2.78 NA XXX
multiple.
78588 ................ A Perfusion lung image.. 1.09 3.43 NA 0.20 4.72 NA XXX
78588 26 A Perfusion lung image.. 1.09 0.39 0.39 0.05 1.53 1.53 XXX
78588 TC A Perfusion lung image.. 0.00 3.04 NA 0.15 3.19 NA XXX
78591 ................ A Vent image, 1 breath, 0.40 2.86 NA 0.14 3.40 NA XXX
1 proj.
78591 26 A Vent image, 1 breath, 0.40 0.15 0.15 0.02 0.57 0.57 XXX
1 proj.
78591 TC A Vent image, 1 breath, 0.00 2.71 NA 0.12 2.83 NA XXX
1 proj.
78593 ................ A Vent image, 1 proj, 0.49 3.46 NA 0.17 4.12 NA XXX
gas.
78593 26 A Vent image, 1 proj, 0.49 0.18 0.18 0.02 0.69 0.69 XXX
gas.
78593 TC A Vent image, 1 proj, 0.00 3.28 NA 0.15 3.43 NA XXX
gas.
78594 ................ A Vent image, mult proj, 0.53 4.92 NA 0.23 5.68 NA XXX
gas.
78594 26 A Vent image, mult proj, 0.53 0.19 0.19 0.02 0.74 0.74 XXX
gas.
78594 TC A Vent image, mult proj, 0.00 4.73 NA 0.21 4.94 NA XXX
gas.
78596 ................ A Lung differential 1.27 7.17 NA 0.36 8.80 NA XXX
function.
78596 26 A Lung differential 1.27 0.46 0.46 0.05 1.78 1.78 XXX
function.
78596 TC A Lung differential 0.00 6.71 NA 0.31 7.02 NA XXX
function.
78599 ................ C Respiratory nuclear 0.00 0.00 0.00 0.00 0.00 0.00 XXX
exam.
78599 26 C Respiratory nuclear 0.00 0.00 0.00 0.00 0.00 0.00 XXX
exam.
78599 TC C Respiratory nuclear 0.00 0.00 0.00 0.00 0.00 0.00 XXX
exam.
78600 ................ A Brain imaging, ltd 0.44 2.90 NA 0.14 3.48 NA XXX
static.
78600 26 A Brain imaging, ltd 0.44 0.16 0.16 0.02 0.62 0.62 XXX
static.
78600 TC A Brain imaging, ltd 0.00 2.74 NA 0.12 2.86 NA XXX
static.
78601 ................ A Brain imaging, ltd w/ 0.51 3.41 NA 0.17 4.09 NA XXX
flow.
78601 26 A Brain imaging, ltd w/ 0.51 0.18 0.18 0.02 0.71 0.71 XXX
flow.
78601 TC A Brain imaging, ltd w/ 0.00 3.23 NA 0.15 3.38 NA XXX
flow.
78605 ................ A Brain imaging, 0.53 3.42 NA 0.17 4.12 NA XXX
complete.
78605 26 A Brain imaging, 0.53 0.19 0.19 0.02 0.74 0.74 XXX
complete.
78605 TC A Brain imaging, 0.00 3.23 NA 0.15 3.38 NA XXX
complete.
78606 ................ A Brain imaging, compl w/ 0.64 3.90 NA 0.20 4.74 NA XXX
flow.
78606 26 A Brain imaging, compl w/ 0.64 0.23 0.23 0.03 0.90 0.90 XXX
flow.
78606 TC A Brain imaging, compl w/ 0.00 3.67 NA 0.17 3.84 NA XXX
flow.
78607 ................ A Brain imaging (3D).... 1.23 6.70 NA 0.34 8.27 NA XXX
78607 26 A Brain imaging (3D).... 1.23 0.47 0.47 0.05 1.75 1.75 XXX
78607 TC A Brain imaging (3D).... 0.00 6.23 NA 0.29 6.52 NA XXX
78608 ................ N Brain imaging (PET)... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
78609 ................ N Brain imaging (PET)... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
78610 ................ A Brain flow imaging 0.30 1.61 NA 0.09 2.00 NA XXX
only.
78610 26 A Brain flow imaging 0.30 0.11 0.11 0.01 0.42 0.42 XXX
only.
78610 TC A Brain flow imaging 0.00 1.50 NA 0.08 1.58 NA XXX
only.
78615 ................ A Cerebral vascular flow 0.42 3.81 NA 0.19 4.42 NA XXX
image.
78615 26 A Cerebral vascular flow 0.42 0.16 0.16 0.02 0.60 0.60 XXX
image.
78615 TC A Cerebral vascular flow 0.00 3.65 NA 0.17 3.82 NA XXX
image.
78630 ................ A Cerebrospinal fluid 0.68 5.02 NA 0.25 5.95 NA XXX
scan.
78630 26 A Cerebrospinal fluid 0.68 0.24 0.24 0.03 0.95 0.95 XXX
scan.
78630 TC A Cerebrospinal fluid 0.00 4.78 NA 0.22 5.00 NA XXX
scan.
78635 ................ A CSF ventriculography.. 0.61 2.67 NA 0.14 3.42 NA XXX
78635 26 A CSF ventriculography.. 0.61 0.25 0.25 0.02 0.88 0.88 XXX
78635 TC A CSF ventriculography.. 0.00 2.42 NA 0.12 2.54 NA XXX
78645 ................ A CSF shunt evaluation.. 0.57 3.47 NA 0.17 4.21 NA XXX
78645 26 A CSF shunt evaluation.. 0.57 0.21 0.21 0.02 0.80 0.80 XXX
78645 TC A CSF shunt evaluation.. 0.00 3.26 NA 0.15 3.41 NA XXX
78647 ................ A Cerebrospinal fluid 0.90 5.94 NA 0.29 7.13 NA XXX
scan.
78647 26 A Cerebrospinal fluid 0.90 0.33 0.33 0.03 1.26 1.26 XXX
scan.
78647 TC A Cerebrospinal fluid 0.00 5.61 NA 0.26 5.87 NA XXX
scan.
78650 ................ A CSF leakage imaging... 0.61 4.63 NA 0.22 5.46 NA XXX
78650 26 A CSF leakage imaging... 0.61 0.22 0.22 0.02 0.85 0.85 XXX
78650 TC A CSF leakage imaging... 0.00 4.41 NA 0.20 4.61 NA XXX
78660 ................ A Nuclear exam of tear 0.53 2.20 NA 0.12 2.85 NA XXX
flow.
78660 26 A Nuclear exam of tear 0.53 0.19 0.19 0.02 0.74 0.74 XXX
flow.
78660 TC A Nuclear exam of tear 0.00 2.01 NA 0.10 2.11 NA XXX
flow.
78699 ................ C Nervous system nuclear 0.00 0.00 0.00 0.00 0.00 0.00 XXX
exam.
78699 26 C Nervous system nuclear 0.00 0.00 0.00 0.00 0.00 0.00 XXX
exam.
78699 TC C Nervous system nuclear 0.00 0.00 0.00 0.00 0.00 0.00 XXX
exam.
78700 ................ A Kidney imaging, static 0.45 3.05 NA 0.15 3.65 NA XXX
78700 26 A Kidney imaging, static 0.45 0.16 0.16 0.02 0.63 0.63 XXX
78700 TC A Kidney imaging, static 0.00 2.89 NA 0.13 3.02 NA XXX
78701 ................ A Kidney imaging with 0.49 3.55 NA 0.17 4.21 NA XXX
flow.
78701 26 A Kidney imaging with 0.49 0.17 0.17 0.02 0.68 0.68 XXX
flow.
78701 TC A Kidney imaging with 0.00 3.38 NA 0.15 3.53 NA XXX
flow.
78704 ................ A Imaging renogram...... 0.74 4.03 NA 0.20 4.97 NA XXX
[[Page 55430]]
78704 26 A Imaging renogram...... 0.74 0.27 0.27 0.03 1.04 1.04 XXX
78704 TC A Imaging renogram...... 0.00 3.76 NA 0.17 3.93 NA XXX
78707 ................ A Kidney flow/function 0.96 4.59 NA 0.23 5.78 NA XXX
image.
78707 26 A Kidney flow/function 0.96 0.35 0.35 0.04 1.35 1.35 XXX
image.
78707 TC A Kidney flow/function 0.00 4.24 NA 0.19 4.43 NA XXX
image.
78708 ................ A Kidney flow/function 1.21 4.68 NA 0.24 6.13 NA XXX
image.
78708 26 A Kidney flow/function 1.21 0.44 0.44 0.05 1.70 1.70 XXX
image.
78708 TC A Kidney flow/function 0.00 4.24 NA 0.19 4.43 NA XXX
image.
78709 ................ A Kidney flow/function 1.41 4.75 NA 0.25 6.41 NA XXX
image.
78709 26 A Kidney flow/function 1.41 0.51 0.51 0.06 1.98 1.98 XXX
image.
78709 TC A Kidney flow/function 0.00 4.24 NA 0.19 4.43 NA XXX
image.
78710 ................ A Kidney imaging (3D)... 0.66 5.84 NA 0.29 6.79 NA XXX
78710 26 A Kidney imaging (3D)... 0.66 0.23 0.23 0.03 0.92 0.92 XXX
78710 TC A Kidney imaging (3D)... 0.00 5.61 NA 0.26 5.87 NA XXX
78715 ................ A Renal vascular flow 0.30 1.61 NA 0.09 2.00 NA XXX
exam.
78715 26 A Renal vascular flow 0.30 0.11 0.11 0.01 0.42 0.42 XXX
exam.
78715 TC A Renal vascular flow 0.00 1.50 NA 0.08 1.58 NA XXX
exam.
78725 ................ A Kidney function study. 0.38 1.83 NA 0.10 2.31 NA XXX
78725 26 A Kidney function study. 0.38 0.14 0.14 0.01 0.53 0.53 XXX
78725 TC A Kidney function study. 0.00 1.69 NA 0.09 1.78 NA XXX
78730 ................ A Urinary bladder 0.36 1.52 NA 0.09 1.97 NA XXX
retention.
78730 26 A Urinary bladder 0.36 0.13 0.13 0.02 0.51 0.51 XXX
retention.
78730 TC A Urinary bladder 0.00 1.39 NA 0.07 1.46 NA XXX
retention.
78740 ................ A Ureteral reflux study. 0.57 2.22 NA 0.12 2.91 NA XXX
78740 26 A Ureteral reflux study. 0.57 0.21 0.21 0.02 0.80 0.80 XXX
78740 TC A Ureteral reflux study. 0.00 2.01 NA 0.10 2.11 NA XXX
78760 ................ A Testicular imaging.... 0.66 2.77 NA 0.15 3.58 NA XXX
78760 26 A Testicular imaging.... 0.66 0.23 0.23 0.03 0.92 0.92 XXX
78760 TC A Testicular imaging.... 0.00 2.54 NA 0.12 2.66 NA XXX
78761 ................ A Testicular imaging/ 0.71 3.30 NA 0.17 4.18 NA XXX
flow.
78761 26 A Testicular imaging/ 0.71 0.26 0.26 0.03 1.00 1.00 XXX
flow.
78761 TC A Testicular imaging/ 0.00 3.04 NA 0.14 3.18 NA XXX
flow.
78799 ................ C Genitourinary nuclear 0.00 0.00 0.00 0.00 0.00 0.00 XXX
exam.
78799 26 C Genitourinary nuclear 0.00 0.00 0.00 0.00 0.00 0.00 XXX
exam.
78799 TC C Genitourinary nuclear 0.00 0.00 0.00 0.00 0.00 0.00 XXX
exam.
78800 ................ A Tumor imaging, limited 0.66 3.46 NA 0.18 4.30 NA XXX
area.
78800 26 A Tumor imaging, limited 0.66 0.23 0.23 0.03 0.92 0.92 XXX
area.
78800 TC A Tumor imaging, limited 0.00 3.23 NA 0.15 3.38 NA XXX
area.
78801 ................ A Tumor imaging, mult 0.79 4.30 NA 0.21 5.30 NA XXX
areas.
78801 26 A Tumor imaging, mult 0.79 0.29 0.29 0.03 1.11 1.11 XXX
areas.
78801 TC A Tumor imaging, mult 0.00 4.01 NA 0.18 4.19 NA XXX
areas.
78802 ................ A Tumor imaging, whole 0.86 5.57 NA 0.28 6.71 NA XXX
body.
78802 26 A Tumor imaging, whole 0.86 0.32 0.32 0.03 1.21 1.21 XXX
body.
78802 TC A Tumor imaging, whole 0.00 5.25 NA 0.25 5.50 NA XXX
body.
78803 ................ A Tumor imaging (3D).... 1.09 6.64 NA 0.33 8.06 NA XXX
78803 26 A Tumor imaging (3D).... 1.09 0.41 0.41 0.04 1.54 1.54 XXX
78803 TC A Tumor imaging (3D).... 0.00 6.23 NA 0.29 6.52 NA XXX
78805 ................ A Abscess imaging, ltd 0.73 3.50 NA 0.18 4.41 NA XXX
area.
78805 26 A Abscess imaging, ltd 0.73 0.27 0.27 0.03 1.03 1.03 XXX
area.
78805 TC A Abscess imaging, ltd 0.00 3.23 NA 0.15 3.38 NA XXX
area.
78806 ................ A Abscess imaging, whole 0.86 6.43 NA 0.32 7.61 NA XXX
body.
78806 26 A Abscess imaging, whole 0.86 0.32 0.32 0.03 1.21 1.21 XXX
body.
78806 TC A Abscess imaging, whole 0.00 6.11 NA 0.29 6.40 NA XXX
body.
78807 ................ A Nuclear localization/ 1.09 6.66 NA 0.33 8.08 NA XXX
abscess.
78807 26 A Nuclear localization/ 1.09 0.43 0.43 0.04 1.56 1.56 XXX
abscess.
78807 TC A Nuclear localization/ 0.00 6.23 NA 0.29 6.52 NA XXX
abscess.
78810 ................ N Tumor imaging (PET)... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
78810 26 N Tumor imaging (PET)... +1.93 0.77 0.77 0.09 2.79 2.79 XXX
78810 TC N Tumor imaging (PET)... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
78890 ................ B Nuclear medicine data +0.05 1.26 NA 0.06 1.37 NA XXX
proc.
78890 26 B Nuclear medicine data +0.05 0.02 0.02 0.01 0.08 0.08 XXX
proc.
78890 TC B Nuclear medicine data +0.00 1.24 NA 0.05 1.29 NA XXX
proc.
78891 ................ B Nuclear med data proc. +0.10 2.53 NA 0.12 2.75 NA XXX
78891 26 B Nuclear med data proc. +0.10 0.04 0.04 0.01 0.15 0.15 XXX
78891 TC B Nuclear med data proc. +0.00 2.49 NA 0.11 2.60 NA XXX
78990 ................ I Provide diag 0.00 0.00 0.00 0.00 0.00 0.00 XXX
radionuclide(s).
78999 ................ C Nuclear diagnostic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
exam.
78999 26 C Nuclear diagnostic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
exam.
78999 TC C Nuclear diagnostic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
exam.
79000 ................ A Init hyperthyroid 1.80 3.14 NA 0.19 5.13 NA XXX
therapy.
79000 26 A Init hyperthyroid 1.80 0.65 0.65 0.07 2.52 2.52 XXX
therapy.
79000 TC A Init hyperthyroid 0.00 2.49 NA 0.12 2.61 NA XXX
therapy.
79001 ................ A Repeat hyperthyroid 1.05 1.63 NA 0.10 2.78 NA XXX
therapy.
[[Page 55431]]
79001 26 A Repeat hyperthyroid 1.05 0.39 0.39 0.04 1.48 1.48 XXX
therapy.
79001 TC A Repeat hyperthyroid 0.00 1.24 NA 0.06 1.30 NA XXX
therapy.
79020 ................ A Thyroid ablation...... 1.81 3.13 NA 0.19 5.13 NA XXX
79020 26 A Thyroid ablation...... 1.81 0.64 0.64 0.07 2.52 2.52 XXX
79020 TC A Thyroid ablation...... 0.00 2.49 NA 0.12 2.61 NA XXX
79030 ................ A Thyroid ablation, 2.10 3.26 NA 0.20 5.56 NA XXX
carcinoma.
79030 26 A Thyroid ablation, 2.10 0.77 0.77 0.08 2.95 2.95 XXX
carcinoma.
79030 TC A Thyroid ablation, 0.00 2.49 NA 0.12 2.61 NA XXX
carcinoma.
79035 ................ A Thyroid metastatic 2.52 3.43 NA 0.21 6.16 NA XXX
therapy.
79035 26 A Thyroid metastatic 2.52 0.94 0.94 0.09 3.55 3.55 XXX
therapy.
79035 TC A Thyroid metastatic 0.00 2.49 NA 0.12 2.61 NA XXX
therapy.
79100 ................ A Hematopoetic nuclear 1.32 3.00 NA 0.17 4.49 NA XXX
therapy.
79100 26 A Hematopoetic nuclear 1.32 0.51 0.51 0.05 1.88 1.88 XXX
therapy.
79100 TC A Hematopoetic nuclear 0.00 2.49 NA 0.12 2.61 NA XXX
therapy.
79200 ................ A Intracavitary nuclear 1.99 3.23 NA 0.19 5.41 NA XXX
trmt.
79200 26 A Intracavitary nuclear 1.99 0.74 0.74 0.07 2.80 2.80 XXX
trmt.
79200 TC A Intracavitary nuclear 0.00 2.49 NA 0.12 2.61 NA XXX
trmt.
79300 ................ C Interstitial nuclear 0.00 0.00 0.00 0.00 0.00 0.00 XXX
therapy.
79300 26 A Interstitial nuclear 1.60 0.68 0.68 0.07 2.35 2.35 XXX
therapy.
79300 TC C Interstitial nuclear 0.00 0.00 0.00 0.00 0.00 0.00 XXX
therapy.
79400 ................ A Nonhemato nuclear 1.96 3.22 NA 0.20 5.38 NA XXX
therapy.
79400 26 A Nonhemato nuclear 1.96 0.73 0.73 0.08 2.77 2.77 XXX
therapy.
79400 TC A Nonhemato nuclear 0.00 2.49 NA 0.12 2.61 NA XXX
therapy.
79420 ................ C Intravascular nuclear 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ther.
79420 26 A Intravascular nuclear 1.51 0.54 0.54 0.06 2.11 2.11 XXX
ther.
79420 TC C Intravascular nuclear 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ther.
79440 ................ A Nuclear joint therapy. 1.99 3.29 NA 0.20 5.48 NA XXX
79440 26 A Nuclear joint therapy. 1.99 0.80 0.80 0.08 2.87 2.87 XXX
79440 TC A Nuclear joint therapy. 0.00 2.49 NA 0.12 2.61 NA XXX
79900 ................ C Provide ther 0.00 0.00 0.00 0.00 0.00 0.00 XXX
radiopharm(s).
79999 ................ C Nuclear medicine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
therapy.
79999 26 C Nuclear medicine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
therapy.
79999 TC C Nuclear medicine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
therapy.
80048 ................ X Basic metabolic panel. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80050 ................ N General health panel.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80051 ................ X Electrolyte panel..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80053 ................ X Comprehen metabolic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
panel.
80055 ................ I Obstetric panel....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80061 ................ X Lipid panel........... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80069 ................ X Renal function panel.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80072 ................ D Arthritis panel....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80074 ................ X Acute hepatitis panel. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80076 ................ X Hepatic function panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80090 ................ X Torch antibody panel.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80100 ................ X Drug screen, qualitate/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
multi.
80101 ................ X Drug screen, single... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80102 ................ X Drug confirmation..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80103 ................ X Drug analysis, tissue 0.00 0.00 0.00 0.00 0.00 0.00 XXX
prep.
80150 ................ X Assay of amikacin..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80152 ................ X Assay of amitriptyline 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80154 ................ X Assay of 0.00 0.00 0.00 0.00 0.00 0.00 XXX
benzodiazepines.
80156 ................ X Assay, carbamazepine, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
total.
80157 ................ X Assay, carbamazepine, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
free.
80158 ................ X Assay of cyclosporine. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80160 ................ X Assay of desipramine.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80162 ................ X Assay of digoxin...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80164 ................ X Assay, dipropylacetic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
acid.
80166 ................ X Assay of doxepin...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80168 ................ X Assay of ethosuximide. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80170 ................ X Assay of gentamicin... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80172 ................ X Assay of gold......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80173 ................ X Assay of haloperidol.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80174 ................ X Assay of imipramine... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80176 ................ X Assay of lidocaine.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80178 ................ X Assay of lithium...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80182 ................ X Assay of nortriptyline 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80184 ................ X Assay of phenobarbital 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80185 ................ X Assay of phenytoin, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
total.
80186 ................ X Assay of phenytoin, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
free.
80188 ................ X Assay of primidone.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80190 ................ X Assay of procainamide. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80192 ................ X Assay of procainamide. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80194 ................ X Assay of quinidine.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
[[Page 55432]]
80196 ................ X Assay of salicylate... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80197 ................ X Assay of tacrolimus... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80198 ................ X Assay of theophylline. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80200 ................ X Assay of tobramycin... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80201 ................ X Assay of topiramate... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80202 ................ X Assay of vancomycin... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80299 ................ X Quantitative assay, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
drug.
80400 ................ X Acth stimulation panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80402 ................ X Acth stimulation panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80406 ................ X Acth stimulation panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80408 ................ X Aldosterone 0.00 0.00 0.00 0.00 0.00 0.00 XXX
suppression eval.
80410 ................ X Calcitonin stimul 0.00 0.00 0.00 0.00 0.00 0.00 XXX
panel.
80412 ................ X CRH stimulation panel. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80414 ................ X Testosterone response. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80415 ................ X Estradiol response 0.00 0.00 0.00 0.00 0.00 0.00 XXX
panel.
80416 ................ X Renin stimulation 0.00 0.00 0.00 0.00 0.00 0.00 XXX
panel.
80417 ................ X Renin stimulation 0.00 0.00 0.00 0.00 0.00 0.00 XXX
panel.
80418 ................ X Pituitary evaluation 0.00 0.00 0.00 0.00 0.00 0.00 XXX
panel.
80420 ................ X Dexamethasone panel... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80422 ................ X Glucagon tolerance 0.00 0.00 0.00 0.00 0.00 0.00 XXX
panel.
80424 ................ X Glucagon tolerance 0.00 0.00 0.00 0.00 0.00 0.00 XXX
panel.
80426 ................ X Gonadotropin hormone 0.00 0.00 0.00 0.00 0.00 0.00 XXX
panel.
80428 ................ X Growth hormone panel.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80430 ................ X Growth hormone panel.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80432 ................ X Insulin suppression 0.00 0.00 0.00 0.00 0.00 0.00 XXX
panel.
80434 ................ X Insulin tolerance 0.00 0.00 0.00 0.00 0.00 0.00 XXX
panel.
80435 ................ X Insulin tolerance 0.00 0.00 0.00 0.00 0.00 0.00 XXX
panel.
80436 ................ X Metyrapone panel...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80438 ................ X TRH stimulation panel. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80439 ................ X TRH stimulation panel. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80440 ................ X TRH stimulation panel. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
80500 ................ A Lab pathology 0.37 0.21 0.17 0.01 0.59 0.55 XXX
consultation.
80502 ................ A Lab pathology 1.33 0.63 0.61 0.05 2.01 1.99 XXX
consultation.
81000 ................ X Urinalysis, nonauto w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
scope.
81001 ................ X Urinalysis, auto w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
scope.
81002 ................ X Urinalysis nonauto w/o 0.00 0.00 0.00 0.00 0.00 0.00 XXX
scope.
81003 ................ X Urinalysis, auto, w/o 0.00 0.00 0.00 0.00 0.00 0.00 XXX
scope.
81005 ................ X Urinalysis............ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
81007 ................ X Urine screen for 0.00 0.00 0.00 0.00 0.00 0.00 XXX
bacteria.
81015 ................ X Microscopic exam of 0.00 0.00 0.00 0.00 0.00 0.00 XXX
urine.
81020 ................ X Urinalysis, glass test 0.00 0.00 0.00 0.00 0.00 0.00 XXX
81025 ................ X Urine pregnancy test.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
81050 ................ X Urinalysis, volume 0.00 0.00 0.00 0.00 0.00 0.00 XXX
measure.
81099 ................ X Urinalysis test 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
82000 ................ X Assay of blood 0.00 0.00 0.00 0.00 0.00 0.00 XXX
acetaldehyde.
82003 ................ X Assay of acetaminophen 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82009 ................ X Test for acetone/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ketones.
82010 ................ X Acetone assay......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82013 ................ X Acetylcholinesterase 0.00 0.00 0.00 0.00 0.00 0.00 XXX
assay.
82016 ................ X Acylcarnitines, qual.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82017 ................ X Acylcarnitines, quant. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82024 ................ X Assay of acth......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82030 ................ X Assay of adp & amp.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82040 ................ X Assay of serum albumin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82042 ................ X Assay of urine albumin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82043 ................ X Microalbumin, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
quantitative.
82044 ................ X Microalbumin, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
semiquant.
82055 ................ X Assay of ethanol...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82075 ................ X Assay of breath 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ethanol.
82085 ................ X Assay of aldolase..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82088 ................ X Assay of aldosterone.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82101 ................ X Assay of urine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
alkaloids.
82103 ................ X Alpha-1-antitrypsin, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
total.
82104 ................ X Alpha-1-antitrypsin, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
pheno.
82105 ................ X Alpha-fetoprotein, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
serum.
82106 ................ X Alpha-fetoprotein, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
amniotic.
82108 ................ X Assay of aluminum..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82120 ................ X Amines, vaginal fluid 0.00 0.00 0.00 0.00 0.00 0.00 XXX
qual.
82127 ................ X Amino acid, single 0.00 0.00 0.00 0.00 0.00 0.00 XXX
qual.
82128 ................ X Amino acids, mult qual 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82131 ................ X Amino acids, single 0.00 0.00 0.00 0.00 0.00 0.00 XXX
quant.
82135 ................ X Assay, aminolevulinic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
acid.
82136 ................ X Amino acids, quant, 2- 0.00 0.00 0.00 0.00 0.00 0.00 XXX
5.
[[Page 55433]]
82139 ................ X Amino acids, quan, 6 0.00 0.00 0.00 0.00 0.00 0.00 XXX
or more.
82140 ................ X Assay of ammonia...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82143 ................ X Amniotic fluid scan... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82145 ................ X Assay of amphetamines. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82150 ................ X Assay of amylase...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82154 ................ X Androstanediol 0.00 0.00 0.00 0.00 0.00 0.00 XXX
glucuronide.
82157 ................ X Assay of 0.00 0.00 0.00 0.00 0.00 0.00 XXX
androstenedione.
82160 ................ X Assay of androsterone. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82163 ................ X Assay of angiotensin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
II.
82164 ................ X Angiotensin I enzyme 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
82172 ................ X Assay of 0.00 0.00 0.00 0.00 0.00 0.00 XXX
apolipoprotein.
82175 ................ X Assay of arsenic...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82180 ................ X Assay of ascorbic acid 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82190 ................ X Atomic absorption..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82205 ................ X Assay of barbiturates. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82232 ................ X Assay of beta-2 0.00 0.00 0.00 0.00 0.00 0.00 XXX
protein.
82239 ................ X Bile acids, total..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82240 ................ X Bile acids, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cholylglycine.
82247 ................ X Bilirubin, total...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82248 ................ X Bilirubin, direct..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82252 ................ X Fecal bilirubin test.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82261 ................ X Assay of biotinidase.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82270 ................ X Test for blood, feces. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82273 ................ X Test for blood, other 0.00 0.00 0.00 0.00 0.00 0.00 XXX
source.
82274 ................ X Assay test for blood, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
fecal.
82286 ................ X Assay of bradykinin... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82300 ................ X Assay of cadmium...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82306 ................ X Assay of vitamin D.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82307 ................ X Assay of vitamin D.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82308 ................ X Assay of calcitonin... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82310 ................ X Assay of calcium...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82330 ................ X Assay of calcium...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82331 ................ X Calcium infusion test. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82340 ................ X Assay of calcium in 0.00 0.00 0.00 0.00 0.00 0.00 XXX
urine.
82355 ................ X Calculus analysis, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
qual.
82360 ................ X Calculus assay, quant. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82365 ................ X Calculus spectroscopy. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82370 ................ X X-ray assay, calculus. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82373 ................ X Assay, c-d transfer 0.00 0.00 0.00 0.00 0.00 0.00 XXX
measure.
82374 ................ X Assay, blood carbon 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dioxide.
82375 ................ X Assay, blood carbon 0.00 0.00 0.00 0.00 0.00 0.00 XXX
monoxide.
82376 ................ X Test for carbon 0.00 0.00 0.00 0.00 0.00 0.00 XXX
monoxide.
82378 ................ X Carcinoembryonic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
antigen.
82379 ................ X Assay of carnitine.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82380 ................ X Assay of carotene..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82382 ................ X Assay, urine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
catecholamines.
82383 ................ X Assay, blood 0.00 0.00 0.00 0.00 0.00 0.00 XXX
catecholamines.
82384 ................ X Assay, three 0.00 0.00 0.00 0.00 0.00 0.00 XXX
catecholamines.
82387 ................ X Assay of cathepsin-d.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82390 ................ X Assay of ceruloplasmin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82397 ................ X Chemiluminescent assay 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82415 ................ X Assay of 0.00 0.00 0.00 0.00 0.00 0.00 XXX
chloramphenicol.
82435 ................ X Assay of blood 0.00 0.00 0.00 0.00 0.00 0.00 XXX
chloride.
82436 ................ X Assay of urine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
chloride.
82438 ................ X Assay, other fluid 0.00 0.00 0.00 0.00 0.00 0.00 XXX
chlorides.
82441 ................ X Test for 0.00 0.00 0.00 0.00 0.00 0.00 XXX
chlorohydrocarbons.
82465 ................ X Assay, bld/serum 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cholesterol.
82480 ................ X Assay, serum 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cholinesterase.
82482 ................ X Assay, rbc 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cholinesterase.
82485 ................ X Assay, chondroitin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sulfate.
82486 ................ X Gas/liquid 0.00 0.00 0.00 0.00 0.00 0.00 XXX
chromatography.
82487 ................ X Paper chromatography.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82488 ................ X Paper chromatography.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82489 ................ X Thin layer 0.00 0.00 0.00 0.00 0.00 0.00 XXX
chromatography.
82491 ................ X Chromotography, quant, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sing.
82492 ................ X Chromotography, quant, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mult.
82495 ................ X Assay of chromium..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82507 ................ X Assay of citrate...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82520 ................ X Assay of cocaine...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82523 ................ X Collagen crosslinks... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82525 ................ X Assay of copper....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82528 ................ X Assay of 0.00 0.00 0.00 0.00 0.00 0.00 XXX
corticosterone.
82530 ................ X Cortisol, free........ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
[[Page 55434]]
82533 ................ X Total cortisol........ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82540 ................ X Assay of creatine..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82541 ................ X Column chromotography, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
qual.
82542 ................ X Column chromotography, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
quant.
82543 ................ X Column chromotograph/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
isotope.
82544 ................ X Column chromotograph/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
isotope.
82550 ................ X Assay of ck (cpk)..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82552 ................ X Assay of cpk in blood. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82553 ................ X Creatine, MB fraction. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82554 ................ X Creatine, isoforms.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82565 ................ X Assay of creatinine... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82570 ................ X Assay of urine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
creatinine.
82575 ................ X Creatinine clearance 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
82585 ................ X Assay of 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cryofibrinogen.
82595 ................ X Assay of cryoglobulin. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82600 ................ X Assay of cyanide...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82607 ................ X Vitamin B-12.......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82608 ................ X B-12 binding capacity. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82615 ................ X Test for urine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cystines.
82626 ................ X Dehydroepiandrosterone 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82627 ................ X Dehydroepiandrosterone 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82633 ................ X Desoxycorticosterone.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82634 ................ X Deoxycortisol......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82638 ................ X Assay of dibucaine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
number.
82646 ................ X Assay of 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dihydrocodeinone.
82649 ................ X Assay of 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dihydromorphinone.
82651 ................ X Assay of 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dihydrotestosterone.
82652 ................ X Assay of 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dihydroxyvitamin d.
82654 ................ X Assay of dimethadione. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82657 ................ X Enzyme cell activity.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82658 ................ X Enzyme cell activity, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ra.
82664 ................ X Electrophoretic test.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82666 ................ X Assay of 0.00 0.00 0.00 0.00 0.00 0.00 XXX
epiandrosterone.
82668 ................ X Assay of 0.00 0.00 0.00 0.00 0.00 0.00 XXX
erythropoietin.
82670 ................ X Assay of estradiol.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82671 ................ X Assay of estrogens.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82672 ................ X Assay of estrogen..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82677 ................ X Assay of estriol...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82679 ................ X Assay of estrone...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82690 ................ X Assay of ethchlorvynol 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82693 ................ X Assay of ethylene 0.00 0.00 0.00 0.00 0.00 0.00 XXX
glycol.
82696 ................ X Assay of 0.00 0.00 0.00 0.00 0.00 0.00 XXX
etiocholanolone.
82705 ................ X Fats/lipids, feces, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
qual.
82710 ................ X Fats/lipids, feces, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
quant.
82715 ................ X Assay of fecal fat.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82725 ................ X Assay of blood fatty 0.00 0.00 0.00 0.00 0.00 0.00 XXX
acids.
82726 ................ X Long chain fatty acids 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82728 ................ X Assay of ferritin..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82731 ................ X Assay of fetal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
fibronectin.
82735 ................ X Assay of fluoride..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82742 ................ X Assay of flurazepam... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82746 ................ X Blood folic acid serum 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82747 ................ X Assay of folic acid, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
rbc.
82757 ................ X Assay of semen 0.00 0.00 0.00 0.00 0.00 0.00 XXX
fructose.
82759 ................ X Assay of rbc 0.00 0.00 0.00 0.00 0.00 0.00 XXX
galactokinase.
82760 ................ X Assay of galactose.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82775 ................ X Assay galactose 0.00 0.00 0.00 0.00 0.00 0.00 XXX
transferase.
82776 ................ X Galactose transferase 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
82784 ................ X Assay of gammaglobulin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
igm.
82785 ................ X Assay of gammaglobulin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ige.
82787 ................ X Igg 1, 2, 3 or 4, each 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82800 ................ X Blood pH.............. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82803 ................ X Blood gases: pH, pO2 & 0.00 0.00 0.00 0.00 0.00 0.00 XXX
pCO2.
82805 ................ X Blood gases W/02 0.00 0.00 0.00 0.00 0.00 0.00 XXX
saturation.
82810 ................ X Blood gases, O2 sat 0.00 0.00 0.00 0.00 0.00 0.00 XXX
only.
82820 ................ X Hemoglobin-oxygen 0.00 0.00 0.00 0.00 0.00 0.00 XXX
affinity.
82926 ................ X Assay of gastric acid. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82928 ................ X Assay of gastric acid. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82938 ................ X Gastrin test.......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82941 ................ X Assay of gastrin...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82943 ................ X Assay of glucagon..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82945 ................ X Glucose other fluid... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82946 ................ X Glucagon tolerance 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
[[Page 55435]]
82947 ................ X Assay, glucose, blood 0.00 0.00 0.00 0.00 0.00 0.00 XXX
quant.
82948 ................ X Reagent strip/blood 0.00 0.00 0.00 0.00 0.00 0.00 XXX
glucose.
82950 ................ X Glucose test.......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82951 ................ X Glucose tolerance test 0.00 0.00 0.00 0.00 0.00 0.00 XXX
(GTT).
82952 ................ X GTT-added samples..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82953 ................ X Glucose-tolbutamide 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
82955 ................ X Assay of g6pd enzyme.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82960 ................ X Test for G6PD enzyme.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82962 ................ X Glucose blood test.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82963 ................ X Assay of glucosidase.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82965 ................ X Assay of gdh enzyme... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82975 ................ X Assay of glutamine.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82977 ................ X Assay of GGT.......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82978 ................ X Assay of glutathione.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82979 ................ X Assay, rbc glutathione 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82980 ................ X Assay of glutethimide. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
82985 ................ X Glycated protein...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83001 ................ X Gonadotropin (FSH).... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83002 ................ X Gonadotropin (LH)..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83003 ................ X Assay, growth hormone 0.00 0.00 0.00 0.00 0.00 0.00 XXX
(hgh).
83008 ................ X Assay of guanosine.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83010 ................ X Assay of haptoglobin, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
quant.
83012 ................ X Assay of haptoglobins. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83013 ................ X H pylori analysis..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83014 ................ X H pylori drug admin/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
collect.
83015 ................ X Heavy metal screen.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83018 ................ X Quantitative screen, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
metals.
83020 ................ X Hemoglobin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
electrophoresis.
83020 26 A Hemoglobin 0.37 0.17 0.17 0.01 0.55 0.55 XXX
electrophoresis.
83021 ................ X Hemoglobin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
chromotography.
83026 ................ X Hemoglobin, copper 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sulfate.
83030 ................ X Fetal hemoglobin, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
chemical.
83033 ................ X Fetal hemoglobin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
assay, qual.
83036 ................ X Glycated hemoglobin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
83045 ................ X Blood methemoglobin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
83050 ................ X Blood methemoglobin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
assay.
83051 ................ X Assay of plasma 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hemoglobin.
83055 ................ X Blood sulfhemoglobin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
83060 ................ X Blood sulfhemoglobin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
assay.
83065 ................ X Assay of hemoglobin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
heat.
83068 ................ X Hemoglobin stability 0.00 0.00 0.00 0.00 0.00 0.00 XXX
screen.
83069 ................ X Assay of urine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hemoglobin.
83070 ................ X Assay of hemosiderin, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
qual.
83071 ................ X Assay of hemosiderin, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
quant.
83080 ................ X Assay of b 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hexosaminidase.
83088 ................ X Assay of histamine.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83090 ................ X Assay of homocystine.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83150 ................ X Assay of for hva...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83491 ................ X Assay of 0.00 0.00 0.00 0.00 0.00 0.00 XXX
corticosteroids.
83497 ................ X Assay of 5-hiaa....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83498 ................ X Assay of progesterone. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83499 ................ X Assay of progesterone. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83500 ................ X Assay, free 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hydroxyproline.
83505 ................ X Assay, total 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hydroxyproline.
83516 ................ X Immunoassay, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
nonantibody.
83518 ................ X Immunoassay, dipstick. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83519 ................ X Immunoassay, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
nonantibody.
83520 ................ X Immunoassay, RIA...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83525 ................ X Assay of insulin...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83527 ................ X Assay of insulin...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83528 ................ X Assay of intrinsic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
factor.
83540 ................ X Assay of iron......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83550 ................ X Iron binding test..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83570 ................ X Assay of idh enzyme... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83582 ................ X Assay of ketogenic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
steroids.
83586 ................ X Assay 17- ketosteroids 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83593 ................ X Fractionation, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ketosteroids.
83605 ................ X Assay of lactic acid.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83615 ................ X Lactate (LD) (LDH) 0.00 0.00 0.00 0.00 0.00 0.00 XXX
enzyme.
83625 ................ X Assay of ldh enzymes.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83632 ................ X Placental lactogen.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83633 ................ X Test urine for lactose 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83634 ................ X Assay of urine for 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lactose.
[[Page 55436]]
83655 ................ X Assay of lead......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83661 ................ X L/s ratio, fetal lung. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83662 ................ X Foam stability, fetal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lung.
83663 ................ X Fluoro polarize, fetal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lung.
83664 ................ X Lamellar bdy, fetal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lung.
83670 ................ X Assay of lap enzyme... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83690 ................ X Assay of lipase....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83715 ................ X Assay of blood 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lipoproteins.
83716 ................ X Assay of blood 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lipoproteins.
83718 ................ X Assay of lipoprotein.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83719 ................ X Assay of blood 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lipoprotein.
83721 ................ X Assay of blood 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lipoprotein.
83727 ................ X Assay of lrh hormone.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83735 ................ X Assay of magnesium.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83775 ................ X Assay of md enzyme.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83785 ................ X Assay of manganese.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83788 ................ X Mass spectrometry qual 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83789 ................ X Mass spectrometry 0.00 0.00 0.00 0.00 0.00 0.00 XXX
quant.
83805 ................ X Assay of meprobamate.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83825 ................ X Assay of mercury...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83835 ................ X Assay of metanephrines 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83840 ................ X Assay of methadone.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83857 ................ X Assay of methemalbumin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83858 ................ X Assay of methsuximide. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83864 ................ X Mucopolysaccharides... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83866 ................ X Mucopolysaccharides 0.00 0.00 0.00 0.00 0.00 0.00 XXX
screen.
83872 ................ X Assay synovial fluid 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mucin.
83873 ................ X Assay of csf protein.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83874 ................ X Assay of myoglobin.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83883 ................ X Assay, nephelometry 0.00 0.00 0.00 0.00 0.00 0.00 XXX
not spec.
83885 ................ X Assay of nickel....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83887 ................ X Assay of nicotine..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83890 ................ X Molecule isolate...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83891 ................ X Molecule isolate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
nucleic.
83892 ................ X Molecular diagnostics. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83893 ................ X Molecule dot/slot/blot 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83894 ................ X Molecule gel 0.00 0.00 0.00 0.00 0.00 0.00 XXX
electrophor.
83896 ................ X Molecular diagnostics. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83897 ................ X Molecule nucleic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
transfer.
83898 ................ X Molecule nucleic ampli 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83901 ................ X Molecule nucleic ampli 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83902 ................ X Molecular diagnostics. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83903 ................ X Molecule mutation scan 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83904 ................ X Molecule mutation 0.00 0.00 0.00 0.00 0.00 0.00 XXX
identify.
83905 ................ X Molecule mutation 0.00 0.00 0.00 0.00 0.00 0.00 XXX
identify.
83906 ................ X Molecule mutation 0.00 0.00 0.00 0.00 0.00 0.00 XXX
identify.
83912 ................ X Genetic examination... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83912 26 A Genetic examination... 0.37 0.17 0.17 0.01 0.55 0.55 XXX
83915 ................ X Assay of nucleotidase. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83916 ................ X Oligoclonal bands..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83918 ................ X Organic acids, total, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
quant.
83919 ................ X Organic acids, qual, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
each.
83921 ................ X Organic acid, single, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
quant.
83925 ................ X Assay of opiates...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83930 ................ X Assay of blood 0.00 0.00 0.00 0.00 0.00 0.00 XXX
osmolality.
83935 ................ X Assay of urine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
osmolality.
83937 ................ X Assay of osteocalcin.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83945 ................ X Assay of oxalate...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83950 ................ X Oncorprotein, her-2/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
neu.
83970 ................ X Assay of parathormone. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
83986 ................ X Assay of body fluid 0.00 0.00 0.00 0.00 0.00 0.00 XXX
acidity.
83992 ................ X Assay for 0.00 0.00 0.00 0.00 0.00 0.00 XXX
phencyclidine.
84022 ................ X Assay of phenothiazine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84030 ................ X Assay of blood pku.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84035 ................ X Assay of phenylketones 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84060 ................ X Assay acid phosphatase 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84061 ................ X Phosphatase, forensic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
exam.
84066 ................ X Assay prostate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
phosphatase.
84075 ................ X Assay alkaline 0.00 0.00 0.00 0.00 0.00 0.00 XXX
phosphatase.
84078 ................ X Assay alkaline 0.00 0.00 0.00 0.00 0.00 0.00 XXX
phosphatase.
84080 ................ X Assay alkaline 0.00 0.00 0.00 0.00 0.00 0.00 XXX
phosphatases.
84081 ................ X Amniotic fluid enzyme 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
84085 ................ X Assay of rbc pg6d 0.00 0.00 0.00 0.00 0.00 0.00 XXX
enzyme.
[[Page 55437]]
84087 ................ X Assay phosphohexose 0.00 0.00 0.00 0.00 0.00 0.00 XXX
enzymes.
84100 ................ X Assay of phosphorus... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84105 ................ X Assay of urine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
phosphorus.
84106 ................ X Test for 0.00 0.00 0.00 0.00 0.00 0.00 XXX
porphobilinogen.
84110 ................ X Assay of 0.00 0.00 0.00 0.00 0.00 0.00 XXX
porphobilinogen.
84119 ................ X Test urine for 0.00 0.00 0.00 0.00 0.00 0.00 XXX
porphyrins.
84120 ................ X Assay of urine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
porphyrins.
84126 ................ X Assay of feces 0.00 0.00 0.00 0.00 0.00 0.00 XXX
porphyrins.
84127 ................ X Assay of feces 0.00 0.00 0.00 0.00 0.00 0.00 XXX
porphyrins.
84132 ................ X Assay of serum 0.00 0.00 0.00 0.00 0.00 0.00 XXX
potassium.
84133 ................ X Assay of urine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
potassium.
84134 ................ X Assay of prealbumin... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84135 ................ X Assay of pregnanediol. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84138 ................ X Assay of pregnanetriol 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84140 ................ X Assay of pregnenolone. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84143 ................ X Assay of 17- 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hydroxypregneno.
84144 ................ X Assay of progesterone. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84146 ................ X Assay of prolactin.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84150 ................ X Assay of prostaglandin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84152 ................ X Assay of psa, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
complexed.
84153 ................ X Assay of psa, total... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84154 ................ X Assay of psa, free.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84155 ................ X Assay of protein...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84160 ................ X Assay of serum protein 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84165 ................ X Assay of serum 0.00 0.00 0.00 0.00 0.00 0.00 XXX
proteins.
84165 26 A Assay of serum 0.37 0.17 0.17 0.01 0.55 0.55 XXX
proteins.
84181 ................ X Western blot test..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84181 26 A Western blot test..... 0.37 0.15 0.15 0.01 0.53 0.53 XXX
84182 ................ X Protein, western blot 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
84182 26 A Protein, western blot 0.37 0.15 0.15 0.01 0.53 0.53 XXX
test.
84202 ................ X Assay RBC 0.00 0.00 0.00 0.00 0.00 0.00 XXX
protoporphyrin.
84203 ................ X Test RBC 0.00 0.00 0.00 0.00 0.00 0.00 XXX
protoporphyrin.
84206 ................ X Assay of proinsulin... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84207 ................ X Assay of vitamin b-6.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84210 ................ X Assay of pyruvate..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84220 ................ X Assay of pyruvate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
kinase.
84228 ................ X Assay of quinine...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84233 ................ X Assay of estrogen..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84234 ................ X Assay of progesterone. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84235 ................ X Assay of endocrine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hormone.
84238 ................ X Assay, nonendocrine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
receptor.
84244 ................ X Assay of renin........ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84252 ................ X Assay of vitamin b-2.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84255 ................ X Assay of selenium..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84260 ................ X Assay of serotonin.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84270 ................ X Assay of sex hormone 0.00 0.00 0.00 0.00 0.00 0.00 XXX
globul.
84275 ................ X Assay of sialic acid.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84285 ................ X Assay of silica....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84295 ................ X Assay of serum sodium. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84300 ................ X Assay of urine sodium. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84305 ................ X Assay of somatomedin.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84307 ................ X Assay of somatostatin. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84311 ................ X Spectrophotometry..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84315 ................ X Body fluid specific 0.00 0.00 0.00 0.00 0.00 0.00 XXX
gravity.
84375 ................ X Chromatogram assay, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sugars.
84376 ................ X Sugars, single, qual.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84377 ................ X Sugars, multiple, qual 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84378 ................ X Sugars single quant... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84379 ................ X Sugars multiple quant. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84392 ................ X Assay of urine sulfate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84402 ................ X Assay of testosterone. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84403 ................ X Assay of total 0.00 0.00 0.00 0.00 0.00 0.00 XXX
testosterone.
84425 ................ X Assay of vitamin b-1.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84430 ................ X Assay of thiocyanate.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84432 ................ X Assay of thyroglobulin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84436 ................ X Assay of total 0.00 0.00 0.00 0.00 0.00 0.00 XXX
thyroxine.
84437 ................ X Assay of neonatal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
thyroxine.
84439 ................ X Assay of free 0.00 0.00 0.00 0.00 0.00 0.00 XXX
thyroxine.
84442 ................ X Assay of thyroid 0.00 0.00 0.00 0.00 0.00 0.00 XXX
activity.
84443 ................ X Assay thyroid stim 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hormone.
84445 ................ X Assay of tsi.......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84446 ................ X Assay of vitamin e.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84449 ................ X Assay of transcortin.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
[[Page 55438]]
84450 ................ X Transferase (AST) 0.00 0.00 0.00 0.00 0.00 0.00 XXX
(SGOT).
84460 ................ X Alanine amino (ALT) 0.00 0.00 0.00 0.00 0.00 0.00 XXX
(SGPT).
84466 ................ X Assay of transferrin.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84478 ................ X Assay of triglycerides 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84479 ................ X Assay of thyroid (t3 0.00 0.00 0.00 0.00 0.00 0.00 XXX
or t4).
84480 ................ X Assay, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
triiodothyronine (t3).
84481 ................ X Free assay (FT-3)..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84482 ................ X Reverse assay (t3).... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84484 ................ X Assay of troponin, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
quant.
84485 ................ X Assay duodenal fluid 0.00 0.00 0.00 0.00 0.00 0.00 XXX
trypsin.
84488 ................ X Test feces for trypsin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84490 ................ X Assay of feces for 0.00 0.00 0.00 0.00 0.00 0.00 XXX
trypsin.
84510 ................ X Assay of tyrosine..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84512 ................ X Assay of troponin, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
qual.
84520 ................ X Assay of urea nitrogen 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84525 ................ X Urea nitrogen semi- 0.00 0.00 0.00 0.00 0.00 0.00 XXX
quant.
84540 ................ X Assay of urine/urea-n. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84545 ................ X Urea-N clearance test. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84550 ................ X Assay of blood/uric 0.00 0.00 0.00 0.00 0.00 0.00 XXX
acid.
84560 ................ X Assay of urine/uric 0.00 0.00 0.00 0.00 0.00 0.00 XXX
acid.
84577 ................ X Assay of feces/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
urobilinogen.
84578 ................ X Test urine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
urobilinogen.
84580 ................ X Assay of urine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
urobilinogen.
84583 ................ X Assay of urine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
urobilinogen.
84585 ................ X Assay of urine vma.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84586 ................ X Assay of vip.......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84588 ................ X Assay of vasopressin.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84590 ................ X Assay of vitamin a.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84591 ................ X Assay of nos vitamin.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84597 ................ X Assay of vitamin k.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84600 ................ X Assay of volatiles.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84620 ................ X Xylose tolerance test. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84630 ................ X Assay of zinc......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84681 ................ X Assay of c-peptide.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84702 ................ X Chorionic gonadotropin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
84703 ................ X Chorionic gonadotropin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
assay.
84830 ................ X Ovulation tests....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
84999 ................ X Clinical chemistry 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
85002 ................ X Bleeding time test.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85007 ................ X Differential WBC count 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85008 ................ X Nondifferential WBC 0.00 0.00 0.00 0.00 0.00 0.00 XXX
count.
85009 ................ X Differential WBC count 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85013 ................ X Hematocrit............ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85014 ................ X Hematocrit............ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85018 ................ X Hemoglobin............ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85021 ................ X Automated hemogram.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85022 ................ X Automated hemogram.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85023 ................ X Automated hemogram.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85024 ................ X Automated hemogram.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85025 ................ X Automated hemogram.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85027 ................ X Automated hemogram.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85031 ................ X Manual hemogram, cbc.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85041 ................ X Red blood cell (RBC) 0.00 0.00 0.00 0.00 0.00 0.00 XXX
count.
85044 ................ X Reticulocyte count.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85045 ................ X Reticulocyte count.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85046 ................ X Reticyte/hgb 0.00 0.00 0.00 0.00 0.00 0.00 XXX
concentrate.
85048 ................ X White blood cell (WBC) 0.00 0.00 0.00 0.00 0.00 0.00 XXX
count.
85060 ................ A Blood smear 0.45 0.19 0.19 0.02 0.66 0.66 XXX
interpretation.
85095 ................ D Bone marrow aspiration 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85097 ................ A Bone marrow 0.94 1.75 0.43 0.03 2.72 1.40 XXX
interpretation.
85102 ................ D Bone marrow biopsy.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85130 ................ X Chromogenic substrate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
assay.
85170 ................ X Blood clot retraction. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85175 ................ X Blood clot lysis time. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85210 ................ X Blood clot factor II 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
85220 ................ X Blood clot factor V 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
85230 ................ X Blood clot factor VII 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
85240 ................ X Blood clot factor VIII 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
85244 ................ X Blood clot factor VIII 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
85245 ................ X Blood clot factor VIII 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
85246 ................ X Blood clot factor VIII 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
85247 ................ X Blood clot factor VIII 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
85250 ................ X Blood clot factor IX 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
[[Page 55439]]
85260 ................ X Blood clot factor X 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
85270 ................ X Blood clot factor XI 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
85280 ................ X Blood clot factor XII 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
85290 ................ X Blood clot factor XIII 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
85291 ................ X Blood clot factor XIII 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
85292 ................ X Blood clot factor 0.00 0.00 0.00 0.00 0.00 0.00 XXX
assay.
85293 ................ X Blood clot factor 0.00 0.00 0.00 0.00 0.00 0.00 XXX
assay.
85300 ................ X Antithrombin III test. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85301 ................ X Antithrombin III test. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85302 ................ X Blood clot inhibitor 0.00 0.00 0.00 0.00 0.00 0.00 XXX
antigen.
85303 ................ X Blood clot inhibitor 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
85305 ................ X Blood clot inhibitor 0.00 0.00 0.00 0.00 0.00 0.00 XXX
assay.
85306 ................ X Blood clot inhibitor 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
85307 ................ X Assay activated 0.00 0.00 0.00 0.00 0.00 0.00 XXX
protein c.
85335 ................ X Factor inhibitor test. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85337 ................ X Thrombomodulin........ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85345 ................ X Coagulation time...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85347 ................ X Coagulation time...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85348 ................ X Coagulation time...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85360 ................ X Euglobulin lysis...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85362 ................ X Fibrin degradation 0.00 0.00 0.00 0.00 0.00 0.00 XXX
products.
85366 ................ X Fibrinogen test....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85370 ................ X Fibrinogen test....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85378 ................ X Fibrin degradation.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85379 ................ X Fibrin degradation.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85384 ................ X Fibrinogen............ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85385 ................ X Fibrinogen............ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85390 ................ X Fibrinolysins screen.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85390 26 A Fibrinolysins screen.. 0.37 0.12 0.12 0.01 0.50 0.50 XXX
85400 ................ X Fibrinolytic plasmin.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85410 ................ X Fibrinolytic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
antiplasmin.
85415 ................ X Fibrinolytic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
plasminogen.
85420 ................ X Fibrinolytic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
plasminogen.
85421 ................ X Fibrinolytic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
plasminogen.
85441 ................ X Heinz bodies, direct.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85445 ................ X Heinz bodies, induced. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85460 ................ X Hemoglobin, fetal..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85461 ................ X Hemoglobin, fetal..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85475 ................ X Hemolysin............. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85520 ................ X Heparin assay......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85525 ................ X Heparin............... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85530 ................ X Heparin-protamine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
tolerance.
85535 ................ D Iron stain, blood 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cells.
85536 ................ X Iron stain peripheral 0.00 0.00 0.00 0.00 0.00 0.00 XXX
blood.
85540 ................ X Wbc alkaline 0.00 0.00 0.00 0.00 0.00 0.00 XXX
phosphatase.
85547 ................ X RBC mechanical 0.00 0.00 0.00 0.00 0.00 0.00 XXX
fragility.
85549 ................ X Muramidase............ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85555 ................ X RBC osmotic fragility. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85557 ................ X RBC osmotic fragility. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85576 ................ X Blood platelet 0.00 0.00 0.00 0.00 0.00 0.00 XXX
aggregation.
85576 26 A Blood platelet 0.37 0.16 0.16 0.01 0.54 0.54 XXX
aggregation.
85585 ................ X Blood platelet 0.00 0.00 0.00 0.00 0.00 0.00 XXX
estimation.
85590 ................ X Platelet count, manual 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85595 ................ X Platelet count, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
automated.
85597 ................ X Platelet 0.00 0.00 0.00 0.00 0.00 0.00 XXX
neutralization.
85610 ................ X Prothrombin time...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85611 ................ X Prothrombin test...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85612 ................ X Viper venom 0.00 0.00 0.00 0.00 0.00 0.00 XXX
prothrombin time.
85613 ................ X Russell viper venom, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
diluted.
85635 ................ X Reptilase test........ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85651 ................ X Rbc sed rate, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
nonautomated.
85652 ................ X Rbc sed rate, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
automated.
85660 ................ X RBC sickle cell test.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85670 ................ X Thrombin time, plasma. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85675 ................ X Thrombin time, titer.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
85705 ................ X Thromboplastin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inhibition.
85730 ................ X Thromboplastin time, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
partial.
85732 ................ X Thromboplastin time, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
partial.
85810 ................ X Blood viscosity 0.00 0.00 0.00 0.00 0.00 0.00 XXX
examination.
85999 ................ X Hematology procedure.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86000 ................ X Agglutinins, febrile.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86001 ................ X Allergen specific igg. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86003 ................ X Allergen specific IgE. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
[[Page 55440]]
86005 ................ X Allergen specific IgE. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86021 ................ X WBC antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX
identification.
86022 ................ X Platelet antibodies... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86023 ................ X Immunoglobulin assay.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86038 ................ X Antinuclear antibodies 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86039 ................ X Antinuclear antibodies 0.00 0.00 0.00 0.00 0.00 0.00 XXX
(ANA).
86060 ................ X Antistreptolysin o, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
titer.
86063 ................ X Antistreptolysin o, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
screen.
86077 ................ A Physician blood bank 0.94 0.48 0.43 0.03 1.45 1.40 XXX
service.
86078 ................ A Physician blood bank 0.94 0.51 0.43 0.03 1.48 1.40 XXX
service.
86079 ................ A Physician blood bank 0.94 0.50 0.44 0.03 1.47 1.41 XXX
service.
86140 ................ X C-reactive protein.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86141 ................ X C-reactive protein, hs 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86146 ................ X Glycoprotein antibody. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86147 ................ X Cardiolipin antibody.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86148 ................ X Phospholipid antibody. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86155 ................ X Chemotaxis assay...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86156 ................ X Cold agglutinin, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
screen.
86157 ................ X Cold agglutinin, titer 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86160 ................ X Complement, antigen... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86161 ................ X Complement/function 0.00 0.00 0.00 0.00 0.00 0.00 XXX
activity.
86162 ................ X Complement, total 0.00 0.00 0.00 0.00 0.00 0.00 XXX
(CH50).
86171 ................ X Complement fixation, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
each.
86185 ................ X Counterimmunoelectroph 0.00 0.00 0.00 0.00 0.00 0.00 XXX
oresis.
86215 ................ X Deoxyribonuclease, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
antibody.
86225 ................ X DNA antibody.......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86226 ................ X DNA antibody, single 0.00 0.00 0.00 0.00 0.00 0.00 XXX
strand.
86235 ................ X Nuclear antigen 0.00 0.00 0.00 0.00 0.00 0.00 XXX
antibody.
86243 ................ X Fc receptor........... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86255 ................ X Fluorescent antibody, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
screen.
86255 26 A Fluorescent antibody, 0.37 0.17 0.17 0.01 0.55 0.55 XXX
screen.
86256 ................ X Fluorescent antibody, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
titer.
86256 26 A Fluorescent antibody, 0.37 0.17 0.17 0.01 0.55 0.55 XXX
titer.
86277 ................ X Growth hormone 0.00 0.00 0.00 0.00 0.00 0.00 XXX
antibody.
86280 ................ X Hemagglutination 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inhibition.
86294 ................ X Immunoassay, tumor 0.00 0.00 0.00 0.00 0.00 0.00 XXX
qual.
86300 ................ X Immunoassay, tumor ca 0.00 0.00 0.00 0.00 0.00 0.00 XXX
15-3.
86301 ................ X Immunoassay, tumor ca 0.00 0.00 0.00 0.00 0.00 0.00 XXX
19-9.
86304 ................ X Immunoassay, tumor, ca 0.00 0.00 0.00 0.00 0.00 0.00 XXX
125.
86308 ................ X Heterophile antibodies 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86309 ................ X Heterophile antibodies 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86310 ................ X Heterophile antibodies 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86316 ................ X Immunoassay, tumor 0.00 0.00 0.00 0.00 0.00 0.00 XXX
other.
86317 ................ X Immunoassay, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
infectious agent.
86318 ................ X Immunoassay, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
infectious agent.
86320 ................ X Serum 0.00 0.00 0.00 0.00 0.00 0.00 XXX
immunoelectrophoresis.
86320 26 A Serum 0.37 0.17 0.17 0.01 0.55 0.55 XXX
immunoelectrophoresis.
86325 ................ X Other 0.00 0.00 0.00 0.00 0.00 0.00 XXX
immunoelectrophoresis.
86325 26 A Other 0.37 0.17 0.17 0.01 0.55 0.55 XXX
immunoelectrophoresis.
86327 ................ X Immunoelectrophoresis 0.00 0.00 0.00 0.00 0.00 0.00 XXX
assay.
86327 26 A Immunoelectrophoresis 0.42 0.20 0.20 0.01 0.63 0.63 XXX
assay.
86329 ................ X Immunodiffusion....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86331 ................ X Immunodiffusion 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ouchterlony.
86332 ................ X Immune complex assay.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86334 ................ X Immunofixation 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
86334 26 A Immunofixation 0.37 0.17 0.17 0.01 0.55 0.55 XXX
procedure.
86336 ................ X Inhibin A............. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86337 ................ X Insulin antibodies.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86340 ................ X Intrinsic factor 0.00 0.00 0.00 0.00 0.00 0.00 XXX
antibody.
86341 ................ X Islet cell antibody... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86343 ................ X Leukocyte histamine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
release.
86344 ................ X Leukocyte phagocytosis 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86353 ................ X Lymphocyte 0.00 0.00 0.00 0.00 0.00 0.00 XXX
transformation.
86359 ................ X T cells, total count.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86360 ................ X T cell, absolute count/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ratio.
86361 ................ X T cell, absolute count 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86376 ................ X Microsomal antibody... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86378 ................ X Migration inhibitory 0.00 0.00 0.00 0.00 0.00 0.00 XXX
factor.
86382 ................ X Neutralization test, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
viral.
86384 ................ X Nitroblue tetrazolium 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dye.
86403 ................ X Particle agglutination 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
86406 ................ X Particle agglutination 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
86430 ................ X Rheumatoid factor test 0.00 0.00 0.00 0.00 0.00 0.00 XXX
[[Page 55441]]
86431 ................ X Rheumatoid factor, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
quant.
86485 ................ C Skin test, candida.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86490 ................ A Coccidioidomycosis 0.00 0.28 NA 0.02 0.30 NA XXX
skin test.
86510 ................ A Histoplasmosis skin 0.00 0.30 NA 0.02 0.32 NA XXX
test.
86580 ................ A TB intradermal test... 0.00 0.24 NA 0.02 0.26 NA XXX
86585 ................ A TB tine test.......... 0.00 0.19 NA 0.01 0.20 NA XXX
86586 ................ C Skin test, unlisted... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86590 ................ X Streptokinase, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
antibody.
86592 ................ X Blood serology, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
qualitative.
86593 ................ X Blood serology, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
quantitative.
86602 ................ X Antinomyces antibody.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86603 ................ X Adenovirus antibody... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86606 ................ X Aspergillus antibody.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86609 ................ X Bacterium antibody.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86611 ................ X Bartonella antibody... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86612 ................ X Blastomyces antibody.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86615 ................ X Bordetella antibody... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86617 ................ X Lyme disease antibody. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86618 ................ X Lyme disease antibody. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86619 ................ X Borrelia antibody..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86622 ................ X Brucella antibody..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86625 ................ X Campylobacter antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86628 ................ X Candida antibody...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86631 ................ X Chlamydia antibody.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86632 ................ X Chlamydia igm antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86635 ................ X Coccidioides antibody. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86638 ................ X Q fever antibody...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86641 ................ X Cryptococcus antibody. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86644 ................ X CMV antibody.......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86645 ................ X CMV antibody, IgM..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86648 ................ X Diphtheria antibody... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86651 ................ X Encephalitis antibody. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86652 ................ X Encephalitis antibody. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86653 ................ X Encephalitis antibody. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86654 ................ X Encephalitis antibody. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86658 ................ X Enterovirus antibody.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86663 ................ X Epstein-barr antibody. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86664 ................ X Epstein-barr antibody. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86665 ................ X Epstein-barr antibody. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86666 ................ X Ehrlichia antibody.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86668 ................ X Francisella tularensis 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86671 ................ X Fungus antibody....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86674 ................ X Giardia lamblia 0.00 0.00 0.00 0.00 0.00 0.00 XXX
antibody.
86677 ................ X Helicobacter pylori... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86682 ................ X Helminth antibody..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86683 ................ D Hemoglobin, fecal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
antibody.
86684 ................ X Hemophilus influenza.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86687 ................ X Htlv-i antibody....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86688 ................ X Htlv-ii antibody...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86689 ................ X HTLV/HIV confirmatory 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
86692 ................ X Hepatitis, delta agent 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86694 ................ X Herpes simplex test... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86695 ................ X Herpes simplex test... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86696 ................ X Herpes simplex type 2. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86698 ................ X Histoplasma........... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86701 ................ X HIV-1................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86702 ................ X HIV-2................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86703 ................ X HIV-1/HIV-2, single 0.00 0.00 0.00 0.00 0.00 0.00 XXX
assay.
86704 ................ X Hep b core antibody, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
total.
86705 ................ X Hep b core antibody, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
igm.
86706 ................ X Hep b surface antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86707 ................ X Hep be antibody....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86708 ................ X Hep a antibody, total. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86709 ................ X Hep a antibody, igm... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86710 ................ X Influenza virus 0.00 0.00 0.00 0.00 0.00 0.00 XXX
antibody.
86713 ................ X Legionella antibody... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86717 ................ X Leishmania antibody... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86720 ................ X Leptospira antibody... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86723 ................ X Listeria monocytogenes 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ab.
86727 ................ X Lymph choriomeningitis 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ab.
86729 ................ X Lympho venereum 0.00 0.00 0.00 0.00 0.00 0.00 XXX
antibody.
86732 ................ X Mucormycosis antibody. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86735 ................ X Mumps antibody........ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
[[Page 55442]]
86738 ................ X Mycoplasma antibody... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86741 ................ X Neisseria meningitidis 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86744 ................ X Nocardia antibody..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86747 ................ X Parvovirus antibody... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86750 ................ X Malaria antibody...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86753 ................ X Protozoa antibody nos. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86756 ................ X Respiratory virus 0.00 0.00 0.00 0.00 0.00 0.00 XXX
antibody.
86757 ................ X Rickettsia antibody... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86759 ................ X Rotavirus antibody.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86762 ................ X Rubella antibody...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86765 ................ X Rubeola antibody...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86768 ................ X Salmonella antibody... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86771 ................ X Shigella antibody..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86774 ................ X Tetanus antibody...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86777 ................ X Toxoplasma antibody... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86778 ................ X Toxoplasma antibody, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
igm.
86781 ................ X Treponema pallidum, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
confirm.
86784 ................ X Trichinella antibody.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86787 ................ X Varicella-zoster 0.00 0.00 0.00 0.00 0.00 0.00 XXX
antibody.
86790 ................ X Virus antibody nos.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86793 ................ X Yersinia antibody..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86800 ................ X Thyroglobulin antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86803 ................ X Hepatitis c ab test... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86804 ................ X Hep c ab test, confirm 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86805 ................ X Lymphocytotoxicity 0.00 0.00 0.00 0.00 0.00 0.00 XXX
assay.
86806 ................ X Lymphocytotoxicity 0.00 0.00 0.00 0.00 0.00 0.00 XXX
assay.
86807 ................ X Cytotoxic antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX
screening.
86808 ................ X Cytotoxic antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX
screening.
86812 ................ X HLA typing, A, B, or C 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86813 ................ X HLA typing, A, B, or C 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86816 ................ X HLA typing, DR/DQ..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86817 ................ X HLA typing, DR/DQ..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86821 ................ X Lymphocyte culture, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mixed.
86822 ................ X Lymphocyte culture, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
primed.
86849 ................ X Immunology procedure.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86850 ................ X RBC antibody screen... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86860 ................ X RBC antibody elution.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86870 ................ X RBC antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX
identification.
86880 ................ X Coombs test........... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86885 ................ X Coombs test........... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86886 ................ X Coombs test........... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86890 ................ X Autologous blood 0.00 0.00 0.00 0.00 0.00 0.00 XXX
process.
86891 ................ X Autologous blood, op 0.00 0.00 0.00 0.00 0.00 0.00 XXX
salvage.
86900 ................ X Blood typing, ABO..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86901 ................ X Blood typing, Rh (D).. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86903 ................ X Blood typing, antigen 0.00 0.00 0.00 0.00 0.00 0.00 XXX
screen.
86904 ................ X Blood typing, patient 0.00 0.00 0.00 0.00 0.00 0.00 XXX
serum.
86905 ................ X Blood typing, RBC 0.00 0.00 0.00 0.00 0.00 0.00 XXX
antigens.
86906 ................ X Blood typing, Rh 0.00 0.00 0.00 0.00 0.00 0.00 XXX
phenotype.
86910 ................ N Blood typing, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
paternity test.
86911 ................ N Blood typing, antigen 0.00 0.00 0.00 0.00 0.00 0.00 XXX
system.
86915 ................ X Bone marrow/stem cell 0.00 0.00 0.00 0.00 0.00 0.00 XXX
prep.
86920 ................ X Compatibility test.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86921 ................ X Compatibility test.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86922 ................ X Compatibility test.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86927 ................ X Plasma, fresh frozen.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86930 ................ X Frozen blood prep..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86931 ................ X Frozen blood thaw..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86932 ................ X Frozen blood freeze/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
thaw.
86940 ................ X Hemolysins/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
agglutinins, auto.
86941 ................ X Hemolysins/agglutinins 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86945 ................ X Blood product/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
irradiation.
86950 ................ X Leukacyte transfusion. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86965 ................ X Pooling blood 0.00 0.00 0.00 0.00 0.00 0.00 XXX
platelets.
86970 ................ X RBC pretreatment...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86971 ................ X RBC pretreatment...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86972 ................ X RBC pretreatment...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
86975 ................ X RBC pretreatment, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
serum.
86976 ................ X RBC pretreatment, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
serum.
86977 ................ X RBC pretreatment, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
serum.
86978 ................ X RBC pretreatment, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
serum.
86985 ................ X Split blood or 0.00 0.00 0.00 0.00 0.00 0.00 XXX
products.
86999 ................ X Transfusion procedure. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
[[Page 55443]]
87001 ................ X Small animal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inoculation.
87003 ................ X Small animal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inoculation.
87015 ................ X Specimen concentration 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87040 ................ X Blood culture for 0.00 0.00 0.00 0.00 0.00 0.00 XXX
bacteria.
87045 ................ X Feces culture, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
bacteria.
87046 ................ X Stool cultr, bacteria, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
each.
87070 ................ X Culture, bacteria, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
other.
87071 ................ X Culture bacteri 0.00 0.00 0.00 0.00 0.00 0.00 XXX
aerobic othr.
87073 ................ X Culture bacteria 0.00 0.00 0.00 0.00 0.00 0.00 XXX
anaerobic.
87075 ................ X Culture bacteria 0.00 0.00 0.00 0.00 0.00 0.00 XXX
anaerobic.
87076 ................ X Culture anaerobe 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ident, each.
87077 ................ X Culture aerobic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
identify.
87081 ................ X Culture screen only... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87084 ................ X Culture of specimen by 0.00 0.00 0.00 0.00 0.00 0.00 XXX
kit.
87086 ................ X Urine culture/colony 0.00 0.00 0.00 0.00 0.00 0.00 XXX
count.
87088 ................ X Urine bacteria culture 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87101 ................ X Skin fungi culture.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87102 ................ X Fungus isolation 0.00 0.00 0.00 0.00 0.00 0.00 XXX
culture.
87103 ................ X Blood fungus culture.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87106 ................ X Fungi identification, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
yeast.
87107 ................ X Fungi identification, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mold.
87109 ................ X Mycoplasma............ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87110 ................ X Chlamydia culture..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87116 ................ X Mycobacteria culture.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87118 ................ X Mycobacteric 0.00 0.00 0.00 0.00 0.00 0.00 XXX
identification.
87140 ................ X Culture type 0.00 0.00 0.00 0.00 0.00 0.00 XXX
immunofluoresc.
87143 ................ X Culture typing, glc/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hplc.
87147 ................ X Culture type, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
immunologic.
87149 ................ X Culture type, nucleic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
acid.
87152 ................ X Culture type pulse 0.00 0.00 0.00 0.00 0.00 0.00 XXX
field gel.
87158 ................ X Culture typing, added 0.00 0.00 0.00 0.00 0.00 0.00 XXX
method.
87164 ................ X Dark field examination 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87164 26 A Dark field examination 0.37 0.12 0.11 0.01 0.50 0.49 XXX
87166 ................ X Dark field examination 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87168 ................ X Macroscopic exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX
arthropod.
87169 ................ X Macacroscopic exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX
parasite.
87172 ................ X Pinworm exam.......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87176 ................ X Tissue homogenization, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cultr.
87177 ................ X Ova and parasites 0.00 0.00 0.00 0.00 0.00 0.00 XXX
smears.
87181 ................ X Microbe susceptible, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
diffuse.
87184 ................ X Microbe susceptible, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
disk.
87185 ................ X Microbe susceptible, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
enzyme.
87186 ................ X Microbe susceptible, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mic.
87187 ................ X Microbe susceptible, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mlc.
87188 ................ X Microbe suscept, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
macrobroth.
87190 ................ X Microbe suscept, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mycobacteri.
87197 ................ X Bactericidal level, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
serum.
87198 ................ X Cytomegalovirus 0.00 0.00 0.00 0.00 0.00 0.00 XXX
antibody dfa.
87199 ................ X Enterovirus antibody, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dfa.
87205 ................ X Smear, gram stain..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87206 ................ X Smear, fluorescent/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
acid stai.
87207 ................ X Smear, special stain.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87207 26 A Smear, special stain.. 0.37 0.18 0.17 0.01 0.56 0.55 XXX
87210 ................ X Smear, wet mount, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
saline/ink.
87220 ................ X Tissue exam for fungi. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87230 ................ X Assay, toxin or 0.00 0.00 0.00 0.00 0.00 0.00 XXX
antitoxin.
87250 ................ X Virus inoculate, eggs/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
animal.
87252 ................ X Virus inoculation, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
tissue.
87253 ................ X Virus inoculate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
tissue, addl.
87254 ................ X Virus inoculation, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
shell via.
87260 ................ X Adenovirus ag, if..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87265 ................ X Pertussis ag, if...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87270 ................ X Chlamydia trachomatis 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ag, if.
87272 ................ X Cryptosporidum/gardia 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ag, if.
87273 ................ X Herpes simplex 2, ag, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
if.
87274 ................ X Herpes simplex 1, ag, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
if.
87275 ................ X Influenza b, ag, if... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87276 ................ X Influenza a, ag, if... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87277 ................ X Legionella micdadei, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ag, if.
87278 ................ X Legion pneumophilia 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ag, if.
87279 ................ X Parainfluenza, ag, if. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87280 ................ X Respiratory syncytial 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ag, if.
87281 ................ X Pneumocystis carinii, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ag, if.
[[Page 55444]]
87283 ................ X Rubeola, ag, if....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87285 ................ X Treponema pallidum, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ag, if.
87290 ................ X Varicella zoster, ag, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
if.
87299 ................ X Antibody detection, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
nos, if.
87300 ................ X Ag detection, polyval, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
if.
87301 ................ X Adenovirus ag, eia.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87320 ................ X Chylmd trach ag, eia.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87324 ................ X Clostridium ag, eia... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87327 ................ X Cryptococcus neoform 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ag, eia.
87328 ................ X Cryptospor ag, eia.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87332 ................ X Cytomegalovirus ag, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
eia.
87335 ................ X E coli 0157 ag, eia... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87336 ................ X Entamoeb hist dispr, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ag, eia.
87337 ................ X Entamoeb hist group, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ag, eia.
87338 ................ X Hpylori, stool, eia... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87339 ................ X H pylori ag, eia...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87340 ................ X Hepatitis b surface 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ag, eia.
87341 ................ X Hepatitis b surface, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ag, eia.
87350 ................ X Hepatitis be ag, eia.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87380 ................ X Hepatitis delta ag, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
eia.
87385 ................ X Histoplasma capsul ag, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
eia.
87390 ................ X Hiv-1 ag, eia......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87391 ................ X Hiv-2 ag, eia......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87400 ................ X Influenza a/b, ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87420 ................ X Resp syncytial ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87425 ................ X Rotavirus ag, eia..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87427 ................ X Shiga-like toxin ag, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
eia.
87430 ................ X Strep a ag, eia....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87449 ................ X Ag detect nos, eia, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mult.
87450 ................ X Ag detect nos, eia, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
single.
87451 ................ X Ag detect polyval, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
eia, mult.
87470 ................ X Bartonella, dna, dir 0.00 0.00 0.00 0.00 0.00 0.00 XXX
probe.
87471 ................ X Bartonella, dna, amp 0.00 0.00 0.00 0.00 0.00 0.00 XXX
probe.
87472 ................ X Bartonella, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87475 ................ X Lyme dis, dna, dir 0.00 0.00 0.00 0.00 0.00 0.00 XXX
probe.
87476 ................ X Lyme dis, dna, amp 0.00 0.00 0.00 0.00 0.00 0.00 XXX
probe.
87477 ................ X Lyme dis, dna, quant.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87480 ................ X Candida, dna, dir 0.00 0.00 0.00 0.00 0.00 0.00 XXX
probe.
87481 ................ X Candida, dna, amp 0.00 0.00 0.00 0.00 0.00 0.00 XXX
probe.
87482 ................ X Candida, dna, quant... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87485 ................ X Chylmd pneum, dna, dir 0.00 0.00 0.00 0.00 0.00 0.00 XXX
probe.
87486 ................ X Chylmd pneum, dna, amp 0.00 0.00 0.00 0.00 0.00 0.00 XXX
probe.
87487 ................ X Chylmd pneum, dna, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
quant.
87490 ................ X Chylmd trach, dna, dir 0.00 0.00 0.00 0.00 0.00 0.00 XXX
probe.
87491 ................ X Chylmd trach, dna, amp 0.00 0.00 0.00 0.00 0.00 0.00 XXX
probe.
87492 ................ X Chylmd trach, dna, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
quant.
87495 ................ X Cytomeg, dna, dir 0.00 0.00 0.00 0.00 0.00 0.00 XXX
probe.
87496 ................ X Cytomeg, dna, amp 0.00 0.00 0.00 0.00 0.00 0.00 XXX
probe.
87497 ................ X Cytomeg, dna, quant... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87510 ................ X Gardner vag, dna, dir 0.00 0.00 0.00 0.00 0.00 0.00 XXX
probe.
87511 ................ X Gardner vag, dna, amp 0.00 0.00 0.00 0.00 0.00 0.00 XXX
probe.
87512 ................ X Gardner vag, dna, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
quant.
87515 ................ X Hepatitis b, dna, dir 0.00 0.00 0.00 0.00 0.00 0.00 XXX
probe.
87516 ................ X Hepatitis b, dna, amp 0.00 0.00 0.00 0.00 0.00 0.00 XXX
probe.
87517 ................ X Hepatitis b, dna, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
quant.
87520 ................ X Hepatitis c, rna, dir 0.00 0.00 0.00 0.00 0.00 0.00 XXX
probe.
87521 ................ X Hepatitis c, rna, amp 0.00 0.00 0.00 0.00 0.00 0.00 XXX
probe.
87522 ................ X Hepatitis c, rna, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
quant.
87525 ................ X Hepatitis g, dna, dir 0.00 0.00 0.00 0.00 0.00 0.00 XXX
probe.
87526 ................ X Hepatitis g, dna, amp 0.00 0.00 0.00 0.00 0.00 0.00 XXX
probe.
87527 ................ X Hepatitis g, dna, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
quant.
87528 ................ X Hsv, dna, dir probe... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87529 ................ X Hsv, dna, amp probe... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87530 ................ X Hsv, dna, quant....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87531 ................ X Hhv-6, dna, dir probe. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87532 ................ X Hhv-6, dna, amp probe. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87533 ................ X Hhv-6, dna, quant..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87534 ................ X Hiv-1, dna, dir probe. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87535 ................ X Hiv-1, dna, amp probe. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87536 ................ X Hiv-1, dna, quant..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87537 ................ X Hiv-2, dna, dir probe. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87538 ................ X Hiv-2, dna, amp probe. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87539 ................ X Hiv-2, dna, quant..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
[[Page 55445]]
87540 ................ X Legion pneumo, dna, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dir prob.
87541 ................ X Legion pneumo, dna, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
amp prob.
87542 ................ X Legion pneumo, dna, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
quant.
87550 ................ X Mycobacteria, dna, dir 0.00 0.00 0.00 0.00 0.00 0.00 XXX
probe.
87551 ................ X Mycobacteria, dna, amp 0.00 0.00 0.00 0.00 0.00 0.00 XXX
probe.
87552 ................ X Mycobacteria, dna, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
quant.
87555 ................ X M.tuberculo, dna, dir 0.00 0.00 0.00 0.00 0.00 0.00 XXX
probe.
87556 ................ X M.tuberculo, dna, amp 0.00 0.00 0.00 0.00 0.00 0.00 XXX
probe.
87557 ................ X M.tuberculo, dna, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
quant.
87560 ................ X M.avium-intra, dna, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dir prob.
87561 ................ X M.avium-intra, dna, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
amp prob.
87562 ................ X M.avium-intra, dna, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
quant.
87580 ................ X M.pneumon, dna, dir 0.00 0.00 0.00 0.00 0.00 0.00 XXX
probe.
87581 ................ X M.pneumon, dna, amp 0.00 0.00 0.00 0.00 0.00 0.00 XXX
probe.
87582 ................ X M.pneumon, dna, quant. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87590 ................ X N.gonorrhoeae, dna, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dir prob.
87591 ................ X N.gonorrhoeae, dna, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
amp prob.
87592 ................ X N.gonorrhoeae, dna, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
quant.
87620 ................ X Hpv, dna, dir probe... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87621 ................ X Hpv, dna, amp probe... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87622 ................ X Hpv, dna, quant....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87650 ................ X Strep a, dna, dir 0.00 0.00 0.00 0.00 0.00 0.00 XXX
probe.
87651 ................ X Strep a, dna, amp 0.00 0.00 0.00 0.00 0.00 0.00 XXX
probe.
87652 ................ X Strep a, dna, quant... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87797 ................ X Detect agent nos, dna, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dir.
87798 ................ X Detect agent nos, dna, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
amp.
87799 ................ X Detect agent nos, dna, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
quant.
87800 ................ X Detect agnt mult, dna, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
direc.
87801 ................ X Detect agnt mult, dna, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ampli.
87802 ................ X Strep b assay w/optic. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87803 ................ X Clostridium toxin a w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
optic.
87804 ................ X Influenza assay w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
optic.
87810 ................ X Chylmd trach assay w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
optic.
87850 ................ X N. gonorrhoeae assay w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
optic.
87880 ................ X Strep a assay w/optic. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87899 ................ X Agent nos assay w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
optic.
87901 ................ X Genotype, dna, hiv 0.00 0.00 0.00 0.00 0.00 0.00 XXX
reverse t.
87902 ................ X Genotype, dna, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hepatitis C.
87903 ................ X Phenotype, dna hiv w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
culture.
87904 ................ X Phenotype, dna hiv w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
clt add.
87999 ................ X Microbiology procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX
88000 ................ N Autopsy (necropsy), 0.00 0.00 0.00 0.00 0.00 0.00 XXX
gross.
88005 ................ N Autopsy (necropsy), 0.00 0.00 0.00 0.00 0.00 0.00 XXX
gross.
88007 ................ N Autopsy (necropsy), 0.00 0.00 0.00 0.00 0.00 0.00 XXX
gross.
88012 ................ N Autopsy (necropsy), 0.00 0.00 0.00 0.00 0.00 0.00 XXX
gross.
88014 ................ N Autopsy (necropsy), 0.00 0.00 0.00 0.00 0.00 0.00 XXX
gross.
88016 ................ N Autopsy (necropsy), 0.00 0.00 0.00 0.00 0.00 0.00 XXX
gross.
88020 ................ N Autopsy (necropsy), 0.00 0.00 0.00 0.00 0.00 0.00 XXX
complete.
88025 ................ N Autopsy (necropsy), 0.00 0.00 0.00 0.00 0.00 0.00 XXX
complete.
88027 ................ N Autopsy (necropsy), 0.00 0.00 0.00 0.00 0.00 0.00 XXX
complete.
88028 ................ N Autopsy (necropsy), 0.00 0.00 0.00 0.00 0.00 0.00 XXX
complete.
88029 ................ N Autopsy (necropsy), 0.00 0.00 0.00 0.00 0.00 0.00 XXX
complete.
88036 ................ N Limited autopsy....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
88037 ................ N Limited autopsy....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
88040 ................ N Forensic autopsy 0.00 0.00 0.00 0.00 0.00 0.00 XXX
(necropsy).
88045 ................ N Coroner's autopsy 0.00 0.00 0.00 0.00 0.00 0.00 XXX
(necropsy).
88099 ................ N Necropsy (autopsy) 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
88104 ................ A Cytopathology, fluids. 0.56 0.72 NA 0.04 1.32 NA XXX
88104 26 A Cytopathology, fluids. 0.56 0.26 0.26 0.02 0.84 0.84 XXX
88104 TC A Cytopathology, fluids. 0.00 0.46 NA 0.02 0.48 NA XXX
88106 ................ A Cytopathology, fluids. 0.56 0.72 NA 0.04 1.32 NA XXX
88106 26 A Cytopathology, fluids. 0.56 0.26 0.26 0.02 0.84 0.84 XXX
88106 TC A Cytopathology, fluids. 0.00 0.46 NA 0.02 0.48 NA XXX
88107 ................ A Cytopathology, fluids. 0.76 1.01 NA 0.05 1.82 NA XXX
88107 26 A Cytopathology, fluids. 0.76 0.35 0.35 0.03 1.14 1.14 XXX
88107 TC A Cytopathology, fluids. 0.00 0.66 NA 0.02 0.68 NA XXX
88108 ................ A Cytopath, concentrate 0.56 0.94 NA 0.04 1.54 NA XXX
tech.
88108 26 A Cytopath, concentrate 0.56 0.26 0.26 0.02 0.84 0.84 XXX
tech.
88108 TC A Cytopath, concentrate 0.00 0.68 NA 0.02 0.70 NA XXX
tech.
88125 ................ A Forensic cytopathology 0.26 0.30 NA 0.02 0.58 NA XXX
88125 26 A Forensic cytopathology 0.26 0.12 0.12 0.01 0.39 0.39 XXX
88125 TC A Forensic cytopathology 0.00 0.18 NA 0.01 0.19 NA XXX
88130 ................ X Sex chromatin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
identification.
[[Page 55446]]
88140 ................ X Sex chromatin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
identification.
88141 ................ A Cytopath, c/v, 0.42 0.19 0.19 0.01 0.62 0.62 XXX
interpret.
88142 ................ X Cytopath, c/v, thin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
layer.
88143 ................ X Cytopath, c/v, thin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lyr redo.
88144 ................ X Cytopath, c/v, thin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lyr redo.
88145 ................ X Cytopath, c/v, thin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lyr sel.
88147 ................ X Cytopath, c/v, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
automated.
88148 ................ X Cytopath, c/v, auto 0.00 0.00 0.00 0.00 0.00 0.00 XXX
rescreen.
88150 ................ X Cytopath, c/v, manual. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
88152 ................ X Cytopath, c/v, auto 0.00 0.00 0.00 0.00 0.00 0.00 XXX
redo.
88153 ................ X Cytopath, c/v, redo... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
88154 ................ X Cytopath, c/v, select. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
88155 ................ X Cytopath, c/v, index 0.00 0.00 0.00 0.00 0.00 0.00 XXX
add-on.
88160 ................ A Cytopath smear, other 0.50 1.01 NA 0.04 1.55 NA XXX
source.
88160 26 A Cytopath smear, other 0.50 0.23 0.23 0.02 0.75 0.75 XXX
source.
88160 TC A Cytopath smear, other 0.00 0.78 NA 0.02 0.80 NA XXX
source.
88161 ................ A Cytopath smear, other 0.50 1.22 NA 0.04 1.76 NA XXX
source.
88161 26 A Cytopath smear, other 0.50 0.23 0.23 0.02 0.75 0.75 XXX
source.
88161 TC A Cytopath smear, other 0.00 0.99 NA 0.02 1.01 NA XXX
source.
88162 ................ A Cytopath smear, other 0.76 0.73 NA 0.05 1.54 NA XXX
source.
88162 26 A Cytopath smear, other 0.76 0.35 0.35 0.03 1.14 1.14 XXX
source.
88162 TC A Cytopath smear, other 0.00 0.38 NA 0.02 0.40 NA XXX
source.
88164 ................ X Cytopath tbs, c/v, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
manual.
88165 ................ X Cytopath tbs, c/v, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
redo.
88166 ................ X Cytopath tbs, c/v, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
auto redo.
88167 ................ X Cytopath tbs, c/v, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
select.
88170 ................ D Fine needle aspiration 0.00 0.00 NA 0.00 0.00 NA XXX
88170 26 D Fine needle aspiration 0.00 0.00 0.00 0.00 0.00 0.00 XXX
88170 TC D Fine needle aspiration 0.00 0.00 NA 0.00 0.00 NA XXX
88171 ................ D Fine needle aspiration 0.00 0.00 NA 0.00 0.00 NA XXX
88171 26 D Fine needle aspiration 0.00 0.00 0.00 0.00 0.00 0.00 XXX
88171 TC D Fine needle aspiration 0.00 0.00 NA 0.00 0.00 NA XXX
88172 ................ A Cytopathology eval of 0.60 0.68 NA 0.04 1.32 NA XXX
fna.
88172 26 A Cytopathology eval of 0.60 0.28 0.28 0.02 0.90 0.90 XXX
fna.
88172 TC A Cytopathology eval of 0.00 0.40 NA 0.02 0.42 NA XXX
fna.
88173 ................ A Cytopath eval, fna, 1.39 1.80 NA 0.07 3.26 NA XXX
report.
88173 26 A Cytopath eval, fna, 1.39 0.64 0.64 0.05 2.08 2.08 XXX
report.
88173 TC A Cytopath eval, fna, 0.00 1.16 NA 0.02 1.18 NA XXX
report.
88180 ................ A Cell marker study..... 0.36 0.60 NA 0.03 0.99 NA XXX
88180 26 A Cell marker study..... 0.36 0.17 0.17 0.01 0.54 0.54 XXX
88180 TC A Cell marker study..... 0.00 0.43 NA 0.02 0.45 NA XXX
88182 ................ A Cell marker study..... 0.77 1.81 NA 0.06 2.64 NA XXX
88182 26 A Cell marker study..... 0.77 0.36 0.36 0.03 1.16 1.16 XXX
88182 TC A Cell marker study..... 0.00 1.45 NA 0.03 1.48 NA XXX
88199 ................ C Cytopathology 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
88199 26 C Cytopathology 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
88199 TC C Cytopathology 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
88230 ................ X Tissue culture, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lymphocyte.
88233 ................ X Tissue culture, skin/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
biopsy.
88235 ................ X Tissue culture, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
placenta.
88237 ................ X Tissue culture, bone 0.00 0.00 0.00 0.00 0.00 0.00 XXX
marrow.
88239 ................ X Tissue culture, tumor. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
88240 ................ X Cell cryopreserve/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
storage.
88241 ................ X Frozen cell 0.00 0.00 0.00 0.00 0.00 0.00 XXX
preparation.
88245 ................ X Chromosome analysis, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
20-25.
88248 ................ X Chromosome analysis, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
50-100.
88249 ................ X Chromosome analysis, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
100.
88261 ................ X Chromosome analysis, 5 0.00 0.00 0.00 0.00 0.00 0.00 XXX
88262 ................ X Chromosome analysis, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
15-20.
88263 ................ X Chromosome analysis, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
45.
88264 ................ X Chromosome analysis, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
20-25.
88267 ................ X Chromosome analys, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
placenta.
88269 ................ X Chromosome analys, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
amniotic.
88271 ................ X Cytogenetics, dna 0.00 0.00 0.00 0.00 0.00 0.00 XXX
probe.
88272 ................ X Cytogenetics, 3-5..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
88273 ................ X Cytogenetics, 10-30... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
88274 ................ X Cytogenetics, 25-99... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
88275 ................ X Cytogenetics, 100-300. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
88280 ................ X Chromosome karyotype 0.00 0.00 0.00 0.00 0.00 0.00 XXX
study.
88283 ................ X Chromosome banding 0.00 0.00 0.00 0.00 0.00 0.00 XXX
study.
88285 ................ X Chromosome count, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
additional.
88289 ................ X Chromosome study, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
additional.
88291 ................ A Cyto/molecular report. 0.52 0.23 0.23 0.02 0.77 0.77 XXX
[[Page 55447]]
88299 ................ C Cytogenetic study..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
88300 ................ A Surgical path, gross.. 0.08 0.34 NA 0.02 0.44 NA XXX
88300 26 A Surgical path, gross.. 0.08 0.04 0.04 0.01 0.13 0.13 XXX
88300 TC A Surgical path, gross.. 0.00 0.30 NA 0.01 0.31 NA XXX
88302 ................ A Tissue exam by 0.13 0.73 NA 0.03 0.89 NA XXX
pathologist.
88302 26 A Tissue exam by 0.13 0.06 0.06 0.01 0.20 0.20 XXX
pathologist.
88302 TC A Tissue exam by 0.00 0.67 NA 0.02 0.69 NA XXX
pathologist.
88304 ................ A Tissue exam by 0.22 0.95 NA 0.03 1.20 NA XXX
pathologist.
88304 26 A Tissue exam by 0.22 0.10 0.10 0.01 0.33 0.33 XXX
pathologist.
88304 TC A Tissue exam by 0.00 0.85 NA 0.02 0.87 NA XXX
pathologist.
88305 ................ A Tissue exam by 0.75 1.78 NA 0.05 2.58 NA XXX
pathologist.
88305 26 A Tissue exam by 0.75 0.35 0.35 0.02 1.12 1.12 XXX
pathologist.
88305 TC A Tissue exam by 0.00 1.43 NA 0.03 1.46 NA XXX
pathologist.
88307 ................ A Tissue exam by 1.59 2.71 NA 0.11 4.41 NA XXX
pathologist.
88307 26 A Tissue exam by 1.59 0.74 0.74 0.06 2.39 2.39 XXX
pathologist.
88307 TC A Tissue exam by 0.00 1.97 NA 0.05 2.02 NA XXX
pathologist.
88309 ................ A Tissue exam by 2.28 3.40 NA 0.13 5.81 NA XXX
pathologist.
88309 26 A Tissue exam by 2.28 1.05 1.05 0.08 3.41 3.41 XXX
pathologist.
88309 TC A Tissue exam by 0.00 2.35 NA 0.05 2.40 NA XXX
pathologist.
88311 ................ A Decalcify tissue...... 0.24 0.21 NA 0.02 0.47 NA XXX
88311 26 A Decalcify tissue...... 0.24 0.11 0.11 0.01 0.36 0.36 XXX
88311 TC A Decalcify tissue...... 0.00 0.10 NA 0.01 0.11 NA XXX
88312 ................ A Special stains........ 0.54 1.69 NA 0.03 2.26 NA XXX
88312 26 A Special stains........ 0.54 0.25 0.25 0.02 0.81 0.81 XXX
88312 TC A Special stains........ 0.00 1.44 NA 0.01 1.45 NA XXX
88313 ................ A Special stains........ 0.24 1.47 NA 0.02 1.73 NA XXX
88313 26 A Special stains........ 0.24 0.11 0.11 0.01 0.36 0.36 XXX
88313 TC A Special stains........ 0.00 1.36 NA 0.01 1.37 NA XXX
88314 ................ A Histochemical stain... 0.45 0.86 NA 0.04 1.35 NA XXX
88314 26 A Histochemical stain... 0.45 0.20 0.20 0.02 0.67 0.67 XXX
88314 TC A Histochemical stain... 0.00 0.66 NA 0.02 0.68 NA XXX
88318 ................ A Chemical 0.42 0.59 NA 0.02 1.03 NA XXX
histochemistry.
88318 26 A Chemical 0.42 0.20 0.20 0.01 0.63 0.63 XXX
histochemistry.
88318 TC A Chemical 0.00 0.39 NA 0.01 0.40 NA XXX
histochemistry.
88319 ................ A Enzyme histochemistry. 0.53 2.45 NA 0.04 3.02 NA XXX
88319 26 A Enzyme histochemistry. 0.53 0.24 0.24 0.02 0.79 0.79 XXX
88319 TC A Enzyme histochemistry. 0.00 2.21 NA 0.02 2.23 NA XXX
88321 ................ A Microslide 1.30 0.62 0.60 0.04 1.96 1.94 XXX
consultation.
88323 ................ A Microslide 1.35 1.37 NA 0.07 2.79 NA XXX
consultation.
88323 26 A Microslide 1.35 0.63 0.63 0.05 2.03 2.03 XXX
consultation.
88323 TC A Microslide 0.00 0.74 NA 0.02 0.76 NA XXX
consultation.
88325 ................ A Comprehensive review 2.22 0.98 0.98 0.08 3.28 3.28 XXX
of data.
88329 ................ A Path consult introp... 0.67 0.39 0.31 0.02 1.08 1.00 XXX
88331 ................ A Path consult intraop, 1.19 0.87 NA 0.07 2.13 NA XXX
1 bloc.
88331 26 A Path consult intraop, 1.19 0.55 0.55 0.04 1.78 1.78 XXX
1 bloc.
88331 TC A Path consult intraop, 0.00 0.32 NA 0.03 0.35 NA XXX
1 bloc.
88332 ................ A Path consult intraop, 0.59 0.47 NA 0.04 1.10 NA XXX
addl.
88332 26 A Path consult intraop, 0.59 0.27 0.27 0.02 0.88 0.88 XXX
addl.
88332 TC A Path consult intraop, 0.00 0.20 NA 0.02 0.22 NA XXX
addl.
88342 ................ A Immunocytochemistry... 0.85 1.43 NA 0.05 2.33 NA XXX
88342 26 A Immunocytochemistry... 0.85 0.39 0.39 0.03 1.27 1.27 XXX
88342 TC A Immunocytochemistry... 0.00 1.04 NA 0.02 1.06 NA XXX
88346 ................ A Immunofluorescent 0.86 1.20 NA 0.05 2.11 NA XXX
study.
88346 26 A Immunofluorescent 0.86 0.39 0.39 0.03 1.28 1.28 XXX
study.
88346 TC A Immunofluorescent 0.00 0.81 NA 0.02 0.83 NA XXX
study.
88347 ................ A Immunofluorescent 0.86 1.90 NA 0.05 2.81 NA XXX
study.
88347 26 A Immunofluorescent 0.86 0.38 0.38 0.03 1.27 1.27 XXX
study.
88347 TC A Immunofluorescent 0.00 1.52 NA 0.02 1.54 NA XXX
study.
88348 ................ A Electron microscopy... 1.51 6.96 NA 0.11 8.58 NA XXX
88348 26 A Electron microscopy... 1.51 0.69 0.69 0.05 2.25 2.25 XXX
88348 TC A Electron microscopy... 0.00 6.27 NA 0.06 6.33 NA XXX
88349 ................ A Scanning electron 0.76 8.51 NA 0.08 9.35 NA XXX
microscopy.
88349 26 A Scanning electron 0.76 0.35 0.35 0.03 1.14 1.14 XXX
microscopy.
88349 TC A Scanning electron 0.00 8.16 NA 0.05 8.21 NA XXX
microscopy.
88355 ................ A Analysis, skeletal 1.85 2.41 NA 0.12 4.38 NA XXX
muscle.
88355 26 A Analysis, skeletal 1.85 0.86 0.86 0.07 2.78 2.78 XXX
muscle.
88355 TC A Analysis, skeletal 0.00 1.55 NA 0.05 1.60 NA XXX
muscle.
88356 ................ A Analysis, nerve....... 3.02 4.96 NA 0.16 8.14 NA XXX
88356 26 A Analysis, nerve....... 3.02 1.37 1.37 0.10 4.49 4.49 XXX
88356 TC A Analysis, nerve....... 0.00 3.59 NA 0.06 3.65 NA XXX
88358 ................ A Analysis, tumor....... 2.82 1.76 NA 0.16 4.74 NA XXX
88358 26 A Analysis, tumor....... 2.82 1.30 1.30 0.10 4.22 4.22 XXX
88358 TC A Analysis, tumor....... 0.00 0.46 NA 0.06 0.52 NA XXX
[[Page 55448]]
88362 ................ A Nerve teasing 2.17 3.36 NA 0.12 5.65 NA XXX
preparations.
88362 26 A Nerve teasing 2.17 0.99 0.99 0.07 3.23 3.23 XXX
preparations.
88362 TC A Nerve teasing 0.00 2.37 NA 0.05 2.42 NA XXX
preparations.
88365 ................ A Tissue hybridization.. 0.93 2.03 NA 0.05 3.01 NA XXX
88365 26 A Tissue hybridization.. 0.93 0.43 0.43 0.03 1.39 1.39 XXX
88365 TC A Tissue hybridization.. 0.00 1.60 NA 0.02 1.62 NA XXX
88371 ................ X Protein, western blot 0.00 0.00 0.00 0.00 0.00 0.00 XXX
tissue.
88371 26 A Protein, western blot 0.37 0.15 0.14 0.01 0.53 0.52 XXX
tissue.
88372 ................ X Protein analysis w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
probe.
88372 26 A Protein analysis w/ 0.37 0.17 0.17 0.01 0.55 0.55 XXX
probe.
88380 ................ C Microdissection....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
88380 26 C Microdissection....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
88380 TC C Microdissection....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
88399 ................ C Surgical pathology 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
88399 26 C Surgical pathology 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
88399 TC C Surgical pathology 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
88400 ................ X Bilirubin total 0.00 0.00 0.00 0.00 0.00 0.00 XXX
transcut.
89050 ................ X Body fluid cell count. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
89051 ................ X Body fluid cell count. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
89060 ................ X Exam synovial fluid 0.00 0.00 0.00 0.00 0.00 0.00 XXX
crystals.
89060 26 A Exam synovial fluid 0.37 0.18 0.17 0.01 0.56 0.55 XXX
crystals.
89100 ................ A Sample intestinal 0.60 2.29 0.23 0.02 2.91 0.85 XXX
contents.
89105 ................ A Sample intestinal 0.50 2.25 0.18 0.02 2.77 0.70 XXX
contents.
89125 ................ X Specimen fat stain.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
89130 ................ A Sample stomach 0.45 2.21 0.13 0.02 2.68 0.60 XXX
contents.
89132 ................ A Sample stomach 0.19 1.15 0.05 0.01 1.35 0.25 XXX
contents.
89135 ................ A Sample stomach 0.79 2.53 0.25 0.03 3.35 1.07 XXX
contents.
89136 ................ A Sample stomach 0.21 2.05 0.08 0.01 2.27 0.30 XXX
contents.
89140 ................ A Sample stomach 0.94 2.36 0.19 0.03 3.33 1.16 XXX
contents.
89141 ................ A Sample stomach 0.85 3.14 0.40 0.03 4.02 1.28 XXX
contents.
89160 ................ X Exam feces for meat 0.00 0.00 0.00 0.00 0.00 0.00 XXX
fibers.
89190 ................ X Nasal smear for 0.00 0.00 0.00 0.00 0.00 0.00 XXX
eosinophils.
89250 ................ X Fertilization of 0.00 0.00 0.00 0.00 0.00 0.00 XXX
oocyte.
89251 ................ X Culture oocyte w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
embryos.
89252 ................ X Assist oocyte 0.00 0.00 0.00 0.00 0.00 0.00 XXX
fertilization.
89253 ................ X Embryo hatching....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
89254 ................ X Oocyte identification. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
89255 ................ X Prepare embryo for 0.00 0.00 0.00 0.00 0.00 0.00 XXX
transfer.
89256 ................ X Prepare cryopreserved 0.00 0.00 0.00 0.00 0.00 0.00 XXX
embryo.
89257 ................ X Sperm identification.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
89258 ................ X Cryopreservation, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
embryo.
89259 ................ X Cryopreservation, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sperm.
89260 ................ X Sperm isolation, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
simple.
89261 ................ X Sperm isolation, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
complex.
89264 ................ X Identify sperm tissue. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
89300 ................ X Semen analysis........ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
89310 ................ X Semen analysis........ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
89320 ................ X Semen analysis........ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
89321 ................ X Semen analysis........ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
89325 ................ X Sperm antibody test... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
89329 ................ X Sperm evaluation test. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
89330 ................ X Evaluation, cervical 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mucus.
89350 ................ A Sputum specimen 0.00 0.39 NA 0.02 0.41 NA XXX
collection.
89355 ................ X Exam feces for starch. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
89360 ................ A Collect sweat for test 0.00 0.43 NA 0.02 0.45 NA XXX
89365 ................ X Water load test....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
89399 ................ C Pathology lab 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
89399 26 C Pathology lab 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
89399 TC C Pathology lab 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
90281 ................ I Human ig, im.......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90283 ................ I Human ig, iv.......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90287 ................ I Botulinum antitoxin... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90288 ................ I Botulism ig, iv....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90291 ................ I Cmv ig, iv............ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90296 ................ E Diphtheria antitoxin.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90371 ................ E Hep b ig, im.......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90375 ................ E Rabies ig, im/sc...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90376 ................ E Rabies ig, heat 0.00 0.00 0.00 0.00 0.00 0.00 XXX
treated.
90378 ................ X Rsv ig, im, 50mg...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90379 ................ I Rsv ig, iv............ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90384 ................ I Rh ig, full-dose, im.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90385 ................ E Rh ig, minidose, im... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90386 ................ I Rh ig, iv............. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
[[Page 55449]]
90389 ................ I Tetanus ig, im........ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90393 ................ E Vaccina ig, im........ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90396 ................ E Varicella-zoster ig, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
im.
90399 ................ I Immune globulin....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90471 ................ A Immunization admin.... 0.00 0.10 NA 0.01 0.11 NA XXX
90472 ................ A Immunization admin, 0.00 0.10 NA 0.01 0.11 NA ZZZ
each add.
90473 ................ N Immune admin oral/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
nasal.
90474 ................ N Immune admin oral/ 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
nasal addl.
90476 ................ E Adenovirus vaccine, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
type 4.
90477 ................ E Adenovirus vaccine, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
type 7.
90581 ................ E Anthrax vaccine, sc... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90585 ................ E Bcg vaccine, percut... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90586 ................ E Bcg vaccine, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
intravesical.
90632 ................ E Hep a vaccine, adult 0.00 0.00 0.00 0.00 0.00 0.00 XXX
im.
90633 ................ E Hep a vacc, ped/adol, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
2 dose.
90634 ................ E Hep a vacc, ped/adol, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
3 dose.
90636 ................ E Hep a/hep b vacc, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
adult im.
90645 ................ E Hib vaccine, hboc, im. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90646 ................ E Hib vaccine, prp-d, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90647 ................ E Hib vaccine, prp-omp, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
im.
90648 ................ E Hib vaccine, prp-t, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90657 ................ X Flu vaccine, 6-35 mo, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
im.
90658 ................ X Flu vaccine, 3 yrs, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90659 ................ X Flu vaccine, whole, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90660 ................ X Flu vaccine, nasal.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90665 ................ E Lyme disease vaccine, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
im.
90669 ................ N Pneumococcal vacc, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ped5.
90675 ................ E Rabies vaccine, im.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90676 ................ E Rabies vaccine, id.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90680 ................ E Rotovirus vaccine, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
oral.
90690 ................ E Typhoid vaccine, oral. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90691 ................ E Typhoid vaccine, im... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90692 ................ E Typhoid vaccine, h-p, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sc/id.
90693 ................ E Typhoid vaccine, akd, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sc.
90700 ................ E Dtap vaccine, im...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90701 ................ E Dtp vaccine, im....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90702 ................ E Dt vaccine 7, im..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90703 ................ E Tetanus vaccine, im... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90704 ................ E Mumps vaccine, sc..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90705 ................ E Measles vaccine, sc... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90706 ................ E Rubella vaccine, sc... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90707 ................ E Mmr vaccine, sc....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90708 ................ E Measles-rubella 0.00 0.00 0.00 0.00 0.00 0.00 XXX
vaccine, sc.
90709 ................ E Rubella & mumps 0.00 0.00 0.00 0.00 0.00 0.00 XXX
vaccine, sc.
90710 ................ E Mmrv vaccine, sc...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90712 ................ E Oral poliovirus 0.00 0.00 0.00 0.00 0.00 0.00 XXX
vaccine.
90713 ................ E Poliovirus, ipv, sc... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90716 ................ E Chicken pox vaccine, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sc.
90717 ................ E Yellow fever vaccine, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sc.
90718 ................ E Td vaccine > 7, im.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90719 ................ E Diphtheria vaccine, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90720 ................ E Dtp/hib vaccine, im... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90721 ................ E Dtap/hib vaccine, im.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90723 ................ X Dtap-hep b-ipv 0.00 0.00 0.00 0.00 0.00 0.00 XXX
vaccine, im.
90725 ................ E Cholera vaccine, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injectable.
90727 ................ E Plague vaccine, im.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90732 ................ X Pneumococcal vaccine.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90733 ................ E Meningococcal vaccine, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sc.
90735 ................ E Encephalitis vaccine, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sc.
90740 ................ X Hepb vacc, ill pat 3 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dose im.
90743 ................ X Hep b vacc, adol, 2 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dose, im.
90744 ................ X Hepb vacc ped/adol 3 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dose im.
90746 ................ X Hep b vaccine, adult, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
im.
90747 ................ X Hepb vacc, ill pat 4 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dose im.
90748 ................ E Hep b/hib vaccine, im. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90749 ................ E Vaccine toxoid........ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90780 ................ A IV infusion therapy, 1 0.00 1.06 NA 0.06 1.12 NA XXX
hour.
90781 ................ A IV infusion, 0.00 0.53 NA 0.03 0.56 NA ZZZ
additional hour.
90782 ................ T Injection, sc/im...... 0.00 0.10 NA 0.01 0.11 NA XXX
90783 ................ T Injection, ia......... 0.00 0.39 NA 0.02 0.41 NA XXX
90784 ................ T Injection, iv......... 0.00 0.45 NA 0.03 0.48 NA XXX
90788 ................ T Injection of 0.00 0.11 NA 0.01 0.12 NA XXX
antibiotic.
90799 ................ C Ther/prophylactic/dx 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inject.
[[Page 55450]]
90801 ................ A Psy dx interview...... 2.80 1.14 0.93 0.06 4.00 3.79 XXX
90802 ................ A Intac psy dx interview 3.01 1.17 0.99 0.07 4.25 4.07 XXX
90804 ................ A Psytx, office, 20-30 1.21 0.53 0.40 0.03 1.77 1.64 XXX
min.
90805 ................ A Psytx, off, 20-30 min 1.37 0.59 0.44 0.03 1.99 1.84 XXX
w/e&m.
90806 ................ A Psytx, off, 45-50 min. 1.86 0.75 0.62 0.04 2.65 2.52 XXX
90807 ................ A Psytx, off, 45-50 min 2.02 0.79 0.66 0.05 2.86 2.73 XXX
w/e&m.
90808 ................ A Psytx, office, 75-80 2.79 1.06 0.93 0.07 3.92 3.79 XXX
min.
90809 ................ A Psytx, off, 75-80, w/ 2.95 1.11 0.97 0.07 4.13 3.99 XXX
e&m.
90810 ................ A Intac psytx, off, 20- 1.32 0.56 0.44 0.03 1.91 1.79 XXX
30 min.
90811 ................ A Intac psytx, 20-30, w/ 1.48 0.63 0.48 0.03 2.14 1.99 XXX
e&m.
90812 ................ A Intac psytx, off, 45- 1.97 0.80 0.69 0.05 2.82 2.71 XXX
50 min.
90813 ................ A Intac psytx, 45-50 min 2.13 0.87 0.71 0.05 3.05 2.89 XXX
w/e&m.
90814 ................ A Intac psytx, off, 75- 2.90 1.15 1.01 0.07 4.12 3.98 XXX
80 min.
90815 ................ A Intac psytx, 75-80 w/ 3.06 1.15 1.02 0.07 4.28 4.15 XXX
e&m.
90816 ................ A Psytx, hosp, 20-30 min 1.25 0.57 0.43 0.03 1.85 1.71 XXX
90817 ................ A Psytx, hosp, 20-30 min 1.41 0.62 0.45 0.03 2.06 1.89 XXX
w/e&m.
90818 ................ A Psytx, hosp, 45-50 min 1.89 0.80 0.65 0.04 2.73 2.58 XXX
90819 ................ A Psytx, hosp, 45-50 min 2.05 0.83 0.66 0.05 2.93 2.76 XXX
w/e&m.
90821 ................ A Psytx, hosp, 75-80 min 2.83 1.11 0.97 0.06 4.00 3.86 XXX
90822 ................ A Psytx, hosp, 75-80 min 2.99 1.30 0.97 0.07 4.36 4.03 XXX
w/e&m.
90823 ................ A Intac psytx, hosp, 20- 1.36 0.65 0.45 0.03 2.04 1.84 XXX
30 min.
90824 ................ A Intac psytx, hsp 20-30 1.52 0.70 0.50 0.03 2.25 2.05 XXX
w/e&m.
90826 ................ A Intac psytx, hosp, 45- 2.01 0.89 0.68 0.04 2.94 2.73 XXX
50 min.
90827 ................ A Intac psytx, hsp 45-50 2.16 0.91 0.70 0.05 3.12 2.91 XXX
w/e&m.
90828 ................ A Intac psytx, hosp, 75- 2.94 1.90 1.02 0.07 4.91 4.03 XXX
80 min.
90829 ................ A Intac psytx, hsp 75-80 3.10 1.23 1.02 0.07 4.40 4.19 XXX
w/e&m.
90845 ................ A Psychoanalysis........ 1.79 0.71 0.57 0.04 2.54 2.40 XXX
90846 ................ R Family psytx w/o 1.83 0.73 0.62 0.04 2.60 2.49 XXX
patient.
90847 ................ R Family psytx w/patient 2.21 0.86 0.75 0.05 3.12 3.01 XXX
90849 ................ R Multiple family group 0.59 0.31 0.20 0.01 0.91 0.80 XXX
psytx.
90853 ................ A Group psychotherapy... 0.59 0.35 0.20 0.01 0.95 0.80 XXX
90857 ................ A Intac group psytx..... 0.63 0.37 0.21 0.02 1.02 0.86 XXX
90862 ................ A Medication management. 0.95 0.44 0.31 0.02 1.41 1.28 XXX
90865 ................ A Narcosynthesis........ 2.84 1.70 0.94 0.07 4.61 3.85 XXX
90870 ................ A Electroconvulsive 1.88 0.74 0.74 0.04 2.66 2.66 000
therapy.
90871 ................ A Electroconvulsive 2.72 NA 1.04 0.06 NA 3.82 000
therapy.
90875 ................ N Psychophysiological +1.20 0.90 0.48 0.03 2.13 1.71 XXX
therapy.
90876 ................ N Psychophysiological +1.90 1.18 0.76 0.04 3.12 2.70 XXX
therapy.
90880 ................ A Hypnotherapy.......... 2.19 0.91 0.71 0.05 3.15 2.95 XXX
90882 ................ N Environmental 0.00 0.00 0.00 0.00 0.00 0.00 XXX
manipulation.
90885 ................ B Psy evaluation of +0.97 0.39 0.39 0.02 1.38 1.38 XXX
records.
90887 ................ B Consultation with +1.48 0.83 0.59 0.03 2.34 2.10 XXX
family.
90889 ................ B Preparation of report. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90899 ................ C Psychiatric service/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
therapy.
90901 ................ A Biofeedback train, any 0.41 0.82 0.17 0.02 1.25 0.60 000
meth.
90911 ................ A Biofeedback peri/uro/ 0.89 0.87 0.39 0.04 1.80 1.32 000
rectal.
90918 ................ A ESRD related services, 11.18 5.53 5.53 0.30 17.01 17.01 XXX
month.
90919 ................ A ESRD related services, 8.54 4.53 4.53 0.24 13.31 13.31 XXX
month.
90920 ................ A ESRD related services, 7.27 4.02 4.02 0.19 11.48 11.48 XXX
month.
90921 ................ A ESRD related services, 4.47 2.96 2.96 0.12 7.55 7.55 XXX
month.
90922 ................ A ESRD related services, 0.37 0.17 0.17 0.01 0.55 0.55 XXX
day.
90923 ................ A ESRD related services, 0.28 0.15 0.15 0.01 0.44 0.44 XXX
day.
90924 ................ A ESRD related services, 0.24 0.13 0.13 0.01 0.38 0.38 XXX
day.
90925 ................ A ESRD related services, 0.15 0.10 0.10 0.01 0.26 0.26 XXX
day.
90935 ................ A Hemodialysis, one 1.22 NA 0.86 0.03 NA 2.11 000
evaluation.
90937 ................ A Hemodialysis, repeated 2.11 NA 1.20 0.06 NA 3.37 000
eval.
90939 ................ X Hemodialysis study, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
transcut.
90940 ................ X Hemodialysis access 0.00 0.00 0.00 0.00 0.00 0.00 XXX
study.
90945 ................ A Dialysis, one 1.28 NA 0.89 0.04 NA 2.21 000
evaluation.
90947 ................ A Dialysis, repeated 2.16 NA 1.24 0.06 NA 3.46 000
eval.
90989 ................ X Dialysis training, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
complete.
90993 ................ X Dialysis training, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
incompl.
90997 ................ A Hemoperfusion......... 1.84 NA 1.10 0.05 NA 2.99 000
90999 ................ C Dialysis procedure.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
91000 ................ A Esophageal intubation. 0.73 0.32 NA 0.04 1.09 NA 000
91000 26 A Esophageal intubation. 0.73 0.25 0.25 0.03 1.01 1.01 000
91000 TC A Esophageal intubation. 0.00 0.07 NA 0.01 0.08 NA 000
91010 ................ A Esophagus motility 1.25 2.60 NA 0.10 3.95 NA 000
study.
91010 26 A Esophagus motility 1.25 0.46 0.46 0.05 1.76 1.76 000
study.
91010 TC A Esophagus motility 0.00 2.14 NA 0.05 2.19 NA 000
study.
91011 ................ A Esophagus motility 1.50 2.71 NA 0.10 4.31 NA 000
study.
91011 26 A Esophagus motility 1.50 0.55 0.55 0.05 2.10 2.10 000
study.
91011 TC A Esophagus motility 0.00 2.16 NA 0.05 2.21 NA 000
study.
[[Page 55451]]
91012 ................ A Esophagus motility 1.46 2.35 NA 0.12 3.93 NA 000
study.
91012 26 A Esophagus motility 1.46 0.54 0.54 0.06 2.06 2.06 000
study.
91012 TC A Esophagus motility 0.00 1.81 NA 0.06 1.87 NA 000
study.
91020 ................ A Gastric motility...... 1.44 2.96 NA 0.11 4.51 NA 000
91020 26 A Gastric motility...... 1.44 0.51 0.51 0.06 2.01 2.01 000
91020 TC A Gastric motility...... 0.00 2.45 NA 0.05 2.50 NA 000
91030 ................ A Acid perfusion of 0.91 2.27 NA 0.05 3.23 NA 000
esophagus.
91030 26 A Acid perfusion of 0.91 0.34 0.34 0.03 1.28 1.28 000
esophagus.
91030 TC A Acid perfusion of 0.00 1.93 NA 0.02 1.95 NA 000
esophagus.
91032 ................ A Esophagus, acid reflux 1.21 2.26 NA 0.10 3.57 NA 000
test.
91032 26 A Esophagus, acid reflux 1.21 0.44 0.44 0.05 1.70 1.70 000
test.
91032 TC A Esophagus, acid reflux 0.00 1.82 NA 0.05 1.87 NA 000
test.
91033 ................ A Prolonged acid reflux 1.30 2.64 NA 0.14 4.08 NA 000
test.
91033 26 A Prolonged acid reflux 1.30 0.48 0.48 0.05 1.83 1.83 000
test.
91033 TC A Prolonged acid reflux 0.00 2.16 NA 0.09 2.25 NA 000
test.
91052 ................ A Gastric analysis test. 0.79 2.19 NA 0.05 3.03 NA 000
91052 26 A Gastric analysis test. 0.79 0.29 0.29 0.03 1.11 1.11 000
91052 TC A Gastric analysis test. 0.00 1.90 NA 0.02 1.92 NA 000
91055 ................ A Gastric intubation for 0.94 2.22 NA 0.06 3.22 NA 000
smear.
91055 26 A Gastric intubation for 0.94 0.28 0.28 0.04 1.26 1.26 000
smear.
91055 TC A Gastric intubation for 0.00 1.94 NA 0.02 1.96 NA 000
smear.
91060 ................ A Gastric saline load 0.45 0.28 NA 0.04 0.77 NA 000
test.
91060 26 A Gastric saline load 0.45 0.15 0.15 0.02 0.62 0.62 000
test.
91060 TC A Gastric saline load 0.00 0.13 NA 0.02 0.15 NA 000
test.
91065 ................ A Breath hydrogen test.. 0.20 4.55 NA 0.03 4.78 NA 000
91065 26 A Breath hydrogen test.. 0.20 0.07 0.07 0.01 0.28 0.28 000
91065 TC A Breath hydrogen test.. 0.00 4.48 NA 0.02 4.50 NA 000
91100 ................ A Pass intestine 1.08 NA 0.48 0.06 NA 1.62 000
bleeding tube.
91105 ................ A Gastric intubation 0.37 NA 0.21 0.02 NA 0.60 000
treatment.
91122 ................ A Anal pressure record.. 1.77 2.77 NA 0.17 4.71 NA 000
91122 26 A Anal pressure record.. 1.77 0.63 0.63 0.10 2.50 2.50 000
91122 TC A Anal pressure record.. 0.00 2.14 NA 0.07 2.21 NA 000
91123 ................ B Irrigate fecal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
impaction.
91132 ................ C Electrogastrography... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
91132 26 A Electrogastrography... 0.52 0.21 NA 0.03 0.76 NA XXX
91132 TC C Electrogastrography... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
91133 ................ C Electrogastrography w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
91133 26 A Electrogastrography w/ 0.66 0.26 NA 0.03 0.95 NA XXX
test.
91133 TC C Electrogastrography w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
91299 ................ C Gastroenterology 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
91299 26 C Gastroenterology 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
91299 TC C Gastroenterology 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
92002 ................ A Eye exam, new patient. 0.88 0.96 0.38 0.02 1.86 1.28 XXX
92004 ................ A Eye exam, new patient. 1.67 1.71 0.73 0.03 3.41 2.43 XXX
92012 ................ A Eye exam established 0.67 1.01 0.31 0.01 1.69 0.99 XXX
pat.
92014 ................ A Eye exam & treatment.. 1.10 1.40 0.50 0.02 2.52 1.62 XXX
92015 ................ N Refraction............ +0.38 1.51 0.15 0.01 1.90 0.54 XXX
92018 ................ A New eye exam & 2.50 NA 1.14 0.03 NA 3.67 XXX
treatment.
92019 ................ A Eye exam & treatment.. 1.31 NA 0.61 0.03 NA 1.95 XXX
92020 ................ A Special eye evaluation 0.37 0.95 0.17 0.01 1.33 0.55 XXX
92060 ................ A Special eye evaluation 0.69 0.74 NA 0.02 1.45 NA XXX
92060 26 A Special eye evaluation 0.69 0.31 0.31 0.01 1.01 1.01 XXX
92060 TC A Special eye evaluation 0.00 0.43 NA 0.01 0.44 NA XXX
92065 ................ A Orthoptic/pleoptic 0.37 1.19 NA 0.02 1.58 NA XXX
training.
92065 26 A Orthoptic/pleoptic 0.37 0.15 0.15 0.01 0.53 0.53 XXX
training.
92065 TC A Orthoptic/pleoptic 0.00 1.04 NA 0.01 1.05 NA XXX
training.
92070 ................ A Fitting of contact 0.70 1.12 0.34 0.01 1.83 1.05 XXX
lens.
92081 ................ A Visual field 0.36 1.84 NA 0.02 2.22 NA XXX
examination(s).
92081 26 A Visual field 0.36 0.16 0.16 0.01 0.53 0.53 XXX
examination(s).
92081 TC A Visual field 0.00 1.68 NA 0.01 1.69 NA XXX
examination(s).
92082 ................ A Visual field 0.44 0.85 NA 0.02 1.31 NA XXX
examination(s).
92082 26 A Visual field 0.44 0.20 0.20 0.01 0.65 0.65 XXX
examination(s).
92082 TC A Visual field 0.00 0.65 NA 0.01 0.66 NA XXX
examination(s).
92083 ................ A Visual field 0.50 1.51 NA 0.02 2.03 NA XXX
examination(s).
92083 26 A Visual field 0.50 0.23 0.23 0.01 0.74 0.74 XXX
examination(s).
92083 TC A Visual field 0.00 1.28 NA 0.01 1.29 NA XXX
examination(s).
92100 ................ A Serial tonometry 0.92 0.75 0.40 0.02 1.69 1.34 XXX
exam(s).
92120 ................ A Tonography & eye 0.81 0.81 0.31 0.02 1.64 1.14 XXX
evaluation.
92130 ................ A Water provocation 0.81 0.92 0.32 0.02 1.75 1.15 XXX
tonography.
92135 ................ A Ophthalmic dx imaging. 0.35 1.48 NA 0.02 1.85 NA XXX
92135 26 A Ophthalmic dx imaging. 0.35 0.17 0.17 0.01 0.53 0.53 XXX
92135 TC A Ophthalmic dx imaging. 0.00 1.31 NA 0.01 1.32 NA XXX
92136 ................ A Ophthalmic biometry... 0.54 1.52 NA 0.07 2.13 NA XXX
[[Page 55452]]
92136 26 A Ophthalmic biometry... 0.54 0.22 0.22 0.01 0.77 0.77 XXX
92136 TC A Ophthalmic biometry... 0.00 1.30 NA 0.06 1.36 NA XXX
92140 ................ A Glaucoma provocative 0.50 1.01 0.22 0.01 1.52 0.73 XXX
tests.
92225 ................ A Special eye exam, 0.38 0.23 0.17 0.01 0.62 0.56 XXX
initial.
92226 ................ A Special eye exam, 0.33 0.22 0.15 0.01 0.56 0.49 XXX
subsequent.
92230 ................ A Eye exam with photos.. 0.60 1.73 0.21 0.02 2.35 0.83 XXX
92235 ................ A Eye exam with photos.. 0.81 2.62 NA 0.07 3.50 NA XXX
92235 26 A Eye exam with photos.. 0.81 0.39 0.39 0.02 1.22 1.22 XXX
92235 TC A Eye exam with photos.. 0.00 2.23 NA 0.05 2.28 NA XXX
92240 ................ A Icg angiography....... 1.10 5.24 NA 0.07 6.41 NA XXX
92240 26 A Icg angiography....... 1.10 0.53 0.53 0.02 1.65 1.65 XXX
92240 TC A Icg angiography....... 0.00 4.71 NA 0.05 4.76 NA XXX
92250 ................ A Eye exam with photos.. 0.44 1.37 NA 0.02 1.83 NA XXX
92250 26 A Eye exam with photos.. 0.44 0.20 0.20 0.01 0.65 0.65 XXX
92250 TC A Eye exam with photos.. 0.00 1.17 NA 0.01 1.18 NA XXX
92260 ................ A Ophthalmoscopy/ 0.20 0.24 0.10 0.01 0.45 0.31 XXX
dynamometry.
92265 ................ A Eye muscle evaluation. 0.81 1.23 NA 0.04 2.08 NA XXX
92265 26 A Eye muscle evaluation. 0.81 0.38 0.38 0.02 1.21 1.21 XXX
92265 TC A Eye muscle evaluation. 0.00 0.85 NA 0.02 0.87 NA XXX
92270 ................ A Electro-oculography... 0.81 1.15 NA 0.05 2.01 NA XXX
92270 26 A Electro-oculography... 0.81 0.37 0.37 0.03 1.21 1.21 XXX
92270 TC A Electro-oculography... 0.00 0.78 NA 0.02 0.80 NA XXX
92275 ................ A Electroretinography... 1.01 1.25 NA 0.04 2.30 NA XXX
92275 26 A Electroretinography... 1.01 0.46 0.46 0.02 1.49 1.49 XXX
92275 TC A Electroretinography... 0.00 0.79 NA 0.02 0.81 NA XXX
92283 ................ A Color vision 0.17 0.74 NA 0.02 0.93 NA XXX
examination.
92283 26 A Color vision 0.17 0.07 0.07 0.01 0.25 0.25 XXX
examination.
92283 TC A Color vision 0.00 0.67 NA 0.01 0.68 NA XXX
examination.
92284 ................ A Dark adaptation eye 0.24 1.75 NA 0.02 2.01 NA XXX
exam.
92284 26 A Dark adaptation eye 0.24 0.09 0.09 0.01 0.34 0.34 XXX
exam.
92284 TC A Dark adaptation eye 0.00 1.66 NA 0.01 1.67 NA XXX
exam.
92285 ................ A Eye photography....... 0.20 0.80 NA 0.02 1.02 NA XXX
92285 26 A Eye photography....... 0.20 0.09 0.09 0.01 0.30 0.30 XXX
92285 TC A Eye photography....... 0.00 0.71 NA 0.01 0.72 NA XXX
92286 ................ A Internal eye 0.66 3.00 NA 0.03 3.69 NA XXX
photography.
92286 26 A Internal eye 0.66 0.32 0.32 0.01 0.99 0.99 XXX
photography.
92286 TC A Internal eye 0.00 2.68 NA 0.02 2.70 NA XXX
photography.
92287 ................ A Internal eye 0.81 3.16 0.31 0.02 3.99 1.14 XXX
photography.
92310 ................ N Contact lens fitting.. +1.17 1.10 0.47 0.03 2.30 1.67 XXX
92311 ................ A Contact lens fitting.. 1.08 1.17 0.31 0.03 2.28 1.42 XXX
92312 ................ A Contact lens fitting.. 1.26 1.17 0.45 0.03 2.46 1.74 XXX
92313 ................ A Contact lens fitting.. 0.92 1.21 0.33 0.02 2.15 1.27 XXX
92314 ................ N Prescription of +0.69 0.91 0.28 0.01 1.61 0.98 XXX
contact lens.
92315 ................ A Prescription of 0.45 0.95 0.17 0.01 1.41 0.63 XXX
contact lens.
92316 ................ A Prescription of 0.68 1.03 0.30 0.01 1.72 0.99 XXX
contact lens.
92317 ................ A Prescription of 0.45 0.97 0.18 0.01 1.43 0.64 XXX
contact lens.
92325 ................ A Modification of 0.00 0.38 NA 0.01 0.39 NA XXX
contact lens.
92326 ................ A Replacement of contact 0.00 1.55 NA 0.05 1.60 NA XXX
lens.
92330 ................ A Fitting of artificial 1.08 1.01 0.38 0.04 2.13 1.50 XXX
eye.
92335 ................ A Fitting of artificial 0.45 0.99 0.17 0.01 1.45 0.63 XXX
eye.
92340 ................ N Fitting of spectacles. +0.37 0.68 0.15 0.01 1.06 0.53 XXX
92341 ................ N Fitting of spectacles. +0.47 0.72 0.19 0.01 1.20 0.67 XXX
92342 ................ N Fitting of spectacles. +0.53 0.74 0.21 0.01 1.28 0.75 XXX
92352 ................ B Special spectacles +0.37 0.68 0.15 0.01 1.06 0.53 XXX
fitting.
92353 ................ B Special spectacles +0.50 0.73 0.20 0.02 1.25 0.72 XXX
fitting.
92354 ................ B Special spectacles +0.00 8.41 NA 0.08 8.49 NA XXX
fitting.
92355 ................ B Special spectacles +0.00 4.11 NA 0.01 4.12 NA XXX
fitting.
92358 ................ B Eye prosthesis service +0.00 0.92 NA 0.04 0.96 NA XXX
92370 ................ N Repair & adjust +0.32 0.54 0.13 0.02 0.88 0.47 XXX
spectacles.
92371 ................ B Repair & adjust +0.00 0.59 NA 0.02 0.61 NA XXX
spectacles.
92390 ................ N Supply of spectacles.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
92391 ................ N Supply of contact 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lenses.
92392 ................ I Supply of low vision +0.00 3.84 NA 0.02 3.86 NA XXX
aids.
92393 ................ I Supply of artificial +0.00 11.92 NA 0.47 12.39 NA XXX
eye.
92395 ................ I Supply of spectacles.. +0.00 1.30 NA 0.08 1.38 NA XXX
92396 ................ I Supply of contact +0.00 2.19 NA 0.06 2.25 NA XXX
lenses.
92499 ................ C Eye service or 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
92499 26 C Eye service or 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
92499 TC C Eye service or 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
92502 ................ A Ear and throat 1.51 NA 1.28 0.06 NA 2.85 000
examination.
92504 ................ A Ear microscopy 0.18 1.10 0.09 0.01 1.29 0.28 XXX
examination.
92506 ................ A Speech/hearing 0.86 1.72 0.43 0.04 2.62 1.33 XXX
evaluation.
92507 ................ A Speech/hearing therapy 0.52 1.54 0.28 0.02 2.08 0.82 XXX
[[Page 55453]]
92508 ................ A Speech/hearing therapy 0.26 1.77 0.15 0.01 2.04 0.42 XXX
92510 ................ A Rehab for ear implant. 1.50 2.11 0.83 0.06 3.67 2.39 XXX
92511 ................ A Nasopharyngoscopy..... 0.84 1.36 0.42 0.03 2.23 1.29 000
92512 ................ A Nasal function studies 0.55 1.13 0.17 0.02 1.70 0.74 XXX
92516 ................ A Facial nerve function 0.43 0.94 0.24 0.02 1.39 0.69 XXX
test.
92520 ................ A Laryngeal function 0.76 0.52 0.43 0.03 1.31 1.22 XXX
studies.
92525 ................ I Oral function +1.50 1.69 0.60 0.07 3.26 2.17 XXX
evaluation.
92526 ................ A Oral function therapy. 0.55 1.55 0.27 0.02 2.12 0.84 XXX
92531 ................ B Spontaneous nystagmus 0.00 0.00 0.00 0.00 0.00 0.00 XXX
study.
92532 ................ B Positional nystagmus 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
92533 ................ B Caloric vestibular 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
92534 ................ B Optokinetic nystagmus 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
92541 ................ A Spontaneous nystagmus 0.40 1.45 NA 0.04 1.89 NA XXX
test.
92541 26 A Spontaneous nystagmus 0.40 0.20 0.20 0.02 0.62 0.62 XXX
test.
92541 TC A Spontaneous nystagmus 0.00 1.25 NA 0.02 1.27 NA XXX
test.
92542 ................ A Positional nystagmus 0.33 1.39 NA 0.03 1.75 NA XXX
test.
92542 26 A Positional nystagmus 0.33 0.17 0.17 0.01 0.51 0.51 XXX
test.
92542 TC A Positional nystagmus 0.00 1.22 NA 0.02 1.24 NA XXX
test.
92543 ................ A Caloric vestibular 0.10 0.39 NA 0.02 0.51 NA XXX
test.
92543 26 A Caloric vestibular 0.10 0.05 0.05 0.01 0.16 0.16 XXX
test.
92543 TC A Caloric vestibular 0.00 0.34 NA 0.01 0.35 NA XXX
test.
92544 ................ A Optokinetic nystagmus 0.26 1.35 NA 0.03 1.64 NA XXX
test.
92544 26 A Optokinetic nystagmus 0.26 0.13 0.13 0.01 0.40 0.40 XXX
test.
92544 TC A Optokinetic nystagmus 0.00 1.22 NA 0.02 1.24 NA XXX
test.
92545 ................ A Oscillating tracking 0.23 1.32 NA 0.03 1.58 NA XXX
test.
92545 26 A Oscillating tracking 0.23 0.12 0.12 0.01 0.36 0.36 XXX
test.
92545 TC A Oscillating tracking 0.00 1.20 NA 0.02 1.22 NA XXX
test.
92546 ................ A Sinusoidal rotational 0.29 2.22 NA 0.03 2.54 NA XXX
test.
92546 26 A Sinusoidal rotational 0.29 0.14 0.14 0.01 0.44 0.44 XXX
test.
92546 TC A Sinusoidal rotational 0.00 2.08 NA 0.02 2.10 NA XXX
test.
92547 ................ A Supplemental 0.00 1.21 NA 0.05 1.26 NA ZZZ
electrical test.
92548 ................ A Posturography......... 0.50 2.09 NA 0.13 2.72 NA XXX
92548 26 A Posturography......... 0.50 0.28 0.28 0.02 0.80 0.80 XXX
92548 TC A Posturography......... 0.00 1.81 NA 0.11 1.92 NA XXX
92551 ................ N Pure tone hearing 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test, air.
92552 ................ A Pure tone audiometry, 0.00 0.42 NA 0.03 0.45 NA XXX
air.
92553 ................ A Audiometry, air & bone 0.00 0.62 NA 0.05 0.67 NA XXX
92555 ................ A Speech threshold 0.00 0.36 NA 0.03 0.39 NA XXX
audiometry.
92556 ................ A Speech audiometry, 0.00 0.54 NA 0.05 0.59 NA XXX
complete.
92557 ................ A Comprehensive hearing 0.00 1.13 NA 0.10 1.23 NA XXX
test.
92559 ................ N Group audiometric 0.00 0.00 0.00 0.00 0.00 0.00 XXX
testing.
92560 ................ N Bekesy audiometry, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
screen.
92561 ................ A Bekesy audiometry, 0.00 0.68 NA 0.05 0.73 NA XXX
diagnosis.
92562 ................ A Loudness balance test. 0.00 0.39 NA 0.03 0.42 NA XXX
92563 ................ A Tone decay hearing 0.00 0.36 NA 0.03 0.39 NA XXX
test.
92564 ................ A Sisi hearing test..... 0.00 0.45 NA 0.04 0.49 NA XXX
92565 ................ A Stenger test, pure 0.00 0.38 NA 0.03 0.41 NA XXX
tone.
92567 ................ A Tympanometry.......... 0.00 0.50 NA 0.05 0.55 NA XXX
92568 ................ A Acoustic reflex 0.00 0.36 NA 0.03 0.39 NA XXX
testing.
92569 ................ A Acoustic reflex decay 0.00 0.39 NA 0.03 0.42 NA XXX
test.
92571 ................ A Filtered speech 0.00 0.37 NA 0.03 0.40 NA XXX
hearing test.
92572 ................ A Staggered spondaic 0.00 0.08 NA 0.01 0.09 NA XXX
word test.
92573 ................ A Lombard test.......... 0.00 0.33 NA 0.03 0.36 NA XXX
92575 ................ A Sensorineural acuity 0.00 0.28 NA 0.02 0.30 NA XXX
test.
92576 ................ A Synthetic sentence 0.00 0.42 NA 0.04 0.46 NA XXX
test.
92577 ................ A Stenger test, speech.. 0.00 0.68 NA 0.06 0.74 NA XXX
92579 ................ A Visual audiometry 0.00 0.69 NA 0.05 0.74 NA XXX
(vra).
92582 ................ A Conditioning play 0.00 0.69 NA 0.05 0.74 NA XXX
audiometry.
92583 ................ A Select picture 0.00 0.84 NA 0.07 0.91 NA XXX
audiometry.
92584 ................ A Electrocochleography.. 0.00 2.35 NA 0.17 2.52 NA XXX
92585 ................ A Auditor evoke potent, 0.50 1.98 NA 0.14 2.62 NA XXX
compre.
92585 26 A Auditor evoke potent, 0.50 0.23 0.23 0.02 0.75 0.75 XXX
compre.
92585 TC A Auditor evoke potent, 0.00 1.75 NA 0.12 1.87 NA XXX
compre.
92586 ................ A Auditor evoke potent, 0.00 1.75 NA 0.12 1.87 NA XXX
limit.
92587 ................ A Evoked auditory test.. 0.13 1.31 NA 0.10 1.54 NA XXX
92587 26 A Evoked auditory test.. 0.13 0.07 0.07 0.01 0.21 0.21 XXX
92587 TC A Evoked auditory test.. 0.00 1.24 NA 0.09 1.33 NA XXX
92588 ................ A Evoked auditory test.. 0.36 1.58 NA 0.12 2.06 NA XXX
92588 26 A Evoked auditory test.. 0.36 0.18 0.18 0.01 0.55 0.55 XXX
92588 TC A Evoked auditory test.. 0.00 1.40 NA 0.11 1.51 NA XXX
92589 ................ A Auditory function 0.00 0.51 NA 0.05 0.56 NA XXX
test(s).
92590 ................ N Hearing aid exam, one 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ear.
92591 ................ N Hearing aid exam, both 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ears.
[[Page 55454]]
92592 ................ N Hearing aid check, one 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ear.
92593 ................ N Hearing aid check, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
both ears.
92594 ................ N Electro hearng aid 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test, one.
92595 ................ N Electro hearng aid 0.00 0.00 0.00 0.00 0.00 0.00 XXX
tst, both.
92596 ................ A Ear protector 0.00 0.56 NA 0.05 0.61 NA XXX
evaluation.
92599 ................ C ENT procedure/service. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
92599 26 C ENT procedure/service. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
92599 TC C ENT procedure/service. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
92950 ................ A Heart/lung 3.80 1.59 1.18 0.21 5.60 5.19 000
resuscitation cpr.
92953 ................ A Temporary external 0.23 NA 0.23 0.01 NA 0.47 000
pacing.
92960 ................ A Cardioversion 2.25 2.23 0.91 0.08 4.56 3.24 000
electric, ext.
92961 ................ A Cardioversion, 4.60 NA 1.85 0.17 NA 6.62 000
electric, int.
92970 ................ A Cardioassist, internal 3.52 NA 1.27 0.17 NA 4.96 000
92971 ................ A Cardioassist, external 1.77 NA 0.86 0.06 NA 2.69 000
92973 ................ A Percut coronary 3.28 NA 1.37 0.17 NA 4.82 ZZZ
thrombectomy.
92974 ................ A Cath place, cardio 3.00 NA 1.26 1.18 NA 5.44 ZZZ
brachytx.
92975 ................ A Dissolve clot, heart 7.25 NA 3.01 0.22 NA 10.48 000
vessel.
92977 ................ A Dissolve clot, heart 0.00 7.65 NA 0.38 8.03 NA XXX
vessel.
92978 ................ A Intravasc us, heart 1.80 5.09 NA 0.26 7.15 NA ZZZ
add-on.
92978 26 A Intravasc us, heart 1.80 0.76 0.76 0.06 2.62 2.62 ZZZ
add-on.
92978 TC A Intravasc us, heart 0.00 4.33 NA 0.20 4.53 NA ZZZ
add-on.
92979 ................ A Intravasc us, heart 1.44 2.76 NA 0.15 4.35 NA ZZZ
add-on.
92979 26 A Intravasc us, heart 1.44 0.58 0.58 0.04 2.06 2.06 ZZZ
add-on.
92979 TC A Intravasc us, heart 0.00 2.18 NA 0.11 2.29 NA ZZZ
add-on.
92980 ................ A Insert intracoronary 14.84 NA 6.22 0.78 NA 21.84 000
stent.
92981 ................ A Insert intracoronary 4.17 NA 1.75 0.21 NA 6.13 ZZZ
stent.
92982 ................ A Coronary artery 10.98 NA 4.59 0.57 NA 16.14 000
dilation.
92984 ................ A Coronary artery 2.97 NA 1.24 0.16 NA 4.37 ZZZ
dilation.
92986 ................ A Revision of aortic 21.80 NA 10.43 1.14 NA 33.37 090
valve.
92987 ................ A Revision of mitral 22.70 NA 10.85 1.18 NA 34.73 090
valve.
92990 ................ A Revision of pulmonary 17.34 NA 8.41 0.90 NA 26.65 090
valve.
92992 ................ C Revision of heart 0.00 0.00 0.00 0.00 0.00 0.00 090
chamber.
92993 ................ C Revision of heart 0.00 0.00 0.00 0.00 0.00 0.00 090
chamber.
92995 ................ A Coronary atherectomy.. 12.09 NA 5.06 0.63 NA 17.78 000
92996 ................ A Coronary atherectomy 3.26 NA 1.37 0.17 NA 4.80 ZZZ
add-on.
92997 ................ A Pul art balloon repr, 12.00 NA 4.55 0.63 NA 17.18 000
percut.
92998 ................ A Pul art balloon repr, 6.00 NA 2.06 0.31 NA 8.37 ZZZ
percut.
93000 ................ A Electrocardiogram, 0.17 0.50 NA 0.03 0.70 NA XXX
complete.
93005 ................ A Electrocardiogram, 0.00 0.43 NA 0.02 0.45 NA XXX
tracing.
93010 ................ A Electrocardiogram 0.17 0.07 0.07 0.01 0.25 0.25 XXX
report.
93012 ................ A Transmission of ecg... 0.00 2.24 NA 0.15 2.39 NA XXX
93014 ................ A Report on transmitted 0.52 0.19 0.19 0.02 0.73 0.73 XXX
ecg.
93015 ................ A Cardiovascular stress 0.75 1.90 NA 0.11 2.76 NA XXX
test.
93016 ................ A Cardiovascular stress 0.45 0.18 0.18 0.01 0.64 0.64 XXX
test.
93017 ................ A Cardiovascular stress 0.00 1.60 NA 0.09 1.69 NA XXX
test.
93018 ................ A Cardiovascular stress 0.30 0.12 0.12 0.01 0.43 0.43 XXX
test.
93024 ................ A Cardiac drug stress 1.17 1.55 NA 0.11 2.83 NA XXX
test.
93024 26 A Cardiac drug stress 1.17 0.48 0.48 0.04 1.69 1.69 XXX
test.
93024 TC A Cardiac drug stress 0.00 1.07 NA 0.07 1.14 NA XXX
test.
93025 ................ A Microvolt t-wave 0.75 6.42 NA 0.11 7.28 NA XXX
assess.
93040 ................ A Rhythm ECG with report 0.16 0.19 NA 0.02 0.37 NA XXX
93041 ................ A Rhythm ECG, tracing... 0.00 0.14 NA 0.01 0.15 NA XXX
93042 ................ A Rhythm ECG, report.... 0.16 0.05 0.05 0.01 0.22 0.22 XXX
93224 ................ A ECG monitor/report, 24 0.52 3.47 NA 0.21 4.20 NA XXX
hrs.
93225 ................ A ECG monitor/record, 24 0.00 1.18 NA 0.07 1.25 NA XXX
hrs.
93226 ................ A ECG monitor/report, 24 0.00 2.08 NA 0.12 2.20 NA XXX
hrs.
93227 ................ A ECG monitor/review, 24 0.52 0.21 0.21 0.02 0.75 0.75 XXX
hrs.
93230 ................ A ECG monitor/report, 24 0.52 3.72 NA 0.22 4.46 NA XXX
hrs.
93231 ................ A Ecg monitor/record, 24 0.00 1.44 NA 0.09 1.53 NA XXX
hrs.
93232 ................ A ECG monitor/report, 24 0.00 2.07 NA 0.11 2.18 NA XXX
hrs.
93233 ................ A ECG monitor/review, 24 0.52 0.21 0.21 0.02 0.75 0.75 XXX
hrs.
93235 ................ A ECG monitor/report, 24 0.45 2.66 NA 0.13 3.24 NA XXX
hrs.
93236 ................ A ECG monitor/report, 24 0.00 2.49 NA 0.12 2.61 NA XXX
hrs.
93237 ................ A ECG monitor/review, 24 0.45 0.17 0.17 0.01 0.63 0.63 XXX
hrs.
93268 ................ A ECG record/review..... 0.52 3.62 NA 0.24 4.38 NA XXX
93270 ................ A ECG recording......... 0.00 1.18 NA 0.07 1.25 NA XXX
93271 ................ A Ecg/monitoring and 0.00 2.24 NA 0.15 2.39 NA XXX
analysis.
93272 ................ A Ecg/review, interpret 0.52 0.20 0.20 0.02 0.74 0.74 XXX
only.
93278 ................ A ECG/signal-averaged... 0.25 1.19 NA 0.10 1.54 NA XXX
93278 26 A ECG/signal-averaged... 0.25 0.10 0.10 0.01 0.36 0.36 XXX
93278 TC A ECG/signal-averaged... 0.00 1.09 NA 0.09 1.18 NA XXX
93303 ................ A Echo transthoracic.... 1.30 4.16 NA 0.23 5.69 NA XXX
93303 26 A Echo transthoracic.... 1.30 0.50 0.50 0.04 1.84 1.84 XXX
[[Page 55455]]
93303 TC A Echo transthoracic.... 0.00 3.66 NA 0.19 3.85 NA XXX
93304 ................ A Echo transthoracic.... 0.75 2.15 NA 0.13 3.03 NA XXX
93304 26 A Echo transthoracic.... 0.75 0.30 0.30 0.02 1.07 1.07 XXX
93304 TC A Echo transthoracic.... 0.00 1.85 NA 0.11 1.96 NA XXX
93307 ................ A Echo exam of heart.... 0.92 4.04 NA 0.22 5.18 NA XXX
93307 26 A Echo exam of heart.... 0.92 0.38 0.38 0.03 1.33 1.33 XXX
93307 TC A Echo exam of heart.... 0.00 3.66 NA 0.19 3.85 NA XXX
93308 ................ A Echo exam of heart.... 0.53 2.07 NA 0.13 2.73 NA XXX
93308 26 A Echo exam of heart.... 0.53 0.22 0.22 0.02 0.77 0.77 XXX
93308 TC A Echo exam of heart.... 0.00 1.85 NA 0.11 1.96 NA XXX
93312 ................ A Echo transesophageal.. 2.20 4.45 NA 0.32 6.97 NA XXX
93312 26 A Echo transesophageal.. 2.20 0.86 0.86 0.08 3.14 3.14 XXX
93312 TC A Echo transesophageal.. 0.00 3.59 NA 0.24 3.83 NA XXX
93313 ................ A Echo transesophageal.. 0.95 5.29 0.22 0.05 6.29 1.22 XXX
93314 ................ A Echo transesophageal.. 1.25 4.10 NA 0.28 5.63 NA XXX
93314 26 A Echo transesophageal.. 1.25 0.51 0.51 0.04 1.80 1.80 XXX
93314 TC A Echo transesophageal.. 0.00 3.59 NA 0.24 3.83 NA XXX
93315 ................ A Echo transesophageal.. 2.78 4.70 NA 0.34 7.82 NA XXX
93315 26 A Echo transesophageal.. 2.78 1.11 1.11 0.10 3.99 3.99 XXX
93315 TC A Echo transesophageal.. 0.00 3.59 NA 0.24 3.83 NA XXX
93316 ................ A Echo transesophageal.. 0.95 6.39 0.25 0.05 7.39 1.25 XXX
93317 ................ A Echo transesophageal.. 1.83 4.31 NA 0.30 6.44 NA XXX
93317 26 A Echo transesophageal.. 1.83 0.72 0.72 0.06 2.61 2.61 XXX
93317 TC A Echo transesophageal.. 0.00 3.59 NA 0.24 3.83 NA XXX
93318 ................ C Echo transesophageal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
intraop.
93318 26 A Echo transesophageal 2.20 0.88 NA 0.06 3.14 NA XXX
intraop.
93318 TC C Echo transesophageal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
intraop.
93320 ................ A Doppler echo exam, 0.38 1.79 NA 0.11 2.28 NA ZZZ
heart.
93320 26 A Doppler echo exam, 0.38 0.16 0.16 0.01 0.55 0.55 ZZZ
heart.
93320 TC A Doppler echo exam, 0.00 1.63 NA 0.10 1.73 NA ZZZ
heart.
93321 ................ A Doppler echo exam, 0.15 1.12 NA 0.08 1.35 NA ZZZ
heart.
93321 26 A Doppler echo exam, 0.15 0.06 0.06 0.01 0.22 0.22 ZZZ
heart.
93321 TC A Doppler echo exam, 0.00 1.06 NA 0.07 1.13 NA ZZZ
heart.
93325 ................ A Doppler color flow add- 0.07 2.78 NA 0.18 3.03 NA ZZZ
on.
93325 26 A Doppler color flow add- 0.07 0.03 0.03 0.01 0.11 0.11 ZZZ
on.
93325 TC A Doppler color flow add- 0.00 2.75 NA 0.17 2.92 NA ZZZ
on.
93350 ................ A Echo transthoracic.... 1.48 2.28 NA 0.13 3.89 NA XXX
93350 26 A Echo transthoracic.... 1.48 0.61 0.61 0.02 2.11 2.11 XXX
93350 TC A Echo transthoracic.... 0.00 1.67 NA 0.11 1.78 NA XXX
93501 ................ A Right heart 3.02 17.23 NA 1.03 21.28 NA 000
catheterization.
93501 26 A Right heart 3.02 1.24 1.24 0.16 4.42 4.42 000
catheterization.
93501 TC A Right heart 0.00 15.99 NA 0.87 16.86 NA 000
catheterization.
93503 ................ A Insert/place heart 2.91 NA 0.71 0.16 NA 3.78 000
catheter.
93505 ................ A Biopsy of heart lining 4.38 3.67 NA 0.36 8.41 NA 000
93505 26 A Biopsy of heart lining 4.38 1.80 1.80 0.23 6.41 6.41 000
93505 TC A Biopsy of heart lining 0.00 1.87 NA 0.13 2.00 NA 000
93508 ................ A Cath placement, 4.10 13.64 NA 0.75 18.49 NA 000
angiography.
93508 26 A Cath placement, 4.10 1.71 1.71 0.21 6.02 6.02 000
angiography.
93508 TC A Cath placement, 0.00 11.93 NA 0.54 12.47 NA 000
angiography.
93510 ................ A Left heart 4.33 36.77 NA 2.13 43.23 NA 000
catheterization.
93510 26 A Left heart 4.33 1.82 1.82 0.22 6.37 6.37 000
catheterization.
93510 TC A Left heart 0.00 34.95 NA 1.91 36.86 NA 000
catheterization.
93511 ................ A Left heart 5.03 36.12 NA 2.11 43.26 NA 000
catheterization.
93511 26 A Left heart 5.03 2.10 2.10 0.26 7.39 7.39 000
catheterization.
93511 TC A Left heart 0.00 34.02 NA 1.85 35.87 NA 000
catheterization.
93514 ................ A Left heart 7.05 36.79 NA 2.22 46.06 NA 000
catheterization.
93514 26 A Left heart 7.05 2.77 2.77 0.37 10.19 10.19 000
catheterization.
93514 TC A Left heart 0.00 34.02 NA 1.85 35.87 NA 000
catheterization.
93524 ................ A Left heart 6.95 47.32 NA 2.79 57.06 NA 000
catheterization.
93524 26 A Left heart 6.95 2.86 2.86 0.36 10.17 10.17 000
catheterization.
93524 TC A Left heart 0.00 44.46 NA 2.43 46.89 NA 000
catheterization.
93526 ................ A Rt & Lt heart 5.99 48.18 NA 2.81 56.98 NA 000
catheters.
93526 26 A Rt & Lt heart 5.99 2.50 2.50 0.31 8.80 8.80 000
catheters.
93526 TC A Rt & Lt heart 0.00 45.68 NA 2.50 48.18 NA 000
catheters.
93527 ................ A Rt & Lt heart 7.28 47.49 NA 2.81 57.58 NA 000
catheters.
93527 26 A Rt & Lt heart 7.28 3.03 3.03 0.38 10.69 10.69 000
catheters.
93527 TC A Rt & Lt heart 0.00 44.46 NA 2.43 46.89 NA 000
catheters.
93528 ................ A Rt & Lt heart 9.00 48.27 NA 2.90 60.17 NA 000
catheters.
93528 26 A Rt & Lt heart 9.00 3.81 3.81 0.47 13.28 13.28 000
catheters.
93528 TC A Rt & Lt heart 0.00 44.46 NA 2.43 46.89 NA 000
catheters.
93529 ................ A Rt< heart 4.80 46.46 NA 2.68 53.94 NA 000
catheterization.
93529 26 A Rt< heart 4.80 2.00 2.00 0.25 7.05 7.05 000
catheterization.
93529 TC A Rt< heart 0.00 44.46 NA 2.43 46.89 NA 000
catheterization.
[[Page 55456]]
93530 ................ A Rt heart cath, 4.23 17.59 NA 1.11 22.93 NA 000
congenital.
93530 26 A Rt heart cath, 4.23 1.60 1.60 0.24 6.07 6.07 000
congenital.
93530 TC A Rt heart cath, 0.00 15.99 NA 0.87 16.86 NA 000
congenital.
93531 ................ A R & l heart cath, 8.35 48.92 NA 2.96 60.23 NA 000
congenital.
93531 26 A R & l heart cath, 8.35 3.24 3.24 0.46 12.05 12.05 000
congenital.
93531 TC A R & l heart cath, 0.00 45.68 NA 2.50 48.18 NA 000
congenital.
93532 ................ A R & l heart cath, 10.00 48.58 NA 2.95 61.53 NA 000
congenital.
93532 26 A R & l heart cath, 10.00 4.12 4.12 0.52 14.64 14.64 000
congenital.
93532 TC A R & l heart cath, 0.00 44.46 NA 2.43 46.89 NA 000
congenital.
93533 ................ A R & l heart cath, 6.70 47.01 NA 2.86 56.57 NA 000
congenital.
93533 26 A R & l heart cath, 6.70 2.55 2.55 0.43 9.68 9.68 000
congenital.
93533 TC A R & l heart cath, 0.00 44.46 NA 2.43 46.89 NA 000
congenital.
93536 ................ D Insert circulation 0.00 NA 0.00 0.00 NA 0.00 000
assi.
93539 ................ A Injection, cardiac 0.40 0.84 0.17 0.01 1.25 0.58 000
cath.
93540 ................ A Injection, cardiac 0.43 0.86 0.18 0.01 1.30 0.62 000
cath.
93541 ................ A Injection for lung 0.29 NA 0.12 0.01 NA 0.42 000
angiogram.
93542 ................ A Injection for heart x- 0.29 NA 0.12 0.01 NA 0.42 000
rays.
93543 ................ A Injection for heart x- 0.29 0.55 0.12 0.01 0.85 0.42 000
rays.
93544 ................ A Injection for 0.25 0.53 0.10 0.01 0.79 0.36 000
aortography.
93545 ................ A Inject for coronary x- 0.40 0.85 0.17 0.01 1.26 0.58 000
rays.
93555 ................ A Imaging, cardiac cath. 0.81 6.27 NA 0.31 7.39 NA XXX
93555 26 A Imaging, cardiac cath. 0.81 0.34 0.34 0.03 1.18 1.18 XXX
93555 TC A Imaging, cardiac cath. 0.00 5.93 NA 0.28 6.21 NA XXX
93556 ................ A Imaging, cardiac cath. 0.83 9.71 NA 0.45 10.99 NA XXX
93556 26 A Imaging, cardiac cath. 0.83 0.35 0.35 0.03 1.21 1.21 XXX
93556 TC A Imaging, cardiac cath. 0.00 9.36 NA 0.42 9.78 NA XXX
93561 ................ A Cardiac output 0.50 0.67 NA 0.07 1.24 NA 000
measurement.
93561 26 A Cardiac output 0.50 0.16 0.16 0.02 0.68 0.68 000
measurement.
93561 TC A Cardiac output 0.00 0.51 NA 0.05 0.56 NA 000
measurement.
93562 ................ A Cardiac output 0.16 0.34 NA 0.04 0.54 NA 000
measurement.
93562 26 A Cardiac output 0.16 0.05 0.05 0.01 0.22 0.22 000
measurement.
93562 TC A Cardiac output 0.00 0.29 NA 0.03 0.32 NA 000
measurement.
93571 ................ A Heart flow reserve 1.80 5.06 NA 0.31 7.17 NA ZZZ
measure.
93571 26 A Heart flow reserve 1.80 0.73 0.73 0.11 2.64 2.64 ZZZ
measure.
93571 TC A Heart flow reserve 0.00 4.33 NA 0.20 4.53 NA ZZZ
measure.
93572 ................ A Heart flow reserve 1.44 2.70 NA 0.28 4.42 NA ZZZ
measure.
93572 26 A Heart flow reserve 1.44 0.52 0.52 0.17 2.13 2.13 ZZZ
measure.
93572 TC A Heart flow reserve 0.00 2.18 NA 0.11 2.29 NA ZZZ
measure.
93600 ................ A Bundle of His 2.12 2.74 NA 0.22 5.08 NA 000
recording.
93600 26 A Bundle of His 2.12 0.89 0.89 0.11 3.12 3.12 000
recording.
93600 TC A Bundle of His 0.00 1.85 NA 0.11 1.96 NA 000
recording.
93602 ................ A Intra-atrial recording 2.12 1.94 NA 0.18 4.24 NA 000
93602 26 A Intra-atrial recording 2.12 0.88 0.88 0.12 3.12 3.12 000
93602 TC A Intra-atrial recording 0.00 1.06 NA 0.06 1.12 NA 000
93603 ................ A Right ventricular 2.12 2.46 NA 0.20 4.78 NA 000
recording.
93603 26 A Right ventricular 2.12 0.86 0.86 0.11 3.09 3.09 000
recording.
93603 TC A Right ventricular 0.00 1.60 NA 0.09 1.69 NA 000
recording.
93607 ................ D Left ventricular 0.00 0.00 0.00 0.00 0.00 0.00 000
recording.
93607 26 D Left ventricular 0.00 0.00 0.00 0.00 0.00 0.00 000
recording.
93607 TC D Left ventricular 0.00 0.00 0.00 0.00 0.00 0.00 000
recording.
93609 ................ A Map tachycardia, add- 4.81 4.59 NA 0.66 10.06 NA ZZZ
on.
93609 26 A Map tachycardia, add- 4.81 2.01 2.01 0.52 7.34 7.34 ZZZ
on.
93609 TC A Map tachycardia, add- 0.00 2.58 NA 0.14 2.72 NA ZZZ
on.
93610 ................ A Intra-atrial pacing... 3.02 2.52 NA 0.25 5.79 NA 000
93610 26 A Intra-atrial pacing... 3.02 1.23 1.23 0.17 4.42 4.42 000
93610 TC A Intra-atrial pacing... 0.00 1.29 NA 0.08 1.37 NA 000
93612 ................ A Intraventricular 3.02 2.76 NA 0.26 6.04 NA 000
pacing.
93612 26 A Intraventricular 3.02 1.23 1.23 0.17 4.42 4.42 000
pacing.
93612 TC A Intraventricular 0.00 1.53 NA 0.09 1.62 NA 000
pacing.
93613 ................ C Electrophys map, 3d, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
add-on.
93613 26 A Electrophys map, 3d, 7.00 2.79 2.79 0.52 10.31 10.31 XXX
add-on.
93613 TC C Electrophys map, 3d, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
add-on.
93615 ................ A Esophageal recording.. 0.99 0.66 NA 0.05 1.70 NA 000
93615 26 A Esophageal recording.. 0.99 0.36 0.36 0.03 1.38 1.38 000
93615 TC A Esophageal recording.. 0.00 0.30 NA 0.02 0.32 NA 000
93616 ................ A Esophageal recording.. 1.49 0.80 NA 0.08 2.37 NA 000
93616 26 A Esophageal recording.. 1.49 0.50 0.50 0.06 2.05 2.05 000
93616 TC A Esophageal recording.. 0.00 0.30 NA 0.02 0.32 NA 000
93618 ................ A Heart rhythm pacing... 4.26 5.54 NA 0.42 10.22 NA 000
93618 26 A Heart rhythm pacing... 4.26 1.78 1.78 0.22 6.26 6.26 000
93618 TC A Heart rhythm pacing... 0.00 3.76 NA 0.20 3.96 NA 000
93619 ................ A Electrophysiology 7.32 10.32 NA 0.77 18.41 NA 000
evaluation.
93619 26 A Electrophysiology 7.32 3.00 3.00 0.38 10.70 10.70 000
evaluation.
[[Page 55457]]
93619 TC A Electrophysiology 0.00 7.32 NA 0.39 7.71 NA 000
evaluation.
93620 ................ A Electrophysiology 11.59 13.33 NA 1.04 25.96 NA 000
evaluation.
93620 26 A Electrophysiology 11.59 4.82 4.82 0.60 17.01 17.01 000
evaluation.
93620 TC A Electrophysiology 0.00 8.51 NA 0.44 8.95 NA 000
evaluation.
93621 ................ C Electrophysiology 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
evaluation.
93621 26 A Electrophysiology 2.10 0.88 0.88 0.15 3.13 3.13 ZZZ
evaluation.
93621 TC C Electrophysiology 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
evaluation.
93622 ................ C Electrophysiology 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
evaluation.
93622 26 A Electrophysiology 3.10 1.30 1.30 0.67 5.07 5.07 ZZZ
evaluation.
93622 TC C Electrophysiology 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
evaluation.
93623 ................ C Stimulation, pacing 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
heart.
93623 26 A Stimulation, pacing 2.85 1.19 1.19 0.15 4.19 4.19 ZZZ
heart.
93623 TC C Stimulation, pacing 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
heart.
93624 ................ A Electrophysiologic 4.81 3.87 NA 0.36 9.04 NA 000
study.
93624 26 A Electrophysiologic 4.81 1.99 1.99 0.25 7.05 7.05 000
study.
93624 TC A Electrophysiologic 0.00 1.88 NA 0.11 1.99 NA 000
study.
93631 ................ A Heart pacing, mapping. 7.60 8.65 NA 1.17 17.42 NA 000
93631 26 A Heart pacing, mapping. 7.60 2.81 2.81 0.66 11.07 11.07 000
93631 TC A Heart pacing, mapping. 0.00 5.84 NA 0.51 6.35 NA 000
93640 ................ A Evaluation heart 3.52 8.27 NA 0.53 12.32 NA 000
device.
93640 26 A Evaluation heart 3.52 1.46 1.46 0.18 5.16 5.16 000
device.
93640 TC A Evaluation heart 0.00 6.81 NA 0.35 7.16 NA 000
device.
93641 ................ A Electrophysiology 5.93 9.28 NA 0.66 15.87 NA 000
evaluation.
93641 26 A Electrophysiology 5.93 2.47 2.47 0.31 8.71 8.71 000
evaluation.
93641 TC A Electrophysiology 0.00 6.81 NA 0.35 7.16 NA 000
evaluation.
93642 ................ A Electrophysiology 4.89 8.85 NA 0.51 14.25 NA 000
evaluation.
93642 26 A Electrophysiology 4.89 2.04 2.04 0.16 7.09 7.09 000
evaluation.
93642 TC A Electrophysiology 0.00 6.81 NA 0.35 7.16 NA 000
evaluation.
93650 ................ A Ablate heart dysrhythm 10.51 NA 4.32 0.55 NA 15.38 000
focus.
93651 ................ A Ablate heart dysrhythm 16.25 NA 6.78 0.85 NA 23.88 000
focus.
93652 ................ A Ablate heart dysrhythm 17.68 NA 7.36 0.92 NA 25.96 000
focus.
93660 ................ A Tilt table evaluation. 1.89 2.39 NA 0.08 4.36 NA 000
93660 26 A Tilt table evaluation. 1.89 0.79 0.79 0.06 2.74 2.74 000
93660 TC A Tilt table evaluation. 0.00 1.60 NA 0.02 1.62 NA 000
93662 ................ C Intracardiac ecg (ice) +0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
93662 26 A Intracardiac ecg (ice) 2.80 1.12 1.12 0.41 4.33 4.33 ZZZ
93662 TC C Intracardiac ecg (ice) +0.00 0.00 NA 0.00 0.00 NA XXX
93668 ................ N Peripheral vascular 0.00 0.00 0.00 0.00 0.00 0.00 XXX
rehab.
93701 ................ A Bioimpedance, thoracic 0.17 0.78 NA 0.02 0.97 NA XXX
93701 26 A Bioimpedance, thoracic 0.17 0.07 0.07 0.01 0.25 0.25 XXX
93701 TC A Bioimpedance, thoracic 0.00 0.71 NA 0.01 0.72 NA XXX
93720 ................ A Total body 0.17 0.73 NA 0.06 0.96 NA XXX
plethysmography.
93721 ................ A Plethysmography 0.00 0.67 NA 0.05 0.72 NA XXX
tracing.
93722 ................ A Plethysmography report 0.17 0.06 0.06 0.01 0.24 0.24 XXX
93724 ................ A Analyze pacemaker 4.89 5.80 NA 0.38 11.07 NA 000
system.
93724 26 A Analyze pacemaker 4.89 2.04 2.04 0.18 7.11 7.11 000
system.
93724 TC A Analyze pacemaker 0.00 3.76 NA 0.20 3.96 NA 000
system.
93727 ................ A Analyze ilr system.... 0.52 0.21 0.21 0.05 0.78 0.78 XXX
93731 ................ A Analyze pacemaker 0.45 0.66 NA 0.05 1.16 NA XXX
system.
93731 26 A Analyze pacemaker 0.45 0.19 0.19 0.02 0.66 0.66 XXX
system.
93731 TC A Analyze pacemaker 0.00 0.47 NA 0.03 0.50 NA XXX
system.
93732 ................ A Analyze pacemaker 0.92 0.87 NA 0.06 1.85 NA XXX
system.
93732 26 A Analyze pacemaker 0.92 0.38 0.38 0.03 1.33 1.33 XXX
system.
93732 TC A Analyze pacemaker 0.00 0.49 NA 0.03 0.52 NA XXX
system.
93733 ................ A Telephone analy, 0.17 0.76 NA 0.06 0.99 NA XXX
pacemaker.
93733 26 A Telephone analy, 0.17 0.07 0.07 0.01 0.25 0.25 XXX
pacemaker.
93733 TC A Telephone analy, 0.00 0.69 NA 0.05 0.74 NA XXX
pacemaker.
93734 ................ A Analyze pacemaker 0.38 0.49 NA 0.03 0.90 NA XXX
system.
93734 26 A Analyze pacemaker 0.38 0.16 0.16 0.01 0.55 0.55 XXX
system.
93734 TC A Analyze pacemaker 0.00 0.33 NA 0.02 0.35 NA XXX
system.
93735 ................ A Analyze pacemaker 0.74 0.72 NA 0.06 1.52 NA XXX
system.
93735 26 A Analyze pacemaker 0.74 0.30 0.30 0.03 1.07 1.07 XXX
system.
93735 TC A Analyze pacemaker 0.00 0.42 NA 0.03 0.45 NA XXX
system.
93736 ................ A Telephone analy, 0.15 0.66 NA 0.06 0.87 NA XXX
pacemaker.
93736 26 A Telephone analy, 0.15 0.06 0.06 0.01 0.22 0.22 XXX
pacemaker.
93736 TC A Telephone analy, 0.00 0.60 NA 0.05 0.65 NA XXX
pacemaker.
93737 ................ D Analyze cardio/ 0.00 0.00 NA 0.00 0.00 NA XXX
defibrillator.
93737 26 D Analyze cardio/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
defibrillator.
93737 TC D Analyze cardio/ 0.00 0.00 NA 0.00 0.00 NA XXX
defibrillator.
93738 ................ D Analyze cardio/ 0.00 0.00 NA 0.00 0.00 NA XXX
defibrillator.
93738 26 D Analyze cardio/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
defibrillator.
93738 TC D Analyze cardio/ 0.00 0.00 NA 0.00 0.00 NA XXX
defibrillator.
93740 ................ B Temperature gradient +0.16 0.21 NA 0.02 0.39 NA XXX
studies.
[[Page 55458]]
93740 26 B Temperature gradient +0.16 0.06 0.06 0.01 0.23 0.23 XXX
studies.
93740 TC B Temperature gradient +0.00 0.15 NA 0.01 0.16 NA XXX
studies.
93741 ................ A Analyze ht pace device 0.80 0.96 NA 0.05 1.81 NA XXX
sngl.
93741 26 A Analyze ht pace device 0.80 0.33 0.33 0.02 1.15 1.15 XXX
sngl.
93741 TC A Analyze ht pace device 0.00 0.63 NA 0.03 0.66 NA XXX
sngl.
93742 ................ A Analyze ht pace device 0.91 1.01 NA 0.05 1.97 NA XXX
sngl.
93742 26 A Analyze ht pace device 0.91 0.38 0.38 0.02 1.31 1.31 XXX
sngl.
93742 TC A Analyze ht pace device 0.00 0.63 NA 0.03 0.66 NA XXX
sngl.
93743 ................ A Analyze ht pace device 1.03 1.13 NA 0.06 2.22 NA XXX
dual.
93743 26 A Analyze ht pace device 1.03 0.43 0.43 0.03 1.49 1.49 XXX
dual.
93743 TC A Analyze ht pace device 0.00 0.70 NA 0.03 0.73 NA XXX
dual.
93744 ................ A Analyze ht pace device 1.18 1.12 NA 0.06 2.36 NA XXX
dual.
93744 26 A Analyze ht pace device 1.18 0.49 0.49 0.03 1.70 1.70 XXX
dual.
93744 TC A Analyze ht pace device 0.00 0.63 NA 0.03 0.66 NA XXX
dual.
93760 ................ N Cephalic thermogram... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
93762 ................ N Peripheral thermogram. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
93770 ................ B Measure venous +0.16 0.09 NA 0.02 0.27 NA XXX
pressure.
93770 26 B Measure venous +0.16 0.06 0.06 0.01 0.23 0.23 XXX
pressure.
93770 TC B Measure venous +0.00 0.03 NA 0.01 0.04 NA XXX
pressure.
93784 ................ N Ambulatory BP 0.00 0.00 0.00 0.00 0.00 0.00 XXX
monitoring.
93786 ................ N Ambulatory BP 0.00 0.00 0.00 0.00 0.00 0.00 XXX
recording.
93788 ................ N Ambulatory BP analysis 0.00 0.00 0.00 0.00 0.00 0.00 XXX
93790 ................ N Review/report BP 0.00 0.00 0.00 0.00 0.00 0.00 XXX
recording.
93797 ................ A Cardiac rehab......... 0.18 0.33 0.07 0.01 0.52 0.26 000
93798 ................ A Cardiac rehab/monitor. 0.28 0.44 0.11 0.01 0.73 0.40 000
93799 ................ C Cardiovascular 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
93799 26 C Cardiovascular 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
93799 TC C Cardiovascular 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
93875 ................ A Extracranial study.... 0.22 1.13 NA 0.10 1.45 NA XXX
93875 26 A Extracranial study.... 0.22 0.08 0.08 0.01 0.31 0.31 XXX
93875 TC A Extracranial study.... 0.00 1.05 NA 0.09 1.14 NA XXX
93880 ................ A Extracranial study.... 0.60 3.76 NA 0.33 4.69 NA XXX
93880 26 A Extracranial study.... 0.60 0.22 0.22 0.04 0.86 0.86 XXX
93880 TC A Extracranial study.... 0.00 3.54 NA 0.29 3.83 NA XXX
93882 ................ A Extracranial study.... 0.40 2.50 NA 0.22 3.12 NA XXX
93882 26 A Extracranial study.... 0.40 0.15 0.15 0.04 0.59 0.59 XXX
93882 TC A Extracranial study.... 0.00 2.35 NA 0.18 2.53 NA XXX
93886 ................ A Intracranial study.... 0.94 4.40 NA 0.37 5.71 NA XXX
93886 26 A Intracranial study.... 0.94 0.40 0.40 0.05 1.39 1.39 XXX
93886 TC A Intracranial study.... 0.00 4.00 NA 0.32 4.32 NA XXX
93888 ................ A Intracranial study.... 0.62 2.91 NA 0.26 3.79 NA XXX
93888 26 A Intracranial study.... 0.62 0.24 0.24 0.04 0.90 0.90 XXX
93888 TC A Intracranial study.... 0.00 2.67 NA 0.22 2.89 NA XXX
93922 ................ A Extremity study....... 0.25 1.18 NA 0.13 1.56 NA XXX
93922 26 A Extremity study....... 0.25 0.09 0.09 0.02 0.36 0.36 XXX
93922 TC A Extremity study....... 0.00 1.09 NA 0.11 1.20 NA XXX
93923 ................ A Extremity study....... 0.45 2.24 NA 0.22 2.91 NA XXX
93923 26 A Extremity study....... 0.45 0.16 0.16 0.04 0.65 0.65 XXX
93923 TC A Extremity study....... 0.00 2.08 NA 0.18 2.26 NA XXX
93924 ................ A Extremity study....... 0.50 2.43 NA 0.26 3.19 NA XXX
93924 26 A Extremity study....... 0.50 0.18 0.18 0.05 0.73 0.73 XXX
93924 TC A Extremity study....... 0.00 2.25 NA 0.21 2.46 NA XXX
93925 ................ A Lower extremity study. 0.58 3.76 NA 0.33 4.67 NA XXX
93925 26 A Lower extremity study. 0.58 0.21 0.21 0.04 0.83 0.83 XXX
93925 TC A Lower extremity study. 0.00 3.55 NA 0.29 3.84 NA XXX
93926 ................ A Lower extremity study. 0.39 2.51 NA 0.22 3.12 NA XXX
93926 26 A Lower extremity study. 0.39 0.14 0.14 0.03 0.56 0.56 XXX
93926 TC A Lower extremity study. 0.00 2.37 NA 0.19 2.56 NA XXX
93930 ................ A Upper extremity study. 0.46 3.93 NA 0.34 4.73 NA XXX
93930 26 A Upper extremity study. 0.46 0.16 0.16 0.03 0.65 0.65 XXX
93930 TC A Upper extremity study. 0.00 3.77 NA 0.31 4.08 NA XXX
93931 ................ A Upper extremity study. 0.31 2.62 NA 0.22 3.15 NA XXX
93931 26 A Upper extremity study. 0.31 0.11 0.11 0.02 0.44 0.44 XXX
93931 TC A Upper extremity study. 0.00 2.51 NA 0.20 2.71 NA XXX
93965 ................ A Extremity study....... 0.35 1.17 NA 0.12 1.64 NA XXX
93965 26 A Extremity study....... 0.35 0.13 0.13 0.02 0.50 0.50 XXX
93965 TC A Extremity study....... 0.00 1.04 NA 0.10 1.14 NA XXX
93970 ................ A Extremity study....... 0.68 4.16 NA 0.38 5.22 NA XXX
93970 26 A Extremity study....... 0.68 0.24 0.24 0.05 0.97 0.97 XXX
93970 TC A Extremity study....... 0.00 3.92 NA 0.33 4.25 NA XXX
93971 ................ A Extremity study....... 0.45 2.77 NA 0.25 3.47 NA XXX
93971 26 A Extremity study....... 0.45 0.16 0.16 0.03 0.64 0.64 XXX
93971 TC A Extremity study....... 0.00 2.61 NA 0.22 2.83 NA XXX
[[Page 55459]]
93975 ................ A Vascular study........ 1.80 5.10 NA 0.47 7.37 NA XXX
93975 26 A Vascular study........ 1.80 0.64 0.64 0.11 2.55 2.55 XXX
93975 TC A Vascular study........ 0.00 4.46 NA 0.36 4.82 NA XXX
93976 ................ A Vascular study........ 1.21 3.41 NA 0.31 4.93 NA XXX
93976 26 A Vascular study........ 1.21 0.43 0.43 0.06 1.70 1.70 XXX
93976 TC A Vascular study........ 0.00 2.98 NA 0.25 3.23 NA XXX
93978 ................ A Vascular study........ 0.65 3.88 NA 0.36 4.89 NA XXX
93978 26 A Vascular study........ 0.65 0.23 0.23 0.05 0.93 0.93 XXX
93978 TC A Vascular study........ 0.00 3.65 NA 0.31 3.96 NA XXX
93979 ................ A Vascular study........ 0.44 2.59 NA 0.24 3.27 NA XXX
93979 26 A Vascular study........ 0.44 0.16 0.16 0.04 0.64 0.64 XXX
93979 TC A Vascular study........ 0.00 2.43 NA 0.20 2.63 NA XXX
93980 ................ A Penile vascular study. 1.25 3.75 NA 0.35 5.35 NA XXX
93980 26 A Penile vascular study. 1.25 0.44 0.44 0.07 1.76 1.76 XXX
93980 TC A Penile vascular study. 0.00 3.31 NA 0.28 3.59 NA XXX
93981 ................ A Penile vascular study. 0.44 3.21 NA 0.28 3.93 NA XXX
93981 26 A Penile vascular study. 0.44 0.15 0.15 0.02 0.61 0.61 XXX
93981 TC A Penile vascular study. 0.00 3.06 NA 0.26 3.32 NA XXX
93990 ................ A Doppler flow testing.. 0.25 2.46 NA 0.21 2.92 NA XXX
93990 26 A Doppler flow testing.. 0.25 0.09 0.09 0.02 0.36 0.36 XXX
93990 TC A Doppler flow testing.. 0.00 2.37 NA 0.19 2.56 NA XXX
94010 ................ A Breathing capacity 0.17 0.82 NA 0.03 1.02 NA XXX
test.
94010 26 A Breathing capacity 0.17 0.06 0.06 0.01 0.24 0.24 XXX
test.
94010 TC A Breathing capacity 0.00 0.76 NA 0.02 0.78 NA XXX
test.
94014 ................ A Patient recorded 0.52 0.46 NA 0.03 1.01 NA XXX
spirometry.
94015 ................ A Patient recorded 0.00 0.29 NA 0.01 0.30 NA XXX
spirometry.
94016 ................ A Review patient 0.52 0.17 0.17 0.02 0.71 0.71 XXX
spirometry.
94060 ................ A Evaluation of wheezing 0.31 1.36 NA 0.06 1.73 NA XXX
94060 26 A Evaluation of wheezing 0.31 0.10 0.10 0.01 0.42 0.42 XXX
94060 TC A Evaluation of wheezing 0.00 1.26 NA 0.05 1.31 NA XXX
94070 ................ A Evaluation of wheezing 0.60 3.38 NA 0.10 4.08 NA XXX
94070 26 A Evaluation of wheezing 0.60 0.19 0.19 0.02 0.81 0.81 XXX
94070 TC A Evaluation of wheezing 0.00 3.19 NA 0.08 3.27 NA XXX
94150 ................ B Vital capacity test... +0.07 0.63 NA 0.02 0.72 NA XXX
94150 26 B Vital capacity test... +0.07 0.03 0.03 0.01 0.11 0.11 XXX
94150 TC B Vital capacity test... +0.00 0.60 NA 0.01 0.61 NA XXX
94200 ................ A Lung function test 0.11 0.33 NA 0.03 0.47 NA XXX
(MBC/MVV).
94200 26 A Lung function test 0.11 0.04 0.04 0.01 0.16 0.16 XXX
(MBC/MVV).
94200 TC A Lung function test 0.00 0.29 NA 0.02 0.31 NA XXX
(MBC/MVV).
94240 ................ A Residual lung capacity 0.26 1.26 NA 0.05 1.57 NA XXX
94240 26 A Residual lung capacity 0.26 0.08 0.08 0.01 0.35 0.35 XXX
94240 TC A Residual lung capacity 0.00 1.18 NA 0.04 1.22 NA XXX
94250 ................ A Expired gas collection 0.11 0.61 NA 0.02 0.74 NA XXX
94250 26 A Expired gas collection 0.11 0.04 0.04 0.01 0.16 0.16 XXX
94250 TC A Expired gas collection 0.00 0.57 NA 0.01 0.58 NA XXX
94260 ................ A Thoracic gas volume... 0.13 0.38 NA 0.04 0.55 NA XXX
94260 26 A Thoracic gas volume... 0.13 0.04 0.04 0.01 0.18 0.18 XXX
94260 TC A Thoracic gas volume... 0.00 0.34 NA 0.03 0.37 NA XXX
94350 ................ A Lung nitrogen washout 0.26 1.01 NA 0.04 1.31 NA XXX
curve.
94350 26 A Lung nitrogen washout 0.26 0.08 0.08 0.01 0.35 0.35 XXX
curve.
94350 TC A Lung nitrogen washout 0.00 0.93 NA 0.03 0.96 NA XXX
curve.
94360 ................ A Measure airflow 0.26 0.50 NA 0.06 0.82 NA XXX
resistance.
94360 26 A Measure airflow 0.26 0.08 0.08 0.01 0.35 0.35 XXX
resistance.
94360 TC A Measure airflow 0.00 0.42 NA 0.05 0.47 NA XXX
resistance.
94370 ................ A Breath airway closing 0.26 2.03 NA 0.03 2.32 NA XXX
volume.
94370 26 A Breath airway closing 0.26 0.08 0.08 0.01 0.35 0.35 XXX
volume.
94370 TC A Breath airway closing 0.00 1.95 NA 0.02 1.97 NA XXX
volume.
94375 ................ A Respiratory flow 0.31 0.46 NA 0.03 0.80 NA XXX
volume loop.
94375 26 A Respiratory flow 0.31 0.10 0.10 0.01 0.42 0.42 XXX
volume loop.
94375 TC A Respiratory flow 0.00 0.36 NA 0.02 0.38 NA XXX
volume loop.
94400 ................ A CO2 breathing response 0.40 0.70 NA 0.06 1.16 NA XXX
curve.
94400 26 A CO2 breathing response 0.40 0.13 0.13 0.01 0.54 0.54 XXX
curve.
94400 TC A CO2 breathing response 0.00 0.57 NA 0.05 0.62 NA XXX
curve.
94450 ................ A Hypoxia response curve 0.40 0.85 NA 0.04 1.29 NA XXX
94450 26 A Hypoxia response curve 0.40 0.12 0.12 0.02 0.54 0.54 XXX
94450 TC A Hypoxia response curve 0.00 0.73 NA 0.02 0.75 NA XXX
94620 ................ A Pulmonary stress test/ 0.64 1.66 NA 0.10 2.40 NA XXX
simple.
94620 26 A Pulmonary stress test/ 0.64 0.21 0.21 0.02 0.87 0.87 XXX
simple.
94620 TC A Pulmonary stress test/ 0.00 1.45 NA 0.08 1.53 NA XXX
simple.
94621 ................ A Pulm stress test/ 1.42 1.25 NA 0.13 2.80 NA XXX
complex.
94621 26 A Pulm stress test/ 1.42 0.47 0.47 0.05 1.94 1.94 XXX
complex.
94621 TC A Pulm stress test/ 0.00 0.78 NA 0.08 0.86 NA XXX
complex.
94640 ................ A Airway inhalation 0.00 0.74 NA 0.02 0.76 NA XXX
treatment.
[[Page 55460]]
94642 ................ C Aerosol inhalation 0.00 0.00 0.00 0.00 0.00 0.00 XXX
treatment.
94650 ................ A Pressure breathing 0.00 0.67 NA 0.02 0.69 NA XXX
(IPPB).
94651 ................ A Pressure breathing 0.00 0.62 NA 0.02 0.64 NA XXX
(IPPB).
94652 ................ A Pressure breathing 0.00 0.77 NA 0.06 0.83 NA XXX
(IPPB).
94656 ................ A Initial ventilator 1.22 NA 0.33 0.06 NA 1.61 XXX
mgmt.
94657 ................ A Continued ventilator 0.83 NA 0.26 0.03 NA 1.12 XXX
mgmt.
94660 ................ A Pos airway pressure, 0.76 0.67 0.24 0.03 1.46 1.03 XXX
CPAP.
94662 ................ A Neg press ventilation, 0.76 NA 0.24 0.02 NA 1.02 XXX
cnp.
94664 ................ A Aerosol or vapor 0.00 0.53 NA 0.03 0.56 NA XXX
inhalations.
94665 ................ A Aerosol or vapor 0.00 0.53 NA 0.04 0.57 NA XXX
inhalations.
94667 ................ A Chest wall 0.00 1.01 NA 0.04 1.05 NA XXX
manipulation.
94668 ................ A Chest wall 0.00 0.75 NA 0.02 0.77 NA XXX
manipulation.
94680 ................ A Exhaled air analysis, 0.26 1.17 NA 0.06 1.49 NA XXX
o2.
94680 26 A Exhaled air analysis, 0.26 0.09 0.09 0.01 0.36 0.36 XXX
o2.
94680 TC A Exhaled air analysis, 0.00 1.08 NA 0.05 1.13 NA XXX
o2.
94681 ................ A Exhaled air analysis, 0.20 1.32 NA 0.11 1.63 NA XXX
o2/co2.
94681 26 A Exhaled air analysis, 0.20 0.07 0.07 0.01 0.28 0.28 XXX
o2/co2.
94681 TC A Exhaled air analysis, 0.00 1.25 NA 0.10 1.35 NA XXX
o2/co2.
94690 ................ A Exhaled air analysis.. 0.07 1.59 NA 0.04 1.70 NA XXX
94690 26 A Exhaled air analysis.. 0.07 0.02 0.02 0.01 0.10 0.10 XXX
94690 TC A Exhaled air analysis.. 0.00 1.57 NA 0.03 1.60 NA XXX
94720 ................ A Monoxide diffusing 0.26 1.32 NA 0.06 1.64 NA XXX
capacity.
94720 26 A Monoxide diffusing 0.26 0.08 0.08 0.01 0.35 0.35 XXX
capacity.
94720 TC A Monoxide diffusing 0.00 1.24 NA 0.05 1.29 NA XXX
capacity.
94725 ................ A Membrane diffusion 0.26 0.71 NA 0.11 1.08 NA XXX
capacity.
94725 26 A Membrane diffusion 0.26 0.08 0.08 0.01 0.35 0.35 XXX
capacity.
94725 TC A Membrane diffusion 0.00 0.63 NA 0.10 0.73 NA XXX
capacity.
94750 ................ A Pulmonary compliance 0.23 1.06 NA 0.04 1.33 NA XXX
study.
94750 26 A Pulmonary compliance 0.23 0.07 0.07 0.01 0.31 0.31 XXX
study.
94750 TC A Pulmonary compliance 0.00 0.99 NA 0.03 1.02 NA XXX
study.
94760 ................ T Measure blood oxygen 0.00 0.10 NA 0.02 0.12 NA XXX
level.
94761 ................ T Measure blood oxygen 0.00 0.14 NA 0.05 0.19 NA XXX
level.
94762 ................ A Measure blood oxygen 0.00 0.74 NA 0.08 0.82 NA XXX
level.
94770 ................ A Exhaled carbon dioxide 0.15 0.91 NA 0.07 1.13 NA XXX
test.
94770 26 A Exhaled carbon dioxide 0.15 0.04 0.04 0.01 0.20 0.20 XXX
test.
94770 TC A Exhaled carbon dioxide 0.00 0.87 NA 0.06 0.93 NA XXX
test.
94772 ................ C Breath recording, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
infant.
94772 26 C Breath recording, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
infant.
94772 TC C Breath recording, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
infant.
94799 ................ C Pulmonary service/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
94799 26 C Pulmonary service/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
94799 TC C Pulmonary service/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
95004 ................ A Allergy skin tests.... 0.00 0.09 NA 0.01 0.10 NA XXX
95010 ................ A Sensitivity skin tests 0.15 0.45 0.07 0.01 0.61 0.23 XXX
95015 ................ A Sensitivity skin tests 0.15 0.39 0.06 0.01 0.55 0.22 XXX
95024 ................ A Allergy skin tests.... 0.00 0.14 NA 0.01 0.15 NA XXX
95027 ................ A Skin end point 0.00 0.14 NA 0.01 0.15 NA XXX
titration.
95028 ................ A Allergy skin tests.... 0.00 0.22 NA 0.01 0.23 NA XXX
95044 ................ A Allergy patch tests... 0.00 0.19 NA 0.01 0.20 NA XXX
95052 ................ A Photo patch test...... 0.00 0.24 NA 0.01 0.25 NA XXX
95056 ................ A Photosensitivity tests 0.00 0.17 NA 0.01 0.18 NA XXX
95060 ................ A Eye allergy tests..... 0.00 0.33 NA 0.02 0.35 NA XXX
95065 ................ A Nose allergy test..... 0.00 0.19 NA 0.01 0.20 NA XXX
95070 ................ A Bronchial allergy 0.00 2.17 NA 0.02 2.19 NA XXX
tests.
95071 ................ A Bronchial allergy 0.00 2.77 NA 0.02 2.79 NA XXX
tests.
95075 ................ A Ingestion challenge 0.95 0.80 0.43 0.03 1.78 1.41 XXX
test.
95078 ................ A Provocative testing... 0.00 0.24 NA 0.02 0.26 NA XXX
95115 ................ A Immunotherapy, one 0.00 0.37 NA 0.02 0.39 NA 000
injection.
95117 ................ A Immunotherapy 0.00 0.48 NA 0.02 0.50 NA 000
injections.
95120 ................ I Immunotherapy, one 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
95125 ................ I Immunotherapy, many 0.00 0.00 0.00 0.00 0.00 0.00 XXX
antigens.
95130 ................ I Immunotherapy, insect 0.00 0.00 0.00 0.00 0.00 0.00 XXX
venom.
95131 ................ I Immunotherapy, insect 0.00 0.00 0.00 0.00 0.00 0.00 XXX
venoms.
95132 ................ I Immunotherapy, insect 0.00 0.00 0.00 0.00 0.00 0.00 XXX
venoms.
95133 ................ I Immunotherapy, insect 0.00 0.00 0.00 0.00 0.00 0.00 XXX
venoms.
95134 ................ I Immunotherapy, insect 0.00 0.00 0.00 0.00 0.00 0.00 XXX
venoms.
95144 ................ A Antigen therapy 0.06 0.25 0.03 0.01 0.32 0.10 000
services.
95145 ................ A Antigen therapy 0.06 0.47 0.03 0.01 0.54 0.10 000
services.
95146 ................ A Antigen therapy 0.06 0.62 0.03 0.01 0.69 0.10 000
services.
95147 ................ A Antigen therapy 0.06 0.91 0.03 0.01 0.98 0.10 000
services.
95148 ................ A Antigen therapy 0.06 0.81 0.03 0.01 0.88 0.10 000
services.
95149 ................ A Antigen therapy 0.06 1.04 0.03 0.01 1.11 0.10 000
services.
95165 ................ A Antigen therapy 0.06 0.21 0.02 0.01 0.28 0.09 000
services.
[[Page 55461]]
95170 ................ A Antigen therapy 0.06 0.26 0.02 0.01 0.33 0.09 000
services.
95180 ................ A Rapid desensitization. 2.01 1.66 0.85 0.04 3.71 2.90 000
95199 ................ C Allergy immunology 0.00 0.00 0.00 0.00 0.00 0.00 000
services.
95250 ................ A Glucose monitoring, 0.00 1.44 NA 0.01 1.45 NA XXX
cont.
95805 ................ A Multiple sleep latency 1.88 5.89 NA 0.34 8.11 NA XXX
test.
95805 26 A Multiple sleep latency 1.88 0.70 0.70 0.06 2.64 2.64 XXX
test.
95805 TC A Multiple sleep latency 0.00 5.19 NA 0.28 5.47 NA XXX
test.
95806 ................ A Sleep study, 1.66 4.31 NA 0.32 6.29 NA XXX
unattended.
95806 26 A Sleep study, 1.66 0.57 0.57 0.06 2.29 2.29 XXX
unattended.
95806 TC A Sleep study, 0.00 3.74 NA 0.26 4.00 NA XXX
unattended.
95807 ................ A Sleep study, attended. 1.66 10.70 NA 0.40 12.76 NA XXX
95807 26 A Sleep study, attended. 1.66 0.56 0.56 0.05 2.27 2.27 XXX
95807 TC A Sleep study, attended. 0.00 10.14 NA 0.35 10.49 NA XXX
95808 ................ A Polysomnography, 1-3.. 2.65 3.86 NA 0.44 6.95 NA XXX
95808 26 A Polysomnography, 1-3.. 2.65 0.99 0.99 0.09 3.73 3.73 XXX
95808 TC A Polysomnography, 1-3.. 0.00 2.87 NA 0.35 3.22 NA XXX
95810 ................ A Polysomnography, 4 or 3.53 15.66 NA 0.47 19.66 NA XXX
more.
95810 26 A Polysomnography, 4 or 3.53 1.26 1.26 0.12 4.91 4.91 XXX
more.
95810 TC A Polysomnography, 4 or 0.00 14.40 NA 0.35 14.75 NA XXX
more.
95811 ................ A Polysomnography w/cpap 3.80 13.63 NA 0.49 17.92 NA XXX
95811 26 A Polysomnography w/cpap 3.80 1.34 1.34 0.13 5.27 5.27 XXX
95811 TC A Polysomnography w/cpap 0.00 12.29 NA 0.36 12.65 NA XXX
95812 ................ A Electroencephalogram 1.08 3.96 NA 0.13 5.17 NA XXX
(EEG).
95812 26 A Electroencephalogram 1.08 0.48 0.48 0.04 1.60 1.60 XXX
(EEG).
95812 TC A Electroencephalogram 0.00 3.48 NA 0.09 3.57 NA XXX
(EEG).
95813 ................ A Electroencephalogram 1.73 5.53 NA 0.15 7.41 NA XXX
(EEG).
95813 26 A Electroencephalogram 1.73 0.73 0.73 0.06 2.52 2.52 XXX
(EEG).
95813 TC A Electroencephalogram 0.00 4.80 NA 0.09 4.89 NA XXX
(EEG).
95816 ................ A Electroencephalogram 1.08 3.42 NA 0.12 4.62 NA XXX
(EEG).
95816 26 A Electroencephalogram 1.08 0.49 0.49 0.04 1.61 1.61 XXX
(EEG).
95816 TC A Electroencephalogram 0.00 2.93 NA 0.08 3.01 NA XXX
(EEG).
95819 ................ A Electroencephalogram 1.08 4.34 NA 0.12 5.54 NA XXX
(EEG).
95819 26 A Electroencephalogram 1.08 0.49 0.49 0.04 1.61 1.61 XXX
(EEG).
95819 TC A Electroencephalogram 0.00 3.85 NA 0.08 3.93 NA XXX
(EEG).
95822 ................ A Sleep 1.08 1.78 NA 0.15 3.01 NA XXX
electroencephalogram.
95822 26 A Sleep 1.08 0.49 0.49 0.04 1.61 1.61 XXX
electroencephalogram.
95822 TC A Sleep 0.00 1.29 NA 0.11 1.40 NA XXX
electroencephalogram.
95824 ................ C Electroencephalography +0.00 0.00 0.00 0.00 0.00 0.00 XXX
95824 26 A Electroencephalography 0.74 0.30 0.30 0.05 1.09 1.09 ZZZ
95824 TC C Electroencephalography +0.00 0.00 NA 0.00 0.00 NA XXX
95827 ................ A Night 1.08 2.64 NA 0.15 3.87 NA XXX
electroencephalogram.
95827 26 A Night 1.08 0.46 0.46 0.03 1.57 1.57 XXX
electroencephalogram.
95827 TC A Night 0.00 2.18 NA 0.12 2.30 NA XXX
electroencephalogram.
95829 ................ A Surgery 6.21 31.39 NA 0.33 37.93 NA XXX
electrocorticogram.
95829 26 A Surgery 6.21 2.90 2.90 0.31 9.42 9.42 XXX
electrocorticogram.
95829 TC A Surgery 0.00 28.49 NA 0.02 28.51 NA XXX
electrocorticogram.
95830 ................ A Insert electrodes for 1.70 3.76 0.78 0.07 5.53 2.55 XXX
EEG.
95831 ................ A Limb muscle testing, 0.28 0.52 0.12 0.01 0.81 0.41 XXX
manual.
95832 ................ A Hand muscle testing, 0.29 0.48 0.11 0.01 0.78 0.41 XXX
manual.
95833 ................ A Body muscle testing, 0.47 0.54 0.24 0.01 1.02 0.72 XXX
manual.
95834 ................ A Body muscle testing, 0.60 0.59 0.28 0.02 1.21 0.90 XXX
manual.
95851 ................ A Range of motion 0.16 0.55 0.08 0.01 0.72 0.25 XXX
measurements.
95852 ................ A Range of motion 0.11 0.49 0.05 0.01 0.61 0.17 XXX
measurements.
95857 ................ A Tensilon test......... 0.53 0.66 0.24 0.02 1.21 0.79 XXX
95858 ................ A Tensilon test & 1.56 1.10 NA 0.07 2.73 NA XXX
myogram.
95858 26 A Tensilon test & 1.56 0.72 0.72 0.04 2.32 2.32 XXX
myogram.
95858 TC A Tensilon test & 0.00 0.38 NA 0.03 0.41 NA XXX
myogram.
95860 ................ A Muscle test, one limb. 0.96 1.18 NA 0.05 2.19 NA XXX
95860 26 A Muscle test, one limb. 0.96 0.45 0.45 0.03 1.44 1.44 XXX
95860 TC A Muscle test, one limb. 0.00 0.73 NA 0.02 0.75 NA XXX
95861 ................ A Muscle test, two limbs 1.54 1.42 NA 0.10 3.06 NA XXX
95861 26 A Muscle test, two limbs 1.54 0.72 0.72 0.05 2.31 2.31 XXX
95861 TC A Muscle test, two limbs 0.00 0.70 NA 0.05 0.75 NA XXX
95863 ................ A Muscle test, 3 limbs.. 1.87 1.76 NA 0.11 3.74 NA XXX
95863 26 A Muscle test, 3 limbs.. 1.87 0.87 0.87 0.06 2.80 2.80 XXX
95863 TC A Muscle test, 3 limbs.. 0.00 0.89 NA 0.05 0.94 NA XXX
95864 ................ A Muscle test, 4 limbs.. 1.99 2.62 NA 0.16 4.77 NA XXX
95864 26 A Muscle test, 4 limbs.. 1.99 0.93 0.93 0.06 2.98 2.98 XXX
95864 TC A Muscle test, 4 limbs.. 0.00 1.69 NA 0.10 1.79 NA XXX
95867 ................ A Muscle test, head or 0.79 0.92 NA 0.06 1.77 NA XXX
neck.
95867 26 A Muscle test, head or 0.79 0.37 0.37 0.03 1.19 1.19 XXX
neck.
95867 TC A Muscle test, head or 0.00 0.55 NA 0.03 0.58 NA XXX
neck.
95868 ................ A Muscle test, head or 1.18 1.23 NA 0.08 2.49 NA XXX
neck.
[[Page 55462]]
95868 26 A Muscle test, head or 1.18 0.57 0.57 0.04 1.79 1.79 XXX
neck.
95868 TC A Muscle test, head or 0.00 0.66 NA 0.04 0.70 NA XXX
neck.
95869 ................ A Muscle test, thor 0.37 0.37 NA 0.03 0.77 NA XXX
paraspinal.
95869 26 A Muscle test, thor 0.37 0.17 0.17 0.01 0.55 0.55 XXX
paraspinal.
95869 TC A Muscle test, thor 0.00 0.20 NA 0.02 0.22 NA XXX
paraspinal.
95870 ................ A Muscle test, 0.37 0.37 NA 0.03 0.77 NA XXX
nonparaspinal.
95870 26 A Muscle test, 0.37 0.17 0.17 0.01 0.55 0.55 XXX
nonparaspinal.
95870 TC A Muscle test, 0.00 0.20 NA 0.02 0.22 NA XXX
nonparaspinal.
95872 ................ A Muscle test, one fiber 1.50 1.25 NA 0.08 2.83 NA XXX
95872 26 A Muscle test, one fiber 1.50 0.68 0.68 0.04 2.22 2.22 XXX
95872 TC A Muscle test, one fiber 0.00 0.57 NA 0.04 0.61 NA XXX
95875 ................ A Limb exercise test.... 1.10 1.38 NA 0.09 2.57 NA XXX
95875 26 A Limb exercise test.... 1.10 0.49 0.49 0.04 1.63 1.63 XXX
95875 TC A Limb exercise test.... 0.00 0.89 NA 0.05 0.94 NA XXX
95900 ................ A Motor nerve conduction 0.42 0.73 NA 0.03 1.18 NA XXX
test.
95900 26 A Motor nerve conduction 0.42 0.20 0.20 0.01 0.63 0.63 XXX
test.
95900 TC A Motor nerve conduction 0.00 0.53 NA 0.02 0.55 NA XXX
test.
95903 ................ A Motor nerve conduction 0.60 0.51 NA 0.04 1.15 NA XXX
test.
95903 26 A Motor nerve conduction 0.60 0.27 0.27 0.02 0.89 0.89 XXX
test.
95903 TC A Motor nerve conduction 0.00 0.24 NA 0.02 0.26 NA XXX
test.
95904 ................ A Sense nerve conduction 0.34 0.64 NA 0.03 1.01 NA XXX
test.
95904 26 A Sense nerve conduction 0.34 0.16 0.16 0.01 0.51 0.51 XXX
test.
95904 TC A Sense nerve conduction 0.00 0.48 NA 0.02 0.50 NA XXX
test.
95920 ................ A Intraop nerve test add- 2.11 2.23 NA 0.20 4.54 NA ZZZ
on.
95920 26 A Intraop nerve test add- 2.11 0.99 0.99 0.14 3.24 3.24 ZZZ
on.
95920 TC A Intraop nerve test add- 0.00 1.24 NA 0.06 1.30 NA ZZZ
on.
95921 ................ A Autonomic nerv 0.90 0.70 NA 0.05 1.65 NA XXX
function test.
95921 26 A Autonomic nerv 0.90 0.34 0.34 0.03 1.27 1.27 XXX
function test.
95921 TC A Autonomic nerv 0.00 0.36 NA 0.02 0.38 NA XXX
function test.
95922 ................ A Autonomic nerv 0.96 0.79 NA 0.05 1.80 NA XXX
function test.
95922 26 A Autonomic nerv 0.96 0.43 0.43 0.03 1.42 1.42 XXX
function test.
95922 TC A Autonomic nerv 0.00 0.36 NA 0.02 0.38 NA XXX
function test.
95923 ................ A Autonomic nerv 0.90 2.57 NA 0.05 3.52 NA XXX
function test.
95923 26 A Autonomic nerv 0.90 0.40 0.40 0.03 1.33 1.33 XXX
function test.
95923 TC A Autonomic nerv 0.00 2.17 NA 0.02 2.19 NA XXX
function test.
95925 ................ A Somatosensory testing. 0.54 1.10 NA 0.07 1.71 NA XXX
95925 26 A Somatosensory testing. 0.54 0.24 0.24 0.02 0.80 0.80 XXX
95925 TC A Somatosensory testing. 0.00 0.86 NA 0.05 0.91 NA XXX
95926 ................ A Somatosensory testing. 0.54 1.11 NA 0.07 1.72 NA XXX
95926 26 A Somatosensory testing. 0.54 0.25 0.25 0.02 0.81 0.81 XXX
95926 TC A Somatosensory testing. 0.00 0.86 NA 0.05 0.91 NA XXX
95927 ................ A Somatosensory testing. 0.54 1.13 NA 0.08 1.75 NA XXX
95927 26 A Somatosensory testing. 0.54 0.27 0.27 0.03 0.84 0.84 XXX
95927 TC A Somatosensory testing. 0.00 0.86 NA 0.05 0.91 NA XXX
95930 ................ A Visual evoked 0.35 0.84 NA 0.02 1.21 NA XXX
potential test.
95930 26 A Visual evoked 0.35 0.16 0.16 0.01 0.52 0.52 XXX
potential test.
95930 TC A Visual evoked 0.00 0.68 NA 0.01 0.69 NA XXX
potential test.
95933 ................ A Blink reflex test..... 0.59 1.01 NA 0.07 1.67 NA XXX
95933 26 A Blink reflex test..... 0.59 0.27 0.27 0.02 0.88 0.88 XXX
95933 TC A Blink reflex test..... 0.00 0.74 NA 0.05 0.79 NA XXX
95934 ................ A H-reflex test......... 0.51 0.44 NA 0.04 0.99 NA XXX
95934 26 A H-reflex test......... 0.51 0.24 0.24 0.02 0.77 0.77 XXX
95934 TC A H-reflex test......... 0.00 0.20 NA 0.02 0.22 NA XXX
95936 ................ A H-reflex test......... 0.55 0.45 NA 0.04 1.04 NA XXX
95936 26 A H-reflex test......... 0.55 0.25 0.25 0.02 0.82 0.82 XXX
95936 TC A H-reflex test......... 0.00 0.20 NA 0.02 0.22 NA XXX
95937 ................ A Neuromuscular junction 0.65 0.60 NA 0.04 1.29 NA XXX
test.
95937 26 A Neuromuscular junction 0.65 0.28 0.28 0.02 0.95 0.95 XXX
test.
95937 TC A Neuromuscular junction 0.00 0.32 NA 0.02 0.34 NA XXX
test.
95950 ................ A Ambulatory eeg 1.51 4.93 NA 0.44 6.88 NA XXX
monitoring.
95950 26 A Ambulatory eeg 1.51 0.70 0.70 0.08 2.29 2.29 XXX
monitoring.
95950 TC A Ambulatory eeg 0.00 4.23 NA 0.36 4.59 NA XXX
monitoring.
95951 ................ A EEG monitoring/ 6.00 16.38 NA 0.58 22.96 NA XXX
videorecord.
95951 26 A EEG monitoring/ 6.00 2.72 2.72 0.20 8.92 8.92 XXX
videorecord.
95951 TC A EEG monitoring/ 0.00 13.66 NA 0.38 14.04 NA XXX
videorecord.
95953 ................ A EEG monitoring/ 3.08 7.39 NA 0.46 10.93 NA XXX
computer.
95953 26 A EEG monitoring/ 3.08 1.38 1.38 0.10 4.56 4.56 XXX
computer.
95953 TC A EEG monitoring/ 0.00 6.01 NA 0.36 6.37 NA XXX
computer.
95954 ................ A EEG monitoring/giving 2.45 4.43 NA 0.15 7.03 NA XXX
drugs.
95954 26 A EEG monitoring/giving 2.45 1.07 1.07 0.10 3.62 3.62 XXX
drugs.
95954 TC A EEG monitoring/giving 0.00 3.36 NA 0.05 3.41 NA XXX
drugs.
95955 ................ A EEG during surgery.... 1.01 2.26 NA 0.19 3.46 NA XXX
95955 26 A EEG during surgery.... 1.01 0.40 0.40 0.05 1.46 1.46 XXX
[[Page 55463]]
95955 TC A EEG during surgery.... 0.00 1.86 NA 0.14 2.00 NA XXX
95956 ................ A Eeg monitoring, cable/ 3.08 7.43 NA 0.47 10.98 NA XXX
radio.
95956 26 A Eeg monitoring, cable/ 3.08 1.35 1.35 0.11 4.54 4.54 XXX
radio.
95956 TC A Eeg monitoring, cable/ 0.00 6.08 NA 0.36 6.44 NA XXX
radio.
95957 ................ A EEG digital analysis.. 1.98 2.52 NA 0.17 4.67 NA XXX
95957 26 A EEG digital analysis.. 1.98 0.90 0.90 0.07 2.95 2.95 XXX
95957 TC A EEG digital analysis.. 0.00 1.62 NA 0.10 1.72 NA XXX
95958 ................ A EEG monitoring/ 4.25 3.51 NA 0.29 8.05 NA XXX
function test.
95958 26 A EEG monitoring/ 4.25 1.86 1.86 0.18 6.29 6.29 XXX
function test.
95958 TC A EEG monitoring/ 0.00 1.65 NA 0.11 1.76 NA XXX
function test.
95961 ................ A Electrode stimulation, 2.97 2.67 NA 0.24 5.88 NA XXX
brain.
95961 26 A Electrode stimulation, 2.97 1.43 1.43 0.18 4.58 4.58 XXX
brain.
95961 TC A Electrode stimulation, 0.00 1.24 NA 0.06 1.30 NA XXX
brain.
95962 ................ A Electrode stim, brain 3.21 2.72 NA 0.23 6.16 NA ZZZ
add-on.
95962 26 A Electrode stim, brain 3.21 1.48 1.48 0.17 4.86 4.86 ZZZ
add-on.
95962 TC A Electrode stim, brain 0.00 1.24 NA 0.06 1.30 NA ZZZ
add-on.
95965 ................ C Meg, spontaneous...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
95965 26 A Meg, spontaneous...... 8.00 3.19 3.19 0.20 11.39 11.39 XXX
95965 TC C Meg, spontaneous...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
95966 ................ C Meg, evoked, single... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
95966 26 A Meg, evoked, single... 4.00 1.60 1.60 0.18 5.78 5.78 XXX
95966 TC C Meg, evoked, single... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
95967 ................ C Meg, evoked, each addl 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
95967 26 A Meg, evoked, each addl 3.50 1.40 1.40 0.17 5.07 5.07 ZZZ
95967 TC C Meg, evoked, each addl 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
95970 ................ A Analyze neurostim, no 0.45 0.18 0.16 0.03 0.66 0.64 XXX
prog.
95971 ................ A Analyze neurostim, 0.78 0.28 0.24 0.06 1.12 1.08 XXX
simple.
95972 ................ A Analyze neurostim, 1.50 0.62 0.51 0.17 2.29 2.18 XXX
complex.
95973 ................ A Analyze neurostim, 0.92 0.42 0.36 0.07 1.41 1.35 ZZZ
complex.
95974 ................ A Cranial neurostim, 3.00 1.37 1.37 0.15 4.52 4.52 XXX
complex.
95975 ................ A Cranial neurostim, 1.70 0.78 0.78 0.07 2.55 2.55 ZZZ
complex.
95999 ................ C Neurological procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX
96000 ................ A Motion analysis, video/ 1.80 NA 0.72 0.02 NA 2.54 XXX
3d.
96001 ................ A Motion test w/ft press 2.15 NA 0.86 0.02 NA 3.03 XXX
meas.
96002 ................ A Dynamic surface emg... 0.41 NA 0.16 0.02 NA 0.59 XXX
96003 ................ A Dynamic fine wire emg. 0.37 NA 0.15 0.03 NA 0.55 XXX
96004 ................ A Phys review of motion 1.80 0.72 0.72 0.08 2.60 2.60 XXX
tests.
96100 ................ A Psychological testing. 0.00 1.67 NA 0.15 1.82 NA XXX
96105 ................ A Assessment of aphasia. 0.00 1.67 NA 0.15 1.82 NA XXX
96110 ................ C Developmental test, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lim.
96111 ................ A Developmental test, 0.00 1.67 NA 0.15 1.82 NA XXX
extend.
96115 ................ A Neurobehavior status 0.00 1.67 NA 0.15 1.82 NA XXX
exam.
96117 ................ A Neuropsych test 0.00 1.67 NA 0.15 1.82 NA XXX
battery.
96150 ................ A Assess hlth/behave, 0.50 0.21 0.20 0.02 0.73 0.72 XXX
init.
96151 ................ A Assess hlth/behave, 0.48 0.21 0.19 0.02 0.71 0.69 XXX
subseq.
96152 ................ A Intervene hlth/behave, 0.46 0.20 0.18 0.02 0.68 0.66 XXX
indiv.
96153 ................ A Intervene hlth/behave, 0.10 0.04 0.04 0.01 0.15 0.15 XXX
group.
96154 ................ A Interv hlth/behav, fam 0.45 0.19 0.18 0.02 0.66 0.65 XXX
w/pt.
96155 ................ A Interv hlth/behav fam 0.44 0.18 0.18 0.02 0.64 0.64 XXX
no pt.
96400 ................ A Chemotherapy, sc/im... 0.00 0.13 NA 0.01 0.14 NA XXX
96405 ................ A Intralesional chemo 0.52 1.88 0.24 0.02 2.42 0.78 000
admin.
96406 ................ A Intralesional chemo 0.80 2.94 0.41 0.02 3.76 1.23 000
admin.
96408 ................ A Chemotherapy, push 0.00 0.92 NA 0.05 0.97 NA XXX
technique.
96410 ................ A Chemotherapy infusion 0.00 1.47 NA 0.07 1.54 NA XXX
method.
96412 ................ A Chemo, infuse method 0.00 1.09 NA 0.06 1.15 NA ZZZ
add-on.
96414 ................ A Chemo, infuse method 0.00 1.27 NA 0.07 1.34 NA XXX
add-on.
96420 ................ A Chemotherapy, push 0.00 1.18 NA 0.07 1.25 NA XXX
technique.
96422 ................ A Chemotherapy infusion 0.00 1.17 NA 0.07 1.24 NA XXX
method.
96423 ................ A Chemo, infuse method 0.00 0.46 NA 0.02 0.48 NA ZZZ
add-on.
96425 ................ A Chemotherapy infusion 0.00 1.36 NA 0.07 1.43 NA XXX
method.
96440 ................ A Chemotherapy, 2.37 7.99 1.06 0.12 10.48 3.55 000
intracavitary.
96445 ................ A Chemotherapy, 2.20 8.74 1.08 0.07 11.01 3.35 000
intracavitary.
96450 ................ A Chemotherapy, into CNS 1.89 6.79 0.95 0.06 8.74 2.90 000
96520 ................ A Pump refilling, 0.00 0.84 NA 0.05 0.89 NA XXX
maintenance.
96530 ................ A Pump refilling, 0.00 1.01 NA 0.05 1.06 NA XXX
maintenance.
96542 ................ A Chemotherapy injection 1.42 4.70 0.55 0.05 6.17 2.02 XXX
96545 ................ B Provide chemotherapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX
agent.
96549 ................ C Chemotherapy, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
unspecified.
96567 ................ A Photodynamic tx, skin. 0.00 1.63 NA 0.03 1.66 NA XXX
96570 ................ A Photodynamic tx, 30 1.10 0.46 0.38 0.04 1.60 1.52 ZZZ
min.
96571 ................ A Photodynamic tx, addl 0.55 0.22 0.20 0.02 0.79 0.77 ZZZ
15 min.
96900 ................ A Ultraviolet light 0.00 0.45 NA 0.02 0.47 NA XXX
therapy.
96902 ................ B Trichogram............ +0.41 0.25 0.16 0.01 0.67 0.58 XXX
[[Page 55464]]
96910 ................ A Photochemotherapy with 0.00 1.37 NA 0.03 1.40 NA XXX
UV-B.
96912 ................ A Photochemotherapy with 0.00 1.54 NA 0.04 1.58 NA XXX
UV-A.
96913 ................ A Photochemotherapy, UV- 0.00 2.26 NA 0.08 2.34 NA XXX
A or B.
96999 ................ C Dermatological 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
97001 ................ A Pt evaluation......... 1.20 0.56 0.37 0.10 1.86 1.67 XXX
97002 ................ A Pt re-evaluation...... 0.60 0.35 0.27 0.04 0.99 0.91 XXX
97003 ................ A Ot evaluation......... 1.20 0.69 0.32 0.05 1.94 1.57 XXX
97004 ................ A Ot re-evaluation...... 0.60 0.69 0.12 0.02 1.31 0.74 XXX
97005 ................ I Athletic train eval... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
97006 ................ I Athletic train reeval. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
97010 ................ B Hot or cold packs +0.06 0.04 0.04 0.01 0.11 0.11 XXX
therapy.
97012 ................ A Mechanical traction 0.25 0.11 0.11 0.01 0.37 0.37 XXX
therapy.
97014 ................ A Electric stimulation 0.18 0.19 0.19 0.01 0.38 0.38 XXX
therapy.
97016 ................ A Vasopneumatic device 0.18 0.14 0.14 0.01 0.33 0.33 XXX
therapy.
97018 ................ A Paraffin bath therapy. 0.06 0.12 0.12 0.01 0.19 0.19 XXX
97020 ................ A Microwave therapy..... 0.06 0.05 0.05 0.01 0.12 0.12 XXX
97022 ................ A Whirlpool therapy..... 0.17 0.26 0.26 0.01 0.44 0.44 XXX
97024 ................ A Diathermy treatment... 0.06 0.05 0.05 0.01 0.12 0.12 XXX
97026 ................ A Infrared therapy...... 0.06 0.05 0.05 0.01 0.12 0.12 XXX
97028 ................ A Ultraviolet therapy... 0.08 0.06 0.06 0.01 0.15 0.15 XXX
97032 ................ A Electrical stimulation 0.25 0.21 0.21 0.01 0.47 0.47 XXX
97033 ................ A Electric current 0.26 0.12 0.12 0.02 0.40 0.40 XXX
therapy.
97034 ................ A Contrast bath therapy. 0.21 0.14 0.14 0.01 0.36 0.36 XXX
97035 ................ A Ultrasound therapy.... 0.21 0.08 0.08 0.01 0.30 0.30 XXX
97036 ................ A Hydrotherapy.......... 0.28 0.34 0.34 0.01 0.63 0.63 XXX
97039 ................ A Physical therapy 0.20 0.07 0.07 0.01 0.28 0.28 XXX
treatment.
97110 ................ A Therapeutic exercises. 0.45 0.25 0.25 0.03 0.73 0.73 XXX
97112 ................ A Neuromuscular 0.45 0.29 0.29 0.02 0.76 0.76 XXX
reeducation.
97113 ................ A Aquatic therapy/ 0.44 0.33 0.33 0.03 0.80 0.80 XXX
exercises.
97116 ................ A Gait training therapy. 0.40 0.21 0.21 0.02 0.63 0.63 XXX
97124 ................ A Massage therapy....... 0.35 0.21 0.21 0.01 0.57 0.57 XXX
97139 ................ A Physical medicine 0.21 0.21 0.21 0.01 0.43 0.43 XXX
procedure.
97140 ................ A Manual therapy........ 0.43 0.23 0.23 0.02 0.68 0.68 XXX
97150 ................ A Group therapeutic 0.27 0.20 0.20 0.02 0.49 0.49 XXX
procedures.
97504 ................ A Orthotic training..... 0.45 0.25 0.25 0.03 0.73 0.73 XXX
97520 ................ A Prosthetic training... 0.45 0.21 0.21 0.02 0.68 0.68 XXX
97530 ................ A Therapeutic activities 0.44 0.45 0.45 0.02 0.91 0.91 XXX
97532 ................ A Cognitive skills 0.44 0.17 0.17 0.01 0.62 0.62 XXX
development.
97533 ................ A Sensory integration... 0.44 0.21 0.21 0.01 0.66 0.66 XXX
97535 ................ A Self care mngment 0.45 0.35 0.35 0.02 0.82 0.82 XXX
training.
97537 ................ A Community/work 0.45 0.20 0.20 0.01 0.66 0.66 XXX
reintegration.
97542 ................ A Wheelchair mngment 0.45 0.22 0.22 0.01 0.68 0.68 XXX
training.
97545 ................ R Work hardening........ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
97546 ................ R Work hardening add-on. 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
97601 ................ A Wound(s) care, 0.50 1.90 1.90 0.04 2.44 2.44 XXX
selective.
97602 ................ B Wound(s) care non- 0.00 0.00 0.00 0.00 0.00 0.00 XXX
selective.
97703 ................ A Prosthetic checkout... 0.25 0.44 0.44 0.02 0.71 0.71 XXX
97750 ................ A Physical performance 0.45 0.24 0.24 0.02 0.71 0.71 XXX
test.
97780 ................ N Acupuncture w/o stimul 0.00 0.00 0.00 0.00 0.00 0.00 XXX
97781 ................ N Acupuncture w/stimul.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
97799 ................ C Physical medicine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
97802 ................ A Medical nutrition, 0.00 0.45 0.45 0.01 0.46 0.46 XXX
indiv, in.
97803 ................ A Med nutrition, indiv, 0.00 0.45 0.45 0.01 0.46 0.46 XXX
subseq.
97804 ................ A Medical nutrition, 0.00 0.17 0.17 0.01 0.18 0.18 XXX
group.
98925 ................ A Osteopathic 0.45 0.38 0.14 0.01 0.84 0.60 000
manipulation.
98926 ................ A Osteopathic 0.65 0.44 0.25 0.02 1.11 0.92 000
manipulation.
98927 ................ A Osteopathic 0.87 0.52 0.31 0.03 1.42 1.21 000
manipulation.
98928 ................ A Osteopathic 1.03 0.59 0.38 0.03 1.65 1.44 000
manipulation.
98929 ................ A Osteopathic 1.19 0.65 0.39 0.04 1.88 1.62 000
manipulation.
98940 ................ A Chiropractic 0.45 0.25 0.13 0.01 0.71 0.59 000
manipulation.
98941 ................ A Chiropractic 0.65 0.31 0.19 0.02 0.98 0.86 000
manipulation.
98942 ................ A Chiropractic 0.87 0.37 0.25 0.03 1.27 1.15 000
manipulation.
98943 ................ N Chiropractic +0.40 0.34 0.16 0.01 0.75 0.57 XXX
manipulation.
99000 ................ B Specimen handling..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
99001 ................ B Specimen handling..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
99002 ................ B Device handling....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
99024 ................ B Postop follow-up visit 0.00 0.00 0.00 0.00 0.00 0.00 XXX
99025 ................ B Initial surgical 0.00 0.00 0.00 0.00 0.00 0.00 XXX
evaluation.
99050 ................ B Medical services after 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hrs.
99052 ................ B Medical services at 0.00 0.00 0.00 0.00 0.00 0.00 XXX
night.
99054 ................ B Medical servcs, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
unusual hrs.
99056 ................ B Non-office medical 0.00 0.00 0.00 0.00 0.00 0.00 XXX
services.
99058 ................ B Office emergency care. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
[[Page 55465]]
99070 ................ B Special supplies...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
99071 ................ B Patient education 0.00 0.00 0.00 0.00 0.00 0.00 XXX
materials.
99075 ................ N Medical testimony..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
99078 ................ B Group health education 0.00 0.00 0.00 0.00 0.00 0.00 XXX
99080 ................ B Special reports or 0.00 0.00 0.00 0.00 0.00 0.00 XXX
forms.
99082 ................ C Unusual physician 0.00 0.00 0.00 0.00 0.00 0.00 XXX
travel.
99090 ................ B Computer data analysis 0.00 0.00 0.00 0.00 0.00 0.00 XXX
99091 ................ B Collect/review data 0.00 0.00 0.00 0.00 0.00 0.00 XXX
from pt.
99100 ................ B Special anesthesia 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
service.
99116 ................ B Anesthesia with 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
hypothermia.
99135 ................ B Special anesthesia 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
procedure.
99140 ................ B Emergency anesthesia.. 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
99141 ................ B Sedation, iv/im or +0.80 2.12 0.39 0.04 2.96 1.23 XXX
inhalant.
99142 ................ B Sedation, oral/rectal/ +0.60 1.24 0.31 0.03 1.87 0.94 XXX
nasal.
99170 ................ A Anogenital exam, child 1.75 2.02 0.55 0.07 3.84 2.37 000
99172 ................ N Ocular function screen 0.00 0.00 0.00 0.00 0.00 0.00 XXX
99173 ................ N Visual acuity screen.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
99175 ................ A Induction of vomiting. 0.00 1.32 NA 0.08 1.40 NA XXX
99183 ................ A Hyperbaric oxygen 2.34 NA 0.77 0.12 NA 3.23 XXX
therapy.
99185 ................ A Regional hypothermia.. 0.00 0.61 NA 0.03 0.64 NA XXX
99186 ................ A Total body hypothermia 0.00 1.69 NA 0.37 2.06 NA XXX
99190 ................ X Special pump services. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
99191 ................ X Special pump services. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
99192 ................ X Special pump services. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
99195 ................ A Phlebotomy............ 0.00 0.42 NA 0.02 0.44 NA XXX
99199 ................ C Special service/proc/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
report.
99201 ................ A Office/outpatient 0.45 0.47 0.16 0.02 0.94 0.63 XXX
visit, new.
99202 ................ A Office/outpatient 0.88 0.77 0.33 0.05 1.70 1.26 XXX
visit, new.
99203 ................ A Office/outpatient 1.34 1.12 0.50 0.08 2.54 1.92 XXX
visit, new.
99204 ................ A Office/outpatient 2.00 1.51 0.74 0.10 3.61 2.84 XXX
visit, new.
99205 ................ A Office/outpatient 2.67 1.80 0.98 0.12 4.59 3.77 XXX
visit, new.
99211 ................ A Office/outpatient 0.17 0.38 0.06 0.01 0.56 0.24 XXX
visit, est.
99212 ................ A Office/outpatient 0.45 0.53 0.17 0.02 1.00 0.64 XXX
visit, est.
99213 ................ A Office/outpatient 0.67 0.69 0.24 0.03 1.39 0.94 XXX
visit, est.
99214 ................ A Office/outpatient 1.10 1.04 0.41 0.04 2.18 1.55 XXX
visit, est.
99215 ................ A Office/outpatient 1.77 1.36 0.66 0.07 3.20 2.50 XXX
visit, est.
99217 ................ A Observation care 1.28 NA 0.45 0.05 NA 1.78 XXX
discharge.
99218 ................ A Observation care...... 1.28 NA 0.45 0.05 NA 1.78 XXX
99219 ................ A Observation care...... 2.14 NA 0.75 0.08 NA 2.97 XXX
99220 ................ A Observation care...... 2.99 NA 1.06 0.11 NA 4.16 XXX
99221 ................ A Initial hospital care. 1.28 NA 0.47 0.05 NA 1.80 XXX
99222 ................ A Initial hospital care. 2.14 NA 0.77 0.08 NA 2.99 XXX
99223 ................ A Initial hospital care. 2.99 NA 1.08 0.10 NA 4.17 XXX
99231 ................ A Subsequent hospital 0.64 NA 0.24 0.02 NA 0.90 XXX
care.
99232 ................ A Subsequent hospital 1.06 NA 0.39 0.03 NA 1.48 XXX
care.
99233 ................ A Subsequent hospital 1.51 NA 0.55 0.05 NA 2.11 XXX
care.
99234 ................ A Observ/hosp same date. 2.56 NA 0.93 0.11 NA 3.60 XXX
99235 ................ A Observ/hosp same date. 3.42 NA 1.21 0.13 NA 4.76 XXX
99236 ................ A Observ/hosp same date. 4.27 NA 1.49 0.17 NA 5.93 XXX
99238 ................ A Hospital discharge day 1.28 NA 0.51 0.04 NA 1.83 XXX
99239 ................ A Hospital discharge day 1.75 NA 0.71 0.05 NA 2.51 XXX
99241 ................ A Office consultation... 0.64 0.62 0.24 0.04 1.30 0.92 XXX
99242 ................ A Office consultation... 1.29 1.03 0.50 0.09 2.41 1.88 XXX
99243 ................ A Office consultation... 1.72 1.38 0.67 0.10 3.20 2.49 XXX
99244 ................ A Office consultation... 2.58 1.83 0.98 0.13 4.54 3.69 XXX
99245 ................ A Office consultation... 3.43 2.29 1.30 0.16 5.88 4.89 XXX
99251 ................ A Initial inpatient 0.66 NA 0.26 0.04 NA 0.96 XXX
consult.
99252 ................ A Initial inpatient 1.32 NA 0.53 0.08 NA 1.93 XXX
consult.
99253 ................ A Initial inpatient 1.82 NA 0.72 0.09 NA 2.63 XXX
consult.
99254 ................ A Initial inpatient 2.64 NA 1.03 0.11 NA 3.78 XXX
consult.
99255 ................ A Initial inpatient 3.65 NA 1.41 0.15 NA 5.21 XXX
consult.
99261 ................ A Follow-up inpatient 0.42 NA 0.16 0.02 NA 0.60 XXX
consult.
99262 ................ A Follow-up inpatient 0.85 NA 0.32 0.03 NA 1.20 XXX
consult.
99263 ................ A Follow-up inpatient 1.27 NA 0.48 0.04 NA 1.79 XXX
consult.
99271 ................ A Confirmatory 0.45 0.67 0.17 0.03 1.15 0.65 XXX
consultation.
99272 ................ A Confirmatory 0.84 0.89 0.32 0.06 1.79 1.22 XXX
consultation.
99273 ................ A Confirmatory 1.19 1.13 0.47 0.07 2.39 1.73 XXX
consultation.
99274 ................ A Confirmatory 1.73 1.41 0.68 0.09 3.23 2.50 XXX
consultation.
99275 ................ A Confirmatory 2.31 1.68 0.88 0.10 4.09 3.29 XXX
consultation.
99281 ................ A Emergency dept visit.. 0.33 NA 0.09 0.02 NA 0.44 XXX
99282 ................ A Emergency dept visit.. 0.55 NA 0.15 0.03 NA 0.73 XXX
99283 ................ A Emergency dept visit.. 1.24 NA 0.32 0.08 NA 1.64 XXX
99284 ................ A Emergency dept visit.. 1.95 NA 0.49 0.12 NA 2.56 XXX
[[Page 55466]]
99285 ................ A Emergency dept visit.. 3.06 NA 0.75 0.19 NA 4.00 XXX
99288 ................ B Direct advanced life 0.00 0.00 0.00 0.00 0.00 0.00 XXX
support.
99289 ................ I Pt transport, 30-74 0.00 0.00 0.00 0.00 0.00 0.00 XXX
min.
99290 ................ I Pt transport, addl 30 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
min.
99291 ................ A Critical care, first 4.00 1.63 1.34 0.14 5.77 5.48 XXX
hour.
99292 ................ A Critical care, addl 30 2.00 0.92 0.66 0.07 2.99 2.73 ZZZ
min.
99295 ................ A Neonatal critical care 16.00 NA 4.53 0.70 NA 21.23 XXX
99296 ................ A Neonatal critical care 8.00 NA 2.58 0.23 NA 10.81 XXX
99297 ................ A Neonatal critical care 4.00 NA 1.32 0.12 NA 5.44 XXX
99298 ................ A Neonatal critical care 2.75 NA 0.97 0.10 NA 3.82 XXX
99301 ................ A Nursing facility care. 1.20 0.70 0.42 0.04 1.94 1.66 XXX
99302 ................ A Nursing facility care. 1.61 0.98 0.57 0.05 2.64 2.23 XXX
99303 ................ A Nursing facility care. 2.01 1.21 0.70 0.06 3.28 2.77 XXX
99311 ................ A Nursing fac care, 0.60 0.49 0.21 0.02 1.11 0.83 XXX
subseq.
99312 ................ A Nursing fac care, 1.00 0.68 0.35 0.03 1.71 1.38 XXX
subseq.
99313 ................ A Nursing fac care, 1.42 0.87 0.50 0.04 2.33 1.96 XXX
subseq.
99315 ................ A Nursing fac discharge 1.13 0.74 0.40 0.04 1.91 1.57 XXX
day.
99316 ................ A Nursing fac discharge 1.50 0.95 0.53 0.05 2.50 2.08 XXX
day.
99321 ................ A Rest home visit, new 0.71 0.49 NA 0.02 1.22 NA XXX
patient.
99322 ................ A Rest home visit, new 1.01 0.70 NA 0.03 1.74 NA XXX
patient.
99323 ................ A Rest home visit, new 1.28 0.93 NA 0.04 2.25 NA XXX
patient.
99331 ................ A Rest home visit, est 0.60 0.47 NA 0.02 1.09 NA XXX
pat.
99332 ................ A Rest home visit, est 0.80 0.59 NA 0.03 1.42 NA XXX
pat.
99333 ................ A Rest home visit, est 1.00 0.73 NA 0.03 1.76 NA XXX
pat.
99341 ................ A Home visit, new 1.01 0.56 NA 0.05 1.62 NA XXX
patient.
99342 ................ A Home visit, new 1.52 0.87 NA 0.05 2.44 NA XXX
patient.
99343 ................ A Home visit, new 2.27 1.29 NA 0.07 3.63 NA XXX
patient.
99344 ................ A Home visit, new 3.03 1.57 NA 0.10 4.70 NA XXX
patient.
99345 ................ A Home visit, new 3.79 1.86 NA 0.12 5.77 NA XXX
patient.
99347 ................ A Home visit, est 0.76 0.49 NA 0.03 1.28 NA XXX
patient.
99348 ................ A Home visit, est 1.26 0.74 NA 0.04 2.04 NA XXX
patient.
99349 ................ A Home visit, est 2.02 1.08 NA 0.06 3.16 NA XXX
patient.
99350 ................ A Home visit, est 3.03 1.47 NA 0.10 4.60 NA XXX
patient.
99354 ................ A Prolonged service, 1.77 1.46 0.66 0.06 3.29 2.49 ZZZ
office.
99355 ................ A Prolonged service, 1.77 1.24 0.65 0.06 3.07 2.48 ZZZ
office.
99356 ................ A Prolonged service, 1.71 NA 0.61 0.06 NA 2.38 ZZZ
inpatient.
99357 ................ A Prolonged service, 1.71 NA 0.63 0.06 NA 2.40 ZZZ
inpatient.
99358 ................ B Prolonged serv, w/o 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
contact.
99359 ................ B Prolonged serv, w/o 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
contact.
99360 ................ X Physician standby 0.00 0.00 0.00 0.00 0.00 0.00 XXX
services.
99361 ................ B Physician/team 0.00 0.00 0.00 0.00 0.00 0.00 XXX
conference.
99362 ................ B Physician/team 0.00 0.00 0.00 0.00 0.00 0.00 XXX
conference.
99371 ................ B Physician phone 0.00 0.00 0.00 0.00 0.00 0.00 XXX
consultation.
99372 ................ B Physician phone 0.00 0.00 0.00 0.00 0.00 0.00 XXX
consultation.
99373 ................ B Physician phone 0.00 0.00 0.00 0.00 0.00 0.00 XXX
consultation.
99374 ................ B Home health care +1.10 1.47 0.44 0.04 2.61 1.58 XXX
supervision.
99377 ................ B Hospice care +1.10 1.47 0.44 0.04 2.61 1.58 XXX
supervision.
99379 ................ B Nursing fac care +1.10 1.47 0.44 0.03 2.60 1.57 XXX
supervision.
99380 ................ B Nursing fac care +1.73 1.72 0.69 0.05 3.50 2.47 XXX
supervision.
99381 ................ N Prev visit, new, +1.19 1.50 0.48 0.04 2.73 1.71 XXX
infant.
99382 ................ N Prev visit, new, age 1- +1.36 1.54 0.54 0.04 2.94 1.94 XXX
4.
99383 ................ N Prev visit, new, age 5- +1.36 1.48 0.54 0.04 2.88 1.94 XXX
11.
99384 ................ N Prev visit, new, age +1.53 1.55 0.61 0.05 3.13 2.19 XXX
12-17.
99385 ................ N Prev visit, new, age +1.53 1.55 0.61 0.05 3.13 2.19 XXX
18-39.
99386 ................ N Prev visit, new, age +1.88 1.74 0.75 0.06 3.68 2.69 XXX
40-64.
99387 ................ N Prev visit, new, 65 & +2.06 1.87 0.82 0.06 3.99 2.94 XXX
over.
99391 ................ N Prev visit, est, +1.02 1.02 0.41 0.03 2.07 1.46 XXX
infant.
99392 ................ N Prev visit, est, age 1- +1.19 1.09 0.48 0.04 2.32 1.71 XXX
4.
99393 ................ N Prev visit, est, age 5- +1.19 1.06 0.48 0.04 2.29 1.71 XXX
11.
99394 ................ N Prev visit, est, age +1.36 1.15 0.54 0.04 2.55 1.94 XXX
12-17.
99395 ................ N Prev visit, est, age +1.36 1.18 0.54 0.04 2.58 1.94 XXX
18-39.
99396 ................ N Prev visit, est, age +1.53 1.27 0.61 0.05 2.85 2.19 XXX
40-64.
99397 ................ N Prev visit, est, 65 & +1.71 1.37 0.68 0.05 3.13 2.44 XXX
over.
99401 ................ N Preventive counseling, +0.48 0.62 0.19 0.01 1.11 0.68 XXX
indiv.
99402 ................ N Preventive counseling, +0.98 0.86 0.39 0.02 1.86 1.39 XXX
indiv.
99403 ................ N Preventive counseling, +1.46 1.10 0.58 0.03 2.59 2.07 XXX
indiv.
99404 ................ N Preventive counseling, +1.95 1.35 0.78 0.04 3.34 2.77 XXX
indiv.
99411 ................ N Preventive counseling, +0.15 0.18 0.06 0.01 0.34 0.22 XXX
group.
99412 ................ N Preventive counseling, +0.25 0.24 0.10 0.01 0.50 0.36 XXX
group.
99420 ................ N Health risk assessment 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
99429 ................ N Unlisted preventive 0.00 0.00 0.00 0.00 0.00 0.00 XXX
service.
99431 ................ A Initial care, normal 1.17 NA 0.39 0.04 NA 1.60 XXX
newborn.
99432 ................ A Newborn care, not in 1.26 1.12 0.50 0.06 2.44 1.82 XXX
hosp.
[[Page 55467]]
99433 ................ A Normal newborn care/ 0.62 NA 0.21 0.02 NA 0.85 XXX
hospital.
99435 ................ A Newborn discharge day 1.50 NA 0.54 0.05 NA 2.09 XXX
hosp.
99436 ................ A Attendance, birth..... 1.50 0.50 0.50 0.05 2.05 2.05 XXX
99440 ................ A Newborn resuscitation. 2.93 NA 1.17 0.11 NA 4.21 XXX
99450 ................ N Life/disability 0.00 0.00 0.00 0.00 0.00 0.00 XXX
evaluation.
99455 ................ R Disability examination 0.00 0.00 0.00 0.00 0.00 0.00 XXX
99456 ................ R Disability examination 0.00 0.00 0.00 0.00 0.00 0.00 XXX
99499 ................ C Unlisted e&m service.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
99500 ................ I Home visit, prenatal.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
99501 ................ I Home visit, postnatal. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
99502 ................ I Home visit, nb care... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
99503 ................ I Home visit, resp 0.00 0.00 0.00 0.00 0.00 0.00 XXX
therapy.
99504 ................ I Home visit, mech 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ventilator.
99505 ................ I Home visit, stoma care 0.00 0.00 0.00 0.00 0.00 0.00 XXX
99506 ................ I Home visit, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
99507 ................ I Home visit, cath 0.00 0.00 0.00 0.00 0.00 0.00 XXX
maintain.
99508 ................ I Home visit, sleep 0.00 0.00 0.00 0.00 0.00 0.00 XXX
studies.
99509 ................ I Home visit, day life 0.00 0.00 0.00 0.00 0.00 0.00 XXX
activity.
99510 ................ I Home visit, sing/m/fam 0.00 0.00 0.00 0.00 0.00 0.00 XXX
couns.
99511 ................ I Home visit, fecal/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
enema mgmt.
99512 ................ I Home visit, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hemodialysis.
99539 ................ I Home visit, nos....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
99551 ................ I Home infuse, pain 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mgmt, iv/sc.
99552 ................ I Home infuse pain mgmt, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
epid/ith.
99553 ................ I Home infuse, tocolytic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
tx.
99554 ................ I Home infuse, hormone/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
platelet.
99555 ................ I Home infuse, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
chemotheraphy.
99556 ................ I Home infuse, antibio/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
fung/vir.
99557 ................ I Home infuse, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
anticoagulant.
99558 ................ I Home infuse, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
immunotherapy.
99559 ................ I Home infuse, periton 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dialysis.
99560 ................ I Home infuse, entero 0.00 0.00 0.00 0.00 0.00 0.00 XXX
nutrition.
99561 ................ I Home infuse, hydration 0.00 0.00 0.00 0.00 0.00 0.00 XXX
tx.
99562 ................ I Home infuse, parent 0.00 0.00 0.00 0.00 0.00 0.00 XXX
nutrition.
99563 ................ I Home admin, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
pentamidine.
99564 ................ I Home infuse, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
antihemophil agnt.
99565 ................ I Home infuse, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
proteinase inhib.
99566 ................ I Home infuse, iv 0.00 0.00 0.00 0.00 0.00 0.00 XXX
therapy.
99567 ................ I Home infuse, sympath 0.00 0.00 0.00 0.00 0.00 0.00 XXX
agent.
99568 ................ I Home infuse, misc 0.00 0.00 0.00 0.00 0.00 0.00 XXX
drug, daily.
99569 ................ I Home infuse, each addl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
tx.
A0021 ................ I Outside state 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ambulance serv.
A0080 ................ I Noninterest escort in 0.00 0.00 0.00 0.00 0.00 0.00 XXX
non er.
A0090 ................ I Interest escort in non 0.00 0.00 0.00 0.00 0.00 0.00 XXX
er.
A0100 ................ I Nonemergency transport 0.00 0.00 0.00 0.00 0.00 0.00 XXX
taxi.
A0110 ................ I Nonemergency transport 0.00 0.00 0.00 0.00 0.00 0.00 XXX
bus.
A0120 ................ I Noner transport mini- 0.00 0.00 0.00 0.00 0.00 0.00 XXX
bus.
A0130 ................ I Noner transport 0.00 0.00 0.00 0.00 0.00 0.00 XXX
wheelch van.
A0140 ................ I Nonemergency transport 0.00 0.00 0.00 0.00 0.00 0.00 XXX
air.
A0160 ................ I Noner transport case 0.00 0.00 0.00 0.00 0.00 0.00 XXX
worker.
A0170 ................ I Noner transport 0.00 0.00 0.00 0.00 0.00 0.00 XXX
parking fees.
A0180 ................ I Noner transport lodgng 0.00 0.00 0.00 0.00 0.00 0.00 XXX
recip.
A0190 ................ I Noner transport meals 0.00 0.00 0.00 0.00 0.00 0.00 XXX
recip.
A0200 ................ I Noner transport lodgng 0.00 0.00 0.00 0.00 0.00 0.00 XXX
escrt.
A0210 ................ I Noner transport meals 0.00 0.00 0.00 0.00 0.00 0.00 XXX
escort.
A0380 ................ X Basic life support 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mileage.
A0382 ................ X Basic support routine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
suppls.
A0384 ................ X Bls defibrillation 0.00 0.00 0.00 0.00 0.00 0.00 XXX
supplies.
A0390 ................ X Advanced life support 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mileag.
A0392 ................ X Als defibrillation 0.00 0.00 0.00 0.00 0.00 0.00 XXX
supplies.
A0394 ................ X Als IV drug therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX
supplies.
A0396 ................ X Als esophageal intub 0.00 0.00 0.00 0.00 0.00 0.00 XXX
suppls.
A0398 ................ X Als routine disposble 0.00 0.00 0.00 0.00 0.00 0.00 XXX
suppls.
A0420 ................ X Ambulance waiting \1/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
2\ hr.
A0422 ................ X Ambulance 02 life 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sustaining.
A0424 ................ X Extra ambulance 0.00 0.00 0.00 0.00 0.00 0.00 XXX
attendant.
A0425 ................ X Ground mileage........ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A0426 ................ X Als 1................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A0427 ................ X ALS1-emergency........ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A0428 ................ X bls................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A0429 ................ X BLS-emergency......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A0430 ................ X Fixed wing air 0.00 0.00 0.00 0.00 0.00 0.00 XXX
transport.
A0431 ................ X Rotary wing air 0.00 0.00 0.00 0.00 0.00 0.00 XXX
transport.
[[Page 55468]]
A0432 ................ X PI volunteer ambulance 0.00 0.00 0.00 0.00 0.00 0.00 XXX
co.
A0433 ................ X als 2................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A0434 ................ X Specialty care 0.00 0.00 0.00 0.00 0.00 0.00 XXX
transport.
A0435 ................ X Fixed wing air mileage 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A0436 ................ X Rotary wing air 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mileage.
A0888 ................ N Noncovered ambulance 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mileage.
A0999 ................ X Unlisted ambulance 0.00 0.00 0.00 0.00 0.00 0.00 XXX
service.
A4206 ................ I 1 CC sterile 0.00 0.00 0.00 0.00 0.00 0.00 XXX
syringe&needle.
A4207 ................ I 2 CC sterile 0.00 0.00 0.00 0.00 0.00 0.00 XXX
syringe&needle.
A4208 ................ I 3 CC sterile 0.00 0.00 0.00 0.00 0.00 0.00 XXX
syringe&needle.
A4209 ................ I 5+ CC sterile 0.00 0.00 0.00 0.00 0.00 0.00 XXX
syringe&needle.
A4210 ................ N Nonneedle injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX
device.
A4211 ................ P Supp for self-adm 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injections.
A4212 ................ P Non coring needle or 0.00 0.00 0.00 0.00 0.00 0.00 XXX
stylet.
A4213 ................ I 20+ CC syringe only... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4214 ................ P 30 CC sterile water/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
saline.
A4215 ................ I Sterile needle........ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4220 ................ P Infusion pump refill 0.00 0.00 0.00 0.00 0.00 0.00 XXX
kit.
A4221 ................ X Maint drug infus cath 0.00 0.00 0.00 0.00 0.00 0.00 XXX
per wk.
A4222 ................ X Drug infusion pump 0.00 0.00 0.00 0.00 0.00 0.00 XXX
supplies.
A4230 ................ X Infus insulin pump non 0.00 0.00 0.00 0.00 0.00 0.00 XXX
needl.
A4231 ................ X Infusion insulin pump 0.00 0.00 0.00 0.00 0.00 0.00 XXX
needle.
A4232 ................ X Syringe w/needle 0.00 0.00 0.00 0.00 0.00 0.00 XXX
insulin 3cc.
A4244 ................ I Alcohol or peroxide 0.00 0.00 0.00 0.00 0.00 0.00 XXX
per pint.
A4245 ................ I Alcohol wipes per box. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4246 ................ I Betadine/phisohex 0.00 0.00 0.00 0.00 0.00 0.00 XXX
solution.
A4247 ................ I Betadine/iodine swabs/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
wipes.
A4250 ................ N Urine reagent strips/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
tablets.
A4253 ................ P Blood glucose/reagent 0.00 0.00 0.00 0.00 0.00 0.00 XXX
strips.
A4254 ................ X Battery for glucose 0.00 0.00 0.00 0.00 0.00 0.00 XXX
monitor.
A4255 ................ X Glucose monitor 0.00 0.00 0.00 0.00 0.00 0.00 XXX
platforms.
A4256 ................ P Calibrator solution/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
chips.
A4257 ................ X Replace Lensshield 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Cartridge.
A4258 ................ P Lancet device each.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4259 ................ P Lancets per box....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4260 ................ N Levonorgestrel implant 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4261 ................ N Cervical cap 0.00 0.00 0.00 0.00 0.00 0.00 XXX
contraceptive.
A4262 ................ B Temporary tear duct 0.00 0.00 0.00 0.00 0.00 0.00 XXX
plug.
A4263 ................ I Permanent tear duct 0.00 0.00 0.00 0.00 0.00 0.00 XXX
plug.
A4265 ................ P Paraffin.............. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4270 ................ B Disposable endoscope 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sheath.
A4280 ................ X Brst prsths adhsv 0.00 0.00 0.00 0.00 0.00 0.00 XXX
attchmnt.
A4290 ................ X Sacral nerve stim test 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lead.
A4300 ................ B Cath impl vasc access 0.00 0.00 0.00 0.00 0.00 0.00 XXX
portal.
A4301 ................ P Implantable access 0.00 0.00 0.00 0.00 0.00 0.00 XXX
syst perc.
A4305 ................ P Drug delivery system 0.00 0.00 0.00 0.00 0.00 0.00 XXX
>=50 ML.
A4306 ................ P Drug delivery system 0.00 0.00 0.00 0.00 0.00 0.00 XXX
=5 ML.
A4310 ................ P Insert tray w/o bag/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cath.
A4311 ................ P Catheter w/o bag 2-way 0.00 0.00 0.00 0.00 0.00 0.00 XXX
latex.
A4312 ................ P Cath w/o bag 2-way 0.00 0.00 0.00 0.00 0.00 0.00 XXX
silicone.
A4313 ................ P Catheter w/bag 3-way.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4314 ................ P Cath w/drainage 2-way 0.00 0.00 0.00 0.00 0.00 0.00 XXX
latex.
A4315 ................ P Cath w/drainage 2-way 0.00 0.00 0.00 0.00 0.00 0.00 XXX
silcne.
A4316 ................ P Cath w/drainage 3-way. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4319 ................ X Sterile H2O irrigation 0.00 0.00 0.00 0.00 0.00 0.00 XXX
solut.
A4320 ................ P Irrigation tray....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4321 ................ X Cath therapeutic irrig 0.00 0.00 0.00 0.00 0.00 0.00 XXX
agent.
A4322 ................ P Irrigation syringe.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4323 ................ P Saline irrigation 0.00 0.00 0.00 0.00 0.00 0.00 XXX
solution.
A4324 ................ X Male ext cath w/adh 0.00 0.00 0.00 0.00 0.00 0.00 XXX
coating.
A4325 ................ X Male ext cath w/adh 0.00 0.00 0.00 0.00 0.00 0.00 XXX
strip.
A4326 ................ P Male external catheter 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4327 ................ P Fem urinary collect 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dev cup.
A4328 ................ P Fem urinary collect 0.00 0.00 0.00 0.00 0.00 0.00 XXX
pouch.
A4329 ................ D External catheter 0.00 0.00 0.00 0.00 0.00 0.00 XXX
start set.
A4330 ................ P Stool collection pouch 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4331 ................ X Extension drainage 0.00 0.00 0.00 0.00 0.00 0.00 XXX
tubing.
A4332 ................ X Lubricant for cath 0.00 0.00 0.00 0.00 0.00 0.00 XXX
insertion.
A4333 ................ X Urinary cath anchor 0.00 0.00 0.00 0.00 0.00 0.00 XXX
device.
A4334 ................ X Urinary cath leg strap 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4335 ................ P Incontinence supply... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4338 ................ P Indwelling catheter 0.00 0.00 0.00 0.00 0.00 0.00 XXX
latex.
A4340 ................ P Indwelling catheter 0.00 0.00 0.00 0.00 0.00 0.00 XXX
special.
[[Page 55469]]
A4344 ................ P Cath indw foley 2 way 0.00 0.00 0.00 0.00 0.00 0.00 XXX
silicn.
A4346 ................ P Cath indw foley 3 way. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4347 ................ P Male external catheter 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4348 ................ X Male ext cath extended 0.00 0.00 0.00 0.00 0.00 0.00 XXX
wear.
A4351 ................ P Straight tip urine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
catheter.
A4352 ................ P Coude tip urinary 0.00 0.00 0.00 0.00 0.00 0.00 XXX
catheter.
A4353 ................ X Intermittent urinary 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cath.
A4354 ................ P Cath insertion tray w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
bag.
A4355 ................ P Bladder irrigation 0.00 0.00 0.00 0.00 0.00 0.00 XXX
tubing.
A4356 ................ P Ext ureth clmp or 0.00 0.00 0.00 0.00 0.00 0.00 XXX
compr dvc.
A4357 ................ P Bedside drainage bag.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4358 ................ P Urinary leg or abdomen 0.00 0.00 0.00 0.00 0.00 0.00 XXX
bag.
A4359 ................ P Urinary suspensory w/o 0.00 0.00 0.00 0.00 0.00 0.00 XXX
leg b.
A4360 ................ N Adult incontinence 0.00 0.00 0.00 0.00 0.00 0.00 XXX
garment.
A4361 ................ P Ostomy face plate..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4362 ................ P Solid skin barrier.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4364 ................ P Adhesive, liquid or 0.00 0.00 0.00 0.00 0.00 0.00 XXX
equal.
A4365 ................ X Adhesive remover wipes 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4367 ................ P Ostomy belt........... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4368 ................ X Ostomy filter......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4369 ................ X Skin barrier liquid 0.00 0.00 0.00 0.00 0.00 0.00 XXX
per oz.
A4370 ................ X Skin barrier paste per 0.00 0.00 0.00 0.00 0.00 0.00 XXX
oz.
A4371 ................ X Skin barrier powder 0.00 0.00 0.00 0.00 0.00 0.00 XXX
per oz.
A4372 ................ X Skin barrier solid 4x4 0.00 0.00 0.00 0.00 0.00 0.00 XXX
equiv.
A4373 ................ X Skin barrier with 0.00 0.00 0.00 0.00 0.00 0.00 XXX
flange.
A4374 ................ X Skin barrier extended 0.00 0.00 0.00 0.00 0.00 0.00 XXX
wear.
A4375 ................ X Drainable plastic pch 0.00 0.00 0.00 0.00 0.00 0.00 XXX
w fcpl.
A4376 ................ X Drainable rubber pch w 0.00 0.00 0.00 0.00 0.00 0.00 XXX
fcplt.
A4377 ................ X Drainable plstic pch w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
o fp.
A4378 ................ X Drainable rubber pch w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
o fp.
A4379 ................ X Urinary plastic pouch 0.00 0.00 0.00 0.00 0.00 0.00 XXX
w fcpl.
A4380 ................ X Urinary rubber pouch w 0.00 0.00 0.00 0.00 0.00 0.00 XXX
fcplt.
A4381 ................ X Urinary plastic pouch 0.00 0.00 0.00 0.00 0.00 0.00 XXX
w/o fp.
A4382 ................ X Urinary hvy plstc pch 0.00 0.00 0.00 0.00 0.00 0.00 XXX
w/o fp.
A4383 ................ X Urinary rubber pouch w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
o fp.
A4384 ................ X Ostomy faceplt/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
silicone ring.
A4385 ................ X Ost skn barrier sld 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ext wear.
A4386 ................ X Ost skn barrier w flng 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ex wr.
A4387 ................ X Ost clsd pouch w att 0.00 0.00 0.00 0.00 0.00 0.00 XXX
st barr.
A4388 ................ X Drainable pch w ex 0.00 0.00 0.00 0.00 0.00 0.00 XXX
wear barr.
A4389 ................ X Drainable pch w st 0.00 0.00 0.00 0.00 0.00 0.00 XXX
wear barr.
A4390 ................ X Drainable pch ex wear 0.00 0.00 0.00 0.00 0.00 0.00 XXX
convex.
A4391 ................ X Urinary pouch w ex 0.00 0.00 0.00 0.00 0.00 0.00 XXX
wear barr.
A4392 ................ X Urinary pouch w st 0.00 0.00 0.00 0.00 0.00 0.00 XXX
wear barr.
A4393 ................ X Urine pch w ex wear 0.00 0.00 0.00 0.00 0.00 0.00 XXX
bar conv.
A4394 ................ X Ostomy pouch liq 0.00 0.00 0.00 0.00 0.00 0.00 XXX
deodorant.
A4395 ................ X Ostomy pouch solid 0.00 0.00 0.00 0.00 0.00 0.00 XXX
deodorant.
A4396 ................ X Peristomal hernia 0.00 0.00 0.00 0.00 0.00 0.00 XXX
supprt blt.
A4397 ................ P Irrigation supply 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sleeve.
A4398 ................ P Ostomy irrigation bag. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4399 ................ P Ostomy irrig cone/cath 0.00 0.00 0.00 0.00 0.00 0.00 XXX
w brs.
A4400 ................ P Ostomy irrigation set. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4402 ................ P Lubricant per ounce... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4404 ................ P Ostomy ring each...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4421 ................ P Ostomy supply misc.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4454 ................ P Tape all types all 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sizes.
A4455 ................ P Adhesive remover per 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ounce.
A4460 ................ P Elastic compression 0.00 0.00 0.00 0.00 0.00 0.00 XXX
bandage.
A4462 ................ X Abdmnl drssng holder/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
binder.
A4464 ................ N Joint support device/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
garment.
A4465 ................ P Non-elastic extremity 0.00 0.00 0.00 0.00 0.00 0.00 XXX
binder.
A4470 ................ P Gravlee jet washer.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4480 ................ P Vabra aspirator....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4481 ................ X Tracheostoma filter... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4483 ................ X Moisture exchanger.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4490 ................ N Above knee surgical 0.00 0.00 0.00 0.00 0.00 0.00 XXX
stocking.
A4495 ................ N Thigh length surg 0.00 0.00 0.00 0.00 0.00 0.00 XXX
stocking.
A4500 ................ N Below knee surgical 0.00 0.00 0.00 0.00 0.00 0.00 XXX
stocking.
A4510 ................ N Full length surg 0.00 0.00 0.00 0.00 0.00 0.00 XXX
stocking.
A4550 ................ I Surgical trays........ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4554 ................ N Disposable underpads.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4556 ................ P Electrodes, pair...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4557 ................ P Lead wires, pair...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
[[Page 55470]]
A4558 ................ P Conductive paste or 0.00 0.00 0.00 0.00 0.00 0.00 XXX
gel.
A4561 ................ X Pessary rubber, any 0.00 0.00 0.00 0.00 0.00 0.00 XXX
type.
A4562 ................ X Pessary, non rubber, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
any type.
A4565 ................ X Slings................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4570 ................ I Splint................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4572 ................ X Rib belt.............. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4575 ................ N Hyperbaric o2 chamber 0.00 0.00 0.00 0.00 0.00 0.00 XXX
disps.
A4580 ................ I Cast supplies 0.00 0.00 0.00 0.00 0.00 0.00 XXX
(plaster).
A4590 ................ I Special casting 0.00 0.00 0.00 0.00 0.00 0.00 XXX
material.
A4595 ................ X TENS suppl 2 lead per 0.00 0.00 0.00 0.00 0.00 0.00 XXX
month.
A4608 ................ X Transtracheal oxygen 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cath.
A4611 ................ X Heavy duty battery.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4612 ................ X Battery cables........ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4613 ................ X Battery charger....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4614 ................ X Hand-held PEFR meter.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4615 ................ X Cannula nasal......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4616 ................ X Tubing (oxygen) per 0.00 0.00 0.00 0.00 0.00 0.00 XXX
foot.
A4617 ................ X Mouth piece........... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4618 ................ X Breathing circuits.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4619 ................ X Face tent............. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4620 ................ X Variable concentration 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mask.
A4621 ................ X Tracheotomy mask or 0.00 0.00 0.00 0.00 0.00 0.00 XXX
collar.
A4622 ................ X Tracheostomy or 0.00 0.00 0.00 0.00 0.00 0.00 XXX
larngectomy.
A4623 ................ X Tracheostomy inner 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cannula.
A4624 ................ X Tracheal suction tube. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4625 ................ X Trach care kit for new 0.00 0.00 0.00 0.00 0.00 0.00 XXX
trach.
A4626 ................ X Tracheostomy cleaning 0.00 0.00 0.00 0.00 0.00 0.00 XXX
brush.
A4627 ................ N Spacer bag/reservoir.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4628 ................ X Oropharyngeal suction 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cath.
A4629 ................ X Tracheostomy care kit. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4630 ................ X Repl bat t.e.n.s. own 0.00 0.00 0.00 0.00 0.00 0.00 XXX
by pt.
A4631 ................ X Wheelchair battery.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4635 ................ X Underarm crutch pad... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4636 ................ X Handgrip for cane etc. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4637 ................ X Repl tip cane/crutch/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
walker.
A4640 ................ X Alternating pressure 0.00 0.00 0.00 0.00 0.00 0.00 XXX
pad.
A4641 ................ E Diagnostic imaging 0.00 0.00 0.00 0.00 0.00 0.00 XXX
agent.
A4642 ................ E Satumomab pendetide 0.00 0.00 0.00 0.00 0.00 0.00 XXX
per dose.
A4643 ................ E High dose contrast MRI 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4644 ................ E Contrast 100-199 MGs 0.00 0.00 0.00 0.00 0.00 0.00 XXX
iodine.
A4645 ................ E Contrast 200-299 MGs 0.00 0.00 0.00 0.00 0.00 0.00 XXX
iodine.
A4646 ................ E Contrast 300-399 MGs 0.00 0.00 0.00 0.00 0.00 0.00 XXX
iodine.
A4647 ................ B Supp- paramagnetic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
contr mat.
A4649 ................ P Surgical supplies..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4650 ................ D Supp esrd centrifuge.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4651 ................ X Calibrated microcap 0.00 0.00 0.00 0.00 0.00 0.00 XXX
tube.
A4652 ................ X Microcapillary tube 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sealant.
A4655 ................ D Esrd syringe/needle... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4656 ................ X Dialysis needle....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4657 ................ X Dialysis syringe w/wo 0.00 0.00 0.00 0.00 0.00 0.00 XXX
needle.
A4660 ................ X Sphyg/bp app w cuff 0.00 0.00 0.00 0.00 0.00 0.00 XXX
and stet.
A4663 ................ X Dialysis blood 0.00 0.00 0.00 0.00 0.00 0.00 XXX
pressure cuff.
A4670 ................ N Automatic bp monitor, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dial.
A4680 ................ X Actificial carbon 0.00 0.00 0.00 0.00 0.00 0.00 XXX
filter, ea.
A4690 ................ X Dialyzer, each........ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4700 ................ D Standard dialysate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
solution.
A4705 ................ D Bicarb dialysate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
solution.
A4706 ................ X Bicarbonate conc sol 0.00 0.00 0.00 0.00 0.00 0.00 XXX
per gal.
A4707 ................ X Bicarbonate conc pow 0.00 0.00 0.00 0.00 0.00 0.00 XXX
per pac.
A4708 ................ X Acetate conc sol per 0.00 0.00 0.00 0.00 0.00 0.00 XXX
gallon.
A4709 ................ X Acid conc sol per 0.00 0.00 0.00 0.00 0.00 0.00 XXX
gallon.
A4712 ................ X Sterile water inj per 0.00 0.00 0.00 0.00 0.00 0.00 XXX
10 ml.
A4714 ................ X Treated water per 0.00 0.00 0.00 0.00 0.00 0.00 XXX
gallon.
A4719 ................ X ``Y set'' tubing...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4720 ................ X Dialysat sol fld vol > 0.00 0.00 0.00 0.00 0.00 0.00 XXX
249cc.
A4721 ................ X Dialysat sol fld vol > 0.00 0.00 0.00 0.00 0.00 0.00 XXX
999cc.
A4722 ................ X Dialys sol fld vol > 0.00 0.00 0.00 0.00 0.00 0.00 XXX
1999cc.
A4723 ................ X Dialys sol fld vol > 0.00 0.00 0.00 0.00 0.00 0.00 XXX
2999cc.
A4724 ................ X Dialys sol fld vol > 0.00 0.00 0.00 0.00 0.00 0.00 XXX
3999cc.
A4725 ................ X Dialys sol fld vol > 0.00 0.00 0.00 0.00 0.00 0.00 XXX
4999cc.
A4726 ................ X Dialys sol fld vol > 0.00 0.00 0.00 0.00 0.00 0.00 XXX
5999cc.
A4730 ................ X Fistula cannulation 0.00 0.00 0.00 0.00 0.00 0.00 XXX
set, ea.
A4735 ................ D Local/topical 0.00 0.00 0.00 0.00 0.00 0.00 XXX
anesthetics.
[[Page 55471]]
A4736 ................ X Topical anesthetic, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
per gram.
A4737 ................ X Inj anesthetic per 10 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ml.
A4740 ................ X Shunt accessory....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4750 ................ X Art or venous blood 0.00 0.00 0.00 0.00 0.00 0.00 XXX
tubing.
A4755 ................ X Comb art/venous blood 0.00 0.00 0.00 0.00 0.00 0.00 XXX
tubing.
A4760 ................ X Dialysate sol test 0.00 0.00 0.00 0.00 0.00 0.00 XXX
kit, each.
A4765 ................ X Dialysate conc pow per 0.00 0.00 0.00 0.00 0.00 0.00 XXX
pack.
A4766 ................ X Dialysate conc sol add 0.00 0.00 0.00 0.00 0.00 0.00 XXX
10 ml.
A4770 ................ X Blood collection tube/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
vacuum.
A4771 ................ X Serum clotting time 0.00 0.00 0.00 0.00 0.00 0.00 XXX
tube.
A4772 ................ X Blood glucose test 0.00 0.00 0.00 0.00 0.00 0.00 XXX
strips.
A4773 ................ X Occult blood test 0.00 0.00 0.00 0.00 0.00 0.00 XXX
strips.
A4774 ................ X Ammonia test strips... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4780 ................ D Esrd sterilizing agent 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4790 ................ D Esrd cleansing agents. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4800 ................ D Heparin/antidote 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dialysis.
A4801 ................ X Heparin per 1000 units 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4802 ................ X Protamine sulfate per 0.00 0.00 0.00 0.00 0.00 0.00 XXX
50 mg.
A4820 ................ D Supplies hemodialysis 0.00 0.00 0.00 0.00 0.00 0.00 XXX
kit.
A4850 ................ D Rubber tipped 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hemostats.
A4860 ................ X Disposable catheter 0.00 0.00 0.00 0.00 0.00 0.00 XXX
tips.
A4870 ................ X Plumb/elec wk hm hemo 0.00 0.00 0.00 0.00 0.00 0.00 XXX
equip.
A4880 ................ D Water storage tanks... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4890 ................ R Repair/maint cont hemo 0.00 0.00 0.00 0.00 0.00 0.00 XXX
equip.
A4900 ................ D Capd supply kit....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4901 ................ D Ccpd supply kit....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4905 ................ D Ipd supply kit........ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4910 ................ D Esrd nonmedical 0.00 0.00 0.00 0.00 0.00 0.00 XXX
supplies.
A4911 ................ X Drain bag/bottle...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4912 ................ D Gomco drain bottle.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4913 ................ X Misc dialysis supplies 0.00 0.00 0.00 0.00 0.00 0.00 XXX
noc.
A4914 ................ D Preparation kit....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4918 ................ X Venous pressure clamp. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4919 ................ D Supp dialysis dialyzer 0.00 0.00 0.00 0.00 0.00 0.00 XXX
holde.
A4920 ................ D Harvard pressure clamp 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4921 ................ D Measuring cylinder.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4927 ................ X Non-sterile gloves.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4928 ................ X Surgical mask......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A4929 ................ X Tourniquet for 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dialysis, ea.
A5051 ................ P Pouch clsd w barr 0.00 0.00 0.00 0.00 0.00 0.00 XXX
attached.
A5052 ................ P Clsd ostomy pouch w/o 0.00 0.00 0.00 0.00 0.00 0.00 XXX
barr.
A5053 ................ P Clsd ostomy pouch 0.00 0.00 0.00 0.00 0.00 0.00 XXX
faceplate.
A5054 ................ P Clsd ostomy pouch w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
flange.
A5055 ................ P Stoma cap............. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A5061 ................ P Pouch drainable w 0.00 0.00 0.00 0.00 0.00 0.00 XXX
barrier at.
A5062 ................ P Drnble ostomy pouch w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
o barr.
A5063 ................ P Drain ostomy pouch w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
flange.
A5064 ................ D Drain ostomy pouch w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
fceplte.
A5071 ................ P Urinary pouch w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
barrier.
A5072 ................ P Urinary pouch w/o 0.00 0.00 0.00 0.00 0.00 0.00 XXX
barrier.
A5073 ................ P Urinary pouch on barr 0.00 0.00 0.00 0.00 0.00 0.00 XXX
w/flng.
A5074 ................ D Urinary pouch w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
faceplate.
A5075 ................ D Urinary pouch on 0.00 0.00 0.00 0.00 0.00 0.00 XXX
faceplate.
A5081 ................ P Continent stoma plug.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A5082 ................ P Continent stoma 0.00 0.00 0.00 0.00 0.00 0.00 XXX
catheter.
A5093 ................ P Ostomy accessory 0.00 0.00 0.00 0.00 0.00 0.00 XXX
convex inse.
A5102 ................ P Bedside drain btl w/wo 0.00 0.00 0.00 0.00 0.00 0.00 XXX
tube.
A5105 ................ P Urinary suspensory.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A5112 ................ P Urinary leg bag....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A5113 ................ P Latex leg strap....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A5114 ................ P Foam/fabric leg strap. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A5119 ................ P Skin barrier wipes box 0.00 0.00 0.00 0.00 0.00 0.00 XXX
pr 50.
A5121 ................ P Solid skin barrier 6x6 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A5122 ................ P Solid skin barrier 8x8 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A5123 ................ P Skin barrier with 0.00 0.00 0.00 0.00 0.00 0.00 XXX
flange.
A5126 ................ P Disk/foam pad + or - 0.00 0.00 0.00 0.00 0.00 0.00 XXX
adhesive.
A5131 ................ P Appliance cleaner..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A5200 ................ X Percutaneous catheter 0.00 0.00 0.00 0.00 0.00 0.00 XXX
anchor.
A5500 ................ X Diab shoe for density 0.00 0.00 0.00 0.00 0.00 0.00 XXX
insert.
A5501 ................ X Diabetic custom molded 0.00 0.00 0.00 0.00 0.00 0.00 XXX
shoe.
A5502 ................ D Diabetic shoe density 0.00 0.00 0.00 0.00 0.00 0.00 XXX
insert.
A5503 ................ X Diabetic shoe w/roller/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
rockr.
A5504 ................ X Diabetic shoe with 0.00 0.00 0.00 0.00 0.00 0.00 XXX
wedge.
[[Page 55472]]
A5505 ................ X Diab shoe w/metatarsal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
bar.
A5506 ................ X Diabetic shoe w/off 0.00 0.00 0.00 0.00 0.00 0.00 XXX
set heel.
A5507 ................ X Modification diabetic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
shoe.
A5508 ................ X Diabetic deluxe shoe.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A5509 ................ X Direct heat form shoe 0.00 0.00 0.00 0.00 0.00 0.00 XXX
insert.
A5510 ................ X Compression form shoe 0.00 0.00 0.00 0.00 0.00 0.00 XXX
insert.
A5511 ................ X Custom fab molded shoe 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inser.
A6000 ................ X Wound warming wound 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cover.
A6010 ................ X Collagen based wound 0.00 0.00 0.00 0.00 0.00 0.00 XXX
filler.
A6020 ................ D Collagen wound 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dressing.
A6021 ................ X Collagen dressing =16 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sq in.
A6022 ................ X Collagen drsg>6=48 sq 0.00 0.00 0.00 0.00 0.00 0.00 XXX
in.
A6023 ................ X Collagen dressing >48 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sq in.
A6024 ................ X Collagen dsg wound 0.00 0.00 0.00 0.00 0.00 0.00 XXX
filler.
A6025 ................ I Silicone gel sheet, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
each.
A6154 ................ P Wound pouch each...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A6196 ................ P Alginate dressing =16 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sq in.
A6197 ................ P Alginate drsg >16 =48 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sq in.
A6198 ................ P alginate dressing >48 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sq in.
A6199 ................ P Alginate drsg wound 0.00 0.00 0.00 0.00 0.00 0.00 XXX
filler.
A6200 ................ X Compos drsg =16 no 0.00 0.00 0.00 0.00 0.00 0.00 XXX
border.
A6201 ................ X Compos drsg >16=48 no 0.00 0.00 0.00 0.00 0.00 0.00 XXX
bdr.
A6202 ................ X Compos drsg >48 no 0.00 0.00 0.00 0.00 0.00 0.00 XXX
border.
A6203 ................ P Composite drsg =16 sq 0.00 0.00 0.00 0.00 0.00 0.00 XXX
in.
A6204 ................ P Composite drsg >16=48 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sq in.
A6205 ................ P Composite drsg >48 sq 0.00 0.00 0.00 0.00 0.00 0.00 XXX
in.
A6206 ................ P Contact layer =16 sq 0.00 0.00 0.00 0.00 0.00 0.00 XXX
in.
A6207 ................ P Contact layer >16=48 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sq in.
A6208 ................ P Contact layer >48 sq 0.00 0.00 0.00 0.00 0.00 0.00 XXX
in.
A6209 ................ P Foam drsg =16 sq in w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
o bdr.
A6210 ................ P Foam drg >16=48 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX
w/o b.
A6211 ................ P Foam drg >48 sq in w/o 0.00 0.00 0.00 0.00 0.00 0.00 XXX
brdr.
A6212 ................ P Foam drg =16 sq in w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
border.
A6213 ................ P Foam drg >16=48 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX
w/bdr.
A6214 ................ P Foam drg >48 sq in w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
border.
A6215 ................ P Foam dressing wound 0.00 0.00 0.00 0.00 0.00 0.00 XXX
filler.
A6216 ................ P Non-sterile gauze =16 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sq in.
A6217 ................ P Non-sterile gauze 0.00 0.00 0.00 0.00 0.00 0.00 XXX
>16=48 sq.
A6218 ................ P Non-sterile gauze >48 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sq in.
A6219 ................ P Gauze =16 sq in w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
border.
A6220 ................ P Gauze >16 =48 sq in w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
bordr.
A6221 ................ P Gauze >48 sq in w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
border.
A6222 ................ P Gauze =16 in no w/sal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
w/o b.
A6223 ................ P Gauze >16=48 no w/sal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
w/o b.
A6224 ................ P Gauze >48 in no w/sal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
w/o b.
A6228 ................ P Gauze =16 sq in water/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sal.
A6229 ................ P Gauze >16=48 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX
watr/sal.
A6230 ................ P Gauze >48 sq in water/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
salne.
A6231 ................ X Hydrogel dsg =16 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A6232 ................ X Hydrogel dsg >16=48 sq 0.00 0.00 0.00 0.00 0.00 0.00 XXX
in.
A6233 ................ X Hydrogel dressing >48 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sq in.
A6234 ................ P Hydrocolld drg =16 w/o 0.00 0.00 0.00 0.00 0.00 0.00 XXX
bdr.
A6235 ................ P Hydrocolld drg >16=48 0.00 0.00 0.00 0.00 0.00 0.00 XXX
w/o b.
A6236 ................ P Hydrocolld drg >48 in 0.00 0.00 0.00 0.00 0.00 0.00 XXX
w/o b.
A6237 ................ P Hydrocolld drg =16 in 0.00 0.00 0.00 0.00 0.00 0.00 XXX
w/bdr.
A6238 ................ P Hydrocolld drg >16=48 0.00 0.00 0.00 0.00 0.00 0.00 XXX
w/bdr.
A6239 ................ P Hydrocolld drg >48 in 0.00 0.00 0.00 0.00 0.00 0.00 XXX
w/bdr.
A6240 ................ P Hydrocolld drg filler 0.00 0.00 0.00 0.00 0.00 0.00 XXX
paste.
A6241 ................ P Hydrocolloid drg 0.00 0.00 0.00 0.00 0.00 0.00 XXX
filler dry.
A6242 ................ P Hydrogel drg =16 in w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
o bdr.
A6243 ................ P Hydrogel drg >16=48 w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
o bdr.
A6244 ................ P Hydrogel drg >48 in w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
o bdr.
A6245 ................ P Hydrogel drg =16 in w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
bdr.
A6246 ................ P Hydrogel drg >16=48 in 0.00 0.00 0.00 0.00 0.00 0.00 XXX
w/b.
A6247 ................ P Hydrogel drg >48 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX
w/b.
A6248 ................ P Hydrogel drsg gel 0.00 0.00 0.00 0.00 0.00 0.00 XXX
filler.
A6250 ................ P Skin seal protect 0.00 0.00 0.00 0.00 0.00 0.00 XXX
moisturizr.
A6251 ................ P Absorpt drg =16 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX
w/o b.
A6252 ................ P Absorpt drg >16=48 w/o 0.00 0.00 0.00 0.00 0.00 0.00 XXX
bdr.
A6253 ................ P Absorpt drg >48 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX
w/o b.
A6254 ................ P Absorpt drg =16 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX
w/bdr.
A6255 ................ P Absorpt drg >16=48 in 0.00 0.00 0.00 0.00 0.00 0.00 XXX
w/bdr.
A6256 ................ P Absorpt drg >48 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX
w/bdr.
[[Page 55473]]
A6257 ................ P Transparent film =16 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sq in.
A6258 ................ P Transparent film 0.00 0.00 0.00 0.00 0.00 0.00 XXX
>16=48 in.
A6259 ................ P Transparent film >48 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sq in.
A6260 ................ P Wound cleanser any 0.00 0.00 0.00 0.00 0.00 0.00 XXX
type/size.
A6261 ................ P Wound filler gel/paste/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
oz.
A6262 ................ P Wound filler dry form/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
gram.
A6263 ................ P Non-sterile elastic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
gauze/yd.
A6264 ................ P Non-sterile no elastic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
gauze.
A6265 ................ P Tape per 18 sq inches. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A6266 ................ P Impreg gauze no h20/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sal/yard.
A6402 ................ P Sterile gauze =16 sq 0.00 0.00 0.00 0.00 0.00 0.00 XXX
in.
A6403 ................ P Sterile gauze >16=48 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sq in.
A6404 ................ P Sterile gauze >48 sq 0.00 0.00 0.00 0.00 0.00 0.00 XXX
in.
A6405 ................ P Sterile elastic gauze/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
yd.
A6406 ................ P Sterile non-elastic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
gauze/yd.
A7000 ................ X Disposable canister 0.00 0.00 0.00 0.00 0.00 0.00 XXX
for pump.
A7001 ................ X Nondisposable pump 0.00 0.00 0.00 0.00 0.00 0.00 XXX
canister.
A7002 ................ X Tubing used w suction 0.00 0.00 0.00 0.00 0.00 0.00 XXX
pump.
A7003 ................ X Nebulizer 0.00 0.00 0.00 0.00 0.00 0.00 XXX
administration set.
A7004 ................ X Disposable nebulizer 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sml vol.
A7005 ................ X Nondisposable 0.00 0.00 0.00 0.00 0.00 0.00 XXX
nebulizer set.
A7006 ................ X Filtered nebulizer 0.00 0.00 0.00 0.00 0.00 0.00 XXX
admin set.
A7007 ................ X Lg vol nebulizer 0.00 0.00 0.00 0.00 0.00 0.00 XXX
disposable.
A7008 ................ X Disposable nebulizer 0.00 0.00 0.00 0.00 0.00 0.00 XXX
prefill.
A7009 ................ X Nebulizer reservoir 0.00 0.00 0.00 0.00 0.00 0.00 XXX
bottle.
A7010 ................ X Disposable corrugated 0.00 0.00 0.00 0.00 0.00 0.00 XXX
tubing.
A7011 ................ X Nondispos corrugated 0.00 0.00 0.00 0.00 0.00 0.00 XXX
tubing.
A7012 ................ X Nebulizer water collec 0.00 0.00 0.00 0.00 0.00 0.00 XXX
devic.
A7013 ................ X Disposable compressor 0.00 0.00 0.00 0.00 0.00 0.00 XXX
filter.
A7014 ................ X Compressor nondispos 0.00 0.00 0.00 0.00 0.00 0.00 XXX
filter.
A7015 ................ X Aerosol mask used w 0.00 0.00 0.00 0.00 0.00 0.00 XXX
nebulize.
A7016 ................ X Nebulizer dome & 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mouthpiece.
A7017 ................ X Nebulizer not used w 0.00 0.00 0.00 0.00 0.00 0.00 XXX
oxygen.
A7018 ................ X Water distilled w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
nebulizer.
A7019 ................ X Saline solution 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dispenser.
A7020 ................ X Sterile H2O or NSS w 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lgv neb.
A7501 ................ X Tracheostoma valve w 0.00 0.00 0.00 0.00 0.00 0.00 XXX
diaphra.
A7502 ................ X Replacement diaphragm/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
fplate.
A7503 ................ X HMES filter holder or 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cap.
A7504 ................ X Tracheostoma HMES 0.00 0.00 0.00 0.00 0.00 0.00 XXX
filter.
A7505 ................ X HMES or trach valve 0.00 0.00 0.00 0.00 0.00 0.00 XXX
housing.
A7506 ................ X HMES/trachvalve 0.00 0.00 0.00 0.00 0.00 0.00 XXX
adhesive disk.
A7507 ................ X Integrated filter & 0.00 0.00 0.00 0.00 0.00 0.00 XXX
holder.
A7508 ................ X Housing & Integrated 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Adhesiv.
A7509 ................ X Heat & moisture 0.00 0.00 0.00 0.00 0.00 0.00 XXX
exchange sys.
A9150 ................ E Misc/exper non- 0.00 0.00 0.00 0.00 0.00 0.00 XXX
prescript dru.
A9160 ................ D Podiatrist non-covered 0.00 0.00 0.00 0.00 0.00 0.00 XXX
servi.
A9170 ................ D Chiropractor non- 0.00 0.00 0.00 0.00 0.00 0.00 XXX
covered ser.
A9190 ................ D Misc/expe personal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
comfort i.
A9270 ................ N Non-covered item or 0.00 0.00 0.00 0.00 0.00 0.00 XXX
service.
A9300 ................ N Exercise equipment.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A9500 ................ E Technetium TC 99m 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sestamibi.
A9502 ................ X Technetium TC 99M 0.00 0.00 0.00 0.00 0.00 0.00 XXX
tetrofosmin.
A9503 ................ E Technetium TC 99m 0.00 0.00 0.00 0.00 0.00 0.00 XXX
medronate.
A9504 ................ X Technetium tc 99m 0.00 0.00 0.00 0.00 0.00 0.00 XXX
apcitide.
A9505 ................ E Thallous chloride TL 0.00 0.00 0.00 0.00 0.00 0.00 XXX
201/mci.
A9507 ................ X Indium/111 capromab 0.00 0.00 0.00 0.00 0.00 0.00 XXX
pendetid.
A9508 ................ X Iobenguane sulfate I- 0.00 0.00 0.00 0.00 0.00 0.00 XXX
131.
A9510 ................ X Technetium TC99m 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Disofenin.
A9511 ................ X Technetium TC 99m 0.00 0.00 0.00 0.00 0.00 0.00 XXX
depreotide.
A9600 ................ X Strontium-89 chloride. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
A9605 ................ X Samarium sm153 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lexidronamm.
A9700 ................ X Echocardiography 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Contrast.
A9900 ................ X Supply/accessory/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
service.
A9901 ................ X Delivery/set up/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dispensing.
D0120 ................ N Periodic oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX
evaluation.
D0140 ................ N Limit oral eval problm 0.00 0.00 0.00 0.00 0.00 0.00 XXX
focus.
D0150 ................ R Comprehensve oral 0.00 0.00 0.00 0.00 0.00 0.00 YYY
evaluation.
D0160 ................ N Extensv oral eval prob 0.00 0.00 0.00 0.00 0.00 0.00 XXX
focus.
D0170 ................ N Re-eval,est pt,problem 0.00 0.00 0.00 0.00 0.00 0.00 XXX
focus.
D0210 ................ I Intraor complete film 0.00 0.00 0.00 0.00 0.00 0.00 XXX
series.
D0220 ................ I Intraoral periapical 0.00 0.00 0.00 0.00 0.00 0.00 XXX
first f.
D0230 ................ I Intraoral periapical 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ea add.
[[Page 55474]]
D0240 ................ R Intraoral occlusal 0.00 0.00 0.00 0.00 0.00 0.00 YYY
film.
D0250 ................ R Extraoral first film.. 0.00 0.00 0.00 0.00 0.00 0.00 YYY
D0260 ................ R Extraoral ea 0.00 0.00 0.00 0.00 0.00 0.00 YYY
additional film.
D0270 ................ R Dental bitewing single 0.00 0.00 0.00 0.00 0.00 0.00 YYY
film.
D0272 ................ R Dental bitewings two 0.00 0.00 0.00 0.00 0.00 0.00 YYY
films.
D0274 ................ R Dental bitewings four 0.00 0.00 0.00 0.00 0.00 0.00 YYY
films.
D0277 ................ R Vert bitewings-sev to 0.00 0.00 0.00 0.00 0.00 0.00 XXX
eight.
D0290 ................ I Dental film skull/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
facial bon.
D0310 ................ I Dental saliography.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D0320 ................ I Dental tmj arthrogram 0.00 0.00 0.00 0.00 0.00 0.00 XXX
incl i.
D0321 ................ I Dental other tmj films 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D0322 ................ I Dental tomographic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
survey.
D0330 ................ I Dental panoramic film. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D0340 ................ I Dental cephalometric 0.00 0.00 0.00 0.00 0.00 0.00 XXX
film.
D0350 ................ I Oral/facial images.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D0415 ................ N Bacteriologic study... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D0425 ................ N Caries susceptibility 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
D0460 ................ R Pulp vitality test.... 0.00 0.00 0.00 0.00 0.00 0.00 YYY
D0470 ................ N Diagnostic casts...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D0472 ................ R Gross exam, prep & 0.00 0.00 0.00 0.00 0.00 0.00 XXX
report.
D0473 ................ R Micro exam, prep & 0.00 0.00 0.00 0.00 0.00 0.00 XXX
report.
D0474 ................ R Micro w/exam of surg 0.00 0.00 0.00 0.00 0.00 0.00 XXX
margins.
D0480 ................ R Cytopath smear prep & 0.00 0.00 0.00 0.00 0.00 0.00 XXX
report.
D0501 ................ R Histopathologic 0.00 0.00 0.00 0.00 0.00 0.00 YYY
examinations.
D0502 ................ R Other oral pathology 0.00 0.00 0.00 0.00 0.00 0.00 YYY
procedu.
D0999 ................ R Unspecified diagnostic 0.00 0.00 0.00 0.00 0.00 0.00 YYY
proce.
D1110 ................ N Dental prophylaxis 0.00 0.00 0.00 0.00 0.00 0.00 XXX
adult.
D1120 ................ N Dental prophylaxis 0.00 0.00 0.00 0.00 0.00 0.00 XXX
child.
D1201 ................ N Topical fluor w/prophy 0.00 0.00 0.00 0.00 0.00 0.00 XXX
child.
D1203 ................ N Topical fluor w/o 0.00 0.00 0.00 0.00 0.00 0.00 XXX
prophy chi.
D1204 ................ N Topical fluor w/o 0.00 0.00 0.00 0.00 0.00 0.00 XXX
prophy adu.
D1205 ................ N Topical fluoride w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
prophy a.
D1310 ................ N Nutri counsel-control 0.00 0.00 0.00 0.00 0.00 0.00 XXX
caries.
D1320 ................ N Tobacco counseling.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D1330 ................ N Oral hygiene 0.00 0.00 0.00 0.00 0.00 0.00 XXX
instruction.
D1351 ................ N Dental sealant per 0.00 0.00 0.00 0.00 0.00 0.00 XXX
tooth.
D1510 ................ R Space maintainer fxd 0.00 0.00 0.00 0.00 0.00 0.00 YYY
unilat.
D1515 ................ R Fixed bilat space 0.00 0.00 0.00 0.00 0.00 0.00 YYY
maintainer.
D1520 ................ R Remove unilat space 0.00 0.00 0.00 0.00 0.00 0.00 YYY
maintain.
D1525 ................ R Remove bilat space 0.00 0.00 0.00 0.00 0.00 0.00 YYY
maintain.
D1550 ................ R Recement space 0.00 0.00 0.00 0.00 0.00 0.00 YYY
maintainer.
D2110 ................ N Amalgam one surface 0.00 0.00 0.00 0.00 0.00 0.00 XXX
primary.
D2120 ................ N Amalgam two surfaces 0.00 0.00 0.00 0.00 0.00 0.00 XXX
primary.
D2130 ................ N Amalgam three surfaces 0.00 0.00 0.00 0.00 0.00 0.00 XXX
prima.
D2131 ................ N Amalgam four/more surf 0.00 0.00 0.00 0.00 0.00 0.00 XXX
prima.
D2140 ................ N Amalgam one surface 0.00 0.00 0.00 0.00 0.00 0.00 XXX
permanen.
D2150 ................ N Amalgam two surfaces 0.00 0.00 0.00 0.00 0.00 0.00 XXX
permane.
D2160 ................ N Amalgam three surfaces 0.00 0.00 0.00 0.00 0.00 0.00 XXX
perma.
D2161 ................ N Amalgam 4 or > 0.00 0.00 0.00 0.00 0.00 0.00 XXX
surfaces perm.
D2330 ................ N Resin one surface- 0.00 0.00 0.00 0.00 0.00 0.00 XXX
anterior.
D2331 ................ N Resin two surfaces- 0.00 0.00 0.00 0.00 0.00 0.00 XXX
anterior.
D2332 ................ N Resin three surfaces- 0.00 0.00 0.00 0.00 0.00 0.00 XXX
anterio.
D2335 ................ N Resin 4/> surf or w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
incis an.
D2336 ................ N Composite resin crown. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D2337 ................ N Compo resin crown ant- 0.00 0.00 0.00 0.00 0.00 0.00 XXX
perm.
D2380 ................ N Resin one surf poster 0.00 0.00 0.00 0.00 0.00 0.00 XXX
primar.
D2381 ................ N Resin two surf poster 0.00 0.00 0.00 0.00 0.00 0.00 XXX
primar.
D2382 ................ N Resin three/more surf 0.00 0.00 0.00 0.00 0.00 0.00 XXX
post p.
D2385 ................ N Resin one surf poster 0.00 0.00 0.00 0.00 0.00 0.00 XXX
perman.
D2386 ................ N Resin two surf poster 0.00 0.00 0.00 0.00 0.00 0.00 XXX
perman.
D2387 ................ N Resin three/more surf 0.00 0.00 0.00 0.00 0.00 0.00 XXX
post p.
D2388 ................ N Resin four/more, post 0.00 0.00 0.00 0.00 0.00 0.00 XXX
perm.
D2410 ................ N Dental gold foil one 0.00 0.00 0.00 0.00 0.00 0.00 XXX
surface.
D2420 ................ N Dental gold foil two 0.00 0.00 0.00 0.00 0.00 0.00 XXX
surface.
D2430 ................ N Dental gold foil three 0.00 0.00 0.00 0.00 0.00 0.00 XXX
surfa.
D2510 ................ N Dental inlay metalic 1 0.00 0.00 0.00 0.00 0.00 0.00 XXX
surf.
D2520 ................ N Dental inlay metallic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
2 surf.
D2530 ................ N Dental inlay metl 3/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
more sur.
D2542 ................ N Dental onlay metallic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
2 surf.
D2543 ................ N Dental onlay metallic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
3 surf.
D2544 ................ N Dental onlay metl 4/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
more sur.
D2610 ................ N Inlay porcelain/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ceramic 1 su.
D2620 ................ N Inlay porcelain/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ceramic 2 su.
[[Page 55475]]
D2630 ................ N Dental onlay porc 3/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
more sur.
D2642 ................ N Dental onlay porcelin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
2 surf.
D2643 ................ N Dental onlay porcelin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
3 surf.
D2644 ................ N Dental onlay porc 4/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
more sur.
D2650 ................ N Inlay composite/resin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
one su.
D2651 ................ N Inlay composite/resin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
two su.
D2652 ................ N Dental inlay resin 3/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mre sur.
D2662 ................ N Dental onlay resin 2 0.00 0.00 0.00 0.00 0.00 0.00 XXX
surface.
D2663 ................ N Dental onlay resin 3 0.00 0.00 0.00 0.00 0.00 0.00 XXX
surface.
D2664 ................ N Dental onlay resin 4/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
more sur.
D2710 ................ N Crown resin laboratory 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D2720 ................ N Crown resin w/high 0.00 0.00 0.00 0.00 0.00 0.00 XXX
noble me.
D2721 ................ N Crown resin w/base 0.00 0.00 0.00 0.00 0.00 0.00 XXX
metal.
D2722 ................ N Crown resin w/noble 0.00 0.00 0.00 0.00 0.00 0.00 XXX
metal.
D2740 ................ N Crown porcelain/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ceramic subs.
D2750 ................ N Crown porcelain w/h 0.00 0.00 0.00 0.00 0.00 0.00 XXX
noble m.
D2751 ................ N Crown porcelain fused 0.00 0.00 0.00 0.00 0.00 0.00 XXX
base m.
D2752 ................ N Crown porcelain w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
noble met.
D2780 ................ N Crown 3/4 cast hi 0.00 0.00 0.00 0.00 0.00 0.00 XXX
noble met.
D2781 ................ N Crown 3/4 cast base 0.00 0.00 0.00 0.00 0.00 0.00 XXX
metal.
D2782 ................ N Crown \3/4\ cast noble 0.00 0.00 0.00 0.00 0.00 0.00 XXX
metal.
D2783 ................ N Crown \3/4\ porcelain/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ceramic.
D2790 ................ N Crown full cast high 0.00 0.00 0.00 0.00 0.00 0.00 XXX
noble m.
D2791 ................ N Crown full cast base 0.00 0.00 0.00 0.00 0.00 0.00 XXX
metal.
D2792 ................ N Crown full cast noble 0.00 0.00 0.00 0.00 0.00 0.00 XXX
metal.
D2799 ................ N Provisional crown..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D2910 ................ N Dental recement inlay. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D2920 ................ N Dental recement crown. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D2930 ................ N Prefab stnlss steel 0.00 0.00 0.00 0.00 0.00 0.00 XXX
crwn pri.
D2931 ................ N Prefab stnlss steel 0.00 0.00 0.00 0.00 0.00 0.00 XXX
crown pe.
D2932 ................ N Prefabricated resin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
crown.
D2933 ................ N Prefab stainless steel 0.00 0.00 0.00 0.00 0.00 0.00 XXX
crown.
D2940 ................ N Dental sedative 0.00 0.00 0.00 0.00 0.00 0.00 XXX
filling.
D2950 ................ N Core build-up incl any 0.00 0.00 0.00 0.00 0.00 0.00 XXX
pins.
D2951 ................ N Tooth pin retention... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D2952 ................ N Post and core cast + 0.00 0.00 0.00 0.00 0.00 0.00 XXX
crown.
D2953 ................ N Each addtnl cast post. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D2954 ................ N Prefab post/core + 0.00 0.00 0.00 0.00 0.00 0.00 XXX
crown.
D2955 ................ N Post removal.......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D2957 ................ N Each addtnl prefab 0.00 0.00 0.00 0.00 0.00 0.00 XXX
post.
D2960 ................ N Laminate labial veneer 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D2961 ................ N Lab labial veneer 0.00 0.00 0.00 0.00 0.00 0.00 XXX
resin.
D2962 ................ N Lab labial veneer 0.00 0.00 0.00 0.00 0.00 0.00 XXX
porcelain.
D2970 ................ R Temporary-fractured 0.00 0.00 0.00 0.00 0.00 0.00 YYY
tooth.
D2980 ................ N Crown repair.......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D2999 ................ R Dental unspec 0.00 0.00 0.00 0.00 0.00 0.00 YYY
restorative pr.
D3110 ................ N Pulp cap direct....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D3120 ................ N Pulp cap indirect..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D3220 ................ N Therapeutic pulpotomy. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D3221 ................ N Gross pulpal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
debridement.
D3230 ................ N Pulpal therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX
anterior prim.
D3240 ................ N Pulpal therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX
posterior pri.
D3310 ................ N Anterior.............. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D3320 ................ N Root canal therapy 2 0.00 0.00 0.00 0.00 0.00 0.00 XXX
canals.
D3330 ................ N Root canal therapy 3 0.00 0.00 0.00 0.00 0.00 0.00 XXX
canals.
D3331 ................ N Non-surg tx root canal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
obs.
D3332 ................ N Incomplete endodontic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
tx.
D3333 ................ N Internal root repair.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D3346 ................ N Retreat root canal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
anterior.
D3347 ................ N Retreat root canal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
bicuspid.
D3348 ................ N Retreat root canal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
molar.
D3351 ................ N Apexification/recalc 0.00 0.00 0.00 0.00 0.00 0.00 XXX
initial.
D3352 ................ N Apexification/recalc 0.00 0.00 0.00 0.00 0.00 0.00 XXX
interim.
D3353 ................ N Apexification/recalc 0.00 0.00 0.00 0.00 0.00 0.00 XXX
final.
D3410 ................ N Apicoect/perirad surg 0.00 0.00 0.00 0.00 0.00 0.00 XXX
anter.
D3421 ................ N Root surgery bicuspid. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D3425 ................ N Root surgery molar.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D3426 ................ N Root surgery ea add 0.00 0.00 0.00 0.00 0.00 0.00 XXX
root.
D3430 ................ N Retrograde filling.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D3450 ................ N Root amputation....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D3460 ................ R Endodontic endosseous 0.00 0.00 0.00 0.00 0.00 0.00 YYY
implan.
D3470 ................ N Intentional 0.00 0.00 0.00 0.00 0.00 0.00 XXX
replantation.
D3910 ................ N Isolation-tooth w/rubb 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dam.
[[Page 55476]]
D3920 ................ N Tooth splitting....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D3950 ................ N Canal prep/fitting of 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dowel.
D3999 ................ R Endodontic procedure.. 0.00 0.00 0.00 0.00 0.00 0.00 YYY
D4210 ................ I Gingivectomy/plasty 0.00 0.00 0.00 0.00 0.00 0.00 XXX
per quad.
D4211 ................ I Gingivectomy/plasty 0.00 0.00 0.00 0.00 0.00 0.00 XXX
per toot.
D4220 ................ N Gingival curettage per 0.00 0.00 0.00 0.00 0.00 0.00 XXX
quadr.
D4240 ................ N Gingival flap proc w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
planin.
D4245 ................ N Apically positioned 0.00 0.00 0.00 0.00 0.00 0.00 XXX
flap.
D4249 ................ N Crown lengthen hard 0.00 0.00 0.00 0.00 0.00 0.00 XXX
tissue.
D4260 ................ R Osseous surgery per 0.00 0.00 0.00 0.00 0.00 0.00 YYY
quadrant.
D4263 ................ R Bone replce graft 0.00 0.00 0.00 0.00 0.00 0.00 YYY
first site.
D4264 ................ R Bone replce graft each 0.00 0.00 0.00 0.00 0.00 0.00 YYY
add.
D4266 ................ N Guided tiss regen 0.00 0.00 0.00 0.00 0.00 0.00 XXX
resorble.
D4267 ................ N Guided tiss regen 0.00 0.00 0.00 0.00 0.00 0.00 XXX
nonresorb.
D4268 ................ R Surgical revision 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedure.
D4270 ................ R Pedicle soft tissue 0.00 0.00 0.00 0.00 0.00 0.00 YYY
graft pr.
D4271 ................ R Free soft tissue graft 0.00 0.00 0.00 0.00 0.00 0.00 YYY
proc.
D4273 ................ R Subepithelial tissue 0.00 0.00 0.00 0.00 0.00 0.00 YYY
graft.
D4274 ................ N Distal/proximal wedge 0.00 0.00 0.00 0.00 0.00 0.00 XXX
proc.
D4320 ................ N Provision splnt 0.00 0.00 0.00 0.00 0.00 0.00 XXX
intracoronal.
D4321 ................ N Provisional splint 0.00 0.00 0.00 0.00 0.00 0.00 XXX
extracoro.
D4341 ................ N Periodontal scaling & 0.00 0.00 0.00 0.00 0.00 0.00 XXX
root.
D4355 ................ R Full mouth debridement 0.00 0.00 0.00 0.00 0.00 0.00 YYY
D4381 ................ R Localized chemo 0.00 0.00 0.00 0.00 0.00 0.00 YYY
delivery.
D4910 ................ N Periodontal maint 0.00 0.00 0.00 0.00 0.00 0.00 XXX
procedures.
D4920 ................ N Unscheduled dressing 0.00 0.00 0.00 0.00 0.00 0.00 XXX
change.
D4999 ................ N Unspecified 0.00 0.00 0.00 0.00 0.00 0.00 XXX
periodontal proc.
D5110 ................ N Dentures complete 0.00 0.00 0.00 0.00 0.00 0.00 XXX
maxillary.
D5120 ................ N Dentures complete 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mandible.
D5130 ................ N Dentures immediat 0.00 0.00 0.00 0.00 0.00 0.00 XXX
maxillary.
D5140 ................ N Dentures immediat 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mandible.
D5211 ................ N Dentures maxill part 0.00 0.00 0.00 0.00 0.00 0.00 XXX
resin.
D5212 ................ N Dentures mand part 0.00 0.00 0.00 0.00 0.00 0.00 XXX
resin.
D5213 ................ N Dentures maxill part 0.00 0.00 0.00 0.00 0.00 0.00 XXX
metal.
D5214 ................ N Dentures mandibl part 0.00 0.00 0.00 0.00 0.00 0.00 XXX
metal.
D5281 ................ N Removable partial 0.00 0.00 0.00 0.00 0.00 0.00 XXX
denture.
D5410 ................ N Dentures adjust cmplt 0.00 0.00 0.00 0.00 0.00 0.00 XXX
maxil.
D5411 ................ N Dentures adjust cmplt 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mand.
D5421 ................ N Dentures adjust part 0.00 0.00 0.00 0.00 0.00 0.00 XXX
maxill.
D5422 ................ N Dentures adjust part 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mandbl.
D5510 ................ N Dentur repr broken 0.00 0.00 0.00 0.00 0.00 0.00 XXX
compl bas.
D5520 ................ N Replace denture teeth 0.00 0.00 0.00 0.00 0.00 0.00 XXX
complt.
D5610 ................ N Dentures repair resin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
base.
D5620 ................ N Rep part denture cast 0.00 0.00 0.00 0.00 0.00 0.00 XXX
frame.
D5630 ................ N Rep partial denture 0.00 0.00 0.00 0.00 0.00 0.00 XXX
clasp.
D5640 ................ N Replace part denture 0.00 0.00 0.00 0.00 0.00 0.00 XXX
teeth.
D5650 ................ N Add tooth to partial 0.00 0.00 0.00 0.00 0.00 0.00 XXX
denture.
D5660 ................ N Add clasp to partial 0.00 0.00 0.00 0.00 0.00 0.00 XXX
denture.
D5710 ................ N Dentures rebase cmplt 0.00 0.00 0.00 0.00 0.00 0.00 XXX
maxil.
D5711 ................ N Dentures rebase cmplt 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mand.
D5720 ................ N Dentures rebase part 0.00 0.00 0.00 0.00 0.00 0.00 XXX
maxill.
D5721 ................ N Dentures rebase part 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mandbl.
D5730 ................ N Denture reln cmplt 0.00 0.00 0.00 0.00 0.00 0.00 XXX
maxil ch.
D5731 ................ N Denture reln cmplt 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mand chr.
D5740 ................ N Denture reln part 0.00 0.00 0.00 0.00 0.00 0.00 XXX
maxil chr.
D5741 ................ N Denture reln part mand 0.00 0.00 0.00 0.00 0.00 0.00 XXX
chr.
D5750 ................ N Denture reln cmplt max 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lab.
D5751 ................ N Denture reln cmplt 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mand lab.
D5760 ................ N Denture reln part 0.00 0.00 0.00 0.00 0.00 0.00 XXX
maxil lab.
D5761 ................ N Denture reln part mand 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lab.
D5810 ................ N Denture interm cmplt 0.00 0.00 0.00 0.00 0.00 0.00 XXX
maxill.
D5811 ................ N Denture interm cmplt 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mandbl.
D5820 ................ N Denture interm part 0.00 0.00 0.00 0.00 0.00 0.00 XXX
maxill.
D5821 ................ N Denture interm part 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mandbl.
D5850 ................ N Denture tiss conditn 0.00 0.00 0.00 0.00 0.00 0.00 XXX
maxill.
D5851 ................ N Denture tiss condtin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mandbl.
D5860 ................ N Overdenture complete.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D5861 ................ N Overdenture partial... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D5862 ................ N Precision attachment.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D5867 ................ N Replacement of 0.00 0.00 0.00 0.00 0.00 0.00 XXX
precision att.
D5875 ................ N Prosthesis 0.00 0.00 0.00 0.00 0.00 0.00 XXX
modification.
D5899 ................ N Removable 0.00 0.00 0.00 0.00 0.00 0.00 XXX
prosthodontic proc.
D5911 ................ R Facial moulage 0.00 0.00 0.00 0.00 0.00 0.00 YYY
sectional.
[[Page 55477]]
D5912 ................ R Facial moulage 0.00 0.00 0.00 0.00 0.00 0.00 YYY
complete.
D5913 ................ I Nasal prosthesis...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D5914 ................ I Auricular prosthesis.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D5915 ................ I Orbital prosthesis.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D5916 ................ I Ocular prosthesis..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D5919 ................ I Facial prosthesis..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D5922 ................ I Nasal septal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
prosthesis.
D5923 ................ I Ocular prosthesis 0.00 0.00 0.00 0.00 0.00 0.00 XXX
interim.
D5924 ................ I Cranial prosthesis.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D5925 ................ I Facial augmentation 0.00 0.00 0.00 0.00 0.00 0.00 XXX
implant.
D5926 ................ I Replacement nasal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
prosthesis.
D5927 ................ I Auricular replacement. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D5928 ................ I Orbital replacement... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D5929 ................ I Facial replacement.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D5931 ................ I Surgical obturator.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D5932 ................ I Postsurgical obturator 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D5933 ................ I Refitting of obturator 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D5934 ................ I Mandibular flange 0.00 0.00 0.00 0.00 0.00 0.00 XXX
prosthesis.
D5935 ................ I Mandibular denture 0.00 0.00 0.00 0.00 0.00 0.00 XXX
prosth.
D5936 ................ I Temp obturator 0.00 0.00 0.00 0.00 0.00 0.00 XXX
prosthesis.
D5937 ................ I Trismus appliance..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D5951 ................ R Feeding aid........... 0.00 0.00 0.00 0.00 0.00 0.00 YYY
D5952 ................ I Pediatric speech aid.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D5953 ................ I Adult speech aid...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D5954 ................ I Superimposed 0.00 0.00 0.00 0.00 0.00 0.00 XXX
prosthesis.
D5955 ................ I Palatal lift 0.00 0.00 0.00 0.00 0.00 0.00 XXX
prosthesis.
D5958 ................ I Intraoral con def 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inter plt.
D5959 ................ I Intraoral con def mod 0.00 0.00 0.00 0.00 0.00 0.00 XXX
palat.
D5960 ................ I Modify speech aid 0.00 0.00 0.00 0.00 0.00 0.00 XXX
prosthesis.
D5982 ................ I Surgical stent........ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D5983 ................ R Radiation applicator.. 0.00 0.00 0.00 0.00 0.00 0.00 YYY
D5984 ................ R Radiation shield...... 0.00 0.00 0.00 0.00 0.00 0.00 YYY
D5985 ................ R Radiation cone locator 0.00 0.00 0.00 0.00 0.00 0.00 YYY
D5986 ................ N Fluoride applicator... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D5987 ................ R Commissure splint..... 0.00 0.00 0.00 0.00 0.00 0.00 YYY
D5988 ................ I Surgical splint....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D5999 ................ I Maxillofacial 0.00 0.00 0.00 0.00 0.00 0.00 XXX
prosthesis.
D6010 ................ I Odontics endosteal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
implant.
D6020 ................ I Odontics abutment 0.00 0.00 0.00 0.00 0.00 0.00 XXX
placement.
D6040 ................ I Odontics eposteal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
implant.
D6050 ................ I Odontics transosteal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
implnt.
D6055 ................ I Implant connecting bar 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D6056 ................ N Prefabricated abutment 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D6057 ................ N Custom abutment....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D6058 ................ N Abutment supported 0.00 0.00 0.00 0.00 0.00 0.00 XXX
crown.
D6059 ................ N Abutment supported mtl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
crown.
D6060 ................ N Abutment supported mtl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
crown.
D6061 ................ N Abutment supported mtl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
crown.
D6062 ................ N Abutment supported mtl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
crown.
D6063 ................ N Abutment supported mtl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
crown.
D6064 ................ N Abutment supported mtl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
crown.
D6065 ................ N Implant supported 0.00 0.00 0.00 0.00 0.00 0.00 XXX
crown.
D6066 ................ N Implant supported mtl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
crown.
D6067 ................ N Implant supported mtl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
crown.
D6068 ................ N Abutment supported 0.00 0.00 0.00 0.00 0.00 0.00 XXX
retainer.
D6069 ................ N Abutment supported 0.00 0.00 0.00 0.00 0.00 0.00 XXX
retainer.
D6070 ................ N Abutment supported 0.00 0.00 0.00 0.00 0.00 0.00 XXX
retainer.
D6071 ................ N Abutment supported 0.00 0.00 0.00 0.00 0.00 0.00 XXX
retainer.
D6072 ................ N Abutment supported 0.00 0.00 0.00 0.00 0.00 0.00 XXX
retainer.
D6073 ................ N Abutment supported 0.00 0.00 0.00 0.00 0.00 0.00 XXX
retainer.
D6074 ................ N Abutment supported 0.00 0.00 0.00 0.00 0.00 0.00 XXX
retainer.
D6075 ................ N Implant supported 0.00 0.00 0.00 0.00 0.00 0.00 XXX
retainer.
D6076 ................ N Implant supported 0.00 0.00 0.00 0.00 0.00 0.00 XXX
retainer.
D6077 ................ N Implant supported 0.00 0.00 0.00 0.00 0.00 0.00 XXX
retainer.
D6078 ................ N Implnt/abut suprtd 0.00 0.00 0.00 0.00 0.00 0.00 XXX
fixd dent.
D6079 ................ N Implnt/abut suprtd 0.00 0.00 0.00 0.00 0.00 0.00 XXX
fixd dent.
D6080 ................ I Implant maintenance... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D6090 ................ I Repair implant........ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D6095 ................ I Odontics repr abutment 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D6100 ................ I Removal of implant.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D6199 ................ I Implant procedure..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D6210 ................ N Prosthodont high noble 0.00 0.00 0.00 0.00 0.00 0.00 XXX
metal.
D6211 ................ N Bridge base metal cast 0.00 0.00 0.00 0.00 0.00 0.00 XXX
[[Page 55478]]
D6212 ................ N Bridge noble metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cast.
D6240 ................ N Bridge porcelain high 0.00 0.00 0.00 0.00 0.00 0.00 XXX
noble.
D6241 ................ N Bridge porcelain base 0.00 0.00 0.00 0.00 0.00 0.00 XXX
metal.
D6242 ................ N Bridge porcelain nobel 0.00 0.00 0.00 0.00 0.00 0.00 XXX
metal.
D6245 ................ N Bridge porcelain/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ceramic.
D6250 ................ N Bridge resin w/high 0.00 0.00 0.00 0.00 0.00 0.00 XXX
noble.
D6251 ................ N Bridge resin base 0.00 0.00 0.00 0.00 0.00 0.00 XXX
metal.
D6252 ................ N Bridge resin w/noble 0.00 0.00 0.00 0.00 0.00 0.00 XXX
metal.
D6519 ................ N Inlay/onlay porce/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ceramic.
D6520 ................ N Dental retainer two 0.00 0.00 0.00 0.00 0.00 0.00 XXX
surfaces.
D6530 ................ N Retainer metallic 3+ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
surface.
D6543 ................ N Dental retainr onlay 3 0.00 0.00 0.00 0.00 0.00 0.00 XXX
surf.
D6544 ................ N Dental retainr onlay 4/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
more.
D6545 ................ N Dental retainr cast 0.00 0.00 0.00 0.00 0.00 0.00 XXX
metl.
D6548 ................ N Porcelain/ceramic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
retainer.
D6720 ................ N Retain crown resin w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hi nble.
D6721 ................ N Crown resin w/base 0.00 0.00 0.00 0.00 0.00 0.00 XXX
metal.
D6722 ................ N Crown resin w/noble 0.00 0.00 0.00 0.00 0.00 0.00 XXX
metal.
D6740 ................ N Crown porcelain/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ceramic.
D6750 ................ N Crown porcelain high 0.00 0.00 0.00 0.00 0.00 0.00 XXX
noble.
D6751 ................ N Crown porcelain base 0.00 0.00 0.00 0.00 0.00 0.00 XXX
metal.
D6752 ................ N Crown porcelain noble 0.00 0.00 0.00 0.00 0.00 0.00 XXX
metal.
D6780 ................ N Crown \3/4\ high noble 0.00 0.00 0.00 0.00 0.00 0.00 XXX
metal.
D6781 ................ N Crown \3/4\ cast based 0.00 0.00 0.00 0.00 0.00 0.00 XXX
metal.
D6782 ................ N Crown \3/4\ cast noble 0.00 0.00 0.00 0.00 0.00 0.00 XXX
metal.
D6783 ................ N Crown \3/4\ porcelain/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ceramic.
D6790 ................ N Crown full high noble 0.00 0.00 0.00 0.00 0.00 0.00 XXX
metal.
D6791 ................ N Crown full base metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cast.
D6792 ................ N Crown full noble metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cast.
D6920 ................ R Dental connector bar.. 0.00 0.00 0.00 0.00 0.00 0.00 YYY
D6930 ................ N Dental recement bridge 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D6940 ................ N Stress breaker........ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D6950 ................ N Precision attachment.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D6970 ................ N Post & core plus 0.00 0.00 0.00 0.00 0.00 0.00 XXX
retainer.
D6971 ................ N Cast post bridge 0.00 0.00 0.00 0.00 0.00 0.00 XXX
retainer.
D6972 ................ N Prefab post & core 0.00 0.00 0.00 0.00 0.00 0.00 XXX
plus reta.
D6973 ................ N Core build up for 0.00 0.00 0.00 0.00 0.00 0.00 XXX
retainer.
D6975 ................ N Coping metal.......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D6976 ................ N Each addtnl cast post. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D6977 ................ N Each addtl prefab post 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D6980 ................ N Bridge repair......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D6999 ................ N Fixed prosthodontic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
proc.
D7110 ................ R Oral surgery single 0.00 0.00 0.00 0.00 0.00 0.00 YYY
tooth.
D7120 ................ R Each add tooth 0.00 0.00 0.00 0.00 0.00 0.00 YYY
extraction.
D7130 ................ R Tooth root removal.... 0.00 0.00 0.00 0.00 0.00 0.00 YYY
D7210 ................ R Rem imp tooth w/ 0.00 0.00 0.00 0.00 0.00 0.00 YYY
mucoper flp.
D7220 ................ R Impact tooth remov 0.00 0.00 0.00 0.00 0.00 0.00 YYY
soft tiss.
D7230 ................ R Impact tooth remov 0.00 0.00 0.00 0.00 0.00 0.00 YYY
part bony.
D7240 ................ R Impact tooth remov 0.00 0.00 0.00 0.00 0.00 0.00 YYY
comp bony.
D7241 ................ R Impact tooth rem bony 0.00 0.00 0.00 0.00 0.00 0.00 YYY
w/comp.
D7250 ................ R Tooth root removal.... 0.00 0.00 0.00 0.00 0.00 0.00 YYY
D7260 ................ R Oral antral fistula 0.00 0.00 0.00 0.00 0.00 0.00 YYY
closure.
D7270 ................ N Tooth reimplantation.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D7272 ................ N Tooth transplantation. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D7280 ................ N Exposure impact tooth 0.00 0.00 0.00 0.00 0.00 0.00 XXX
orthod.
D7281 ................ N Exposure tooth aid 0.00 0.00 0.00 0.00 0.00 0.00 XXX
eruption.
D7285 ................ I Biopsy of oral tissue 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hard.
D7286 ................ I Biopsy of oral tissue 0.00 0.00 0.00 0.00 0.00 0.00 XXX
soft.
D7290 ................ N Repositioning of teeth 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D7291 ................ R Transseptal fiberotomy 0.00 0.00 0.00 0.00 0.00 0.00 YYY
D7310 ................ I Alveoplasty w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
extraction.
D7320 ................ I Alveoplasty w/o 0.00 0.00 0.00 0.00 0.00 0.00 XXX
extraction.
D7340 ................ I Vestibuloplasty ridge 0.00 0.00 0.00 0.00 0.00 0.00 XXX
extens.
D7350 ................ I Vestibuloplasty exten 0.00 0.00 0.00 0.00 0.00 0.00 XXX
graft.
D7410 ................ I Rad exc lesion up to 0.00 0.00 0.00 0.00 0.00 0.00 XXX
1.25 cm.
D7420 ................ I Lesion > 1.25 cm...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D7430 ................ I Exc benign tumor to 0.00 0.00 0.00 0.00 0.00 0.00 XXX
1.25 cm.
D7431 ................ I Benign tumor exc > 0.00 0.00 0.00 0.00 0.00 0.00 XXX
1.25 cm.
D7440 ................ I Malig tumor exc to 0.00 0.00 0.00 0.00 0.00 0.00 XXX
1.25 cm.
D7441 ................ I Malig tumor > 1.25 cm. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D7450 ................ I Rem odontogen cyst to 0.00 0.00 0.00 0.00 0.00 0.00 XXX
1.25 cm.
D7451 ................ I Rem odontogen cyst > 0.00 0.00 0.00 0.00 0.00 0.00 XXX
1.25 cm.
D7460 ................ I Rem nonodonto cyst to 0.00 0.00 0.00 0.00 0.00 0.00 XXX
1.25 cm.
[[Page 55479]]
D7461 ................ I Rem nonodonto cyst > 0.00 0.00 0.00 0.00 0.00 0.00 XXX
1.25 cm.
D7465 ................ I Lesion destruction.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D7471 ................ I Rem exostosis any site 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D7480 ................ I Partial ostectomy..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D7490 ................ I Mandible resection.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D7510 ................ I I&d absc intraoral 0.00 0.00 0.00 0.00 0.00 0.00 XXX
soft tiss.
D7520 ................ I I&d abscess extraoral. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D7530 ................ I Removal fb skin/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
areolar tiss.
D7540 ................ I Removal of fb reaction 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D7550 ................ I Removal of sloughed 0.00 0.00 0.00 0.00 0.00 0.00 XXX
off bone.
D7560 ................ I Maxillary sinusotomy.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D7610 ................ I Maxilla open reduct 0.00 0.00 0.00 0.00 0.00 0.00 XXX
simple.
D7620 ................ I Clsd reduct simpl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
maxilla fx.
D7630 ................ I Open red simpl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mandible fx.
D7640 ................ I Clsd red simpl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mandible fx.
D7650 ................ I Open red simp malar/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
zygom fx.
D7660 ................ I Clsd red simp malar/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
zygom fx.
D7670 ................ I Closd rductn splint 0.00 0.00 0.00 0.00 0.00 0.00 XXX
alveolus.
D7680 ................ I Reduct simple facial 0.00 0.00 0.00 0.00 0.00 0.00 XXX
bone fx.
D7710 ................ I Maxilla open reduct 0.00 0.00 0.00 0.00 0.00 0.00 XXX
compound.
D7720 ................ I Clsd reduct compd 0.00 0.00 0.00 0.00 0.00 0.00 XXX
maxilla fx.
D7730 ................ I Open reduct compd 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mandble fx.
D7740 ................ I Clsd reduct compd 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mandble fx.
D7750 ................ I Open red comp malar/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
zygma fx.
D7760 ................ I Clsd red comp malar/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
zygma fx.
D7770 ................ I Open reduc compd 0.00 0.00 0.00 0.00 0.00 0.00 XXX
alveolus fx.
D7780 ................ I Reduct compnd facial 0.00 0.00 0.00 0.00 0.00 0.00 XXX
bone fx.
D7810 ................ I Tmj open reduct- 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dislocation.
D7820 ................ I Closed tmp 0.00 0.00 0.00 0.00 0.00 0.00 XXX
manipulation.
D7830 ................ I Tmj manipulation under 0.00 0.00 0.00 0.00 0.00 0.00 XXX
anest.
D7840 ................ I Removal of tmj condyle 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D7850 ................ I Tmj meniscectomy...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D7852 ................ I Tmj repair of joint 0.00 0.00 0.00 0.00 0.00 0.00 XXX
disc.
D7854 ................ I Tmj excisn of joint 0.00 0.00 0.00 0.00 0.00 0.00 XXX
membrane.
D7856 ................ I Tmj cutting of a 0.00 0.00 0.00 0.00 0.00 0.00 XXX
muscle.
D7858 ................ I Tmj reconstruction.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D7860 ................ I Tmj cutting into joint 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D7865 ................ I Tmj reshaping 0.00 0.00 0.00 0.00 0.00 0.00 XXX
components.
D7870 ................ I Tmj aspiration joint 0.00 0.00 0.00 0.00 0.00 0.00 XXX
fluid.
D7871 ................ N Lysis + lavage w 0.00 0.00 0.00 0.00 0.00 0.00 XXX
catheters.
D7872 ................ I Tmj diagnostic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
arthroscopy.
D7873 ................ I Tmj arthroscopy lysis 0.00 0.00 0.00 0.00 0.00 0.00 XXX
adhesn.
D7874 ................ I Tmj arthroscopy disc 0.00 0.00 0.00 0.00 0.00 0.00 XXX
reposit.
D7875 ................ I Tmj arthroscopy 0.00 0.00 0.00 0.00 0.00 0.00 XXX
synovectomy.
D7876 ................ I Tmj arthroscopy 0.00 0.00 0.00 0.00 0.00 0.00 XXX
discectomy.
D7877 ................ I Tmj arthroscopy 0.00 0.00 0.00 0.00 0.00 0.00 XXX
debridement.
D7880 ................ I Occlusal orthotic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
appliance.
D7899 ................ I Tmj unspecified 0.00 0.00 0.00 0.00 0.00 0.00 XXX
therapy.
D7910 ................ I Dent sutur recent wnd 0.00 0.00 0.00 0.00 0.00 0.00 XXX
to 5 cm.
D7911 ................ I Dental suture wound to 0.00 0.00 0.00 0.00 0.00 0.00 XXX
5 cm.
D7912 ................ I Suture complicate wnd 0.00 0.00 0.00 0.00 0.00 0.00 XXX
> 5 cm.
D7920 ................ I Dental skin graft..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D7940 ................ R Reshaping bone 0.00 0.00 0.00 0.00 0.00 0.00 YYY
orthognathic.
D7941 ................ I Bone cutting ramus 0.00 0.00 0.00 0.00 0.00 0.00 XXX
closed.
D7943 ................ I Cutting ramus open w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
graft.
D7944 ................ I Bone cutting segmented 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D7945 ................ I Bone cutting body 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mandible.
D7946 ................ I Reconstruction maxilla 0.00 0.00 0.00 0.00 0.00 0.00 XXX
total.
D7947 ................ I Reconstruct maxilla 0.00 0.00 0.00 0.00 0.00 0.00 XXX
segment.
D7948 ................ I Reconstruct midface no 0.00 0.00 0.00 0.00 0.00 0.00 XXX
graft.
D7949 ................ I Reconstruct midface w/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
graft.
D7950 ................ I Mandible graft........ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D7955 ................ I Repair maxillofacial 0.00 0.00 0.00 0.00 0.00 0.00 XXX
defects.
D7960 ................ I Frenulectomy/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
frenulotomy.
D7970 ................ I Excision hyperplastic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
tissue.
D7971 ................ I Excision pericoronal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
gingiva.
D7980 ................ I Sialolithotomy........ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D7981 ................ I Excision of salivary 0.00 0.00 0.00 0.00 0.00 0.00 XXX
gland.
D7982 ................ I Sialodochoplasty...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D7983 ................ I Closure of salivary 0.00 0.00 0.00 0.00 0.00 0.00 XXX
fistula.
D7990 ................ I Emergency tracheotomy. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D7991 ................ I Dental coronoidectomy. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D7995 ................ I Synthetic graft facial 0.00 0.00 0.00 0.00 0.00 0.00 XXX
bones.
[[Page 55480]]
D7996 ................ I Implant mandible for 0.00 0.00 0.00 0.00 0.00 0.00 XXX
augment.
D7997 ................ N Appliance removal..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D7999 ................ I Oral surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D8010 ................ N Limited dental tx 0.00 0.00 0.00 0.00 0.00 0.00 XXX
primary.
D8020 ................ N Limited dental tx 0.00 0.00 0.00 0.00 0.00 0.00 XXX
transition.
D8030 ................ N Limited dental tx 0.00 0.00 0.00 0.00 0.00 0.00 XXX
adolescent.
D8040 ................ N Limited dental tx 0.00 0.00 0.00 0.00 0.00 0.00 XXX
adult.
D8050 ................ N Intercep dental tx 0.00 0.00 0.00 0.00 0.00 0.00 XXX
primary.
D8060 ................ N Intercep dental tx 0.00 0.00 0.00 0.00 0.00 0.00 XXX
transitn.
D8070 ................ N Compre dental tx 0.00 0.00 0.00 0.00 0.00 0.00 XXX
transition.
D8080 ................ N Compre dental tx 0.00 0.00 0.00 0.00 0.00 0.00 XXX
adolescent.
D8090 ................ N Compre dental tx adult 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D8210 ................ N Orthodontic rem 0.00 0.00 0.00 0.00 0.00 0.00 XXX
appliance tx.
D8220 ................ N Fixed appliance 0.00 0.00 0.00 0.00 0.00 0.00 XXX
therapy habt.
D8660 ................ N Preorthodontic tx 0.00 0.00 0.00 0.00 0.00 0.00 XXX
visit.
D8670 ................ N Periodic orthodontc tx 0.00 0.00 0.00 0.00 0.00 0.00 XXX
visit.
D8680 ................ N Orthodontic retention. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D8690 ................ N Orthodontic treatment. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D8691 ................ N Repair ortho appliance 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D8692 ................ N Replacement retainer.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D8999 ................ N Orthodontic procedure. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D9110 ................ R Tx dental pain minor 0.00 0.00 0.00 0.00 0.00 0.00 YYY
proc.
D9210 ................ I Dent anesthesia w/o 0.00 0.00 0.00 0.00 0.00 0.00 XXX
surgery.
D9211 ................ I Regional block 0.00 0.00 0.00 0.00 0.00 0.00 XXX
anesthesia.
D9212 ................ I Trigeminal block 0.00 0.00 0.00 0.00 0.00 0.00 XXX
anesthesia.
D9215 ................ I Local anesthesia...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D9220 ................ I General anesthesia.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D9221 ................ I General anesthesia ea 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ad 15m.
D9230 ................ R Analgesia............. 0.00 0.00 0.00 0.00 0.00 0.00 YYY
D9241 ................ I Intravenous sedation.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D9242 ................ I IV sedation ea ad 30 m 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D9248 ................ R Sedation (non-iv)..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D9310 ................ I Dental consultation... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D9410 ................ I Dental house call..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D9420 ................ I Hospital call......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D9430 ................ I Office visit during 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hours.
D9440 ................ I Office visit after 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hours.
D9610 ................ I Dent therapeutic drug 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inject.
D9630 ................ R Other drugs/ 0.00 0.00 0.00 0.00 0.00 0.00 YYY
medicaments.
D9910 ................ N Dent appl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
desensitizing med.
D9911 ................ N Appl desensitizing 0.00 0.00 0.00 0.00 0.00 0.00 XXX
resin.
D9920 ................ N Behavior management... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D9930 ................ R Treatment of 0.00 0.00 0.00 0.00 0.00 0.00 YYY
complications.
D9940 ................ R Dental occlusal guard. 0.00 0.00 0.00 0.00 0.00 0.00 YYY
D9941 ................ N Fabrication athletic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
guard.
D9950 ................ R Occlusion analysis.... 0.00 0.00 0.00 0.00 0.00 0.00 YYY
D9951 ................ R Limited occlusal 0.00 0.00 0.00 0.00 0.00 0.00 YYY
adjustment.
D9952 ................ R Complete occlusal 0.00 0.00 0.00 0.00 0.00 0.00 YYY
adjustment.
D9970 ................ N Enamel microabrasion.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D9971 ................ N Odontoplasty 1-2 teeth 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D9972 ................ N Extrnl bleaching per 0.00 0.00 0.00 0.00 0.00 0.00 XXX
arch.
D9973 ................ N Extrnl bleaching per 0.00 0.00 0.00 0.00 0.00 0.00 XXX
tooth.
D9974 ................ N Intrnl bleaching per 0.00 0.00 0.00 0.00 0.00 0.00 XXX
tooth.
D9999 ................ I Adjunctive procedure.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
G0001 ................ X Drawing blood for 0.00 0.00 0.00 0.00 0.00 0.00 XXX
specimen.
G0002 ................ A Temporary urinary 0.50 3.32 0.17 0.03 3.85 0.70 000
catheter.
G0004 ................ A ECG transm phys review 0.52 7.10 NA 0.45 8.07 NA XXX
& int.
G0005 ................ A ECG 24 hour recording. 0.00 1.18 NA 0.07 1.25 NA XXX
G0006 ................ A ECG transmission & 0.00 5.71 NA 0.36 6.07 NA XXX
analysis.
G0007 ................ A ECG phy review & 0.52 0.21 0.21 0.02 0.75 0.75 XXX
interpret.
G0008 ................ X Admin influenza virus 0.00 0.00 0.00 0.00 0.00 0.00 XXX
vac.
G0009 ................ X Admin pneumococcal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
vaccine.
G0010 ................ X Admin hepatitis b 0.00 0.00 0.00 0.00 0.00 0.00 XXX
vaccine.
G0015 ................ A Post symptom ECG 0.00 5.71 NA 0.36 6.07 NA XXX
tracing.
G0016 ................ D Post symptom ECG md 0.00 0.00 0.00 0.00 0.00 0.00 XXX
review.
G0025 ................ I Collagen skin test kit 0.00 0.00 0.00 0.00 0.00 0.00 XXX
G0026 ................ X Fecal leukocyte 0.00 0.00 0.00 0.00 0.00 0.00 XXX
examination.
G0027 ................ X Semen analysis........ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
G0030 ................ C PET imaging prev PET 0.00 0.00 0.00 0.00 0.00 0.00 XXX
single.
G0030 26 A PET imaging prev PET 1.50 0.52 0.52 0.04 2.06 2.06 XXX
single.
G0030 TC C PET imaging prev PET 0.00 0.00 0.00 0.00 0.00 0.00 XXX
single.
G0031 ................ C PET imaging prev PET 0.00 0.00 0.00 0.00 0.00 0.00 XXX
multple.
G0031 26 A PET imaging prev PET 1.87 0.70 0.70 0.06 2.63 2.63 XXX
multple.
[[Page 55481]]
G0031 TC C PET imaging prev PET 0.00 0.00 0.00 0.00 0.00 0.00 XXX
multple.
G0032 ................ C PET follow SPECT 78464 0.00 0.00 0.00 0.00 0.00 0.00 XXX
singl.
G0032 26 A PET follow SPECT 78464 1.50 0.52 0.52 0.05 2.07 2.07 XXX
singl.
G0032 TC C PET follow SPECT 78464 0.00 0.00 0.00 0.00 0.00 0.00 XXX
singl.
G0033 ................ C PET follow SPECT 78464 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mult.
G0033 26 A PET follow SPECT 78464 1.87 0.70 0.70 0.06 2.63 2.63 XXX
mult.
G0033 TC C PET follow SPECT 78464 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mult.
G0034 ................ C PET follow SPECT 76865 0.00 0.00 0.00 0.00 0.00 0.00 XXX
singl.
G0034 26 A PET follow SPECT 76865 1.50 0.52 0.52 0.05 2.07 2.07 XXX
singl.
G0034 TC C PET follow SPECT 76865 0.00 0.00 0.00 0.00 0.00 0.00 XXX
singl.
G0035 ................ C PET follow SPECT 78465 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mult.
G0035 26 A PET follow SPECT 78465 1.87 0.70 0.70 0.06 2.63 2.63 XXX
mult.
G0035 TC C PET follow SPECT 78465 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mult.
G0036 ................ C PET follow cornry 0.00 0.00 0.00 0.00 0.00 0.00 XXX
angio sing.
G0036 26 A PET follow cornry 1.50 0.52 0.52 0.04 2.06 2.06 XXX
angio sing.
G0036 TC C PET follow cornry 0.00 0.00 0.00 0.00 0.00 0.00 XXX
angio sing.
G0037 ................ C PET follow cornry 0.00 0.00 0.00 0.00 0.00 0.00 XXX
angio mult.
G0037 26 A PET follow cornry 1.87 0.70 0.70 0.06 2.63 2.63 XXX
angio mult.
G0037 TC C PET follow cornry 0.00 0.00 0.00 0.00 0.00 0.00 XXX
angio mult.
G0038 ................ C PET follow myocard 0.00 0.00 0.00 0.00 0.00 0.00 XXX
perf sing.
G0038 26 A PET follow myocard 1.50 0.52 0.52 0.04 2.06 2.06 XXX
perf sing.
G0038 TC C PET follow myocard 0.00 0.00 0.00 0.00 0.00 0.00 XXX
perf sing.
G0039 ................ C PET follow myocard 0.00 0.00 0.00 0.00 0.00 0.00 XXX
perf mult.
G0039 26 A PET follow myocard 1.87 0.70 0.70 0.07 2.64 2.64 XXX
perf mult.
G0039 TC C PET follow myocard 0.00 0.00 0.00 0.00 0.00 0.00 XXX
perf mult.
G0040 ................ C PET follow stress echo 0.00 0.00 0.00 0.00 0.00 0.00 XXX
singl.
G0040 26 A PET follow stress echo 1.50 0.52 0.52 0.04 2.06 2.06 XXX
singl.
G0040 TC C PET follow stress echo 0.00 0.00 0.00 0.00 0.00 0.00 XXX
singl.
G0041 ................ C PET follow stress echo 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mult.
G0041 26 A PET follow stress echo 1.87 0.70 0.70 0.05 2.62 2.62 XXX
mult.
G0041 TC C PET follow stress echo 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mult.
G0042 ................ C PET follow 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ventriculogm sing.
G0042 26 A PET follow 1.50 0.52 0.52 0.04 2.06 2.06 XXX
ventriculogm sing.
G0042 TC C PET follow 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ventriculogm sing.
G0043 ................ C PET follow 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ventriculogm mult.
G0043 26 A PET follow 1.87 0.70 0.70 0.06 2.63 2.63 XXX
ventriculogm mult.
G0043 TC C PET follow 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ventriculogm mult.
G0044 ................ C PET following rest ECG 0.00 0.00 0.00 0.00 0.00 0.00 XXX
singl.
G0044 26 A PET following rest ECG 1.50 0.52 0.52 0.04 2.06 2.06 XXX
singl.
G0044 TC C PET following rest ECG 0.00 0.00 0.00 0.00 0.00 0.00 XXX
singl.
G0045 ................ C PET following rest ECG 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mult.
G0045 26 A PET following rest ECG 1.87 0.70 0.70 0.06 2.63 2.63 XXX
mult.
G0045 TC C PET following rest ECG 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mult.
G0046 ................ C PET follow stress ECG 0.00 0.00 0.00 0.00 0.00 0.00 XXX
singl.
G0046 26 A PET follow stress ECG 1.50 0.52 0.52 0.04 2.06 2.06 XXX
singl.
G0046 TC C PET follow stress ECG 0.00 0.00 0.00 0.00 0.00 0.00 XXX
singl.
G0047 ................ C PET follow stress ECG 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mult.
G0047 26 A PET follow stress ECG 1.87 0.70 0.70 0.06 2.63 2.63 XXX
mult.
G0047 TC C PET follow stress ECG 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mult.
G0050 ................ A Residual urine by 0.00 0.81 NA 0.04 0.85 NA XXX
ultrasound.
G0101 ................ A CA screen; pelvic/ 0.45 0.52 0.18 0.01 0.98 0.64 XXX
breast exam.
G0102 ................ A Prostate ca screening; 0.17 0.38 0.06 0.01 0.56 0.24 XXX
dre.
G0103 ................ X Psa, total screening.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
G0104 ................ A CA screen; flexi 0.96 1.92 0.53 0.05 2.93 1.54 000
sigmoidscope.
G0105 ................ A Colorectal scrn; hi 3.70 8.79 1.77 0.20 12.69 5.67 000
risk ind.
G0106 ................ A Colon CA screen; 0.99 2.47 NA 0.15 3.61 NA XXX
barium enema.
G0106 26 A Colon CA screen; 0.99 0.35 0.35 0.04 1.38 1.38 XXX
barium enema.
G0106 TC A Colon CA screen; 0.00 2.12 NA 0.11 2.23 NA XXX
barium enema.
G0107 ................ X CA screen; fecal blood 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
G0108 ................ A Diab manage trn per 0.00 1.64 NA 0.01 1.65 NA XXX
indiv.
G0109 ................ A Diab manage trn ind/ 0.00 0.96 NA 0.01 0.97 NA XXX
group.
G0110 ................ R Nett pulm-rehab educ; 0.90 0.67 0.36 0.03 1.60 1.29 XXX
ind.
G0111 ................ R Nett pulm-rehab educ; 0.27 0.29 0.11 0.01 0.57 0.39 XXX
group.
G0112 ................ R Nett; nutrition guid, 1.72 1.24 0.69 0.05 3.01 2.46 XXX
initial.
G0113 ................ R Nett; nutrition guid, 1.29 0.97 0.51 0.04 2.30 1.84 XXX
subseqnt.
G0114 ................ R Nett; psychosocial 1.20 0.49 0.48 0.03 1.72 1.71 XXX
consult.
G0115 ................ R Nett; psychological 1.20 0.57 0.48 0.04 1.81 1.72 XXX
testing.
G0116 ................ R Nett; psychosocial 1.11 0.69 0.44 0.04 1.84 1.59 XXX
counsel.
G0117 ................ T Glaucoma scrn hgh risk 0.45 0.97 0.22 0.02 1.44 0.69 XXX
direc.
G0118 ................ T Glaucoma scrn hgh risk 0.17 0.84 0.08 0.01 1.02 0.26 XXX
direc.
G0120 ................ A Colon ca scrn; barium 0.99 2.47 NA 0.15 3.61 NA XXX
enema.
G0120 26 A Colon ca scrn; barium 0.99 0.35 0.35 0.04 1.38 1.38 XXX
enema.
G0120 TC A Colon ca scrn; barium 0.00 2.12 NA 0.11 2.23 NA XXX
enema.
[[Page 55482]]
G0121 ................ A Colon ca scrn not hi 3.70 8.79 1.77 0.20 12.69 5.67 000
rsk ind.
G0122 ................ N Colon ca scrn; barium +0.99 2.52 NA 0.15 3.66 NA XXX
enema.
G0122 26 N Colon ca scrn; barium +0.99 0.40 0.40 0.04 1.43 1.43 XXX
enema.
G0122 TC N Colon ca scrn; barium +0.00 2.12 NA 0.11 2.23 NA XXX
enema.
G0123 ................ X Screen cerv/vag thin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
layer.
G0124 ................ A Screen c/v thin layer 0.42 0.19 0.19 0.01 0.62 0.62 XXX
by MD.
G0125 ................ A PET img WhBD sgl pulm 1.50 56.10 NA 2.00 59.60 NA XXX
ring.
G0125 26 A PET img WhBD sgl pulm 1.50 0.52 0.52 0.05 2.07 2.07 XXX
ring.
G0125 TC A PET img WhBD sgl pulm 0.00 55.58 NA 1.95 57.53 NA XXX
ring.
G0126 ................ D Lung image (PET) 0.00 0.00 NA 0.00 0.00 NA XXX
staging.
G0126 26 D Lung image (PET) 0.00 0.00 0.00 0.00 0.00 0.00 XXX
staging.
G0126 TC D Lung image (PET) 0.00 0.00 NA 0.00 0.00 NA XXX
staging.
G0127 ................ R Trim nail(s).......... 0.17 0.26 0.07 0.01 0.44 0.25 000
G0128 ................ R CORF skilled nursing 0.08 0.03 0.03 0.01 0.12 0.12 XXX
service.
G0130 ................ A Single energy x-ray 0.22 0.90 NA 0.05 1.17 NA XXX
study.
G0130 26 A Single energy x-ray 0.22 0.11 0.11 0.01 0.34 0.34 XXX
study.
G0130 TC A Single energy x-ray 0.00 0.79 NA 0.04 0.83 NA XXX
study.
G0131 ................ A CT scan, bone density 0.25 3.18 NA 0.14 3.57 NA XXX
study.
G0131 26 A CT scan, bone density 0.25 0.13 0.13 0.01 0.39 0.39 XXX
study.
G0131 TC A CT scan, bone density 0.00 3.05 NA 0.13 3.18 NA XXX
study.
G0132 ................ A CT scan, bone density 0.22 0.90 NA 0.05 1.17 NA XXX
study.
G0132 26 A CT scan, bone density 0.22 0.11 0.11 0.01 0.34 0.34 XXX
study.
G0132 TC A CT scan, bone density 0.00 0.79 NA 0.04 0.83 NA XXX
study.
G0141 ................ A Scr c/v cyto, autosys 0.42 0.19 0.19 0.01 0.62 0.62 XXX
and md.
G0143 ................ X Scr c/v cyto, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
thinlayer,rescr.
G0144 ................ X Scr c/v cyto, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
thinlayer,rescr.
G0145 ................ X Scr c/v cyto, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
thinlayer,rescr.
G0147 ................ X Scr c/v cyto, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
automated sys.
G0148 ................ X Scr c/v cyto, autosys, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
rescr.
G0163 ................ D Pet for rec of 0.00 0.00 NA 0.00 0.00 NA XXX
colorectal ca.
G0163 26 D Pet for rec of 0.00 0.00 0.00 0.00 0.00 0.00 XXX
colorectal ca.
G0163 TC D Pet for rec of 0.00 0.00 NA 0.00 0.00 NA XXX
colorectal ca.
G0164 ................ D Pet for lymphoma 0.00 0.00 NA 0.00 0.00 NA XXX
staging.
G0164 26 D Pet for lymphoma 0.00 0.00 0.00 0.00 0.00 0.00 XXX
staging.
G0164 TC D Pet for lymphoma 0.00 0.00 NA 0.00 0.00 NA XXX
staging.
G0165 ................ D Pet, rec of melanoma/ 0.00 0.00 NA 0.00 0.00 NA XXX
met ca.
G0165 26 D Pet, rec of melanoma/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
met ca.
G0165 TC D Pet, rec of melanoma/ 0.00 0.00 NA 0.00 0.00 NA XXX
met ca.
G0166 ................ A Extrnl counterpulse, 0.07 4.17 0.03 0.01 4.25 0.11 XXX
per tx.
G0167 ................ C Hyperbaric oz tx; no 0.00 0.00 0.00 0.00 0.00 0.00 XXX
md reqrd.
G0168 ................ A Wound closure by 0.45 2.33 0.19 0.01 2.79 0.65 000
adhesive.
G0173 ................ X Stereo radoisurgery, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
complete.
G0174 ................ D Intensitymodulatedradi 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ation.
G0175 ................ X OPPS Service, sched 0.00 0.00 0.00 0.00 0.00 0.00 XXX
team conf.
G0176 ................ X OPPS/PHP; activity 0.00 0.00 0.00 0.00 0.00 0.00 XXX
therapy.
G0177 ................ X OPPS/PHP; train & educ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
serv.
G0178 ................ D Intensitymodulatedradi 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ation.
G0179 ................ A MD recertification HHA 0.45 1.21 NA 0.01 1.67 NA XXX
PT.
G0180 ................ A MD certification HHA 0.67 1.29 NA 0.02 1.98 NA XXX
patient.
G0181 ................ A Home health care 1.73 1.57 NA 0.06 3.36 NA XXX
supervision.
G0182 ................ A Hospice care 1.73 1.97 NA 0.06 3.76 NA XXX
supervision.
G0184 ................ D Ocular photdynamicTx 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
2nd eye.
G0185 ................ C Transpuppillary 0.00 0.00 0.00 0.00 0.00 0.00 YYY
thermotx.
G0186 ................ C Dstry eye lesn, fdr 0.00 0.00 0.00 0.00 0.00 0.00 YYY
vssl tech.
G0187 ................ C Dstry mclr drusen, 0.00 0.00 0.00 0.00 0.00 0.00 YYY
photocoag.
G0188 ................ D Xray lwr extrmty-full 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lngth.
G0188 26 D Xray lwr extrmty-full 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lngth.
G0188 TC D Xray lwr extrmty-full 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lngth.
G0190 ................ D Immunization 0.00 0.00 0.00 0.00 0.00 0.00 XXX
administration.
G0191 ................ D Immunization admin, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
each add.
G0192 ................ N Immunization oral/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
intranasal.
G0193 ................ C Endoscopicstudyswallow 0.00 0.00 0.00 0.00 0.00 0.00 XXX
functn.
G0194 ................ C Sensorytestingendoscop 0.00 0.00 0.00 0.00 0.00 0.00 XXX
icstud.
G0195 ................ A Clinicalevalswallowing 1.50 1.95 0.76 0.07 3.52 2.33 XXX
funct.
G0196 ................ A Eval of swallowing 1.50 1.95 0.76 0.07 3.52 2.33 XXX
with radio opa.
G0197 ................ A Eval of pt for prescip 1.35 2.11 0.75 0.04 3.50 2.14 XXX
speech devi.
G0198 ................ A Patient adapation & 0.99 1.14 0.58 0.03 2.16 1.60 XXX
train for spe.
G0199 ................ A Reevaluation of 1.01 1.92 0.56 0.03 2.96 1.60 XXX
patient uses pec.
G0200 ................ A Eval of patient 1.35 2.11 0.75 0.04 3.50 2.14 XXX
prescip of voice p.
G0201 ................ A Modi for training in 0.99 1.14 0.58 0.03 2.16 1.60 XXX
use voice pro.
G0202 ................ A Screening 0.70 2.70 NA 0.09 3.49 NA XXX
mammographydigital.
G0202 26 A Screening 0.70 0.28 0.28 0.03 1.01 1.01 XXX
mammographydigital.
G0202 TC A Screening 0.00 2.42 NA 0.06 2.48 NA XXX
mammographydigital.
[[Page 55483]]
G0203 ................ D Screen 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mammographyfilmdigita
l.
G0204 ................ A Diagnostic 0.87 2.73 NA 0.09 3.69 NA XXX
mammographydigital.
G0204 26 A Diagnostic 0.87 0.35 0.35 0.03 1.25 1.25 XXX
mammographydigital.
G0204 TC A Diagnostic 0.00 2.38 NA 0.06 2.44 NA XXX
mammographydigital.
G0205 ................ D Diagnostic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mammographyfilmpro.
G0205 26 D Diagnostic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mammographyfilmpro.
G0205 TC D Diagnostic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mammographyfilmpro.
G0206 ................ A Diagnostic 0.70 2.20 NA 0.08 2.98 NA XXX
mammographydigital.
G0206 26 A Diagnostic 0.70 0.28 0.28 0.03 1.01 1.01 XXX
mammographydigital.
G0206 TC A Diagnostic 0.00 1.92 NA 0.05 1.97 NA XXX
mammographydigital.
G0207 ................ D Diagnostic mammography 0.00 0.00 0.00 0.00 0.00 0.00 XXX
film.
G0207 26 D Diagnostic mammography 0.00 0.00 0.00 0.00 0.00 0.00 XXX
film.
G0207 TC D Diagnostic mammography 0.00 0.00 0.00 0.00 0.00 0.00 XXX
film.
G0210 ................ C PET img WhBD ring 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dxlung ca.
G0210 26 A PET img WhBD ring 1.50 0.60 0.60 0.04 2.14 2.14 XXX
dxlung ca.
G0210 TC C PET img WhBD ring 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dxlung ca.
G0211 ................ C PET img WhBD ring init 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lung.
G0211 26 A PET img WhBD ring init 1.50 0.60 0.60 0.04 2.14 2.14 XXX
lung.
G0211 TC C PET img WhBD ring init 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lung.
G0212 ................ C PET img WhBD ring 0.00 0.00 0.00 0.00 0.00 0.00 XXX
restag lun.
G0212 26 A PET img WhBD ring 1.50 0.60 0.60 0.04 2.14 2.14 XXX
restag lun.
G0212 TC C PET img WhBD ring 0.00 0.00 0.00 0.00 0.00 0.00 XXX
restag lun.
G0213 ................ C PET img WhBD ring dx 0.00 0.00 0.00 0.00 0.00 0.00 XXX
colorec.
G0213 26 A PET img WhBD ring dx 1.50 0.60 0.60 0.04 2.14 2.14 XXX
colorec.
G0213 TC C PET img WhBD ring dx 0.00 0.00 0.00 0.00 0.00 0.00 XXX
colorec.
G0214 ................ C PET img WhBD ring init 0.00 0.00 0.00 0.00 0.00 0.00 XXX
colre.
G0214 26 A PET img WhBD ring init 1.50 0.60 0.60 0.04 2.14 2.14 XXX
colre.
G0214 TC C PET img WhBD ring init 0.00 0.00 0.00 0.00 0.00 0.00 XXX
colre.
G0215 ................ C PET img WhBD restag 0.00 0.00 0.00 0.00 0.00 0.00 XXX
col.
G0215 26 A PET img WhBD restag 1.50 0.60 0.60 0.04 2.14 2.14 XXX
col.
G0215 TC C PET img WhBD restag 0.00 0.00 0.00 0.00 0.00 0.00 XXX
col.
G0216 ................ C PET img WhBD ring dx 0.00 0.00 0.00 0.00 0.00 0.00 XXX
melanom.
G0216 26 A PET img WhBD ring dx 1.50 0.60 0.60 0.04 2.14 2.14 XXX
melanom.
G0216 TC C PET img WhBD ring dx 0.00 0.00 0.00 0.00 0.00 0.00 XXX
melanom.
G0217 ................ C PET img WhBD ring init 0.00 0.00 0.00 0.00 0.00 0.00 XXX
melan.
G0217 26 A PET img WhBD ring init 1.50 0.60 0.60 0.04 2.14 2.14 XXX
melan.
G0217 TC C PET img WhBD ring init 0.00 0.00 0.00 0.00 0.00 0.00 XXX
melan.
G0218 ................ C PET img WhBD ring 0.00 0.00 0.00 0.00 0.00 0.00 XXX
restag mel.
G0218 26 A PET img WhBD ring 1.50 0.60 0.60 0.04 2.14 2.14 XXX
restag mel.
G0218 TC C PET img WhBD ring 0.00 0.00 0.00 0.00 0.00 0.00 XXX
restag mel.
G0219 ................ N PET img WhBD ring +1.50 0.60 0.60 0.04 2.14 2.14 XXX
noncov ind.
G0219 26 N PET img WhBD ring +1.50 0.60 0.60 0.04 2.14 2.14 XXX
noncov ind.
G0219 TC N PET img WhBD ring 0.00 0.00 0.00 0.00 0.00 0.00 XXX
noncov ind.
G0220 ................ C PET img WhBD ring dx 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lymphom.
G0220 26 A PET img WhBD ring dx 1.50 0.60 0.60 0.04 2.14 2.14 XXX
lymphom.
G0220 TC C PET img WhBD ring dx 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lymphom.
G0221 ................ C PET img WhBD ring init 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lymph.
G0221 26 A PET img WhBD ring init 1.50 0.60 0.60 0.04 2.14 2.14 XXX
lymph.
G0221 TC C PET img WhBD ring init 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lymph.
G0222 ................ C PET img WhBD ring 0.00 0.00 0.00 0.00 0.00 0.00 XXX
resta lymp.
G0222 26 A PET img WhBD ring 1.50 0.60 0.60 0.04 2.14 2.14 XXX
resta lymp.
G0222 TC C PET img WhBD ring 0.00 0.00 0.00 0.00 0.00 0.00 XXX
resta lymp.
G0223 ................ C PET img WhBD reg ring 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dx hea.
G0223 26 A PET img WhBD reg ring 1.50 0.60 0.60 0.04 2.14 2.14 XXX
dx hea.
G0223 TC C PET img WhBD reg ring 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dx hea.
G0224 ................ C PET img WhBD reg ring 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ini hea.
G0224 26 A PET img WhBD reg ring 1.50 0.60 0.60 0.04 2.14 2.14 XXX
ini hea.
G0224 TC C PET img WhBD reg ring 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ini hea.
G0225 ................ C PET img WhBD ring 0.00 0.00 0.00 0.00 0.00 0.00 XXX
restag hea.
G0225 26 A PET img WhBD ring 1.50 0.60 0.60 0.04 2.14 2.14 XXX
restag hea.
G0225 TC C PET img WhBD ring 0.00 0.00 0.00 0.00 0.00 0.00 XXX
restag hea.
G0226 ................ C PET img WhBD dx 0.00 0.00 0.00 0.00 0.00 0.00 XXX
esophag.
G0226 26 A PET img WhBD dx 1.50 0.60 0.60 0.04 2.14 2.14 XXX
esophag.
G0226 TC C PET img WhBD dx 0.00 0.00 0.00 0.00 0.00 0.00 XXX
esophag.
G0227 ................ C PET img WhBD ini 0.00 0.00 0.00 0.00 0.00 0.00 XXX
esopha.
G0227 26 A PET img WhBD ini 1.50 0.60 0.60 0.04 2.14 2.14 XXX
esopha.
G0227 TC C PET img WhBD ini 0.00 0.00 0.00 0.00 0.00 0.00 XXX
esopha.
G0228 ................ C PET img WhBD ring 0.00 0.00 0.00 0.00 0.00 0.00 XXX
restg esop.
G0228 26 A PET img WhBD ring 1.50 0.60 0.60 0.04 2.14 2.14 XXX
restg esop.
G0228 TC C PET img WhBD ring 0.00 0.00 0.00 0.00 0.00 0.00 XXX
restg esop.
G0229 ................ C PET img metabolic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
brain ring.
G0229 26 A PET img metabolic 1.50 0.60 0.60 0.04 2.14 2.14 XXX
brain ring.
G0229 TC C PET img metabolic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
brain ring.
[[Page 55484]]
G0230 ................ C PET myocard viability 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ring.
G0230 26 A PET myocard viability 1.50 0.60 0.60 0.04 2.14 2.14 XXX
ring.
G0230 TC C PET myocard viability 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ring.
G0231 ................ C PET WhBD colorec; 0.00 0.00 0.00 0.00 0.00 0.00 XXX
gamma cam.
G0231 26 A PET WhBD colorec; 1.50 0.60 0.60 0.04 2.14 2.14 XXX
gamma cam.
G0231 TC C PET WhBD colorec; 0.00 0.00 0.00 0.00 0.00 0.00 XXX
gamma cam.
G0232 ................ C PET WhBD lymphoma; 0.00 0.00 0.00 0.00 0.00 0.00 XXX
gamma cam.
G0232 26 A PET WhBD lymphoma; 1.50 0.60 0.60 0.04 2.14 2.14 XXX
gamma cam.
G0232 TC C PET WhBD lymphoma; 0.00 0.00 0.00 0.00 0.00 0.00 XXX
gamma cam.
G0233 ................ C PET WhBD melanoma; 0.00 0.00 0.00 0.00 0.00 0.00 XXX
gamma cam.
G0233 26 A PET WhBD melanoma; 1.50 0.60 0.60 0.04 2.14 2.14 XXX
gamma cam.
G0233 TC C PET WhBD melanoma; 0.00 0.00 0.00 0.00 0.00 0.00 XXX
gamma cam.
G0234 ................ C PET WhBD pulm nod; 0.00 0.00 0.00 0.00 0.00 0.00 XXX
gamma cam.
G0234 26 A PET WhBD pulm nod; 1.50 0.60 0.60 0.04 2.14 2.14 XXX
gamma cam.
G0234 TC C PET WhBD pulm nod; 0.00 0.00 0.00 0.00 0.00 0.00 XXX
gamma cam.
G0236 ................ A digital film convert 0.06 0.31 NA 0.02 0.39 NA ZZZ
diag ma.
G0236 26 A digital film convert 0.06 0.02 0.02 0.01 0.09 0.09 ZZZ
diag ma.
G0236 TC A digital film convert 0.00 0.29 NA 0.01 0.30 NA ZZZ
diag ma.
G0237 ................ A Therapeutic procd strg 0.00 0.45 NA 0.02 0.47 NA XXX
endur.
G0238 ................ C Oth resp proc, indiv.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
G0239 ................ C Oth resp proc, group.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
G0240 ................ A Critic care by MD 4.00 1.60 1.60 0.14 5.74 5.74 XXX
transport.
G0241 ................ A Each additional 30 2.00 0.80 0.80 0.07 2.87 2.87 ZZZ
minutes.
G0242 ................ X Multisource photon 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ster plan.
G0243 ................ X Multisour photon stero 0.00 0.00 0.00 0.00 0.00 0.00 XXX
treat.
G0244 ................ X Observ care by 0.00 0.00 0.00 0.00 0.00 0.00 XXX
facility topt.
G9001 ................ X MCCD, initial rate.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
G9002 ................ X MCCD, maintenance rate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
G9003 ................ X MCCD, risk adj hi, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
initial.
G9004 ................ X MCCD, risk adj lo, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
initial.
G9005 ................ X MCCD, risk adj, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
maintenance.
G9006 ................ X MCCD, Home monitoring. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
G9007 ................ X MCCD, sch team conf... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
G9008 ................ X MCCD, phys coor-care 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ovrsght.
G9009 ................ X MCCD, risk adj, level 0.00 0.00 0.00 0.00 0.00 0.00 XXX
3.
G9010 ................ X MCCD, risk adj, level 0.00 0.00 0.00 0.00 0.00 0.00 XXX
4.
G9011 ................ X MCCD, risk adj, level 0.00 0.00 0.00 0.00 0.00 0.00 XXX
5.
G9012 ................ X Other Specified Case 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Mgmt.
G9016 ................ N Demo-smoking cessation 0.00 0.00 0.00 0.00 0.00 0.00 XXX
coun.
H0001 ................ I Alcohol and/or drug 0.00 0.00 0.00 0.00 0.00 0.00 XXX
assess.
H0002 ................ I Alcohol and/or drug 0.00 0.00 0.00 0.00 0.00 0.00 XXX
screenin.
H0003 ................ I Alcohol and/or drug 0.00 0.00 0.00 0.00 0.00 0.00 XXX
screenin.
H0004 ................ I Alcohol and/or drug 0.00 0.00 0.00 0.00 0.00 0.00 XXX
services.
H0005 ................ I Alcohol and/or drug 0.00 0.00 0.00 0.00 0.00 0.00 XXX
services.
H0006 ................ I Alcohol and/or drug 0.00 0.00 0.00 0.00 0.00 0.00 XXX
services.
H0007 ................ I Alcohol and/or drug 0.00 0.00 0.00 0.00 0.00 0.00 XXX
services.
H0008 ................ I Alcohol and/or drug 0.00 0.00 0.00 0.00 0.00 0.00 XXX
services.
H0009 ................ I Alcohol and/or drug 0.00 0.00 0.00 0.00 0.00 0.00 XXX
services.
H0010 ................ I Alcohol and/or drug 0.00 0.00 0.00 0.00 0.00 0.00 XXX
services.
H0011 ................ I Alcohol and/or drug 0.00 0.00 0.00 0.00 0.00 0.00 XXX
services.
H0012 ................ I Alcohol and/or drug 0.00 0.00 0.00 0.00 0.00 0.00 XXX
services.
H0013 ................ I Alcohol and/or drug 0.00 0.00 0.00 0.00 0.00 0.00 XXX
services.
H0014 ................ I Alcohol and/or drug 0.00 0.00 0.00 0.00 0.00 0.00 XXX
services.
H0015 ................ I Alcohol and/or drug 0.00 0.00 0.00 0.00 0.00 0.00 XXX
services.
H0016 ................ I Alcohol and/or drug 0.00 0.00 0.00 0.00 0.00 0.00 XXX
services.
H0017 ................ I Alcohol and/or drug 0.00 0.00 0.00 0.00 0.00 0.00 XXX
services.
H0018 ................ I Alcohol and/or drug 0.00 0.00 0.00 0.00 0.00 0.00 XXX
services.
H0019 ................ I Alcohol and/or drug 0.00 0.00 0.00 0.00 0.00 0.00 XXX
services.
H0020 ................ I Alcohol and/or drug 0.00 0.00 0.00 0.00 0.00 0.00 XXX
services.
H0021 ................ I Alcohol and/or drug 0.00 0.00 0.00 0.00 0.00 0.00 XXX
training.
H0022 ................ I Alcohol and/or drug 0.00 0.00 0.00 0.00 0.00 0.00 XXX
interven.
H0023 ................ I Alcohol and/or drug 0.00 0.00 0.00 0.00 0.00 0.00 XXX
outreach.
H0024 ................ I Alcohol and/or drug 0.00 0.00 0.00 0.00 0.00 0.00 XXX
preventi.
H0025 ................ I Alcohol and/or drug 0.00 0.00 0.00 0.00 0.00 0.00 XXX
preventi.
H0026 ................ I Alcohol and/or drug 0.00 0.00 0.00 0.00 0.00 0.00 XXX
preventi.
H0027 ................ I Alcohol and/or drug 0.00 0.00 0.00 0.00 0.00 0.00 XXX
preventi.
H0028 ................ I Alcohol and/or drug 0.00 0.00 0.00 0.00 0.00 0.00 XXX
preventi.
H0029 ................ I Alcohol and/or drug 0.00 0.00 0.00 0.00 0.00 0.00 XXX
preventi.
H0030 ................ I Alcohol and/or drug 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hotline.
H1000 ................ I Prenatal care atrisk 0.00 0.00 0.00 0.00 0.00 0.00 XXX
assessm.
H1001 ................ I Antepartum management. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
H1002 ................ I Care coordination 0.00 0.00 0.00 0.00 0.00 0.00 XXX
prenatal.
H1003 ................ I Prenatal at risk 0.00 0.00 0.00 0.00 0.00 0.00 XXX
education.
[[Page 55485]]
H1004 ................ I Follow up home visit/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
prental.
H1005 ................ I Prenatal care enhanced 0.00 0.00 0.00 0.00 0.00 0.00 XXX
srv pk.
J0120 ................ E Tetracyclin injection. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J0130 ................ E Abciximab injection... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J0150 ................ E Injection adenosine 6 0.00 0.00 0.00 0.00 0.00 0.00 XXX
MG.
J0151 ................ E Adenosine injection... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J0170 ................ E Adrenalin epinephrin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inject.
J0190 ................ E Inj biperiden lactate/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
5 mg.
J0200 ................ E Alatrofloxacin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mesylate.
J0205 ................ E Alglucerase injection. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J0207 ................ E Amifostine............ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J0210 ................ E Methyldopate hcl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J0256 ................ E Alpha 1 proteinase 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inhibitor.
J0270 ................ E Alprostadil for 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J0275 ................ E Alprostadil urethral 0.00 0.00 0.00 0.00 0.00 0.00 XXX
suppos.
J0280 ................ E Aminophyllin 250 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J0282 ................ E Amiodarone HCl........ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J0285 ................ E Amphotericin B........ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J0286 ................ E Amphotericin B lipid 0.00 0.00 0.00 0.00 0.00 0.00 XXX
complex.
J0290 ................ E Ampicillin 500 MG inj. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J0295 ................ E Ampicillin sodium per 0.00 0.00 0.00 0.00 0.00 0.00 XXX
1.5 gm.
J0300 ................ E Amobarbital 125 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J0330 ................ E Succinycholine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
chloride inj.
J0340 ................ D Nandrolon 0.00 0.00 0.00 0.00 0.00 0.00 XXX
phenpropionate inj.
J0350 ................ E Injection anistreplase 0.00 0.00 0.00 0.00 0.00 0.00 XXX
30 u.
J0360 ................ E Hydralazine hcl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J0380 ................ E Inj metaraminol 0.00 0.00 0.00 0.00 0.00 0.00 XXX
bitartrate.
J0390 ................ E Chloroquine injection. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J0395 ................ E Arbutamine HCl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J0400 ................ D Inj trimethaphan 0.00 0.00 0.00 0.00 0.00 0.00 XXX
camsylate.
J0456 ................ E Azithromycin.......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J0460 ................ E Atropine sulfate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J0470 ................ E Dimecaprol injection.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J0475 ................ E Baclofen 10 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J0476 ................ E Baclofen intrathecal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
trial.
J0500 ................ E Dicyclomine injection. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J0510 ................ D Benzquinamide 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J0515 ................ E Inj benztropine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mesylate.
J0520 ................ E Bethanechol chloride 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inject.
J0530 ................ E Penicillin g 0.00 0.00 0.00 0.00 0.00 0.00 XXX
benzathine inj.
J0540 ................ E Penicillin g 0.00 0.00 0.00 0.00 0.00 0.00 XXX
benzathine inj.
J0550 ................ E Penicillin g 0.00 0.00 0.00 0.00 0.00 0.00 XXX
benzathine inj.
J0560 ................ E Penicillin g 0.00 0.00 0.00 0.00 0.00 0.00 XXX
benzathine inj.
J0570 ................ E Penicillin g 0.00 0.00 0.00 0.00 0.00 0.00 XXX
benzathine inj.
J0580 ................ E Penicillin g 0.00 0.00 0.00 0.00 0.00 0.00 XXX
benzathine inj.
J0585 ................ E Botulinum toxin a per 0.00 0.00 0.00 0.00 0.00 0.00 XXX
unit.
J0587 ................ E Botulinum toxin type B 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J0590 ................ D Ethylnorepinephrine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hcl inj.
J0600 ................ E Edetate calcium 0.00 0.00 0.00 0.00 0.00 0.00 XXX
disodium inj.
J0610 ................ E Calcium gluconate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J0620 ................ E Calcium glycer & lact/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
10 ML.
J0630 ................ E Calcitonin salmon 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J0635 ................ E Calcitriol injection.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J0640 ................ E Leucovorin calcium 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J0670 ................ E Inj mepivacaine HCL/10 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ml.
J0690 ................ E Cefazolin sodium 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J0692 ................ E Cefepime HCl for 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J0694 ................ E Cefoxitin sodium 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J0695 ................ D Cefonocid sodium 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J0696 ................ E Ceftriaxone sodium 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J0697 ................ E Sterile cefuroxime 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J0698 ................ E Cefotaxime sodium 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J0702 ................ E Betamethasone acet&sod 0.00 0.00 0.00 0.00 0.00 0.00 XXX
phosp.
J0704 ................ E Betamethasone sod 0.00 0.00 0.00 0.00 0.00 0.00 XXX
phosp/4 MG.
J0706 ................ E Caffeine citrate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J0710 ................ E Cephapirin sodium 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J0713 ................ E Inj ceftazidime per 0.00 0.00 0.00 0.00 0.00 0.00 XXX
500 mg.
J0715 ................ E Ceftizoxime sodium/500 0.00 0.00 0.00 0.00 0.00 0.00 XXX
MG.
J0720 ................ E Chloramphenicol sodium 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injec.
J0725 ................ E Chorionic gonadotropin/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
1000u.
J0730 ................ D Chlorpheniramin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
maleate inj.
J0735 ................ E Clonidine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hydrochloride.
J0740 ................ E Cidofovir injection... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
[[Page 55486]]
J0743 ................ E Cilastatin sodium 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J0744 ................ E Ciprofloxacin iv...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J0745 ................ E Inj codeine phosphate/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
30 MG.
J0760 ................ E Colchicine injection.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J0770 ................ E Colistimethate sodium 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J0780 ................ E Prochlorperazine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J0800 ................ E Corticotropin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J0810 ................ D Cortisone injection... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J0835 ................ E Inj cosyntropin per 0.00 0.00 0.00 0.00 0.00 0.00 XXX
0.25 MG.
J0850 ................ E Cytomegalovirus imm IV 0.00 0.00 0.00 0.00 0.00 0.00 XXX
/vial.
J0895 ................ E Deferoxamine mesylate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J0900 ................ E Testosterone enanthate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J0945 ................ E Brompheniramine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
maleate inj.
J0970 ................ E Estradiol valerate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J1000 ................ E Depo-estradiol 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cypionate inj.
J1020 ................ E Methylprednisolone 20 0.00 0.00 0.00 0.00 0.00 0.00 XXX
MG inj.
J1030 ................ E Methylprednisolone 40 0.00 0.00 0.00 0.00 0.00 0.00 XXX
MG inj.
J1040 ................ E Methylprednisolone 80 0.00 0.00 0.00 0.00 0.00 0.00 XXX
MG inj.
J1050 ................ E Medroxyprogesterone 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J1055 ................ N Medroxyprogester 0.00 0.00 0.00 0.00 0.00 0.00 XXX
acetate inj.
J1056 ................ E MA/EC contraceptive 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J1060 ................ E Testosterone cypionate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
1 ML.
J1070 ................ E Testosterone cypionate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
100 MG.
J1080 ................ E Testosterone cypionate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
200 MG.
J1090 ................ D Testosterone cypionate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
50 MG.
J1095 ................ E Inj dexamethasone 0.00 0.00 0.00 0.00 0.00 0.00 XXX
acetate.
J1100 ................ E Dexamethasone sodium 0.00 0.00 0.00 0.00 0.00 0.00 XXX
phos.
J1110 ................ E Inj dihydroergotamine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mesylt.
J1120 ................ E Acetazolamid sodium 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J1160 ................ E Digoxin injection..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J1165 ................ E Phenytoin sodium 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J1170 ................ E Hydromorphone 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J1180 ................ E Dyphylline injection.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J1190 ................ E Dexrazoxane HCl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J1200 ................ E Diphenhydramine hcl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J1205 ................ E Chlorothiazide sodium 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J1212 ................ E Dimethyl sulfoxide 50% 0.00 0.00 0.00 0.00 0.00 0.00 XXX
50 ML.
J1230 ................ E Methadone injection... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J1240 ................ E Dimenhydrinate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J1245 ................ E Dipyridamole injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J1250 ................ E Inj dobutamine HCL/250 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mg.
J1260 ................ E Dolasetron mesylate... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J1270 ................ E Injection, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
doxercalciferol.
J1320 ................ E Amitriptyline 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J1325 ................ E Epoprostenol injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J1327 ................ E Eptifibatide injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J1330 ................ E Ergonovine maleate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J1362 ................ D Erythromycin glucep/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
250 MG.
J1364 ................ E Erythro lactobionate/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
500 MG.
J1380 ................ E Estradiol valerate 10 0.00 0.00 0.00 0.00 0.00 0.00 XXX
MG inj.
J1390 ................ E Estradiol valerate 20 0.00 0.00 0.00 0.00 0.00 0.00 XXX
MG inj.
J1410 ................ E Inj estrogen conjugate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
25 MG.
J1435 ................ E Injection estrone per 0.00 0.00 0.00 0.00 0.00 0.00 XXX
1 MG.
J1436 ................ E Etidronate disodium 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J1438 ................ E Etanercept injection.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J1440 ................ E Filgrastim 300 mcg 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J1441 ................ E Filgrastim 480 mcg 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J1450 ................ E Fluconazole........... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J1452 ................ E Intraocular Fomivirsen 0.00 0.00 0.00 0.00 0.00 0.00 XXX
na.
J1455 ................ E Foscarnet sodium 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J1460 ................ E Gamma globulin 1 CC 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J1470 ................ E Gamma globulin 2 CC 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J1480 ................ E Gamma globulin 3 CC 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J1490 ................ E Gamma globulin 4 CC 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J1500 ................ E Gamma globulin 5 CC 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J1510 ................ E Gamma globulin 6 CC 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J1520 ................ E Gamma globulin 7 CC 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J1530 ................ E Gamma globulin 8 CC 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J1540 ................ E Gamma globulin 9 CC 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J1550 ................ E Gamma globulin 10 CC 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J1560 ................ E Gamma globulin > 10 CC 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J1561 ................ E Immune globulin 500 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J1563 ................ E IV immune globulin.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
[[Page 55487]]
J1565 ................ E RSV-ivig.............. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J1570 ................ E Ganciclovir sodium 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J1580 ................ E Garamycin gentamicin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J1590 ................ E Gatifloxacin injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J1600 ................ E Gold sodium 0.00 0.00 0.00 0.00 0.00 0.00 XXX
thiomaleate inj.
J1610 ................ E Glucagon hydrochloride/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
1 MG.
J1620 ................ E Gonadorelin hydroch/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
100 mcg.
J1626 ................ E Granisetron HCl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J1630 ................ E Haloperidol injection. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J1631 ................ E Haloperidol decanoate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J1642 ................ E Inj heparin sodium per 0.00 0.00 0.00 0.00 0.00 0.00 XXX
10 u.
J1644 ................ E Inj heparin sodium per 0.00 0.00 0.00 0.00 0.00 0.00 XXX
1000u.
J1645 ................ E Dalteparin sodium..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J1650 ................ E Inj enoxaparin sodium. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J1655 ................ E Tinzaparin sodium 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J1670 ................ E Tetanus immune 0.00 0.00 0.00 0.00 0.00 0.00 XXX
globulin inj.
J1690 ................ D Prednisolone tebutate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J1700 ................ E Hydrocortisone acetate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J1710 ................ E Hydrocortisone sodium 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ph inj.
J1720 ................ E Hydrocortisone sodium 0.00 0.00 0.00 0.00 0.00 0.00 XXX
succ i.
J1730 ................ E Diazoxide injection... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J1739 ................ D Hydroxyprogesterone 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cap 125.
J1741 ................ D Hydroxyprogesterone 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cap 250.
J1742 ................ E Ibutilide fumarate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J1745 ................ E Infliximab injection.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J1750 ................ E Iron dextran.......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J1755 ................ E Iron sucrose injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J1785 ................ E Injection imiglucerase 0.00 0.00 0.00 0.00 0.00 0.00 XXX
/unit.
J1790 ................ E Droperidol injection.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J1800 ................ E Propranolol injection. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J1810 ................ E Droperidol/fentanyl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J1820 ................ E Insulin injection..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J1825 ................ E Interferon beta-1a.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J1830 ................ E Interferon beta-1b/.25 0.00 0.00 0.00 0.00 0.00 0.00 XXX
MG.
J1835 ................ E Intraconazole 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J1840 ................ E Kanamycin sulfate 500 0.00 0.00 0.00 0.00 0.00 0.00 XXX
MG inj.
J1850 ................ E Kanamycin sulfate 75 0.00 0.00 0.00 0.00 0.00 0.00 XXX
MG inj.
J1885 ................ E Ketorolac tromethamine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J1890 ................ E Cephalothin sodium 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J1910 ................ E Kutapressin injection. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J1930 ................ D Propiomazine injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J1940 ................ E Furosemide injection.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J1950 ................ E Leuprolide acetate/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
3.75 MG.
J1955 ................ E Inj levocarnitine per 0.00 0.00 0.00 0.00 0.00 0.00 XXX
1 gm.
J1956 ................ E Levofloxacin injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J1960 ................ E Levorphanol tartrate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J1970 ................ D Methotrimeprazine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J1980 ................ E Hyoscyamine sulfate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J1990 ................ E Chlordiazepoxide 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J2000 ................ E Lidocaine injection... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J2010 ................ E Lincomycin injection.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J2020 ................ E Linezolid injection... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J2060 ................ E Lorazepam injection... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J2150 ................ E Mannitol injection.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J2175 ................ E Meperidine hydrochl/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
100 MG.
J2180 ................ E Meperidine/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
promethazine inj.
J2210 ................ E Methylergonovin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
maleate inj.
J2240 ................ D Metocurine iodide 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J2250 ................ E Inj midazolam 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hydrochloride.
J2260 ................ E Inj milrinone lactate/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
5 ML.
J2270 ................ E Morphine sulfate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J2271 ................ E Morphine so4 injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX
100mg.
J2275 ................ E Morphine sulfate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J2300 ................ E Inj nalbuphine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hydrochloride.
J2310 ................ E Inj naloxone 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hydrochloride.
J2320 ................ E Nandrolone decanoate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
50 MG.
J2321 ................ E Nandrolone decanoate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
100 MG.
J2322 ................ E Nandrolone decanoate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
200 MG.
J2330 ................ D Thiothixene injection. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J2350 ................ D Niacinamide/niacin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J2352 ................ E Octreotide acetate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J2355 ................ E Oprelvekin injection.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J2360 ................ E Orphenadrine injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX
[[Page 55488]]
J2370 ................ E Phenylephrine hcl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J2400 ................ E Chloroprocaine hcl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J2405 ................ E Ondansetron hcl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J2410 ................ E Oxymorphone hcl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J2430 ................ E Pamidronate disodium/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
30 MG.
J2440 ................ E Papaverin hcl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J2460 ................ E Oxytetracycline 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J2480 ................ D Hydrochlorides of 0.00 0.00 0.00 0.00 0.00 0.00 XXX
opium inj.
J2500 ................ E Paricalcitol.......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J2510 ................ E Penicillin g procaine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J2512 ................ D Inj pentagastrin per 2 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ML.
J2515 ................ E Pentobarbital sodium 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J2540 ................ E Penicillin g potassium 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J2543 ................ E Piperacillin/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
tazobactam.
J2545 ................ E Pentamidine isethionte/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
300mg.
J2550 ................ E Promethazine hcl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J2560 ................ E Phenobarbital sodium 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J2590 ................ E Oxytocin injection.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J2597 ................ E Inj desmopressin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
acetate.
J2640 ................ D Prednisolone sodium ph 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J2650 ................ E Prednisolone acetate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J2670 ................ E Totazoline hcl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J2675 ................ D Inj progesterone per 0.00 0.00 0.00 0.00 0.00 0.00 XXX
50 MG.
J2680 ................ E Fluphenazine decanoate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
25 MG.
J2690 ................ E Procainamide hcl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J2700 ................ E Oxacillin sodium 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J2710 ................ E Neostigmine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
methylslfte inj.
J2720 ................ E Inj protamine sulfate/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
10 MG.
J2725 ................ E Inj protirelin per 250 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mcg.
J2730 ................ E Pralidoxime chloride 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J2760 ................ E Phentolaine mesylate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J2765 ................ E Metoclopramide hcl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J2770 ................ E Quinupristin/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dalfopristin.
J2780 ................ E Ranitidine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hydrochloride inj.
J2790 ................ E Rho (D) immune 0.00 0.00 0.00 0.00 0.00 0.00 XXX
globulin inj.
J2792 ................ E Rho(D) immune globulin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
h, sd.
J2795 ................ E Ropivacaine HCl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J2800 ................ E Methocarbamol 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J2810 ................ E Inj theophylline per 0.00 0.00 0.00 0.00 0.00 0.00 XXX
40 MG.
J2820 ................ E Sargramostim injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J2860 ................ D Secobarbital sodium 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J2910 ................ E Aurothioglucose 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J2912 ................ E Sodium chloride 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J2915 ................ E NA Ferric Gluconate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Complex.
J2920 ................ E Methylprednisolone 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J2930 ................ E Methylprednisolone 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J2940 ................ E Somatrem injection.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J2941 ................ E Somatropin injection.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J2950 ................ E Promazine hcl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J2970 ................ D Methicillin sodium 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J2993 ................ E Reteplase injection... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J2995 ................ E Inj streptokinase/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
250,000 IU.
J2997 ................ E Alteplase recombinant. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J3000 ................ E Streptomycin injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J3010 ................ E Fentanyl citrate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J3030 ................ E Sumatriptan succinate/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
6 MG.
J3070 ................ E Pentazocine hcl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J3080 ................ D Chlorprothixene 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J3100 ................ E Tenecteplase injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J3105 ................ E Terbutaline sulfate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J3120 ................ E Testosterone enanthate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J3130 ................ E Testosterone enanthate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J3140 ................ E Testosterone 0.00 0.00 0.00 0.00 0.00 0.00 XXX
suspension inj.
J3150 ................ E Testosteron propionate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J3230 ................ E Chlorpromazine hcl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J3240 ................ E Thyrotropin injection. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J3245 ................ E Tirofiban 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hydrochloride.
J3250 ................ E Trimethobenzamide hcl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J3260 ................ E Tobramycin sulfate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J3265 ................ E Injection torsemide 10 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mg/ml.
J3270 ................ D Imipramine hcl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J3280 ................ E Thiethylperazine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
maleate inj.
J3301 ................ E Triamcinolone 0.00 0.00 0.00 0.00 0.00 0.00 XXX
acetonide inj.
[[Page 55489]]
J3302 ................ E Triamcinolone 0.00 0.00 0.00 0.00 0.00 0.00 XXX
diacetate inj.
J3303 ................ E Triamcinolone 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hexacetonl inj.
J3305 ................ E Inj trimetrexate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
glucoronate.
J3310 ................ E Perphenazine injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J3320 ................ E Spectinomycn di-hcl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J3350 ................ E Urea injection........ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J3360 ................ E Diazepam injection.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J3364 ................ E Urokinase 5,000 IU 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J3365 ................ E Urokinase 250,000 IU 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J3370 ................ R Vancomycin hcl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J3390 ................ D Methoxamine injection. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J3395 ................ E Verteporfin injection. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J3400 ................ E Triflupromazine hcl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J3410 ................ E Hydroxyzine hcl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J3420 ................ E Vitamin b12 injection. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J3430 ................ E Vitamin k phytonadione 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J3450 ................ D Mephentermine sulfate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J3470 ................ E Hyaluronidase 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J3475 ................ E Inj magnesium sulfate. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J3480 ................ E Inj potassium chloride 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J3485 ................ E Zidovudine............ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J3490 ................ E Drugs unclassified 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J3520 ................ N Edetate disodium per 0.00 0.00 0.00 0.00 0.00 0.00 XXX
150 mg.
J3530 ................ E Nasal vaccine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inhalation.
J3535 ................ N Metered dose inhaler 0.00 0.00 0.00 0.00 0.00 0.00 XXX
drug.
J3570 ................ N Laetrile amygdalin vit 0.00 0.00 0.00 0.00 0.00 0.00 XXX
B17.
J7030 ................ E Normal saline solution 0.00 0.00 0.00 0.00 0.00 0.00 XXX
infus.
J7040 ................ E Normal saline solution 0.00 0.00 0.00 0.00 0.00 0.00 XXX
infus.
J7042 ................ E 5% dextrose/normal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
saline.
J7050 ................ E Normal saline solution 0.00 0.00 0.00 0.00 0.00 0.00 XXX
infus.
J7051 ................ E Sterile saline/water.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J7060 ................ E 5% dextrose/water..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J7070 ................ E D5w infusion.......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J7100 ................ E Dextran 40 infusion... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J7110 ................ E Dextran 75 infusion... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J7120 ................ E Ringers lactate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
infusion.
J7130 ................ E Hypertonic saline 0.00 0.00 0.00 0.00 0.00 0.00 XXX
solution.
J7190 ................ X Factor viii........... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J7191 ................ X Factor VIII (porcine). 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J7192 ................ X Factor viii 0.00 0.00 0.00 0.00 0.00 0.00 XXX
recombinant.
J7193 ................ E Factor IX non- 0.00 0.00 0.00 0.00 0.00 0.00 XXX
recombinant.
J7194 ................ X Factor ix complex..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J7195 ................ E Factor IX recombinant. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J7197 ................ X Antithrombin iii 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J7198 ................ E Anti-inhibitor........ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J7199 ................ E Hemophilia clot factor 0.00 0.00 0.00 0.00 0.00 0.00 XXX
noc.
J7300 ................ N Intraut copper 0.00 0.00 0.00 0.00 0.00 0.00 XXX
contraceptive.
J7302 ................ N Levonorgestrel iu 0.00 0.00 0.00 0.00 0.00 0.00 XXX
contracept.
J7308 ................ E Aminolevulinic acid 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hcl top.
J7310 ................ E Ganciclovir long act 0.00 0.00 0.00 0.00 0.00 0.00 XXX
implant.
J7315 ................ D Sodium hyaluronate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J7316 ................ E Sodium hyaluronate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J7320 ................ E Hylan G-F 20 injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J7330 ................ E Cultured chondrocytes 0.00 0.00 0.00 0.00 0.00 0.00 XXX
implnt.
J7340 ................ E Metabolic active D/E 0.00 0.00 0.00 0.00 0.00 0.00 XXX
tissue.
J7500 ................ X Azathioprine oral 50 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mg.
J7501 ................ X Azathioprine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
parenteral.
J7502 ................ E Cyclosporine oral 100 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mg.
J7504 ................ X Lymphocyte immune 0.00 0.00 0.00 0.00 0.00 0.00 XXX
globulin.
J7505 ................ X Monoclonal antibodies. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J7506 ................ X Prednisone oral....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J7507 ................ E Tacrolimus oral per 1 0.00 0.00 0.00 0.00 0.00 0.00 XXX
MG.
J7508 ................ E Tacrolimus oral per 5 0.00 0.00 0.00 0.00 0.00 0.00 XXX
MG.
J7509 ................ X Methylprednisolone 0.00 0.00 0.00 0.00 0.00 0.00 XXX
oral.
J7510 ................ X Prednisolone oral per 0.00 0.00 0.00 0.00 0.00 0.00 XXX
5 mg.
J7511 ................ E Antithymocyte globuln 0.00 0.00 0.00 0.00 0.00 0.00 XXX
rabbit.
J7513 ................ E Daclizumab, parenteral 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J7515 ................ E Cyclosporine oral 25 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mg.
J7516 ................ E Cyclosporin parenteral 0.00 0.00 0.00 0.00 0.00 0.00 XXX
250 mg.
J7517 ................ E Mycophenolate mofetil 0.00 0.00 0.00 0.00 0.00 0.00 XXX
oral.
J7520 ................ E Sirolimus, oral....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J7525 ................ E Tacrolimus injection.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J7599 ................ X Immunosuppressive drug 0.00 0.00 0.00 0.00 0.00 0.00 XXX
noc.
[[Page 55490]]
J7608 ................ E Acetylcysteine inh sol 0.00 0.00 0.00 0.00 0.00 0.00 XXX
u d.
J7618 ................ E Albuterol inh sol con. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J7619 ................ E Albuterol inh sol u d. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J7622 ................ E Beclomethasome 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inhalatn sol.
J7624 ................ E Betamethasome 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inhalation sol.
J7626 ................ E Budesonide inhalation 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sol.
J7628 ................ E Bitolterol mes inhal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sol con.
J7629 ................ E Bitolterol mes inh sol 0.00 0.00 0.00 0.00 0.00 0.00 XXX
u d.
J7631 ................ E Cromolyn sodium inh 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sol u d.
J7635 ................ E Atropine inhal sol con 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J7636 ................ E Atropine inhal sol 0.00 0.00 0.00 0.00 0.00 0.00 XXX
unit dose.
J7637 ................ E Dexamethasone inhal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sol con.
J7638 ................ E Dexamethasone inhal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sol u d.
J7639 ................ E Dornase alpha inhal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sol u d.
J7641 ................ E Flunisolide, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inhalation sol.
J7642 ................ E Glycopyrrolate inhal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sol con.
J7643 ................ E Glycopyrrolate inhal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sol u d.
J7644 ................ E Ipratropium brom inh 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sol u d.
J7648 ................ E Isoetharine hcl inh 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sol con.
J7649 ................ E Isoetharine hcl inh 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sol u d.
J7658 ................ E Isoproterenolhcl inh 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sol con.
J7659 ................ E Isoproterenol hcl inh 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sol ud.
J7668 ................ E Metaproterenol inh sol 0.00 0.00 0.00 0.00 0.00 0.00 XXX
con.
J7669 ................ E Metaproterenol inh sol 0.00 0.00 0.00 0.00 0.00 0.00 XXX
u d.
J7680 ................ E Terbutaline so4 inh 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sol con.
J7681 ................ E Terbutaline so4 inh 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sol u d.
J7682 ................ E Tobramycin inhalation 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sol.
J7683 ................ E Triamcinolone inh sol 0.00 0.00 0.00 0.00 0.00 0.00 XXX
con.
J7684 ................ E Triamcinolone inh sol 0.00 0.00 0.00 0.00 0.00 0.00 XXX
u d.
J7699 ................ E Inhalation solution 0.00 0.00 0.00 0.00 0.00 0.00 XXX
for DME.
J7799 ................ E Non-inhalation drug 0.00 0.00 0.00 0.00 0.00 0.00 XXX
for DME.
J8499 ................ N Oral prescrip drug non 0.00 0.00 0.00 0.00 0.00 0.00 XXX
chemo.
J8510 ................ E Oral busulfan......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J8520 ................ E Capecitabine, oral, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
150 mg.
J8521 ................ E Capecitabine, oral, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
500 mg.
J8530 ................ E Cyclophosphamide oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX
25 MG.
J8560 ................ E Etoposide oral 50 MG.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J8600 ................ E Melphalan oral 2 MG... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J8610 ................ E Methotrexate oral 2.5 0.00 0.00 0.00 0.00 0.00 0.00 XXX
MG.
J8700 ................ E Temozolmide........... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J8999 ................ E Oral prescription drug 0.00 0.00 0.00 0.00 0.00 0.00 XXX
chemo.
J9000 ................ E Doxorubic hcl 10 MG vl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
chemo.
J9001 ................ E Doxorubicin hcl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
liposome inj.
J9015 ................ E Aldesleukin/single use 0.00 0.00 0.00 0.00 0.00 0.00 XXX
vial.
J9017 ................ E Arsenic trioxide...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J9020 ................ E Asparaginase injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J9031 ................ E Bcg live intravesical 0.00 0.00 0.00 0.00 0.00 0.00 XXX
vac.
J9040 ................ E Bleomycin sulfate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J9045 ................ E Carboplatin injection. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J9050 ................ E Carmus bischl nitro 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J9060 ................ E Cisplatin 10 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J9062 ................ E Cisplatin 50 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J9065 ................ E Inj cladribine per 1 0.00 0.00 0.00 0.00 0.00 0.00 XXX
MG.
J9070 ................ E Cyclophosphamide 100 0.00 0.00 0.00 0.00 0.00 0.00 XXX
MG inj.
J9080 ................ E Cyclophosphamide 200 0.00 0.00 0.00 0.00 0.00 0.00 XXX
MG inj.
J9090 ................ E Cyclophosphamide 500 0.00 0.00 0.00 0.00 0.00 0.00 XXX
MG inj.
J9091 ................ E Cyclophosphamide 1.0 0.00 0.00 0.00 0.00 0.00 0.00 XXX
grm inj.
J9092 ................ E Cyclophosphamide 2.0 0.00 0.00 0.00 0.00 0.00 0.00 XXX
grm inj.
J9093 ................ E Cyclophosphamide 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lyophilized.
J9094 ................ E Cyclophosphamide 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lyophilized.
J9095 ................ E Cyclophosphamide 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lyophilized.
J9096 ................ E Cyclophosphamide 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lyophilized.
J9097 ................ E Cyclophosphamide 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lyophilized.
J9100 ................ E Cytarabine hcl 100 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J9110 ................ E Cytarabine hcl 500 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J9120 ................ E Dactinomycin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
actinomycin d.
J9130 ................ E Dacarbazine 10 MG inj. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J9140 ................ E Dacarbazine 200 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J9150 ................ E Daunorubicin.......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J9151 ................ E Daunorubicin citrate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
liposom.
J9160 ................ E Denileukin diftitox, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
300 mcg.
J9165 ................ E Diethylstilbestrol 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J9170 ................ E Docetaxel............. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
[[Page 55491]]
J9180 ................ E Epirubicin HCl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J9181 ................ E Etoposide 10 MG inj... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J9182 ................ E Etoposide 100 MG inj.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J9185 ................ E Fludarabine phosphate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J9190 ................ E Fluorouracil injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J9200 ................ E Floxuridine injection. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J9201 ................ E Gemcitabine HCl....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J9202 ................ E Goserelin acetate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
implant.
J9206 ................ E Irinotecan injection.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J9208 ................ E Ifosfomide injection.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J9209 ................ E Mesna injection....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J9211 ................ E Idarubicin hcl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J9212 ................ E Interferon alfacon-1.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J9213 ................ E Interferon alfa-2a inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J9214 ................ E Interferon alfa-2b inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J9215 ................ E Interferon alfa-n3 inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J9216 ................ E Interferon gamma 1-b 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J9217 ................ E Leuprolide acetate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
suspnsion.
J9218 ................ E Leuprolide acetate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
injection.
J9219 ................ E Leuprolide acetate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
implant.
J9230 ................ E Mechlorethamine hcl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J9245 ................ E Inj melphalan hydrochl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
50 MG.
J9250 ................ E Methotrexate sodium 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J9260 ................ E Methotrexate sodium 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J9265 ................ E Paclitaxel injection.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J9266 ................ E Pegaspargase/singl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dose vial.
J9268 ................ E Pentostatin injection. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J9270 ................ E Plicamycin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
(mithramycin) inj.
J9280 ................ E Mitomycin 5 MG inj.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J9290 ................ E Mitomycin 20 MG inj... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J9291 ................ E Mitomycin 40 MG inj... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J9293 ................ E Mitoxantrone hydrochl/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
5 MG.
J9300 ................ E Gemtuzumab ozogamicin. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J9310 ................ E Rituximab cancer 0.00 0.00 0.00 0.00 0.00 0.00 XXX
treatment.
J9320 ................ E Streptozocin injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J9340 ................ E Thiotepa injection.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J9350 ................ E Topotecan............. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J9355 ................ E Trastuzumab........... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J9357 ................ E Valrubicin, 200 mg.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J9360 ................ E Vinblastine sulfate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
J9370 ................ E Vincristine sulfate 1 0.00 0.00 0.00 0.00 0.00 0.00 XXX
MG inj.
J9375 ................ E Vincristine sulfate 2 0.00 0.00 0.00 0.00 0.00 0.00 XXX
MG inj.
J9380 ................ E Vincristine sulfate 5 0.00 0.00 0.00 0.00 0.00 0.00 XXX
MG inj.
J9390 ................ E Vinorelbine tartrate/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
10 mg.
J9600 ................ E Porfimer sodium....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
J9999 ................ E Chemotherapy drug..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
M0064 ................ A Visit for drug 0.37 0.25 0.12 0.01 0.63 0.50 XXX
monitoring.
M0075 ................ N Cellular therapy...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
M0076 ................ N Prolotherapy.......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
M0100 ................ N Intragastric 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hypothermia.
M0300 ................ N IV chelationtherapy... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
M0301 ................ N Fabric wrapping of 0.00 0.00 0.00 0.00 0.00 0.00 XXX
aneurysm.
M0302 ................ D Assessment of cardiac 0.00 0.00 NA 0.00 0.00 NA XXX
output.
M0302 26 D Assessment of cardiac 0.00 0.00 0.00 0.00 0.00 0.00 XXX
output.
M0302 TC D Assessment of cardiac 0.00 0.00 NA 0.00 0.00 NA XXX
output.
P2028 ................ X Cephalin floculation 0.00 0.00 0.00 0.00 0.00 0.00 XXX
test.
P2029 ................ X Congo red blood test.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
P2031 ................ N Hair analysis......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
P2033 ................ X Blood thymol turbidity 0.00 0.00 0.00 0.00 0.00 0.00 XXX
P2038 ................ X Blood mucoprotein..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
P3000 ................ X Screen pap by tech w 0.00 0.00 0.00 0.00 0.00 0.00 XXX
md supv.
P3001 ................ A Screening pap smear by 0.42 0.19 0.19 0.01 0.62 0.62 XXX
phys.
P7001 ................ I Culture bacterial 0.00 0.00 0.00 0.00 0.00 0.00 XXX
urine.
P9010 ................ E Whole blood for 0.00 0.00 0.00 0.00 0.00 0.00 XXX
transfusion.
P9011 ................ E Blood split unit...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
P9012 ................ E Cryoprecipitate each 0.00 0.00 0.00 0.00 0.00 0.00 XXX
unit.
P9016 ................ E RBC leukocytes reduced 0.00 0.00 0.00 0.00 0.00 0.00 XXX
P9017 ................ E One donor fresh frozn 0.00 0.00 0.00 0.00 0.00 0.00 XXX
plasma.
P9019 ................ E Platelets, each unit.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
P9020 ................ E Plaelet rich plasma 0.00 0.00 0.00 0.00 0.00 0.00 XXX
unit.
P9021 ................ E Red blood cells unit.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
P9022 ................ E Washed red blood cells 0.00 0.00 0.00 0.00 0.00 0.00 XXX
unit.
P9023 ................ X Frozen plasma, pooled, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sd.
[[Page 55492]]
P9031 ................ X Platelets leukocytes 0.00 0.00 0.00 0.00 0.00 0.00 XXX
reduced.
P9032 ................ X Platelets, irradiated. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
P9033 ................ X Platelets leukoreduced 0.00 0.00 0.00 0.00 0.00 0.00 XXX
irrad.
P9034 ................ X Platelets, pheresis... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
P9035 ................ X Platelet pheres 0.00 0.00 0.00 0.00 0.00 0.00 XXX
leukoreduced.
P9036 ................ X Platelet pheresis 0.00 0.00 0.00 0.00 0.00 0.00 XXX
irradiated.
P9037 ................ X Plate pheres leukoredu 0.00 0.00 0.00 0.00 0.00 0.00 XXX
irrad.
P9038 ................ X RBC irradiated........ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
P9039 ................ X RBC deglycerolized.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
P9040 ................ X RBC leukoreduced 0.00 0.00 0.00 0.00 0.00 0.00 XXX
irradiated.
P9041 ................ X Albumin (human), 5%, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
50 ml.
P9042 ................ D Albumin (human), 25%.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
P9043 ................ X Plasma protein 0.00 0.00 0.00 0.00 0.00 0.00 XXX
fract,t5%,50 ml.
P9044 ................ X Cryoprecipitatereduced 0.00 0.00 0.00 0.00 0.00 0.00 XXX
plasma.
P9045 ................ X Albumin (human), 5%, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
250 ml.
P9046 ................ X Albumin (human), 25%, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
20 ml.
P9047 ................ X Albumin (human), 25%, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
50 ml.
P9048 ................ X Plasmaprotein fract, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
5%, 250 ml.
P9050 ................ X Granulocytes, pheresis 0.00 0.00 0.00 0.00 0.00 0.00 XXX
unit.
P9603 ................ X One-way allow prorated 0.00 0.00 0.00 0.00 0.00 0.00 XXX
miles.
P9604 ................ X One-way allow prorated 0.00 0.00 0.00 0.00 0.00 0.00 XXX
trip.
P9612 ................ X Catheterize for urine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
spec.
P9615 ................ X Urine specimen collect 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mult.
Q0035 ................ A Cardiokymography...... 0.17 0.44 NA 0.03 0.64 NA XXX
Q0035 26 A Cardiokymography...... 0.17 0.07 0.07 0.01 0.25 0.25 XXX
Q0035 TC A Cardiokymography...... 0.00 0.37 NA 0.02 0.39 NA XXX
Q0091 ................ A Obtaining screen pap 0.37 0.68 0.15 0.01 1.06 0.53 XXX
smear.
Q0092 ................ A Set up port x-ray 0.00 0.30 NA 0.01 0.31 NA XXX
equipment.
Q0111 ................ X Wet mounts/w 0.00 0.00 0.00 0.00 0.00 0.00 XXX
preparations.
Q0112 ................ X Potassium hydroxide 0.00 0.00 0.00 0.00 0.00 0.00 XXX
preps.
Q0113 ................ X Pinworm examinations.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q0114 ................ X Fern test............. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q0115 ................ X Post-coital mucous 0.00 0.00 0.00 0.00 0.00 0.00 XXX
exam.
Q0136 ................ E Non esrd epoetin alpha 0.00 0.00 0.00 0.00 0.00 0.00 XXX
inj.
Q0144 ................ D Azithromycin 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dihydrate, oral.
Q0160 ................ D Factor IX non- 0.00 0.00 0.00 0.00 0.00 0.00 XXX
recombinant.
Q0161 ................ D Factor IX recombinant. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q0163 ................ X Diphenhydramine HCl 50 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mg.
Q0164 ................ X Prochlorperazine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
maleate 5 mg.
Q0165 ................ X Prochlorperazine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
maleate 10 mg.
Q0166 ................ X Granisetron HCl 1 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX
oral.
Q0167 ................ X Dronabinol 2.5 mg oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q0168 ................ X Dronabinol 5 mg oral.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q0169 ................ X Promethazine HCl 12.5 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mg oral.
Q0170 ................ X Promethazine HCl 25 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX
oral.
Q0171 ................ X Chlorpromazine HCl 10 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mg oral.
Q0172 ................ X Chlorpromazine HCl 25 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mg oral.
Q0173 ................ X Trimethobenzamide HCl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
250 mg.
Q0174 ................ X Thiethylperazine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
maleate 10 mg.
Q0175 ................ X Perphenazine 4 mg oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q0176 ................ X Perphenazine 8 mg oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q0177 ................ X Hydroxyzine pamoate 25 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mg.
Q0178 ................ X Hydroxyzine pamoate 50 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mg.
Q0179 ................ X Ondansetron HCl 8 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX
oral.
Q0180 ................ X Dolasetron mesylate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
oral.
Q0181 ................ X Unspecified oral anti- 0.00 0.00 0.00 0.00 0.00 0.00 XXX
emetic.
Q0183 ................ X Nonmetabolic active 0.00 0.00 0.00 0.00 0.00 0.00 XXX
tissue.
Q0184 ................ X Metabolically active 0.00 0.00 0.00 0.00 0.00 0.00 XXX
tissue.
Q0185 ................ D Metabolic active D/E 0.00 0.00 0.00 0.00 0.00 0.00 XXX
tissue.
Q0187 ................ E Factor viia 0.00 0.00 0.00 0.00 0.00 0.00 XXX
recombinant.
Q1001 ................ X Ntiol category 1...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q1002 ................ X Ntiol category 2...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q1003 ................ X Ntiol category 3...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q1004 ................ X Ntiol category 4...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q1005 ................ X Ntiol category 5...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q2001 ................ N Oral cabergoline 0.5 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mg.
Q2002 ................ E Elliotts b solution 0.00 0.00 0.00 0.00 0.00 0.00 XXX
per ml.
Q2003 ................ E Aprotinin, 10,000 kiu. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q2004 ................ E Bladder calculi irrig 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sol.
Q2005 ................ E Corticorelin ovine 0.00 0.00 0.00 0.00 0.00 0.00 XXX
triflutat.
Q2006 ................ E Digoxin immune fab 0.00 0.00 0.00 0.00 0.00 0.00 XXX
(ovine).
Q2007 ................ E Ethanolamine oleate 0.00 0.00 0.00 0.00 0.00 0.00 XXX
100 mg.
Q2008 ................ E Fomepizole, 15 mg..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
[[Page 55493]]
Q2009 ................ E Fosphenytoin, 50 mg... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q2010 ................ E Glatiramer acetate, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
per dose.
Q2011 ................ E Hemin, per 1 mg....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q2012 ................ E Pegademase bovine, 25 0.00 0.00 0.00 0.00 0.00 0.00 XXX
iu.
Q2013 ................ E Pentastarch 10% 0.00 0.00 0.00 0.00 0.00 0.00 XXX
solution.
Q2014 ................ E Sermorelin acetate, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
0.5 mg.
Q2015 ................ D Somatrem, 5 mg........ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q2016 ................ D Somatropin, 1 mg...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q2017 ................ E Teniposide, 50 mg..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q2018 ................ E Urofollitropin, 75 iu. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q2019 ................ E Basiliximab........... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q2020 ................ E Histrelin acetate..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q2021 ................ E Lepirudin............. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q2022 ................ E VonWillebrandFactrCmpl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
xperIU.
Q3001 ................ E Brachytherapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Radioelements.
Q3002 ................ E Gallium ga 67......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q3003 ................ E Technetium tc99m 0.00 0.00 0.00 0.00 0.00 0.00 XXX
bicisate.
Q3004 ................ E Xenon xe 133.......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q3005 ................ E Technetium tc99m 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mertiatide.
Q3006 ................ E Technetium tc99m 0.00 0.00 0.00 0.00 0.00 0.00 XXX
glucepatate.
Q3007 ................ E Sodium phosphate p32.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q3008 ................ E Indium 111-in 0.00 0.00 0.00 0.00 0.00 0.00 XXX
pentetreotide.
Q3009 ................ E Technetium tc99m 0.00 0.00 0.00 0.00 0.00 0.00 XXX
oxidronate.
Q3010 ................ E Technetium 0.00 0.00 0.00 0.00 0.00 0.00 XXX
tc99mlabeledrbcs.
Q3011 ................ E Chromic phosphate p32. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q3012 ................ E Cyanocobalamin cobalt 0.00 0.00 0.00 0.00 0.00 0.00 XXX
co57.
Q3013 ................ D Verteporfin injection. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q3014 ................ E Telehealth facility 0.00 0.00 0.00 0.00 0.00 0.00 XXX
fee.
Q3017 ................ E ALS assessment........ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q4001 ................ X Cast sup body cast 0.00 0.00 0.00 0.00 0.00 0.00 XXX
plaster.
Q4002 ................ X Cast sup body cast 0.00 0.00 0.00 0.00 0.00 0.00 XXX
fiberglas.
Q4003 ................ X Cast sup shoulder cast 0.00 0.00 0.00 0.00 0.00 0.00 XXX
plstr.
Q4004 ................ X Cast sup shoulder cast 0.00 0.00 0.00 0.00 0.00 0.00 XXX
fbrgl.
Q4005 ................ X Cast sup long arm 0.00 0.00 0.00 0.00 0.00 0.00 XXX
adult plst.
Q4006 ................ X Cast sup long arm 0.00 0.00 0.00 0.00 0.00 0.00 XXX
adult fbrg.
Q4007 ................ X Cast sup long arm ped 0.00 0.00 0.00 0.00 0.00 0.00 XXX
plster.
Q4008 ................ X Cast sup long arm ped 0.00 0.00 0.00 0.00 0.00 0.00 XXX
fbrgls.
Q4009 ................ X Cast sup sht arm adult 0.00 0.00 0.00 0.00 0.00 0.00 XXX
plstr.
Q4010 ................ X Cast sup sht arm adult 0.00 0.00 0.00 0.00 0.00 0.00 XXX
fbrgl.
Q4011 ................ X Cast sup sht arm ped 0.00 0.00 0.00 0.00 0.00 0.00 XXX
plaster.
Q4012 ................ X Cast sup sht arm ped 0.00 0.00 0.00 0.00 0.00 0.00 XXX
fbrglas.
Q4013 ................ X Cast sup gauntlet 0.00 0.00 0.00 0.00 0.00 0.00 XXX
plaster.
Q4014 ................ X Cast sup gauntlet 0.00 0.00 0.00 0.00 0.00 0.00 XXX
fiberglass.
Q4015 ................ X Cast sup gauntlet ped 0.00 0.00 0.00 0.00 0.00 0.00 XXX
plster.
Q4016 ................ X Cast sup gauntlet ped 0.00 0.00 0.00 0.00 0.00 0.00 XXX
fbrgls.
Q4017 ................ X Cast sup lng arm 0.00 0.00 0.00 0.00 0.00 0.00 XXX
splint plst.
Q4018 ................ X Cast sup lng arm 0.00 0.00 0.00 0.00 0.00 0.00 XXX
splint fbrg.
Q4019 ................ X Cast sup lng arm splnt 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ped p.
Q4020 ................ X Cast sup lng arm splnt 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ped f.
Q4021 ................ X Cast sup sht arm 0.00 0.00 0.00 0.00 0.00 0.00 XXX
splint plst.
Q4022 ................ X Cast sup sht arm 0.00 0.00 0.00 0.00 0.00 0.00 XXX
splint fbrg.
Q4023 ................ X Cast sup sht arm splnt 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ped p.
Q4024 ................ X Cast sup sht arm splnt 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ped f.
Q4025 ................ X Cast sup hip spica 0.00 0.00 0.00 0.00 0.00 0.00 XXX
plaster.
Q4026 ................ X Cast sup hip spica 0.00 0.00 0.00 0.00 0.00 0.00 XXX
fiberglas.
Q4027 ................ X Cast sup hip spica ped 0.00 0.00 0.00 0.00 0.00 0.00 XXX
plstr.
Q4028 ................ X Cast sup hip spica ped 0.00 0.00 0.00 0.00 0.00 0.00 XXX
fbrgl.
Q4029 ................ X Cast sup long leg 0.00 0.00 0.00 0.00 0.00 0.00 XXX
plaster.
Q4030 ................ X Cast sup long leg 0.00 0.00 0.00 0.00 0.00 0.00 XXX
fiberglass.
Q4031 ................ X Cast sup lng leg ped 0.00 0.00 0.00 0.00 0.00 0.00 XXX
plaster.
Q4032 ................ X Cast sup lng leg ped 0.00 0.00 0.00 0.00 0.00 0.00 XXX
fbrgls.
Q4033 ................ X Cast sup lng leg 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cylinder pl.
Q4034 ................ X Cast sup lng leg 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cylinder fb.
Q4035 ................ X Cast sup lng leg 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cylndr ped p.
Q4036 ................ X Cast sup lng leg 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cylndr ped f.
Q4037 ................ X Cast sup shrt leg 0.00 0.00 0.00 0.00 0.00 0.00 XXX
plaster.
Q4038 ................ X Cast sup shrt leg 0.00 0.00 0.00 0.00 0.00 0.00 XXX
fiberglass.
Q4039 ................ X Cast sup shrt leg ped 0.00 0.00 0.00 0.00 0.00 0.00 XXX
plster.
Q4040 ................ X Cast sup shrt leg ped 0.00 0.00 0.00 0.00 0.00 0.00 XXX
fbrgls.
Q4041 ................ X Cast sup lng leg splnt 0.00 0.00 0.00 0.00 0.00 0.00 XXX
plstr.
Q4042 ................ X Cast sup lng leg splnt 0.00 0.00 0.00 0.00 0.00 0.00 XXX
fbrgl.
Q4043 ................ X Cast sup lng leg splnt 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ped p.
Q4044 ................ X Cast sup lng leg splnt 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ped f.
[[Page 55494]]
Q4045 ................ X Cast sup sht leg splnt 0.00 0.00 0.00 0.00 0.00 0.00 XXX
plstr.
Q4046 ................ X Cast sup sht leg splnt 0.00 0.00 0.00 0.00 0.00 0.00 XXX
fbrgl.
Q4047 ................ X Cast sup sht leg splnt 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ped p.
Q4048 ................ X Cast sup sht leg splnt 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ped f.
Q4049 ................ X Finger splint, static. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q4050 ................ X Cast supplies unlisted 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q4051 ................ X Splint supplies misc.. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q9920 ................ E Epoetin with hct = 20. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q9921 ................ E Epoetin with hct = 21. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q9922 ................ E Epoetin with hct = 22. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q9923 ................ E Epoetin with hct = 23. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q9924 ................ E Epoetin with hct = 24. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q9925 ................ E Epoetin with hct = 25. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q9926 ................ E Epoetin with hct = 26. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q9927 ................ E Epoetin with hct = 27. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q9928 ................ E Epoetin with hct = 28. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q9929 ................ E Epoetin with hct = 29. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q9930 ................ E Epoetin with hct = 30. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q9931 ................ E Epoetin with hct = 31. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q9932 ................ E Epoetin with hct = 32. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q9933 ................ E Epoetin with hct = 33. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q9934 ................ E Epoetin with hct = 34. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q9935 ................ E Epoetin with hct = 35. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q9936 ................ E Epoetin with hct = 36. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q9937 ................ E Epoetin with hct = 37. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q9938 ................ E Epoetin with hct = 38. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q9939 ................ E Epoetin with hct = 39. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Q9940 ................ E Epoetin with hct >= 40 0.00 0.00 0.00 0.00 0.00 0.00 XXX
R0070 ................ C Transport portable x- 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ray.
R0075 ................ C Transport port x-ray 0.00 0.00 0.00 0.00 0.00 0.00 XXX
multipl.
R0076 ................ B Transport portable EKG 0.00 0.00 0.00 0.00 0.00 0.00 XXX
T1000 ................ I Private duty/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
independent nsg.
T1001 ................ I Nursing assessment/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
evaluatn.
T1002 ................ I RN services up to 15 0.00 0.00 0.00 0.00 0.00 0.00 XXX
minutes.
T1003 ................ I LPN/LVN services up to 0.00 0.00 0.00 0.00 0.00 0.00 XXX
15 min.
T1004 ................ I Nsg aide service up to 0.00 0.00 0.00 0.00 0.00 0.00 XXX
15 min.
T1005 ................ I Respite care service 0.00 0.00 0.00 0.00 0.00 0.00 XXX
15 min.
T1006 ................ I Family/Couple 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Counseling.
T1007 ................ I Treatment Plan 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Development.
T1008 ................ I Day Treatment for 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Individual.
T1009 ................ I Child Sitting Services 0.00 0.00 0.00 0.00 0.00 0.00 XXX
T1010 ................ I Meals when Receive 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Services.
T1011 ................ I Alcohol/Substance 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Abuse NOC.
T1012 ................ I Alcohol/Substance 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Abuse Skil.
T1013 ................ I Sign Lang/Oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Interpreter.
T1014 ................ I Telehealth transmit, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
per min.
T1015 ................ I Clinic service........ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
V2020 ................ X Vision svcs frames 0.00 0.00 0.00 0.00 0.00 0.00 XXX
purchases.
V2025 ................ N Eyeglasses delux 0.00 0.00 0.00 0.00 0.00 0.00 XXX
frames.
V2100 ................ X Lens spher single 0.00 0.00 0.00 0.00 0.00 0.00 XXX
plano 4.00.
V2101 ................ X Single visn sphere 0.00 0.00 0.00 0.00 0.00 0.00 XXX
4.12-7.00.
V2102 ................ X Singl visn sphere 7.12- 0.00 0.00 0.00 0.00 0.00 0.00 XXX
20.00.
V2103 ................ X Spherocylindr 4.00d/12- 0.00 0.00 0.00 0.00 0.00 0.00 XXX
2.00d.
V2104 ................ X Spherocylindr 4.00d/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
2.12-4d.
V2105 ................ X Spherocylinder 4.00d/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
4.25-6d.
V2106 ................ X Spherocylinder 4.00d/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
>6.00d.
V2107 ................ X Spherocylinder 4.25d/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
12-2d.
V2108 ................ X Spherocylinder 4.25d/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
2.12-4d.
V2109 ................ X Spherocylinder 4.25d/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
4.25-6d.
V2110 ................ X Spherocylinder 4.25d/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
over 6d.
V2111 ................ X Spherocylindr 7.25d/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
.25-2.25.
V2112 ................ X Spherocylindr 7.25d/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
2.25-4d.
V2113 ................ X Spherocylindr 7.25d/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
4.25-6d.
V2114 ................ X Spherocylinder over 0.00 0.00 0.00 0.00 0.00 0.00 XXX
12.00d.
V2115 ................ X Lens lenticular 0.00 0.00 0.00 0.00 0.00 0.00 XXX
bifocal.
V2116 ................ X Nonaspheric lens 0.00 0.00 0.00 0.00 0.00 0.00 XXX
bifocal.
V2117 ................ X Aspheric lens bifocal. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
V2118 ................ X Lens aniseikonic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
single.
V2199 ................ X Lens single vision not 0.00 0.00 0.00 0.00 0.00 0.00 XXX
oth c.
V2200 ................ X Lens spher bifoc plano 0.00 0.00 0.00 0.00 0.00 0.00 XXX
4.00d.
V2201 ................ X Lens sphere bifocal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
4.12-7.0.
V2202 ................ X Lens sphere bifocal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
7.12-20.
V2203 ................ X Lens sphcyl bifocal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
4.00d/.1.
[[Page 55495]]
V2204 ................ X Lens sphcy bifocal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
4.00d/2.1.
V2205 ................ X Lens sphcy bifocal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
4.00d/4.2.
V2206 ................ X Lens sphcy bifocal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
4.00d/ove.
V2207 ................ X Lens sphcy bifocal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
4.25-7d/.
V2208 ................ X Lens sphcy bifocal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
4.25-7/2.
V2209 ................ X Lens sphcy bifocal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
4.25-7/4.
V2210 ................ X Lens sphcy bifocal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
4.25-7/ov.
V2211 ................ X Lens sphcy bifo 7.25- 0.00 0.00 0.00 0.00 0.00 0.00 XXX
12/.25-.
V2212 ................ X Lens sphcyl bifo 7.25- 0.00 0.00 0.00 0.00 0.00 0.00 XXX
12/2.2.
V2213 ................ X Lens sphcyl bifo 7.25- 0.00 0.00 0.00 0.00 0.00 0.00 XXX
12/4.2.
V2214 ................ X Lens sphcyl bifocal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
over 12.
V2215 ................ X Lens lenticular 0.00 0.00 0.00 0.00 0.00 0.00 XXX
bifocal.
V2216 ................ X Lens lenticular 0.00 0.00 0.00 0.00 0.00 0.00 XXX
nonaspheric.
V2217 ................ X Lens lenticular 0.00 0.00 0.00 0.00 0.00 0.00 XXX
aspheric bif.
V2218 ................ X Lens aniseikonic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
bifocal.
V2219 ................ X Lens bifocal seg width 0.00 0.00 0.00 0.00 0.00 0.00 XXX
over.
V2220 ................ X Lens bifocal add over 0.00 0.00 0.00 0.00 0.00 0.00 XXX
3.25d.
V2299 ................ X Lens bifocal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
speciality.
V2300 ................ X Lens sphere trifocal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
4.00d.
V2301 ................ X Lens sphere trifocal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
4.12-7.
V2302 ................ X Lens sphere trifocal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
7.12-20.
V2303 ................ X Lens sphcy trifocal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
4.0/.12-.
V2304 ................ X Lens sphcy trifocal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
4.0/2.25.
V2305 ................ X Lens sphcy trifocal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
4.0/4.25.
V2306 ................ X Lens sphcyl trifocal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
4.00/>6.
V2307 ................ X Lens sphcy trifocal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
4.25-7/.
V2308 ................ X Lens sphc trifocal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
4.25-7/2.
V2309 ................ X Lens sphc trifocal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
4.25-7/4.
V2310 ................ X Lens sphc trifocal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
4.25-7/>6.
V2311 ................ X Lens sphc trifo 7.25- 0.00 0.00 0.00 0.00 0.00 0.00 XXX
12/.25-.
V2312 ................ X Lens sphc trifo 7.25- 0.00 0.00 0.00 0.00 0.00 0.00 XXX
12/2.25.
V2313 ................ X Lens sphc trifo 7.25- 0.00 0.00 0.00 0.00 0.00 0.00 XXX
12/4.25.
V2314 ................ X Lens sphcyl trifocal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
over 12.
V2315 ................ X Lens lenticular 0.00 0.00 0.00 0.00 0.00 0.00 XXX
trifocal.
V2316 ................ X Lens lenticular 0.00 0.00 0.00 0.00 0.00 0.00 XXX
nonaspheric.
V2317 ................ X Lens lenticular 0.00 0.00 0.00 0.00 0.00 0.00 XXX
aspheric tri.
V2318 ................ X Lens aniseikonic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
trifocal.
V2319 ................ X Lens trifocal seg 0.00 0.00 0.00 0.00 0.00 0.00 XXX
width > 28.
V2320 ................ X Lens trifocal add over 0.00 0.00 0.00 0.00 0.00 0.00 XXX
3.25d.
V2399 ................ X Lens trifocal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
speciality.
V2410 ................ X Lens variab 0.00 0.00 0.00 0.00 0.00 0.00 XXX
asphericity sing.
V2430 ................ X Lens variable 0.00 0.00 0.00 0.00 0.00 0.00 XXX
asphericity bi.
V2499 ................ X Variable asphericity 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lens.
V2500 ................ X Contact lens pmma 0.00 0.00 0.00 0.00 0.00 0.00 XXX
spherical.
V2501 ................ X Cntct lens pmma-toric/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
prism.
V2502 ................ X Contact lens pmma 0.00 0.00 0.00 0.00 0.00 0.00 XXX
bifocal.
V2503 ................ X Cntct lens pmma color 0.00 0.00 0.00 0.00 0.00 0.00 XXX
vision.
V2510 ................ X Cntct gas permeable 0.00 0.00 0.00 0.00 0.00 0.00 XXX
sphericl.
V2511 ................ X Cntct toric prism 0.00 0.00 0.00 0.00 0.00 0.00 XXX
ballast.
V2512 ................ X Cntct lens gas permbl 0.00 0.00 0.00 0.00 0.00 0.00 XXX
bifocl.
V2513 ................ X Contact lens extended 0.00 0.00 0.00 0.00 0.00 0.00 XXX
wear.
V2520 ................ P Contact lens 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hydrophilic.
V2521 ................ X Cntct lens hydrophilic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
toric.
V2522 ................ X Cntct lens hydrophil 0.00 0.00 0.00 0.00 0.00 0.00 XXX
bifocl.
V2523 ................ X Cntct lens hydrophil 0.00 0.00 0.00 0.00 0.00 0.00 XXX
extend.
V2530 ................ X Contact lens gas 0.00 0.00 0.00 0.00 0.00 0.00 XXX
impermeable.
V2531 ................ X Contact lens gas 0.00 0.00 0.00 0.00 0.00 0.00 XXX
permeable.
V2599 ................ X Contact lens/es other 0.00 0.00 0.00 0.00 0.00 0.00 XXX
type.
V2600 ................ X Hand held low vision 0.00 0.00 0.00 0.00 0.00 0.00 XXX
aids.
V2610 ................ X Single lens spectacle 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mount.
V2615 ................ X Telescop/othr compound 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lens.
V2623 ................ X Plastic eye prosth 0.00 0.00 0.00 0.00 0.00 0.00 XXX
custom.
V2624 ................ X Polishing artifical 0.00 0.00 0.00 0.00 0.00 0.00 XXX
eye.
V2625 ................ X Enlargemnt of eye 0.00 0.00 0.00 0.00 0.00 0.00 XXX
prosthesis.
V2626 ................ X Reduction of eye 0.00 0.00 0.00 0.00 0.00 0.00 XXX
prosthesis.
V2627 ................ X Scleral cover shell... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
V2628 ................ X Fabrication & fitting. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
V2629 ................ X Prosthetic eye other 0.00 0.00 0.00 0.00 0.00 0.00 XXX
type.
V2630 ................ X Anter chamber 0.00 0.00 0.00 0.00 0.00 0.00 XXX
intraocul lens.
V2631 ................ X Iris support intraoclr 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lens.
V2632 ................ X Post chmbr intraocular 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lens.
V2700 ................ X Balance lens.......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
V2710 ................ X Glass/plastic slab off 0.00 0.00 0.00 0.00 0.00 0.00 XXX
prism.
[[Page 55496]]
V2715 ................ X Prism lens/es......... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
V2718 ................ X Fresnell prism press- 0.00 0.00 0.00 0.00 0.00 0.00 XXX
on lens.
V2730 ................ X Special base curve.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
V2740 ................ X Rose tint plastic..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
V2741 ................ X Non-rose tint plastic. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
V2742 ................ X Rose tint glass....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
V2743 ................ X Non-rose tint glass... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
V2744 ................ X Tint photochromatic 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lens/es.
V2750 ................ X Anti-reflective 0.00 0.00 0.00 0.00 0.00 0.00 XXX
coating.
V2755 ................ X UV lens/es............ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
V2760 ................ X Scratch resistant 0.00 0.00 0.00 0.00 0.00 0.00 XXX
coating.
V2770 ................ X Occluder lens/es...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
V2780 ................ X Oversize lens/es...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
V2781 ................ X Progressive lens per 0.00 0.00 0.00 0.00 0.00 0.00 XXX
lens.
V2785 ................ X Corneal tissue 0.00 0.00 0.00 0.00 0.00 0.00 XXX
processing.
V2790 ................ X Amniotic membrane..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
V2799 ................ X Miscellaneous vision 0.00 0.00 0.00 0.00 0.00 0.00 XXX
service.
V5008 ................ N Hearing screening..... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
V5010 ................ N Assessment for hearing 0.00 0.00 0.00 0.00 0.00 0.00 XXX
aid.
V5011 ................ N Hearing aid fitting/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
checking.
V5014 ................ N Hearing aid repair/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
modifying.
V5020 ................ N Conformity evaluation. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
V5030 ................ N Body-worn hearing aid 0.00 0.00 0.00 0.00 0.00 0.00 XXX
air.
V5040 ................ N Body-worn hearing aid 0.00 0.00 0.00 0.00 0.00 0.00 XXX
bone.
V5050 ................ N Hearing aid monaural 0.00 0.00 0.00 0.00 0.00 0.00 XXX
in ear.
V5060 ................ N Behind ear hearing aid 0.00 0.00 0.00 0.00 0.00 0.00 XXX
V5070 ................ N Glasses air conduction 0.00 0.00 0.00 0.00 0.00 0.00 XXX
V5080 ................ N Glasses bone 0.00 0.00 0.00 0.00 0.00 0.00 XXX
conduction.
V5090 ................ N Hearing aid dispensing 0.00 0.00 0.00 0.00 0.00 0.00 XXX
fee.
V5100 ................ N Body-worn bilat 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hearing aid.
V5110 ................ N Hearing aid dispensing 0.00 0.00 0.00 0.00 0.00 0.00 XXX
fee.
V5120 ................ N Body-worn binaur 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hearing aid.
V5130 ................ N In ear binaural 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hearing aid.
V5140 ................ N Behind ear binaur 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hearing ai.
V5150 ................ N Glasses binaural 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hearing aid.
V5160 ................ N Dispensing fee 0.00 0.00 0.00 0.00 0.00 0.00 XXX
binaural.
V5170 ................ N Within ear cros 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hearing aid.
V5180 ................ N Behind ear cros 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hearing aid.
V5190 ................ N Glasses cros hearing 0.00 0.00 0.00 0.00 0.00 0.00 XXX
aid.
V5200 ................ N Cros hearing aid 0.00 0.00 0.00 0.00 0.00 0.00 XXX
dispens fee.
V5210 ................ N In ear bicros hearing 0.00 0.00 0.00 0.00 0.00 0.00 XXX
aid.
V5220 ................ N Behind ear bicros 0.00 0.00 0.00 0.00 0.00 0.00 XXX
hearing ai.
V5230 ................ N Glasses bicros hearing 0.00 0.00 0.00 0.00 0.00 0.00 XXX
aid.
V5240 ................ N Dispensing fee bicros. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
V5241 ................ N Dispensing fee, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
monaural.
V5242 ................ N Hearing aid, monaural, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cic.
V5243 ................ N Hearing aid, monaural, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
itc.
V5244 ................ N Hearing aid, prog, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mon, cic.
V5245 ................ N Hearing aid, prog, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mon, itc.
V5246 ................ N Hearing aid, prog, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mon, ite.
V5247 ................ N Hearing aid, prog, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mon, bte.
V5248 ................ N Hearing aid, binaural, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
cic.
V5249 ................ N Hearing aid, binaural, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
itc.
V5250 ................ N Hearing aid, prog, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
bin, cic.
V5251 ................ N Hearing aid, prog, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
bin, itc.
V5252 ................ N Hearing aid, prog, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
bin, ite.
V5253 ................ N Hearing aid, prog, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
bin, bte.
V5254 ................ N Hearing aid, digit, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mon, cic.
V5255 ................ N Hearing aid, digit, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mon, itc.
V5256 ................ N Hearing aid, digit, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mon, ite.
V5257 ................ N Hearing aid, digit, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
mon, bte.
V5258 ................ N Hearing aid, digit, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
bin, cic.
V5259 ................ N Hearing aid, digit, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
bin, itc.
V5260 ................ N Hearing aid, digit, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
bin, ite.
V5261 ................ N Hearing aid, digit, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
bin, bte.
V5262 ................ N Hearing aid, disp, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
monaural.
V5263 ................ N Hearing aid, disp, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
binaural.
V5264 ................ N Ear mold/insert....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
V5265 ................ N Ear mold/insert, disp. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
V5266 ................ N Battery for hearing 0.00 0.00 0.00 0.00 0.00 0.00 XXX
device.
V5267 ................ N Hearing aid supply/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
accessory.
V5268 ................ N ALD Telephone 0.00 0.00 0.00 0.00 0.00 0.00 XXX
Amplifier.
V5269 ................ N Alerting device, any 0.00 0.00 0.00 0.00 0.00 0.00 XXX
type.
[[Page 55497]]
V5270 ................ N ALD, TV amplifier, any 0.00 0.00 0.00 0.00 0.00 0.00 XXX
type.
V5271 ................ N ALD, TV caption 0.00 0.00 0.00 0.00 0.00 0.00 XXX
decoder.
V5272 ................ N Tdd................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
V5273 ................ N ALD for cochlear 0.00 0.00 0.00 0.00 0.00 0.00 XXX
implant.
V5274 ................ N ALD unspecified....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
V5275 ................ N Ear impression........ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
V5299 ................ R Hearing service....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
V5336 ................ N Repair communication 0.00 0.00 0.00 0.00 0.00 0.00 XXX
device.
V5362 ................ R Speech screening...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
V5363 ................ R Language screening.... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
V5364 ................ R Dysphagia screening... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ CPT codes and descriptions only are copyright 2001 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply.
\2\ Copyright 1994 American Dental Association. All rights reserved.
\3\ +Indicates RVUs are not used for Medicare payment.
Federal Register / Vol. 66, No. 212 / Thursday, November 1, 2001 /
Rules and Regulations
[[Page 55497]]
Addendum C.--Codes With Interim RVUs
--------------------------------------------------------------------------------------------------------------------------------------------------------
Fully Fully
Physician implemented Fully Mal- implemented Fully
CPT \1\/ MOD Status Description Work RVUs non- implemented practice non- implemented Global
HCPCS \3\ facility PE facility PE RVUs facility facility
\2\ RVUs RVUs total total
--------------------------------------------------------------------------------------------------------------------------------------------------------
11981 ................ A Insert drug implant 1.48 1.58 0.59 0.14 3.20 2.21 XXX
device.
11982 ................ A Remove drug implant 1.78 1.70 0.71 0.17 3.65 2.66 XXX
device.
11983 ................ A Remove/insert drug 3.30 2.31 1.32 0.31 5.92 4.93 XXX
implant.
20526 ................ A Ther injection carpal 0.86 0.78 0.39 0.06 1.70 1.31 000
tunnel.
20551 ................ A Inject tendon origin/ 0.86 0.78 0.39 0.06 1.70 1.31 000
insert.
20552 ................ A Inject trigger point, 0.86 0.78 0.39 0.06 1.70 1.31 000
1 or 2.
20553 ................ A Inject trigger points, 0.86 0.78 0.39 0.06 1.70 1.31 000
> 3.
24300 ................ A Manipulate elbow w/ 3.75 NA 5.46 0.52 NA 9.73 090
anesth.
24332 ................ A Tenolysis, triceps.... 7.45 NA 5.23 0.77 NA 13.45 090
24343 ................ A Repr elbow lat ligmnt 8.65 NA 7.91 1.21 NA 17.77 090
w/tiss.
24344 ................ A Reconstruct elbow lat 14.00 NA 10.87 1.95 NA 26.82 090
ligmnt.
24345 ................ A Repr elbw med ligmnt w/ 8.65 NA 7.91 1.21 NA 17.77 090
tiss.
24346 ................ A Reconstruct elbow med 14.00 NA 10.87 1.95 NA 26.82 090
ligmnt.
25001 ................ A Incise flexor carpi 3.38 NA 4.30 0.45 NA 8.13 090
radialis.
25024 ................ A Decompress forearm 2 9.50 NA 8.17 1.20 NA 18.87 090
spaces.
25025 ................ A Decompress forearm 2 16.54 NA 12.05 1.91 NA 30.50 090
spaces.
25259 ................ A Manipulate wrist w/ 3.75 NA 5.35 0.52 NA 9.62 090
anesthes.
25275 ................ A Repair forearm tendon 8.50 NA 7.53 1.11 NA 17.14 090
sheath.
25394 ................ A Repair carpal bone, 10.40 NA 8.43 1.15 NA 19.98 090
shorten.
25430 ................ A Vasc graft into carpal 9.25 NA 7.82 0.56 NA 17.63 090
bone.
25431 ................ A Repair nonunion carpal 10.44 NA 6.42 0.56 NA 17.42 090
bone.
25651 ................ A Pin ulnar styloid 5.36 NA 4.39 0.73 NA 10.48 090
fracture.
25652 ................ A Treat fracture ulnar 7.60 NA 6.90 0.97 NA 15.47 090
styloid.
25671 ................ A Pin radioulnar 6.00 NA 6.02 0.75 NA 12.77 090
dislocation.
26340 ................ A Manipulate finger w/ 2.50 NA 4.53 0.32 NA 7.35 090
anesth.
26587 ................ A Reconstruct extra 14.05 4.67 NA 1.08 19.80 NA 090
finger.
28299 ................ A Correction of bunion.. 10.58 11.55 9.21 1.24 23.37 21.03 090
29086 ................ A Apply finger cast..... 0.62 0.81 0.50 0.07 1.50 1.19 000
29805 ................ A Shoulder arthroscopy, 5.89 3.23 3.23 0.83 9.95 9.95 090
dx.
29806 ................ A Shoulder arthroscopy/ 14.37 NA 11.33 2.01 NA 27.71 090
surgery.
29807 ................ A Shoulder arthroscopy/ 13.90 NA 11.06 2.01 NA 26.97 090
surgery.
29824 ................ A Shoulder arthroscopy/ 8.25 NA 7.48 1.16 NA 16.89 090
surgery.
29900 ................ A Mcp joint arthroscopy, 5.42 NA 5.88 0.69 NA 11.99 090
dx.
29901 ................ A Mcp joint arthroscopy, 6.13 NA 6.28 0.81 NA 13.22 090
surg.
29902 ................ A Mcp joint arthroscopy, 6.70 NA 6.60 0.89 NA 14.19 090
surg.
33967 ................ A Insert ia percut 4.85 2.01 1.96 0.27 7.13 7.08 000
device.
33979 ................ C Insert intracorporeal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
device.
33980 ................ C Remove intracorporeal 0.00 0.00 0.00 0.00 0.00 0.00 090
device.
35646 ................ A Artery bypass graft... 31.00 NA 13.26 2.98 NA 47.24 090
35647 ................ A Artery bypass graft... 28.00 NA 11.97 2.98 NA 42.95 090
35685 ................ A Bypass graft patency/ 4.05 NA 1.50 0.41 NA 5.96 ZZZ
patch.
35686 ................ A Bypass graft/av fist 3.35 NA 1.24 0.34 NA 4.93 ZZZ
patency.
36002 ................ A Pseudoaneurysm 1.96 2.95 1.03 0.08 4.99 3.07 000
injection trt.
36400 ................ A Drawing blood......... 0.38 0.72 0.10 0.01 1.11 0.49 XXX
36820 ................ A Av fusion/forearm vein 14.00 NA 6.56 1.53 NA 22.09 090
43239 ................ A Upper GI endoscopy, 2.87 6.79 1.27 0.14 9.80 4.28 000
biopsy.
43313 ................ A Esophagoplasty 45.28 NA 22.01 5.43 NA 72.72 090
congential.
43314 ................ A Tracheo-esophagoplasty 50.27 NA 24.07 5.53 NA 79.87 090
cong.
44120 ................ A Removal of small 17.00 NA 7.67 1.46 NA 26.13 090
intestine.
44126 ................ A Enterectomy w/taper, 35.50 NA 18.03 0.36 NA 53.89 090
cong.
44127 ................ A Enterectomy w/o taper, 41.00 NA 20.56 0.41 NA 61.97 090
cong.
44128 ................ A Enterectomy cong, add- 4.45 NA 1.78 0.45 NA 6.68 ZZZ
on.
[[Page 55498]]
44160 ................ A Removal of colon...... 18.62 NA 8.65 1.55 NA 28.82 090
44203 ................ A Lap resect s/ 4.45 NA 1.60 0.45 NA 6.50 ZZZ
intestine, addl.
44204 ................ A Laparo partial 25.08 NA 10.46 1.83 NA 37.37 090
colectomy.
44205 ................ A Lap colectomy part w/ 22.23 NA 9.31 1.55 NA 33.09 090
ileum.
45136 ................ A Excise ileoanal 27.30 NA 12.66 2.19 NA 42.15 090
reservoir.
45380 ................ A Colonoscopy and biopsy 4.44 9.28 2.05 0.21 13.93 6.70 000
46020 ................ A Placement of seton.... 2.90 3.09 2.36 0.22 6.21 5.48 010
47370 ................ A Laparo ablate liver 18.00 7.19 7.19 0.85 26.04 26.04 090
tumor rf.
47371 ................ A Laparo ablate liver 16.94 6.76 6.76 0.85 24.55 24.55 090
cryosug.
47380 ................ A Open ablate liver 21.25 8.48 8.48 0.85 30.58 30.58 090
tumor rf.
47381 ................ A Open ablate liver 21.00 8.38 8.38 0.85 30.23 30.23 090
tumor cryo.
47382 ................ A Percut ablate liver rf 12.00 NA 5.37 0.85 NA 18.22 010
49491 ................ A Repairing hern premie 11.13 NA 5.65 1.00 NA 17.78 090
reduc.
49492 ................ A Rpr ing hern premie, 14.03 NA 6.40 1.42 NA 21.85 090
blocked.
52001 ................ A Cystoscopy, removal of 2.37 NA 0.98 0.32 NA 3.67 000
clots.
52347 ................ A Cystoscopy, resect 5.28 NA 2.14 0.33 NA 7.75 000
ducts.
53431 ................ A Reconstruct urethra/ 19.89 7.94 7.94 1.25 29.08 29.08 090
bladder.
53444 ................ A Insert tandem cuff.... 13.40 NA 6.66 0.79 NA 20.85 090
53446 ................ A Remove uro sphincter.. 10.23 NA 8.46 0.61 NA 19.30 090
53447 ................ A Remove/replace ur 13.49 NA 7.90 0.79 NA 22.18 090
sphincter.
53448 ................ A Remov/replc ur 21.15 NA 12.35 1.27 NA 34.77 090
sphinctr comp.
53853 ................ A Prostatic water 4.14 52.75 2.55 0.38 57.27 7.07 090
thermother.
54162 ................ A Lysis penil circumcis 3.00 NA 2.91 0.18 NA 6.09 010
lesion.
54163 ................ A Repair of circumcision 3.00 NA 2.54 0.18 NA 5.72 010
54164 ................ A Frenulotomy of penis.. 2.50 NA 2.37 0.15 NA 5.02 010
54406 ................ A Remove multi-comp 12.10 NA 6.09 0.80 NA 18.99 090
penis pros.
54408 ................ A Repair multi-comp 12.75 NA 6.46 0.80 NA 20.01 090
penis pros.
54410 ................ A Remove/replace penis 15.50 NA 7.36 0.80 NA 23.66 090
prosth.
54411 ................ A Remv/replc penis pros, 16.00 NA 8.98 0.80 NA 25.78 090
comp.
54415 ................ A Remove self-contd 8.20 NA 5.35 0.55 NA 14.10 090
penis pros.
54416 ................ A Remv/repl penis 10.87 NA 6.94 0.55 NA 18.36 090
contain pros.
54417 ................ A Remv/replc penis pros, 14.19 NA 7.89 0.55 NA 22.63 090
compl.
56605 ................ A Biopsy of vulva/ 1.10 1.90 0.50 0.11 3.11 1.71 000
perineum.
56810 ................ A Repair of perineum.... 4.13 NA 2.91 0.41 NA 7.45 010
57155 ................ A Insert uteri tandems/ 6.27 NA 3.67 0.63 NA 10.57 090
ovoids.
58100 ................ A Biopsy of uterus 1.53 1.56 0.76 0.07 3.16 2.36 000
lining.
58346 ................ A Insert heyman uteri 6.75 NA 3.84 0.68 NA 11.27 090
capsule.
58953 ................ A Tah, rad dissect for 32.00 NA 15.59 3.20 NA 50.79 090
debulk.
58954 ................ A Tah, rad debulk/lymph 35.00 NA 16.71 3.50 NA 55.21 090
remove.
59001 ................ A Amniocentesis, 3.00 NA 1.37 0.23 NA 4.60 000
therapeutic.
64561 ................ A Implant 6.74 15.28 3.83 0.11 22.13 10.68 010
neuroelectrodes.
64581 ................ A Implant 13.50 NA 6.72 0.37 NA 20.59 090
neuroelectrodes.
64821 ................ A Remove sympathetic 8.75 NA 7.09 0.99 NA 16.83 090
nerves.
64822 ................ A Remove sympathetic 8.75 NA 7.09 0.99 NA 16.83 090
nerves.
64823 ................ A Remove sympathetic 10.37 NA 7.89 1.17 NA 19.43 090
nerves.
67225 ................ A Eye photodynamic ther 0.47 0.24 0.19 0.50 1.21 1.16 ZZZ
add-on.
76085 ................ A Computer mammogram add- 0.06 0.31 NA 0.02 0.39 NA ZZZ
on.
76092 ................ A Mammogram, screening.. 0.70 1.44 NA 0.09 2.23 NA XXX
76362 ................ A Cat scan for tissue 4.00 9.24 NA 1.38 14.62 NA XXX
ablation.
76394 ................ A Mri for tissue 4.25 12.13 NA 1.43 17.81 NA XXX
ablation.
76490 ................ A Us for tissue ablation 2.00 2.13 NA 0.36 4.49 NA XXX
76819 ................ A Fetal biophys profil w/ 0.77 1.83 NA 0.10 2.70 NA XXX
o nst.
77301 ................ A Radioltherapy dos 8.00 29.72 NA 1.41 39.13 NA XXX
plan, imrt.
77418 ................ A Radiation tx delivery, 0.00 16.07 NA 0.11 16.18 NA XXX
imrt.
88380 ................ C Microdissection....... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90471 ................ A Immunization admin.... 0.00 0.10 NA 0.01 0.11 NA XXX
90472 ................ A Immunization admin, 0.00 0.10 NA 0.01 0.11 NA ZZZ
each add.
90473 ................ N Immune admin oral/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
nasal.
90474 ................ N Immune admin oral/ 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
nasal addl.
90939 ................ X Hemodialysis study, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
transcut.
91123 ................ B Irrigate fecal 0.00 0.00 0.00 0.00 0.00 0.00 XXX
impaction.
92136 ................ A Ophthalmic biometry... 0.54 1.52 NA 0.07 2.13 NA XXX
92973 ................ A Percut coronary 3.28 NA 1.37 0.17 NA 4.82 ZZZ
thrombectomy.
92974 ................ A Cath place, cardio 3.00 NA 1.26 1.18 NA 5.44 ZZZ
brachytx.
93025 ................ A Microvolt t-wave 0.75 6.42 NA 0.11 7.28 NA XXX
assess.
93609 ................ A Map tachycardia, add- 4.81 4.59 NA 0.66 10.06 NA ZZZ
on.
93613 ................ C Electrophys map, 3d, 0.00 0.00 0.00 0.00 0.00 0.00 XXX
add-on.
93621 ................ C Electrophysiology 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
evaluation.
93622 ................ C Electrophysiology 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
evaluation.
93701 ................ A Bioimpedance, thoracic 0.17 0.78 NA 0.02 0.97 NA XXX
95250 ................ A Glucose monitoring, 0.00 1.44 NA 0.01 1.45 NA XXX
cont.
95875 ................ A Limb exercise test.... 1.10 1.38 NA 0.09 2.57 NA XXX
95965 ................ C Meg, spontaneous...... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
95966 ................ C Meg, evoked, single... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
95967 ................ C Meg, evoked, each addl 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
96000 ................ A Motion analysis, video/ 1.80 NA 0.72 0.02 NA 2.54 XXX
3d.
96001 ................ A Motion test w/ft press 2.15 NA 0.86 0.02 NA 3.03 XXX
meas.
96002 ................ A Dynamic surface emg... 0.41 NA 0.16 0.02 NA 0.59 XXX
[[Page 55499]]
96003 ................ A Dynamic fine wire emg. 0.37 NA 0.15 0.03 NA 0.55 XXX
96004 ................ A Phys review of motion 1.80 0.72 0.72 0.08 2.60 2.60 XXX
tests.
96150 ................ A Assess hlth/behave, 0.50 0.21 0.20 0.02 0.73 0.72 XXX
init.
96151 ................ A Assess hlth/behave, 0.48 0.21 0.19 0.02 0.71 0.69 XXX
subseq.
96152 ................ A Intervene hlth/behave, 0.46 0.20 0.18 0.02 0.68 0.66 XXX
indiv.
96153 ................ A Intervene hlth/behave, 0.10 0.04 0.04 0.01 0.15 0.15 XXX
group.
96154 ................ A Interv hlth/behav, fam 0.45 0.19 0.18 0.02 0.66 0.65 XXX
w/pt.
96155 ................ A Interv hlth/behav fam 0.44 0.18 0.18 0.02 0.64 0.64 XXX
no pt.
96567 ................ A Photodynamic tx, skin. 0.00 1.63 NA 0.03 1.66 NA XXX
97602 ................ B Wound(s) care non- 0.00 0.00 0.00 0.00 0.00 0.00 XXX
selective.
97802 ................ A Medical nutrition, 0.00 0.45 0.45 0.01 0.46 0.46 XXX
indiv, in.
97803 ................ A Med nutrition, indiv, 0.00 0.45 0.45 0.01 0.46 0.46 XXX
subseq.
97804 ................ A Medical nutrition, 0.00 0.17 0.17 0.01 0.18 0.18 XXX
group.
99091 ................ B Collect/review data 0.00 0.00 0.00 0.00 0.00 0.00 XXX
from pt.
99289 ................ I Pt transport, 30-74 0.00 0.00 0.00 0.00 0.00 0.00 XXX
min.
99290 ................ I Pt transport, addl 30 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ
min.
G0117 ................ T Glaucoma scrn hgh risk 0.45 0.97 0.22 0.02 1.44 0.69 XXX
direc.
G0118 ................ T Glaucoma scrn hgh risk 0.17 0.84 0.08 0.01 1.02 0.26 XXX
direc.
G0202 26 A Screeningmammographydi 0.70 0.28 0.28 0.03 1.01 1.01 XXX
gital.
G0204 26 A Diagnosticmammographyd 0.87 0.35 0.35 0.03 1.25 1.25 XXX
igital.
G0206 26 A Diagnosticmammographyd 0.70 0.28 0.28 0.03 1.01 1.01 XXX
igital.
G0236 26 A digital film convert 0.06 0.02 0.02 0.01 0.09 0.09 ZZZ
diag ma.
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ CPT codes and descriptions only are copyright 2001 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply.
\2\ Copyright 1994 American Dental Association. All rights reserved.
\3\+ Indicates RVUs are not used for Medicare payment.
Addendum D.--2002 Geographic Practice Cost Indices by Medicare Carrier
and Locality
------------------------------------------------------------------------
Carrier Locality Practice
No. No. Locality name Work expense Malpractice
------------------------------------------------------------------------
00510 00 ALABAMA......... 0.978 0.870 0.807
00831 01 ALASKA.......... 1.064 1.172 1.223
00832 00 ARIZONA......... 0.994 0.978 1.111
00520 13 ARKANSAS........ 0.953 0.847 0.340
31146 26 ANAHEIM/SANTA 1.037 1.184 0.955
ANA, CA........
31146 18 LOS ANGELES, CA. 1.056 1.139 0.955
31140 03 MARIN/NAPA/ 1.015 1.248 0.687
SOLANO, CA.....
31140 07 OAKLAND/ 1.041 1.235 0.687
BERKELEY, CA...
31140 05 SAN FRANCISCO, 1.068 1.458 0.687
CA.............
31140 06 SAN MATEO, CA... 1.048 1.432 0.687
31140 09 SANTA CLARA, CA. 1.063 1.380 0.639
31146 17 VENTURA, CA..... 1.028 1.125 0.783
31146 99 REST OF 1.007 1.034 0.748
CALIFORNIA*....
31140 99 REST OF 1.007 1.034 0.748
CALIFORNIA*....
00824 01 COLORADO........ 0.985 0.992 0.840
00591 00 CONNECTICUT..... 1.050 1.156 0.966
00902 01 DELAWARE........ 1.019 1.035 0.712
00903 01 DC + MD/VA 1.050 1.166 0.909
SUBURBS........
00590 03 FORT LAUDERDALE, 0.996 1.018 1.877
FL.............
00590 04 MIAMI, FL....... 1.015 1.052 2.528
00590 99 REST OF FLORIDA. 0.975 0.946 1.265
00511 01 ATLANTA, GA..... 1.006 1.059 0.935
00511 99 REST OF GEORGIA. 0.970 0.892 0.935
00833 01 HAWAII/GUAM..... 0.997 1.124 0.834
05130 00 IDAHO........... 0.960 0.881 0.497
00952 16 CHICAGO, IL..... 1.028 1.092 1.797
00952 12 EAST ST. LOUIS, 0.988 0.924 1.691
IL.............
00952 15 SUBURBAN 1.006 1.071 1.645
CHICAGO, IL....
00952 99 REST OF ILLINOIS 0.964 0.889 1.157
00630 00 INDIANA......... 0.981 0.922 0.481
00826 00 IOWA............ 0.959 0.876 0.596
00650 00 KANSAS*......... 0.963 0.895 0.756
00740 04 KANSAS*......... 0.963 0.895 0.756
00660 00 KENTUCKY........ 0.970 0.866 0.877
00528 01 NEW ORLEANS, LA. 0.998 0.945 1.283
00528 99 REST OF 0.968 0.870 1.073
LOUISIANA......
31142 03 SOUTHERN MAINE.. 0.979 0.999 0.666
31142 99 REST OF MAINE... 0.961 0.910 0.666
00901 01 BALTIMORE/SURR. 1.021 1.038 0.916
CNTYS, MD......
00901 99 REST OF MARYLAND 0.984 0.972 0.774
31143 01 METROPOLITAN 1.041 1.239 0.784
BOSTON.........
31143 99 REST OF 1.010 1.129 0.784
MASSACHUSETTS..
00953 01 DETROIT, MI..... 1.043 1.038 2.738
00953 99 REST OF MICHIGAN 0.997 0.938 1.571
00954 00 MINNESOTA....... 0.990 0.974 0.452
00512 00 MISSISSIPPI..... 0.957 0.837 0.779
[[Page 55500]]
00740 02 METROPOLITAN 0.988 0.967 0.846
KANSAS CITY, MO
00523 01 METROPOLITAN ST. 0.994 0.938 0.846
LOUIS, MO......
00740 99 REST OF 0.946 0.825 0.793
MISSOURI*......
00523 99 REST OF 0.946 0.825 0.793
MISSOURI*......
00751 01 MONTANA......... 0.950 0.876 0.727
00655 00 NEBRASKA........ 0.948 0.877 0.430
00834 00 NEVADA.......... 1.005 1.039 1.209
31144 40 NEW HAMPSHIRE... 0.986 1.030 0.825
00805 01 NORTHERN NJ..... 1.058 1.193 0.860
00805 99 REST OF NEW 1.029 1.110 0.860
JERSEY.........
00521 05 NEW MEXICO...... 0.973 0.900 0.902
00803 01 MANHATTAN, NY... 1.094 1.351 1.668
00803 02 NYC SUBURBS/LONG 1.068 1.251 1.952
I., NY.........
00803 03 POUGHKPSIE/N NYC 1.011 1.075 1.275
SUBURBS, NY....
14330 04 QUEENS, NY...... 1.058 1.228 1.871
00801 99 REST OF NEW YORK 0.998 0.944 0.764
05535 00 NORTH CAROLINA.. 0.970 0.931 0.595
00820 01 NORTH DAKOTA.... 0.950 0.880 0.657
16360 00 OHIO............ 0.988 0.944 0.957
00522 00 OKLAHOMA........ 0.968 0.876 0.444
00835 01 PORTLAND, OR.... 0.996 1.049 0.436
00835 99 REST OF OREGON.. 0.961 0.933 0.436
00865 01 METROPOLITAN 1.023 1.092 1.413
PHILADELPHIA,
PA.............
00865 99 REST OF 0.989 0.929 0.774
PENNSYLVANIA...
00973 20 PUERTO RICO..... 0.881 0.712 0.275
00870 01 RHODE ISLAND.... 1.017 1.065 0.883
00880 01 SOUTH CAROLINA.. 0.974 0.904 0.279
00820 02 SOUTH DAKOTA.... 0.935 0.878 0.406
05440 35 TENNESSEE....... 0.975 0.900 0.592
00900 31 AUSTIN, TX...... 0.986 0.996 0.859
00900 20 BEAUMONT, TX.... 0.992 0.890 1.338
00900 09 BRAZORIA, TX.... 0.992 0.978 1.338
00900 11 DALLAS, TX...... 1.010 1.065 0.931
00900 28 FORT WORTH, TX.. 0.987 0.981 0.931
00900 15 GALVESTON, TX... 0.988 0.969 1.338
00900 18 HOUSTON, TX..... 1.020 1.007 1.336
00900 99 REST OF TEXAS... 0.966 0.880 0.956
00910 09 UTAH............ 0.976 0.941 0.644
31145 50 VERMONT......... 0.973 0.986 0.539
00973 50 VIRGIN ISLANDS.. 0.965 1.023 1.002
00904 00 VIRGINIA........ 0.984 0.938 0.500
00836 02 SEATTLE (KING 1.005 1.100 0.788
CNTY), WA......
00836 99 REST OF 0.981 0.972 0.788
WASHINGTON.....
16510 16 WEST VIRGINIA... 0.963 0.850 1.378
00951 00 WISCONSIN....... 0.981 0.929 0.939
00825 21 WYOMING......... 0.967 0.895 1.005
------------------------------------------------------------------------
* Payment locality is serviced by two carriers.
Note: Work GPCI reflects only \1/4\ work GPCI in accordance with section
1848(e)(1)(A)(iii) of the Social Security Act. GPCIs rescaled by the
following factors for budget neutrality: Work = 0.99699; Practice
Expense = 0.99235; Malpractice Expense = 1.00215.
Addendum E.--Updated List of CPT 1/HCPCS Codes Used To Describe Certain
Designated Health Services Under the Physician Referral Provisions
[Section 1877 of the Social Security Act]
------------------------------------------------------------------------
------------------------------------------------------------------------
CLINICAL LABORATORY SERVICES
INCLUDE CPT codes for all clinical laboratory services in the 80000
series, except EXCLUDE CPT codes for the following blood component
collection services:
86890................................. Autologous blood process
86891................................. Autologous blood, op salvage
86915................................. Bone marrow/stem cell prep
86927................................. Plasma, fresh frozen
86930................................. Frozen blood prep
86931................................. Frozen blood thaw
86932................................. Frozen blood freeze/thaw
86945................................. Blood product/irradiation
86950................................. Leukacyte transfusion
86965................................. Pooling blood platelets
86985................................. Split blood or products
INCLUDE the following HCPCS level 2 codes for other clinical laboratory
services:
G0001................................. Drawing blood for specimen
G0026................................. Fecal leukocyte examination
G0027................................. Semen analysis
G0103................................. Psa, total screening
G0107................................. CA screen; fecal blood test
G0123................................. Screen cerv/vag thin layer
G0124................................. Screen c/v thin layer by MD
G0141................................. Scr c/v cyto,autosys and md
G0143-G0145........................... Scr c/v cyto,thinlayer, rescr
G0147................................. Scr c/v cyto, automated sys
G0148................................. Scr c/v cyto, autosys, rescr
P2028................................. Cephalin floculation test
P2029................................. Congo red blood test
P2031................................. Hair analysis
P2033................................. Blood thymol turbidity
P2038................................. Blood mucoprotein
P3000................................. Screen pap by tech w md supv
P3001................................. Screening pap smear by phys
P7001................................. Culture bacterial urine
P9612................................. Catheterize for urine spec
P9615................................. Urine specimen collect mult
Q0111................................. Wet mounts/w preparations
Q0112................................. Potassium hydroxide preps
Q0113................................. Pinworm examinations
Q0114................................. Fern test
Q0115................................. Post-coital mucous exam
PHYSICAL THERAPY/OCCUPATIONAL THERAPY/SPEECH-LANGUAGE PATHOLOGY
INCLUDE the following CPT codes for the physical therapy/occupational
therapy/speech-language pathology services in the 97000 series:
97001................................. Pt evaluation
97002................................. Pt re-evaluation
97003................................. Ot evaluation
97004................................. Ot re-evaluation
97010................................. Hot or cold packs therapy
97012................................. Mechanical traction therapy
97014................................. Electric stimulation therapy
97016................................. Vasopneumatic device therapy
97018................................. Paraffin bath therapy
[[Page 55501]]
97020................................. Microwave therapy
97022................................. Whirlpool therapy
97024................................. Diathermy treatment
97026................................. Infrared therapy
97028................................. Ultraviolet therapy
97032................................. Electrical stimulation
97033................................. Electric current therapy
97034................................. Contrast bath therapy
97035................................. Ultrasound therapy
97036................................. Hydrotherapy
97039................................. Physical therapy treatment
97110................................. Therapeutic exercises
97112................................. Neuromuscular reeducation
97113................................. Aquatic therapy/exercises
97116................................. Gait training therapy
97124................................. Massage therapy
97139................................. Physical medicine procedure
97140................................. Manual therapy
97150................................. Group therapeutic procedures
97504................................. Orthotic training
97520................................. Prosthetic training
97530................................. Therapeutic activities
97532................................. Cognitive skills development
97533................................. Sensory integration
97535................................. Self care mngment training
97537................................. Community/work reintegration
97542................................. Wheelchair mngment training
97545................................. Work hardening
97546................................. Work hardening add-on
97703................................. Prosthetic checkout
97750................................. Physical performance test
97799................................. Physical medicine procedure
INCLUDE CPT codes for physical therapy/occupational therapy/speech-
language pathology services not in the 97000 series:
64550................................. Apply neurostimulator
90901................................. Biofeedback train, any meth
90911................................. Biofeedback peri/uro/rectal
92506................................. Speech/hearing evaluation
92507-92508........................... Speech/hearing therapy
92510................................. Rehab for ear implant
92526................................. Oral function therapy
93797................................. Cardiac rehab
93798................................. Cardiac rehab/monitor
94667-94668........................... Chest wall manipulation
94762................................. Measure blood oxygen level
95831................................. Limb muscle testing, manual
95832................................. Hand muscle testing, manual
95833-95834........................... Body muscle testing, manual
95851-95852........................... Range of motion measurements
96000................................. Motion analysis, video/3d
96001................................. Motion test w/ft press meas
96002................................. Dynamic surface emg
96003................................. Dynamic fine wire emg
96105................................. Assessment of aphasia
96110................................. Developmental test, lim
96111................................. Developmental test, extend
96115................................. Neurobehavior status exam
INCLUDE HCPCS level 2 codes for the following physical therapy/
occupational therapy/speech-language pathology services:
G0193................................. Endoscopic study swallow functn
G0194................................. Sensory testing endoscopic stud
G0195................................. Clinical eval swallowing funct
G0196................................. Eval of swallowing with radioopa
G0197................................. Eval of pt for prescip speech
devi
G0198................................. Patient adapation & train for
spe
G0199................................. Reevaluation of patient use spec
G0200................................. Eval of patient prescip of voice
p
G0201................................. Modi for training in use voice
pro
Q0086................................. Physical therapy evaluation/
RADIOLOGY
INCLUDE the following radiology and certain other imaging services in
the CPT 70000 series:
70100-70110........................... X-ray exam of jaw
70120-70130........................... X-ray exam of mastoids
70134................................. X-ray exam of middle ear
70140-70150........................... X-ray exam of facial bones
70160................................. X-ray exam of nasal bones
70190-70200........................... X-ray exam of eye sockets
70210-70220........................... X-ray exam of sinuses
70240................................. X-ray exam, pituitary saddle
70250-70260........................... X-ray exam of skull
70300-70310........................... X-ray exam of teeth
70320................................. Full mouth x-ray of teeth
70328................................. X-ray exam of jaw joint
70330................................. X-ray exam of jaw joints
70336................................. Magnetic image, jaw joint
70350................................. X-ray head for orthodontia
70355................................. Panoramic x-ray of jaws
70360................................. X-ray exam of neck
70370................................. Throat x-ray & fluoroscopy
70371................................. Speech evaluation, complex
70380................................. X-ray exam of salivary gland
70450................................. Ct head/brain w/o dye
70460................................. Ct head/brain w/dye
70470................................. Ct head/brain w/o&w dye
70480................................. Ct orbit/ear/fossa w/o dye
70481................................. Ct orbit/ear/fossa w/dye
70482................................. Ct orbit/ear/fossa w/o&w dye
70486................................. Ct maxillofacial w/o dye
70487................................. Ct maxillofacial w/dye
70488................................. Ct maxillofacial w/o&w dye
70490................................. Ct soft tissue neck w/o dye
70491................................. Ct soft tissue neck w/dye
70492................................. Ct sft tsue nck w/o & w/dye
70496................................. Ct angiography, head
70498................................. Ct angiography, neck
70540................................. Mri orbit/face/neck w/o dye
70542................................. Mri orbit/face/neck w/dye
70543................................. Mri orbt/fac/nck w/o&w dye
70544................................. Mr angiography head w/o dye
70545................................. Mr angiography head w/dye
70546................................. Mr angiograph head w/o&w dye
70547................................. Mr angiography neck w/o dye
70548................................. Mr angiography neck w/dye
70549................................. Mr angiograph neck w/o&w dye
70551................................. Mri brain w/o dye
70552................................. Mri brain w/dye
70553................................. Mri brain w/o&w dye
71010-71022........................... Chest x-ray
71023................................. Chest x-ray and fluoroscopy
71030................................. Chest x-ray
71034................................. Chest x-ray and fluoroscopy
71035................................. Chest x-ray
71100................................. X-ray exam of ribs
71101................................. X-ray exam of ribs/chest
71110................................. X-ray exam of ribs
71111................................. X-ray exam of ribs/ chest
71120-71130........................... X-ray exam of breastbone
71250................................. Ct thorax w/o dye
71260................................. Ct thorax w/dye
71270................................. Ct thorax w/o&w dye
71275................................. Ct angiography, chest
71550................................. Mri chest w/o dye
71551................................. Mri chest w/dye
71552................................. Mri chest w/o&w dye
71555................................. Mri angio chest w or w/o dye
72010-72020........................... X-ray exam of spine
72040-72052........................... X-ray exam of neck spine
72069................................. X-ray exam of trunk spine
72070-72074........................... X-ray exam of thoracic spine
72080-72090........................... X-ray exam of trunk spine
72100-72120........................... X-ray exam of lower spine
72125................................. Ct neck spine w/o dye
72126................................. Ct neck spine w/dye
72127................................. Ct neck spine w/o&w dye
72128................................. Ct chest spine w/o dye
72129................................. Ct chest spine w/dye
72130................................. Ct chest spine w/o&w dye
72131................................. Ct lumbar spine w/o dye
72132................................. Ct lumbar spine w/dye
72133................................. Ct lumbar spine w/o&w dye
72141................................. Mri neck spine w/o dye
72142................................. Mri neck spine w/dye
72146................................. Mri chest spine w/o dye
72147................................. Mri chest spine w/dye
72148................................. Mri lumbar spine w/o dye
72149................................. Mri lumbar spine w/dye
72156................................. Mri neck spine w/o&w dye
72157................................. Mri chest spine w/o&w dye
72158................................. Mri lumbar spine w/o&w dye
72170-72190........................... X-ray exam of pelvis
72191................................. Ct angiograph pelv w/o&w dye
72192................................. Ct pelvis w/o dye
72193................................. Ct pelvis w/dye
72194................................. Ct pelvis w/o&w dye
72195................................. Mri pelvis w/o dye
72196................................. Mri pelvis w/dye
72197................................. Mri pelvis w/o & w dye
72200-72202........................... X-ray exam sacroiliac joints
72220................................. X-ray exam of tailbone
73000................................. X-ray exam of collar bone
73010................................. X-ray exam of shoulder blade
73020-73030........................... X-ray exam of shoulder
73050................................. X-ray exam of shoulders
73060................................. X-ray exam of humerus
73070-73080........................... X-ray exam of elbow
73090................................. X-ray exam of forearm
73092................................. X-ray exam of arm, infant
73100-73110........................... X-ray exam of wrist
73120-73130........................... X-ray exam of hand
73140................................. X-ray exam of finger(s)
73200................................. Ct upper extremity w/o dye
73201................................. Ct upper extremity w/dye
73202................................. Ct uppr extremity w/o&w dye
73206................................. Ct angio upr extrm w/o&w dye
73218................................. Mri upper extremity w/o dye
73219................................. Mri upper extremity w/dye
73220................................. Mri uppr extremity w/o&w dye
73221................................. Mri joint upr extrem w/o dye
73222................................. Mri joint upr extrem w/ dye
73223................................. Mri joint upr extr w/o&w dye
73500-73510........................... X-ray exam of hip
73520................................. X-ray exam of hips
73540................................. X-ray exam of pelvis & hips
73550................................. X-ray exam of thigh
73560................................. X-ray exam of knee, 1 or 2
73562................................. X-ray exam of knee, 3
73564................................. X-ray exam, knee, 4 or more
73565................................. X-ray exam of knees
73590................................. X-ray exam of lower leg
73592................................. X-ray exam of leg, infant
73600-73610........................... X-ray exam of ankle
73620-73630........................... X-ray exam of foot
73650................................. X-ray exam of heel
73660................................. X-ray exam of toe(s)
73700................................. Ct lower extremity w/o dye
73701................................. Ct lower extremity w/dye
73702................................. Ct lwr extremity w/o&w dye
73706................................. Ct angio lwr extr w/o&w dye
73718................................. Mri lower extremity w/o dye
73719................................. Mri lower extremity w/dye
73720................................. Mri lwr extremity w/o&w dye
73721................................. Mri joint of lwr extre w/o d
73722................................. Mri joint of lwr extr w/dye
[[Page 55502]]
73723................................. Mri joint lwr extr w/o&w dye
73725................................. Mr ang lwr ext w or w/o dye
74000-74020........................... X-ray exam of abdomen
74022................................. X-ray exam series, abdomen
74150................................. Ct abdomen w/o dye
74160................................. Ct abdomen w/dye
74170................................. Ct abdomen w/o&w dye
74175................................. Ct angio abdom w/o&w dye
74181................................. Mri abdomen w/o dye
74182................................. Mri abdomen w/dye
74183................................. Mri abdomen w/o&w dye
74185................................. Mri angio, abdom w or w/o dy
74210................................. Contrst x-ray exam of throat
74220................................. Contrast x-ray, esophagus
74230................................. Cine/video x-ray, throat/eso
74240-74245........................... X-ray exam, upper gi tract
74246-74249........................... Contrst x-ray uppr gi tract
74250................................. X-ray exam of small bowel
74290................................. Contrast x-ray, gallbladder
74291................................. Contrast x-rays, gallbladder
74710................................. X-ray measurement of pelvis
75552................................. Heart mri for morph w/o dye
75553................................. Heart mri for morph w/dye
75554................................. Cardiac MRI/function
75555................................. Cardiac MRI/limited study
75635................................. Ct angio abdominal arteries
76000................................. Fluoroscope examination
76006................................. X-ray stress view
76010................................. X-ray, nose to rectum
76020................................. X-rays for bone age
76040................................. X-rays, bone evaluation
76061-76062........................... X-rays, bone survey
76065................................. X-rays, bone evaluation
76066................................. Joint survey, single view
76085................................. Computer mammogram add-on
76090................................. Mammogram, one breast
76091................................. Mammogram, both breasts
76092................................. Mammogram, screening
76093................................. Magnetic image, breast
76094................................. Magnetic image, both breasts
76100................................. X-ray exam of body section
76101................................. Complex body section x-ray
76102................................. Complex body section x-rays
76120................................. Cine/video x-rays
76125................................. Cine/ video x-rays add-on
76150................................. X-ray exam, dry process
76370................................. CAT scan for therapy guide
76375................................. 3d/holograph reconstr add-on
76380................................. CAT scan follow-up study
76390................................. Mr spectroscopy
76400................................. Magnetic image, bone marrow
76499................................. Radiographic procedure
76506................................. Echo exam of head
76511-76512........................... Echo exam of eye
76513................................. Echo exam of eye, water bath
76516-76519........................... Echo exam of eye
76536................................. Us exam of head and neck
76604................................. Us exam, chest, b-scan
76645................................. Us exam, breast(s)
76700................................. Us exam, abdom, complete
76705................................. Us exam, abdom, limited
76770................................. Us exam abdo back wall, comp
76775................................. Us exam abdo back wall, lim
76778................................. Us exam kidney transplant
76800................................. Us exam, spinal canal
76805................................. Us exam, pg uterus, compl
76810................................. Us exam, pg uterus, mult
76815................................. Us exam, pg uterus limit
76816................................. Us exam pg uterus repeat
76818................................. Fetal biophy profile w/nst
76819................................. Fetal biophys profil w/o nst
76825-76828........................... Echo exam of fetal heart
76830................................. Us exam, transvaginal
76831................................. Echo exam, uterus
76856................................. Us exam, pelvic, complete
76857................................. Us exam, pelvic, limited
76870................................. Us exam, scrotum
76872................................. Echo exam, transrectal
76873................................. Echograp trans r, pros study
76880................................. Us exam, extremity
76885................................. Us exam infant hips, dynamic
76886................................. Us exam infant hips, static
76970................................. Ultrasound exam follow-up
76977................................. Us bone density measure
76999................................. Echo examination procedure
INCLUDE the following CPT codes for echocardiography and vascular
ultrasound:
93303-93304........................... Echo transthoracic
93307-93308........................... Echo exam of heart
93320-93321........................... Doppler echo exam, heart, if
used in conjunction with 93303-
93308
93325................................. Doppler color flow add-on, if
used in conjunction with 93303-
93308
93875-93882........................... Extracranial study
93886-93888........................... Intracranial study
93922-93924........................... Extremity study
93925-93926........................... Lower extremity study
93930-93931........................... Upper extremity study
93965-93971........................... Extremity study
93975-93979........................... Vascular study
93980-93981........................... Penile vascular study
93990................................. Doppler flow testing
INCLUDE miscellaneous other HCPCS level 2 codes for radiology and
certain other imaging services:
G0050................................. Residual urine by ultrasound
G0131-132............................. CT scan, bone density study
G0188................................. Xray lwr extrmty-full lngth
G0202................................. Screening mammography digital
G0204................................. Diagnostic mammography digital
G0206................................. Diagnostic mammography digital
G0236................................. digital film convert diag ma
R0070................................. Transport portable x-ray
R0075................................. Transport port x-ray multipl
RADIATION THERAPY SERVICES AND SUPPLIES
INCLUDE CPT codes for all radiation therapy services and supplies in the
CPT 70000 series:
77261-77263........................... Radiation therapy planning
77280-77295........................... Set radiation therapy field
77299................................. Radiation therapy planning
77300................................. Radiation therapy dose plan
77301................................. Radioltherapy dos plan, imrt
77305-77315........................... Radiation therapy dose plan
77321................................. Radiation therapy port plan
77326-77328........................... Radiation therapy dose plan
77331................................. Special radiation dosimetry
77332-77334........................... Radiation treatment aid(s)
77336-77370........................... Radiation physics consult
77399................................. External radiation dosimetry
77401-77416........................... Radiation treatment delivery
77417................................. Radiology port film(s)
77418................................. Radiation tx delivery, imrt
77427................................. Radiation tx management, x5
77431................................. Radiation therapy management
77432................................. Stereotactic radiation trmt
77470................................. Special radiation treatment
77499................................. Radiation therapy management
77520................................. Proton trmt, simple w/o comp
77522................................. Proton trmt, simple w/comp
77523................................. Proton trmt, intermediate
77525................................. Proton treatment, complex
77600-77620........................... Hyperthermia treatment
77750................................. Infuse radioactive materials
77761................................. Apply intrcav radiat simple
77762................................. Apply intrcav radiat interm
77763................................. Apply intrcav radiat compl
77776................................. Apply interstit radiat simpl
77777................................. Apply interstit radiat inter
77778................................. Apply iterstit radiat compl
77781-77784........................... High intensity brachytherapy
77789................................. Apply surface radiation
77790................................. Radiation handling
77799................................. Radium/radioisotope therapy
INCLUDE CPT codes for radiation therapy classified elsewhere:
31643................................. Diag bronchoscope/catheter
50559................................. Renal endoscopy/radiotracer
55859................................. Percut/needle insert, pros
61770................................. Incise skull for treatment
61793................................. Focus radiation beam
92974................................. Cath place, cardio brachytx
PREVENTIVE SCREENING TESTS, IMMUNIZATIONS AND VACCINES
The following CPT and HCPCS codes are excluded under Sec. 411.355(h) as
screening tests:
76085................................. Computer mammogram add-on
76092................................. Mammogram, screening
76977................................. Us bone density measure
G0103................................. Psa, total screening
G0107................................. CA screen; fecal blood test
G0123................................. Screen cerv/vag thin layer
G0124................................. Screen c/v thin layer by MD
G0141................................. Scr c/v cyto, autosys and md
G0143-G0145........................... Scr c/v cyto, thinlayer, rescr
G0147................................. Scr c/v cyto, automated sys
G0148................................. Scr c/v cyto, autosys, rescr
G0202................................. Screening mammography digital
P3000................................. Screen pap by tech w md supv
P3001................................. Screening pap smear by phys
The following CPT and HCPCS codes are excluded under Sec. 411.355(h) as
vaccines:
90657................................. Flu vaccine, 6-35 mo, im
90658................................. Flu vaccine, 3 yrs, im
90659................................. Flu vacine, whole, im
90732................................. Pneumococcal vaccine
90748................................. Hep b/hib vaccine, im
Q3018................................. Hepatitis B vaccine
DRUGS USED BY PATIENTS UNDERGOING DIALYSIS
The following HCPCS codes are excluded under Sec. 411.355(g) as EPO and
other dialysis related outpatient prescription drugs furnished in or by
an ESRD facility:
J0635................................. Calcitriol injection
J0895................................. Deferoxamine mesylate inj
J1270................................. Injection, doxercalciferol
J1750................................. Iron dextran
J1755................................. Iron sucrose injection
J2915................................. NA Ferric Gluconate Complex
J2997................................. Alteplase recombinant
Q9920................................. Epoetin with hct =20
Q9921................................. Epoetin with hct = 21
Q9922................................. Epoetin with hct = 22
Q9923................................. Epoetin with hct = 23
Q9924................................. Epoetin with hct = 24
Q9925................................. Epoetin with hct = 25
Q9926................................. Epoetin with hct = 26
Q9927................................. Epoetin with hct = 27
Q9928................................. Epoetin with hct = 28
Q9929................................. Epoetin with hct = 29
Q9930................................. Epoetin with hct = 30
Q9931................................. Epoetin with hct = 31
Q9932................................. Epoetin with hct = 32
Q9933................................. Epoetin with hct = 33
Q9934................................. Epoetin with hct = 34
Q9935................................. Epoetin with hct = 35
[[Page 55503]]
Q9936................................. Epoetin with hct = 36
Q9937................................. Epoetin with hct = 37
Q9938................................. Epoetin with hct = 38
Q9939................................. Epoetin with hct = 39
Q9940................................. Epoetin with hct >= 40
------------------------------------------------------------------------
\1\ CPT codes and descriptions only are copyright 2001 American Medical
Association. All rights are reserved and applicable FARS/DFARS clauses
apply.
[FR Doc. 01-27275 Filed 10-31-01; 8:45 am]
BILLING CODE 4120-01-P