Medicare Program; Proposed Changes to the Hospital Outpatient Prospective Payment System and Calendar Year 2006 Payment Rates; Correction

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Parts 419 and 485

[CMS-1501-CN]

RIN 0938-AN46

Medicare Program; Proposed Changes to the Hospital Outpatient Prospective Payment System and Calendar Year 2006 Payment Rates; Correction

AGENCY:

Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION:

Proposed rule; correction.

SUMMARY:

This document corrects technical errors that appeared in the proposed rule published in the

Federal Register

on July 25, 2005 entitled “Medicare Program; Proposed Changes to the Hospital Outpatient Prospective Payment System and Calendar Year 2006 Payment Rates; Proposed Rule.”

FOR FURTHER INFORMATION CONTACT:

Rebecca Kane, (410) 786-0378.

SUPPLEMENTARY INFORMATION:

I. Background

FR Doc. 05-14448 contains our proposed rule to update the Medicare Outpatient Prospective Payment System for calendar year (CY) 2006. We have identified a number of technical errors in the “Summary of Errors” section and are correcting them in the “Correction of Errors” section below.

II. Summary of Errors

A. Corrections Related to the Rural Adjustment Calculation

The calendar year (CY) 2006 Outpatient Prospective Payment System (OPPS) proposed rule that we published in the

Federal Register

on July 25, 2005 included a proposed 6.6 percent adjustment for rural sole community hospitals. The calculations used to develop the conversion factor and budget neutrality scalar inadvertently incorporated this adjustment as 6.4 percent. The rural adjustment is used in calculations that determine the scalar and conversion factor, and therefore affects the payment rates and copayment amounts published in the proposed rule. The corrected scalar is 1.003753831, and the corrected conversion factor is $59.343. The various changes to the preamble are specified under section III. of this correction notice. In addition to preamble text changes, we are correcting specific tables and addenda which also reflected the inadvertent use of a 6.4 percent rural adjustment factor, which we have described below.

On page 42709, we published Table 11. We are correcting the last column of this table to present the corrected proposed CY 2006 payment amounts. In section III. of this notice, we republish Table 11 as corrected.

On pages 42761-42762, we published Table 33. In section III. of this notice, we republish Table 33 as corrected.

On pages 42764-42775, we published Addendum A, which provides the payment rates and copayment amounts for Ambulatory Payment Classification (APC) groups used for payment purposes under the OPPS. A corrected Addendum A is posted on the OPPS Web site at

http://www.cms.hhs.gov/providers/hopps/2006p/1501p.asp.

On pages 42776-42965, we published Addendum B, which provides the payment rates and copayment amounts for services payable under OPPS. A corrected Addendum B, including additional technical errors affecting HCPCS codes 78814, 78815, 78816, 91035, and 95950 is posted on the OPPS Web site at

http://www.cms.hhs.gov/providers/hopps/2006p/1501p.asp.

We are posting the corrected Addendum A and Addendum B on our Web site rather than publishing them in this notice because of the large volume of data included in these addenda. Hard copies of these tables are available by contacting the CMS staff member identified above.

We note that as soon as we discovered these inadvertent errors that affected the payment rates noted in the proposed rule, we posted the corrections on the CMS Web site at:

http://www.cms.hhs.gov/providers/hopps/2006p/1501p.asp.

B. Other Corrections

We also noted other typographical, formatting, and other technical errors in the proposed rule.

On page 42714, we published Table 15. The proposed “unadjusted” and “adjusted” CY 2006 APC median cost for APC 0085 Level II Electrophysiologic Evaluation contained a typographical error and should read $2,123.38. We are correcting this under section III. of this notice.

On page 42761, column 2 includes a comparison that discusses the differences in copayments from CY 2005 to CY 2006. While the analysis of this example is correct, the example incorrectly identifies the comparison as being the “minimum unadjusted copayment” rather than the “national unadjusted copayment”. We are making this correction under section III. of this notice to refer to the “national unadjusted copayment”.

On page 42737, we published Table 26, which inadvertently excluded C2636 (Brachytherapy linear source, Palladium -103, per 1 mm) which was accurately described in the text of page 42736 as a proposed separately payable brachytherapy source. In section III. of the notice we append the excluded row to correct table 26 as published.

The other technical, typographical, formatting, and other errors that appeared on various other pages of the

Federal Register

are corrected as noted in section III. of this notice.

III. Correction of Errors

In FR Doc. 05-14448 of July 25, 2005 (70 FR 42674), make the following corrections:

1. On page 42690, in column 3, in the last paragraph, in line 20, the figure “0.999207669” is corrected to read “1.003753831”.

2. On page 42691, in column 1, in the second full paragraph, line 8, the year “2006” is corrected to read “2007”.

3. On page 42694,

a. In column 1, in the second full paragraph, in line 8, the figure “$240.51” is corrected to read “$241.57”.

b. In column 1, in the second full paragraph, in line 8, the figure “$48.10” is corrected to read “$48.31”.

c. In column 3, in the third full paragraph, in line 8, the figure “1.002015212” is corrected to read “1.002023412”.

d. In column 3, in the third full paragraph, in line 18, the figure “0.99652023” is corrected to read “0.99639633”.

e. In column 3, in the last partial paragraph, in line 5, the figure “1.002015212” is corrected to read “1.002023412”.

4. On page 42695,

a. In column 1, in the first partial paragraph, in line 5, the figure “0.99652023” is corrected to read “0.99639633”.

b. In column 1, in the first partial paragraph, in line 7, the figure “$59.350” is corrected to read “$59.343”.

5. On page 42703,

a. In column 1, in the second full paragraph, in line 5, the figure “$9.95” is corrected to read “$7.00”.

b. In column 1, in the second full paragraph, in line 5, the figure “40” is corrected to read “28”.

c. In column 1, in the second full paragraph, in line 6, the figure “$24.89” is corrected to read “$25.00”.

6. On page 42709,

a. In column 1, in the first full paragraph, in line 22, the figure “$1,297” is corrected to read “$1,274”.

b. In column 1, in the first full paragraph, in line 23, the figure “$1,366” is corrected to read “$1,244”.

c. In column 1, in the first full paragraph, in line 25, the figure “$1,100” is corrected to read “$1,025”.

d. Table 11 is corrected to read as follows:

Table 11.—Proposed APC Reassignment of New Technology Procedures Into Clinical APCs for CY 2006

HCPCS

Descriptor

CY 2005 APC

CY 2005 status

indicator

Proposed CY 2006 APC

Proposed CY 2006 status

indicator

CY 2005 payment amount

Proposed CY 2006 payment amount

0027T

Endoscopic epidural lysis

1547

T

0220

T

$850

$1,030.11

33225

L ventric pacing lead add-on

1525

S

0418

T

3,750

6,486.45

61623

Endovasc tempory vessel occl

1555

T

0081

T

1,650

2,044.21

92974

Cath place, cardio brachytx

1559

T

0103

T

2,250

873.18

93580

Transcath closure of asd

1559

T

0434

T

2,250

5,387.61

93581

Transcath closure of vsd

1559

T

0434

T

2,250

5,387.61

95965

Meg, spontaneous

1528

S

0430

T

5,250

676.75

95966

Meg, evoked, single

1516

S

0430

T

1,450

676.75

95967

Meg, evoked, each add'l

1511

S

0430

T

950

676.75

C9713

Non-contact laser vap prosta

1525

S

0429

T

3,750

2,511.08

7. On page 42710, in column 2, in the first full paragraph, in line 19, the figure “$93.71” is corrected to read “$93.37”.

8. On page 42714, Table 15, APC 0085, in columns 5 and 7, in row 7, both occurrences of the figure “$2,123.46” are corrected to read “$2,123.38”.

9. On page 42737, Table 26, “Proposed Separately payable Brachytherapy Sources for CY 2006” is appended with the following row:

HCPCS

Long descriptor

APC

APC title

New status indicator

C2636

Brachytherapy linear source, Palladium-103, per 1mm

2636

Brachytx linear source, P-103

H

10. On page 42756, in column 1, in the first partial paragraph, in line 5, the figure “1.8” is corrected to read “1.7”.

11. On page 42758, in column 2, in the third full paragraph, in line 13, the figure “$59.35” is corrected to read “$59.34”.

12. On page 42759,

a. In column 1, in the first partial paragraph, in line 21, the figure “5.8” is corrected to read “5.6”.

b. In column 1, in the first partial paragraph, in line 31, the figure “1.2” is corrected to read “1.3”.

c. In column 1, in the first partial paragraph, in line 31, the figure “1.8” is corrected to read “1.7”.

d. In column 1, in the first partial paragraph, in line 36, the figure “2.6” is corrected to read “2.5”.

e. In column 1, in the second partial paragraph, in line 22, the figure “2.9” is corrected to read “2.7”.

f. In column 1, in the second partial paragraph, in line 25, the figure “0.7” is corrected to read “0.6”.

g. In column 1, in the second partial paragraph, in line 30, the text “West South Central” is corrected to read “New England”.

h. In column 2, in the first partial paragraph, in line 2, the figure “1.9” is corrected to read “1.7”.

i. In column 2, in the first partial paragraph, in line 2, the figure “1.8” is corrected to read “1.6”.

j. In column 2, in the first full paragraph, in line 4, the figure “0.4” is corrected to read “0.3”.

k. In column 2, in the first full paragraph, in line 5, the figure “0.5” is corrected to read “0.3”.

l. In column 2, in the first full paragraph, in line 9, the figure “0.9” is corrected to read “1.6”.

m. In column 2, in the first full paragraph, in line 10, the figure “1.4” is corrected to read “2.2”.

n. In column 2, in the first full paragraph, in line 21, the sentence portion “1.3 percent and voluntary and government hospitals will gain at least 0.1 percent.” is corrected to read “1.1 percent, voluntary hospitals would gain 0.2 percent, and government hospitals will see no changes as a result of changes to APC structure.”

o. In column 3, in the second full paragraph, in line 7, the figure “0.997” is corrected to read “0.996”.

p. In column 3, in the second full paragraph, in line 10, the figure “0.3” is corrected to read “0.4”.

q. In column 3, in the second full paragraph, in line 13, the figure “5.2” is corrected to read “5.4”.

13. On page 42760,

a. In column 1, in the first partial paragraph, in line 6, the figure “0.3” is corrected to read “0.4”.

b. In column 1, in the first full paragraph, in line 19, the figure “5.8” is corrected to read “5.6”.

c. In column 1, in the first full paragraph, in line 24, the figure “-2.8” is corrected to read “-2.4”.

d. In column 1, in the first full paragraph, in line 32, the figure “1.2” is corrected to read “1.3”.

e. In column 1, in the first full paragraph, in line 35, the figure “0.3” is corrected to read “0.4”.

f. In column 1, in the first full paragraph, in line 37, the figure “1.5” is corrected to read “1.4”.

g. In column 1, in the last paragraph, in line 7, the figure “8.6” is corrected to read “8.7”.

h. In column 1, in the third partial paragraph, in line 12, the figure “5.0” is corrected to read “4.7”.

i. In column 3, in the first partial paragraph, in line 6, the figure “2.6” is corrected to read “2.5”.

j. In column 3, in the first partial paragraph, in line 12, the figure “2.1” is corrected to read “1.8”.

k. In column 3, in the first partial paragraph, in line 32, the figure “3.7” is corrected to read “3.6”.

l. In column 3, in the first full paragraph, in line 11, the figure “3.4” is corrected to read “3.5”.

m. In column 3, in the first full paragraph, in line 13, the figure “6.4” is corrected to read “6.5”.

n. In column 3, in the first full paragraph, in line 30, the text “greater than” is corrected to read “of at least”.

o. In column 3, in the first full paragraph, in lines 33 and 34, the figure “only 1.0” is corrected to read “1.4” and the text “and 0.8 percent, respectively.” is appended to the end of the sentence.

14. On page 42761

a. In column 1, in the first partial paragraph, in line 3, the figure “1.9” is corrected to read “2.6”.

b. In column 1, in the first partial paragraph, in line 6, the figure “2.6” is corrected to read “3.4”.

c. In column 1, in the first partial paragraph, in line 11, the figure “0.8” is corrected to read “0.6”.

d. In column 1, in line 12, the designation for the heading “Estimated Impacts of This Proposed Rule on Beneficiaries” is corrected from “G” to read “F”.

e. In column 1, in the second partial paragraph, in line 12, the figure “$11.86” is corrected to read “$11.91”.

f. In column 2, in the first partial paragraph, in lines 4 and 6, the term “minimum” is corrected to read “national”.

g. In column 2, in the first partial paragraph, in line 8, the figure “$223.91” is corrected to read “$224.91”.

h. Table 33 is corrected to read as follows:

Table 33.—Impact of Proposed Changes for CY 2006 Hospital Outpatient Prospective Payment System

Hospital category

Number of

hospitals

APC changes

New wage index

New adj for rural sole community hospitals

Cumulative (Cols 2,3,4) with market basket update

All changes

(1)

(2)

(3)

(4)

(5)

(6)

ALL HOSPITALS

4212

0.0

0.0

0.0

3.2

1.9

URBAN HOSPITALS

2949

0.0

0.0

−0.4

2.8

1.6

LARGE URBAN

1624

−0.8

0.0

−0.4

2.0

0.8

OTHER URBAN

1325

1.0

0.0

−0.4

3.8

2.5

RURAL HOSPITALS

1263

−0.1

0.1

1.8

5.0

3.5

SOLE COMMUNITY

478

−0.1

0.0

5.4

8.7

6.5

OTHER RURAL

785

−0.1

0.1

−0.4

2.8

1.6

BEDS (URBAN):

0-99 BEDS

917

0.0

0.2

−0.4

3.0

2.1

100-199 BEDS

964

−0.4

0.0

−0.4

2.5

1.5

200-299 BEDS

503

0.2

0.1

−0.4

3.2

2.4

300-499 BEDS

402

−0.1

−0.1

−0.4

2.6

1.5

500 + BEDS

163

0.3

0.0

−0.4

3.1

1.0

BEDS (RURAL):

0-49 BEDS

551

−0.9

0.2

2.1

4.6

3.1

50-100 BEDS

419

−0.8

0.2

2.3

4.8

3.0

101-149 BEDS

180

1.4

0.0

1.1

5.8

4.7

150-199 BEDS

62

−0.2

−0.2

1.8

4.7

3.7

200 + BEDS

51

0.1

0.0

1.7

5.1

3.1

VOLUME (URBAN):

LT 5,000 claim lines

600

−5.6

0.5

−0.4

−2.4

−1.8

5,000-10,999

180

−2.4

0.2

−0.4

0.5

0.6

11,000-20,999

299

−0.6

0.2

−0.4

2.4

2.5

21,000-42,999

575

−0.6

0.1

−0.4

2.3

1.9

GT 42,999

1295

0.2

0.0

−0.4

3.0

1.6

VOLUME (RURAL):

LT 5,000 claim lines

119

−2.7

0.0

1.4

1.7

1.4

5,000-10,999

195

−1.9

0.0

2.1

3.4

2.4

11,000-20,999

325

−0.9

−0.1

2.0

4.3

3.4

21,000-42,999

364

−0.9

0.2

1.9

4.5

3.0

GT 42,999

260

0.6

0.0

1.7

5.7

3.8

REGION (URBAN):

NEW ENGLAND

166

−1.3

−0.1

−0.4

1.4

−0.2

MIDDLE ATLANTIC

393

0.6

−0.1

−0.4

3.4

2.1

SOUTH ATLANTIC

453

−0.4

−0.4

−0.4

2.0

1.0

EAST NORTH CENT

466

0.4

−0.1

−0.4

3.2

1.7

EAST SOUTH CENT

197

1.5

0.0

−0.4

4.4

3.4

WEST NORTH CENT

184

2.5

−0.3

−0.4

5.1

3.6

WEST SOUTH CENT

445

−0.3

−0.1

−0.4

2.5

1.3

MOUNTAIN

163

−0.1

−0.2

−0.4

2.5

1.3

PACIFIC

431

−1.7

1.1

−0.4

2.2

1.4

PUERTO RICO

51

0.4

−0.3

−0.4

2.9

2.2

REGION (RURAL):

NEW ENGLAND

37

−1.1

0.9

1.2

4.2

0.8

MIDDLE ATLANTIC

78

1.7

−0.4

1.4

6.0

4.1

SOUTH ATLANTIC

189

−0.4

−0.2

1.7

4.4

3.3

EAST NORTH CENT

171

−0.6

0.1

1.4

4.1

2.2

EAST SOUTH CENT

202

−0.7

0.5

0.5

3.5

3.0

WEST NORTH CENT

188

1.6

−0.3

2.6

7.2

4.7

WEST SOUTH CENT

242

−0.9

−0.2

2.2

4.4

3.7

MOUNTAIN

95

−1.0

0.1

4.6

7.0

5.2

PACIFIC

61

−0.7

1.8

2.7

7.2

5.3

TEACHING STATUS:

NON-TEACHING

3115

−0.3

0.1

0.3

3.2

2.3

MINOR

769

0.3

0.0

−0.2

3.3

2.3

MAJOR

328

0.3

−0.2

−0.3

3.0

0.6

DSH PATIENT PERCENT:

0

16

0.3

0.0

−0.4

3.1

3.1

GT 0-0.10

386

0.1

−0.2

−0.3

2.8

1.7

0.10-0.16

555

0.0

0.1

0.2

3.5

2.4

0.16-0.23

802

0.1

0.0

0.1

3.5

2.3

0.23-0.35

977

0.1

−0.1

0.0

3.2

1.9

GE 0.35

792

−0.3

0.1

−0.1

3.0

1.8

TEFRA: DSH NOT AVAIL

1

684

−1.6

0.0

−0.4

1.2

−2.6

URBAN TEACHING/DSH:

TEACHING & DSH

944

0.4

−0.1

−0.4

3.1

1.7

NO TEACHING/DSH

1401

−0.3

0.1

−0.4

2.5

1.8

NO TEACHING/NO DSH

16

0.3

0.0

−0.4

3.1

3.1

TEFRA: DSH NOT AVAIL

1

588

−2.2

0.1

−0.4

0.7

−3.4

TYPE OF OWNERSHIP:

VOLUNTARY

2397

0.2

0.0

0.0

3.3

2.0

PROPRIETARY

1091

−1.1

0.0

0.0

2.1

1.6

GOVERNMENT

724

0.0

0.1

0.2

3.6

1.7

Col (1) Total Hospitals in 2006.

Col (2) This column shows the impact of changes resulting from the reclassification of HCPCS codes among APC groups and from the addition of multiple procedure discounting for radiology procedures (budget neutral overall).

Col (3) This column shows the adjustment for updating the wage index (budget neutral overall).

Col (4) This column shows the adjustment for rural sole community hospitals (budget neutral overall).

Col (5) This column shows the cumulative impact of cols 2 through 4 and the addition of the market basket update.

Col (6) The column shows the impact of the change in MMA dollars in 2006 (drugs and 508) and outlier changes.

1

Complete DSH numbers are not available for hospitals that are not paid under IPPS.

15. On pages 42764-42775, Addendum A is corrected to read as follows:

Addendum A.—List of Ambulatory Payment Classifications (APCs) with Status Indicators, Relative Weights, Payment Rates, and Copayment Amounts Calendar Year 2006

APC

Group title

SI

Relative weight

Payment rate

National unadjusted copayment

Minimum unadjusted copayment

0001

Level I Photochemotherapy

S

0.4213

$25.00

$7.00

$5.00

0002

Level I Fine Needle Biopsy/Aspiration

T

0.9559

$56.73

$11.35

0003

Bone Marrow Biopsy/Aspiration

T

2.6530

$157.44

$31.49

0004

Level I Needle Biopsy/ Aspiration Except Bone Marrow

T

1.7646

$104.72

$22.36

$20.94

0005

Level II Needle Biopsy/Aspiration Except Bone Marrow

T

3.5994

$213.60

$71.59

$42.72

0006

Level I Incision & Drainage

T

1.5500

$91.98

$22.28

$18.40

0007

Level II Incision & Drainage

T

11.4501

$679.48

$135.90

0008

Level III Incision and Drainage

T

16.4989

$979.09

$195.82

0009

Nail Procedures

T

0.6680

$39.64

$8.34

$7.93

0010

Level I Destruction of Lesion

T

0.5719

$33.94

$9.65

$6.79

0011

Level II Destruction of Lesion

T

2.0839

$123.66

$25.17

$24.73

0012

Level I Debridement & Destruction

T

0.8497

$50.42

$11.18

$10.08

0013

Level II Debridement & Destruction

T

1.1078

$65.74

$14.20

$13.15

0015

Level III Debridement & Destruction

T

1.6514

$98.00

$20.29

$19.60

0016

Level IV Debridement & Destruction

T

2.5834

$153.31

$33.57

$30.66

0017

Level VI Debridement & Destruction

T

18.4211

$1,093.16

$227.84

$218.63

0018

Biopsy of Skin/Puncture of Lesion

T

1.1726

$69.59

$16.04

$13.92

0019

Level I Excision/ Biopsy

T

4.0547

$240.62

$71.87

$48.12

0020

Level II Excision/ Biopsy

T

6.9433

$412.04

$107.40

$82.41

0021

Level III Excision/ Biopsy

T

14.9776

$888.82

$219.48

$177.76

0022

Level IV Excision/ Biopsy

T

19.6472

$1,165.92

$354.45

$233.18

0023

Exploration Penetrating Wound

T

4.7775

$283.51

$56.70

0024

Level I Skin Repair

T

1.6084

$95.45

$31.25

$19.09

0025

Level II Skin Repair

T

5.4938

$326.02

$101.85

$65.20

0027

Level IV Skin Repair

T

18.4182

$1,092.99

$329.72

$218.60

0028

Level I Breast Surgery

T

19.5801

$1,161.94

$303.74

$232.39

0029

Level II Breast Surgery

T

32.0476

$1,901.80

$632.64

$380.36

0030

Level III Breast Surgery

T

40.0825

$2,378.62

$763.55

$475.72

0033

Partial Hospitalization

P

4.0708

$241.57

$48.31

0035

Venous Cutdown

T

0.7158

$42.48

$8.50

0036

Level II Fine Needle Biopsy/Aspiration

T

2.1773

$129.21

$25.84

0037

Level IV Needle Biopsy/Aspiration Except Bone Marrow

T

9.4751

$562.28

$224.91

$112.46

0039

Level I Implantation of Neurostimulator

S

181.4000

$10,764.82

$2,152.96

0040

Level I Implantation of Neurostimulator Electrodes

S

55.3297

$3,283.43

$656.69

0041

Level I Arthroscopy

T

28.1318

$1,669.43

$333.89

0042

Level II Arthroscopy

T

43.9753

$2,609.63

$804.74

$521.93

0043

Closed Treatment Fracture Finger/Toe/Trunk

T

1.7694

$105.00

$21.00

0045

Bone/Joint Manipulation Under Anesthesia

T

14.4945

$860.15

$268.47

$172.03

0046

Open/Percutaneous Treatment Fracture or Dislocation

T

37.7023

$2,237.37

$535.76

$447.47

0047

Arthroplasty without Prosthesis

T

31.6107

$1,875.87

$537.03

$375.17

0048

Level I Arthroplasty with Prosthesis

T

43.1288

$2,559.39

$570.30

$511.88

0049

Level I Musculoskeletal Procedures Except Hand and Foot

T

20.3707

$1,208.86

$241.77

0050

Level II Musculoskeletal Procedures Except Hand and Foot

T

23.9081

$1,418.78

$283.76

0051

Level III Musculoskeletal Procedures Except Hand and Foot

T

36.5271

$2,167.63

$433.53

0052

Level IV Musculoskeletal Procedures Except Hand and Foot

T

43.9378

$2,607.40

$521.48

0053

Level I Hand Musculoskeletal Procedures

T

15.6795

$930.47

$253.49

$186.09

0054

Level II Hand Musculoskeletal Procedures

T

25.3711

$1,505.60

$301.12

0055

Level I Foot Musculoskeletal Procedures

T

20.0692

$1,190.97

$355.34

$238.19

0056

Level II Foot Musculoskeletal Procedures

T

40.2957

$2,391.27

$478.25

0057

Bunion Procedures

T

27.5493

$1,634.86

$475.91

$326.97

0058

Level I Strapping and Cast Application

S

1.0934

$64.89

$12.98

0060

Manipulation Therapy

S

0.4935

$29.29

$5.86

0068

CPAP Initiation

S

1.2293

$72.95

$29.18

$14.59

0069

Thoracoscopy

T

30.6775

$1,820.49

$591.64

$364.10

0070

Thoracentesis/Lavage Procedures

T

3.2101

$190.50

$38.10

0071

Level I Endoscopy Upper Airway

T

0.7915

$46.97

$11.31

$9.39

0072

Level II Endoscopy Upper Airway

T

1.4361

$85.22

$21.27

$17.04

0074

Level IV Endoscopy Upper Airway

T

15.7757

$936.18

$295.70

$187.24

0075

Level V Endoscopy Upper Airway

T

21.3426

$1,266.53

$445.92

$253.31

0076

Level I Endoscopy Lower Airway

T

9.4592

$561.34

$189.82

$112.27

0077

Level I Pulmonary Treatment

S

0.3444

$20.44

$7.74

$4.09

0078

Level II Pulmonary Treatment

S

1.0236

$60.74

$14.55

$12.15

0079

Ventilation Initiation and Management

S

2.3482

$139.35

$27.87

0080

Diagnostic Cardiac Catheterization

T

37.1361

$2,203.77

$838.92

$440.75

0081

Non-Coronary Angioplasty or Atherectomy

T

34.4473

$2,044.21

$408.84

0082

Coronary Atherectomy

T

85.0126

$5,044.90

$1,085.20

$1,008.98

0083

Coronary Angioplasty and Percutaneous Valvuloplasty

T

50.8925

$3,020.11

$604.02

0084

Level I Electrophysiologic Evaluation

S

10.0205

$594.65

$118.93

0085

Level II Electrophysiologic Evaluation

T

35.1882

$2,088.17

$426.25

$417.63

0086

Ablate Heart Dysrhythm Focus

T

44.2596

$2,626.50

$833.33

$525.30

0087

Cardiac Electrophysiologic Recording/Mapping

T

30.7101

$1,822.43

$364.49

0088

Thrombectomy

T

36.5617

$2,169.68

$655.22

$433.94

0089

Insertion/Replacement of Permanent Pacemaker and Electrodes

T

105.6143

$6,267.47

$1,682.28

$1,253.49

0090

Insertion/Replacement of Pacemaker Pulse Generator

T

89.1574

$5,290.87

$1,612.80

$1,058.17

0091

Level II Vascular Ligation

T

28.9999

$1,720.94

$348.23

$344.19

0092

Level I Vascular Ligation

T

23.4516

$1,391.69

$278.34

0093

Vascular Reconstruction/Fistula Repair without Device

0094

Level I Resuscitation and Cardioversion

S

2.5363

$150.51

$47.62

$30.10

0095

Cardiac Rehabilitation

S

0.5885

$34.92

$13.96

$6.98

0096

Non-Invasive Vascular Studies

S

1.6307

$96.77

$38.70

$19.35

0097

Cardiac and Ambulatory Blood Pressure Monitoring

X

1.0223

$60.67

$23.79

$12.13

0098

Injection of Sclerosing Solution

T

1.1346

$67.33

$13.47

0099

Electrocardiograms

S

0.3821

$22.67

$4.53

0100

Cardiac Stress Tests

X

2.4968

$148.17

$41.44

$29.63

0101

Tilt Table Evaluation

S

4.2787

$253.91

$101.56

$50.78

0103

Miscellaneous Vascular Procedures

T

14.7142

$873.18

$223.63

$174.64

0104

Transcatheter Placement of Intracoronary Stents

T

79.0094

$4,688.65

$937.73

0105

Revision/Removal of Pacemakers, AICD, or Vascular

T

22.3685

$1,327.41

$370.40

$265.48

0106

Insertion/Replacement/Repair of Pacemaker and/or Electrodes

T

45.4851

$2,699.22

$539.84

0107

Insertion of Cardioverter-Defibrillator

T

260.0295

$15,430.93

$3,103.22

$3,086.19

0108

Insertion/Replacement/Repair of Cardioverter-Defibrillator Leads

T

349.1681

$20,720.68

$4,144.14

0109

Removal of Implanted Devices

T

11.0433

$655.34

$131.49

$131.07

0110

Transfusion

S

3.6594

$217.16

$43.43

0111

Blood Product Exchange

S

12.3956

$735.59

$200.18

$147.12

0112

Apheresis, Photopheresis, and Plasmapheresis

S

26.7948

$1,590.08

$438.94

$318.02

0113

Excision Lymphatic System

T

21.4653

$1,273.82

$254.76

0114

Thyroid/Lymphadenectomy Procedures

T

40.7652

$2,419.13

$485.91

$483.83

0115

Cannula/Access Device Procedures

T

31.4727

$1,867.68

$459.35

$373.54

0116

Chemotherapy Administration by Other Technique Except Infusion

S

1.1453

$67.97

$13.59

0117

Chemotherapy Administration by Infusion Only

S

3.2378

$192.14

$42.54

$38.43

0120

Infusion Therapy Except Chemotherapy

S

2.0193

$119.83

$28.21

$23.97

0121

Level I Tube changes and Repositioning

T

2.2766

$135.10

$43.80

$27.02

0122

Level II Tube changes and Repositioning

T

6.9721

$413.75

$84.85

$82.75

0123

Bone Marrow Harvesting and Bone Marrow/Stem Cell Transplant

S

22.9902

$1,364.31

$272.86

0125

Refilling of Infusion Pump

T

1.9331

$114.72

$22.94

0130

Level I Laparoscopy

T

31.9271

$1,894.65

$659.53

$378.93

0131

Level II Laparoscopy

T

43.3389

$2,571.86

$1,001.89

$514.37

0132

Level III Laparoscopy

T

62.9914

$3,738.10

$1,239.22

$747.62

0140

Esophageal Dilation without Endoscopy

T

5.4737

$324.83

$94.18

$64.97

0141

Level I Upper GI Procedures

T

8.1835

$485.63

$143.38

$97.13

0142

Small Intestine Endoscopy

T

9.3487

$554.78

$152.78

$110.96

0143

Lower GI Endoscopy

T

8.6869

$515.51

$186.06

$103.10

0146

Level I Sigmoidoscopy and Anoscopy

T

4.6374

$275.20

$64.40

$55.04

0147

Level II Sigmoidoscopy and Anoscopy

T

7.9679

$472.84

$94.57

0148

Level I Anal/Rectal Procedures

T

3.7383

$221.84

$57.21

$44.37

0149

Level III Anal/Rectal Procedures

T

18.0726

$1,072.48

$293.06

$214.50

0150

Level IV Anal/Rectal Procedures

T

23.8654

$1,416.24

$437.12

$283.25

0151

Endoscopic Retrograde Cholangio-Pancreatography (ERCP)

T

18.7338

$1,111.72

$245.46

$222.34

0152

Level I Percutaneous Abdominal and Biliary Procedures

T

12.2833

$728.93

$145.79

0153

Peritoneal and Abdominal Procedures

T

21.6961

$1,287.51

$382.75

$257.50

0154

Hernia/Hydrocele Procedures

T

28.7847

$1,708.17

$464.85

$341.63

0155

Level II Anal/Rectal Procedures

T

16.2546

$964.60

$192.92

0156

Level II Urinary and Anal Procedures

T

2.5751

$152.81

$40.52

$30.56

0157

Colorectal Cancer Screening: Barium Enema

S

2.2904

$135.92

$27.18

0158

Colorectal Cancer Screening: Colonoscopy

T

7.6588

$454.50

$113.63

0159

Colorectal Cancer Screening: Flexible Sigmoidoscopy

S

3.1455

$186.66

$46.67

0160

Level I Cystourethroscopy and other Genitourinary Procedures

T

6.6753

$396.13

$105.06

$79.23

0161

Level II Cystourethroscopy and other Genitourinary Procedures

T

18.5576

$1,101.26

$249.36

$220.25

0162

Level III Cystourethroscopy and other Genitourinary Procedures

T

23.3918

$1,388.14

$277.63

0163

Level IV Cystourethroscopy and other Genitourinary Procedures

T

33.7354

$2,001.96

$400.39

0164

Level I Urinary and Anal Procedures

T

1.1855

$70.35

$17.29

$14.07

0165

Level III Urinary and Anal Procedures

T

16.6689

$989.18

$197.84

0166

Level I Urethral Procedures

T

17.6743

$1,048.85

$218.73

$209.77

0168

Level II Urethral Procedures

T

28.2685

$1,677.54

$388.03

$335.51

0169

Lithotripsy

T

43.0133

$2,552.54

$1,021.01

$510.51

0170

Dialysis

S

5.8994

$350.09

$70.02

0180

Circumcision

T

19.8827

$1,179.90

$304.87

$235.98

0181

Penile Procedures

T

30.8663

$1,831.70

$621.82

$366.34

0183

Testes/Epididymis Procedures

T

23.6415

$1,402.96

$280.59

0184

Prostate Biopsy

T

4.3566

$258.53

$96.27

$51.71

0188

Level II Female Reproductive Proc

T

1.1400

$67.65

$13.53

0189

Level III Female Reproductive Proc

T

2.3710

$140.70

$28.14

0190

Level I Hysteroscopy

T

21.0653

$1,250.08

$424.28

$250.02

0191

Level I Female Reproductive Proc

T

0.1670

$9.91

$2.78

$1.98

0192

Level IV Female Reproductive Proc

T

4.3082

$255.66

$51.13

0193

Level V Female Reproductive Proc

T

14.5843

$865.48

$173.10

0194

Level VIII Female Reproductive Proc

T

20.7525

$1,231.52

$397.84

$246.30

0195

Level IX Female Reproductive Proc

T

26.6791

$1,583.22

$483.80

$316.64

0196

Dilation and Curettage

T

17.0974

$1,014.61

$338.23

$202.92

0197

Infertility Procedures

T

2.3572

$139.88

$27.98

0198

Pregnancy and Neonatal Care Procedures

T

1.3683

$81.20

$32.19

$16.24

0200

Level VII Female Reproductive Proc

T

17.8728

$1,060.63

$263.69

$212.13

0201

Level VI Female Reproductive Proc

T

17.6047

$1,044.72

$329.65

$208.94

0202

Level X Female Reproductive Proc

T

40.3866

$2,396.66

$958.66

$479.33

0203

Level IV Nerve Injections

T

10.4015

$617.26

$246.90

$123.45

0204

Level I Nerve Injections

T

2.1910

$130.02

$40.13

$26.00

0206

Level II Nerve Injections

T

5.4920

$325.91

$75.55

$65.18

0207

Level III Nerve Injections

T

6.0109

$356.70

$86.92

$71.34

0208

Laminotomies and Laminectomies

T

42.3409

$2,512.64

$502.53

0209

Extended EEG Studies and Sleep Studies, Level II

S

11.5713

$686.68

$274.67

$137.34

0212

Nervous System Injections

T

2.9740

$176.49

$70.59

$35.30

0213

Extended EEG Studies and Sleep Studies, Level I

S

2.2932

$136.09

$54.43

$27.22

0214

Electroencephalogram

S

1.1353

$67.37

$26.94

$13.47

0215

Level I Nerve and Muscle Tests

S

0.6115

$36.29

$14.51

$7.26

0216

Level III Nerve and Muscle Tests

S

2.6720

$158.56

$31.71

0218

Level II Nerve and Muscle Tests

S

1.1408

$67.70

$13.54

0220

Level I Nerve Procedures

T

17.3586

$1,030.11

$206.02

0221

Level II Nerve Procedures

T

29.9209

$1,775.60

$463.62

$355.12

0222

Implantation of Neurological Device

T

179.0982

$10,628.22

$2,125.64

0223

Implantation or Revision of Pain Management Catheter

T

28.1230

$1,668.90

$333.78

0224

Implantation of Reservoir/Pump/Shunt

T

40.6455

$2,412.03

$482.41

0225

Level II Implantation of Neurostimulator Electrodes

S

234.6925

$13,927.36

$2,785.47

0226

Implantation of Drug Infusion Reservoir

T

138.8695

$8,240.93

$1,648.19

0227

Implantation of Drug Infusion Device

T

136.4922

$8,099.86

$1,619.97

0228

Creation of Lumbar Subarachnoid Shunt

T

51.7258

$3,069.56

$613.91

0229

Transcatherter Placement of Intravascular Shunts

T

64.4545

$3,824.92

$771.23

$764.98

0230

Level I Eye Tests & Treatments

S

0.7858

$46.63

$14.97

$9.33

0231

Level III Eye Tests & Treatments

S

1.9278

$114.40

$44.61

$22.88

0232

Level I Anterior Segment Eye Procedures

T

6.6732

$396.01

$103.17

$79.20

0233

Level II Anterior Segment Eye Procedures

T

14.9673

$888.20

$266.33

$177.64

0234

Level III Anterior Segment Eye Procedures

T

21.9741

$1,304.01

$511.31

$260.80

0235

Level I Posterior Segment Eye Procedures

T

4.6593

$276.50

$67.40

$55.30

0236

Level II Posterior Segment Eye Procedures

T

17.0229

$1,010.19

$202.04

0237

Level III Posterior Segment Eye Procedures

T

28.9401

$1,717.39

$343.48

0238

Level I Repair and Plastic Eye Procedures

T

2.5933

$153.89

$30.78

0239

Level II Repair and Plastic Eye Procedures

T

6.9097

$410.04

$82.01

0240

Level III Repair and Plastic Eye Procedures

T

18.1508

$1,077.12

$315.31

$215.42

0241

Level IV Repair and Plastic Eye Procedures

T

23.3036

$1,382.91

$384.47

$276.58

0242

Level V Repair and Plastic Eye Procedures

T

30.5464

$1,812.72

$597.36

$362.54

0243

Strabismus/Muscle Procedures

T

22.1671

$1,315.46

$431.39

$263.09

0244

Corneal Transplant

T

38.3723

$2,277.13

$803.26

$455.43

0245

Level I Cataract Procedures without IOL Insert

T

13.3625

$792.97

$221.89

$158.59

0246

Cataract Procedures with IOL Insert

T

23.4597

$1,392.17

$495.96

$278.43

0247

Laser Eye Procedures Except Retinal

T

5.0330

$298.67

$104.31

$59.73

0248

Laser Retinal Procedures

T

4.6769

$277.54

$93.98

$55.51

0249

Level II Cataract Procedures without IOL Insert

T

27.9369

$1,657.86

$524.67

$331.57

0250

Nasal Cauterization/Packing

T

1.2896

$76.53

$26.79

$15.31

0251

Level I ENT Procedures

T

2.0101

$119.29

$23.86

0252

Level II ENT Procedures

T

7.8673

$466.87

$113.41

$93.37

0253

Level III ENT Procedures

T

16.1357

$957.54

$282.29

$191.51

0254

Level IV ENT Procedures

T

23.4040

$1,388.86

$321.35

$277.77

0256

Level V ENT Procedures

T

37.3204

$2,214.70

$442.94

0258

Tonsil and Adenoid Procedures

T

22.2466

$1,320.18

$437.25

$264.04

0259

Level VI ENT Procedures

T

366.3317

$21,739.22

$8,070.21

$4,347.84

0260

Level I Plain Film Except Teeth

X

0.7555

$44.83

$17.93

$8.97

0261

Level II Plain Film Except Teeth Including Bone Density Measurement

X

1.2901

$76.56

$15.31

0262

Plain Film of Teeth

X

0.9228

$54.76

$10.95

0263

Level I Miscellaneous Radiology Procedures

X

1.7476

$103.71

$24.40

$20.74

0264

Level II Miscellaneous Radiology Procedures

X

3.5240

$209.12

$79.41

$41.82

0265

Level I Diagnostic Ultrasound

S

1.0213

$60.61

$24.24

$12.12

0266

Level II Diagnostic Ultrasound

S

1.6393

$97.28

$38.91

$19.46

0267

Level III Diagnostic Ultrasound

S

2.6327

$156.23

$62.18

$31.25

0268

Ultrasound Guidance Procedures

S

1.0610

$62.96

$12.59

0269

Level III Echocardiogram Except Transesophageal

S

3.2437

$192.49

$76.99

$38.50

0270

Transesophageal Echocardiogram

S

6.0192

$357.20

$142.88

$71.44

0272

Level I Fluoroscopy

X

1.3801

$81.90

$32.76

$16.38

0274

Myelography

S

3.0413

$180.48

$72.19

$36.10

0275

Arthrography

S

3.5779

$212.32

$69.09

$42.46

0276

Level I Digestive Radiology

S

1.5319

$90.91

$36.36

$18.18

0277

Level II Digestive Radiology

S

2.3852

$141.54

$56.61

$28.31

0278

Diagnostic Urography

S

2.6434

$156.87

$62.74

$31.37

0279

Level II Angiography and Venography except Extremity

S

8.9319

$530.05

$150.03

$106.01

0280

Level III Angiography and Venography except Extremity

S

20.7902

$1,233.75

$353.85

$246.75

0282

Miscellaneous Computerized Axial Tomography

S

1.6542

$98.17

$39.26

$19.63

0283

Computerized Axial Tomography with Contrast Material

S

4.4253

$262.61

$105.04

$52.52

0284

Magnetic Resonance Imaging and Magnetic Resonance Angiography with Contras

S

6.4201

$380.99

$152.39

$76.20

0285

Myocardial Positron Emission Tomography (PET)

S

17.1798

$1,019.50

$318.72

$203.90

0288

Bone Density: Axial Skeleton

S

1.2568

$74.58

$14.92

0296

Level I Therapeutic Radiologic Procedures

S

2.2452

$133.24

$53.29

$26.65

0297

Level II Therapeutic Radiologic Procedures

S

5.2530

$311.73

$122.13

$62.35

0299

Miscellaneous Radiation Treatment

S

5.8482

$347.05

$69.41

0300

Level I Radiation Therapy

S

1.5198

$90.19

$18.04

0301

Level II Radiation Therapy

S

2.2195

$131.71

$26.34

0302

Level III Radiation Therapy

S

4.6145

$273.84

$103.74

$54.77

0303

Treatment Device Construction

X

2.8356

$168.27

$66.95

$33.65

0304

Level I Therapeutic Radiation Treatment Preparation

X

1.7738

$105.26

$41.52

$21.05

0305

Level II Therapeutic Radiation Treatment Preparation

X

4.0036

$237.59

$91.38

$47.52

0310

Level III Therapeutic Radiation Treatment Preparation

X

13.9490

$827.78

$325.27

$165.56

0312

Radioelement Applications

S

5.0032

$296.90

$59.38

0313

Brachytherapy

S

12.8655

$763.48

$152.70

0314

Hyperthermic Therapies

S

5.9945

$355.73

$98.36

$71.15

0315

Level II Implantation of Neurostimulator

T

290.6470

$17,247.86

$3,449.57

0320

Electroconvulsive Therapy

S

5.3765

$319.06

$80.06

$63.81

0321

Biofeedback and Other Training

S

1.3579

$80.58

$21.71

$16.12

0322

Brief Individual Psychotherapy

S

1.2319

$73.10

$14.62

0323

Extended Individual Psychotherapy

S

1.6227

$96.30

$20.08

$19.26

0324

Family Psychotherapy

S

2.0997

$124.60

$24.92

0325

Group Psychotherapy

S

1.3189

$78.27

$17.10

$15.65

0330

Dental Procedures

S

7.1756

$425.82

$85.16

0332

Computerized Axial Tomography and Computerized Angiography without Contras

S

3.2694

$194.02

$77.60

$38.80

0333

Computerized Axial Tomography and Computerized Angio w/o Contrast Material

S

5.2836

$313.54

$125.41

$62.71

0335

Magnetic Resonance Imaging, Miscellaneous

S

5.1581

$306.10

$122.43

$61.22

0336

Magnetic Resonance Imaging and Magnetic Resonance Angiography without Cont

S

6.0742

$360.46

$144.18

$72.09

0337

MRI and Magnetic Resonance Angiography without Contrast Material followed

S

8.7945

$521.89

$208.75

$104.38

0339

Observation

S

7.1403

$423.73

$84.75

0340

Minor Ancillary Procedures

X

0.6384

$37.88

$7.58

0341

Skin Tests

X

0.1112

$6.60

$2.62

$1.32

0342

Level I Pathology

X

0.1560

$9.26

$3.70

$1.85

0343

Level III Pathology

X

0.4786

$28.40

$11.10

$5.68

0344

Level IV Pathology

X

0.7996

$47.45

$15.66

$9.49

0345

Level I Transfusion Laboratory Procedures

X

0.2277

$13.51

$3.01

$2.70

0346

Level II Transfusion Laboratory Procedures

X

0.3434

$20.38

$4.54

$4.08

0347

Level III Transfusion Laboratory Procedures

X

0.8434

$50.05

$12.35

$10.01

0348

Fertility Laboratory Procedures

X

0.7927

$47.04

$9.41

0350

Administration of flu and PPV vaccines

X

0.3954

$23.46

$0.00

$0.00

0352

Level I Injections

X

0.1413

$8.39

$1.68

0353

Level II Injections

X

0.3954

$23.46

$4.69

0359

Level III Injections

X

0.8312

$49.33

$9.87

0360

Level I Alimentary Tests

X

1.4739

$87.47

$34.98

$17.49

0361

Level II Alimentary Tests

X

3.6216

$214.92

$83.23

$42.98

0362

Contact Lens and Spectacle Services

X

2.6607

$157.89

$31.58

0363

Level I Otorhinolaryngologic Function Tests

X

0.9128

$54.17

$17.44

$10.83

0364

Level I Audiometry

X

0.4708

$27.94

$9.06

$5.59

0365

Level II Audiometry

X

1.2356

$73.32

$18.95

$14.66

0366

Level III Audiometry

X

1.7743

$105.29

$30.04

$21.06

0367

Level I Pulmonary Test

X

0.6659

$39.52

$14.80

$7.90

0368

Level II Pulmonary Tests

X

0.9761

$57.92

$23.16

$11.58

0369

Level III Pulmonary Tests

X

2.7519

$163.31

$44.18

$32.66

0370

Allergy Tests

X

1.1232

$66.65

$13.33

0372

Therapeutic Phlebotomy

X

0.5700

$33.83

$10.09

$6.77

0373

Neuropsychological Testing

X

2.1926

$130.12

$26.02

0374

Monitoring Psychiatric Drugs

X

1.0414

$61.80

$12.36

0375

Ancillary Outpatient Services When Patient Expires

T

42.5900

$2,527.42

$505.48

0376

Level II Cardiac Imaging

S

5.1975

$308.44

$121.42

$61.69

0377

Level III Cardiac Imaging

S

6.8344

$405.57

$162.22

$81.11

0378

Level II Pulmonary Imaging

S

5.4997

$326.37

$130.54

$65.27

0379

Injection adenosine

K

$33.45

$6.69

0381

Single Allergy Tests

X

0.1884

$11.18

$2.35

$2.24

0384

GI Procedures with Stents

T

22.3392

$1,325.68

$287.93

$265.14

0385

Level I Prosthetic Urological Procedures

S

75.6446

$4,488.98

$897.80

0386

Level II Prosthetic Urological Procedures

S

120.1694

$7,131.21

$1,426.24

0387

Level II Hysteroscopy

T

32.5445

$1,931.29

$655.55

$386.26

0388

Discography

S

12.3294

$731.66

$292.66

$146.33

0389

Non-imaging Nuclear Medicine

S

1.4976

$88.87

$35.54

$17.77

0390

Level I Endocrine Imaging

S

2.5562

$151.69

$60.67

$30.34

0391

Level II Endocrine Imaging

S

2.8774

$170.75

$68.30

$34.15

0393

Red Cell/Plasma Studies

S

3.4438

$204.37

$81.74

$40.87

0394

Hepatobiliary Imaging

S

4.4630

$264.85

$105.93

$52.97

0395

GI Tract Imaging

S

3.8699

$229.65

$91.86

$45.93

0396

Bone Imaging

S

4.1426

$245.83

$98.33

$49.17

0397

Vascular Imaging

S

2.2646

$134.39

$53.75

$26.88

0398

Level I Cardiac Imaging

S

4.3093

$255.73

$102.29

$51.15

0399

Nuclear Medicine Add-on Imaging

S

1.5192

$90.15

$36.06

$18.03

0400

Hematopoietic Imaging

S

4.1335

$245.29

$98.11

$49.06

0401

Level I Pulmonary Imaging

S

3.4150

$202.66

$81.06

$40.53

0402

Brain Imaging

S

5.1847

$307.68

$123.07

$61.54

0403

CSF Imaging

S

3.6138

$214.45

$85.78

$42.89

0404

Renal and Genitourinary Studies Level I

S

3.8559

$228.82

$91.52

$45.76

0405

Renal and Genitourinary Studies Level II

S

4.2674

$253.24

$101.29

$50.65

0406

Tumor/Infection Imaging

S

4.3035

$255.38

$102.15

$51.08

0407

Radionuclide Therapy

S

3.9839

$236.42

$94.56

$47.28

0409

Red Blood Cell Tests

X

0.1258

$7.47

$2.22

$1.49

0411

Respiratory Procedures

S

0.3869

$22.96

$4.59

0412

IMRT Treatment Delivery

S

5.3643

$318.33

$63.67

0415

Level II Endoscopy Lower Airway

T

22.0955

$1,311.21

$459.92

$262.24

0416

Level I Intravascular and Intracardiac Ultrasound and Flow Reserve

S

19.5542

$1,160.40

$232.08

0417

Computerized Reconstruction

S

4.0750

$241.82

$48.36

0418

Insertion of Left Ventricular Pacing Elect

T

109.3043

$6,486.45

$1,297.29

0421

Prolonged Physiologic Monitoring

X

1.6600

$98.51

$19.70

0422

Level II Upper GI Procedures

T

22.9647

$1,362.79

$448.81

$272.56

0423

Level II Percutaneous Abdominal and Biliary Procedures

T

40.2866

$2,390.73

$478.15

0425

Level II Arthroplasty with Prosthesis

T

100.2058

$5,946.51

$1,378.01

$1,189.30

0426

Level II Strapping and Cast Application

S

2.1243

$126.06

$25.21

0427

Level III Tube Changes and Repositioning

T

10.1977

$605.16

$124.11

$121.03

0428

Level III Sigmoidoscopy and Anoscopy

T

19.9022

$1,181.06

$236.21

0429

Level V Cystourethroscopy and other Genitourinary Procedures

T

42.3147

$2,511.08

$502.22

0430

Level IV Nerve and Muscle Tests

T

11.4040

$676.75

$135.35

0432

Health and Behavior Services

S

0.6949

$41.24

$8.25

0433

Level II Pathology

X

0.2581

$15.32

$6.12

$3.06

0434

Cardiac Defect Repair

T

90.7877

$5,387.61

$1,077.52

0600

Low Level Clinic Visits

V

0.8688

$51.56

$10.31

0601

Mid Level Clinic Visits

V

1.0038

$59.57

$11.91

0602

High Level Clinic Visits

V

1.4284

$84.77

$16.95

0610

Low Level Emergency Visits

V

1.2947

$76.83

$19.48

$15.37

0611

Mid Level Emergency Visits

V

2.2718

$134.82

$35.76

$26.96

0612

High Level Emergency Visits

V

3.9853

$236.50

$54.12

$47.30

0620

Critical Care

S

8.2996

$492.52

$135.68

$98.50

0621

Level I Vascular Access Procedures

T

8.2986

$492.46

$98.49

0622

Level II Vascular Access Procedures

T

21.2671

$1,262.05

$252.41

0623

Level III Vascular Access Procedures

T

27.1105

$1,608.82

$321.76

0648

Breast Reconstruction with Prosthesis

T

50.4459

$2,993.61

$598.72

0651

Complex Interstitial Radiation Source Application

S

12.1448

$720.71

$144.14

0652

Insertion of Intraperitoneal Catheters

T

28.8948

$1,714.70

$342.94

0653

Vascular Reconstruction/Fistula Repair with Device

T

30.5339

$1,811.97

$362.39

0654

Insertion/Replacement of a permanent dual chamber pacemaker

T

100.9294

$5,989.45

$1,197.89

0655

Insertion/Replacement/Conversion of a permanent dual chamber pacemaker

T

133.7768

$7,938.72

$1,587.74

0656

Transcatheter Placement of Intracoronary Drug-Eluting Stents

T

109.9237

$6,523.20

$1,304.64

0657

Placement of Tissue Clips

S

1.7092

$101.43

$20.29

0658

Percutaneous Breast Biopsies

T

6.1049

$362.28

$72.46

0659

Hyperbaric Oxygen

S

1.5473

$91.82

$18.36

0660

Level II Otorhinolaryngologic Function Tests

X

1.6419

$97.44

$30.66

$19.49

0661

Level V Pathology

X

3.3775

$200.43

$80.17

$40.09

0662

CT Angiography

S

5.1621

$306.33

$122.53

$61.27

0664

Level I Proton Beam Radiation Therapy

S

12.9439

$768.13

$153.63

0665

Bone Density: AppendicularSkeleton

S

0.6464

$38.36

$7.67

0667

Level II Proton Beam Radiation Therapy

S

15.4857

$918.97

$183.79

0668

Level I Angiography and Venography except Extremity

S

6.5024

$385.87

$114.67

$77.17

0670

Level II Intravascular and Intracardiac Ultrasound and Flow Reserve

S

25.4131

$1,508.09

$472.46

$301.62

0671

Level II Echocardiogram Except Transesophageal

S

1.7028

$101.05

$40.42

$20.21

0672

Level IV Posterior Segment Eye Procedures

T

36.9284

$2,191.44

$438.29

0673

Level IV Anterior Segment Eye Procedures

T

29.2582

$1,736.27

$649.56

$347.25

0674

Prostate Cryoablation

T

95.7856

$5,684.20

$1,136.84

0675

Prostatic Thermotherapy

T

43.7329

$2,595.24

$519.05

0676

Thrombolysis and Thrombectomy

T

2.4105

$143.05

$28.61

0678

External Counterpulsation

T

1.7276

$102.52

$20.50

0679

Level II Resuscitation and Cardioversion

S

5.5774

$330.98

$95.30

$66.20

0680

Insertion of Patient Activated Event Recorders

S

62.9082

$3,733.16

$746.63

0681

Knee Arthroplasty

T

137.1630

$8,139.66

$2,081.48

$1,627.93

0682

Level V Debridement & Destruction

T

6.9107

$410.10

$162.42

$82.02

0683

Level II Photochemotherapy

S

1.9006

$112.79

$25.34

$22.56

0685

Level III Needle Biopsy/Aspiration Except Bone Marrow

T

6.0174

$357.09

$115.47

$71.42

0686

Level III Skin Repair

T

13.8287

$820.64

$164.13

0687

Revision/Removal of Neurostimulator Electrodes

T

19.2347

$1,141.44

$456.57

$228.29

0688

Revision/Removal of Neurostimulator Pulse Generator Receiver

T

43.0444

$2,554.38

$1,021.75

$510.88

0689

Electronic Analysis of Cardioverter-defibrillators

S

0.5735

$34.03

$6.81

0690

Electronic Analysis of Pacemakers and other Cardiac Devices

S

0.3755

$22.28

$8.91

$4.46

0691

Electronic Analysis of Programmable Shunts/Pumps

S

2.5252

$149.85

$59.94

$29.97

0692

Electronic Analysis of Neurostimulator Pulse Generators

S

2.0111

$119.34

$30.16

$23.87

0693

Level II Breast Reconstruction

T

42.2254

$2,505.78

$798.17

$501.16

0694

Mohs Surgery

T

3.8452

$228.19

$61.86

$45.64

0695

Level VII Debridement & Destruction

T

20.3164

$1,205.64

$266.59

$241.13

0697

Level I Echocardiogram Except Transesophageal

S

1.5357

$91.13

$36.45

$18.23

0698

Level II Eye Tests & Treatments

S

1.2438

$73.81

$16.55

$14.76

0699

Level IV Eye Tests & Treatments

T

10.0177

$594.48

$118.90

0700

Antepartum Manipulation

T

5.3614

$318.16

$63.63

0701

SR 89 chloride, per mCi

H

0702

SM 153 lexidronam

H

0704

IN 111 Satumomab pendetide per dose

H

0705

Technetium TC99M tetrofosmin

H

0726

Dexrazoxane hcl injection

K

$216.39

$43.28

0728

Filgrastim injection

K

$178.39

$35.68

0730

Pamidronate disodium

K

$58.42

$11.68

0731

Sargramostim injection

K

$21.11

$4.22

0732

Mesna injection

K

$13.68

$2.74

0733

Non esrd epoetin alpha inj

K

$9.99

$2.00

0734

Injection, darbepoetin alfa (for non-ESRD)

K

$3.28

$0.66

0735

Ampho b cholesteryl sulfate

K

$12.24

$2.45

0736

Amphotericin b liposome inj

K

$21.91

$4.38

0737

Ammonia N-13, per dose

H

0738

Rasburicase

G

$109.18

$21.84

0750

Dolasetron mesylate

K

$6.55

$1.31

0763

Dolasetron mesylate oral

K

$48.54

$9.71

0764

Granisetron HCl injection

K

$7.24

$1.45

0765

Granisetron HCl oral

K

$33.51

$6.70

0768

Ondansetron hcl injection

K

$3.80

$0.76

0769

Ondansetron hcl oral

K

$32.02

$6.40

0800

Leuprolide acetate

K

$441.78

$88.36

0802

Etoposide oral

K

$41.12

$8.22

0807

Aldesleukin/single use vial

K

$701.76

$140.35

0809

Bcg live intravesical vac

K

$121.74

$24.35

0810

Goserelin acetate implant

K

$196.25

$39.25

0811

Carboplatin injection

K

$77.16

$15.43

0812

Carmus bischl nitro inj

K

$141.29

$28.26

0814

Asparaginase injection

K

$55.42

$11.08

0819

Dacarbazine inj

K

$6.20

$1.24

0820

Daunorubicin

K

$35.28

$7.06

0821

Daunorubicin citrate liposom

K

$57.56

$11.51

0823

Docetaxel

K

$301.17

$60.23

0827

Floxuridine injection

K

$60.17

$12.03

0828

Gemcitabine HCL

K

$117.45

$23.49

0830

Irinotecan injection

K

$129.08

$25.82

0831

Ifosfomide injection

K

$53.54

$10.71

0832

Idarubicin hcl injection

K

$314.00

$62.80

0834

Interferon alfa-2a inj

K

$31.75

$6.35

0835

Inj cosyntropin

K

$69.27

$13.85

0836

Interferon alfa-2b inj recombinant, 1 million

K

$13.22

$2.64

0838

Interferon gamma 1-b inj

K

$277.79

$55.56

0840

Melphalan hydrochl

K

$523.22

$104.64

0842

Fludarabine phosphate inj

K

$262.41

$52.48

0843

Pegaspargase

K

$1,528.80

$305.76

0844

Pentostatin injection

K

$1,868.91

$373.78

0849

Rituximab

K

$447.97

$89.59

0850

Streptozocin injection

K

$153.33

$30.67

0851

Thiotepa injection

K

$44.55

$8.91

0852

Topotecan

K

$755.51

$151.10

0855

Vinorelbine tartrate

K

$62.85

$12.57

0856

Porfimer sodium

K

$2,457.97

$491.59

0857

Bleomycin sulfate injection

K

$54.18

$10.84

0858

Cladribine

K

$39.37

$7.87

0860

Plicamycin (mithramycin) inj

K

$80.54

$16.11

0861

Leuprolide acetate injection

K

$10.96

$2.19

0862

Mitomycin

K

$26.36

$5.27

0863

Paclitaxel injection

K

$19.11

$3.82

0864

Mitoxantrone hcl

K

$329.69

$65.94

0865

Interferon alfa-n3 inj, human leukocyte derived, 2

K

$8.77

$1.75

0868

Oral aprepitant

G

$4.75

$0.95

0869

IVIG lyophil 1g

K

$39.46

$7.89

0870

IVIG lyophil 10 mg

K

$0.40

$0.08

0871

IVIG non-lyophil 1g

K

$57.26

$11.45

0872

IVIG non-lyophil 10 mg

K

$0.57

$0.11

0876

Caffeine citrate injection

K

$3.34

$0.67

0880

Penicillin g benzathine inj

K

$72.26

$14.45

0884

Rho d immune globulin inj

K

$113.91

$22.78

0887

Azathioprine parenteral

K

$47.40

$9.48

0888

Cyclosporine oral

K

$3.94

$0.79

0890

Lymphocyte immune globulin

K

$290.30

$58.06

0891

Tacrolimus oral

K

$3.37

$0.67

0892

Edetate calcium disodium inj

K

$40.34

$8.07

0893

Calcitonin salmon injection

K

$35.68

$7.14

0895

Deferoxamine mesylate inj

K

$14.91

$2.98

0900

Alglucerase injection

K

$39.94

$7.99

0901

Alpha 1 proteinase inhibitor

K

$3.30

$0.66

0902

Botulinum toxin a, per unit

K

$4.80

$0.96

0903

Cytomegalovirus imm IV/vial

K

$683.07

$136.61

0906

RSV-ivig

K

$15.56

$3.11

0910

Interferon beta-1b

K

$81.95

$16.39

0911

Streptokinase

K

$83.36

$16.67

0912

Interferon alfacon-1

K

$3.91

$0.78

0913

Ganciclovir long act implant

K

$4,318.68

$863.74

0916

Injection imiglucerase /unit

K

$3.98

$0.80

0917

Adenosine injection

K

$71.53

$14.31

0925

Factor viii

K

$0.51

$0.10

0926

Factor VIII (porcine)

K

$1.75

$0.35

0927

Factor viii recombinant

K

$0.94

$0.19

0928

Factor ix complex

K

$0.52

$0.10

0929

Anti-inhibitor per iu

K

$1.12

$0.22

0931

Factor IX non-recombinant

K

$0.75

$0.15

0932

Factor IX recombinant

K

$0.86

$0.17

0935

Clonidine hydrochloride

K

$57.47

$11.49

0949

Plasma, Pooled Multiple Donor, Solvent/Detergent T

K

1.1956

$70.95

$14.19

0950

Blood (Whole) For Transfusion

K

2.0123

$119.42

$23.88

0952

Cryoprecipitate

K

0.7395

$43.88

$8.78

0954

RBC leukocytes reduced

K

2.7370

$162.42

$32.48

0955

Plasma, Fresh Frozen

K

1.2934

$76.75

$15.35

0956

Plasma Protein Fraction

K

1.1226

$66.62

$13.32

0957

Platelet Concentrate

K

0.8317

$49.36

$9.87

0958

Platelet Rich Plasma

K

5.1815

$307.49

$61.50

0959

Red Blood Cells

K

2.0301

$120.47

$24.09

0960

Washed Red Blood Cells

K

2.9707

$176.29

$35.26

0961

Infusion, Albumin (Human) 5%, 50 ml

K

0.5119

$30.38

$6.08

0963

Albumin (human), 5%

K

1.3869

$82.30

$16.46

0964

Albumin (human), 25%

K

0.4878

$28.95

$5.79

0965

Albumin (human), 25%

K

1.1117

$65.97

$13.19

0966

Plasmaprotein fract, 5%

K

4.9564

$294.13

$58.83

0967

Split unit of blood

K

1.2698

$75.35

$15.07

0968

Platelets leukocyte reduced irradiated

K

2.3639

$140.28

$28.06

0969

Red blood cell leukocyte reduced irradiated

K

3.6451

$216.31

$43.26

1009

Cryoprecip reduced plasma

K

1.3062

$77.51

$15.50

1010

Blood, L/R, CMV-neg

K

2.9692

$176.20

$35.24

1011

Platelets, HLA-m, L/R, unit

K

10.9690

$650.93

$130.19

1013

Platelet concentrate, L/R, unit

K

1.6023

$95.09

$19.02

1016

Blood, L/R, froz/deglycerol/washed

K

5.2631

$312.33

$62.47

1017

Platelets, aph/pher, L/R, CMV-neg, unit

K

8.5998

$510.34

$102.07

1018

Blood, L/R, irradiated

K

2.8004

$166.18

$33.24

1019

Platelets, aph/pher, L/R, irradiated, unit

K

9.5131

$564.54

$112.91

1020

Pit, pher, L/R, CMV, irrad

K

10.1551

$602.63

$120.53

1021

RBC, frz/deg/wsh, L/R, irrad

K

4.8787

$289.52

$57.90

1022

RBC, L/R, CMV neg, irrad

K

4.2901

$254.59

$50.92

1045

Iobenguane sulfate I-131

H

1052

Injection, Voriconazole

K

$4.63

$0.93

1064

I-131 sodium iodide capsule

H

1065

I-131 sodium iodide solution

H

1080

I-131 tositumomab, dx

H

1081

I-131 tositumomab, tx

H

1082

Treprostinil

K

$55.02

$11.00

1083

Injection, Adalimumab

K

$300.10

$60.02

1084

Denileukin diftitox

K

$1,235.33

$247.07

1085

Injection, Gallium Nitrate

K

$1.30

$0.26

1086

Temozolomide,oral

K

$7.28

$1.46

1088

Dx I131 so iodide cap millic

H

1091

IN 111 Oxyquinoline

H

1092

IN 111 Pentetate

H

1093

TC99M fanolesomab

H

1096

TC 99M Exametazime, per dose

H

1150

Th I131 so iodide sol millic

H

1166

Cytarabine liposome

K

$366.43

$73.29

1167

Epirubicin hcl

K

$25.15

$5.03

1178

Busulfan IV

K

0.2851

$16.92

$3.38

1201

TC 99M SUCCIMER, PER Vial

H

1203

Verteporfin for injection

K

$9.16

$1.83

1207

Octreotide injection, depot

K

$87.40

$17.48

1210

Inj dihydroergotamine mesylt

K

$27.82

$5.56

1280

Corticotropin injection

K

$95.44

$19.09

1305

Apligraf

K

12.9222

$766.84

$153.37

1330

Ergonovine maleate injection

K

0.5263

$31.23

$6.25

1409

Factor viia recombinant

K

$1,080.11

$216.02

1436

Etidronate disodium inj

K

$68.69

$13.74

1491

New Technology—Level I ($0-$10)

S

$5.00

$1.00

1492

New Technology—Level I ($10-$20)

S

$15.00

$3.00

1493

New Technology—Level I ($20-$30)

S

$25.00

$5.00

1494

New Technology—Level I ($30-$40)

S

$35.00

$7.00

1495

New Technology—Level I ($40-$50)

S

$45.00

$9.00

1496

New Technology—Level I ($0-$10)

T

$5.00

$1.00

1497

New Technology—Level I ($10-$20)

T

$15.00

$3.00

1498

New Technology—Level I ($20-$30)

T

$25.00

$5.00

1499

New Technology—Level I ($30-$40)

T

$35.00

$7.00

1500

New Technology—Level I ($40-$50)

T

$45.00

$9.00

1502

New Technology—Level II ($50-$100)

S

$75.00

$15.00

1503

New Technology—Level III ($100-$200)

S

$150.00

$30.00

1504

New Technology—Level IV ($200-$300)

S

$250.00

$50.00

1505

New Technology—Level V ($300-$400)

S

$350.00

$70.00

1506

New Technology—Level VI ($400-$500)

S

$450.00

$90.00

1507

New Technology—Level VII ($500-$600)

S

$550.00

$110.00

1508

New Technology—Level VIII ($600-$700)

S

$650.00

$130.00

1509

New Technology—Level IX ($700-$800)

S

$750.00

$150.00

1510

New Technology—Level X ($800-$900)

S

$850.00

$170.00

1511

New Technology—Level XI ($900-$1000)

S

$950.00

$190.00

1512

New Technology—Level XII ($1000-$1100)

S

$1,050.00

$210.00

1513

New Technology—Level XIII ($1100-$1200)

S

$1,150.00

$230.00

1514

New Technology—Level XIV ($1200-$1300)

S

$1,250.00

$250.00

1515

New Technology—Level XV ($1300-$1400)

S

$1,350.00

$270.00

1516

New Technology—Level XVI ($1400-$1500)

S

$1,450.00

$290.00

1517

New Technology—Level XVII ($1500-$1600)

S

$1,550.00

$310.00

1518

New Technology—Level XVIII ($1600-$1700)

S

$1,650.00

$330.00

1519

New Technology—Level IXX ($1700-$1800)

S

$1,750.00

$350.00

1520

New Technology—Level XX ($1800-$1900)

S

$1,850.00

$370.00

1521

New Technology—Level XXI ($1900-$2000)

S

$1,950.00

$390.00

1522

New Technology—Level XXII ($2000-$2500)

S

$2,250.00

$450.00

1523

New Technology—Level XXIII ($2500-$3000)

S

$2,750.00

$550.00

1524

New Technology—Level XIV ($3000-$3500)

S

$3,250.00

$650.00

1525

New Technology—Level XXV ($3500-$4000)

S

$3,750.00

$750.00

1526

New Technology—Level XXVI ($4000-$4500)

S

$4,250.00

$850.00

1527

New Technology—Level XXVII ($4500-$5000)

S

$4,750.00

$950.00

1528

New Technology—Level XXVIII ($5000-$5500)

S

$5,250.00

$1,050.00

1529

New Technology—Level XXIX ($5500-$6000)

S

$5,750.00

$1,150.00

1530

New Technology—Level XXX ($6000-$6500)

S

$6,250.00

$1,250.00

1531

New Technology—Level XXXI ($6500-$7000)

S

$6,750.00

$1,350.00

1532

New Technology—Level XXXII ($7000-$7500)

S

$7,250.00

$1,450.00

1533

New Technology—Level XXXIII ($7500-$8000)

S

$7,750.00

$1,550.00

1534

New Technology—Level XXXIV ($8000-$8500)

S

$8,250.00

$1,650.00

1535

New Technology—Level XXXV ($8500-$9000)

S

$8,750.00

$1,750.00

1536

New Technology—Level XXXVI ($9000-$9500)

S

$9,250.00

$1,850.00

1537

New Technology—Level XXXVII ($9500-$10000)

S

$9,750.00

$1,950.00

1539

New Technology—Level II ($50-$100)

T

$75.00

$15.00

1540

New Technology—Level III ($100-$200)

T

$150.00

$30.00

1541

New Technology—Level IV ($200-$300)

T

$250.00

$50.00

1542

New Technology—Level V ($300-$400)

T

$350.00

$70.00

1543

New Technology—Level VI ($400-$500)

T

$450.00

$90.00

1544

New Technology—Level VII ($500-$600)

T

$550.00

$110.00

1545

New Technology—Level VIII ($600-$700)

T

$650.00

$130.00

1546

New Technology—Level IX ($700-$800)

T

$750.00

$150.00

1547

New Technology—Level X ($800-$900)

T

$850.00

$170.00

1548

New Technology—Level XI ($900-$1000)

T

$950.00

$190.00

1549

New Technology—Level XII ($1000-$1100)

T

$1,050.00

$210.00

1550

New Technology—Level XIII ($1100-$1200)

T

$1,150.00

$230.00

1551

New Technology—Level XIV ($1200- $1300)

T

$1,250.00

$250.00

1552

New Technology—Level XV ($1300-$1400)

T

$1,350.00

$270.00

1553

New Technology—Level XVI ($1400-$1500)

T

$1,450.00

$290.00

1554

New Technology—Level XVII ($1500-$1600)

T

$1,550.00

$310.00

1555

New Technology—Level XVIII ($1600-$1700)

T

$1,650.00

$330.00

1556

New Technology—Level XIX ($1700-$1800)

T

$1,750.00

$350.00

1557

New Technology—Level XX ($1800-$1900)

T

$1,850.00

$370.00

1558

New Technology—Level XXI ($1900-$2000)

T

$1,950.00

$390.00

1559

New Technology—Level XXII ($2000-$2500)

T

$2,250.00

$450.00

1560

New Technology—Level XXIII ($2500-$3000)

T

$2,750.00

$550.00

1561

New Technology—Level XXIV ($3000-$3500)

T

$3,250.00

$650.00

1562

New Technology—Level XXV ($3500-$4000)

T

$3,750.00

$750.00

1563

New Technology—Level XXVI ($4000-$4500)

T

$4,250.00

$850.00

1564

New Technology—Level XXVII ($4500-$5000)

T

$4,750.00

$950.00

1565

New Technology—Level XXVIII ($5000-$5500)

T

$5,250.00

$1,050.00

1566

New Technology—Level XXIX ($5500-$6000)

T

$5,750.00

$1,150.00

1567

New Technology—Level XXX ($6000-$6500)

T

$6,250.00

$1,250.00

1568

New Technology—Level XXXI ($6500-$7000)

T

$6,750.00

$1,350.00

1569

New Technology—Level XXXII ($7000-$7500)

T

$7,250.00

$1,450.00

1570

New Technology—Level XXXIII ($7500-$8000)

T

$7,750.00

$1,550.00

1571

New Technology—Level XXXIV ($8000-$8500)

T

$8,250.00

$1,650.00

1572

New Technology—Level XXXV ($8500-$9000)

T

$8,750.00

$1,750.00

1573

New Technology—Level XXXVI ($9000-$9500)

T

$9,250.00

$1,850.00

1574

New Technology—Level XXXVII ($9500-$10000)

T

$9,750.00

$1,950.00

1600

Technetium TC 99m sestamibi

H

1603

Thallous chloride TL 201

H

1604

IN 111 capromab pendetide, per dose

H

1605

Abciximab injection

K

$450.60

$90.12

1607

Eptifibatide injection

K

$12.73

$2.55

1608

Etanercept injection

K

$152.11

$30.42

1609

Rho(D) immune globulin h, sd

K

$12.04

$2.41

1611

Hylan G-F 20 injection

K

$203.15

$40.63

1612

Daclizumab, parenteral

K

$381.48

$76.30

1613

Trastuzumab

K

$53.98

$10.80

1615

Basiliximab

K

$1,473.57

$294.71

1618

Vonwillebrandfactrcmplx, per iu

K

$0.74

$0.15

1619

Gallium ga 67

H

1620

Technetium tc99m bicisate

H

1622

Technetium tc99m mertiatide

H

1624

Sodium phosphate p32

H

1625

Indium 111-in pentetreotide

H

1628

Chromic phosphate p32

H

1655

Tinzaparin sodium injection

K

$2.53

$0.51

1670

Tetanus immune globulin inj

K

$76.90

$15.38

1716

Brachytx source, Gold 198

H

1717

Brachytx source, HDR Ir-192

H

1718

Brachytx source, Iodine 125

H

1719

Brachytx sour, Non-HDR Ir-192

H

1720

Brachytx sour, Palladium 103

H

1740

Diazoxide injection

K

$113.86

$22.77

1775

FDG, per dose (4-40 mCi/ml)

H

2210

Methyldopate hcl injection

K

$9.58

$1.92

2616

Brachytx source, Yttrium-90

H

2632

Brachytx sol, I-125, per mCi

H

2633

Brachytx source, Cesium-131

H

2634

Brachytx source, HA, I-125

H

2635

Brachytx source, HA, P-103

H

2636

Brachytx linear source, P-103

H

2730

Pralidoxime chloride inj

K

$76.68

$15.34

2770

Quinupristin/dalfopristin

K

$105.48

$21.10

2940

Somatrem injection

K

$43.14

$8.63

3030

Sumatriptan succinate

K

$51.03

$10.21

7000

Amifostine

K

$436.01

$87.20

7005

Gonadorelin hydroch

K

$173.44

$34.69

7011

Oprelvekin injection

K

$249.06

$49.81

7015

Busulfan, oral

K

$1.98

$0.40

7019

Aprotinin

K

$2.20

$0.44

7024

Corticorelin ovine triflutat

K

$386.53

$77.31

7025

Digoxin immune FAB (ovine)

K

$552.18

$110.44

7026

Ethanolamine oleate

K

$64.53

$12.91

7027

Fomepizole

K

$12.31

$2.46

7028

Fosphenytoin

K

$5.19

$1.04

7030

Hemin

K

$6.51

$1.30

7034

Somatropin injection

K

$42.93

$8.59

7035

Teniposide

K

$266.23

$53.25

7036

Urokinase inj

K

$415.69

$83.14

7037

Urofollitropin

K

$44.74

$8.95

7038

Monoclonal antibodies

K

$885.36

$177.07

7040

Pentastarch 10% solution

K

$12.45

$2.49

7041

Tirofiban hcl

K

$7.89

$1.58

7042

Capecitabine, oral

K

$3.30

$0.66

7043

Infliximab injection

K

$54.20

$10.84

7045

Trimetrexate glucoronate

K

$139.85

$27.97

7046

Doxorubicin hcl liposome inj

K

$365.64

$73.13

7048

Alteplase recombinant

K

$30.65

$6.13

7049

Filgrastim injection

K

$282.29

$56.46

7051

Leuprolide acetate implant

K

$2,262.19

$452.44

7308

Aminolevulinic acid hcl top

K

$96.79

$19.36

7316

Sodium hyaluronate injection

K

$110.65

$22.13

7515

Cyclosporine oral

K

$1.00

$0.20

9001

Linezolid injection

K

$24.15

$4.83

9002

Tenecteplase

K

$2,052.77

$410.55

9003

Palivizumab

K

4.1491

$246.22

$49.24

9004

Gemtuzumab ozogamicin

K

$2,245.04

$449.01

9005

Reteplase injection

K

$898.81

$179.76

9006

Tacrolimus injection

K

$126.61

$25.32

9008

Baclofen Refill Kit-500mcg

K

0.2447

$14.52

$2.90

9009

Baclofen refill kit—per 2000 mcg

K

0.7209

$42.78

$8.56

9012

Arsenic Trioxide

K

$33.76

$6.75

9015

Mycophenolate mofetil oral

K

$2.50

$0.50

9018

Botulinum toxin B

K

$7.89

$1.58

9019

Caspofungin acetate

K

$32.35

$6.47

9020

Sirolimus tablet

K

$6.85

$1.37

9022

IM inj interferon beta 1-a

K

$89.10

$17.82

9023

Rho d immune globulin

K

$25.08

$5.02

9024

Amphotericin b lipid complex

K

$11.95

$2.39

9025

Rubidium-Rb-82

H

9030

Amphotericin B

K

$30.70

$6.14

9031

Arbutamine HCl injection

K

$163.15

$32.63

9032

Baclofen 10 MG injection

K

$188.01

$37.60

9033

Cidofovir injection

K

$782.98

$156.60

9038

Inj estrogen conjugate

K

$57.77

$11.55

9040

Intraocular Fomivirsen na

K

$203.93

$40.79

9042

Glucagon hydrochloride

K

$62.16

$12.43

9044

Ibutilide fumarate injection

K

$243.34

$48.67

9045

Iron dextran

K

$11.43

$2.29

9046

Iron sucrose injection

K

$0.38

$0.08

9047

Itraconazole injection

K

$36.93

$7.39

9051

Urea injection

K

1.0454

$62.04

$12.41

9054

Metabolically active tissue

K

$15.69

$3.14

9055

Injectable human tissue

K

$3.54

$0.71

9057

Lepirudin

K

$128.17

$25.63

9100

Iodinated I-131 serumalbumin, per 5uci

H

9104

Anti-thymocycte globulin rabbit

K

$299.47

$59.89

9105

Hep B imm glob

K

1.8813

$111.64

$22.33

9108

Thyrotropin alfa

K

$712.58

$142.52

9110

Alemtuzumab injection

K

$516.87

$103.37

9112

Inj Perflutren lipid micros, ml

K

$63.51

$12.70

9114

Nesiritide

K

$75.19

$15.04

9115

Inj, zoledronic acid

K

$202.41

$40.48

9117

Yttrium 90 ibritumomab tiuxetan

H

9118

In-111 ibritumomab tiuxetan

H

9119

Pegfilgrastim

K

$2,178.28

$435.66

9120

Inj, Fulvestrant

K

$82.90

$16.58

9121

Inj, Argatroban

K

0.1897

$11.26

$2.25

9122

Triptorelin pamoate

K

$369.98

$74.00

9123

Transcyte

K

$719.41

$143.88

9124

Injection, daptomycin

G

$0.30

$0.06

9125

Risperidone, long acting

G

$4.71

$0.94

9126

Injection, natalizumab

G

$6.51

$1.30

9127

Paclitaxel protein pr

K

$8.59

$1.72

9128

Inj pegaptanib sodium

K

$1,074.27

$214.85

9130

Na chromateCr51, per 0.25mCi

H

9132

51 Na Chromate, 50mCi

H

9133

Rabies ig, im/sc

K

$64.56

$12.91

9134

Rabies ig, heat treated

K

$69.79

$13.96

9135

Varicella-zoster ig, im

K

$96.58

$19.32

9136

Adenovirus vaccine, type 4

K

0.9499

$56.37

$11.27

9137

Bcg vaccine, percut

K

$124.54

$24.91

9138

Hep a/hep b vacc, adult im

K

0.9674

$57.41

$11.48

9139

Rabies vaccine, im

K

$128.04

$25.61

9140

Rabies vaccine, id

K

1.4959

$88.77

$17.75

9141

Measles-rubella vaccine, sc

K

0.9467

$56.18

$11.24

9142

Chicken pox vaccine, sc

K

$64.29

$12.86

9143

Meningococcal vaccine, sc

K

$56.75

$11.35

9144

Encephalitis vaccine, sc

K

$67.73

$13.55

9145

Meningococcal vaccine, im

K

0.8948

$53.10

$10.62

9146

Technetium TC99m Disofenin

H

9147

Technetium TC 99M Depreotide

H

9148

I-123 sodium iodide capsule

H

9149

Dx I131 so iodide microcurie

H

9150

I-125 serum albumin micro

H

9151

Tc 99M ARCITUMOMAB PER VIAL

H

9152

Baclofen Intrathecal kit-1am

K

0.8562

$50.81

$10.16

9153

Na Iothalamate I-125, 10 uCi

H

9154

Technetium tc99m glucepatate

H

9155

Technetium tc99mlabeledrbcs

H

9156

Nonmetabolic active tissue

K

$53.76

$10.75

9157

LOCM <=149 mg/ml iodine

K

$0.51

$0.10

9158

LOCM 150-199mg/ml iodine

K

$2.00

$0.40

9159

LOCM 200-249mg/ml iodine

K

$0.78

$0.16

9160

LOCM 250-299mg/ml iodine

K

$0.66

$0.13

9161

LOCM 300-349mg/ml iodine

K

$0.41

$0.08

9162

LOCM 350-399mg/ml iodine

K

$0.27

$0.05

9163

LOCM >= 400 mg/ml iodine

K

$0.20

$0.04

9164

Inj Gad-base MR contrast

K

$3.01

$0.60

9165

Oral MR contrast

K

$9.01

$1.80

9166

Dyphylline injection

K

$7.74

$1.55

9167

Valrubicin

K

$376.87

$75.37

9168

Pegademase bovine

K

$161.16

$32.23

9169

Anthrax vaccine, sc

K

$128.95

$25.79

9200

Orcel

K

2.6893

$159.59

$31.92

9201

Dermagraft

K

6.2066

$368.32

$73.66

9202

Inj Octafluoropropane mic,ml

K

$41.42

$8.28

9203

Inj Perflexane lipid micros, ml

K

$13.49

$2.70

9205

Oxaliplatin

K

$84.06

$16.81

9206

Integra

K

$9.23

$1.85

9207

Injection, bortezomib

K

$28.90

$5.78

9208

Injection, agalsidase beta

K

$123.35

$24.67

9209

Injection, laronidase

K

$23.16

$4.63

9210

Injection, palonosetron HCL

K

18.42

$3.68

9211

Inj, alefacept, IV

K

$571.01

$114.20

9212

Inj, alefacept, IM

K

$402.00

$80.40

9213

Injection, Pemetrexed

G

$41.29

$8.26

9214

Injection, Bevacizumab

G

$58.17

$11.63

9215

Injection, Cetuximab

G

$50.59

$10.12

9216

Abarelix Injection

G

$66.96

$13.39

9217

Leuprolide acetate suspnsion

K

$230.87

$46.17

9218

Injection, Azacitidine

K

$4.03

$0.81

9219

Mycophenolic Acid

G

$2.47

$0.49

9220

Sodium hyaluronate

G

$203.84

$40.77

9221

Graftjacket Reg Matrix

G

$1,234.36

$246.87

9222

Graftjacket SftTis

G

$890.74

$178.15

9300

Injection, Omalizumab

G

$15.98

$3.20

9500

Platelets, irradiated

K

1.3589

$80.64

$16.13

9501

Platelets, pheresis, leukocytes reduced

K

8.1495

$483.62

$96.72

9502

Platelet pheresis irradiated

K

5.1895

$307.96

$61.59

9503

Fresh frozen plasma, ea unit

K

1.6241

$96.38

$19.28

9504

RBC deglycerolized

K

6.4314

$381.66

$76.33

9505

RBC irradiated

K

2.3876

$141.69

$28.34

9506

Granulocytes, pheresis

K

15.6155

$926.67

$185.33

9507

Platelets, pheresis

K

6.8988

$409.40

$81.88

9508

Plasma, frozen w/in 8 hours

K

1.2038

$71.44

$14.29

6. On pages 42776-42965, Addendum B is corrected to read as follows:

——————————

* Code is subject to contiguous body area imaging discount policy discussed in Section XIV of this proposed rule.

CPT codes and descriptions only are copyright American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply.

Copyright American Dental Association. All Rights Reserved.

Addendum B.—Payment Status by HCPCS Code and Related Information Calendar Year 2006

CPT/HCPCS

SI

CI

Description

APC

Relative weight

Payment rate

National unadjusted copayment

Minimum unadjusted copayment

0003T

S

Cervicography

1492

$15.00

$3.00

0008T

T

Upper gi endoscopy w/suture

0422

22.9647

$1,362.79

$448.81

$272.56

00100

N

Anesth, salivary gland

00102

N

Anesth, repair of cleft lip

00103

N

Anesth, blepharoplasty

00104

N

Anesth, electroshock

0010T

A

Tb test, gamma interferon

00120

N

Anesth, ear surgery

00124

N

Anesth, ear exam

00126

N

Anesth, tympanotomy

00140

N

Anesth, procedures on eye

00142

N

Anesth, lens surgery

00144

N

Anesth, corneal transplant

00145

N

Anesth, vitreoretinal surg

00147

N

Anesth, iridectomy

00148

N

Anesth, eye exam

00160

N

Anesth, nose/sinus surgery

00162

N

Anesth, nose/sinus surgery

00164

N

Anesth, biopsy of nose

0016T

T

Thermotx choroid vasc lesion

0235

4.6593

$276.50

$67.40

$55.30

00170

N

Anesth, procedure on mouth

00172

N

Anesth, cleft palate repair

00174

N

Anesth, pharyngeal surgery

00176

C

Anesth, pharyngeal surgery

0017T

E

Photocoagulat macular drusen

0018T

S

Transcranial magnetic stimul

0215

0.6115

$36.29

$14.51

$7.26

00190

N

Anesth, face/skull bone surg

00192

C

Anesth, facial bone surgery

0019T

E

Extracorp shock wave tx, ms

0020T

B

Extracorp shock wave tx, ft

00210

N

Anesth, open head surgery

00212

N

Anesth, skull drainage

00214

C

Anesth, skull drainage

00215

C

Anesth, skull repair/fract

00216

N

Anesth, head vessel surgery

00218

N

Anesth, special head surgery

0021T

C

Fetal oximetry, trnsvag/cerv

00220

N

Anesth, intrcrn nerve

00222

N

Anesth, head nerve surgery

0023T

A

Phenotype drug test, hiv 1

0024T

C

Transcath cardiac reduction

0026T

A

Measure remnant lipoproteins

0027T

T

Endoscopic epidural lysis

0220

17.3586

$1,030.11

$206.02

0028T

N

Dexa body composition study

0029T

A

Magnetic tx for incontinence

00300

N

Anesth, head/neck/ptrunk

0030T

A

Antiprothrombin antibody

0031T

N

Speculoscopy

00320

N

Anesth, neck organ, 1 & over

00322

N

Anesth, biopsy of thyroid

00326

N

Anesth, larynx/trach, < 1 yr

0032T

N

Speculoscopy w/direct sample

0033T

C

Endovasc taa repr incl subcl

0034T

C

Endovasc taa repr w/o subcl

00350

N

Anesth, neck vessel surgery

00352

N

Anesth, neck vessel surgery

0035T

C

Insert endovasc prosth, taa

0036T

C

Endovasc prosth, taa, add-on

0037T

C

Artery transpose/endovas taa

0038T

C

Rad endovasc taa rpr w/cover

0039T

C

Rad s/i, endovasc taa repair

00400

N

Anesth, skin, ext/per/atrunk

00402

N

Anesth, surgery of breast

00404

C

Anesth, surgery of breast

00406

C

Anesth, surgery of breast

0040T

C

Rad s/i, endovasc taa prosth

00410

N

Anesth, correct heart rhythm

0041T

A

Detect ur infect agnt w/cpas

0042T

N

Ct perfusion w/contrast, cbf

0043T

A

Co expired gas analysis

0044T

N

Whole body photography

00450

N

Anesth, surgery of shoulder

00452

C

Anesth, surgery of shoulder

00454

N

Anesth, collar bone biopsy

0045T

N

Whole body photography

0046T

T

Cath lavage, mammary duct(s)

0021

14.9776

$888.82

$219.48

$177.76

00470

N

Anesth, removal of rib

00472

N

Anesth, chest wall repair

00474

C

Anesth, surgery of rib(s)

0047T

T

Cath lavage, mammary duct(s)

0021

14.9776

$888.82

$219.48

$177.76

0048T

C

Implant ventricular device

0049T

C

External circulation assist

00500

N

Anesth, esophageal surgery

0050T

C

Removal circulation assist

0051T

C

Implant total heart system

00520

N

Anesth, chest procedure

00522

N

Anesth, chest lining biopsy

00524

C

Anesth, chest drainage

00528

N

Anesth, chest partition view

00529

N

Anesth, chest partition view

0052T

C

Replace component heart syst

00530

N

Anesth, pacemaker insertion

00532

N

Anesth, vascular access

00534

N

Anesth, cardioverter/defib

00537

N

Anesth, cardiac electrophys

00539

N

Anesth, trach-bronch reconst

0053T

C

Replace component heart syst

00540

C

Anesth, chest surgery

00541

N

Anesth, one lung ventilation

00542

C

Anesth, release of lung

00546

C

Anesth, lung,chest wall surg

00548

N

Anesth, trachea,bronchi surg

0054T

B

Bone surgery using computer

00550

N

Anesth, sternal debridement

0055T

B

Bone surgery using computer

00560

C

Anesth, open heart surgery

00561

C

Anesth, heart surg < age 1

00562

C

Anesth, open heart surgery

00563

N

Anesth, heart proc w/pump

00566

N

Anesth, cabg w/o pump

0056T

B

Bone surgery using computer

00580

C

Anesth, heart/lung transplnt

0058T

X

Cryopreservation, ovary tiss

0348

0.7927

$47.04

$9.41

0059T

X

Cryopreservation, oocyte

0348

0.7927

$47.04

$9.41

00600

N

Anesth, spine, cord surgery

00604

C

Anesth, sitting procedure

0060T

B

Electrical impedance scan

0061T

B

Destruction of tumor, breast

00620

N

Anesth, spine, cord surgery

00622

C

Anesth, removal of nerves

0062T

T

Rep intradisc annulus1 lev

0203

10.4015

$617.26

$246.90

$123.45

00630

N

Anesth, spine, cord surgery

00632

C

Anesth, removal of nerves

00634

N

Anesth for chemonucleolysis

00635

N

Anesth, lumbar puncture

0063T

T

Rep intradisc annulus>1lev

0203

10.4015

$617.26

$246.90

$123.45

00640

N

Anesth, spine manipulation

0064T

A

Spectroscop eval expired gas

0065T

A

Ocular photoscreen bilat

0066T

E

Ct colonography screen

00670

C

Anesth, spine, cord surgery

0067T*

S

Ct colonography dx

0333

5.2836

$313.54

$125.41

$62.71

0068T

B

Interp/rept heart sound

0069T

N

Analysis only heart sound

00700

N

Anesth, abdominal wall surg

00702

N

Anesth, for liver biopsy

0070T

N

Interp only heart sound

0071T

T

U/s leiomyomata ablate <200

0193

14.5843

$865.48

$173.10

0072T

T

U/s leiomyomata ablate >200

0193

14.5843

$865.48

$173.10

00730

N

Anesth, abdominal wall surg

0073T

S

Delivery, comp imrt

0412

5.3643

$318.33

$63.67

00740

N

Anesth, upper gi visualize

0074T

E

Online physician e/m

00750

N

Anesth, repair of hernia

00752

N

Anesth, repair of hernia

00754

N

Anesth, repair of hernia

00756

N

Anesth, repair of hernia

0075T

C

Perq stent/chest vert art

0076T

C

S&i stent/chest vert art

00770

N

Anesth, blood vessel repair

0077T

C

Cereb therm perfusion probe

0078T

C

Endovasc aort repr w/device

00790

N

Anesth, surg upper abdomen

00792

C

Anesth, hemorr/excise liver

00794

C

Anesth, pancreas removal

00796

C

Anesth, for liver transplant

00797

N

Anesth, surgery for obesity

0079T

C

Endovasc visc extnsn repr

00800

N

Anesth, abdominal wall surg

00802

C

Anesth, fat layer removal

0080T

C

Endovasc aort repr rad s&i

00810

N

Anesth, low intestine scope

0081T

C

Endovasc visc extnsn s&i

00820

N

Anesth, abdominal wall surg

0082T

B

Stereotactic rad delivery

00830

N

Anesth, repair of hernia

00832

N

Anesth, repair of hernia

00834

N

Anesth, hernia repair< 1 yr

00836

N

Anesth hernia repair preemie

0083T

N

Stereotactic rad tx mngmt

00840

N

Anesth, surg lower abdomen

00842

N

Anesth, amniocentesis

00844

C

Anesth, pelvis surgery

00846

C

Anesth, hysterectomy

00848

C

Anesth, pelvic organ surg

0084T

T

Temp prostate urethral stent

0164

1.1855

$70.35

$17.29

$14.07

00851

N

Anesth, tubal ligation

0085T

X

Breath test heart reject

0340

0.6384

$37.88

$7.58

00860

N

Anesth, surgery of abdomen

00862

N

Anesth, kidney/ureter surg

00864

C

Anesth, removal of bladder

00865

C

Anesth, removal of prostate

00866

C

Anesth, removal of adrenal

00868

C

Anesth, kidney transplant

0086T

N

L ventricle fill pressure

00870

N

Anesth, bladder stone surg

00872

N

Anesth kidney stone destruct

00873

N

Anesth kidney stone destruct

0087T

X

Sperm eval hyaluronan

0348

0.7927

$47.04

$9.41

00880

N

Anesth, abdomen vessel surg

00882

C

Anesth, major vein ligation

0088T

T

Rf tongue base vol reduxn

0253

16.1357

$957.54

$282.29

$191.51

00902

N

Anesth, anorectal surgery

00904

C

Anesth, perineal surgery

00906

N

Anesth, removal of vulva

00908

C

Anesth, removal of prostate

00910

N

Anesth, bladder surgery

00912

N

Anesth, bladder tumor surg

00914

N

Anesth, removal of prostate

00916

N

Anesth, bleeding control

00918

N

Anesth, stone removal

00920

N

Anesth, genitalia surgery

00921

N

Anesth, vasectomy

00922

N

Anesth, sperm duct surgery

00924

N

Anesth, testis exploration

00926

N

Anesth, removal of testis

00928

N

Anesth, removal of testis

00930

N

Anesth, testis suspension

00932

C

Anesth, amputation of penis

00934

C

Anesth, penis, nodes removal

00936

C

Anesth, penis, nodes removal

00938

N

Anesth, insert penis device

00940

N

Anesth, vaginal procedures

00942

N

Anesth, surg on vag/urethral

00944

C

Anesth, vaginal hysterectomy

00948

N

Anesth, repair of cervix

00950

N

Anesth, vaginal endoscopy

00952

N

Anesth, hysteroscope/graph

01112

N

Anesth, bone aspirate/bx

01120

N

Anesth, pelvis surgery

01130

N

Anesth, body cast procedure

01140

C

Anesth, amputation at pelvis

01150

C

Anesth, pelvic tumor surgery

01160

N

Anesth, pelvis procedure

01170

N

Anesth, pelvis surgery

01173

N

Anesth, fx repair, pelvis

01180

N

Anesth, pelvis nerve removal

01190

N

Anesth, pelvis nerve removal

01200

N

Anesth, hip joint procedure

01202

N

Anesth, arthroscopy of hip

01210

N

Anesth, hip joint surgery

01212

C

Anesth, hip disarticulation

01214

C

Anesth, hip arthroplasty

01215

N

Anesth, revise hip repair

01220

N

Anesth, procedure on femur

01230

N

Anesth, surgery of femur

01232

C

Anesth, amputation of femur

01234

C

Anesth, radical femur surg

01250

N

Anesth, upper leg surgery

01260

N

Anesth, upper leg veins surg

01270

N

Anesth, thigh arteries surg

01272

C

Anesth, femoral artery surg

01274

C

Anesth, femoral embolectomy

01320

N

Anesth, knee area surgery

01340

N

Anesth, knee area procedure

01360

N

Anesth, knee area surgery

01380

N

Anesth, knee joint procedure

01382

N

Anesth, dx knee arthroscopy

01390

N

Anesth, knee area procedure

01392

N

Anesth, knee area surgery

01400

N

Anesth, knee joint surgery

01402

C

Anesth, knee arthroplasty

01404

C

Anesth, amputation at knee

01420

N

Anesth, knee joint casting

01430

N

Anesth, knee veins surgery

01432

N

Anesth, knee vessel surg

01440

N

Anesth, knee arteries surg

01442

C

Anesth, knee artery surg

01444

C

Anesth, knee artery repair

01462

N

Anesth, lower leg procedure

01464

N

Anesth, ankle/ft arthroscopy

01470

N

Anesth, lower leg surgery

01472

N

Anesth, achilles tendon surg

01474

N

Anesth, lower leg surgery

01480

N

Anesth, lower leg bone surg

01482

N

Anesth, radical leg surgery

01484

N

Anesth, lower leg revision

01486

C

Anesth, ankle replacement

01490

N

Anesth, lower leg casting

01500

N

Anesth, leg arteries surg

01502

C

Anesth, lwr leg embolectomy

01520

N

Anesth, lower leg vein surg

01522

N

Anesth, lower leg vein surg

01610

N

Anesth, surgery of shoulder

01620

N

Anesth, shoulder procedure

01622

N

Anes dx shoulder arthroscopy

01630

N

Anesth, surgery of shoulder

01632

C

Anesth, surgery of shoulder

01634

C

Anesth, shoulder joint amput

01636

C

Anesth, forequarter amput

01638

C

Anesth, shoulder replacement

01650

N

Anesth, shoulder artery surg

01652

C

Anesth, shoulder vessel surg

01654

C

Anesth, shoulder vessel surg

01656

C

Anesth, arm-leg vessel surg

01670

N

Anesth, shoulder vein surg

01680

N

Anesth, shoulder casting

01682

N

Anesth, airplane cast

01710

N

Anesth, elbow area surgery

01712

N

Anesth, uppr arm tendon surg

01714

N

Anesth, uppr arm tendon surg

01716

N

Anesth, biceps tendon repair

01730

N

Anesth, uppr arm procedure

01732

N

Anesth, dx elbow arthroscopy

01740

N

Anesth, upper arm surgery

01742

N

Anesth, humerus surgery

01744

N

Anesth, humerus repair

01756

C

Anesth, radical humerus surg

01758

N

Anesth, humeral lesion surg

01760

N

Anesth, elbow replacement

01770

N

Anesth, uppr arm artery surg

01772

N

Anesth, uppr arm embolectomy

01780

N

Anesth, upper arm vein surg

01782

N

Anesth, uppr arm vein repair

01810

N

Anesth, lower arm surgery

01820

N

Anesth, lower arm procedure

01829

N

Anesth, dx wrist arthroscopy

01830

N

Anesth, lower arm surgery

01832

N

Anesth, wrist replacement

01840

N

Anesth, lwr arm artery surg

01842

N

Anesth, lwr arm embolectomy

01844

N

Anesth, vascular shunt surg

01850

N

Anesth, lower arm vein surg

01852

N

Anesth, lwr arm vein repair

01860

N

Anesth, lower arm casting

01905

N

Anes, spine inject, x-ray/re

01916

N

Anesth, dx arteriography

01920

N

Anesth, catheterize heart

01922

N

Anesth, cat or MRI scan

01924

N

Anes, ther interven rad, art

01925

N

Anes, ther interven rad, car

01926

N

Anes, tx interv rad hrt/cran

01930

N

Anes, ther interven rad, vei

01931

N

Anes, ther interven rad, tip

01932

N

Anes, tx interv rad, th vein

01933

N

Anes, tx interv rad, cran v

01951

N

Anesth, burn, less 4 percent

01952

N

Anesth, burn, 4-9 percent

01953

N

Anesth, burn, each 9 percent

01958

N

Anesth, antepartum manipul

01960

N

Anesth, vaginal delivery

01961

N

Anesth, cs delivery

01962

N

Anesth, emer hysterectomy

01963

N

Anesth, cs hysterectomy

01964

N

Anesth, abortion procedures

01967

N

Anesth/analg, vag delivery

01968

N

Anes/analg cs deliver add-on

01969

N

Anesth/analg cs hyst add-on

01990

C

Support for organ donor

01991

N

Anesth, nerve block/inj

01992

N

Anesth, n block/inj, prone

01995

N

Regional anesthesia limb

01996

N

Hosp manage cont drug admin

01999

N

Unlisted anesth procedure

0500F

E

Initial prenatal care visit

0501F

E

Prenatal flow sheet

0502F

E

Subsequent prenatal care

0503F

E

Postpartum care visit

1000F

E

Tobacco use, smoking, assess

1001F

E

Tobacco use, non-smoking

10021

T

Fna w/o image

0002

0.9559

$56.73

$11.35

10022

T

Fna w/image

0036

2.1773

$129.21

$25.84

1002F

E

Assess anginal symptom/level

10040

T

Acne surgery

0010

0.5719

$33.94

$9.65

$6.79

10060

T

Drainage of skin abscess

0006

1.55

$91.98

$22.28

$18.40

10061

T

Drainage of skin abscess

0006

1.55

$91.98

$22.28

$18.40

10080

T

Drainage of pilonidal cyst

0006

1.55

$91.98

$22.28

$18.40

10081

T

Drainage of pilonidal cyst

0007

11.4501

$679.48

$135.90

10120

T

Remove foreign body

0006

1.55

$91.98

$22.28

$18.40

10121

T

Remove foreign body

0021

14.9776

$888.82

$219.48

$177.76

10140

T

Drainage of hematoma/fluid

0007

11.4501

$679.48

$135.90

10160

T

Puncture drainage of lesion

0018

1.1726

$69.59

$16.04

$13.92

10180

T

Complex drainage, wound

0008

16.4989

$979.09

$195.82

11000

T

Debride infected skin

0015

1.6514

$98.00

$20.29

$19.60

11001

T

Debride infected skin add-on

0012

0.8497

$50.42

$11.18

$10.08

11004

C

Debride genitalia & perineum

11005

C

Debride abdom wall

11006

C

Debride genit/per/abdom wall

11008

C

Remove mesh from abd wall

11010

T

Debride skin, fx

0019

4.0547

$240.62

$71.87

$48.12

11011

T

Debride skin/muscle, fx

0019

4.0547

$240.62

$71.87

$48.12

11012

T

Debride skin/muscle/bone, fx

0019

4.0547

$240.62

$71.87

$48.12

11040

T

Debride skin, partial

0015

1.6514

$98.00

$20.29

$19.60

11041

T

Debride skin, full

0015

1.6514

$98.00

$20.29

$19.60

11042

T

Debride skin/tissue

0016

2.5834

$153.31

$33.57

$30.66

11043

T

Debride tissue/muscle

0016

2.5834

$153.31

$33.57

$30.66

11044

T

Debride tissue/muscle/bone

0682

6.9107

$410.10

$162.42

$82.02

11055

T

Trim skin lesion

0012

0.8497

$50.42

$11.18

$10.08

11056

T

Trim skin lesions, 2 to 4

0012

0.8497

$50.42

$11.18

$10.08

11057

T

Trim skin lesions, over 4

0013

1.1078

$65.74

$14.20

$13.15

11100

T

Biopsy, skin lesion

0018

1.1726

$69.59

$16.04

$13.92

11101

T

Biopsy, skin add-on

0018

1.1726

$69.59

$16.04

$13.92

11200

T

Removal of skin tags

0013

1.1078

$65.74

$14.20

$13.15

11201

T

Remove skin tags add-on

0015

1.6514

$98.00

$20.29

$19.60

11300

T

Shave skin lesion

0012

0.8497

$50.42

$11.18

$10.08

11301

T

Shave skin lesion

0012

0.8497

$50.42

$11.18

$10.08

11302

T

Shave skin lesion

0013

1.1078

$65.74

$14.20

$13.15

11303

T

Shave skin lesion

0015

1.6514

$98.00

$20.29

$19.60

11305

T

Shave skin lesion

0013

1.1078

$65.74

$14.20

$13.15

11306

T

Shave skin lesion

0013

1.1078

$65.74

$14.20

$13.15

11307

T

Shave skin lesion

0013

1.1078

$65.74

$14.20

$13.15

11308

T

Shave skin lesion

0013

1.1078

$65.74

$14.20

$13.15

11310

T

Shave skin lesion

0013

1.1078

$65.74

$14.20

$13.15

11311

T

Shave skin lesion

0013

1.1078

$65.74

$14.20

$13.15

11312

T

Shave skin lesion

0013

1.1078

$65.74

$14.20

$13.15

11313

T

Shave skin lesion

0016

2.5834

$153.31

$33.57

$30.66

11400

T

Removal of skin lesion

0019

4.0547

$240.62

$71.87

$48.12

11401

T

Removal of skin lesion

0019

4.0547

$240.62

$71.87

$48.12

11402

T

Removal of skin lesion

0019

4.0547

$240.62

$71.87

$48.12

11403

T

Removal of skin lesion

0020

6.9433

$412.04

$107.40

$82.41

11404

T

Removal of skin lesion

0021

14.9776

$888.82

$219.48

$177.76

11406

T

Removal of skin lesion

0021

14.9776

$888.82

$219.48

$177.76

11420

T

Removal of skin lesion

0020

6.9433

$412.04

$107.40

$82.41

11421

T

Removal of skin lesion

0020

6.9433

$412.04

$107.40

$82.41

11422

T

Removal of skin lesion

0020

6.9433

$412.04

$107.40

$82.41

11423

T

Removal of skin lesion

0021

14.9776

$888.82

$219.48

$177.76

11424

T

Removal of skin lesion

0021

14.9776

$888.82

$219.48

$177.76

11426

T

Removal of skin lesion

0022

19.6472

$1,165.92

$354.45

$233.18

11440

T

Removal of skin lesion

0019

4.0547

$240.62

$71.87

$48.12

11441

T

Removal of skin lesion

0019

4.0547

$240.62

$71.87

$48.12

11442

T

Removal of skin lesion

0020

6.9433

$412.04

$107.40

$82.41

11443

T

Removal of skin lesion

0020

6.9433

$412.04

$107.40

$82.41

11444

T

Removal of skin lesion

0020

6.9433

$412.04

$107.40

$82.41

11446

T

Removal of skin lesion

0022

19.6472

$1,165.92

$354.45

$233.18

11450

T

Removal, sweat gland lesion

0022

19.6472

$1,165.92

$354.45

$233.18

11451

T

Removal, sweat gland lesion

0022

19.6472

$1,165.92

$354.45

$233.18

11462

T

Removal, sweat gland lesion

0022

19.6472

$1,165.92

$354.45

$233.18

11463

T

Removal, sweat gland lesion

0022

19.6472

$1,165.92

$354.45

$233.18

11470

T

Removal, sweat gland lesion

0022

19.6472

$1,165.92

$354.45

$233.18

11471

T

Removal, sweat gland lesion

0022

19.6472

$1,165.92

$354.45

$233.18

11600

T

Removal of skin lesion

0019

4.0547

$240.62

$71.87

$48.12

11601

T

Removal of skin lesion

0019

4.0547

$240.62

$71.87

$48.12

11602

T

Removal of skin lesion

0019

4.0547

$240.62

$71.87

$48.12

11603

T

Removal of skin lesion

0020

6.9433

$412.04

$107.40

$82.41

11604

T

Removal of skin lesion

0020

6.9433

$412.04

$107.40

$82.41

11606

T

Removal of skin lesion

0021

14.9776

$888.82

$219.48

$177.76

11620

T

Removal of skin lesion

0020

6.9433

$412.04

$107.40

$82.41

11621

T

Removal of skin lesion

0019

4.0547

$240.62

$71.87

$48.12

11622

T

Removal of skin lesion

0020

6.9433

$412.04

$107.40

$82.41

11623

T

Removal of skin lesion

0021

14.9776

$888.82

$219.48

$177.76

11624

T

Removal of skin lesion

0021

14.9776

$888.82

$219.48

$177.76

11626

T

Removal of skin lesion

0022

19.6472

$1,165.92

$354.45

$233.18

11640

T

Removal of skin lesion

0020

6.9433

$412.04

$107.40

$82.41

11641

T

Removal of skin lesion

0020

6.9433

$412.04

$107.40

$82.41

11642

T

Removal of skin lesion

0020

6.9433

$412.04

$107.40

$82.41

11643

T

Removal of skin lesion

0020

6.9433

$412.04

$107.40

$82.41

11644

T

Removal of skin lesion

0021

14.9776

$888.82

$219.48

$177.76

11646

T

Removal of skin lesion

0022

19.6472

$1,165.92

$354.45

$233.18

11719

T

Trim nail(s)

0009

0.668

$39.64

$8.34

$7.93

11720

T

Debride nail, 1-5

0009

0.668

$39.64

$8.34

$7.93

11721

T

Debride nail, 6 or more

0009

0.668

$39.64

$8.34

$7.93

11730

T

Removal of nail plate

0013

1.1078

$65.74

$14.20

$13.15

11732

T

Remove nail plate, add-on

0012

0.8497

$50.42

$11.18

$10.08

11740

T

Drain blood from under nail

0009

0.668

$39.64

$8.34

$7.93

11750

T

Removal of nail bed

0019

4.0547

$240.62

$71.87

$48.12

11752

T

Remove nail bed/finger tip

0022

19.6472

$1,165.92

$354.45

$233.18

11755

T

Biopsy, nail unit

0019

4.0547

$240.62

$71.87

$48.12

11760

T

Repair of nail bed

0024

1.6084

$95.45

$31.25

$19.09

11762

T

Reconstruction of nail bed

0024

1.6084

$95.45

$31.25

$19.09

11765

T

Excision of nail fold, toe

0015

1.6514

$98.00

$20.29

$19.60

11770

T

Removal of pilonidal lesion

0022

19.6472

$1,165.92

$354.45

$233.18

11771

T

Removal of pilonidal lesion

0022

19.6472

$1,165.92

$354.45

$233.18

11772

T

Removal of pilonidal lesion

0022

19.6472

$1,165.92

$354.45

$233.18

11900

T

Injection into skin lesions

0012

0.8497

$50.42

$11.18

$10.08

11901

T

Added skin lesions injection

0012

0.8497

$50.42

$11.18

$10.08

11920

T

Correct skin color defects

0024

1.6084

$95.45

$31.25

$19.09

11921

T

Correct skin color defects

0024

1.6084

$95.45

$31.25

$19.09

11922

T

Correct skin color defects

0024

1.6084

$95.45

$31.25

$19.09

11950

T

Therapy for contour defects

0024

1.6084

$95.45

$31.25

$19.09

11951

T

Therapy for contour defects

0024

1.6084

$95.45

$31.25

$19.09

11952

T

Therapy for contour defects

0024

1.6084

$95.45

$31.25

$19.09

11954

T

Therapy for contour defects

0024

1.6084

$95.45

$31.25

$19.09

11960

T

Insert tissue expander(s)

0027

18.4182

$1,092.99

$329.72

$218.60

11970

T

Replace tissue expander

0027

18.4182

$1,092.99

$329.72

$218.60

11971

T

Remove tissue expander(s)

0022

19.6472

$1,165.92

$354.45

$233.18

11975

E

Insert contraceptive cap

11976

T

Removal of contraceptive cap

0019

4.0547

$240.62

$71.87

$48.12

11977

E

Removal/reinsert contra cap

11980

X

Implant hormone pellet(s)

0340

0.6384

$37.88

$7.58

11981

X

Insert drug implant device

0340

0.6384

$37.88

$7.58

11982

X

Remove drug implant device

0340

0.6384

$37.88

$7.58

11983

X

Remove/insert drug implant

0340

0.6384

$37.88

$7.58

12001

T

Repair superficial wound(s)

0024

1.6084

$95.45

$31.25

$19.09

12002

T

Repair superficial wound(s)

0024

1.6084

$95.45

$31.25

$19.09

12004

T

Repair superficial wound(s)

0024

1.6084

$95.45

$31.25

$19.09

12005

T

Repair superficial wound(s)

0024

1.6084

$95.45

$31.25

$19.09

12006

T

Repair superficial wound(s)

0024

1.6084

$95.45

$31.25

$19.09

12007

T

Repair superficial wound(s)

0024

1.6084

$95.45

$31.25

$19.09

12011

T

Repair superficial wound(s)

0024

1.6084

$95.45

$31.25

$19.09

12013

T

Repair superficial wound(s)

0024

1.6084

$95.45

$31.25

$19.09

12014

T

Repair superficial wound(s)

0024

1.6084

$95.45

$31.25

$19.09

12015

T

Repair superficial wound(s)

0024

1.6084

$95.45

$31.25

$19.09

12016

T

Repair superficial wound(s)

0024

1.6084

$95.45

$31.25

$19.09

12017

T

Repair superficial wound(s)

0024

1.6084

$95.45

$31.25

$19.09

12018

T

Repair superficial wound(s)

0024

1.6084

$95.45

$31.25

$19.09

12020

T

Closure of split wound

0024

1.6084

$95.45

$31.25

$19.09

12021

T

Closure of split wound

0024

1.6084

$95.45

$31.25

$19.09

12031

T

Layer closure of wound(s)

0024

1.6084

$95.45

$31.25

$19.09

12032

T

Layer closure of wound(s)

0024

1.6084

$95.45

$31.25

$19.09

12034

T

Layer closure of wound(s)

0024

1.6084

$95.45

$31.25

$19.09

12035

T

Layer closure of wound(s)

0024

1.6084

$95.45

$31.25

$19.09

12036

T

Layer closure of wound(s)

0024

1.6084

$95.45

$31.25

$19.09

12037

T

Layer closure of wound(s)

0025

5.4938

$326.02

$101.85

$65.20

12041

T

Layer closure of wound(s)

0024

1.6084

$95.45

$31.25

$19.09

12042

T

Layer closure of wound(s)

0024

1.6084

$95.45

$31.25

$19.09

12044

T

Layer closure of wound(s)

0024

1.6084

$95.45

$31.25

$19.09

12045

T

Layer closure of wound(s)

0024

1.6084

$95.45

$31.25

$19.09

12046

T

Layer closure of wound(s)

0024

1.6084

$95.45

$31.25

$19.09

12047

T

Layer closure of wound(s)

0025

5.4938

$326.02

$101.85

$65.20

12051

T

Layer closure of wound(s)

0024

1.6084

$95.45

$31.25

$19.09

12052

T

Layer closure of wound(s)

0024

1.6084

$95.45

$31.25

$19.09

12053

T

Layer closure of wound(s)

0024

1.6084

$95.45

$31.25

$19.09

12054

T

Layer closure of wound(s)

0024

1.6084

$95.45

$31.25

$19.09

12055

T

Layer closure of wound(s)

0024

1.6084

$95.45

$31.25

$19.09

12056

T

Layer closure of wound(s)

0024

1.6084

$95.45

$31.25

$19.09

12057

T

Layer closure of wound(s)

0025

5.4938

$326.02

$101.85

$65.20

13100

T

Repair of wound or lesion

0025

5.4938

$326.02

$101.85

$65.20

13101

T

Repair of wound or lesion

0025

5.4938

$326.02

$101.85

$65.20

13102

T

Repair wound/lesion add-on

0024

1.6084

$95.45

$31.25

$19.09

13120

T

Repair of wound or lesion

0024

1.6084

$95.45

$31.25

$19.09

13121

T

Repair of wound or lesion

0024

1.6084

$95.45

$31.25

$19.09

13122

T

Repair wound/lesion add-on

0024

1.6084

$95.45

$31.25

$19.09

13131

T

Repair of wound or lesion

0024

1.6084

$95.45

$31.25

$19.09

13132

T

Repair of wound or lesion

0024

1.6084

$95.45

$31.25

$19.09

13133

T

Repair wound/lesion add-on

0024

1.6084

$95.45

$31.25

$19.09

13150

T

Repair of wound or lesion

0025

5.4938

$326.02

$101.85

$65.20

13151

T

Repair of wound or lesion

0024

1.6084

$95.45

$31.25

$19.09

13152

T

Repair of wound or lesion

0025

5.4938

$326.02

$101.85

$65.20

13153

T

Repair wound/lesion add-on

0024

1.6084

$95.45

$31.25

$19.09

13160

T

Late closure of wound

0027

18.4182

$1,092.99

$329.72

$218.60

14000

T

Skin tissue rearrangement

0686

13.8287

$820.64

$164.13

14001

T

Skin tissue rearrangement

0027

18.4182

$1,092.99

$329.72

$218.60

14020

T

Skin tissue rearrangement

0686

13.8287

$820.64

$164.13

14021

T

Skin tissue rearrangement

0027

18.4182

$1,092.99

$329.72

$218.60

14040

T

Skin tissue rearrangement

0686

13.8287

$820.64

$164.13

14041

T

Skin tissue rearrangement

0027

18.4182

$1,092.99

$329.72

$218.60

14060

T

Skin tissue rearrangement

0027

18.4182

$1,092.99

$329.72

$218.60

14061

T

Skin tissue rearrangement

0686

13.8287

$820.64

$164.13

14300

T

Skin tissue rearrangement

0027

18.4182

$1,092.99

$329.72

$218.60

14350

T

Skin tissue rearrangement

0027

18.4182

$1,092.99

$329.72

$218.60

15000

T

Skin graft

0025

5.4938

$326.02

$101.85

$65.20

15001

T

Skin graft add-on

0025

5.4938

$326.02

$101.85

$65.20

15050

T

Skin pinch graft

0025

5.4938

$326.02

$101.85

$65.20

15100

T

Skin split graft

0027

18.4182

$1,092.99

$329.72

$218.60

15101

T

Skin split graft add-on

0027

18.4182

$1,092.99

$329.72

$218.60

15120

T

Skin split graft

0027

18.4182

$1,092.99

$329.72

$218.60

15121

T

Skin split graft add-on

0027

18.4182

$1,092.99

$329.72

$218.60

15200

T

Skin full graft

0027

18.4182

$1,092.99

$329.72

$218.60

15201

T

Skin full graft add-on

0025

5.4938

$326.02

$101.85

$65.20

15220

T

Skin full graft

0027

18.4182

$1,092.99

$329.72

$218.60

15221

T

Skin full graft add-on

0025

5.4938

$326.02

$101.85

$65.20

15240

T

Skin full graft

0686

13.8287

$820.64

$164.13

15241

T

Skin full graft add-on

0025

5.4938

$326.02

$101.85

$65.20

15260

T

Skin full graft

0686

13.8287

$820.64

$164.13

15261

T

Skin full graft add-on

0025

5.4938

$326.02

$101.85

$65.20

15342

T

Cultured skin graft, 25 cm

0024

1.6084