01-27275. Medicare Program; Revisions to Payment Policies and Five-Year Review of and Adjustments to the Relative Value Units Under the Physician Fee Schedule for Calendar Year 2002
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AGENCY:
Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION:
Final rule with comment period.
SUMMARY:
This final rule with comment period makes several changes affecting Medicare Part B payment. The changes affect: refinement of resource-based practice expense relative value units (RVUs); services and supplies incident to a physician's professional service; anesthesia base unit variations; recognition of CPT tracking codes; and nurse practitioners, physician assistants, and clinical nurse specialists performing screening sigmoidoscopies. It also addresses comments received on the June 8, 2001 proposed notice for the 5-year review of work RVUs and finalizes these work RVUs. In addition, we acknowledge comments received on our request for information on our policy for CPT modifier 62 that is used to report the work of co-surgeons. The rule also updates the list of certain services subject to the physician self-referral prohibitions to reflect changes to CPT codes and Healthcare Common Procedure Coding System codes effective January 1, 2002. These refinements and changes will ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services.
The Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 modernizes the mammography screening benefit and authorizes payment under the physician fee schedule effective January 1, 2002; provides for biennial screening pelvic examinations for certain beneficiaries effective July 1, 2001; provides for annual glaucoma screenings for high-risk beneficiaries effective January 1, 2002; expands coverage for screening colonoscopies to all beneficiaries effective July 1, 2001; establishes coverage for medical nutrition therapy services for certain beneficiaries effective January 1, 2002; expands payment for telehealth services effective October 1, 2001; requires certain Indian Health Service providers to be paid for some services under the physician fee schedule effective July 1, 2001; and revises the payment for certain physician pathology services effective January 1, 2001. This final rule will conform our regulations to reflect these statutory provisions.
In addition, we are finalizing the calendar year (CY) 2001 interim RVUs and are issuing interim RVUs for new and revised procedure codes for calendar year (CY) 2002. As required by the statute, we are announcing that the physician fee schedule update for CY 2002 is −4.8 percent, the initial estimate of the Sustainable Growth Rate (SGR) for CY 2002 is 5.6 percent, and the conversion factor for CY 2002 is $36.1992.
DATES:
Effective date: This rule is effective January 1, 2002.
Comment date: We will consider comments on the Clinical Practice Expert Panel data, the physician self-referral designated health services identified in Table 8, and the interim RVUs for selected procedure codes identified in Addendum C if we receive them at the appropriate address, as provided below, no later than 5 p.m. on December 31, 2001.
ADDRESSES:
Mail written comments (1 original and 2 copies) to the following address: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-1169-FC, P.O. Box 8013, Baltimore, MD 21244-8013.
To insure that mailed comments are received in time for us to consider them, please allow for possible delays in delivering them. If you prefer, you may deliver your written comments (1 original and 2 copies) by courier to one of the following addresses: Room C5-14-03, 7500 Security Boulevard, Baltimore, MD 21244-8013 or Room 443-G, Hubert H. Humphrey Building, 200 Independence Avenue, SW., Washington, DC 20201.
Comments mailed to the two above addresses may be delayed and received too late for us to consider them.
Because of staff and resource limitations, we cannot accept comments by facsimile (FAX) transmission. In commenting, please refer to file code CMS-1169-FC.
For information on viewing public comments, please see the beginning of the Supplementary Information section below.
Start Further InfoFOR FURTHER INFORMATION CONTACT:
Carolyn Mullen, (410) 786-4589 or Marc Hartstein, (410) 786-4539 (for issues related to resource-based practice expense relative value units).
Carlos Cano, (410) 786-0245 (for issues related to screening sigmoidoscopies).
Paul W. Kim, (410) 786-7410 (for issues related to incident to services).
Rick Ensor, (410) 786-5617 (for issues related to screening mammography).
Bill Larson, (410) 786-4639 (for issues related to screening pelvic examinations, screening for glaucoma, and coverage for screening colonoscopies).
Bob Ulikowski, (410) 786-5721 (for issues related to the payment for screening colonoscopies).
Mary Stojak, (410) 786-6939 (for issues related to medical nutrition therapy).
Joan Mitchell, (410) 786-4508 (for issues related to the payment for medical nutrition therapy).
Craig Dobyski, (410) 786-4584 (for issues related to telehealth).
Terri Harris, (410) 786-6830 (for issues related to Indian Health Service providers).
Jim Menas, (410) 786-4507 (for issues related to anesthesia and pathology services).
Joanne Sinsheimer (410) 786-4620 (for issues related to updates to the list of certain services subject to the physician self-referral prohibitions).
Diane Milstead, (410) 786-3355 (for all other issues).
End Further Info End Preamble Start Supplemental InformationSUPPLEMENTARY INFORMATION:
Inspection of Public Comments
Comments received timely will be available for public inspection as they are received, generally beginning approximately 3 weeks after publication of a document, at 7500 Security Blvd, Baltimore, Maryland 21244, Monday through Friday of each week from 8:30 a.m. to 5 p.m. Please call (410) 786-7197 to make an appointment to view the public comments.
Copies
To order copies of the Federal Register containing this document, send your request to: New Orders, Superintendent of Documents, P.O. Box 371954, Pittsburgh, PA 15250-7954. Specify the date of the issue requested and enclose a check or money order payable to the Superintendent of Documents, or enclose your Visa or Master Card number and expiration date. Credit card orders can also be placed by calling the order desk at (202) 512-1800 or by faxing to (202) 512-2250. The cost for each copy is $9. As an alternative, you can view and photocopy the Federal Register Start Printed Page 55247document at most libraries designated as Federal Depository Libraries and at many other public and academic libraries throughout the country that receive the Federal Register.
To order the disks containing this document, send your request to: Superintendent of Documents, Attention: Electronic Products, P.O. Box 37082, Washington, DC 20013-7082. Please specify, “Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2001,” and enclose a check or money order payable to the Superintendent of Documents, or enclose your VISA, Discover, or MasterCard number and expiration date. Credit card orders can be placed by calling the order clerk at (202) 512-1530 (or toll free at 1-888-293-6498) or by faxing to (202) 512-1262.
This Federal Register document is also available from the Federal Register online database through GPO Access, a service of the U.S. Government Printing Office. The Website address is: http://www.access.gpo.gov/nara/index.html.
Information on the physician fee schedule can be found on our homepage. You can access these data by using the following directions:
1. Go to the CMS homepage (http://www.cms.hhs.gov).
2. Click on “Professionals.”
3. Under the heading “Physicians and Health Care Professionals,” click on “Medicare Coding and Payment Systems.”
4. Select Physician Fee Schedule.
Or, you can go directly to the Physician Fee Schedule page by typing the following: http://www.hcfa.gov/medicare/pfsmain.htm.
To assist readers in referencing sections contained in this preamble, we are providing the following table of contents. Some of the issues discussed in this preamble affect the payment policies but do not require changes to the regulations in the Code of Federal Regulations. Information on the regulation's impact appears throughout the preamble and is not exclusively in section XIII.
Table of Contents
I. Background
A. Legislative History
B. Published Changes to the Fee Schedule
C. Components of the Fee Schedule Payment Amounts
D. Development of the Relative Value Units
II. Specific Provisions for Calendar Year 2002
A. Resource-Based Practice Expense Relative Value Units
B. Nurse Practitioners, Physician Assistants, and Clinical Nurse Specialists Performing Screening Sigmoidoscopies
C. Services and Supplies Incident to a Physician's Professional Services: Conditions
D. Anesthesia Services
E. Performance Measurement and Emerging Technology Codes
F. Payment Policy for CPT Modifier 62 (Co-Surgery)
III. Implementation of Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000
A. Screening Mammography
B. Screening Pelvic Examinations
C. Screening for Glaucoma
D. Screening Colonoscopy
E. Medical Nutrition Therapy
F. Telehealth Services
G. Indian Health Service
H. Pathology Services
IV. Five-Year Review of Work Relative Value Units Under the Physician Fee Schedule; Responses to Public Comments on the Five-Year Review of Work Relative Value Units
V. Refinement of Relative Value Units for Calendar Year 2002 and Response to Public Comments on Interim Relative Value Units for 2001 (Including the Interim Relative Value Units Contained in the August 2001 Proposed Rule)
A. Summary of Issues Discussed Related to the Adjustment of Relative Value Units
B. Process for Establishing Work Relative Value Units for the 2002 Physician Fee Schedule
VI. Physician Self-Referral Prohibitions
VII. Physician Fee Schedule Update for Calendar Year 2002
VIII. Allowed Expenditures for Physicians' Services and the Sustainable Growth Rate for Calendar Year 2002
A. Medicare Sustainable Growth Rate
B. Physicians' Services
C. Provisions Related to the SGR
D. Preliminary Estimate of the SGR for 2002
E. Sustainable Growth Rate for CY 2001
F. Sustainable Growth Rate for FY 2001
G. Calculation of the FY 2001, CY 2001, and CY 2002 Sustainable Growth Rates
IX. Anesthesia and Physician Fee Schedule Conversion Factors for CY 2002
X. Provisions of the Final Rule
XI. Collection of Information Requirements
XII. Response to Comments
XIII. Regulatory Impact Analysis
Addendum A—Explanation and Use of Addendum B
Addendum B—2002 Relative Value Units and Related Information Used in Determining Medicare Payments for 2002
Addendum C—Codes with Interim RVUs
Addendum D—2002 Geographic Practice Cost Indices by Medicare Carrier and Locality
Addendum E—Updated List of CPT/HCPCS Codes Used to Describe Certain Designated Health Services Under the Physician Self-Referral Provision
In addition, because of the many organizations and terms to which we refer by acronym in this final rule, we are listing these acronyms and their corresponding terms in alphabetical order below:
AMA American Medical Association
BBA Balanced Budget Act of 1997
BBRA Balanced Budget Refinement Act of 1999
CF Conversion factor
CFR Code of Federal Regulations
CPT [Physicians'] Current Procedural Terminology [4th Edition, 1997, copyrighted by the American Medical Association]
CPEP Clinical Practice Expert Panel
CRNA Certified Registered Nurse Anesthetist
E/M Evaluation and management
EB Electrical bioimpedance
FMR Fair market rental
GAF Geographic adjustment factor
GPCI Geographic practice cost index
GDP Gross Domestic Product
CMS Centers for Medicare & Medicaid Services
HCPCS Healthcare Common Procedure Coding System
HHA Home health agency
HHS [Department of] Health and Human Services
IDTFs Independent Diagnostic Testing Facilities
MCM Medicare Carrier Manual
MedPAC Medicare Payment Advisory Commission
MEI Medicare Economic Index
MGMA Medical Group Management Association
MSA Metropolitan Statistical Area
NAMCS National Ambulatory Medical Care Survey
NCD National coverage determination
PC Professional component
PEAC Practice Expense Advisory Committee
PPAC Practicing Physicians Advisory Council
PPS Prospective payment system
RUC [AMA's Specialty Society] Relative [Value] Update Committee
RVU Relative value unit
SGR Sustainable growth rate
SMS [AMA's] Socioeconomic Monitoring System
TC Technical component
I. Background
A. Legislative History
Since January 1, 1992, Medicare has paid for physicians' services under section 1848 of the Social Security Act (the Act), “Payment for Physicians' Services.” This section provides for three major elements: (1) a fee schedule for the payment of physicians’ services; (2) a sustainable growth rate for the rates of increase in Medicare expenditures for physicians' services; and (3) limits on the amounts that nonparticipating physicians can charge beneficiaries. The Act requires that payments under the fee schedule be based on national uniform relative value units (RVUs) based on the resources used in furnishing a service. Section 1848(c) of the Act requires that national RVUs be established for physician work, practice expense, and malpractice expense. Start Printed Page 55248Section 1848(c)(2)(B)(ii)(II) of the Act provides that adjustments in RVUs may not cause total physician fee schedule payments to differ by more than $20 million from what they would have been had the adjustments not been made. If adjustments to RVUs cause expenditures to change by more than $20 million, we must make adjustments to preserve budget neutrality.
B. Published Changes to the Fee Schedule
In the July 17, 2000 proposed rule (65 FR 44177), we listed all of the final rules published through November 1999 relating to the updates to the RVUs and revisions to payment policies under the physician fee schedule.
In the June 8, 2001 Federal Register (66 FR 31028), we published a proposed notice concerning the 5-year review of work RVUs.
In the August 2, 2001 proposed rule (66 FR 40373) we discussed revisions contained in the November 1, 2000 final rule with comment period and the following issues affecting Medicare payment under the physician fee schedule:
- We listed the revisions to payment policies under the physician fee schedule that were made in the November 2000 final rule with comment period (65 FR 65376).
- We discussed policy issues affecting Medicare payment for physicians' services, including—
—refinement of the resource-based practice expense relative value units;
—services and supplies incident to a physician's professional service;
—anesthesia base unit variations;
—recognition of CPT tracking codes; and
—nurse practitioners, physician assistants, and clinical nurse specialists performing screening sigmoidoscopies.
We also solicited comments on the payment policy for CPT modifier 62 used to report the work of co-surgeons.
In addition, the August 2, 2001 proposed rule addressed the following provisions of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA):
- Payment for the screening mammography benefit under the physician fee schedule effective January 1, 2002.
- Biennial screening pelvic examinations for certain beneficiaries effective July 1, 2001.
- Annual glaucoma screenings for high-risk beneficiaries effective January 1, 2002.
- Expansion of coverage for screening colonoscopies to all beneficiaries effective July 1, 2001.
- Coverage for medical nutrition therapy services for certain beneficiaries effective January 1, 2002.
- Expansion of payment for telehealth services effective October 1, 2001.
- Payment for some services of certain Indian Health Service providers under the physician fee schedule effective July 1, 2001.
- Revision to the payment for certain physician pathology services effective January 1, 2001.
This final rule affects the regulations set forth at Part 405, Federal health insurance for the aged and disabled; Part 410, Supplementary medical insurance (SMI) benefits; Part 411, Exclusions from Medicare and limitations on Medicare payment; Part 414, Payment for Part B medical and other health services; and Part 415, Services furnished by physicians in providers, supervising physicians in teaching settings, and residents in certain settings.
The information in this final rule finalizes information in the June 8, 2001 proposed notice and the August 2, 2001 proposed rule.
C. Components of the Fee Schedule Payment Amounts
Under the formula set forth in section 1848(b)(1) of the Act, the payment amount for each service paid under the physician fee schedule is the product of three factors—(1) a nationally uniform relative value for the service; (2) a geographic adjustment factor (GAF) for each physician fee schedule area; and (3) a nationally uniform conversion factor (CF) for the service. The CF converts the relative values into payment amounts.
For each physician fee schedule service, there are three relative values—(1) an RVU for physician work; (2) an RVU for practice expense; and (3) an RVU for malpractice expense. For each of these components of the fee schedule, there is a geographic practice cost index (GPCI) for each fee schedule area. The GPCIs reflect the relative costs of practice expenses, malpractice insurance, and physician work in an area compared to the national average for each component.
The general formula for calculating the Medicare fee schedule amount for a given service in a given fee schedule area can be expressed as:
Payment = [(RVU work × GPCI work) + (RVU practice expense × GPCI practice expense) + (RVU malpractice × GPCI malpractice)] × CF
The CF for calendar year (CY) 2002 appears in section XIII. The RVUs for CY 2002 are in Addendum B. The GPCIs for CY 2002 can be found in Addendum D.
Section 1848(e) of the Act requires us to develop GAFs for all physician fee schedule areas. The total GAF for a fee schedule area is equal to a weighted average of the individual GPCIs for each of the three components of the service. In accordance with the statute, however, the GAF for the physician's work reflects one-quarter of the relative cost of physician's work compared to the national average.
D. Development of the Relative Value System
1. Work Relative Value Units
Approximately 7,500 codes represent services included in the physician fee schedule. The work RVUs established for the implementation of the fee schedule in January 1992 were developed with extensive input from the physician community. A research team at the Harvard School of Public Health developed the original work RVUs for most codes in a cooperative agreement with us. In constructing the vignettes for the original RVUs, Harvard worked with expert panels of physicians and obtained input from physicians from numerous specialties.
The RVUs for radiology services were based on the American College of Radiology (ACR) relative value scale, which we integrated into the overall physician fee schedule. The RVUs for anesthesia services were based on RVUs from a uniform relative value guide. We established a separate CF for anesthesia services, and we continue to recognize time as a factor in determining payment for these services. As a result, there is a separate payment system for anesthesia services.
II. Specific Proposals for Calendar Year 2002
In response to the publication of the August 2001 proposed rule, we received approximately 2,000 comments. We received comments from individual physicians, health care workers, and professional associations and societies. The majority of comments addressed the proposals related to medical nutrition therapy and the practice expense refinement.
The proposed rule discussed policies that affected the number of RVUs on which payment for certain services would be based. Certain changes implemented through this final rule are subject to the $20 million limitation on Start Printed Page 55249annual adjustments contained in section 1848(c)(2)(B)(ii)(II) of the Act.
After reviewing the comments and determining the policies we would implement, we have estimated the costs and savings of these policies and added those costs and savings to the estimated costs associated with any other changes in RVUs for 2002. We discuss in detail the effects of these changes in the Regulatory Impact Analysis in section XIII.
For the convenience of the reader, the headings for the policy issues correspond to the headings used in the August 2001 proposed rule. More detailed background information for each issue can be found in the June 2001 proposed notice with comment period and the August 2001 proposed rule.
A. Resource-Based Practice Expense Relative Value Units
1. Resource-Based Practice Expense Legislation
Section 121 of the Social Security Act Amendments of 1994 (Public Law 103-432), enacted on October 31, 1994, required us to develop a methodology for a resource-based system for determining practice expense RVUs for each physician's service beginning in 1998. In developing the methodology, we were to consider the staff, equipment, and supplies used in providing medical and surgical services in various settings. The legislation specifically required that, in implementing the new system of practice expense RVUs, we apply the same budget-neutrality provisions that we apply to other adjustments under the physician fee schedule.
Section 4505(a) of the BBA amended section 1848(c)(2)(ii) of the Act and delayed the effective date of the resource-based practice expense RVU system until January 1, 1999. In addition, section 4505(b) of the BBA provided for a 4-year transition period from charge-based practice expense RVUs to resource-based RVUs. The practice expense RVUs for CY 1999 were the product of 75 percent of charge-based RVUs and 25 percent of the resource-based RVUs. For CY 2000, the RVUs were 50 percent charge-based RVUs and 50 percent resource-based RVUs. For CY 2001, the RVUs are 25 percent charge-based and 75 percent resource-based. After CY 2001, the RVUs will be totally resource-based.
Section 4505(e) of the BBA amended section 1848(c)(2) of the Act by providing that 1998 practice expense RVUs be adjusted for certain services in anticipation of implementation of resource-based practice expenses beginning in 1999. As a result, the statute required us to increase practice expense RVUs for office visits. For other services in which practice expense RVUs exceeded 110 percent of the work RVUs and were furnished less than 75 percent of the time in an office setting, the statute required us to reduce the 1998 practice expense RVUs to a number equal to 110 percent of the work RVUs. This reduction did not apply to services that had proposed resource-based practice expense RVUs that increased from their 1997 practice expense RVUs as reflected in the June 18, 1997 proposed rule (62 FR 33196). The services affected and the final RVUs for 1998 were published in the October 1997 final rule (62 FR 59103).
Further legislation affecting resource-based practice expense RVUs was included in the Balanced Budget Refinement Act of 1999 (BBRA) (Public Law 106-113). Section 212 of the BBRA amended section 1848(c)(2)(ii) of the Act by directing us to establish a process under which we accept and use, to the maximum extent practicable and consistent with sound data practices, data collected or developed by entities and organizations. These data would supplement the data we normally collect in determining the practice expense component of the physician fee schedule for payments in CY 2001 and CY 2002.
2. Current Methodology for Computing the Practice Expense Relative Value Unit System
Effective with services furnished on or after January 1, 1999, we established a new methodology for computing resource-based practice expense RVUs that used the two significant sources of actual practice expense data we have available—the Clinical Practice Expert Panel (CPEP) data and the American Medical Association's (AMA) Socioeconomic Monitoring System (SMS) data. The methodology was based on an assumption that current aggregate specialty practice costs are a reasonable way to establish initial estimates of relative resource costs for physicians' services across specialties. The methodology allocated these aggregate specialty practice costs to specific procedures and, thus, can be seen as a “top-down” approach. Discussion of the various elements of the methodology and their application follows.
a. Practice Expense Cost Pools
We used actual practice expense data by specialty, derived from the 1995 through 1998 SMS survey data, to create six cost pools—administrative labor, clinical labor, medical supplies, medical equipment, office supplies, and all other expenses. There were three steps in the creation of the cost pools. (Please note that the 1999 SMS data are being incorporated for CY 2002.)
- Step (1) We used the AMA's SMS survey of actual cost data to determine practice expenses per hour by cost category. The practice expenses per hour for each physician respondent's practice were calculated as the practice expenses for the practice divided by the total number of hours spent in patient care activities. The practice expenses per hour for the specialty were an average of the practice expenses per hour for the respondent physicians in that specialty. For the CY 2000 physician fee schedule, we also used data from a survey submitted by the Society of Thoracic Surgeons (STS) in calculating thoracic and cardiac surgeons' practice expenses per hour. (Please see the November 1999 final rule (64 FR 59391) for additional information concerning acceptance of these data.) For CY 2001, we used these STS data, as well as survey data submitted by the American Society of Vascular Surgery and the Society of Vascular Surgery. (Please see the November 2000 final rule (65 FR 65385) for additional information on the acceptance of these data.)
- Step (2) We determined the total number of physician hours (by specialty) spent treating Medicare patients. This was calculated from physician time data for each procedure code and from Medicare claims data.
- Step (3) We calculated the practice expense pools by specialty and by cost category by multiplying the specialty practice expenses per hour for each category by the total physician hours.
For services with work RVUs equal to zero (including the technical component (TC) of services with a TC and a professional component (PC)), we created a separate practice expense pool using the average clinical staff time from the Clinical Practice Expert Panel (CPEP) data (since these codes, by definition, do not have physician time) and the “all physicians” practice expense per hour.
b. Cost Allocation Methodology
For each specialty, we divided the six practice expense pools into two groups, based on whether direct or indirect costs were involved, and we used a different allocation basis for each group. The first group included clinical labor, medical supplies, and medical equipment. The second group included administrative labor, office expenses, and all other expenses.Start Printed Page 55250
(i) Direct Costs
For direct costs (including clinical labor, medical supplies, and medical equipment), we used the CPEP data as the allocation basis. The CPEP data for clinical labor, medical supplies, and medical equipment were used to allocate the costs for each of the respective cost pools.
For the separate practice expense pool for services with work RVUs equal to zero, we used adjusted 1998 practice expense RVUs as an interim measure to allocate the direct cost pools. (Please see the November 1998 final rule (63 FR 58891) for further information related to this adjustment.) Also, for all radiology services that are assigned work RVUs, we used the adjusted 1998 practice expense RVUs for radiology services as an interim measure to allocate the direct practice expense cost pool for radiology. For all other specialties that perform radiology services, we used the CPEP data for radiology services in the allocation of that specialty's direct practice expense cost pools.
(ii) Indirect Costs
To allocate the cost pools for indirect costs, including administrative labor, office expenses, and all other expenses, we used the total direct costs, as described above, in combination with the physician fee schedule work RVUs. We converted the work RVUs to dollars using the Medicare CF (expressed in 1995 dollars for consistency with the SMS survey years).
The SMS pool was divided by the CPEP pool for each specialty to produce a scaling factor that was applied to the CPEP direct cost inputs. This was intended to match costs counted as practice expenses in the SMS survey with items counted as practice expenses in the CPEP process. When the specialty-specific scaling factor exceeded the average scaling factor by more than 3 standard deviations, we used the average scaling factor. (Please see the November 1999 final rule (64 FR 59390) for further discussion of this issue.)
For procedures performed by more than one specialty, the final procedure code allocation was a weighted average of allocations for the specialties that perform the procedure, with the weights being the frequency with which each specialty performs the procedure on Medicare patients.
c. Other Methodological Issues
(i) Global Practice Expense Relative Value Units
For services with the PC and TC paid under the physician fee schedule, the global practice expense RVUs were set equal to the sum of the PC and TC.
(ii) Practice Expenses per Hour Adjustments and Specialty Crosswalks
Since many specialties identified in our claims data did not correspond exactly to the specialties included in the practice expense tables from the SMS survey data, it was necessary to crosswalk these specialties to the most appropriate SMS specialty category. We also made the following adjustments to the practice expense per hour data. (For the rationale for these adjustments to the practice expense per hour, see the November 1998 final rule (63 FR 58841)).
- We set the medical materials and supplies practice expenses per hour for the specialty of “oncology” equal to the “all physician” medical materials and supplies practice expenses per hour.
- We based the administrative payroll, office, and other practice expenses per hour for the specialties of “physical therapy” and “occupational therapy” on data used to develop the salary equivalency guidelines for these specialties. We set the remaining practice expense per hour categories equal to the “all physician” practice expenses per hour from the SMS survey data. (Note that in the November 2000 final rule (65 FR 65403), we increased the space allotment for therapy services to 750 square feet.)
- Due to uncertainty concerning the appropriate crosswalk and time data for the nonphysician specialty “audiologist,” we derived the resource-based practice expense RVUs for codes performed by audiologists from the practice expenses per hour of the other specialties that perform these services.
- For the specialty of “emergency medicine,” we used the “all physician” practice expense per hour to create practice expense cost pools for the categories “clerical payroll” and “other expenses.”
- For the specialty of “podiatry,” we used the “all physician” practice expense per hour to create the practice expense pool.
- For the specialty of “pathology,” we removed the supervision and autopsy hours reimbursed through Part A of the Medicare program from the practice expense per hour calculation.
- For the specialty “maxillofacial prosthetics,” we used the “all physician” practice expense per hour to create practice expense cost pools and, as an interim measure, allocated these pools using the adjusted 1998 practice expense RVUs.
- We split the practice expenses per hour for the specialty “radiology” into “radiation oncology” and “radiology other than radiation oncology” and used this split practice expense per hour to create practice expense cost pools for these specialties.
(iii) Time Associated With the Work RVUs
The time data resulting from the refinement of the work RVUs have been, on average, 25 percent greater than the time data obtained by the Harvard study for the same services. We adjusted the Harvard study's time data to ensure consistency between these data sources.
For services with no assigned physician time, such as dialysis, physical therapy, psychology, and many radiology and other diagnostic services, we calculated estimated total physician time based on work RVUs, maximum clinical staff time for each service as shown in the CPEP data, or the judgment of our clinical staff.
We calculated the time for CPT codes (hereafter referred to as “codes”) 00100 through 01996 using the base and time units from the anesthesia fee schedule and the Medicare allowed claims data.
3. Refinement
a. Background
Section 4505(d)(1)(C) of the BBA directed us to develop a refinement process to be used during each of the 4 years of the transition period. We did not propose a specific long-term refinement process in the June 1998 proposed rule (63 FR 30835). Rather, we set out the parameters for an acceptable refinement process for practice expense RVUs and solicited comments on our proposal. We received a variety of comments about broad methodology issues, practice expense per-hour data, and detailed code-level data. We made adjustments to our proposal based on the comments we received. We also indicated that we would consider other comments for possible refinement and that the RVUs for all codes would be considered interim for 1999 and for future years during the transition period.
We outlined in the November 1998 final rule (63 FR 58832) the steps we were undertaking as part of the initial refinement process. These steps included the following:
- Establishment of a mechanism to receive independent advice for dealing with broad practice expense RVU technical and methodological issues.
- Evaluation of any additional recommendations from the General Accounting Office, the Medicare Payment Advisory Commission (MedPAC), and the Practicing Physicians Advisory Council (PPAC).Start Printed Page 55251
- Consultation with physician and other groups about these issues.
We also discussed a proposal submitted by the AMA's Specialty Society Relative Value Update Committee (RUC) for development of a new advisory committee, the Practice Expense Advisory Committee (PEAC), to review comments and recommendations on the code-specific CPEP data during the refinement period. In addition, we solicited comments and suggestions about our practice expense methodology from organizations that have a broad range of interests and expertise in practice expense and survey issues.
b. Current Status of Refinement Activities
In the 1999 and 2000 final rules and the 2001 proposed rule, we provided further information on refinement activities underway, including the AMA's formation of the PEAC and the support contract that we awarded to the Lewin Group to focus on methodologic issues. In addition, in these rules, we announced actions taken and decisions made in response to the hundreds of comments received on our resource-based physician practice expense initiative. Because the transition will be completed in CY 2002 and the practice expense RVUs will then be totally resource-based, it is appropriate to recap the specific achievements reached and decisions implemented during this refinement effort to date.
(i) Use of the Top-Down Approach
Most of the physician organizations commenting agreed that this methodology was preferred for computing resource-based practice expense RVUs and that it was in accordance with the requirements of the BBA. KPMG Peat Marwick, under contract to us, reviewed the top-down methodology in which aggregate specialty costs are applied to specific procedures and concluded that it followed reasonable cost accounting principles. A 1999 GAO report concludes, “HCFA's new approach represents a reasonable starting point for creating resource-based practice expense RVUs. It uses the best available data for this purpose and explicitly recognizes specialty differences in practice expense.” Based on these comments and assessments, we made the decision to continue to use the top-down methodology to calculate the resource-based practice expense RVUs.
(ii) Use of the SMS Survey
The supplemental non-SMS survey data submitted by several specialties in response to the 1998 proposed rule, with the exception of the survey data from the thoracic surgeons, were not compatible with the format or methodology of the SMS. We awarded a contract to the Lewin Group to recommend criteria for the acceptance of specialty-specific practice expense data so that we could supplement the SMS data as appropriate. These recommended criteria are contained in the final report, “An Evaluation of the Health Care Financing Administration's Resource-Based Practice Expense Methodology.” This report is available on our web page under the same title. (Access to our web site is discussed in the Supplementary Information section above.)
The report also contains recommendations for revisions to the SMS or other surveys to efficiently meet the needs of our practice expense methodology. We augmented these recommendations and forwarded our suggestions for revisions to any future surveys to the AMA. For example, we developed supplementary survey questions that would allow us to distinguish both costs and direct patient care hours for all midlevel practitioners. We also suggested revisions that would capture the necessary information on separately billable supplies and services so that we could eliminate these costs from the specialty-specific practice expense per-hour calculations.
To obtain supplementary specialty-specific practice expense data that could be used in computing practice expense RVUs beginning January 1, 2001, we published an interim final rule on May 3, 2000 (65 FR 25664) that set forth the criteria applicable to supplemental survey data submitted to us by August 1, 2000.
We also provided a 60-day period for submission of public comments on our criteria for survey data submitted between August 2, 2000 and August 1, 2001 for use in computing the practice expense RVUs for the CY 2002 physician fee schedule.
In the November 1, 2000 final rule (65 FR 65385), we responded to comments received on the interim final rule and made modifications to the criteria for supplemental survey data that will be considered in computing practice expense RVUs for the CY 2002 physician fee schedule. These data can then be used to supplement the SMS survey data currently used to estimate each specialty's aggregate practice costs or to replace the crosswalks used for specialties not represented in the SMS.
In our November 1999 final rule, we accepted supplementary data submitted by the thoracic surgeons and, in our November 2000 final rule, we accepted survey data from the vascular surgeons that replaced the previously crosswalked practice expense per hour data for that specialty. In the November 2000 final rule, we also stated that if we received additional specialty-specific survey data before August 1, 2001 that met the criteria outlined in that rule, we would use these supplementary data in calculating the CY 2002 practice expense RVUs.
We accepted our contractor's recommendation to incorporate the latest SMS data into our practice expense per hour calculations. For CY 2001, we incorporated the 1998 SMS data into a 4-year average, and we are incorporating the 1999 SMS data into a 5-year average to calculate the CY 2002 practice expense RVUs.
We also accepted the contractor's recommendation to standardize the survey practice expense data to a common year. We adjusted the data to reflect a 1995 cost year.
We received comments that urged us to use the median SMS specialty-specific data instead of the mean, as well as comments supporting our use of the mean values. We made a decision to continue to use the mean in calculating the specialty-specific practice expense per hour. We believe that, in a small sample, using the median could eliminate outlying data from the calculation that represent real costs and thus should be considered.
(iii) CPEP Data
The AMA has formed a multispecialty sub-committee of their Relative Value Update Committee (RUC), the Practice Expense Advisory Committee (PEAC), to review the CPEP clinical staff, equipment, and supply data for all physicians' services. This multispecialty committee, which includes representatives from all major specialty societies, will then make recommendations on suggested refinements to these data. We indicated in our November 1998 final rule (63 FR 58833) that we would work with the PEAC and RUC to refine the practice expense direct cost inputs. This refinement process was supported in comments we received from almost every major physician specialty society.
In our November 1999 physician fee schedule final rule, we implemented most clinical staff time, supply and equipment refinements recommended by the RUC. For the November 2000 final rule, the RUC forwarded to us significant additional refinement recommendations that reflected multispecialty agreement on the typical resources for many important services, including visit codes, which account for Start Printed Page 55252approximately 24 percent of Medicare spending for physicians' services. Again we accepted almost all of these RUC recommendations. In addition, at its October 2000, February 2001, and April 2001 meetings, the PEAC focused on refining high-volume services and on standardizing inputs across wide ranges of services. The RUC and PEAC forwarded to us recommendation on refinements for over 1,100 services. We anticipate that the pace of refinement of the CPEP inputs will continue to accelerate.
In addition to implementing most of the RUC-recommended refinements, we responded to comments on errors and anomalies in the CPEP data in both the November 1999 and November 2000 final rules. For example, we removed separately billable casting supplies and drugs from all services; we adjusted the prices of certain supplies that were clearly in error; we removed duplicated equipment from the direct inputs of the nuclear medicine codes; we added clearly essential equipment that was missing from the lithotripsy and photochemotherapy codes; we corrected anomalies in inputs within several families of codes; and we changed the crosswalks for the CPEP inputs of several codes not valued by the CPEP panels when a commenter suggested more appropriate crosswalks.
We simplified the refinement of equipment inputs by combining both the procedure-specific and overhead equipment into a single equipment category. We also deleted stand-by equipment and equipment used for multiple services at one time from the direct cost inputs because of the difficulty of allocating these costs at the code-specific level.
We are resolving issues related to averaging input costs for codes that were valued by more than one CPEP panel. While we have received comments agreeing and disagreeing with our use of mean costs, the issue is moot because we are substituting refined data for the data previously produced by multiple CPEPs.
(iv) Physician Time Data
In the November 1999 rule (64 FR 59404), we stated that, in general, requests for revisions for the procedure-specific physician times should be deferred to either the RUC process or the 5-year review process. However, we did adopt the newer data to correct the physician time for the pediatric surgery codes and made the requested revisions to correct anomalies in the times of certain psychotherapy codes.
In response to comments on the times associated with physical and occupational therapy services, we added preservice and postservice times to all of these codes.
(v) Crosswalk Issues
In response to concerns expressed by specialty societies representing emergency medicine that the SMS data did not capture the costs of uncompensated care, we crosswalked emergency medicine's cost pools for administrative labor and other expenses to the practice expense per hour for “all physicians.”
We resolved issues related to the specialty crosswalk for nursing specialties by eliminating the separate practice expense pools for midlevel practitioners.
(vi) Calculation of Practice Expense Pools—Other Issues
We addressed concerns that potential errors in our specialty utilization data will have an effect on the calculation of practice expense RVUs. In the July 2000 proposed rule (65 FR 44178), we discussed our simulations that demonstrated that the small percentage of potential errors in our very large database have no adverse effect on specialty-specific practice expense RVUs.
We have created the zero-work pool for services with no physician work to ensure that these services are not inappropriately disadvantaged by our methodology. We have also agreed with the request of all the specialty societies that commented that their services should be moved out of the zero-work pool and into the specialty-specific pool. The specialties whose services remain in the zero-work pool have indicated that they wish their services to remain there. We plan to eliminate this separate pool for services with no physician work only when we have determined what revisions to our methodology are required so that we can value these services appropriately outside of the zero-work pool.
(vii) Calculation of Indirect Cost
We requested that our contractor evaluate various options for calculating indirect costs. The final report, referenced above, contains an analysis of the impacts of six alternative allocation methodologies. In confirming the suitability of our allocation methodology, the report concludes that “HCFA's approach is broadly consistent with most of the alternative methods. This consistency suggests that, from a broad perspective, no other allocation methodology offers a compelling reason to abandon the current HCFA approach.”
(viii) Site-of-Service
The practice expense RVUs would be expected to be higher in the nonfacility setting, where the practitioner bears the costs of the necessary staff, supplies, and equipment, than in the facility setting. To prevent potential anomalies in our calculations due to the different mix of specialties performing a given service in different settings, we capped the practice expense RVUs for a physician service in facilities at the nonfacility practice expense level for each specific service.
In the November 1999 final rule (64 FR 59407), in response to a comment from the Renal Physicians Association, we agreed that the monthly capitated service codes should always be reported using the nonfacility designation. The site-of-service designations are not meaningful for a monthly service that may be provided in different settings for the same patient during a given month.
Although we are continuing our refinement of all practice expense RVUs, we believe that the above description of our actions to date illustrates that much has been accomplished. We also believe that it demonstrates that we have been responsive to comments from the medical community and have established a process that enables this community to participate fully in the refinement of both the specialty-specific practice expense per hour and the CPEP code-specific inputs.
4. Practice Expense Provisions for Calendar Year 2002
a. SMS Data
(i) Use of 1999 SMS Survey Data
We are currently using data from the 1995 through the 1998 SMS surveys (1994 through 1997 practice expense data) in order to calculate the specialty-specific practice expense per hour. The 1999 SMS survey data are now available. Because we want to incorporate the most recent survey data into our methodology during the transition period, we proposed in our August 2001 rule (66 FR 40377) to add this 1999 data to the 4 years of data we are currently using.
We proposed to use these 5 years of data in addition to any supplemental specialty-specific data that meet our criteria as the basis of the practice expense per hour calculations until the first 5-year review of practice expense RVUs in 2007. At that time, we anticipate that newer practice expense survey data might be available.
Comment: Specialty societies representing internal medicine, family Start Printed Page 55253practice and a number of their subspecialties were opposed to using the 1999 SMS data in the calculation of the practice expense RVUs. While many of these commenters were generally supportive of incorporating the most current SMS data, they are concerned that the sample size and results from the 1999 SMS data may not warrant their inclusion. Several of these commenters indicated that the American Medical Association is on record stating that “it normally would not provide or publish data with so few responses for some specialties.”
A number of these commenters suggested that the practice expense information from the 1999 SMS would be less reliable because the data were collected after CMS announced the new resource-based practice expense methodology in the Federal Register. These commenters suggested that the opportunity for “gaming” now exists because the public was aware that the SMS data were used to calculate Medicare payments.
One commenter noted that the practice expense per hour for cardiology dropped by 15 percent in one year and doubted that the actual change in practice expense of this magnitude could have occurred. Another commenter indicated that the cardiac subspecialty of electrophysiology is very likely not represented at all in this flawed data set.
One association that represents eye surgeons commented that the 1999 SMS survey included about half as many usable responses as the 1995 through 1997 surveys. This commenter questioned our decision to disregard responses received by mail and indicated that an already poor response rate to the survey has become even lower. Another commenter that represents ophthalmology indicated that use of 1999 data with such low response rates violates good statistical practice. The 1999 responses included only 23 ophthalmologists, while over 200 offered responses to the survey in years before 1999. Another commenter that represents gastroenterology indicated that the SMS is perhaps the best available source of data on multispecialty practice costs. However, this comment indicated that it is by no means a perfect data source for the manner in which it has been used by CMS and is even less reliable for certain specialties, such as gastroenterology. This commenter appreciates our willingness to accept supplementary data from specialties, but believes that it is our responsibility to overcome data deficiencies. We were encouraged to develop a uniform and fair process to overcome data deficiencies, without relying on individual medical specialties to provide such data.
In light of AMA's suspension of the SMS survey, this commenter urged us to discuss in the final rule our plans for updating practice expense RVUs in future years beginning with 2003, and, if need be, for replacing the SMS survey with an alternative data source. Another commenter expressed concern that the newer data from the SMS surveys will not be incorporated until the first 5-year review of practice expense RVUs in 2007; by that time, some of the practice expense data will have been in existence for 13 years.
Similarly, another commenter expressed concern that using the SMS data set from 1995 through 1999 until 2007 will mean that the data will not accurately reflect the changes in technology that will increase costs, particularly for specialties with rapid changes in technology.
Response: In response to the comment that the SMS data are not a perfect data source for developing practice expense RVUs, as we have said previously, we believe the SMS survey is the best available source of data on multispecialty practice costs. This comment was echoed by one of the same commenters that objected to including the 1999 SMS data in the practice expense methodology for determining 2002 RVUs. While we have previously acknowledged that the data have potential limitations for determining practice expense RVUs, there are no alternative data sources that are better for this purpose.
Since there are no other data on aggregate multispecialty practice costs that are better than the SMS, our only alternative would be to eliminate the SMS data from the methodology and rely solely on estimates of practice expense inputs for individual codes. We believe a better approach would be to continue using the SMS data in the practice expense methodology and to work with the physician community to develop even better data for establishing practice expense RVUs in the future.
One commenter noted that we only included telephone survey responses and not mail responses from the 1999 SMS and suggested that this decision further reduces an already low response rate. Our understanding is that the AMA, as a result of concerns about a declining number of responses to the SMS survey, used several approaches to obtain more surveys in the 1999 SMS. As part of this effort, some survey respondents received a mail survey instead of the normal telephone survey. Our review of information from the AMA suggested that there were significant differences between the mail and telephone surveys on questions related to practice expense. Since our objective has been to use a consistent approach to obtaining practice expense data for use in our methodology, we felt that it would be better to incorporate only the traditional telephone survey responses in the methodology consistent with how the data were obtained in earlier years.
While a few commenters indicated that the SMS data are not representative of a particular specialty's costs, they provided no information to support the contention. One commenter suggested that electrophysiology, a subspecialty of cardiology, was unlikely to be included in the SMS survey. Since the SMS survey draws a random sample from the AMA's Physician Masterfile, we believe all physicians are equally likely to be selected for participation in the survey. We would further note that the SMS weights response information based on known characteristics of the population to make the final figures as representative of the self-employed population as possible. As we have stated previously, we believe the SMS survey is the best source of data for specialty practice expenses. If a specialty believes that the SMS is unrepresentative of their actual practice expenses, we have established a process by which additional data can be submitted to us. To date, we have used two specialty practice expense surveys in addition to or in place of the SMS survey. We encourage specialties to use this process to provide us with additional practice expense data that improve the representativeness of the data that we are using to determine the practice expense RVUs.
One commenter doubted that cardiology practice expense could have declined as much as suggested by the 1999 SMS data. We would note that the practice expense per hour in any given year can show more variability than the change in practice expense per hour over time. While the specialty of cardiology shows some level of variability in practice expense per hour, with some years showing a higher value than the average and other years a lower value, the change in practice expense per hour including the 1999 SMS data is far more modest than that suggested by the commenter. There is a −2.0 percent change in practice expense per hour as a result of including the 1999 SMS data. As indicated below, use of the 1999 SMS data changed average specialty level payments to cardiologists by less than 0.5 percent.Start Printed Page 55254
We acknowledge that response rates and the number of usable responses from the 1999 SMS are lower than in prior years. Nevertheless, as we have stated previously, it is unclear to us why this alone indicates that we should reject incorporating the data. To the extent that there are few responses to the latest SMS survey, there will be less impact on a given specialty because the practice expense per hour calculation is weighted by the number of respondents from each respective year. Further, we believe inclusion of more survey data will improve the data's representativeness and lead to more stability in the practice expense per hour. The use of the 1999 SMS data appears to have little effect on the practice expense RVUs. In our August 2, 2001 proposed rule (66 FR 40397), we simulated the impact of including the 1999 SMS data on average specialty level payments. The increase or decrease in average specialty level payment was less than 0.5 percent for 29 of the 35 specialties listed, including nearly all of the specialties that expressed concern about including the latest SMS data. For 4 of the remaining 6 specialties, the increase or decrease in payments was between 0.5 and 1.0 percent. Payments for the remaining two specialties (pathology and suppliers) increased by more than 2 percent.
We are doubtful that respondents “gamed” responses in the 1999 SMS because of an awareness that reporting higher practice expenses would lead to increased payments from Medicare. We observed no noticeable increase in practice expense per hour from the 1999 SMS survey than from earlier years. In fact, the inflation-adjusted all-physician practice expense per hour from the 1999 SMS data is lower than the same figure from the 1998 SMS data. Further, if the concern is that physicians were aware of how the data would be used and would “game” responses to obtain higher payments from Medicare, our expectation would be that the number of responses in the 1999 SMS would be higher, not lower, than in prior years. For these reasons, we are doubtful that there is any reason to assume that the 1999 SMS survey would show more bias than surveys from previous years.
We welcome the comments that suggest that we develop a long-term strategy for using aggregate specialty practice expense data to make refinements to RVUs. As noted by some commenters, the AMA is no longer conducting the SMS survey in its current form. We would like to engage physician specialty societies, as well as other practitioner groups and representatives of organizations affected by Medicare physician fee schedule payments, in discussions of how to best obtain practice expense data that will be useful in updating our methodology for determining practice expense RVUs. Although it has been beneficial to use 5 years of SMS data to develop practice expense RVUs, we believe that it may not be necessary to make annual updates to aggregate specialty practice cost data if relative practice expenses do not change significantly from year to year. However, it may be beneficial to periodically review aggregate practice expenses and make changes when necessary. For instance, one commenter suggested that technological innovation may change relative expenses among services. For this reason, we believe a review of aggregate practice costs at least every 5 years is necessary. In fact, the statute requires that we review RVUs at least every 5 years. At this time, we have incorporated all of the data from the SMS surveys into the practice expense methodology. We will consider public input on the best way to obtain practice expense data for use in future practice expense calculations.
(ii) Supplemental Practice Expense Survey Data
To ensure the maximum opportunity for specialties to submit supplementary practice expense data, we proposed to accept survey data that meet the criteria set forth in the November 2000 final rule for an additional 2 years. The deadlines for submission of such supplemental data to be considered in CY 2003 and CY 2004 are August 1, 2002 and August 1, 2003, respectively.
Comment: Several commenters expressed their strong support for our decision to accept specialty-specific practice expense surveys for an additional 2 years. Specialty societies representing podiatry, pediatrics, internal medicine, rheumatology and surgery, as well as the American Medical Association (AMA) stated their agreement with this decision.
An organization representing medical colleges commented that this will send an important message to the physician community about our willingness to consider all legitimate data sources in analyses of this critical portion of payments, and one that has been a subject of controversy within the community. A specialty society representing dermatology stated that the additional time will allow specialties to collect specialty-specific data that should be useful as we determine practice expense RVUs.
The AMA and a commenter representing podiatry expressed some concern about the criteria for the acceptance of survey data and the AMA also expressed hope that we would be flexible concerning any data submitted. The commenter representing emergency medicine argued that collecting specialty-specific data would be fruitless, due to a number of stringent criteria for submitting supplemental practice expense survey data.
On the other hand, three commenters indicated that we should accept only survey data that meet our criteria. The commenter representing rheumatology stated that it is critically important that any data accepted must meet the criteria in the November 2000 final rule.
Response: We received only comments supporting this proposal, and we will be extending the period of acceptance of supplemental survey data for another 2 years, as proposed. We hope to demonstrate flexibility in helping those specialties that conduct a survey to do so successfully, and we understand that for some specialties some revision to the survey format may be necessary. For example, questions regarding uncompensated care for emergency physicians or separately billable drugs for oncologists might need to be added to a survey to determine the appropriate practice expense for these specialties. However, like several of the commenters, we believe that fairness to all can only be achieved if we consistently apply the rules for determining validity to any survey that is submitted.
Comment: A specialty society representing geriatrics expressed concern regarding the use of SMS data in formulating practice expense costs because the sample size for geriatricians is not large enough to yield reliable data. The commenter stated that smaller specialty societies will be unable to provide supplementary survey data because of expense limitations and recommended that we continue to review alternative data sources that recognize the greater resources spent in caring for frail elderly persons. The society further recommended that we consider the use of “non-compliant” survey data for smaller specialty groups that do not meet our stringent and costly criteria.
Response: We could not justify accepting “non-compliant” surveys from some specialties, due solely to the specialty's size, while holding others to a more rigorous standard. However, though we would welcome survey data from any specialty that submits a survey that meets our criteria, we do recognize that performing a survey can be costly. We, therefore, suggest that the specialty society consider in advance the extent to which any possible survey result Start Printed Page 55255might actually alter the practice expense RVUs for their services. Note that we have only one payment amount for each service on the fee schedule. We have no authority to pay more to one specialty than to another for performing the same service. If a small specialty provides only a small percentage of a given service, a change in the practice expense per hour for that small specialty could have very little effect on the payment for the service. For example, if geriatricians perform mainly evaluation and management (E/M) services, even a survey that shows increased practice costs for geriatricians would not necessarily have any effect on the practice expense RVUs for E/M services because geriatricians' services would represent only a small part of the universe of E/M services. However, it is incumbent upon each specialty society to weigh both the costs and benefits to their specialty to determine whether conducting a practice expense survey would be worthwhile.
(iii) Submission of Supplemental Surveys
Three organizations submitted supplemental survey data for consideration for CY 2002. Survey data were submitted by the American Physical Therapy Association (APTA), the American Optometric Association (AOA), and the American Academy of Pediatrics (AAP). Our contractor, The Lewin Group, has evaluated the data submitted by each organization. They have recommended that we use the data submitted by APTA and AOA and reject the data submitted by AAP. The full recommendation and discussion will be made available on the CMS web site. (See the Supplementary Information section of this rule for directions on accessing our web site.)
We have decided not to use the data submitted by APTA, AOA, or AAP because none of the surveys met all of our stated criteria. In our May 3, 2000 interim final rule (65 FR 25666), we indicated that, based on our review of existing physician practice expense surveys, we believe that an achievable level of precision is a coefficient of variation (that is, the ratio of the standard error of the mean to the mean expressed as a percent) not greater than 10 percent for overall practice expenses or practice expenses per hour. For existing surveys, the standard deviation is frequently the same magnitude as the mean. We indicated in the May 2000 interim final rule that we would consider practice expenses for which the precision of practice expenses is equal to or better than this level of precision and that meet the other survey criteria. None of the surveys submitted for 2002 met the level of precision criteria; therefore, we have decided not to use the survey data.
b. CPEP Data
(i) 2000 RUC Recommendations on CPEP Inputs
In the November 2000 final rule (65 FR 65393), we responded to the RUC recommendations for the refinement of the direct inputs for 49 CPT codes and for the supply and equipment inputs for four additional services. These recommendations reflected multispecialty agreement on the typical resources for many important services, including visit codes, which account for approximately 24 percent of Medicare spending for physicians' services. We accepted almost all of these recommendations. We received the following comments on our responses to the RUC recommendations and on the PEAC/RUC refinement process:
Comment: Several specialty societies representing osteopaths, rheumatologists, neurologists, ophthalmologists, obstetricians, and gynecologists commended us for implementing the refinements submitted by the PEAC and RUC as part of the on-going refinement process. One specialty society stated that it was encouraged by the direction pursued with the physician fee schedule for 2001, because it demonstrated the ability to achieve refinement within the parameters of the fee schedule comment process. Another commenter expressed appreciation for our support of the PEAC and RUC refinement process because this relationship is critical to establishing fair and balanced payment policies.
In addition, other commenters praised our staff for being helpful in responding to the PEAC members' questions during meetings, as well as for the willingness to work with physician specialty societies toward establishing fair and appropriate reimbursement values. The RUC commented that it agreed that the PEAC has made significant progress in its ability to review and refine direct practice expense inputs for individual CPT codes.
Response: We appreciate the above comments and are also encouraged by the progress that the PEAC and RUC have made in refining the practice expense inputs.
Comment: The RUC agreed that the PEAC should continue to meet and refine the direct practice expense data. Therefore, it hopes that we will state that the practice expense RVUs will continue to be interim and subject to refinement as the PEAC continues its review. A specialty society representing ophthalmology echoed this request stating that, because the PEAC is continuing the refinement process, the interim status of the practice expense RVUs should be reaffirmed in the rule. The commenter requested that the RVUs remain interim and subject to change until 2007, that is, until the first update of the five-year review of practice expense RVUs.
Response: We are pleased that the RUC and PEAC are willing to continue the task of helping us to refine the practice expense inputs for the approximately 7,000 services in the physician fee schedule. We intend to keep the practice expense RVUs as interim as long as this refinement process is necessary. Also, as noted above, we will accept, for another 2 years, supplemental survey data that meet our criteria. During this period, we will also continue to make improvements to our practice expense methodology.
Comment: A commenter representing three ophthalmology sub-specialties, though appreciative of our implementation of the PEAC recommendations, expressed disappointment that we have not made the non-controversial revisions to correct additional errors in the CPEP database. The commenter encouraged us to explore alternative ways to improve the quality of the CPEP data without waiting for the PEAC to consider each of the thousands of alleged errors.
Response: We have made changes to the CPEP data in those instances when there was a clear anomaly in the data and when the more appropriate revision would be obvious, without the benefit of a multispecialty recommendation. However, we have found that the input and recommendations of a multispecialty group, such as the PEAC, have played a crucial role for the vast majority of suggested revisions when clinical judgment is involved.
Comment: An organization representing diagnostic imaging centers stated that it would be inappropriate for the PEAC to constitute the review body for direct cost data for technical component services, because the PEAC does not include any representatives of diagnostic imaging centers. The commenter requested that, if any of the CPEP direct cost data form the basis for future payment for technical component services, the accuracy of these data should be reviewed by representatives of centers that actually provide the services involved.
Response: We do not agree that it is inappropriate for the PEAC to review Start Printed Page 55256the direct cost inputs for imaging services. The presentations for each service discussed at the PEAC are based either on surveys or panels of individuals who are familiar with the procedure in question. In addition, any of the recommendations of the PEAC that we accept are subject to review and comment by any interested party.
Comment: Societies representing surgeons, urologists, ophthalmologists, pediatrics, internists, and family physicians strongly support our acceptance of the revisions of CPEP inputs for office-based E/M services. One specialty society commented that the refined inputs for these services reflect the work of a multidisciplinary workgroup and demonstrate a major positive step toward streamlining practice expense inputs. One surgical specialty society did not fully agree that it is appropriate to use these E/M inputs to refine postsurgical visits because the direct costs associated with these visits are not necessarily comparable to the typical E/M visit. On the other hand, a primary care specialty society commented that the “rolling” implementation of CPEP refinement creates an anomaly because the surgical global services have not yet had these lower PEAC estimates for the E/M visits applied.
Response: We also saw the refinement of the practice expense inputs for the E/M codes as a significant milestone in the whole refinement process. These codes not only represent a sizeable portion of Medicare payments, but they also are used by most medical specialties, and, thus, most members of the PEAC had a stake in the outcome of this issue. We believe that, as a result of the extensive multispecialty discussion held by the PEAC on this issue, the recommendations on the E/M codes represent the best available estimates of the direct inputs needed for performing these services. With respect to the issue of applying these E/M inputs to the surgical global services, we will not be taking separate action now, but will be responding to the specific PEAC recommendations. We understand that it is expected that all the 90-day global surgical services will be refined by the PEAC by next year.
Comment: A specialty society representing internal medicine commented that the registered nurse (RN) and licensed practical nurse (LPN) staff mix should be used for the E/M codes rather than the RN, LPN, and medical assistant staff mix, which is less typical. The commenter also stated that we should increase the postservice clinical staff work for these services by 20 percent.
Response: We do not agree with changing the staff mix at this time, particularly because the PEAC recommendations have used this staff mix across the majority of refined services. We also have seen no evidence to suggest that the post-times for these services were undervalued.
(ii) 2001 RUC Recommendations on CPEP Inputs
We have received recommendations from the PEAC on the refinement to the CPEP inputs for over 1,100 codes. These include refinements of large numbers of orthopedic, dermatology, pathology, physical medicine, and ophthalmology services. In addition, the PEAC confirmed that there were no inputs for over 150 ZZZ-global procedures that are performed only in the facility and no supply or equipment inputs for almost 700 facility-only services with an XXX or 0-day global period. We believe this large increase in the number of CPT codes that have been refined demonstrates that the PEAC refinement process is working due to the valiant efforts of the AMA staff and the specialty societies participating in this mammoth undertaking. There is also reason to believe that the pace of refinement will continue to increase because of the steps that the PEAC is taking to create standardized packages of clinical staff time, supplies, or equipment that can be applied over a wide range of services.
We have reviewed the submitted PEAC recommendations and have accepted most of them with only minor revisions. The complete PEAC recommendations and the revised CPEP database can be found on our web site. (See the Supplementary Information section of this rule for directions on accessing our web site.)The following is a list of the only revisions we made to the PEAC recommendations:
- We substituted the multispecialty minimum visit supply package or the ophthalmology supply package for the list of individual supplies, when appropriate.
- We deleted separately billable supplies, for example, drugs, fluids, and casting supplies, when listed in the recommended supply list.
- We rounded fractions of minutes of clinical staff time to the nearest minute.
- For CPT code 52281, cystoscopy and treatment, we deleted the bougie a boule from the equipment list. The specialty society supplied us with the price of $105 for this item, which does not meet the minimum cost of $500 for an item to be included in the equipment list.
- For several ophthalmology services that did not involve dilation of the pupil, we consulted with the specialty society and deleted the ophthalmology visit supply package that was listed for the post-procedure visit. This package is intended for those services where dilation is necessary. The society confirmed that no supplies are needed for the post-procedure visit for these services.
- The recommendation did not specify the number of EEG electrodes for CPT code 92585, auditory evoked potential, comprehensive. We added seven electrodes, which is the same number assigned to the visual evoked potential code.
- The PEAC/RUC recommendations included time for the clinical staff type, “Physical Therapy Assistant (PTA),” which currently is not included in our CPEP input database. We are pricing the PTAs by using the Bureau of Labor Statistics wage estimates for physical therapy assistants. The base annual salary we are using will be $33,690. After factoring in benefits and adjusting this to 2001 dollars, the per minute rate will be $0.386.
- We have two concerns about the PEAC recommendations for therapy services. First, we believe that some of the duties ascribed to the physical therapy assistant are actually therapist services that are already captured in the work RVUs. Therefore, we are deleting from all the therapy codes the clinical staff time for obtaining vital signs and measurements, patient education, and phone calls. Because we believe that the resulting clinical staff times may be too low for the physical therapy and occupational therapy evaluation and reevaluation services, we are adding 7 additional minutes for the therapy aide in each of these codes. In addition, some of the occupational therapy codes contain several pieces of very expensive equipment called environmental modules. Because it is unclear how many of these modules would typically be used for each service, we are only including one module for each code that might use this equipment. We note that for three services, CPT codes 97530, 97535, and 97537, the PEAC did not submit a recommendation for equipment, presumably because of the difficulty of determining what would be typically used. In those cases, as in those with a PEAC recommendation, we are allowing for one module and some smaller equipment that was suggested by the specialty. We would hope to work with the specialty societies to obtain more precise information on the appropriate equipment for all of these therapy services.Start Printed Page 55257
- We note that one of the services for which we received recommendations, the casting/strapping procedure CPT code 29799, is carrier-priced. In addition, we received recommendations for two fine needle aspiration services, CPT codes 88170 and 88171, which are now deleted.
(iii) Other Comments on Refinement of CPEP Inputs
Comment: Several commenters were pleased that we finalized certain proposals regarding CPEP inputs, such as the following:
- The reinstatement of the pre-procedure clinical staff time in the facility setting for certain 0-day global services as well as pre-service time for the vitrectomy codes.
- Our decision to uphold the proposed refinements regarding inpatient dialysis CPT codes 90935 and 90945.
- The clarification of Medicare payment policy for cast supplies when used for non-fracture/dislocation procedures.
- The decision to retain Unna boot in the supplies for CPT code 29580.
- The correction of the supply list for CPT code 88104 and the establishment of a separate nonfacility practice expense RVU for CPT code 85607 in the 2001 fee schedule.
- The extension of the code-specific refinement beyond 2002.
Response: We appreciate the above comments and will strive to continue refining the practice expense RVUs in a manner that is fair and beneficial to the medical community.
Comment: An allergy clinic commented that because of our definition of a dose for CPT code 95165, Allergy Immunotherapy, doctors will be forced to use a dosage that could be harmful to certain patients.
Response: The definition of a dose will be used only for pricing the practice expense inputs for this service. Physicians should use their clinical judgment in determining what dose to use for any particular patient.
Comment: A commenter noted that the two codes for anal balloon sphincterplasty (CPT codes 49505 and 49510) did not have the balloon listed in the supply inputs.
Response: We agree that this was an omission and have added the balloon to the supply list for both services.
Comment: A commenter stated that there are no practice expense inputs assigned to CPT code 36533, insertion of implantable venous access port, with or without subcutaneous reservoir, in the nonfacility setting, because the CPEP panels priced it only in the facility. In particular, the supply inputs do not contain the cost of the catheter that is an integral part of the procedure.
Response: It is true that the original CPEP panel did not price this in the nonfacility setting; however, we subsequently crosswalked the inputs from the facility to the nonfacility setting for supplies, equipment, and clinical staff, adding clinical staff time for the intraservice period in the office. However, we agree that the catheter is an appropriate supply and have added it to the supply list for this code.
Comment: A specialty society representing podiatrists questioned why the practice expense RVUs for the nail trimming codes G0127 and CPT code 11719 are not the same. The commenter stated that they should have the same CPEP inputs since both were refined by the PEAC this year with identical inputs.
Response: The CPEP inputs are now identical for both codes, except that the supplies recommendation for CPT code 11719 does not include a surgical mask. However, none of this year's PEAC recommendations were reflected in the August 2001 proposed rule. In addition, even codes with identical CPEP inputs can have different practice expense RVUs if a different mix of specialties performs each service.
Comment: Two specialty societies representing cardiologists and electrophysiologists commented that we have allowed 60 minutes of clinical staff time to arrange for surgical procedures with a 90-day global period, but we have not yet allowed the same for 0-day global period procedures in facilities. The commenters stated that they may present specific codes to the PEAC with the recommendation that this time be recognized for these services, and they hope that we will be receptive to these recommendations.
Response: We will be glad to review any PEAC recommendations on clinical staff pre-service time for 0-day global period services in the facility setting if and when we receive them.
(iv) Repricing of Clinical Staff Wage Rates
In the August 2, 2001 proposed rule (66 FR 40378), we proposed modifications of wage rates for the clinical staff types contained in the CPEP database. Our contractor, Abt Associates, assigned the costs of the original CPEP inputs for staff, supplies, and equipment based primarily on 1994 and 1995 pricing data.
The original Abt Associates' estimates of clinical staff wage rates relied primarily on the Bureau of Labor Statistics (BLS) data. Abt's report on the CPEP cost estimation stated that, “* * * the BLS data were considered to be the preferred data set. The BLS” reputation for publishing valid estimates that are nationally representative led to the choice of the BLS data as the main source. If more than one data set provided an exact mapping for a receptionist, then the BLS wage was chosen over any other mapping.”
We agreed with this assessment and have used the most current BLS survey (1999) as the main source of wage data.
It should be noted that the BLS discontinued the Occupational Compensation Survey used by Abt in 1995 and now conducts the National Compensation Survey that has a breakdown of staff types different from the earlier survey. Also, this survey does not cover all the staff types contained in the CPEP data. Therefore, it was necessary for us to crosswalk or extrapolate the wages for several staff types using supplementary data sources for verification whenever possible.
We used three other data sources to price wages of staff types that were not referenced in the BLS data:
- The American Society of Clinical Pathologists' survey of laboratory staff salaries (found at www.ascp.org).
- The survey performed by the American Academy of Health Physics and the American Board of Health Physics (found at www.hps1.org).
- The national salary data from the Salary Expert, an Internet site that develops national and local salary ranges and averages for thousands of job titles using mainly government sources. (A detailed explanation of the methodology used to determine the specific job salaries can be found at www.salaryexpert.com).
We also solicited any valid survey data that commenters might be able to submit to us.
The proposed cost per minute for each staff type was derived by dividing the proposed annual salary (converted to 2001 dollars using the Medicare Economic Index) by 2080 to arrive at the hourly wage rate and then again by 60 to arrive at the per minute cost. To account for the employers' cost of providing fringe benefits, such as sick leave, we used the same benefits multiplier of 1.366 used by Abt Associates.
Comment: We received several supportive comments on our efforts to update the clinical staff salaries used in calculating the practice expense RVUs. Specialty societies representing family physicians and surgeons supported the proposal to reprice clinical staff salaries to approximate current practice Start Printed Page 55258expenses. A specialty society representing rheumatology stated that the repricing of clinical staff salary data represents an overdue positive step toward more accurate refinement of practice expense inputs. A specialty society representing dermatology agreed with the appropriateness of bundling similar clinical staff types into more easily identified and easily tracked clinical labor blended categories.
Response: We agree that using current wage data to price the clinical staff CPEP inputs is one step in ensuring that the practice expense RVUs are based on the resources needed to perform each service. We also would like to express our appreciation to the groups that included salary survey data on various staff types as part of their comments. These additional data have helped us to make appropriate revisions to our original proposals.
The following is a discussion of the specific proposals we made on the pricing of clinical staff types.
- We received no comments on the following proposals. Therefore, they will be implemented as proposed.
- We will price as proposed the staff types physical therapy aide, LPN, RN, certified surgical technician, laboratory technician, cytotechnologist, cardiovascular technician, nuclear medicine technician, optician, respiratory therapist, speech pathologist, audiologist, and counselor.
- We will collapse the medical assistant, technical aide, medical technician, EKG technician, anesthesia technician, technician, and cast technician staff types into a new staff type, “medical or technical assistant (MTA),” that will be priced at the medical assistant wage rate of $0.26 per minute.
+ We will bundle the staff type “RN-cardiology” into the staff type “RN.”
+ We will adjust the wage rate for the oncology-certified nurse to be 18 percent higher than the RN.
+ We will bundle the staff type “surgery assistant” into the staff type “certified surgical technician (CST).”
+ We will use the average hourly rate of $15.60 for histologic technologists from the 1998 American Society of Clinical Pathologists' survey to price the histotechnologist staff type.
+ We will use the BLS salary data for electroneurodiagnostic technologists contained in the BLS Occupational Outlook Handbook to price the electrodiagnostic technologist staff type.
+ We will price the wage rate for the EEG technician using survey data from the Salary Expert.
+ We will merge the nuclear cardiology technician in with the nuclear medicine technician staff type.
- We were unable to find any national salary data for the electron microscopy technician and, in the absence of such data, proposed crosswalking the salary from the wage rate for the histotechnologist. Though this represented an increase in the per minute cost for this staff type, we stated that we would welcome reliable national survey data from the specialty that we could use in pricing electron microscopy technicians.
Comment: The specialty society representing pathologists recommended that the wage rate for electron microscopy (EM) technician, which we proposed crosswalking from that of the histologic technologist, should more accurately be priced at the same wage rate as the cytotechnologist. The commenter stated that histologic technologists are generally bachelor degree level personnel, whereas EM technicians generally have post-baccalaureate education, parallel to that of a cytotechnologist. In addition, they receive salaries that are higher than general histotechnologists. The commenter also recommended that the title of the EM technician category be changed to EM technologist.
Response: We are persuaded that the commenter has proposed a more suitable crosswalk for this staff type. Therefore, we will crosswalk the wage rate for the EM technologist from that of the cytotechnologist. We will also change the title as suggested by the specialty society.
- We were unable to find any national salary data for registered electroencephalograph technologists (REEGTs) and proposed to maintain the current rate, since the speciality society had recently recommended this rate of pay. However, we also requested reliable national survey data from the specialty that we could use in pricing these three levels of neurodiagnostic staff.
Comment: The American Academy of Neurology (AAN), on behalf of seven related organizations, submitted an abbreviated version of the 2000 American Society of Electroneurodiagnostic Technologists (ASET) Salary Survey. The commenter stated that this national salary survey has been collected triennially by ASET, the main national body representing this allied health professional field, and was not collected for any purpose connected with the physician fee schedule. For office-based registered electroencephalograph technologists, there were 31 responses and a mean salary per hour of $20.11. For all REEGTs, there were 559 responses and a mean salary of $20.53 per hour. The commenters recommend that we substitute either of these salary rates to determine the costs for the REEGT staff type. The specialty society representing sleep medicine requested that we consider the updated salary data that AAN included in its comments on the proposed rule.
Response: We have reviewed this survey and believe that it provides a more appropriate estimate of the wage rate of REEGTs than did our crosswalk to a staff type used in a different specialty. We will use the data for the office-based REEGTS, which results in a wage rate of $0.47 per minute, which we note is not significantly different from our proposed rate for the REEGT staff type.
- We proposed to bundle the vascular technician with the cardiovascular technologist staff type. Currently both are priced at the same rate.
Comment: The American Association for Vascular Surgery, American Society of Neuroimaging, Society of Diagnostic Medical Sonography, Society for Vascular Surgery, and Society of Vascular Technology submitted a joint comment as “The Coalition.” The Coalition argued that the BLS was wrong to classify vascular technologists with cardiovascular technologists and technicians because the BLS description of duties for this classification does not include any of the duties performed by a vascular technologist. In addition, the commenters contended that, unlike most cardiovascular technicians, a vascular technologist functions as a direct and largely independent health care practitioner. A skilled vascular technologist undergoes between 2 and 4 years of didactic and clinical post-secondary education as evidenced by the presence of a baccalaureate degree program in vascular technology.
The Coalition recommended that we base the salaries for vascular technologists on data from a survey conducted earlier this year by nVision Research that surveyed by mail 406 randomly selected vascular technologists from a variety of settings. The response rate for this survey was 55 percent. Based on the survey, nVision Research determined that the median annual salary of a vascular technologist is $49,758. A copy of the survey was included with the comment. The commenters also recommended that we change the description of the “vascular technician” to “vascular technologist.” A specialty society representing echocardiography urged that we adopt the classification of “vascular Start Printed Page 55259technologist” as proposed by the above groups.
Response: We agree that the nomenclature of the staff type should be changed to “vascular technologist.” We have studied the data provided by the Coalition and have consulted with our medical advisors and now also agree that the salary shown in the submitted survey better represents the current wage rate for vascular technologists. Therefore, we will assign the vascular technologist staff type the recommended yearly salary of $49,758 which results in a per minute wage rate of $0.54.
- We proposed to merge the x-ray technician and radiation technologist staff types, which are currently priced at the same rate, into a staff type called “Radiologic Technologist.”
Comment: The American Society of Radiologic Technologists (ASRT) submitted with their comment the 2001 “Radiologic Technologist Wage and Salary Survey” commissioned by the organization. The comment disagreed with our proposal to merge the x-ray technician and radiation technologist staff types. The society stated that the radiation technologist has completed a formal educational program and has successfully passed a nationally recognized credentialing examination; an x-ray technician denotes a person who is most likely informally trained and who is often employed to perform only very limited x-ray examinations. On the other hand, a society representing therapeutic radiology and oncology recommended that we not crosswalk radiation technologists to “radiologic technologists and technicians,” but, instead, change the crosswalk and the name to “radiation therapist.”
Response: We can understand why the original nomenclature assigned by the CPEP panels to these staff types would be confusing to the commenters. However, it is clear from the imaging services to which the radiation technologist is assigned that this staff type was not considered to be a radiation therapist. In addition, we do not disagree with the distinction made by ASRT between an x-ray technician and a radiation technologist. However, the CPEP panel did not appear to make this same distinction. In fact, the x-ray technician is often assigned to more complex services than the radiation therapist and Abt Associates priced the two staff types at the same wage rate. Therefore, we have made the decision to consider both staff types to be at the same level and to change the title of both to “radiologic technologist.” If it is necessary to make a distinction between different levels of radiologic staff, this can be done as part of the refinement process.
Comment: A commenter representing imaging centers recommended that we substitute the “more accurate and recent salary information” obtained by the ASRT for the pricing of radiologic technologists. The commenter stated that these data indicate that the mean salary of full-time radiologic technologists is $53,919.
Response: We have reviewed the survey submitted to us by ASRT and have found it to be both comprehensive and useful. We would note that the $53,919 referenced in the comment is the mean salary for all radiologic personnel and includes the salaries of staff level personnel as well as chief technologists and of radiography staff as well as dosimetrists. Therefore, this is not salary information that can be used to price the specific radiology staff types in our database. However, as discussed below, we have used other ASRT data to price certain staff types for which we had no other pricing information. It is interesting to note that the mean salary in the ASRT survey for radiography staff is $36,862, while the 2001 salary rate for the equivalent staff based on the BLS is $37,126; the use of either figure would result in an almost identical per-minute wage rate. This information gives us extra confidence in our proposed wage rate of $0.41 per minute for radiologic technologists, and we will be implementing this salary rate as proposed.
- Because we were unable to find any national survey data regarding the salaries for CAT scan technician, MRI technician, or angiographic technician, we proposed crosswalking these staff types to the BLS radiologic technologist pay scale. We also stated that we would welcome any reliable national survey data that would allow us to separately price these staff types.
Comment: The American Society of Radiologic Technologists (ASRT) recommended that we use the 2001 ASRT survey submitted with its comment to price the MRI, CAT scan and angiographic technologists, rather than crosswalking their wage rate from the radiologic technologist. The ASRT data show an annual salary of $42,143 for a CAT scan technologist and $43,118 for an MRI technologist.
Response: We have reviewed the ASRT data for MRI and CAT scan technologists and will use that data for MRI and CT staff to price these staff types. There is a close congruence between the ASRT and the BLS salaries for those radiologic staff for whom we have data from both sources. Therefore, we have confidence that the wage rate we will use for the CAT scan and MRI technologists will be relatively correct. The wage rate for the CAT scan technologist will be $0.46 per minute and for the MRI technologist $0.47 per minute. We could not find data in the ASRT survey corresponding to the angiographic technician. Therefore, until some reliable national data are available, we will continue to crosswalk this wage rate from that of the radiologic technologist.
- We proposed merging the cardiac sonographer and the ultrasound technician into the sonographer staff type. Currently, all three are priced at the same rate.
Comment: The group of specialty societies commenting as the “Coalition” recommended that we maintain the description, “cardiac sonographer,” eliminate the description, “ultrasound technician,” and change the description “sonographer” to “diagnostic medical sonographer.” A specialty society representing echocardiography strongly urged that we adopt the above classifications proposed by the Coalition. This commenter also contended that crosswalking the salary for cardiac sonographers from that of diagnostic medical sonographers does not adequately reflect the salaries currently paid to cardiac sonographers. The society is currently seeking a reliable source of current survey information so that we can price cardiac sonographers separately.
Response: We have already proposed eliminating the description “ultrasound technician” and will accept the description of “diagnostic medical sonographer.” We proposed merging the cardiac sonographer into the sonographer classification because the two staff types were currently priced the same and we did not have any other salary data for the cardiac sonographers. However, we will accept the recommendation to keep the category “cardiac sonographer” and would be willing to reconsider the pricing if valid salary data are submitted.
- Because we were unable to find salary information for the staff type “dosimetrist,” we proposed crosswalking their salary from that of radiation therapists.
Comment: The American Society of Radiologic Technologists (ASRT) recommended that we review our proposed equal wages rates for radiation therapists and dosimetrists. The commenter reported that the annual salary of $57,330 for staff dosimetrists shown in the submitted 2001 ASRT survey is considerably higher than that for radiation therapists, which reflects their additional educational Start Printed Page 55260requirements. The specialty society representing radiology also opposed combining dosimetrists and radiation therapists in the same group because these two staff types provide very different services for radiation oncology procedures and are paid on different pay scales. This commenter agreed with the proposed increased wage rate for radiation therapists, but believed that the dosimetrists would be paid approximately 20 percent more than their proposed rate. Two other societies, one representing therapeutic radiology and oncology and one representing radiation oncology centers, also supported an increase for dosimetrists and one commenter suggested that we substitute the title “medical dosimetrist.” In addition, these two commenters recommended that we use the ASRT data for radiation therapists as well.
Response: We appreciate receiving the ASRT data for dosimetrists and agree that the annual salary suggested by the ASRT survey more accurately reflects the appropriate wage rate for this staff type. The wage rate will be $0.63 per minute. We will also change the title for this staff type to “medical dosimetrist.” We will continue to use the BLS data to determine the wage rate for radiation therapists since there has been no evidence presented to show that the BLS survey was in any way not representative.
- We proposed using the average salary data for all certified health physicists from the 1999 survey conducted by the American Academy of Health Physics and the American Board of Health Physics to price the “physicist” staff type.
Comment: Three specialty societies representing radiology, therapeutic radiology and oncology, and radiation oncology centers recommended that we use the Professional Information Survey data from The American Association of Physicists in Medicine (AAPM) rather than from the American Academy of Health Physics (AAHP). One commenter pointed out that the AAHP survey does not include physicists working in radiation oncology. The AAPM survey for CY 2000 had an overall response rate of 58 percent and demonstrated an average annual salary of $107,900. One commenter suggested that we also change the title to “medical physicist.”
Response: No copy of the AAPM survey was included with any of the comments, and we have been unable to review it at this time. However, we would not question the commenters' assertion that the AAPM survey was more relevant to physicists working in radiation oncology than the survey we used to determine our proposed wage rate. Therefore, we are using the AAPM survey salary of $107,900 on an interim basis to price the physicist wage rate and will endeavor to obtain and review this survey to finalize this issue. The wage rate for 2002 will be $1.21 per minute. For clarity, we will also accept the recommendation to change the title to “medical physicist.”
- We were unable to obtain representative national salary data for the certified ophthalmic technician (COT), the certified ophthalmic medical technologist (COMT), or the orthoptist staff types. We proposed to crosswalk the COT and COMT to the laboratory technician and histotechnician, respectively, since we believe that the skill and responsibility of these staff types would generally correspond. In the absence of any national salary data for the orthoptist, we proposed to crosswalk the salary from that of the COMT, the highest level of ophthalmic medical personnel. We also proposed crosswalking the salary data for the certified retinal angiographer from the data listed for ophthalmic photographers in the Salary Expert. We stated that we would welcome reliable and representative national salary data for these staff types.
Comment: The specialty society representing ophthalmologists commented that they would be pleased to offer additional assistance to validate the salaries for ophthalmic medical technicians and other ophthalmic clinical staff. At this time, the commenter agreed that the proposed crosswalks for these staff types are acceptable.
Response: We will be implementing these crosswalks as proposed.
- We proposed to crosswalk the wage rate for the staff type “dietitian” from the BLS salary data for dietitians and nutritionists.
Comment: The American Dietetic Association (ADA) commented that it believed that the BLS database includes salaries for non-credentialed dietitians and nutritionists and that we should reference ADA data from its membership surveys that estimates 2001 adjusted median annual income for dietitians to be $51,006.
Response: We would be willing to look at the ADA survey data if they were submitted to us. We would, of course, have to review and analyze these alternative survey data before we could substitute them for the BLS data that we have proposed to use. However, until we are convinced that the ADA data were equally or more representative of dietitians who serve as clinical staff for services on the fee schedule, we will continue to use the BLS data as our source of salary data for dietitians.
- We proposed to delete those clinical staff that can bill separately from the list of CPEP staff types. Therefore, we proposed substituting physical therapy aide for physical therapist, registered nurse for physician assistant, nurse practitioner and psychologist, and counselor for social worker.
Comment: Two specialty societies representing internal medicine and family practice expressed support for this proposal because these staff types, for example, nurse practitioners, are used as physician extenders and their salaries should not be considered as practice expense. A society representing geriatrics argued that we should not delete the clinical staff that can bill separately from the list of CPEP staff types because not all of these individuals bill separately, resulting in a negative impact on geriatrics.
Response: We will implement our proposal to delete clinical staff that can bill independently from our practice expense input database, with the two exceptions noted below. We believe that the costs of these staff types are not practice expenses and should be captured in the work RVUs. This revision to our clinical staff list should not have a negative impact on geriatrics because none of the deleted staff types were assigned to any of the E/M services that would make up a large percentage of geriatricians' case loads.
Comment: A society representing social workers commented that it was not opposed to the deletion from the practice expense inputs of staff types that can bill directly. However, the commenter pointed out that only clinical social workers are able to bill directly, while other social workers cannot. Therefore, the society is opposed to the deletion of the staff type, “social worker,” from the CPEP inputs and the substitution of the staff type, “counselor.” In addition, the society would at least want the BLS data for “social worker” to be used for pricing, though it believes that the BLS data does not differentiate enough between the various types of practice within social work.
Response: The commenter is correct in stating that not all social workers can bill directly. Therefore, we will keep the social worker staff type in our database and will use the BLS data for “social worker” to determine the appropriate wage rate. In addition, we will not delete the staff type, “psychologist,” which is listed as the clinical staff for the psychological testing services. Because these services have no Start Printed Page 55261physician work RVUs, the work of the psychologist can only be captured through the practice expense RVUs. We can find no appropriate national salary at this time for this staff type. Therefore, we will use the current wage rate of $0.82 per minute.
- We proposed to delete, as redundant, the ophthalmic medical personnel (OMP) staff type and to substitute the COMT/COT/RN/CST blend that was suggested by the American Academy of Ophthalmology and recommended by the PEAC.
Comment: The specialty society representing optometrists agrees with our proposal to delete, as redundant, the ophthalmic medical personnel (OMP) staff type and substitute the COMT/COT/RN/CST staff blend.
Response: We will implement this as proposed. Table 1 lists each staff type remaining in our practice expense input database, the source of the data, the staff type crosswalk used, the proposed annual salary in 2001 dollars, the 2002 wage rate per minute (including benefits) and the current cost per minute (including benefits).
Table 1.—Revised Wage Rates for CPEP Staff Types
Description Source Crosswalk Mean yrly 2001 Hrly + benefits Revised per minute Current per minute Physical Therapy Aide BLS Physical Therapist Aides 21,077 13.84 0.23 0.23 Physical Therapy Assistant BLS Physical Therapist Assistants 35,223 23.13 0.39 N/A Medical or Technical Assistant BLS Medical Assistants 23,681 15.55 0.26 0.16 LPN BLS Licensed Practical Nurses 30,341 19.93 0.33 0.27 RN BLS Registered Nurses 46,494 30.53 0.51 0.42 RN Oncology BLS Registered Nurses plus adjustment 54,862 36.03 0.60 0.50 Certified Surgical Technician BLS Surgical Technologists 28,814 18.92 0.32 0.26 Lab Technician BLS Medical and Clinical Laboratory Technicians 29,724 19.52 0.33 0.29 Histotechnologist ASCP Histologic Technologist 33,925 22.28 0.37 0.31 Electron Microscopy Technologist X-WALK Cytotechnologist 41,099 26.99 0.45 0.31 Cytotechnologist BLS Medical and Clinical Laboratory Technologists 41,099 26.99 0.45 0.42 EEG Technician Salary Expert Electroencephalographic Technician 29,151 19.14 0.32 0.28 Electrodiagnostic Technologist BLS Electroneurodiagnostic Technologists 33,529 22.02 0.37 0.30 Registered EEG Technologist ASET Registered EEG Technologist 42,707 28.05 0.47 0.40 Vascular Technologist nVision Survey Vascular Technologist 49,758 32.68 0.54 0.35 Cardiovascular Technician BLS Cardiovascular Technologists and Technicians 34,794 22.85 0.38 0.35 Radiologic Technologist BLS Radiologic Technologists and Technicians 37,126 24.38 0.41 0.32 Mammography Technologist ASRT Mammography Technologist 39,212 25.75 0.43 N/A Angiographic Technician BLS Radiologic Technologists and Technicians 37,126 24.38 0.41 0.35 CAT Scan Technologist ASRT Computed Tomography Technologist 42,143 27.68 0.46 0.32 MRI Technologist ASRT Magnetic Resonance Imaging Technologist 43,118 28.32 0.47 0.32 Nuclear Medicine Technician BLS Nuclear Medicine Technologists 44,361 29.13 0.49 0.39 Diagnostic Medical Sonographer BLS Diagnostic Medical Sonographers 45,751 30.05 0.50 0.39 Cardiac Sonographer BLS Diagnostic Medical Sonographers 45,751 30.05 0.50 0.39 Radiation Technical Therapist BLS Radiation Therapists 45,333 29.77 0.50 0.40 Medical Dosimetrist ASRT Medical Dosimetrist 57,330 37.65 0.63 0.50 Medical Physicist AAPM Medical Physicist 110,166 72.35 1.21 0.97 COT X-WALK Lab Technician 29,724 19.52 0.33 0.26 COMT X-WALK Histotechnician 33,925 22.28 0.37 0.28 Optician BLS Opticians, Dispensing 26,336 17.30 0.29 0.28 Certified Retinal Angiographer Salary Expert Ophthalmic Photographer 35,453 23.28 0.39 0.35 Orthoptist X-WALK COMT 33,925 22.28 0.37 0.32 Respiratory Therapist BLS Respiratory Therapists 38,537 25.31 0.42 0.42 Speech Pathologist BLS Speech-Language Pathologists 49,996 32.83 0.55 0.42 Audiologist BLS Audiologists 47,748 31.36 0.52 0.41 Registered Dietician BLS Dieticians and Nutritionists 39,050 25.65 0.43 0.37 Counselor BLS Mental Health Counselors 30,769 20.21 0.34 0.42 Social Worker BLS Medical and Public Health Social Workers 37,011 24.31 0.41 0.33 The CPEP clinical staff inputs also include blends of staff types that are used for those services when more than one type of clinical staff may be used in the performance of the service. We will establish the payment rates for these blends by calculating a simple average of the wage rates of the staff types included. Table 2 shows the blended staff types, the 2002 cost per minute and the current cost per minute.
Note:
We received no comments on the proposed cost per minute for the staff blends, so these rates will be implemented as proposed.
Table 2.—Revised Wage Rates for CPEP Blended Clinical Staff Types
Description Revised per minute Current per minute COMT/COT/RN/CST 0.38 0.307Start Printed Page 55262 Lab Tech/Histotech 0.35 0.297 Lab Tech/MTA 0.30 0.257 Optician/COMT 0.33 0.278 RN/LPN 0.42 0.389 RN/LPN/MTA 0.37 0.317 RN/OCN 0.56 0.497 RN/Respiratory Therapist 0.47 0.421 RN/Sonographer 0.51 0.405 Dosimetrist/Physicist 0.920 N/A (v) Revision of the Ophthalmology Visit Supply Package
In its May 2000 submission to us, the RUC recommended the use of an ophthalmology visit supply package that would contain the routine supplies typically used in each 90-day global postsurgical visit for ophthalmology services. We accepted this recommendation. However, upon further review, we noted that two of the supplies, rev eyes and post myd spectacles, were not used in many of the postsurgical office visits. Therefore, after consulting with the ophthalmology specialty society, we proposed to remove these two items from the ophthalmology visit package. Instead, we proposed including these items as appropriate on a code-by-code basis.
Note:
Since we received no comments on this issue, we will implement this revision on the supply package as proposed.
(vi) Deletion of Contrast Agents from the Practice Expense Inputs
Section 430(b) of BIPA amends section 1861(t)(1) of the Act to include contrast agents in the definition of drugs and biologicals. Previously, contrast agents were defined as supplies and were included in the list of CPEP supplies for the appropriate services. Therefore, we proposed to delete the costs of the following contrast agents from our CPEP data: hypaque, methylene blue, high-density barium, polibar, telopaque tablets, barium paste contrast, effervescent sparkies (fizzies), and renographin-60 iodinated contrast.
Comment: The specialty society representing radiology had no comment on the suggested list of deletions from the CPEP supplies. However, the society expressed concern that there are no HCPCS codes established for these deleted items and wanted information on how to bill for these supplies.
Response: As stated above, we proposed to delete contrast agents from the practice expense inputs in response to legislation that included contrast agents in the definition of drugs. This proposal was made to ensure that we did not include in the practice expense the costs of items that could also be billed separately. However, section 1842(o)(1) of the Act makes clear that the payment of 95 percent of the average wholesale price (AWP) can be made only if the drug is not paid on a cost or prospective payment basis. We believe that if we do include payment for any contrast agent in the practice expense RVUs, no other payment should be made for this item. After further consideration of this issue, however, we will continue to include the contrast agents listed in our proposal in our practice expense inputs at this time. Therefore, we are withdrawing the proposal.
c. Physician Time
RUC Time Database
The primary sources for the physician time data used in creating the specialty-specific practice expense pools are the surveys performed for the initial establishment of the work RVUs and the surveys submitted to the AMA RUC. The AMA informed us that some of the times used for the November 1998 final rule (63 FR 58823) differed from the official RUC database, and we agreed to use the RUC-verified physician time database when we received it from the AMA. Subsequently, the AMA notified us that there were gaps in its own database for certain global surgery codes and that a revised time database would be sent to us once all the times were verified. We have now received this revised database and proposed to use it in the calculation of the specialty-specific practice expense pools. It should be noted that the RUC database reflects the physician times for those codes that were surveyed as part of the second 5-year review of physician work.
Comment: We received a number of comments that supported using the physician time data. One commenter indicated that the new time database is expected to provide greater accuracy and consistency in the practice expense calculations. While commenters representing family physicians, internists, and rheumatologists supported use of the new time data, they also indicated that improvement is still needed. Specifically, these commenters suggested that the number and level of postoperative visits and the corresponding physician time included in the global surgical period may be overstated. The commenters noted that we previously indicated that we would study length of stay data relative to the number of postoperative visits and included in the surgical period, and they encouraged us to use this information to further refine the physician time data. One commenter indicated that surgeons rarely meet the criteria for billing critical care services in the postoperative period even though the time and value of critical care services are proposed for inclusion in the global period of some surgical codes.
Organizations representing thoracic surgeons indicated that we should not incorporate the new time data that will result in additional practice expense reductions for thoracic and cardiac surgery. These commenters said that no further reductions in the practice expense RVUs for cardiac surgery should be made until new studies of practice expense related issues by the Office of Inspector General and the General Accounting Office are completed. This commenter indicated that the new physician time data covers only 585 of the 7,928 codes in the physician fee schedule but directly affects cardiothoracic surgery because there are revised times for many high volume heart and chest procedures. The commenter suggested that the new time information needs to be put in the context of changes in physician time that may have occurred in the last five to ten years on the remaining 7,343 procedure codes where there are no new physician times. Another commenter representing a cardiology subspecialty indicated that we incorporated RUC time data for only 1,900 of the more than 7,000 procedure codes. This commenter suggested that we should continue using available time from a single source until a consistent source that includes information on all CPT codes is available.
Response: As indicated in the proposed rule, the RUC submitted physician time data for nearly 2,000 CPT codes in May 2001 and recommended that we use these new physician times in the practice expense methodology. The RUC recently sent new time for use in the final rule that reflected refinements for a few codes. We note that the source of the RUC times are actually the physician specialty societies themselves, including those associations that have objected to our use of the data. The data largely come from the specialty society surveys that were forwarded to the RUC to support requests for physician work RVUs for new and revised codes or services that were part of the 5-year review. The RUC made a comprehensive effort to validate these times before forwarding them to us. The RUC indicated to us that, over a period of 2 Start Printed Page 55263years, specialties had been provided with an opportunity to review the data and determine that they were accurately recorded.
While the new times forwarded by the RUC represent a minority of CPT procedure codes, we note that they account for over 60 percent of the allowed services that are paid under the physician fee schedule. In response to the comment that we should make changes only when we have a single source of time data for all codes, we note that there has never been a single source of time for all codes. While time for some codes is based on the original work of Harvard University, there are many codes that came into existence since the Harvard survey was completed. The only data source for these codes is the RUC.
We acknowledge that the Office of Inspector General is studying issues related to physicians bringing clinical staff to the hospital and the General Accounting Office is reviewing our use of supplemental practice expense survey data. Since these studies are unrelated to physician time, we do not believe they constitute a reason to suspend incorporation of the new time data into the practice expense methodology.
In response to the comments that suggest that the physician times in the postoperative period may be overstated, the RUC indicated to us that “a number of improvements were made to the specifications regarding the level of postoperative visits to more accurately capture each element of physician time.” While the total times we received from the RUC reflect the number, types, and level of E/M services furnished in the postoperative surgical period, these services are not separately paid when furnished as part of a global surgical service. Since these services are not paid separately, it is difficult to find objective information that indicates how E/M services are provided in the postoperative period. Currently, the only source of information we can use is information that the RUC has supplied and data that previously existed in our files. While we have undertaken research that combines information on inpatient hospital stays with claims for physicians' services, these data have limitations for determining the level or type of visit being furnished in the postoperative period. We would consider any further evaluation by the RUC on this issue.
d. Calculation of Practice Expense—Other Issues
Comment: Several commenters requested additional clarification and information concerning the cause of reductions of 9 to 13 percent in the practice expense RVUs for electrophysiology services. One commenter indicated that there was no explanation of the proposed reduction in practice expense for CPT codes 33207, 33208, 33249, and 93651. The commenter suggested that we should provide a more complete explanation of the proposed reductions or rescind them.
Response: Our observation is that there is no more than a 9 percent reduction in practice expense RVUs for any of these codes. We also note that the change in total payment for these codes as a result of the change in practice expense RVUs is less than half of this amount. We modeled five different changes to the practice expense methodology in our August 2, 2001 proposed rule (66 FR 40397). Of these changes, the change to physician time has the greatest effect on these codes. Since the change in the practice expense RVUs results from new information that affects payments for all procedure codes, we are continuing to implement the reduction in practice expense RVUs that were proposed for these codes.
Comment: We received one comment expressing concern that the separate professional interpretation and technical components for CPT code 95824 (cerebral death evaluation) have been eliminated. The commenter requested that we restore the professional and technical components of this service and crosswalk the technical component value from a similar code, CPT code 95822 (EEG, sleep only). The commenter also suggested that the work RVUs should be 1.08 RVUs, the same as similar EEG codes.
Response: We have restored the separate professional and technical components of this service. This service will likely be exclusively furnished for patients who are in an institutional setting. Thus, we will pay under the physician fee schedule only for the professional interpretation. Payment for the technical component of the service will be made through our payment to the institution for facility services. Since the technical component of this service is never provided outside of a hospital, we do not have enough information under the resource-based methodology to establish nonfacility pricing. In the unlikely event that this service is provided in the nonfacility setting, we are making the global and technical component of this service subject to carrier pricing. This change will apply to several other services that are not furnished in nonfacility settings. We are not making changes to the physician work RVUs for cerebral death evaluation in this final rule. There were no requests to revise the work RVUs for this code as part of the 5-year review of physician work.
Comment: An organization representing vascular surgeons stated that the methodology used to incorporate the supplemental practice expense survey data has failed. This commenter indicated that the practice expense per hour for vascular surgeons increased by 9 percent from using supplemental data; however, payments actually declined between the November 2000 final rule and the August 2001 proposed rule. The commenter provided potential explanations for the change to practice expense RVUs. The commenter suggested that the results are inconsistent with the statute that requires payments to recognize all costs and violates the Administrative Procedure Act that rulemaking cannot be arbitrary and capricious.
The commenter suggested an option that would result in a total increase in vascular surgery payments of 9 percent, consistent with the results of the supplemental survey. This option would involve identifying vascular surgery procedure codes that decreased in payment and reallocating RVUs such that aggregate payments to vascular surgeons would increase by 9 percent.
Response: While the commenter is correct in stating that the practice RVUs for several high-volume vascular surgery procedures declined in our proposed rule, it is important to note that the changes occurred independent of the use of supplemental practice expense survey data. The supplemental practice expense survey data were incorporated into the methodology in the November 1, 2000 final rule (65 FR 65385).
The changes that occurred between the November 2000 final rule and the August 2001 proposed rule were the result of the five changes to the methodology that we modeled and described in the August 2, 2001 (66 FR 40397) proposed rule. The additional reductions in practice expense payments for vascular surgery codes that concern this commenter are attributed to the changes we made to physician time. As we have stated previously, the explanation of how time affects specific codes is complex and requires extensive data analysis. We would be willing to meet with interested parties to discuss the effects of the practice expense methodology further.
The commenter suggests that we make decisions about an appropriate increase Start Printed Page 55264in value for specific services and reallocate RVUs consistent with these decisions. We do not believe that such a policy would be appropriate. We have established a methodology for determining practice expenses and have valued all services using that process with the exception of services that have no physician work RVUs. For these services, we have established RVUs using an alternative methodology. It is not possible to deviate from those methodologies and reallocate RVUs to achieve particular results that may be more desirable to some individuals than to others. Such decisions about “appropriateness” would become highly subjective and would, in our view, be more likely to be criticized as arbitrary and capricious.
Comment: We received comments from specialty societies representing technical component providers regarding the status of the zero-work pool. Commenters representing radiology, cardiology, echocardiography and radiation oncology centers strongly supported our position of maintaining the status of the zero-work pool until an appropriate alternative methodology can be determined. Two commenters argued that none of the direct or indirect cost information resulting from the CPEP process should be utilized to establish payment amounts for technical component services unless and until we further consider the entire methodology to be applied for technical component services. All commenters urged us to consult closely with associations representing the zero-work pool providers before making any changes in this regard. One commenter emphasized that no changes should be made without further research and discussion.
Response: We agree that the status of the zero-work pool should not be changed until an alternate approach that values technical component services appropriately can be developed. Over the next several months, we will be analyzing the options for such an alternative approach contained in the report, “The Resource-Based Practice Expense Methodology: An Analysis of Selected Topics,” prepared by our contractor, The Lewin Group. This report can be found on our web site, and we would welcome comments on these options from all interested parties. (See the Supplementary Information section of this rule for directions on accessing our web site.) We also agree with the commenters that we should consult with the affected specialties as we proceed, and we will seek to maintain an open dialogue with the medical community on this issue.
Comment: A commenter representing speech, language, and hearing professionals recommended that the zero-work pool be modified to accept the clinical staff wage increases. Seventy percent of the procedure codes used by audiologists that are covered by Medicare are in that pool and, thus, even though the proposed wage rate for audiologist has increased by 24 percent, this increase will not be reflected for those non-work services.
Response: The commenter is correct in stating that, because the CPEP data are not used as allocators in the zero-work pool, the increases in the clinical staff wage rates will not affect the payments for audiology services at this time. However, as we mentioned above, we are seeking to develop an appropriate alternative for the zero-work pool and, when such an alternative is implemented, the revised wage rates will be applied to audiology services. In addition, we allow specialties to withdraw their services from the zero-work pool if the specialty believes that their services will be more appropriately valued outside that pool.
Comment: An organization representing diagnostic imaging centers stated that, if we adopt the suggestion in the report of The Lewin Group to establish specialty-specific zero-work pools, it has already conducted a survey that establishes the costs per hour of providing diagnostic imaging technical component services. The commenter added that, regardless of the approach that we choose, the organization welcomes the opportunity to work with us with respect to any changes that may be contemplated in the zero-work pool methodology.
Response: As we have noted above in our discussion on specialty-specific supplementary surveys, all of these surveys must meet the criteria stated in our November 2000 final rule. We would be willing to review the survey to see if the data can be used to develop a specialty-specific practice expense per hour. In addition, we, too, would welcome the opportunity to work with the organization as we develop an alternative to the zero-work methodology.
e. Site-of-Service
Comments on Site-of-Service Clarification of Payment Policy
In the November 2, 1998 final rule (63 FR 58830) and the November 2, 1999 final rule (64 FR 59407), we indicated the circumstances under which either the facility or the nonfacility RVUs are used to calculate payment for a service. Specifically, we indicated that the lower facility practice expense RVUs apply when the service is performed in an Ambulatory Surgical Center (ASC) and the procedure is on the ASC-approved procedures list. The higher nonfacility practice expense RVUs apply to procedures performed in an ASC that are not on the ASC-approved list because there will be no separate facility payment for these services. As explained in the August 2001 proposed rule, we have received a number of inquiries about the place-of-service that should be used on the Medicare claim when a service that is not on the ASC-approved procedures list is furnished in an ASC. In these circumstances, we stated that physicians should indicate ASC as the place-of-service on the Medicare claim. Other questions have arisen as to whether a beneficiary can be billed for the ASC facility fee when Medicare does not pay a facility fee because a procedure not on the ASC list is performed in a certified ASC. In this situation, Medicare pays the physician the higher nonfacility practice expense RVUs because the ASC is effectively serving as a physician's office, and Medicare's payment for the physician's service includes payment for all practice expenses incurred in furnishing the service. The ASC benefit is not implicated since the services do not meet the provisions of section 1833(i) of the Act. The services are covered as physicians' services and paid under the physician fee schedule. Therefore, payment to the physician reflects payment for the whole service, and the beneficiary cannot be charged in excess of the limiting charge for the physician fee schedule service.
Comment: Two commenters indicated that conditions of participation and/or survey and certification guidelines limit physicians in an ASC to furnishing only surgical procedures on the ASC approved list of procedures. They stated that such restrictions interfere with providing medical care that is in the patient's interest. The commenters request that we revise the regulations to allow physicians to furnish surgical and other medical procedures that are not on the approved ASC list in an ASC.
Response: Because our proposal relates only to payment policy, we are finalizing it as proposed. The payment policy will apply to services furnished in an ASC that are not on the ASC-approved list to the extent that such services are permitted under the conditions of participation developed by our Office of Clinical Standards and Quality (OCSQ) and by the survey rules developed by our Center for Medicaid and State Operations (CMSO). It is our understanding that current regulations Start Printed Page 55265that restrict ASCs to furnishing surgical services does not limit them to surgical services on the ASC-approved list, but rather, includes all surgical services. However, questions about rules that limit services that can be furnished in an ASC are beyond the scope of this final rule.
B. Nurse Practitioners, Physician Assistants, and Clinical Nurse Specialists Performing Screening Sigmoidoscopies
Based on our review of current medical literature, we believe that nurse practitioners (NPs), clinical nurse specialists (CNSs), and physician assistants (PAs) whose services are covered under Medicare and who have been trained are qualified to perform screening sigmoidoscopies safely and accurately. Therefore, in the August 2, 2001 proposed rule, we proposed revising § 410.37(d) to provide that, in order for screening sigmoidoscopies to be covered, they must be performed by medical doctors, doctors of osteopathy, PAs, NPs, and CNSs, if they meet the applicable Medicare qualification requirements in §§ 410.74, 410.75, and 410.76, and if they are authorized to perform these services under State law.
Comment: Fifteen commenters addressed the issue of whether to allow non-physician health care professionals to perform screening flexible sigmoidoscopies for Medicare coverage and payment purposes. Four of the commenters representing national non-physician health care professional organizations and a health care consultant group enthusiastically supported the proposal. Ten commenters, all national medical associations or medical specialty groups, expressed various concerns about the proposal but agreed that it was appropriate for NPs, PAs, and CNSs to perform these services. These commenters suggested clarification and revision of the rule in a number of different areas, such as the need for physician supervision and appropriate training and experience standards, to ensure quality of care in the non-physician performance of these examinations. Two of these ten commenters that suggested the need for additional requirements were national gastroenterological physician groups which were divided in their enthusiasm for the proposal. The American Gastroenterological Association indicated that properly trained physician assistants, nurse practitioners and clinical nurse specialists are capable and qualified to perform screening flexible sigmoidoscopies. However, the Association insisted that in no case should such practitioners be permitted to do so without being directly supervised by an appropriately trained and qualified onsite physician. In addition, the Association urged that these non-physician providers should never be allowed to perform these examinations without some assurance that they have been properly educated and trained to perform them. These comments were echoed by several other physician groups. On the other hand, the American College of Gastroenterologists supported the proposal without specifically mentioning the need for physician supervision and education and experience requirements. The College emphasized that there is a great need for sigmoidoscopy screening to be performed in the Medicare age group. Moreover, they observed that there may not be sufficient numbers of physicians available to perform the procedure, posing an access problem for our beneficiaries. The College stated that, if we proceed with the proposal, non-physician practitioners should be required to provide certain specific information to beneficiaries stating who had performed the examination and its impact on available benefits in future years.
Another organization representing family physicians also noted conditions which should be met if these practitioners provide this service as proposed, but indicated that the existing Medicare regulations for these practitioners suggested that these conditions are met. For example, existing Medicare regulations require general (not onsite) rather than direct (onsite) supervision of PAs. Several other physician organizations in their recommendations also appear to support a requirement less strict than direct physician supervision.
One other commenter—a national medical association—opposed the proposal because of concerns as to whether non-physician health care professionals could respond appropriately to problems or complications that might possibly occur during the performance of the screening procedure when a physician (with a higher level of medical skills) is not present at the facility. None of the commenters who suggested revisions to the proposed rule to specify requirements for physician supervision and/or formal training and experience, or who opposed it, produced scientific evidence in support of their views.
Response: As we indicated in the proposed rule, a growing body of evidence from the medical literature has shown that certain properly trained non-physician health care professionals can carry out screening by flexible sigmoidoscopy as accurately and safely as physicians. (Scheon et al. Archives of Internal Medicine 2000) This procedure requires fewer supervised examinations to attain objective measures of technical competency than other endoscopic procedures, does not require sedation, and has a low rate of related complications. In the studies reviewed, physician and non-physician endoscopists achieved similar polyp detection rates and depth of insertion in screening performed independently. No significant complications from sigmoidoscopy were reported in any of these studies. The level of satisfaction with the procedure was similar for all practitioners.
This demonstration of the ability of non-physician practitioners to perform flexible sigmoidoscopy screening safely and accurately is a very significant development. As the American College of Gastroenterology noted in its comments, there is a physician availability and a related beneficiary access problem of concern to CMS. The Balanced Budget Act of 1997, effective January 1, 1998, expanded Medicare coverage of non-physician practitioner services to address concerns about access to services, especially in rural and other areas of the United States where there is a lack of availability of physicians for performing certain services such as screening flexible sigmoidoscopies. The law and related regulations also outline the level of supervision or medical direction for these non-physician practitioners.
Flexible sigmoidoscopy is one of the promising modalities available for decreasing mortality from colorectal cancer. The American Cancer Society estimates that more than 56,000 Americans will die of colorectal cancer this year. Studies have found that the use of screening flexible sigmoidoscopy could lead to a 30 percent reduction in total colorectal cancer mortality. (Selby et al. New England Journal of Medicine 1992.) In view of limited Medicare beneficiary access in certain areas, because screening flexible sigmoidoscopy remains an underused cancer-prevention procedure, and, in the absence of any submitted scientific literature that contradicts the underlying medical evidence supporting the proposal, we do not believe that commenters have presented us with a basis for revising the proposal as they have suggested. However, we have found that a number of commenters have offered us interesting suggestions for implementing the proposal and clarifying the agency's intent in this Start Printed Page 55266regard, which we explain in our response to the more specific comments summarized below.
Comment: Several commenters referenced a recent OIG report entitled “Medicare Coverage of Non-Physician Practitioner Services” (OEI-02-00-00290), which they believe makes clear that CMS does not have systems in place to ensure that non-physician practitioners who provide beneficiaries with medical services and who bill Medicare directly, are performing their services in accordance with State law. One commenter states that the report implies that it is not possible for Medicare to ensure that a State law allows non-physician practitioners to provide flexible sigmoidoscopies or that the services are provided in an integrated practice arrangement with appropriate physician supervision. For example, the commenter pointed out that 16 carrier medical directors interviewed by the OIG reported that they do not verify that non-physician practitioners are performing services within their State scope of practice, and at least 22 carriers do not check the collaborative agreement required for nurse practitioners and clinical nurse specialists. The commenter indicated that the OIG concluded that services performed and billed by non-physician practitioners create potential payment and quality of care vulnerabilities since, (1) “non-physician practitioner billings are rising rapidly, but controls, which are based on scopes of practice, are limited”, and (2) carriers “do not have sufficient guidance to distinguish which non-physician practitioner services should be reimbursed by the program and which should not.” In light of these OIG findings, the commenter urges CMS to review whether and how the agency and its carriers can ensure that the above-mentioned concerns are resolved successfully when non-physician practitioners perform screening flexible sigmoidoscopies. The commenter says that “it is vital that CMS takes steps to ensure the fulfillment of these requirements to minimize any risk of experiencing the vulnerabilities referenced in the OIG report with respect to quality and payment issues.”
Response: We agree with OIG's conclusion identifying program vulnerabilities when non-physician practitioners bill Medicare directly for their services. We also respect beneficiaries' choices and their need for access to medical services. While appreciative of OIG's suggestion that it may be appropriate to consider additional controls for Medicare payments to non-physician practitioners, we are sensitive to issues that might arise from different treatment of different classes of practitioners. As appropriate, we will monitor non-physician practitioner services for both overall trends and for complex services.
Medicare currently defers to State licensing boards for regulating and enforcing scope of practice laws. Before issuing a Medicare billing number to a nurse practitioner or a nurse clinical specialist, contractors first determine whether the applicant has a valid license within the State. If a licensing board subsequently acts to suspend a practitioner's license to practice, then Medicare suspends payments under the practitioner's Medicare billing number. This practice is the same for physician and non-physician practitioners.
To protect the integrity of the Medicare program, all claims submitted are subject to data analysis that may lead to a focused or a random review by a Medicare contractor. If Medicare is to begin monitoring practitioners for compliance with State laws and regulations, the program will have to develop additional regulations and policies and impose additional workloads on contractors and perhaps for all practitioners as well. In deciding whether such a process is necessary and appropriate, we will carefully consider these comments in this regard.
Comment: One commenter asked CMS, in implementing the proposal, to ensure that non-physician practitioners are required to tender a standard notification to Medicare beneficiaries providing them with a clear statement that the screening flexible sigmoidoscopy is being furnished by a non-physician practitioner. In addition, the commenter suggests that the beneficiary be notified that under the new colorectal cancer screening benefit, effective July 1, 2001, any average-risk individual receiving a covered screening flexible sigmoidoscopy will be precluded by law from receiving Medicare payment for a screening colonoscopy (which under Medicare regulations (§ 410.37(f) must be furnished by a physician)) for four years.
Response: We believe that our Medicare beneficiaries generally are knowledgeable about the identity of the Medicare practitioner that is furnishing them with a flexible sigmoidoscopy screening examination. Accordingly, we believe that there is no need for non-physician practitioners to provide beneficiaries with any formal notification statement in this regard. As for the suggestion that a non-physician practitioner should notify an average-risk beneficiary that providing him/her with a screening flexible sigmoidoscopy will preclude Medicare from paying for a screening colonoscopy (which must be performed by a physician) for four years, we believe that all Medicare practitioners should help to inform beneficiaries with respect to this limitation. However, we do not believe that any practitioner should be required to formally notify beneficiaries to this effect. While we believe that our Medicare contractors, and all our practitioners have an important role to play in educating our beneficiaries about the various conditions of coverage and payment limitations that apply to different colorectal cancer screening options that are available to them, we will not use these regulations as a mechanism for implementing the requested educational efforts.
Comment: One commenter suggested that we allow registered nurses to perform these as well, as a delegated act, under a physician's direction with the physician billing Medicare for the procedure.
Response: The regulation proposal to allow nurse practitioners, physician assistants, and clinical nurse specialists to perform screening flexible sigmoidoscopies for Medicare purposes was designed to increase beneficiary access to these screening services, especially in rural and other areas where there is a shortage or a lack of availability of physicians who are trained and qualified to perform these examinations. These non-physician practitioners are typically licensed independent practitioners who are recognized under the Medicare law and regulations for coverage and payment purposes. Under Medicare, these non-physician practitioners may be paid under the physician fee schedule for their tests (and treatments) that would be physicians' services if furnished by a physician when they are authorized by the State to perform such services. Registered nurses are not licensed independent practitioners who are recognized under Medicare law for coverage and payment purposes.
Comment: One commenter suggested that we should monitor beneficiary health outcomes that result from the performance of sigmoidoscopy examinations by non-physician practitioners to ensure that they are done safely and accurately.
Response: We had not planned to monitor beneficiary outcomes that might be related to implementation of the proposal to allow non-physician practitioners to perform flexible sigmoidoscopy screening because of the available evidence that they can provide these services safely and effectively. If we were to consider doing this, Start Printed Page 55267however, we would probably want to consider doing a comparative study of health outcomes of beneficiaries who have been screened by both physician and non-physician practitioners who have performed these examinations.
Such a study would mean that a number of physician and non-physician practitioners would have to collect and report data to us on their Medicare patients for a certain period of time, which could be burdensome for them. We may be interested in doing a study in this area in the future if we had any credible evidence of a serious problem in this area, but, at this time, we do not believe a study is necessary.
Result of Evaluation of Comments
We are adopting our proposal to allow certain non-physician practitioners to perform screening flexible sigmoidoscopies.
C. Services and Supplies Incident to a Physician's Professional Services: Conditions
Section 1861(s)(2)(A) of the Act authorizes coverage of services and supplies (including drugs and biologicals that are not usually self-administered by the patient) furnished incident to a physician's service. These drugs and biologicals are commonly furnished in physicians' offices without charge or included in the physicians' bills. This statutory “incident to” benefit differs from the “incident to” benefit in the hospital setting as set forth in section 1861(s)(2)(B) of the Act, which authorizes coverage of hospital services (including drugs and biologicals which are not usually self-administered by the patient) incident to a physician's service furnished to outpatients and partial hospitalization services furnished to outpatients incident to a physician's service. This provision only addresses coverage of “incident to” services under section 1861(s)(2)(A) of the Act. In addition, the statute provides Medicare coverage of services incident to practitioners other than physicians.
The Medicare Carriers Manual currently requires that the physician (or other practitioner) be either the employer of the auxiliary personnel or be an employee of the same entity that employs the auxiliary personnel. In the August 2, 2001 rule, we proposed to revise § 410.26 to codify our existing policy outlined in section 2050 of the manual. Specifically, we proposed to codify the definitions of auxiliary personnel, direct supervision, independent contractor, leased employment, non-institutional setting, practitioner, and services and supplies for purposes of services provided incident to a physician's service.
In addition, we proposed to allow auxiliary personnel to provide services incident to the services of physicians (or other practitioners) who supervise them, regardless of the employment relationship of the physician (or other practitioner) to the entity that employed the auxiliary personnel.
All commenters supported the proposal. Their specific comments are addressed below.
Comment: Commenters noted three errors in the proposed text of the regulation. First, in the definition of auxiliary personnel set forth in § 410.26(a)(1), after the phrase “under the supervision of a physician,” the term “(or other practitioner)” was omitted. Second, in the definition of services and supplies set forth in § 410.26(a)(7), the phrase “(including drugs and biologicals that, as determined in accordance with regulations, cannot be self-administered)” should be changed to “(including drugs and biologicals which are not usually self-administered by the patient)” in accordance with section 112 of the BIPA, which amended sections 1861(s)(2)(A) and (B) of the Act. Third, in the supervision requirement set forth in § 410.26(b)(5), the word “direct” was omitted.
Response: We agree with these comments, and we have corrected these errors.
Comment: One commenter requested that independent contractor physicians also be recognized as employees under the reassignment policy set forth in section 3060 of the Medicare Carrier Manual.
Response: As stated in the August 2, 2001 rule, this proposal only applies to the incident to policy. Furthermore, we are not defining or re-defining the term employment. Instead, we proposed to permit physicians (or other practitioners) to directly supervise auxiliary personnel regardless of the employment relationship of the physicians (or other practitioners) with the entity that hired the auxiliary personnel. In order to bill and receive payment from Medicare under this policy, all other applicable requirements must also be met. For example, the service must be medically reasonable and necessary, and appropriate reassignment must be executed.
Comment: One commenter suggested using in § 410.26(b) all of the terms defined in § 410.26(a) or deleting the terms not used in § 410.26(b).
Response: We found one term—leased employment—that was not used in § 410.26(b). However, we will not eliminate this term because it is used to define the term auxiliary personnel.
Comment: Several commenters requested that we clarify and distinguish between the physician (or other practitioner) ordering the incident to service and the physician (or other practitioner) supervising the auxiliary personnel who perform the incident to service. They stated that confusion exists as to whose Medicare Part B billing number should be used on the claim form.
Response: Inherent in the definition of an incident to service is the requirement that the incident to service be furnished incident to a professional service of a physician (or other practitioner). When a claim is submitted to Medicare under the billing number of a physician (or other practitioner) for an incident to service, the physician is stating that he or she either performed the service or directly supervised the auxiliary personnel performing the service. Accordingly, the Medicare billing number of the ordering physician (or other practitioner) should not be used if that person did not directly supervise the auxiliary personnel. We added language to the supervision requirement set forth in § 410.26(b)(5) to reflect this clarification.
Comment: One commenter pointed out that the claim form currently requires the physician (or other practitioner) to certify that he or she personally supervised the employee. Therefore, the commenter requested that we update the claim form to reflect the proposed regulations.
Response: We plan to update not only the claim form but also section 2050 of the Medicare Carriers Manual to reflect the new regulations.
Comment: A few commenters noted that the individual does not always receive an IRS-1099 form under an independent contractor arrangement. Instead, when a clinic, for example, contracts with an entity that has hired individuals to be furnished to the clinic, then the entity (and not the individual) receives the IRS-1099 form.
Response: We agree with these commenters. Therefore, we have added language to the definition of an independent contractor set forth in § 410.26(a)(3) to reflect this practice. However, we again emphasize that the applicable reassignment rules must also be met and that this incident to policy does not in any way alter the current requirements for valid reassignment.
Comment: One commenter encouraged us to specify in the regulations the acceptability of forms (other than the IRS W-2 form) that the Internal Revenue Service recognizes as Start Printed Page 55268proof of employment, such as the Payroll Agent arrangement where IRS forms 2678 and 1997C are used instead.
Response: Under our proposal, the employment relationship is irrelevant to whether a physician (or other practitioner) can effectively furnish direct supervision of the auxiliary staff. Therefore, we decline to include language that may define or re-define the term employment.
Comment: One commenter suggested that we also include Ambulatory Surgical Centers (ASCs) and Community Mental Health Clinics (CMHCs) in the definition of a non-institutional setting because Medicare Part B payments for services provided in these settings are paid through the facility relative value units (RVUs) rather than the non-facility RVUs.
Response: The definition of a non-institutional setting is not derived from the definition of a facility used to determine the site of service and the application of the facility or non-facility RVUs. Because section 1861(s)(2)(B) of the Act authorizes payment for hospital incident to services, section 1861(s)(2)(A) of the Act cannot authorize payment for hospital incident to services. This provision is reiterated in § 411.15(m)(2). Similarly, § 411.15(p)(2)(ii) specifically excludes payment for incident to services in skilled nursing facilities (SNFs). Consequently, we defined non-institutional settings as all settings except hospitals and SNFs, and we do not plan to define ASCs and CMHCs as institutional settings.
Comment: Many commenters wanted us to restrict the definition of auxiliary personnel so that only certain individuals may perform a given incident to service. For example, they want us to mandate that only audiologists may perform cochlear implant rehabilitation services as incident to services. Likewise, they want us to permit only physical or occupational therapists to perform physical or occupational therapy as incident to services. In support, they noted that section 4541(b) of the BBA amended section 1862(a)(20) of the Act and required that physical or occupational therapy furnished as an incident to service meet the same requirements outlined in the physical or occupational therapy benefit set forth in sections 1861(g) and (p) of the Act.
Response: We have not further clarified who may serve as auxiliary personnel for a particular incident to service because the scope of practice of the auxiliary personnel and the supervising physician (or other practitioner) is determined by State law. We deliberately used the term any individual so that the physician (or other practitioner), under his or her discretion and license, may use the service of anyone ranging from another physician to a medical assistant. In addition, it is impossible to exhaustively list all incident to services and those specific auxiliary personnel who may perform each service.
Comment: Many commenters wanted us to re-emphasize that incident to services set forth in section 1861(s)(2)(A) of the Act do not include Medicare benefits separately and independently listed in the Act, such as diagnostic services set forth in section 1861(s)(3). Some even requested that we not permit these separately and independently listed services to be rendered as incident to services.
Response: We realize, as did the Congress with the enactment of section 4541(b) of the BBA, that many services—even those that are separately and independently listed—can be furnished as incident to services. However, this fact of medical practice is not inconsistent with our policy. We maintain that a separately and independently listed service can be furnished as an incident to service but is not required to be furnished as an incident to service. Furthermore, even if a separately and independently listed service is provided as an incident to service, the specific requirements of that separately and independently listed service must be met. For instance, a diagnostic test under section 1861(s)(3) may be furnished as an incident to service. Nevertheless, it must also meet the requirements of the diagnostic test benefit set forth in § 410.32. Namely, the test must be ordered by the treating practitioner, and it must be supervised by a physician. Thus, if a test requires a higher level of physician supervision than direct supervision, then that higher level of supervision must exist even if the test is furnished as an incident to service. Accordingly, we decline to prohibit a separately and independently listed service from being rendered as an incident to service. Instead, we reiterate that a separately and independently listed service need not meet the requirements of an incident to service.
Comment: Recognizing that this proposal affords flexibility in the way physicians (or other practitioners) are hired by an office or clinic, one commenter requested that non-physician practitioners be permitted to stand as locum tenens (taking the place of) for other non-physician practitioners as well.
Response: This proposed rule does not alter in any way the current locum tenens policy.
Result of Evaluation of Comments
We are finalizing our proposed revisions to § 410.26 with the corrections noted above.
D. Anesthesia Services
We generally use the 1988 American Society of Anesthesiologists' (ASA) Relative Value Guide as the basis for the uniform relative value guide. This guide is used in all carrier localities to determine payment for anesthesia services furnished by physicians under Medicare Part B. We proposed using the ASA base unit values from the 1999 guide beginning in CY 2002 for eight codes with ASA base unit values that were different from CMS's values (specifically, CPT codes 00810; 00902; 01150; 01214; 01432; 01440; 01770; and 01921). These are older codes and, while we accepted the ASA base unit value initially, the ASA has changed this base unit subsequently and no additional adjustment was made by us to the base unit. For CPT codes 00142 and 00147, we proposed maintaining the current base unit values although they differed from the ASA values because values for these two codes were established under the “inherent reasonableness” process in 1987.
Comment: The ASA identified additional CPT codes 00548, 00700, 00800, and 01916 with different base unit values in the most current ASA guide from our base unit values.
Response: We are accepting the ASA's comments subject to the following clarification. In all, 12 codes were presented where the ASA base unit differs from our base unit. Of these, code 01921, which appeared on the list in the August 2, 2001 proposed rule, will be deleted in 2002. Since this code has been deleted and will no longer be used, we will not assign base units to it and, as a result, only 11 codes will be considered.
These additional four codes were added to CPT before CY 2000. New and revised codes starting in CY 2000 and for subsequent years are evaluated on a code-specific basis under our usual process after we receive recommendations from the RUC. Thus, because we review the RUC recommendations and may make changes based on them, there could be differences between the ASA guide and our base unit values beginning in 2000. If the RUC or other commenters recommend and we agree to a base unit different from what ASA recommends, we will use that value and not the ASA Start Printed Page 55269value, even though it may be published in the ASA's guide.
Result of Evaluation of Comments
The complete list of 11 CPT codes for which we will assign the ASA base unit values instead of the current CMS base unit values are as follows:
Code CMS ASA 00548 15 17 00700 3 4 00800 3 4 00810 6 5 00902 4 5 01150 8 10 01214 10 8 01432 5 6 01440 5 8 01770 8 6 01916 5 6 A related issue is the treatment of base unit values for new codes for 2002 as discussed in section V. The RUC reviewed the work values for 19 new anesthesia codes for 2002. We agree with the RUC on 17 of these codes but recommend lower values for 2 codes. The RUC recommended 9 units for CPT code 00797 (anesthesia for gastric restrictive procedure for morbid obesity) and we proposed 8 units. The RUC recommended 3 units for CPT code 01968 (cesarean delivery following neuraxial labor analgesia/anesthesia—list separately in addition to the code for primary procedure), and we proposed 2 units. (See section V for additional information on the valuing of these new anesthesia services.)
Result of Evaluation of Comments
We are implementing the base units for the 11 existing codes where there are differences between the ASA's guide and our base units and for which we received comments. In addition, we are implementing the base units which the RUC recommended for 17 new codes and the base units which we recommended and which are lower than the RUC's recommendation for 2 new codes.
E. Performance Measurement and Emerging Technology Codes
In the August 2, 2001 proposed rule (66 FR 40383) we included a discussion of the two new categories of CPT codes: Performance Measure codes, referred to as Category II CPT codes, which are intended to facilitate data collection; and, Emerging Technology codes, referred to as Category III CPT codes, which are intended to track new and emerging technologies.
For the Performance Measure codes, which have a syntax of four digits followed by the letter “F,” we stated that no values would be placed on the Performance Measure codes and no additional payment would be made for the use of these codes. Practitioners would, however, be able to report them on their Medicare bills to enable us to track these services.
For the Emerging Technology Codes, which have a syntax of four digits followed by the letter “T,” we stated that we would pay, on a case-by-case basis in specific situations, when we determine that the codes represent services that are not, in fact, experimental, but have been shown to be safe and effective. If the coverage policy is not consistent with the existing tracking codes, a Medicare-specific code may need to be developed to allow payment for the service. Thus, only specific emerging technology codes would be recognized for Medicare payment.
Comment: Commenters expressed appreciation for our recognition of these new categories of CPT codes. However, one commenter believed that we should refrain from categorically denying payment for category III (emerging technology) CPT codes, because these CPT codes may sometimes warrant payment. Another commenter believed that we were proposing not to pay for these codes at all. The commenter recommended that we clarify in the final rule that carriers may determine if payment should be made for a particular emerging technology code.
Response: We believe that these codes will serve a useful purpose. We regret that some commenters believed that the discussion in the proposed rule implied that these services should not be covered. We only intended to indicate that by publishing these codes we are not indicating that we would pay for these services in all instances. As the commenter indicates, coverage of emerging technologies and payment for these services is at the discretion of the carriers. We also want to clarify that our carriers will be able to incorporate these codes only after they are entered into our system during our regularly scheduled updates and not as soon as the AMA posts them on the CPT web site.
Result of Evaluation of Comments
We would like to clarify the intent of our proposal regarding emerging technology CPT codes. The emerging technology CPT codes will be published in the physician fee schedule with a status indicator of “C” to indicate that coverage and payment of these services is at the discretion of the carrier. The only exceptions will be for those emerging technology CPT codes that describe services for which Medicare has issued an NCD. In these situations, coverage will be based on the NCD, and we may establish national payment or may leave payment to the discretion of the carriers. It is also possible that an NCD or an established payment policy may foreclose coverage and/or payment for an emerging technology CPT code. In summary, we will finalize our proposal to allow both the CPT Performance Measure Codes (that is, codes with four digits followed by the letter “F”) and Emerging Technology Codes (that is, codes with four digits followed by the letter “T”) to be listed on Medicare bills and provide payment for the emerging technology codes as determined by the carrier.
F. Payment Policy for CPT Modifier 62 (Co-Surgery)
The CPT modifier code 62 is used to report the work of co-surgeons. Currently, if we pay for co-surgery, we pay a total of 125 percent of the fee schedule amount to the co-surgeons who each receive half of this total payment. In the August 2, 2001 proposed rule (66 FR 40383), we stated that we would be examining our payment policies for co-surgery to consider possible ways to ensure that they reflect current clinical practices and properly reflect the relative resources and work effort required to perform these services. We outlined several issues under consideration and specifically solicited information to assist us in deciding whether to make a future proposal affecting payments for co-surgery.
Result of Evaluation of Comments
Commenters responded to the specific questions in the proposed rule. Many commenters believe that the current payment policy is reasonable and that the focus should be on education efforts to ensure the appropriate use of the modifier. We will review carefully the information the commenters have provided. If we determine that we need to proceed with a change in payment policy for co-surgery, the change would be proposed as part of future rulemaking.
III. Implementation of Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000
The Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA) (Public Law 106-554), enacted on December 21, 2000, provides for revisions to policies applicable to the physician fee Start Printed Page 55270schedule. These revisions are presented below.
A. Screening Mammography
Medicare has paid for screening mammography since January 1, 1991. Section 1834(c) of the Act governing these screenings did not include screening mammography under the physician fee schedule; it provided for payment under a separate statutory methodology. Section 104 of BIPA amends section 1848(j)(3) of the Act to include screening mammography as a physician's service for which payment is made under the physician fee schedule beginning January 1, 2002. In the August 2001 proposed rule, we proposed amending §§ 405.534 and 405.535 to reflect the inclusion of screening mammography as a physician's service which will be payable under the physician fee schedule. In addition, we proposed amending § 414.2 to include screening mammography under the definition for physicians' services. In accordance with part 414, payments for screening mammography will be resource-based and will have geographic adjustments that reflect cost differences among areas as do all other services under the physician fee schedule, including diagnostic mammography.
The following is a summary of the RVUs proposed for the professional and technical components (PC and TC) of a screening mammography, CPT code 76092, under the physician fee schedule.
Professional Component
A screening mammography service typically requires the same number of views as a unilateral diagnostic mammography. Therefore, for screening mammography, we proposed a physician work RVU of 0.70 based on the physician work established for a unilateral diagnostic mammography. This value is equal to the proposed work RVUs from the 5-year review of physician work for CPT code 76090, unilateral diagnostic mammogram (see June 8, 2001 proposed notice, “Five-Year Review of Work Relative Value Units Under the Physician Fee Schedule”). Since we believe that the practice expense and malpractice expense for the professional component of screening mammography is similar to the professional component of unilateral diagnostic mammography, we proposed establishing 0.25 practice expense RVUs and 0.03 malpractice RVUs for the PC of screening mammography.
Technical Component
We proposed valuing the technical component of screening mammography using a methodology that updates the original statutory limit for the technical component of screening mammography of $37.40, by the cumulative increase in physician fee schedule rates between 1992 and 2001 (see the August 2, 2001 proposed rule (66 FR 40384) for specific information on methodology). This resulted in proposed practice expense and malpractice RVUs for the technical component of screening mammography of 1.27 and 0.06, respectively.
Overall, the total proposed RVUs associated with the combined PC and TC of CPT code 76092 were 2.31 (0.70 work RVUs, 1.52 practice expense RVUs, and 0.09 malpractice expense RVUs).
New Technology Mammography
The BIPA also required us to determine whether the assignment of new HCPCS codes is appropriate for both screening and diagnostic mammography performed using new digital technologies.
We determined that new HCPCS codes are appropriate for the new digital technology mammography beginning January 1, 2002. We proposed three separate codes for directly taking a digital image (one for screening and one each for unilateral and bilateral diagnostic). We also proposed a single add-on code for computer-aided diagnosis with conversion of standard film images to digital images, since, at the time of the development of the proposed rule, the FDA approved computer-aided diagnosis only for screening mammography. Following is a summary of our proposed coding and payment methodologies for digital mammography.
Screening Mammography, Direct Digital Image (Gxxx1)
We proposed HCPCS code Gxxx1 to report screening mammography performed using direct digital images as opposed to mammography that is performed using the standard film images associated with CPT code 76092, or conversion of a standard film image to a digital image. For the PC of HCPCS code Gxxx1, we proposed 0.70 work RVUs, 0.28 practice expense RVUs, and 0.03 malpractice expense RVUs. For the TC of HCPCS code Gxxx1, for which there is no physician work associated, we proposed 2.50 practice expense RVUs and 0.06 malpractice RVUs.
Diagnostic Mammography, Unilateral, Direct Digital Image (Gxxx2)
We proposed HCPCS code Gxxx2 to report unilateral diagnostic mammography performed using direct digital images as opposed to mammography performed using the standard film images associated with CPT code 76090, or conversion of a standard film image to a digital image.
For the professional component of HCPCS code Gxxx2, we proposed 0.70 work RVUs, 0.28 practice expense RVUs, and 0.03 malpractice expense RVUs. For the TC of HCPCS code Gxxx2, with which there is no physician work associated, we proposed 1.99 practice expense RVUs and 0.05 malpractice expense RVUs.
Diagnostic Mammography, Bilateral, Direct Digital Image (Gxxx3)
We proposed HCPCS code Gxxx3 to report bilateral diagnostic mammography that is performed using direct digital images as opposed to mammography performed using the standard film images associated with CPT code 76091, or conversion of a standard film image to a digital image.
For the PC of HCPCS code Gxxx3, we proposed 0.87 work RVUs, 0.34 practice expense RVUs, and 0.03 malpractice expense RVUs. For the TC of HCPCS code Gxxx3, with which there is no physician work associated, we proposed 2.47 practice expense RVUs and 0.06 malpractice expense RVUs.
Computer-Aided Detection, With Either Direct Digital Image or Conversion of Standard Film Images to Digital Images (HCPCS Code Gxxx4)
We proposed HCPCS code Gxxx4 to report conversion of standard film images to digital images when used in conjunction with computer-aided diagnosis software. This code was proposed as an add-on code that can be billed only in conjunction with the primary service, CPT code 76092, based on our understanding that the only FDA-approved use of the computer-aided diagnosis mammography software is with screening film images. If there are other FDA-approved uses of computer-aided diagnosis, we stated we would allow for use of Gxxx4 as an add-on to other mammography services.
For the PC of code Gxxx4, we proposed 0.06 work RVUs, 0.02 practice expense RVUs, and 0.01 malpractice expense RVUs. For the TC of HCPCS code Gxxx4, with which there is no physician work associated, we proposed 0.41 practice expense RVUs and 0.01 malpractice expense RVUs.
Since publication of the proposed rule, the FDA has also approved the use Start Printed Page 55271of computer-aided diagnosis with diagnostic mammography.
Comment: The majority of comments received from manufacturers, specialty organizations, individuals, and representatives of the Congress were supportive of our proposed payment of mammography services beginning January 1, 2002. The general consensus from commenters was that the proposed 21 and 26 percent increase, respectively, in payments for unilateral and bilateral diagnostic mammography, as a result of the 5-year review of work (see section IV), the new resource-based payment for screening mammography, the new resource-based payments for both digital screening and digital diagnostic mammography, and the payments for computer-aided diagnosis reflect the relative resources associated with each individual service.
However, two commenters still believe that the 21 percent and 26 percent increase in payments for unilateral and bilateral diagnostic mammography, respectively, was still inadequate to cover the costs of these services.
Response: In agreement with the majority of comments received, we continue to believe that our proposed relative values are an accurate reflection of the resources associated with the provision of these services.
Comment: We received comments that suggested that Medicare payment is inadequate to cover the cost of screening mammography. One commenter stated that, due to the Federally-mandated Mammography Quality Standards Act (MQSA) requirements intrinsic to mammography (both screening and diagnostic), it is difficult to use the current methodology to account for all practice expenses. This commenter did indicate support for our proposal to develop practice expense RVUs for screening mammography using a comparison to unilateral diagnostic mammography.
Response: We are currently using the “no work” methodology to price the technical component of diagnostic mammography and a special method for the technical component of screening mammography. We believe that most costs associated with mammography services are likely to be associated with the technical component. At this time, we plan to continue using these methods to establish the practice expense relative value units for the technical component of mammography services. However, if we propose a change to the methodology for no-work services in the future, we agree that it is important to consider whether MQSA costs are incorporated in the data sources we are using to develop RVUs.
Comment: We received two comments that suggested Medicare should not pay for screening mammography using the physician fee schedule until payment is set at an appropriate level so as not to require reduction in payments for other services. The commenters were concerned about the reduction in payment for other services that would result from the increase in payment for screening mammography using the methodology we proposed. These commenters acknowledged that the statute requires us to pay for screening mammography using the physician fee schedule. One commenter appreciated the significant effort that CMS put forth to comply with the mandate.
Response: As indicated by the comments, section 104(a) of the BIPA requires us to pay for screening mammography using the Medicare physician fee schedule beginning January 1, 2002. We estimate that payment in 2002 for screening mammography under the statutory methodology would have been about $71, which is less than the $81 that Medicare will pay under the physician fee schedule. Since screening mammography is paid under the physician fee schedule, the increase in payment will be subject to the budget neutrality calculations under section 1848(c) of the Act. The increase in payment, although large, will have little effect on payment for other physician fee schedule services. The required adjustment to other physician fee schedule payments is less than −0.1 percent.
Comment: We received comments about coding for new technology screening mammograms. These comments indicated support for our proposed coding but noted that two developments have since occurred that we could not have taken into account in our proposed rule. First, CPT created a new code for computer-aided detection (CAD) as an add-on for screening mammography. Second, the Food and Drug Administration approved use of CAD for diagnostic mammography. The commenters requested that we use the CPT code for CAD as an add-on to screening mammography and create a slightly modified HCPCS alphanumeric code as an add-on for diagnostic mammography. The modification would specify that the alphanumeric code is to be used as an add-on for diagnostic mammography. Commenters also suggested that we accommodate potential future FDA approved uses of CAD as an add-on to digital mammography through necessary coding and payment changes as soon as possible without having to await the next rulemaking cycle.
Response: We agree with the comments about coding of CAD. Medicare will recognize CPT code 76085 for CAD as an add-on to screening mammography and procedure code G0236 as an add-on to diagnostic mammography. The code descriptors make clear that the CPT code is for use as an add-on to screening mammography and the alphanumeric code is an add-on to diagnostic mammography. Payment for the revised codes follows the proposed rule approach for physician work, practice expense and malpractice for all mammography services. There may be slight changes to the RVUs for practice expenses as a result of updated information included in this final rule that affect all physician fee schedule services.
In response to the comment about potential future FDA approved uses of CAD as add-on to digital mammography, it is possible that additional coding changes will be necessary or that editorial revisions to existing codes will allow for CAD to be paid as an add-on for digital mammography. We would like to coordinate our efforts with those of the CPT to minimize the need for alphanumeric codes and additional CPT codes.
Comment: One commenter expressed concern about the payment associated with the Outpatient Prospective Payment System for all forms of mammography.
Response: Any issues related to the Outpatient Prospective Payment System are outside the scope of this regulation and will be addressed by a separate regulation.
Comment: One commenter asked for clarification on Federally Qualified Health Centers (FQHC) reimbursement for screening mammography and other new services.
Response: Any issues related to FQHC reimbursement are outside the scope of this regulation.
Comment: One commenter expressed concern that CMS did not work more closely with the CPT codes in the establishment of coding for digital mammography.
Response: Whenever possible, CMS works with the American Medical Association's CPT Editorial Panel to establish coding for new technologies. The AMA CPT Editorial Panel has not established codes for digital mammography; therefore, CMS proactively established temporary G-codes for the digital mammography and Start Printed Page 55272computer-aided detection for diagnostic mammograms.
Comment: One commenter indicated that the malpractice expense for screening mammography should be higher than the unilateral diagnostic value of 0.03 since most mammography malpractice claims arise from allegations of cancers not detected or inappropriate follow-up of screening mammograms, not diagnostic studies. In addition, the screening mammography malpractice apportionment should be reversed for the PC and TC portions as the malpractice expense and risk is primarily with the interpreter of the screening mammogram, not the facility producing the technical component.
Response: We will consider the malpractice RVUs for these services interim for 2002 and will examine this issue with respect to the methodology used to establish malpractice RVUs.
Result of Evaluation of Comments
We will finalize our proposed relative values, because we believe they are an accurate reflection of the cost associated with the provision of these services. Additionally, we will also establish a temporary G-code (G0236) for the recent FDA approval of computer-aided detection used in conjunction with diagnostic mammography.
Table 3.—2002 Mammography Payments
CPT 1 HCPCS MOD Descriptor Work RVU Practice Expense RVU Malpractice RVU Total 76090 Mammogram, one breast 0.70 1.25 0.08 2.03 76090 26 Mammogram, one breast 0.70 0.25 0.03 0.98 76090 TC Mammogram, one breast 0.00 1.00 0.05 1.05 76091 Mammogram, both breast 0.87 1.54 0.09 2.50 76091 26 Mammogram, both breast 0.87 0.30 0.03 1.20 76091 TC Mammogram, both breast 0.00 1.24 0.06 1.30 76092 Mammogram, screening 0.70 1.44 0.09 2.23 76092 26 Mammogram, screening 0.70 0.25 0.03 0.98 76092 TC Mammogram, screening 0.00 1.19 0.06 1.25 G0202 Mammogram, screen, dir dig 0.70 2.52 0.09 3.31 G0202 26 Mammogram, screen, dir dig 0.70 0.30 0.03 1.03 G0202 TC Mammogram, screen, dir dig 0.00 2.42 0.06 2.48 G0204 Diag mammo, bilat, dir dig 0.87 2.73 0.09 3.69 G0204 26 Diag mammo, bilat, dir dig 0.87 0.35 0.03 1.25 G0204 TC Diag mammo, bilat, dir dig 0.00 2.38 0.06 2.44 G0206 Diag mammo, unilat, dir dig 0.70 2.20 0.08 2.98 G0206 26 Diag mammo, unilat, dir dig 0.70 0.28 0.03 1.01 G0206 TC Diag mammo, unilat, dir dig 0.00 1.92 0.05 1.97 G0236 Computer aided detect, diag 0.06 0.31 0.02 0.39 G0236 26 Computer aided detect, diag 0.06 0.02 0.01 0.09 G0236 TC Computer aided detect, diag 0.00 0.29 0.01 0.30 76085 Computer aided detection 0.06 0.31 0.02 0.39 76085 26 Computer aided detection 0.06 0.02 0.01 0.09 76085 TC Computer aided detection 0.00 0.29 0.01 0.30 1 CPT codes and descriptions only are copyright 2002 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. B. Screening Pelvic Examinations
Section 101 of the BIPA amends section 1861(nn)(2) of the Act (effective July 1, 2001) to provide that a woman who does not qualify for annual coverage of a screening pelvic examination under one of the statutory exceptions, qualifies for coverage of a screening pelvic examination (including a clinical breast examination) once every 2 years rather than once every 3 years.
In the August 2, 2001 proposed rule, we made conforming changes to § 410.56 (Screening Pelvic Examinations) of the regulations to reflect this statutory provision that has been implemented through sections 4603, 3628.1 and 4731 of the Medicare Carrier Manual, the Medicare Intermediary Manual, and the Medicare Hospital Manual, respectively.We received only one specific comment on the new screening pelvic examination proposal. That comment supported our proposed rule and recognized that the regulations are consistent with the Medicare law.
Result of Evaluation of Comments
We are adopting our proposal to conform the regulations to the law to provide coverage for biennial screening pelvic examination for women not at high risk for cervical or vaginal cancer, effective July 1, 2001.
C. Screening for Glaucoma
Section 102 of the BIPA provides for Medicare coverage under Part B for screening for glaucoma for individuals with diabetes, a family history of glaucoma, or others determined to be at “high risk” for glaucoma effective for services furnished on or after January 1, 2002. The statute provides for coverage of glaucoma screening, including (1) a dilated eye examination with an intraocular pressure measurement, and (2) a direct ophthalmoscopy or a slit-lamp biomicroscopic examination, subject to certain frequency and other limitations.
In the August 2, 2001 rule, we proposed a new § 410.23 (Screening for Glaucoma: Conditions for and Limitations on Coverage), to provide for coverage of the various types of glaucoma screening examinations specified in the statute. As provided in the statute, this new coverage allows payment for one glaucoma screening examination every year. To implement the statutory provisions, we proposed definitions for the following terms—screening for glaucoma, eligible beneficiaries, and direct supervision.
In keeping with the language of section 102(b) of the BIPA we proposed defining the term “screening for glaucoma” to mean a dilated eye examination with an intraocular pressure measurement and a direct ophthalmoscopy or a slit-lamp biomicroscopic examination for the Start Printed Page 55273early detection of glaucoma. This section also provides that the screening examinations that are to be covered under Medicare are to be furnished by or under the direct supervision of an optometrist or ophthalmologist who is legally authorized to furnish these services under State law (or the State regulatory mechanism provided by State law) of the State in which the services are furnished. These are services that would otherwise be covered if furnished by a physician or as incident to a physician's professional service. We also proposed incorporating this language in § 410.23.
We used the term “eligible beneficiaries” to indicate who may qualify for the new screening glaucoma benefit, and we proposed defining that term to include—individuals with diabetes mellitus, individuals with a family history of glaucoma, and African-Americans age 50 and over. As explained in the August 2 proposed rule, based on our review of the medical literature, and consultation with staff of the National Eye Institute and representatives of the American Academy of Ophthalmology and the American Optometric Association, we interpreted the statutory language, “individuals determined to be at high risk for glaucoma” to include Medicare beneficiaries who are African-Americans age 50 and over.
We felt that the medical evidence available at this time was only sufficient to support inclusion of African-Americans age 50 and over in the statutory “high risk” category, in addition to individuals with diabetes and those with a family history of glaucoma who are covered separately under the new screening benefit. However, we specifically solicited public comment on the appropriateness of including other individuals in the statutory definition of “high risk” for glaucoma, with supporting documentation from medical literature.
Section 102(b) of the BIPA provides that the glaucoma screening examination is to be furnished by or under the direct supervision of an ophthalmologist or optometrist who is legally authorized to furnish such services under State law or regulation in which the services are furnished. We proposed defining the term “direct supervision” as that term is defined in § 410.32(b)(3)(ii) for purposes of the oversight of covered diagnostic laboratory services as they are performed in the office setting. Specifically, for purposes of screening glaucoma we proposed defining the term “direct supervision” to mean that the ophthalmologist or optometrist must be present in the office suite and immediately available to furnish assistance and direction throughout the performance of the procedure. The definition states that the term “direct supervision” does not mean the physician must be present in the room when the procedure is performed.
We also proposed conforming changes to specify an exception to the list of examples of routine physical checkups excluded from coverage in §§ 411.15(a)(1) and 411.15(k)(9) for glaucoma screening examinations that meet the frequency limitation and the conditions for coverage that we are specifying under new § 410.23.
We received six comments that generally supported the proposal to implement section 102 of BIPA that provides for Medicare coverage of screening for glaucoma. Four of these comments were submitted by national medical associations, one was submitted by a pharmaceutical company, and another was provided by a consulting group. Only one commenter had a suggestion for revising the specific coverage provisions of the proposal.
Comment: One commenter responded to our invitation to the public in the proposed rule to submit comments on the question of whether it might be appropriate to include other individuals (and not just African-Americans over age 50) in the statutory definition of those at “high risk” for glaucoma. First, the commenter cites an article from the medical literature that notes that “one of the clearest factors relating to increased glaucoma prevalence is age.” (Gilchrist. Ophthalmic Physiol Opt 2000) Second, the commenter refers to other eye experts in the research of the epidemiology of glaucoma who have suggested that “the appropriate age at which screening might be most effective is 6 to 10 years younger among those of African descent because of the earlier onset of disease.” (Quigley and Vitale. Invest Ophthalmol Vis Sci 1997) Third, the commenter states that the latter conclusion is supported by data showing that in African-Americans who eventually develop glaucoma, the disease is present in 25 percent by age 54, 50 percent by age 65, and 75 percent by age 75. The commenter cites from the same Quigley article that comparable ages for these percentages of disease development in non-African-Americans are 64, 72, and 81 years, respectively. Finally, the commenter concludes that this literature supports a policy that would provide the glaucoma screening benefit for non-African Americans at an age 6 to 10 years older than for African-Americans (for example, 50 years of age), or beginning at age 56 to 60 years of age.
Response: We believe that the commenter has not interpreted the results of the Quigley and Vitale studies correctly. The article by Quigley and Vitale reported the results of a meta-analysis and statistical modeling to estimate the prevalence and incidence of glaucoma. In general, results from meta-analysis and remodeling are often limited by the quality and comparability of the original source data. In the proposed rule, we used data reported directly from the Baltimore Eye Study (Tielsch, et al. JAMA 1991) and the Beaver Dam Eye Study (Klein, et al. JAMA 1992), two of the largest published studies on glaucoma. These studies indicated that the prevalence of glaucoma in non-African-Americans starts to increase after the age of 65 to 70 years, whereas the prevalence increases much earlier in African-Americans. Our decision to include African-Americans in the statutory category of those at “high risk” for glaucoma was based on these studies and the increased prevalence of glaucoma in African-Americans.
Although we have decided not to add new populations to the definition of high risk at this time, the comment does raise the issue of how we should revise the definition in the future, if there is evidence to do so. We have decided to revise the proposed language in § 410.23(a)(2) so that it specifically refers to “individuals in the following high risk categories” to make it more consistent with the statute. This new structure for the regulation language will permit CMS to more easily add high risk groups to the glaucoma screening benefit through the rulemaking process should the evidence in the medical literature warrant it.
Payment for Glaucoma Screening
We believe that services provided as part of glaucoma screening will often overlap with services a physician provides during a patient encounter for ophthalmological services without requiring any additional work or practice expense. Therefore, we proposed bundling payment for glaucoma screening when it is provided on the same day as an evaluation and management (E/M) service or when it is provided as part of any ophthalmology service. In instances when glaucoma screening is the only service provided or when it is provided as part of an otherwise non-covered service (for example, CPT code 99397, preventive services visit,) we proposed the following HCPCS codes and payments: Start Printed Page 55274Gxxx5, Glaucoma Screening Furnished by a Physician for High Risk Patients.
For physician work and for malpractice, we proposed work and malpractice RVUs of 0.45 and 0.02, respectively, by crosswalking these values from CPT code 99212. Gxxx6, Glaucoma Screening Furnished Under the Direct Supervision of a Physician for High Risk Patients.
For physician work and for malpractice, we believe this new HCPCS code represents a level of work comparable to other E/M services performed “incident to” a physician's service and therefore proposed to crosswalk the work and malpractice RVUs from CPT code 99211 (E/M service that may not require the presence of a physician) which are 0.17 and 0.01, respectively.
For non-facility settings, we proposed the following practice expense inputs for both of the above HCPCS Codes— clinical staff time-certified ophthalmic medical technologist/certified ophthalmic technician/registered nurse: five minutes; equipment: screening lane; and supplies: ophthalmology visit supply package.
Comment: We received a comment from the American Academy of Ophthalmology (AAO) agreeing with our decision to bundle glaucoma screening with other E/M services and with our decision to create two levels of glaucoma screening services based on whether or not the physician performed the evaluation. The AAO also agreed with our proposal regarding RVUs for glaucoma screening performed “incident to” but commented that the level of payment for glaucoma screening performed by a physician was too low. They believe that payment rate should be a blend between CPT codes 99202 (Office or other outpatient visit for evaluation and management of a new patient) and 99213 (Office or other outpatient visit for evaluation and management of an established patient). This is based on the expectation that some patients receiving the service will be “new” patients to the ophthalmologist while others will have previously seen the ophthalmologist and therefore be “established” patients.
The AAO proposes that for 2002, payment be equivalent to CPT code 99202 for both physician work and practice expense, that for 2003, payment be equivalent to a 4.4 percent/95.6 percent blend of CPT codes 99202 and 99213 for both physician work and practice expense, that for 2004, payment be equivalent to a blend of 4.5 percent/95.5 percent blend of CPT codes 99202/99213, and that for 2005 and thereafter, payment be equivalent to a blend of 4.6 percent/95.4 percent of CPT codes 99202/99213. The AAO believes that the amount of history, physical examination, and medical decision making required for glaucoma screening approximates the amount of history, physical examination and medical decision making required for CPT code 99202 at the time of the first glaucoma screening and approximates the amount of history, physical examination, and medical decision making required for 99213 at the time of subsequent glaucoma screenings.
The American Optometric Association (AOA) echoed the AAO's comments concerning the crosswalk for physician work. They also noted that the practice expense inputs should be crosswalked to the intermediate ophthalmologic codes.
Response: We are finalizing our proposal to assign 0.45 work RVUs and .02 malpractice RVUs to Gxxx5, glaucoma screening performed by a physician (now G0117). This service is a screening service and therefore cannot be easily compared to the key components of a level III evaluation and management service (CPT code 99213). We also believe that the vast majority of beneficiaries receiving this service will be patients who have been previously seen by the ophthalmologist performing the service and, therefore, CPT code 99202 would not be an appropriate crosswalk for this service. We believe the work required for this service is similar whether or not the patient is “new” or “established”. Patients undergoing a screening service have no chief complaint or history of present illness. To perform this service, the only historical information required is a determination as to whether the beneficiary meets the criteria in the law, (for example, is at high risk for glaucoma). Therefore, the requirements for taking a history are actually less than the requirements of CPT code 99212. Additionally, the physical examination requirements are specified in the statute and are similar to the requirements of CPT code 99212. Furthermore, the vast majority of patients undergoing screening will not have glaucoma, so the typical screening service will require routine medical decision making. For those few patients with glaucoma who will need to schedule a return visit, the medical decision making is straightforward. Therefore, the glaucoma screening requirements are similar to CPT code 99212. Our decision to assign 0.45 work RVUs to this service is also consistent with the time required to perform the service and places it in correct rank order with regard to other screening services payable under Medicare. We have decided to accept the recommendation of AOA on practice expense inputs and will crosswalk the inputs from CPT code 92012, brief ophthalmic exam performed on an established patient, rather than using the practice expense inputs from CPT codes 99202 and 99213 as suggested by AAO.
Because we received no comments on the RVUs for the Gxxx6 code, Glaucoma Screening Furnished Under the Direct Supervision of a Physician for High Risk Patients (now G0118), we will implement this as proposed and will assign .17 work RVUs and .01 malpractice RVUs. For practice expense, we will also crosswalk this code to CPT 92012.
Comment: Several commenters noted that medical technicians do not have the education or training to provide screening glaucoma services. One commenter noted that ophthalmic medical personnel (OMP) are not licensed by State regulatory agencies and are precluded from ordering medications, including eyedrops. The commenter states that, according to the Joint Commission on Allied Health Personnel in Ophthalmology and the Association of Technical Personnel in Ophthalmology, OMPs cannot be independent practitioners, cannot diagnose or treat eye disorders and cannot prescribe medications. Since a dilated eye exam requires medication, the OMP cannot perform the exam without the patient first being seen by an ophthalmologist or optometrist.
Response: The regulation is drafted based on the statutory provision; however, it does not supersede any State laws or licensing requirements.
Result of Evaluation of Comments
We are adopting our proposal to include only African-Americans age 50 and over in the statutory category of those at “high risk” for glaucoma. We are revising the regulation in § 410.23(a)(2) to read “Eligible beneficiary means individuals in the following high risk categories.” This should allow CMS to more easily add high risk groups by rulemaking should the medical evidence warrant it.
For G0117 Glaucoma Screening for High Risk Patients Furnished by an Optometrist or Ophthalmologist—we will assign 0.45 work RVUs, .02 malpractice RVUs and we will crosswalk practice expense inputs from CPT code 92012.
For G0118 Glaucoma Screening for High Risk Patients Furnished Under the Direct Supervision of an Optometrist or Ophthalmologist—we will assign .17 work RVUs and .01 malpractice RVUs. Start Printed Page 55275For practice expense we will also crosswalk this code to CPT code 92012.
D. Screening Colonoscopy
Before the enactment of the BIPA, sections 1861(pp)(1)(C) and 1834(d)(3)(E) of the Act authorized Medicare coverage of screening colonoscopies once every 2 years for individuals at high risk for colorectal cancer. Individuals not at high risk for colorectal cancer did not qualify for coverage of screening colonoscopies under the colorectal cancer screening benefit, but they did qualify for coverage of other colorectal cancer screening examinations specified in the statute. These other examinations that were covered for individuals not at high risk for colorectal cancer included screening fecal-occult blood tests, screening flexible sigmoidoscopies, and screening barium enema examinations at certain frequency intervals specified in the statute and the regulations at § 410.37 (Colorectal cancer screening tests).
Section 103 of the BIPA amended sections 1861(pp)(1)(C), 1834(d)(2)(E)(ii), and 1834(d)(3)(F) of the Act to add coverage of screening colonoscopies once every 10 years for individuals not at high risk for colorectal cancer. However, in the case of an individual who is not at high risk for colorectal cancer, but who has had a screening flexible sigmoidoscopy within the last 4 years, the statute provides that payment may be made for a screening colonoscopy only after at least 47 months have passed following the month in which the last screening flexible sigmoidoscopy was performed. In addition, the statute provides that, in the case of an individual who is not at high risk for colorectal cancer but who does have a screening colonoscopy performed on or after July 1, 2001, payment may be made for a screening flexible sigmoidoscopy only after at least 119 months have passed following the month in which the last screening colonoscopy was performed.
In view of the statutory changes, we are conforming §§ 410.37(e) and 410.37(g) (related to limitations on coverage of screening colonoscopies and screening flexible sigmoidoscopies) to make them consistent with the new provisions of the statute that have been implemented through manual provisions of the Medicare Carriers Manual, the Medicare Intermediary Manual Part III, and the Medicare Hospital Manual in transmittal numbers 6097, 1824, and 7069, respectively, in February 2001.
Payment for Screening Colonoscopy
Payment for screening colonoscopy will be made under HCPCS code G0121: colorectal screening; colonoscopy for an individual not meeting criteria for high risk. As with current code G0105, screening colonoscopy for an individual at high risk, payment will be made at the level for a diagnostic colonoscopy, CPT code 45378, because the work is the same whether a procedure is screening or diagnostic. As the statute requires that, for both individuals who are or are not at high risk, if, during the course of the screening colonoscopy, a lesion or growth is detected that results in a biopsy or removal of the growth, the appropriate diagnostic procedure classified as colonoscopy with biopsy or removal should be billed and paid rather than HCPCS code G0105 or G0121.
We received four comments in support of the proposal to conform the regulations to the Medicare law implementing the new screening colonoscopy provision (section 103 of the BIPA) for individuals not at high risk for colorectal cancer. One of the commenters, however, did have a suggestion for how we could improve the manual instructions that we issue to our carriers on this subject.
Comment: The commenter suggests that we instruct our Medicare carriers to identify which International Classification of Diseases—Volume Nine (ICD-9) codes are acceptable to use in conjunction with the interim GO121 code that has been proposed for billing for covered screening colonoscopies performed for individuals not at high risk for colorectal cancer. The commenter stated that our failure to do this for screening flexible sigmoidoscopy code G0104 in the billing instructions we issued to our carriers in 1998 created problems for everyone concerned because individual carriers adopted a variety of acceptable ICD-9 codes, but did not inform the public under what circumstances the examinations were covered and when they were not.
Response: We are not aware of the problems stated above with respect to the Medicare billing codes for screening flexible sigmoidoscopies in 1998. In addition, we have not received any complaints about the new billing instructions that we released to our carriers in February of this year in conjunction with the interim G0121 code that was issued (effective July 1, 2001) for use in billing for screening colonoscopies for individuals not at high risk for colorectal cancer. Since individuals who might qualify for coverage under this new screening benefit are those who would not be at “high risk” for colorectal cancer, it is not clear to us why the physician billing for the service would need to provide any ICD-9 code for the examination to the carrier for Medicare payment to be made. We do not require that such information be submitted to the carrier at the present time in these circumstances.
Result of Evaluation of Comments
We are implementing our proposal as stated above. In view of the comment, we will review the matter, and we will take any necessary action that might be deemed appropriate.
E. Medical Nutrition Therapy
Section 105 of the BIPA amended section 1861(s)(2) of the Act to authorize Medicare Part B coverage of medical nutrition therapy (MNT) for certain beneficiaries who have diabetes or a renal disease, effective for services furnished on or after January 1, 2002. This new benefit is similar to a benefit initially established by section 4105 of the BBA as a component of the diabetes outpatient self-management training (DSMT) benefit. The DSMT benefit, described at section 1861(qq) of the Act, is a comprehensive diabetes training program, of which nutrition training is only one component.
Consistent with section 105(a)(3) of the BIPA, we considered the protocols of the American Dietetic Association (ADA) and the National Kidney Foundation (NKF) regarding medical nutrition therapy training for both diabetes and renal disease in order to establish criteria for coverage of these services. Because the protocols were inconclusive with respect to duration and frequency issues, we proposed to determine the duration and frequency of the benefit through the NCD process rather than through the rulemaking process.
We proposed to set forth the provisions regarding medical nutrition therapy at Part 410, subpart G and at § 414.64. The MNT provisions of the final rule follow.
Definitions (§ 410.130)
We defined “renal disease” for the purpose of this benefit as only chronic renal insufficiency and post-transplant care provided after discharge from the hospital. We proposed to limit post-transplant care to care furnished within 6 months after discharge from the hospital, if the transplant is viable and effective, because, under such conditions, we believe the beneficiary would no longer have renal disease and Start Printed Page 55276would not be eligible to receive the benefit under the statutory provision. We specifically solicited comments on this proposed time period, and requested that the commenters support their comments with articles from medical journals. We also established definitions of “diabetes”, “renal disease”, and “chronic renal insufficiency” for the purpose of this benefit using definitions from the Institute of Medicine report, “The Role of Nutrition in Maintaining Health in the Nation's Elderly,” published in 2000.
We proposed defining “episode of care” as a time period not to exceed 12 months, starting with the assessment (based on a referral from a physician), and including all covered interventions. Finally, in accordance with the statute, we defined MNT services as nutritional diagnostic, therapy, and counseling services provided by a registered dietitian or nutrition professional for the purpose of managing disease.
Medical Nutrition Therapy (§ 410.132)
At § 410.132(a), we proposed the conditions for coverage of MNT services. Specifically, we proposed that Medicare Part B pay for MNT services furnished by a registered dietitian or nutrition professional as defined in § 410.134 when the beneficiary is referred for the service by the beneficiary's treating physician. We proposed to limit the definition of physician to “treating physician” to ensure that the physician establishing the need for MNT is actually treating the beneficiary for a covered chronic disease and that the therapy is coordinated with the care being provided by the treating physician.
We proposed that the services covered consist of nutritional assessment, interventions, reassessment, and follow-up interventions. We chose not to define the specific components of the benefit in more detail because we anticipated that registered dietitians and nutritionists would use nationally recognized protocols, such as those developed by the ADA, as they normally would in their practice. As previously mentioned, we also proposed to use the NCD process to develop duration and frequency limits.
At § 410.132(b), we set forth the coverage limitations for MNT services. In accordance with section 1861(s)(2)(V)(ii) of the Act, we provided that MNT services would not be covered for beneficiaries on dialysis for end-stage renal disease. We did not exclude all beneficiaries who are diagnosed with end-stage renal disease because a few individuals with end-stage renal disease do not receive maintenance dialysis, and the statute specifically excludes beneficiaries receiving maintenance dialysis under section 1881 of the Act. The other provisions of this section outlined the coordination of referrals for MNT for diabetes and renal disease, and coordination of MNT and DSMT services.
Eligibility for MNT services will be dependent upon diagnoses and referrals made by the treating physician. At § 410.132(c), we proposed that referral only be made by the treating physician when the beneficiary has been diagnosed with diabetes or a renal disease, with documentation maintained by the referring physician in the beneficiary's medical record. Referrals must be made for each episode of care.
At § 410.132(d), we discussed requirements regarding reassessment and follow-up interventions. Specifically, we proposed that reassessments and follow-up interventions would only be covered when the referring physician determined that there was a change of diagnosis or medical condition within an episode of care that made a change in diet necessary.
Provider Qualifications (§ 410.134)
The BIPA specifies how we must define “registered dietitian or nutrition professional” for the purposes of this benefit, and allows for the grandfathering of nutrition professionals licensed or certified by States at the time of its enactment. The proposed qualifications for a registered dietitian or nutrition professional are set forth at § 410.134, and include alternative criteria for recognition of registered dietitians in States that do not provide for licensure or certification of these individuals.
We received nearly 1,000 comments on the MNT portion of the proposed rule. The most frequently received comments concerned: the definitions of diabetes, renal disease, and treating physician; the coordination of the diabetes self-management training and MNT benefits; and proposed reimbursement. We also received comments about provider qualifications.
Comment: We received a large number of comments that stated we had defined diabetes and renal disease too narrowly and asked for further clarification of the definitions.
Response: Our definition of diabetes does not specifically state how physicians should perform lab tests to determine if a beneficiary should be diagnosed with diabetes. However, as with the national protocols for medical nutrition therapy, we assume that physicians will conduct tests in accordance with nationally accepted clinical guidelines, which require testing on multiple occasions to determine a diagnosis of diabetes. We are clarifying our definition of diabetes by adding a sentence to further explain the etiology of the disease. We also have extended coverage to include gestational diabetes for the few Medicare beneficiaries who would need such coverage. We believe that we do not have the statutory authority to extend coverage to beneficiaries who have not yet been diagnosed with diabetes.
We also expand the definition of renal disease in this final rule. First, we clarify that beneficiaries with end-stage renal disease who are not receiving dialysis are eligible for the service. In addition, we have expanded the time period in which we will cover MNT for beneficiaries who have received a renal transplant to 36 months, to bring the coverage into conformance with the Medicare eligibility period for individuals under age 65.
Comment: A few commenters requested that we change our definition for renal disease to encompass all patients with glomerular filtration rates (GFR) below 60. The GFR is the measurement of renal function and has a range in normal adult males of 98 to 150 ml/min/1.7m2 and in normal adult females of 106 to 132 ml/min/1.72. The commenters believe that we did not fulfill the intent of the Congress.
Response: We disagree with the comment. Neither the BIPA nor its legislative history indicates any specific intention regarding how to define renal disease for purposes of eligibility for this benefit. Section 4108 of the BBA required the Department of Health and Human Services to contract with the National Academy of Sciences (NAS) to examine the benefits and costs associated with extending Medicare coverage for certain services, including medical nutrition therapy. We believe the NAS Institute of Medicine (IOM) report, “The Role of Nutrition in Maintaining Health in the Nation's Elderly,” published in 2000, provides a reasonable definition for determining the scope of the benefit. In that report, “renal disease” is defined as chronic renal insufficiency, end-stage renal disease, and the beneficiary's condition following renal transplant. The GFR rate for chronic renal insufficiency (GFR of 13 to 50 ml/min/1.73m2) used in the proposed rule was also in the IOM report.
The IOM report did not cover the period of time MNT should be available to beneficiaries following a renal Start Printed Page 55277transplant. The Congress has authorized us to provide a reasonable interpretation of how much coverage will be provided for beneficiaries after renal transplant.
The suggested eligibility criterion of a GFR under 60 suggested by commentators appears to be too expansive, because typically the GFR for beneficiaries after they receive a transplant never goes above 60. We also received comments recommending that we match our coverage to the length of time an under-65 beneficiary is entitled to post-transplant coverage. We agree that this is a reasonable criterion for our coverage of MNT services for post-renal-transplant beneficiaries.
Comment: We received a large number of comments expressing concern about our use of the term “treating physician”. Most commenters believe that the term does not include both primary care physicians and specialists. One commenter believes we exceeded our statutory authority. Also, some commenters believe that we should allow any physician to provide a referral for the service.
Response: We did not intend to exclude primary care physicians from the term “treating physician”. In this final rule, we now define the term “treating physician” to mean the primary care physician or specialist coordinating care for the beneficiary with diabetes or renal disease.
Regarding our statutory authority, the statute, as amended at section 1861(s)(2)(V)(iii) of the Act, clearly states that the Secretary has authority to impose other criteria, after considering protocols established by dietetic or nutrition professional organizations. Requiring referral by the treating physician is within this statutory authority. We continue to believe that we must assure the quality of services received by Medicare beneficiaries. Therefore, our coverage guidelines must require coordination of care for beneficiaries with chronic diseases in order to assure that quality. We have not changed the final rule to allow any physician to make the referral for MNT.
Comment: We also received comments concerning the definition of the benefit and episode of care.
Response: As stated in the proposed rule, we relied on the national dietetic therapy protocols of major organizations to define the basic benefit. In seeking to understand the reason for these comments, we discovered that the use of the term “reassessment and follow-up interventions” in §§ 410.132(a) and (d) was confusing to many commenters. In the national protocols, reassessments and follow-up interventions are always considered part of the basic service. In the proposed rule, we had used the terms to define a special circumstance that happens only when a beneficiary has a change in medical condition or diagnosis.
In this final rule, we clarify our policy by eliminating the use of the terms “reassessment” and “follow-up interventions”. We also have changed the language slightly in several other parts of the final rule to help clarify our intent, such as adding, “treatment regimen” as another reason why we would allow additional coverage in special circumstances. Our definition of “episode of care” (except in the case of coordination of services with initial DSMT and gestational diabetes) is based on our intent to pay providers of the service more efficiently by conforming the definition to our claims processing requirements. Our intent continues to be that dietitians and nutritionists should follow national MNT protocols.
Comment: Some commenters stated that the DSMT and MNT benefits for beneficiaries with diabetes should only be coordinated to the extent of reducing the total of number of MNT hours by one hour.
Response: In the proposed rule, we assumed that all of the MNT benefit for diabetes would be provided as part of the initial DSMT benefit and that follow-up DSMT and MNT for diabetes should be fully coordinated. In our discussions with interested organizations concerning the amount of services that should be covered for the NCD process, great concern was expressed about the coordination of the DSMT and MNT benefits. Therefore, we have spent a great deal of time researching this issue. We have found no evidence to date to suggest that the language of the proposed rule should be changed for this requirement. However, because we are still developing our NCD concerning the duration and frequency of the MNT benefit, we will continue to consider any evidence that might lead to the conclusion that additional hours should be covered when both benefits are provided during the same time period.
Until such time as an NCD alters this requirement, if initial DSMT and MNT benefits for diabetes are provided in the same 12 month episode of care, only 10 total hours of services will be covered, regardless of whether the hours are covered as MNT, DSMT, or a combination of both. In situations where follow-up DSMT and MNT for diabetes is provided, only the total amount of hours allowed under the MNT benefit will be covered. (The MNT cap will be applied to any DSMT services provided to a beneficiary during the follow-up period, until such time as an NCD alters this requirement.)
Comment: We received comments that MNT for a diagnosis of renal disease and MNT for a diagnosis of diabetes should not be fully coordinated.
Response: In this final rule, we are not changing this requirement because the provision at § 410.132(d) (in this final rule § 410.132(b)(5)) already provides for additional coverage in this situation and we believe that additional coverage is not necessary. However, we are clarifying that beneficiaries receiving initial DSMT can receive the full initial DSMT benefit.
Comment: One commenter was concerned that providers that had completed a full course of study of dietetics or nutrition after completion of a bachelor's degree would be excluded. We also received comments asking us to clarify the requirements further.
Response: We agree that individuals that complete the full course of study of an accredited dietetics or nutrition program after completion of a bachelor's degree would still meet the intent of the legislation. Therefore, we have altered the regulatory language to include these individuals. However, we will require our contractors to require the practitioner to provide proof of completion of the course of study in addition to proof of receiving the degree.
In situations where the individual is credentialed as a registered dietitian by an organization appropriate for this purpose, we will recognize that credential as proof that the individual meets both the education and experience required in the regulation. We have added language at §§ 410.134(a) and (d) to change the final rule.
Comment: A commenter noted that State licensure requirements vary considerably; providers will need to obtain multiple licenses when they perform services in more than one State; and providers will have to meet different requirements if State licensure provisions change.
Response: The statutory intent to recognize State licensure and State licensure requirements is clear. We cannot require States to have similar licensure requirements, recognize licensure by other States, or to provide for grandfathering of providers when State licensure laws change. Therefore, we have not changed the final rule to reflect these comments.Start Printed Page 55278
Payment for Medical Nutrition Therapy (§ 414.64)
Section 105(c) of the BIPA requires that we pay for medical nutrition therapy services at 80 percent of the lesser of the actual charge for the services or 85 percent of the amount determined under the physician fee schedule for the same services if the services had been furnished by a physician. Based upon consultation with the American Dietetic Association (ADA) to assess the types of resource inputs used to furnish a 15-minute medical nutrition therapy session by a registered dietitian or professional nutritionist, we proposed the following:
For CPT code 97802—Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes, we did not propose physician work RVUs for this service, based on the statutory provision that specifically provides that medical nutrition therapy services may only be furnished by registered dietitians or nutrition professionals. For practice expense, we proposed 0.47 RVUs and, for malpractice, we proposed 0.01 RVUs for a total of 0.48 RVUs.
For CPT code 97803—Reassessments and intervention, individual, face-to-face with the patient, each 15 minutes, we proposed 0.0 work RVUs, 0.34 practice expense RVUs and 0.01 malpractice RVUs for a total of 0.35 RVUs.
For CPT code 97804—Group, 2 or more individuals, each 30 minutes, we proposed 0.0 work RVUs, 0.14 practice expense RVUs and 0.01 malpractice RVUs for a total of 0.15 RVUs. To determine payment, the RVUs shown above would need to be multiplied by the physician fee schedule conversion factor and 0.85 (to reflect the statutory requirement that payment be 85 percent of the amount determined under the physician fee schedule).
We also stated that, consistent with the definition in the CPT's Physical Medicine Rehabilitation codes, a group is considered to be 2 or more individuals and that Medicare co-payments and deductibles would apply for medical nutritional therapy services.
Comment: The American Dietetic Association (ADA) and many individuals submitted comments concerning the proposed reimbursement rate for medical nutrition therapy services. They stated that the proposed reimbursement rate for these services is too low and would result in limited beneficiary access to these services since private practice dietitians will choose not to participate. Some commenters referenced reimbursement rates currently paid by private insurers of $85 to $125 for 1 to 11/2 hours for an initial visit and $85 per hour for follow-up. They believe that the proposed rate for Medicare is far short of what was envisioned by the Congress. Commenters indicated that the statute clearly states that medical nutrition therapy payment should be 80 percent of the lesser of the actual charge or 85 percent of the amount determined under the physician fee schedule for the same service, provided by a physician. According to commenters, physicians who are also registered dietitians, use E/M codes 99213 through 99215 and 99244 when providing medical nutrition therapy services. The commenters stated that E/M codes 99203 through 99205 are appropriate reference points for determining medical nutrition therapy payment. The commenters also stated that any refinement of medical nutrition therapy values should be based on the underlying E/M codes that they believe are the statutory basis for medical nutrition therapy payment. While commenters acknowledge that physicians may perform other tasks besides nutritional assessment, therapy and counseling during an office visit, they believe those additional services are the basis for the Congress' instruction to reimburse non-physician providers of medical nutrition therapy at 85 percent of the amount physicians receive. The AMA's Health Care Professionals Advisory Committee (HCPAC) submitted a comment that suggested there should be physician work for medical nutrition therapy. This group provides recommendations on valuing services for codes used by non-physician providers. The HCPAC indicated that it evaluated each of the medical nutrition therapy codes and compared them to services that are available to other providers but not nutritionists (for example, physical therapy services). The comment further stated that the 15 percent reduction should not apply because the HCPAC took this into account when developing the recommendations. The HCPAC further added that there should be work values for medical nutrition therapy just as there are for physical and occupational therapy.
Response: We have reviewed the statute and legislative history. There is no indication that Congress envisioned a particular payment amount or expected us to use an E/M service to determine the value of medical nutrition therapy. Section 105(c) of the BIPA states that “the amount paid shall be 80 percent of the lesser of the actual charge for the services or 85 percent of the amount determined under the fee schedule established under section 1848(b) of the Act for the same services if furnished by a physician.” The BIPA Conference Report indicates that payment will equal “the lesser of the actual charge for the service or 85 percent of the amount that would be paid under the physician fee schedule if such services were provided by a physician.” The statute and Conference Report direct us to establish the physician fee schedule amount for nutrition therapy services. The Medicare allowed charge would equal 100 percent of the physician fee schedule amount if the services are performed by a physician and 85 percent of the physician fee schedule amount if the services are performed by a registered dietitian or nutrition professional. The commenters suggest that physicians currently bill for an E/M service when they provide nutrition services. We do not believe that it is appropriate to compare medical nutrition therapy provided by a registered dietitian to an E/M service provided by a physician. Registered dietitians do not take medical histories, they are not trained to and do not perform physical examinations, nor do they make medical decisions. Furthermore, when physicians use an E/M code to report the provision of counseling or coordination of care, they typically have also performed a medical history, physical examination, and engaged in medical decision making as part of that service. If such an individual performed a service that met the requirements of an E/M service, then it would be be appropriate for him or her to report an E/M service. Further, we note that the E/M services include not only an amount attributable to physician work, but also payment for physician practice expenses. For instance, a level 3 new patient office visit (CPT code 99203) includes payment for 50 minutes of nurse time. A level 3 established patient office visit (CPT code 99213) includes 36 minutes of nurse time. Both of these codes include additional compensation for medical equipment and supplies that are typically used in an office visit but are not used as part of a medical nutrition therapy service. If we were to adopt the commenters' view and crosswalk values for medical nutrition therapy to an E/M service, we would be including payment not only for the counseling service of the practitioner, but also, inappropriately for the costs of clinical personnel that are not involved in the nutrition therapy service.Start Printed Page 55279
Commenters indicated that the statute established the 85 percent adjustment to account for activities that are typically performed by a physician during an E/M service are not performed by a nutritionist. The statute and legislative history do not indicate that the 85 percent adjustment is intended to serve this purpose. In fact, the commenters themselves note that “consistent with other non-physician providers, reimbursement is set at a percentage of the physician's fee schedule.” Under the physician fee schedule, we will pay a physician 80 percent of 100 percent of the physician fee schedule amount, and, if a non-physician practitioner provides an identical service, Medicare pays 80 percent of 85 percent of the physician fee schedule amount. For instance, under CPT code 99213, a level 3 established patient office visit is one of the most common services provided by physicians, physician assistants and nurse practitioners. Even though the service is considered to be identical, we can by law pay a physician assistant and nurse practitioner only 85 percent of what we pay a physician to do the same service. Thus, in the case of other practitioners, the percentage does not reflect that a non-physician practitioner provides fewer services than a physician. Because there is no indication in the statute that the 85 percent adjustment should apply differently in the context of medical nutrition therapy than for other services performed by non-physician practitioners, we believe it is appropriate to pay 80 percent of 100 percent of the physician fee schedule amount when medical nutrition therapy is provided by a physician and 80 percent of 85 percent of the physician fee schedule amount when the service is provided by a registered dietitian or nutrition professional.
In response to the comment about payment rates of private insurers for medical nutrition therapy, we cannot use such information in a relative value system to establish payment. Section 1848(c) of the Act requires us to establish RVUs that recognize the relative resources involved in furnishing different physician fee schedule services. Thus, our role is to establish the appropriate relative payment amounts. The total payment amount is determined under a formula prescribed in section 1848(d) of the Act. We have no authority to change the formula.
In response to the HCPAC recommendation, we reiterate that it is inappropriate to compare medical nutrition therapy services to E/M services performed by physicians. While medical nutrition therapy may be performed by a physician who is also a registered dietitian, this does not make it a physician's service that requires a work RVU. Physicians may occasionally perform other services that have no physician work, such as chemotherapy administration or the technical component of a diagnostic x-ray test. When such services with no physician work are performed by a physician, we do not establish a physician work RVU just because the service was performed by a physician in that instance. Physicians will occasionally meet the statutory qualifications to be considered a registered dietitian or nutrition professional who can bill Medicare for medical nutrition therapy services. In these circumstances, we will pay the physician 80 percent of 100 percent of the physician fee schedule amount. In this unusual circumstance, we are paying for a medical nutrition therapy service provided by a physician under section 1861(s)(2)(V) and not a physician's service under section 1861(s)(1) of the Act.
Comment: One comment indicated that the 85 percent adjustment should not apply because the RVUs we used are not based on physician work or physician practice expenses to deliver the service. This commenter indicated that we proposed an inadequate payment by not following the statutory scheme and proceeded to apply a 15 percent discount that is neither fair nor reasonable.
Response: The statute requires us to establish a physician fee schedule amount for the service and pay 80 percent of 100 percent of the amount if the service is provided by a physician and 80 percent of 85 percent if the service is provided by a registered dietitian or nutrition professional. We initially anticipated that physicians would never bill Medicare for medical nutrition therapy services because they generally would not meet the statutory requirements to be considered registered dietitians or nutrition professionals. In this circumstance, we agree that it seems unusual to apply a reduction for a service that seldom would be furnished by a physician. However, we believe that the statute requires that Medicare payment be based on the 85 percent level. We understand that, although not common, there are physicians who do meet the statutory requirements to be considered registered dietitians or nutrition professionals. In these circumstances, our payment to the physician will be based on 100 percent of the physician fee schedule amount, not the 85 percent that we will pay to a registered dietitian or nutrition professional. We believe the statute would not allow a physician who does not meet the statutory requirements for a registered dietitian or nutrition professional to be paid for a medical nutrition therapy service. If a physician provides medical nutrition counseling as part of a patient encounter that meets the requirements for an E/M service, the physician can bill Medicare for a physician's service.
Comment: We received one comment requesting that we clarify that Medicare will pay qualified providers in private practice settings or physician offices where they may be independent contractors. The commenter also asked how we intend to pay for medical nutrition therapy in the hospital outpatient department. The commenter also asked for clarification on reassignment of payment if a registered dietitian is an employee of physicians or hospital outpatient facilities.
Response: Medicare will pay qualified dietitians and nutrition professionals who enroll in the Medicare program regardless of whether they provide medical nutrition therapy services in an independent practice setting, hospital outpatient department or any other setting, with the exception of services provided to patients in an inpatient stay in a hospital or skilled nursing facility. In these circumstances, our payment to the hospital or skilled nursing facility includes payment for medical nutrition therapy. If a qualified practitioner provides medical nutrition therapy in any other setting, including a private practice setting, section 1833(a)(1)(T) of the Act requires that Medicare payment equal 80 percent of the lesser of actual charges or 80 percent of 85 percent of the amount determined under the physician fee schedule. Payment in the hospital outpatient department will be made under the physician fee schedule, not under the hospital outpatient prospective payment system.
Current rules regarding reassignment of benefits would apply to medical nutrition therapy. We want to emphasize that medical nutrition therapy cannot be provided incident to a physician's service unless the physician also meets the qualifications to bill Medicare as a registered dietitian or nutrition professional.
Comment: Commenters objected to the methodology used to establish the proposed RVUs for this service. They believe it is inappropriate to use the top-down or no-work pool methodology to determine medical nutrition therapy payment. They believe that medical nutrition therapy payment should not be based on comparison to a preventive medicine code (CPT code 99401) in the zero-work pool methodology. The Start Printed Page 55280commenters indicated that preventive medicine services omit the problem-oriented components of the comprehensive history, as well as other essential assessment points, such as the patient's chief complaint and history of present illness. They disagree with our assertion in the proposed rule that physicians do not perform nutrition services and assert that it is inappropriate to use the top-down or zero-work methodology to establish the RVU for medical nutrition therapy.
Response: We use the top-down methodology or no-work pool methodology to price the practice expense RVUs for all services priced under the Medicare physician fee schedule. Given that the statute indicates that medical nutrition therapy should be paid using the physician fee schedule, we believe it is reasonable and appropriate to use the same methodologies that we use to develop RVUs for other physician fee schedule services. With respect to use of the preventive medicine service, we used a service that we felt had similar practice expenses to medical nutrition therapy. It is not clear why practice expenses for a counseling service would differ based on the health status of the patient.
Comment: A commenter representing dietitians asked us to review the relativity of payment across the three medical nutrition CPT codes. The commenter indicated that payment for CPT code 97803 was set at 72.9 percent of proposed RVUs for CPT code 97802 and 97804 was set at 31 percent of CPT code 97802. The commenter argues that, because reassessments are shorter than initial assessments, the proposed RVUs are actually discounted twice (that is, less payment per 15 minutes of time as well as less total time). They believe that the value of CPT codes 97802 and 97803 should be identical. The commenters indicated that E/M services provided by physicians do not receive the same discount. The commenter also stated that the payment for CPT code 97804 was less than for other group services and gave the example of a nurse or pharmacist providing nutrition instruction under the diabetes self-management training benefit.
Response: We have reviewed the payments for CPT codes 97802 and 97803 and agree with the commenter that these two codes should have the same values. The essential difference between an initial and follow up medical nutrition therapy service is the time spent performing the service. Initial visits will be longer than follow-up visits and will likely involve Medicare payment for more increments of service. We will pay less for follow up visits because they will typically involve fewer 15 minute increments of time than an initial visit. The payment rate we are establishing in this final rule for CPT code 97803 will be the same as the proposed rate for CPT code 97802. We have also changed the payment rate for CPT code 97804 assuming that the code will normally be billed for 4 to 6 patients with the average of 5. Using the revised values, the payment rate for group medical nutrition therapy would approximate the hourly rate paid for other medical nutrition therapy services. (We note that the RVU units between the proposed and final rule show some marginal change because of changes made in the practice expense methodology that affect all physician fee schedule services). We do not agree with the comment that “evaluation and management services provided by physicians do not receive the same discount.” E/M service are not time based services and, as stated above, for many reasons are inappropriate comparisons to medical nutrition therapy service codes.
Comment: Many commenters stated that co-payments must be structured so that they are not barriers to the medical nutrition therapy benefit.
Response: Section 105(c) of the BIPA modifies section 1833(a)(1) of the Act to add subparagraph (T) that requires that Medicare payment equal 80 percent of the lesser of the actual charge for the services or 85 percent of the amount determined under physician fee schedule. The statute requires the same coinsurance for medical nutrition therapy services that applies to other Part B services.
Comment: Commenters suggested that initial medical nutrition therapy sessions for treatment of diabetes or renal disease should be billed under CPT code 97802 and subsequent medical nutrition therapy sessions should be billed under CPT code 97803. New diagnoses due to a change in medical condition or unanticipated complications should be billed under CPT code 97802 and subsequent medical nutrition therapy sessions should be billed under CPT code 97803.
Response: At the present time, we are requiring that medical nutrition therapy be reported by using CPT codes 97802, 97803, and 97804. We will revisit our coding requirements when we publish the NCD for medical nutrition therapy. The NCD will set forth the structure of the medical nutrition therapy benefit in detail. We will make a decision concerning creation or modification of codes and creation of modifiers for reporting medical nutrition therapy once the NCD has been published. Until the NCD is published, creation or modification of codes and creation of modifiers would be premature. Therefore, we are requiring that the initial individual medical nutrition therapy visit be reported as CPT code 97802 and all follow up visits (for interventions and reassessments) for individual medical nutrition therapy be reported as CPT code 97803. All group medical nutrition therapy visits should be reported as CPT code 97804 whether they are initial or follow up visits.
Comment: Commenters urged us to define medical nutrition therapy descriptors consistently. They stated that the descriptors in Table 5 of the proposed rule should agree with the descriptors in § 414.132.
Response: We agree. We will make the descriptors for medical nutrition therapy consistent with the nomenclature in CPT and our regulations.
Comment: We received a comment that recommended that we consider including additional items in the practice expense inputs for medical nutrition therapy. The commenter indicated that inputs should include staff costs for training on billing procedures, Health Insurance Portability and Accountability Act training, audit expenses, and other costs resulting from Medicare policies and procedures. The commenter indicated that expenses of registered dietitians in private practice differ little from other practitioners.
Response: There are two major data sources used in the practice expense methodology—estimates of direct inputs and aggregate practice expense per hour information from the AMA's Socioeconomic Monitoring Survey. At this time, we are using the practice expense per hour for all physicians to establish the practice expense RVUs for medical nutrition therapy. We are not currently using the estimates of direct expenses for medical nutrition therapy because the services are valued in the no-work pool. However, we are researching alternatives to the no-work pool that would allow all no-work services to be priced under the top-down methodology. If we develop such an alternative, the estimates of direct expenses will be important in determining the RVUs for medical nutrition therapy. Indirect expenses are based on physician work and direct inputs. We believe that many of the costs identified by this commenter are indirect costs that would likely be included in practice expenses reported through the SMS survey. Since the commenter has suggested that practice expenses for private practice registered dietitians differ little from other Start Printed Page 55281practitioners, we believe the average practice expense per hour for all physicians is sufficient to use in the practice expense methodology.
Result of Evaluation of Comments
The payment rate we are establishing in this final rule for CPT code 97803 will be the same as the rate for CPT code 97802. We are also changing the payment rate for CPT code 97804 using the assumption that the code will normally be billed for 4 to 6 patients with the average of 5. Using these revised values, the payment rate for group medical nutrition therapy will approximate the hourly rate paid for other medical nutrition therapy services.
F. Telehealth Services
Beginning October 1, 2001, the BIPA amended section 1834 of the Act to specify that we pay a physician (as defined in section 1861(r) of the Act) or a practitioner (described in section 1842(b)(18)(C) of the Act) for telehealth services that are furnished via a telecommunications system to an eligible telehealth individual.
The BIPA defined Medicare telehealth services as professional consultations, office or other outpatient visits, and office psychiatry services identified as of July 1, 2000, by CPT codes 99241 through 99275; 99201 through 99215, 90804 through 90809 and 90862 (and as we may subsequently modify) and any additional service we specify. The BIPA defines an eligible telehealth individual as an individual enrolled under Part B who receives a telehealth service furnished at an originating site.
Section 1834(m) of the Act, as added by the BIPA, limited an originating site to a physician's or practitioner's office, hospital, critical access hospital, rural health clinic, or Federally qualified health center. Additionally, the BIPA specified that the originating site must be located in one of the following geographic areas:
- In an area that is designated as a rural health professional shortage area (HPSA) under section 332(a)(1)(A) of the Public Health Service Act.
- In a county that is not included in a Metropolitan Statistical Area (MSA).
However, an entity participating in a Federal telemedicine demonstration project that has been approved by, or receives funding from us as of December 31, 2000 would not be required to be in a rural HPSA or non-MSA.
The BIPA also required that we pay a physician or practitioner located at a distant site that furnishes a telehealth service to an eligible telehealth beneficiary an amount equal to the amount that the physician or practitioner would have been paid under Medicare had the service been furnished without the use of a telecommunications system.
This section also provided for a facility fee payment for the period beginning October 1, 2001 through December 31, 2002, to the originating site of $20. For each subsequent year, the facility fee for the preceding year is increased by the percentage increase in the MEI as defined in section 1842(i)(3) of the Act. The BIPA also amended section 1833(a)(1) of the Act to specify that the amount paid must be 80 percent of the lesser of the actual charge or the amounts specified in new section 1834(m)(2) of the Act.
In order for us to have this benefit expansion implemented timely, we have used a program memorandum. The program memorandum was effective October 1, 2001. This final rule will be effective January 1, 2002.
The rule published on August 2, 2001 proposed to establish policies for implementing the provisions of section 1834(m) of the Act, as added by the BIPA, that change Medicare payment for telehealth services.
We proposed to revise § 410.78 to specify that Medicare beneficiaries are eligible for telehealth services only if they receive services from an originating site located in either a rural HPSA as defined by section 332(a)(1)(A) of the Public Health Services Act or in a county outside of a MSA as defined by section 1886(d)(2)(D) of the Act.
1. Definitions
Section 1834(m)(4)(F) of the Act, which was added by the BIPA and became effective for services beginning October 1, 2001, defined telehealth services as professional consultations, office and other outpatient visits, individual psychotherapy, pharmacologic management, and any additional service we specify. Additionally, this provision identified covered services by HCPCS codes identified as of July 1, 2000. We proposed to revise § 410.78 to implement this coverage expansion to include the following services (and corresponding CPT codes):
- Consultations (codes 99241 through 99275).
- Office and other outpatient visits (codes 99201 through 99215).
- Individual psychotherapy (codes 90804 through 90809).
- Pharmacologic management (code 90862).
We solicited comments regarding the guidelines that we should use to make additions or deletions of services. We also solicited comments about specific services that may be appropriate to be covered under the Medicare telehealth benefit.
In this final rule, we are specifying at § 410.78 that, except for the use of store and forward technology in the demonstration programs conducted in Alaska or Hawaii, an interactive telecommunications system must be used and the medical examination of the patient must be at the control of the physician or practitioner at the distant site. We are defining interactive telecommunications system as multimedia communications equipment that includes, at a minimum, audio and video equipment permitting two-way, real-time interactive communication between the patient and physician or practitioner at the distant site. We are also specifying that telephones, facsimile machines, and electronic mail systems do not meet the definition of an interactive telecommunications system.
A patient need not be present for a Federal telemedicine demonstration program conducted in Alaska or Hawaii. We are specifying that for Federal telemedicine demonstration programs conducted in Alaska or Hawaii, Medicare payment is permitted for telehealth when asynchronous store and forward technologies, in single or multimedia formats, are used as a substitute for an interactive telecommunications system. Additionally, we are specifying that the physician or practitioner at the distant site must be affiliated with the demonstration program.
We are defining asynchronous, store and forward technologies, as the transmission of the patient's medical information from an originating site to the physician or practitioner at the distant site. The physician or practitioner at the distant site can review the medical case without the patient being present. An asynchronous telecommunications system in single media format does not include telephone calls, images transmitted via facsimile machines, and text messages without visualization of the patient (electronic mail). Photographs must be specific to the patient's medical condition and adequate for rendering or confirming a diagnosis or treatment plan. Finally, we are defining the originating site as the location of an eligible telehealth individual at the time the service being furnished via a telecommunications system occurs.
2. Conditions of Payment
The BIPA changed the telepresenter requirements. In accordance with section 1834(m)(2)(C) of the Act, a Start Printed Page 55282telepresenter is not required to be present. Therefore, we would not require a telepresenter as a condition of Medicare payment.
Section 1834(m)(1) of the Act requires that Medicare make payments for telehealth services furnished via a telecommunications system by a physician or a practitioner (described in section 1842(b)(18)(C) of the Act). Non-physician practitioners described in this section of the Act include nurse practitioners, physician assistants, clinical nurse specialists, certified nurse midwives, clinical psychologists, clinical social workers, and certified registered nurse anesthetists or anesthesiologists' assistants. Section 1834(m)(2) of the Act specifies that we pay the physician or practitioner at the distant site who furnishes a telehealth service an amount equal to the amount that the physician or practitioner would have been paid under Medicare had the service been furnished without the use of a telecommunications system.
Certified registered nurse anesthetists and anesthesiologists' assistants would not be permitted to bill for and receive payment for a telehealth service under this provision. Under the Medicare program, these practitioners do not receive payment for office visits, consultation, individual psychotherapy, or pharmacologic management when these services are furnished without the use of a telecommunications system. Section 1834(m)(2) of the Act specifies that we pay to the distant site physician or practitioner an amount equal to what would have been paid for the service without the use of a telecommunications system. Therefore, certified registered nurse anesthetists and anesthesiologists' assistants would not receive payment for telehealth services.
We proposed at § 410.78 that, as a condition of Part B payment for telehealth services, the physician or practitioner at the distant site must be licensed to provide the service under State law.
Section 1834(m)(2)(A) of the Act specifies that the payment amount for the professional service is equal to the amount that would have been paid without the use of a telecommunications system. Medicare payment for physicians' services is generally based, under section 1848 of the Act, on the resource-based physician fee schedule. Payment to other health care practitioners listed earlier, authorized under section 1833 of the Act, is based on a percentage of the physician fee schedule payment amount. Therefore, we will pay for office or other outpatient visits, consultation, individual psychotherapy, and pharmacologic management services furnished by physicians at 80 percent of the lower of the actual charge or the fee schedule amount for physicians' services. We will also pay for services furnished by other practitioners at 80 percent of the lower of the actual charge or that practitioner's respective percentage of the physician fee schedule.
Section 1834(m)(2) of the Act provides for a professional fee for the physician or practitioner at the distant site (equal to the applicable Part B fee schedule amount) and a $20 facility fee for the originating site. Telepresenters are not required, unless one is deemed medically necessary by the physician or practitioner at the distant site. The BIPA does not address the issue of payment for the telepresenter. The Office of the Inspector General has advised us that permitting the physician or practitioner at the distant site to pay the telepresenter creates a significant risk under the anti-kickback statute. Therefore, we establish in § 414.65 that payments made to the distant site physician or practitioner for professional fees, including deductible and coinsurance (for the professional service), are not to be shared with the referring practitioner or telepresenter.
However, the telepresenter could bill and receive payment for services that are not telehealth services that a telepresenter would otherwise be allowed to provide under the Medicare statute, including services furnished on the same day as the telehealth service.
The BBA prohibited any payment for line charges or facility fees associated with a professional consultation via a telecommunications system. Section 1834(m)(2)(B) of the Act, as added by the BIPA, provides for a facility fee payment to the originating site, specifying that the amount of payment is 80 percent of the lesser of the actual charge or a facility fee of $20.00. The BIPA further specifies that, beginning January 1, 2003, the originating facility fee be increased annually by the Medicare Economic Index (MEI) as defined in section 1842(i)(3) of the Act. Additionally, we clarify that the Geographic Practice Cost Index (GPCI) would not apply to the facility fee for the originating site. This fee is statutorily set and is not subject to the geographic payment adjustments authorized under the physician's fee schedule. The beneficiary is responsible for any unmet deductible amount and Medicare coinsurance. We would revise § 414.65 to provide for payment of a facility fee to the originating site.
Section 1834(m)(3) of the Act specifies that sections 1842(b)(18)(A) and (B) apply to physicians and practitioners receiving payment for telehealth services and to originating sites receiving a facility fee, in the same manner as they apply to practitioners. This section requires that payment for such services may only be made on an assignment-related basis. We did not reflect this provision in the proposed rule. Because this requirement is specified in the BIPA and we have no discretion, we are implementing it in this final rule in new § 414.65(d).
Comment: One commenter believed that requiring an originating site to be located in a rural HPSA or non-MSA county would not permit medical practitioners located in urban and suburban areas to offer telehealth services.
Response: We clarify that, as a condition of payment under Medicare, the originating site must be located in a rural HPSA or non-MSA county. The physician or practitioner at the distant site, who provides the telehealth service, is not subject to these limitations. For example, a psychologist in Salt Lake City, Utah would be able to provide a mental health visit to a beneficiary at a physician's office located in a non-MSA county.
Comment: We received various comments on the definition of an originating site. Many commenters believe that the list of facilities eligible to be a telehealth originating site should be expanded beyond those specified in the statute. Specific suggestions were received to include the patient's residence, skilled nursing facilities, nursing homes, and community mental health centers as originating site facilities within this provision. Another commenter suggested that we recommend legislative changes to remove the requirement that an originating site facility be located in a HPSA or non-MSA county.
Moreover, one organization requested that all locations included within the Alaska Native Tribal Health Consortium, including but not limited to outpatient health facilities recognized by the Indian Health Service as tribal health facilities be included as an originating site. The commenter requested that these sites be defined as an originating site regardless of whether they are certified as a Medicare Federally qualified health center or not.
Response: Section 1834(m) of the Act defines an originating site facility to include only a physician's or practitioner's office, hospital, critical access hospital, rural health clinic or Federally qualified health center. Start Printed Page 55283Further, the Act specifies that the originating site must be located in a rural HPSA or non-MSA county. We do not have the legislative authority to expand the definition of a telehealth originating site beyond this provision. However, we will be studying this issue as part of a report to the Congress as authorized by section 223(d) of the BIPA.
Comment: One specialty college requested confirmation that the patient's medical information provided via store and forward telehealth is furnished to the physician or practitioner at the distant site in order to recommend or confirm a diagnosis and or treatment plan and not to provide a formal interpretation of imaging exams.
Response: The commenter is correct. Payment for services via store and forward technology under this provision does not include formal interpretation of an imaging exam. Medicare currently allows coverage and payment for medical services delivered via a telecommunications system that do not require a face-to-face “hands on” encounter. Section 2020(A) of the Medicare Carriers Manual addresses this issue and lists radiology, electrocardiogram, and electroencephalogram interpretations as examples of such services.
Comment: In the proposed rule, we requested comments on the guidelines that we should use to make additions or deletions to covered Medicare telehealth services. We also requested suggestions and comments about specific services that may be appropriate for payment under the Medicare telehealth benefit. In response to our solicitation, we received one comment regarding the guidelines we should use to make changes to the scope of Medicare telehealth coverage. Ten commenters provided specific suggestions regarding additional services that may be appropriate for the Medicare telehealth benefit.
Several commenters indicated that a psychiatric diagnostic interview, CPT code 90801, would be appropriate for Medicare telehealth payment. One association stated that the elements of this service are directly comparable to a new patient office visit, which the law defines as a telehealth service. Given that the law permits us to add additional services as appropriate, this commenter suggested that we include a psychiatric diagnostic interview within the definition of a telehealth service. Another association suggested that interactive psychotherapy, CPT codes 90810, 90812 and 90814, should be covered Medicare telehealth services. Interactive psychotherapy uses play equipment, physical devices and other mechanisms of non-verbal communication in an office or outpatient facility.
Several commenters suggested that telerehabilitation interventions that provide education, mentoring and consultation be included within the scope of Medicare telehealth coverage. The commenters specifically note that speech therapy and physical and occupational therapy should be included as telehealth services.
One consortium requested that all services provided under the Federal telehealth project in Alaska be included as covered telehealth services within this provision. The commenter believes that virtually all evaluation & management and psychiatry services should be included as Medicare telehealth services. Additionally, the commenter notes that many respiratory, digestive, ophthalmology and otorhinolaryngology services are appropriate for telehealth coverage.
One organization suggested that we consider guidelines similar to those currently in place for non-telehealth services. For instance, the commenter stated the service should be reasonable and necessary, safe and effective, medically appropriate, and provided within the purview of accepted standards of medical practice. The commenter stresses that the type of technology used to deliver the service should be secondary to the reasonable and necessary criteria.
Response: We will use these comments and suggestions to assist us in establishing guidelines for a telehealth coverage process and the addition of specific telehealth services that may be appropriate for Medicare beneficiaries. However, we do not believe it would be appropriate to expand the scope of telehealth services beyond the services explicitly listed in the Act until we have a process in place for adding new telehealth services.
Comment: With regard to the definition of a “telecommunications system”, one organization encouraged us to permit store and forward technologies in other circumstances beyond federal telemedicine demonstration projects conducted in Alaska or Hawaii. The commenter believes that emphasis should be given to whether a particular service is reasonable and necessary rather than specific technology requirements. Moreover, the commenter stated that the face-to-face requirement is outdated for telehealth as well as other areas of the Medicare fee schedule and suggested that current technology, such as electronic mail, permits physicians to care for their patients even when the patient is not present.
Response: Section 1834(m) of the Act defines a telehealth service as office and other outpatient visits (99201 through 99215), professional consultations (99241 through 99275), individual psychotherapy (90804 through 90809), and pharmacologic management (90862). Further, the law specifies that payment must be equal to what would have been paid without the use of a telecommunications system.
As a condition of payment under Medicare, these services require a face-to-face patient encounter. We believe that the patient's presence and use of an interactive audio and video telecommunications system permitting the distant site practitioner to interact with the patient provides a reasonable substitute for a face-to-face encounter. The law provides for the use of asynchronous, store and forward technologies for delivering telehealth services only for telemedicine demonstration projects conducted in Alaska or Hawaii. We do not have the authority to expand the use of store and forward technology in delivering telehealth services.
Comment: One organization in a remote region requested that a definition of a telepresenter be added to § 410.78. The commenter suggested we permit a certified community health aid to present a patient when the aide is the only medical professional available to act as a telepresenter.
Response: The physician or practitioner at the distant site has the authority to determine whether it is medically necessary to require a telepresenter and, if necessary, the appropriate medical professional needed to present the patient. We do not believe it is appropriate for us to specify the type of medical professionals that are necessary to act as a telepresenter.
Comment: We received conflicting comments concerning interstate telehealth services. One organization requested that we require the physician or practitioner at the distant site to be licensed in the State where the originating site is located. On the other hand, an association requested clarification that the physician or practitioner at the distant site only needs to be licensed in the State where he or she is located and does not need to be licensed in the State where the originating site is located. Another commenter requested that we clarify that the service is considered rendered where the distant site physician or practitioner is located.
Response: We defer to State law regarding licensure issues. When the Start Printed Page 55284State law for the originating site permits an out-of-State practitioner to provide a telehealth service, without being licensed in the State in which the originating site is located, Medicare would make payment for the telehealth service. However, when State law precludes an out-of-State practitioner from delivering a telehealth service, Medicare would not pay for that service.
We clarify that for payment purposes, the site of service for the telehealth service is the location of the physician or practitioner at the distant site. Given that section 1834(m) of the Act specifies that payment to the physician or practitioner at the distant site must be equal to the amount that would have been paid without the use of telehealth, it is appropriate to use the Geographic Practice Cost Index (GPCI) relevant to the distant site. However, our determination of the distant site physician's or practitioner's location as the site of service for Medicare payment is not intended to make a comment regarding the scope of medical practice.
Comment: One consortium believes that the proposed rule would not permit the physician or practitioner at the distant site to bill for a telehealth service when State or Federal law exempts a physician or practitioner from being licensed in the State in which he or she is currently employed. The consortium is a Federal telemedicine demonstration project that would be permitted to use store and forward telecommunications technologies in delivering telehealth services. The commenter notes that the State of Alaska exempts physicians or practitioners who are part of the military or Public Health Service that provide health care services in Alaska from its licensure requirements. Further, the commenter stated that Federal law authorizes health care professionals who are members of the military providing services for the Department of Defense to practice in any State provided the professionals are licensed in a State, the District of Columbia or other specific locations. The commenter also noted that current Medicare manual instructions specify that when a physician in a Federal hospital provides services to the public generally as a community institution, he or she may be considered as meeting the statutory definition of a physician even though he or she may not have a license to practice in the State in which he or she is employed.
Response: The telehealth provision does not affect State or Federal legislation providing certain physicians or practitioners an exemption from State licensure. When Federal or State law exempts a physician or practitioner from State licensure, then the physician or practitioner at the distant site is permitted to provide a telehealth service regardless of whether he or she is licensed within the State where he or she is employed.
Comment: One organization requested that § 414.65(a)(2) be revised to specify for what services the physician or practitioner who presents the patient could bill. The commenter believes that when the physician at the distant site determines that it is medically necessary for another practitioner to assist in providing the telehealth service, the telepresenter should be compensated. The commenter suggested that a telepresenter be permitted to bill for a consultation or confirmatory consultation.
Response: On the day the telehealth service occurs, the telepresenter may bill and receive payment for services that are not telehealth services that he or she would otherwise be allowed to provide under Medicare. A telepresenter, for example, a nurse practitioner, could bill for and be paid for a medically necessary office, outpatient or inpatient visit preceding or subsequent to a telehealth service. Additionally, the telepresenter could be paid for other medically necessary services requested by the physician or practitioner at the distant site. However, the physician at the distant site may not share any portion of the telehealth payment with the telepresenter or referring practitioner. We do not agree that § 414.65(a)(2) should be changed to specify the services for which a telepresenter can and cannot bill. This section implements payment for telehealth services only, and the Act does not provide for a payment to the telepresenter for telehealth services.
Comment: Many organizations and individual commenters expressed overall support for the revision of Medicare payment for telehealth. Specifically, commenters mentioned removal of the fee sharing requirement, relaxed conditions of payment, and the addition of non-MSA counties to the geographic areas eligible for telehealth under Medicare. The commenters noted that these changes will have a positive effect on health care delivery and will help provide services to areas where specialty care is sparse.
Response: We agree that the proposed revisions to Medicare telehealth coverage and payment policies, as authorized by the BIPA, remove significant barriers for physicians and practitioners wishing to provide telehealth services.
Comment: One commenter indicated that the cost of collecting the coinsurance for the originating site facility fee could easily exceed the amount the facility would collect from the beneficiary. The commenter encouraged us to permit originating sites to waive the coinsurance in those situations where the telehealth facility charge is the only amount to be billed to the beneficiary.
Response: We do not have the authority to eliminate the coinsurance requirement outright for telehealth originating sites. However, Medicare permits the waiver of coinsurance for limited situations. Section 5220 of the Medicare Carriers Manual specifies that physicians and suppliers may waive billing for or collection of coinsurance or deductibles for indigent patients or when the physicians' or suppliers' cost of billing or collecting exceeds or is disproportionate to the amounts to be collected. Documentation must be sufficient to support that costs for billing the beneficiary exceed or are disproportionate to the amount collected from the beneficiary. In this instance, the amount collected refers to 20 percent of the originating site telehealth facility fee.
We clarify that when the patient owes additional coinsurance to the originating site for other Medicare services, billing for the telehealth facility fee coinsurance amount may be consolidated with the coinsurance amount owed for those services. We believe that this would resolve the commenter's concern that the cost for billing and or collecting the coinsurance for a single facility fee could exceed or be disproportionate to the amount collected from the beneficiary.
Comment: One association submitted a number of comments that have payment implications for the Federally qualified health center benefit.
Response: These issues involve specific aspects of the Federally qualified health center payment methodology and are beyond the scope of this provision. We will take these comments into consideration in formulating future instructions for payment implications on FQHCs.
Result of Evaluation of Comments
We are implementing this provision as stated above.
G. Indian Health Service
The Indian health care system provides primary health care to many American Indian and Alaska Native Medicare beneficiaries. This system consists of programs operated by a Federal agency, the Indian Health Start Printed Page 55285Service (IHS), and Federally funded programs operated by Indian tribes, tribal organizations, and urban Indian organizations (as those terms are defined in section 4 of the Indian Health Care Improvement Act). These programs deliver a range of clinical and preventive health services to their beneficiaries through a network of facilities including hospitals and outpatient clinics. Programs operated in IHS-owned or leased facilities, by IHS or by tribes or tribal organizations, are considered “Federal providers” by Medicare. Sections 1814(c) and 1835(d) of the Act generally prohibit payment to Federal providers, subject to exceptions contained in section 1880 of the Act for these IHS facilities. Before enactment of the BIPA, the exception in section 1880 of the Act was applicable only to IHS owned or leased hospitals, provider-based clinics, and skilled nursing facilities (regardless of whether the entity is tribally operated). The exception did not permit Medicare to pay for services furnished by IHS owned or leased free-standing outpatient clinics or to pay any IHS owned or leased facilities for services by physicians and other practitioners paid under a fee schedule.
Effective July 1, 2001, section 432 of the BIPA extends the exception in section 1880 of the Act to permit Medicare payments to hospitals and outpatient clinics (provider-based or free-standing), operated by the IHS or by a tribe or tribal organization, for services furnished by physicians and specified non-physician practitioners in or at the direction of the hospital or outpatient clinic. Payments for these services are made to the hospital or outpatient clinic, not to the physician or other practitioner. These payments are subject to the same situations, terms, and conditions as would apply if the services were furnished in, or at the direction of, a hospital or outpatient clinic that is not operated by the IHS or by a tribe or tribal organization. The payments include incentive payments for physicians furnishing covered physicians' services in rural or urban health professional shortage areas (HPSAs) if the usual HPSA criteria are met. (For further information see section 1833 of the Act and § 414.42 of our regulations.) Payments will not be made under these provisions to the extent that Medicare is otherwise paying for the same services under other provisions (for example, as part of a bundled payment, or if a tribal outpatient clinic continues to bill as a Federally qualified health center (FQHC)).
We have added a new § 410.46 to our regulations to reflect this new statutory provision. Due to the statutory effective date of July 1, 2001, we implemented this BIPA provision through program memorandum instructions.
Result of Evaluation of Comments
We received no comments on the statutory requirement to pay Indian Health Service and tribal hospitals and clinics for the services of physicians and other practitioners under Medicare fee schedules.
H. Pathology Services
The November 2, 1999 final rule (64 FR 59380) provided that, for services furnished on or after January 1, 2001, carriers would no longer pay claims to independent laboratories under the physician fee schedule for the technical component (TC) of physician pathology services for hospital inpatients. Before that rule, independent laboratories could bill the carrier under the physician fee schedule for the TC of a physician pathology service furnished to a hospital inpatient. Also, under that rule, independent laboratories would still have been able to bill and receive payment for the TC of physician pathology services furnished to patients who are not hospital inpatients.
Section 542 of the BIPA requires the Medicare carrier to continue to pay for the TC of physician pathology services when an independent laboratory furnishes these services to an inpatient or outpatient of a covered hospital. The BIPA provisions apply to TC services furnished during the 2-year period beginning January 1, 2001 and continuing through December 31, 2002. We informed the carriers and the intermediaries of this provision through program memorandum AB-01-47, which was issued in March 2001. This program memorandum requested the carriers to notify independent laboratories of this provision in their next regularly scheduled bulletin and to place this bulletin on their Internet web site. In the absence of further legislation, the policy of the November 1999 final rule will take effect for the TC of physician pathology services furnished to hospital patients after December 31, 2002. We have revised § 415.130 to conform to the statutory change in section 542 of BIPA concerning the payment for the TC of physician pathology services.
Result of Evaluation of Comments
We have received no comments on this issue.
IV. Five-Year Review of Work Relative Value Units Under the Physician Fee Schedule; Responses to Public Comments on the Five-Year Review of Work Relative Value Units
A. Scope of Five-Year Review
This final rule includes the culmination of the 5-year review of work RVUs required by statute. The work RVUs affected by this review will be effective for services furnished beginning January 1, 2002.
In our June 8, 2001 proposed notice (66 FR 31028), we explained the process used to conduct the 5-year review of work RVUs. During the comment period we received approximately 35 public comments on approximately 900 codes. After review by our medical staff, we forwarded all of the comments we received concerning potentially misvalued services to the AMA's Specialty Society Relative Value Update Committee (RUC).
The RUC submitted work RVU recommendations for all of the codes we forwarded with the exception of the anesthesia codes and conscious sedation codes. We analyzed all of the RUC recommendations and evaluated both the recommended work RVUs and the rationale for the recommendations. If we had concerns about the application of a particular methodology, but thought the recommended work RVUs were reasonable, we verified that the recommended work RVUs were appropriate by using alternative methodologies. (For additional information on the review process, please see the proposed notice published June 8, 2001.)
B. Review of Comments (Includes Table 4 Work RVU Refinements of 5-Year Review Codes Commented on in Response to the June 8, 2001 Proposed Notice)
During the comment period for our June 8, 2001 proposed notice, commenters generally supported our proposed changes. We received more than 125 comments on approximately 39 specific codes plus all the anesthesia services. The majority of these comments addressed the gastrointestinal endoscopy codes and anesthesia services.
We convened a multispecialty panel of physicians to assist us in the review of the comments. The comments we did not submit for panel review are discussed at the end of this section. The panel was moderated by our medical staff and consisted of:
- Clinicians representing the commenting specialties, based on our determination of those specialties which Start Printed Page 55286are most identified with the services in question. Although commenting specialties were welcomed to observe the entire refinement process, they were only involved in the discussion of those services for which they were invited to participate.
- Primary care clinicians nominated by the American Academy of Family Physicians and the American College of Physicians and American Society of Internal Medicine.
- Four carrier medical directors.
- Four clinicians with practices in related specialties who had knowledge of the services under review.
We submitted 6 codes for evaluation by the panel. The panel discussed the work RVUs involved in each procedure under review in comparison to the work RVUs associated with other services on the fee schedule. We assembled a set of reference services and asked each panel member to compare the clinical aspects for the services they believed were incorrectly valued to one or more of the reference services. In compiling the reference set, we attempted to include—(1) services that are commonly performed whose work RVUs are not controversial; (2) services that span the entire work spectrum from the easiest to the most difficult; and (3) at least three services performed by each of the major specialties so that each specialty would be represented. The reference set listed over 300 services. Group members were encouraged to make comparisons to these reference services. The intent of the panel process was to capture each participant's independent judgement based on the discussion and his or her clinical experience. Following each discussion, each participant rated the work for the procedure. Ratings were individual and confidential; there was no attempt to achieve consensus among the panel members.
We then analyzed the ratings based on a presumption that the RVUs in the proposed notice were correct. To overcome this presumption, the inaccuracy of the proposed RVUs had to be apparent to the broad range of physicians participating in each panel.
Ratings of work were analyzed for consistency among the groups represented on each panel. We used statistical tests to determine whether there was enough agreement among the groups on the panel, and whether the agreed-upon RVUs were significantly different from the proposed RVUs published in the June 8, 2001 proposed notice. We did not modify the RVUs unless there was a clear indication for a change. If there was agreement across groups for change, but the groups did not agree on what the new RVUs should be, we eliminated the outlier group, and looked for agreement among the remaining groups as the basis for new RVUs. We used the same methodology in analyzing the ratings that we first used in the refinement process for the 1993 fee schedule. The statistical tests we used are described in detail in the November 25, 1992 final rule (57 FR 55938).
Our decision to convene a multispecialty refinement panel of physicians and to apply the statistical tests referred to above was based on our need to balance the interests of those who commented on the work RVUs against the redistributive effects that would occur in other specialties. Of the 6 codes reviewed by the multispecialty panel, all were the subject of requests for increased values.
We also received comments that we did not submit to the panels for a variety of reasons. These comments are discussed later in this section. Of the proposed codes that were reviewed, 3 increased, and 3 were not changed.
Table 4.—Work Relative Value Unit Refinements of Five-Year Review Codes Commented on in Response to the June 8, 2001 Proposed Notice
Table 4 lists the codes reviewed during the 5-year review on which we received comments. This table includes the following information:
- CPT/HCPCS Code. This is the CPT or alphanumeric HCPCS code for a service.
- Modifier. A modifier-26 is shown if the work RVUs represent the professional component of the service.
- Description. This is an abbreviated version of the narrative description of the code.
- Proposed Work RVUs. This column includes the work RVUs proposed in the June 8, 2001 proposed notice for each reviewed code.
- Requested Work RVUs. This column identifies the work RVUs requested by the commenters. If the commenters requested different RVUs, the table lists the highest requested RVUs. For some codes we received recommendations for an increase but no specific RVUs were recommended.
- RUC Recommendation. This column identifies the work RVUs recommended by the RUC if the RUC made a specific work value recommendation as part of its comments on the June 8, 2001 proposed notice.
- 2002 Work RVUs. This column contains the 2002 work RVUs.
- Basis for Decision. This column indicates whether:
+ The recommendations of the multispecialty refinement panel were the basis upon which we determined that the proposed work RVUs published June 8, 2001 should be retained (indicator 1).
+ A new value emerged from our analysis of the refinement panel ratings (indicator 2).
+ A new or retained value came from review of the comment(s) received (indicator 3).
+ A new value came from the need to make a rank-order change to maintain or correct existing relationships among services (indicator 4).
+ A value is retained and the code has been referred to the RUC (indicator 5).
+ There is no change in value but we have adjusted the global period (indicator 6).
Table 4.—Work RVU Refinements of the Five-Year Review Codes Commented on in Response to June 8, 2001 Proposed Notice
CPT/HCPCS Code 1 Mod Descriptor Proposed Work RVU Requested Work RVU RUC REC 2002 Work RVU Basis for decision 00100-01999 Anesthesia services (2) (3) (2) #5 11055 Trim skin lesion 0.27 0.43 0.43 #3 11056 Trim skin lesion, 2 to 4 0.39 0.61 0.61 #3 11057 Trim skin lesions, over 4 0.50 0.79 0.79 #3 11719 Trim nail(s) 0.11 0.17 0.17 #3 27286 Fusion of hip joint 23.45 23.45 #4Start Printed Page 55287 36400 Drawing blood 0.18 0.38 0.38 #2 36405 Drawing blood 0.18 0.32 0.31 #2 38510 Biopsy/removal, lymph nodes 6.43 6.43 #6 38571 Laparoscopy, lymphadenectomy 12.38 19.84 14.68 #2 38740 Remove armpit lymph nodes 10.02 10.03 10.03 #3 38745 Remove armpit lymph nodes 13.00 13.10 13.10 #3 38760 Remove groin lymph nodes 12.94 12.95 12.95 #3 39503 Repair of diaphragm hernia 34.85 95.00 95.00 #3 43219 Esophagus endoscopy 2.80 3.18 2.80 #3 43239 Upper GI endoscopy, biopsy 2.69 2.87 1 2.87 #3 43244 Upper GI endoscopy/ligation 4.59 5.05 5.05 #3 43247 Operative upper GI endoscopy 3.39 3.40 3.39 #3 43249 Esoph endoscopy, dilation 2.90 3.25 2.90 #3 43255 Operative upper GI endoscopy 4.40 4.82 4.82 #3 43259 Endoscopic ultrasound exam 4.89 6.53 4.89 #3 43263 Endo cholangiopancreatograph 6.19 7.29 7.29 #3 43265 Endo cholangiopancreatograph 8.90 10.02 10.02 #3 43269 Endo cholangiopancreatograph 6.04 8.21 8.21 #3 44388 Colon endoscopy 2.82 3.24 2.82 #3 44389 Colonoscopy with biopsy 3.13 3.54 3.13 #3 44390 Colonoscopy for foreign body 3.83 4.25 3.83 #3 44391 Colonoscopy for bleeding 4.32 5.25 4.32 #3 44392 Colonoscopy and polypectomy 3.82 4.23 3.82 #3 44393 Colonoscopy, lesion removal 4.84 5.79 4.84 #3 45380 Colonoscopy and biopsy 4.01 4.44 1 4.44 #3 49605 Repair umbilical lesion 22.66 76.00 76.00 #3 56515 Destruction, vulva lesion(s) 2.76 3.63 2.76 #1 56605 Biopsy of vulva/perineum 1.10 1.10 4 1.10 #3 56810 Repair of perineum 4.13 4.13 4 4.13 #3 57500 Biopsy of cervix 0.97 0.97 #5 58100 Biopsy of uterus lining 0.71 1.53 4 1.53 #3 76090 Mammogram, one breast 0.70 0.93 0.70 #1 76091 Mammogram, both breasts 0.87 1.10 0.87 #1 G0127 Trim nail(s) 0.11 0.17 #3 1 All CPT codes and descriptors copyright 2000 American Medical Association.Start Printed Page 55288 2 No change. 3 26% incr. 4 RVUS to remain interim for 2002. C. Discussion of Comments by Clinical Area
In this section, we discuss the comments we received on the 39 codes of the more than 900 codes for which we sought public comment. For the codes for which we did not receive any comments, our proposed RVUs are being made final. We have categorized the comments into the same clinical areas we used in the June 8, 2001 notice. Within each clinical area, listed below, we discuss the comments received in CPT code order.
1. Vascular Surgery
Comment: The American Association for Vascular Surgery and the Society for Vascular Surgery expressed appreciation that we agreed with the RUC recommendations for work RVUs for the vascular surgery codes reviewed under the second 5-year review. However, it indicated that some of these services may still be undervalued. It will be reviewing these services as well as a small number of vascular surgery services that were not submitted this year and possibly submit these under the next 5-year review.
Response and final decision: We will finalize the RVUs for the vascular surgery codes as proposed.
2. General Surgery and Colon and Rectal Surgery
Family 2 Lymphadenectomy
Comment: The American College of Surgery (ACS) was supportive of the work performed by CMS medical officers to ensure that rank order anomalies were eliminated from 6 families of codes where acceptance of the RUC recommendations would create distortions in family work value relativity and the rest of the physician fee schedule.
The ACS pointed out a typographical error in the proposed notice. For Family 2 Lymphadenectomy, CMS disagreed with the RUC, and stated that the median survey result of 13 is appropriate for CPT code 38745. The ACS commented that the survey median is actually 13.10. The correction of this error would lead to increases for related family codes 38740 (from 10.02 to 10.03) and 38760 (from 12.94 to 12.95).
Response and final decision: We agree with the commenter's response and will adjust the work values for CPT code 38740 to 10.03; for CPT code 38745 to 13.10; and for CPT code 38760 to 12.95.
Family 3 Lymph Nodes and Lymphatic Channels—Incision/Excision
Comment: The American Academy of Otolaryngology recommended that CMS change the global surgical period of CPT code 38510 from 90 days to 10 days following the RUC survey data for this CPT code. It alleges that there were no postoperative visits beyond 10 days associated with this procedure for the relative work established.
Response: The RUC valued this service based on the fact that it is typically furnished to an outpatient. The value of a hospital discharge day was subtracted from the median survey value. The median survey value is based on one followup office visit. We believe there is merit to the group's point and will change the global period from 90 days to 10 days.
3. Thoracic Surgery
Comment: The Society of Thoracic Surgeons expressed appreciation that we had accepted the RUC recommendations for corrections to work values of many thoracic and cardiac procedures.
Response and final decision: We will finalize the RVUs for these codes as proposed.
4. Orthopedic Surgery
We received no comments on these codes. Therefore, we will finalize all of the proposed work RVUs for the orthopedic surgery codes. We would also note that, in the June rule, we proposed to correct a rank order anomaly by increasing values for CPT code 27286. This code, however, was inadvertently omitted from the table and addendum; it is included in Table 4 and Addendum A of this final rule.
5. Ophthalmology
We received no comments on these codes. Therefore, we will finalize all of the proposed work RVUs for the ophthalmology codes.
6. Urology
We received no comments on these codes. Therefore, we will finalize all of the proposed work RVUs for the urology codes.
7. Obstetrics/Gynecology
CPT Code 38571, Laparoscopy, Surgical; With Bilateral Total Pelvic Lympadenectomy
Comment: The Society of Gynecologic Oncologists (SGO) stated that, while we had proposed an increase for CPT code 38572, an increase was not proposed for CPT code 38571. The SGO believes that both of these codes are undervalued based on insufficient work RVUs being assigned for the laparoscopy with bilateral total pelvic lymphadenectomy procedure, which is common to both codes. It requested that a proportional increase in work RVUs be made for CPT 38571 as well.
Response: We accepted the RUC recommendation that no increase be made in the work RVU for this service based on the lack of compelling evidence to support an increase, and we had proposed retaining the current work RVU for this service. However, based on the comments received, we referred this code to a multispecialty refinement panel for review.
Final decision: As a result of our analysis of the multispecialty refinement panel ratings, we are increasing the work RVUs for CPT code 38571 to 14.68 work RVUs.
CPT Code 56515, Destruction of Lesion(s), Vulva; Extensive, Any Method
Comment: For CPT code 56515, SGO disagreed with the rationale that CPT codes 56515 and 46924 have comparable physician and intraservice work time. It indicated that CPT code 56515 involves lasering a much larger area; therefore, the amount of intraservice time and the number of postoperative visits can be significantly higher.
Response: We had accepted the RUC recommendation of 2.76 work RVUs for this code which was lower than the 3.625 which had been requested by the specialty. Based on the comments received, we referred this code to a multispecialty refinement panel for review.
Final decision: As a result of our analysis of the refinement panel ratings, we are retaining the work RVU of 2.76.
CPT Code 57500, Biopsy, Single or Multiple, or Excision of Lesion, With or Without Fulguration (Separate Procedure)
Comment: In addition to comments on the 2 codes referenced above, SGO also recommended that, while CPT code 57500 was not considered part of the 5-year review, this gender-specific code be forwarded to the RUC for evaluation. It believes the amount of physician time and level of pre- and postoperative work for this procedure is similar to that for the male-specific procedures of CPT Start Printed Page 55289code 54100 (Biopsy of penis (separate procedure)), and CPT code 54505 (Biopsy of testis, incisional (separate procedure)), and thus the physician work for CPT code 57500 should be increased.
Response and final decision: We will refer this code to the RUC for review.
Comment: In our June 8, 2001 proposed notice, we also stated that we referred three female-specific procedure codes that appeared to be misvalued to the RUC for review. As part of its comments on the proposed notice, and in response to our request to review these services, the RUC has provided recommendations on work RVUs for the three codes as follows:
- CPT code 56605, Biopsy of vulva or perineum (separate procedure); one lesion.
The RUC stated that this code was reviewed during the first 5-year review and was increased at that time to double the original work RVU for CPT code 56605. While the current work RVU for this code is less than CPT code 54100, Biopsy of penis (WRVU 1.90), the structure of CPT code 56605 allows additional reporting when more than one lesion is biopsied, while the penile code (54100) may be only reported once, regardless of the number of biopsies. The RUC recommended that the current work RVU of 1.10 be maintained for CPT code 56605.
- CPT code 56810, Perineoplasty, repair of perineum, nonobsterical (separate procedure).
The RUC indicated that the specialty stated that this service may be undervalued; however, perineoplasty is performed so rarely as a separate procedure that it would be difficult to obtain valid survey data to appropriately value this service. In addition, the specialty is currently considering CPT revisions to this family of codes and will review this issue at that time. The RUC recommended that the current work RVU of 4.13 be maintained for the service.
- CPT code 58100, Endometrial sampling (biopsy) with or without endocervical sampling (biopsy), without cervical dilation, any method (separate procedure).
The RUC indicated that, based on a review of survey data, CPT code 58100 is undervalued. The RUC compared this code to CPT code 55700 and determined that these 2 services are similar in time and intensity. The RUC also agreed that 58100 is more work than the reference procedure, CPT code 57505, and recommended an increase in the work RVU for CPT code 58100 to 1.53. The RUC also provided refinements to the practice expense inputs for this code.
Response and final decision: We agree with the RUC recommendations for these three codes and will maintain the current work RVUs of 1.10 for CPT code 56605 and 4.13 for CPT code 56810 and increase the work RVUs for CPT code 58100 to 1.53. Because the public has not had a chance to comment on these work RVUs, we will consider them to be interim and will accept comments on values for these 3 codes.
8. Gastroenterology
In the June 8, 2001 proposed notice, we explained that, for the selected series of gastrointestinal endoscopy codes for the 5-year review, the RUC recommended increases in work RVUs for some of the codes and no change in work for other codes. While some of these endoscopy codes may be misvalued, we proposed to keep all work RVUs for gastrointestinal endoscopy codes unchanged. We also requested that the RUC perform a comprehensive review of all gastrointestinal endoscopy codes to ensure that all codes are properly valued and that no rank-order anomalies within and across specialties are created or exacerbated.
With respect to the RUC recommendation concerning permitting separate reporting and payment of conscious sedation codes 90141 and 90142, we stated we would be reviewing data concerning this issue. Any proposal we would have concerning payment and reporting of conscious sedation codes would be the subject of future rulemaking.
Comment: Many physicians and several medical organizations expressed concern about our decision to propose no changes for the 17 endoscopy codes for which the RUC had recommended increases. The American Society for Gastrointestinal Endoscopy, the American College of Gastroenterology, and the American Gastroenterological Association provided an extensive discussion on each of the codes which we will summarize and respond to below.
CPT Code 43219, Esophagoscopy, Rigid or Flexible; With Insertion of Plastic Tube or Stent
The RUC recommended an increase in work RVUs from 2.8 to 3.18 for CPT code 43219 based upon the increased complexity of the condition of the patients receiving these stents. We proposed to maintain the current work RVUs due to our concerns about creating rank order anomalies in the fee schedule.
Comment: We received comments regarding this code from several societies representing gastroenterologists who said that the incremental work involved with esophageal stent placement, presently valued at 1.21 RVUs, should be increased to 1.59 RVUs. The commenters agreed with CMS that several other stent codes were recently reviewed by the RUC and valued using the incremental work value of 1.21 RVUs. Increasing the incremental work value for CPT code 43219 to 1.59 RVUs would result in rank order anomalies for several codes. The commenters acknowledged that these anomalies resulted from the timing of the 5-year review and the valuation of new stent placement codes. In spite of this, the commenters felt the RUC-recommended value was appropriate.
Response: We feel the current work increment of 1.21 RVUs for placement of a stent over the base code 43200 is the appropriate value when assessing incremental work. We do not agree that the incremental work for stent placement should be increased to 1.59 RVUs. The upper GI endoscopy base CPT code 43235 has RVUs of 2.39 and CPT code 43256, upper GI endoscopy with stent placement (including predilation) has work RVUs of 4.35. This results in an incremental value of 1.96 RVUs which includes placement of the stent (1.21 RVUs) and predilation (0.75 RVUs).
Furthermore, diagnostic bronchoscopy, CPT code 31622, has work RVUs of 2.78, and bronchoscopy with tracheal dilation and placement of a tracheal stent (CPT code 31631) has an RVU of 4.37. This means that the incremental work value for tracheal dilation and stent placement is 1.59 RVUs which is significantly less than the work increment of 1.96 listed for CPT code 43256. We also note that CPT code 43219 will be billed with CPT code 43226 (dilation of the esophagus over a guidewire) which has an incremental value of 0.75 work RVUs. This means that when an esophageal stent is placed, the total work value is 1.59 (base code) plus 1.21 (stent placement) plus 0.75 (dilation) for a total of 3.55 RVUs.
More important, the incremental work of placing the stent is 1.96 RVUs which is similar to the incremental work of placing a stent elsewhere in the GI tract and more than the incremental work of placing a stent in the trachea. Increasing the incremental work of placing an esophageal stent to 1.59 RVUs from 1.21 would create a significant rank order anomaly in the physician fee schedule because esophageal stent placement would be valued more than stent placement elsewhere.Start Printed Page 55290
Lastly, we note that less work is required to place a plastic stent than to place a wire stent. Both, however, are coded using CPT code 43219 and are valued similarly. For these reasons, we have decided to maintain the current RVUs of 2.80 for this code, and we would like the RUC to review all of the GI endoscopic stent placement codes and all of the GI endoscopic dilation codes simultaneously. Because these services are performed by gastroenterologists and various surgical specialties (general surgery, thoracic surgery, otolaryngology, and colorectal surgery), the RUC should obtain input from all specialties performing these services.
CPT Code 43239, Upper Gastrointestinal Endoscopy Including Esophagus, Stomach, and Either the Duodenum and/or Jejunum as Appropriate, With Biopsy, Single or Multiple
The RUC recommended an increase in work RVUs from 2.69 to 2.87 based on an increase in the number of biopsies obtained during each procedure. The RUC also stated that technological advances allowing for greater precision and detail in finding abnormalities have increased the complexity of this service. The RUC also stated that technological advances have allowed results to be reported more quickly which increases the postservice work because biopsy information and treatment guidance are conveyed to the patient the same day as the procedure. We disagreed, and in the June rule we proposed to maintain the current work RVUs.
Comment: We received comments from several societies representing gastroenterologists and the following concerns were expressed: First, they did not feel that the work of performing biopsy procedures at different sites in the GI tract was the same. They commented that biopsy of lesions in different anatomic sites required different amounts of work. Second, they felt that even though CPT code 43239 was used to report both single and multiple biopsies, the typical patient requires multiple biopsies.
Response: We reviewed these comments and compared the intraservice time for this procedure to other endoscopic biopsy procedures and we have decided to accept the RUC recommendations for this code. However, we are making this value interim. Please see the discussion under CPT code 45380 regarding this issue.
CPT Code 43244, Upper Gastrointestinal Endoscopy Including Esophagus, Stomach, and Either the Duodenum and/or Jejunum as Appropriate; With Band Ligation of Esophageal and or Gastric Varices; CPT Code 43255, Upper Gastrointestinal Endoscopy Including Esophagus, Stomach, and Either the Duodenum and/or Jejunum as Appropriate; With Control of Bleeding, Any Method
The RUC recommended an increase in work RVUs for CPT code 43255 from 4.4 to 4.82 work RVUs, based on the use of new technology, such as lasers, to control bleeding. The RUC also recommended an increase in work RVUs for CPT code 43244 from 4.59 to 5.05 RVUs, based on the increased number of bands typically used to treat esophageal varices. We disagreed and proposed to maintain the current work RVUs.
Comment: We received comments from several societies representing gastroenterologists and the following concerns were expressed: First, they felt that we had incorrectly determined that these two services should be valued identically because the RUC stated that they were “similar” in terms of work. Second, although they acknowledged that the use of cautery to control bleeding is not new, they said that the service is undervalued irrespective of which method is used to control bleeding.
Response: We reviewed these comments and compared the intraservice time to other similar procedures and have decided to accept the RUC recommendations for the above CPT codes.
CPT Code 43247, Upper Gastrointestinal Endoscopy Including Esophagus, Stomach, and Either the Duodenum and/or Jejunum as Appropriate; With Removal of Foreign Body
The RUC recommended an increase in work RVUs for this CPT code from 3.39 to 3.59 work RVUs, based on increased complexity of patients undergoing this procedure with a concomitant increase in risk of morbidity. We disagreed and proposed to maintain the current work RVUs.
Comment: We received comments from several societies representing gastroenterologists with the following concerns: First, they felt the increase in the work RVU for this procedure was justified because the procedure is usually performed under emergent conditions. Second, they did not favor uniform incremental work values for removal of foreign bodies from different sites in the gastrointestinal tract.
Response: The RUC used a building-block approach to validate its acceptance of the median work RVUs from the survey. We do not believe the approach used by the RUC is valid for this CPT code. We compared this service to other similar services and continue to believe that the RUC recommendation does not represent the appropriate work increments for foreign body removal from various gastrointestinal sites. Furthermore, it would create a clear rank-order anomaly with CPT code 43215 that should have an identical work increment. Therefore, we will maintain the current work RVUs for this procedure. If the RUC reviews this service again, we ask that all GI endoscopic services for removal of foreign bodies be included in the review.
CPT Code 43249, Upper Gastrointestinal Endoscopy Including Esophagus, Stomach, and Either the Duodenum and/or Jejunum as Appropriate; With Balloon Dilation
The RUC recommended an increase from 2.9 to 3.35 work RVUs for this CPT code based on increased complexity of the condition of patients undergoing this procedure. We disagreed and proposed to maintain the current work RVUs.
Comment: We received comments from several organizations representing gastroenterologists who felt the increase in incremental work value was justified based on their survey. However, they admitted that revaluing CPT code 43249 would create a rank order anomaly with CPT code 43220, an identical procedure. They stated that CPT code 43220 is also undervalued.
Response: The current work increment for “balloon dilation of esophagus (less than 30mm diameter)” is 0.51 RVUs for both the esophagus and upper gastrointestinal endoscopy families. Since this is the same procedure in both families, it is unclear why the work should be increased for the upper gastrointestinal family only. This would create a rank-order anomaly. We have decided to maintain the current work RVUs for CPT code 43249. We plan to ask the RUC to review the incremental work RVUs for both CPT code 43249 and CPT code 43220.
CPT Code 43259, Upper Gastrointestinal Endoscopy Including Esophagus, Stomach, and Either the Duodenum and/or Jejunum as Appropriate; With Endoscopic Ultrasound Examination
The RUC recommended an increase in work RVUs from 4.59 to 8.59 based on the complexity of the equipment and the skill and judgement required. The Start Printed Page 55291RUC also noted that the survey results supported this procedure as requiring more work than CPT code 43260—diagnostic endoscopic retrograde cholangio-pancreatography (ERCP)—which has 5.96 work RVUs.
Comment: We received comments from several societies representing gastroenterologists who agreed with us that the RUC values for the new endoscopic ultrasound codes (EUS) were inconsistent with the value recommended by the RUC for CPT code 43259. They felt that new survey data should have been used by the RUC when valuing CPT code 43259 instead of the current incremental work values used by the RUC for the 5-year review.
Response: The RUC used the following building-block methodology to arrive at its recommendation for 43259—1) The RUC added 1.5 work RVUs, which is approximately 75 percent of the difference between the RUC recommendation from the last 5-year review (6.11 work RVUs) and the work RVUs that we assigned (4.0 work RVUs); (2) the RUC then added 2.2 work RVUs, which are the work RVUs of CPT code
93312 (Echocardiography, Transesophageal, Real Time With Image Documentation (2D) (With or Without M-Mode Recording); Including Probe Placement, Image Acquisition, Interpretation and report)
Not only do we disagree with the RUC methodology for this recommendation, but we also note that the RUC has used the current work RVUs for CPT code 43259 to value not only other gastrointestinal transendoscopic ultrasound procedures but also many transendoscopic ultrasound guided biopsy codes. We also note that the RUC has recently re-evaluated CPT code 43231, Esophagoscopy, rigid or flexible; with endoscopic ultrasound examination, and recommended much lower RVUs for the incremental work of the ultrasound examination. Therefore, accepting the RUC recommendation for this code would be inconsistent with the RUC's reevaluation of CPT code 43231, would invalidate the work valuation of many other gastrointestinal endoscopy codes, and would create numerous rank-order anomalies. Therefore, we recommend that the RUC review CPT code 43259 along with all the other endoscopic ultrasound examination codes and all the transendoscopic ultrasound guided biopsy codes.
CPT Code 43263, Endoscopic Retrograde Cholangio-pancreatography (ERCP); With Pressure Measurement of Sphincter of Oddi (Pancreatic Duct or Common Bile Duct)
CPT Code 43265, Endoscopic Retrograde Cholangio-pancreatography (ERCP) With Endoscopic Retrograde Destruction, Lithotripsy of Stone(s), Any Method
CPT Code 43269, Endoscopic Retrograde Cholangio-pancreatography (ERCP); With Endoscopic Retrograde Removal of Foreign Body and/or Change of Tube or Stent
The RUC recommended an increase in work RVUs from 6.19 to 7.29 for CPT code 43263 based on the need to measure pressures in both the biliary and pancreatic sphincters, as well as the need for prolonged postoperative monitoring.
The RUC recommended an increase in work RVUs from 8.9 to 10.02 for CPT code 43265 based on a rank-order anomaly with code 43264 because this procedure is considered to be more time-consuming and complex than CPT code 43264.
The RUC recommended an increase in work RVUs from 6.04 to 8.21 for CPT code 43269 based on a rank-order anomaly between this code and CPT code 43268.
Comment: We received comments on these three codes from several organizations representing gastroenterologists. It was their position that these codes were commonly performed, undervalued procedures and that the survey data the organizations provided justify the increase in RVUs. We disagreed and proposed to maintain the current work RVUs for these three codes.
Response: We have reviewed the codes and compared their intraservice times to other similar procedures and have decided to accept the RUC recommendations.
CPT Code 44388, Colonoscopy Through Stoma; Diagnostic With or Without Collection of Specimen(s) by Brushing or Washing (Separate Procedure)
CPT Code 44389, Colonoscopy Through Stoma; With Biopsy, Single or Multiple
CPT Code 44390, Colonoscopy Through Stoma; With Removal of Foreign Body
CPT Code 44391, Colonoscopy Through Stoma; With Control of Bleeding, any Method
CPT Code 44392, Colonoscopy Through Stoma; With Removal of Tumor(s), Polyp(s), or Other Lesion(s) by Hot Biopsy Forceps or Bipolar Cautery
CPT Code 44393, Colonoscopy Through Stoma: With Ablation of Tumor(s), Polyp(s), or Other Lesion(s) Not Amenable to Removal by Hot Biopsy Forceps, Bipolar Cautery or Snare Technique
These 6 codes are in the same family, and the RUC recommended an increase for each code in this family primarily because it felt that the base CPT code, 44388, should be valued the same as CPT code 45378, diagnostic colonoscopy, at 3.7 work RVUs. The RUC also recommended that the values for the other codes in this family be increased to maintain their relativity to CPT code 44388. We disagreed and proposed to maintain the current work RVUs for all codes in this family.
Comment: We received comments from several societies representing gastroenterologists who commented that, although performing a colonoscopy through a stoma involves less physician work than performing a standard colonoscopy, they believed that performing a colonoscopy through a stoma is more technically challenging than performing a standard colonoscopy.
Response: We disagree with valuing the performance of a colonoscopy through a stoma identically to performing a standard colonoscopy. We feel the proposed valuation creates a series of rank-order anomalies. Consequently, we will finalize our proposal to maintain the current RVUs for this family of codes. In addition to determining that the RUC recommendation for the base code 44388 was incorrect, we note that the RUC recommendations create increments of work for performance of “biopsy, single or multiple,” “control of bleeding, any method,” “removal of tumors,” and “ablation of tumors” during a colonoscopy through a stoma, which are inconsistent with the same increments for the complete colonoscopy family of codes that begins Start Printed Page 55292with code 45378. We note that, in addition to gastroenterologists, general surgeons and colorectal surgeons perform these procedures. Therefore, if the RUC reconsiders the work values of these codes, we believe that information should be obtained from all physicians who perform these services.
CPT Code 45380, Colonoscopy, Flexible Proximal to Splenic Flexure; With Biopsy, Single or Multiple
The RUC recommended an increase in work RVUs from 3.98 to 4.44 for this CPT code, based on the increased number of biopsies generally taken during this procedure and the increased difficulty in removing these polyps. We disagreed and proposed to maintain the current work RVUs for this service.
Comment: We received comments from several societies representing gastroenterologists who commented that work increments for performing biopsies at different sites within the gastrointestinal tract are different. Furthermore, the societies believe that the incremental work of biopsy procedures performed by different specialties (for example, gastrointestinal endoscopic biopsies and tracheobronchial endoscopic biopsies) need not be valued identically. They also note that even though this code is reported for both single and multiple biopsies, the “typical” patient usually has multiple biopsies performed.
Response: We have reviewed these comments and compared the intraservice time of this code to the intraservice time of other similar procedures. We have decided to accept the RUC recommendation. However, CMS believes the best approach to accurately value gastrointestinal endoscopy biopsy procedures is to evaluate all the biopsy procedures in the gastrointestinal tract. This would provide the opportunity to establish the correct incremental work RVUs and avoid creating rank-order anomalies. Therefore, we will make the work values for CPT code 43239 (as indicated earlier) and 45380, interim until we receive further recommendations from the RUC regarding the entire spectrum of gastrointestinal biopsy procedures.
9. Conscious Sedation
Comment: The American Academy of Family Physicians indicated that the RUC has appointed an ad hoc workgroup to review the issue of conscious sedation, including identifying codes where conscious sedation is not inherently included as a component of the physician work. It recommended that, when the workgroup and RUC complete this review, we allow separate reporting and payment for CPT codes 90141 and 90142 in conjunction with the identified codes. The AMA and the RUC also referred to the newly formed workgroup in their comments, and the AMA urged us to work with the RUC and the CPT to reach a solution on the coding and payment issues surrounding conscious sedation.
Response and Final Decision: We welcome suggestions on this issue from both the coding and payment perspective. When the workgroup review of these issues is complete, we will evaluate any recommendations we receive for the development of any future proposals.
10. Pulmonary Medicine/Critical Care
We received no comments on these codes. Therefore, we will finalize the proposed work RVUs for the pulmonary medicine and critical care codes.
11. Cardiology
CPT Code 93350, Transthoracic Echocardiography
Comment: The American College of Cardiology expressed appreciation of our acceptance of the RUC recommendation to increase the work RVUs for this code.
Response and Final Decision: We are finalizing the proposed RVUs for CPT code 93350 and maintaining the work values for the other 2 CPT codes, 32234 and 32235, as discussed in the proposed notice.
12. Pediatrics
CPT Code 36400 (Venipuncture Under Age 3 Years; Femoral, Jugular or Sagittal Sinus) and CPT Code 36405 (Venipuncture, Under Age 3 Years, Scalp Vein)
Comment: The American Academy of Pediatrics (AAP) disagreed with our recommendations for CPT codes 36400 and 36405. The RUC recommended work RVUs of .38 and .32, respectively. We proposed that the work RVUs remain unchanged at .18 for each code. We do not believe it is appropriate to compare the work RVUs of a venipuncture to the work of an evaluation and management service. The AAP pointed out that the work involved in providing a venipuncture to a patient under age 3 is more intense than it has been in the past.
Response: Based on the comments received, we referred this code to a multispecialty refinement panel for review.
Final decision: As a result of our analysis of the multispecialty refinement panel ratings, we are increasing the work RVUs for CPT code 36400 to 0.38 and also increasing the work RVUs for CPT code 36405 to 0.31.
13. Pediatric Surgery
CPT Code 39503 (Repair, Neonatal Diaphragmatic Hernia, With or Without Chest Tube Insertion and With or Without Creation of Ventral Hernia) and CPT Code 49605 (Repair of Large Omphalacele or Gastroschisis; With or Without Prosthesis)
Comment: The AAP and the American Pediatric Surgical Association (ASPA) recommend that codes 39503 (Repair, neonatal diaphragmatic hernia, with or without chest tube insertion and with or without creation of ventral hernia), and 49605 (Repair of large omphalacele or gastroschisis; with or without prosthesis) receive interim values of 95 and 76, respectively, until the issue of critical care in the postoperative period is resolved. We had proposed to maintain the current work RVUs of 37.54 and 24.94, respectively, as interim 2002 work values and asked the RUC to resubmit recommendations for work RVUs for CPT codes 39503 and 49605 with either a 000 or 010 global period. As an option, pending resolution of the critical care issue, the APSA recommended that the interim work values for CPT codes 39503 and 49605 be 46.35 and 30.14, respectively.
The RUC agreed that the physician work in the postoperative period caring for these seriously ill neonates was significant and required the services of both surgeon and the neonatologist. The RUC requests that CMS treat these codes in the same manner as the other 90-day global codes that include extensive postoperative care.
Response: Upon further review, we agree with the RUC's recommendation and will establish the work values for CPT codes 39503 and 49605 at 95 and 76 units, respectively.
14. Radiology
CPT Code 76090, Mammography; Unilateral and CPT Code 76091 Mammography; Bilateral
Comment: The American College of Radiology (ACR) requested that CMS increase the work RVUs for unilateral mammography, that is, CPT code 76090, from the proposed .70, to .93 and for bilateral mammography, that is, code 76091, from the proposed .87, to 1.10. The ACR believes these values, which are the median survey values, more accurately reflect the work involved with these two procedures. The ACR points out that there is a significant amount of physician time associated Start Printed Page 55293with reviewing the results with these anxious patients and complying with the mandatory Mammography Quality Standards Act requirements.
The ACR commented that the chart at 66 FR 31045 of the June 8, 2001 proposed rule indicates that CPT code 76005 had a RUC recommendation of 10.60. However, that column should read .60.
The ACR also took exception to the requested work RVUs reported in the chart at 66 FR 31045 for codes 76065, 76090 and 76091. The chart displayed requested work RVUs of .60 for 76065, .64 for 76090, and .76 for code 76091. The ACR asked that the chart be corrected to reflect the actual requested work RVUs for each code. These corrected values, based on the median survey values, are .70 for CPT code 76065, .93 for 76090, and 1.10 for CPT code 76091.
Response: Based on the comments received, we referred these codes to a refinement panel for review. We regret the error in the chart concerning the requested work RVUs.
Final decision: As a result of our analysis of the multispecialty panel ratings, we are retaining the work RVU of 0.70 for CPT code 76090 and 0.87 for CPT code 76091, the work RVUs we proposed in the June 8 proposed rule.
CPT Code 76092, Screening Mammography, Bilateral Two View Film Study of Each Breast
In addition, we had requested the RUC to review the work RVUs for code 76092 (Screening mammography, bilateral two view film study of each breast). In its comments on the June 8, 2001 proposed rule, the RUC indicated it had placed this issue on the September 2001 meeting agenda and would provide recommendations to us following that meeting. The September meeting had to be cancelled and the issues to be addressed at that meeting will be discussed at the first meeting early next year. Therefore, we are finalizing the current RVUs for this code.
15. Plastic Surgery
We received no comments on these codes. Therefore, we will finalize the proposed work RVUs for the plastic surgery codes.
B. Other Comments
1. Anesthesia Services
In our June 8, 2001 proposed rule (66 FR 31065), we stated that the American Society of Anesthesiologists (ASA) contended that the work of anesthesia services is undervalued and, based on discussions with the RUC, the ASA requested a 24 percent increase in anesthesia work. However, the RUC furnished no recommendation on anesthesia services; instead, it assigned to a newly created workgroup the responsibility for reviewing anesthesia services in the context of the physician fee schedule. We indicated that the ASA will be working with this workgroup on clinical issues, such as induction and postinduction intensity, and did not propose any changes to the anesthesia CF at this time to reflect the 5-year review of physician work for anesthesia services. However, we did indicate that we might make changes in response to recommendations the RUC may provide.
Comment: Many individual anesthesiologists commented that their services are undervalued. The American Society of Anesthesiologists also commented that its services are undervalued and asked that we accept the results of the first RUC workgroup (weighted average increase of 26 percent on representative codes) and extrapolate this to all anesthesia codes. We also received letters from individuals indicating that anesthesia services are undervalued.
In its comments, the RUC stated that it had not come to an agreement on extrapolating the results of the work of the 19 studied anesthesia codes to all anesthesia codes. The RUC agreed that the five quintiles for postinduction anesthesia and the examples associated with each quintile were appropriate. The RUC also examined the intensity values assigned to each quintile and made adjustments to the intensity values based on comparisons to evaluation and management codes and critical care services. It agreed to the following values—.224 for Level 1; .031 for Level 2; .051 for Level 3; .070 for Level 4; and .085 for Level 5.
The RUC approved the following intensity factors for the induction period—.067 for induction of general anesthesia; .067 for induction of spinal and epidural anesthesia; and .051 for induction of regional anesthesia.
Although the RUC recommended acceptance of the building block work values for the 19 codes studied, it did not resolve issues related to how often anesthesiologists provide the retrobulbar bloc for code 00142 and agreed that the distribution of postinduction time among the quintiles should be reviewed in more detail after it receives more input from surgical specialties.
Response and final decision: The RUC has informed us that it will continue to look at anesthesia work beginning at its first meeting in CY 2002. We will review the RUC recommendation and address anesthesia work in next year's proposed physician fee schedule rule.
2. Spine Injection Procedures
We received no comments on these codes. Therefore we will finalize the proposed work RVUs for the spine injection procedure codes.
3. Biofeedback
We received no comments on these codes. Therefore, we will finalize the proposed work RVUs for the biofeedback codes.
4. Surgical Management of Burn Wounds
We received no comments on these codes. Therefore, we will finalize the proposed work RVUs for the codes involving surgical management of burn wounds.
5. Transplantation
We received no comments on these codes. Therefore, we will finalize the proposed work RVUs for the transplantation codes.
6. Arthroscopy Services
We received no comments on these codes. Therefore, we will finalize the proposed work RVUs for the arthroscopy service codes.
7. Wheelchair Management
We received no comments on these codes. Therefore, we will finalize the proposed work RVUs for the wheelchair management codes.
8. Psychological Testing
We received no comments on these codes. Therefore, we will finalize the proposed work RVUs for the psychological testing codes.
9. Podiatric Services
In our June 8, 2001 proposed notice (66 FR 31067), we stated the American Podiatric Medical Association (APMA) submitted 5 codes (trim skin lesions/trim nails) for review (11719, 11055, 11056, 11057, and G0127) and that the HCPAC requested we review our current utilization data to ensure that the original utilization assumptions were correct. The HCPAC recommended that the current review of data should be based on actual 1999 utilization data since these codes were not fully implemented until April 1, 1998. We stated that we would review the utilization data associated with the aforementioned codes to ensure the original assumptions are still correct and that we would publish our decision in the final rule.Start Printed Page 55294
Comment: The APMA was pleased that we would review the utilization data; however, it indicated that the work RVUs should not be revised based on current utilization. It recommended that we accept the original RUC recommendations since these values were based on the results of surveys of practicing podiatrists that were considered and approved by the RUC.
Response and final decision: Based on our review of the data and the APMA recommendation that we accept the original RUC recommended values, we are increasing the work values for these services as follows:
- CPT code 11719, Trimming of nondystrophic nails, any number, a work RVU of 0.17.
- CPT code 11055, Paring or cutting of benign hyperkeratotic lesion (for example, corn or callus) single lesion, a work RVU of 0.43.
- CPT code 11056, two to four lesions, a work RVU of 0.61.
CPT code 11057, more than four lesions, a work RVU of 0.79 .
For HCPCS code G0127, Trim nails, while we did not receive a RUC recommendation on this code (since we created the code), we are increasing the work RVU to 0.17 to be consistent with the increase made to CPT code 11719.
D. Other Issues
1. Critical Care Services in a Global Period
The June 8, 2001 proposed rule included a discussion on critical care services (66 FR 31067-68). We stated that current Medicare policy allows separate payment to the surgeon for postoperative critical care services during the surgical global period only when the patient has suffered trauma or burns. If the surgeon provides critical care services during the global period, for reasons unrelated to the surgery, that is separately payable as well. However, the approach the RUC used for the 5-year review had previously been used to validate postoperative work. That approach compared the work of a postoperative intensive care unit visit by the surgeon to code 99291, Critical care, evaluation and management of the critically ill or critically injured patient, first 30-74 minutes, which is valued at 4.00 work RVUs, rather than comparing a level three subsequent hospital visit (code 99233), which is valued at 1.51 work RVUs).
We indicated that valuing the surgeon's postoperative intensive care unit visits as critical care services had raised a number of issues that could require a change in payment policy to ensure that postoperative critical care is appropriately paid. In order to ensure that we make appropriate payments to physicians furnishing postoperative critical care services to Medicare beneficiaries, we specifically solicited information and comments on several questions and issues. We also proposed that the work RVUs for those surgical codes where any postoperative intensive care unit visits were valued as critical care remain interim, until we address the issues discussed above.
Many individual physicians, specialty societies, and health benefit programs provided comments and addressed the points we had outlined in the proposed notice. We appreciate their responses and will carefully review this information as we determine whether to make a future proposal.
2. Budget Neutrality
As explained in the proposed rule published June 8, 2001 (66 FR 31068-69), section 1848(c)(2)(B)(ii)(II) of the Act requires that increases or decreases in RVUs may not cause the amount of expenditures for the year to differ by more than $20 million from what expenditures would have been in the absence of these changes. If this threshold is exceeded, we make across-the-board adjustments to preserve budget neutrality. Based on the proposed changes in work RVUs, we indicated that budget-neutrality adjustments would be required. We proposed to reduce the conversion factor to meet the budget neutrality requirement, rather than applying a reduction to all work RVUs. We also indicated that revisions in payment policies, including the establishment of interim and final RVUs for coding changes contained in a separate proposed rule, might result in additional budget-neutrality adjustments.
Comment: The American Academy of Family Physicians, American College of Radiology, American College of Physicians, American Society for Internal Medicine, and the American Medical Association Specialty Society RVUs Update Committee indicated that they supported our proposal to maintain budget neutrality by adjusting the conversion factor.
Response and final decision: We will proceed with our proposal to maintain budget neutrality by adjusting the conversion factor.
V. Refinement of Relative Value Units for Calendar Year 2002 and Responses to Public Comments on Interim Relative Value Units for 2001
A. Summary of Issues Discussed Related to the Adjustment of Relative Value Units
Section V.B of this final rule describes the methodology used to review the comments received on the RVUs for physician work and the process used to establish RVUs for new and revised CPT codes. Changes to codes on the physician fee schedule (Addendum B) are effective for services furnished beginning January 1, 2002.
B. Process for Establishing Work Relative Value Units for the 2002 Fee Schedule and Clarification of CPT Definitions
Our November 1, 2000 final rule on the 2001 physician fee schedule (65 FR 65376) announced the final work RVUs for Medicare payment for existing procedure codes under the physician fee schedule and interim RVUs for new and revised codes. The RVUs contained in the rule applied to physician services furnished beginning January 1, 2001. We announced that we considered the RVUs for the interim codes to be subject to public comment under the annual refinement process. In this section, we summarize the refinements to the interim work RVUs that have occurred since publication of the November 2000 final rule and our establishment of the interim work RVUs for new and revised codes for the 2002 fee schedule.
1. Work Relative Value Unit Refinements of Interim and Related Relative Value Units
a. Methodology (Includes Table 5, Refinements of the 2001 Interim Work Relative Value Units)
Although the RVUs in the November 2000 final rule were used to calculate 2001 payment amounts, we considered the RVUs for the new or revised codes to be interim. We accepted comments for a period of 60 days. We received substantive comments from many individual physicians and several specialty societies on 52 CPT codes with interim work RVUs. Only comments on codes listed in Addendum C of the November 2000 final rule were considered.
We used a process similar to the process used in 1997 to address substantive comments. (See the October 31, 1997 final rule on the physician fee schedule (62 FR 59084) for the discussion of refinement of CPT codes with interim work RVUs.) We convened Start Printed Page 55295a multispecialty refinement panel of physicians to assist us in the review of the comments. The comments that we did not submit to panel review are discussed at the end of this section, as well as those comments that were reviewed by the panel. We invited representatives from each of the specialty societies from which substantive comments were received to attend a panel for discussion of the codes on which they had commented. The panel was moderated by our medical staff and consisted of the following voting members:
- One to two clinicians representing the commenting specialty or specialties, based upon our determination of those specialties which are most identified with the service(s) in question. Although commenting specialties were welcome to observe the entire refinement process, they were only involved in the discussion of those services for which they were invited to participate.
- Two primary care clinicians nominated by the American Academy of Family Physicians and the American Society of Internal Medicine.
- Four carrier medical directors.
- Four clinicians with practices in related specialties, who were expected to have knowledge of the services under review.
The panel discussed the work involved in each procedure under review in comparison to the work associated with other services on the fee schedule. We assembled a set of reference services and asked the panel members to compare the clinical aspects of the work of services they believed were incorrectly valued to one or more of the reference services. In compiling the set, we attempted to include—(1) services that are commonly performed whose work RVUs are not controversial; (2) services that span the entire spectrum from the easiest to the most difficult; and (3) at least three services performed by each of the major specialties so that each specialty would be represented. The set contained approximately 300 services. Group members were encouraged to make comparisons to reference services. The intent of the panel process was to capture each participant's independent judgement based on the discussion and his or her clinical experience. Following each discussion, each participant rated the work for the procedure. Ratings were individual and confidential, and there was no attempt to achieve consensus among the panel members.
We then analyzed the ratings based on a presumption that the interim RVUs were correct. To overcome this presumption, the inaccuracy of the interim RVUs had to be apparent to a broad range of physicians participating in the panel.
Ratings of work were analyzed for consistency among the groups represented on the panel. In general, we used statistical tests to determine whether there was enough agreement among the groups of the panel, and whether the agreed-upon RVUs were significantly different from the interim RVUs published in Addendum C of the November 2000 final rule. We did not modify the RVUs unless there was a clear indication for a change. If there was agreement across groups for change, but the groups did not agree on what the new RVUs should be, we eliminated the outlier group and looked for agreement among the remaining groups as the basis for new RVUs. We used the same methodology in analyzing the ratings that we first used in the refinement process for the 1993 fee schedule. The statistical tests were described in detail in the November 25, 1992 final rule (57 FR 55938).
Our decision to convene a multispecialty refinement panel of physicians and to apply the statistical tests described above was based on our need to balance the interests of those who commented on the work RVUs against the redistributive effects that would occur in other specialties. Of the 3 codes reviewed by the multispecialty panel, all were the subject of requests for increased values. Of the 3 interim work RVUs that were reviewed, 2 were increased and 1 was unchanged.
We also received comments on RVUs that were interim for 2001, but which we did not submit to the panel for review for a variety of reasons. These comments and our decisions on those comments are discussed in further detail below.
Table 5 lists the interim and related codes reviewed during the refinement process described in this section. This table includes the following information:
- CPT Code. This is the CPT code for a service.
- Descriptor. This is an abbreviated version of the narrative description of the code.
- 2001 Work RVU. The work RVUs that appeared in the November 2000 rule are shown for each reviewed code.
- Requested Work RVU. This column identifies the work RVUs requested by commenters.
- 2002 Work RVU. This column contains the final RVUs for physician work.
Table 5.—Refinement of 2001 Interim Work Relative Value Units
1 CPT code Descriptor 2001 work RVU Requested work RVU 2002 work RVU 19102 Bx breast percut w/image 2.00 2.73 2.00 19103 Bx breast percut w/device 2.37 5.55 3.70 22522 Percutaneous vertebroplasty, addl 3.00 4.31 4.31 1 All CPT codes and descriptions copyright 2002 American Medical Association. 2. Interim 2001 Codes
Stenting Procedures—(CPT Codes 43256, 44370, 44379, 44383, 44397, 45345, 45387, and 45342)
We accepted the RUC recommended increase over the base code of 1.96 work RVUs. Commenters suggested that this increment should be increased to 2.59 work RVUs to reflect the work increase the RUC had recommended for CPT code 43219 (one of the codes used to arrive at this increase) as part of the 5-year review. Additionally, they also commented that the increment for the pre-dilation service should be from the dilation of gastric outlet in connection with an upper GI as opposed to the esophagoscopy code. Finally, commenters did not believe that these services should be subject to “within family work neutrality adjustments” (see Final Decision below) and instead believed that any increase in total RVUs should be addressed through the SGR or conversion factor. They felt that these stent placements are new technology and should not be viewed as code splitting/unbundling of services. They stated that stent placements have only been performed over the last 4-5 years and any work associated with them is Start Printed Page 55296not reflected in current work values for endoscopic codes.
Final decision: “Within family work neutrality adjustments” are used for new or revised services that are not considered new technologies. To achieve work neutrality within families of services, we compare the new or revised work RVUs (weighted by projected frequency) to the old work RVUs (weighted by actual frequency) to ensure that additional RVUs have not been added based on fragmentation of existing codes. We agree with the commenter that these services are new technologies and thus should not be subject to within family work neutrality adjustments. With regard to the final work value for CPT code 43219 and the use of dilation and stent placement codes in assigning a work value to 43219, please see our discussion elsewhere in this rule.
Cryosurgical Ablation of the Prostate—CPT Code 55873
We agreed with the RUC recommended work RVU for CPT code 55873 as we felt that the comparison to CPT code 55801, Prostatectomy, perineal, subtotal, was appropriate to aid in setting the work RVU of CPT code 55873. One commenter did not agree that this comparison was appropriate. The commenter indicated that the RUC was being requested to review this service again at its February meeting.
Final decision: The RUC provided comments on interim valued CPT code 55873 that re-visited the appropriate comparison service. Based upon comments received, the final work RVUs for CPT code 55873 will be increased to 19.47.
Percutaneous Vertebroplasty—CPT Code 22522
We disagreed with the RUC-recommended work RVUs of 4.31 for this service. CPT code 22522 is an add-on code that should have no associated pre- or postservice work. We removed the pre- and postservice work from the weighted average of CPT codes 22520 and 22521, which are the base services with which add-on CPT code 22522 should be billed in conjunction, and recalculated the value. Thus, we assigned interim work RVUs of 3.00 for CPT code 22522. Several commenters disagreed and do not believe that our methodology has appropriately valued this add-on service. Commenters felt we should sum the work RVUs of CPT codes 22520 and 22521 and then take 50 percent of this value. They believe that this is how we historically have calculated work RVUs for add-on services. Based on these comments, we referred this code to a multispecialty refinement panel for review.
Final decision: As a result of the statistical analysis of the refinement panel ratings, the final work RVUs are 4.31 for CPT code 22522.
Fetal Biophysical Stress Testing—CPT Codes 76818 and 76819
Although we agreed with the relativity presented by the RUC, we reduced the RVUs for these aforementioned services due to within family work neutrality adjustments. As previously discussed, within family work neutrality adjustments are used to ensure that additional relative values are not added based on fragmentation of existing codes. One specialty organization felt that we inappropriately determined that the work associated with the original CPT code 76818 (CPT code 76819 was added for January 1, 2001), included the average work of both with and without non-stress test. It believes that the survey data presented to the RUC suggest that this assumption is invalid and that the inappropriate within family neutralization of these services creates a rank-order anomaly in this family of codes.
The survey data indicated that CPT code 76818 required more time and greater mental effort than CPT code 76805 (Complete OB ultrasound), which has 0.99 work RVUs, since the ultrasound portion of CPT code 76818, while less extensive, is typically performed in a high-risk situation. In addition, CPT code 76818 also includes CPT code 59025 (Fetal non-stress test) with work RVUs of 0.53. The specialty organization also reported that CPT code 76819 requires more work than CPT code 76815 (Limited obstetric ultrasound) with work RVUs of 0.65. The assignment of 0.86 RVUs to CPT code 76818 and 0.63 RVUs to 76819 creates a rank-order anomaly with this family of obstetric ultrasound procedures.
Final Decision: We agree with the commenter that the within family neutrality adjustment we made for 2001 was not appropriate and created a rank-order anomaly within this family of services. We will remove the neutrality adjustments for January 1, 2002.
Cognitive Skills and Sensory Integrative Techniques—CPT Codes 97532 and 97533
We did not agree with the HCPAC recommendation for CPT codes 97532 and 97533 (work RVUs of 0.51 and 0.48, respectively). These two new services were created to replace deleted CPT code 97770. We believed that the work associated with these new services is analogous to deleted CPT code 97770 and therefore, we assigned work RVUs of 0.44 (the value assigned to the deleted code) to these new replacement codes. Commenters felt that assignment of this work value was arbitrary on our part, particularly since the HCPAC information had been based on information from a survey completed by the practitioners who provide these services.
Final Decision: We disagree with the commenters and are finalizing the interim work values. This is an example of replacing one CPT code with two new CPT codes that describe identical work. Because there is no new technology involved, we will finalize the interim work RVUs.
Wound Care CPT Codes
Absent a HCPAC recommendation for either of the aforementioned CPT codes, we valued the work of CPT code 97601 as 0.50 RVUs, the same as deleted service G0169 that described the work in the new code. We considered CPT code 97602 to be bundled into CPT code 97601 and therefore did not establish work RVUs for this service. Commenters believed that we inappropriately bundled CPT code 97602 into 97601 since they represent distinct services. The commenters requested that we reconsider bundling CPT code 97602.
Final Decision: We have re-examined our determination but have not changed our decision. CPT code 97602 describes services that typically involve placement of a wound covering, for example, wet-to-dry gauze or enzyme-treated dressing. It also includes nonspecific removal of devitalized tissue that is an inherent part of changing a dressing. This service is already included in the work and practice expenses of CPT code 97601. In the typical service described by 97601, the patient has a dressing placed over the wound. We would add that the services described by 97602 are also included in the work and practice expenses of the whirlpool code, CPT 97022. For this reason, we consider this a bundled service that is not paid separately.
Percutaneous Breast Biopsy—CPT Codes 19102 and 19103
We agreed with the RUC recommended work RVUs of CPT codes 19102 (RVU = 2.00) and 19103 (RVU = 2.37). Commenters believed that the work RVUs assigned to these codes were inappropriately low and did not accurately reflect the time and intensity of the work involved. Commenters supplied information to support their request for increasing the work RVUs for Start Printed Page 55297these services. Based on these comments, we referred this code to a multispecialty refinement panel for review.
Final decision: As a result of the statistical analysis of the multispecialty refinement panel ratings, the final work RVUs for CPT code 19102 are 2.00, and the final work RVUs for CPT code 19103 are 3.70.
Magnetic Resonance Imaging Procedures—CPT codes 70540, 70542, 70543, 71550, 71551, 71552, 72195, 72196, 72197, 73218, 73219, 73220, 73221, 73222, 73223, 73718, 73719, 73720, 73721, 73722, 73723, 74181, 74182, and 74183
We received a RUC recommendation for only 3 of these codes (70540, 70542, 70543) for January 1, 2001. However, this recommendation did not reflect the required within family work neutrality adjustment. The work RVUs of 0.98, 1.17, and 1.56 were assigned to these services to ensure that there would not be additional work RVUs introduced into the system. We did not receive work recommendations or utilization data for any of the other new MRI codes and assigned work RVUs for these other codes based on the methodology outlined in the November 2000 final rule.
Commenters expressed concern about the within family work neutrality adjustment applied to the RUC-recommended work RVUs, and the methodology that was used to establish work values for the other MRI procedures. Commenters requested that we re-evaluate the within family work neutrality adjustment based upon updated information supplied in their respective comments.
Final decision: We are accepting the work values for these services which were submitted by the RUC in its comment on the interim work values we assigned in last year's final rule. We note that these work values are virtually identical to the work values that we assigned as interim last year. Based upon comments received, we have re-evaluated the utilization crosswalks upon which our within family work neutrality adjustments were based.
Since 2001 is the first year for which actual data is available for these services, we used available data (first two quarters of 2001) to capture the actual utilization of these new services. This utilization was then subjected to a standard analysis of reporting trends to estimate the completion percentage of 2001 utilization data. The available utilization was then “aged” to represent one full year of data for 2001. After determining the utilization for 2001, we applied this revised within family work neutrality adjustment across the entire family of MRI procedures rather than applying this adjustment to subsets. We are finalizing these within family work neutral values and note that the re-calculation of this neutrality adjustment results in increases to the work RVUs of the MRI services referenced above.
Computed Tomographic Angiography (CTA)—CPT Codes 70496, 70498, 71275, 72191, 73206, 73706, 74175 and 75635
We agreed with the RUC recommendation of 1.75 for CPT codes 70496 and 70498 for January 1, 2001. However, the RUC did not submit work recommendations for the other CTA codes. We assigned work RVUs for these other codes based on the methodology outlined in the November 2000 rule. Commenters disagreed with the interim values we had proposed for CTA codes and provided additional information for valuing these services. The commenter felt that our decisions created rank-order anomalies between anatomic sites.
Final decision: We are accepting the work values for these services which were submitted by the RUC in its comment on the interim work values we assigned in last year's final rule. We will implement them as final values for 2002.
Practice Expense Refinements of 2001 Interim and Revised RVUs
Percutaneous Breast Biopsy—CPT Codes 19102 and 19103
Comment: A specialty organization representing breast surgeons submitted its suggested direct cost inputs for these two services and had several comments on their practice expenses. The commenter indicated that the price in the database for the biopsy driver was too low, that the clinical staff type should be a registered nurse rather than a technician and that there should be pre- and postservice clinical staff time when the procedure is performed in the facility setting. In addition, the commenter questioned whether the 50 percent utilization rate used to price equipment was realistic for new technology and recommended that device-specific utilization rates be determined. The society also questioned the lack of direct cost inputs for equipment and supplies for CPT 76095, the associated procedure for image guidance. A manufacturer commented that the equipment inputs for CPT 19102 were erroneously dropped from the CPEP database.
Response: We had accepted the RUC recommendations on these two services, making only the following technical changes to the supplies and equipment: we did not include the cost of the crash cart, because we consider this an indirect expense, nor the cost of the biopsy gun handle, because this was less than the $500 required for an item to be on the equipment list. We also did not include separately billable fluids, the formalin that would be supplied by the lab, or the biohazard bag and skin marking pen that could be used for more than one procedure.
If the specialty that was involved in the presentation of these codes to the RUC now believes that the direct inputs do not adequately represent the costs of performing these services, one option would be to have these codes refined by the PEAC. In the meantime, we are prepared to make certain changes to the CPEP data in response to the recommendations made by the commenters. We will add the power table and surgical lamp to both codes and will increase the price associated with the biopsy device driver, subject to verification when we undertake our repricing of the CPEP equipment inputs. Because the specialties presenting the codes to the RUC, and the RUC itself, recommended using radiologic staff for these services, we will not change the staff type to registered nurse at this time. However, we will substitute the higher-paid mammography technologist, which we have just added to our staff type list, for the current x-ray technician staff type.
We have in the past solicited information from the specialties regarding equipment-specific utilization rates, but we have never received sufficient information to propose any changes in our policy. Additionally, for most services, changing the utilization rate would have very little effect.
The commenter is correct that the associated procedure for image guidance, CPT 76095, currently does not have CPEP inputs assigned to the non-facility setting. However, at this time, it is priced as a part of the “zero work” pool, and the CPEP inputs are not used to calculate the practice expense RVUs for this service. We would hope that this code could be refined in the near future and given the appropriate inputs for the office setting.
CPT Codes 34812, 34820, 34830, 34831 and 34832 for Repair of Aortic Aneurysm
Comment: A specialty organization representing vascular surgery stated that CPT codes 34812 and 34820 should have clinical staff preservice time added and that CPT codes 34830, 34831 and Start Printed Page 5529834832 were assigned inappropriately low postservice clinical staff times.
Response: We accepted the RUC recommendations for all of these services. There was no preservice time included in the RUC recommendation for CPT codes 34812 and 34820. In addition, we have assigned 99 minutes of clinical staff postservice time to CPT codes 34830, 34831 and 34832, as recommended by the RUC. These codes can be refined by the PEAC which now has a standard package for 90-day global pre- and postservice times for clinical staff and is also discussing the coordination of care clinical staff times for 0-day global services.
We received the following comments on HCPCS codes established in the November 1, 2000 final rule.
- G0169 Removal of Devitalized tissue, without use of anesthesia.
Comment: The American Podiatric Medical Association recognized that, effective January 1, 2001, this code was eliminated and we have adopted CPT code 97601, which is sufficiently similar to the services described by G0169. However, it requested we address a policy issue related to the discussion of this service. In the November 2, 1999 Federal Register (64 FR 59426), we stated that G0169 was created because CPT codes 11040 through 11044 for debridement were created to describe “complex surgical services requiring the use of general anesthesia.” APMA indicates that there had never been a policy requiring the use of any anesthesia, much less general anesthesia, when performing surgical debridement that is reported with CPT codes 11040 through 11044. However, as a result of the statement in the November 2 Federal Register, some carriers developed policies denying payment for these codes if anesthesia was not used. The APMA urged us to clarify that anesthesia, whether general or local, is not required when billing CPT codes 11040 through 11044.
Response: We acknowledge that the use of “general anesthesia” in the preamble to the November 2, 1999 rule was an error, and we believe all our contractors are aware of our misstatement. As the commenter stated, the code G0169 has been deleted and replaced by CPT code 97601, Removal of devitalized tissue from wound(s); selective debridement, without anesthesia (e.g., high pressure waterjet, shape selective debridement with scissors, scalpel, and tweezers) including topical application(s), wound assessment, and instruction(s) for ongoing care, one session. We expect that our contractors will develop policies to distinguish this service from the debridement codes, 11040 through 11044. We anticipate that they may consider a variety of factors, including the extent of the debridement and the amount of medical skill required to perform the service, and not simply whether a local anesthetic was used in the procedure.
Comment: The American College of Surgeons urged us to issue instructions to carriers specifying that the use of CPT code 97061 is limited to physical therapists and other non-physician practitioners and that the debridement of wounds by surgeons is properly reported with a code from the CPT debridement codes 11040-11044.
Response: As we stated in the response to the previous comment, we believe that our contractors are likely to make this distinction in their local policies. If we determine that relying on local carrier policies is unsatisfactory, then we will consider whether national guidance is needed.
- G0181 and G0182, Care plan Oversight.
Comment: A few organizations expressed disappointment that we finalized our proposal to establish two new G codes for care plan oversight services, rather than continue to recognize the CPT codes related to these services.
Response: The CPT codes for care plan oversight were modified so that they included services that extend beyond the limits of our current payment policy. As a result, we will continue to use the G-codes that are consistent with our payment policies.
- G0180 and G0179 Certification and Recertification of Medicare Covered Home Health Services.
Comment: Several specialty organizations expressed appreciation for our willingness to recognize and compensate physicians for these services and supported our decision to pursue this coding and reimbursement issue through the CPT and RUC processes. The American College of Surgeons expressed concern that claims submitted by surgeons for physician certification or recertification would be denied inappropriately due to longstanding rules that preclude payment for services that are provided during the global period.
Response: As was stated in the November 1, 2000 final rule (66 FR 65408), surgeons performing these services could be paid for G0179 and G0180 during the global period. We have heard no specific complaints that this policy has not been implemented appropriately.
G Codes Related to Swallowing Function
Comment: The American College of Surgeons objected to the creation of these G codes and requested that we discontinue their use and work with the otolaryngologists to submit a coding request on these services to the CPT Editorial Panel. The American Academy of Otolaryngology—Head and Neck Surgery, Inc. (AAO-HNS) also expressed concern about creation of these codes. It felt that our description of the codes was incomplete and inaccurate.
In the November 1, 2000 final rule we proposed 4 new G codes and stated that these would replace the more general CPT code 92525, Evaluation of swallowing and oral function for feeding. AAO-HNS believes that this incorrectly implies that the single code 92525 includes 4 unique services and, therefore, we have significantly understated the work and practice expenses required for these procedures.
For G0193, Endoscopy study of swallowing function, and GO194 Sensory testing during endoscoping study of swallowing, we stated that coverage of these services remains at the discretion of the carrier and that they would be carrier priced. AAO-HNS expressed concern that carriers might misinterpret this statement to mean the codes should not be covered and, if covered, the payment might be inappropriately low. AAO-HNS requested we clarify that these services should be covered and recommended that pricing for GO193 should equal to the sum of the RVUs for CPT code 31575, Laryngoscopy, flexible fiberoptic; diagnostic, and CPT code 92525.
AAO-HNS also did not agree with our decision to treat G0194 as an “add-on” code as this group felt this would create confusion. Rather, AAO-HNS suggested that GO194 be treated as a stand-alone code with RVUs equal to CPT codes 31575, 92525 and 92520 (Laryngeal function studies).
In addition, AAO-HNS was concerned about our statement that CPT code 31575 and CPT code 31579 (Laryngoscopy, flexible or rigid fiberoptic, with stroboscopy) should not be used for evaluations of swallowing and urged that we clarify that these codes could still be used to report flexible fiberoptic laryngosopies for patients with swallowing problems.
Response: These G codes related to swallowing function were created because of the ambiguity of the CPT code, 92525. The CPT editorial panel will be reviewing codes designed to substitute for the G-codes created. The specialty advisors, including AAO-Start Printed Page 55299HNS, will have the opportunity to comment on these proposals and to create codes that they believe will describe the services more accurately. If the CPT editorial panel adopts these revised codes, they could be in the 2003 CPT book.
Comment: The American Occupational Therapy Association stated that in the specific discussion of code GO195, and by implication the related codes, we stated these services are performed typically by a speech and language pathologist. While AOTA does not disagree with this characterization, it requested that we clarify that other professionals, specifically occupational therapists, also may be trained in these procedures. It noted that in some areas of the country occupational therapists typically perform swallowing evaluations, particularly in conjunction with feeding and eating deficits.
Response: These G codes did not specify which professionals could perform these services. The description of the new G codes only stated that these services would be most commonly performed by speech and language pathologists. Our contractors, who have the capacity to be responsive to local differences in practice patterns, will be aware of whether occupational therapists have the qualifications to perform these evaluations and will make the decisions about whether the service performed matches the services described by the code.
Comment: The American College of Radiology requested clarification on the specialties we anticipate using G0196; they asked if this G code would be used by the speech pathologist while the radiologist would use CPT code 74230. ACR expressed concern that provision of such a G code would promote performance of fluoroscopy by non-trained individuals.
Response: We do not believe that the development of these G codes should lead to non-trained individuals performing fluoroscopy. Prior to the development of the G codes, we were asked by speech and language pathologists if they could bill 74230 to describe the work they did in conjunction with a fluoroscopic or video evaluation of swallowing. We did not think that the speech and language pathologists should bill the code 74230 and created this G code to describe the portion of the examination that they typically performed.
We were also asked whether the services of a speech and language pathologist should have remained bundled into the technical portion of the 74230 examination, because this may have been the method of billing these services prior to the development of the G code. Because this new G code separates the services of the speech and language pathologists in this examination, we may need to clarify which services are included in the technical portion of 74230. None of these concerns would lead a non-skilled practitioner to perform either of these services.
G Codes Related to Speech Generating Devices and Voice Prostheses G0197-G0201
Comment: AAO-HNS expressed concern about the establishment of G codes related to speech generating devices and voice prostheses. It continues to believe that the creation of codes used to describe services that are already described in CPT makes compliance with Medicare policy difficult and confusing.
Response: The current CPT codes, 92597 and 92598, identify two distinct services—evaluation or modification of voice prosthetics and augmentative or alternative communicative devices. Since different types of patients require either voice prosthetics (for example, an artificial larynx) or augmentative or alternative communicative devices, we believe that separating these two services through the use of G-codes actually should make compliance with Medicare policies easier, since the services being delivered are more accurately described.
Revisions to Malpractice RVUs for New and Revised CPT Codes for 2001
Malpractice RVUs are calculated using the methodology described in detail at Addendum G of our November 1, 2000 final rule (65 FR 65589). Because of the timing of the release of new and revised CPT codes each year, the malpractice RVUs for the first year of these codes are extrapolated from existing similar codes, based on the advice of our medical consultants, and are considered interim subject to public comment and revision. The following year these codes are given values based on our malpractice RVU methodology and a review of comments received.
The malpractice RVUs for 2001 new and revised codes published in Addendum B of the November 1, 2000 final rule were thus extrapolated from (RVUs for existing similar codes). The malpractice RVUs for these codes in this year's Addendum B were calculated by our consultant, KPMG, using the same methodology used for all other codes. Likewise, the malpractice RVUs for new and revised 2002 codes are being extrapolated from existing similar codes and will be calculated using the malpractice RVU methodology next year.
Comment: One commenter stated that malpractice premiums are rapidly increasing all over the country and that we should ensure that the physician fee schedule reflect these increases.
Response: We agree that changes in malpractice premiums should, to the extent possible, be reflected in the physician fee schedule. The most recent malpractice data available were used in constructing the 2001 malpractice RVUs and the revised 2001 GPCIs. In addition, the relative weights of the component cost shares (work, practice expense, malpractice) in the physician fee schedule and in the MEI are periodically adjusted when the most recent AMA SMS data indicate significant shifts among physician practice cost components. However, because of the time needed to collect the data and propose changes through the rulemaking process, there is a time lag in making these changes.
Establishment of Interim Work Relative Value Units for New and Revised Physician's Current Procedural Terminology (CPT) Codes and New Healthcare Common Procedure Coding System Codes (HCPCS) for 2002 (Includes Table 6, AMA RUC and HCPAC Work RVU Recommendations and CMS Decisions for New and Revised 2002 CPT Codes)
One aspect of establishing RVUs for 2002 was related to the assignment of interim work RVUs for all new and revised CPT codes. As described in our November 25, 1992 notice in the 1993 fee schedule (57 FR 55983), and in section III.B. of our November 22, 1996 final rule (61 FR 59505-59506), we established a process, based on recommendations received from the AMA's RUC, for establishing interim work RVUs for new and revised codes.
This year we received RUC work RVU recommendations for approximately 314 new and revised CPT codes. Our staff and medical officers reviewed the RUC recommendations by comparing them to our reference set or to other comparable services for which work RVUs had been previously established, or to both of these criteria. We also considered the relationships among the new and revised codes for which we received RUC recommendations. We agreed with the majority of these relationships reflected in the RUC values. In some instances, when we agreed with the relationships, we revised the work RVUs to achieve work neutrality within families of codes, that is, the work RVUs have been adjusted so that the sum of the new or revised work RVUs Start Printed Page 55300(weighted by projected frequency of use) for a family will be the same as the sum of the current work RVUs (weighted by projected frequency of use for that family of codes). For approximately 93 percent of the RUC recommendations, proposed work RVUs were accepted, and for approximately 7 percent, we disagreed with the RUC recommendation. In a majority of instances, we agreed with the relativity proposed by the RUC, but needed to decrease work RVUs to retain budget neutrality.
There were also 10 CPT codes for which we did not receive a RUC recommendation. After a review of these CPT codes by our staff and medical officers, we established interim work RVUs for the majority of these services. For those services for which we could not arrive at interim work RVUs, we have assigned a carrier-priced status until such time as the RUC provides work RVU recommendations.
We received 18 recommendations from the Health Care Professionals Advisory Committee (HCPAC). We accepted 12, or 67 percent, of the HCPAC recommendations.
Table 6, AMA RUC and HCPAC Work RVU Recommendations and CMS Decisions for New and Revised 2002 CPT Codes, lists the new or revised CPT codes, and their associated work RVUs, that will be interim in 2002. This table includes the following information:
- A “#” identifies a new code for 2002.
- CPT code. This is the CPT code for a service.
- Modifier. A “26” in this column indicates that the work RVUs are for the professional component of the code.
- Description. This is an abbreviated version of the narrative description of the code.
- RUC recommendations. This column identifies the work RVUs recommended by the RUC.
- HCPAC recommendations. This column identifies the work RVUs recommended by the HCPAC.
- CMS decision. This column indicates whether we agreed with the RUC recommendation (“agree”) or we disagreed with the RUC recommendation (“disagree”). Codes for which we did not accept the RUC recommendation are discussed in greater detail following this table. An “(a)” indicates that no RUC recommendation was provided. A discussion follows the table.
- 2002 Work RVUs. This column establishes the 2002 work RVUs for physician work.
Table 6.—AMA RUC and HCPAC Work RVU Recommendations and CMS Decisions for New and Revised 2002 CPT Codes
* CPT CODE Mod Description RUC recommendation HCPAC recommendation CMS decision 2002 work RVU 10021 # 26 FNA W/O IMAGE 1.27 Agree 1.27 10022 # 26 FNA W/IMAGE 1.27 Agree 1.27 11755 BIOPSY, NAIL UNIT 1.31 Agree 1.31 11981 # INSERT DRUG IMPLANT DEVICE 1.48 Agree 1.48 11982 # REMOVE DRUG IMPLANT DEVICE 1.78 Agree 1.78 11983 # REMOVE/INSERT DRUG IMPLANT 3.30 Agree 3.30 17000 DESTROY BENIGN/PREMAL LESION 0.60 Agree 0.60 17003 DESTROY LESIONS, 2-14 0.15 Agree 0.15 17004 DESTROY LESIONS, 15 OR MORE 2.79 Agree 2.79 17110 DESTRUCT LESION, 1-14 0.65 Agree 0.65 17111 DESTRUCT LESION, 15 OR MORE 0.92 Agree 0.92 17260 DESTRUCTION OF SKIN LESIONS 0.91 Agree 0.91 17261 DESTRUCTION OF SKIN LESIONS 1.71 Agree 1.71 17262 DESTRUCTION OF SKIN LESIONS 1.58 Agree 1.58 17263 DESTRUCTION OF SKIN LESIONS 1.79 Agree 1.79 17264 DESTRUCTION OF SKIN LESIONS 1.94 Agree 1.94 17266 DESTRUCTION OF SKIN LESIONS 2.34 Agree 2.34 17270 DESTRUCTION OF SKIN LESIONS 1.32 Agree 1.32 17271 DESTRUCTION OF SKIN LESIONS 1.49 Agree 1.49 17272 DESTRUCTION OF SKIN LESIONS 1.77 Agree 1.77 17273 DESTRUCTION OF SKIN LESIONS 2.05 Agree 2.05 17274 DESTRUCTION OF SKIN LESIONS 2.59 Agree 2.59 17276 DESTRUCTION OF SKIN LESIONS 3.20 Agree 3.20 17280 DESTRUCTION OF SKIN LESIONS 1.17 Agree 1.17 17281 DESTRUCTION OF SKIN LESIONS 1.72 Agree 1.72 17282 DESTRUCTION OF SKIN LESIONS 2.04 Agree 2.04 17283 DESTRUCTION OF SKIN LESIONS 2.64 Agree 2.64 17284 DESTRUCTION OF SKIN LESIONS 3.21 Agree 3.21 17286 DESTRUCTION OF SKIN LESIONS 4.44 Agree 4.44 20225 BONE BIOPSY, TROCAR/NEEDLE 1.87 Agree 1.87 20526 # THER INJECTION, CARPAL TUNNEL 0.86 Agree 0.86 20550 INJECT TENDON/LIGAMENT/CYST 0.86 Agree 0.86 20551 # INJECT TENDON ORIGIN/INSERT 0.86 Agree 0.86 20552 # INJECT TRIGGER POINT, 1 OR 2 0.86 Agree 0.86 20553 # INJECT TRIGGER POINTS, 3 0.86 Agree 0.86 23000 REMOVAL OF CALCIUM DEPOSITS 4.36 Agree 4.36 23350 INJECTION FOR SHOULDER X-RAY 1.00 Agree 1.00 24075 REMOVE ARM/ELBOW LESION 3.92 Agree 3.92 24076 REMOVE ARM/ELBOW LESION 6.30 Agree 6.30 24300 # MANIPULATE ELBOW W/ANESTH 3.75 Agree 3.75 24332 # TENOLYSIS, TRICEPS 7.45 Agree 7.45 24343 # REPR ELBOW LAT LIGMNT W/TISS 8.65 Agree 8.65 24344 # RECONSTRUCT ELBOW LAT LIGMNT 14.00 Agree 14.00Start Printed Page 55301 24345 # REPR ELBW MED LIGMNT W/TISS 8.65 Agree 8.65 24346 # RECONSTRUCT ELBOW MED LIGMNT 14.00 Agree 14.00 25001 # INCISE FLEXOR CARPI RADIALIS 3.38 Agree 3.38 25020 DECOMPRESS FOREARM 1 SPACE 5.92 Agree 5.92 25023 DECOMPRESS FOREARM 1 SPACE 12.96 Agree 12.96 25024 # DECOMPRESS FOREARM 2 SPACES 9.50 Agree 9.50 25025 # DECOMPRESS FORAM 2 SPACES 16.54 Agree 16.54 25075 REMOVE FOREARM LESION SUBCUT 3.74 Agree 3.74 25076 REMOVE FOREARM LESION DEEP 4.92 Agree 4.92 25259 # MANIPULATE WRIST W/ANESTHES 3.75 Agree 3.75 25274 REPAIR FOREARM TENDON/MUSCLE 8.75 Agree 8.75 25275 # REPAIR FOREARM TENDON SHEATH 8.50 Agree 8.50 25394 # REPAIR CARPAL BONE, SHORTEN 10.40 Agree 10.40 25405 REPAIR/GRAFT RADIUS OR ULNA 14.38 Agree 14.38 25420 REPAIR/GRAFT RADIUS & ULNA 16.33 Agree 16.33 25430 # VASC GRAFT INTO CARPAL BONE 9.25 Agree 9.25 25431 # REPAIR NONUNION CARPAL BONE 10.44 Agree 10.44 25440 REPAIR/GRAFT WRIST BONE 10.44 Agree 10.44 25520 TREAT FRACTURE OR RADIUS 6.26 Agree 6.26 25526 TREAT FRACTURE OF RADIUS 12.98 Agree 12.98 25645 TREAT WRITST BONE FRACTURE 7.25 Agree 7.25 25651 # PIN ULNAR STYLOID FRACTURE 5.36 Agree 5.36 25652 # TREAT FRACTURE ULNAR STYLOID 7.60 Agree 7.60 25671 # PIN RADIOULNAR DISLOCATION 6.00 Agree 6.00 26115 REMOVE HAND LESION SUBCUT 3.86 Agree 3.86 26116 REMOVE HAND LESION, DEEP 5.53 Agree 5.53 26160 REMOVE TENDON SHEATH LESION 3.15 Agree 3.15 26250 EXTENSIVE HAND SURGERY 7.55 Agree 7.55 26255 EXTENSIVE HAND SURGERY 12.43 Agree 12.43 26340 # MANIPULATE FINGER W/ANESTH 2.50 Agree 2.50 26350 REPAIR FINGER/HAND TENDON 5.99 Agree 5.99 26352 REPAIR/GRAFT HAND TENDON 7.68 Agree 7.68 26356 REPAIR FINGER/HAND TENDON 8.07 Agree 8.07 26357 REPAIR FINGER/HAND TENDON 8.58 Agree 8.58 26358 REPAIR/GRAFT HAND TENDON 9.14 Agree 9.14 26390 REVISE HAND/FINGER TENDON 9.19 Agree 9.19 26392 REPAIR/GRAFT HAND TENDON 10.26 Agree 10.26 26415 EXCISION, HAND/FINGER TENDON 8.34 Agree 8.34 26416 GRAFT HAND OR FINGER TENDON 9.37 Agree 9.37 26426 REPAIR FINGER/HAND TENDON 6.15 Agree 6.15 26428 REPAIR/GRAFT FINGER TENDON 7.21 Agree 7.21 26445 RELEASE HAND/FINGER TENDON 4.31 Agree 4.31 26510 THUMB TENDON TRANSFER 5.43 Agree 5.43 26587 RECONSTRUCT EXTRA FINGER 14.05 Agree 14.05 26590 REPAIR FINGER DEFORMITY 17.96 Agree 17.96 26607 TREAT METACARPAL FRACTURE 5.36 Agree 5.36 26608 TREAT METACARPAL FRACTURE 5.36 Agree 5.36 26670 TREAT HAND DISLOCATION 3.69 Agree 3.69 26675 TREAT HAND DISLOCATION 4.54 Agree 4.54 26676 PINE HAND DISLOCATION 5.52 Agree 5.52 26685 TREAT HAND DISLOCATION 6.98 Agree 6.98 26843 FUSION OF HAND JOINT 7.61 Agree 7.61 26844 FUSION/GRAFT OF HAND JOINT 8.73 Agree 8.73 27096 INJECT SACROILIAC JOINT 1.40 Agree 1.40 28299 CORRECTION OF BUNION 10.58 Agree 10.58 29086 # APPLY FINGER CAST 0.62 Agree 0.62 29805 # SHOULDER ARTHROSCOPY, DX 5.89 Agree 5.89 29806 # SHOULDER ARTHROSCOPY/SURGERY 14.37 Agree 14.37 29807 # SHOULDER ARTHROSCOPY/SURGERY 13.90 Agree 13.90 29819 SHOULDER ARTHROSCOPY/SURGERY 7.62 Agree 7.62 29820 SHOULDER ARTHROSCOPY/SURGERY 7.07 Agree 7.07 29821 SHOULDER ARTHROSCOPY/SURGERY 7.72 Agree 7.72 29822 SHOULDER ARTHROSCOPY/SURGERY 7.43 Agree 7.43Start Printed Page 55302 29823 SHOULDER ARTHROSCOPY/SURGERY 8.17 Agree 8.17 29824 # SHOULDER ARTHROSCOPY/SURGERY 8.25 Agree 8.25 29900 # MCP JOINT ARTHROSCOPY, DX 5.42 Agree 5.42 29901 # MCP JOINT ARTHROSCOPY, SURG 6.13 Agree 6.13 29902 # MCP JOINT ARTHROSCOPY, SURG 6.70 Agree 6.70 30117 REMOVAL OF INTRANASAL LESION 3.16 Agree 3.16 30118 REMOVAL OF INTRANASAL LESION 9.69 Agree 9.69 31641 BRONCHOSCOPY, TREAT BLOCKAGE 5.03 Agree 5.03 32650 THORACOSCOPY, SURGICAL 10.75 Agree 10.75 33967 # INSERT IA PERCUT DEVICE 4.85 Agree 4.85 33975 IMPLANT VENTRICULAR DEVICE 21.00 Agree 21.00 33976 IMPLANT VENTRICULAR DEVICE 23.00 Agree 23.00 33977 REMOVE VENTRICULAR DEVICE 19.29 Agree 19.29 33978 REMOVE VENTRICULAR DEVICE 21.73 Agree 21.73 33979 # INSERT INTRACORPOREAL DEVICE carrier Agree carrier 33980 # REMOVE INTRACORPOREAL DEVICE carrier Agree carrier 35646 ARTERY BYPASS GRAFT 31.00 Agree 31.00 35647 # ARTERY BYPASS GRAFT 28.00 Agree 28.00 35685 BYPASS GRAFT PATENCY/PATCH 4.05 Agree 4.05 35686 # BYPASS GRAFT/AV FIST PATENCY 3.35 Agree 3.35 36002 # PSEUDOANEURYSM INJECTION TRT 1.96 Agree 1.96 36005 INJECTION EXT VENOGRAPHY 0.95 Agree 0.95 36400 DRAWING BLOOD 0.38 Agree 0.38 36819 AV FUSION/UPPR ARM VEIN 14.00 Agree 14.00 36820 # AV FUSION/FOREARM VEIN 14.00 Agree 14.00 36823 INSERTION OF CANNULA(S) 21.00 Agree 21.00 38220 # BONE MARROW ASPIRATION 1.08 Agree 1.08 38221 # BONE MARROW BIOPSY 1.37 Agree 1.37 43200 ESOPHAGUS ENDOSCOPY 1.59 Agree 1.59 43227 ESOPH ENDOSCOPY, REPAIR 3.60 Agree 3.60 43245 OPERATIVE UPPER GI ENDOSCOPY 3.39 Agree 3.39 43310 REPAIR OF ESOPHAGUS 27.47 Agree 27.47 43312 REPAIR ESOPHAGUS AND FISTULA 30.50 Agree 30.50 43313 # ESOPHAGOPLASTY CONGENITAL 45.28 Agree 45.28 43314 # TRACHEO-ESOPHAGOPLASTY CONG 50.27 Agree 50.27 44120 REMOVAL OF SMALL INTESTINE 17.00 Agree 17.00 44121 REMOVAL OF SMALL INTESTINE 4.45 Agree 4.45 44126 # ENTERECTOMY W/TAPER, CONG 35.50 Agree 35.50 44127 # ENTERECTOMY W/O TAPER, CONG 41.00 Agree 41.00 44128 # ENTERECTOMY CONG, ADD-ON 4.45 Agree 4.45 44140 PARTIAL REMOVAL OF COLON 18.35 Agree 18.35 44160 REMOVAL OF COLON 18.62 Agree 18.62 44202 LAP RESPECT S/INTESTINE SINGL 22.04 Agree 22.04 44203 # LAP RESECT S/INTESTINE, ADDL 4.45 Agree 4.45 44204 # LAPARO PARTIAL COLECTOMY 22.00 Disagree 25.08 44205 # LAP COLECTOMY PART W/ILEUM 19.50 Disagree 22.23 44366 SMALL BOWEL ENDOSCOPY 4.41 Agree 4.41 44378 SMALL BOWEL ENDOSCOPY 5.26 Agree 5.26 44391 COLONOSCOPY FOR BLEEDING 3.82 Agree 3.82 45136 # EXCISE ILEOANAL RESERVOIR 27.30 Agree 27.30 45190 DESTRUCTION, RECTAL TUMOR 8.28 Agree 8.28 45303 PROCTOSIGMOIDOSCOPY DILATE 0.44 Agree 0.44 45317 PROTOSIGMOIDOSCOPY BLEED 1.50 Agree 1.50 45334 SIGMOIDOSCOPY FOR BLEEDING 2.73 Agree 2.73 45382 COLONOSCOPY/CONTROL BLEEDING 5.69 Agree 5.69 46020 # PLACEMENT OF SETON 2.90 Agree 2.90 46604 ANOSCOPY AND DILATION 1.31 Agree 1.31 46614 ANOSCOPY/CONTROL BLEEDING 2.01 Agree 2.01 46924 DESTRUCTION, ANAL LESION(S) 2.76 Agree 2.76 47370 # LAPARO ABLATE LIVER TUMORE RF (a) (a) 18.00 47371 # LAPARO ABLATE LIVER CRYOSUG (a) (a) 16.94 47380 # OPEN ABLATE LIVER TUMOR RF (a) (a) 21.25 47381 # OPEN ABLATE LIVER TUMOR CRYO (a) (a) 21.00 47382 # PERCUT ABLATE LIVER RF (a) (a) 12.00 48100 BIOPSY OF PANCREAS, OPEN 11.08 Agree 11.08 49424 ASSESS CYST, CONTRAST INJECT 0.76 Agree 0.76 49491 # REPAIRING HERN PREMIE REDUC 11.13 Agree 11.13Start Printed Page 55303 49492 # RPR ING HERN PREMIE, BLOCKED 14.03 Agree 14.03 49495 RPR ING HERNIA BABY, REDUC 5.89 Agree 5.89 49496 RPR ING HERNIA BABY, BLOCKED 8.79 Agree 8.79 50220 REMOVE KIDNEY, OPEN 17.15 Agree 17.15 50225 REMOVAL KIDNEY OPEN, COMPLEX 20.23 Agree 20.23 50230 REMOVAL KIDNEY OPEN, RADICAL 22.07 Agree 22.07 51596 REMOVE BLADDER/CREATE POUCH 39.52 Agree 39.52 52001 # CYSTOSCOPY, REMOVAL OF CLOTS 5.45 Disagree 2.37 52347 # CYSTOSCOPY, RESECT DUCTS 5.28 Agree 5.28 52510 DILATIONPROSTATIC URETHRA 6.72 Agree 6.72 53431 # RECONSTRUCT URETHRA/BLADDER 19.89 Agree 19.89 53444 # INSERT TANDEM CUFF 13.40 Agree 13.40 53445 INSERT URO./VES NCK SPHINCTER 14.06 Agree 14.06 53446 # REMOVE URO SPHINCTER 10.23 Agree 10.23 53447 REMOVE/REPLACE UR SPHINCTER 13.49 Agree 13.49 53448 # REMOVE/REPLC UR SPHINCTR COMP 21.15 Agree 21.15 53449 REPAIR URO SPHINCTER 9.70 Agree 9.70 53853 # PROSTATIC WATER THERMOTHER 6.41 Disagree 4.14 54065 DESTRUCTION, PENIS LESION(S) 2.42 Agree 2.42 54162 # LYSIS PENIL CIRCUMCIS LESION 3.00 Agree 3.00 54163 # REPAIR OF CIRCUMSION 3.00 Agree 3.00 54164 # FRENULOTOMY OF PENIS 2.50 Agree 2.50 54400 INSERT SEMI-RIGID PROSTHESIS 8.99 Agree 8.99 54401 INSERT SELF-CONTD PROSTHESIS 10.28 Agree 10.28 54405 INSERT MULTI-COMP PENIS PROS 13.43 Agree 13.43 54406 # REMOVE MULTI-COMP PENIS PROS 12.10 Agree 12.10 54408 # REPAIR MUTLI-COMP PENIS PROS 12.75 Agree 12.75 54410 # REMOVE/REPLACE PENIS PROSTH 15.50 Agree 15.50 54411 # REMV/REPLC PENIS PROS, COMP 16.00 Agree 16.00 54415 # REMOVE SELF-CONTD PENIS PROS 8.20 Agree 8.20 54416 # REMV/REPL PENIS CONTAIN PROS 10.87 Agree 10.87 54417 # REMV/REPLC PENIS PROS, COMPL 14.19 Agree 14.19 54512 EXCISE LESION TESTIS 8.58 Agree 8.58 56501 DESTROY, VULVA LESIONS, SIMP 1.53 Agree 1.53 56515 DESTROY VULVA LESION/S COMPL 1.88 Agree 1.88 56605 BIOPSY OF VULVA/PERINEUM 1.10 Agree 1.10 56810 REPAIR OF PERINEUM 4.13 Agree 4.13 57022 I & D VAGINAL HEMATOMA, PP 2.56 Agree 2.56 57061 DESTROY VAG LESIONS, SIMPLE 1.25 Agree 1.25 57065 DESTROY VAG LESIONS, COMPLEX 2.61 Agree 2.61 57155 # INSERT UTERI TANDEMNS/OVOIDS 6.27 Agree 6.27 58100 BIOPSY OF UTERUS LINING 1.53 Agree 1.53 58346 # INSERT HEYMAN UTERI CAPSULE 6.75 Agree 6.75 58563 HYSTEROSCOPY, ABLATION 6.17 Agree 6.17 58953 # TAH, RAD DISSECT FOR DEBULK 32.00 Agree 32.00 58954 # TAH RAD DEBULK/LYMPH REMOVE 35.00 Agree 35.00 59000 AMNIOCENTESIS, DIAGNOSTIC 1.30 Agree 1.30 59001 # AMINOCENTESIS, THERAPEUTIC 3.00 Agree 3.00 64555 IMPLANT NEUROELECTRODES 2.27 Agree 2.27 64561 # IMPLANT NEUROELECTRODES 6.74 Agree 6.74 64575 IMPLANT NEUROELECTRODES 4.53 Agree 4.53 64581 # IMPLANT NEUROELECTRODES 13.50 Agree 13.50 64820 REMOVE SYMPATHETIC NERVES 10.37 Agree 10.37 64821 # REMOVE SYMPATHETIC NERVES 8.75 Agree 8.75 64822 # REMOVE SYMPATHETIC NERVES 8.75 Agree 8.75 64823 # REMOVE SYMPATHETIC NERVES 10.37 Agree 10.37 66982 CATARACT SURGERY, COMPLEX 13.50 Agree 13.50 67225 # EYE PHOTODYNAMIC THER ADD-ON (a) (a) 0.47 69990 MICROSURGERY ADD-ON 3.47 Agree 3.47 74230 26 CINE/VIDEO X-RAY, THROAT/ESO 0.53 Agree 0.53 74305 26 X-RAY BILE DUCTS/PANCREAS 0.42 Agree 0.42 76066 26 JOINT SURVEY, SINGLE VIEW 0.31 Agree 0.31 76078 26 RADIOGRAPHIC ABSORPTIONMETRY 0.20 Agree 0.20 76085 # 26 COMPUTER MAMMOGRAM ADD-ON (a) (a) 0.06 76120 26 CINE/VIDEO X-RAYS 0.38 Agree 0.38 76125 26 CINE/VIDEO X-RAYS ADD-ON 0.27 Agree 0.27 76362 # 26 CAT SCAN FOR TISSUE ABLATION (a) (a) 4.00 76394 # 26 MRI FOR TISSUE ABLATION (a) (a) 4.25 76490 # 26 US FOR TISSUE ABLATION (a) (a) 2.00Start Printed Page 55304 76819 26 FETAL BIOPHYS PROFIL W/O NST 0.63 Disagree 0.77 76885 26 US EXAM INFANT HIPS, DYNAMIC 0.74 Agree 0.74 76886 26 US EXAM INFANT HIPS, STATIC 0.62 Agree 0.62 77300 26 RADIATION THERAPY DOSE PLAN 0.62 Agree 0.62 77301 # 26 RADIOL THERAPY DOSE PLAN, IMRT 8.00 Agree 8.00 77418 # RADIATION TX DELIVERY, IMRT 0.00 Agree 0.00 85097 BONE MARROW INTERPRETATION 0.94 Agree 0.94 88380 # 26 MICRODISSECTION carrier Agree carrier 90471 IMMUNIZATION ADMIN 0.17 Disagree 0.00 90472 IMMUNIZATION ADMIN, EACH ADD 0.15 Disagree 0.00 90473 # IMMUNE ADMIN ORAL/NASAL 0.17 Disagree 0.00 90939 # HEMODIALYSIS STUDY, TRANSCUT 0.00 Agree 0.00 91123 # IRRIGATE FECAL IMPACTION 0.00 Agree 0.00 92136 # 26 OPHTHALMIC BIOMETRY 0.54 Agree 0.54 92973 # PERCUT CORONARY THROMBECTOMY 3.28 Agree 3.28 92974 # CATH PLACE, CARDIO BRACHYTX 3.00 Agree 3.00 93025 # MICROVOLT T-WAVE ASSESS 0.75 Agree 0.75 93609 26 MAP TACHYCARDIA, ADD-ON (a) Disagree 4.81 93612 26 INTRAVENTRICULAR PACING 3.02 Agree 3.02 93613 # 26 ELECTROPHYS MAP, 3D, ADD-ON carrier Disagree 7.00 93619 26 ELECTROPHYSIOLOGY EVALUATION 7.32 Agree 7.32 93620 2 ELECTROPHYSIOLOGY EVALUATION 11.59 Agree 11.59 93621 26 ELECTROPHYSIOLOGY EVALUATION 2.10 Agree 2.10 93622 26 ELECTROPHYSIOLOGY EVALUATION 3.10 Agree 3.10 93701 # 26 BIOIMPEDANCE, THORACIC 0.00 Disagree 0.17 94720 26 MONOXIDE DIFFUSING CAPACITY 0.26 Agree 0.26 94750 26 PULMONARY COMPLIANCE STUDY 0.23 Agree 0.23 95144 ANTIGEN THERAPY SERVICES 0.06 Agree 0.06 95145 ANTIGEN THERAPY SERVICES 0.06 Agree 0.06 95165 ANTIGEN THERAPY SERVICES 0.06 Agree 0.06 95170 ANTIGEN THERAPY SERVICES 0.06 Agree 0.06 95250 # GLUCOSE MONITORING, CONT 0.00 Agree 0.00 95875 26 LIMB EXERCISE TEST 1.10 Agree 1.10 95904 26 SENSE NERVE CONDUCTION TEST 0.34 Agree 0.34 95965 # 26 MEG, SPONTANEOUS 8.00 Agree 8.00 95966 # 26 MEG, EVOKED, SINGLE 4.00 Agree 4.00 95967 # 26 MEG, EVOKED, EACH ADDL 3.50 Agree 3.50 96000 # MOTION ANALYSIS, VIDEO/3D carrier Disagree 1.80 96001 # MOTION TEST W/FT PRESS MEAS carrier Disagree 2.15 96002 # DYNAMIC SURFACE EMG carrier Disagree 0.41 96003 # DYNAMIC FINE WIRE EMG carrier Disagree 0.37 96004 # PHYS REVIEW OF MOTION TESTS carrier Disagree 1.80 96150 # ASSESS HLTH/BEHAVE, INIT 0.50 Agree 0.50 96151 # ASSESS HLTH/BEHAVE, SUBSEQ 0.48 Agree 0.48 96152 # INTERVENE HLTH/BEHAVE, INDIV 0.46 Agree 0.46 96153 # INTERVENE HLTH/BEHAVE, GROUP 0.10 Agree 0.10 96154 # INTERV HLTH/BEHAV, FAM W/PT 0.45 Agree 0.45 96155 # INTERV HLTH/BEHAV FAM NO PT 0.44 Agree 0.44 96567 # PHOTODYNAMIC TX, SKIN 0.00 Agree 0.00 97005 # ATHLETIC TRAIN EVAL (a) Agree 0.00 97006 # ATHLETIC TRAIN REEVAL (a) Agree 0.00 97112 NEUROMUSCULAR REEDUCATION 0.45 Agree 0.45 97504 ORTHOTIC TRAINING 0.45 Agree 0.45 97535 SELF CARE MNGMENT TRAINING 0.45 Agree 0.45 97601 WOUND CARE SELECTIVE 0.50 Agree 0.50 97602 WOUND CARE NON-SELECTIVE 0.32 Disagree 0.00 99090 COMPUTER DATA ANALYSIS 0.00 Agree 0.00 99091 # COLLECT/REVIEW DATA FROM PT 1.10 Disagree 0.00 99289 # PT TRANSPORT, 30-74 MIN 4.80 Disagree 0.00 99290 # PT TRANSPORT, ADDL 30 MIN 2.40 Disagree 0.00 99374 HOME HEALTH CARE SUPERVISION 1.10 Agree 1.10 99375 HOME HEALTH CARE SUPERVISION 1.73 Agree 1.73 99377 HOSPICE CARE SUPERVISION 1.10 Agree 1.10 99378 HOSPICE CARE SUPERVISION 1.73 Agree 1.73 99379 NURSING FAC CARE SUPERVISION 1.10 Agree 1.10 99380 NURSING FAC CARE SUPERVISION 1.73 Agree 1.73 99381 PREV VISIT, NEW, INFANT 1.19 Agree 1.19 99382 PREV VISIT, NEW, AGE 1-4 1.36 Agree 1.36Start Printed Page 55305 99383 PREV VISIT, NEW, AGE 5-11 1.36 Agree 1.36 99384 PREV VISIT, NEW, AGE 12-17 1.53 Agree 1.53 99385 PREV VISIT, NEW, AGE 18-39 1.53 Agree 1.53 99386 PREV VISIT, NEW, AGE 40-64 1.88 Agree 1.88 99387 PREV VISIT, NEW, 65 & OVER 2.06 Agree 2.06 99391 PREV VISIT, EST, INFANT 1.02 Agree 1.02 99392 PREV VISIT, EST, AGE 1-4 1.19 Agree 1.19 99393 PREV VISIT, EST, AGE 5-11 1.19 Agree 1.19 99394 PREV VISIT, EST, AGE 12-17 1.36 Agree 1.36 99395 PREV VISIT, EST, AGE 18-39 1.36 Agree 1.36 99396 PREV VISIT, EST, AGE 40-64 1.53 Agree 1.53 99397 PREV VISIT, EST, 65 & OVER 1.71 Agree 1.71 (a) No RUC recommendation provided. # New CPT codes. * All CPT codes copyright 2002 American Medical Association. Table 7, AMA RUC Anesthesia Recommendations and CMS Decisions for New and Revised 2002 CPT Codes, lists the new or revised CPT codes for anesthesia and their base units that will be interim in 2002. This table includes the following information:
- CPT code. This is the CPT code for a service.
- Description. This is an abbreviated version of the narrative description of the code.
- RUC recommendations. This column identifies the base units recommended by the RUC.
- CMS decision. This column indicates whether we agreed with the RUC recommendation (“agree”) or we disagreed with the RUC recommendation (“disagree”). Codes for which we did not accept the RUC recommendation are discussed in greater detail following this table.
- 2002 Base Units. This column establishes the 2002 base units for these services.
Table 7.—AMA RUC Anesthesia Recommendations and CMS Decisions for New and Revised 2002 CPT Codes
*CPT code Description RUC recommendation CMS decision 2002 Base units 00797 ANESTH, SURGERY FOR OBESITY 9 Disagree 8 00851 ANESTH, TUBAL LIGATION 6 Agree 6 00869 ANESTH, VASECTOMY 3 Agree 3 01905 ANES, SPINE INJECT, X-RAY/RE 5 Agree 5 01916 ANESTH, DX ARTERIOGRAPHY 5 Agree 5 01924 ANES, THER INTERVEN RAD, ART 5 Agree 5 01925 ANES, THER INTERVEN RAD, CAR 7 Agree 7 01926 ANES, TX INTERV RAD HRT/CRAN 8 Agree 8 01930 ANES, THER INTERVEN RAD, VEI 5 Agree 5 01931 ANES, THER INTERVEN RAD, TIP 7 Agree 7 01932 ANES, TX INTERV RAD, TH VEIN 6 Agree 6 01933 ANES, TX INTERV RAD, CRAN V 7 Agree 7 01951 ANESTH, BURN, LESS 4 PERCENT 3 Agree 3 01952 ANESTH, BURN, 4-9 PERCENT 5 Agree 5 01960 ANESTH, VAGINAL DELIVERY 5 Agree 5 01961 ANESTH, CS DELIVERY 7 Agree 7 01962 ANESTH, EMER HYSTERECTOMY 8 Agree 8 01963 ANESTH, CS HYSTERECTOMY 8 Agree 8 01964 ANESTH, ABORTION PROCEDURES 4 Agree 4 01967 ANESTH/ANALG, VAG DELIVERY 5 Agree 5 01968 ANES/ANALG CS DELIVER ADD-ON 3 Disagree 2 01969 ANESTH/ANALG CS HYST ADD-ON 5 Agree 5 * All CPT codes copyright 2002 American Medical Association. Discussion of Codes for Which There Were No RUC Recommendations or for which the RUC Recommendations Were Not Accepted
The following is a summary of our rationale for not accepting particular RUC work RVU or base unit recommendations. It is arranged by type of service in CPT code order. Additionally, we also discuss those CPT codes for which we received no RUC recommendations for physician work RVUs. This summary refers only to work RVUs.
Anesthesia for Intraperitoneal Procedures in Upper Abdomen Including Laparoscopy; Gastric Restrictive Procedure for Morbid Obesity (CPT Code 00797).
The RUC recommended that 9 base units be assigned to this procedure Start Printed Page 55306based on a comparison to CPT code 00790 (Anesthesia for intraperitoneal procedures in the upper abdomen including laparoscopy; not otherwise specified). We disagree. We believe that assigning 9 base units to 00797 creates a rank order anomaly with CPT code 00794 (Anesthesia for intraperitoneal procedures in the upper abdomen including laparoscopy; pancreatectomy, partial or total (for example, Whipple procedure)) which is assigned 8 base units.
While obese patients do make the work of an anesthesiologist more difficult, we believe that the vignette used in the RUC survey was atypical and exaggerated the required work because the patient in the vignette was described as having asthma. We believe the work of an anesthesiologist is greater for patients undergoing Whipple procedures because, typically, these patients are sicker and require longer operative time and more intense anesthesia care than patients undergoing gastric restrictive procedures. Therefore, we are assigning 8 base units to 00797.
Cesarean Delivery Following Neuraxial Labor Analgesia/Anesthesia (List Separately in Addition to Code for Primary Procedure (CPT Code 01968))
The RUC recommended 3 base units for this add-on procedure. This procedure is reported in addition to CPT code 01967 (Neuraxial labor analgesia/anesthesia for planned vaginal delivery (this includes any repeat subarachnoid needle placement and drug injection and/or any necessary replacement of an epidural catheter during labor)), when a patient who has been given neuraxial anesthesia for a planned vaginal delivery requires conversion to a cesarian delivery and must be given anesthesia for the cesarian delivery. The RUC recommended 7 base units for CPT code 01961 (Anesthesia for, cesarian delivery only), a recommendation with which we agree. We note the following:
- The base units of 01961, anesthesia for cesarian delivery, are the same as the base units of 01967 plus 01968.
- The survey respondents valued the add-on code 01968 as if it were a stand-alone code with a median base unit of 7 and an intraservice time of 75 minutes. Both the median base units and the intraservice time are identical to the survey results for 01961.
- CPT code 01968 is currently reported (per the American Society of Anesthesiologists) as 00857 (Neuraxial analgesia/anesthesia for labor ending in a cesarian delivery (this includes any repeat subarachnoid needle placement and drug injection and/or any necessary replacement of an epidural catheter during labor), which is valued at 7 base units. Moreover, the work of CPT code 01967 plus CPT code 01968 is completely described by CPT code 00857 so it is unclear why the sum of the base units assigned to 01967 and 01968 should not be identical to the base units currently assigned to CPT code 00857.
In view of these concerns, we are assigning 2 base units to CPT code 01968. We are also making a neutrality adjustment to the anesthesia conversion factor based on our analysis of the estimated difference in base units between previously repeated anesthesia codes and the new codes.
Injection, Therapeutic (Eg, Local Anesthetic, Corticosteroid); Carpal Canal, (CPT Code 20526) Injection; Tendon Sheath, Ligament, Ganglion Cyst, (CPT Code 20550)
Injection; Tendon Origin/Insertion, (CPT Code 20551)
Injection; Single or Multiple Trigger Point(s), One or Two Muscle Group(s) (CPT Code 20552), and
Injection; Single or Multiple Trigger Point(s), Three or More Muscle Groups (CPT Code 20553)
CPT codes 20526, 20551, 20552, and 20553 are new codes, while 20550 is being revised from its current descriptor “Injection, tendon sheath, ligament; ganglion cyst, or trigger points” to the descriptor above. We received an interim recommendation of 0.86 work RVUs for these codes, from the RUC, based on the fact that all these procedures are currently reported as 20550 which is valued at 0.86 RVUs.
CPT code 20550 comprises several procedures with varying amounts of physician work that will now be reported separately. We are assigning 0.86 RVUs to all these codes on an interim basis, and will review this further for 2002 if we receive recommendations from the RUC. At that time we will also have utilization data on these services to assist us in making work neutrality adjustments should any adjustments be required.
Laparoscopy, Surgical; Colectomy, Partial With Anastomosis (CPT Code 44204) and Laparoscopy, Surgical; Colectomy, Partial, With Removal of Terminal Ileum With Ileocecostomy (CPT Code 44205)
The RUC recommended 22.00 RVUs for CPT code 44204 and 19.50 RVUs for CPT Code 44205 based on the reference code 44140 (Colectomy, partial; with anastomosis) which, at the time of the recommendation, had a work RVU of 18.35. We increased the work RVU of CPT Code 44140 to 21 as part of the 5-year review of physician work. In order to prevent rank order anomalies we are assigning work RVUs of 25.08 and 22.23 to CPT Codes 44204 and 44205, respectively. These work RVUs represent a 14 percent increase over the RUC recommendation and are consistent with our valuation of CPT Code 44140.
Laparoscopy, Surgical, Ablation of One or More Liver Tumor(s); Radiofrequency (CPT Code 47370), Laparoscopy, Surgical, Ablation of One or More Liver Tumor(s); Cryosurgical (CPT Code 47371), Ablation, Open, of One or More Liver Tumor(s); Radiofrequency (CPT Code 47380), Ablation, Open, of One or More Liver Tumor(s); Cryosurgical (CPT Code 47381), Ablation, One or More Liver Tumor(s), Percutaneous, Radiofrequency (CPT Code 47382), Computerized Axial Tomography Guidance for, and Monitoring of, Tissue Ablation (CPT Code 76362), Magnetic Resonance Guidance for, and Monitoring of, Tissue Ablation (CPT Code 76394); and Ultrasound Guidance for, and Monitoring of, Tissue Ablation (CPT Code 76490)
We have not received recommendations from the RUC for these procedures. We have assigned work RVUs as follows:
47370—18 work RVUs
47371—16.94 work RVUs
47380—21.25 work RVUs
47381—21.00 work RVUs
47382—12.00 work RVUs
To arrive at the values listed above, we compared the time and intensity of these services to other open and laparoscopic liver, colon, and renal procedures. We believe that the RVUs assigned place them in the correct rank order with these other services and with respect to each other.
76362—4.00 work RVUs
76394—4.25 work RVUs
76490—2.00 work RVUs
To arrive at the values above, we compared the time and intensity of these procedures to other radiologic guidance codes and to radiologic supervision and interpretation codes. We believe that the assigned RVUs place them in correct rank order to other radiologic guidance services and to each other.
Cystourethroscopy with irrigation and evacuation of clots, (CPT Code 52001)
The RUC recommended 5.45 work RVUs based on a comparison to the reference procedures CPT code 52315 (Cystourethroscopy, with removal of Start Printed Page 55307foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); complicated), and CPT Code 52235 (Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; medium bladder tumor(s) (2.0 to 5.0 cm)).
We are concerned that 52001, with its current descriptor, will be reported whenever a cystoscopy is performed and blood is present during the examination. As written, the code may be reported whenever any blood clots are present. The RUC recommendation is based upon the urologists' response to a scenario where the bladder outlet was obstructed due to large blood clots and removal of the blood clots required a resectoscope. Unfortunately, the code descriptor does not require the presence of bladder obstruction due to blood clots, nor does it require the use of a resectoscope. Therefore, until the descriptor of this code is clarified by the AMA CPT editorial panel, we are assigning 2.37 RVUs to this procedure. As the CPT code is now written, the time and intensity of the physician work for this procedure are comparable to CPT Code 52005. (Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service).
Transurethral Destruction of Prostatic Tissue; By Water Induced Thermotherapy (CPT Code 53853)
The RUC recommended 6.41 work RVUs for this procedure based on a comparison to CPT Code 54670 (Suture or repair of testicular injury) which has a similar work value and similar pre-, intra-, and postservice times to the median times in the survey for 53853. The RUC also noted that CPT Code 53850 (Transurethral destruction of prostate; by microwave thermotherapy) has 90 minutes of intraservice time as compared to 60 minutes for CPT code 53853 and that the recommended work value for CPT code 53853 was approximately 2/3 of the work value for CPT code 53850.
We note that although the intraservice time for CPT code 53853 is 60 minutes, most of that time is spent monitoring the flow of hot water through a catheter and balloon and checking the water's temperature. We estimate that the maximum amount of time spent on activities other than monitoring is 20 minutes. This means that the work intensity for the intraservice portion of this procedure is significantly less than it is for most other surgical procedures and, specifically, the reference codes examined by the RUC. Therefore, we believe it is more appropriate to compare CPT code 53853 to 90-day global procedures with less than 30 minutes of intraservice time. For these reasons we compared CPT code 58350 to the following procedures:
CPT code Work RVU Intraservice time (minutes) Pre/post service time 53853 Transurethral destruction of prostate tissue; by water-induced thermotherapy RUC Recommendation—6.41 60 *113 CMS assigned RVU 4.14 30130 Excision turbinate, partial or complete, any method 3.38 27 78 42826 Tonsillectomy, primary or secondary; age 12 or over 3.38 28 82 46045 Incision and drainage of intramural, intramuscular, or submucosal abscess, transanal, under anesthesia 4.32 25 206 46946 Ligation of internal hemorrhoids; multiple procedures 3.0 25 75 58800 Drainage of ovarian cyst(s), unilateral or bilateral, (separate procedure); vaginal approach 4.14 23 100 61105 Twist burr hole for subdural or ventricular puncture 5.14 27 97 65810 Paracentesis of anterior chamber of eye (separate procedure); with removal of vitreous and/or discission of anterior hyaloid membrane, with or without air injection 4.87 28 104 67031 Severing of vitreous strands, vitreous face adhesions, sheets, membranes, or opacities, laser surgery (one or more stages) 3.67 26 79 * see below. The RUC sent us a postservice time of 131 minutes, which we believe is incorrect. The RUC assigned 3 postservice visits to this procedure which have a combined time of 35 minutes, not 53 minutes as recommended by the RUC. Therefore, the correct postservice time is 118 minutes.
With respect to the services listed above, we note that all of them carry significant risks to the patient and have intraservice work of high intensity. In fact, we believe the intraservice work of all the above procedures is of greater intensity than any portion of the intraservice work of CPT code 53853. After review of the procedures considered by the RUC and the above procedures, we believe that the time and intensity of CPT code 53853 is most comparable to CPT code 58800 and are assigning 4.14 work RVUs to CPT code 53853. This places CPT code 53853 in the correct rank order with respect not only to the procedures listed above but also to the prostate ablation, cystourethroscopy, and testicular procedures considered by the RUC.
Destruction of Localized Lesion of Choroids (eg, Choroidal Neovascularization); Photodynamic Therapy, Second Eye, at Single Session (List Separately in Addition To Code for Primary Eye Treatment) CPT Code 67225
We did not receive a RUC recommendation on this code. We are assigning work RVUs of 0.47, which is the work value for G0184, the code previously used for reporting this service.
Immunization Administration (Includes Percutaneous, Intradermal, Subcutaneous, Intramuscular and Jet Injections); One Vaccine (Single or Combination Vaccine/Toxoid) (CPT Code 90471), Immunization Administration (Includes Percutaneous, Intradermal, Subcutaneous, Intramuscular and Jet Injections); Each Additional Vaccine/Toxoid (List Separately in Addition To Code for Primary Procedure) One Vaccine (CPT Code 90472)
The RUC recommended a work RVU of .17 for CPT code 90471 and .15 work RVUs for CPT code 90472. These Start Printed Page 55308services are analogous to CPT code 90872 (Therapeutic, prophylactic or diagnostic injection (specify material injected); subcutaneous or intramuscular) which has no physician work RVUs. They are services performed by a nurse and have no physician work. If the physician performs any counseling related to this service, it is considered part of the work of the preventive medicine visit during which the immunization was administered. If the vaccine is administered during a visit other than a preventive medicine service, any physician counseling should be billed separately as an E/M service. For these reasons we are not assigning work RVUs to these codes.
Immunization Administration by Intranasal or Oral Route; One Vaccine (Single or Combination Vaccine/Toxoid) (CPT Code 90473); and, Immunization Administration by Intranasal or Oral Route Each Additional Vaccine/Toxoid (List Separately in Addition To Code for Primary Procedure) CPT Code 90474
The RUC recommended a work RVU of .17 for CPT code 90473 and .15 work RVUs for CPT code 90474. These are noncovered services. Medicare does not cover self-administered vaccines, and, therefore, we are not assigning work RVUs to these services.
Intraventricular and/or Intra-Atrial Mapping of Tachycardia Site(s) With Catheter Manipulation to Record From Multiple Sites to Identify Origin of Tachycardia (CPT Code 93609)
We have not received a recommendation from the RUC for this service. The descriptor for this service has not changed but the AMA CPT editorial panel changed the global period for this service from a zero day global to a ZZZ global. This means that it is now an “add on” code and the physician work RVUs will no longer include any pre- or postservice work. It currently has a work RVU of 10.07. In order to appropriately value this add on service, we compared it to several other electrophysiology services, including CPT code 93619, (Comprehensive electrophyisologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, His bundle recording, including insertion and repositioning of multiple electrode catheters; without induction or attempted induction of arrhythmia) with a work RVU of 7.32, and CPT code 93618, Induction of arrhythmia by electrical pacing (work RVU 4.26), and CPT code 93624, (Electrophysiologic follow up study with pacing and recording to test effectiveness of therapy, including induction of attempted induction of arrhythmia), with a work RVU of 4.81. After reviewing these services, we believe that the time and intensity of physician work for CPT code 93609 as an add-on code is most similar to CPT code 93624 and are assigning a work RVU of 4.81 to CPT code 93609.
Intracardiac Electrophysiologic 3-Dimensional Mapping (CPT Code 93613)
This is a new add-on code for which we have not received a recommendation from the RUC. As an add-on code, this service does not include and pre- or postservice work. We compared this service to CPT code 93619 (Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, His bundle recording, including insertion and repositioning of multiple electrode catheters; without induction or attempted induction of arrhythmia) with work RVUs of 7.32 and to CPT code 93651 (Intracardiac catheter ablation of arrhythmogenic focus; for treatment of supraventricular tachycardia by ablation of fast or slow atrioventricular pathways, accessory atrioventricular connections or other atrial foci, singly or in combination) with work RVUs of 16.25. We also wanted to ensure that the work value for this service was placed in correct rank order to CPT code 93609 (see above). We believe that the intraservice time and intensity of this service is slightly less than that of CPT code 93619 and are assigning 7.00 work RVUs to CPT code 93613.
Bioimpedence, Thoracic, Electrical CPT Code 93701
We received a RUC recommendation that this service has no physician work. We currently cover this service under the HCPCS code M0302. We assigned 0.17 physician work RVUs to this service in the November 2000 final rule after conducting a notice and comment period. We will consider the RUC recommendation. If we considered changing the work RVUs for this service, we would discuss any proposed change in a future notice of proposed rule making. However, we are going to discontinue HCPCS code M0302 and will recognize CPT Code 93701 for this service.
Comprehensive Computer-Based Motion Analysis by Video-Taping And 3-D Kinematics (CPT Code 96000), Comprehensive Computer-Based Motion Analysis by Video-Taping and 3-D Kinematics; With Dynamic Plantar Pressure Measurements During Walking (CPT Code 96001), Dynamic Surface Electromyography, During Walking or Other Functional Activities, 1-12 Muscles (CPT Code 96002), Dynamic Fine Wire Electromyography, During Walking or Other Functional Activities, 1 Muscle (CPT Code 96003), and Physician Review and Interpretation of Comprehensive Computer Based Motion Analysis, Dynamic Plantar Pressure Measurements, Dynamic Surface Electromyography During Walking or Other Functional Activities, and Dynamic Fine Wire Electromyography, With Written Report (CPT Code 96004)
HCPAC recommended that these services be carrier priced. We disagree and are assigning work RVUs to these services as follows:
CPT code 96000—1.8 work RVUs
CPT code 96001—2.15 work RVUs
CPT code 96002—.41 work RVUs
CPT code 96003—.37 work RVUs
CPT code 96004—1.8 work RVUs
To arrive at these values, we compared the time and intensity of CPT codes 96000 and 96001 to other physical therapy services. We believe that the assigned RVUs place these services in the correct rank order with other physical therapy services. We compared the time and intensity of CPT codes 96002 and 96003 to other electromyography services and believe that the assigned RVUs place these services in the correct rank order with other electromyography services. We compared the time and intensity of CPT code 96004 with other physical therapy services and physician consultation services and believe the assigned RVUs place CPT code 96004 in the correct rank order with these other services.
Removal of Devitalized Tissue From Wound(s); Non-Selective Debridement, Without Anesthesia (eg, Wet-To-Moist Dressings, Enzymatic, Abrasion), Including Topical Applications(s), Wound Assessment and Instruction(s) for Ongoing Care, Per Session, CPT 97602
The HCPAC recommended a work RVU of .32 for this service. We disagree with this recommendation as we continue to believe that this code is bundled into 97602 for the reasons discussed earlier in this section. Therefore, we are not establishing work RVUs for this service.Start Printed Page 55309
Collection and Interpretation of Physiologic Data (eg, ECG, Blood Pressure, Glucose Monitoring) Digitally Stored and/or Transmitted by the Patient and/or Caregiver to the Physician or Other Qualified Health Care Professional, Requiring a Minimum of 30 Minutes of Time CPT CODE 99091
The RUC recommended work RVUs of 1.10 for this code. We disagree as this work is considered part of the pre and postservice work of an E/M service and propose to bundle payment for this code. (Note that payment for similar CPT code, 99090, Analysis of clinical data in computers (eg, ECGs, blood pressures, hematologic data, is also currently bundled.)
CPT Codes 99289, Physician Constant Attention of the Critically Ill or Injured Patient During an Interfacility Transport; First 30-74 Minutes, and 99290 Each Additional 30 Minutes (List Separately in Addition To Code for Primary Service)
These two new codes were created for CPT 2002 that describe services provided during patient transport. The RUC recommended that CPT code 99289 be valued at 4.8 work RVUs and CPT code 99290 be valued at 2.4 work RVUs. The CPT explanatory notes accompanying these two new codes state:
The following codes 99289 and 99290 are used to report the physical attendance and direct face-to-face care by a physician during the interfacility transport of a critically ill or injured patient. For the purposes of reporting codes 99289 and 99290, face-to-face care begins when the physician assumes the primary responsibility of the patient at the referring hospital or facility, and ends when the receiving hospital or facility accepts responsibility for the patient's care. Only the time the physician spends in direct face-to-face contact the patient during the transport should be reported. Patient transport services involving less than 30 minutes of face-to-face physician care should not be reported using 99289, 99290.
Procedure(s) or service(s) performed by other members of the transporting team may not be reported by the supervising physician. Any procedure(s) or service(s) performed by the physician before or during transport that are identified in CPT may be reported separately with the exception of routine monitoring evaluations (eg, heart rate, respiratory rate, blood pressure, and pulse oximetry) and the initiation of mechanical ventilation.
The time spent by the physician performing separately reportable services or procedures should not be included in the face-to-face time reported by codes 99289, 99290. The direction of emergency care to transporting staff by a physician located in a hospital or other facility by two-way communication is not considered direct face-to-face care and should not be reported with codes 99289, 99290.
The CPT explanatory notes go on to state that physicians should report emergency department services codes, initial hospital care codes, and critical care codes only after the patient has been admitted to the emergency department, the inpatient floor, or the critical care unit of the receiving facility.
Decision: We would like to note that, currently, physician services provided to patients during interfacility transport are reported, and paid, using the appropriate E/M service codes (for example, outpatient visits, emergency visits, prolonged services, critical care).
We have several significant concerns about the new CPT codes, 99289 and 99290. First, other than requiring face-to-face contact with the patient, there is no requirement for delivery of any specific physician service. This is in contrast to requirements for reporting critical care services under CPT codes 99291, 99292, 99295, 99296, 99297, and 99298. When reporting CPT codes 99291 and 99292 the CPT requires that, in addition to the patient being critically ill or critically injured, and the physician devoting his or her full attention to the patient, “high complexity decision making to assess, manipulate, and support vital system function(s) to treat single or multiple vital organ system failure and/or to prevent further life-threatening deterioration of the patient's condition.” These codes are valued at 4.0 work RVUs and 2.0 work RVUs, respectively.
The CPT goes on to state that—
“Although critical care typically requires interpretation of multiple physiologic parameters and/or application of advanced technology(s), critical care may be provided in life threatening situations when those elements are not present.”
“ * * * Providing medical care to a critically ill, injured, or postoperative patient qualifies as a critical care service only if both the illness or injury and the treatment being provided, meet the above requirements.”
As the code descriptors are written, the care described by the new CPT patient transport codes 99289 and 99290 do not meet the requirements for critical care. In fact, some services that will be reported as 99289 and 99290 would also be more appropriately reported as a new or established outpatient visit, an emergency visit, or as prolonged services, depending on the type of care that was delivered. We believe that the descriptors for CPT codes 99289 and 99290 will make it difficult for physicians to know when to report 99289 and 99290 appropriately.
Second, the beginning and ending times for 99289 and 99290 are unclear. We do not believe time spent in the referring and receiving facility should be counted towards this service. Time spent in the facility prior to and after transfer may not require any physician services even though the physician is face-to-face with the patient. Furthermore, if services are provided at the referring or receiving facility they should be billed as the appropriate E/M service (for example, new patient visit, emergency visit).
Third, we note that the descriptors for 99289 and 99290 include the phrase “ * * * critically ill or injured patient” while the descriptors for 99291 and 99292 include the phrase “ * * * critically ill or critically injured patient.” We realize that CPT descriptors are carefully developed, so we are concerned about this discrepancy and believe it needs to be clarified.
Fourth, we note that although CPT specifically includes (or bundles) certain services into critical care, it does not include those same services in the payment for 99289 and 99290 (for example, gastric intubation, temporary transcutaneous pacing).
Therefore, after careful review of the descriptors and explanatory notes for CPT codes 99289 and 99290, we have decided to not recognize these codes for Medicare purposes. Instead, we have created two HCPCS Level II codes to describe critical care services provided to patients during inter-facility transport. These codes are:
G0240—Critical Care Service delivered by a physician; face-to-face, during inter-facility transport of a critically ill or critically injured patient: first 30-74 minutes of active transport.
G0240 will be valued at 4.0 work RVUs.
G0241—each additional 30 minutes (list separately in addition to G0240)
G0241 will be valued at 2.0 work RVUs.
We believe that these two G codes carry out the intent of 99289 and 99290 with less ambiguity and thus will facilitate accurate reporting of these services by physicians. We have decided to value these services at the present value for 99291 (4.0 work RVUs) and 99292 (2.0 work RVUs). Although critical care is the most intense E/M service delivered by physicians, there is considerable variation in the intensity range of the services provided under the umbrella of critical care. We value all critical care services uniformly and do not believe there is a need to develop a Start Printed Page 55310tiered approach to valuing critical care services.
We will apply all the requirements for critical care services (CPT codes 99291 and 99292) to G0240 and G0241 with the following two exceptions: (1) All time counted towards patient transport time must be face-to-face time with the patient; (2) We will only allow face-to-face time spent in actual transport to be counted towards G0240 and G0241; E/M services delivered in the referring and receiving facilities may be reported under other appropriate E/M codes (for example, outpatient, emergency, or critical care services).
If the actual transportation time is less than 30 minutes and/or the service does not meet the requirements of G0240 and G0241, then the physician may report his or her services under the appropriate E/M code (for example, outpatient visit, emergency visit, prolonged services).
In order for G0240 and G0241 to be payable, the medical record must document the time spent in actual patient transport, the nature of the patient's critical illness or critical injury, and the critical care services delivered to the patient. Consistent with the teaching physician policies in section 15016 of the Medicare Carriers Manual, residents who provide this service are paid through graduate medical education payments. Therefore, their services are not payable through Medicare Part B.
Any services delivered, or face-to-face time spent with the patient, by a resident, nurse, emergency medical technician, or other non-physician may not be billed using G0240 or G0241. Nor may any services performed by any physician or non-physician who is not physically present with the patient during interfacility transport be billed. Time spent in the referring facility, the receiving facility, and time spent prior to transport are not countable towards G0240 and G0241. Additionally, any time spent performing separately billable procedures may not be counted towards G0240 and G0241 (for example, insertion of chest tubes, insertion of intravenous lines and pacemakers, and cardiopulmonary resuscitation). All services bundled into 99291 and 99292 will also be bundled into G0240 and G0241.
Establishment of Interim Practice Expense Relative Value Units for New and Revised Physician's Current Procedural Terminology (CPT) Codes and New HCFA Common Procedure Coding System Codes for 2002
We have developed a process for establishing interim practice expense RVUs (PERVUs) for new and revised codes that is similar to that used for work RVUs. Under this process, the RUC recommends the practice expense direct inputs, that is, the staff time, supplies and equipment associated with each new code. We then review the recommendations in a manner similar to our evaluation of the recommended work RVUs.
The RUC recommendations on the practice expense inputs for the new and revised 2002 codes were submitted to us as interim recommendations. We, therefore, consider that these recommendations are still subject to further refinement by the PEAC, or by us, if it is determined that such future review is needed. We may also revisit these inputs in light of future decisions of the PEAC regarding supply and equipment packages and standardized approaches to pre- and postservice clinical staff times.
We have accepted, at least in the interim, almost all of the practice expense recommendations submitted by the RUC for the codes listed in table 6, AMA RUC and HCPAC Work RVU Recommendations and CMS Decisions for New and Revised 2002 CPT Codes.” We made the following minor changes to the inputs where relevant:
- We substituted the RUC agreed-upon multispecialty minimum visit supply package for the list of individual supplies where appropriate.
- We deleted separately billable supplies, for example, drugs, fluids, casting supplies, when listed in the recommended supply list.
- We rounded fractions of minutes of clinical staff time to the nearest minute.
- The RUC agreed with the specialty society representing neurology that the magnetoencephalography codes, CPT 95965, 95966, 95967, are only performed in the facility setting and that they therefore had no direct practice expense inputs. However, we have subsequently heard from the specialty society that it has determined that a small number of practitioners do perform these services in the office setting and that there would be costs in that setting that should be reflected. We have accepted the suggestion that the TC of these codes be carrier-priced, at least until we can ascertain what direct cost inputs should be included when these services are performed in the non-facility setting.
- We are accepting the practice expense inputs recommended for CPT code 77418 (Intensity modulated treatment delivery, single or multiple fields/arcs, via narrow spatially and temporally modulated beams (binary, dynamic, MLC, etc.), per treatment session, with the exception of the time for the radiation therapist which we are reducing from the recommended 123 minutes to 60 minutes. We are concerned that there may be overlap in the staff time for other codes billed in conjunction with CPT code 77418, such as CPT code 76950 (Ultrasound guidance for placement of radiation therapy fields) and CPT code 77417 (Therapeutic radiology port film(s)).
Further, we understand that the code was valued assuming the typical time for the service was 60 minutes and included the time of two radiation therapists. We believe that the service commonly takes less than the recommended 123 minutes and it may involve only one therapist. As a result of these concerns, we are valuing the service using 60 minutes of radiation technician time. This valuation is considered interim during the refinement of practice expense RVUs. We also note that the practice expense RVUs for 77418 are being determined under the resource-based methodology even though the service has no physician work. We believe that the service will have a more appropriate relative payment amount if the practice expense RVUs are determined outside of the no work methodology.
- We did not receive a RUC recommendation for CPT code 93613, Intracardiac electrophysiology, or CPT 96004, Gait and motion studies. We have assumed that these services are performed only in the facility setting and have no direct inputs.
For the following CPT codes we did not receive practice expense recommendations. Therefore, we are providing practice expense inputs through crosswalking to an existing code as indicated below:
New/revised CPT code Existing CPT/HCPCS code 20553 Therapeutic Injections 20550 Therapeutic Injections. 47370 Ablation of Hepatic Tumors 47562 Laparoscopic cholecystectomy. 47371 Ablation of Hepatic Tumors 47562 Laparoscopic cholecystectomy. 47380 Ablation of Hepatic Tumors 47350 Repair liver wound.Start Printed Page 55311 47381 Ablation of Hepatic Tumors 47350 Repair liver wound. 47382 Ablation of Hepatic Tumors 47525 Change bile duct catheter. 67225 Ocular Photodynamic Therapy G0184 Ocular photodynamic tx, 2nd. 76362 Ablation of Hepatic Tumors 76360 CAT scan for needle biopsy. 76394 Ablation of Hepatic Tumors 76393 Mr guidance for needle place. 76490 Ablation of Hepatic Tumors 76942 Echo guide for biopsy. C. Other Changes to the 2002 Physician Fee Schedule and Clarification of CPT Definitions
For the 2002 physician fee schedule, we are establishing or revising several alpha-numeric HCPCS codes for reporting certain services that are not clearly described by existing CPT codes.
In addition to the two new HCPCS codes for patient transport we have discussed in section IV.B., “Establishment of Interim Work Relative Value Units for New and Revised Physician's Current Procedural Terminology (CPT) Codes and New Healthcare Common Procedure Coding System Codes (HCPCS) for 2002” above; we are also establishing the HCPCS codes for the respiratory therapy services below.
Respiratory Therapy Codes
Respiratory therapists can deliver services incident to a physician's service or in a provider setting such as an outpatient hospital or a comprehensive outpatient rehabilitation facility. In the past, services delivered by respiratory therapists or other health professionals often have not been clearly described by the existing CPT codes. In order to clarify coding of these services, typically delivered by respiratory therapists, but at times delivered by other specially trained health professionals, we are instituting new G codes to describe these services.
We developed three codes for use to describe services to improve respiratory function:
G0237 Therapeutic Procedures To Increase Strength or Endurance of Respiratory Muscles, Face-to-Face, One-on-One, Each 15 Minutes (Includes Monitoring).
This service is to be billed when the therapist works with the patient to perform specific exercises aimed at strengthening the main and accessory muscles of respiration.
We have provided a specific value for this code based upon the time that a respiratory therapist, who we believe will be the typical professional providing this service, will spend performing this service and practice expenses crosswalked from other similar services. This code will have no physician work.
G0238 Therapeutic Procedures To Improve Respiratory Function, Other Than Ones Described by G0237, One-on-One, Face-to-Face, per 15 Minutes (Includes Monitoring)
G0239 Therapeutic Procedures To Improve Respiratory Function, Two or More Patients Treated During the Same Period, Face-to-Face (Includes Monitoring)
Codes G0237 and G0238 are billed in 15-minute increments. The method for “counting” the 15 minutes will be consistent with the method for counting minutes in many of the 97000 series CPT codes (see PM-01-68 for details). These codes would describe activities, such as monitored exercise, that improve respiratory function. Both G0238 and G0239 would be carrier-priced. The carriers have the authority to request information about the specific nature of the services delivered. CPT codes G0237-G0239 may not be billed with codes G0110 and G0111, which are restricted to services in the National Emphysema Treatment Trial (NETT), since they represent the same services.
These codes are designed to provide more specific information about the services being delivered. The availability of codes for services to improve respiratory function will make billing of CPT codes 97000-97799 inappropriate for professionals involved in treating respiratory conditions, unless these services are delivered by physical and occupational therapists and meet the other requirements for physical and occupational therapy services. We recognize that speech and language pathologists also occasionally treat patients to improve respiratory function as part of their treatment of speech and language disorders. Because the primary goal of these services is not to improve respiratory function, but to restore speech and communication, these services should be coded with 92507, “treatment of speech, language, voice, communication, and/or auditory processing disorder (includes aural rehabilitation, individual).”
VI. Update of the Codes for the Physician Self-Referral Prohibition
On January 4, 2001 we published in the Federal Register a final rule with comment period, “Medicare and Medicaid Programs; Physicians' Referrals to Health Care Entities With Which They Have Financial Relationships” (66 FR 856). That final rule incorporated into regulations the provisions in paragraphs (a), (b) and (h) of section 1877 of the Social Security Act (the Act). Section 1877 of the Act prohibits a physician from referring a Medicare patient for certain “designated health services” to a health care entity with which the physician (or a member of the physician's immediate family) has a financial relationship, unless an exception applies. In the final rule, we published an attachment listing all of the CPT and HCPCS codes that defined the entire scope of the following designated health services for purposes of section 1877 of the Act: clinical laboratory services; physical therapy services (including speech-language pathology services); occupational therapy services; radiology and certain other imaging services; and radiation therapy services and supplies.
In the January 4, 2001 final rule, we stated that we would update the list of codes used to define these designated health services in an addendum to the annual final rule concerning physician fee schedule payment policies. Thus, we are now publishing an updated all-inclusive list of codes at Addendum E. We also will provide that update on our website at www.hcfa.gov/medlearn/refphys.htm. The purpose of this update is to conform the code list to the most recent publication of CPT and HCPCS codes. The list of codes will become effective on January 4, 2002. We are using the January 4, 2002 date because that is the effective date for all but one provision of the January 4, 2001 physician self-referral final rule (changes made to 42 CFR 424.22 in the final rule became effective on April 6, 2001). In future years, we intend to use a January 1 effective date to coincide with the effective date of the new CPT and HCPCS codes.
Table 8, below, identifies the CPT and HCPCS codes that have been added to Start Printed Page 55312or deleted from the list of codes published as an attachment to the January 4, 2001 physician self-referral final rule. In that final rule, we stated that we would consider timely comments regarding the updated code list. Accordingly, we will consider comments with respect to the codes listed in Table 8, below, if we receive them by the date specified in the date section of this final rule.
Table 8.—Additions and Deletions to the Physician Self-Referral Codes
CPT1 or HCPCS code Additions 76085 Computer mammogram add-on. 77301 Radioltherapy dos plan, imrt. 77418 Radiation tx delivery, imrt. 92974 Cath place, cardio brachytx. 96000 Motion analysis, video/3d. 96001 Motion test w/ft press meas. 96002 Dynamic surface emg. 96003 Dynamic fine wire emg. G0202 Screening mammography digital. G0204 Diagnostic mammography digital. G0206 Diagnostic mammography digital. G0236 Digital film convert diag ma. J1270 Injection, doxercalciferol. J1755 Iron sucrose injection. Q3018 Hepatitis B vaccine. Deletions 90744 Hepb vacc ped/adol 3 dose im. 90746 Hep B vaccine, adult, im. 90747 Hepb vacc, ill pat 4 dose im. 1 CPT codes, descriptions and other data only are copyright 2001 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Clauses Apply. Table 8 includes 2 codes (J1270 and J1755) that we have identified as dialysis-related outpatient prescription drugs. The physician self-referral prohibition will not apply to these services if they meet the conditions set forth in § 411.355(g) concerning the exception to the physician self-referral rule for EPO and other dialysis-related outpatient prescription drugs furnished in or by an ESRD facility. Table 8 also includes codes (G0202, 76085 and Q3018) that we have identified as screening tests and a vaccine. The physician self-referral prohibition will not apply to these services if they meet the conditions at § 411.355(h) concerning the exception for preventive screening tests, immunizations, and vaccines.
We note that, in response to our January 4, 2001 final rule with comment, we received a number of comments regarding designated health services. We intend to address those comments in a second final rule regarding the physician self-referral prohibition.
VII. Physician Fee Schedule Update for Calendar Year 2002
A. Physician Fee Schedule Update
The physician fee schedule update for 2002 is -4.8 percent. Under section 1848(d)(3) of the Act, the update is equal to 1 plus the product of the Medicare Economic Index (MEI) (divided by 100) and 1 plus the update adjustment factor. For 2002, the MEI is equal to 2.6 percent (1.026). A more detailed description of the MEI and its calculation follows. The update adjustment factor is equal to -7.0 percent (0.930). Section 1848(d)(4)(F) of the Act requires an additional -0.2 percent (0.998) reduction to the update for 2002. Thus, the product of the MEI (1.026), the update adjustment factor (0.930), and the statutory adjustment factor (0.998) equals the 2002 update of -4.8 percent (0.9523). The MEI and the update adjustment factor are described below.
B. The Percentage Change in the Medicare Economic Index
The MEI measures the weighted-average annual price change for various inputs needed to produce physicians' services. The MEI is a fixed-weight input price index, with an adjustment for the change in economy-wide labor productivity. This index, which has 1996 base weights, is comprised of two broad categories—physician's own time and physician's practice expense.
The physician's own time component represents the net income portion of business receipts and primarily reflects the input of the physician's own time into the production of physicians' services in physicians' offices. This category consists of two subcomponents—wages and salaries, and fringe benefits. These components are adjusted by the 10-year moving average annual percent change in output per man-hour for the nonfarm business sector to reflect productivity growth in physicians' offices.
The physician's practice expense category represents the rate of price growth in nonphysician inputs to the production of services in physicians' offices. This category consists of wages and salaries and fringe benefits for nonphysician staff and other nonlabor inputs. Like physician's own time, the nonphysician staff categories are adjusted for productivity using the 10-year moving average annual percent change in output per man-hour for the nonfarm business sector. The physician's practice expense component also includes the following categories of nonlabor inputs—office expense, medical materials and supplies, professional liability insurance, medical equipment, professional car, and other expense. Table 9 presents a listing of the MEI cost categories with associated weights and percent changes for price proxies for the 2002 update. The calendar year 2002 MEI is 2.6 percent.
Table 9.—Increase in the Medicare Economic Index Update for Calendar Year 2002 1
Cost categories and price measures 1996 Weights 2 CY 2002 percent changes Medicare Economic Index Total 100.0 2.6 1. Physician's Own Time 3 4 54.5 2.1Start Printed Page 55313 a. Wages and Salaries: Average hourly earnings private nonfarm, net of productivity 44.2 2.0 b. Fringe Benefits: Employment Cost Index, benefits, private nonfarm, net of productivity 10.3 3.2 2. Physician's Practice Expense 3 4 45.5 3.0 a. Nonphysician Employee Compensation 16.8 2.5 1. Wages and Salaries: Employment Cost Index, wages and salaries, weighted by occupation, net of productivity 12.4 2.3 2. Fringe Benefits: Employment Cost Index, fringe benefits, white collar, net of productivity 4.4 3.7 b. Office Expense: Consumer Price Index for Urban Consumers (CPI-U), housing 11.6 4.2 c. Medical Materials and Supplies: Producer Price Index (PPI), ethical drugs/PPI, surgical appliances and supplies/CPI-U, medical equipment and supplies (equally weighted) 4.5 1.8 d. Professional Liability Insurance: HCFA professional liability insurance survey 5 3.2 4.0 e. Medical Equipment: PPI, medical instruments and equipment 1.9 0.6 f. Other Professional Expense 7.6 2.8 1. Professional Car: CP-U, private transportation 1.3 3.9 Other: CPI-U, all items less food and energy 6.3 2.6 Addendum: Productivity: 10-year moving average of output per man-hour, nonfarm business sector n/a 2.0 Physician's Own Time, not productivity adjusted 54.5 4.3 Wages and salaries, not productivity adjusted 44.2 4.1 Fringe benefits, not productivity adjusted 10.3 5.3 Nonphysician Employee Compensation, not productivity adjusted 16.8 4.7 Wages and salaries, not productivity adjusted 12.4 4.3 Fringe benefits, not productivity adjusted 4.4 5.9 1 The rates of historical change are for the 12-month period ending June 30, 2001, which is the period used for computing the calendar year 2002 update. The price proxy values are based upon the latest available Bureau of Labor Statistics data as of September 18, 2001. 2 The weights shown for the MEI components are the 1996 base-year weights, which may not sum to subtotals or totals because of rounding. The MEI is a fixed-weight, Laspeyres-type input price index whose category weights indicate the distribution of expenditures among the inputs to physicians' services for calendar year 1996. To determine the MEI level for a given year, the price proxy level for each component is multiplied by its 1996 weight. The sum of these products (weights multiplied by the price index levels) over all cost categories yields the composite MEI level for a given year. The annual percent change in the MEI levels is an estimate of price change over time for a fixed market basket of inputs to physicians' services. 3 The Physician's Own Time and Nonphysician Employee Compensation category price measures include an adjustment for productivity. The price measure for each category is divided by the 10-year moving average of output per man-hour in the nonfarm business sector. For example, the fringe benefits component of the Physician's Own Time category is calculated by dividing the rate of growth in the employment cost index-benefits for private, nonfarm workers by the 10-year moving average rate of growth of output per man-hour for the nonfarm business sector. Dividing one plus the decimal form of the percent change in the employment cost index-benefits (1+.053=1.053) by one plus the decimal form of the percent change in the 10-year moving average of labor productivity(1+.020=1.020) equals one plus the change in the employment cost index-benefits for white collar workers net of the change in output per manhour (1.053/1.020=1.032). All Physician's Own Time and Nonphysician Employee Compensation categories are adjusted in this way. Due to a higher level of precision the computer calculated quotient may differ from the quotient calculated from rounded individual percent changes. 4 The measures of productivity, average hourly earnings, Employment Cost Indexes, as well as the various Producer and Consumer Price Indexes can be found on the Bureau of Labor Statistics website—http://stats.bls.gov. 5 Derived from a CMS survey of several major insurers (the latest available historical percent change data are for the period ending second quarter of 2001). n/a Productivity is factored into the MEI compensation categories as an adjustment to the price variables; therefore, no explicit weight exists for productivity in the MEI. C. The Update Adjustment Factor
Paragraphs (3) and (4) of section 1848(d)(3) of the Act indicate that the physician fee schedule update is equal to the product of the Medicare Economic Index and an “update adjustment factor.” The update adjustment factor is applied to the inflation update to reflect success or failure in meeting the expenditure target that the law refers to as “allowed expenditures.” Allowed expenditures are equal to actual expenditures in a base period updated each year by the sustainable growth rate (SGR). The SGR is a percentage increase that is determined by a formula specified in section 1848(f) of the Act. The next section of this final rule describes the SGR and its calculation in detail. The update adjustment factor is determined based on a comparison of actual and allowed expenditures. For years beginning with 1999, the BBA required that the update adjustment factor be determined under section 1848(d)(3) of the Act to equal—
- The difference between (1) the sum of the allowed expenditures for physicians' services (as determined under subparagraph (C)) for the period beginning April 1, 1997, and ending on March 31 of the year involved, and (2) the amount of actual expenditures for physicians' services furnished during the period beginning April 1, 1997, and ending on March 31 of the preceding year; divided by—
- The actual expenditures for physicians' services for the 12-month period ending on March 31 of the preceding year, increased by the sustainable growth rate under subsection (f) for the fiscal year which begins during such 12-month period.
The BBRA made changes to the methodology for determining the physician fee schedule update beginning in 2001. In particular, it established that the methodology in section 1848(d)(3) of the Act would only be used for determining the physician fee schedule update for 1999 and 2000; the physician fee schedule update for 2001 and subsequent years is determined under section 1848(d)(4) of the Act. While the general principle of adjusting the inflation update (the MEI) based on a comparison of actual and target expenditures (the update adjustment factor) is continuing, the BBRA made fundamental changes to the calculation of the update adjustment factor. These changes do two things. First, the measurement of actual Start Printed Page 55314expenditures will occur on the basis of a calendar year rather than a April 1 to March 31 year. This essentially conforms the measurement of actual expenditures with other aspects of the SGR system that are also occurring on the basis of a calendar year as a result of BBRA amendments. As explained in our April 10, 2000 SGR notice (65 FR 19000), the BBRA essentially changed the SGR system from one that spanned 3 different time periods (1—Measurement of actual expenditures on the basis of a April 1 to March 31 period; 2—calculation of the SGR rate of increase on a Federal fiscal year basis; and 3—application of the update on a calendar year basis) to one that spans only one time period (all three elements are computed on the basis of a calendar year). Second, it ensures that any deviation between cumulative actual expenditures and cumulative allowed expenditures will be corrected over several years rather than in a single year. This will result in less year-to-year volatility in the physician fee schedule update than will occur if adjustments to the update are made to bring expenditures in line with the target in one year.
Under section 1848(d)(4)(A) of the Act, the physician fee schedule update for a year is equal to the product of—(1) 1 plus the Secretary's estimate of the percentage increase in the MEI for the year, and (2) 1 plus the Secretary's estimate of the update adjustment factor for the year. Under section 1848(d)(4)(B) of the Act, the update adjustment factor for a year beginning with 2001 is equal to the sum of the following—
- Prior Year Adjustment Component. An amount determined by—
+ Computing the difference (which may be positive or negative) between the amount of the allowed expenditures for physicians' services for the prior year (the year prior to the year for which the update is being determined) and the amount of the actual expenditures for such services for that year;
+ Dividing that difference by the amount of the actual expenditures for such services for that year; and
+ Multiplying that quotient by 0.75.
- Cumulative Adjustment Component. An amount determined by—
+ Computing the difference (which may be positive or negative) between the amount of the allowed expenditures for physicians' services from April 1, 1996 through the end of the prior year and the amount of the actual expenditures for such services during that period;
+ Dividing that difference by actual expenditures for such services for the prior year as increased by the sustainable growth rate for the year for which the update adjustment factor is to be determined; and
+ Multiplying that quotient by 0.33.
Section 1848(d)(4)(D) of the Act indicates that the update adjustment factor determined under section 1848(d)(4)(B) for a year may not be less than −0.07 or greater than 0.03. At this time, we estimate that the sum of the prior year and cumulative adjustment components will be less than −0.07 limit. In a letter to the Medicare Payment Advisory Commission and in data we made available to the public on the CMS website in March, we indicated that the estimated update adjustment factor for 2002 would be −1.5 percent. However, we also indicated that a number of factors could change our estimate of the update adjustment factor. Since our March estimate, a number of factors have changed that lower our estimate of allowed expenditures and increase our estimate of actual expenditures. Allowed expenditures have declined because real per capita gross domestic product (GDP) growth for 2000 is lower than the estimates in March. This occurs because of changes to economic figures for 2000 made at the Bureau of Economic Analysis. Further, current estimates of real GDP per capita growth for 2001 and 2002 are lower than in March. We provide a more detailed explanation of factors that affect our estimate of allowed expenditures in the next section of this final regulation on the SGR. An explanation of changes to actual expenditures follows.
As indicated above, we are currently estimating higher 2001 actual expenditures than we did in March. We did not have any Medicare claims data to develop our March estimates of actual expenditures for 2001. At this time, we are using claims received through June 30 to estimate actual expenditures for all of 2001. Based on the claims received in the first half of the year, our current estimates of actual expenditures for 2001 are higher than earlier estimates. We will be revising the measurement of actual expenditures for CY 2001 based on claims received through June 30, 2002. These revised figures will be determined no later than November 1, 2002. If the revised figures are different than current estimates, the difference will be reflected in the update adjustment factor used in determining the 2003 physician fee schedule update.
After taking into account the factors described above that affect allowed and actual expenditures, we originally estimated that the update adjustment factor for 2002 would be −5.4 percent or 1.6 percentage points more than the −7.0 percent limit on the update adjustment factor. However, in making updates to the list of codes that are included in the SGR, we discovered that a number of new procedure codes were inadvertently not included in the measurement of actual expenditures beginning in 1998. Therefore, the measurement of actual expenditures for 1998, 1999, and 2000 was lower than it should have been. As a result, the physician fee schedule update was higher in 2000 and 2001 than if we had included these codes. Including these codes in the measurement of actual expenditures results in a lower update adjustment factor than we earlier estimated. We will be making no changes to physician fee schedule payments made for services furnished in 2000 and 2001. However, under section 1848(d) of the Act, we must include these codes in the measurement of actual expenditures for historical, current, and future periods. While we do not currently know the precise effect of not measuring expenditures for all codes included in the SGR on the update adjustment factor for 2002, we are certain that it is in excess of 1.6 percentage points and is of sufficient magnitude to result in the update adjustment factor being less than the −7.0 percent statutory limit. In the near future, we expect to complete this analysis and update information that we make available on the CMS website. We plan to provide complete data that show quarterly allowed and actual expenditures for all procedure codes included in the SGR, as well as a list of the codes themselves.
Section 1848(d)(4)(A)(ii) of the Act indicates that 1 should be added to the update adjustment factor determined under section 1848(d)(4)(B) of the Act. Thus, adding 1 to −0.070 makes the update adjustment factor equal to 0.930.
(As indicated in the SGR discussion below, allowed expenditures through the end of CY 2001 will be revised one more time, not later than November 1, 2002. We will also be revising the measurement of actual expenditures for CY 2001 based on claims received through June 30, 2002, not later than November 1, 2002. The SGR for 2001 will also be revised one more time, and the SGR for 2002 will be revised two more times. The resulting effect from revisions of estimates will be reflected in the update adjustment factor determined for 2003.)Start Printed Page 55315
VIII. Allowed Expenditures for Physicians' Services and the Sustainable Growth Rate
A. Medicare Sustainable Growth Rate
Section 1848(f) of the Act, as amended by section 4503 of the BBA, replaced the Medicare Volume Performance Standard (MVPS) with a Sustainable Growth Rate (SGR). Section 1848(f)(2) of the Act specifies the formula for establishing yearly SGR targets for physicians' services under Medicare. The use of SGR targets is intended to control the actual growth in aggregate Medicare expenditures for physicians' services.
The SGR targets are not limits on expenditures. Payments for services are not withheld if the SGR target is exceeded by actual expenditures. Rather, the appropriate fee schedule update, as specified in section 1848(d)(3) of the Act, is adjusted to reflect the success or failure in meeting the SGR target. If expenditures exceed the target, the update is reduced. If expenditures are less than the target, the update is increased.
As with the MVPS, the statute specifies a formula to calculate the SGR based on our estimate of the change in each of four factors. The four factors for calculating the SGR are as follows—
(1) The estimated change in fees for physicians' services.
(2) The estimated change in the average number of Medicare fee-for-service beneficiaries.
(3) The estimated projected growth in real GDP per capita.
(4) The estimated change in expenditures due to changes in law or regulations.
Section 211 of the BBRA amended sections 1848(d) and 1848(f) of the Act with respect to the physician fee schedule update and the SGR. Section 211(b) of the BBRA maintains the formula for calculating the SGR, but amends section 1848(f)(2) of the Act to apply the SGR on a calendar year (CY) basis beginning with 2000 while maintaining the SGR on a fiscal year (FY) basis for FY 1998 through FY 2000. Specifically, section 1848(f)(2) of the Act, as amended by section 211(b) of the BBRA, states that “* * * [t]he sustainable growth rate for all physicians' services for a fiscal year (beginning with fiscal year 1998 and ending with fiscal year 2000) and a year beginning with 2000 shall be equal to the product of—
(1) 1 plus the Secretary's estimate of the weighted average percentage increase (divided by 100) in the fees for all physicians' services in the applicable period involved,
(2) 1 plus the Secretary's estimate of the percentage change (divided by 100) in the average number of individuals enrolled under this part (other than Medicare+Choice plan enrollees) from the previous applicable period to the applicable period involved,
(3) 1 plus the Secretary's estimate of the projected percentage growth in real gross domestic product per capita (divided by 100) from the previous applicable period to the applicable period involved; and
(4) 1 plus the Secretary's estimate of the percentage change (divided by 100) in expenditures for all physicians' services in the applicable period (compared with the previous applicable period) which will result from changes in law and regulations, determined without taking into account estimated changes in expenditures resulting from the update adjustment factor determined under section 1848 (d)(3)(B) or (d)(4)(B) of the Act, as the case may be, minus 1 and multiplied by 100.”
Under section 1848(f)(4)(C) of the Act, the term “applicable period” means—(1) a FY, in the case of FY 1998, FY 1999 and FY 2000, and (2) a CY with respect to a year beginning with 2000.
Section 1848(d)(4)(C) of the Act requires us to make the transition from a FY SGR to a CY SGR in 1999 by using the FY 1999 SGR for the first 3 months of 1999 and the FY 2000 SGR for the 9-month period beginning April 1, 1999. Allowed expenditures for the year are equal to the sum of allowed expenditures for each respective period. The SGR for CY 2000 is then applied to allowed expenditures for CY 1999.
As stated in the April 10, 2000 final notice (65 FR 19000), the BBRA requires the estimates of the FY 2000 and CY 2000 SGRs to be revised based on more recent data, but, as explained below, the BBRA does not provide for revision of either the FY 1998 or the FY 1999 SGR. This means that, for the transition to a calendar year SGR system, allowed expenditures for the period April 1, 1999 through December 31, 1999 (determined by applying the FY 2000 SGR to allowed expenditures for the 12-month period ending March 31, 1999) are subject to change based on revision of the FY 2000 SGR; allowed expenditures for the period January 1, 1999 through March 31, 1999 (determined using the FY 1999 SGR) are not subject to revision.
In general, the BBRA requires us to publish SGRs for 3 different time periods, no later than November 1 of each year, using the best data available as of September 1 of each year. Under section 1848(f)(3)(C)(i) of the Act, as added by section 211(b)(5) of the BBRA, the SGR is estimated and subsequently revised twice (beginning with the FY and CY 2000 SGRs) based on later data. Under section 1848(f)(3)(C)(ii) of the Act, there are no further revisions to the SGR once it has been estimated and subsequently revised in each of the 2 years following the initial estimate.
The requirement of revisions to the SGR based on later data means that we will estimate and publish an SGR for the upcoming year, the contemporaneous year, and the preceding year by no later than November 1 of each year. For example, by no later than November 1, 2002, we will publish an estimate of the SGR for CY 2003, a revision of the CY 2002 SGR that is first being estimated in this notice, and a revision of the CY 2001 SGR first estimated in the final rule published on November 2, 2000 (65 FR 65429) and revised in this final rule. Under section 1848(f)(3)(C)(ii) of the Act, the final revision to the CY 2001 SGR will be announced in the Federal Register no later than November 1, 2002.
Subparagraphs (A) and (B) of section 1848(f)(3) of the Act, specify special rules with respect to the SGR and the CY 2001 and CY 2002 updates. Section 1848(f)(3)(A) of the Act required us, no later than November 1, 2000, to revise the SGRs for FY 2000 and CY 2000 and to establish the SGR for CY 2001, based on the best data available, as of September 1, 2000. We published our first estimate of the SGRs for FY 2000 and CY 2000 in a Federal Register notice on April 10, 2000 (65 FR 19000). Revised estimates of the SGRs for FY 2000 and CY 2000 and our original estimate of the SGR for CY 2001 appeared in the Federal Register on November 1, 2000 (65 FR 65429). We used each of the SGRs published in the November 1, 2000 Federal Register to determine the physician fee schedule update for 2001. Section 1848(f)(3)(B) of the Act requires us, by no later than November 1, 2001, to revise the SGRs for FY 2000 and CYs 2000 and 2001 and establish the SGR for CY 2002, based on the best data available as of September 1, 2001 and to use each of these SGRs to determine the physician fee schedule update for 2002. We are using each of the SGRs established in this notice to determine the 2002 physician fee schedule update. In accordance with section 1848(f)(3)(C)(ii) of the Act, there will be no further revisions to the FY 2000 and CY 2000 SGRs after the revisions we are making in this final rule.
B. Physicians' Services
Section 1848(f)(4)(A) of the Act defines the scope of physicians' services Start Printed Page 55316covered by the SGR. The statute indicates that the term “physicians’ services” includes other items and services (such as clinical diagnostic laboratory tests and radiology services), specified by the Secretary, that are commonly performed or furnished by a physician or in a physician's office, but does not include services furnished to a Medicare+Choice plan enrollee. The BBA and BBRA made no changes to this definition which was also used for the MVPS. We published a definition of physicians' services for use in the MVPS and subsequent SGR in the Federal Register (61 FR 59717) on November 22, 1996. We defined “physicians’ services” to include many of the medical and other health services listed in section 1861(s) of the Act. Since the statute has made a number of changes to the definition of medical and other health services included in section 1861(s), we are updating our definition of physicians' services consistent with the statutory changes. Our practice has been to make adjustments to the SGR for medical and other health services added to the statute that meet the criterion of being “commonly performed by a physician or a physicians’ office.” For instance, the BBA and the BIPA amended section 1861(s) of the Act to add new preventive benefits to the Medicare statute. Since these preventive services are generally provided by physicians or in physicians' offices, we made adjustments to the SGR to reflect additional Medicare expenditures for the newly-added Medicare benefits. Physicians' services for the SGR include the following medical and other health services if bills for the items and services are processed and paid by Medicare carriers:
- Physicians' services.
- Services and supplies furnished incident to physicians' services.
- Outpatient physical therapy services and outpatient occupational therapy services.
- Antigens prepared by or under the direct supervision of a physician.
- Services of physician assistants, certified registered nurse anesthetists, certified nurse midwives, clinical psychologists, clinical social workers, nurse practitioners, and clinical nurse specialists.
- Screening tests for prostate cancer, colorectal cancer, glaucoma.
- Screening mammography, screening pap smears and screening pelvic exams.
- Diabetes outpatient self-management training services.
- Medical nutrition therapy services.
- Diagnostic x-ray tests, diagnostic laboratory tests and other diagnostic tests.
- X-ray, radium, and radioactive isotope therapy.
- Surgical dressings, splints, casts, and other devices used for the reduction of fractures and dislocations.
- Bone mass measurements.
C. Provisions Related to the SGR
Section 211(b)(1) of the BBRA amends section 1848(f)(1) of the Act to require that SGR estimates be published in the Federal Register not later than November 1 of every year. In this notice, we are publishing our initial estimate of the SGR for 2002, a revised estimate of the SGR for 2001 and final estimates of the SGRs for FY and CY 2000.
In general, the update for a year is based on the Medicare Economic Index (MEI) as adjusted, within bounds, by the amount of actual expenditures for physicians' services compared to target (referred to as “allowed” in the statute) expenditures. A key difference between the MVPS and the SGR is that the comparison of actual and allowed expenditures is made on a cumulative basis under the SGR, while it was made on an annual basis under the MVPS. The “update adjustment factor” in section 1848(d)(4)(B) of the Act is an adjustment to the MEI that reflects the difference between actual expenditures and target expenditures.
Section 1848(d)(3)(C) of the Act, as modified by the BBA, defines allowed expenditures for the 12-month period ending March 31, 1997 to be equal to actual expenditures for physicians' services during that period (that is, April 1, 1996 through March 31, 1997), as we have estimated. Section 1848(d)(3)(C) of the Act defines allowed expenditures for subsequent 12-month periods to be equal to allowed expenditures for physicians' services for the previous year increased by the SGR for the FY which begins during the 12-month period. For example, allowed expenditures for the 12-month period April 1, 1997 through March 31, 1998 are equal to allowed expenditures for the 12 months ending March 31, 1997, increased by the SGR for FY 1998. The BBRA subsequently provided for a transition to a calendar year SGR system in 1999. Allowed expenditures for the first quarter of 1999 are determined using the FY 1999 SGR and allowed expenditures for the April 1, 1999 to December 31, 1999 period are determined using the FY 2000 SGR. Allowed expenditures in 2000 are equal to 1999 allowed expenditures increased by the 2000 SGR. Allowed expenditures for each subsequent year will equal expenditures from the prior year updated by the SGR.
Table 10 shows annual and cumulative allowed expenditures for physicians' services for each of the 12-month periods between April 1, 1996 and March 31, 2000, for 1999 and 2000.
Start Printed Page 55317Table 10
Period Annual allowed expenditures (in billions) Cumulative allowed expenditures (in billions) FY or CY SGR 4/1/96-3/31/97 $48.9 $48.9 N/A 4/1/97-3/31/98 49.6 98.5 FY 1998=1.5% 4/1/98-3/31/99 49.4 47.9 FY 1998=−0.3% 1/1/99-3/31/99 12.5 (1) FY 1999=−0.3% 4/1/99-12/31/99 39.6 (2) FY 2000=6.9% 1/1/99-12/31/99 52.1 187.6 FY 1999/FY 2000 1/1/00-12/31/00 55.9 243.5 CY 2000=7.3% 1/1/01-12/31/01 59.3 302.7 CY 2001=6.1% 1/1/02-12/31/02 62.6 365.3 CY 2002=5.6% 1 Included in $147.9 above. 2 Included in $187.6 below. Note:
Allowed Expenditures for the first quarter of 1999 are based on the FY 1999 SGR and allowed expenditures for the last three quarters of 1999 are based on the FY 2000 SGR.
Allowed Expenditures in the First Year
(April 1, 1996-March 31, 1997) are equal to actual expenditures. All subsequent figures are equal to quarterly allowed expenditure figures increased by the applicable SGR. Cumulative allowed expenditures are equal to the sum of annual allowed expenditures. We provide more detailed quarterly allowed and actual expenditure data on the CMS website under the Medicare Actuary's publications at the following address: http://www.hcfa.gov/pubforms/actuary/. We expect to update this information in November.
Allowed expenditures for the April 1, 1999 through the December 31, 1999 period are based on the FY 2000 SGR. As previously discussed, section 1848(f)(3) of the Act requires two revisions to the FY and CY 2000 SGR. We made the first revision to the FY and CY 2000 SGR in the physician fee schedule final rule published in the Federal Register on November 1, 2000 (65 FR 65427). We are making the second and final revision in this final rule. Consistent with section 1848(f)(3)(B) of the Act, the revised FY and CY 2000 SGR uses the best data available to us as of September 1, 2001.
D. Preliminary Estimate of the SGR for 2002
According to subparagraphs (A) through (D) of section 1848(f)(2) of the Act, as amended by section 211(b) of the BBRA, we have determined the preliminary estimate of the CY 2002 SGR to be 5.6 percent. We first estimated the CY 2002 SGR in March and made the estimate available to the Medicare Payment Advisory Commission and our website. Our March and current estimates of the four statutory factors are indicated in table 11:
Table 11
Statutory factors March estimate Current estimate Fees 1.6 2.3 Enrollment 0.4 0.7 Real Per Capita GDP 2.4 1.7 Law and Regulation 1.5 0.8 Total 6.0 5.6 Note:
Consistent with section 1848(f)(2) of the Act, the statutory factors are multiplied, not added, to produce the total (that is, 1.023 × 1.007 × 1.017 × 1.008 = 1.056.) A more detailed explanation of each figure is provided below in section H.1.
E. Sustainable Growth Rate for CY 2001
According to subparagraphs (A) through (D) of section 1848(f)(2) of the Act, as amended by section 211(b) of the BBRA, our current estimate of the CY 2001 SGR is 6.1 percent. Table 12 shows our original estimate of the CY 2001 SGR published in the Federal Register on November 1, 2000 (65 FR 65433) and current estimates of the four statutory factors that determine the CY 2001 SGR:
Table 12
Statutory factors 11/1/00 estimate Current estimate Fees 1.9 1.9 Enrollment 0.9 3.0 Real Per Capita GDP 2.7 0.7 Law and Regulation 0.0 0.4 Total 5.6 6.1 A more detailed explanation of each figure is provided below in section H.2.
F. Sustainable Growth Rate for CY 2000
According to subparagraphs (A) through (D) of section 1848(f)(2) of the Act, as amended by section 211(b) of the BBRA, our current estimate of the CY 2000 SGR is 7.3 percent. Table 13 shows estimates included in the November 1, 2000 Federal Register (65 FR 65433) and current estimates of the four statutory factors that determine the CY 2000 SGR:
Table 13
Statutory factors 11/1/00 estimate Current estimate Fees 2.1 2.1 Enrollment 1.0 1.0 Real Per Capita GDP 4.3 3.2 Law and Regulation 0.5 0.8 Total 8.1 7.3 A more detailed explanation of each figure is provided below in section H.3.
G. Sustainable Growth Rate for FY 2000
According to subparagraphs (A) through (D) of section 1848(f)(2) of the Act, as amended by section 211(b) of the BBRA, our current estimate of the FY 2000 SGR is 6.9 percent. Table 14 shows estimates included in the November 1, 2000 Federal Register (65 FR 65433) and current estimates of the four statutory factors that determine the FY 2000 SGR:
Table 14
Statutory factors 11/1/00 estimate Current estimate Fees 2.1 2.1 Enrollment 0.8 0.5 Real Per Capita GDP 4.5 3.6 Law and Regulation 0.3 0.6 Total 7.9 6.9 A more detailed explanation of each figure is provided below in section H.3.
H. Calculation of the FY 2000, CY 2000, CY 2001, and CY 2002 Sustainable Growth Rates
1. Detail on the CY 2002 SGR
A more detailed discussion of our preliminary estimates of the four elements of the 2002 SGR follows.
Factor 1—Changes in Fees for Physicians' Services (Before Applying Legislative Adjustments) for CY 2002
This factor was calculated as a weighted average of the CY 2002 fee increases that apply for the different types of services included in the definition of physicians' services for the SGR.
Physicians' services as defined in sections 1861(s)(1) and (2) of the Act represent approximately 89 percent of allowed charges for physicians' services under the SGR and are updated by the Medicare Economic Index (MEI). Our current estimate of the MEI for 2002 is 2.6 percent. Diagnostic laboratory tests represent approximately 11 percent of the Medicare allowed charges for physicians' services under the SGR. The BBA provided for a 0.0 percent update for CY 2002 for laboratory services. Table 15 shows both the physicians' and laboratory service updates that were used to determine the percentage increase in physicians' fees for CY 2002.
Table 15
Weight Update Physician 0.89 2.6 Laboratory 0.11 0.0 Weighted Average 1.0 2.3 After taking into account the elements described in the table, we estimate that the weighted-average increase in fees for CY 2002 for physicians' services under the SGR (before applying any legislative adjustments) will be 2.3 percent.
Factor 2—The Percentage Change in the Average Number of Part B Enrollees From CY 2001 to CY 2002
This factor is our estimate of the percent change in the average number of Start Printed Page 55318fee-for-service enrollees for CY 2002 as compared to CY 2001 Medicare+Choice (M+C) plan enrollees, whose Medicare-covered medical care is outside the scope of the SGR, and who are excluded from this estimate. Our actuaries estimate that the average number of Medicare Part B fee-for-service enrollees (excluding beneficiaries enrolled in M+C plans) will increase by 0.7 percent in calendar year 2002. This estimate was derived by subtracting estimated M+C enrollment from estimated overall Medicare enrollment as illustrated in table 16.
Table 16
[In millions]
2001 2002 Overall 37.828 38.149 Medicare+Choice 5.662 5.761 Net 32.166 32.388 Percent Increase: 0.7 Since 2002 has yet to begin, we currently only have estimates of this figure for 2002. An important factor affecting fee-for-service enrollment is beneficiary enrollment in Medicare+Choice plans. At this time, we do not know how actual enrollment in Medicare+Choice plans will compare to current estimates. While we do receive information on whether a Medicare+Choice plan will continue to participate or withdraw from the program, it remains difficult to estimate the number of beneficiaries who will select a Medicare+Choice plan or fee-for-service before the start of the calendar year. While some plans will no longer offer a Medicare+Choice plan, other plans are available as an option to most beneficiaries in areas where there have been plan withdrawals. It is difficult to estimate the size of the Medicare+Choice enrollee population before the start of a calendar year. Because we determine the fee-for-service enrollment figure net of the change in Medicare+Choice enrollment, early estimates of this factor are difficult to make. Our estimate of this factor is preliminary and only has minimal effect on the physician fee schedule update for CY 2002. The CY 2002 SGR will also be used in the calculation of the 2003 physician fee schedule update in a final rule to be published no later than November 1, 2002. By that time, we will have information on actual enrollment in Medicare+Choice plans for the first 8 months of CY 2002 and will be better able to predict the change in fee-for-service enrollment for the year.
Factor 3—Estimated Real Gross Domestic Product Per Capita Growth in CY 2002
Section 1848(f)(2)(C) of the Act, as amended by section 211 of the BBRA, requires us to estimate growth in real GDP per capita. This factor is applied on a CY basis beginning with the CY 2000 SGR. We estimate that the growth in real per capita GDP will be 1.7 percent in CY 2002. Our past experience indicates that there have also been large changes in estimates of real per capita GDP growth and the actual change in this factor. It is likely that this figure will change further as actual information on economic performance becomes available to us in 2002. Again, we note that we will use revised estimates of real per capita GDP growth in setting future year updates.
Factor 4—Percentage Change in Expenditures for Physicians' Services Resulting From Changes in Law or Regulations in CY 2002 Compared With CY 2001
Sections 101 through 104 of BIPA added Medicare coverage for screening glaucoma, authorized Medicare to pay for specific new technology mammography services, and changed coverage for screening pap smears, screening pelvic exams, and screening colonoscopy for average-risk individuals. In addition, section 105 of the BIPA also establishes a new benefit for medical nutrition therapy and expands access to telehealth services in section 223. Section 432 of the BIPA also requires that Medicare make payment to Indian Health Service hospitals and ambulatory clinics for physicians' and practitioners' services as well as outpatient physical and occupational therapy services that are included in the definition of physicians' services for purposes of the SGR. Since these provisions will increase Medicare expenditures for services that are included in the SGR, we are making an upward adjustment to reflect additional Medicare expenditures in 2002. Our estimates of the cost of these provisions for the period FY 2002-FY 2006 are included in our Notice of Proposed Rulemaking published in the Federal Register on August 2, 2001 (66 FR 40400).
We are making an adjustment to the SGR for one additional factor. In section VI.B. of this final rule, we provided a definition of physicians' services for purposes of the SGR. Historically, we have not measured expenditures for screening mammography under the SGR. However, section 1848(f)(4) of the Act indicates that “physicians” services includes other items and services (such as clinical diagnostic laboratory tests and radiology services), specified by the Secretary, that are commonly performed or furnished by a physician or in a physician's office.” Screening mammography services are “radiology services” that are performed by “physicians or in a physician's office.” As a result, we are using this rule to add screening mammography to the list of services that are part of the SGR definition. Since we have not previously measured expenditures for screening mammography services under the SGR, it is appropriate to make an adjustment to this factor for the change to the definition of physicians' services. We are making an adjustment that reflects estimated payments for screening mammography services in CY 2002. We will make a subsequent revision based on actual expenditures for screening mammography.
After taking these provisions into account, the percentage change in expenditures for physicians' services resulting from changes in law or regulations is estimated to be 0.8 percent for 2002. In March, we estimated that this figure would be 1.5 percent. The 0.7 percentage point difference is due to a change in our estimate of the BIPA provisions. In March, we had no information about implementation of these provisions. We used updated assumptions about pricing and utilization based on proposed policies published in the August 2, 2001 proposed rule (66 FR 40400).
2. Detail on the CY 2001 SGR
A more detailed discussion of our current estimates of the four elements of the 2001 SGR follows.
Factor 1—Changes in Fees for Physicians' Services (Before Applying Legislative Adjustments) for CY 2001
We are continuing to use 1.9 percent for this element of the SGR for the CY 2001 SGR. This factor is unchanged from earlier estimates previously described for CY 2001 in the November 1, 2000 Federal Register (65 FR 65433).
Factor 2—The Percentage Change in the Average Number of Fee-for-Service Part B Enrollees From CY 2000 to CY 2001
This factor is our estimate of the percent change in the average number of fee-for-service enrollees for CY 2001 as compared to CY 2000. As we indicated above, this factor is difficult to estimate prior to the beginning of the period for which the estimates are being made because of the interaction of the fee-for-service and Medicare+Choice program and the lack of availability of actual data Start Printed Page 55319on beneficiary selection of Medicare+Choice enrollment. We currently have information on actual enrollment in the Medicare+Choice program for CY 2001 and CY 2000 that permits estimates of the change in fee-for-service enrollment for these years that will be more reflective of the final actual enrollment and percent year-to-year change. The estimates for CY 2000 and CY 2001 were derived by subtracting estimated M+C enrollment from estimated overall Medicare enrollment as illustrated in table 17.
Table 17
[In millions]
2000 2001 Overall 37.453 37.828 Medicare+Choice 6.233 5.662 Net 31.221 32.166 Percent Increase 3.0 Our actuaries estimate of the percent change in the average number of fee-for-service enrollees net of Medicare+Choice enrollment for 2001 compared to 2000 of 3.0 percent is more than our early estimate of this factor (0.9 percent for CY 2001 from the November 1, 2000 Federal Register (65 FR 65433)) because the historical base from which our actuarial estimate is made has changed. We currently have complete information on Medicare fee-for-service enrollment for 2000 that is lower than the figure we used one year ago. Further, we now have information on actual fee-for-service enrollment for the first 8 months of 2001. This figure is slightly higher than the figure used in the November 1, 2000 Federal Register (65 FR 65433). We would caution that our estimate of fee-for-service enrollment for 2001 may change once we have complete information for the entire year.
Factor 3—Estimated Real Gross Domestic Product Per Capita Growth in CY 2001
Section 1848(f)(2)(C) of the Act, as amended by section 211 of the BBRA, requires us to estimate growth in real GDP per capita. We estimate that the growth in real per capita GDP will be 0.7 percent in CY 2001. There have also been large changes in initial estimates of real per capita GDP growth and the actual change in this factor. There could be further changes in this factor once we have complete information on economic performance for the entire year. Again, we note that we will use revised estimates of real per capita GDP growth in setting future year updates.
Factor 4—Percentage Change in Expenditures for Physicians' Services Resulting From Changes in Law or Regulations in CY 2001 Compared With CY 2000
As described above, the BIPA makes changes to the Act that affect Medicare expenditures for services that are included in the SGR. Some of these provisions have no effect on Medicare expenditures in 2001 because they do not go into effect until 2002. Other provisions are effective at some time during 2001. Provisions that become effective in 2001 relate to new technology mammography and coverage changes for screening pap smears, screening pelvic exams and screening colonoscopy, expanded access to telehealth services and Medicare payment for services provided in Indian Health Service hospitals and clinics. After taking these provisions into account, the percentage change in expenditures for physicians' services resulting from changes in law or regulations is estimated to be 0.4 percent for 2001.
3. Detail on Calculation of the FY 2000 and CY 2000 SGRs
A more detailed discussion of our revised estimates of the four elements of the FY 2000 and CY 2000 SGRs follows.
Factor 1—Changes in Fees for Physicians' Services (Before Applying Legislative Adjustments) for FY 2000 SGR and CY 2000 SGR
We are continuing to use 2.1 percent for this element of the SGR for the FY 2000 SGR and the CY 2000 SGR. This factor is unchanged from earlier estimates previously described respectively for FY 2000 and CY 2000 in the October 1, 1999 Federal Register (64 FR 53395), the April 10, 2000 Federal Register (65 FR 19003) and the August 2, 2001 Federal Register (66 FR 40397).
Factor 2—The Percentage Change in the Average Number of Fee-for-Service Part B Enrollees for the FY 2000 SGR and CY 2000 SGR
This factor is our estimate of the percent change in the average number of fee-for-service enrollees for FY 2000 as compared to FY 1999 and CY 2000 as compared to CY 1999. We currently have complete information on actual enrollment in the Medicare+Choice program for FY 2000 and CY 2000 that permits a measure of change in fee-for-service enrollment for these years that reflects the actual change. The estimates for CY 2000 were derived by subtracting estimated M+C enrollment from estimated overall Medicare enrollment as illustrated in table 18.
Table 18
[In millions]
1999 2000 Overall 37.115 37.453 Medicare+Choice 6.191 6.233 Net 30.923 31.221 Percent Increase 1.0 Our actuaries' estimate of the percent change in the average number of fee-for-service enrollees net of Medicare+Choice enrollment for 2000 compared to 1999 of 1.0 percent is the same as our estimate of this factor at this time last year (1.0 percent). However, the current estimate of 0.5 percent for FY 2000 is lower than the 0.8 percent estimate of this factor at this time last year.
Factor 3—Estimated Real Gross Domestic Product Per Capita Growth in FY 2000 and CY 2000
We estimate that real GDP per capita growth will be 3.6 percent for FY 2000 and 3.2 percent for CY 2000. In the FY 2000 SGR notice published on October 1, 1999 (64 FR 53396), we estimated that real GDP per capita growth for FY 2000 would be 1.8 percent. In our April 10, 2000 SGR notice, we estimated that real GDP per capita growth for CY 2000 would be 2.5 percent. In our November 1, 2000 final rule (65 FR 65433), we estimated that real GDP per capita growth would be 4.5 percent for FY 2000 and 4.3 percent CY 2000. The final figures that we will use for this factor are 3.6 percent for FY 2000 and 3.2 percent for CY 2000. The latest figures on real GDP per capita growth are approximately one percentage point less than estimated last year. The lower estimates are due to annual revisions of the National Income and Product Accounts (NIPA) by the Bureau of Economic Analysis. Usually, in annual revisions of the NIPA, new estimates incorporate source data that are more complete, more detailed, and otherwise more appropriate than those that were previously incorporated. In addition, several methodological changes have been made. (For detailed description of the NIPA revisions, see Brent R. Moulton, Eugene P. Seskin, and David F. Sullivan, “Annual Revision of the National Income and Product Accounts: Annual Estimates, 1998-2000, Quarterly Estimates, 1998: 1-2000: I, Survey of Current Business” (August, 2001): 7-32.)Start Printed Page 55320
Factor 4—Percentage Change in Expenditures for Physicians' Services Resulting From Changes in Law or Regulations in FY 2000 Compared with FY 1999, and CY 2000, Compared With CY 1999
As we explained in our October 1, 1999 and April 10, 2000 SGR notices, legislative changes contained in the BBA and the BBRA will have an impact on expenditures for physicians' services under the SGR in FY 2000 and CY 2000. Section 4103 of the BBA mandates a new prostate screening benefit effective January 1, 2000. Additionally, effective January 1, 2000, section 4513 of the BBA removes the requirement that a subluxation of the spine be demonstrated by an x-ray before Medicare payment can be made for chiropractic services furnished to a beneficiary. This provision will also result in a small increase in expenditures in FY 2000 and CY 2000. The impact of BBA Medicare Secondary Payer provisions will have small marginal impact on reducing expenditures in FY 2000 and CY 2000.
Certain BBRA provisions also have a small impact on expenditures in FY 2000 and CY 2000. Section 224 of the BBRA increases payments for pap smears and is slightly increasing expenditures. Section 221 of the BBRA postponed the implementation of payment caps on physical and occupational therapy and speech-language pathology services. The effect of this provision on physicians and independent practitioners is a small increase in expenditures for these years. Medicare expenditures for outpatient physical and occupational therapy services by therapists in independent practice are growing rapidly as a result of provisions of section 4541 of the BBA that require Medicare to make payments for facility-based therapy services under the physician fee schedule. Physical and occupational therapy services previously paid on the basis of a cost report through the Medicare fiscal intermediaries are more likely to be billed by therapists in independent practice because these services are no longer being paid on a cost basis. We analyzed growth in Medicare expenditures for physical and occupational therapy and believe that the larger rate of increase in Medicare expenditures for these services billed to carriers is likely a result of the statutory provisions that require the services to be paid under the Medicare physician fee schedule. We are making an upward adjustment to the SGR for this factor.
After taking into account these provisions, the percentage change in expenditures for physicians' services resulting from changes in law or regulations is estimated to be 0.6 percent for FY 2000 and 0.8 percent for CY 2000.
IX. Calculation of the 2002 Physician Fee Schedule and Anesthesia Conversion Factor
The 2002 physician fee schedule conversion factor is $36.1992. The separate 2002 national average anesthesia conversion factor is $16.60.
The specific calculations to determine the physician fee schedule and anesthesia conversion factor for calendar year 2002 are explained below.
Detail on Calculation of the Calendar Year 2002 Physician Fee Schedule Conversion Factor
- Physician Fee Schedule Conversion Factor
Under section 1848(d)(1)(A) of the Act, the physician fee schedule conversion factor is equal to the conversion factor for the previous year multiplied by the update determined under section 1848(d)(4) of the Act. In addition, section 1848(c)(2)(B)(ii)(II) of the Act requires that changes to relative value units (RVUs) cannot cause expenditures to increase or decrease by more than $20 million from the amount of expenditures that would have been made if such adjustments had not been made. We implement this requirement through a uniform budget neutrality adjustment to the conversion factor. There are two changes that will require us to make an adjustment to the conversion factor to comply with the budget neutrality requirement in section 1848(c)(2)(B)(ii)(II) of the Act. We are making a 0.460 percent reduction (0.9954) in the conversion factor to account for the increase in work RVUs resulting from the 5-year review. We are also making a 0.18 percent (0.9982) reduction in the conversion factor to account for an anticipated increase in the volume and intensity of services in response to the final year of the implementation of resource-based practice expense RVUs. As a result of the 5-year review of RVUs and additional budget-neutrality adjustments required by law, the conversion factor is 5.4 percent lower than last year's conversion factor.
The two budget neutrality factors are applied after the update is applied to the 2001 conversion factor:
Table 19
2001 Conversion Factor $38.2581 2002 Update 0.9523 Budget-Neutrality Adjustment: 5 Year Review 0.9954 Budget-Neutrality Adjustment: Practice Expense Transition 0.9982 2002 Conversion Factor $36.1992 - Anesthesia Fee Schedule Conversion Factor
Section 1848(b)(2)(B) of the Act indicates that, to the extent practicable, the Secretary will use the anesthesia relative value guide with appropriate adjustment of the conversion factor, in a manner to assure that the fee schedule amounts for anesthesia services are consistent with the fee schedule amounts for other services. The statute also requires the Secretary to adjust the conversion factor by geographic adjustment factors in the same manner as for other physician fee schedule services. Unlike other physician fee schedule services, anesthesia services are paid using a system of base and time units. The base and time units are summed and multiplied by a conversion factor. The base unit is fixed depending upon the type of anesthesia procedure performed, and the time units will vary based on the length of the anesthesia time associated with the surgical procedure. Thus, Medicare's payment will increase as anesthesia time lengthens. The same anesthesia service provided in two different surgeries will be paid different amounts if the associated anesthesia time is different. This system differs from other physician fee schedule services where payment is determined based on the product of RVUs and a conversion factor; payment for a given procedure will not vary based on the length of time it takes to perform the procedure in a specific instance.
Since anesthesia services do not have RVUs like other physician fee schedule services, we have had to make appropriate adjustments to the anesthesia fee schedule conversion factor to simulate changes to RVUs. We modeled the resource-based practice expense methodology using imputed anesthesia RVUs that were made comparable to other physician fee schedule services. As a result of modeling these changes, we are incorporating a 1.89 percent reduction (0.9811) to the anesthesia fee schedule conversion factor. We are incorporating an additional increase of 0.2 percent (1.002) to account for base unit revisions for 2002, both for the five-year review and for the alignment of CMS base units with ASA base units. All other adjustments (physician fee schedule update, adjustment for 5-year review of Start Printed Page 55321physician work, adjustment for volume and intensity changes) made to the anesthesia fee schedule conversion factor are the same as those applied to the physician fee schedule. To determine the anesthesia fee schedule conversion factor for 2002, we used the following figures:
Table 20
2001 Anesthesia Conversion Factor $17.83 2002 Update 0.9523 Practice Expense RVU Adjustment for 2002 0.9823 Adjustment for Base Unit Alignment 1.0020 5-Year Review 0.9954 Volume and Intensity Adjustment 0.9982 2003 Conversion Factor $16.60 X. Provisions of the Final Rule
The provisions of this final rule restate the provisions of the August 2001 proposed rule, except as noted elsewhere in the preamble. Following is a highlight of the changes made from the proposed rule:
For screening glaucoma, we are revising the regulation in § 410.23(a)(2) to read “Eligible beneficiary means individuals in the following high risk categories.” This should allow us to more easily add high-risk groups by rulemaking should the medical evidence warrant it.
For G0117 Glaucoma Screening for High Risk Patients Furnished by an Optometrist or Ophthalmologist, we will assign 0.45 work RVUs, .02 malpractice RVUs, and we will crosswalk practice expense inputs from CPT code 92012.
For G0118 Glaucoma Screening for High Risk Patients Furnished Under the Direct Supervision of an Optometrist or Ophthalmologist, we will assign 0.17 work RVUs and 0.01 malpractice RVUs. For practice expense, we will also crosswalk this code to CPT code 92012.
For medical nutrition therapy, we made various changes in response to comments received. For detailed information, see section III.G.
For telehealth services section 1834(m)(3) of the Act specifies that sections 1842(b)(18)(A) and (B) apply to physicians and practitioners receiving payment for telehealth services and to originating sites receiving a facility fee, in the same manner as they apply to practitioners. This section requires that payment for these services may only be made on an assignment-related basis. We did not reflect this provision in the proposed rule. Nonetheless, because this requirement is required by the plain language of the law and because we are without discretion with respect to its application, we are implementing it in this final rule in new § 414.65(d).
Other Issues
Included in the comments we received were issues and topics that were not specifically included as proposals in the August 2, 2001 proposed rule such as coding issues on specific services, the need to expand dissemination of information on Medicare benefits and a variety of other topics. While we do not address these specifically in this rule, we will ensure that the appropriate CMS components are aware of the concerns expressed and would hope that these concerns can be addressed through appropriate channels.
XI. Collection of Information Requirements
Under the Paperwork Reduction Act (PRA) of 1995, we are required to provide 30-day notice in the Federal Register and solicit public comment before a collection of information requirement is submitted to the Office of Management and Budget (OMB) for review and approval. In order to fairly evaluate whether an information collection should be approved by OMB, section 3506(c)(2)(A) of the Paperwork Reduction Act of 1995 requires that we solicit comment on the following issues:
- The need for the information collection and its usefulness in carrying out the proper functions of our agency.
- The accuracy of our estimate of the information collection burden.
- The quality, utility, and clarity of the information to be collected.
- Recommendations to minimize the information collection burden on the affected public, including automated collection techniques.
We are soliciting public comment on each of these issues for § 410.132 in this document, which contains information collection requirements.
Paragraph (c) of this section requires a referring physician or practitioner to maintain referral documentation in the beneficiary's medical record for each referral.
We believe the burden associated with these provisions is exempt in accordance with 5 CFR 1320.3(b)(2) because the time, effort, and financial resources necessary to comply with these requirements would be incurred by referring physicians and practitioners in the normal course of business activities.
If you comment on these information collection and recordkeeping requirements, please mail copies directly to the following:
Centers for Medicare & Medicaid Services, Office of Information Services, Information Technology Investment Management Group, Attn.: John Burke, CMS-1169-FC, Room N2-14-26, 7500 Security Boulevard, Baltimore, MD 21244-1850.
Office of Information and Regulatory Affairs, Office of Management and Budget, Room 10235, New Executive Office Building, Washington, DC 20503, Attn: Allison Eydt, CMS Desk Officer.
XII. Response to Comments
Because of the large number of items of correspondence we normally receive on Federal Register documents published for comment, we are not able to acknowledge or respond to them individually. We will consider all comments we receive by the date and time specified in the DATES section of this preamble, and, if we proceed with a subsequent document, we will respond to the comments in the preamble to that document.
XIII. Regulatory Impact Analysis
We have examined the impact of this final rule as required by Executive Order 12866, the Unfunded Mandates Reform Act of 1995 (UMRA) (Pub. L. 104-4), the Regulatory Flexibility Act of 1980 (RFA) (Pub. L. 96-354), and Executive Order 13132 of August 4, 1999 (Federalism).
EO 12866 directs agencies to assess costs and benefits of available regulatory alternatives and, when regulation is necessary, to select regulatory approaches that maximize net benefits (including potential economic, environmental, public health and safety effects, distributive impacts, and equity). A regulatory impact analysis (RIA) must be prepared for major rules with economically significant effects ($100 million or more annually). While the changes in the Medicare physician fee schedule are, for the most part, budget neutral, they do involve redistribution of Medicare spending among procedures and physician specialties. The redistributive effect of this rule on any particular specialty is in our estimate likely to exceed $100 million for at least one specialty group. For this reason we are considering this a major economic rule.
However, it is important to note, as indicated in section VII of this preamble, the physician fee update for 2002 under section 1848(d) of the Act is −4.8 percent of an estimated $41.2 billion in physician expenditures for 2001. Even though the physician fee schedule update is −4.8 percent, we project that the total Medicare Start Printed Page 55322expenditures for physicians' services will increase from $41.2 billion to $41.7 billion in 2002.
The UMRA also requires (in section 202) that agencies prepare an assessment of anticipated costs and benefits before developing any rule that may result in expenditure in any one year by State, local, or tribal governments, in the aggregate, or by the private sector, of $110 million or more. We have determined that this rule has no consequential effect on State, local, or tribal governments. We believe the private sector cost of this rule falls below the above-stated threshold as well.
The RFA requires that we analyze regulatory options for small businesses and other small entities. We prepare a Regulatory Flexibility Analysis unless we certify that a rule would not have a significant economic impact on a substantial number of small entities. The analysis must include a justification concerning the reason action is being taken, the kinds and number of small entities the rule affects, and an explanation of any meaningful options that achieve the objectives and lessen significant adverse economic impact on the small entities.
In addition, section 1102(b) of the Act requires us to prepare a regulatory impact analysis if a rule may have a significant impact on the operations of a substantial number of small rural hospitals. This analysis must conform to the provisions of section 604 of the RFA. For purposes of section 1102(b) of the Act, we define a small rural hospital as a hospital that is located outside of a Metropolitan Statistical Area and has fewer than 100 beds.
For purposes of the RFA, all physicians are considered to be small entities. There are about 700,000 physicians and other practitioners who receive Medicare payment under the physician fee schedule.
For the purpose of EO 12866 and the RFA we have prepared the following analysis, which, together with the rest of this preamble, meets all four assessment requirements. It explains the rationale for and purpose of the rule, details the costs and benefits of the rule, analyzes alternatives, and presents the measures we considered to minimize the burden on small entities.
A. 5 Year Review of Physician Work and Resource-Based Practice Expense Relative Value Units
Revisions in physician work and resource-based practice expense RVUs for physicians' services are required by law to be budget neutral. We calculate total payments from the revisions to work and practice expense relative value units such that total payments do not change more than $20 million as a result of the revisions. Increases in payments for some services are necessarily offset by decreases in payments for other services. For revisions to physician work values that are occuring as part of the 5-year review, we are making a budget neutrality adjustment to the physician fee schedule conversion factor. For practice expense, we adjust all the practice expense RVUs upwards or downwards to meet the budget neutrality requirement in the statute. This means that increases in practice expense RVUs for some services will be offset by corresponding decreases in values for other services. We showed the impact of proposed changes in physician work and practice expense RVUs in our Notice of Proposed Rulemaking in the Federal Register on August 2, 2001 (65 FR 40397). Table 21 shows the impact on total allowed charges by specialty of this final rule's physician work and practice expense RVU changes. We are showing the impact of the proposed rule changes as well additional changes that are occurring as a result of this final rule. There are five changes we are adopting in this final rule that result in changes to the impacts displayed in the proposed rule. Table 21 incorporates additional impacts that result from using 2000 utilization data to determine the resource-based practice expense RVUs. This change has a very modest effect on payment for nearly all specialties. Based on public comments to our notice of proposed rulemaking, we have also made changes to physician work RVUs that were part of the 5-year review. These changes will increase payments to Gastronterology, General Surgery, Obstetrics and Gynecology and Podiatry. We also incorporated revised physician time data supplied to us by the Relative Value Update Committee (RUC). Relative to the physician times used in our proposed rule, there were slight refinements to some codes. With the exception of Nephrology, the new times have virtually no impact on specialty level payments. Nephrology payments will go up as a result of using new physician times supplied to us by the RUC. The RUC supplied us with a time of 186 minutes for the highest volume nephrology procedure code, 90921. This compared to a physician time of 153 minutes that was previously used. Finally, we also incorporated refinements to the practice expense inputs that are being recommended by the Practice Expense Advisory Committee (PEAC) and the RUC. These changes will result in a reduction in average payments to rheumatology of about 6 percent. This occurs primarily as a result of refinements to 4 codes that are frequently performed by rheumatologists (20610, 20550, 20605 and 20600). Based on the PEAC and RUC comments, we made changes to the practice expense inputs that result in a reduction in relative payments for these procedure codes. Other specialties that will experience a smaller reduction in payments as a result of the practice expense refinements for 2002 are Orthopedic Surgery, Podiatry and Urology. Since the changes are budget neutral, the reductions in practice expense RVUs will be offset by increases in practice expense payments that will be broadly distributed among other physician specialties.
Table 21 shows the impact of this final rule compared to the proposed rule that was published on August 2, 2001. We note that the table shows the impact of this rule only and does not incorporate practice expense changes from three other final rules, November 2, 1998 (63 FR 58895), November 2, 1999 (64 FR 59433) and November 1, 2000 (65 FR 65377). The table shows the average specialty change in payments in CY 2002 that are occurring as a result of this final rule relative to what would have occurred in 2002 had this rule not been published. The rule shows the redistributive (or relative) change in payments among specialties. It does not show the absolute average change in specialty level payments from 2001 to 2002 that are also affected by the final year of the transition to resource-based practice expense RVUs and the physician fee schedule update. The transition to resource-based RVUs is complete in CY 2002 and has no effect when comparing the impact on CY 2002 payments before and after changes made in this final rule. The physician fee schedule update and change to the conversion factor are discussed in sections VII and IX, respectively.Start Printed Page 55323
Table 21.—Impact of Physician Work and Practice Expense Relative Value Unit Changes—Final Rule Compared to Proposed Rule
Specialty Allowed charges (billions) Proposed rule impact (percent) Final rule impact (percent) Anesthesiology $1.5 1 1 Cardiac Surgery 0.3 0 0 Cardiology 4.2 0 −1 Chiropractor 0.4 0 0 Clinics 1.6 0 0 Dermatology 1.4 1 2 Emergency Medicine 1.0 0 0 Family Practice 3.3 0 0 Gastroenterology 1.2 1 3 General Practice 1.0 0 0 General Surgery 2.0 4 4 Hematology Oncology 0.6 0 1 Internal Medicine 7.1 0 1 Nephrology 1.0 0 2 Neurology 0.9 0 0 Neurosurgery 0.4 0 0 Nonphysician Practitioner 1.2 0 1 Obstetrics/Gynecology 0.4 1 2 Ophthalmology 3.9 -1 -1 Optometrist 0.5 0 -3 Orthopedic Surgery 2.3 0 -1 Other Physician 1.4 1 0 Otolaryngology 0.6 0 1 Pathology 0.6 3 3 Plastic Surgery 0.2 0 1 Podiatry 1.1 1 0 Psychiatry 1.1 0 0 Pulmonary 1.1 0 1 Radiation Oncology 0.7 0 −2 Radiology 3.3 0 −1 Rheumatology 0.3 0 −6 Suppliers 0.7 2 0 Thoracic Surgery 0.5 1 0 Urology 1.3 1 1 Vascular Surgery 0.3 2 1 Table 22, titled Impact of 5-Year Review and Proposed Rule on Medicare Payments for Selected Procedures, shows the percentage change in total payment (in CY 2002 physician fee schedule dollars) for selected high-volume procedures that result from changes to the physician work, practice expense and malpractice announced in this final rule. These tables reflect the impact of this final rule only on the fully implemented fee schedule amount. The payments in these columns are determined using a conversion factor $36.1992. The RVUs used for calculating payment in the “old” columns are from the November 1, 2000 final rule. The RVUs used in calculating payments in the “new” columns are from this final rule. By using the same conversion factor of $36.1992 to calculate payments in both the “old” and “new” columns, the impact of changes to the RVUs that are included in this final rule are illustrated. These tables do not show the actual impact on payment from 2001 to 2002 that are also affected by the final year of the practice expense transition and physician fee schedule update.
Table 22.—Impact of 5 Year Review and Proposed Rule on Medicare Payment for Selected Procedures
HCPCS MOD DESC Old non- facility New non- facility Percent change Old facility New facility Percent change 11721 Debride nail, 6 or more $40.18 $36.92 −8 $28.96 $28.96 0 17000 Destroy benign/premal lesion 60.45 62.62 4 32.58 32.94 1 27130 Total hip replacement NA NA NA 1,419.01 1,452.31 2 27236 Treat thigh fracture NA NA NA 1,088.87 1,113.85 2 27244 Treat thigh fracture NA NA NA 1,111.68 1,137.38 2 27447 Total knee replacement NA NA NA 1,483.08 1,514.21 2 33533 CABG, arterial, single NA NA NA 1,756.02 1,827.34 4 35301 Rechanneling of artery NA NA NA 1,107.33 1,061.36 −4 43239 Upper GI endoscopy, biopsy 281.99 354.75 26 148.78 154.93 4 45385 Lesion removal colonoscopy 474.93 571.22 20 283.44 287.78 2 66821 After cataract laser surgery 217.56 229.50 6 203.44 213.94 5 66984 Cataract surg w/iol, i stage NA NA NA 660.27 669.32 1 67210 Treatment of retinal lesion 594.03 603.08 2 544.44 546.61 0Start Printed Page 55324 71010 26 Chest x-ray 9.05 9.05 0 9.05 9.05 0 71020 26 Chest x-ray 11.22 11.22 0 11.22 11.22 0 76091 Mammogram, both breasts 84.34 90.50 7 NA NA NA 76091 26 Mammogram, both breasts 35.11 43.44 24 35.11 43.44 24 76092 Mammogram, screening 71.03 80.72 14 71.03 80.72 14 76092 26 Mammogram, screening 22.73 35.48 56 22.73 35.48 56 77427 Radiation tx management, x5 167.24 167.96 0 167.24 167.96 0 78465 26 Heart image (3d), multiple 75.29 74.93 −1 75.29 74.93 −1 88305 26 Tissue exam by pathologist 39.82 40.54 2 39.82 40.54 2 90801 Psy dx interview 145.52 144.80 −1 137.19 137.19 0 90806 Psytx, off, 45-50 min 96.65 95.93 −1 91.22 91.22 0 90807 Psytx, off, 45-50 min w/e&m 103.89 103.53 0 98.82 98.82 0 90862 Medication management 51.04 51.04 0 46.33 46.33 0 90921 ESRD related services, month 263.89 273.30 4 263.89 273.30 4 90935 Hemodialysis, one evaluation NA NA NA 73.48 76.38 4 92004 Eye exam, new patient 124.16 123.44 −1 87.60 87.96 0 92012 Eye exam established pat 62.62 61.18 −2 35.84 35.84 0 92014 Eye exam & treatment 89.77 91.22 2 59.00 58.64 −1 92980 Insert intracoronary stent NA NA NA 799.64 790.59 −1 92982 Coronary artery dilation NA NA NA 592.22 584.26 −1 93000 Electrocardiogram, complete 26.06 25.34 −3 NA NA NA 93010 Electrocardiogram report 9.05 9.05 0 9.05 9.05 0 93015 Cardiovascular stress test 102.81 99.91 −3 NA NA NA 93307 26 Echo exam of heart 48.51 48.14 −1 48.51 48.14 −1 93510 26 Left heart catheterization 232.76 230.59 −1 232.76 230.59 −1 98941 Chiropractic manipulation 35.48 35.48 0 30.77 31.13 1 99202 Office/outpatient visit, new 60.45 61.54 2 45.61 45.61 0 99203 Office/outpatient visit, new 90.50 91.95 2 69.50 69.50 0 99204 Office/outpatient visit, new 130.32 130.68 0 102.81 102.81 0 99205 Office/outpatient visit, new 165.07 166.15 1 136.11 136.47 0 99211 Office/outpatient visit, est 19.91 20.27 2 8.69 8.69 0 99212 Office/outpatient visit, est 35.48 36.20 2 23.17 23.17 0 99213 Office/outpatient visit, est 49.59 50.32 2 34.03 34.03 0 99214 Office/outpatient visit, est 78.19 78.91 1 55.75 56.11 1 99215 Office/outpatient visit, est 114.39 115.84 1 90.14 90.50 0 99221 Initial hospital care NA NA NA 65.16 65.16 0 99222 Initial hospital care NA NA NA 107.87 108.24 0 99223 Initial hospital care NA NA NA 150.59 150.95 0 99231 Subsequent hospital care NA NA NA 32.58 32.58 0 99232 Subsequent hospital care NA NA NA 53.21 53.57 1 99233 Subsequent hospital care NA NA NA 76.02 76.38 1 99236 Observ/hosp same date NA NA NA 213.58 214.66 1 99238 Hospital discharge day NA NA NA 64.07 66.24 3 99239 Hospital discharge day NA NA NA 87.60 90.86 4 99241 Office consultation 46.33 47.06 2 32.94 33.30 1 99242 Office consultation 86.15 87.24 1 67.69 68.05 1 99243 Office consultation 114.39 115.84 1 90.14 90.14 0 99244 Office consultation 162.53 164.34 1 133.21 133.58 0 99245 Office consultation 211.04 212.85 1 176.65 177.01 0 99251 Initial inpatient consult NA NA NA 36.20 34.75 −4 99252 Initial inpatient consult NA NA NA 71.31 69.86 −2 99253 Initial inpatient consult NA NA NA 96.65 95.20 −2 99254 Initial inpatient consult NA NA NA 138.28 136.83 −1 99255 Initial inpatient consult NA NA NA 189.68 188.60 −1 99261 Follow-up inpatient consult NA NA NA 23.53 21.72 −8 99262 Follow-up inpatient consult NA NA NA 45.25 43.44 −4 99263 Follow-up inpatient consult NA NA NA 66.24 64.80 −2 99282 Emergency dept visit NA NA NA 26.43 26.43 0 99283 Emergency dept visit NA NA NA 59.37 59.37 0 99284 Emergency dept visit NA NA NA 92.67 92.67 0 99285 Emergency dept visit NA NA NA 144.43 144.80 0 99291 Critical care, first hour NA NA NA 197.65 198.37 0 99292 Critical care, addl 30 min NA NA NA 98.46 98.82 0 99301 Nursing facility care 60.09 70.23 17 60.09 60.09 0 99302 Nursing facility care 80.36 95.57 19 80.36 80.72 0 99303 Nursing facility care 99.91 118.73 19 99.91 100.27 0 99311 Nursing fac care, subseq 30.05 40.18 34 30.05 30.05 0 99312 Nursing fac care, subseq 49.59 61.90 25 49.59 49.95 1 99313 Nursing fac care, subseq 70.59 84.34 20 70.59 70.95 1Start Printed Page 55325 99348 Home visit, est patient 73.12 73.85 1 NA NA NA 99350 Home visit, est patient 166.88 166.52 0 NA NA NA (In two different places above, we indicate that the tables do not include the effect of the “final” year of the practice expense transition. While we note that resource-based practice expense will be fully implemented in 2002, our expectation is that we would continue to make refinements that improve the practice expense relative value units. We acknowledge that the efforts of the PEAC and RUC to make useful comments on practice expense inputs have resulted in significant improvements to the data we are using to determine practice expense relative value units. The refinements we have made to date have affected hundreds of procedure codes accounting for a high percentage of Medicare expenditures paid under the physician fee schedule. Our expectation is that this work will continue and we continue, to welcome comments and input from all members of the public interested in these issues).
B. Nurse Practitioners, Physician Assistants, and Clinical Nurse Specialists Performing Screening Sigmoidoscopies
As discussed in section II.B. of the preamble, this regulation will expand the list of practitioners for whose services Medicare may make payment for screening flexible sigmoidoscopies to include nurse practitioners, physician assistants, and clinical nurse specialists, as long as those practitioners meet applicable Medicare qualification requirements, and they are authorized to perform those screening services under State law. At present, the Medicare condition of coverage for screening flexible sigmoidoscopies limits coverage of those services to those that are performed by either a doctor of medicine or osteopathy (as defined in section 1861(r)(1) of the Act) who is authorized under State law to perform the examination.
We estimate that this expansion in the scope of practitioners who can receive Medicare payment for screening flexible sigmoidoscopies will increase beneficiary access to these screening services and will result in an increase in the number of covered exams that are performed. At the same time, we estimate that this final rule will result in a decrease in payments that are made for certain screening flexible sigmoidoscopies because they will be performed by nurse practitioners, physician assistants, and clinical nurse specialists, since services they provide are paid at 85 percent of the amount of payment that is made to physicians for the same screening service. Taking these factors into account, we estimate that this provision will result in negligible additional Medicare program costs. For a more detailed discussion of this provision see section II.B. of this preamble.
C. Services and Supplies Incident to a Physician's Professional Services—Conditions
Under this rule auxiliary personnel may provide services incident to the services of physicians (or other practitioners) who supervise them, regardless of the employment relationship. There are no costs or savings to the Medicare program associated with this provision. This provision could result in increased beneficiary access to the auxiliary personnel. For a more detailed discussion of this provision see section II.C. of this preamble.
D. Anesthesia Services—Anesthesia Base Units
As previously discussed in section II.D. of the preamble, with the exception of codes 00142 and 00147, we are using the same anesthesia base unit per anesthesia code as the ASA provides in its uniform relative value guide. There are eleven codes where our base unit value for an anesthesia code differed from the corresponding ASA base unit. Using the ASA base units resulted in an increase for 8 codes and a decrease for 3 codes. New and revised codes starting in CY 2000 and for subsequent years are evaluated on a code-specific basis under our usual process after we receive recommendations from the RUC. Thus, because of our review of the RUC recommendations, there could be differences between the ASA's guide and our base units beginning in CY 2000.
We have determined the budget neutrality impact on the anesthesia CF for the 11 codes for which CMS's base units are equal to the ASA's base units as well as the addition of 19 new anesthesia codes in CY 2002. The impact was determined by estimating the increase or decrease in base units between our base units and the ASA's base units for existing codes as well as the increase and decrease in base units between the new 2002 codes and the previous codes by which the services would have been reported. This results in an increase of approximately .2 percent in the 2002 anesthesia CF. For a more detailed discussion of this provision see section II.D. of this preamble.
E. Performance Measurement and Emerging Technology Codes
As previously discussed in section II.E. of the preamble, the AMA has developed two new categories of codes—performance codes and emerging technology. Allowing the performance measurement code to be recorded on Medicare billing forms will have no budgetary impact since we are not proposing payment for these codes. We are allowing for carrier pricing of the emerging technology codes.
We expect that the emerging technology codes will be used infrequently and may be used in place of “unlisted” procedure codes that are also carrier-priced. There would be few, if any, Medicare program costs associated with this proposal. For a more detailed discussion of this provision see section II.E. of this preamble.
F. BIPA Provisions Included in This Final Rule
The following provisions of the BIPA are discussed in detail in section III of this preamble. This final rule conforms the regulations text to the BIPA provisions. We showed the anticipated costs associated with the BIPA provisions in our August 2, 2001 proposed rule (66 FR 40400). We are showing that same table again in table 23 below.Start Printed Page 55326
Table 23.—Medicare Cost Estimates for BIPA 2000 Provisions
[In millions]
BIPA provisions FY 2002 FY 2003 FY 2004 FY 2005 FY 2006 Sec. 101 Biennial Pelvic Examinations 10 20 20 20 20 Sec. 102 Screening Glaucoma 30 50 50 60 60 Sec. 103 Screening Colonoscopy 40 40 30 10 10 Sec. 104 Screening Mammography 30 40 40 40 50 Sec. 105 Medical Nutrition 20 50 60 70 70 Sec. 223 Telehealth Services 20 30 40 50 60 Sec. 432 Indian Health 60 70 80 80 90 1. Screening Mammography
As discussed in section III.A. of the preamble, the BIPA eliminates the statutorily prescribed payment rate for screening mammography and specifies that it will be paid under the physician fee schedule beginning January 1, 2002. To pay for the professional component of the screening mammography, we are using the work and malpractice RVUs that have been established for unilateral diagnostic mammography. We are establishing the practice expense RVUs for the professional component under the resource-based methodology. The process we used to establish the practice expense RVU for the TC is described in detail in section III.A. Currently, we pay for screening mammography under section 1834(c) of the Act. Payment for screening mammography under that section is not subject to the budget neutrality requirements that apply to physician fee schedule services under section 1848(c)(2)(B)(ii)(II) of the Act. However, effective January 1, 2002, screening mammography will be paid under the physician fee schedule and, thus, subject to the budget neutrality requirements that apply to physician fee schedule services. We will include the current payment amounts for screening mammography in aggregate physician fee schedule payments subject to the budget neutrality requirements. As a result, the BIPA requirement that we pay for screening mammography under the physician fee schedule will not result in an increase in Medicare program expenditures. However, the increase in payment for screening mammography under the physician fee schedule will be included in the budget neutrality adjustments that apply to physician fee schedule services. The BIPA also establishes a methodology for determining payment for certain types of new technology that are used in providing both diagnostic and screening mammography services. The statutory provisions are in effect from April 1, 2001 to December 31, 2001. The statute gives us the authority to determine whether separate codes and payment amounts are appropriate for screening and diagnostic mammography services that involve use of a new technology on or after January 1, 2002. We are establishing several new codes and fee schedule amounts for screening and diagnostic mammography services that involve use of a new technology. We believe this will help ensure that all Medicare beneficiaries have access to the benefits of mammography, including recent advances that further enhance the clinical capability of this vital health service for women. The BIPA provisions related to new technology mammography will result in the Medicare program costs shown in Table 23. The BIPA makes no changes to provisions for Medicare coverage of screening mammography.
2. Screening Pelvic Examinations
As discussed in section III.B. of the preamble, section 101 of the BIPA provides for expanded coverage for screening pelvic examinations (including a clinical breast examination) furnished on or after July 1, 2001. Specifically, the revised benefit will allow for biennial coverage of screening pelvic examination for all women who do not qualify under the law for annual coverage of such tests. We estimate that this change in the frequency of coverage for certain beneficiaries will result in an increase in Medicare payments. These payments will be made to a large number of physicians and other practitioners who provide these tests and for any medically necessary follow-up tests, or treatment that may be required as a result of the increased frequency of coverage of these tests. Medicare program expenditures associated with screening pelvic examinations have been included in the President's budget for Medicare expenditures. The impact of this provision is shown in Table 23.
3. Screening for Glaucoma
As discussed in section III.C. of the preamble, section 102 of the BIPA authorizes coverage of glaucoma screening examinations effective January 1, 2002, subject to certain frequency and other limitations. We believe services provided as part of glaucoma screening will often overlap with other services a physician provides during a patient encounter that is associated with a higher payment amount. We believe that physicians will more commonly provide glaucoma tests in conjunction with other services and will rarely provide only glaucoma screening to Medicare patients. Based on the projected utilization of these screening services and related medically necessary follow-up tests and treatment that may be required for the beneficiaries screened, we estimate that this new benefit will result in an increase in Medicare payments. These payments will be made to ophthalmologists or optometrists who will provide these screening tests and for any related follow-up tests and treatment that may be required. Medicare program expenditures associated with the BIPA provision that establishes coverage for screening glaucoma are shown in Table 23. The addition of the screening glaucoma benefit will allow a greater number of beneficiaries access to a preventive service.
4. Screening Colonoscopy
As discussed in section III.D. of the preamble, section 103 of the BIPA amended the Act to add coverage of screening colonoscopies once every 10 years for individuals not at high risk for colorectal cancer. We estimate that this new benefit will result in an increase in Medicare payments. These payments will be made to practitioners who will provide these screening tests and related follow-up tests and treatment that may be required. The addition of the screening colonoscopy benefit will allow beneficiaries who are not at high risk for colorectal cancer greater access to preventive services. The impact of this provision is shown in Table 23.
5. Medical Nutrition Therapy
As discussed in section III.E. of the preamble, section 105 of the BIPA Start Printed Page 55327amended the Act to authorize Medicare coverage under Part B of medical nutrition therapy (MNT) for beneficiaries who have diabetes or renal disease, effective for services furnished on or after January 1, 2002. We are implementing this provision in 42 CFR at part 410, in subpart G. Specifically, the final rule discusses the education, experience, and licensing requirements for dietitians or nutritionists furnishing the service. In addition, the final rule discusses a referral requirement and the manner by which the medical nutrition therapy and diabetes outpatient self-management training benefits will be coordinated to avoid duplicate payment. We are also establishing payment amounts for these services under the physician fee schedule.
We estimate that this new benefit will result in an increase in Medicare payments. These payments will be made to dietitians and nutrition professionals who will provide these diagnostic therapy and counseling services. Costs to the Medicare program associated with this provision are shown in Table 23.
6. Telehealth
We estimate that the cost of providing office or other outpatient visits, consultation services, individual psychotherapy, and pharmacologic management in accordance with section 223 of the BIPA will be approximately $20 million in FY 2002 and approximately $60 million by FY 2006, as indicated above in Table 23.
This final rule does not mandate that entities provide consultation, office or other outpatient visits, individual psychotherapy or pharmacological management services via a telecommunications system. Thus, this final rule will not require entities to purchase telehealth equipment or to acquire the telecommunications infrastructure necessary to deliver these services via a telecommunications system. Therefore, this final rule does not impose costs associated with starting and operating a telehealth network.
7. Indian Health Services
As discussed in section III.G. of the preamble, section 432 of the BIPA authorizes payment under the physician fee schedule to physicians and certain practitioners for services furnished in a hospital and an ambulatory care clinic, whether provider-based or free-standing, of the Indian Health Service effective for services furnished on or after July 1, 2001. We are adding a new § 410.46 to conform our regulations to the statute. Costs to the Medicare program for this BIPA provision are shown in Table 23.
8. Pathology Services
As discussed in section III.H. of the preamble, in the November 2, 1999 physician fee schedule final rule (64 FR 59381), we stated that we would implement a policy to pay only hospitals for the TC of physician pathology services furnished to hospital inpatients. Before the effective date of this proposal, any independent laboratory could bill the carrier under the physician fee schedule for the TC of physician pathology to a hospital inpatient. That regulation provided that for services furnished on or after January 1, 2001, the carriers would no longer pay claims to an independent laboratory under the physician fee schedule for the TC of physician pathology services furnished for hospital inpatients. Similar treatment was provided under the hospital outpatient prospective payment system for the TC of physician pathology services to hospital outpatients. We delayed implementation of this provision for one year; it was to take effect for services furnished on or after January 1, 2001. The delay was intended to allow independent laboratories and hospitals sufficient time to negotiate arrangements.
Section 542 of the BIPA requires Medicare to continue to pay for the TC of physician pathology services when an independent laboratory furnishes this service to an inpatient or outpatient of a covered hospital. This provision applies to TC services furnished during the 2-year period beginning on January 1, 2001.
In the November 2, 1999 final rule, we estimated that payment under the physician fee schedule for TC billings by independent laboratories would decrease by $6 million per year if the original proposal had been implemented on January 1, 2001. As a result of the BIPA, these savings are not realized for two years.
G. Update of the Codes for the Physician Self-Referral Prohibition
As discussed in section VI of this preamble, we are updating the list of codes used to define certain designated health services for the purposes of section 1877 of the Act. We are not making any substantive change to the description of any designated health service as set forth in the January 4, 2001 physician self-referral final rule (66 FR 856). Instead, we are merely updating our list of codes to conform to coding changes in the most recent publication of CPT and HCPCS codes. For this reason, we certify that the changes we are making will not have a significant economic effect on a substantial number of small entities or on the operations of a substantial number of small rural hospitals. For an in-depth discussion of the anticipated effects of the recent physician self-referral final rule, refer to the regulatory impact statement in that rule as published in the January 4, 2001 Federal Register (66 FR 856).
H. Budget-Neutrality
The increase in physician work RVUs will necessitate an adjustment to meet the statute's budget neutrality requirements. We are reducing the physician fee schedule CF by -0.46 percent (CF X 0.9954) to ensure that the increase in physician work RVUs remains budget neutral across all physician fee schedule services. Each year since the fee schedule has been implemented, our actuaries have determined any adjustments needed to meet the budget-neutrality requirement of the statute. A component of the actuarial determination of budget-neutrality involves estimating the impact of changes in the volume and intensity of physicians' services provided to Medicare beneficiaries as a result of the proposed changes to relative value units. Consistent with the provision in the November 1998 final rule, the actuaries would use a model that assumes a 30 percent volume-and-intensity response to price reductions. Based on the practice expense changes that will occur in 2002, the actuaries estimate that a -0.18 (CF X 0.9982) percent adjustment to the conversion factor is necessary to meet the budget neutrality requirements in the statute. If the assumed volume and intensity offset does not occur, the offset applied to the RVUs will be, in essence, returned because there will be a future year adjustment to the physician fee schedule update.
I. Impact on Beneficiaries
Although changes in physicians' payments when the physician fee schedule was implemented in 1992 were large, we detected no problems with beneficiary access to care. Furthermore, since beginning our transition to a resource-based practice expense system in 1999, we have not found that there are problems with beneficiary access to care.
J. Federalism
We have reviewed this proposed rule under the threshold criteria of EO 13132, Federalism, and we have determined that the proposed rule does Start Printed Page 55328not significantly affect the rights, roles, and responsibilities of States.
Start List of SubjectsList of Subjects
42 CFR Part 405
- Administrative practice and procedure
- Health facilities
- Health professions
- Kidney diseases
- Medicare
- Reporting and recordkeeping requirements
- Rural areas
- X-rays
42 CFR Part 410
- Health facilities
- Health professions
- Kidney diseases
- Laboratories
- Medicare
- Rural areas
- X-rays
42 CFR Part 411
- Kidney diseases
- Medicare
- Reporting and recordkeeping requirements
42 CFR Part 414
- Administrative practice and procedure
- Health facilities
- Health professions
- Kidney diseases
- Medicare
- Reporting and recordkeeping requirements
- Rural areas
- X-rays
42 CFR Part 415
- Health facilities
- Health professions
- Medicare
- Reporting and recordkeeping requirements
For the reasons set forth in the preamble, the Centers for Medicare and Medicaid amends 42 CFR chapter IV as follows:
End Amendment Part Start PartPART 405—FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED
End Part Start Amendment Part1. The authority citation for part 405 continues to read as follows:
End Amendment Part Start Amendment Part2. In § 405.534, an introductory paragraph is added to read as follows:
End Amendment PartLimitation on payment for screening mammography services.The provisions in paragraphs (a), (b), and (c) of this section apply for services provided from January 1, 1991 until December 31, 2001. Screening mammography services provided after December 31, 2001 are paid under the physician fee schedule in accordance with § 414.2 of this chapter.
* * * * *3. In § 405.535, the section heading is revised and the introductory text is amended by adding two sentences to the beginning to read as follows:
End Amendment PartSpecial rule for nonparticipating physicians and suppliers furnishing screening mammography services before January 1, 2002.The provisions in this section apply for screening mammography services provided from January 1, 1991 until December 31, 2001. Screening mammography services provided after December 31, 2001 are physician services pursuant to § 414.2 of this chapter paid under the physician fee schedule. * * *
* * * * *PART 410—SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS
End Part Start Amendment Part1. The authority citation for part 410 continues to read as follows:
End Amendment Part Start Amendment Part2. Section 410.3 is amended by revising paragraph (a)(1) to read as follows:
End Amendment PartScope of benefits.(a) * * *
(1) Medical and other health services such as physicians' services, outpatient services furnished by a hospital or a CAH, diagnostic tests, outpatient physical therapy and speech pathology services, rural health clinic services, Federally qualified health center services, IHS, Indian tribe, or tribal organization facility services, and outpatient renal dialysis services.
* * * * *3. Section 410.10 is amended by adding paragraph (x) to read as follows:
End Amendment PartMedical and other health services: Included services.* * * * *(x) Services of physicians and other practitioners furnished in or at the direction of an IHS or Indian tribal hospital or clinic.
4. Section 410.22 is redesignated as § 410.21, § 410.23 is redesignated as § 410.22, and a new § 410.23 is added to read as follows:
End Amendment PartScreening for glaucoma: Conditions for and limitations on coverage.(a) Definitions: As used in this section, the following definitions apply:
(1) Direct supervision in the office setting means the optometrist or the ophthalmologist must be present in the office suite and be immediately available to furnish assistance and direction throughout the performance of the procedure. It does not mean the physician must be present in the room when the procedure is performed.
(2) Eligible beneficiary means individuals in the following high risk categories:
(i) Individual with diabetes mellitus;
(ii) Individual with a family history of glaucoma; or
(iii) African-Americans age 50 and over.
(3) Screening for glaucoma means the following procedures furnished to an individual for the early detection of glaucoma:
(i) A dilated eye examination with an intraocular pressure measurement.
(ii) A direct ophthalmoscopy examination, or a slit-lamp biomicroscopic examination.
(b) Condition for coverage of screening for glaucoma.
Medicare Part B pays for glaucoma screening examinations provided to eligible beneficiaries as described in paragraph (a)(2) of this section if they are furnished by or under the direct supervision in the office setting of an optometrist or ophthalmologist who is legally authorized to perform these services under State law (or the State regulatory mechanism provided by State law) of the State in which the services are furnished, as would otherwise be covered if furnished by a physician or incident to a physician's professional service.
(c) Limitations on coverage of glaucoma screening examinations.
(1) Payment may not be made for a glaucoma screening examination that is performed for an individual who is not an eligible beneficiary as described in paragraph (a)(2) of this section.
(2) Payment may be made for a glaucoma screening examination that is performed on an individual who is an eligible beneficiary as described in paragraph (a)(2) of this section, after at least 11 months have passed following the month in which the last glaucoma screening examination was performed.
5. In § 410.26, paragraph (b) is redesignated as paragraph (c), paragraph (a) is redesignated as paragraph (b) and revised, a new paragraph (a) is added, and newly designated paragraph (c) is amended by adding a paragraph heading:
End Amendment PartServices and supplies incident to a physician's professional service: Conditions.(a) Definitions. For purposes of this section, the following definitions apply:
(1) Auxiliary personnel means any individual who is acting under the supervision of a physician (or other practitioner), regardless of whether the individual is an employee, leased employee, or independent contractor of the physician (or other practitioner) or of the same entity that employs or contracts with the physician (or other practitioner).
(2) Direct supervision means the level of supervision by the physician (or other practitioner) of auxiliary personnel as defined in § 410.32(b)(3)(ii).Start Printed Page 55329
(3) Independent contractor means an individual who performs part-time or full-time work for which the individual receives an IRS-1099 form.
(4) Leased employment means an employment relationship that is recognized by applicable State law and that is established by two employers by a contract such that one employer hires the services of an employee of the other employer.
(5) Noninstitutional setting means all settings other than a hospital or skilled nursing facility.
(6) Practitioner means a non-physician practitioner who is authorized by the Act to receive payment for services incident to his or her own services.
(7) Services and supplies means any services or supplies (including drugs or biologicals that are not usually self-administered) that are included in section 1861(s)(2)(A) of the Act and are not specifically listed in the Act as a separate benefit included in the Medicare program.
(b) Medicare Part B pays for services and supplies incident to the service of a physician (or other practitioner).
(1) Services and supplies must be furnished in a noninstitutional setting to noninstitutional patients.
(2) Services and supplies must be an integral, though incidental, part of the service of a physician (or other practitioner) in the course of diagnosis or treatment of an injury or illness.
(3) Services and supplies must be commonly furnished without charge or included in the bill of a physician (or other practitioner).
(4) Services and supplies must be of a type that are commonly furnished in the office or clinic of a physician (or other practitioner).
(5) Services and supplies must be furnished under the direct supervision of the physician (or other practitioner). The physician (or other practitioner) directly supervising the auxiliary personnel need not be the same physician (or other practitioner) upon whose professional service the incident to service is based.
(6) Services and supplies must be furnished by the physician, practitioner with an incident to benefit, or auxiliary personnel.
(7) A physician (or other practitioner) may be an employee or an independent contractor.
(c) Limitation. * * *
6. In § 410.37, paragraphs (d), (e)(2), and (g) are revised and paragraph (e)(3) is added to read as follows:
End Amendment PartColorectal cancer screening tests: Conditions for and limitations on coverage.* * * * *(d) Condition for coverage of flexible sigmoidoscopy screening. Medicare Part B pays for a flexible sigmoidoscopy screening service if it is performed by a doctor of medicine or osteopathy (as defined in section 1861(r)(1) of the Act), or by a physician assistant, nurse practitioner, or clinical nurse specialist (as defined in section 1861(aa)(5) of the Act and §§ 410.74, 410.75, and 410.76) who is authorized under State law to perform the examination.
(e) Limitations on coverage of screening flexible sigmoidoscopies. * * *
(2) For an individual 50 years of age or over, except as described in paragraph (e)(3) of this section, payment may be made for screening flexible sigmoidoscopy after at least 47 months have passed following the month in which the last screening flexible sigmoidoscopy or, as provided in paragraphs (h) and (i) of this section, the last screening barium enema was performed.
(3) In the case of an individual who is not at high risk for colorectal cancer as described in paragraph (a)(3) of this section but who has had a screening colonoscopy performed, payment may be made for a screening flexible sigmoidosocopy only after at least 119 months have passed following the month in which the last screening colonoscopy was performed.
* * * * *(g) Limitations on coverage of screening colonoscopies. (1) Effective for services furnished on or after January 1, 1998 through June 30, 2001, payment may not be made for a screening colonoscopy for an individual who is not at high risk for colorectal cancer as described in paragraph (a)(3) of this section.
(2) Effective for services furnished on or after July 1, 2001, except as described in paragraph (g)(4) of this section, payment may be made for a screening colonoscopy performed for an individual who is not at high risk for colorectal cancer as described in paragraph (a)(3) of this section, after at least 119 months have passed following the month in which the last screening colonoscopy was performed.
(3) Payment may be made for a screening colonoscopy performed for an individual who is at high risk for colorectal cancer as described in paragraph (a)(3) of this section, after at least 23 months have passed following the month in which the last screening colonoscopy was performed, or, as provided in paragraphs (h) and (i) of this section, the last screening barium enema was performed.
(4) In the case of an individual who is not at high risk for colorectal cancer as described in paragraph (a)(3) of this section but who has had a screening flexible sigmoidoscopy performed, payment may be made for a screening colonoscopy only after at least 47 months have passed following the month in which the last screening flexible sigmoidoscopy was performed.
* * * * *7. Section 410.46 is added to read as follows:
End Amendment PartPhysician and other practitioner services furnished in or at the direction of an IHS or Indian tribal hospital or clinic: Scope and conditions.(a) Medicare Part B pays, in accordance with the physician fee schedule, for services furnished in or at the direction of a hospital or outpatient clinic (provider-based or free-standing) that is operated by the Indian Health Service (IHS) or by an Indian tribe or tribal organization (as those terms are defined in section 4 of the Indian Health Care Improvement Act). These services are subject to the same situations, terms, and conditions that would apply if the services were furnished in or at the direction of a hospital or clinic that is not operated by IHS or by an Indian tribe or tribal organization. Payments include health professional shortage areas incentive payments when the requirements for these incentive payments in § 414.42 of this chapter are met.
(b) Payment is not made under this section to the extent that Medicare otherwise pays for the same services under other provisions.
(c) Payment is made under these provisions for the following services:
(1) Services for which payment is made under the physician fee schedule in accordance with part 414 of this chapter.
(2) Services furnished by non-physician practitioners for which payment under Part B is made under the physician fee schedule.
(3) Services furnished by a physical therapist or occupational therapist, for which payment under Part B is made under the physician fee schedule.
(d) Payments under these provisions will be paid to the IHS or tribal hospital or clinic.
8. In § 410.56, paragraphs (b)(1), the introductory text of (b)(2), and (b)(3) are revised to read as follows:
End Amendment PartScreening pelvic examinations.* * * * *Start Printed Page 55330(b) * * *
(1) General rule. Except as specified in paragraphs (b)(2) and (b)(3) of this section, payment may be made for a pelvic examination performed on an asymptomatic woman only if the individual has not had a pelvic examination paid for by Medicare during the preceding 23 months following the month in which her last Medicare-covered screening pelvic examination was performed.
(2) More frequent screening based on high-risk factors. Subject to the limitation as specified in paragraph (b)(4) of this section, payment may be made for a screening pelvic examination performed more frequently than once every 24 months if the test is performed by a physician or other practitioner specified in paragraph (a) of this section, and there is evidence that the woman is at high risk (on the basis of her medical history or other findings) of developing cervical cancer or vaginal cancer, as determined in accordance with the following risk factors:
* * * * *(3) More frequent screening for women of childbearing age. Subject to the limitation as specified in paragraph (b)(4) of this section, payment may be made for a screening pelvic examination performed more frequently than once every 24 months if the test is performed by a physician or other practitioner as specified in paragraph (a) of this section for a woman of childbearing age who has had an examination that indicated the presence of cervical or vaginal cancer or other abnormality during any of the preceding 3 years. The term “woman of childbearing age” means a woman who is premenopausal, and has been determined by a physician, or a qualified practitioner, as specified in paragraph (a) of this section, to be of childbearing age, based on her medical history or other findings.
* * * * *9. Section 410.78 is revised to read as follows:
End Amendment PartOffice and other outpatient visits, consultation, individual psychotherapy and pharmacologic management via an interactive telecommunications system.(a) Definitions. For the purposes of this section the following definitions apply:
(1) Asynchronous store and forward technologies means the transmission of a patient's medical information from an originating site to the physician or practitioner at the distant site. The physician or practitioner at the distant site can review the medical case without the patient being present. An asynchronous telecommunications system in single media format does not include telephone calls, images transmitted via facsimile machines and text messages without visualization of the patient (electronic mail). Photographs visualized by a telecommunications system must be specific to the patient's medical condition and adequate for furnishing or confirming a diagnosis and or treatment plan. Dermatological photographs, for example, a photograph of a skin lesion, may be considered to meet the requirement of a single media format under this provision.
(2) Distant site means the site at which the physician or practitioner delivering the service is located at the time the service is provided via a telecommunications system.
(3) Interactive telecommunications system means multimedia communications equipment that includes, at a minimum, audio and video equipment permitting two-way, real-time interactive communication between the patient and distant site physician or practitioner. Telephones, facsimile machines, and electronic mail systems do not meet the definition of an interactive telecommunications system.
(4) Originating site means, for purposes of a consultation, office or other outpatient visit, individual psychotherapy, or pharmacologic management via an interactive telecommunications system, the location of an eligible Medicare beneficiary at the time the service being furnished via a telecommunications system occurs. For asynchronous store and forward telecommunications technologies, the only originating sites are Federal telemedicine demonstration programs conducted in Alaska or Hawaii.
(b) General rule. Medicare Part B pays for office and other outpatient visits, professional consultation, individual psychotherapy, and pharmacologic management furnished by means of an interactive telecommunications system if the following conditions are met:
(1) The physician or practitioner at the distant site must be licensed to provide the service under State law. When the physician or practitioner at the distant site is licensed under State law to provide a covered telehealth service (that is, professional consultations, office and other outpatient visits, individual psychotherapy, and pharmacologic management), he or she may bill for, and receive payment for, this service when delivered via a telecommunications system.
(2) The practitioner at the distant site is one of the following:
(i) A physician as described in § 410.20.
(ii) A physician assistant as described § 410.74.
(iii) A nurse practitioner as described in § 410.75.
(iv) A clinical nurse specialist as described in § 410.76.
(v) A nurse-midwife as described in § 410.77.
(vi) A clinical psychologist as described in § 410.71.
(vii) A clinical social worker as described in § 410.73.
(3) The services are furnished to a beneficiary at an originating site, which is one of the following:
(i) The office of a physician or practitioner.
(ii) A critical access hospital (as described in section 1861(mm)(1) of the Act).
(iii) A rural health clinic (as described in section 1861(aa)(2) of the Act).
(iv) A Federally qualified health center (as defined in section 1861(aa)(4) of the Act).
(v) A hospital (as defined in section 1861(e) of the Act).
(4) Originating sites must be located in either a rural health professional shortage area as defined under section 332(a)(1)(A) of the Public Health Service Act (42 U.S.C. 254e(a)(1)(A)) or in a county that is not included in a Metropolitan Statistical Area as defined in section 1886(d)(2)(D) of the Act. Entities participating in a Federal telemedicine demonstration project that have been approved by, or receive funding from, the Secretary as of December 31, 2000 qualify as an eligible originating site regardless of geographic location.
(5) The medical examination of the patient is under the control of the physician or practitioner at the distant site.
(c) Telepresenter not required. A telepresenter is not required as a condition of payment unless a telepresenter is medically necessary as determined by the physician or practitioner at the distant site.
(d) Exception to the interactive telecommunications system requirement. For Federal telemedicine demonstration programs conducted in Alaska or Hawaii only, Medicare payment is permitted for telehealth when asynchronous store and forward technologies, in single or multimedia formats, are used as a substitute for an interactive telecommunications system.
(e) Limitation. A clinical psychologist and a clinical social worker may bill and receive payment for individual psychotherapy via a telecommunications system, but may Start Printed Page 55331not seek payment for medical evaluation and management services.
10. A new subpart G is added to read as follows:
End Amendment PartSubpart G—Medical Nutrition Therapy
Definitions.For the purposes of this subpart, the following definitions apply:
Chronic renal insufficiency means the stage of renal disease associated with a reduction in renal function not severe enough to require dialysis or transplantation (glomerular filtration rate [GFR] 13-50 ml/min/1.73m2).
Diabetes means diabetes mellitus consisting of two types. Type 1 is an autoimmune disease that destroys the beta cells of the pancreas, leading to insulin deficiency. Type 2 is familial hyperglycemia that occurs primarily in adults but can also occur in children and adolescents. It is caused by an insulin resistance whose etiology is multiple and not totally understood. Gestational diabetes is any degree of glucose intolerance with onset or first recognition during pregnancy. The diagnostic criterion for a diagnosis of diabetes for a fasting glucose tolerance test is greater than or equal to 126 mg/dL.
Episode of care means services covered in a 12-month time period when coordinated with initial diabetes self-management training (DSMT) and one calendar year for each year thereafter, starting with the assessment and including all covered interventions based on referral(s) from a physician as specified in § 410.132(c). The time period covered for gestational diabetes extends only until the pregnancy ends.
Medical nutrition therapy services means nutritional diagnostic, therapeutic, and counseling services provided by a registered dietitian or nutrition professional for the purpose of managing diabetes or a renal disease.
Physician means a doctor of medicine or osteopathy legally authorized to practice medicine and surgery by the State in which he or she performs such function or action (including a physician within the meaning of section of 1101(a)(7) of the Act).
Renal disease means chronic renal insufficiency, end-stage renal disease when dialysis is not received, or the medical condition of a beneficiary for 36 months after kidney transplant.
Treating physician means the primary care physician or specialist coordinating care for the beneficiary with diabetes or renal disease.
Medical nutrition therapy.(a) Conditions for coverage of MNT services. Medicare Part B pays for MNT services provided by a registered dietitian or nutrition professional as defined in § 410.134 when the beneficiary is referred for the service by the treating physician. Services covered consist of face-to-face nutritional assessments and interventions in accordance with nationally accepted dietary or nutritional protocols.
(b) Limitations on coverage of MNT services.
(1) MNT services based on a diagnosis of renal disease as described in this subpart are not covered for beneficiaries receiving maintenance dialysis for which payment is made under section 1881 of the Act.
(2) A beneficiary may only receive the maximum number of hours covered under the DSMT benefit for both DSMT and MNT during the initial DSMT training period unless additional hours are determined to be medically necessary under the national coverage determination process.
(3) In years when the beneficiary is eligible for MNT and follow-up DSMT, the beneficiary may only receive the maximum number of hours covered under MNT unless additional hours are determined to be medically necessary under the national coverage determination process.
(4) If a beneficiary has both diabetes and renal disease, the beneficiary may only receive the maximum number of hours covered under the renal MNT benefit in one episode of care unless he or she is receiving initial DSMT services, in which case the beneficiary would receive whichever is greater.
(5) An exception to the maximum number of hours in (b)(2), (3), and (4) of this section may be made when the treating physician determines that there is a change of diagnosis, medical condition, or treatment regimen related to diabetes or renal disease that requires a change in MNT during an episode of care.
(c) Referrals. Referral may only be made by the treating physician when the beneficiary has been diagnosed with diabetes or renal disease as defined in this subpart with documentation maintained by the referring physician in the beneficiary's medical record. Referrals must be made for each episode of care and any additional assessments or interventions required by a change of diagnosis, medical condition, or treatment regimen during an episode of care.
Provider qualifications.For Medicare Part B coverage of MNT, only a registered dietitian or nutrition professional may provide the services. “Registered dietitian or nutrition professional” means an individual who, on or after December 22, 2000:
(a) Holds a bachelor's or higher degree granted by a regionally accredited college or university in the United States (or an equivalent foreign degree) with completion of the academic requirements of a program in nutrition or dietetics accredited by an appropriate national accreditation organization recognized for this purpose.
(b) Has completed at least 900 hours of supervised dietetics practice under the supervision of a registered dietitian or nutrition professional.
(c) Is licensed or certified as a dietitian or nutrition professional by the State in which the services are performed. In a State that does not provide for licensure or certification, the individual will be deemed to have met this requirement if he or she is recognized as a “registered dietitian” by the Commission on Dietetic Registration or its successor organization, or meets the requirements of paragraphs (a) and (b) of this section.
(d) Exceptions.
(i) A dietitian or nutritionist licensed or certified in a State as of December 21, 2000 is not required to meet the requirements of (a) and (b) of this section.
(ii) A “registered dietician” in good standing, as recognized by the Commission of Dietetic Registration or its successor organization, is deemed to have met the requirements of (a) and (b) of this section.
PART 411—EXCLUSIONS FROM MEDICARE AND LIMITATIONS ON MEDICARE PAYMENT
End Part Start Amendment Part1. The authority citation for part 411 continues to read as follows:
End Amendment Part Start Amendment Part2. In § 411.15, paragraph (a)(1) is revised, and a new paragraph (k)(10) is added to read as follows:
End Amendment PartParticular services excluded from coverage.* * * * *(a) * * *
(1) Examinations performed for a purpose other than treatment or diagnosis of a specific illness, symptoms, complaint, or injury, except for screening mammography, colorectal cancer screening tests, screening pelvic examinations, prostate cancer screening Start Printed Page 55332tests, or glaucoma screening exams that meet the criteria specified in paragraphs (k)(6) through (k)(10) of this section.
* * * * *(k) * * *
(10) In the case of screening exams for glaucoma, for the purpose of early detection of glaucoma, subject to the conditions and limitations specified in § 410.23 of this chapter.
* * * * *PART 414—PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES
End Part Start Amendment Part1. The authority citation for part 414 continues to read as follows:
End Amendment Part Start Amendment Part2. In 414.2, the definition of “Physician services” is amended by adding a new paragraph (8) to read as follows:
End Amendment PartDefinitions.* * * * *Physician Services * * *
(8) Screening mammography services.
* * * * *3. A new § 414.64 is added to read as follows:
End Amendment PartPayment for medical nutrition therapy.(a) Payment under the physician fee schedule. Medicare payment for medical nutrition therapy is made under the physician fee schedule in accordance with subpart B of this part. Payment to non-physician professionals, as specified in paragraph (b) of this section, is the lesser of the actual charges or 80 percent of 85 percent of the physician fee schedule amount.
(b) To whom payment may be made. Payment may be made to a registered dietician or nutrition professional qualified to furnish medical nutrition therapy in accordance with part 410, subpart G of this chapter.
(c) Effective date of payment. Medicare pays suppliers of medical nutrition therapy on or after the effective date of enrollment of the supplier at the carrier.
(d) Limitation on payment. Payment is made only for documented nutritional therapy sessions actually attended by the beneficiary.
(e) Other conditions for fee-for-service payment. Payment is made only if the beneficiary:
(1) Is not an inpatient of a hospital, SNF, nursing home, or hospice.
(2) Is not receiving services in an RHC, FQHC or ESRD dialysis facility.
4. Section 414.65 is revised to read as follows:
End Amendment PartPayment for office or other outpatient visits, consultation, individual psychotherapy, and pharmacologic management via interactive telecommunications systems.(a) Professional service. Medicare payment for the professional service via an interactive telecommunications system is made according to the following limitations:
(1) The Medicare payment amount for office or other outpatient visits, consultation, individual psychotherapy, and pharmacologic management via an interactive telecommunications system is equal to the current fee schedule amount applicable to services of the physician or practitioner.
(2) Only the physician or practitioner at the distant site may bill and receive payment for the professional service via an interactive telecommunications system.
(3) Payments made to the physician or practitioner at the distant site, including deductible and coinsurance, for the professional service may not be shared with the referring practitioner or telepresenter.
(b) Originating site facility fee. For office or other outpatient visits, consultation, individual psychotherapy, or pharmacologic management services delivered via an interactive telecommunications system furnished on or after October 1, 2001:
(1) For services furnished on or after October 1, 2001 through December 31, 2002, the payment amount to the originating site is the lesser of the actual charge or the originating site facility fee of $20. For services furnished on or after January 1 of each subsequent year, the facility fee for the originating site will be updated by the Medicare Economic Index (MEI) as defined in section 1842(i)(3) of the Act.
(2) Only the originating site may bill for the originating site facility fee and only on an assignment-related basis. The distant site physician or practitioner may not bill for or receive payment for facility fees associated with the professional service furnished via an interactive telecommunications system.
(c) Deductible and coinsurance apply. The payment for the professional service and originating site facility fee is subject to the coinsurance and deductible requirements of sections 1833(a)(1) and (b) of the Act.
(d) Assignment required for physicians, practitioners, and originating sites. Payment to physicians, practitioners, and originating sites is made only on an assignment-related basis.
(e) Sanctions. A distant site practitioner or originating site facility may be subject to the applicable sanctions provided for in chapter IV, part 402 and chapter V, parts 1001, 1002, and 1003 of this title if he or she does any of the following:
(1) Knowingly and willfully bills or collects for services in violation of the limitation of this section.
(2) Fails to timely correct excess charges by reducing the actual charge billed for the service in an amount that does not exceed the limiting charge for the service or fails to timely refund excess collections.
(3) Fails to submit a claim on a standard form for services provided for which payment is made on a fee schedule basis.
(4) Imposes a charge for completing and submitting the standard claims form.
PART 415—SERVICES FURNISHED BY PHYSICIANS IN PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS
End Part Start Amendment Part1. The authority citation for part 415 continues to read as follows:
End Amendment Part Start Amendment Part2. Section 415.130 is amended by:
End Amendment Part Start Amendment PartA. Redesignating paragraphs (a), (b), and (c) as paragraphs (b), (c), and (d).
End Amendment Part Start Amendment PartB. Adding a new paragraph (a).
End Amendment Part Start Amendment PartC. Amending newly designated paragraph (b)(3) by removing the reference “paragraph (b)” and adding “paragraph (c)” in its place.
End Amendment Part Start Amendment PartD. Amending newly designated paragraph (b)(4) by removing the reference “paragraphs (b)(1), (b)(3), and (b)(4)” and adding “paragraphs (c)(1), (c)(3), and (c)(4)” in their place.
End Amendment Part Start Amendment PartE. Revising newly designated paragraph (d).
End Amendment PartConditions for payment: Physician pathology services.(a) Definitions. The following definitions are used in this section.
(1) Covered hospital means, with respect to an inpatient or an outpatient, a hospital that had an arrangement with an independent laboratory that was in effect as of July 22, 1999, under which a laboratory furnished the technical component of physician pathology services to fee-for-service Medicare beneficiaries who were hospital inpatients or outpatients, and submitted claims for payment for this technical component directly to a Medicare carrier.
(2) Fee-for-service Medicare beneficiaries means those beneficiaries who are entitled to benefits under Part Start Printed Page 55333A or are enrolled under Part B of Title XVIII of the Act or both and are not enrolled in any of the following:
(i) A Medicare+Choice plan under Part C of Title XVIII of the Act.
(ii) A plan offered by an eligible organization under section 1876 of the Act;
(iii) A program of all-inclusive care for the elderly (PACE) under 1894 of the Act; or
(iv) A social health maintenance organization (SHMO) demonstration project established under section 4018(b) of the Omnibus Budget Reconciliation Act of 1987.
* * * * *(d) Physician pathology services furnished by an independent laboratory. The technical component of physician pathology services furnished by an independent laboratory to a hospital inpatient or outpatient before January 1, 2001 may be paid to the laboratory on a fee schedule basis. After December 31, 2000 but before January 1, 2003, if an independent laboratory furnishes the technical component of a physician pathology service to a fee-for-service Medicare beneficiary who is an inpatient or outpatient of a covered hospital, the carrier will treat the technical component as a service for which payment will be made to the laboratory under the physician fee schedule. For these two years the service will not be treated as an inpatient hospital service for which payment is made to the hospital under section 1886(d) of the Act or as an outpatient hospital service for which payment is made to the hospital under section 1833(t) of the Act. After December 31, 2002, the technical component for physician pathology services furnished by an independent laboratory to a hospital inpatient or outpatient is paid only to the hospital.
(Catalog of Federal Domestic Assistance Program No. 93.774, Medicare—Supplementary Medical Insurance Program)
Dated: October 22, 2001.
Thomas A. Scully,
Administrator, Centers for Medicare & Medicaid Services.
Approved: October 24, 2001.
Tommy G. Thompson,
Secretary.
Note:
These addenda will not appear in the Code of Federal Regulations.
Addendum A—Explanation and Use of Addenda B
The addenda on the following pages provide various data pertaining to the Medicare fee schedule for physicians' services furnished in 2002. Addendum B contains the RVUs for work, non-facility practice expense, facility practice expense, and malpractice expense, and other information for all services included in the physician fee schedule.
Addendum B—2002 Relative Value Units and Related Information Used in Determining Medicare Payments for 2002
This addendum contains the following information for each CPT code and alphanumeric HCPCS code, except for alphanumeric codes beginning with B (enteral and parenteral therapy), E (durable medical equipment), K (temporary codes for nonphysicians' services or items), or L (orthotics), and codes for anesthesiology.
1. CPT/HCPCS code. This is the CPT or alphanumeric HCPCS number for the service. Alphanumeric HCPCS codes are included at the end of this addendum.
2. Modifier. A modifier is shown if there is a technical component (modifier TC) and a professional component (PC) (modifier −26) for the service. If there is a PC and a TC for the service, Addendum B contains three entries for the code: One for the global values (both professional and technical); one for modifier −26 (PC); and one for modifier TC. The global service is not designated by a modifier, and physicians must bill using the code without a modifier if the physician furnishes both the PC and the TC of the service.
Modifier −53 is shown for a discontinued procedure. There will be RVUs for the code (CPT code 45378) with this modifier.
3. Status indicator. This indicator shows whether the CPT/HCPCS code is in the physician fee schedule and whether it is separately payable if the service is covered.
A = Active code. These codes are separately payable under the fee schedule if covered. There will be RVUs for codes with this status. The presence of an “A” indicator does not mean that Medicare has made a national decision regarding the coverage of the service. Carriers remain responsible for coverage decisions in the absence of a national Medicare policy.
B = Bundled code. Payment for covered services is always bundled into payment for other services not specified. If RVUs are shown, they are not used for Medicare payment. If these services are covered, payment for them is subsumed by the payment for the services to which they are incident. (An example is a telephone call from a hospital nurse regarding care of a patient.)
C = Carrier-priced code. Carriers will establish RVUs and payment amounts for these services, generally on a case-by-case basis following review of documentation, such as an operative report.
D = Deleted code. These codes are deleted effective with the beginning of the calendar year.
E = Excluded from physician fee schedule by regulation. These codes are for items or services that we chose to exclude from the physician fee schedule payment by regulation. No RVUs are shown, and no payment may be made under the physician fee schedule for these codes. Payment for them, if they are covered, continues under reasonable charge or other payment procedures.
G = Code not valid for Medicare purposes. Medicare does not recognize codes assigned this status. Medicare uses another code for reporting of, and payment for, these services.
H = Deleted modifier (code used to have modifier of TC and PC).
I = Code not valid for Medicare purposes. Medicare does not recognize codes assigned this status. Medicare uses another code for the reporting of, and payment for, these services. This indicator is treated in the same manner as status indicator “G”. It's use allows for more efficient processing of Medicare claims.
N = Noncovered service. These codes are noncovered services. Medicare payment may not be made for these codes. If RVUs are shown, they are not used for Medicare payment.
P = Bundled or excluded code. There are no RVUs for these services. No separate payment should be made for them under the physician fee schedule.
—If the item or service is covered as incident to a physician's service and is furnished on the same day as a physician's service, payment for it is bundled into the payment for the physician's service to which it is incident (an example is an elastic bandage furnished by a physician incident to a physician's service).
—If the item or service is covered as other than incident to a physician's service, it is excluded from the physician fee schedule (for example, colostomy supplies) and is paid under the other payment provisions of the Act.
R = Restricted coverage. Special coverage instructions apply. If the service is covered and no RVUs are shown, it is carrier-priced.
T = There are RVUs for these services, but they are only paid if there are no other services payable under the physician fee schedule billed on the same date by the same provider. If any other services payable under the physician fee schedule are billed on the same date by the same provider, these Start Printed Page 55334services are bundled into the service(s) for which payment is made.
X = Exclusion by law. These codes represent an item or service that is not within the definition of “physicians' services” for physician fee schedule payment purposes. No RVUs are shown for these codes, and no payment may be made under the physician fee schedule. (Examples are ambulance services and clinical diagnostic laboratory services.)
4. Description of code. This is an abbreviated version of the narrative description of the code.
5. Physician work RVUs. These are the RVUs for the physician work for this service in 2000. Codes that are not used for Medicare payment are identified with a “+.”
6. Facility practice expense RVUs. These are the fully implemented resource-based practice expense RVUs for facility settings.
7. Non-facility practice expense RVUs. These are the fully implemented resource-based practice expense RVUs for non-facility settings.
8. Malpractice expense RVUs. These are the RVUs for the malpractice expense for the service for 2000.
9. Facility total. This is the sum of the work, fully implemented facility practice expense, and malpractice expense RVUs.
10. Non-facility total. This is the sum of the work, fully implemented non-facility practice expense, and malpractice expense RVUs.
11. Global period. This indicator shows the number of days in the global period for the code (0, 10, or 90 days). An explanation of the alpha codes follows:
MMM = The code describes a service furnished in uncomplicated maternity cases including antepartum care, delivery, and postpartum care. The usual global surgical concept does not apply. See the 1999 Physicians' Current Procedural Terminology for specific definitions.
XXX = The global concept does not apply.
YYY = The global period is to be set by the carrier (for example, unlisted surgery codes).
ZZZ = The code is part of another service and falls within the global period for the other service.
—————————— 1 CPT codes and descriptions only are copyright 2001 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved. 3 +Indicates RVUs are not used for Medicare payment.Start Printed Page 55334Start Printed Page 55497Addendum B.—Relative Value Units (RVUs) and Related Information
CPT 1/HCPCS 2 MOD Status Description Physician work RVUs 3 Fully implemented non-facility PE RVUs Fully implemented facility PE RVUs Mal- practice RVUs Fully implemented non-facility total Fully implemented facility total Global 0001T C Endovas repr abdo ao aneurys 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0002T C Endovas repr abdo ao aneurys 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0003T C Cervicography 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0005T C Perc cath stent/brain cv art 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0006T C Perc cath stent/brain cv art 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0007T C Perc cath stent/brain cv art 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0008T C Upper gi endoscopy w/suture 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0009T C Endometrial cryoablation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0010T C Tb test, gamma interferon 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0012T C Osteochondral knee autograft 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0013T C Osteochondral knee allograft 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0014T C Meniscal transplant, knee 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0016T C Thermotx choroid vasc lesion 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0017T C Photocoagulat macular drusen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0018T C Transcranial magnetic stimul 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0019T C Extracorp shock wave tx, ms 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0020T C Extracorp shock wave tx, ft 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0021T C Fetal oximetry, trnsvag/cerv 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0023T C Phenotype drug test, hiv 1 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0024T C Transcath cardiac reduction 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0025T C Ultrasonic pachymetry 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0026T C Measure remnant lipoproteins 0.00 0.00 0.00 0.00 0.00 0.00 XXX 10021 A Fna w/o image 1.27 1.02 NA 0.10 2.39 NA XXX 10021 26 A Fna w/o image 1.27 0.55 0.55 0.07 1.89 1.89 XXX 10021 TC A Fna w/o image 0.00 0.47 NA 0.03 0.50 NA XXX 10022 A Fna w/image 1.27 1.11 NA 0.08 2.46 NA XXX 10022 26 A Fna w/image 1.27 0.48 0.48 0.05 1.80 1.80 XXX 10022 TC A Fna w/image 0.00 0.63 NA 0.03 0.66 NA XXX 10040 A Acne surgery 1.18 1.00 0.54 0.05 2.23 1.77 010 10060 A Drainage of skin abscess 1.17 1.51 0.70 0.08 2.76 1.95 010 10061 A Drainage of skin abscess 2.40 1.88 1.48 0.17 4.45 4.05 010 10080 A Drainage of pilonidal cyst 1.17 2.18 0.75 0.09 3.44 2.01 010 10081 A Drainage of pilonidal cyst 2.45 3.02 1.61 0.19 5.66 4.25 010 10120 A Remove foreign body 1.22 1.52 0.36 0.10 2.84 1.68 010 10121 A Remove foreign body 2.69 2.99 1.83 0.25 5.93 4.77 010 10140 A Drainage of hematoma/fluid 1.53 1.54 0.90 0.15 3.22 2.58 010 10160 A Puncture drainage of lesion 1.20 0.74 0.43 0.11 2.05 1.74 010 10180 A Complex drainage, wound 2.25 1.51 1.33 0.25 4.01 3.83 010 11000 A Debride infected skin 0.60 0.66 0.24 0.05 1.31 0.89 000 11001 A Debride infected skin add-on 0.30 0.37 0.11 0.02 0.69 0.43 ZZZ 11010 A Debride skin, fx 4.20 2.53 2.10 0.45 7.18 6.75 010 11011 A Debride skin/muscle, fx 4.95 3.90 2.69 0.53 9.38 8.17 000 11012 A Debride skin/muscle/bone, fx 6.88 5.52 4.35 0.89 13.29 12.12 000 11040 A Debride skin, partial 0.50 0.55 0.22 0.05 1.10 0.77 000 11041 A Debride skin, full 0.82 0.69 0.34 0.08 1.59 1.24 000 11042 A Debride skin/tissue 1.12 1.04 0.47 0.11 2.27 1.70 000Start Printed Page 55335 11043 A Debride tissue/muscle 2.38 2.72 1.42 0.24 5.34 4.04 010 11044 A Debride tissue/muscle/bone 3.06 3.30 1.86 0.34 6.70 5.26 010 11055 R Trim skin lesion 0.43 0.52 0.19 0.02 0.97 0.64 000 11056 R Trim skin lesions, 2 to 4 0.61 0.59 0.26 0.03 1.23 0.90 000 11057 R Trim skin lesions, over 4 0.79 0.66 0.34 0.04 1.49 1.17 000 11100 A Biopsy of skin lesion 0.81 1.49 0.38 0.04 2.34 1.23 000 11101 A Biopsy, skin add-on 0.41 0.71 0.20 0.02 1.14 0.63 ZZZ 11200 A Removal of skin tags 0.77 1.20 0.32 0.04 2.01 1.13 010 11201 A Remove skin tags add-on 0.29 0.53 0.12 0.02 0.84 0.43 ZZZ 11300 A Shave skin lesion 0.51 1.05 0.22 0.03 1.59 0.76 000 11301 A Shave skin lesion 0.85 1.12 0.39 0.04 2.01 1.28 000 11302 A Shave skin lesion 1.05 1.21 0.49 0.05 2.31 1.59 000 11303 A Shave skin lesion 1.24 1.36 0.55 0.06 2.66 1.85 000 11305 A Shave skin lesion 0.67 0.77 0.29 0.04 1.48 1.00 000 11306 A Shave skin lesion 0.99 1.02 0.44 0.05 2.06 1.48 000 11307 A Shave skin lesion 1.14 1.15 0.51 0.05 2.34 1.70 000 11308 A Shave skin lesion 1.41 1.29 0.62 0.07 2.77 2.10 000 11310 A Shave skin lesion 0.73 1.15 0.34 0.04 1.92 1.11 000 11311 A Shave skin lesion 1.05 1.24 0.51 0.05 2.34 1.61 000 11312 A Shave skin lesion 1.20 1.32 0.58 0.06 2.58 1.84 000 11313 A Shave skin lesion 1.62 1.63 0.74 0.09 3.34 2.45 000 11400 A Removal of skin lesion 0.91 1.68 0.36 0.06 2.65 1.33 010 11401 A Removal of skin lesion 1.32 1.83 0.53 0.09 3.24 1.94 010 11402 A Removal of skin lesion 1.61 2.61 0.98 0.12 4.34 2.71 010 11403 A Removal of skin lesion 1.92 2.84 1.12 0.16 4.92 3.20 010 11404 A Removal of skin lesion 2.20 3.02 1.19 0.18 5.40 3.57 010 11406 A Removal of skin lesion 2.76 3.33 1.41 0.25 6.34 4.42 010 11420 A Removal of skin lesion 1.06 1.52 0.44 0.08 2.66 1.58 010 11421 A Removal of skin lesion 1.53 1.84 0.64 0.11 3.48 2.28 010 11422 A Removal of skin lesion 1.76 2.60 1.08 0.14 4.50 2.98 010 11423 A Removal of skin lesion 2.17 3.02 1.26 0.17 5.36 3.60 010 11424 A Removal of skin lesion 2.62 3.20 1.43 0.21 6.03 4.26 010 11426 A Removal of skin lesion 3.78 3.81 1.89 0.34 7.93 6.01 010 11440 A Removal of skin lesion 1.15 2.26 0.53 0.08 3.49 1.76 010 11441 A Removal of skin lesion 1.61 2.48 0.74 0.11 4.20 2.46 010 11442 A Removal of skin lesion 1.87 2.91 1.30 0.14 4.92 3.31 010 11443 A Removal of skin lesion 2.49 3.41 1.64 0.18 6.08 4.31 010 11444 A Removal of skin lesion 3.42 3.92 2.08 0.25 7.59 5.75 010 11446 A Removal of skin lesion 4.49 4.37 2.58 0.30 9.16 7.37 010 11450 A Removal, sweat gland lesion 2.73 4.20 1.03 0.26 7.19 4.02 090 11451 A Removal, sweat gland lesion 3.95 5.23 1.33 0.39 9.57 5.67 090 11462 A Removal, sweat gland lesion 2.51 4.32 0.98 0.23 7.06 3.72 090 11463 A Removal, sweat gland lesion 3.95 5.67 1.67 0.40 10.02 6.02 090 11470 A Removal, sweat gland lesion 3.25 4.97 1.26 0.30 8.52 4.81 090 11471 A Removal, sweat gland lesion 4.41 5.54 1.74 0.40 10.35 6.55 090 11600 A Removal of skin lesion 1.41 2.48 1.08 0.09 3.98 2.58 010 11601 A Removal of skin lesion 1.93 2.52 1.36 0.12 4.57 3.41 010 11602 A Removal of skin lesion 2.09 2.66 1.40 0.13 4.88 3.62 010 11603 A Removal of skin lesion 2.35 2.93 1.49 0.16 5.44 4.00 010 11604 A Removal of skin lesion 2.58 3.27 1.56 0.18 6.03 4.32 010 11606 A Removal of skin lesion 3.43 3.88 1.85 0.28 7.59 5.56 010 11620 A Removal of skin lesion 1.34 2.47 1.09 0.09 3.90 2.52 010 11621 A Removal of skin lesion 1.97 2.56 1.41 0.12 4.65 3.50 010 11622 A Removal of skin lesion 2.34 2.87 1.60 0.15 5.36 4.09 010 11623 A Removal of skin lesion 2.93 3.30 1.86 0.20 6.43 4.99 010 11624 A Removal of skin lesion 3.43 3.72 2.08 0.25 7.40 5.76 010 11626 A Removal of skin lesion 4.30 4.48 2.57 0.35 9.13 7.22 010 11640 A Removal of skin lesion 1.53 2.51 1.29 0.10 4.14 2.92 010 11641 A Removal of skin lesion 2.44 2.94 1.78 0.15 5.53 4.37 010 11642 A Removal of skin lesion 2.93 3.37 2.03 0.18 6.48 5.14 010 11643 A Removal of skin lesion 3.50 3.83 2.32 0.24 7.57 6.06 010 11644 A Removal of skin lesion 4.55 4.81 2.95 0.33 9.69 7.83 010 11646 A Removal of skin lesion 5.95 5.68 3.77 0.46 12.09 10.18 010 11719 R Trim nail(s) 0.17 0.25 0.07 0.01 0.43 0.25 000 11720 A Debride nail, 1-5 0.32 0.34 0.13 0.02 0.68 0.47 000 11721 A Debride nail, 6 or more 0.54 0.44 0.22 0.04 1.02 0.80 000 11730 A Removal of nail plate 1.13 0.83 0.46 0.09 2.05 1.68 000 11732 A Remove nail plate, add-on 0.57 0.30 0.24 0.05 0.92 0.86 ZZZ 11740 A Drain blood from under nail 0.37 0.81 0.14 0.03 1.21 0.54 000 11750 A Removal of nail bed 1.86 1.75 0.78 0.16 3.77 2.80 010 11752 A Remove nail bed/finger tip 2.67 2.20 1.77 0.33 5.20 4.77 010 11755 A Biopsy, nail unit 1.31 1.10 0.60 0.06 2.47 1.97 000 11760 A Repair of nail bed 1.58 1.80 1.28 0.17 3.55 3.03 010Start Printed Page 55336 11762 A Reconstruction of nail bed 2.89 2.28 1.95 0.32 5.49 5.16 010 11765 A Excision of nail fold, toe 0.69 1.14 0.51 0.05 1.88 1.25 010 11770 A Removal of pilonidal lesion 2.61 3.11 1.26 0.24 5.96 4.11 010 11771 A Removal of pilonidal lesion 5.74 5.80 4.01 0.56 12.10 10.31 090 11772 A Removal of pilonidal lesion 6.98 6.95 4.44 0.68 14.61 12.10 090 11900 A Injection into skin lesions 0.52 0.77 0.23 0.02 1.31 0.77 000 11901 A Added skin lesions injection 0.80 0.89 0.38 0.03 1.72 1.21 000 11920 R Correct skin color defects 1.61 2.25 0.81 0.17 4.03 2.59 000 11921 R Correct skin color defects 1.93 2.78 1.02 0.21 4.92 3.16 000 11922 R Correct skin color defects 0.49 0.40 0.26 0.05 0.94 0.80 ZZZ 11950 R Therapy for contour defects 0.84 1.23 0.47 0.06 2.13 1.37 000 11951 R Therapy for contour defects 1.19 1.47 0.49 0.10 2.76 1.78 000 11952 R Therapy for contour defects 1.69 1.65 0.64 0.17 3.51 2.50 000 11954 R Therapy for contour defects 1.85 2.62 0.97 0.19 4.66 3.01 000 11960 A Insert tissue expander(s) 9.08 NA 11.54 0.88 NA 21.50 090 11970 A Replace tissue expander 7.06 NA 5.15 0.77 NA 12.98 090 11971 A Remove tissue expander(s) 2.13 6.10 4.07 0.21 8.44 6.41 090 11975 N Insert contraceptive cap +1.48 1.58 0.59 0.14 3.20 2.21 XXX 11976 R Removal of contraceptive cap 1.78 1.72 0.69 0.17 3.67 2.64 000 11977 N Removal/reinsert contra cap +3.30 2.31 1.32 0.31 5.92 4.93 XXX 11980 A Implant hormone pellet(s) 1.48 1.14 0.58 0.10 2.72 2.16 000 11981 A Insert drug implant device 1.48 1.58 0.59 0.14 3.20 2.21 XXX 11982 A Remove drug implant device 1.78 1.70 0.71 0.17 3.65 2.66 XXX 11983 A Remove/insert drug implant 3.30 2.31 1.32 0.31 5.92 4.93 XXX 12001 A Repair superficial wound(s) 1.70 2.13 0.44 0.13 3.96 2.27 010 12002 A Repair superficial wound(s) 1.86 2.21 0.95 0.15 4.22 2.96 010 12004 A Repair superficial wound(s) 2.24 2.47 1.07 0.17 4.88 3.48 010 12005 A Repair superficial wound(s) 2.86 3.04 1.25 0.23 6.13 4.34 010 12006 A Repair superficial wound(s) 3.67 3.59 1.59 0.31 7.57 5.57 010 12007 A Repair superficial wound(s) 4.12 4.26 1.85 0.37 8.75 6.34 010 12011 A Repair superficial wound(s) 1.76 2.30 0.45 0.14 4.20 2.35 010 12013 A Repair superficial wound(s) 1.99 2.45 0.99 0.16 4.60 3.14 010 12014 A Repair superficial wound(s) 2.46 2.72 1.11 0.18 5.36 3.75 010 12015 A Repair superficial wound(s) 3.19 3.38 1.31 0.24 6.81 4.74 010 12016 A Repair superficial wound(s) 3.93 3.89 1.58 0.32 8.14 5.83 010 12017 A Repair superficial wound(s) 4.71 NA 1.93 0.39 NA 7.03 010 12018 A Repair superficial wound(s) 5.53 NA 2.18 0.46 NA 8.17 010 12020 A Closure of split wound 2.62 2.51 1.44 0.24 5.37 4.30 010 12021 A Closure of split wound 1.84 1.65 1.02 0.19 3.68 3.05 010 12031 A Layer closure of wound(s) 2.15 2.21 0.81 0.15 4.51 3.11 010 12032 A Layer closure of wound(s) 2.47 2.84 1.36 0.15 5.46 3.98 010 12034 A Layer closure of wound(s) 2.92 3.12 1.51 0.21 6.25 4.64 010 12035 A Layer closure of wound(s) 3.43 3.20 1.73 0.30 6.93 5.46 010 12036 A Layer closure of wound(s) 4.05 5.33 2.50 0.41 9.79 6.96 010 12037 A Layer closure of wound(s) 4.67 5.57 2.86 0.49 10.73 8.02 010 12041 A Layer closure of wound(s) 2.37 2.41 0.87 0.17 4.95 3.41 010 12042 A Layer closure of wound(s) 2.74 3.03 1.49 0.17 5.94 4.40 010 12044 A Layer closure of wound(s) 3.14 3.22 1.67 0.24 6.60 5.05 010 12045 A Layer closure of wound(s) 3.64 3.54 1.93 0.34 7.52 5.91 010 12046 A Layer closure of wound(s) 4.25 6.24 2.62 0.40 10.89 7.27 010 12047 A Layer closure of wound(s) 4.65 7.21 2.86 0.41 12.27 7.92 010 12051 A Layer closure of wound(s) 2.47 3.11 1.49 0.16 5.74 4.12 010 12052 A Layer closure of wound(s) 2.77 3.00 1.47 0.17 5.94 4.41 010 12053 A Layer closure of wound(s) 3.12 3.20 1.63 0.20 6.52 4.95 010 12054 A Layer closure of wound(s) 3.46 3.52 1.72 0.25 7.23 5.43 010 12055 A Layer closure of wound(s) 4.43 4.49 2.27 0.35 9.27 7.05 010 12056 A Layer closure of wound(s) 5.24 7.31 3.26 0.43 12.98 8.93 010 12057 A Layer closure of wound(s) 5.96 6.31 3.66 0.50 12.77 10.12 010 13100 A Repair of wound or lesion 3.12 3.39 1.93 0.21 6.72 5.26 010 13101 A Repair of wound or lesion 3.92 3.59 2.39 0.22 7.73 6.53 010 13102 A Repair wound/lesion add-on 1.24 0.75 0.60 0.10 2.09 1.94 ZZZ 13120 A Repair of wound or lesion 3.30 3.48 1.95 0.23 7.01 5.48 010 13121 A Repair of wound or lesion 4.33 3.84 2.52 0.25 8.42 7.10 010 13122 A Repair wound/lesion add-on 1.44 0.89 0.67 0.12 2.45 2.23 ZZZ 13131 A Repair of wound or lesion 3.79 3.75 2.30 0.25 7.79 6.34 010 13132 A Repair of wound or lesion 5.95 4.57 3.38 0.32 10.84 9.65 010 13133 A Repair wound/lesion add-on 2.19 1.23 1.08 0.17 3.59 3.44 ZZZ 13150 A Repair of wound or lesion 3.81 5.19 2.75 0.29 9.29 6.85 010 13151 A Repair of wound or lesion 4.45 5.07 3.19 0.28 9.80 7.92 010 13152 A Repair of wound or lesion 6.33 5.78 4.14 0.38 12.49 10.85 010 13153 A Repair wound/lesion add-on 2.38 1.38 1.20 0.18 3.94 3.76 ZZZ 13160 A Late closure of wound 10.48 NA 6.47 1.19 NA 18.14 090 14000 A Skin tissue rearrangement 5.89 7.58 4.83 0.46 13.93 11.18 090Start Printed Page 55337 14001 A Skin tissue rearrangement 8.47 8.72 6.18 0.65 17.84 15.30 090 14020 A Skin tissue rearrangement 6.59 8.05 5.56 0.50 15.14 12.65 090 14021 A Skin tissue rearrangement 10.06 9.29 7.38 0.69 20.04 18.13 090 14040 A Skin tissue rearrangement 7.87 8.19 6.27 0.53 16.59 14.67 090 14041 A Skin tissue rearrangement 11.49 9.90 8.17 0.68 22.07 20.34 090 14060 A Skin tissue rearrangement 8.50 8.64 7.13 0.59 17.73 16.22 090 14061 A Skin tissue rearrangement 12.29 10.85 9.08 0.75 23.89 22.12 090 14300 A Skin tissue rearrangement 11.76 10.11 8.68 0.88 22.75 21.32 090 14350 A Skin tissue rearrangement 9.61 NA 6.48 1.09 NA 17.18 090 15000 A Skin graft 4.00 2.51 1.91 0.37 6.88 6.28 000 15001 A Skin graft add-on 1.00 0.64 0.43 0.11 1.75 1.54 ZZZ 15050 A Skin pinch graft 4.30 4.98 4.12 0.46 9.74 8.88 090 15100 A Skin split graft 9.05 6.27 6.26 0.94 16.26 16.25 090 15101 A Skin split graft add-on 1.72 1.40 0.76 0.18 3.30 2.66 ZZZ 15120 A Skin split graft 9.83 8.62 6.97 0.87 19.32 17.67 090 15121 A Skin split graft add-on 2.67 1.83 1.23 0.27 4.77 4.17 ZZZ 15200 A Skin full graft 8.03 9.90 5.64 0.73 18.66 14.40 090 15201 A Skin full graft add-on 1.32 1.00 0.68 0.14 2.46 2.14 ZZZ 15220 A Skin full graft 7.87 9.38 6.47 0.68 17.93 15.02 090 15221 A Skin full graft add-on 1.19 0.92 0.60 0.12 2.23 1.91 ZZZ 15240 A Skin full graft 9.04 9.01 7.27 0.77 18.82 17.08 090 15241 A Skin full graft add-on 1.86 1.47 0.95 0.17 3.50 2.98 ZZZ 15260 A Skin full graft 10.06 9.01 7.74 0.63 19.70 18.43 090 15261 A Skin full graft add-on 2.23 1.59 1.16 0.17 3.99 3.56 ZZZ 15342 A Cultured skin graft, 25 cm 1.00 2.18 1.04 0.09 3.27 2.13 010 15343 A Cultured skin graft addl 25 cm 0.25 0.42 0.10 0.02 0.69 0.37 ZZZ 15350 A Skin homograft 4.00 7.78 4.23 0.42 12.20 8.65 090 15351 A Skin homograft add-on 1.00 0.85 0.42 0.11 1.96 1.53 ZZZ 15400 A Skin heterograft 4.00 4.89 4.89 0.40 9.29 9.29 090 15401 A Skin heterograft add-on 1.00 1.59 0.47 0.11 2.70 1.58 ZZZ 15570 A Form skin pedicle flap 9.21 7.80 6.37 0.96 17.97 16.54 090 15572 A Form skin pedicle flap 9.27 8.08 6.34 0.93 18.28 16.54 090 15574 A Form skin pedicle flap 9.88 8.61 7.14 0.92 19.41 17.94 090 15576 A Form skin pedicle flap 8.69 8.89 6.55 0.72 18.30 15.96 090 15600 A Skin graft 1.91 6.66 2.51 0.19 8.76 4.61 090 15610 A Skin graft 2.42 5.90 2.67 0.25 8.57 5.34 090 15620 A Skin graft 2.94 7.04 3.54 0.28 10.26 6.76 090 15630 A Skin graft 3.27 6.09 3.83 0.28 9.64 7.38 090 15650 A Transfer skin pedicle flap 3.97 5.69 3.99 0.36 10.02 8.32 090 15732 A Muscle-skin graft, head/neck 17.84 NA 11.63 1.50 NA 30.97 090 15734 A Muscle-skin graft, trunk 17.79 NA 11.49 1.91 NA 31.19 090 15736 A Muscle-skin graft, arm 16.27 NA 11.14 1.78 NA 29.19 090 15738 A Muscle-skin graft, leg 17.92 NA 11.47 1.95 NA 31.34 090 15740 A Island pedicle flap graft 10.25 8.74 7.20 0.62 19.61 18.07 090 15750 A Neurovascular pedicle graft 11.41 NA 8.45 1.12 NA 20.98 090 15756 A Free muscle flap, microvasc 35.23 NA 22.50 3.11 NA 60.84 090 15757 A Free skin flap, microvasc 35.23 NA 22.54 3.37 NA 61.14 090 15758 A Free fascial flap, microvasc 35.10 NA 22.75 3.52 NA 61.37 090 15760 A Composite skin graft 8.74 9.27 6.93 0.72 18.73 16.39 090 15770 A Derma-fat-fascia graft 7.52 NA 6.14 0.78 NA 14.44 090 15775 R Hair transplant punch grafts 3.96 3.12 1.60 0.43 7.51 5.99 000 15776 R Hair transplant punch grafts 5.54 3.97 2.97 0.60 10.11 9.11 000 15780 A Abrasion treatment of skin 7.29 6.41 6.13 0.41 14.11 13.83 090 15781 A Abrasion treatment of skin 4.85 5.17 4.83 0.27 10.29 9.95 090 15782 A Abrasion treatment of skin 4.32 4.37 4.09 0.21 8.90 8.62 090 15783 A Abrasion treatment of skin 4.29 5.02 3.51 0.26 9.57 8.06 090 15786 A Abrasion, lesion, single 2.03 1.73 1.29 0.11 3.87 3.43 010 15787 A Abrasion, lesions, add-on 0.33 0.39 0.18 0.02 0.74 0.53 ZZZ 15788 R Chemical peel, face, epiderm 2.09 3.15 1.07 0.11 5.35 3.27 090 15789 R Chemical peel, face, dermal 4.92 5.65 3.32 0.27 10.84 8.51 090 15792 R Chemical peel, nonfacial 1.86 2.87 1.63 0.10 4.83 3.59 090 15793 A Chemical peel, nonfacial 3.74 NA 3.81 0.17 NA 7.72 090 15810 A Salabrasion 4.74 4.04 4.04 0.42 9.20 9.20 090 15811 A Salabrasion 5.39 5.85 5.06 0.52 11.76 10.97 090 15819 A Plastic surgery, neck 9.38 NA 6.24 0.77 NA 16.39 090 15820 A Revision of lower eyelid 5.15 10.34 7.13 0.30 15.79 12.58 090 15821 A Revision of lower eyelid 5.72 11.87 7.34 0.31 17.90 13.37 090 15822 A Revision of upper eyelid 4.45 10.58 6.58 0.22 15.25 11.25 090 15823 A Revision of upper eyelid 7.05 11.38 7.60 0.32 18.75 14.97 090 15824 R Removal of forehead wrinkles 0.00 0.00 0.00 0.00 0.00 0.00 000 15825 R Removal of neck wrinkles 0.00 0.00 0.00 0.00 0.00 0.00 000 15826 R Removal of brow wrinkles 0.00 0.00 0.00 0.00 0.00 0.00 000 15828 R Removal of face wrinkles 0.00 0.00 0.00 0.00 0.00 0.00 000Start Printed Page 55338 15829 R Removal of skin wrinkles 0.00 0.00 0.00 0.00 0.00 0.00 000 15831 A Excise excessive skin tissue 12.40 NA 8.14 1.30 NA 21.84 090 15832 A Excise excessive skin tissue 11.59 NA 8.04 1.21 NA 20.84 090 15833 A Excise excessive skin tissue 10.64 NA 7.34 1.17 NA 19.15 090 15834 A Excise excessive skin tissue 10.85 NA 7.59 1.18 NA 19.62 090 15835 A Excise excessive skin tissue 11.67 NA 7.94 1.13 NA 20.74 090 15836 A Excise excessive skin tissue 9.34 NA 6.51 0.95 NA 16.80 090 15837 A Excise excessive skin tissue 8.43 7.30 6.38 0.78 16.51 15.59 090 15838 A Excise excessive skin tissue 7.13 NA 5.70 0.58 NA 13.41 090 15839 A Excise excessive skin tissue 9.38 7.64 5.97 0.88 17.90 16.23 090 15840 A Graft for face nerve palsy 13.26 NA 10.10 1.15 NA 24.51 090 15841 A Graft for face nerve palsy 23.26 NA 14.68 2.65 NA 40.59 090 15842 A Flap for face nerve palsy 37.96 NA 22.81 3.99 NA 64.76 090 15845 A Skin and muscle repair, face 12.57 NA 8.81 0.80 NA 22.18 090 15850 B Removal of sutures +0.78 1.43 0.31 0.04 2.25 1.13 XXX 15851 A Removal of sutures 0.86 1.64 0.35 0.05 2.55 1.26 000 15852 A Dressing change, not for burn 0.86 1.93 0.36 0.07 2.86 1.29 000 15860 A Test for blood flow in graft 1.95 1.35 0.84 0.13 3.43 2.92 000 15876 R Suction assisted lipectomy 0.00 0.00 0.00 0.00 0.00 0.00 000 15877 R Suction assisted lipectomy 0.00 0.00 0.00 0.00 0.00 0.00 000 15878 R Suction assisted lipectomy 0.00 0.00 0.00 0.00 0.00 0.00 000 15879 R Suction assisted lipectomy 0.00 0.00 0.00 0.00 0.00 0.00 000 15920 A Removal of tail bone ulcer 7.95 NA 5.90 0.83 NA 14.68 090 15922 A Removal of tail bone ulcer 9.90 NA 7.78 1.06 NA 18.74 090 15931 A Remove sacrum pressure sore 9.24 NA 5.89 0.95 NA 16.08 090 15933 A Remove sacrum pressure sore 10.85 NA 8.32 1.14 NA 20.31 090 15934 A Remove sacrum pressure sore 12.69 NA 8.48 1.35 NA 22.52 090 15935 A Remove sacrum pressure sore 14.57 NA 10.12 1.56 NA 26.25 090 15936 A Remove sacrum pressure sore 12.38 NA 8.81 1.32 NA 22.51 090 15937 A Remove sacrum pressure sore 14.21 NA 10.75 1.51 NA 26.47 090 15940 A Remove hip pressure sore 9.34 NA 6.17 0.98 NA 16.49 090 15941 A Remove hip pressure sore 11.43 NA 10.44 1.23 NA 23.10 090 15944 A Remove hip pressure sore 11.46 NA 8.77 1.21 NA 21.44 090 15945 A Remove hip pressure sore 12.69 NA 9.73 1.38 NA 23.80 090 15946 A Remove hip pressure sore 21.57 NA 14.65 2.32 NA 38.54 090 15950 A Remove thigh pressure sore 7.54 NA 5.43 0.80 NA 13.77 090 15951 A Remove thigh pressure sore 10.72 NA 8.07 1.14 NA 19.93 090 15952 A Remove thigh pressure sore 11.39 NA 7.86 1.19 NA 20.44 090 15953 A Remove thigh pressure sore 12.63 NA 9.24 1.38 NA 23.25 090 15956 A Remove thigh pressure sore 15.52 NA 10.71 1.64 NA 27.87 090 15958 A Remove thigh pressure sore 15.48 NA 11.20 1.66 NA 28.34 090 15999 C Removal of pressure sore 0.00 0.00 0.00 0.00 0.00 0.00 YYY 16000 A Initial treatment of burn(s) 0.89 1.09 0.27 0.06 2.04 1.22 000 16010 A Treatment of burn(s) 0.87 1.21 0.37 0.07 2.15 1.31 000 16015 A Treatment of burn(s) 2.35 2.01 1.03 0.22 4.58 3.60 000 16020 A Treatment of burn(s) 0.80 1.20 0.27 0.06 2.06 1.13 000 16025 A Treatment of burn(s) 1.85 1.94 0.69 0.16 3.95 2.70 000 16030 A Treatment of burn(s) 2.08 3.36 0.97 0.18 5.62 3.23 000 16035 A Incision of burn scab, initi 3.75 NA 1.56 0.36 NA 5.67 090 16036 A Incise burn scab, addl incis 1.50 NA 0.62 0.11 NA 2.23 ZZZ 17000 A Detroy benign/premal lesion 0.60 1.10 0.28 0.03 1.73 0.91 010 17003 A Destroy lesions, 2-14 0.15 0.24 0.07 0.01 0.40 0.23 ZZZ 17004 A Destroy lesions, 15 or more 2.79 2.56 1.30 0.12 5.47 4.21 010 17106 A Destruction of skin lesions 4.59 4.88 2.88 0.28 9.75 7.75 090 17107 A Destruction of skin lesions 9.16 6.92 5.28 0.53 16.61 14.97 090 17108 A Destruction of skin lesions 13.20 8.87 7.26 0.89 22.96 21.35 090 17110 A Destruct lesion, 1-14 0.65 1.11 0.26 0.04 1.80 0.95 010 17111 A Destruct lesion, 15 or more 0.92 1.13 0.41 0.04 2.09 1.37 010 17250 A Chemical cautery, tissue 0.50 0.76 0.21 0.04 1.30 0.75 000 17260 A Destruction of skin lesions 0.91 1.37 0.39 0.04 2.32 1.34 010 17261 A Destruction of skin lesions 1.17 1.48 0.56 0.05 2.70 1.78 010 17262 A Destruction of skin lesions 1.58 1.69 0.76 0.07 3.34 2.41 010 17263 A Destruction of skin lesions 1.79 1.80 0.83 0.08 3.67 2.70 010 17264 A Destruction of skin lesions 1.94 1.87 0.87 0.08 3.89 2.89 010 17266 A Destruction of skin lesions 2.34 2.08 1.05 0.11 4.53 3.50 010 17270 A Destruction of skin lesions 1.32 1.57 0.60 0.06 2.95 1.98 010 17271 A Destruction of skin lesions 1.49 1.65 0.72 0.06 3.20 2.27 010 17272 A Destruction of skin lesions 1.77 1.79 0.86 0.07 3.63 2.70 010 17273 A Destruction of skin lesions 2.05 1.93 0.97 0.09 4.07 3.11 010 17274 A Destruction of skin lesions 2.59 2.21 1.20 0.11 4.91 3.90 010 17276 A Destruction of skin lesions 3.20 2.52 1.84 0.15 5.87 5.19 010 17280 A Destruction of skin lesions 1.17 1.41 0.54 0.05 2.63 1.76 010 17281 A Destruction of skin lesions 1.72 1.77 0.83 0.07 3.56 2.62 010Start Printed Page 55339 17282 A Destruction of skin lesions 2.04 1.93 0.99 0.09 4.06 3.12 010 17283 A Destruction of skin lesions 2.64 2.23 1.24 0.11 4.98 3.99 010 17284 A Destruction of skin lesions 3.21 2.52 1.51 0.14 5.87 4.86 010 17286 A Destruction of skin lesions 4.44 3.23 2.52 0.22 7.89 7.18 010 17304 A Chemosurgery of skin lesion 7.60 7.76 3.74 0.31 15.67 11.65 000 17305 A 2nd stage chemosurgery 2.85 3.60 1.40 0.12 6.57 4.37 000 17306 A 3rd stage chemosurgery 2.85 3.64 1.41 0.12 6.61 4.38 000 17307 A Followup skin lesion therapy 2.85 3.62 1.43 0.12 6.59 4.40 000 17310 A Extensive skin chemosurgery 0.95 1.54 0.48 0.05 2.54 1.48 000 17340 A Cryotherapy of skin 0.76 0.39 0.27 0.04 1.19 1.07 010 17360 A Skin peel therapy 1.43 1.46 0.73 0.06 2.95 2.22 010 17380 R Hair removal by electrolysis 0.00 0.00 0.00 0.00 0.00 0.00 000 17999 C Skin tissue procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 19000 A Drainage of breast lesion 0.84 1.27 0.30 0.07 2.18 1.21 000 19001 A Drain breast lesion add-on 0.42 0.86 0.15 0.03 1.31 0.60 ZZZ 19020 A Incision of breast lesion 3.57 7.13 3.51 0.35 11.05 7.43 090 19030 A Injection for breast x-ray 1.53 3.70 0.54 0.07 5.30 2.14 000 19100 A Bx breast percut w/o image 1.27 1.50 0.45 0.10 2.87 1.82 000 19101 A Biopsy of breast, open 3.18 5.27 1.97 0.20 8.65 5.35 010 19102 A Bx breast percut w/image 2.00 5.13 0.71 0.13 7.26 2.84 000 19103 A Bx breast percut w/device 3.70 12.73 1.31 0.16 16.59 5.17 000 19110 A Nipple exploration 4.30 9.79 4.56 0.44 14.53 9.30 090 19112 A Excise breast duct fistula 3.67 10.91 3.19 0.38 14.96 7.24 090 19120 A Removal of breast lesion 5.56 5.18 3.20 0.56 11.30 9.32 090 19125 A Excision, breast lesion 6.06 5.36 3.36 0.61 12.03 10.03 090 19126 A Excision, addl breast lesion 2.93 NA 1.06 0.30 NA 4.29 ZZZ 19140 A Removal of breast tissue 5.14 10.26 3.79 0.52 15.92 9.45 090 19160 A Removal of breast tissue 5.99 NA 4.62 0.61 NA 11.22 090 19162 A Remove breast tissue, nodes 13.53 NA 8.07 1.38 NA 22.98 090 19180 A Removal of breast 8.80 NA 6.08 0.88 NA 15.76 090 19182 A Removal of breast 7.73 NA 5.06 0.79 NA 13.58 090 19200 A Removal of breast 15.49 NA 9.33 1.51 NA 26.33 090 19220 A Removal of breast 15.72 NA 9.52 1.56 NA 26.80 090 19240 A Removal of breast 16.00 NA 8.94 1.62 NA 26.56 090 19260 A Removal of chest wall lesion 15.44 NA 9.12 1.64 NA 26.20 090 19271 A Revision of chest wall 18.90 NA 11.13 2.27 NA 32.30 090 19272 A Extensive chest wall surgery 21.55 NA 12.36 2.54 NA 36.45 090 19290 A Place needle wire, breast 1.27 2.95 0.45 0.06 4.28 1.78 000 19291 A Place needle wire, breast 0.63 1.74 0.22 0.03 2.40 0.88 ZZZ 19295 A Place breast clip, percut 0.00 2.83 NA 0.01 2.84 NA ZZZ 19316 A Suspension of breast 10.69 NA 8.00 1.15 NA 19.84 090 19318 A Reduction of large breast 15.62 NA 10.64 1.69 NA 27.95 090 19324 A Enlarge breast 5.85 NA 4.41 0.63 NA 10.89 090 19325 A Enlarge breast with implant 8.45 NA 7.00 0.90 NA 16.35 090 19328 A Removal of breast implant 5.68 NA 4.73 0.61 NA 11.02 090 19330 A Removal of implant material 7.59 NA 5.41 0.81 NA 13.81 090 19340 A Immediate breast prosthesis 6.33 NA 3.30 0.68 NA 10.31 ZZZ 19342 A Delayed breast prosthesis 11.20 NA 8.15 1.21 NA 20.56 090 19350 A Breast reconstruction 8.92 14.55 7.09 0.95 24.42 16.96 090 19355 A Correct inverted nipple(s) 7.57 12.42 5.93 0.80 20.79 14.30 090 19357 A Breast reconstruction 18.16 NA 14.40 1.96 NA 34.52 090 19361 A Breast reconstruction 19.26 NA 12.45 2.08 NA 33.79 090 19364 A Breast reconstruction 41.00 NA 25.45 3.91 NA 70.36 090 19366 A Breast reconstruction 21.28 NA 12.02 2.27 NA 35.57 090 19367 A Breast reconstruction 25.73 NA 15.77 2.78 NA 44.28 090 19368 A Breast reconstruction 32.42 NA 19.04 3.51 NA 54.97 090 19369 A Breast reconstruction 29.82 NA 18.29 3.24 NA 51.35 090 19370 A Surgery of breast capsule 8.05 NA 6.39 0.86 NA 15.30 090 19371 A Removal of breast capsule 9.35 NA 7.46 1.01 NA 17.82 090 19380 A Revise breast reconstruction 9.14 NA 7.35 0.98 NA 17.47 090 19396 A Design custom breast implant 2.17 7.08 0.87 0.23 9.48 3.27 000 19499 C Breast surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 20000 A Incision of abscess 2.12 2.23 1.20 0.17 4.52 3.49 010 20005 A Incision of deep abscess 3.42 3.07 2.22 0.34 6.83 5.98 010 20100 A Explore wound, neck 10.08 6.49 4.12 0.99 17.56 15.19 010 20101 A Explore wound, chest 3.22 3.03 1.64 0.24 6.49 5.10 010 20102 A Explore wound, abdomen 3.94 3.43 1.85 0.35 7.72 6.14 010 20103 A Explore wound, extremity 5.30 4.41 3.01 0.57 10.28 8.88 010 20150 A Excise epiphyseal bar 13.69 NA 9.72 0.96 NA 24.37 090 20200 A Muscle biopsy 1.46 1.72 0.62 0.17 3.35 2.25 000 20205 A Deep muscle biopsy 2.35 4.04 0.98 0.23 6.62 3.56 000 20206 A Needle biopsy, muscle 0.99 3.27 0.36 0.06 4.32 1.41 000 20220 A Bone biopsy, trocar/needle 1.27 4.96 2.98 0.06 6.29 4.31 000Start Printed Page 55340 20225 A Bone biopsy, trocar/needle 1.87 4.47 3.06 0.11 6.45 5.04 000 20240 A Bone biopsy, excisional 3.23 NA 4.15 0.33 NA 7.71 010 20245 A Bone biopsy, excisional 7.78 NA 6.91 0.44 NA 15.13 010 20250 A Open bone biopsy 5.03 NA 4.37 0.50 NA 9.90 010 20251 A Open bone biopsy 5.56 NA 4.86 0.79 NA 11.21 010 20500 A Injection of sinus tract 1.23 5.34 3.91 0.10 6.67 5.24 010 20501 A Inject sinus tract for x-ray 0.76 3.32 0.27 0.03 4.11 1.06 000 20520 A Removal of foreign body 1.85 5.62 3.62 0.17 7.64 5.64 010 20525 A Removal of foreign body 3.50 7.26 4.40 0.40 11.16 8.30 010 20526 A Ther injection carpal tunnel 0.86 0.78 0.39 0.06 1.70 1.31 000 20550 A Inject tendon/ligament/cyst 0.86 0.85 0.28 0.06 1.77 1.20 000 20551 A Inject tendon origin/insert 0.86 0.78 0.39 0.06 1.70 1.31 000 20552 A Inject trigger point, 1 or 2 0.86 0.78 0.39 0.06 1.70 1.31 000 20553 A Inject trigger points, > 3 0.86 0.78 0.39 0.06 1.70 1.31 000 20600 A Drain/inject, joint/bursa 0.66 0.67 0.37 0.06 1.39 1.09 000 20605 A Drain/inject, joint/bursa 0.68 0.78 0.38 0.06 1.52 1.12 000 20610 A Drain/inject, joint/bursa 0.79 0.96 0.44 0.08 1.83 1.31 000 20615 A Treatment of bone cyst 2.28 4.89 2.52 0.19 7.36 4.99 010 20650 A Insert and remove bone pin 2.23 5.06 3.19 0.28 7.57 5.70 010 20660 A Apply, remove fixation device 2.51 NA 1.49 0.48 NA 4.48 000 20661 A Application of head brace 4.89 NA 6.74 0.92 NA 12.55 090 20662 A Application of pelvis brace 6.07 NA 5.12 0.81 NA 12.00 090 20663 A Application of thigh brace 5.43 NA 4.94 0.77 NA 11.14 090 20664 A Halo brace application 8.06 NA 8.55 1.49 NA 18.10 090 20665 A Removal of fixation device 1.31 2.33 1.25 0.17 3.81 2.73 010 20670 A Removal of support implant 1.74 5.73 3.42 0.23 7.70 5.39 010 20680 A Removal of support implant 3.35 5.04 5.04 0.46 8.85 8.85 090 20690 A Apply bone fixation device 3.52 NA 1.91 0.47 NA 5.90 090 20692 A Apply bone fixation device 6.41 NA 3.57 0.60 NA 10.58 090 20693 A Adjust bone fixation device 5.86 NA 12.98 0.85 NA 19.69 090 20694 A Remove bone fixation device 4.16 8.96 6.30 0.57 13.69 11.03 090 20802 A Replantation, arm, complete 41.15 NA 28.95 5.81 NA 75.91 090 20805 A Replant, forearm, complete 50.00 NA 38.72 3.95 NA 92.67 090 20808 A Replantation hand, complete 61.65 NA 56.41 6.49 NA 124.55 090 20816 A Replantation digit, complete 30.94 NA 49.50 3.01 NA 83.45 090 20822 A Replantation digit, complete 25.59 NA 45.97 3.07 NA 74.63 090 20824 A Replantation thumb, complete 30.94 NA 49.10 3.48 NA 83.52 090 20827 A Replantation thumb, complete 26.41 NA 45.65 3.21 NA 75.27 090 20838 A Replantation foot, complete 41.41 NA 25.82 5.85 NA 73.08 090 20900 A Removal of bone for graft 5.58 5.97 5.97 0.77 12.32 12.32 090 20902 A Removal of bone for graft 7.55 NA 8.91 1.06 NA 17.52 090 20910 A Remove cartilage for graft 5.34 9.09 6.94 0.50 14.93 12.78 090 20912 A Remove cartilage for graft 6.35 NA 7.68 0.55 NA 14.58 090 20920 A Removal of fascia for graft 5.31 NA 5.44 0.54 NA 11.29 090 20922 A Removal of fascia for graft 6.61 8.50 6.28 0.88 15.99 13.77 090 20924 A Removal of tendon for graft 6.48 NA 7.03 0.82 NA 14.33 090 20926 A Removal of tissue for graft 5.53 NA 6.54 0.73 NA 12.80 090 20930 B Spinal bone allograft 0.00 0.00 0.00 0.00 0.00 0.00 XXX 20931 A Spinal bone allograft 1.81 NA 0.98 0.34 NA 3.13 ZZZ 20936 B Spinal bone autograft 0.00 0.00 0.00 0.00 0.00 0.00 XXX 20937 A Spinal bone autograft 2.79 NA 1.54 0.43 NA 4.76 ZZZ 20938 A Spinal bone autograft 3.02 NA 1.64 0.52 NA 5.18 ZZZ 20950 A Fluid pressure, muscle 1.26 NA 2.15 0.16 NA 3.57 000 20955 A Fibula bone graft, microvasc 39.21 NA 30.52 4.35 NA 74.08 090 20956 A Iliac bone graft, microvasc 39.27 NA 28.18 5.77 NA 73.22 090 20957 A Mt bone graft, microvasc 40.65 NA 21.71 5.74 NA 68.10 090 20962 A Other bone graft, microvasc 39.27 NA 28.54 5.19 NA 73.00 090 20969 A Bone/skin graft, microvasc 43.92 NA 33.31 4.34 NA 81.57 090 20970 A Bone/skin graft, iliac crest 43.06 NA 30.08 4.64 NA 77.78 090 20972 A Bone/skin graft, metatarsal 42.99 NA 18.23 6.07 NA 67.29 090 20973 A Bone/skin graft, great toe 45.76 NA 30.52 4.65 NA 80.93 090 20974 A Electrical bone stimulation 0.62 0.47 0.34 0.09 1.18 1.05 000 20975 A Electrical bone stimulation 2.60 NA 1.42 0.42 NA 4.44 000 20979 A Us bone stimulation 0.62 0.58 0.25 0.04 1.24 0.91 000 20999 C Musculoskeletal surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY 21010 A Incision of jaw joint 10.14 NA 7.24 0.54 NA 17.92 090 21015 A Resection of facial tumor 5.29 NA 7.38 0.52 NA 13.19 090 21025 A Excision of bone, lower jaw 10.06 7.40 7.00 0.79 18.25 17.85 090 21026 A Excision of facial bone(s) 4.85 5.23 5.12 0.40 10.48 10.37 090 21029 A Contour of face bone lesion 7.71 7.18 6.73 0.74 15.63 15.18 090 21030 A Removal of face bone lesion 6.46 5.47 4.94 0.60 12.53 12.00 090 21031 A Remove exostosis, mandible 3.24 3.39 2.19 0.28 6.91 5.71 090 21032 A Remove exostosis, maxilla 3.24 3.38 2.47 0.27 6.89 5.98 090Start Printed Page 55341 21034 A Removal of face bone lesion 16.17 10.59 10.59 1.37 28.13 28.13 090 21040 A Removal of jaw bone lesion 2.11 3.03 1.81 0.19 5.33 4.11 090 21041 A Removal of jaw bone lesion 6.71 5.68 4.46 0.56 12.95 11.73 090 21044 A Removal of jaw bone lesion 11.86 NA 8.33 0.87 NA 21.06 090 21045 A Extensive jaw surgery 16.17 NA 10.63 1.20 NA 28.00 090 21050 A Removal of jaw joint 10.77 NA 11.93 0.84 NA 23.54 090 21060 A Remove jaw joint cartilage 10.23 NA 10.59 1.16 NA 21.98 090 21070 A Remove coronoid process 8.20 NA 6.36 0.67 NA 15.23 090 21076 A Prepare face/oral prosthesis 13.42 9.87 7.41 1.36 24.65 22.19 010 21077 A Prepare face/oral prosthesis 33.75 24.83 18.64 3.43 62.01 55.82 090 21079 A Prepare face/oral prosthesis 22.34 17.55 12.90 1.59 41.48 36.83 090 21080 A Prepare face/oral prosthesis 25.10 19.72 14.49 2.55 47.37 42.14 090 21081 A Prepare face/oral prosthesis 22.88 17.97 13.21 1.87 42.72 37.96 090 21082 A Prepare face/oral prosthesis 20.87 15.35 11.53 1.46 37.68 33.86 090 21083 A Prepare face/oral prosthesis 19.30 15.16 11.14 1.96 36.42 32.40 090 21084 A Prepare face/oral prosthesis 22.51 17.68 12.99 1.57 41.76 37.07 090 21085 A Prepare face/oral prosthesis 9.00 6.62 4.97 0.65 16.27 14.62 010 21086 A Prepare face/oral prosthesis 24.92 19.58 14.39 1.86 46.36 41.17 090 21087 A Prepare face/oral prosthesis 24.92 18.33 13.76 2.22 45.47 40.90 090 21088 C Prepare face/oral prosthesis 0.00 0.00 0.00 0.00 0.00 0.00 090 21089 C Prepare face/oral prosthesis 0.00 0.00 0.00 0.00 0.00 0.00 090 21100 A Maxillofacial fixation 4.22 5.66 3.70 0.18 10.06 8.10 090 21110 A Interdental fixation 5.21 5.25 4.48 0.28 10.74 9.97 090 21116 A Injection, jaw joint x-ray 0.81 7.88 0.30 0.05 8.74 1.16 000 21120 A Reconstruction of chin 4.93 7.96 4.98 0.29 13.18 10.20 090 21121 A Reconstruction of chin 7.64 7.68 6.65 0.56 15.88 14.85 090 21122 A Reconstruction of chin 8.52 NA 7.95 0.59 NA 17.06 090 21123 A Reconstruction of chin 11.16 NA 7.68 1.16 NA 20.00 090 21125 A Augmentation, lower jaw bone 10.62 9.56 7.84 0.72 20.90 19.18 090 21127 A Augmentation, lower jaw bone 11.12 10.66 7.33 0.76 22.54 19.21 090 21137 A Reduction of forehead 9.82 NA 8.20 0.53 NA 18.55 090 21138 A Reduction of forehead 12.19 NA 8.82 1.47 NA 22.48 090 21139 A Reduction of forehead 14.61 NA 8.23 1.02 NA 23.86 090 21141 A Reconstruct midface, lefort 18.10 NA 10.69 1.63 NA 30.42 090 21142 A Reconstruct midface, lefort 18.81 NA 13.80 1.16 NA 33.77 090 21143 A Reconstruct midface, lefort 19.58 NA 11.21 0.90 NA 31.69 090 21145 A Reconstruct midface, lefort 19.94 NA 11.69 2.09 NA 33.72 090 21146 A Reconstruct midface, lefort 20.71 NA 11.61 2.13 NA 34.45 090 21147 A Reconstruct midface, lefort 21.77 NA 12.07 1.52 NA 35.36 090 21150 A Reconstruct midface, lefort 25.24 NA 17.20 1.09 NA 43.53 090 21151 A Reconstruct midface, lefort 28.30 NA 21.35 1.98 NA 51.63 090 21154 A Reconstruct midface, lefort 30.52 NA 21.03 4.86 NA 56.41 090 21155 A Reconstruct midface, lefort 34.45 NA 23.20 5.48 NA 63.13 090 21159 A Reconstruct midface, lefort 42.38 NA 21.72 6.74 NA 70.84 090 21160 A Reconstruct midface, lefort 46.44 NA 30.39 4.39 NA 81.22 090 21172 A Reconstruct orbit/forehead 27.80 NA 16.39 1.91 NA 46.10 090 21175 A Reconstruct orbit/forehead 33.17 NA 19.79 5.16 NA 58.12 090 21179 A Reconstruct entire forehead 22.25 NA 18.94 2.48 NA 43.67 090 21180 A Reconstruct entire forehead 25.19 NA 18.33 2.15 NA 45.67 090 21181 A Contour cranial bone lesion 9.90 NA 8.46 0.97 NA 19.33 090 21182 A Reconstruct cranial bone 32.19 NA 21.97 2.53 NA 56.69 090 21183 A Reconstruct cranial bone 35.31 NA 22.93 2.75 NA 60.99 090 21184 A Reconstruct cranial bone 38.24 NA 19.54 4.12 NA 61.90 090 21188 A Reconstruction of midface 22.46 NA 15.86 1.85 NA 40.17 090 21193 A Reconst lwr jaw w/o graft 17.15 NA 10.77 1.53 NA 29.45 090 21194 A Reconst lwr jaw w/graft 19.84 NA 12.44 1.39 NA 33.67 090 21195 A Reconst lwr jaw w/o fixation 17.24 NA 12.36 1.20 NA 30.80 090 21196 A Reconst lwr jaw w/fixation 18.91 NA 12.83 1.62 NA 33.36 090 21198 A Reconstr lwr jaw segment 14.16 NA 12.30 1.05 NA 27.51 090 21199 A Reconstr lwr jaw w/advance 16.00 NA 10.85 1.26 NA 28.11 090 21206 A Reconstruct upper jaw bone 14.10 NA 9.39 1.01 NA 24.50 090 21208 A Augmentation of facial bones 10.23 8.95 8.62 0.92 20.10 19.77 090 21209 A Reduction of facial bones 6.72 8.05 6.54 0.60 15.37 13.86 090 21210 A Face bone graft 10.23 8.82 8.28 0.88 19.93 19.39 090 21215 A Lower jaw bone graft 10.77 8.95 7.48 1.04 20.76 19.29 090 21230 A Rib cartilage graft 10.77 NA 10.85 0.96 NA 22.58 090 21235 A Ear cartilage graft 6.72 11.90 8.36 0.52 19.14 15.60 090 21240 A Reconstruction of jaw joint 14.05 NA 11.79 1.15 NA 26.99 090 21242 A Reconstruction of jaw joint 12.95 NA 10.85 1.40 NA 25.20 090 21243 A Reconstruction of jaw joint 20.79 NA 13.97 1.85 NA 36.61 090 21244 A Reconstruction of lower jaw 11.86 NA 9.56 0.95 NA 22.37 090 21245 A Reconstruction of jaw 11.86 24.85 10.25 0.88 37.59 22.99 090 21246 A Reconstruction of jaw 12.47 10.20 10.20 1.21 23.88 23.88 090Start Printed Page 55342 21247 A Reconstruct lower jaw bone 22.63 NA 20.17 2.21 NA 45.01 090 21248 A Reconstruction of jaw 11.48 8.91 7.86 1.01 21.40 20.35 090 21249 A Reconstruction of jaw 17.52 11.44 10.35 1.39 30.35 29.26 090 21255 A Reconstruct lower jaw bone 16.72 NA 13.16 1.13 NA 31.01 090 21256 A Reconstruction of orbit 16.19 NA 13.87 1.04 NA 31.10 090 21260 A Revise eye sockets 16.52 NA 13.54 1.25 NA 31.31 090 21261 A Revise eye sockets 31.49 NA 20.04 2.20 NA 53.73 090 21263 A Revise eye sockets 28.42 NA 15.09 2.16 NA 45.67 090 21267 A Revise eye sockets 18.90 NA 14.75 1.35 NA 35.00 090 21268 A Revise eye sockets 24.48 NA 15.15 0.79 NA 40.42 090 21270 A Augmentation, cheek bone 10.23 10.39 9.99 0.73 21.35 20.95 090 21275 A Revision, orbitofacial bones 11.24 NA 11.02 1.03 NA 23.29 090 21280 A Revision of eyelid 6.03 NA 6.27 0.27 NA 12.57 090 21282 A Revision of eyelid 3.49 NA 5.38 0.21 NA 9.08 090 21295 A Revision of jaw muscle/bone 1.53 NA 4.34 0.13 NA 6.00 090 21296 A Revision of jaw muscle/bone 4.25 NA 4.09 0.30 NA 8.64 090 21299 C Cranio/maxillofacial surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY 21300 A Treatment of skull fracture 0.72 2.77 0.30 0.09 3.58 1.11 000 21310 A Treatment of nose fracture 0.58 2.70 0.15 0.05 3.33 0.78 000 21315 A Treatment of nose fracture 1.51 3.49 1.27 0.12 5.12 2.90 010 21320 A Treatment of nose fracture 1.85 4.96 2.10 0.15 6.96 4.10 010 21325 A Treatment of nose fracture 3.77 NA 3.73 0.31 NA 7.81 090 21330 A Treatment of nose fracture 5.38 NA 5.67 0.48 NA 11.53 090 21335 A Treatment of nose fracture 8.61 NA 7.34 0.64 NA 16.59 090 21336 A Treat nasal septal fracture 5.72 NA 5.74 0.45 NA 11.91 090 21337 A Treat nasal septal fracture 2.70 5.24 3.42 0.22 8.16 6.34 090 21338 A Treat nasoethmoid fracture 6.46 NA 5.75 0.53 NA 12.74 090 21339 A Treat nasoethmoid fracture 8.09 NA 6.97 0.76 NA 15.82 090 21340 A Treatment of nose fracture 10.77 NA 8.78 0.85 NA 20.40 090 21343 A Treatment of sinus fracture 12.95 NA 9.48 1.06 NA 23.49 090 21344 A Treatment of sinus fracture 19.72 NA 13.82 1.72 NA 35.26 090 21345 A Treat nose/jaw fracture 8.16 10.36 7.91 0.60 19.12 16.67 090 21346 A Treat nose/jaw fracture 10.61 NA 10.12 0.85 NA 21.58 090 21347 A Treat nose/jaw fracture 12.69 NA 9.68 1.14 NA 23.51 090 21348 A Treat nose/jaw fracture 16.69 NA 11.57 1.50 NA 29.76 090 21355 A Treat cheek bone fracture 3.77 3.89 2.54 0.29 7.95 6.60 010 21356 A Treat cheek bone fracture 4.15 NA 3.31 0.36 NA 7.82 010 21360 A Treat cheek bone fracture 6.46 NA 5.74 0.52 NA 12.72 090 21365 A Treat cheek bone fracture 14.95 NA 11.72 1.30 NA 27.97 090 21366 A Treat cheek bone fracture 17.77 NA 14.28 1.41 NA 33.46 090 21385 A Treat eye socket fracture 9.16 NA 8.04 0.64 NA 17.84 090 21386 A Treat eye socket fracture 9.16 NA 8.43 0.76 NA 18.35 090 21387 A Treat eye socket fracture 9.70 NA 8.55 0.78 NA 19.03 090 21390 A Treat eye socket fracture 10.13 NA 8.73 0.70 NA 19.56 090 21395 A Treat eye socket fracture 12.68 NA 9.24 1.09 NA 23.01 090 21400 A Treat eye socket fracture 1.40 3.29 1.05 0.12 4.81 2.57 090 21401 A Treat eye socket fracture 3.26 4.34 3.65 0.34 7.94 7.25 090 21406 A Treat eye socket fracture 7.01 NA 7.20 0.59 NA 14.80 090 21407 A Treat eye socket fracture 8.61 NA 7.99 0.67 NA 17.27 090 21408 A Treat eye socket fracture 12.38 NA 10.29 1.24 NA 23.91 090 21421 A Treat mouth roof fracture 5.14 7.23 6.84 0.42 12.79 12.40 090 21422 A Treat mouth roof fracture 8.32 NA 7.93 0.69 NA 16.94 090 21423 A Treat mouth roof fracture 10.40 NA 8.63 0.95 NA 19.98 090 21431 A Treat craniofacial fracture 7.05 NA 8.44 0.58 NA 16.07 090 21432 A Treat craniofacial fracture 8.61 NA 8.06 0.55 NA 17.22 090 21433 A Treat craniofacial fracture 25.35 NA 17.29 2.46 NA 45.10 090 21435 A Treat craniofacial fracture 17.25 NA 12.97 1.66 NA 31.88 090 21436 A Treat craniofacial fracture 28.04 NA 16.02 2.32 NA 46.38 090 21440 A Treat dental ridge fracture 2.70 5.44 3.73 0.22 8.36 6.65 090 21445 A Treat dental ridge fracture 5.38 7.14 5.04 0.55 13.07 10.97 090 21450 A Treat lower jaw fracture 2.97 6.45 2.90 0.23 9.65 6.10 090 21451 A Treat lower jaw fracture 4.87 6.46 6.11 0.39 11.72 11.37 090 21452 A Treat lower jaw fracture 1.98 13.44 4.35 0.14 15.56 6.47 090 21453 A Treat lower jaw fracture 5.54 7.32 6.69 0.49 13.35 12.72 090 21454 A Treat lower jaw fracture 6.46 NA 5.72 0.55 NA 12.73 090 21461 A Treat lower jaw fracture 8.09 8.40 8.26 0.73 17.22 17.08 090 21462 A Treat lower jaw fracture 9.79 10.06 8.18 0.80 20.65 18.77 090 21465 A Treat lower jaw fracture 11.91 NA 8.42 0.84 NA 21.17 090 21470 A Treat lower jaw fracture 15.34 NA 10.31 1.36 NA 27.01 090 21480 A Reset dislocated jaw 0.61 1.62 0.18 0.05 2.28 0.84 000 21485 A Reset dislocated jaw 3.99 3.82 3.34 0.31 8.12 7.64 090 21490 A Repair dislocated jaw 11.86 NA 7.69 1.31 NA 20.86 090 21493 A Treat hyoid bone fracture 1.27 NA 3.68 0.10 NA 5.05 090Start Printed Page 55343 21494 A Treat hyoid bone fracture 6.28 NA 4.21 0.44 NA 10.93 090 21495 A Treat hyoid bone fracture 5.69 NA 5.28 0.41 NA 11.38 090 21497 A Interdental wiring 3.86 4.68 3.81 0.31 8.85 7.98 090 21499 C Head surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 21501 A Drain neck/chest lesion 3.81 4.50 3.64 0.36 8.67 7.81 090 21502 A Drain chest lesion 7.12 NA 7.05 0.79 NA 14.96 090 21510 A Drainage of bone lesion 5.74 NA 7.47 0.67 NA 13.88 090 21550 A Biopsy of neck/chest 2.06 2.32 1.25 0.13 4.51 3.44 010 21555 A Remove lesion, neck/chest 4.35 4.25 2.43 0.41 9.01 7.19 090 21556 A Remove lesion, neck/chest 5.57 NA 3.29 0.51 NA 9.37 090 21557 A Remove tumor, neck/chest 8.88 NA 7.87 0.85 NA 17.60 090 21600 A Partial removal of rib 6.89 NA 7.80 0.81 NA 15.50 090 21610 A Partial removal of rib 14.61 NA 11.26 1.85 NA 27.72 090 21615 A Removal of rib 9.87 NA 7.90 1.20 NA 18.97 090 21616 A Removal of rib and nerves 12.04 NA 8.94 1.31 NA 22.29 090 21620 A Partial removal of sternum 6.79 NA 8.13 0.77 NA 15.69 090 21627 A Sternal debridement 6.81 NA 12.16 0.82 NA 19.79 090 21630 A Extensive sternum surgery 17.38 NA 14.03 1.95 NA 33.36 090 21632 A Extensive sternum surgery 18.14 NA 12.35 2.16 NA 32.65 090 21700 A Revision of neck muscle 6.19 8.63 7.19 0.31 15.13 13.69 090 21705 A Revision of neck muscle/rib 9.60 NA 7.87 0.92 NA 18.39 090 21720 A Revision of neck muscle 5.68 8.71 5.93 0.80 15.19 12.41 090 21725 A Revision of neck muscle 6.99 NA 7.28 0.90 NA 15.17 090 21740 A Reconstruction of sternum 16.50 NA 12.85 2.03 NA 31.38 090 21750 A Repair of sternum separation 10.77 NA 9.41 1.35 NA 21.53 090 21800 A Treatment of rib fracture 0.96 2.31 1.11 0.09 3.36 2.16 090 21805 A Treatment of rib fracture 2.75 NA 4.08 0.29 NA 7.12 090 21810 A Treatment of rib fracture(s) 6.86 NA 7.49 0.60 NA 14.95 090 21820 A Treat sternum fracture 1.28 2.80 1.58 0.15 4.23 3.01 090 21825 A Treat sternum fracture 7.41 NA 9.90 0.84 NA 18.15 090 21899 C Neck/chest surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 21920 A Biopsy soft tissue of back 2.06 2.40 0.77 0.12 4.58 2.95 010 21925 A Biopsy soft tissue of back 4.49 10.19 4.79 0.44 15.12 9.72 090 21930 A Remove lesion, back or flank 5.00 4.55 2.66 0.49 10.04 8.15 090 21935 A Remove tumor, back 17.96 NA 13.53 1.87 NA 33.36 090 22100 A Remove part of neck vertebra 9.73 NA 8.36 1.55 NA 19.64 090 22101 A Remove part, thorax vertebra 9.81 NA 9.04 1.51 NA 20.36 090 22102 A Remove part, lumbar vertebra 9.81 NA 9.18 1.46 NA 20.45 090 22103 A Remove extra spine segment 2.34 NA 1.27 0.37 NA 3.98 ZZZ 22110 A Remove part of neck vertebra 12.74 NA 11.06 2.20 NA 26.00 090 22112 A Remove part, thorax vertebra 12.81 NA 10.95 1.96 NA 25.72 090 22114 A Remove part, lumbar vertebra 12.81 NA 10.71 1.98 NA 25.50 090 22116 A Remove extra spine segment 2.32 NA 1.26 0.40 NA 3.98 ZZZ 22210 A Revision of neck spine 23.82 NA 17.42 4.23 NA 45.47 090 22212 A Revision of thorax spine 19.42 NA 14.60 2.78 NA 36.80 090 22214 A Revision of lumbar spine 19.45 NA 15.32 2.78 NA 37.55 090 22216 A Revise, extra spine segment 6.04 NA 3.31 0.98 NA 10.33 ZZZ 22220 A Revision of neck spine 21.37 NA 15.61 3.65 NA 40.63 090 22222 A Revision of thorax spine 21.52 NA 15.08 3.08 NA 39.68 090 22224 A Revision of lumbar spine 21.52 NA 15.70 3.20 NA 40.42 090 22226 A Revise, extra spine segment 6.04 NA 3.22 1.01 NA 10.27 ZZZ 22305 A Treat spine process fracture 2.05 3.25 2.01 0.29 5.59 4.35 090 22310 A Treat spine fracture 2.61 4.77 3.54 0.37 7.75 6.52 090 22315 A Treat spine fracture 8.84 NA 9.32 1.37 NA 19.53 090 22318 A Treat odontoid fx w/o graft 21.50 NA 15.02 4.26 NA 40.78 090 22319 A Treat odontoid fx w/graft 24.00 NA 17.42 4.76 NA 46.18 090 22325 A Treat spine fracture 18.30 NA 14.94 2.61 NA 35.85 090 22326 A Treat neck spine fracture 19.59 NA 15.67 3.54 NA 38.80 090 22327 A Treat thorax spine fracture 19.20 NA 15.43 2.75 NA 37.38 090 22328 A Treat each add spine fx 4.61 NA 2.43 0.66 NA 7.70 ZZZ 22505 A Manipulation of spine 1.87 4.58 3.20 0.27 6.72 5.34 010 22520 A Percut vertebroplasty thor 8.91 NA 4.15 0.99 NA 14.05 010 22521 A Percut vertebroplasty lumb 8.34 NA 3.92 0.93 NA 13.19 010 22522 A Percut vertebroplasty addl 4.31 NA 1.75 0.33 NA 6.39 ZZZ 22548 A Neck spine fusion 25.82 NA 18.08 4.98 NA 48.88 090 22554 A Neck spine fusion 18.62 NA 13.94 3.51 NA 36.07 090 22556 A Thorax spine fusion 23.46 NA 16.80 3.78 NA 44.04 090 22558 A Lumbar spine fusion 22.28 NA 15.27 3.18 NA 40.73 090 22585 A Additional spinal fusion 5.53 NA 2.94 0.98 NA 9.45 ZZZ 22590 A Spine & skull spinal fusion 20.51 NA 15.56 3.81 NA 39.88 090 22595 A Neck spinal fusion 19.39 NA 14.58 3.62 NA 37.59 090 22600 A Neck spine fusion 16.14 NA 12.66 2.89 NA 31.69 090 22610 A Thorax spine fusion 16.02 NA 12.98 2.66 NA 31.66 090Start Printed Page 55344 22612 A Lumbar spine fusion 21.00 NA 15.75 3.28 NA 40.03 090 22614 A Spine fusion, extra segment 6.44 NA 3.54 1.04 NA 11.02 ZZZ 22630 A Lumbar spine fusion 20.84 NA 16.01 3.79 NA 40.64 090 22632 A Spine fusion, extra segment 5.23 NA 2.75 0.90 NA 8.88 ZZZ 22800 A Fusion of spine 18.25 NA 14.30 2.71 NA 35.26 090 22802 A Fusion of spine 30.88 NA 21.88 4.42 NA 57.18 090 22804 A Fusion of spine 36.27 NA 24.48 5.23 NA 65.98 090 22808 A Fusion of spine 26.27 NA 18.27 4.36 NA 48.90 090 22810 A Fusion of spine 30.27 NA 19.63 4.49 NA 54.39 090 22812 A Fusion of spine 32.70 NA 21.89 4.67 NA 59.26 090 22818 A Kyphectomy, 1-2 segments 31.83 NA 21.69 5.01 NA 58.53 090 22819 A Kyphectomy, 3 or more 36.44 NA 22.19 5.20 NA 63.83 090 22830 A Exploration of spinal fusion 10.85 NA 10.05 1.73 NA 22.63 090 22840 A Insert spine fixation device 12.54 NA 6.84 2.03 NA 21.41 ZZZ 22841 B Insert spine fixation device 0.00 0.00 0.00 0.00 0.00 0.00 XXX 22842 A Insert spine fixation device 12.58 NA 6.83 2.04 NA 21.45 ZZZ 22843 A Insert spine fixation device 13.46 NA 7.39 2.10 NA 22.95 ZZZ 22844 A Insert spine fixation device 16.44 NA 9.26 2.42 NA 28.12 ZZZ 22845 A Insert spine fixation device 11.96 NA 6.38 2.22 NA 20.56 ZZZ 22846 A Insert spine fixation device 12.42 NA 6.70 2.26 NA 21.38 ZZZ 22847 A Insert spine fixation device 13.80 NA 7.08 2.36 NA 23.24 ZZZ 22848 A Insert pelv fixation device 6.00 NA 3.38 0.88 NA 10.26 ZZZ 22849 A Reinsert spinal fixation 18.51 NA 14.22 2.87 NA 35.60 090 22850 A Remove spine fixation device 9.52 NA 8.89 1.51 NA 19.92 090 22851 A Apply spine prosth device 6.71 NA 3.54 1.11 NA 11.36 ZZZ 22852 A Remove spine fixation device 9.01 NA 8.60 1.40 NA 19.01 090 22855 A Remove spine fixation device 15.13 NA 11.67 2.74 NA 29.54 090 22899 C Spine surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 22900 A Remove abdominal wall lesion 5.80 NA 4.42 0.58 NA 10.80 090 22999 C Abdomen surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 23000 A Removal of calcium deposits 4.36 9.04 6.97 0.50 13.90 11.83 090 23020 A Release shoulder joint 8.93 NA 10.53 1.23 NA 20.69 090 23030 A Drain shoulder lesion 3.43 6.40 4.44 0.42 10.25 8.29 010 23031 A Drain shoulder bursa 2.74 5.80 4.16 0.33 8.87 7.23 010 23035 A Drain shoulder bone lesion 8.61 NA 16.13 1.19 NA 25.93 090 23040 A Exploratory shoulder surgery 9.20 NA 11.71 1.28 NA 22.19 090 23044 A Exploratory shoulder surgery 7.12 NA 10.73 0.97 NA 18.82 090 23065 A Biopsy shoulder tissues 2.27 2.61 1.34 0.14 5.02 3.75 010 23066 A Biopsy shoulder tissues 4.16 8.34 6.16 0.50 13.00 10.82 090 23075 A Removal of shoulder lesion 2.39 5.40 3.17 0.25 8.04 5.81 010 23076 A Removal of shoulder lesion 7.63 NA 8.36 0.87 NA 16.86 090 23077 A Remove tumor of shoulder 16.09 NA 14.41 1.81 NA 32.31 090 23100 A Biopsy of shoulder joint 6.03 NA 8.73 0.81 NA 15.57 090 23101 A Shoulder joint surgery 5.58 NA 8.63 0.77 NA 14.98 090 23105 A Remove shoulder joint lining 8.23 NA 10.18 1.13 NA 19.54 090 23106 A Incision of collarbone joint 5.96 NA 9.27 0.82 NA 16.05 090 23107 A Explore treat shoulder joint 8.62 NA 10.41 1.19 NA 20.22 090 23120 A Partial removal, collar bone 7.11 NA 9.55 0.99 NA 17.65 090 23125 A Removal of collar bone 9.39 NA 10.78 1.27 NA 21.44 090 23130 A Remove shoulder bone, part 7.55 NA 9.82 1.06 NA 18.43 090 23140 A Removal of bone lesion 6.89 NA 8.31 0.82 NA 16.02 090 23145 A Removal of bone lesion 9.09 NA 10.87 1.24 NA 21.20 090 23146 A Removal of bone lesion 7.83 NA 10.70 1.11 NA 19.64 090 23150 A Removal of humerus lesion 8.48 NA 10.14 1.14 NA 19.76 090 23155 A Removal of humerus lesion 10.35 NA 12.33 1.20 NA 23.88 090 23156 A Removal of humerus lesion 8.68 NA 10.45 1.18 NA 20.31 090 23170 A Remove collar bone lesion 6.86 NA 11.33 0.84 NA 19.03 090 23172 A Remove shoulder blade lesion 6.90 NA 9.59 0.95 NA 17.44 090 23174 A Remove humerus lesion 9.51 NA 11.74 1.30 NA 22.55 090 23180 A Remove collar bone lesion 8.53 NA 16.16 1.18 NA 25.87 090 23182 A Remove shoulder blade lesion 8.15 NA 16.18 1.08 NA 25.41 090 23184 A Remove humerus lesion 9.38 NA 16.43 1.24 NA 27.05 090 23190 A Partial removal of scapula 7.24 NA 8.74 0.97 NA 16.95 090 23195 A Removal of head of humerus 9.81 NA 10.03 1.38 NA 21.22 090 23200 A Removal of collar bone 12.08 NA 14.39 1.48 NA 27.95 090 23210 A Removal of shoulder blade 12.49 NA 13.96 1.61 NA 28.06 090 23220 A Partial removal of humerus 14.56 NA 15.57 2.03 NA 32.16 090 23221 A Partial removal of humerus 17.74 NA 16.93 2.51 NA 37.18 090 23222 A Partial removal of humerus 23.92 NA 20.66 3.37 NA 47.95 090 23330 A Remove shoulder foreign body 1.85 6.15 3.49 0.18 8.18 5.52 010 23331 A Remove shoulder foreign body 7.38 NA 9.70 1.02 NA 18.10 090 23332 A Remove shoulder foreign body 11.62 NA 12.12 1.62 NA 25.36 090 23350 A Injection for shoulder x-ray 1.00 7.22 0.35 0.05 8.27 1.40 000Start Printed Page 55345 23395 A Muscle transfer, shoulder/arm 16.85 NA 14.09 2.29 NA 33.23 090 23397 A Muscle transfers 16.13 NA 13.86 2.24 NA 32.23 090 23400 A Fixation of shoulder blade 13.54 NA 14.52 1.91 NA 29.97 090 23405 A Incision of tendon & muscle 8.37 NA 9.66 1.12 NA 19.15 090 23406 A Incise tendon(s) & muscle(s) 10.79 NA 11.55 1.48 NA 23.82 090 23410 A Repair of tendon(s) 12.45 NA 12.55 1.72 NA 26.72 090 23412 A Repair of tendon(s) 13.31 NA 13.05 1.86 NA 28.22 090 23415 A Release of shoulder ligament 9.97 NA 10.22 1.39 NA 21.58 090 23420 A Repair of shoulder 13.30 NA 13.94 1.86 NA 29.10 090 23430 A Repair biceps tendon 9.98 NA 11.15 1.40 NA 22.53 090 23440 A Remove/transplant tendon 10.48 NA 11.54 1.47 NA 23.49 090 23450 A Repair shoulder capsule 13.40 NA 13.02 1.86 NA 28.28 090 23455 A Repair shoulder capsule 14.37 NA 13.62 2.01 NA 30.00 090 23460 A Repair shoulder capsule 15.37 NA 14.21 2.17 NA 31.75 090 23462 A Repair shoulder capsule 15.30 NA 13.68 2.16 NA 31.14 090 23465 A Repair shoulder capsule 15.85 NA 14.47 1.61 NA 31.93 090 23466 A Repair shoulder capsule 14.22 NA 13.63 2.00 NA 29.85 090 23470 A Reconstruct shoulder joint 17.15 NA 15.16 2.40 NA 34.71 090 23472 A Reconstruct shoulder joint 21.10 NA 17.40 2.37 NA 40.87 090 23480 A Revision of collar bone 11.18 NA 11.94 1.56 NA 24.68 090 23485 A Revision of collar bone 13.43 NA 13.10 1.84 NA 28.37 090 23490 A Reinforce clavicle 11.86 NA 13.74 1.11 NA 26.71 090 23491 A Reinforce shoulder bones 14.21 NA 13.54 2.00 NA 29.75 090 23500 A Treat clavicle fracture 2.08 3.87 2.60 0.26 6.21 4.94 090 23505 A Treat clavicle fracture 3.69 5.98 4.02 0.50 10.17 8.21 090 23515 A Treat clavicle fracture 7.41 NA 8.24 1.03 NA 16.68 090 23520 A Treat clavicle dislocation 2.16 3.91 2.67 0.26 6.33 5.09 090 23525 A Treat clavicle dislocation 3.60 7.16 4.08 0.44 11.20 8.12 090 23530 A Treat clavicle dislocation 7.31 NA 7.94 0.85 NA 16.10 090 23532 A Treat clavicle dislocation 8.01 NA 8.67 1.13 NA 17.81 090 23540 A Treat clavicle dislocation 2.23 4.56 2.63 0.24 7.03 5.10 090 23545 A Treat clavicle dislocation 3.25 4.99 3.65 0.39 8.63 7.29 090 23550 A Treat clavicle dislocation 7.24 NA 8.29 0.94 NA 16.47 090 23552 A Treat clavicle dislocation 8.45 NA 8.82 1.18 NA 18.45 090 23570 A Treat shoulder blade fx 2.23 3.84 2.70 0.29 6.36 5.22 090 23575 A Treat shoulder blade fx 4.06 6.22 4.18 0.53 10.81 8.77 090 23585 A Treat scapula fracture 8.96 NA 9.31 1.25 NA 19.52 090 23600 A Treat humerus fracture 2.93 5.65 3.71 0.39 8.97 7.03 090 23605 A Treat humerus fracture 4.87 8.32 6.55 0.67 13.86 12.09 090 23615 A Treat humerus fracture 9.35 NA 10.19 1.31 NA 20.85 090 23616 A Treat humerus fracture 21.27 NA 16.26 2.98 NA 40.51 090 23620 A Treat humerus fracture 2.40 5.35 3.43 0.32 8.07 6.15 090 23625 A Treat humerus fracture 3.93 7.35 5.57 0.53 11.81 10.03 090 23630 A Treat humerus fracture 7.35 NA 8.20 1.03 NA 16.58 090 23650 A Treat shoulder dislocation 3.39 5.58 3.67 0.31 9.28 7.37 090 23655 A Treat shoulder dislocation 4.57 NA 4.39 0.52 NA 9.48 090 23660 A Treat shoulder dislocation 7.49 NA 8.27 1.01 NA 16.77 090 23665 A Treat dislocation/fracture 4.47 7.68 5.81 0.60 12.75 10.88 090 23670 A Treat dislocation/fracture 7.90 NA 8.72 1.10 NA 17.72 090 23675 A Treat dislocation/fracture 6.05 8.22 6.71 0.83 15.10 13.59 090 23680 A Treat dislocation/fracture 10.06 NA 9.89 1.39 NA 21.34 090 23700 A Fixation of shoulder 2.52 NA 3.48 0.35 NA 6.35 010 23800 A Fusion of shoulder joint 14.16 NA 14.28 1.97 NA 30.41 090 23802 A Fusion of shoulder joint 16.60 NA 15.83 2.34 NA 34.77 090 23900 A Amputation of arm & girdle 19.72 NA 16.35 2.47 NA 38.54 090 23920 A Amputation at shoulder joint 14.61 NA 13.70 1.92 NA 30.23 090 23921 A Amputation follow-up surgery 5.49 NA 6.67 0.78 NA 12.94 090 23929 C Shoulder surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 23930 A Drainage of arm lesion 2.94 6.10 4.01 0.32 9.36 7.27 010 23931 A Drainage of arm bursa 1.79 5.76 3.74 0.21 7.76 5.74 010 23935 A Drain arm/elbow bone lesion 6.09 NA 12.90 0.84 NA 19.83 090 24000 A Exploratory elbow surgery 5.82 NA 6.06 0.77 NA 12.65 090 24006 A Release elbow joint 9.31 NA 8.64 1.27 NA 19.22 090 24065 A Biopsy arm/elbow soft tissue 2.08 5.50 3.25 0.14 7.72 5.47 010 24066 A Biopsy arm/elbow soft tissue 5.21 8.48 6.40 0.61 14.30 12.22 090 24075 A Remove arm/elbow lesion 3.92 7.80 5.91 0.43 12.15 10.26 090 24076 A Remove arm/elbow lesion 6.30 NA 7.39 0.70 NA 14.39 090 24077 A Remove tumor of arm/elbow 11.76 NA 14.23 1.32 NA 27.31 090 24100 A Biopsy elbow joint lining 4.93 NA 5.83 0.62 NA 11.38 090 24101 A Explore/treat elbow joint 6.13 NA 6.82 0.84 NA 13.79 090 24102 A Remove elbow joint lining 8.03 NA 7.81 1.09 NA 16.93 090 24105 A Removal of elbow bursa 3.61 NA 5.26 0.49 NA 9.36 090 24110 A Remove humerus lesion 7.39 NA 9.75 0.99 NA 18.13 090Start Printed Page 55346 24115 A Remove/graft bone lesion 9.63 NA 10.80 1.15 NA 21.58 090 24116 A Remove/graft bone lesion 11.81 NA 12.20 1.66 NA 25.67 090 24120 A Remove elbow lesion 6.65 NA 6.96 0.87 NA 14.48 090 24125 A Remove/graft bone lesion 7.89 NA 6.67 0.88 NA 15.44 090 24126 A Remove/graft bone lesion 8.31 NA 7.79 0.90 NA 17.00 090 24130 A Removal of head of radius 6.25 NA 6.91 0.87 NA 14.03 090 24134 A Removal of arm bone lesion 9.73 NA 16.50 1.31 NA 27.54 090 24136 A Remove radius bone lesion 7.99 NA 7.09 0.85 NA 15.93 090 24138 A Remove elbow bone lesion 8.05 NA 8.06 1.12 NA 17.23 090 24140 A Partial removal of arm bone 9.18 NA 16.67 1.23 NA 27.08 090 24145 A Partial removal of radius 7.58 NA 11.43 1.01 NA 20.02 090 24147 A Partial removal of elbow 7.54 NA 11.40 1.04 NA 19.98 090 24149 A Radical resection of elbow 14.20 NA 11.28 1.90 NA 27.38 090 24150 A Extensive humerus surgery 13.27 NA 14.92 1.81 NA 30.00 090 24151 A Extensive humerus surgery 15.58 NA 16.64 2.19 NA 34.41 090 24152 A Extensive radius surgery 10.06 NA 9.96 1.19 NA 21.21 090 24153 A Extensive radius surgery 11.54 NA 7.55 0.64 NA 19.73 090 24155 A Removal of elbow joint 11.73 NA 9.66 1.42 NA 22.81 090 24160 A Remove elbow joint implant 7.83 NA 7.77 1.07 NA 16.67 090 24164 A Remove radius head implant 6.23 NA 6.93 0.84 NA 14.00 090 24200 A Removal of arm foreign body 1.76 5.80 3.25 0.15 7.71 5.16 010 24201 A Removal of arm foreign body 4.56 8.42 6.97 0.56 13.54 12.09 090 24220 A Injection for elbow x-ray 1.31 11.16 0.47 0.07 12.54 1.85 000 24300 A Manipulate elbow w/anesth 3.75 NA 5.46 0.52 NA 9.73 090 24301 A Muscle/tendon transfer 10.20 NA 9.11 1.30 NA 20.61 090 24305 A Arm tendon lengthening 7.45 NA 7.70 0.98 NA 16.13 090 24310 A Revision of arm tendon 5.98 NA 8.43 0.74 NA 15.15 090 24320 A Repair of arm tendon 10.56 NA 11.29 1.00 NA 22.85 090 24330 A Revision of arm muscles 9.60 NA 8.79 1.21 NA 19.60 090 24331 A Revision of arm muscles 10.65 NA 9.25 1.41 NA 21.31 090 24332 A Tenolysis, triceps 7.45 NA 5.23 0.77 NA 13.45 090 24340 A Repair of biceps tendon 7.89 NA 7.74 1.08 NA 16.71 090 24341 A Repair arm tendon/muscle 7.90 NA 7.85 1.08 NA 16.83 090 24342 A Repair of ruptured tendon 10.62 NA 9.37 1.48 NA 21.47 090 24343 A Repr elbow lat ligmnt w/tiss 8.65 NA 7.91 1.21 NA 17.77 090 24344 A Reconstruct elbow lat ligmnt 14.00 NA 10.87 1.95 NA 26.82 090 24345 A Repr elbw med ligmnt w/tiss 8.65 NA 7.91 1.21 NA 17.77 090 24346 A Reconstruct elbow med ligmnt 14.00 NA 10.87 1.95 NA 26.82 090 24350 A Repair of tennis elbow 5.25 NA 6.25 0.72 NA 12.22 090 24351 A Repair of tennis elbow 5.91 NA 6.72 0.82 NA 13.45 090 24352 A Repair of tennis elbow 6.43 NA 7.01 0.90 NA 14.34 090 24354 A Repair of tennis elbow 6.48 NA 6.85 0.88 NA 14.21 090 24356 A Revision of tennis elbow 6.68 NA 7.21 0.90 NA 14.79 090 24360 A Reconstruct elbow joint 12.34 NA 10.26 1.69 NA 24.29 090 24361 A Reconstruct elbow joint 14.08 NA 11.30 1.95 NA 27.33 090 24362 A Reconstruct elbow joint 14.99 NA 11.30 1.92 NA 28.21 090 24363 A Replace elbow joint 18.49 NA 13.80 2.52 NA 34.81 090 24365 A Reconstruct head of radius 8.39 NA 7.96 1.11 NA 17.46 090 24366 A Reconstruct head of radius 9.13 NA 8.48 1.28 NA 18.89 090 24400 A Revision of humerus 11.06 NA 12.48 1.53 NA 25.07 090 24410 A Revision of humerus 14.82 NA 13.75 1.89 NA 30.46 090 24420 A Revision of humerus 13.44 NA 16.08 1.82 NA 31.34 090 24430 A Repair of humerus 12.81 NA 12.88 1.80 NA 27.49 090 24435 A Repair humerus with graft 13.17 NA 13.98 1.84 NA 28.99 090 24470 A Revision of elbow joint 8.74 NA 6.59 1.23 NA 16.56 090 24495 A Decompression of forearm 8.12 NA 10.33 0.92 NA 19.37 090 24498 A Reinforce humerus 11.92 NA 12.31 1.67 NA 25.90 090 24500 A Treat humerus fracture 3.21 5.09 3.38 0.41 8.71 7.00 090 24505 A Treat humerus fracture 5.17 8.88 6.81 0.72 14.77 12.70 090 24515 A Treat humerus fracture 11.65 NA 11.40 1.63 NA 24.68 090 24516 A Treat humerus fracture 11.65 NA 11.85 1.63 NA 25.13 090 24530 A Treat humerus fracture 3.50 6.19 4.86 0.47 10.16 8.83 090 24535 A Treat humerus fracture 6.87 8.81 6.72 0.96 16.64 14.55 090 24538 A Treat humerus fracture 9.43 NA 10.61 1.25 NA 21.29 090 24545 A Treat humerus fracture 10.46 NA 10.18 1.47 NA 22.11 090 24546 A Treat humerus fracture 15.69 NA 13.69 2.18 NA 31.56 090 24560 A Treat humerus fracture 2.80 4.87 3.23 0.35 8.02 6.38 090 24565 A Treat humerus fracture 5.56 8.09 5.82 0.74 14.39 12.12 090 24566 A Treat humerus fracture 7.79 NA 9.96 1.10 NA 18.85 090 24575 A Treat humerus fracture 10.66 NA 8.49 1.44 NA 20.59 090 24576 A Treat humerus fracture 2.86 4.62 3.26 0.38 7.86 6.50 090 24577 A Treat humerus fracture 5.79 8.22 6.13 0.81 14.82 12.73 090 24579 A Treat humerus fracture 11.60 NA 11.32 1.62 NA 24.54 090Start Printed Page 55347 24582 A Treat humerus fracture 8.55 NA 10.46 1.20 NA 20.21 090 24586 A Treat elbow fracture 15.21 NA 11.23 2.12 NA 28.56 090 24587 A Treat elbow fracture 15.16 NA 11.13 2.14 NA 28.43 090 24600 A Treat elbow dislocation 4.23 6.82 5.12 0.49 11.54 9.84 090 24605 A Treat elbow dislocation 5.42 NA 5.02 0.72 NA 11.16 090 24615 A Treat elbow dislocation 9.42 NA 7.94 1.31 NA 18.67 090 24620 A Treat elbow fracture 6.98 NA 6.63 0.90 NA 14.51 090 24635 A Treat elbow fracture 13.19 NA 16.55 1.84 NA 31.58 090 24640 A Treat elbow dislocation 1.20 3.35 1.88 0.11 4.66 3.19 010 24650 A Treat radius fracture 2.16 4.55 2.92 0.28 6.99 5.36 090 24655 A Treat radius fracture 4.40 7.33 5.22 0.58 12.31 10.20 090 24665 A Treat radius fracture 8.14 NA 9.40 1.13 NA 18.67 090 24666 A Treat radius fracture 9.49 NA 10.18 1.32 NA 20.99 090 24670 A Treat ulnar fracture 2.54 4.49 3.10 0.33 7.36 5.97 090 24675 A Treat ulnar fracture 4.72 7.55 5.49 0.65 12.92 10.86 090 24685 A Treat ulnar fracture 8.80 NA 9.79 1.23 NA 19.82 090 24800 A Fusion of elbow joint 11.20 NA 9.90 1.41 NA 22.51 090 24802 A Fusion/graft of elbow joint 13.69 NA 11.50 1.89 NA 27.08 090 24900 A Amputation of upper arm 9.60 NA 11.37 1.18 NA 22.15 090 24920 A Amputation of upper arm 9.54 NA 13.96 1.22 NA 24.72 090 24925 A Amputation follow-up surgery 7.07 NA 9.64 0.95 NA 17.66 090 24930 A Amputation follow-up surgery 10.25 NA 10.86 1.23 NA 22.34 090 24931 A Amputate upper arm & implant 12.72 NA 11.63 1.56 NA 25.91 090 24935 A Revision of amputation 15.56 NA 13.22 1.58 NA 30.36 090 24940 C Revision of upper arm 0.00 0.00 0.00 0.00 0.00 0.00 090 24999 C Upper arm/elbow surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY 25000 A Incision of tendon sheath 3.38 NA 7.49 0.45 NA 11.32 090 25001 A Incise flexor carpi radialis 3.38 NA 4.30 0.45 NA 8.13 090 25020 A Decompress forearm 1 space 5.92 NA 11.49 0.75 NA 18.16 090 25023 A Decompress forearm 1 space 12.96 NA 17.50 1.50 NA 31.96 090 25024 A Decompress forearm 2 spaces 9.50 NA 8.17 1.20 NA 18.87 090 25025 A Decompress forearm 2 spaces 16.54 NA 12.05 1.91 NA 30.50 090 25028 A Drainage of forearm lesion 5.25 NA 10.20 0.61 NA 16.06 090 25031 A Drainage of forearm bursa 4.14 NA 10.24 0.50 NA 14.88 090 25035 A Treat forearm bone lesion 7.36 NA 16.18 0.98 NA 24.52 090 25040 A Explore/treat wrist joint 7.18 NA 9.40 0.96 NA 17.54 090 25065 A Biopsy forearm soft tissues 1.99 2.53 2.53 0.12 4.64 4.64 010 25066 A Biopsy forearm soft tissues 4.13 NA 8.40 0.49 NA 13.02 090 25075 A Remove forearm lesion subcut 3.74 NA 7.13 0.40 NA 11.27 090 25076 A Remove forearm lesion deep 4.92 NA 12.68 0.59 NA 18.19 090 25077 A Remove tumor, forearm/wrist 9.76 NA 15.66 1.10 NA 26.52 090 25085 A Incision of wrist capsule 5.50 NA 11.29 0.71 NA 17.50 090 25100 A Biopsy of wrist joint 3.90 NA 7.99 0.50 NA 12.39 090 25101 A Explore/treat wrist joint 4.69 NA 7.75 0.60 NA 13.04 090 25105 A Remove wrist joint lining 5.85 NA 11.22 0.77 NA 17.84 090 25107 A Remove wrist joint cartilage 6.43 NA 11.41 0.82 NA 18.66 090 25110 A Remove wrist tendon lesion 3.92 NA 8.94 0.48 NA 13.34 090 25111 A Remove wrist tendon lesion 3.39 NA 6.70 0.42 NA 10.51 090 25112 A Reremove wrist tendon lesion 4.53 NA 7.43 0.54 NA 12.50 090 25115 A Remove wrist/forearm lesion 8.82 NA 17.19 1.11 NA 27.12 090 25116 A Remove wrist/forearm lesion 7.11 NA 16.20 0.90 NA 24.21 090 25118 A Excise wrist tendon sheath 4.37 NA 7.93 0.55 NA 12.85 090 25119 A Partial removal of ulna 6.04 NA 11.45 0.80 NA 18.29 090 25120 A Removal of forearm lesion 6.10 NA 14.87 0.81 NA 21.78 090 25125 A Remove/graft forearm lesion 7.48 NA 16.11 1.02 NA 24.61 090 25126 A Remove/graft forearm lesion 7.55 NA 15.76 1.00 NA 24.31 090 25130 A Removal of wrist lesion 5.26 NA 8.33 0.66 NA 14.25 090 25135 A Remove & graft wrist lesion 6.89 NA 9.00 0.89 NA 16.78 090 25136 A Remove & graft wrist lesion 5.97 NA 9.26 0.58 NA 15.81 090 25145 A Remove forearm bone lesion 6.37 NA 15.43 0.82 NA 22.62 090 25150 A Partial removal of ulna 7.09 NA 12.00 0.96 NA 20.05 090 25151 A Partial removal of radius 7.39 NA 16.22 0.93 NA 24.54 090 25170 A Extensive forearm surgery 11.09 NA 17.56 1.52 NA 30.17 090 25210 A Removal of wrist bone 5.95 NA 8.71 0.73 NA 15.39 090 25215 A Removal of wrist bones 7.89 NA 12.27 1.02 NA 21.18 090 25230 A Partial removal of radius 5.23 NA 8.23 0.66 NA 14.12 090 25240 A Partial removal of ulna 5.17 NA 10.78 0.69 NA 16.64 090 25246 A Injection for wrist x-ray 1.45 10.20 0.52 0.07 11.72 2.04 000 25248 A Remove forearm foreign body 5.14 NA 10.66 0.54 NA 16.34 090 25250 A Removal of wrist prosthesis 6.60 NA 8.91 0.84 NA 16.35 090 25251 A Removal of wrist prosthesis 9.57 NA 12.52 1.15 NA 23.24 090 25259 A Manipulate wrist w/anesthes 3.75 NA 5.35 0.52 NA 9.62 090 25260 A Repair forearm tendon/muscle 7.80 NA 17.11 0.97 NA 25.88 090Start Printed Page 55348 25263 A Repair forearm tendon/muscle 7.82 NA 15.65 0.94 NA 24.41 090 25265 A Repair forearm tendon/muscle 9.88 NA 17.11 1.19 NA 28.18 090 25270 A Repair forearm tendon/muscle 6.00 NA 16.04 0.76 NA 22.80 090 25272 A Repair forearm tendon/muscle 7.04 NA 16.50 0.89 NA 24.43 090 25274 A Repair forearm tendon/muscle 8.75 NA 17.36 1.11 NA 27.22 090 25275 A Repair forearm tendon sheath 8.50 NA 7.53 1.11 NA 17.14 090 25280 A Revise wrist/forearm tendon 7.22 NA 15.80 0.91 NA 23.93 090 25290 A Incise wrist/forearm tendon 5.29 NA 18.17 0.66 NA 24.12 090 25295 A Release wrist/forearm tendon 6.55 NA 15.16 0.84 NA 22.55 090 25300 A Fusion of tendons at wrist 8.80 NA 10.02 1.07 NA 19.89 090 25301 A Fusion of tendons at wrist 8.40 NA 10.15 1.08 NA 19.63 090 25310 A Transplant forearm tendon 8.14 NA 16.47 1.01 NA 25.62 090 25312 A Transplant forearm tendon 9.57 NA 17.24 1.22 NA 28.03 090 25315 A Revise palsy hand tendon(s) 10.20 NA 18.59 1.26 NA 30.05 090 25316 A Revise palsy hand tendon(s) 12.33 NA 18.40 1.74 NA 32.47 090 25320 A Repair/revise wrist joint 10.77 NA 11.53 1.32 NA 23.62 090 25332 A Revise wrist joint 11.41 NA 11.89 1.46 NA 24.76 090 25335 A Realignment of hand 12.88 NA 13.60 1.66 NA 28.14 090 25337 A Reconstruct ulna/radioulnar 10.17 NA 13.80 1.31 NA 25.28 090 25350 A Revision of radius 8.78 NA 16.68 1.17 NA 26.63 090 25355 A Revision of radius 10.17 NA 17.17 1.44 NA 28.78 090 25360 A Revision of ulna 8.43 NA 16.86 1.17 NA 26.46 090 25365 A Revise radius & ulna 12.40 NA 18.74 1.67 NA 32.81 090 25370 A Revise radius or ulna 13.36 NA 17.84 1.88 NA 33.08 090 25375 A Revise radius & ulna 13.04 NA 16.44 1.84 NA 31.32 090 25390 A Shorten radius or ulna 10.40 NA 17.38 1.38 NA 29.16 090 25391 A Lengthen radius or ulna 13.65 NA 19.01 1.73 NA 34.39 090 25392 A Shorten radius & ulna 13.95 NA 15.59 1.73 NA 31.27 090 25393 A Lengthen radius & ulna 15.87 NA 21.72 1.87 NA 39.46 090 25394 A Repair carpal bone, shorten 10.40 NA 8.43 1.15 NA 19.98 090 25400 A Repair radius or ulna 10.92 NA 17.98 1.50 NA 30.40 090 25405 A Repair/graft radius or ulna 14.38 NA 20.38 1.95 NA 36.71 090 25415 A Repair radius & ulna 13.35 NA 19.14 1.87 NA 34.36 090 25420 A Repair/graft radius & ulna 16.33 NA 21.72 2.20 NA 40.25 090 25425 A Repair/graft radius or ulna 13.21 NA 24.75 1.61 NA 39.57 090 25426 A Repair/graft radius & ulna 15.82 NA 18.15 2.23 NA 36.20 090 25430 A Vasc graft into carpal bone 9.25 NA 7.82 0.56 NA 17.63 090 25431 A Repair nonunion carpal bone 10.44 NA 6.42 0.56 NA 17.42 090 25440 A Repair/graft wrist bone 10.44 NA 11.05 1.41 NA 22.90 090 25441 A Reconstruct wrist joint 12.90 NA 12.24 1.83 NA 26.97 090 25442 A Reconstruct wrist joint 10.85 NA 11.46 1.24 NA 23.55 090 25443 A Reconstruct wrist joint 10.39 NA 13.29 1.30 NA 24.98 090 25444 A Reconstruct wrist joint 11.15 NA 14.29 1.43 NA 26.87 090 25445 A Reconstruct wrist joint 9.69 NA 13.50 1.26 NA 24.45 090 25446 A Wrist replacement 16.55 NA 14.45 2.20 NA 33.20 090 25447 A Repair wrist joint(s) 10.37 NA 11.27 1.34 NA 22.98 090 25449 A Remove wrist joint implant 14.49 NA 16.20 1.77 NA 32.46 090 25450 A Revision of wrist joint 7.87 NA 13.91 0.88 NA 22.66 090 25455 A Revision of wrist joint 9.49 NA 15.22 1.07 NA 25.78 090 25490 A Reinforce radius 9.54 NA 16.70 1.19 NA 27.43 090 25491 A Reinforce ulna 9.96 NA 16.98 1.41 NA 28.35 090 25492 A Reinforce radius and ulna 12.33 NA 16.09 1.62 NA 30.04 090 25500 A Treat fracture of radius 2.45 4.27 2.94 0.28 7.00 5.67 090 25505 A Treat fracture of radius 5.21 7.87 5.65 0.69 13.77 11.55 090 25515 A Treat fracture of radius 9.18 NA 10.00 1.22 NA 20.40 090 25520 A Treat fracture of radius 6.26 8.00 6.28 0.85 15.11 13.39 090 25525 A Treat fracture of radius 12.24 NA 11.65 1.68 NA 25.57 090 25526 A Treat fracture of radius 12.98 NA 15.01 1.80 NA 29.79 090 25530 A Treat fracture of ulna 2.09 4.21 2.87 0.27 6.57 5.23 090 25535 A Treat fracture of ulna 5.14 7.74 5.72 0.68 13.56 11.54 090 25545 A Treat fracture of ulna 8.90 NA 9.88 1.23 NA 20.01 090 25560 A Treat fracture radius & ulna 2.44 4.28 2.93 0.27 6.99 5.64 090 25565 A Treat fracture radius & ulna 5.63 8.02 5.94 0.76 14.41 12.33 090 25574 A Treat fracture radius & ulna 7.01 NA 8.72 0.96 NA 16.69 090 25575 A Treat fracture radius/ulna 10.45 NA 10.74 1.46 NA 22.65 090 25600 A Treat fracture radius/ulna 2.63 4.53 3.10 0.34 7.50 6.07 090 25605 A Treat fracture radius/ulna 5.81 8.18 6.11 0.81 14.80 12.73 090 25611 A Treat fracture radius/ulna 7.77 NA 10.04 1.08 NA 18.89 090 25620 A Treat fracture radius/ulna 8.55 NA 9.67 1.17 NA 19.39 090 25622 A Treat wrist bone fracture 2.61 4.48 3.10 0.33 7.42 6.04 090 25624 A Treat wrist bone fracture 4.53 7.40 5.34 0.61 12.54 10.48 090 25628 A Treat wrist bone fracture 8.43 NA 9.68 1.14 NA 19.25 090 25630 A Treat wrist bone fracture 2.88 4.66 3.20 0.37 7.91 6.45 090Start Printed Page 55349 25635 A Treat wrist bone fracture 4.39 7.45 5.11 0.39 12.23 9.89 090 25645 A Treat wrist bone fracture 7.25 NA 9.56 0.93 NA 17.74 090 25650 A Treat wrist bone fracture 3.05 4.75 3.24 0.37 8.17 6.66 090 25651 A Pin ulnar styloid fracture 5.36 NA 4.39 0.73 NA 10.48 090 25652 A Treat fracture ulnar styloid 7.60 NA 6.90 0.97 NA 15.47 090 25660 A Treat wrist dislocation 4.76 NA 5.45 0.59 NA 10.80 090 25670 A Treat wrist dislocation 7.92 NA 9.54 1.07 NA 18.53 090 25671 A Pin radioulnar dislocation 6.00 NA 6.02 0.75 NA 12.77 090 25675 A Treat wrist dislocation 4.67 7.57 5.39 0.57 12.81 10.63 090 25676 A Treat wrist dislocation 8.04 NA 9.52 1.10 NA 18.66 090 25680 A Treat wrist fracture 5.99 NA 6.45 0.61 NA 13.05 090 25685 A Treat wrist fracture 9.78 NA 10.20 1.25 NA 21.23 090 25690 A Treat wrist dislocation 5.50 NA 7.00 0.78 NA 13.28 090 25695 A Treat wrist dislocation 8.34 NA 9.68 1.07 NA 19.09 090 25800 A Fusion of wrist joint 9.76 NA 10.87 1.30 NA 21.93 090 25805 A Fusion/graft of wrist joint 11.28 NA 11.61 1.51 NA 24.40 090 25810 A Fusion/graft of wrist joint 10.57 NA 11.33 1.37 NA 23.27 090 25820 A Fusion of hand bones 7.45 NA 9.54 0.96 NA 17.95 090 25825 A Fuse hand bones with graft 9.27 NA 10.51 1.20 NA 20.98 090 25830 A Fusion, radioulnar jnt/ulna 10.06 NA 16.99 1.27 NA 28.32 090 25900 A Amputation of forearm 9.01 NA 15.04 1.08 NA 25.13 090 25905 A Amputation of forearm 9.12 NA 14.25 1.06 NA 24.43 090 25907 A Amputation follow-up surgery 7.80 NA 15.26 1.01 NA 24.07 090 25909 A Amputation follow-up surgery 8.96 NA 14.51 1.07 NA 24.54 090 25915 A Amputation of forearm 17.08 NA 15.11 2.41 NA 34.60 090 25920 A Amputate hand at wrist 8.68 NA 10.12 1.06 NA 19.86 090 25922 A Amputate hand at wrist 7.42 NA 7.58 0.93 NA 15.93 090 25924 A Amputation follow-up surgery 8.46 NA 10.19 1.07 NA 19.72 090 25927 A Amputation of hand 8.80 NA 14.11 1.02 NA 23.93 090 25929 A Amputation follow-up surgery 7.59 NA 7.42 0.89 NA 15.90 090 25931 A Amputation follow-up surgery 7.81 NA 15.79 0.88 NA 24.48 090 25999 C Forearm or wrist surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY 26010 A Drainage of finger abscess 1.54 5.24 3.94 0.14 6.92 5.62 010 26011 A Drainage of finger abscess 2.19 7.48 6.50 0.25 9.92 8.94 010 26020 A Drain hand tendon sheath 4.67 NA 13.10 0.59 NA 18.36 090 26025 A Drainage of palm bursa 4.82 NA 13.26 0.60 NA 18.68 090 26030 A Drainage of palm bursa(s) 5.93 NA 14.02 0.72 NA 20.67 090 26034 A Treat hand bone lesion 6.23 NA 14.84 0.79 NA 21.86 090 26035 A Decompress fingers/hand 9.51 NA 15.17 1.12 NA 25.80 090 26037 A Decompress fingers/hand 7.25 NA 12.67 0.87 NA 20.79 090 26040 A Release palm contracture 3.33 NA 12.87 0.45 NA 16.65 090 26045 A Release palm contracture 5.56 NA 14.17 0.74 NA 20.47 090 26055 A Incise finger tendon sheath 2.69 8.12 7.69 0.36 11.17 10.74 090 26060 A Incision of finger tendon 2.81 NA 7.57 0.35 NA 10.73 090 26070 A Explore/treat hand joint 3.69 NA 11.69 0.35 NA 15.73 090 26075 A Explore/treat finger joint 3.79 NA 12.47 0.40 NA 16.66 090 26080 A Explore/treat finger joint 4.24 NA 13.09 0.52 NA 17.85 090 26100 A Biopsy hand joint lining 3.67 NA 8.43 0.45 NA 12.55 090 26105 A Biopsy finger joint lining 3.71 NA 12.95 0.45 NA 17.11 090 26110 A Biopsy finger joint lining 3.53 NA 12.46 0.44 NA 16.43 090 26115 A Remove hand lesion subcut 3.86 7.66 7.66 0.48 12.00 12.00 090 26116 A Remove hand lesion, deep 5.53 NA 13.91 0.69 NA 20.13 090 26117 A Remove tumor, hand/finger 8.55 NA 15.41 1.01 NA 24.97 090 26121 A Release palm contracture 7.54 NA 15.80 0.94 NA 24.28 090 26123 A Release palm contracture 9.29 NA 16.73 1.17 NA 27.19 090 26125 A Release palm contracture 4.61 NA 2.60 0.57 NA 7.78 ZZZ 26130 A Remove wrist joint lining 5.42 NA 15.62 0.65 NA 21.69 090 26135 A Revise finger joint, each 6.96 NA 17.04 0.87 NA 24.87 090 26140 A Revise finger joint, each 6.17 NA 16.33 0.76 NA 23.26 090 26145 A Tendon excision, palm/finger 6.32 NA 16.86 0.77 NA 23.95 090 26160 A Remove tendon sheath lesion 3.15 7.93 7.88 0.39 11.47 11.42 090 26170 A Removal of palm tendon, each 4.77 NA 8.53 0.60 NA 13.90 090 26180 A Removal of finger tendon 5.18 NA 9.19 0.64 NA 15.01 090 26185 A Remove finger bone 5.25 NA 8.76 0.67 NA 14.68 090 26200 A Remove hand bone lesion 5.51 NA 13.97 0.71 NA 20.19 090 26205 A Remove/graft bone lesion 7.70 NA 15.35 0.95 NA 24.00 090 26210 A Removal of finger lesion 5.15 NA 14.32 0.64 NA 20.11 090 26215 A Remove/graft finger lesion 7.10 NA 14.89 0.77 NA 22.76 090 26230 A Partial removal of hand bone 6.33 NA 12.87 0.84 NA 20.04 090 26235 A Partial removal, finger bone 6.19 NA 12.56 0.78 NA 19.53 090 26236 A Partial removal, finger bone 5.32 NA 12.62 0.66 NA 18.60 090 26250 A Extensive hand surgery 7.55 NA 17.33 0.92 NA 25.80 090 26255 A Extensive hand surgery 12.43 NA 18.74 1.05 NA 32.22 090Start Printed Page 55350 26260 A Extensive finger surgery 7.03 NA 16.39 0.83 NA 24.25 090 26261 A Extensive finger surgery 9.09 NA 16.10 0.84 NA 26.03 090 26262 A Partial removal of finger 5.67 NA 14.81 0.70 NA 21.18 090 26320 A Removal of implant from hand 3.98 NA 13.08 0.49 NA 17.55 090 26340 A Manipulate finger w/anesth 2.50 NA 4.53 0.32 NA 7.35 090 26350 A Repair finger/hand tendon 5.99 NA 20.24 0.73 NA 26.96 090 26352 A Repair/graft hand tendon 7.68 NA 19.74 0.93 NA 28.35 090 26356 A Repair finger/hand tendon 8.07 NA 21.55 0.99 NA 30.61 090 26357 A Repair finger/hand tendon 8.58 NA 21.30 1.02 NA 30.90 090 26358 A Repair/graft hand tendon 9.14 NA 22.43 1.07 NA 32.64 090 26370 A Repair finger/hand tendon 7.11 NA 20.61 0.90 NA 28.62 090 26372 A Repair/graft hand tendon 8.76 NA 20.46 1.06 NA 30.28 090 26373 A Repair finger/hand tendon 8.16 NA 22.61 0.98 NA 31.75 090 26390 A Revise hand/finger tendon 9.19 NA 16.93 1.09 NA 27.21 090 26392 A Repair/graft hand tendon 10.26 NA 23.05 1.26 NA 34.57 090 26410 A Repair hand tendon 4.63 NA 16.26 0.57 NA 21.46 090 26412 A Repair/graft hand tendon 6.31 NA 16.83 0.80 NA 23.94 090 26415 A Excision, hand/finger tendon 8.34 NA 18.14 0.77 NA 27.25 090 26416 A Graft hand or finger tendon 9.37 NA 18.95 1.20 NA 29.52 090 26418 A Repair finger tendon 4.25 NA 16.34 0.50 NA 21.09 090 26420 A Repair/graft finger tendon 6.77 NA 17.92 0.83 NA 25.52 090 26426 A Repair finger/hand tendon 6.15 NA 17.05 0.77 NA 23.97 090 26428 A Repair/graft finger tendon 7.21 NA 16.05 0.84 NA 24.10 090 26432 A Repair finger tendon 4.02 NA 13.49 0.48 NA 17.99 090 26433 A Repair finger tendon 4.56 NA 14.42 0.56 NA 19.54 090 26434 A Repair/graft finger tendon 6.09 NA 15.34 0.71 NA 22.14 090 26437 A Realignment of tendons 5.82 NA 14.16 0.74 NA 20.72 090 26440 A Release palm/finger tendon 5.02 NA 18.48 0.62 NA 24.12 090 26442 A Release palm & finger tendon 8.16 NA 19.40 0.94 NA 28.50 090 26445 A Release hand/finger tendon 4.31 NA 18.27 0.54 NA 23.12 090 26449 A Release forearm/hand tendon 7.00 NA 20.16 0.84 NA 28.00 090 26450 A Incision of palm tendon 3.67 NA 8.71 0.46 NA 12.84 090 26455 A Incision of finger tendon 3.64 NA 8.38 0.47 NA 12.49 090 26460 A Incise hand/finger tendon 3.46 NA 8.06 0.44 NA 11.96 090 26471 A Fusion of finger tendons 5.73 NA 13.93 0.73 NA 20.39 090 26474 A Fusion of finger tendons 5.32 NA 13.30 0.69 NA 19.31 090 26476 A Tendon lengthening 5.18 NA 12.72 0.62 NA 18.52 090 26477 A Tendon shortening 5.15 NA 13.73 0.60 NA 19.48 090 26478 A Lengthening of hand tendon 5.80 NA 14.73 0.77 NA 21.30 090 26479 A Shortening of hand tendon 5.74 NA 13.71 0.76 NA 20.21 090 26480 A Transplant hand tendon 6.69 NA 19.63 0.84 NA 27.16 090 26483 A Transplant/graft hand tendon 8.29 NA 19.79 1.03 NA 29.11 090 26485 A Transplant palm tendon 7.70 NA 20.08 0.94 NA 28.72 090 26489 A Transplant/graft palm tendon 9.55 NA 17.34 0.98 NA 27.87 090 26490 A Revise thumb tendon 8.41 NA 14.87 1.05 NA 24.33 090 26492 A Tendon transfer with graft 9.62 NA 15.84 1.19 NA 26.65 090 26494 A Hand tendon/muscle transfer 8.47 NA 13.52 1.13 NA 23.12 090 26496 A Revise thumb tendon 9.59 NA 15.53 1.17 NA 26.29 090 26497 A Finger tendon transfer 9.57 NA 16.42 1.17 NA 27.16 090 26498 A Finger tendon transfer 14.00 NA 18.19 1.74 NA 33.93 090 26499 A Revision of finger 8.98 NA 14.61 0.94 NA 24.53 090 26500 A Hand tendon reconstruction 5.96 NA 15.16 0.66 NA 21.78 090 26502 A Hand tendon reconstruction 7.14 NA 15.14 0.87 NA 23.15 090 26504 A Hand tendon reconstruction 7.47 NA 14.31 0.84 NA 22.62 090 26508 A Release thumb contracture 6.01 NA 14.11 0.76 NA 20.88 090 26510 A Thumb tendon transfer 5.43 NA 14.18 0.71 NA 20.32 090 26516 A Fusion of knuckle joint 7.15 NA 15.06 0.90 NA 23.11 090 26517 A Fusion of knuckle joints 8.83 NA 15.89 0.96 NA 25.68 090 26518 A Fusion of knuckle joints 9.02 NA 15.91 1.13 NA 26.06 090 26520 A Release knuckle contracture 5.30 NA 18.59 0.65 NA 24.54 090 26525 A Release finger contracture 5.33 NA 18.67 0.66 NA 24.66 090 26530 A Revise knuckle joint 6.69 NA 19.35 0.86 NA 26.90 090 26531 A Revise knuckle with implant 7.91 NA 19.41 1.01 NA 28.33 090 26535 A Revise finger joint 5.24 NA 11.10 0.66 NA 17.00 090 26536 A Revise/implant finger joint 6.37 NA 17.97 0.80 NA 25.14 090 26540 A Repair hand joint 6.43 NA 14.54 0.81 NA 21.78 090 26541 A Repair hand joint with graft 8.62 NA 16.36 1.12 NA 26.10 090 26542 A Repair hand joint with graft 6.78 NA 14.51 0.87 NA 22.16 090 26545 A Reconstruct finger joint 6.92 NA 16.16 0.79 NA 23.87 090 26546 A Repair nonunion hand 8.92 NA 15.95 1.14 NA 26.01 090 26548 A Reconstruct finger joint 8.03 NA 16.13 0.98 NA 25.14 090 26550 A Construct thumb replacement 21.24 NA 30.36 1.80 NA 53.40 090 26551 A Great toe-hand transfer 46.58 NA 29.35 6.57 NA 82.50 090Start Printed Page 55351 26553 A Single transfer, toe-hand 46.27 NA 29.23 1.99 NA 77.49 090 26554 A Double transfer, toe-hand 54.95 NA 32.69 7.76 NA 95.40 090 26555 A Positional change of finger 16.63 NA 24.00 2.13 NA 42.76 090 26556 A Toe joint transfer 47.26 NA 29.62 6.67 NA 83.55 090 26560 A Repair of web finger 5.38 NA 12.55 0.60 NA 18.53 090 26561 A Repair of web finger 10.92 NA 18.61 0.69 NA 30.22 090 26562 A Repair of web finger 15.00 NA 13.44 0.98 NA 29.42 090 26565 A Correct metacarpal flaw 6.74 NA 14.77 0.84 NA 22.35 090 26567 A Correct finger deformity 6.82 NA 15.10 0.84 NA 22.76 090 26568 A Lengthen metacarpal/finger 9.08 NA 19.48 1.10 NA 29.66 090 26580 A Repair hand deformity 18.18 NA 17.22 1.46 NA 36.86 090 26585 D Repair finger deformity 0.00 NA 0.00 0.00 NA 0.00 090 26587 A Reconstruct extra finger 14.05 4.67 NA 1.08 19.80 NA 090 26590 A Repair finger deformity 17.96 NA 14.62 1.32 NA 33.90 090 26591 A Repair muscles of hand 3.25 NA 14.22 0.37 NA 17.84 090 26593 A Release muscles of hand 5.31 NA 13.33 0.64 NA 19.28 090 26596 A Excision constricting tissue 8.95 NA 10.26 0.87 NA 20.08 090 26597 D Release of scar contracture 0.00 NA 0.00 0.00 NA 0.00 090 26600 A Treat metacarpal fracture 1.96 4.15 2.83 0.25 6.36 5.04 090 26605 A Treat metacarpal fracture 2.85 6.05 4.29 0.38 9.28 7.52 090 26607 A Treat metacarpal fracture 5.36 NA 8.33 0.70 NA 14.39 090 26608 A Treat metacarpal fracture 5.36 NA 8.85 0.73 NA 14.94 090 26615 A Treat metacarpal fracture 5.33 NA 8.43 0.70 NA 14.46 090 26641 A Treat thumb dislocation 3.94 6.58 4.99 0.42 10.94 9.35 090 26645 A Treat thumb fracture 4.41 7.33 5.30 0.54 12.28 10.25 090 26650 A Treat thumb fracture 5.72 NA 9.02 0.77 NA 15.51 090 26665 A Treat thumb fracture 7.60 NA 9.24 0.97 NA 17.81 090 26670 A Treat hand dislocation 3.69 6.46 4.93 0.36 10.51 8.98 090 26675 A Treat hand dislocation 4.64 6.82 4.71 0.56 12.02 9.91 090 26676 A Pin hand dislocation 5.52 NA 9.36 0.76 NA 15.64 090 26685 A Treat hand dislocation 6.98 NA 8.88 0.95 NA 16.81 090 26686 A Treat hand dislocation 7.94 NA 9.84 1.05 NA 18.83 090 26700 A Treat knuckle dislocation 3.69 5.01 3.02 0.35 9.05 7.06 090 26705 A Treat knuckle dislocation 4.19 6.26 4.33 0.50 10.95 9.02 090 26706 A Pin knuckle dislocation 5.12 NA 5.87 0.64 NA 11.63 090 26715 A Treat knuckle dislocation 5.74 NA 8.62 0.75 NA 15.11 090 26720 A Treat finger fracture, each 1.66 3.06 1.72 0.20 4.92 3.58 090 26725 A Treat finger fracture, each 3.33 5.27 3.26 0.43 9.03 7.02 090 26727 A Treat finger fracture, each 5.23 NA 8.88 0.69 NA 14.80 090 26735 A Treat finger fracture, each 5.98 NA 8.99 0.77 NA 15.74 090 26740 A Treat finger fracture, each 1.94 3.86 2.67 0.24 6.04 4.85 090 26742 A Treat finger fracture, each 3.85 7.21 5.13 0.49 11.55 9.47 090 26746 A Treat finger fracture, each 5.81 NA 8.93 0.74 NA 15.48 090 26750 A Treat finger fracture, each 1.70 3.66 2.47 0.19 5.55 4.36 090 26755 A Treat finger fracture, each 3.10 5.08 3.27 0.37 8.55 6.74 090 26756 A Pin finger fracture, each 4.39 NA 8.74 0.56 NA 13.69 090 26765 A Treat finger fracture, each 4.17 NA 8.02 0.51 NA 12.70 090 26770 A Treat finger dislocation 3.02 4.87 2.80 0.27 8.16 6.09 090 26775 A Treat finger dislocation 3.71 6.07 4.09 0.43 10.21 8.23 090 26776 A Pin finger dislocation 4.80 NA 8.61 0.63 NA 14.04 090 26785 A Treat finger dislocation 4.21 NA 7.95 0.54 NA 12.70 090 26820 A Thumb fusion with graft 8.26 NA 15.80 1.11 NA 25.17 090 26841 A Fusion of thumb 7.13 NA 15.37 0.97 NA 23.47 090 26842 A Thumb fusion with graft 8.24 NA 15.49 1.10 NA 24.83 090 26843 A Fusion of hand joint 7.61 NA 13.91 0.99 NA 22.51 090 26844 A Fusion/graft of hand joint 8.73 NA 15.63 1.12 NA 25.48 090 26850 A Fusion of knuckle 6.97 NA 14.63 0.89 NA 22.49 090 26852 A Fusion of knuckle with graft 8.46 NA 15.19 1.05 NA 24.70 090 26860 A Fusion of finger joint 4.69 NA 13.45 0.60 NA 18.74 090 26861 A Fusion of finger jnt, add-on 1.74 NA 0.99 0.22 NA 2.95 ZZZ 26862 A Fusion/graft of finger joint 7.37 NA 15.18 0.92 NA 23.47 090 26863 A Fuse/graft added joint 3.90 NA 2.25 0.51 NA 6.66 ZZZ 26910 A Amputate metacarpal bone 7.60 NA 13.98 0.90 NA 22.48 090 26951 A Amputation of finger/thumb 4.59 NA 13.06 0.56 NA 18.21 090 26952 A Amputation of finger/thumb 6.31 NA 14.47 0.74 NA 21.52 090 26989 C Hand/finger surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY 26990 A Drainage of pelvis lesion 7.48 NA 15.92 0.92 NA 24.32 090 26991 A Drainage of pelvis bursa 6.68 11.32 9.39 0.85 18.85 16.92 090 26992 A Drainage of bone lesion 13.02 NA 19.95 1.75 NA 34.72 090 27000 A Incision of hip tendon 5.62 NA 7.48 0.76 NA 13.86 090 27001 A Incision of hip tendon 6.94 NA 8.42 0.95 NA 16.31 090 27003 A Incision of hip tendon 7.34 NA 9.01 0.93 NA 17.28 090 27005 A Incision of hip tendon 9.66 NA 10.50 1.36 NA 21.52 090Start Printed Page 55352 27006 A Incision of hip tendons 9.68 NA 10.59 1.33 NA 21.60 090 27025 A Incision of hip/thigh fascia 11.16 NA 10.53 1.38 NA 23.07 090 27030 A Drainage of hip joint 13.01 NA 12.45 1.81 NA 27.27 090 27033 A Exploration of hip joint 13.39 NA 12.62 1.87 NA 27.88 090 27035 A Denervation of hip joint 16.69 NA 19.67 1.70 NA 38.06 090 27036 A Excision of hip joint/muscle 12.88 NA 14.03 1.80 NA 28.71 090 27040 A Biopsy of soft tissues 2.87 6.23 4.00 0.21 9.31 7.08 010 27041 A Biopsy of soft tissues 9.89 NA 8.60 1.01 NA 19.50 090 27047 A Remove hip/pelvis lesion 7.45 9.26 7.03 0.79 17.50 15.27 090 27048 A Remove hip/pelvis lesion 6.25 NA 7.94 0.73 NA 14.92 090 27049 A Remove tumor, hip/pelvis 13.66 NA 13.77 1.60 NA 29.03 090 27050 A Biopsy of sacroiliac joint 4.36 NA 7.52 0.53 NA 12.41 090 27052 A Biopsy of hip joint 6.23 NA 8.24 0.85 NA 15.32 090 27054 A Removal of hip joint lining 8.54 NA 10.67 1.17 NA 20.38 090 27060 A Removal of ischial bursa 5.43 NA 7.21 0.60 NA 13.24 090 27062 A Remove femur lesion/bursa 5.37 NA 7.32 0.74 NA 13.43 090 27065 A Removal of hip bone lesion 5.90 NA 8.65 0.76 NA 15.31 090 27066 A Removal of hip bone lesion 10.33 NA 12.53 1.42 NA 24.28 090 27067 A Remove/graft hip bone lesion 13.83 NA 14.54 1.95 NA 30.32 090 27070 A Partial removal of hip bone 10.72 NA 17.71 1.36 NA 29.79 090 27071 A Partial removal of hip bone 11.46 NA 18.67 1.51 NA 31.64 090 27075 A Extensive hip surgery 35.00 NA 25.75 2.22 NA 62.97 090 27076 A Extensive hip surgery 22.12 NA 20.08 2.86 NA 45.06 090 27077 A Extensive hip surgery 40.00 NA 30.55 3.18 NA 73.73 090 27078 A Extensive hip surgery 13.44 NA 16.30 1.67 NA 31.41 090 27079 A Extensive hip surgery 13.75 NA 13.43 1.86 NA 29.04 090 27080 A Removal of tail bone 6.39 NA 7.64 0.80 NA 14.83 090 27086 A Remove hip foreign body 1.87 5.85 3.70 0.17 7.89 5.74 010 27087 A Remove hip foreign body 8.54 NA 9.04 1.09 NA 18.67 090 27090 A Removal of hip prosthesis 11.15 NA 11.37 1.55 NA 24.07 090 27091 A Removal of hip prosthesis 22.14 NA 15.14 3.11 NA 40.39 090 27093 A Injection for hip x-ray 1.30 13.59 0.53 0.09 14.98 1.92 000 27095 A Injection for hip x-ray 1.50 11.00 0.60 0.10 12.60 2.20 000 27096 A Inject sacroiliac joint 1.40 8.86 0.35 0.08 10.34 1.83 000 27097 A Revision of hip tendon 8.80 NA 8.13 1.22 NA 18.15 090 27098 A Transfer tendon to pelvis 8.83 NA 9.18 1.24 NA 19.25 090 27100 A Transfer of abdominal muscle 11.08 NA 13.03 1.57 NA 25.68 090 27105 A Transfer of spinal muscle 11.77 NA 12.14 1.66 NA 25.57 090 27110 A Transfer of iliopsoas muscle 13.26 NA 12.99 1.38 NA 27.63 090 27111 A Transfer of iliopsoas muscle 12.15 NA 11.77 1.48 NA 25.40 090 27120 A Reconstruction of hip socket 18.01 NA 14.28 2.45 NA 34.74 090 27122 A Reconstruction of hip socket 14.98 NA 14.48 2.08 NA 31.54 090 27125 A Partial hip replacement 14.69 NA 14.02 2.05 NA 30.76 090 27130 A Total hip arthroplasty 20.12 NA 17.18 2.82 NA 40.12 090 27132 A Total hip arthroplasty 23.30 NA 19.00 3.26 NA 45.56 090 27134 A Revise hip joint replacement 28.52 NA 21.82 3.97 NA 54.31 090 27137 A Revise hip joint replacement 21.17 NA 17.54 2.97 NA 41.68 090 27138 A Revise hip joint replacement 22.17 NA 17.94 3.11 NA 43.22 090 27140 A Transplant femur ridge 12.24 NA 11.98 1.67 NA 25.89 090 27146 A Incision of hip bone 17.43 NA 15.87 2.27 NA 35.57 090 27147 A Revision of hip bone 20.58 NA 17.87 2.61 NA 41.06 090 27151 A Incision of hip bones 22.51 NA 18.97 3.12 NA 44.60 090 27156 A Revision of hip bones 24.63 NA 19.84 3.48 NA 47.95 090 27158 A Revision of pelvis 19.74 NA 15.58 2.60 NA 37.92 090 27161 A Incision of neck of femur 16.71 NA 14.47 2.32 NA 33.50 090 27165 A Incision/fixation of femur 17.91 NA 14.92 2.51 NA 35.34 090 27170 A Repair/graft femur head/neck 16.07 NA 14.16 2.20 NA 32.43 090 27175 A Treat slipped epiphysis 8.46 NA 7.26 1.19 NA 16.91 090 27176 A Treat slipped epiphysis 12.05 NA 10.23 1.68 NA 23.96 090 27177 A Treat slipped epiphysis 15.08 NA 12.22 2.11 NA 29.41 090 27178 A Treat slipped epiphysis 11.99 NA 10.13 1.68 NA 23.80 090 27179 A Revise head/neck of femur 12.98 NA 10.90 1.84 NA 25.72 090 27181 A Treat slipped epiphysis 14.68 NA 11.92 1.74 NA 28.34 090 27185 A Revision of femur epiphysis 9.18 NA 10.04 1.29 NA 20.51 090 27187 A Reinforce hip bones 13.54 NA 13.53 1.89 NA 28.96 090 27193 A Treat pelvic ring fracture 5.56 7.14 5.36 0.77 13.47 11.69 090 27194 A Treat pelvic ring fracture 9.65 9.20 7.69 1.32 20.17 18.66 090 27200 A Treat tail bone fracture 1.84 3.13 1.84 0.22 5.19 3.90 090 27202 A Treat tail bone fracture 7.04 NA 21.62 0.69 NA 29.35 090 27215 A Treat pelvic fracture(s) 10.05 NA 10.60 1.37 NA 22.02 090 27216 A Treat pelvic ring fracture 15.19 NA 15.51 2.15 NA 32.85 090 27217 A Treat pelvic ring fracture 14.11 NA 12.83 1.95 NA 28.89 090 27218 A Treat pelvic ring fracture 20.15 NA 16.68 2.85 NA 39.68 090Start Printed Page 55353 27220 A Treat hip socket fracture 6.18 7.48 5.72 0.85 14.51 12.75 090 27222 A Treat hip socket fracture 12.70 NA 10.37 1.77 NA 24.84 090 27226 A Treat hip wall fracture 14.91 NA 10.36 2.07 NA 27.34 090 27227 A Treat hip fracture(s) 23.45 NA 17.22 3.24 NA 43.91 090 27228 A Treat hip fracture(s) 27.16 NA 19.67 3.77 NA 50.60 090 27230 A Treat thigh fracture 5.50 7.62 6.30 0.73 13.85 12.53 090 27232 A Treat thigh fracture 10.68 NA 9.31 1.45 NA 21.44 090 27235 A Treat thigh fracture 12.16 NA 11.24 1.71 NA 25.11 090 27236 A Treat thigh fracture 15.60 NA 12.99 2.18 NA 30.77 090 27238 A Treat thigh fracture 5.52 NA 6.36 0.76 NA 12.64 090 27240 A Treat thigh fracture 12.50 NA 10.38 1.69 NA 24.57 090 27244 A Treat thigh fracture 15.94 NA 13.25 2.23 NA 31.42 090 27245 A Treat thigh fracture 20.31 NA 15.61 2.85 NA 38.77 090 27246 A Treat thigh fracture 4.71 7.31 5.93 0.66 12.68 11.30 090 27248 A Treat thigh fracture 10.45 NA 10.20 1.45 NA 22.10 090 27250 A Treat hip dislocation 6.95 NA 6.55 0.68 NA 14.18 090 27252 A Treat hip dislocation 10.39 NA 8.31 1.37 NA 20.07 090 27253 A Treat hip dislocation 12.92 NA 11.10 1.81 NA 25.83 090 27254 A Treat hip dislocation 18.26 NA 14.29 2.52 NA 35.07 090 27256 A Treat hip dislocation 4.12 NA 4.31 0.49 NA 8.92 010 27257 A Treat hip dislocation 5.22 NA 4.59 0.56 NA 10.37 010 27258 A Treat hip dislocation 15.43 NA 13.93 2.06 NA 31.42 090 27259 A Treat hip dislocation 21.55 NA 18.02 2.99 NA 42.56 090 27265 A Treat hip dislocation 5.05 NA 6.09 0.65 NA 11.79 090 27266 A Treat hip dislocation 7.49 NA 7.50 1.04 NA 16.03 090 27275 A Manipulation of hip joint 2.27 NA 3.62 0.31 NA 6.20 010 27280 A Fusion of sacroiliac joint 13.39 NA 13.95 1.98 NA 29.32 090 27282 A Fusion of pubic bones 11.34 NA 12.33 1.14 NA 24.81 090 27284 A Fusion of hip joint 23.45 NA 18.86 2.36 NA 44.67 090 27286 A Fusion of hip joint 23.45 NA 19.13 2.37 NA 44.95 090 27290 A Amputation of leg at hip 23.28 NA 17.37 2.94 NA 43.59 090 27295 A Amputation of leg at hip 18.65 NA 14.65 2.35 NA 35.65 090 27299 C Pelvis/hip joint surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY 27301 A Drain thigh/knee lesion 6.49 15.30 14.04 0.80 22.59 21.33 090 27303 A Drainage of bone lesion 8.28 NA 14.63 1.14 NA 24.05 090 27305 A Incise thigh tendon & fascia 5.92 NA 8.88 0.77 NA 15.57 090 27306 A Incision of thigh tendon 4.62 NA 7.54 0.62 NA 12.78 090 27307 A Incision of thigh tendons 5.80 NA 8.15 0.78 NA 14.73 090 27310 A Exploration of knee joint 9.27 NA 10.14 1.29 NA 20.70 090 27315 A Partial removal, thigh nerve 6.97 NA 4.04 0.79 NA 11.80 090 27320 A Partial removal, thigh nerve 6.30 NA 5.07 0.78 NA 12.15 090 27323 A Biopsy, thigh soft tissues 2.28 5.57 3.49 0.17 8.02 5.94 010 27324 A Biopsy, thigh soft tissues 4.90 NA 6.79 0.59 NA 12.28 090 27327 A Removal of thigh lesion 4.47 8.47 6.35 0.50 13.44 11.32 090 27328 A Removal of thigh lesion 5.57 NA 7.19 0.66 NA 13.42 090 27329 A Remove tumor, thigh/knee 14.14 NA 15.02 1.68 NA 30.84 090 27330 A Biopsy, knee joint lining 4.97 NA 6.42 0.66 NA 12.05 090 27331 A Explore/treat knee joint 5.88 NA 7.56 0.81 NA 14.25 090 27332 A Removal of knee cartilage 8.27 NA 8.84 1.15 NA 18.26 090 27333 A Removal of knee cartilage 7.30 NA 8.49 1.03 NA 16.82 090 27334 A Remove knee joint lining 8.70 NA 9.80 1.21 NA 19.71 090 27335 A Remove knee joint lining 10.00 NA 10.58 1.41 NA 21.99 090 27340 A Removal of kneecap bursa 4.18 NA 6.03 0.58 NA 10.79 090 27345 A Removal of knee cyst 5.92 NA 7.49 0.81 NA 14.22 090 27347 A Remove knee cyst 5.78 2.64 2.64 0.76 9.18 9.18 090 27350 A Removal of kneecap 8.17 NA 8.95 1.15 NA 18.27 090 27355 A Remove femur lesion 7.65 NA 10.36 1.07 NA 19.08 090 27356 A Remove femur lesion/graft 9.48 NA 11.32 1.29 NA 22.09 090 27357 A Remove femur lesion/graft 10.53 NA 11.75 1.48 NA 23.76 090 27358 A Remove femur lesion/fixation 4.74 NA 2.69 0.67 NA 8.10 ZZZ 27360 A Partial removal, leg bone(s) 10.50 NA 18.43 1.42 NA 30.35 090 27365 A Extensive leg surgery 16.27 NA 14.69 2.26 NA 33.22 090 27370 A Injection for knee x-ray 0.96 11.10 0.35 0.06 12.12 1.37 000 27372 A Removal of foreign body 5.07 8.66 6.28 0.62 14.35 11.97 090 27380 A Repair of kneecap tendon 7.16 NA 8.57 1.00 NA 16.73 090 27381 A Repair/graft kneecap tendon 10.34 NA 10.34 1.44 NA 22.12 090 27385 A Repair of thigh muscle 7.76 NA 8.93 1.09 NA 17.78 090 27386 A Repair/graft of thigh muscle 10.56 NA 11.12 1.49 NA 23.17 090 27390 A Incision of thigh tendon 5.33 NA 8.22 0.69 NA 14.24 090 27391 A Incision of thigh tendons 7.20 NA 9.08 0.99 NA 17.27 090 27392 A Incision of thigh tendons 9.20 NA 11.15 1.23 NA 21.58 090 27393 A Lengthening of thigh tendon 6.39 NA 8.45 0.90 NA 15.74 090 27394 A Lengthening of thigh tendons 8.50 NA 10.51 1.17 NA 20.18 090Start Printed Page 55354 27395 A Lengthening of thigh tendons 11.73 NA 13.19 1.63 NA 26.55 090 27396 A Transplant of thigh tendon 7.86 NA 9.65 1.11 NA 18.62 090 27397 A Transplants of thigh tendons 11.28 NA 11.71 1.58 NA 24.57 090 27400 A Revise thigh muscles/tendons 9.02 NA 10.67 1.18 NA 20.87 090 27403 A Repair of knee cartilage 8.33 NA 8.88 1.16 NA 18.37 090 27405 A Repair of knee ligament 8.65 NA 9.81 1.21 NA 19.67 090 27407 A Repair of knee ligament 10.28 NA 10.67 1.38 NA 22.33 090 27409 A Repair of knee ligaments 12.90 NA 12.11 1.75 NA 26.76 090 27418 A Repair degenerated kneecap 10.85 NA 10.99 1.51 NA 23.35 090 27420 A Revision of unstable kneecap 9.83 NA 9.87 1.38 NA 21.08 090 27422 A Revision of unstable kneecap 9.78 NA 9.83 1.37 NA 20.98 090 27424 A Revision/removal of kneecap 9.81 NA 9.75 1.38 NA 20.94 090 27425 A Lateral retinacular release 5.22 NA 7.29 0.73 NA 13.24 090 27427 A Reconstruction, knee 9.36 NA 9.57 1.29 NA 20.22 090 27428 A Reconstruction, knee 14.00 NA 12.85 1.95 NA 28.80 090 27429 A Reconstruction, knee 15.52 NA 13.69 2.18 NA 31.39 090 27430 A Revision of thigh muscles 9.67 NA 9.90 1.35 NA 20.92 090 27435 A Incision of knee joint 9.49 NA 9.68 1.33 NA 20.50 090 27437 A Revise kneecap 8.46 NA 10.06 1.18 NA 19.70 090 27438 A Revise kneecap with implant 11.23 NA 11.34 1.56 NA 24.13 090 27440 A Revision of knee joint 10.43 NA 10.92 1.42 NA 22.77 090 27441 A Revision of knee joint 10.82 NA 11.24 1.49 NA 23.55 090 27442 A Revision of knee joint 11.89 NA 11.77 1.68 NA 25.34 090 27443 A Revision of knee joint 10.93 NA 11.56 1.52 NA 24.01 090 27445 A Revision of knee joint 17.68 NA 14.98 2.49 NA 35.15 090 27446 A Revision of knee joint 15.84 NA 14.26 2.22 NA 32.32 090 27447 A Total knee arthroplasty 21.48 NA 17.35 3.00 NA 41.83 090 27448 A Incision of thigh 11.06 NA 11.98 1.51 NA 24.55 090 27450 A Incision of thigh 13.98 NA 13.83 1.96 NA 29.77 090 27454 A Realignment of thigh bone 17.56 NA 15.83 2.46 NA 35.85 090 27455 A Realignment of knee 12.82 NA 12.57 1.78 NA 27.17 090 27457 A Realignment of knee 13.45 NA 11.73 1.88 NA 27.06 090 27465 A Shortening of thigh bone 13.87 NA 14.09 1.86 NA 29.82 090 27466 A Lengthening of thigh bone 16.33 NA 16.19 1.92 NA 34.44 090 27468 A Shorten/lengthen thighs 18.97 NA 14.57 2.68 NA 36.22 090 27470 A Repair of thigh 16.07 NA 16.07 2.24 NA 34.38 090 27472 A Repair/graft of thigh 17.72 NA 16.98 2.49 NA 37.19 090 27475 A Surgery to stop leg growth 8.64 NA 9.51 1.13 NA 19.28 090 27477 A Surgery to stop leg growth 9.85 NA 10.10 1.31 NA 21.26 090 27479 A Surgery to stop leg growth 12.80 NA 12.09 1.81 NA 26.70 090 27485 A Surgery to stop leg growth 8.84 NA 9.40 1.24 NA 19.48 090 27486 A Revise/replace knee joint 19.27 NA 16.13 2.70 NA 38.10 090 27487 A Revise/replace knee joint 25.27 NA 19.26 3.54 NA 48.07 090 27488 A Removal of knee prosthesis 15.74 NA 14.21 2.21 NA 32.16 090 27495 A Reinforce thigh 15.55 NA 15.78 2.18 NA 33.51 090 27496 A Decompression of thigh/knee 6.11 NA 7.96 0.77 NA 14.84 090 27497 A Decompression of thigh/knee 7.17 NA 8.16 0.84 NA 16.17 090 27498 A Decompression of thigh/knee 7.99 NA 8.37 0.97 NA 17.33 090 27499 A Decompression of thigh/knee 9.00 NA 9.42 1.18 NA 19.60 090 27500 A Treatment of thigh fracture 5.92 9.84 7.57 0.80 16.56 14.29 090 27501 A Treatment of thigh fracture 5.92 10.92 8.62 0.83 17.67 15.37 090 27502 A Treatment of thigh fracture 10.58 NA 11.27 1.49 NA 23.34 090 27503 A Treatment of thigh fracture 10.58 NA 11.26 1.49 NA 23.33 090 27506 A Treatment of thigh fracture 17.45 NA 14.57 2.33 NA 34.35 090 27507 A Treatment of thigh fracture 13.99 NA 12.58 1.95 NA 28.52 090 27508 A Treatment of thigh fracture 5.83 7.17 5.43 0.80 13.80 12.06 090 27509 A Treatment of thigh fracture 7.71 NA 9.44 1.08 NA 18.23 090 27510 A Treatment of thigh fracture 9.13 NA 7.37 1.26 NA 17.76 090 27511 A Treatment of thigh fracture 13.64 NA 13.38 1.91 NA 28.93 090 27513 A Treatment of thigh fracture 17.92 NA 15.80 2.51 NA 36.23 090 27514 A Treatment of thigh fracture 17.30 NA 14.55 2.41 NA 34.26 090 27516 A Treat thigh fx growth plate 5.37 7.98 5.85 0.74 14.09 11.96 090 27517 A Treat thigh fx growth plate 8.78 9.94 7.90 1.22 19.94 17.90 090 27519 A Treat thigh fx growth plate 15.02 NA 13.11 2.09 NA 30.22 090 27520 A Treat kneecap fracture 2.86 5.48 3.82 0.38 8.72 7.06 090 27524 A Treat kneecap fracture 10.00 NA 8.98 1.40 NA 20.38 090 27530 A Treat knee fracture 3.78 6.00 4.33 0.51 10.29 8.62 090 27532 A Treat knee fracture 7.30 7.65 5.84 1.02 15.97 14.16 090 27535 A Treat knee fracture 11.50 NA 12.15 1.61 NA 25.26 090 27536 A Treat knee fracture 15.65 NA 12.16 2.19 NA 30.00 090 27538 A Treat knee fracture(s) 4.87 7.64 5.60 0.67 13.18 11.14 090 27540 A Treat knee fracture 13.10 NA 10.75 1.80 NA 25.65 090 27550 A Treat knee dislocation 5.76 7.60 5.79 0.68 14.04 12.23 090Start Printed Page 55355 27552 A Treat knee dislocation 7.90 NA 8.04 1.10 NA 17.04 090 27556 A Treat knee dislocation 14.41 NA 14.45 2.01 NA 30.87 090 27557 A Treat knee dislocation 16.77 NA 15.78 2.37 NA 34.92 090 27558 A Treat knee dislocation 17.72 NA 15.91 2.51 NA 36.14 090 27560 A Treat kneecap dislocation 3.82 5.89 4.04 0.40 10.11 8.26 090 27562 A Treat kneecap dislocation 5.79 NA 5.67 0.69 NA 12.15 090 27566 A Treat kneecap dislocation 12.23 NA 10.09 1.73 NA 24.05 090 27570 A Fixation of knee joint 1.74 NA 3.24 0.24 NA 5.22 010 27580 A Fusion of knee 19.37 NA 16.63 2.70 NA 38.70 090 27590 A Amputate leg at thigh 12.03 NA 12.67 1.35 NA 26.05 090 27591 A Amputate leg at thigh 12.68 NA 14.01 1.63 NA 28.32 090 27592 A Amputate leg at thigh 10.02 NA 12.55 1.17 NA 23.74 090 27594 A Amputation follow-up surgery 6.92 NA 9.05 0.82 NA 16.79 090 27596 A Amputation follow-up surgery 10.60 NA 12.64 1.24 NA 24.48 090 27598 A Amputate lower leg at knee 10.53 NA 11.69 1.24 NA 23.46 090 27599 C Leg surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 27600 A Decompression of lower leg 5.65 NA 7.67 0.68 NA 14.00 090 27601 A Decompression of lower leg 5.64 NA 7.68 0.69 NA 14.01 090 27602 A Decompression of lower leg 7.35 NA 8.08 0.85 NA 16.28 090 27603 A Drain lower leg lesion 4.94 16.03 10.54 0.56 21.53 16.04 090 27604 A Drain lower leg bursa 4.47 11.01 8.47 0.54 16.02 13.48 090 27605 A Incision of achilles tendon 2.87 9.81 3.67 0.38 13.06 6.92 010 27606 A Incision of achilles tendon 4.14 13.19 5.08 0.57 17.90 9.79 010 27607 A Treat lower leg bone lesion 7.97 NA 12.78 1.08 NA 21.83 090 27610 A Explore/treat ankle joint 8.34 NA 10.43 1.15 NA 19.92 090 27612 A Exploration of ankle joint 7.33 NA 8.32 1.01 NA 16.66 090 27613 A Biopsy lower leg soft tissue 2.17 5.38 2.96 0.16 7.71 5.29 010 27614 A Biopsy lower leg soft tissue 5.66 10.88 7.17 0.62 17.16 13.45 090 27615 A Remove tumor, lower leg 12.56 NA 17.07 1.39 NA 31.02 090 27618 A Remove lower leg lesion 5.09 11.72 6.72 0.54 17.35 12.35 090 27619 A Remove lower leg lesion 8.40 12.63 9.55 1.01 22.04 18.96 090 27620 A Explore/treat ankle joint 5.98 NA 8.20 0.83 NA 15.01 090 27625 A Remove ankle joint lining 8.30 NA 9.57 1.16 NA 19.03 090 27626 A Remove ankle joint lining 8.91 NA 10.39 1.23 NA 20.53 090 27630 A Removal of tendon lesion 4.80 10.70 6.87 0.60 16.10 12.27 090 27635 A Remove lower leg bone lesion 7.78 NA 11.13 1.06 NA 19.97 090 27637 A Remove/graft leg bone lesion 9.85 NA 12.36 1.38 NA 23.59 090 27638 A Remove/graft leg bone lesion 10.57 NA 12.55 1.47 NA 24.59 090 27640 A Partial removal of tibia 11.37 NA 18.46 1.54 NA 31.37 090 27641 A Partial removal of fibula 9.24 NA 16.52 1.22 NA 26.98 090 27645 A Extensive lower leg surgery 14.17 NA 18.78 1.98 NA 34.93 090 27646 A Extensive lower leg surgery 12.66 NA 18.50 1.55 NA 32.71 090 27647 A Extensive ankle/heel surgery 12.24 NA 11.31 1.64 NA 25.19 090 27648 A Injection for ankle x-ray 0.96 9.49 0.36 0.05 10.50 1.37 000 27650 A Repair achilles tendon 9.69 NA 9.60 1.35 NA 20.64 090 27652 A Repair/graft achilles tendon 10.33 NA 9.90 1.45 NA 21.68 090 27654 A Repair of achilles tendon 10.02 NA 10.34 1.41 NA 21.77 090 27656 A Repair leg fascia defect 4.57 11.38 7.06 0.48 16.43 12.11 090 27658 A Repair of leg tendon, each 4.98 10.63 9.14 0.68 16.29 14.80 090 27659 A Repair of leg tendon, each 6.81 12.77 9.97 0.96 20.54 17.74 090 27664 A Repair of leg tendon, each 4.59 17.85 9.17 0.63 23.07 14.39 090 27665 A Repair of leg tendon, each 5.40 8.95 8.95 0.75 15.10 15.10 090 27675 A Repair lower leg tendons 7.18 NA 8.48 1.01 NA 16.67 090 27676 A Repair lower leg tendons 8.42 NA 9.72 1.15 NA 19.29 090 27680 A Release of lower leg tendon 5.74 NA 8.27 0.80 NA 14.81 090 27681 A Release of lower leg tendons 6.82 NA 8.88 0.92 NA 16.62 090 27685 A Revision of lower leg tendon 6.50 10.37 8.45 0.91 17.78 15.86 090 27686 A Revise lower leg tendons 7.46 15.30 9.89 1.05 23.81 18.40 090 27687 A Revision of calf tendon 6.24 NA 8.70 0.88 NA 15.82 090 27690 A Revise lower leg tendon 8.71 NA 9.61 1.22 NA 19.54 090 27691 A Revise lower leg tendon 9.96 NA 11.10 1.40 NA 22.46 090 27692 A Revise additional leg tendon 1.87 NA 0.99 0.26 NA 3.12 ZZZ 27695 A Repair of ankle ligament 6.51 NA 9.20 0.90 NA 16.61 090 27696 A Repair of ankle ligaments 8.27 NA 9.54 1.16 NA 18.97 090 27698 A Repair of ankle ligament 9.36 NA 9.72 1.31 NA 20.39 090 27700 A Revision of ankle joint 9.29 NA 7.95 1.24 NA 18.48 090 27702 A Reconstruct ankle joint 13.67 NA 13.02 1.92 NA 28.61 090 27703 A Reconstruction, ankle joint 15.87 NA 13.31 2.24 NA 31.42 090 27704 A Removal of ankle implant 7.62 NA 9.40 0.61 NA 17.63 090 27705 A Incision of tibia 10.38 NA 11.55 1.44 NA 23.37 090 27707 A Incision of fibula 4.37 NA 8.48 0.60 NA 13.45 090 27709 A Incision of tibia & fibula 9.95 NA 11.48 1.39 NA 22.82 090 27712 A Realignment of lower leg 14.25 NA 13.92 2.00 NA 30.17 090Start Printed Page 55356 27715 A Revision of lower leg 14.39 NA 15.22 2.00 NA 31.61 090 27720 A Repair of tibia 11.79 NA 13.67 1.66 NA 27.12 090 27722 A Repair/graft of tibia 11.82 NA 13.46 1.65 NA 26.93 090 27724 A Repair/graft of tibia 18.20 NA 17.28 2.10 NA 37.58 090 27725 A Repair of lower leg 15.59 NA 15.62 2.20 NA 33.41 090 27727 A Repair of lower leg 14.01 NA 14.43 1.84 NA 30.28 090 27730 A Repair of tibia epiphysis 7.41 21.54 10.22 0.75 29.70 18.38 090 27732 A Repair of fibula epiphysis 5.32 14.45 7.22 0.63 20.40 13.17 090 27734 A Repair lower leg epiphyses 8.48 NA 10.84 0.85 NA 20.17 090 27740 A Repair of leg epiphyses 9.30 16.04 9.72 1.31 26.65 20.33 090 27742 A Repair of leg epiphyses 10.30 16.44 9.27 1.55 28.29 21.12 090 27745 A Reinforce tibia 10.07 NA 11.60 1.38 NA 23.05 090 27750 A Treatment of tibia fracture 3.19 5.65 4.00 0.43 9.27 7.62 090 27752 A Treatment of tibia fracture 5.84 8.20 6.17 0.82 14.86 12.83 090 27756 A Treatment of tibia fracture 6.78 NA 10.84 0.94 NA 18.56 090 27758 A Treatment of tibia fracture 11.67 NA 12.22 1.52 NA 25.41 090 27759 A Treatment of tibia fracture 13.76 NA 13.46 1.93 NA 29.15 090 27760 A Treatment of ankle fracture 3.01 5.42 3.87 0.39 8.82 7.27 090 27762 A Treatment of ankle fracture 5.25 7.57 5.75 0.71 13.53 11.71 090 27766 A Treatment of ankle fracture 8.36 NA 8.26 1.17 NA 17.79 090 27780 A Treatment of fibula fracture 2.65 5.37 3.69 0.33 8.35 6.67 090 27781 A Treatment of fibula fracture 4.40 6.38 4.62 0.57 11.35 9.59 090 27784 A Treatment of fibula fracture 7.11 NA 8.63 0.98 NA 16.72 090 27786 A Treatment of ankle fracture 2.84 5.38 3.78 0.37 8.59 6.99 090 27788 A Treatment of ankle fracture 4.45 6.65 4.62 0.61 11.71 9.68 090 27792 A Treatment of ankle fracture 7.66 NA 8.18 1.07 NA 16.91 090 27808 A Treatment of ankle fracture 2.83 6.44 4.50 0.38 9.65 7.71 090 27810 A Treatment of ankle fracture 5.13 7.77 5.71 0.71 13.61 11.55 090 27814 A Treatment of ankle fracture 10.68 NA 10.93 1.50 NA 23.11 090 27816 A Treatment of ankle fracture 2.89 5.97 4.55 0.37 9.23 7.81 090 27818 A Treatment of ankle fracture 5.50 7.89 5.88 0.74 14.13 12.12 090 27822 A Treatment of ankle fracture 11.00 NA 13.18 1.29 NA 25.47 090 27823 A Treatment of ankle fracture 13.00 NA 14.39 1.65 NA 29.04 090 27824 A Treat lower leg fracture 2.89 6.43 4.50 0.39 9.71 7.78 090 27825 A Treat lower leg fracture 6.19 8.30 6.32 0.85 15.34 13.36 090 27826 A Treat lower leg fracture 8.54 NA 11.88 1.19 NA 21.61 090 27827 A Treat lower leg fracture 14.06 NA 15.00 1.96 NA 31.02 090 27828 A Treat lower leg fracture 16.23 NA 15.03 2.27 NA 33.53 090 27829 A Treat lower leg joint 5.49 NA 8.67 0.77 NA 14.93 090 27830 A Treat lower leg dislocation 3.79 5.82 4.36 0.44 10.05 8.59 090 27831 A Treat lower leg dislocation 4.56 NA 4.94 0.61 NA 10.11 090 27832 A Treat lower leg dislocation 6.49 NA 8.06 0.91 NA 15.46 090 27840 A Treat ankle dislocation 4.58 NA 6.21 0.47 NA 11.26 090 27842 A Treat ankle dislocation 6.21 NA 5.25 0.76 NA 12.22 090 27846 A Treat ankle dislocation 9.79 NA 10.46 1.36 NA 21.61 090 27848 A Treat ankle dislocation 11.20 NA 11.70 1.55 NA 24.45 090 27860 A Fixation of ankle joint 2.34 NA 3.78 0.31 NA 6.43 010 27870 A Fusion of ankle joint 13.91 NA 13.76 1.95 NA 29.62 090 27871 A Fusion of tibiofibular joint 9.17 NA 11.03 1.29 NA 21.49 090 27880 A Amputation of lower leg 11.85 NA 11.95 1.38 NA 25.18 090 27881 A Amputation of lower leg 12.34 NA 13.44 1.59 NA 27.37 090 27882 A Amputation of lower leg 8.94 NA 13.13 1.03 NA 23.10 090 27884 A Amputation follow-up surgery 8.21 NA 10.78 0.95 NA 19.94 090 27886 A Amputation follow-up surgery 9.32 NA 11.26 1.13 NA 21.71 090 27888 A Amputation of foot at ankle 9.67 NA 11.11 1.26 NA 22.04 090 27889 A Amputation of foot at ankle 9.98 NA 10.45 1.19 NA 21.62 090 27892 A Decompression of leg 7.39 NA 8.41 0.86 NA 16.66 090 27893 A Decompression of leg 7.35 NA 8.58 0.90 NA 16.83 090 27894 A Decompression of leg 10.49 NA 10.09 1.25 NA 21.83 090 27899 C Leg/ankle surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 28001 A Drainage of bursa of foot 2.73 5.62 3.09 0.31 8.66 6.13 010 28002 A Treatment of foot infection 4.62 6.78 4.22 0.56 11.96 9.40 010 28003 A Treatment of foot infection 8.41 11.40 10.63 1.03 20.84 20.07 090 28005 A Treat foot bone lesion 8.68 NA 10.26 1.14 NA 20.08 090 28008 A Incision of foot fascia 4.45 8.17 6.38 0.56 13.18 11.39 090 28010 A Incision of toe tendon 2.84 7.64 5.37 0.39 10.87 8.60 090 28011 A Incision of toe tendons 4.14 9.36 6.79 0.58 14.08 11.51 090 28020 A Exploration of foot joint 5.01 8.12 6.81 0.64 13.77 12.46 090 28022 A Exploration of foot joint 4.67 7.90 6.26 0.62 13.19 11.55 090 28024 A Exploration of toe joint 4.38 8.55 6.64 0.50 13.43 11.52 090 28030 A Removal of foot nerve 6.15 NA 3.50 0.85 NA 10.50 090 28035 A Decompression of tibia nerve 5.09 8.80 5.35 0.71 14.60 11.15 090 28043 A Excision of foot lesion 3.54 7.47 4.96 0.45 11.46 8.95 090Start Printed Page 55357 28045 A Excision of foot lesion 4.72 8.18 5.81 0.62 13.52 11.15 090 28046 A Resection of tumor, foot 10.18 13.58 11.38 1.13 24.89 22.69 090 28050 A Biopsy of foot joint lining 4.25 9.52 6.11 0.55 14.32 10.91 090 28052 A Biopsy of foot joint lining 3.94 8.01 5.76 0.51 12.46 10.21 090 28054 A Biopsy of toe joint lining 3.45 7.70 5.50 0.45 11.60 9.40 090 28060 A Partial removal, foot fascia 5.23 8.72 6.51 0.69 14.64 12.43 090 28062 A Removal of foot fascia 6.52 9.27 6.87 0.85 16.64 14.24 090 28070 A Removal of foot joint lining 5.10 7.98 6.12 0.68 13.76 11.90 090 28072 A Removal of foot joint lining 4.58 8.84 6.67 0.64 14.06 11.89 090 28080 A Removal of foot lesion 3.58 7.82 5.51 0.50 11.90 9.59 090 28086 A Excise foot tendon sheath 4.78 11.87 7.11 0.66 17.31 12.55 090 28088 A Excise foot tendon sheath 3.86 9.97 6.62 0.52 14.35 11.00 090 28090 A Removal of foot lesion 4.41 8.12 5.64 0.57 13.10 10.62 090 28092 A Removal of toe lesions 3.64 8.17 6.08 0.46 12.27 10.18 090 28100 A Removal of ankle/heel lesion 5.66 13.07 7.70 0.76 19.49 14.12 090 28102 A Remove/graft foot lesion 7.73 NA 9.00 0.97 NA 17.70 090 28103 A Remove/graft foot lesion 6.50 8.76 6.93 0.89 16.15 14.32 090 28104 A Removal of foot lesion 5.12 8.49 6.76 0.69 14.30 12.57 090 28106 A Remove/graft foot lesion 7.16 NA 6.97 1.01 NA 15.14 090 28107 A Remove/graft foot lesion 5.56 9.96 7.13 0.74 16.26 13.43 090 28108 A Removal of toe lesions 4.16 7.49 5.36 0.52 12.17 10.04 090 28110 A Part removal of metatarsal 4.08 8.80 6.87 0.49 13.37 11.44 090 28111 A Part removal of metatarsal 5.01 9.09 7.69 0.63 14.73 13.33 090 28112 A Part removal of metatarsal 4.49 8.89 7.47 0.60 13.98 12.56 090 28113 A Part removal of metatarsal 4.79 8.92 7.13 0.63 14.34 12.55 090 28114 A Removal of metatarsal heads 9.79 12.36 10.85 1.36 23.51 22.00 090 28116 A Revision of foot 7.75 9.27 6.38 1.03 18.05 15.16 090 28118 A Removal of heel bone 5.96 9.37 7.24 0.79 16.12 13.99 090 28119 A Removal of heel spur 5.39 8.58 6.15 0.74 14.71 12.28 090 28120 A Part removal of ankle/heel 5.40 11.28 9.83 0.69 17.37 15.92 090 28122 A Partial removal of foot bone 7.29 10.94 9.50 0.96 19.19 17.75 090 28124 A Partial removal of toe 4.81 9.61 7.61 0.65 15.07 13.07 090 28126 A Partial removal of toe 3.52 8.37 6.76 0.49 12.38 10.77 090 28130 A Removal of ankle bone 8.11 NA 8.77 1.11 NA 17.99 090 28140 A Removal of metatarsal 6.91 10.40 7.92 0.84 18.15 15.67 090 28150 A Removal of toe 4.09 8.75 7.07 0.52 13.36 11.68 090 28153 A Partial removal of toe 3.66 8.39 6.22 0.49 12.54 10.37 090 28160 A Partial removal of toe 3.74 8.55 7.22 0.51 12.80 11.47 090 28171 A Extensive foot surgery 9.60 NA 8.27 1.13 NA 19.00 090 28173 A Extensive foot surgery 8.80 10.83 8.88 1.04 20.67 18.72 090 28175 A Extensive foot surgery 6.05 9.54 6.99 0.75 16.34 13.79 090 28190 A Removal of foot foreign body 1.96 6.54 3.53 0.16 8.66 5.65 010 28192 A Removal of foot foreign body 4.64 8.20 5.44 0.52 13.36 10.60 090 28193 A Removal of foot foreign body 5.73 8.94 6.67 0.63 15.30 13.03 090 28200 A Repair of foot tendon 4.60 8.47 6.32 0.59 13.66 11.51 090 28202 A Repair/graft of foot tendon 6.84 12.63 6.83 0.86 20.33 14.53 090 28208 A Repair of foot tendon 4.37 8.17 6.03 0.59 13.13 10.99 090 28210 A Repair/graft of foot tendon 6.35 9.83 6.38 0.77 16.95 13.50 090 28220 A Release of foot tendon 4.53 8.12 6.41 0.63 13.28 11.57 090 28222 A Release of foot tendons 5.62 8.40 6.77 0.77 14.79 13.16 090 28225 A Release of foot tendon 3.66 7.76 5.57 0.50 11.92 9.73 090 28226 A Release of foot tendons 4.53 8.30 6.66 0.62 13.45 11.81 090 28230 A Incision of foot tendon(s) 4.24 8.26 6.83 0.59 13.09 11.66 090 28232 A Incision of toe tendon 3.39 8.12 6.53 0.48 11.99 10.40 090 28234 A Incision of foot tendon 3.37 7.98 6.11 0.46 11.81 9.94 090 28238 A Revision of foot tendon 7.73 9.77 7.60 1.08 18.58 16.41 090 28240 A Release of big toe 4.36 8.17 6.40 0.61 13.14 11.37 090 28250 A Revision of foot fascia 5.92 9.05 7.12 0.81 15.78 13.85 090 28260 A Release of midfoot joint 7.96 11.04 8.08 1.08 20.08 17.12 090 28261 A Revision of foot tendon 11.73 11.16 9.64 1.66 24.55 23.03 090 28262 A Revision of foot and ankle 15.83 15.66 15.09 2.22 33.71 33.14 090 28264 A Release of midfoot joint 10.35 10.98 10.98 1.46 22.79 22.79 090 28270 A Release of foot contracture 4.76 8.75 7.43 0.67 14.18 12.86 090 28272 A Release of toe joint, each 3.80 7.70 5.50 0.52 12.02 9.82 090 28280 A Fusion of toes 5.19 8.39 6.77 0.72 14.30 12.68 090 28285 A Repair of hammertoe 4.59 8.79 6.76 0.64 14.02 11.99 090 28286 A Repair of hammertoe 4.56 8.78 6.75 0.64 13.98 11.95 090 28288 A Partial removal of foot bone 4.74 9.00 8.02 0.65 14.39 13.41 090 28289 A Repair hallux rigidus 7.04 10.54 9.75 0.96 18.54 17.75 090 28290 A Correction of bunion 5.66 9.55 8.81 0.79 16.00 15.26 090 28292 A Correction of bunion 7.04 9.82 7.69 0.98 17.84 15.71 090 28293 A Correction of bunion 9.15 10.67 8.02 1.28 21.10 18.45 090 28294 A Correction of bunion 8.56 10.52 8.30 1.16 20.24 18.02 090Start Printed Page 55358 28296 A Correction of bunion 9.18 10.84 8.65 1.28 21.30 19.11 090 28297 A Correction of bunion 9.18 12.80 10.25 1.31 23.29 20.74 090 28298 A Correction of bunion 7.94 10.10 8.48 1.12 19.16 17.54 090 28299 A Correction of bunion 10.58 11.55 9.21 1.24 23.37 21.03 090 28300 A Incision of heel bone 9.54 14.15 9.43 1.31 25.00 20.28 090 28302 A Incision of ankle bone 9.55 9.55 9.22 1.15 20.25 19.92 090 28304 A Incision of midfoot bones 9.16 9.53 7.88 1.00 19.69 18.04 090 28305 A Incise/graft midfoot bones 10.50 14.52 10.07 0.55 25.57 21.12 090 28306 A Incision of metatarsal 5.86 8.84 6.51 0.81 15.51 13.18 090 28307 A Incision of metatarsal 6.33 13.70 7.74 0.71 20.74 14.78 090 28308 A Incision of metatarsal 5.29 7.97 5.60 0.74 14.00 11.63 090 28309 A Incision of metatarsals 12.78 NA 11.08 1.64 NA 25.50 090 28310 A Revision of big toe 5.43 9.00 6.93 0.76 15.19 13.12 090 28312 A Revision of toe 4.55 8.66 7.87 0.62 13.83 13.04 090 28313 A Repair deformity of toe 5.01 9.06 9.06 0.68 14.75 14.75 090 28315 A Removal of sesamoid bone 4.86 7.95 5.82 0.66 13.47 11.34 090 28320 A Repair of foot bones 9.18 NA 9.02 1.27 NA 19.47 090 28322 A Repair of metatarsals 8.34 11.71 8.38 1.17 21.22 17.89 090 28340 A Resect enlarged toe tissue 6.98 8.96 6.28 0.98 16.92 14.24 090 28341 A Resect enlarged toe 8.41 9.55 6.88 1.18 19.14 16.47 090 28344 A Repair extra toe(s) 4.26 7.38 4.86 0.60 12.24 9.72 090 28345 A Repair webbed toe(s) 5.92 9.48 7.58 0.84 16.24 14.34 090 28360 A Reconstruct cleft foot 13.34 NA 12.22 1.88 NA 27.44 090 28400 A Treatment of heel fracture 2.16 5.76 4.74 0.29 8.21 7.19 090 28405 A Treatment of heel fracture 4.57 6.66 5.87 0.63 11.86 11.07 090 28406 A Treatment of heel fracture 6.31 NA 8.69 0.87 NA 15.87 090 28415 A Treat heel fracture 15.97 NA 15.72 2.24 NA 33.93 090 28420 A Treat/graft heel fracture 16.64 NA 15.95 2.29 NA 34.88 090 28430 A Treatment of ankle fracture 2.09 5.25 4.26 0.27 7.61 6.62 090 28435 A Treatment of ankle fracture 3.40 5.41 4.57 0.47 9.28 8.44 090 28436 A Treatment of ankle fracture 4.71 NA 7.86 0.66 NA 13.23 090 28445 A Treat ankle fracture 15.62 NA 13.94 1.29 NA 30.85 090 28450 A Treat midfoot fracture, each 1.90 5.28 4.07 0.25 7.43 6.22 090 28455 A Treat midfoot fracture, each 3.09 5.51 4.94 0.43 9.03 8.46 090 28456 A Treat midfoot fracture 2.68 NA 6.27 0.36 NA 9.31 090 28465 A Treat midfoot fracture, each 7.01 NA 8.25 0.87 NA 16.13 090 28470 A Treat metatarsal fracture 1.99 4.52 3.41 0.26 6.77 5.66 090 28475 A Treat metatarsal fracture 2.97 5.18 4.38 0.41 8.56 7.76 090 28476 A Treat metatarsal fracture 3.38 NA 6.71 0.46 NA 10.55 090 28485 A Treat metatarsal fracture 5.71 NA 8.16 0.80 NA 14.67 090 28490 A Treat big toe fracture 1.09 2.76 2.21 0.13 3.98 3.43 090 28495 A Treat big toe fracture 1.58 2.82 2.31 0.19 4.59 4.08 090 28496 A Treat big toe fracture 2.33 11.10 4.58 0.32 13.75 7.23 090 28505 A Treat big toe fracture 3.81 11.46 6.74 0.50 15.77 11.05 090 28510 A Treatment of toe fracture 1.09 2.51 2.23 0.13 3.73 3.45 090 28515 A Treatment of toe fracture 1.46 2.83 2.30 0.17 4.46 3.93 090 28525 A Treat toe fracture 3.32 10.82 6.16 0.44 14.58 9.92 090 28530 A Treat sesamoid bone fracture 1.06 2.91 2.91 0.13 4.10 4.10 090 28531 A Treat sesamoid bone fracture 2.35 11.91 4.73 0.33 14.59 7.41 090 28540 A Treat foot dislocation 2.04 3.75 3.75 0.24 6.03 6.03 090 28545 A Treat foot dislocation 2.45 4.76 4.76 0.33 7.54 7.54 090 28546 A Treat foot dislocation 3.20 12.55 6.31 0.46 16.21 9.97 090 28555 A Repair foot dislocation 6.30 13.49 8.36 0.88 20.67 15.54 090 28570 A Treat foot dislocation 1.66 3.67 3.67 0.22 5.55 5.55 090 28575 A Treat foot dislocation 3.31 5.19 5.19 0.45 8.95 8.95 090 28576 A Treat foot dislocation 4.17 12.06 6.85 0.56 16.79 11.58 090 28585 A Repair foot dislocation 7.99 8.75 8.32 1.13 17.87 17.44 090 28600 A Treat foot dislocation 1.89 4.32 3.89 0.24 6.45 6.02 090 28605 A Treat foot dislocation 2.71 4.40 4.40 0.35 7.46 7.46 090 28606 A Treat foot dislocation 4.90 16.14 7.09 0.68 21.72 12.67 090 28615 A Repair foot dislocation 7.77 NA 9.45 1.09 NA 18.31 090 28630 A Treat toe dislocation 1.70 2.35 2.35 0.17 4.22 4.22 010 28635 A Treat toe dislocation 1.91 2.49 2.49 0.24 4.64 4.64 010 28636 A Treat toe dislocation 2.77 4.81 3.22 0.39 7.97 6.38 010 28645 A Repair toe dislocation 4.22 6.69 4.34 0.58 11.49 9.14 090 28660 A Treat toe dislocation 1.23 3.11 2.60 0.11 4.45 3.94 010 28665 A Treat toe dislocation 1.92 2.47 2.47 0.24 4.63 4.63 010 28666 A Treat toe dislocation 2.66 13.30 3.00 0.38 16.34 6.04 010 28675 A Repair of toe dislocation 2.92 9.48 4.90 0.41 12.81 8.23 090 28705 A Fusion of foot bones 18.80 NA 15.67 2.13 NA 36.60 090 28715 A Fusion of foot bones 13.10 NA 12.57 1.84 NA 27.51 090 28725 A Fusion of foot bones 11.61 NA 11.48 1.63 NA 24.72 090 28730 A Fusion of foot bones 10.76 NA 10.76 1.51 NA 23.03 090Start Printed Page 55359 28735 A Fusion of foot bones 10.85 NA 10.45 1.51 NA 22.81 090 28737 A Revision of foot bones 9.64 NA 9.04 1.36 NA 20.04 090 28740 A Fusion of foot bones 8.02 13.03 8.94 1.13 22.18 18.09 090 28750 A Fusion of big toe joint 7.30 12.48 9.13 1.03 20.81 17.46 090 28755 A Fusion of big toe joint 4.74 8.52 6.42 0.66 13.92 11.82 090 28760 A Fusion of big toe joint 7.75 10.39 7.82 1.07 19.21 16.64 090 28800 A Amputation of midfoot 8.21 NA 8.90 0.98 NA 18.09 090 28805 A Amputation thru metatarsal 8.39 NA 9.00 0.97 NA 18.36 090 28810 A Amputation toe & metatarsal 6.21 NA 7.97 0.70 NA 14.88 090 28820 A Amputation of toe 4.41 9.91 7.16 0.51 14.83 12.08 090 28825 A Partial amputation of toe 3.59 10.12 6.95 0.43 14.14 10.97 090 28899 C Foot/toes surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 29000 A Application of body cast 2.25 2.71 1.67 0.30 5.26 4.22 000 29010 A Application of body cast 2.06 2.98 1.72 0.27 5.31 4.05 000 29015 A Application of body cast 2.41 3.17 1.93 0.21 5.79 4.55 000 29020 A Application of body cast 2.11 3.33 1.47 0.16 5.60 3.74 000 29025 A Application of body cast 2.40 3.32 1.86 0.26 5.98 4.52 000 29035 A Application of body cast 1.77 3.05 1.56 0.24 5.06 3.57 000 29040 A Application of body cast 2.22 2.54 1.49 0.35 5.11 4.06 000 29044 A Application of body cast 2.12 3.20 1.81 0.29 5.61 4.22 000 29046 A Application of body cast 2.41 3.31 2.04 0.34 6.06 4.79 000 29049 A Application of figure eight 0.89 1.07 0.57 0.12 2.08 1.58 000 29055 A Application of shoulder cast 1.78 2.40 1.42 0.24 4.42 3.44 000 29058 A Application of shoulder cast 1.31 1.33 0.73 0.14 2.78 2.18 000 29065 A Application of long arm cast 0.87 1.10 0.69 0.12 2.09 1.68 000 29075 A Application of forearm cast 0.77 1.05 0.63 0.11 1.93 1.51 000 29085 A Apply hand/wrist cast 0.87 1.10 0.62 0.11 2.08 1.60 000 29086 A Apply finger cast 0.62 0.81 0.50 0.07 1.50 1.19 000 29105 A Apply long arm splint 0.87 1.05 0.52 0.11 2.03 1.50 000 29125 A Apply forearm splint 0.59 0.88 0.41 0.06 1.53 1.06 000 29126 A Apply forearm splint 0.77 1.21 0.47 0.06 2.04 1.30 000 29130 A Application of finger splint 0.50 0.44 0.18 0.05 0.99 0.73 000 29131 A Application of finger splint 0.55 0.71 0.23 0.03 1.29 0.81 000 29200 A Strapping of chest 0.65 0.85 0.37 0.04 1.54 1.06 000 29220 A Strapping of low back 0.64 0.96 0.41 0.07 1.67 1.12 000 29240 A Strapping of shoulder 0.71 0.92 0.39 0.05 1.68 1.15 000 29260 A Strapping of elbow or wrist 0.55 0.85 0.35 0.04 1.44 0.94 000 29280 A Strapping of hand or finger 0.51 0.91 0.39 0.04 1.46 0.94 000 29305 A Application of hip cast 2.03 2.74 1.60 0.29 5.06 3.92 000 29325 A Application of hip casts 2.32 3.05 1.79 0.31 5.68 4.42 000 29345 A Application of long leg cast 1.40 1.51 1.02 0.19 3.10 2.61 000 29355 A Application of long leg cast 1.53 1.47 1.11 0.20 3.20 2.84 000 29358 A Apply long leg cast brace 1.43 1.72 1.07 0.19 3.34 2.69 000 29365 A Application of long leg cast 1.18 1.38 0.90 0.17 2.73 2.25 000 29405 A Apply short leg cast 0.86 1.03 0.66 0.12 2.01 1.64 000 29425 A Apply short leg cast 1.01 1.05 0.68 0.14 2.20 1.83 000 29435 A Apply short leg cast 1.18 1.35 0.88 0.17 2.70 2.23 000 29440 A Addition of walker to cast 0.57 0.61 0.26 0.07 1.25 0.90 000 29445 A Apply rigid leg cast 1.78 1.58 0.96 0.24 3.60 2.98 000 29450 A Application of leg cast 2.08 1.40 1.11 0.13 3.61 3.32 000 29505 A Application, long leg splint 0.69 1.10 0.48 0.06 1.85 1.23 000 29515 A Application lower leg splint 0.73 0.78 0.48 0.07 1.58 1.28 000 29520 A Strapping of hip 0.54 0.93 0.44 0.02 1.49 1.00 000 29530 A Strapping of knee 0.57 0.83 0.36 0.04 1.44 0.97 000 29540 A Strapping of ankle 0.51 0.40 0.32 0.04 0.95 0.87 000 29550 A Strapping of toes 0.47 0.40 0.29 0.05 0.92 0.81 000 29580 A Application of paste boot 0.57 0.61 0.36 0.05 1.23 0.98 000 29590 A Application of foot splint 0.76 0.50 0.30 0.06 1.32 1.12 000 29700 A Removal/revision of cast 0.57 0.81 0.28 0.07 1.45 0.92 000 29705 A Removal/revision of cast 0.76 0.73 0.39 0.10 1.59 1.25 000 29710 A Removal/revision of cast 1.34 1.50 0.66 0.17 3.01 2.17 000 29715 A Removal/revision of cast 0.94 0.98 0.29 0.08 2.00 1.31 000 29720 A Repair of body cast 0.68 0.95 0.36 0.10 1.73 1.14 000 29730 A Windowing of cast 0.75 0.71 0.36 0.10 1.56 1.21 000 29740 A Wedging of cast 1.12 1.02 0.46 0.15 2.29 1.73 000 29750 A Wedging of clubfoot cast 1.26 1.13 0.62 0.16 2.55 2.04 000 29799 C Casting/strapping procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 29800 A Jaw arthroscopy/surgery 6.43 NA 9.15 0.84 NA 16.42 090 29804 A Jaw arthroscopy/surgery 8.14 NA 8.73 0.66 NA 17.53 090 29805 A Shoulder arthroscopy, dx 5.89 3.23 3.23 0.83 9.95 9.95 090 29806 A Shoulder arthroscopy/surgery 14.37 NA 11.33 2.01 NA 27.71 090 29807 A Shoulder arthroscopy/surgery 13.90 NA 11.06 2.01 NA 26.97 090 29815 D Shoulder arthroscopy 0.00 NA 0.00 0.00 NA 0.00 090Start Printed Page 55360 29819 A Shoulder arthroscopy/surgery 7.62 NA 9.82 1.07 NA 18.51 090 29820 A Shoulder arthroscopy/surgery 7.07 NA 9.55 0.99 NA 17.61 090 29821 A Shoulder arthroscopy/surgery 7.72 NA 9.84 1.08 NA 18.64 090 29822 A Shoulder arthroscopy/surgery 7.43 NA 9.75 1.04 NA 18.22 090 29823 A Shoulder arthroscopy/surgery 8.17 NA 10.14 1.15 NA 19.46 090 29824 A Shoulder arthroscopy/surgery 8.25 NA 7.48 1.16 NA 16.89 090 29825 A Shoulder arthroscopy/surgery 7.62 NA 9.80 1.06 NA 18.48 090 29826 A Shoulder arthroscopy/surgery 8.99 NA 10.65 1.26 NA 20.90 090 29830 A Elbow arthroscopy 5.76 NA 6.14 0.79 NA 12.69 090 29834 A Elbow arthroscopy/surgery 6.28 NA 6.94 0.86 NA 14.08 090 29835 A Elbow arthroscopy/surgery 6.48 NA 6.95 0.88 NA 14.31 090 29836 A Elbow arthroscopy/surgery 7.55 NA 7.62 1.06 NA 16.23 090 29837 A Elbow arthroscopy/surgery 6.87 NA 7.30 0.96 NA 15.13 090 29838 A Elbow arthroscopy/surgery 7.71 NA 7.73 1.07 NA 16.51 090 29840 A Wrist arthroscopy 5.54 NA 8.38 0.69 NA 14.61 090 29843 A Wrist arthroscopy/surgery 6.01 NA 8.70 0.82 NA 15.53 090 29844 A Wrist arthroscopy/surgery 6.37 NA 8.96 0.86 NA 16.19 090 29845 A Wrist arthroscopy/surgery 7.52 NA 9.56 0.84 NA 17.92 090 29846 A Wrist arthroscopy/surgery 6.75 NA 11.67 0.89 NA 19.31 090 29847 A Wrist arthroscopy/surgery 7.08 NA 11.85 0.91 NA 19.84 090 29848 A Wrist endoscopy/surgery 5.44 NA 8.46 0.72 NA 14.62 090 29850 A Knee arthroscopy/surgery 8.19 NA 7.49 0.74 NA 16.42 090 29851 A Knee arthroscopy/surgery 13.10 NA 12.00 1.81 NA 26.91 090 29855 A Tibial arthroscopy/surgery 10.62 NA 10.55 1.50 NA 22.67 090 29856 A Tibial arthroscopy/surgery 14.14 NA 12.49 2.00 NA 28.63 090 29860 A Hip arthroscopy, dx 8.05 NA 8.05 1.14 NA 17.24 090 29861 A Hip arthroscopy/surgery 9.15 NA 8.71 1.29 NA 19.15 090 29862 A Hip arthroscopy/surgery 9.90 NA 9.75 1.39 NA 21.04 090 29863 A Hip arthroscopy/surgery 9.90 NA 10.31 1.40 NA 21.61 090 29870 A Knee arthroscopy, dx 5.07 NA 6.27 0.67 NA 12.01 090 29871 A Knee arthroscopy/drainage 6.55 NA 8.38 0.88 NA 15.81 090 29874 A Knee arthroscopy/surgery 7.05 NA 8.15 0.87 NA 16.07 090 29875 A Knee arthroscopy/surgery 6.31 NA 7.69 0.88 NA 14.88 090 29876 A Knee arthroscopy/surgery 7.92 NA 9.19 1.11 NA 18.22 090 29877 A Knee arthroscopy/surgery 7.35 NA 8.29 1.03 NA 16.67 090 29879 A Knee arthroscopy/surgery 8.04 NA 8.68 1.13 NA 17.85 090 29880 A Knee arthroscopy/surgery 8.50 NA 8.95 1.19 NA 18.64 090 29881 A Knee arthroscopy/surgery 7.76 NA 8.53 1.09 NA 17.38 090 29882 A Knee arthroscopy/surgery 8.65 NA 9.01 1.09 NA 18.75 090 29883 A Knee arthroscopy/surgery 11.05 NA 10.41 1.33 NA 22.79 090 29884 A Knee arthroscopy/surgery 7.33 NA 8.87 1.03 NA 17.23 090 29885 A Knee arthroscopy/surgery 9.09 NA 9.85 1.27 NA 20.21 090 29886 A Knee arthroscopy/surgery 7.54 NA 8.99 1.06 NA 17.59 090 29887 A Knee arthroscopy/surgery 9.04 NA 9.83 1.27 NA 20.14 090 29888 A Knee arthroscopy/surgery 13.90 NA 12.50 1.95 NA 28.35 090 29889 A Knee arthroscopy/surgery 16.00 NA 13.71 2.11 NA 31.82 090 29891 A Ankle arthroscopy/surgery 8.40 NA 8.92 1.17 NA 18.49 090 29892 A Ankle arthroscopy/surgery 9.00 NA 9.04 1.26 NA 19.30 090 29893 A Scope, plantar fasciotomy 5.22 NA 5.56 0.74 NA 11.52 090 29894 A Ankle arthroscopy/surgery 7.21 NA 8.04 1.01 NA 16.26 090 29895 A Ankle arthroscopy/surgery 6.99 NA 8.01 0.97 NA 15.97 090 29897 A Ankle arthroscopy/surgery 7.18 NA 8.73 1.01 NA 16.92 090 29898 A Ankle arthroscopy/surgery 8.32 NA 8.79 1.14 NA 18.25 090 29900 A Mcp joint arthroscopy, dx 5.42 NA 5.88 0.69 NA 11.99 090 29901 A Mcp joint arthroscopy, surg 6.13 NA 6.28 0.81 NA 13.22 090 29902 A Mcp joint arthroscopy, surg 6.70 NA 6.60 0.89 NA 14.19 090 29909 D Arthroscopy of joint 0.00 0.00 0.00 0.00 0.00 0.00 YYY 29999 C Arthroscopy of joint 0.00 0.00 0.00 0.00 0.00 0.00 YYY 30000 A Drainage of nose lesion 1.43 2.53 1.51 0.10 4.06 3.04 010 30020 A Drainage of nose lesion 1.43 2.64 1.57 0.08 4.15 3.08 010 30100 A Intranasal biopsy 0.94 1.34 0.53 0.06 2.34 1.53 000 30110 A Removal of nose polyp(s) 1.63 2.80 0.88 0.12 4.55 2.63 010 30115 A Removal of nose polyp(s) 4.35 NA 4.54 0.31 NA 9.20 090 30117 A Removal of intranasal lesion 3.16 4.95 3.20 0.22 8.33 6.58 090 30118 A Removal of intranasal lesion 9.69 NA 8.55 0.66 NA 18.90 090 30120 A Revision of nose 5.27 5.71 5.71 0.41 11.39 11.39 090 30124 A Removal of nose lesion 3.10 NA 3.31 0.20 NA 6.61 090 30125 A Removal of nose lesion 7.16 NA 6.61 0.54 NA 14.31 090 30130 A Removal of turbinate bones 3.38 NA 3.99 0.22 NA 7.59 090 30140 A Removal of turbinate bones 3.43 NA 4.61 0.24 NA 8.28 090 30150 A Partial removal of nose 9.14 NA 8.83 0.76 NA 18.73 090 30160 A Removal of nose 9.58 NA 8.79 0.78 NA 19.15 090 30200 A Injection treatment of nose 0.78 1.23 0.46 0.06 2.07 1.30 000Start Printed Page 55361 30210 A Nasal sinus therapy 1.08 2.15 0.61 0.08 3.31 1.77 010 30220 A Insert nasal septal button 1.54 2.52 0.84 0.11 4.17 2.49 010 30300 A Remove nasal foreign body 1.04 2.62 0.37 0.07 3.73 1.48 010 30310 A Remove nasal foreign body 1.96 NA 1.92 0.14 NA 4.02 010 30320 A Remove nasal foreign body 4.52 NA 5.26 0.36 NA 10.14 090 30400 R Reconstruction of nose 9.83 NA 8.95 0.80 NA 19.58 090 30410 R Reconstruction of nose 12.98 NA 10.45 1.08 NA 24.51 090 30420 R Reconstruction of nose 15.88 NA 12.50 1.24 NA 29.62 090 30430 R Revision of nose 7.21 NA 7.40 0.62 NA 15.23 090 30435 R Revision of nose 11.71 NA 10.68 1.10 NA 23.49 090 30450 R Revision of nose 18.65 NA 14.37 1.53 NA 34.55 090 30460 A Revision of nose 9.96 NA 9.16 0.85 NA 19.97 090 30462 A Revision of nose 19.57 NA 14.30 1.92 NA 35.79 090 30465 A Repair nasal stenosis 11.64 NA 9.58 0.97 NA 22.19 090 30520 A Repair of nasal septum 5.70 NA 5.93 0.41 NA 12.04 090 30540 A Repair nasal defect 7.75 NA 6.71 0.53 NA 14.99 090 30545 A Repair nasal defect 11.38 NA 9.19 0.80 NA 21.37 090 30560 A Release of nasal adhesions 1.26 2.37 1.52 0.09 3.72 2.87 010 30580 A Repair upper jaw fistula 6.69 5.00 5.00 0.50 12.19 12.19 090 30600 A Repair mouth/nose fistula 6.02 4.90 4.90 0.70 11.62 11.62 090 30620 A Intranasal reconstruction 5.97 NA 6.69 0.45 NA 13.11 090 30630 A Repair nasal septum defect 7.12 NA 7.23 0.51 NA 14.86 090 30801 A Cauterization, inner nose 1.09 2.57 2.31 0.08 3.74 3.48 010 30802 A Cauterization, inner nose 2.03 3.14 2.87 0.15 5.32 5.05 010 30901 A Control of nosebleed 1.21 1.43 0.34 0.09 2.73 1.64 000 30903 A Control of nosebleed 1.54 3.20 0.53 0.12 4.86 2.19 000 30905 A Control of nosebleed 1.97 3.85 0.80 0.15 5.97 2.92 000 30906 A Repeat control of nosebleed 2.45 4.27 1.27 0.17 6.89 3.89 000 30915 A Ligation, nasal sinus artery 7.20 NA 7.13 0.50 NA 14.83 090 30920 A Ligation, upper jaw artery 9.83 NA 8.64 0.69 NA 19.16 090 30930 A Therapy, fracture of nose 1.26 NA 2.17 0.09 NA 3.52 010 30999 C Nasal surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 31000 A Irrigation, maxillary sinus 1.15 2.43 0.66 0.08 3.66 1.89 010 31002 A Irrigation, sphenoid sinus 1.91 NA 2.07 0.14 NA 4.12 010 31020 A Exploration, maxillary sinus 2.94 4.20 3.68 0.20 7.34 6.82 090 31030 A Exploration, maxillary sinus 5.92 4.85 4.68 0.42 11.19 11.02 090 31032 A Explore sinus,remove polyps 6.57 NA 6.16 0.47 NA 13.20 090 31040 A Exploration behind upper jaw 9.42 NA 7.34 0.71 NA 17.47 090 31050 A Exploration, sphenoid sinus 5.28 NA 5.12 0.39 NA 10.79 090 31051 A Sphenoid sinus surgery 7.11 NA 6.66 0.55 NA 14.32 090 31070 A Exploration of frontal sinus 4.28 NA 5.04 0.30 NA 9.62 090 31075 A Exploration of frontal sinus 9.16 NA 8.38 0.64 NA 18.18 090 31080 A Removal of frontal sinus 11.42 NA 9.13 0.78 NA 21.33 090 31081 A Removal of frontal sinus 12.75 NA 9.97 1.84 NA 24.56 090 31084 A Removal of frontal sinus 13.51 NA 10.76 0.96 NA 25.23 090 31085 A Removal of frontal sinus 14.20 NA 11.12 1.18 NA 26.50 090 31086 A Removal of frontal sinus 12.86 NA 10.50 0.90 NA 24.26 090 31087 A Removal of frontal sinus 13.10 NA 10.32 1.15 NA 24.57 090 31090 A Exploration of sinuses 9.53 NA 9.05 0.66 NA 19.24 090 31200 A Removal of ethmoid sinus 4.97 NA 5.86 0.25 NA 11.08 090 31201 A Removal of ethmoid sinus 8.37 NA 7.91 0.58 NA 16.86 090 31205 A Removal of ethmoid sinus 10.24 NA 8.66 0.58 NA 19.48 090 31225 A Removal of upper jaw 19.23 NA 15.42 1.38 NA 36.03 090 31230 A Removal of upper jaw 21.94 NA 17.21 1.57 NA 40.72 090 31231 A Nasal endoscopy, dx 1.10 2.01 0.61 0.08 3.19 1.79 000 31233 A Nasal/sinus endoscopy, dx 2.18 2.66 1.24 0.16 5.00 3.58 000 31235 A Nasal/sinus endoscopy, dx 2.64 2.93 1.49 0.18 5.75 4.31 000 31237 A Nasal/sinus endoscopy, surg 2.98 3.22 1.66 0.21 6.41 4.85 000 31238 A Nasal/sinus endoscopy, surg 3.26 3.75 1.89 0.23 7.24 5.38 000 31239 A Nasal/sinus endoscopy, surg 8.70 NA 6.72 0.46 NA 15.88 010 31240 A Nasal/sinus endoscopy, surg 2.61 NA 1.62 0.18 NA 4.41 000 31254 A Revision of ethmoid sinus 4.65 NA 2.79 0.32 NA 7.76 000 31255 A Removal of ethmoid sinus 6.96 NA 4.14 0.49 NA 11.59 000 31256 A Exploration maxillary sinus 3.29 NA 2.01 0.23 NA 5.53 000 31267 A Endoscopy, maxillary sinus 5.46 NA 3.27 0.38 NA 9.11 000 31276 A Sinus endoscopy, surgical 8.85 NA 5.24 0.62 NA 14.71 000 31287 A Nasal/sinus endoscopy, surg 3.92 NA 2.37 0.27 NA 6.56 000 31288 A Nasal/sinus endoscopy, surg 4.58 NA 2.75 0.32 NA 7.65 000 31290 A Nasal/sinus endoscopy, surg 17.24 NA 11.86 1.20 NA 30.30 010 31291 A Nasal/sinus endoscopy, surg 18.19 NA 12.28 1.73 NA 32.20 010 31292 A Nasal/sinus endoscopy, surg 14.76 NA 10.36 0.99 NA 26.11 010 31293 A Nasal/sinus endoscopy, surg 16.21 NA 11.16 0.97 NA 28.34 010 31294 A Nasal/sinus endoscopy, surg 19.06 NA 12.46 1.04 NA 32.56 010Start Printed Page 55362 31299 C Sinus surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 31300 A Removal of larynx lesion 14.29 NA 17.46 0.99 NA 32.74 090 31320 A Diagnostic incision, larynx 5.26 NA 12.54 0.40 NA 18.20 090 31360 A Removal of larynx 17.08 NA 19.24 1.20 NA 37.52 090 31365 A Removal of larynx 24.16 NA 23.20 1.72 NA 49.08 090 31367 A Partial removal of larynx 21.86 NA 23.92 1.57 NA 47.35 090 31368 A Partial removal of larynx 27.09 NA 28.64 1.90 NA 57.63 090 31370 A Partial removal of larynx 21.38 NA 23.46 1.51 NA 46.35 090 31375 A Partial removal of larynx 20.21 NA 21.16 1.43 NA 42.80 090 31380 A Partial removal of larynx 20.21 NA 21.41 1.40 NA 43.02 090 31382 A Partial removal of larynx 20.52 NA 23.06 1.44 NA 45.02 090 31390 A Removal of larynx & pharynx 27.53 NA 28.90 1.95 NA 58.38 090 31395 A Reconstruct larynx & pharynx 31.09 NA 35.02 2.27 NA 68.38 090 31400 A Revision of larynx 10.31 NA 15.75 0.72 NA 26.78 090 31420 A Removal of epiglottis 10.22 NA 15.60 0.71 NA 26.53 090 31500 A Insert emergency airway 2.33 NA 0.69 0.15 NA 3.17 000 31502 A Change of windpipe airway 0.65 1.97 0.27 0.04 2.66 0.96 000 31505 A Diagnostic laryngoscopy 0.61 1.85 0.35 0.04 2.50 1.00 000 31510 A Laryngoscopy with biopsy 1.92 2.86 1.04 0.15 4.93 3.11 000 31511 A Remove foreign body, larynx 2.16 3.15 0.75 0.16 5.47 3.07 000 31512 A Removal of larynx lesion 2.07 3.00 1.10 0.16 5.23 3.33 000 31513 A Injection into vocal cord 2.10 NA 1.32 0.15 NA 3.57 000 31515 A Laryngoscopy for aspiration 1.80 2.30 0.90 0.12 4.22 2.82 000 31520 A Diagnostic laryngoscopy 2.56 NA 1.41 0.17 NA 4.14 000 31525 A Diagnostic laryngoscopy 2.63 2.94 1.53 0.18 5.75 4.34 000 31526 A Diagnostic laryngoscopy 2.57 NA 1.59 0.18 NA 4.34 000 31527 A Laryngoscopy for treatment 3.27 NA 1.77 0.21 NA 5.25 000 31528 A Laryngoscopy and dilation 2.37 NA 1.24 0.16 NA 3.77 000 31529 A Laryngoscopy and dilation 2.68 NA 1.62 0.18 NA 4.48 000 31530 A Operative laryngoscopy 3.39 NA 1.89 0.24 NA 5.52 000 31531 A Operative laryngoscopy 3.59 NA 2.18 0.25 NA 6.02 000 31535 A Operative laryngoscopy 3.16 NA 1.88 0.22 NA 5.26 000 31536 A Operative laryngoscopy 3.56 NA 2.16 0.25 NA 5.97 000 31540 A Operative laryngoscopy 4.13 NA 2.48 0.29 NA 6.90 000 31541 A Operative laryngoscopy 4.53 NA 2.72 0.32 NA 7.57 000 31560 A Operative laryngoscopy 5.46 NA 3.11 0.38 NA 8.95 000 31561 A Operative laryngoscopy 6.00 NA 2.96 0.42 NA 9.38 000 31570 A Laryngoscopy with injection 3.87 3.97 2.31 0.24 8.08 6.42 000 31571 A Laryngoscopy with injection 4.27 NA 2.46 0.30 NA 7.03 000 31575 A Diagnostic laryngoscopy 1.10 2.08 0.59 0.08 3.26 1.77 000 31576 A Laryngoscopy with biopsy 1.97 2.26 1.08 0.13 4.36 3.18 000 31577 A Remove foreign body, larynx 2.47 2.90 1.31 0.17 5.54 3.95 000 31578 A Removal of larynx lesion 2.84 3.13 1.62 0.20 6.17 4.66 000 31579 A Diagnostic laryngoscopy 2.26 2.97 1.27 0.16 5.39 3.69 000 31580 A Revision of larynx 12.38 NA 16.85 0.87 NA 30.10 090 31582 A Revision of larynx 21.62 NA 22.06 1.52 NA 45.20 090 31584 A Treat larynx fracture 19.64 NA 19.05 1.42 NA 40.11 090 31585 A Treat larynx fracture 4.64 NA 8.92 0.30 NA 13.86 090 31586 A Treat larynx fracture 8.03 NA 12.71 0.56 NA 21.30 090 31587 A Revision of larynx 11.99 NA 14.77 0.88 NA 27.64 090 31588 A Revision of larynx 13.11 NA 17.21 0.92 NA 31.24 090 31590 A Reinnervate larynx 6.97 NA 12.63 0.50 NA 20.10 090 31595 A Larynx nerve surgery 8.34 NA 11.90 0.62 NA 20.86 090 31599 C Larynx surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 31600 A Incision of windpipe 7.18 NA 3.15 0.34 NA 10.67 000 31601 A Incision of windpipe 4.45 NA 2.20 0.39 NA 7.04 000 31603 A Incision of windpipe 4.15 NA 1.88 0.35 NA 6.38 000 31605 A Incision of windpipe 3.58 NA 1.24 0.33 NA 5.15 000 31610 A Incision of windpipe 8.76 NA 10.98 0.69 NA 20.43 090 31611 A Surgery/speech prosthesis 5.64 NA 10.28 0.40 NA 16.32 090 31612 A Puncture/clear windpipe 0.91 1.53 0.48 0.06 2.50 1.45 000 31613 A Repair windpipe opening 4.59 NA 8.94 0.37 NA 13.90 090 31614 A Repair windpipe opening 7.12 NA 12.47 0.51 NA 20.10 090 31615 A Visualization of windpipe 2.09 3.76 1.20 0.14 5.99 3.43 000 31622 A Dx bronchoscope/wash 2.78 3.69 1.20 0.14 6.61 4.12 000 31623 A Dx bronchoscope/brush 2.88 2.97 1.17 0.14 5.99 4.19 000 31624 A Dx bronchoscope/lavage 2.88 2.75 1.17 0.13 5.76 4.18 000 31625 A Bronchoscopy with biopsy 3.37 2.96 1.34 0.16 6.49 4.87 000 31628 A Bronchoscopy with biopsy 3.81 3.38 1.45 0.14 7.33 5.40 000 31629 A Bronchoscopy with biopsy 3.37 NA 1.32 0.13 NA 4.82 000 31630 A Bronchoscopy with repair 3.82 NA 1.99 0.30 NA 6.11 000 31631 A Bronchoscopy with dilation 4.37 NA 2.04 0.31 NA 6.72 000 31635 A Remove foreign body, airway 3.68 NA 1.70 0.21 NA 5.59 000Start Printed Page 55363 31640 A Bronchoscopy & remove lesion 4.94 NA 2.36 0.37 NA 7.67 000 31641 A Bronchoscopy, treat blockage 5.03 NA 2.20 0.30 NA 7.53 000 31643 A Diag bronchoscope/catheter 3.50 1.17 1.17 0.15 4.82 4.82 000 31645 A Bronchoscopy, clear airways 3.16 NA 1.27 0.13 NA 4.56 000 31646 A Bronchoscopy, reclear airway 2.72 NA 1.12 0.12 NA 3.96 000 31656 A Bronchoscopy, inj for xray 2.17 NA 1.05 0.10 NA 3.32 000 31700 A Insertion of airway catheter 1.34 3.44 0.68 0.07 4.85 2.09 000 31708 A Instill airway contrast dye 1.41 NA 0.64 0.06 NA 2.11 000 31710 A Insertion of airway catheter 1.30 NA 0.75 0.06 NA 2.11 000 31715 A Injection for bronchus x-ray 1.11 NA 0.73 0.06 NA 1.90 000 31717 A Bronchial brush biopsy 2.12 3.25 0.89 0.09 5.46 3.10 000 31720 A Clearance of airways 1.06 1.90 0.35 0.06 3.02 1.47 000 31725 A Clearance of airways 1.96 NA 0.61 0.10 NA 2.67 000 31730 A Intro, windpipe wire/tube 2.85 2.54 1.13 0.15 5.54 4.13 000 31750 A Repair of windpipe 13.02 NA 16.22 1.02 NA 30.26 090 31755 A Repair of windpipe 15.93 NA 19.27 1.15 NA 36.35 090 31760 A Repair of windpipe 22.35 NA 12.79 1.48 NA 36.62 090 31766 A Reconstruction of windpipe 30.43 NA 15.03 3.16 NA 48.62 090 31770 A Repair/graft of bronchus 22.51 NA 15.67 2.27 NA 40.45 090 31775 A Reconstruct bronchus 23.54 NA 15.14 2.91 NA 41.59 090 31780 A Reconstruct windpipe 17.72 NA 12.97 1.55 NA 32.24 090 31781 A Reconstruct windpipe 23.53 NA 15.49 2.04 NA 41.06 090 31785 A Remove windpipe lesion 17.23 NA 13.05 1.36 NA 31.64 090 31786 A Remove windpipe lesion 23.98 NA 14.41 2.20 NA 40.59 090 31800 A Repair of windpipe injury 7.43 NA 6.81 0.67 NA 14.91 090 31805 A Repair of windpipe injury 13.13 NA 10.72 1.45 NA 25.30 090 31820 A Closure of windpipe lesion 4.49 8.24 8.07 0.35 13.08 12.91 090 31825 A Repair of windpipe defect 6.81 10.86 10.86 0.50 18.17 18.17 090 31830 A Revise windpipe scar 4.50 7.82 7.82 0.36 12.68 12.68 090 31899 C Airways surgical procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 32000 A Drainage of chest 1.54 3.10 0.51 0.07 4.71 2.12 000 32002 A Treatment of collapsed lung 2.19 NA 0.87 0.11 NA 3.17 000 32005 A Treat lung lining chemically 2.19 NA 0.88 0.17 NA 3.24 000 32020 A Insertion of chest tube 3.98 NA 1.48 0.36 NA 5.82 000 32035 A Exploration of chest 8.67 NA 7.83 1.02 NA 17.52 090 32036 A Exploration of chest 9.68 NA 8.39 1.20 NA 19.27 090 32095 A Biopsy through chest wall 8.36 NA 8.05 0.99 NA 17.40 090 32100 A Exploration/biopsy of chest 15.24 NA 10.30 1.45 NA 26.99 090 32110 A Explore/repair chest 23.00 NA 12.72 1.63 NA 37.35 090 32120 A Re-exploration of chest 11.54 NA 9.34 1.42 NA 22.30 090 32124 A Explore chest free adhesions 12.72 NA 9.53 1.51 NA 23.76 090 32140 A Removal of lung lesion(s) 13.93 NA 9.79 1.68 NA 25.40 090 32141 A Remove/treat lung lesions 14.00 NA 9.98 1.72 NA 25.70 090 32150 A Removal of lung lesion(s) 14.15 NA 9.70 1.60 NA 25.45 090 32151 A Remove lung foreign body 14.21 NA 10.20 1.49 NA 25.90 090 32160 A Open chest heart massage 9.30 NA 6.34 1.01 NA 16.65 090 32200 A Drain, open, lung lesion 15.29 NA 10.08 1.46 NA 26.83 090 32201 A Drain, percut, lung lesion 4.00 NA 5.67 0.18 NA 9.85 000 32215 A Treat chest lining 11.33 NA 9.16 1.34 NA 21.83 090 32220 A Release of lung 24.00 NA 13.56 2.39 NA 39.95 090 32225 A Partial release of lung 13.96 NA 9.95 1.70 NA 25.61 090 32310 A Removal of chest lining 13.44 NA 9.86 1.65 NA 24.95 090 32320 A Free/remove chest lining 24.00 NA 13.21 2.50 NA 39.71 090 32400 A Needle biopsy chest lining 1.76 1.89 0.59 0.07 3.72 2.42 000 32402 A Open biopsy chest lining 7.56 NA 7.76 0.91 NA 16.23 090 32405 A Biopsy, lung or mediastinum 1.93 2.33 0.67 0.09 4.35 2.69 000 32420 A Puncture/clear lung 2.18 NA 0.88 0.11 NA 3.17 000 32440 A Removal of lung 25.00 NA 13.57 2.56 NA 41.13 090 32442 A Sleeve pneumonectomy 26.24 NA 14.35 3.12 NA 43.71 090 32445 A Removal of lung 25.09 NA 13.83 3.11 NA 42.03 090 32480 A Partial removal of lung 23.75 NA 12.78 2.24 NA 38.77 090 32482 A Bilobectomy 25.00 NA 13.39 2.35 NA 40.74 090 32484 A Segmentectomy 20.69 NA 11.97 2.54 NA 35.20 090 32486 A Sleeve lobectomy 23.92 NA 13.32 3.00 NA 40.24 090 32488 A Completion pneumonectomy 25.71 NA 13.89 3.18 NA 42.78 090 32491 R Lung volume reduction 21.25 NA 12.67 2.66 NA 36.58 090 32500 A Partial removal of lung 22.00 NA 12.70 1.77 NA 36.47 090 32501 A Repair bronchus add-on 4.69 NA 1.59 0.56 NA 6.84 ZZZ 32520 A Remove lung & revise chest 21.68 NA 12.56 2.71 NA 36.95 090 32522 A Remove lung & revise chest 24.20 NA 13.63 2.84 NA 40.67 090 32525 A Remove lung & revise chest 26.50 NA 14.22 3.25 NA 43.97 090 32540 A Removal of lung lesion 14.64 NA 9.99 1.84 NA 26.47 090 32601 A Thoracoscopy, diagnostic 5.46 NA 3.60 0.63 NA 9.69 000Start Printed Page 55364 32602 A Thoracoscopy, diagnostic 5.96 NA 3.72 0.70 NA 10.38 000 32603 A Thoracoscopy, diagnostic 7.81 NA 4.33 0.76 NA 12.90 000 32604 A Thoracoscopy, diagnostic 8.78 NA 4.79 0.97 NA 14.54 000 32605 A Thoracoscopy, diagnostic 6.93 NA 4.19 0.86 NA 11.98 000 32606 A Thoracoscopy, diagnostic 8.40 NA 4.55 0.99 NA 13.94 000 32650 A Thoracoscopy, surgical 10.75 NA 8.47 1.25 NA 20.47 090 32651 A Thoracoscopy, surgical 12.91 NA 8.84 1.50 NA 23.25 090 32652 A Thoracoscopy, surgical 18.66 NA 11.16 2.30 NA 32.12 090 32653 A Thoracoscopy, surgical 12.87 NA 9.15 1.55 NA 23.57 090 32654 A Thoracoscopy, surgical 12.44 NA 7.53 1.51 NA 21.48 090 32655 A Thoracoscopy, surgical 13.10 NA 8.86 1.53 NA 23.49 090 32656 A Thoracoscopy, surgical 12.91 NA 9.53 1.61 NA 24.05 090 32657 A Thoracoscopy, surgical 13.65 NA 9.36 1.64 NA 24.65 090 32658 A Thoracoscopy, surgical 11.63 NA 9.05 1.47 NA 22.15 090 32659 A Thoracoscopy, surgical 11.59 NA 9.10 1.39 NA 22.08 090 32660 A Thoracoscopy, surgical 17.43 NA 10.53 2.09 NA 30.05 090 32661 A Thoracoscopy, surgical 13.25 NA 9.15 1.66 NA 24.06 090 32662 A Thoracoscopy, surgical 16.44 NA 10.59 2.01 NA 29.04 090 32663 A Thoracoscopy, surgical 18.47 NA 11.22 2.28 NA 31.97 090 32664 A Thoracoscopy, surgical 14.20 NA 9.43 1.70 NA 25.33 090 32665 A Thoracoscopy, surgical 15.54 NA 9.18 1.79 NA 26.51 090 32800 A Repair lung hernia 13.69 NA 10.05 1.51 NA 25.25 090 32810 A Close chest after drainage 13.05 NA 10.05 1.55 NA 24.65 090 32815 A Close bronchial fistula 23.15 NA 13.32 2.84 NA 39.31 090 32820 A Reconstruct injured chest 21.48 NA 13.99 2.31 NA 37.78 090 32850 X Donor pneumonectomy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 32851 A Lung transplant, single 38.63 NA 19.94 4.90 NA 63.47 090 32852 A Lung transplant with bypass 41.80 NA 21.40 5.17 NA 68.37 090 32853 A Lung transplant, double 47.81 NA 23.49 6.13 NA 77.43 090 32854 A Lung transplant with bypass 50.98 NA 24.35 6.41 NA 81.74 090 32900 A Removal of rib(s) 20.27 NA 12.27 2.42 NA 34.96 090 32905 A Revise & repair chest wall 20.75 NA 12.77 2.54 NA 36.06 090 32906 A Revise & repair chest wall 26.77 NA 14.12 3.30 NA 44.19 090 32940 A Revision of lung 19.43 NA 11.96 2.47 NA 33.86 090 32960 A Therapeutic pneumothorax 1.84 2.16 0.70 0.12 4.12 2.66 000 32997 A Total lung lavage 6.00 NA 2.00 0.55 NA 8.55 000 32999 C Chest surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 33010 A Drainage of heart sac 2.24 NA 1.01 0.13 NA 3.38 000 33011 A Repeat drainage of heart sac 2.24 NA 1.05 0.13 NA 3.42 000 33015 A Incision of heart sac 6.80 NA 4.41 0.64 NA 11.85 090 33020 A Incision of heart sac 12.61 NA 7.91 1.50 NA 22.02 090 33025 A Incision of heart sac 12.09 NA 7.77 1.50 NA 21.36 090 33030 A Partial removal of heart sac 18.71 NA 12.12 2.40 NA 33.23 090 33031 A Partial removal of heart sac 21.79 NA 13.20 2.78 NA 37.77 090 33050 A Removal of heart sac lesion 14.36 NA 10.24 1.73 NA 26.33 090 33120 A Removal of heart lesion 24.56 NA 15.68 3.06 NA 43.30 090 33130 A Removal of heart lesion 21.39 NA 12.40 2.51 NA 36.30 090 33140 A Heart revascularize (tmr) 20.00 NA 10.57 2.27 NA 32.84 090 33141 A Heart tmr w/other procedure 4.84 NA 1.63 0.55 NA 7.02 ZZZ 33200 A Insertion of heart pacemaker 12.48 NA 9.59 1.17 NA 23.24 090 33201 A Insertion of heart pacemaker 10.18 NA 9.39 1.21 NA 20.78 090 33206 A Insertion of heart pacemaker 6.67 NA 5.35 0.50 NA 12.52 090 33207 A Insertion of heart pacemaker 8.04 NA 6.00 0.57 NA 14.61 090 33208 A Insertion of heart pacemaker 8.13 NA 6.14 0.54 NA 14.81 090 33210 A Insertion of heart electrode 3.30 NA 1.34 0.17 NA 4.81 000 33211 A Insertion of heart electrode 3.40 NA 1.41 0.17 NA 4.98 000 33212 A Insertion of pulse generator 5.52 NA 4.44 0.44 NA 10.40 090 33213 A Insertion of pulse generator 6.37 NA 4.85 0.46 NA 11.68 090 33214 A Upgrade of pacemaker system 7.75 NA 5.95 0.52 NA 14.22 090 33216 A Revise eltrd pacing-defib 5.39 NA 4.95 0.36 NA 10.70 090 33217 A Revise eltrd pacing-defib 5.75 NA 5.26 0.36 NA 11.37 090 33218 A Revise eltrd pacing-defib 5.44 NA 4.51 0.40 NA 10.35 090 33220 A Revise eltrd pacing-defib 5.52 NA 4.45 0.39 NA 10.36 090 33222 A Revise pocket, pacemaker 4.96 NA 3.93 0.39 NA 9.28 090 33223 A Revise pocket, pacing-defib 6.46 NA 5.06 0.44 NA 11.96 090 33233 A Removal of pacemaker system 3.29 NA 3.80 0.22 NA 7.31 090 33234 A Removal of pacemaker system 7.82 NA 5.03 0.56 NA 13.41 090 33235 A Removal pacemaker electrode 9.40 NA 6.26 0.68 NA 16.34 090 33236 A Remove electrode/thoracotomy 12.60 NA 9.35 1.49 NA 23.44 090 33237 A Remove electrode/thoracotomy 13.71 NA 9.51 1.57 NA 24.79 090 33238 A Remove electrode/thoracotomy 15.22 NA 9.24 1.56 NA 26.02 090 33240 A Insert pulse generator 7.60 NA 5.49 0.53 NA 13.62 090 33241 A Remove pulse generator 3.24 NA 3.39 0.21 NA 6.84 090Start Printed Page 55365 33243 A Remove eltrd/thoracotomy 22.64 NA 10.88 2.53 NA 36.05 090 33244 A Remove eltrd, transven 13.76 NA 8.22 1.05 NA 23.03 090 33245 A Insert epic eltrd pace-defib 14.30 NA 10.79 1.28 NA 26.37 090 33246 A Insert epic eltrd/generator 20.71 NA 14.16 2.22 NA 37.09 090 33249 A Eltrd/insert pace-defib 14.23 NA 8.98 0.80 NA 24.01 090 33250 A Ablate heart dysrhythm focus 21.85 NA 13.65 1.01 NA 36.51 090 33251 A Ablate heart dysrhythm focus 24.88 NA 14.06 2.41 NA 41.35 090 33253 A Reconstruct atria 31.06 NA 16.58 3.68 NA 51.32 090 33261 A Ablate heart dysrhythm focus 24.88 NA 14.47 2.82 NA 42.17 090 33282 A Implant pat-active ht record 4.17 NA 4.42 0.39 NA 8.98 090 33284 A Remove pat-active ht record 2.50 NA 3.94 0.23 NA 6.67 090 33300 A Repair of heart wound 17.92 NA 11.56 1.91 NA 31.39 090 33305 A Repair of heart wound 21.44 NA 13.24 2.68 NA 37.36 090 33310 A Exploratory heart surgery 18.51 NA 11.85 2.26 NA 32.62 090 33315 A Exploratory heart surgery 22.37 NA 13.43 2.90 NA 38.70 090 33320 A Repair major blood vessel(s) 16.79 NA 11.06 1.66 NA 29.51 090 33321 A Repair major vessel 20.20 NA 13.15 2.70 NA 36.05 090 33322 A Repair major blood vessel(s) 20.62 NA 13.02 2.51 NA 36.15 090 33330 A Insert major vessel graft 21.43 NA 12.35 2.49 NA 36.27 090 33332 A Insert major vessel graft 23.96 NA 12.94 2.45 NA 39.35 090 33335 A Insert major vessel graft 30.01 NA 16.15 3.79 NA 49.95 090 33400 A Repair of aortic valve 28.50 NA 17.04 3.09 NA 48.63 090 33401 A Valvuloplasty, open 23.91 NA 14.85 2.71 NA 41.47 090 33403 A Valvuloplasty, w/cp bypass 24.89 NA 15.99 2.48 NA 43.36 090 33404 A Prepare heart-aorta conduit 28.54 NA 17.22 3.31 NA 49.07 090 33405 A Replacement of aortic valve 35.00 NA 17.69 3.86 NA 56.55 090 33406 A Replacement of aortic valve 37.50 NA 18.53 4.07 NA 60.10 090 33410 A Replacement of aortic valve 32.46 NA 16.93 4.11 NA 53.50 090 33411 A Replacement of aortic valve 36.25 NA 18.07 4.16 NA 58.48 090 33412 A Replacement of aortic valve 42.00 NA 21.90 4.66 NA 68.56 090 33413 A Replacement of aortic valve 43.50 NA 23.05 4.26 NA 70.81 090 33414 A Repair of aortic valve 30.35 NA 17.67 3.79 NA 51.81 090 33415 A Revision, subvalvular tissue 27.15 NA 16.53 3.25 NA 46.93 090 33416 A Revise ventricle muscle 30.35 NA 16.06 3.85 NA 50.26 090 33417 A Repair of aortic valve 28.53 NA 17.09 3.58 NA 49.20 090 33420 A Revision of mitral valve 22.70 NA 11.77 1.48 NA 35.95 090 33422 A Revision of mitral valve 25.94 NA 14.74 3.30 NA 43.98 090 33425 A Repair of mitral valve 27.00 NA 14.98 3.00 NA 44.98 090 33426 A Repair of mitral valve 33.00 NA 17.14 3.87 NA 54.01 090 33427 A Repair of mitral valve 40.00 NA 19.42 4.30 NA 63.72 090 33430 A Replacement of mitral valve 33.50 NA 17.26 3.95 NA 54.71 090 33460 A Revision of tricuspid valve 23.60 NA 13.83 3.02 NA 40.45 090 33463 A Valvuloplasty, tricuspid 25.62 NA 14.60 3.17 NA 43.39 090 33464 A Valvuloplasty, tricuspid 27.33 NA 15.22 3.47 NA 46.02 090 33465 A Replace tricuspid valve 28.79 NA 15.67 3.61 NA 48.07 090 33468 A Revision of tricuspid valve 30.12 NA 19.06 4.00 NA 53.18 090 33470 A Revision of pulmonary valve 20.81 NA 14.20 2.81 NA 37.82 090 33471 A Valvotomy, pulmonary valve 22.25 NA 13.13 3.00 NA 38.38 090 33472 A Revision of pulmonary valve 22.25 NA 13.13 2.92 NA 38.30 090 33474 A Revision of pulmonary valve 23.04 NA 13.45 2.84 NA 39.33 090 33475 A Replacement, pulmonary valve 33.00 NA 18.28 2.64 NA 53.92 090 33476 A Revision of heart chamber 25.77 NA 14.23 2.40 NA 42.40 090 33478 A Revision of heart chamber 26.74 NA 14.43 3.56 NA 44.73 090 33496 A Repair, prosth valve clot 27.25 NA 16.84 3.44 NA 47.53 090 33500 A Repair heart vessel fistula 25.55 NA 13.99 2.80 NA 42.34 090 33501 A Repair heart vessel fistula 17.78 NA 10.24 2.05 NA 30.07 090 33502 A Coronary artery correction 21.04 NA 16.64 2.51 NA 40.19 090 33503 A Coronary artery graft 21.78 NA 13.90 1.42 NA 37.10 090 33504 A Coronary artery graft 24.66 NA 16.55 3.04 NA 44.25 090 33505 A Repair artery w/tunnel 26.84 NA 18.16 1.52 NA 46.52 090 33506 A Repair artery, translocation 35.50 NA 19.27 3.19 NA 57.96 090 33510 A CABG, vein, single 29.00 NA 15.53 3.13 NA 47.66 090 33511 A CABG, vein, two 30.00 NA 16.05 3.34 NA 49.39 090 33512 A CABG, vein, three 31.80 NA 16.65 3.70 NA 52.15 090 33513 A CABG, vein, four 32.00 NA 16.77 3.99 NA 52.76 090 33514 A CABG, vein, five 32.75 NA 17.00 4.37 NA 54.12 090 33516 A Cabg, vein, six or more 35.00 NA 17.74 4.62 NA 57.36 090 33517 A CABG, artery-vein, single 2.57 NA 0.86 0.32 NA 3.75 ZZZ 33518 A CABG, artery-vein, two 4.85 NA 1.62 0.61 NA 7.08 ZZZ 33519 A CABG, artery-vein, three 7.12 NA 2.38 0.89 NA 10.39 ZZZ 33521 A CABG, artery-vein, four 9.40 NA 3.15 1.18 NA 13.73 ZZZ 33522 A CABG, artery-vein, five 11.67 NA 3.91 1.48 NA 17.06 ZZZ 33523 A Cabg, art-vein, six or more 13.95 NA 4.63 1.78 NA 20.36 ZZZStart Printed Page 55366 33533 A CABG, arterial, single 30.00 NA 17.24 3.24 NA 50.48 090 33534 A CABG, arterial, two 32.20 NA 17.45 3.63 NA 53.28 090 33535 A CABG, arterial, three 34.50 NA 17.77 3.97 NA 56.24 090 33536 A Cabg, arterial, four or more 37.50 NA 19.27 3.29 NA 60.06 090 33542 A Removal of heart lesion 28.85 NA 17.05 3.61 NA 49.51 090 33545 A Repair of heart damage 36.78 NA 19.79 4.40 NA 60.97 090 33572 A Open coronary endarterectomy 4.45 NA 1.48 0.55 NA 6.48 ZZZ 33600 A Closure of valve 29.51 NA 17.79 2.30 NA 49.60 090 33602 A Closure of valve 28.54 NA 16.65 2.90 NA 48.09 090 33606 A Anastomosis/artery-aorta 30.74 NA 17.53 3.59 NA 51.86 090 33608 A Repair anomaly w/conduit 31.09 NA 16.38 4.17 NA 51.64 090 33610 A Repair by enlargement 30.61 NA 18.89 4.02 NA 53.52 090 33611 A Repair double ventricle 34.00 NA 19.08 3.28 NA 56.36 090 33612 A Repair double ventricle 35.00 NA 20.17 4.44 NA 59.61 090 33615 A Repair, modified fontan 34.00 NA 19.33 3.15 NA 56.48 090 33617 A Repair single ventricle 37.00 NA 21.25 4.09 NA 62.34 090 33619 A Repair single ventricle 45.00 NA 26.49 4.71 NA 76.20 090 33641 A Repair heart septum defect 21.39 NA 11.82 2.67 NA 35.88 090 33645 A Revision of heart veins 24.82 NA 13.92 3.27 NA 42.01 090 33647 A Repair heart septum defects 28.73 NA 17.08 3.37 NA 49.18 090 33660 A Repair of heart defects 30.00 NA 17.09 2.82 NA 49.91 090 33665 A Repair of heart defects 28.60 NA 16.87 3.81 NA 49.28 090 33670 A Repair of heart chambers 35.00 NA 16.68 2.18 NA 53.86 090 33681 A Repair heart septum defect 30.61 NA 17.83 3.53 NA 51.97 090 33684 A Repair heart septum defect 29.65 NA 17.82 3.77 NA 51.24 090 33688 A Repair heart septum defect 30.62 NA 16.70 3.89 NA 51.21 090 33690 A Reinforce pulmonary artery 19.55 NA 13.55 2.56 NA 35.66 090 33692 A Repair of heart defects 30.75 NA 17.52 3.77 NA 52.04 090 33694 A Repair of heart defects 34.00 NA 17.82 4.27 NA 56.09 090 33697 A Repair of heart defects 36.00 NA 18.62 4.54 NA 59.16 090 33702 A Repair of heart defects 26.54 NA 16.53 3.45 NA 46.52 090 33710 A Repair of heart defects 29.71 NA 16.82 3.85 NA 50.38 090 33720 A Repair of heart defect 26.56 NA 16.51 3.21 NA 46.28 090 33722 A Repair of heart defect 28.41 NA 17.05 3.80 NA 49.26 090 33730 A Repair heart-vein defect(s) 34.25 NA 18.35 2.85 NA 55.45 090 33732 A Repair heart-vein defect 28.16 NA 17.95 2.78 NA 48.89 090 33735 A Revision of heart chamber 21.39 NA 13.00 1.12 NA 35.51 090 33736 A Revision of heart chamber 23.52 NA 14.06 2.70 NA 40.28 090 33737 A Revision of heart chamber 21.76 NA 15.22 2.93 NA 39.91 090 33750 A Major vessel shunt 21.41 NA 12.83 1.74 NA 35.98 090 33755 A Major vessel shunt 21.79 NA 12.94 2.93 NA 37.66 090 33762 A Major vessel shunt 21.79 NA 13.32 1.59 NA 36.70 090 33764 A Major vessel shunt & graft 21.79 NA 14.22 1.93 NA 37.94 090 33766 A Major vessel shunt 22.76 NA 15.16 3.04 NA 40.96 090 33767 A Major vessel shunt 24.50 NA 14.92 3.14 NA 42.56 090 33770 A Repair great vessels defect 37.00 NA 19.01 4.49 NA 60.50 090 33771 A Repair great vessels defect 34.65 NA 18.08 4.67 NA 57.40 090 33774 A Repair great vessels defect 30.98 NA 16.61 4.18 NA 51.77 090 33775 A Repair great vessels defect 32.20 NA 17.10 4.34 NA 53.64 090 33776 A Repair great vessels defect 34.04 NA 17.83 4.58 NA 56.45 090 33777 A Repair great vessels defect 33.46 NA 17.60 4.51 NA 55.57 090 33778 A Repair great vessels defect 40.00 NA 20.21 4.83 NA 65.04 090 33779 A Repair great vessels defect 36.21 NA 17.93 2.40 NA 56.54 090 33780 A Repair great vessels defect 41.75 NA 20.98 5.21 NA 67.94 090 33781 A Repair great vessels defect 36.45 NA 18.80 4.91 NA 60.16 090 33786 A Repair arterial trunk 39.00 NA 19.81 4.69 NA 63.50 090 33788 A Revision of pulmonary artery 26.62 NA 14.87 3.32 NA 44.81 090 33800 A Aortic suspension 16.24 NA 13.12 1.11 NA 30.47 090 33802 A Repair vessel defect 17.66 NA 12.22 1.56 NA 31.44 090 33803 A Repair vessel defect 19.60 NA 13.53 2.63 NA 35.76 090 33813 A Repair septal defect 20.65 NA 14.12 2.78 NA 37.55 090 33814 A Repair septal defect 25.77 NA 15.61 2.52 NA 43.90 090 33820 A Revise major vessel 16.29 NA 10.95 2.10 NA 29.34 090 33822 A Revise major vessel 17.32 NA 11.16 2.33 NA 30.81 090 33824 A Revise major vessel 19.52 NA 11.97 2.61 NA 34.10 090 33840 A Remove aorta constriction 20.63 NA 14.11 2.36 NA 37.10 090 33845 A Remove aorta constriction 22.12 NA 14.85 2.90 NA 39.87 090 33851 A Remove aorta constriction 21.27 NA 12.98 2.86 NA 37.11 090 33852 A Repair septal defect 23.71 NA 14.14 3.19 NA 41.04 090 33853 A Repair septal defect 31.72 NA 18.25 4.23 NA 54.20 090 33860 A Ascending aortic graft 38.00 NA 18.74 4.30 NA 61.04 090 33861 A Ascending aortic graft 42.00 NA 20.15 4.24 NA 66.39 090Start Printed Page 55367 33863 A Ascending aortic graft 45.00 NA 21.10 4.60 NA 70.70 090 33870 A Transverse aortic arch graft 44.00 NA 20.69 5.09 NA 69.78 090 33875 A Thoracic aortic graft 33.06 NA 17.01 4.08 NA 54.15 090 33877 A Thoracoabdominal graft 42.60 NA 19.96 5.07 NA 67.63 090 33910 A Remove lung artery emboli 24.59 NA 14.16 3.06 NA 41.81 090 33915 A Remove lung artery emboli 21.02 NA 12.31 1.20 NA 34.53 090 33916 A Surgery of great vessel 25.83 NA 15.49 3.04 NA 44.36 090 33917 A Repair pulmonary artery 24.50 NA 15.36 3.17 NA 43.03 090 33918 A Repair pulmonary atresia 26.45 NA 14.80 3.42 NA 44.67 090 33919 A Repair pulmonary atresia 40.00 NA 21.02 3.48 NA 64.50 090 33920 A Repair pulmonary atresia 31.95 NA 17.28 3.61 NA 52.84 090 33922 A Transect pulmonary artery 23.52 NA 13.79 2.30 NA 39.61 090 33924 A Remove pulmonary shunt 5.50 NA 2.05 0.74 NA 8.29 ZZZ 33930 X Removal of donor heart/lung 0.00 0.00 0.00 0.00 0.00 0.00 XXX 33935 R Transplantation, heart/lung 60.96 NA 27.93 8.15 NA 97.04 090 33940 X Removal of donor heart 0.00 0.00 0.00 0.00 0.00 0.00 XXX 33945 R Transplantation of heart 42.10 NA 21.67 5.42 NA 69.19 090 33960 A External circulation assist 19.36 NA 6.06 2.14 NA 27.56 000 33961 A External circulation assist 10.93 NA 3.79 1.47 NA 16.19 ZZZ 33967 A Insert ia percut device 4.85 2.01 1.96 0.27 7.13 7.08 000 33968 A Remove aortic assist device 0.64 NA 0.24 0.07 NA 0.95 000 33970 A Aortic circulation assist 6.75 NA 2.37 0.70 NA 9.82 000 33971 A Aortic circulation assist 9.69 NA 7.82 0.97 NA 18.48 090 33973 A Insert balloon device 9.76 NA 3.44 1.01 NA 14.21 000 33974 A Remove intra-aortic balloon 14.41 NA 10.69 1.48 NA 26.58 090 33975 A Implant ventricular device 21.00 NA 7.04 1.72 NA 29.76 XXX 33976 A Implant ventricular device 23.00 NA 7.78 2.82 NA 33.60 XXX 33977 A Remove ventricular device 19.29 NA 10.46 2.44 NA 32.19 090 33978 A Remove ventricular device 21.73 NA 11.27 2.66 NA 35.66 090 33979 C Insert intracorporeal device 0.00 0.00 0.00 0.00 0.00 0.00 XXX 33980 C Remove intracorporeal device 0.00 0.00 0.00 0.00 0.00 0.00 090 33999 C Cardiac surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 34001 A Removal of artery clot 12.91 NA 5.97 1.46 NA 20.34 090 34051 A Removal of artery clot 15.21 NA 7.07 1.90 NA 24.18 090 34101 A Removal of artery clot 10.00 NA 4.84 1.11 NA 15.95 090 34111 A Removal of arm artery clot 10.00 NA 4.88 0.85 NA 15.73 090 34151 A Removal of artery clot 25.00 NA 10.54 1.84 NA 37.38 090 34201 A Removal of artery clot 10.03 NA 5.12 1.02 NA 16.17 090 34203 A Removal of leg artery clot 16.50 NA 7.65 1.37 NA 25.52 090 34401 A Removal of vein clot 25.00 NA 10.47 1.20 NA 36.67 090 34421 A Removal of vein clot 12.00 NA 6.01 0.95 NA 18.96 090 34451 A Removal of vein clot 27.00 NA 11.08 1.59 NA 39.67 090 34471 A Removal of vein clot 10.18 NA 5.18 0.90 NA 16.26 090 34490 A Removal of vein clot 9.86 NA 6.26 0.73 NA 16.85 090 34501 A Repair valve, femoral vein 16.00 NA 8.98 1.37 NA 26.35 090 34502 A Reconstruct vena cava 26.95 NA 11.34 2.99 NA 41.28 090 34510 A Transposition of vein valve 18.95 NA 10.23 1.60 NA 30.78 090 34520 A Cross-over vein graft 17.95 NA 9.59 1.41 NA 28.95 090 34530 A Leg vein fusion 16.64 NA 8.48 2.06 NA 27.18 090 34800 A Endovasc abdo repair w/tube 20.75 NA 9.79 1.49 NA 32.03 090 34802 A Endovasc abdo repr w/device 23.00 NA 10.69 1.65 NA 35.34 090 34804 A Endovasc abdo repr w/device 23.00 NA 10.69 1.65 NA 35.34 090 34808 A Endovasc abdo occlud device 4.13 NA 1.65 0.29 NA 6.07 ZZZ 34812 A Xpose for endoprosth, aortic 6.75 NA 2.69 0.49 NA 9.93 000 34813 A Xpose for endoprosth, femorl 4.80 NA 1.92 0.34 NA 7.06 ZZZ 34820 A Xpose for endoprosth, iliac 9.75 NA 3.89 0.70 NA 14.34 000 34825 A Endovasc extend prosth, init 12.00 NA 6.30 0.86 NA 19.16 090 34826 A Endovasc exten prosth, addl 4.13 NA 1.65 0.29 NA 6.07 ZZZ 34830 A Open aortic tube prosth repr 32.59 NA 14.89 2.34 NA 49.82 090 34831 A Open aortoiliac prosth repr 35.34 NA 15.99 2.53 NA 53.86 090 34832 A Open aortofemor prosth repr 35.34 NA 15.99 2.53 NA 53.86 090 35001 A Repair defect of artery 19.64 NA 8.41 2.44 NA 30.49 090 35002 A Repair artery rupture, neck 21.00 NA 9.12 1.82 NA 31.94 090 35005 A Repair defect of artery 18.12 NA 8.04 1.35 NA 27.51 090 35011 A Repair defect of artery 18.00 NA 7.59 1.30 NA 26.89 090 35013 A Repair artery rupture, arm 22.00 NA 8.98 1.91 NA 32.89 090 35021 A Repair defect of artery 19.65 NA 8.64 1.93 NA 30.22 090 35022 A Repair artery rupture, chest 23.18 NA 9.57 1.99 NA 34.74 090 35045 A Repair defect of arm artery 17.57 NA 7.99 1.25 NA 26.81 090 35081 A Repair defect of artery 28.01 NA 11.69 3.20 NA 42.90 090 35082 A Repair artery rupture, aorta 38.50 NA 15.08 4.07 NA 57.65 090 35091 A Repair defect of artery 35.40 NA 14.22 4.09 NA 53.71 090 35092 A Repair artery rupture, aorta 45.00 NA 17.35 4.31 NA 66.66 090Start Printed Page 55368 35102 A Repair defect of artery 30.76 NA 12.67 3.44 NA 46.87 090 35103 A Repair artery rupture, groin 40.50 NA 15.81 3.79 NA 60.10 090 35111 A Repair defect of artery 25.00 NA 10.43 1.81 NA 37.24 090 35112 A Repair artery rupture,spleen 30.00 NA 12.06 1.95 NA 44.01 090 35121 A Repair defect of artery 30.00 NA 12.39 2.93 NA 45.32 090 35122 A Repair artery rupture, belly 35.00 NA 13.73 3.54 NA 52.27 090 35131 A Repair defect of artery 25.00 NA 10.64 2.11 NA 37.75 090 35132 A Repair artery rupture, groin 30.00 NA 12.14 2.48 NA 44.62 090 35141 A Repair defect of artery 20.00 NA 8.66 1.65 NA 30.31 090 35142 A Repair artery rupture, thigh 23.30 NA 9.76 1.75 NA 34.81 090 35151 A Repair defect of artery 22.64 NA 9.72 1.93 NA 34.29 090 35152 A Repair artery rupture, knee 25.62 NA 10.50 1.93 NA 38.05 090 35161 A Repair defect of artery 18.76 NA 8.96 2.21 NA 29.93 090 35162 A Repair artery rupture 19.78 NA 9.05 2.21 NA 31.04 090 35180 A Repair blood vessel lesion 13.62 NA 6.49 1.44 NA 21.55 090 35182 A Repair blood vessel lesion 30.00 NA 12.39 1.88 NA 44.27 090 35184 A Repair blood vessel lesion 18.00 NA 7.92 1.34 NA 27.26 090 35188 A Repair blood vessel lesion 14.28 NA 6.70 1.53 NA 22.51 090 35189 A Repair blood vessel lesion 28.00 NA 11.71 2.12 NA 41.83 090 35190 A Repair blood vessel lesion 12.75 NA 6.03 1.33 NA 20.11 090 35201 A Repair blood vessel lesion 16.14 NA 7.18 1.17 NA 24.49 090 35206 A Repair blood vessel lesion 13.25 NA 7.60 1.04 NA 21.89 090 35207 A Repair blood vessel lesion 10.15 NA 9.91 1.15 NA 21.21 090 35211 A Repair blood vessel lesion 22.12 NA 13.55 2.83 NA 38.50 090 35216 A Repair blood vessel lesion 18.75 NA 11.83 2.17 NA 32.75 090 35221 A Repair blood vessel lesion 24.39 NA 10.31 1.79 NA 36.49 090 35226 A Repair blood vessel lesion 14.50 NA 8.54 0.84 NA 23.88 090 35231 A Repair blood vessel lesion 20.00 NA 9.45 1.32 NA 30.77 090 35236 A Repair blood vessel lesion 17.11 NA 8.97 1.19 NA 27.27 090 35241 A Repair blood vessel lesion 23.12 NA 14.09 2.90 NA 40.11 090 35246 A Repair blood vessel lesion 26.45 NA 14.32 2.22 NA 42.99 090 35251 A Repair blood vessel lesion 30.20 NA 12.39 1.87 NA 44.46 090 35256 A Repair blood vessel lesion 18.36 NA 9.63 1.32 NA 29.31 090 35261 A Repair blood vessel lesion 17.80 NA 7.56 1.34 NA 26.70 090 35266 A Repair blood vessel lesion 14.91 NA 8.12 1.16 NA 24.19 090 35271 A Repair blood vessel lesion 22.12 NA 13.43 2.77 NA 38.32 090 35276 A Repair blood vessel lesion 24.25 NA 13.56 2.37 NA 40.18 090 35281 A Repair blood vessel lesion 28.00 NA 11.66 1.82 NA 41.48 090 35286 A Repair blood vessel lesion 16.16 NA 8.88 1.36 NA 26.40 090 35301 A Rechanneling of artery 18.70 NA 8.39 2.23 NA 29.32 090 35311 A Rechanneling of artery 27.00 NA 11.10 2.75 NA 40.85 090 35321 A Rechanneling of artery 16.00 NA 6.87 1.36 NA 24.23 090 35331 A Rechanneling of artery 26.20 NA 11.11 2.71 NA 40.02 090 35341 A Rechanneling of artery 25.11 NA 10.70 2.87 NA 38.68 090 35351 A Rechanneling of artery 23.00 NA 9.84 2.29 NA 35.13 090 35355 A Rechanneling of artery 18.50 NA 8.33 1.80 NA 28.63 090 35361 A Rechanneling of artery 28.20 NA 11.60 2.66 NA 42.46 090 35363 A Rechanneling of artery 30.20 NA 12.54 2.77 NA 45.51 090 35371 A Rechanneling of artery 14.72 NA 6.75 1.32 NA 22.79 090 35372 A Rechanneling of artery 18.00 NA 7.91 1.53 NA 27.44 090 35381 A Rechanneling of artery 15.81 NA 7.35 1.80 NA 24.96 090 35390 A Reoperation, carotid add-on 3.19 NA 1.11 0.38 NA 4.68 ZZZ 35400 A Angioscopy 3.00 NA 1.05 0.34 NA 4.39 ZZZ 35450 A Repair arterial blockage 10.07 NA 4.22 0.84 NA 15.13 000 35452 A Repair arterial blockage 6.91 NA 3.11 0.76 NA 10.78 000 35454 A Repair arterial blockage 6.04 NA 2.83 0.67 NA 9.54 000 35456 A Repair arterial blockage 7.35 NA 3.27 0.82 NA 11.44 000 35458 A Repair arterial blockage 9.49 NA 4.03 1.09 NA 14.61 000 35459 A Repair arterial blockage 8.63 NA 3.69 0.96 NA 13.28 000 35460 A Repair venous blockage 6.04 NA 2.70 0.66 NA 9.40 000 35470 A Repair arterial blockage 8.63 NA 3.98 0.50 NA 13.11 000 35471 A Repair arterial blockage 10.07 NA 4.67 0.50 NA 15.24 000 35472 A Repair arterial blockage 6.91 NA 3.32 0.39 NA 10.62 000 35473 A Repair arterial blockage 6.04 NA 3.01 0.34 NA 9.39 000 35474 A Repair arterial blockage 7.36 NA 3.52 0.40 NA 11.28 000 35475 R Repair arterial blockage 9.49 NA 4.23 0.47 NA 14.19 000 35476 A Repair venous blockage 6.04 NA 2.94 0.27 NA 9.25 000 35480 A Atherectomy, open 11.08 NA 4.58 1.13 NA 16.79 000 35481 A Atherectomy, open 7.61 NA 3.54 0.84 NA 11.99 000 35482 A Atherectomy, open 6.65 NA 3.16 0.75 NA 10.56 000 35483 A Atherectomy, open 8.10 NA 3.52 0.81 NA 12.43 000 35484 A Atherectomy, open 10.44 NA 4.21 1.13 NA 15.78 000 35485 A Atherectomy, open 9.49 NA 4.05 1.06 NA 14.60 000Start Printed Page 55369 35490 A Atherectomy, percutaneous 11.08 NA 4.83 0.55 NA 16.46 000 35491 A Atherectomy, percutaneous 7.61 NA 3.59 0.49 NA 11.69 000 35492 A Atherectomy, percutaneous 6.65 NA 3.22 0.43 NA 10.30 000 35493 A Atherectomy, percutaneous 8.10 NA 3.90 0.47 NA 12.47 000 35494 A Atherectomy, percutaneous 10.44 NA 4.57 0.48 NA 15.49 000 35495 A Atherectomy, percutaneous 9.49 NA 4.52 0.51 NA 14.52 000 35500 A Harvest vein for bypass 6.45 NA 2.25 0.63 NA 9.33 ZZZ 35501 A Artery bypass graft 19.19 NA 8.14 2.33 NA 29.66 090 35506 A Artery bypass graft 19.67 NA 8.32 2.33 NA 30.32 090 35507 A Artery bypass graft 19.67 NA 8.29 2.27 NA 30.23 090 35508 A Artery bypass graft 18.65 NA 7.91 2.34 NA 28.90 090 35509 A Artery bypass graft 18.07 NA 7.70 2.12 NA 27.89 090 35511 A Artery bypass graft 21.20 NA 8.80 1.74 NA 31.74 090 35515 A Artery bypass graft 18.65 NA 7.80 2.26 NA 28.71 090 35516 A Artery bypass graft 16.32 NA 4.94 1.88 NA 23.14 090 35518 A Artery bypass graft 21.20 NA 8.80 1.78 NA 31.78 090 35521 A Artery bypass graft 22.20 NA 9.53 1.82 NA 33.55 090 35526 A Artery bypass graft 29.95 NA 12.19 2.18 NA 44.32 090 35531 A Artery bypass graft 36.20 NA 14.53 2.91 NA 53.64 090 35533 A Artery bypass graft 28.00 NA 11.74 2.35 NA 42.09 090 35536 A Artery bypass graft 31.70 NA 12.85 2.62 NA 47.17 090 35541 A Artery bypass graft 25.80 NA 10.98 2.74 NA 39.52 090 35546 A Artery bypass graft 25.54 NA 10.75 2.84 NA 39.13 090 35548 A Artery bypass graft 21.57 NA 9.45 2.45 NA 33.47 090 35549 A Artery bypass graft 23.35 NA 9.88 2.77 NA 36.00 090 35551 A Artery bypass graft 26.67 NA 11.20 3.19 NA 41.06 090 35556 A Artery bypass graft 21.76 NA 9.45 2.48 NA 33.69 090 35558 A Artery bypass graft 21.20 NA 9.11 1.58 NA 31.89 090 35560 A Artery bypass graft 32.00 NA 13.12 2.73 NA 47.85 090 35563 A Artery bypass graft 24.20 NA 10.42 1.68 NA 36.30 090 35565 A Artery bypass graft 23.20 NA 9.99 1.71 NA 34.90 090 35566 A Artery bypass graft 26.92 NA 11.77 3.02 NA 41.71 090 35571 A Artery bypass graft 24.06 NA 12.13 2.14 NA 38.33 090 35582 A Vein bypass graft 27.13 NA 11.35 3.11 NA 41.59 090 35583 A Vein bypass graft 22.37 NA 10.62 2.53 NA 35.52 090 35585 A Vein bypass graft 28.39 NA 14.53 3.21 NA 46.13 090 35587 A Vein bypass graft 24.75 NA 12.79 2.17 NA 39.71 090 35600 A Harvest artery for cabg 4.95 NA 1.98 0.60 NA 7.53 ZZZ 35601 A Artery bypass graft 17.50 NA 7.49 2.08 NA 27.07 090 35606 A Artery bypass graft 18.71 NA 7.93 2.17 NA 28.81 090 35612 A Artery bypass graft 15.76 NA 6.70 1.72 NA 24.18 090 35616 A Artery bypass graft 15.70 NA 7.05 1.84 NA 24.59 090 35621 A Artery bypass graft 20.00 NA 8.79 1.68 NA 30.47 090 35623 A Bypass graft, not vein 24.00 NA 10.22 1.91 NA 36.13 090 35626 A Artery bypass graft 27.75 NA 11.08 2.89 NA 41.72 090 35631 A Artery bypass graft 34.00 NA 13.74 2.83 NA 50.57 090 35636 A Artery bypass graft 29.50 NA 12.26 2.37 NA 44.13 090 35641 A Artery bypass graft 24.57 NA 10.47 2.83 NA 37.87 090 35642 A Artery bypass graft 17.98 NA 7.92 1.84 NA 27.74 090 35645 A Artery bypass graft 17.47 NA 8.36 1.91 NA 27.74 090 35646 A Artery bypass graft 31.00 NA 13.26 2.98 NA 47.24 090 35647 A Artery bypass graft 28.00 NA 11.97 2.98 NA 42.95 090 35650 A Artery bypass graft 19.00 NA 7.93 1.64 NA 28.57 090 35651 A Artery bypass graft 25.04 NA 10.70 2.53 NA 38.27 090 35654 A Artery bypass graft 25.00 NA 10.60 2.10 NA 37.70 090 35656 A Artery bypass graft 19.53 NA 8.44 2.21 NA 30.18 090 35661 A Artery bypass graft 19.00 NA 8.26 1.50 NA 28.76 090 35663 A Artery bypass graft 22.00 NA 9.65 1.55 NA 33.20 090 35665 A Artery bypass graft 21.00 NA 9.18 1.76 NA 31.94 090 35666 A Artery bypass graft 22.19 NA 11.93 2.19 NA 36.31 090 35671 A Artery bypass graft 19.33 NA 10.53 1.68 NA 31.54 090 35681 A Composite bypass graft 1.60 NA 0.56 0.18 NA 2.34 ZZZ 35682 A Composite bypass graft 7.20 NA 2.51 0.83 NA 10.54 ZZZ 35683 A Composite bypass graft 8.50 NA 2.99 0.98 NA 12.47 ZZZ 35685 A Bypass graft patency/patch 4.05 NA 1.50 0.41 NA 5.96 ZZZ 35686 A Bypass graft/av fist patency 3.35 NA 1.24 0.34 NA 4.93 ZZZ 35691 A Arterial transposition 18.05 NA 7.65 2.06 NA 27.76 090 35693 A Arterial transposition 15.36 NA 6.66 1.80 NA 23.82 090 35694 A Arterial transposition 19.16 NA 8.02 2.13 NA 29.31 090 35695 A Arterial transposition 19.16 NA 7.92 2.19 NA 29.27 090 35700 A Reoperation, bypass graft 3.08 NA 1.07 0.36 NA 4.51 ZZZ 35701 A Exploration, carotid artery 8.50 NA 4.70 0.64 NA 13.84 090 35721 A Exploration, femoral artery 7.18 NA 5.10 0.59 NA 12.87 090Start Printed Page 55370 35741 A Exploration popliteal artery 8.00 NA 5.47 0.60 NA 14.07 090 35761 A Exploration of artery/vein 5.37 NA 4.47 0.60 NA 10.44 090 35800 A Explore neck vessels 7.02 NA 3.95 0.79 NA 11.76 090 35820 A Explore chest vessels 12.88 NA 4.32 1.61 NA 18.81 090 35840 A Explore abdominal vessels 9.77 NA 5.21 1.06 NA 16.04 090 35860 A Explore limb vessels 5.55 NA 3.62 0.63 NA 9.80 090 35870 A Repair vessel graft defect 22.17 NA 10.21 2.47 NA 34.85 090 35875 A Removal of clot in graft 10.13 NA 6.63 0.97 NA 17.73 090 35876 A Removal of clot in graft 17.00 NA 9.16 1.88 NA 28.04 090 35879 A Revise graft w/vein 16.00 NA 7.77 1.35 NA 25.12 090 35881 A Revise graft w/vein 18.00 NA 8.65 1.44 NA 28.09 090 35901 A Excision, graft, neck 8.19 NA 5.85 0.90 NA 14.94 090 35903 A Excision, graft, extremity 9.39 NA 8.20 1.03 NA 18.62 090 35905 A Excision, graft, thorax 31.25 NA 15.39 2.15 NA 48.79 090 35907 A Excision, graft, abdomen 35.00 NA 14.97 2.17 NA 52.14 090 36000 A Place needle in vein 0.18 0.65 0.05 0.01 0.84 0.24 XXX 36002 A Pseudoaneurysm injection trt 1.96 2.95 1.03 0.08 4.99 3.07 000 36005 A Injection ext venography 0.95 7.29 0.34 0.04 8.28 1.33 000 36010 A Place catheter in vein 2.43 NA 0.84 0.16 NA 3.43 XXX 36011 A Place catheter in vein 3.14 NA 1.10 0.17 NA 4.41 XXX 36012 A Place catheter in vein 3.52 NA 1.23 0.17 NA 4.92 XXX 36013 A Place catheter in artery 2.52 NA 0.61 0.17 NA 3.30 XXX 36014 A Place catheter in artery 3.02 NA 1.06 0.14 NA 4.22 XXX 36015 A Place catheter in artery 3.52 NA 1.24 0.16 NA 4.92 XXX 36100 A Establish access to artery 3.02 NA 1.16 0.18 NA 4.36 XXX 36120 A Establish access to artery 2.01 NA 0.69 0.11 NA 2.81 XXX 36140 A Establish access to artery 2.01 NA 0.69 0.12 NA 2.82 XXX 36145 A Artery to vein shunt 2.01 NA 0.70 0.10 NA 2.81 XXX 36160 A Establish access to aorta 2.52 NA 0.90 0.20 NA 3.62 XXX 36200 A Place catheter in aorta 3.02 NA 1.09 0.15 NA 4.26 XXX 36215 A Place catheter in artery 4.68 NA 1.68 0.22 NA 6.58 XXX 36216 A Place catheter in artery 5.28 NA 1.89 0.24 NA 7.41 XXX 36217 A Place catheter in artery 6.30 NA 2.29 0.32 NA 8.91 XXX 36218 A Place catheter in artery 1.01 NA 0.37 0.05 NA 1.43 ZZZ 36245 A Place catheter in artery 4.68 NA 1.78 0.23 NA 6.69 XXX 36246 A Place catheter in artery 5.28 NA 1.91 0.26 NA 7.45 XXX 36247 A Place catheter in artery 6.30 NA 2.25 0.32 NA 8.87 XXX 36248 A Place catheter in artery 1.01 NA 0.37 0.06 NA 1.44 ZZZ 36260 A Insertion of infusion pump 9.71 NA 5.63 1.00 NA 16.34 090 36261 A Revision of infusion pump 5.45 NA 3.47 0.50 NA 9.42 090 36262 A Removal of infusion pump 4.02 NA 2.59 0.43 NA 7.04 090 36299 C Vessel injection procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 36400 A Drawing blood 0.38 0.72 0.10 0.01 1.11 0.49 XXX 36405 A Drawing blood 0.31 0.58 0.09 0.01 0.90 0.41 XXX 36406 A Drawing blood 0.18 0.94 0.06 0.01 1.13 0.25 XXX 36410 A Drawing blood 0.18 0.50 0.05 0.01 0.69 0.24 XXX 36415 I Drawing blood 0.00 0.00 0.00 0.00 0.00 0.00 XXX 36420 A Establish access to vein 1.01 NA 0.33 0.09 NA 1.43 XXX 36425 A Establish access to vein 0.76 3.44 0.17 0.05 4.25 0.98 XXX 36430 A Blood transfusion service 0.00 0.95 NA 0.05 1.00 NA XXX 36440 A Blood transfusion service 1.03 NA 0.31 0.08 NA 1.42 XXX 36450 A Exchange transfusion service 2.23 NA 0.71 0.16 NA 3.10 XXX 36455 A Exchange transfusion service 2.43 NA 0.97 0.10 NA 3.50 XXX 36460 A Transfusion service, fetal 6.59 NA 2.55 0.56 NA 9.70 XXX 36468 R Injection(s), spider veins 0.00 0.00 0.00 0.00 0.00 0.00 000 36469 R Injection(s), spider veins 0.00 0.00 0.00 0.00 0.00 0.00 000 36470 A Injection therapy of vein 1.09 2.60 0.40 0.10 3.79 1.59 010 36471 A Injection therapy of veins 1.57 2.65 0.58 0.15 4.37 2.30 010 36481 A Insertion of catheter, vein 6.99 NA 2.86 0.40 NA 10.25 000 36488 A Insertion of catheter, vein 1.35 NA 0.76 0.09 NA 2.20 000 36489 A Insertion of catheter, vein 2.50 4.70 1.08 0.08 7.28 3.66 000 36490 A Insertion of catheter, vein 1.67 NA 0.86 0.17 NA 2.70 000 36491 A Insertion of catheter, vein 1.43 NA 0.75 0.13 NA 2.31 000 36493 A Repositioning of cvc 1.21 NA 0.88 0.06 NA 2.15 000 36500 A Insertion of catheter, vein 3.52 NA 1.31 0.14 NA 4.97 000 36510 A Insertion of catheter, vein 1.09 NA 0.73 0.06 NA 1.88 000 36520 A Plasma and/or cell exchange 1.74 NA 1.07 0.06 NA 2.87 000 36521 A Apheresis w/ adsorp/reinfuse 1.74 NA 1.07 0.06 NA 2.87 000 36522 A Photopheresis 1.67 6.03 1.16 0.07 7.77 2.90 000 36530 R Insertion of infusion pump 6.20 NA 4.17 0.56 NA 10.93 010 36531 R Revision of infusion pump 4.87 NA 3.32 0.44 NA 8.63 010 36532 R Removal of infusion pump 3.30 NA 1.57 0.34 NA 5.21 010 36533 A Insertion of access device 5.32 4.67 3.50 0.49 10.48 9.31 010Start Printed Page 55371 36534 A Revision of access device 2.80 NA 1.55 0.19 NA 4.54 010 36535 A Removal of access device 2.27 2.95 1.89 0.21 5.43 4.37 010 36540 B Collect blood venous device 0.00 0.00 0.00 0.00 0.00 0.00 XXX 36550 A Declot vascular device 0.00 0.38 NA 0.31 0.69 NA XXX 36600 A Withdrawal of arterial blood 0.32 0.43 0.09 0.02 0.77 0.43 XXX 36620 A Insertion catheter, artery 1.15 NA 0.25 0.06 NA 1.46 000 36625 A Insertion catheter, artery 2.11 NA 0.61 0.16 NA 2.88 000 36640 A Insertion catheter, artery 2.10 NA 0.75 0.18 NA 3.03 000 36660 A Insertion catheter, artery 1.40 NA 0.38 0.08 NA 1.86 000 36680 A Insert needle, bone cavity 1.20 NA 0.66 0.08 NA 1.94 000 36800 A Insertion of cannula 2.43 NA 1.59 0.17 NA 4.19 000 36810 A Insertion of cannula 3.97 NA 2.22 0.40 NA 6.59 000 36815 A Insertion of cannula 2.62 NA 1.28 0.26 NA 4.16 000 36819 A Av fusion/uppr arm vein 14.00 NA 6.56 1.53 NA 22.09 090 36820 A Av fusion/forearm vein 14.00 NA 6.56 1.53 NA 22.09 090 36821 A Av fusion direct any site 8.93 NA 5.03 0.97 NA 14.93 090 36822 A Insertion of cannula(s) 5.42 NA 6.81 0.63 NA 12.86 090 36823 A Insertion of cannula(s) 21.00 NA 10.63 2.18 NA 33.81 090 36825 A Artery-vein graft 9.84 NA 5.58 1.09 NA 16.51 090 36830 A Artery-vein graft 12.00 NA 6.14 1.32 NA 19.46 090 36831 A Open thrombect av fistula 8.00 NA 3.99 0.79 NA 12.78 090 36832 A Av fistula revision, open 10.50 NA 5.59 1.13 NA 17.22 090 36833 A Av fistula revision 11.95 NA 6.11 1.29 NA 19.35 090 36834 A Repair A-V aneurysm 9.93 NA 3.93 1.06 NA 14.92 090 36835 A Artery to vein shunt 7.15 NA 4.50 0.80 NA 12.45 090 36860 A External cannula declotting 2.01 2.52 1.33 0.10 4.63 3.44 000 36861 A Cannula declotting 2.52 NA 1.50 0.14 NA 4.16 000 36870 A Percut thrombect av fistula 5.16 41.63 2.45 0.23 47.02 7.84 090 37140 A Revision of circulation 23.60 NA 10.56 1.21 NA 35.37 090 37145 A Revision of circulation 24.61 NA 12.97 2.48 NA 40.06 090 37160 A Revision of circulation 21.60 NA 9.43 2.16 NA 33.19 090 37180 A Revision of circulation 24.61 NA 10.66 2.63 NA 37.90 090 37181 A Splice spleen/kidney veins 26.68 NA 11.02 2.67 NA 40.37 090 37195 A Thrombolytic therapy, stroke 0.00 7.65 NA 0.38 8.03 NA XXX 37200 A Transcatheter biopsy 4.56 NA 1.60 0.19 NA 6.35 000 37201 A Transcatheter therapy infuse 5.00 NA 2.59 0.24 NA 7.83 000 37202 A Transcatheter therapy infuse 5.68 NA 3.33 0.38 NA 9.39 000 37203 A Transcatheter retrieval 5.03 NA 2.62 0.23 NA 7.88 000 37204 A Transcatheter occlusion 18.14 NA 6.36 0.85 NA 25.35 000 37205 A Transcatheter stent 8.28 NA 3.90 0.43 NA 12.61 000 37206 A Transcatheter stent add-on 4.13 NA 1.54 0.22 NA 5.89 ZZZ 37207 A Transcatheter stent 8.28 NA 3.61 0.89 NA 12.78 000 37208 A Transcatheter stent add-on 4.13 NA 1.45 0.44 NA 6.02 ZZZ 37209 A Exchange arterial catheter 2.27 NA 0.80 0.11 NA 3.18 000 37250 A Iv us first vessel add-on 2.10 NA 0.79 0.17 NA 3.06 ZZZ 37251 A Iv us each add vessel add-on 1.60 NA 0.58 0.14 NA 2.32 ZZZ 37565 A Ligation of neck vein 10.88 NA 5.34 0.45 NA 16.67 090 37600 A Ligation of neck artery 11.25 NA 6.51 0.40 NA 18.16 090 37605 A Ligation of neck artery 13.11 NA 6.63 0.77 NA 20.51 090 37606 A Ligation of neck artery 6.28 NA 3.85 0.79 NA 10.92 090 37607 A Ligation of a-v fistula 6.16 NA 3.71 0.67 NA 10.54 090 37609 A Temporal artery procedure 3.00 7.25 2.58 0.21 10.46 5.79 010 37615 A Ligation of neck artery 5.73 NA 3.61 0.57 NA 9.91 090 37616 A Ligation of chest artery 16.49 NA 10.54 1.93 NA 28.96 090 37617 A Ligation of abdomen artery 22.06 NA 9.81 1.69 NA 33.56 090 37618 A Ligation of extremity artery 4.84 NA 3.56 0.54 NA 8.94 090 37620 A Revision of major vein 10.56 NA 5.53 0.75 NA 16.84 090 37650 A Revision of major vein 7.80 NA 4.64 0.56 NA 13.00 090 37660 A Revision of major vein 21.00 NA 9.44 1.17 NA 31.61 090 37700 A Revise leg vein 3.73 NA 3.20 0.40 NA 7.33 090 37720 A Removal of leg vein 5.66 NA 3.72 0.61 NA 9.99 090 37730 A Removal of leg veins 7.33 NA 4.59 0.77 NA 12.69 090 37735 A Removal of leg veins/lesion 10.53 NA 5.94 1.17 NA 17.64 090 37760 A Revision of leg veins 10.47 NA 5.78 1.11 NA 17.36 090 37780 A Revision of leg vein 3.84 NA 2.89 0.41 NA 7.14 090 37785 A Revise secondary varicosity 3.84 7.18 2.91 0.41 11.43 7.16 090 37788 A Revascularization, penis 22.01 NA 14.08 1.35 NA 37.44 090 37790 A Penile venous occlusion 8.34 NA 6.78 0.63 NA 15.75 090 37799 C Vascular surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 38100 A Removal of spleen, total 14.50 NA 6.73 1.30 NA 22.53 090 38101 A Removal of spleen, partial 15.31 NA 7.27 1.38 NA 23.96 090 38102 A Removal of spleen, total 4.80 NA 1.73 0.49 NA 7.02 ZZZ 38115 A Repair of ruptured spleen 15.82 NA 7.23 1.40 NA 24.45 090Start Printed Page 55372 38120 A Laparoscopy, splenectomy 17.00 NA 7.58 1.73 NA 26.31 090 38129 C Laparoscope proc, spleen 0.00 0.00 0.00 0.00 0.00 0.00 YYY 38200 A Injection for spleen x-ray 2.64 NA 0.93 0.12 NA 3.69 000 38220 A Bone marrow aspiration 1.08 4.64 0.44 0.03 5.75 1.55 XXX 38221 A Bone marrow biopsy 1.37 4.74 0.56 0.04 6.15 1.97 XXX 38230 R Bone marrow collection 4.54 NA 2.45 0.25 NA 7.24 010 38231 R Stem cell collection 1.50 NA 0.61 0.05 NA 2.16 000 38240 R Bone marrow/stem transplant 2.24 NA 0.88 0.08 NA 3.20 XXX 38241 R Bone marrow/stem transplant 2.24 NA 0.86 0.08 NA 3.18 XXX 38300 A Drainage, lymph node lesion 1.99 4.88 2.65 0.15 7.02 4.79 010 38305 A Drainage, lymph node lesion 6.00 7.99 6.41 0.36 14.35 12.77 090 38308 A Incision of lymph channels 6.45 NA 5.40 0.51 NA 12.36 090 38380 A Thoracic duct procedure 7.46 NA 7.61 0.68 NA 15.75 090 38381 A Thoracic duct procedure 12.88 NA 9.72 1.58 NA 24.18 090 38382 A Thoracic duct procedure 10.08 NA 8.81 1.08 NA 19.97 090 38500 A Biopsy/removal, lymph nodes 3.75 3.15 2.63 0.28 7.18 6.66 010 38505 A Needle biopsy, lymph nodes 1.14 3.21 1.13 0.09 4.44 2.36 000 38510 A Biopsy/removal, lymph nodes 6.43 NA 5.55 0.38 NA 12.36 010 38520 A Biopsy/removal, lymph nodes 6.67 NA 5.67 0.52 NA 12.86 090 38525 A Biopsy/removal, lymph nodes 6.07 NA 4.51 0.48 NA 11.06 090 38530 A Biopsy/removal, lymph nodes 7.98 NA 5.78 0.63 NA 14.39 090 38542 A Explore deep node(s), neck 5.91 NA 6.09 0.50 NA 12.50 090 38550 A Removal, neck/armpit lesion 6.92 NA 5.01 0.69 NA 12.62 090 38555 A Removal, neck/armpit lesion 14.14 NA 9.47 1.46 NA 25.07 090 38562 A Removal, pelvic lymph nodes 10.49 NA 6.79 0.97 NA 18.25 090 38564 A Removal, abdomen lymph nodes 10.83 NA 6.54 1.06 NA 18.43 090 38570 A Laparoscopy, lymph node biop 9.25 NA 4.63 0.89 NA 14.77 010 38571 A Laparoscopy, lymphadenectomy 14.68 NA 6.50 0.80 NA 21.98 010 38572 A Laparoscopy, lymphadenectomy 16.59 NA 7.71 1.32 NA 25.62 010 38589 C Laparoscope proc, lymphatic 0.00 0.00 0.00 0.00 0.00 0.00 YYY 38700 A Removal of lymph nodes, neck 8.24 NA 13.61 0.60 NA 22.45 090 38720 A Removal of lymph nodes, neck 13.61 NA 16.25 1.03 NA 30.89 090 38724 A Removal of lymph nodes, neck 14.54 NA 16.82 1.10 NA 32.46 090 38740 A Remove armpit lymph nodes 10.03 NA 5.89 0.69 NA 16.61 090 38745 A Remove armpit lymph nodes 13.10 NA 8.47 0.90 NA 22.47 090 38746 A Remove thoracic lymph nodes 4.89 NA 1.65 0.55 NA 7.09 ZZZ 38747 A Remove abdominal lymph nodes 4.89 NA 1.75 0.50 NA 7.14 ZZZ 38760 A Remove groin lymph nodes 12.95 NA 7.36 0.88 NA 21.19 090 38765 A Remove groin lymph nodes 19.98 NA 11.57 1.50 NA 33.05 090 38770 A Remove pelvis lymph nodes 13.23 NA 7.18 0.94 NA 21.35 090 38780 A Remove abdomen lymph nodes 16.59 NA 9.67 1.60 NA 27.86 090 38790 A Inject for lymphatic x-ray 1.29 14.77 0.46 0.09 16.15 1.84 000 38792 A Identify sentinel node 0.52 NA 0.19 0.04 NA 0.75 000 38794 A Access thoracic lymph duct 4.45 NA 1.57 0.17 NA 6.19 090 38999 C Blood/lymph system procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 39000 A Exploration of chest 6.10 NA 7.41 0.73 NA 14.24 090 39010 A Exploration of chest 11.79 NA 9.31 1.46 NA 22.56 090 39200 A Removal chest lesion 13.62 NA 10.10 1.65 NA 25.37 090 39220 A Removal chest lesion 17.42 NA 11.29 2.10 NA 30.81 090 39400 A Visualization of chest 5.61 NA 7.01 0.69 NA 13.31 010 39499 C Chest procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 39501 A Repair diaphragm laceration 13.19 NA 7.82 1.38 NA 22.39 090 39502 A Repair paraesophageal hernia 16.33 NA 8.41 1.68 NA 26.42 090 39503 A Repair of diaphragm hernia 95.00 NA 37.24 3.52 NA 135.76 090 39520 A Repair of diaphragm hernia 16.10 NA 9.59 1.83 NA 27.52 090 39530 A Repair of diaphragm hernia 15.41 NA 8.69 1.66 NA 25.76 090 39531 A Repair of diaphragm hernia 16.42 NA 8.45 1.83 NA 26.70 090 39540 A Repair of diaphragm hernia 13.32 NA 7.79 1.38 NA 22.49 090 39541 A Repair of diaphragm hernia 14.41 NA 7.97 1.52 NA 23.90 090 39545 A Revision of diaphragm 13.37 NA 9.32 1.55 NA 24.24 090 39560 A Resect diaphragm, simple 12.00 NA 7.62 1.35 NA 20.97 090 39561 A Resect diaphragm, complex 17.50 NA 9.84 1.97 NA 29.31 090 39599 C Diaphragm surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 40490 A Biopsy of lip 1.22 1.63 0.63 0.06 2.91 1.91 000 40500 A Partial excision of lip 4.28 5.72 5.72 0.31 10.31 10.31 090 40510 A Partial excision of lip 4.70 6.75 6.52 0.38 11.83 11.60 090 40520 A Partial excision of lip 4.67 7.97 7.15 0.42 13.06 12.24 090 40525 A Reconstruct lip with flap 7.55 NA 8.84 0.68 NA 17.07 090 40527 A Reconstruct lip with flap 9.13 NA 9.60 0.82 NA 19.55 090 40530 A Partial removal of lip 5.40 7.35 6.56 0.47 13.22 12.43 090 40650 A Repair lip 3.64 5.78 5.18 0.31 9.73 9.13 090 40652 A Repair lip 4.26 7.08 7.04 0.39 11.73 11.69 090 40654 A Repair lip 5.31 7.95 7.95 0.48 13.74 13.74 090Start Printed Page 55373 40700 A Repair cleft lip/nasal 12.79 NA 10.88 0.93 NA 24.60 090 40701 A Repair cleft lip/nasal 15.85 NA 14.66 1.36 NA 31.87 090 40702 A Repair cleft lip/nasal 13.04 NA 8.99 1.01 NA 23.04 090 40720 A Repair cleft lip/nasal 13.55 NA 12.89 1.31 NA 27.75 090 40761 A Repair cleft lip/nasal 14.72 NA 12.76 1.41 NA 28.89 090 40799 C Lip surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 40800 A Drainage of mouth lesion 1.17 2.01 0.48 0.09 3.27 1.74 010 40801 A Drainage of mouth lesion 2.53 2.52 1.98 0.18 5.23 4.69 010 40804 A Removal, foreign body, mouth 1.24 2.59 2.03 0.09 3.92 3.36 010 40805 A Removal, foreign body, mouth 2.69 3.27 2.85 0.17 6.13 5.71 010 40806 A Incision of lip fold 0.31 0.89 0.89 0.02 1.22 1.22 000 40808 A Biopsy of mouth lesion 0.96 2.11 2.11 0.07 3.14 3.14 010 40810 A Excision of mouth lesion 1.31 2.70 2.47 0.09 4.10 3.87 010 40812 A Excise/repair mouth lesion 2.31 2.95 2.93 0.17 5.43 5.41 010 40814 A Excise/repair mouth lesion 3.42 4.08 4.08 0.26 7.76 7.76 090 40816 A Excision of mouth lesion 3.67 4.32 4.32 0.27 8.26 8.26 090 40818 A Excise oral mucosa for graft 2.41 4.05 4.05 0.14 6.60 6.60 090 40819 A Excise lip or cheek fold 2.41 3.67 3.48 0.17 6.25 6.06 090 40820 A Treatment of mouth lesion 1.28 2.38 2.30 0.08 3.74 3.66 010 40830 A Repair mouth laceration 1.76 2.48 2.48 0.14 4.38 4.38 010 40831 A Repair mouth laceration 2.46 2.72 2.72 0.21 5.39 5.39 010 40840 R Reconstruction of mouth 8.73 5.93 5.93 0.79 15.45 15.45 090 40842 R Reconstruction of mouth 8.73 5.90 5.90 0.65 15.28 15.28 090 40843 R Reconstruction of mouth 12.10 7.35 7.35 0.84 20.29 20.29 090 40844 R Reconstruction of mouth 16.01 9.01 9.01 1.63 26.65 26.65 090 40845 R Reconstruction of mouth 18.58 12.25 12.25 1.47 32.30 32.30 090 40899 C Mouth surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 41000 A Drainage of mouth lesion 1.30 2.40 1.55 0.09 3.79 2.94 010 41005 A Drainage of mouth lesion 1.26 2.33 1.62 0.09 3.68 2.97 010 41006 A Drainage of mouth lesion 3.24 3.58 3.28 0.25 7.07 6.77 090 41007 A Drainage of mouth lesion 3.10 3.78 3.33 0.22 7.10 6.65 090 41008 A Drainage of mouth lesion 3.37 3.69 3.22 0.24 7.30 6.83 090 41009 A Drainage of mouth lesion 3.59 3.65 3.42 0.25 7.49 7.26 090 41010 A Incision of tongue fold 1.06 3.57 3.57 0.06 4.69 4.69 010 41015 A Drainage of mouth lesion 3.96 4.05 3.39 0.29 8.30 7.64 090 41016 A Drainage of mouth lesion 4.07 4.31 3.61 0.28 8.66 7.96 090 41017 A Drainage of mouth lesion 4.07 4.26 3.46 0.32 8.65 7.85 090 41018 A Drainage of mouth lesion 5.10 4.39 3.87 0.35 9.84 9.32 090 41100 A Biopsy of tongue 1.63 2.67 2.64 0.12 4.42 4.39 010 41105 A Biopsy of tongue 1.42 2.42 2.42 0.10 3.94 3.94 010 41108 A Biopsy of floor of mouth 1.05 2.38 2.38 0.08 3.51 3.51 010 41110 A Excision of tongue lesion 1.51 3.19 2.63 0.11 4.81 4.25 010 41112 A Excision of tongue lesion 2.73 3.56 3.56 0.20 6.49 6.49 090 41113 A Excision of tongue lesion 3.19 3.50 3.50 0.23 6.92 6.92 090 41114 A Excision of tongue lesion 8.47 NA 6.59 0.64 NA 15.70 090 41115 A Excision of tongue fold 1.74 2.69 2.53 0.13 4.56 4.40 010 41116 A Excision of mouth lesion 2.44 3.37 3.37 0.17 5.98 5.98 090 41120 A Partial removal of tongue 9.77 NA 9.12 0.70 NA 19.59 090 41130 A Partial removal of tongue 11.15 NA 9.76 0.81 NA 21.72 090 41135 A Tongue and neck surgery 23.09 NA 16.63 1.66 NA 41.38 090 41140 A Removal of tongue 25.50 NA 17.39 1.85 NA 44.74 090 41145 A Tongue removal, neck surgery 30.06 NA 21.36 2.11 NA 53.53 090 41150 A Tongue, mouth, jaw surgery 23.04 NA 17.64 1.67 NA 42.35 090 41153 A Tongue, mouth, neck surgery 23.77 NA 18.04 1.71 NA 43.52 090 41155 A Tongue, jaw, & neck surgery 27.72 NA 20.44 2.02 NA 50.18 090 41250 A Repair tongue laceration 1.91 2.98 1.77 0.15 5.04 3.83 010 41251 A Repair tongue laceration 2.27 3.12 1.88 0.18 5.57 4.33 010 41252 A Repair tongue laceration 2.97 3.23 2.33 0.23 6.43 5.53 010 41500 A Fixation of tongue 3.71 NA 4.43 0.26 NA 8.40 090 41510 A Tongue to lip surgery 3.42 NA 5.39 0.24 NA 9.05 090 41520 A Reconstruction, tongue fold 2.73 3.06 3.06 0.19 5.98 5.98 090 41599 C Tongue and mouth surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY 41800 A Drainage of gum lesion 1.17 1.96 1.43 0.09 3.22 2.69 010 41805 A Removal foreign body, gum 1.24 2.08 2.08 0.09 3.41 3.41 010 41806 A Removal foreign body, jawbone 2.69 2.54 2.54 0.22 5.45 5.45 010 41820 R Excision, gum, each quadrant 0.00 0.00 0.00 0.00 0.00 0.00 000 41821 R Excision of gum flap 0.00 0.00 0.00 0.00 0.00 0.00 000 41822 R Excision of gum lesion 2.31 2.82 0.98 0.24 5.37 3.53 010 41823 R Excision of gum lesion 3.30 3.54 3.23 0.29 7.13 6.82 090 41825 A Excision of gum lesion 1.31 2.43 2.41 0.10 3.84 3.82 010 41826 A Excision of gum lesion 2.31 2.66 2.66 0.17 5.14 5.14 010 41827 A Excision of gum lesion 3.42 3.63 3.63 0.25 7.30 7.30 090 41828 R Excision of gum lesion 3.09 3.07 2.47 0.22 6.38 5.78 010Start Printed Page 55374 41830 R Removal of gum tissue 3.35 3.39 2.98 0.23 6.97 6.56 010 41850 R Treatment of gum lesion 0.00 0.00 0.00 0.00 0.00 0.00 000 41870 R Gum graft 0.00 0.00 0.00 0.00 0.00 0.00 000 41872 R Repair gum 2.59 2.93 2.93 0.18 5.70 5.70 090 41874 R Repair tooth socket 3.09 2.86 2.45 0.23 6.18 5.77 090 41899 C Dental surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 42000 A Drainage mouth roof lesion 1.23 2.52 1.51 0.10 3.85 2.84 010 42100 A Biopsy roof of mouth 1.31 2.47 2.47 0.10 3.88 3.88 010 42104 A Excision lesion, mouth roof 1.64 2.58 2.58 0.12 4.34 4.34 010 42106 A Excision lesion, mouth roof 2.10 2.66 2.66 0.16 4.92 4.92 010 42107 A Excision lesion, mouth roof 4.44 4.26 4.26 0.32 9.02 9.02 090 42120 A Remove palate/lesion 6.17 NA 6.19 0.44 NA 12.80 090 42140 A Excision of uvula 1.62 3.91 3.36 0.12 5.65 5.10 090 42145 A Repair palate, pharynx/uvula 8.05 NA 7.59 0.56 NA 16.20 090 42160 A Treatment mouth roof lesion 1.80 3.25 2.72 0.13 5.18 4.65 010 42180 A Repair palate 2.50 3.29 2.25 0.19 5.98 4.94 010 42182 A Repair palate 3.83 3.10 3.10 0.27 7.20 7.20 010 42200 A Reconstruct cleft palate 12.00 NA 9.78 0.97 NA 22.75 090 42205 A Reconstruct cleft palate 13.29 NA 9.76 0.82 NA 23.87 090 42210 A Reconstruct cleft palate 14.50 NA 11.47 1.24 NA 27.21 090 42215 A Reconstruct cleft palate 8.82 NA 9.72 0.96 NA 19.50 090 42220 A Reconstruct cleft palate 7.02 NA 6.85 0.41 NA 14.28 090 42225 A Reconstruct cleft palate 9.54 NA 9.16 0.75 NA 19.45 090 42226 A Lengthening of palate 10.01 NA 9.96 0.73 NA 20.70 090 42227 A Lengthening of palate 9.52 NA 9.09 0.70 NA 19.31 090 42235 A Repair palate 7.87 NA 5.93 0.49 NA 14.29 090 42260 A Repair nose to lip fistula 9.80 6.43 6.43 0.85 17.08 17.08 090 42280 A Preparation, palate mold 1.54 1.44 0.60 0.12 3.10 2.26 010 42281 A Insertion, palate prosthesis 1.93 1.57 0.92 0.14 3.64 2.99 010 42299 C Palate/uvula surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY 42300 A Drainage of salivary gland 1.93 2.65 1.98 0.15 4.73 4.06 010 42305 A Drainage of salivary gland 6.07 NA 5.38 0.46 NA 11.91 090 42310 A Drainage of salivary gland 1.56 2.32 1.82 0.11 3.99 3.49 010 42320 A Drainage of salivary gland 2.35 2.79 2.15 0.17 5.31 4.67 010 42325 A Create salivary cyst drain 2.75 3.85 1.26 0.17 6.77 4.18 090 42326 A Create salivary cyst drain 3.78 3.33 1.51 0.34 7.45 5.63 090 42330 A Removal of salivary stone 2.21 2.81 1.20 0.16 5.18 3.57 010 42335 A Removal of salivary stone 3.31 3.71 3.71 0.23 7.25 7.25 090 42340 A Removal of salivary stone 4.60 5.07 5.07 0.34 10.01 10.01 090 42400 A Biopsy of salivary gland 0.78 2.52 0.40 0.06 3.36 1.24 000 42405 A Biopsy of salivary gland 3.29 3.44 3.44 0.24 6.97 6.97 010 42408 A Excision of salivary cyst 4.54 4.71 4.71 0.34 9.59 9.59 090 42409 A Drainage of salivary cyst 2.81 3.34 3.34 0.20 6.35 6.35 090 42410 A Excise parotid gland/lesion 9.34 NA 8.20 0.77 NA 18.31 090 42415 A Excise parotid gland/lesion 16.89 NA 12.82 1.26 NA 30.97 090 42420 A Excise parotid gland/lesion 19.59 NA 14.46 1.45 NA 35.50 090 42425 A Excise parotid gland/lesion 13.02 NA 10.70 0.98 NA 24.70 090 42426 A Excise parotid gland/lesion 21.26 NA 15.44 1.57 NA 38.27 090 42440 A Excise submaxillary gland 6.97 NA 6.13 0.51 NA 13.61 090 42450 A Excise sublingual gland 4.62 4.38 4.38 0.34 9.34 9.34 090 42500 A Repair salivary duct 4.30 5.14 5.10 0.30 9.74 9.70 090 42505 A Repair salivary duct 6.18 6.02 6.02 0.44 12.64 12.64 090 42507 A Parotid duct diversion 6.11 NA 5.44 0.66 NA 12.21 090 42508 A Parotid duct diversion 9.10 NA 8.40 0.64 NA 18.14 090 42509 A Parotid duct diversion 11.54 NA 9.25 1.24 NA 22.03 090 42510 A Parotid duct diversion 8.15 NA 7.27 0.57 NA 15.99 090 42550 A Injection for salivary x-ray 1.25 12.45 0.44 0.06 13.76 1.75 000 42600 A Closure of salivary fistula 4.82 7.89 5.61 0.34 13.05 10.77 090 42650 A Dilation of salivary duct 0.77 1.13 0.41 0.06 1.96 1.24 000 42660 A Dilation of salivary duct 1.13 1.15 1.15 0.07 2.35 2.35 000 42665 A Ligation of salivary duct 2.53 3.03 3.03 0.17 5.73 5.73 090 42699 C Salivary surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 42700 A Drainage of tonsil abscess 1.62 3.30 1.93 0.12 5.04 3.67 010 42720 A Drainage of throat abscess 5.42 4.77 4.77 0.39 10.58 10.58 010 42725 A Drainage of throat abscess 10.72 NA 8.70 0.80 NA 20.22 090 42800 A Biopsy of throat 1.39 3.09 2.63 0.10 4.58 4.12 010 42802 A Biopsy of throat 1.54 3.24 2.72 0.11 4.89 4.37 010 42804 A Biopsy of upper nose/throat 1.24 3.04 2.56 0.09 4.37 3.89 010 42806 A Biopsy of upper nose/throat 1.58 3.53 2.76 0.12 5.23 4.46 010 42808 A Excise pharynx lesion 2.30 5.00 3.17 0.17 7.47 5.64 010 42809 A Remove pharynx foreign body 1.81 3.48 1.77 0.13 5.42 3.71 010 42810 A Excision of neck cyst 3.25 5.66 4.61 0.25 9.16 8.11 090 42815 A Excision of neck cyst 7.07 NA 6.67 0.53 NA 14.27 090Start Printed Page 55375 42820 A Remove tonsils and adenoids 3.91 NA 4.02 0.28 NA 8.21 090 42821 A Remove tonsils and adenoids 4.29 NA 4.30 0.30 NA 8.89 090 42825 A Removal of tonsils 3.42 NA 3.74 0.24 NA 7.40 090 42826 A Removal of tonsils 3.38 NA 3.81 0.23 NA 7.42 090 42830 A Removal of adenoids 2.57 NA 2.51 0.18 NA 5.26 090 42831 A Removal of adenoids 2.71 NA 2.59 0.19 NA 5.49 090 42835 A Removal of adenoids 2.30 NA 3.20 0.17 NA 5.67 090 42836 A Removal of adenoids 3.18 NA 3.69 0.22 NA 7.09 090 42842 A Extensive surgery of throat 8.76 NA 7.96 0.61 NA 17.33 090 42844 A Extensive surgery of throat 14.31 NA 11.57 1.04 NA 26.92 090 42845 A Extensive surgery of throat 24.29 NA 18.00 1.76 NA 44.05 090 42860 A Excision of tonsil tags 2.22 NA 3.08 0.16 NA 5.46 090 42870 A Excision of lingual tonsil 5.40 NA 6.18 0.38 NA 11.96 090 42890 A Partial removal of pharynx 12.94 NA 11.03 0.91 NA 24.88 090 42892 A Revision of pharyngeal walls 15.83 NA 12.68 1.14 NA 29.65 090 42894 A Revision of pharyngeal walls 22.88 NA 17.38 1.64 NA 41.90 090 42900 A Repair throat wound 5.25 NA 3.93 0.39 NA 9.57 010 42950 A Reconstruction of throat 8.10 NA 7.60 0.58 NA 16.28 090 42953 A Repair throat, esophagus 8.96 NA 9.14 0.73 NA 18.83 090 42955 A Surgical opening of throat 7.39 NA 6.55 0.63 NA 14.57 090 42960 A Control throat bleeding 2.33 NA 2.13 0.17 NA 4.63 010 42961 A Control throat bleeding 5.59 NA 5.30 0.40 NA 11.29 090 42962 A Control throat bleeding 7.14 NA 6.35 0.51 NA 14.00 090 42970 A Control nose/throat bleeding 5.43 NA 3.99 0.37 NA 9.79 090 42971 A Control nose/throat bleeding 6.21 NA 5.99 0.45 NA 12.65 090 42972 A Control nose/throat bleeding 7.20 NA 5.73 0.54 NA 13.47 090 42999 C Throat surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 43020 A Incision of esophagus 8.09 NA 6.77 0.70 NA 15.56 090 43030 A Throat muscle surgery 7.69 NA 7.00 0.60 NA 15.29 090 43045 A Incision of esophagus 20.12 NA 11.14 2.15 NA 33.41 090 43100 A Excision of esophagus lesion 9.19 NA 7.58 0.79 NA 17.56 090 43101 A Excision of esophagus lesion 16.24 NA 8.84 1.81 NA 26.89 090 43107 A Removal of esophagus 40.00 NA 18.49 3.29 NA 61.78 090 43108 A Removal of esophagus 34.19 NA 16.39 3.78 NA 54.36 090 43112 A Removal of esophagus 43.50 NA 20.06 3.67 NA 67.23 090 43113 A Removal of esophagus 35.27 NA 16.38 4.33 NA 55.98 090 43116 A Partial removal of esophagus 31.22 NA 18.49 2.62 NA 52.33 090 43117 A Partial removal of esophagus 40.00 NA 18.51 3.51 NA 62.02 090 43118 A Partial removal of esophagus 33.20 NA 15.76 3.56 NA 52.52 090 43121 A Partial removal of esophagus 29.19 NA 15.08 3.44 NA 47.71 090 43122 A Parital removal of esophagus 40.00 NA 18.05 3.27 NA 61.32 090 43123 A Partial removal of esophagus 33.20 NA 15.58 3.96 NA 52.74 090 43124 A Removal of esophagus 27.32 NA 15.15 2.95 NA 45.42 090 43130 A Removal of esophagus pouch 11.75 NA 9.05 1.06 NA 21.86 090 43135 A Removal of esophagus pouch 16.10 NA 10.09 1.85 NA 28.04 090 43200 A Esophagus endoscopy 1.59 7.92 1.22 0.11 9.62 2.92 000 43202 A Esophagus endoscopy, biopsy 1.89 6.46 1.15 0.12 8.47 3.16 000 43204 A Esophagus endoscopy & inject 3.77 NA 1.71 0.18 NA 5.66 000 43205 A Esophagus endoscopy/ligation 3.79 NA 1.71 0.17 NA 5.67 000 43215 A Esophagus endoscopy 2.60 NA 1.26 0.17 NA 4.03 000 43216 A Esophagus endoscopy/lesion 2.40 NA 1.20 0.15 NA 3.75 000 43217 A Esophagus endoscopy 2.90 NA 1.35 0.17 NA 4.42 000 43219 A Esophagus endoscopy 2.80 NA 1.43 0.16 NA 4.39 000 43220 A Esoph endoscopy, dilation 2.10 NA 1.14 0.12 NA 3.36 000 43226 A Esoph endoscopy, dilation 2.34 NA 1.21 0.12 NA 3.67 000 43227 A Esoph endoscopy, repair 3.60 NA 1.64 0.18 NA 5.42 000 43228 A Esoph endoscopy, ablation 3.77 NA 1.77 0.25 NA 5.79 000 43231 A Esoph endoscopy w/us exam 3.19 NA 1.60 0.20 NA 4.99 000 43232 A Esoph endoscopy w/us fn bx 4.48 NA 2.15 0.26 NA 6.89 000 43234 A Upper GI endoscopy, exam 2.01 4.58 1.06 0.13 6.72 3.20 000 43235 A Uppr GI endoscopy, diagnosis 2.39 6.38 1.23 0.13 8.90 3.75 000 43239 A Upper GI endoscopy, biopsy 2.87 6.79 1.27 0.14 9.80 4.28 000 43240 A Esoph endoscope w/drain cyst 6.86 NA 2.97 0.36 NA 10.19 000 43241 A Upper GI endoscopy with tube 2.59 NA 1.27 0.14 NA 4.00 000 43242 A Uppr GI endoscopy w/us fn bx 7.31 2.64 2.64 0.29 10.24 10.24 000 43243 A Upper GI endoscopy & inject 4.57 NA 2.00 0.21 NA 6.78 000 43244 A Upper GI endoscopy/ligation 5.05 NA 2.18 0.21 NA 7.44 000 43245 A Operative upper GI endoscopy 3.39 NA 1.55 0.18 NA 5.12 000 43246 A Place gastrostomy tube 4.33 NA 1.84 0.24 NA 6.41 000 43247 A Operative upper GI endoscopy 3.39 NA 1.56 0.17 NA 5.12 000 43248 A Uppr GI endoscopy/guide wire 3.15 NA 1.49 0.15 NA 4.79 000 43249 A Esoph endoscopy, dilation 2.90 NA 1.39 0.15 NA 4.44 000 43250 A Upper GI endoscopy/tumor 3.20 NA 1.48 0.17 NA 4.85 000Start Printed Page 55376 43251 A Operative upper GI endoscopy 3.70 NA 1.67 0.19 NA 5.56 000 43255 A Operative upper GI endoscopy 4.82 NA 1.97 0.20 NA 6.99 000 43256 A Uppr GI endoscopy w stent 4.60 1.66 1.66 0.23 6.49 6.49 000 43258 A Operative upper GI endoscopy 4.55 NA 1.99 0.22 NA 6.76 000 43259 A Endoscopic ultrasound exam 4.89 NA 2.22 0.22 NA 7.33 000 43260 A Endo cholangiopancreatograph 5.96 NA 2.50 0.27 NA 8.73 000 43261 A Endo cholangiopancreatograph 6.27 NA 2.62 0.29 NA 9.18 000 43262 A Endo cholangiopancreatograph 7.39 NA 3.03 0.34 NA 10.76 000 43263 A Endo cholangiopancreatograph 7.29 NA 3.00 0.28 NA 10.57 000 43264 A Endo cholangiopancreatograph 8.90 NA 3.58 0.41 NA 12.89 000 43265 A Endo cholangiopancreatograph 10.02 NA 3.99 0.42 NA 14.43 000 43267 A Endo cholangiopancreatograph 7.39 NA 3.04 0.34 NA 10.77 000 43268 A Endo cholangiopancreatograph 7.39 NA 3.03 0.34 NA 10.76 000 43269 A Endo cholangiopancreatograph 8.21 NA 3.33 0.28 NA 11.82 000 43271 A Endo cholangiopancreatograph 7.39 NA 3.02 0.34 NA 10.75 000 43272 A Endo cholangiopancreatograph 7.39 NA 3.04 0.34 NA 10.77 000 43280 A Laparoscopy, fundoplasty 17.25 NA 8.43 1.76 NA 27.44 090 43289 C Laparoscope proc, esoph 0.00 0.00 0.00 0.00 0.00 0.00 YYY 43300 A Repair of esophagus 9.14 NA 7.31 0.85 NA 17.30 090 43305 A Repair esophagus and fistula 17.39 NA 12.84 1.36 NA 31.59 090 43310 A Repair of esophagus 25.39 NA 14.51 3.18 NA 43.08 090 43312 A Repair esophagus and fistula 28.42 NA 17.45 3.38 NA 49.25 090 43313 A Esophagoplasty congential 45.28 NA 22.01 5.43 NA 72.72 090 43314 A Tracheo-esophagoplasty cong 50.27 NA 24.07 5.53 NA 79.87 090 43320 A Fuse esophagus & stomach 19.93 NA 10.67 1.59 NA 32.19 090 43324 A Revise esophagus & stomach 20.57 NA 9.79 1.72 NA 32.08 090 43325 A Revise esophagus & stomach 20.06 NA 10.08 1.65 NA 31.79 090 43326 A Revise esophagus & stomach 19.74 NA 10.33 1.84 NA 31.91 090 43330 A Repair of esophagus 19.77 NA 9.78 1.52 NA 31.07 090 43331 A Repair of esophagus 20.13 NA 11.41 1.93 NA 33.47 090 43340 A Fuse esophagus & intestine 19.61 NA 10.31 1.53 NA 31.45 090 43341 A Fuse esophagus & intestine 20.85 NA 11.17 2.14 NA 34.16 090 43350 A Surgical opening, esophagus 15.78 NA 10.50 1.15 NA 27.43 090 43351 A Surgical opening, esophagus 18.35 NA 10.91 1.51 NA 30.77 090 43352 A Surgical opening, esophagus 15.26 NA 9.59 1.28 NA 26.13 090 43360 A Gastrointestinal repair 35.70 NA 17.43 3.00 NA 56.13 090 43361 A Gastrointestinal repair 40.50 NA 17.93 3.52 NA 61.95 090 43400 A Ligate esophagus veins 21.20 NA 10.46 0.99 NA 32.65 090 43401 A Esophagus surgery for veins 22.09 NA 10.34 1.73 NA 34.16 090 43405 A Ligate/staple esophagus 20.01 NA 9.45 1.63 NA 31.09 090 43410 A Repair esophagus wound 13.47 NA 9.35 1.15 NA 23.97 090 43415 A Repair esophagus wound 25.00 NA 12.50 1.92 NA 39.42 090 43420 A Repair esophagus opening 14.35 NA 9.15 0.86 NA 24.36 090 43425 A Repair esophagus opening 21.03 NA 11.00 2.03 NA 34.06 090 43450 A Dilate esophagus 1.38 1.47 0.63 0.07 2.92 2.08 000 43453 A Dilate esophagus 1.51 NA 0.68 0.08 NA 2.27 000 43456 A Dilate esophagus 2.57 NA 1.07 0.14 NA 3.78 000 43458 A Dilate esophagus 3.06 NA 1.26 0.17 NA 4.49 000 43460 A Pressure treatment esophagus 3.80 NA 1.54 0.21 NA 5.55 000 43496 C Free jejunum flap, microvasc 0.00 0.00 0.00 0.00 0.00 0.00 090 43499 C Esophagus surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 43500 A Surgical opening of stomach 11.05 NA 5.23 0.84 NA 17.12 090 43501 A Surgical repair of stomach 20.04 NA 8.86 1.55 NA 30.45 090 43502 A Surgical repair of stomach 23.13 NA 10.16 1.83 NA 35.12 090 43510 A Surgical opening of stomach 13.08 NA 7.50 0.90 NA 21.48 090 43520 A Incision of pyloric muscle 9.99 NA 5.73 0.84 NA 16.56 090 43600 A Biopsy of stomach 1.91 NA 1.05 0.11 NA 3.07 000 43605 A Biopsy of stomach 11.98 NA 5.55 0.93 NA 18.46 090 43610 A Excision of stomach lesion 14.60 NA 6.85 1.14 NA 22.59 090 43611 A Excision of stomach lesion 17.84 NA 8.12 1.38 NA 27.34 090 43620 A Removal of stomach 30.04 NA 12.89 2.29 NA 45.22 090 43621 A Removal of stomach 30.73 NA 13.21 2.36 NA 46.30 090 43622 A Removal of stomach 32.53 NA 13.79 2.48 NA 48.80 090 43631 A Removal of stomach, partial 22.59 NA 9.72 1.99 NA 34.30 090 43632 A Removal of stomach, partial 22.59 NA 9.73 2.00 NA 34.32 090 43633 A Removal of stomach, partial 23.10 NA 9.87 2.05 NA 35.02 090 43634 A Removal of stomach, partial 25.12 NA 10.84 2.18 NA 38.14 090 43635 A Removal of stomach, partial 2.06 NA 0.74 0.21 NA 3.01 ZZZ 43638 A Removal of stomach, partial 29.00 NA 12.13 2.24 NA 43.37 090 43639 A Removal of stomach, partial 29.65 NA 12.30 2.31 NA 44.26 090 43640 A Vagotomy & pylorus repair 17.02 NA 7.72 1.51 NA 26.25 090 43641 A Vagotomy & pylorus repair 17.27 NA 7.82 1.53 NA 26.62 090 43651 A Laparoscopy, vagus nerve 10.15 NA 4.71 1.03 NA 15.89 090Start Printed Page 55377 43652 A Laparoscopy, vagus nerve 12.15 NA 5.53 1.25 NA 18.93 090 43653 A Laparoscopy, gastrostomy 7.73 NA 4.37 0.78 NA 12.88 090 43659 C Laparoscope proc, stom 0.00 0.00 0.00 0.00 0.00 0.00 YYY 43750 A Place gastrostomy tube 4.49 NA 2.72 0.33 NA 7.54 010 43752 B Nasal/orogastric w/stent 0.00 0.00 0.00 0.00 0.00 0.00 XXX 43760 A Change gastrostomy tube 1.10 1.47 0.46 0.07 2.64 1.63 000 43761 A Reposition gastrostomy tube 2.01 NA 0.83 0.10 NA 2.94 000 43800 A Reconstruction of pylorus 13.69 NA 6.60 1.07 NA 21.36 090 43810 A Fusion of stomach and bowel 14.65 NA 6.94 1.10 NA 22.69 090 43820 A Fusion of stomach and bowel 15.37 NA 7.15 1.18 NA 23.70 090 43825 A Fusion of stomach and bowel 19.22 NA 8.56 1.50 NA 29.28 090 43830 A Place gastrostomy tube 9.53 NA 5.06 0.69 NA 15.28 090 43831 A Place gastrostomy tube 7.84 NA 4.67 0.81 NA 13.32 090 43832 A Place gastrostomy tube 15.60 NA 7.66 1.13 NA 24.39 090 43840 A Repair of stomach lesion 15.56 NA 7.21 1.20 NA 23.97 090 43842 A Gastroplasty for obesity 18.47 NA 11.24 1.51 NA 31.22 090 43843 A Gastroplasty for obesity 18.65 NA 11.25 1.53 NA 31.43 090 43846 A Gastric bypass for obesity 24.05 NA 13.68 1.96 NA 39.69 090 43847 A Gastric bypass for obesity 26.92 NA 15.28 2.14 NA 44.34 090 43848 A Revision gastroplasty 29.39 NA 16.54 2.39 NA 48.32 090 43850 A Revise stomach-bowel fusion 24.72 NA 10.42 1.97 NA 37.11 090 43855 A Revise stomach-bowel fusion 26.16 NA 11.12 2.01 NA 39.29 090 43860 A Revise stomach-bowel fusion 25.00 NA 10.58 2.03 NA 37.61 090 43865 A Revise stomach-bowel fusion 26.52 NA 11.21 2.15 NA 39.88 090 43870 A Repair stomach opening 9.69 NA 5.22 0.71 NA 15.62 090 43880 A Repair stomach-bowel fistula 24.65 NA 10.87 1.94 NA 37.46 090 43999 C Stomach surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 44005 A Freeing of bowel adhesion 16.23 NA 7.40 1.39 NA 25.02 090 44010 A Incision of small bowel 12.52 NA 6.48 1.05 NA 20.05 090 44015 A Insert needle cath bowel 2.62 NA 0.93 0.25 NA 3.80 ZZZ 44020 A Explore small intestine 13.99 NA 6.56 1.20 NA 21.75 090 44021 A Decompress small bowel 14.08 NA 7.02 1.18 NA 22.28 090 44025 A Incision of large bowel 14.28 NA 6.65 1.21 NA 22.14 090 44050 A Reduce bowel obstruction 14.03 NA 6.60 1.15 NA 21.78 090 44055 A Correct malrotation of bowel 22.00 NA 9.51 1.32 NA 32.83 090 44100 A Biopsy of bowel 2.01 NA 1.09 0.12 NA 3.22 000 44110 A Excise intestine lesion(s) 11.81 NA 5.84 1.00 NA 18.65 090 44111 A Excision of bowel lesion(s) 14.29 NA 7.10 1.22 NA 22.61 090 44120 A Removal of small intestine 17.00 NA 7.67 1.46 NA 26.13 090 44121 A Removal of small intestine 4.45 NA 1.60 0.45 NA 6.50 ZZZ 44125 A Removal of small intestine 17.54 NA 7.86 1.49 NA 26.89 090 44126 A Enterectomy w/taper, cong 35.50 NA 18.03 0.36 NA 53.89 090 44127 A Enterectomy w/o taper, cong 41.00 NA 20.56 0.41 NA 61.97 090 44128 A Enterectomy cong, add-on 4.45 NA 1.78 0.45 NA 6.68 ZZZ 44130 A Bowel to bowel fusion 14.49 NA 6.78 1.23 NA 22.50 090 44132 R Enterectomy, cadaver donor 0.00 0.00 0.00 0.00 0.00 0.00 XXX 44133 R Enterectomy, live donor 0.00 0.00 0.00 0.00 0.00 0.00 XXX 44135 R Intestine transplant, cadaver 0.00 0.00 0.00 0.00 0.00 0.00 XXX 44136 R Intestine transplant, live 0.00 0.00 0.00 0.00 0.00 0.00 XXX 44139 A Mobilization of colon 2.23 NA 0.80 0.21 NA 3.24 ZZZ 44140 A Partial removal of colon 21.00 NA 9.53 1.83 NA 32.36 090 44141 A Partial removal of colon 19.51 NA 11.93 1.95 NA 33.39 090 44143 A Partial removal of colon 22.99 NA 13.14 2.02 NA 38.15 090 44144 A Partial removal of colon 21.53 NA 11.75 1.89 NA 35.17 090 44145 A Partial removal of colon 26.42 NA 11.90 2.22 NA 40.54 090 44146 A Partial removal of colon 27.54 NA 15.41 2.20 NA 45.15 090 44147 A Partial removal of colon 20.71 NA 10.15 1.74 NA 32.60 090 44150 A Removal of colon 23.95 NA 14.08 2.05 NA 40.08 090 44151 A Removal of colon/ileostomy 26.88 NA 15.74 1.97 NA 44.59 090 44152 A Removal of colon/ileostomy 27.83 NA 17.01 2.36 NA 47.20 090 44153 A Removal of colon/ileostomy 30.59 NA 16.64 2.33 NA 49.56 090 44155 A Removal of colon/ileostomy 27.86 NA 15.28 2.26 NA 45.40 090 44156 A Removal of colon/ileostomy 30.79 NA 17.86 2.19 NA 50.84 090 44160 A Removal of colon 18.62 NA 8.65 1.55 NA 28.82 090 44200 A Laparoscopy, enterolysis 14.44 NA 6.79 1.46 NA 22.69 090 44201 A Laparoscopy, jejunostomy 9.78 NA 5.16 0.97 NA 15.91 090 44202 A Lap resect s/intestine singl 22.04 NA 9.82 2.16 NA 34.02 090 44203 A Lap resect s/intestine, addl 4.45 NA 1.60 0.45 NA 6.50 ZZZ 44204 A Laparo partial colectomy 25.08 NA 10.46 1.83 NA 37.37 090 44205 A Lap colectomy part w/ileum 22.23 NA 9.31 1.55 NA 33.09 090 44209 C Laparoscope proc, intestine 0.00 0.00 0.00 0.00 0.00 0.00 YYY 44300 A Open bowel to skin 12.11 NA 6.79 0.88 NA 19.78 090 44310 A Ileostomy/jejunostomy 15.95 NA 10.50 1.13 NA 27.58 090Start Printed Page 55378 44312 A Revision of ileostomy 8.02 NA 5.25 0.54 NA 13.81 090 44314 A Revision of ileostomy 15.05 NA 10.37 0.99 NA 26.41 090 44316 A Devise bowel pouch 21.09 NA 13.77 1.41 NA 36.27 090 44320 A Colostomy 17.64 NA 12.13 1.28 NA 31.05 090 44322 A Colostomy with biopsies 11.98 NA 10.41 1.18 NA 23.57 090 44340 A Revision of colostomy 7.72 NA 4.86 0.56 NA 13.14 090 44345 A Revision of colostomy 15.43 NA 8.34 1.11 NA 24.88 090 44346 A Revision of colostomy 16.99 NA 8.91 1.20 NA 27.10 090 44360 A Small bowel endoscopy 2.59 NA 1.39 0.14 NA 4.12 000 44361 A Small bowel endoscopy/biopsy 2.87 NA 1.50 0.15 NA 4.52 000 44363 A Small bowel endoscopy 3.50 NA 1.71 0.19 NA 5.40 000 44364 A Small bowel endoscopy 3.74 NA 1.80 0.21 NA 5.75 000 44365 A Small bowel endoscopy 3.31 NA 1.68 0.18 NA 5.17 000 44366 A Small bowel endoscopy 4.41 NA 2.05 0.22 NA 6.68 000 44369 A Small bowel endoscopy 4.52 NA 2.05 0.23 NA 6.80 000 44370 A Small bowel endoscopy/stent 4.80 1.74 1.74 0.21 6.75 6.75 000 44372 A Small bowel endoscopy 4.41 NA 2.04 0.27 NA 6.72 000 44373 A Small bowel endoscopy 3.50 NA 1.80 0.19 NA 5.49 000 44376 A Small bowel endoscopy 5.26 NA 2.36 0.29 NA 7.91 000 44377 A Small bowel endoscopy/biopsy 5.53 NA 2.47 0.28 NA 8.28 000 44378 A Small bowel endoscopy 7.13 NA 3.06 0.37 NA 10.56 000 44379 A S bowel endoscope w/stent 7.47 2.67 2.67 0.38 10.52 10.52 000 44380 A Small bowel endoscopy 1.05 NA 0.79 0.08 NA 1.92 000 44382 A Small bowel endoscopy 1.27 NA 0.90 0.09 NA 2.26 000 44383 A Ileoscopy w/stent 3.26 1.16 1.16 0.13 4.55 4.55 000 44385 A Endoscopy of bowel pouch 1.82 5.26 0.95 0.12 7.20 2.89 000 44386 A Endoscopy, bowel pouch/biop 2.12 6.98 1.09 0.15 9.25 3.36 000 44388 A Colon endoscopy 2.82 6.91 1.42 0.18 9.91 4.42 000 44389 A Colonoscopy with biopsy 3.13 7.62 1.55 0.18 10.93 4.86 000 44390 A Colonoscopy for foreign body 3.83 6.68 1.80 0.22 10.73 5.85 000 44391 A Colonoscopy for bleeding 4.32 6.04 1.78 0.23 10.59 6.33 000 44392 A Colonoscopy & polypectomy 3.82 8.21 1.79 0.23 12.26 5.84 000 44393 A Colonoscopy, lesion removal 4.84 8.45 2.19 0.27 13.56 7.30 000 44394 A Colonoscopy w/snare 4.43 7.71 2.04 0.26 12.40 6.73 000 44397 A Colonoscopy w stent 4.71 NA 2.10 0.28 NA 7.09 000 44500 A Intro, gastrointestinal tube 0.49 NA 0.37 0.02 NA 0.88 000 44602 A Suture, small intestine 16.03 NA 7.34 1.07 NA 24.44 090 44603 A Suture, small intestine 18.66 NA 8.25 1.39 NA 28.30 090 44604 A Suture, large intestine 16.03 NA 7.35 1.42 NA 24.80 090 44605 A Repair of bowel lesion 19.53 NA 8.94 1.54 NA 30.01 090 44615 A Intestinal stricturoplasty 15.93 NA 7.32 1.39 NA 24.64 090 44620 A Repair bowel opening 12.20 NA 5.81 1.05 NA 19.06 090 44625 A Repair bowel opening 15.05 NA 6.86 1.30 NA 23.21 090 44626 A Repair bowel opening 25.36 NA 10.60 2.19 NA 38.15 090 44640 A Repair bowel-skin fistula 21.65 NA 9.70 1.46 NA 32.81 090 44650 A Repair bowel fistula 22.57 NA 10.01 1.49 NA 34.07 090 44660 A Repair bowel-bladder fistula 21.36 NA 9.51 1.14 NA 32.01 090 44661 A Repair bowel-bladder fistula 24.81 NA 10.73 1.53 NA 37.07 090 44680 A Surgical revision, intestine 15.40 NA 7.47 1.37 NA 24.24 090 44700 A Suspend bowel w/prosthesis 16.11 NA 7.57 1.21 NA 24.89 090 44799 C Intestine surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 44800 A Excision of bowel pouch 11.23 NA 5.61 1.11 NA 17.95 090 44820 A Excision of mesentery lesion 12.09 NA 5.98 1.03 NA 19.10 090 44850 A Repair of mesentery 10.74 NA 5.41 0.99 NA 17.14 090 44899 C Bowel surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 44900 A Drain app abscess, open 10.14 NA 5.96 0.84 NA 16.94 090 44901 A Drain app abscess, percut 3.38 NA 5.01 0.17 NA 8.56 000 44950 A Appendectomy 10.00 NA 5.31 0.88 NA 16.19 090 44955 A Appendectomy add-on 1.53 NA 0.57 0.16 NA 2.26 ZZZ 44960 A Appendectomy 12.34 NA 6.50 1.09 NA 19.93 090 44970 A Laparoscopy, appendectomy 8.70 NA 4.21 0.88 NA 13.79 090 44979 C Laparoscope proc, app 0.00 0.00 0.00 0.00 0.00 0.00 YYY 45000 A Drainage of pelvic abscess 4.52 NA 3.80 0.37 NA 8.69 090 45005 A Drainage of rectal abscess 1.99 4.58 1.62 0.18 6.75 3.79 010 45020 A Drainage of rectal abscess 4.72 NA 4.21 0.41 NA 9.34 090 45100 A Biopsy of rectum 3.68 4.86 2.12 0.33 8.87 6.13 090 45108 A Removal of anorectal lesion 4.76 6.40 2.95 0.46 11.62 8.17 090 45110 A Removal of rectum 28.00 NA 13.26 2.26 NA 43.52 090 45111 A Partial removal of rectum 16.48 NA 8.78 1.60 NA 26.86 090 45112 A Removal of rectum 30.54 NA 13.70 2.35 NA 46.59 090 45113 A Partial proctectomy 30.58 NA 13.39 2.13 NA 46.10 090 45114 A Partial removal of rectum 27.32 NA 12.61 2.28 NA 42.21 090 45116 A Partial removal of rectum 24.58 NA 11.58 2.00 NA 38.16 090Start Printed Page 55379 45119 A Remove rectum w/reservoir 30.84 NA 13.25 2.13 NA 46.22 090 45120 A Removal of rectum 24.60 NA 11.63 2.28 NA 38.51 090 45121 A Removal of rectum and colon 27.04 NA 12.53 2.66 NA 42.23 090 45123 A Partial proctectomy 16.71 NA 8.21 1.04 NA 25.96 090 45126 A Pelvic exenteration 45.16 NA 19.12 3.23 NA 67.51 090 45130 A Excision of rectal prolapse 16.44 NA 7.80 1.12 NA 25.36 090 45135 A Excision of rectal prolapse 19.28 NA 9.10 1.52 NA 29.90 090 45136 A Excise ileoanal reservoir 27.30 NA 12.66 2.19 NA 42.15 090 45150 A Excision of rectal stricture 5.67 5.89 3.19 0.46 12.02 9.32 090 45160 A Excision of rectal lesion 15.32 NA 7.14 1.07 NA 23.53 090 45170 A Excision of rectal lesion 11.49 NA 5.89 0.89 NA 18.27 090 45190 A Destruction, rectal tumor 9.74 NA 5.33 0.76 NA 15.83 090 45300 A Proctosigmoidoscopy dx 0.38 1.34 0.23 0.05 1.77 0.66 000 45303 A Proctosigmoidoscopy dilate 0.44 1.55 0.27 0.06 2.05 0.77 000 45305 A Protosigmoidoscopy w/bx 1.01 1.64 0.46 0.09 2.74 1.56 000 45307 A Protosigmoidoscopy fb 0.94 2.68 0.44 0.15 3.77 1.53 000 45308 A Protosigmoidoscopy removal 0.83 1.59 0.39 0.13 2.55 1.35 000 45309 A Protosigmoidoscopy removal 2.01 2.43 0.81 0.17 4.61 2.99 000 45315 A Protosigmoidoscopy removal 1.40 2.84 0.60 0.20 4.44 2.20 000 45317 A Protosigmoidoscopy bleed 1.50 1.94 0.63 0.20 3.64 2.33 000 45320 A Protosigmoidoscopy ablate 1.58 1.88 0.68 0.20 3.66 2.46 000 45321 A Protosigmoidoscopy volvul 1.17 NA 0.52 0.17 NA 1.86 000 45327 A Proctosigmoidoscopy w/stent 1.65 NA 0.89 0.10 NA 2.64 000 45330 A Diagnostic sigmoidoscopy 0.96 1.92 0.53 0.05 2.93 1.54 000 45331 A Sigmoidoscopy and biopsy 1.15 2.38 0.54 0.07 3.60 1.76 000 45332 A Sigmoidoscopy w/fb removal 1.79 4.36 0.76 0.11 6.26 2.66 000 45333 A Sigmoidoscopy & polypectomy 1.79 3.93 0.77 0.12 5.84 2.68 000 45334 A Sigmoidoscopy for bleeding 2.73 NA 1.12 0.16 NA 4.01 000 45337 A Sigmoidoscopy & decompress 2.36 NA 0.97 0.15 NA 3.48 000 45338 A Sigmoidoscpy w/tumr remove 2.34 4.75 0.97 0.15 7.24 3.46 000 45339 A Sigmoidoscopy w/ablate tumr 3.14 3.62 1.27 0.17 6.93 4.58 000 45341 A Sigmoidoscopy w/ultrasound 2.60 NA 1.40 0.20 NA 4.20 000 45342 A Sigmoidoscopy w/us guide bx 4.06 NA 1.85 0.23 NA 6.14 000 45345 A Sigmodoscopy w/stent 2.92 NA 1.44 0.15 NA 4.51 000 45355 A Surgical colonoscopy 3.52 NA 1.28 0.26 NA 5.06 000 45378 A Diagnostic colonoscopy 3.70 8.79 1.77 0.20 12.69 5.67 000 45378 53 A Diagnostic colonoscopy 0.96 1.92 0.53 0.05 2.93 1.54 000 45379 A Colonoscopy w/fb removal 4.69 8.25 2.13 0.25 13.19 7.07 000 45380 A Colonoscopy and biopsy 4.44 9.28 2.05 0.21 13.93 6.70 000 45382 A Colonoscopy/control bleeding 5.69 10.32 2.29 0.27 16.28 8.25 000 45383 A Lesion removal colonoscopy 5.87 10.01 2.56 0.32 16.20 8.75 000 45384 A Lesion remove colonoscopy 4.70 9.74 2.14 0.24 14.68 7.08 000 45385 A Lesion removal colonoscopy 5.31 10.19 2.36 0.28 15.78 7.95 000 45387 A Colonoscopy w/stent 5.91 NA 2.57 0.33 NA 8.81 000 45500 A Repair of rectum 7.29 NA 4.24 0.56 NA 12.09 090 45505 A Repair of rectum 7.58 NA 3.86 0.50 NA 11.94 090 45520 A Treatment of rectal prolapse 0.55 0.77 0.20 0.04 1.36 0.79 000 45540 A Correct rectal prolapse 16.27 NA 8.18 1.17 NA 25.62 090 45541 A Correct rectal prolapse 13.40 NA 7.03 0.88 NA 21.31 090 45550 A Repair rectum/remove sigmoid 23.00 NA 10.40 1.58 NA 34.98 090 45560 A Repair of rectocele 10.58 NA 6.12 0.73 NA 17.43 090 45562 A Exploration/repair of rectum 15.38 NA 7.52 1.15 NA 24.05 090 45563 A Exploration/repair of rectum 23.47 NA 11.34 1.84 NA 36.65 090 45800 A Repair rect/bladder fistula 17.77 NA 8.23 1.14 NA 27.14 090 45805 A Repair fistula w/colostomy 20.78 NA 10.72 1.47 NA 32.97 090 45820 A Repair rectourethral fistula 18.48 NA 8.55 1.17 NA 28.20 090 45825 A Repair fistula w/colostomy 21.25 NA 10.57 0.97 NA 32.79 090 45900 A Reduction of rectal prolapse 2.61 NA 1.04 0.17 NA 3.82 010 45905 A Dilation of anal sphincter 2.30 12.19 0.96 0.14 14.63 3.40 010 45910 A Dilation of rectal narrowing 2.80 17.62 1.15 0.14 20.56 4.09 010 45915 A Remove rectal obstruction 3.14 4.89 1.16 0.17 8.20 4.47 010 45999 C Rectum surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 46020 A Placement of seton 2.90 3.09 2.36 0.22 6.21 5.48 010 46030 A Removal of rectal marker 1.23 2.90 1.22 0.11 4.24 2.56 010 46040 A Incision of rectal abscess 4.96 5.57 3.15 0.48 11.01 8.59 090 46045 A Incision of rectal abscess 4.32 NA 2.88 0.40 NA 7.60 090 46050 A Incision of anal abscess 1.19 3.68 1.37 0.11 4.98 2.67 010 46060 A Incision of rectal abscess 5.69 NA 3.83 0.52 NA 10.04 090 46070 A Incision of anal septum 2.71 NA 2.54 0.27 NA 5.52 090 46080 A Incision of anal sphincter 2.49 3.81 1.65 0.23 6.53 4.37 010 46083 A Incise external hemorrhoid 1.40 4.78 1.59 0.12 6.30 3.11 010 46200 A Removal of anal fissure 3.42 4.01 2.42 0.30 7.73 6.14 090 46210 A Removal of anal crypt 2.67 5.12 2.17 0.26 8.05 5.10 090Start Printed Page 55380 46211 A Removal of anal crypts 4.25 4.97 3.10 0.37 9.59 7.72 090 46220 A Removal of anal tab 1.56 1.32 0.56 0.14 3.02 2.26 010 46221 A Ligation of hemorrhoid(s) 2.04 1.80 1.12 0.12 3.96 3.28 010 46230 A Removal of anal tabs 2.57 4.38 1.69 0.22 7.17 4.48 010 46250 A Hemorrhoidectomy 3.89 5.59 2.71 0.43 9.91 7.03 090 46255 A Hemorrhoidectomy 4.60 6.45 2.96 0.51 11.56 8.07 090 46257 A Remove hemorrhoids & fissure 5.40 NA 3.12 0.59 NA 9.11 090 46258 A Remove hemorrhoids & fistula 5.73 NA 3.30 0.64 NA 9.67 090 46260 A Hemorrhoidectomy 6.37 NA 4.04 0.68 NA 11.09 090 46261 A Remove hemorrhoids & fissure 7.08 NA 4.19 0.70 NA 11.97 090 46262 A Remove hemorrhoids & fistula 7.50 NA 4.35 0.76 NA 12.61 090 46270 A Removal of anal fistula 3.72 5.23 2.65 0.36 9.31 6.73 090 46275 A Removal of anal fistula 4.56 4.65 2.85 0.40 9.61 7.81 090 46280 A Removal of anal fistula 5.98 NA 3.83 0.50 NA 10.31 090 46285 A Removal of anal fistula 4.09 4.28 2.69 0.34 8.71 7.12 090 46288 A Repair anal fistula 7.13 NA 4.25 0.60 NA 11.98 090 46320 A Removal of hemorrhoid clot 1.61 4.00 1.57 0.14 5.75 3.32 010 46500 A Injection into hemorrhoid(s) 1.61 2.89 0.58 0.12 4.62 2.31 010 46600 A Diagnostic anoscopy 0.50 0.82 0.15 0.04 1.36 0.69 000 46604 A Anoscopy and dilation 1.31 0.99 0.47 0.09 2.39 1.87 000 46606 A Anoscopy and biopsy 0.81 0.87 0.29 0.07 1.75 1.17 000 46608 A Anoscopy/remove for body 1.51 1.81 0.49 0.13 3.45 2.13 000 46610 A Anoscopy/remove lesion 1.32 1.46 0.48 0.12 2.90 1.92 000 46611 A Anoscopy 1.81 2.07 0.65 0.15 4.03 2.61 000 46612 A Anoscopy/ remove lesions 2.34 2.65 0.85 0.18 5.17 3.37 000 46614 A Anoscopy/control bleeding 2.01 1.90 0.71 0.14 4.05 2.86 000 46615 A Anoscopy 2.68 1.76 0.96 0.23 4.67 3.87 000 46700 A Repair of anal stricture 9.13 NA 4.78 0.56 NA 14.47 090 46705 A Repair of anal stricture 6.90 NA 4.53 0.73 NA 12.16 090 46715 A Repair of anovaginal fistula 7.20 NA 4.46 0.76 NA 12.42 090 46716 A Repair of anovaginal fistula 15.07 NA 8.05 1.30 NA 24.42 090 46730 A Construction of absent anus 26.75 NA 12.25 2.03 NA 41.03 090 46735 A Construction of absent anus 32.17 NA 15.49 2.64 NA 50.30 090 46740 A Construction of absent anus 30.00 NA 14.61 1.99 NA 46.60 090 46742 A Repair of imperforated anus 35.80 NA 18.31 2.63 NA 56.74 090 46744 A Repair of cloacal anomaly 52.63 NA 22.78 2.27 NA 77.68 090 46746 A Repair of cloacal anomaly 58.22 NA 27.19 2.51 NA 87.92 090 46748 A Repair of cloacal anomaly 64.21 NA 29.58 2.77 NA 96.56 090 46750 A Repair of anal sphincter 10.25 NA 5.79 0.69 NA 16.73 090 46751 A Repair of anal sphincter 8.77 NA 6.14 0.78 NA 15.69 090 46753 A Reconstruction of anus 8.29 NA 4.13 0.58 NA 13.00 090 46754 A Removal of suture from anus 2.20 5.36 1.43 0.12 7.68 3.75 010 46760 A Repair of anal sphincter 14.43 NA 7.07 0.86 NA 22.36 090 46761 A Repair of anal sphincter 13.84 NA 6.87 0.84 NA 21.55 090 46762 A Implant artificial sphincter 12.71 NA 6.08 0.71 NA 19.50 090 46900 A Destruction, anal lesion(s) 1.91 3.52 0.74 0.13 5.56 2.78 010 46910 A Destruction, anal lesion(s) 1.86 3.81 1.48 0.14 5.81 3.48 010 46916 A Cryosurgery, anal lesion(s) 1.86 3.24 1.68 0.09 5.19 3.63 010 46917 A Laser surgery, anal lesions 1.86 5.32 1.62 0.16 7.34 3.64 010 46922 A Excision of anal lesion(s) 1.86 3.96 1.46 0.17 5.99 3.49 010 46924 A Destruction, anal lesion(s) 2.76 4.81 1.77 0.20 7.77 4.73 010 46934 A Destruction of hemorrhoids 3.51 6.62 3.77 0.26 10.39 7.54 090 46935 A Destruction of hemorrhoids 2.43 4.60 0.87 0.17 7.20 3.47 010 46936 A Destruction of hemorrhoids 3.69 6.67 3.58 0.30 10.66 7.57 090 46937 A Cryotherapy of rectal lesion 2.69 4.51 1.72 0.12 7.32 4.53 010 46938 A Cryotherapy of rectal lesion 4.66 6.22 3.27 0.40 11.28 8.33 090 46940 A Treatment of anal fissure 2.32 3.47 0.83 0.17 5.96 3.32 010 46942 A Treatment of anal fissure 2.04 2.84 0.71 0.14 5.02 2.89 010 46945 A Ligation of hemorrhoids 1.84 4.04 2.29 0.17 6.05 4.30 090 46946 A Ligation of hemorrhoids 2.58 5.40 2.61 0.22 8.20 5.41 090 46999 C Anus surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 47000 A Needle biopsy of liver 1.90 8.36 0.67 0.09 10.35 2.66 000 47001 A Needle biopsy, liver add-on 1.90 NA 0.68 0.18 NA 2.76 ZZZ 47010 A Open drainage, liver lesion 16.01 NA 9.60 0.65 NA 26.26 090 47011 A Percut drain, liver lesion 3.70 NA 4.61 0.17 NA 8.48 000 47015 A Inject/aspirate liver cyst 15.11 NA 8.23 0.86 NA 24.20 090 47100 A Wedge biopsy of liver 11.67 NA 6.50 0.75 NA 18.92 090 47120 A Partial removal of liver 35.50 NA 17.02 2.29 NA 54.81 090 47122 A Extensive removal of liver 55.13 NA 24.11 3.60 NA 82.84 090 47125 A Partial removal of liver 49.19 NA 22.12 3.18 NA 74.49 090 47130 A Partial removal of liver 53.35 NA 23.49 3.47 NA 80.31 090 47133 X Removal of donor liver 0.00 0.00 0.00 0.00 0.00 0.00 XXX 47134 R Partial removal, donor liver 39.15 NA 13.91 3.98 NA 57.04 XXXStart Printed Page 55381 47135 R Transplantation of liver 81.52 NA 43.28 8.13 NA 132.93 090 47136 R Transplantation of liver 68.60 NA 47.00 6.93 NA 122.53 090 47300 A Surgery for liver lesion 15.08 NA 7.75 0.97 NA 23.80 090 47350 A Repair liver wound 19.56 NA 9.45 1.25 NA 30.26 090 47360 A Repair liver wound 26.92 NA 12.96 1.71 NA 41.59 090 47361 A Repair liver wound 47.12 NA 19.94 3.11 NA 70.17 090 47362 A Repair liver wound 18.51 NA 9.77 1.22 NA 29.50 090 47370 A Laparo ablate liver tumor rf 18.00 7.19 7.19 0.85 26.04 26.04 090 47371 A Laparo ablate liver cryosug 16.94 6.76 6.76 0.85 24.55 24.55 090 47379 C Laparoscope procedure, liver 0.00 0.00 0.00 0.00 0.00 0.00 YYY 47380 A Open ablate liver tumor rf 21.25 8.48 8.48 0.85 30.58 30.58 090 47381 A Open ablate liver tumor cryo 21.00 8.38 8.38 0.85 30.23 30.23 090 47382 A Percut ablate liver rf 12.00 NA 5.37 0.85 NA 18.22 010 47399 C Liver surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 47400 A Incision of liver duct 32.49 NA 14.99 1.82 NA 49.30 090 47420 A Incision of bile duct 19.88 NA 9.46 1.70 NA 31.04 090 47425 A Incision of bile duct 19.83 NA 9.38 1.60 NA 30.81 090 47460 A Incise bile duct sphincter 18.04 NA 9.26 1.24 NA 28.54 090 47480 A Incision of gallbladder 10.82 NA 6.80 0.85 NA 18.47 090 47490 A Incision of gallbladder 7.23 NA 7.67 0.33 NA 15.23 090 47500 A Injection for liver x-rays 1.96 NA 0.68 0.09 NA 2.73 000 47505 A Injection for liver x-rays 0.76 2.88 0.26 0.03 3.67 1.05 000 47510 A Insert catheter, bile duct 7.83 NA 9.46 0.36 NA 17.65 090 47511 A Insert bile duct drain 10.50 NA 10.57 0.47 NA 21.54 090 47525 A Change bile duct catheter 5.55 NA 3.34 0.24 NA 9.13 010 47530 A Revise/reinsert bile tube 5.85 NA 5.07 0.29 NA 11.21 090 47550 A Bile duct endoscopy add-on 3.02 NA 1.08 0.30 NA 4.40 ZZZ 47552 A Biliary endoscopy thru skin 6.04 NA 2.52 0.42 NA 8.98 000 47553 A Biliary endoscopy thru skin 6.35 NA 2.70 0.30 NA 9.35 000 47554 A Biliary endoscopy thru skin 9.06 NA 3.55 0.74 NA 13.35 000 47555 A Biliary endoscopy thru skin 7.56 NA 3.15 0.35 NA 11.06 000 47556 A Biliary endoscopy thru skin 8.56 NA 3.49 0.38 NA 12.43 000 47560 A Laparoscopy w/cholangio 4.89 NA 1.89 0.49 NA 7.27 000 47561 A Laparo w/cholangio/biopsy 5.18 NA 2.19 0.49 NA 7.86 000 47562 A Laparoscopic cholecystectomy 11.09 NA 5.15 1.13 NA 17.37 090 47563 A Laparo cholecystectomy/graph 11.94 NA 5.43 1.21 NA 18.58 090 47564 A Laparo cholecystectomy/explr 14.23 NA 6.26 1.44 NA 21.93 090 47570 A Laparo cholecystoenterostomy 12.58 NA 5.67 1.28 NA 19.53 090 47579 C Laparoscope proc, biliary 0.00 0.00 0.00 0.00 0.00 0.00 YYY 47600 A Removal of gallbladder 13.58 NA 6.86 1.16 NA 21.60 090 47605 A Removal of gallbladder 14.69 NA 7.23 1.25 NA 23.17 090 47610 A Removal of gallbladder 18.82 NA 8.80 1.61 NA 29.23 090 47612 A Removal of gallbladder 18.78 NA 8.70 1.60 NA 29.08 090 47620 A Removal of gallbladder 20.64 NA 9.35 1.77 NA 31.76 090 47630 A Remove bile duct stone 9.11 NA 3.20 0.46 NA 12.77 090 47700 A Exploration of bile ducts 15.62 NA 8.79 1.40 NA 25.81 090 47701 A Bile duct revision 27.81 NA 13.60 3.00 NA 44.41 090 47711 A Excision of bile duct tumor 23.03 NA 11.34 1.98 NA 36.35 090 47712 A Excision of bile duct tumor 30.24 NA 14.00 2.67 NA 46.91 090 47715 A Excision of bile duct cyst 18.80 NA 8.95 1.59 NA 29.34 090 47716 A Fusion of bile duct cyst 16.44 NA 8.19 1.41 NA 26.04 090 47720 A Fuse gallbladder & bowel 15.91 NA 8.66 1.37 NA 25.94 090 47721 A Fuse upper gi structures 19.12 NA 9.90 1.63 NA 30.65 090 47740 A Fuse gallbladder & bowel 18.48 NA 9.64 1.59 NA 29.71 090 47741 A Fuse gallbladder & bowel 21.34 NA 10.62 1.82 NA 33.78 090 47760 A Fuse bile ducts and bowel 25.85 NA 12.28 2.21 NA 40.34 090 47765 A Fuse liver ducts & bowel 24.88 NA 12.73 2.18 NA 39.79 090 47780 A Fuse bile ducts and bowel 26.50 NA 12.49 2.27 NA 41.26 090 47785 A Fuse bile ducts and bowel 31.18 NA 14.97 2.69 NA 48.84 090 47800 A Reconstruction of bile ducts 23.30 NA 11.57 1.95 NA 36.82 090 47801 A Placement, bile duct support 15.17 NA 10.21 0.69 NA 26.07 090 47802 A Fuse liver duct & intestine 21.55 NA 11.60 1.84 NA 34.99 090 47900 A Suture bile duct injury 19.90 NA 10.25 1.65 NA 31.80 090 47999 C Bile tract surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 48000 A Drainage of abdomen 28.07 NA 12.59 1.32 NA 41.98 090 48001 A Placement of drain, pancreas 35.45 NA 15.04 1.90 NA 52.39 090 48005 A Resect/debride pancreas 42.17 NA 17.39 2.26 NA 61.82 090 48020 A Removal of pancreatic stone 15.70 NA 7.44 1.36 NA 24.50 090 48100 A Biopsy of pancreas, open 12.23 NA 7.03 1.08 NA 20.34 090 48102 A Needle biopsy, pancreas 4.68 8.96 2.45 0.20 13.84 7.33 010 48120 A Removal of pancreas lesion 15.85 NA 7.69 1.35 NA 24.89 090 48140 A Partial removal of pancreas 22.94 NA 10.78 2.12 NA 35.84 090 48145 A Partial removal of pancreas 24.02 NA 11.48 2.25 NA 37.75 090Start Printed Page 55382 48146 A Pancreatectomy 26.40 NA 13.96 2.43 NA 42.79 090 48148 A Removal of pancreatic duct 17.34 NA 9.15 1.61 NA 28.10 090 48150 A Partial removal of pancreas 48.00 NA 21.29 4.43 NA 73.72 090 48152 A Pancreatectomy 43.75 NA 20.74 4.07 NA 68.56 090 48153 A Pancreatectomy 47.89 NA 22.18 4.40 NA 74.47 090 48154 A Pancreatectomy 44.10 NA 20.82 4.10 NA 69.02 090 48155 A Removal of pancreas 24.64 NA 13.89 2.30 NA 40.83 090 48160 N Pancreas removal/transplant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 48180 A Fuse pancreas and bowel 24.72 NA 11.16 2.24 NA 38.12 090 48400 A Injection, intraop add-on 1.95 NA 0.69 0.10 NA 2.74 ZZZ 48500 A Surgery of pancreatic cyst 15.28 NA 7.74 1.35 NA 24.37 090 48510 A Drain pancreatic pseudocyst 14.31 NA 7.45 1.07 NA 22.83 090 48511 A Drain pancreatic pseudocyst 4.00 NA 3.95 0.17 NA 8.12 000 48520 A Fuse pancreas cyst and bowel 15.59 NA 7.49 1.41 NA 24.49 090 48540 A Fuse pancreas cyst and bowel 19.72 NA 8.84 1.82 NA 30.38 090 48545 A Pancreatorrhaphy 18.18 NA 8.88 1.61 NA 28.67 090 48547 A Duodenal exclusion 25.83 NA 11.04 2.30 NA 39.17 090 48550 X Donor pancreatectomy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 48554 R Transpl allograft pancreas 34.17 NA 12.27 3.30 NA 49.74 090 48556 A Removal, allograft pancreas 15.71 NA 8.71 1.52 NA 25.94 090 48999 C Pancreas surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 49000 A Exploration of abdomen 11.68 NA 6.22 1.17 NA 19.07 090 49002 A Reopening of abdomen 10.49 NA 6.10 1.06 NA 17.65 090 49010 A Exploration behind abdomen 12.28 NA 7.05 1.22 NA 20.55 090 49020 A Drain abdominal abscess 22.84 NA 11.41 1.31 NA 35.56 090 49021 A Drain abdominal abscess 3.38 NA 5.84 0.16 NA 9.38 000 49040 A Drain, open, abdom abscess 13.52 NA 8.02 0.84 NA 22.38 090 49041 A Drain, percut, abdom abscess 4.00 NA 6.07 0.18 NA 10.25 000 49060 A Drain, open, retrop abscess 15.86 NA 9.62 0.77 NA 26.25 090 49061 A Drain, percut, retroper absc 3.70 NA 5.99 0.17 NA 9.86 000 49062 A Drain to peritoneal cavity 11.36 NA 7.06 1.08 NA 19.50 090 49080 A Puncture, peritoneal cavity 1.35 4.56 0.48 0.07 5.98 1.90 000 49081 A Removal of abdominal fluid 1.26 3.14 0.60 0.06 4.46 1.92 000 49085 A Remove abdomen foreign body 12.14 NA 6.72 0.88 NA 19.74 090 49180 A Biopsy, abdominal mass 1.73 8.50 0.60 0.08 10.31 2.41 000 49200 A Removal of abdominal lesion 10.25 NA 6.59 0.89 NA 17.73 090 49201 A Removal of abdominal lesion 14.84 NA 8.90 1.44 NA 25.18 090 49215 A Excise sacral spine tumor 33.50 NA 15.52 2.48 NA 51.50 090 49220 A Multiple surgery, abdomen 14.88 NA 7.94 1.51 NA 24.33 090 49250 A Excision of umbilicus 8.35 NA 5.26 0.84 NA 14.45 090 49255 A Removal of omentum 11.14 NA 6.66 1.12 NA 18.92 090 49320 A Diag laparo separate proc 5.10 NA 3.08 0.50 NA 8.68 010 49321 A Laparoscopy, biopsy 5.40 NA 3.07 0.53 NA 9.00 010 49322 A Laparoscopy, aspiration 5.70 NA 3.53 0.57 NA 9.80 010 49323 A Laparo drain lymphocele 9.48 NA 4.18 0.88 NA 14.54 090 49329 C Laparo proc, abdm/per/oment 0.00 0.00 0.00 0.00 0.00 0.00 YYY 49400 A Air injection into abdomen 1.88 NA 0.82 0.11 NA 2.81 000 49420 A Insert abdominal drain 2.22 NA 0.98 0.13 NA 3.33 000 49421 A Insert abdominal drain 5.54 NA 4.08 0.55 NA 10.17 090 49422 A Remove perm cannula/catheter 6.25 NA 3.01 0.63 NA 9.89 010 49423 A Exchange drainage catheter 1.46 NA 0.70 0.07 NA 2.23 000 49424 A Assess cyst, contrast inject 0.76 NA 0.45 0.03 NA 1.24 000 49425 A Insert abdomen-venous drain 11.37 NA 6.79 1.21 NA 19.37 090 49426 A Revise abdomen-venous shunt 9.63 NA 6.17 0.93 NA 16.73 090 49427 A Injection, abdominal shunt 0.89 NA 0.50 0.05 NA 1.44 000 49428 A Ligation of shunt 6.06 NA 3.19 0.31 NA 9.56 010 49429 A Removal of shunt 7.40 NA 3.55 0.81 NA 11.76 010 49491 A Repairing hern premie reduc 11.13 NA 5.65 1.00 NA 17.78 090 49492 A Rpr ing hern premie, blocked 14.03 NA 6.40 1.42 NA 21.85 090 49495 A Rpr ing hernia baby, reduc 5.89 NA 3.72 0.55 NA 10.16 090 49496 A Rpr ing hernia baby, blocked 8.79 NA 5.94 0.89 NA 15.62 090 49500 A Rpr ing hernia, init, reduce 5.48 NA 3.48 0.46 NA 9.42 090 49501 A Rpr ing hernia, init blocked 8.88 NA 4.62 0.76 NA 14.26 090 49505 A Rpr i/hern init reduc>5 yr 7.60 4.58 4.13 0.65 12.83 12.38 090 49507 A Rpr i/hern init block>5 yr 9.57 NA 6.17 0.83 NA 16.57 090 49520 A Rerepair ing hernia, reduce 9.63 NA 5.49 0.84 NA 15.96 090 49521 A Rerepair ing hernia, blocked 11.97 NA 5.85 1.04 NA 18.86 090 49525 A Repair ing hernia, sliding 8.57 NA 4.97 0.74 NA 14.28 090 49540 A Repair lumbar hernia 10.39 NA 5.65 0.90 NA 16.94 090 49550 A Rpr fem hernia, init, reduce 8.63 NA 4.55 0.75 NA 13.93 090 49553 A Rpr fem hernia, init blocked 9.44 NA 4.95 0.83 NA 15.22 090 49555 A Rerepair fem hernia, reduce 9.03 NA 5.30 0.79 NA 15.12 090 49557 A Rerepair fem hernia, blocked 11.15 NA 5.59 0.97 NA 17.71 090Start Printed Page 55383 49560 A Rpr ventral hern init, reduc 11.57 NA 6.11 1.00 NA 18.68 090 49561 A Rpr ventral hern init, block 14.25 NA 6.71 1.23 NA 22.19 090 49565 A Rerepair ventrl hern, reduce 11.57 NA 6.27 1.00 NA 18.84 090 49566 A Rerepair ventrl hern, block 14.40 NA 6.79 1.24 NA 22.43 090 49568 A Hernia repair w/mesh 4.89 NA 1.76 0.50 NA 7.15 ZZZ 49570 A Rpr epigastric hern, reduce 5.69 NA 3.54 0.50 NA 9.73 090 49572 A Rpr epigastric hern, blocked 6.73 NA 4.00 0.58 NA 11.31 090 49580 A Rpr umbil hern, reduc <5 yr 4.11 NA 3.03 0.34 NA 7.48 090 49582 A Rpr umbil hern, block < 5 yr 6.65 NA 5.02 0.57 NA 12.24 090 49585 A Rpr umbil hern, reduc > 5 yr 6.23 NA 4.15 0.53 NA 10.91 090 49587 A Rpr umbil hern, block > 5 yr 7.56 NA 4.27 0.65 NA 12.48 090 49590 A Repair spigelian hernia 8.54 NA 4.96 0.74 NA 14.24 090 49600 A Repair umbilical lesion 10.96 NA 6.30 1.13 NA 18.39 090 49605 A Repair umbilical lesion 76.00 NA 30.79 2.57 NA 109.36 090 49606 A Repair umbilical lesion 18.60 NA 9.61 2.22 NA 30.43 090 49610 A Repair umbilical lesion 10.50 NA 6.87 0.77 NA 18.14 090 49611 A Repair umbilical lesion 8.92 NA 6.56 0.65 NA 16.13 090 49650 A Laparo hernia repair initial 6.27 NA 3.33 0.64 NA 10.24 090 49651 A Laparo hernia repair recur 8.24 NA 4.40 0.84 NA 13.48 090 49659 C Laparo proc, hernia repair 0.00 0.00 0.00 0.00 0.00 0.00 YYY 49900 A Repair of abdominal wall 12.28 NA 6.80 1.23 NA 20.31 090 49905 A Omental flap 6.55 NA 2.44 0.61 NA 9.60 ZZZ 49906 C Free omental flap, microvasc 0.00 0.00 0.00 0.00 0.00 0.00 090 49999 C Abdomen surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 50010 A Exploration of kidney 10.98 NA 7.07 0.79 NA 18.84 090 50020 A Renal abscess, open drain 14.66 NA 13.72 0.80 NA 29.18 090 50021 A Renal abscess, percut drain 3.38 NA 10.46 0.15 NA 13.99 000 50040 A Drainage of kidney 14.94 NA 11.56 0.82 NA 27.32 090 50045 A Exploration of kidney 15.46 NA 8.55 1.06 NA 25.07 090 50060 A Removal of kidney stone 19.30 NA 10.03 1.14 NA 30.47 090 50065 A Incision of kidney 20.79 NA 10.56 1.13 NA 32.48 090 50070 A Incision of kidney 20.32 NA 10.70 1.20 NA 32.22 090 50075 A Removal of kidney stone 25.34 NA 12.65 1.51 NA 39.50 090 50080 A Removal of kidney stone 14.71 NA 11.03 0.86 NA 26.60 090 50081 A Removal of kidney stone 21.80 NA 13.27 1.30 NA 36.37 090 50100 A Revise kidney blood vessels 16.09 NA 9.34 1.64 NA 27.07 090 50120 A Exploration of kidney 15.91 NA 8.93 1.04 NA 25.88 090 50125 A Explore and drain kidney 16.52 NA 9.48 1.07 NA 27.07 090 50130 A Removal of kidney stone 17.29 NA 9.24 1.04 NA 27.57 090 50135 A Exploration of kidney 19.18 NA 9.93 1.18 NA 30.29 090 50200 A Biopsy of kidney 2.63 NA 0.96 0.12 NA 3.71 000 50205 A Biopsy of kidney 11.31 NA 6.52 0.94 NA 18.77 090 50220 A Remove kidney, open 17.15 NA 9.29 1.16 NA 27.60 090 50225 A Removal kidney open, complex 20.23 NA 10.30 1.26 NA 31.79 090 50230 A Removal kidney open, radical 22.07 NA 10.92 1.35 NA 34.34 090 50234 A Removal of kidney & ureter 22.40 NA 11.05 1.37 NA 34.82 090 50236 A Removal of kidney & ureter 24.86 NA 14.27 1.50 NA 40.63 090 50240 A Partial removal of kidney 22.00 NA 13.32 1.36 NA 36.68 090 50280 A Removal of kidney lesion 15.67 NA 8.69 0.99 NA 25.35 090 50290 A Removal of kidney lesion 14.73 NA 8.49 1.11 NA 24.33 090 50300 X Removal of donor kidney 0.00 0.00 0.00 0.00 0.00 0.00 XXX 50320 A Removal of donor kidney 22.21 NA 10.98 1.78 NA 34.97 090 50340 A Removal of kidney 12.15 NA 9.31 1.15 NA 22.61 090 50360 A Transplantation of kidney 31.53 NA 17.87 2.97 NA 52.37 090 50365 A Transplantation of kidney 36.81 NA 21.29 3.51 NA 61.61 090 50370 A Remove transplanted kidney 13.72 NA 9.88 1.26 NA 24.86 090 50380 A Reimplantation of kidney 20.76 NA 13.52 1.80 NA 36.08 090 50390 A Drainage of kidney lesion 1.96 NA 0.68 0.09 NA 2.73 000 50392 A Insert kidney drain 3.38 NA 1.18 0.15 NA 4.71 000 50393 A Insert ureteral tube 4.16 NA 1.44 0.18 NA 5.78 000 50394 A Injection for kidney x-ray 0.76 2.60 0.26 0.04 3.40 1.06 000 50395 A Create passage to kidney 3.38 NA 1.17 0.16 NA 4.71 000 50396 A Measure kidney pressure 2.09 NA 0.89 0.10 NA 3.08 000 50398 A Change kidney tube 1.46 1.06 0.51 0.07 2.59 2.04 000 50400 A Revision of kidney/ureter 19.50 NA 10.06 1.21 NA 30.77 090 50405 A Revision of kidney/ureter 23.93 NA 11.84 1.45 NA 37.22 090 50500 A Repair of kidney wound 19.57 NA 11.37 1.45 NA 32.39 090 50520 A Close kidney-skin fistula 17.23 NA 11.80 1.26 NA 30.29 090 50525 A Repair renal-abdomen fistula 22.27 NA 13.30 1.51 NA 37.08 090 50526 A Repair renal-abdomen fistula 24.02 NA 14.86 1.62 NA 40.50 090 50540 A Revision of horseshoe kidney 19.93 NA 10.42 1.28 NA 31.63 090 50541 A Laparo ablate renal cyst 16.00 NA 6.79 0.99 NA 23.78 090 50544 A Laparoscopy, pyeloplasty 22.40 NA 9.04 1.41 NA 32.85 090Start Printed Page 55384 50545 A Laparo radical nephrectomy 24.00 NA 9.65 1.53 NA 35.18 090 50546 A Laparoscopic nephrectomy 20.48 NA 8.40 1.37 NA 30.25 090 50547 A Laparo removal donor kidney 25.50 NA 11.27 2.04 NA 38.81 090 50548 A Laparo remove k/ureter 24.40 NA 9.70 1.49 NA 35.59 090 50549 C Laparoscope proc, renal 0.00 0.00 0.00 0.00 0.00 0.00 YYY 50551 A Kidney endoscopy 5.60 4.93 1.90 0.33 10.86 7.83 000 50553 A Kidney endoscopy 5.99 16.25 2.05 0.35 22.59 8.39 000 50555 A Kidney endoscopy & biopsy 6.53 20.11 2.25 0.38 27.02 9.16 000 50557 A Kidney endoscopy & treatment 6.62 20.23 2.25 0.39 27.24 9.26 000 50559 A Renal endoscopy/radiotracer 6.78 NA 2.42 0.27 NA 9.47 000 50561 A Kidney endoscopy & treatment 7.59 18.31 2.58 0.44 26.34 10.61 000 50570 A Kidney endoscopy 9.54 NA 3.24 0.56 NA 13.34 000 50572 A Kidney endoscopy 10.35 NA 3.52 0.64 NA 14.51 000 50574 A Kidney endoscopy & biopsy 11.02 NA 3.87 0.65 NA 15.54 000 50575 A Kidney endoscopy 13.98 NA 4.73 0.84 NA 19.55 000 50576 A Kidney endoscopy & treatment 10.99 NA 3.74 0.66 NA 15.39 000 50578 A Renal endoscopy/radiotracer 11.35 NA 4.01 0.67 NA 16.03 000 50580 A Kidney endoscopy & treatment 11.86 NA 4.03 0.70 NA 16.59 000 50590 A Fragmenting of kidney stone 9.09 10.78 5.35 0.54 20.41 14.98 090 50600 A Exploration of ureter 15.84 NA 9.07 0.99 NA 25.90 090 50605 A Insert ureteral support 15.46 NA 8.88 1.13 NA 25.47 090 50610 A Removal of ureter stone 15.92 NA 9.09 1.08 NA 26.09 090 50620 A Removal of ureter stone 15.16 NA 8.55 0.91 NA 24.62 090 50630 A Removal of ureter stone 14.94 NA 8.48 0.90 NA 24.32 090 50650 A Removal of ureter 17.41 NA 9.71 1.07 NA 28.19 090 50660 A Removal of ureter 19.55 NA 10.43 1.19 NA 31.17 090 50684 A Injection for ureter x-ray 0.76 15.02 0.26 0.04 15.82 1.06 000 50686 A Measure ureter pressure 1.51 5.08 0.65 0.09 6.68 2.25 000 50688 A Change of ureter tube 1.17 NA 1.76 0.06 NA 2.99 010 50690 A Injection for ureter x-ray 1.16 15.40 0.40 0.06 16.62 1.62 000 50700 A Revision of ureter 15.21 NA 9.09 0.86 NA 25.16 090 50715 A Release of ureter 18.90 NA 12.37 1.68 NA 32.95 090 50722 A Release of ureter 16.35 NA 10.42 1.41 NA 28.18 090 50725 A Release/revise ureter 18.49 NA 10.61 1.44 NA 30.54 090 50727 A Revise ureter 8.18 NA 6.54 0.51 NA 15.23 090 50728 A Revise ureter 12.02 NA 8.18 0.88 NA 21.08 090 50740 A Fusion of ureter & kidney 18.42 NA 9.66 1.49 NA 29.57 090 50750 A Fusion of ureter & kidney 19.51 NA 10.48 1.24 NA 31.23 090 50760 A Fusion of ureters 18.42 NA 10.11 1.25 NA 29.78 090 50770 A Splicing of ureters 19.51 NA 10.43 1.25 NA 31.19 090 50780 A Reimplant ureter in bladder 18.36 NA 10.01 1.20 NA 29.57 090 50782 A Reimplant ureter in bladder 19.54 NA 11.91 1.13 NA 32.58 090 50783 A Reimplant ureter in bladder 20.55 NA 11.22 1.35 NA 33.12 090 50785 A Reimplant ureter in bladder 20.52 NA 10.83 1.30 NA 32.65 090 50800 A Implant ureter in bowel 14.52 NA 10.02 0.92 NA 25.46 090 50810 A Fusion of ureter & bowel 20.05 NA 12.23 1.78 NA 34.06 090 50815 A Urine shunt to intestine 19.93 NA 11.71 1.31 NA 32.95 090 50820 A Construct bowel bladder 21.89 NA 12.38 1.38 NA 35.65 090 50825 A Construct bowel bladder 28.18 NA 15.30 1.81 NA 45.29 090 50830 A Revise urine flow 31.28 NA 15.96 2.20 NA 49.44 090 50840 A Replace ureter by bowel 20.00 NA 11.83 1.26 NA 33.09 090 50845 A Appendico-vesicostomy 20.89 NA 10.20 1.26 NA 32.35 090 50860 A Transplant ureter to skin 15.36 NA 8.93 1.01 NA 25.30 090 50900 A Repair of ureter 13.62 NA 8.08 0.98 NA 22.68 090 50920 A Closure ureter/skin fistula 14.33 NA 8.37 0.84 NA 23.54 090 50930 A Closure ureter/bowel fistula 18.72 NA 10.80 1.57 NA 31.09 090 50940 A Release of ureter 14.51 NA 8.44 1.04 NA 23.99 090 50945 A Laparoscopy ureterolithotomy 17.00 NA 7.42 1.15 NA 25.57 090 50947 A Laparo new ureter/bladder 24.50 NA 11.74 1.99 NA 38.23 090 50948 A Laparo new ureter/bladder 22.50 NA 10.61 1.83 NA 34.94 090 50949 C Laparoscope proc, ureter 0.00 0.00 0.00 0.00 0.00 0.00 YYY 50951 A Endoscopy of ureter 5.84 5.28 1.98 0.35 11.47 8.17 000 50953 A Endoscopy of ureter 6.24 16.55 2.12 0.37 23.16 8.73 000 50955 A Ureter endoscopy & biopsy 6.75 21.11 2.38 0.38 28.24 9.51 000 50957 A Ureter endoscopy & treatment 6.79 19.64 2.28 0.40 26.83 9.47 000 50959 A Ureter endoscopy & tracer 4.40 NA 1.58 0.18 NA 6.16 000 50961 A Ureter endoscopy & treatment 6.05 23.38 2.04 0.35 29.78 8.44 000 50970 A Ureter endoscopy 7.14 NA 2.43 0.43 NA 10.00 000 50972 A Ureter endoscopy & catheter 6.89 NA 2.52 0.39 NA 9.80 000 50974 A Ureter endoscopy & biopsy 9.17 NA 3.16 0.53 NA 12.86 000 50976 A Ureter endoscopy & treatment 9.04 NA 3.09 0.53 NA 12.66 000 50978 A Ureter endoscopy & tracer 5.10 NA 1.88 0.30 NA 7.28 000 50980 A Ureter endoscopy & treatment 6.85 NA 2.34 0.41 NA 9.60 000Start Printed Page 55385 51000 A Drainage of bladder 0.78 2.03 0.25 0.05 2.86 1.08 000 51005 A Drainage of bladder 1.02 3.37 0.35 0.08 4.47 1.45 000 51010 A Drainage of bladder 3.53 4.42 2.37 0.23 8.18 6.13 010 51020 A Incise & treat bladder 6.71 NA 5.72 0.42 NA 12.85 090 51030 A Incise & treat bladder 6.77 NA 6.01 0.42 NA 13.20 090 51040 A Incise & drain bladder 4.40 NA 4.47 0.27 NA 9.14 090 51045 A Incise bladder/drain ureter 6.77 NA 6.01 0.47 NA 13.25 090 51050 A Removal of bladder stone 6.92 NA 5.27 0.42 NA 12.61 090 51060 A Removal of ureter stone 8.85 NA 6.53 0.54 NA 15.92 090 51065 A Remove ureter calculus 8.85 NA 6.06 0.53 NA 15.44 090 51080 A Drainage of bladder abscess 5.96 NA 5.67 0.35 NA 11.98 090 51500 A Removal of bladder cyst 10.14 NA 6.13 0.88 NA 17.15 090 51520 A Removal of bladder lesion 9.29 NA 6.66 0.58 NA 16.53 090 51525 A Removal of bladder lesion 13.97 NA 8.15 0.85 NA 22.97 090 51530 A Removal of bladder lesion 12.38 NA 7.81 0.82 NA 21.01 090 51535 A Repair of ureter lesion 12.57 NA 8.23 0.90 NA 21.70 090 51550 A Partial removal of bladder 15.66 NA 8.68 1.05 NA 25.39 090 51555 A Partial removal of bladder 21.23 NA 11.00 1.37 NA 33.60 090 51565 A Revise bladder & ureter(s) 21.62 NA 11.62 1.40 NA 34.64 090 51570 A Removal of bladder 24.24 NA 12.60 1.59 NA 38.43 090 51575 A Removal of bladder & nodes 30.45 NA 15.35 1.88 NA 47.68 090 51580 A Remove bladder/revise tract 31.08 NA 16.01 1.94 NA 49.03 090 51585 A Removal of bladder & nodes 35.23 NA 17.34 2.18 NA 54.75 090 51590 A Remove bladder/revise tract 32.66 NA 16.01 2.01 NA 50.68 090 51595 A Remove bladder/revise tract 37.14 NA 17.55 2.23 NA 56.92 090 51596 A Remove bladder/create pouch 39.52 NA 18.94 2.39 NA 60.85 090 51597 A Removal of pelvic structures 38.35 NA 18.06 2.49 NA 58.90 090 51600 A Injection for bladder x-ray 0.88 5.51 0.30 0.04 6.43 1.22 000 51605 A Preparation for bladder x-ray 0.64 16.73 0.22 0.04 17.41 0.90 000 51610 A Injection for bladder x-ray 1.05 16.20 0.36 0.05 17.30 1.46 000 51700 A Irrigation of bladder 0.88 1.32 0.30 0.05 2.25 1.23 000 51705 A Change of bladder tube 1.02 2.15 0.65 0.06 3.23 1.73 010 51710 A Change of bladder tube 1.49 5.11 1.47 0.09 6.69 3.05 010 51715 A Endoscopic injection/implant 3.74 4.44 1.29 0.24 8.42 5.27 000 51720 A Treatment of bladder lesion 1.96 1.68 0.74 0.12 3.76 2.82 000 51725 A Simple cystometrogram 1.51 5.92 NA 0.13 7.56 NA 000 51725 26 A Simple cystometrogram 1.51 0.52 0.52 0.10 2.13 2.13 000 51725 TC A Simple cystometrogram 0.00 5.40 NA 0.03 5.43 NA 000 51726 A Complex cystometrogram 1.71 4.65 NA 0.15 6.51 NA 000 51726 26 A Complex cystometrogram 1.71 0.59 0.59 0.11 2.41 2.41 000 51726 TC A Complex cystometrogram 0.00 4.06 NA 0.04 4.10 NA 000 51736 A Urine flow measurement 0.61 1.07 NA 0.05 1.73 NA 000 51736 26 A Urine flow measurement 0.61 0.21 0.21 0.04 0.86 0.86 000 51736 TC A Urine flow measurement 0.00 0.86 NA 0.01 0.87 NA 000 51741 A Electro-uroflowmetry, first 1.14 1.93 NA 0.09 3.16 NA 000 51741 26 A Electro-uroflowmetry, first 1.14 0.40 0.40 0.07 1.61 1.61 000 51741 TC A Electro-uroflowmetry, first 0.00 1.53 NA 0.02 1.55 NA 000 51772 A Urethra pressure profile 1.61 4.73 NA 0.16 6.50 NA 000 51772 26 A Urethra pressure profile 1.61 0.59 0.59 0.12 2.32 2.32 000 51772 TC A Urethra pressure profile 0.00 4.14 NA 0.04 4.18 NA 000 51784 A Anal/urinary muscle study 1.53 3.36 NA 0.13 5.02 NA 000 51784 26 A Anal/urinary muscle study 1.53 0.53 0.53 0.10 2.16 2.16 000 51784 TC A Anal/urinary muscle study 0.00 2.83 NA 0.03 2.86 NA 000 51785 A Anal/urinary muscle study 1.53 3.46 NA 0.12 5.11 NA 000 51785 26 A Anal/urinary muscle study 1.53 0.53 0.53 0.09 2.15 2.15 000 51785 TC A Anal/urinary muscle study 0.00 2.93 NA 0.03 2.96 NA 000 51792 A Urinary reflex study 1.10 3.33 NA 0.20 4.63 NA 000 51792 26 A Urinary reflex study 1.10 0.43 0.43 0.09 1.62 1.62 000 51792 TC A Urinary reflex study 0.00 2.90 NA 0.11 3.01 NA 000 51795 A Urine voiding pressure study 1.53 4.84 NA 0.18 6.55 NA 000 51795 26 A Urine voiding pressure study 1.53 0.53 0.53 0.10 2.16 2.16 000 51795 TC A Urine voiding pressure study 0.00 4.31 NA 0.08 4.39 NA 000 51797 A Intraabdominal pressure test 1.60 4.87 NA 0.14 6.61 NA 000 51797 26 A Intraabdominal pressure test 1.60 0.56 0.56 0.10 2.26 2.26 000 51797 TC A Intraabdominal pressure test 0.00 4.31 NA 0.04 4.35 NA 000 51800 A Revision of bladder/urethra 17.42 NA 9.59 1.17 NA 28.18 090 51820 A Revision of urinary tract 17.89 NA 10.91 1.45 NA 30.25 090 51840 A Attach bladder/urethra 10.71 NA 6.88 0.87 NA 18.46 090 51841 A Attach bladder/urethra 13.03 NA 8.57 1.04 NA 22.64 090 51845 A Repair bladder neck 9.73 NA 6.90 0.62 NA 17.25 090 51860 A Repair of bladder wound 12.02 NA 7.90 0.89 NA 20.81 090 51865 A Repair of bladder wound 15.04 NA 8.93 1.01 NA 24.98 090 51880 A Repair of bladder opening 7.66 NA 5.98 0.54 NA 14.18 090Start Printed Page 55386 51900 A Repair bladder/vagina lesion 12.97 NA 8.29 0.87 NA 22.13 090 51920 A Close bladder-uterus fistula 11.81 NA 7.65 0.86 NA 20.32 090 51925 A Hysterectomy/bladder repair 15.58 NA 9.65 1.48 NA 26.71 090 51940 A Correction of bladder defect 28.43 NA 16.41 1.97 NA 46.81 090 51960 A Revision of bladder & bowel 23.01 NA 13.39 1.41 NA 37.81 090 51980 A Construct bladder opening 11.36 NA 7.30 0.74 NA 19.40 090 51990 A Laparo urethral suspension 12.50 NA 6.79 1.02 NA 20.31 090 51992 A Laparo sling operation 14.01 NA 6.81 0.93 NA 21.75 090 52000 A Cystoscopy 2.01 3.45 0.69 0.12 5.58 2.82 000 52001 A Cystoscopy, removal of clots 2.37 NA 0.98 0.32 NA 3.67 000 52005 A Cystoscopy & ureter catheter 2.37 13.40 0.91 0.15 15.92 3.43 000 52007 A Cystoscopy and biopsy 3.02 NA 1.02 0.18 NA 4.22 000 52010 A Cystoscopy & duct catheter 3.02 5.91 1.02 0.18 9.11 4.22 000 52204 A Cystoscopy 2.37 6.17 0.80 0.15 8.69 3.32 000 52214 A Cystoscopy and treatment 3.71 6.53 1.26 0.22 10.46 5.19 000 52224 A Cystoscopy and treatment 3.14 6.41 1.07 0.18 9.73 4.39 000 52234 A Cystoscopy and treatment 4.63 NA 1.68 0.27 NA 6.58 000 52235 A Cystoscopy and treatment 5.45 NA 1.97 0.32 NA 7.74 000 52240 A Cystoscopy and treatment 9.72 NA 3.43 0.58 NA 13.73 000 52250 A Cystoscopy and radiotracer 4.50 NA 1.53 0.27 NA 6.30 000 52260 A Cystoscopy and treatment 3.92 NA 1.34 0.23 NA 5.49 000 52265 A Cystoscopy and treatment 2.94 3.77 1.00 0.18 6.89 4.12 000 52270 A Cystoscopy & revise urethra 3.37 6.88 1.14 0.20 10.45 4.71 000 52275 A Cystoscopy & revise urethra 4.70 7.42 1.59 0.28 12.40 6.57 000 52276 A Cystoscopy and treatment 5.00 7.55 1.70 0.30 12.85 7.00 000 52277 A Cystoscopy and treatment 6.17 NA 2.12 0.38 NA 8.67 000 52281 A Cystoscopy and treatment 2.80 14.54 1.08 0.17 17.51 4.05 000 52282 A Cystoscopy, implant stent 6.40 15.36 2.18 0.38 22.14 8.96 000 52283 A Cystoscopy and treatment 3.74 6.58 1.27 0.22 10.54 5.23 000 52285 A Cystoscopy and treatment 3.61 7.06 1.23 0.22 10.89 5.06 000 52290 A Cystoscopy and treatment 4.59 NA 1.56 0.27 NA 6.42 000 52300 A Cystoscopy and treatment 5.31 NA 1.80 0.32 NA 7.43 000 52301 A Cystoscopy and treatment 5.51 NA 1.82 0.39 NA 7.72 000 52305 A Cystoscopy and treatment 5.31 NA 1.80 0.31 NA 7.42 000 52310 A Cystoscopy and treatment 2.81 3.85 1.02 0.17 6.83 4.00 000 52315 A Cystoscopy and treatment 5.21 16.43 1.76 0.31 21.95 7.28 000 52317 A Remove bladder stone 6.72 26.09 2.28 0.40 33.21 9.40 000 52318 A Remove bladder stone 9.19 NA 3.11 0.54 NA 12.84 000 52320 A Cystoscopy and treatment 4.70 NA 1.59 0.28 NA 6.57 000 52325 A Cystoscopy, stone removal 6.16 NA 2.08 0.37 NA 8.61 000 52327 A Cystoscopy, inject material 5.19 NA 1.77 0.32 NA 7.28 000 52330 A Cystoscopy and treatment 5.04 20.79 1.71 0.30 26.13 7.05 000 52332 A Cystoscopy and treatment 2.83 18.84 1.07 0.17 21.84 4.07 000 52334 A Create passage to kidney 4.83 NA 1.63 0.28 NA 6.74 000 52341 A Cysto w/ureter stricture tx 6.00 NA 2.40 0.37 NA 8.77 000 52342 A Cysto w/up stricture tx 6.50 NA 2.59 0.40 NA 9.49 000 52343 A Cysto w/renal stricture tx 7.20 NA 2.87 0.44 NA 10.51 000 52344 A Cysto/uretero, stone remove 7.70 NA 3.07 0.47 NA 11.24 000 52345 A Cysto/uretero w/up stricture 8.20 NA 3.27 0.50 NA 11.97 000 52346 A Cystouretero w/renal strict 9.23 NA 3.68 0.57 NA 13.48 000 52347 A Cystoscopy, resect ducts 5.28 NA 2.14 0.33 NA 7.75 000 52351 A Cystouretro & or pyeloscope 5.86 NA 1.99 0.36 NA 8.21 000 52352 A Cystouretro w/stone remove 6.88 NA 2.33 0.42 NA 9.63 000 52353 A Cystouretero w/lithotripsy 7.97 NA 2.69 0.49 NA 11.15 000 52354 A Cystouretero w/biopsy 7.34 NA 2.49 0.45 NA 10.28 000 52355 A Cystouretero w/excise tumor 8.82 NA 2.99 0.55 NA 12.36 000 52400 A Cystouretero w/congen repr 9.68 NA 5.75 0.60 NA 16.03 090 52450 A Incision of prostate 7.64 NA 6.56 0.46 NA 14.66 090 52500 A Revision of bladder neck 8.47 NA 6.81 0.50 NA 15.78 090 52510 A Dilation prostatic urethra 6.72 NA 5.80 0.40 NA 12.92 090 52601 A Prostatectomy (TURP) 12.37 NA 8.16 0.74 NA 21.27 090 52606 A Control postop bleeding 8.13 NA 6.27 0.49 NA 14.89 090 52612 A Prostatectomy, first stage 7.98 NA 6.72 0.48 NA 15.18 090 52614 A Prostatectomy, second stage 6.84 NA 6.30 0.41 NA 13.55 090 52620 A Remove residual prostate 6.61 NA 6.22 0.39 NA 13.22 090 52630 A Remove prostate regrowth 7.26 NA 6.44 0.43 NA 14.13 090 52640 A Relieve bladder contracture 6.62 NA 5.73 0.39 NA 12.74 090 52647 A Laser surgery of prostate 10.36 59.33 4.85 0.61 70.30 15.82 090 52648 A Laser surgery of prostate 11.21 NA 7.63 0.66 NA 19.50 090 52700 A Drainage of prostate abscess 6.80 NA 6.32 0.41 NA 13.53 090 53000 A Incision of urethra 2.28 7.47 2.63 0.13 9.88 5.04 010 53010 A Incision of urethra 3.64 NA 4.12 0.20 NA 7.96 090 53020 A Incision of urethra 1.77 4.43 0.67 0.11 6.31 2.55 000Start Printed Page 55387 53025 A Incision of urethra 1.13 4.81 0.45 0.07 6.01 1.65 000 53040 A Drainage of urethra abscess 6.40 14.74 8.33 0.41 21.55 15.14 090 53060 A Drainage of urethra abscess 2.63 6.21 2.91 0.23 9.07 5.77 010 53080 A Drainage of urinary leakage 6.29 NA 8.37 0.42 NA 15.08 090 53085 A Drainage of urinary leakage 10.27 NA 10.29 0.67 NA 21.23 090 53200 A Biopsy of urethra 2.59 5.63 0.97 0.17 8.39 3.73 000 53210 A Removal of urethra 12.57 NA 8.00 0.81 NA 21.38 090 53215 A Removal of urethra 15.58 NA 8.81 0.93 NA 25.32 090 53220 A Treatment of urethra lesion 7.00 NA 5.71 0.44 NA 13.15 090 53230 A Removal of urethra lesion 9.58 NA 6.36 0.60 NA 16.54 090 53235 A Removal of urethra lesion 10.14 NA 6.49 0.60 NA 17.23 090 53240 A Surgery for urethra pouch 6.45 NA 5.32 0.42 NA 12.19 090 53250 A Removal of urethra gland 5.89 NA 4.74 0.35 NA 10.98 090 53260 A Treatment of urethra lesion 2.98 6.11 2.44 0.23 9.32 5.65 010 53265 A Treatment of urethra lesion 3.12 6.60 2.42 0.20 9.92 5.74 010 53270 A Removal of urethra gland 3.09 7.03 2.83 0.21 10.33 6.13 010 53275 A Repair of urethra defect 4.53 NA 3.43 0.28 NA 8.24 010 53400 A Revise urethra, stage 1 12.77 NA 8.31 0.85 NA 21.93 090 53405 A Revise urethra, stage 2 14.48 NA 8.61 0.91 NA 24.00 090 53410 A Reconstruction of urethra 16.44 NA 9.21 0.99 NA 26.64 090 53415 A Reconstruction of urethra 19.41 NA 10.16 1.16 NA 30.73 090 53420 A Reconstruct urethra, stage 1 14.08 NA 8.82 0.90 NA 23.80 090 53425 A Reconstruct urethra, stage 2 15.98 NA 9.02 0.97 NA 25.97 090 53430 A Reconstruction of urethra 16.34 NA 9.34 1.01 NA 26.69 090 53431 A Reconstruct urethra/bladder 19.89 7.94 7.94 1.25 29.08 29.08 090 53440 A Correct bladder function 12.34 NA 8.09 0.73 NA 21.16 090 53442 A Remove perineal prosthesis 8.27 NA 6.08 0.55 NA 14.90 090 53443 D Reconstruction of urethra 0.00 NA 0.00 0.00 NA 0.00 090 53444 A Insert tandem cuff 13.40 NA 6.66 0.79 NA 20.85 090 53445 A Insert uro/ves nck sphincter 14.06 NA 8.72 0.84 NA 23.62 090 53446 A Remove uro sphincter 10.23 NA 8.46 0.61 NA 19.30 090 53447 A Remove/replace ur sphincter 13.49 NA 7.90 0.79 NA 22.18 090 53448 A Remov/replc ur sphinctr comp 21.15 NA 12.35 1.27 NA 34.77 090 53449 A Repair uro sphincter 9.70 NA 6.73 0.57 NA 17.00 090 53450 A Revision of urethra 6.14 NA 5.16 0.37 NA 11.67 090 53460 A Revision of urethra 7.12 NA 5.50 0.43 NA 13.05 090 53502 A Repair of urethra injury 7.63 NA 5.80 0.50 NA 13.93 090 53505 A Repair of urethra injury 7.63 NA 5.62 0.46 NA 13.71 090 53510 A Repair of urethra injury 10.11 NA 6.58 0.60 NA 17.29 090 53515 A Repair of urethra injury 13.31 NA 7.81 0.83 NA 21.95 090 53520 A Repair of urethra defect 8.68 NA 6.12 0.53 NA 15.33 090 53600 A Dilate urethra stricture 1.21 1.19 0.46 0.07 2.47 1.74 000 53601 A Dilate urethra stricture 0.98 1.31 0.40 0.06 2.35 1.44 000 53605 A Dilate urethra stricture 1.28 NA 0.44 0.08 NA 1.80 000 53620 A Dilate urethra stricture 1.62 1.91 0.63 0.10 3.63 2.35 000 53621 A Dilate urethra stricture 1.35 2.00 0.52 0.08 3.43 1.95 000 53660 A Dilation of urethra 0.71 1.22 0.33 0.04 1.97 1.08 000 53661 A Dilation of urethra 0.72 1.21 0.31 0.04 1.97 1.07 000 53665 A Dilation of urethra 0.76 NA 0.27 0.05 NA 1.08 000 53670 A Insert urinary catheter 0.50 1.74 0.18 0.03 2.27 0.71 000 53675 A Insert urinary catheter 1.47 2.63 0.58 0.09 4.19 2.14 000 53850 A Prostatic microwave thermotx 9.45 87.54 4.50 0.56 97.55 14.51 090 53852 A Prostatic rf thermotx 9.88 75.53 4.68 0.58 85.99 15.14 090 53853 A Prostatic water thermother 4.14 52.75 2.55 0.38 57.27 7.07 090 53899 C Urology surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 54000 A Slitting of prepuce 1.54 5.66 1.51 0.10 7.30 3.15 010 54001 A Slitting of prepuce 2.19 6.56 2.15 0.14 8.89 4.48 010 54015 A Drain penis lesion 5.32 7.95 3.21 0.33 13.60 8.86 010 54050 A Destruction, penis lesion(s) 1.24 2.85 0.47 0.07 4.16 1.78 010 54055 A Destruction, penis lesion(s) 1.22 6.64 1.42 0.07 7.93 2.71 010 54056 A Cryosurgery, penis lesion(s) 1.24 2.96 0.58 0.06 4.26 1.88 010 54057 A Laser surg, penis lesion(s) 1.24 2.97 1.41 0.08 4.29 2.73 010 54060 A Excision of penis lesion(s) 1.93 5.65 1.66 0.12 7.70 3.71 010 54065 A Destruction, penis lesion(s) 2.42 5.38 2.24 0.13 7.93 4.79 010 54100 A Biopsy of penis 1.90 3.54 0.77 0.10 5.54 2.77 000 54105 A Biopsy of penis 3.50 6.75 2.19 0.21 10.46 5.90 010 54110 A Treatment of penis lesion 10.13 NA 8.20 0.60 NA 18.93 090 54111 A Treat penis lesion, graft 13.57 NA 9.37 0.79 NA 23.73 090 54112 A Treat penis lesion, graft 15.86 NA 10.08 0.94 NA 26.88 090 54115 A Treatment of penis lesion 6.15 11.63 6.77 0.39 18.17 13.31 090 54120 A Partial removal of penis 9.97 NA 8.14 0.60 NA 18.71 090 54125 A Removal of penis 13.53 NA 9.37 0.81 NA 23.71 090 54130 A Remove penis & nodes 20.14 NA 12.00 1.19 NA 33.33 090Start Printed Page 55388 54135 A Remove penis & nodes 26.36 NA 14.68 1.58 NA 42.62 090 54150 A Circumcision 1.81 6.04 1.87 0.17 8.02 3.85 010 54152 A Circumcision 2.31 NA 1.76 0.16 NA 4.23 010 54160 A Circumcision 2.48 5.04 1.82 0.16 7.68 4.46 010 54161 A Circumcision 3.27 NA 2.10 0.20 NA 5.57 010 54162 A Lysis penil circumcis lesion 3.00 NA 2.91 0.18 NA 6.09 010 54163 A Repair of circumcision 3.00 NA 2.54 0.18 NA 5.72 010 54164 A Frenulotomy of penis 2.50 NA 2.37 0.15 NA 5.02 010 54200 A Treatment of penis lesion 1.06 2.87 0.38 0.06 3.99 1.50 010 54205 A Treatment of penis lesion 7.93 NA 7.50 0.47 NA 15.90 090 54220 A Treatment of penis lesion 2.42 2.08 1.04 0.15 4.65 3.61 000 54230 A Prepare penis study 1.34 NA 0.46 0.08 NA 1.88 000 54231 A Dynamic cavernosometry 2.04 2.26 0.83 0.14 4.44 3.01 000 54235 A Penile injection 1.19 1.19 0.41 0.07 2.45 1.67 000 54240 A Penis study 1.31 1.59 NA 0.13 3.03 NA 000 54240 26 A Penis study 1.31 0.45 0.45 0.08 1.84 1.84 000 54240 TC A Penis study 0.00 1.14 NA 0.05 1.19 NA 000 54250 A Penis study 2.22 2.90 NA 0.16 5.28 NA 000 54250 26 A Penis study 2.22 0.75 0.75 0.14 3.11 3.11 000 54250 TC A Penis study 0.00 2.15 NA 0.02 2.17 NA 000 54300 A Revision of penis 10.41 NA 8.89 0.64 NA 19.94 090 54304 A Revision of penis 12.49 NA 10.04 0.74 NA 23.27 090 54308 A Reconstruction of urethra 11.83 NA 9.94 0.70 NA 22.47 090 54312 A Reconstruction of urethra 13.57 NA 10.73 0.81 NA 25.11 090 54316 A Reconstruction of urethra 16.82 NA 11.67 1.00 NA 29.49 090 54318 A Reconstruction of urethra 11.25 NA 10.06 1.15 NA 22.46 090 54322 A Reconstruction of urethra 13.01 NA 9.56 0.77 NA 23.34 090 54324 A Reconstruction of urethra 16.31 NA 12.02 1.03 NA 29.36 090 54326 A Reconstruction of urethra 15.72 NA 11.17 0.93 NA 27.82 090 54328 A Revise penis/urethra 15.65 NA 11.59 0.92 NA 28.16 090 54332 A Revise penis/urethra 17.08 NA 11.87 1.01 NA 29.96 090 54336 A Revise penis/urethra 20.04 NA 13.59 1.90 NA 35.53 090 54340 A Secondary urethral surgery 8.91 NA 9.80 0.72 NA 19.43 090 54344 A Secondary urethral surgery 15.94 NA 10.91 1.10 NA 27.95 090 54348 A Secondary urethral surgery 17.15 NA 12.10 1.02 NA 30.27 090 54352 A Reconstruct urethra/penis 24.74 NA 16.53 1.62 NA 42.89 090 54360 A Penis plastic surgery 11.93 NA 8.82 0.72 NA 21.47 090 54380 A Repair penis 13.18 NA 10.79 1.16 NA 25.13 090 54385 A Repair penis 15.39 NA 12.20 0.71 NA 28.30 090 54390 A Repair penis and bladder 21.61 NA 14.69 1.28 NA 37.58 090 54400 A Insert semi-rigid prosthesis 8.99 NA 6.53 0.53 NA 16.05 090 54401 A Insert self-contd prosthesis 10.28 NA 7.37 0.61 NA 18.26 090 54402 D Remove penis prosthesis 0.00 NA 0.00 0.00 NA 0.00 090 54405 A Insert multi-comp penis pros 13.43 NA 8.45 0.80 NA 22.68 090 54406 A Remove multi-comp penis pros 12.10 NA 6.09 0.80 NA 18.99 090 54407 D Remove multi-comp prosthesis 0.00 NA 0.00 0.00 NA 0.00 090 54408 A Repair multi-comp penis pros 12.75 NA 6.46 0.80 NA 20.01 090 54409 D Revise penis prosthesis 0.00 NA 0.00 0.00 NA 0.00 090 54410 A Remove/replace penis prosth 15.50 NA 7.36 0.80 NA 23.66 090 54411 A Remv/replc penis pros, comp 16.00 NA 8.98 0.80 NA 25.78 090 54415 A Remove self-contd penis pros 8.20 NA 5.35 0.55 NA 14.10 090 54416 A Remv/repl penis contain pros 10.87 NA 6.94 0.55 NA 18.36 090 54417 A Remv/replc penis pros, compl 14.19 NA 7.89 0.55 NA 22.63 090 54420 A Revision of penis 11.42 NA 8.70 0.72 NA 20.84 090 54430 A Revision of penis 10.15 NA 8.17 0.60 NA 18.92 090 54435 A Revision of penis 6.12 NA 6.30 0.36 NA 12.78 090 54440 C Repair of penis 0.00 0.00 0.00 0.00 0.00 0.00 090 54450 A Preputial stretching 1.12 1.10 0.49 0.07 2.29 1.68 000 54500 A Biopsy of testis 1.31 6.26 0.45 0.08 7.65 1.84 000 54505 A Biopsy of testis 3.46 NA 2.75 0.21 NA 6.42 010 54510 D Removal of testis lesion 0.00 NA 0.00 0.00 NA 0.00 090 54512 A Excise lesion testis 8.58 NA 5.19 0.56 NA 14.33 090 54520 A Removal of testis 5.23 NA 3.75 0.33 NA 9.31 090 54522 A Orchiectomy, partial 9.50 NA 6.15 0.62 NA 16.27 090 54530 A Removal of testis 8.58 NA 5.46 0.53 NA 14.57 090 54535 A Extensive testis surgery 12.16 NA 7.62 0.83 NA 20.61 090 54550 A Exploration for testis 7.78 NA 4.97 0.49 NA 13.24 090 54560 A Exploration for testis 11.13 NA 7.10 0.79 NA 19.02 090 54600 A Reduce testis torsion 7.01 NA 4.38 0.45 NA 11.84 090 54620 A Suspension of testis 4.90 NA 3.26 0.31 NA 8.47 010 54640 A Suspension of testis 6.90 NA 4.40 0.49 NA 11.79 090 54650 A Orchiopexy (Fowler-Stephens) 11.45 NA 7.29 0.81 NA 19.55 090 54660 A Revision of testis 5.11 NA 3.65 0.35 NA 9.11 090Start Printed Page 55389 54670 A Repair testis injury 6.41 NA 4.30 0.41 NA 11.12 090 54680 A Relocation of testis(es) 12.65 NA 7.65 0.94 NA 21.24 090 54690 A Laparoscopy, orchiectomy 10.96 NA 7.08 0.99 NA 19.03 090 54692 A Laparoscopy, orchiopexy 12.88 NA 5.84 0.87 NA 19.59 090 54699 C Laparoscope proc, testis 0.00 0.00 0.00 0.00 0.00 0.00 YYY 54700 A Drainage of scrotum 3.43 8.80 3.53 0.23 12.46 7.19 010 54800 A Biopsy of epididymis 2.33 6.45 0.79 0.14 8.92 3.26 000 54820 A Exploration of epididymis 5.14 NA 3.61 0.33 NA 9.08 090 54830 A Remove epididymis lesion 5.38 NA 3.85 0.34 NA 9.57 090 54840 A Remove epididymis lesion 5.20 NA 3.79 0.31 NA 9.30 090 54860 A Removal of epididymis 6.32 NA 4.40 0.38 NA 11.10 090 54861 A Removal of epididymis 8.90 NA 5.28 0.52 NA 14.70 090 54900 A Fusion of spermatic ducts 13.20 NA 6.99 1.34 NA 21.53 090 54901 A Fusion of spermatic ducts 17.94 NA 9.27 1.83 NA 29.04 090 55000 A Drainage of hydrocele 1.43 2.24 0.49 0.10 3.77 2.02 000 55040 A Removal of hydrocele 5.36 NA 3.56 0.35 NA 9.27 090 55041 A Removal of hydroceles 7.74 NA 4.63 0.50 NA 12.87 090 55060 A Repair of hydrocele 5.52 NA 3.64 0.37 NA 9.53 090 55100 A Drainage of scrotum abscess 2.13 10.06 3.63 0.15 12.34 5.91 010 55110 A Explore scrotum 5.70 NA 3.71 0.36 NA 9.77 090 55120 A Removal of scrotum lesion 5.09 NA 3.52 0.33 NA 8.94 090 55150 A Removal of scrotum 7.22 NA 4.76 0.47 NA 12.45 090 55175 A Revision of scrotum 5.24 NA 3.88 0.33 NA 9.45 090 55180 A Revision of scrotum 10.72 NA 6.38 0.72 NA 17.82 090 55200 A Incision of sperm duct 4.24 NA 3.10 0.25 NA 7.59 090 55250 A Removal of sperm duct(s) 3.29 9.72 3.28 0.21 13.22 6.78 090 55300 A Prepare, sperm duct x-ray 3.51 NA 1.56 0.20 NA 5.27 000 55400 A Repair of sperm duct 8.49 NA 5.32 0.50 NA 14.31 090 55450 A Ligation of sperm duct 4.12 8.08 2.62 0.24 12.44 6.98 010 55500 A Removal of hydrocele 5.59 NA 3.76 0.43 NA 9.78 090 55520 A Removal of sperm cord lesion 6.03 NA 3.82 0.56 NA 10.41 090 55530 A Revise spermatic cord veins 5.66 NA 3.92 0.36 NA 9.94 090 55535 A Revise spermatic cord veins 6.56 NA 4.23 0.42 NA 11.21 090 55540 A Revise hernia & sperm veins 7.67 NA 4.37 0.74 NA 12.78 090 55550 A Laparo ligate spermatic vein 6.57 NA 3.67 0.47 NA 10.71 090 55559 C Laparo proc, spermatic cord 0.00 0.00 0.00 0.00 0.00 0.00 YYY 55600 A Incise sperm duct pouch 6.38 NA 4.41 0.38 NA 11.17 090 55605 A Incise sperm duct pouch 7.96 NA 5.39 0.54 NA 13.89 090 55650 A Remove sperm duct pouch 11.80 NA 6.44 0.72 NA 18.96 090 55680 A Remove sperm pouch lesion 5.19 NA 3.77 0.31 NA 9.27 090 55700 A Biopsy of prostate 1.57 4.68 0.73 0.10 6.35 2.40 000 55705 A Biopsy of prostate 4.57 NA 3.92 0.26 NA 8.75 010 55720 A Drainage of prostate abscess 7.64 NA 5.88 0.44 NA 13.96 090 55725 A Drainage of prostate abscess 8.68 NA 6.58 0.51 NA 15.77 090 55801 A Removal of prostate 17.80 NA 9.78 1.08 NA 28.66 090 55810 A Extensive prostate surgery 22.58 NA 11.85 1.35 NA 35.78 090 55812 A Extensive prostate surgery 27.51 NA 13.91 1.69 NA 43.11 090 55815 A Extensive prostate surgery 30.46 NA 15.01 1.84 NA 47.31 090 55821 A Removal of prostate 14.25 NA 8.20 0.85 NA 23.30 090 55831 A Removal of prostate 15.62 NA 8.67 0.94 NA 25.23 090 55840 A Extensive prostate surgery 22.69 NA 12.32 1.37 NA 36.38 090 55842 A Extensive prostate surgery 24.38 NA 12.86 1.48 NA 38.72 090 55845 A Extensive prostate surgery 28.55 NA 14.26 1.71 NA 44.52 090 55859 A Percut/needle insert, pros 12.52 NA 7.71 0.74 NA 20.97 090 55860 A Surgical exposure, prostate 14.45 NA 7.93 0.82 NA 23.20 090 55862 A Extensive prostate surgery 18.39 NA 9.69 1.14 NA 29.22 090 55865 A Extensive prostate surgery 22.87 NA 11.49 1.37 NA 35.73 090 55870 A Electroejaculation 2.58 1.96 0.98 0.14 4.68 3.70 000 55873 A Cryoablate prostate 19.47 NA 10.65 1.02 NA 31.14 090 55899 C Genital surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 55970 N Sex transformation, M to F 0.00 0.00 0.00 0.00 0.00 0.00 XXX 55980 N Sex transformation, F to M 0.00 0.00 0.00 0.00 0.00 0.00 XXX 56405 A I & D of vulva/perineum 1.44 2.50 1.33 0.14 4.08 2.91 010 56420 A Drainage of gland abscess 1.39 2.48 1.33 0.13 4.00 2.85 010 56440 A Surgery for vulva lesion 2.84 3.83 2.40 0.28 6.95 5.52 010 56441 A Lysis of labial lesion(s) 1.97 2.74 2.11 0.17 4.88 4.25 010 56501 A Destroy, vulva lesions, simp 1.53 2.42 1.42 0.15 4.10 3.10 010 56515 A Destroy vulva lesion/s compl 2.76 3.20 2.46 0.18 6.14 5.40 010 56605 A Biopsy of vulva/perineum 1.10 1.90 0.50 0.11 3.11 1.71 000 56606 A Biopsy of vulva/perineum 0.55 1.69 0.23 0.06 2.30 0.84 ZZZ 56620 A Partial removal of vulva 7.47 NA 5.13 0.76 NA 13.36 090 56625 A Complete removal of vulva 8.40 NA 6.20 0.84 NA 15.44 090 56630 A Extensive vulva surgery 12.36 NA 7.93 1.23 NA 21.52 090Start Printed Page 55390 56631 A Extensive vulva surgery 16.20 NA 10.80 1.63 NA 28.63 090 56632 A Extensive vulva surgery 20.29 NA 12.42 2.03 NA 34.74 090 56633 A Extensive vulva surgery 16.47 NA 9.70 1.66 NA 27.83 090 56634 A Extensive vulva surgery 17.88 NA 11.25 1.78 NA 30.91 090 56637 A Extensive vulva surgery 21.97 NA 13.16 2.18 NA 37.31 090 56640 A Extensive vulva surgery 22.17 NA 12.58 2.26 NA 37.01 090 56700 A Partial removal of hymen 2.52 3.18 2.16 0.24 5.94 4.92 010 56720 A Incision of hymen 0.68 1.79 0.57 0.07 2.54 1.32 000 56740 A Remove vagina gland lesion 4.57 4.08 3.08 0.37 9.02 8.02 010 56800 A Repair of vagina 3.89 NA 2.86 0.37 NA 7.12 010 56805 A Repair clitoris 18.86 NA 9.69 1.82 NA 30.37 090 56810 A Repair of perineum 4.13 NA 2.91 0.41 NA 7.45 010 57000 A Exploration of vagina 2.97 NA 2.49 0.28 NA 5.74 010 57010 A Drainage of pelvic abscess 6.03 NA 4.08 0.57 NA 10.68 090 57020 A Drainage of pelvic fluid 1.50 1.63 0.66 0.15 3.28 2.31 000 57022 A I & d vaginal hematoma, pp 2.56 NA 2.14 0.24 NA 4.94 010 57023 A I & d vag hematoma, non-ob 4.75 NA 3.01 0.24 NA 8.00 010 57061 A Destroy vag lesions, simple 1.25 2.37 1.33 0.13 3.75 2.71 010 57065 A Destroy vag lesions, complex 2.61 3.09 2.41 0.26 5.96 5.28 010 57100 A Biopsy of vagina 1.20 1.64 0.53 0.10 2.94 1.83 000 57105 A Biopsy of vagina 1.69 2.35 2.34 0.17 4.21 4.20 010 57106 A Remove vagina wall, partial 6.36 2.67 2.67 0.58 9.61 9.61 090 57107 A Remove vagina tissue, part 23.00 NA 10.65 2.17 NA 35.82 090 57109 A Vaginectomy partial w/nodes 27.00 NA 13.89 1.97 NA 42.86 090 57110 A Remove vagina wall, complete 14.29 NA 7.56 1.43 NA 23.28 090 57111 A Remove vagina tissue, compl 27.00 NA 12.85 2.71 NA 42.56 090 57112 A Vaginectomy w/nodes, compl 29.00 NA 14.38 2.19 NA 45.57 090 57120 A Closure of vagina 7.41 NA 4.85 0.75 NA 13.01 090 57130 A Remove vagina lesion 2.43 NA 2.25 0.23 NA 4.91 010 57135 A Remove vagina lesion 2.67 3.09 2.35 0.26 6.02 5.28 010 57150 A Treat vagina infection 0.55 1.04 0.22 0.06 1.65 0.83 000 57155 A Insert uteri tandems/ovoids 6.27 NA 3.67 0.63 NA 10.57 090 57160 A Insert pessary/other device 0.89 1.12 0.41 0.09 2.10 1.39 000 57170 A Fitting of diaphragm/cap 0.91 1.46 0.36 0.09 2.46 1.36 000 57180 A Treat vaginal bleeding 1.58 2.37 1.55 0.16 4.11 3.29 010 57200 A Repair of vagina 3.94 NA 3.14 0.38 NA 7.46 090 57210 A Repair vagina/perineum 5.17 NA 3.69 0.50 NA 9.36 090 57220 A Revision of urethra 4.31 NA 3.52 0.42 NA 8.25 090 57230 A Repair of urethral lesion 5.64 NA 4.49 0.50 NA 10.63 090 57240 A Repair bladder & vagina 6.07 NA 4.62 0.53 NA 11.22 090 57250 A Repair rectum & vagina 5.53 NA 4.01 0.54 NA 10.08 090 57260 A Repair of vagina 8.27 NA 5.17 0.83 NA 14.27 090 57265 A Extensive repair of vagina 11.34 NA 7.22 1.14 NA 19.70 090 57268 A Repair of bowel bulge 6.76 NA 4.54 0.66 NA 11.96 090 57270 A Repair of bowel pouch 12.11 NA 6.58 1.17 NA 19.86 090 57280 A Suspension of vagina 15.04 NA 7.74 1.44 NA 24.22 090 57282 A Repair of vaginal prolapse 8.86 NA 5.44 0.86 NA 15.16 090 57284 A Repair paravaginal defect 12.70 NA 7.45 1.17 NA 21.32 090 57287 A Revise/remove sling repair 10.71 NA 7.47 0.74 NA 18.92 090 57288 A Repair bladder defect 13.02 NA 7.24 0.86 NA 21.12 090 57289 A Repair bladder & vagina 11.58 NA 7.12 0.95 NA 19.65 090 57291 A Construction of vagina 7.95 NA 5.93 0.78 NA 14.66 090 57292 A Construct vagina with graft 13.09 NA 7.20 1.29 NA 21.58 090 57300 A Repair rectum-vagina fistula 7.61 NA 4.82 0.70 NA 13.13 090 57305 A Repair rectum-vagina fistula 13.77 NA 7.00 1.33 NA 22.10 090 57307 A Fistula repair & colostomy 15.93 NA 7.72 1.59 NA 25.24 090 57308 A Fistula repair, transperine 9.94 NA 5.96 0.91 NA 16.81 090 57310 A Repair urethrovaginal lesion 6.78 NA 4.95 0.45 NA 12.18 090 57311 A Repair urethrovaginal lesion 7.98 NA 5.45 0.51 NA 13.94 090 57320 A Repair bladder-vagina lesion 8.01 NA 5.68 0.60 NA 14.29 090 57330 A Repair bladder-vagina lesion 12.35 NA 6.96 0.86 NA 20.17 090 57335 A Repair vagina 18.73 NA 9.84 1.66 NA 30.23 090 57400 A Dilation of vagina 2.27 NA 1.18 0.22 NA 3.67 000 57410 A Pelvic examination 1.75 2.75 1.12 0.14 4.64 3.01 000 57415 A Remove vaginal foreign body 2.17 3.71 2.18 0.19 6.07 4.54 010 57452 A Examination of vagina 0.99 1.69 0.46 0.10 2.78 1.55 000 57454 A Vagina examination & biopsy 1.27 1.88 0.62 0.13 3.28 2.02 000 57460 A Cervix excision 2.83 2.17 1.19 0.28 5.28 4.30 000 57500 A Biopsy of cervix 0.97 2.29 0.50 0.10 3.36 1.57 000 57505 A Endocervical curettage 1.14 2.05 1.36 0.12 3.31 2.62 010 57510 A Cauterization of cervix 1.90 3.39 1.66 0.18 5.47 3.74 010 57511 A Cryocautery of cervix 1.90 2.54 0.77 0.18 4.62 2.85 010 57513 A Laser surgery of cervix 1.90 2.72 1.66 0.19 4.81 3.75 010Start Printed Page 55391 57520 A Conization of cervix 4.04 4.43 2.93 0.41 8.88 7.38 090 57522 A Conization of cervix 3.36 4.02 2.68 0.34 7.72 6.38 090 57530 A Removal of cervix 4.79 NA 3.78 0.48 NA 9.05 090 57531 A Removal of cervix, radical 28.00 NA 14.44 2.46 NA 44.90 090 57540 A Removal of residual cervix 12.22 NA 6.49 1.21 NA 19.92 090 57545 A Remove cervix/repair pelvis 13.03 NA 6.95 1.30 NA 21.28 090 57550 A Removal of residual cervix 5.53 NA 3.98 0.55 NA 10.06 090 57555 A Remove cervix/repair vagina 8.95 NA 5.90 0.89 NA 15.74 090 57556 A Remove cervix, repair bowel 8.37 NA 5.14 0.80 NA 14.31 090 57700 A Revision of cervix 3.55 NA 2.71 0.33 NA 6.59 090 57720 A Revision of cervix 4.13 NA 3.41 0.41 NA 7.95 090 57800 A Dilation of cervical canal 0.77 1.22 0.36 0.08 2.07 1.21 000 57820 A D & C of residual cervix 1.67 2.70 2.40 0.17 4.54 4.24 010 58100 A Biopsy of uterus lining 1.53 1.56 0.76 0.07 3.16 2.36 000 58120 A Dilation and curettage 3.27 4.01 2.55 0.33 7.61 6.15 010 58140 A Removal of uterus lesion 14.60 NA 7.38 1.46 NA 23.44 090 58145 A Removal of uterus lesion 8.04 NA 5.11 0.80 NA 13.95 090 58150 A Total hysterectomy 15.24 NA 7.90 1.53 NA 24.67 090 58152 A Total hysterectomy 20.60 NA 10.17 1.52 NA 32.29 090 58180 A Partial hysterectomy 15.29 NA 7.90 1.54 NA 24.73 090 58200 A Extensive hysterectomy 21.59 NA 11.62 2.15 NA 35.36 090 58210 A Extensive hysterectomy 28.85 NA 14.67 2.91 NA 46.43 090 58240 A Removal of pelvis contents 38.39 NA 19.71 3.76 NA 61.86 090 58260 A Vaginal hysterectomy 12.98 NA 6.90 1.23 NA 21.11 090 58262 A Vaginal hysterectomy 14.77 NA 7.66 1.42 NA 23.85 090 58263 A Vaginal hysterectomy 16.06 NA 8.22 1.55 NA 25.83 090 58267 A Hysterectomy & vagina repair 17.04 NA 8.81 1.51 NA 27.36 090 58270 A Hysterectomy & vagina repair 14.26 NA 7.43 1.37 NA 23.06 090 58275 A Hysterectomy/revise vagina 15.76 NA 7.94 1.51 NA 25.21 090 58280 A Hysterectomy/revise vagina 17.01 NA 8.46 1.54 NA 27.01 090 58285 A Extensive hysterectomy 22.26 NA 11.15 1.88 NA 35.29 090 58300 N Insert intrauterine device +1.01 1.42 0.40 0.10 2.53 1.51 XXX 58301 A Remove intrauterine device 1.27 1.62 0.51 0.13 3.02 1.91 000 58321 A Artificial insemination 0.92 1.03 0.37 0.10 2.05 1.39 000 58322 A Artificial insemination 1.10 1.05 0.42 0.11 2.26 1.63 000 58323 A Sperm washing 0.23 0.53 0.10 0.02 0.78 0.35 000 58340 A Catheter for hysterography 0.88 12.42 0.33 0.08 13.38 1.29 000 58345 A Reopen fallopian tube 4.66 NA 1.73 0.36 NA 6.75 010 58346 A Insert heyman uteri capsule 6.75 NA 3.84 0.68 NA 11.27 090 58350 A Reopen fallopian tube 1.01 2.15 1.17 0.10 3.26 2.28 010 58353 A Endometr ablate, thermal 3.56 NA 2.28 0.37 NA 6.21 010 58400 A Suspension of uterus 6.36 NA 4.17 0.62 NA 11.15 090 58410 A Suspension of uterus 12.73 NA 6.84 1.09 NA 20.66 090 58520 A Repair of ruptured uterus 11.92 NA 6.24 1.17 NA 19.33 090 58540 A Revision of uterus 14.64 NA 6.96 1.28 NA 22.88 090 58550 A Laparo-asst vag hysterectomy 14.19 NA 7.11 1.44 NA 22.74 010 58551 A Laparoscopy, remove myoma 14.21 NA 7.09 1.45 NA 22.75 010 58555 A Hysteroscopy, dx, sep proc 3.33 2.95 1.49 0.34 6.62 5.16 000 58558 A Hysteroscopy, biopsy 4.75 3.55 2.13 0.49 8.79 7.37 000 58559 A Hysteroscopy, lysis 6.17 2.59 2.59 0.62 9.38 9.38 000 58560 A Hysteroscopy, resect septum 7.00 3.01 3.01 0.71 10.72 10.72 000 58561 A Hysteroscopy, remove myoma 10.00 3.78 3.78 1.02 14.80 14.80 000 58562 A Hysteroscopy, remove fb 5.21 NA 2.34 0.52 NA 8.07 000 58563 A Hysteroscopy, ablation 6.17 2.62 2.62 0.62 9.41 9.41 000 58578 C Laparo proc, uterus 0.00 0.00 0.00 0.00 0.00 0.00 YYY 58579 C Hysteroscope procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 58600 A Division of fallopian tube 5.60 NA 3.51 0.39 NA 9.50 090 58605 A Division of fallopian tube 5.00 NA 3.32 0.33 NA 8.65 090 58611 A Ligate oviduct(s) add-on 1.45 NA 0.61 0.07 NA 2.13 ZZZ 58615 A Occlude fallopian tube(s) 3.90 NA 3.35 0.40 NA 7.65 010 58660 A Laparoscopy, lysis 11.29 NA 5.78 1.14 NA 18.21 090 58661 A Laparoscopy, remove adnexa 11.05 NA 5.47 1.12 NA 17.64 010 58662 A Laparoscopy, excise lesions 11.79 NA 5.75 1.18 NA 18.72 090 58670 A Laparoscopy, tubal cautery 5.60 NA 3.73 0.55 NA 9.88 090 58671 A Laparoscopy, tubal block 5.60 NA 3.74 0.56 NA 9.90 090 58672 A Laparoscopy, fimbrioplasty 12.88 NA 6.81 1.22 NA 20.91 090 58673 A Laparoscopy, salpingostomy 13.74 NA 7.16 1.40 NA 22.30 090 58679 C Laparo proc, oviduct-ovary 0.00 0.00 0.00 0.00 0.00 0.00 YYY 58700 A Removal of fallopian tube 12.05 NA 6.05 0.64 NA 18.74 090 58720 A Removal of ovary/tube(s) 11.36 NA 6.05 1.14 NA 18.55 090 58740 A Revise fallopian tube(s) 14.00 NA 7.34 0.59 NA 21.93 090 58750 A Repair oviduct 14.84 NA 7.60 1.52 NA 23.96 090 58752 A Revise ovarian tube(s) 14.84 NA 7.92 1.51 NA 24.27 090Start Printed Page 55392 58760 A Remove tubal obstruction 13.13 NA 7.00 1.34 NA 21.47 090 58770 A Create new tubal opening 13.97 NA 7.24 1.42 NA 22.63 090 58800 A Drainage of ovarian cyst(s) 4.14 4.43 4.36 0.36 8.93 8.86 090 58805 A Drainage of ovarian cyst(s) 5.88 NA 3.66 0.56 NA 10.10 090 58820 A Drain ovary abscess, open 4.22 NA 3.38 0.29 NA 7.89 090 58822 A Drain ovary abscess, percut 10.13 NA 5.20 0.92 NA 16.25 090 58823 A Drain pelvic abscess, percut 3.38 NA 2.38 0.18 NA 5.94 000 58825 A Transposition, ovary(s) 10.98 NA 5.95 0.62 NA 17.55 090 58900 A Biopsy of ovary(s) 5.99 NA 3.64 0.56 NA 10.19 090 58920 A Partial removal of ovary(s) 11.36 NA 5.85 0.68 NA 17.89 090 58925 A Removal of ovarian cyst(s) 11.36 NA 5.79 1.14 NA 18.29 090 58940 A Removal of ovary(s) 7.29 NA 4.18 0.73 NA 12.20 090 58943 A Removal of ovary(s) 18.43 NA 9.92 1.86 NA 30.21 090 58950 A Resect ovarian malignancy 16.93 NA 9.41 1.55 NA 27.89 090 58951 A Resect ovarian malignancy 22.38 NA 11.81 2.20 NA 36.39 090 58952 A Resect ovarian malignancy 25.01 NA 12.99 2.50 NA 40.50 090 58953 A Tah, rad dissect for debulk 32.00 NA 15.59 3.20 NA 50.79 090 58954 A Tah rad debulk/lymph remove 35.00 NA 16.71 3.50 NA 55.21 090 58960 A Exploration of abdomen 14.65 NA 8.52 1.47 NA 24.64 090 58970 A Retrieval of oocyte 3.53 8.56 1.92 0.36 12.45 5.81 000 58974 C Transfer of embryo 0.00 0.00 0.00 0.00 0.00 0.00 000 58976 A Transfer of embryo 3.83 2.30 1.53 0.39 6.52 5.75 000 58999 C Genital surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 59000 A Amniocentesis, diagnostic 1.30 2.05 0.72 0.23 3.58 2.25 000 59001 A Amniocentesis, therapeutic 3.00 NA 1.37 0.23 NA 4.60 000 59012 A Fetal cord puncture, prenatal 3.45 NA 1.71 0.62 NA 5.78 000 59015 A Chorion biopsy 2.20 1.64 1.11 0.40 4.24 3.71 000 59020 A Fetal contract stress test 0.66 0.78 NA 0.20 1.64 NA 000 59020 26 A Fetal contract stress test 0.66 0.28 0.28 0.12 1.06 1.06 000 59020 TC A Fetal contract stress test 0.00 0.50 NA 0.08 0.58 NA 000 59025 A Fetal non-stress test 0.53 0.44 NA 0.12 1.09 NA 000 59025 26 A Fetal non-stress test 0.53 0.22 0.22 0.10 0.85 0.85 000 59025 TC A Fetal non-stress test 0.00 0.22 NA 0.02 0.24 NA 000 59030 A Fetal scalp blood sample 1.99 NA 1.14 0.36 NA 3.49 000 59050 A Fetal monitor w/report 0.89 NA 0.38 0.16 NA 1.43 XXX 59051 A Fetal monitor/interpret only 0.74 NA 0.31 0.14 NA 1.19 XXX 59100 A Remove uterus lesion 12.35 NA 6.61 2.21 NA 21.17 090 59120 A Treat ectopic pregnancy 11.49 NA 6.35 2.06 NA 19.90 090 59121 A Treat ectopic pregnancy 11.67 NA 6.39 2.09 NA 20.15 090 59130 A Treat ectopic pregnancy 14.22 NA 7.16 2.54 NA 23.92 090 59135 A Treat ectopic pregnancy 13.88 NA 7.27 2.49 NA 23.64 090 59136 A Treat ectopic pregnancy 13.18 NA 6.36 2.36 NA 21.90 090 59140 A Treat ectopic pregnancy 5.46 NA 3.70 0.98 NA 10.14 090 59150 A Treat ectopic pregnancy 11.67 NA 6.69 1.23 NA 19.59 090 59151 A Treat ectopic pregnancy 11.49 NA 6.12 1.41 NA 19.02 090 59160 A D & C after delivery 2.71 3.73 2.29 0.49 6.93 5.49 010 59200 A Insert cervical dilator 0.79 1.41 0.32 0.15 2.35 1.26 000 59300 A Episiotomy or vaginal repair 2.41 2.01 1.01 0.43 4.85 3.85 000 59320 A Revision of cervix 2.48 NA 1.31 0.45 NA 4.24 000 59325 A Revision of cervix 4.07 NA 1.97 0.73 NA 6.77 000 59350 A Repair of uterus 4.95 NA 2.19 0.88 NA 8.02 000 59400 A Obstetrical care 23.06 NA 15.41 4.14 NA 42.61 MMM 59409 A Obstetrical care 13.50 NA 5.57 2.42 NA 21.49 MMM 59410 A Obstetrical care 14.78 NA 6.98 2.65 NA 24.41 MMM 59412 A Antepartum manipulation 1.71 1.38 0.72 0.31 3.40 2.74 MMM 59414 A Deliver placenta 1.61 NA 1.34 0.29 NA 3.24 MMM 59425 A Antepartum care only 4.81 5.36 5.32 0.86 11.03 10.99 MMM 59426 A Antepartum care only 8.28 9.14 9.14 1.49 18.91 18.91 MMM 59430 A Care after delivery 2.13 1.29 1.29 0.38 3.80 3.80 MMM 59510 A Cesarean delivery 26.22 NA 17.61 4.70 NA 48.53 MMM 59514 A Cesarean delivery only 15.97 NA 6.57 2.86 NA 25.40 MMM 59515 A Cesarean delivery 17.37 NA 8.52 3.12 NA 29.01 MMM 59525 A Remove uterus after cesarean 8.54 NA 3.52 1.53 NA 13.59 ZZZ 59610 A Vbac delivery 24.62 NA 16.29 4.41 NA 45.32 MMM 59612 A Vbac delivery only 15.06 NA 6.43 2.70 NA 24.19 MMM 59614 A Vbac care after delivery 16.34 NA 7.70 2.93 NA 26.97 MMM 59618 A Attempted vbac delivery 27.78 NA 18.38 4.98 NA 51.14 MMM 59620 A Attempted vbac delivery only 17.53 NA 6.87 3.15 NA 27.55 MMM 59622 A Attempted vbac after care 18.93 NA 8.91 3.39 NA 31.23 MMM 59812 A Treatment of miscarriage 4.01 3.75 2.51 0.58 8.34 7.10 090 59820 A Care of miscarriage 4.01 3.79 2.85 0.72 8.52 7.58 090 59821 A Treatment of miscarriage 4.47 3.79 3.01 0.80 9.06 8.28 090 59830 A Treat uterus infection 6.11 NA 3.85 1.10 NA 11.06 090Start Printed Page 55393 59840 R Abortion 3.01 4.01 2.47 0.54 7.56 6.02 010 59841 R Abortion 5.24 5.78 3.72 0.94 11.96 9.90 010 59850 R Abortion 5.91 NA 2.75 1.06 NA 9.72 090 59851 R Abortion 5.93 NA 3.22 1.06 NA 10.21 090 59852 R Abortion 8.24 NA 4.58 1.48 NA 14.30 090 59855 R Abortion 6.12 NA 3.38 1.10 NA 10.60 090 59856 R Abortion 7.48 NA 3.74 1.34 NA 12.56 090 59857 R Abortion 9.29 NA 4.46 1.66 NA 15.41 090 59866 R Abortion (mpr) 4.00 NA 1.60 0.72 NA 6.32 000 59870 A Evacuate mole of uterus 6.01 NA 3.83 0.77 NA 10.61 090 59871 A Remove cerclage suture 2.13 2.19 0.93 0.38 4.70 3.44 000 59898 C Laparo proc, ob care/deliver 0.00 0.00 0.00 0.00 0.00 0.00 YYY 59899 C Maternity care procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 60000 A Drain thyroid/tongue cyst 1.76 2.40 2.22 0.14 4.30 4.12 010 60001 A Aspirate/inject thyriod cyst 0.97 1.77 0.35 0.06 2.80 1.38 000 60100 A Biopsy of thyroid 1.56 2.70 0.56 0.05 4.31 2.17 000 60200 A Remove thyroid lesion 9.55 NA 6.88 0.84 NA 17.27 090 60210 A Partial thyroid excision 10.88 NA 6.63 1.01 NA 18.52 090 60212 A Parital thyroid excision 16.03 NA 8.62 1.51 NA 26.16 090 60220 A Partial removal of thyroid 11.90 NA 7.27 0.97 NA 20.14 090 60225 A Partial removal of thyroid 14.19 NA 8.05 1.31 NA 23.55 090 60240 A Removal of thyroid 16.06 NA 9.32 1.50 NA 26.88 090 60252 A Removal of thyroid 20.57 NA 11.64 1.63 NA 33.84 090 60254 A Extensive thyroid surgery 26.99 NA 16.39 1.96 NA 45.34 090 60260 A Repeat thyroid surgery 17.47 NA 10.66 1.39 NA 29.52 090 60270 A Removal of thyroid 20.27 NA 11.54 1.78 NA 33.59 090 60271 A Removal of thyroid 16.83 NA 10.20 1.35 NA 28.38 090 60280 A Remove thyroid duct lesion 5.87 NA 5.29 0.45 NA 11.61 090 60281 A Remove thyroid duct lesion 8.53 NA 6.27 0.67 NA 15.47 090 60500 A Explore parathyroid glands 16.23 NA 7.99 1.61 NA 25.83 090 60502 A Re-explore parathyroids 20.35 NA 9.97 2.00 NA 32.32 090 60505 A Explore parathyroid glands 21.49 NA 11.53 2.14 NA 35.16 090 60512 A Autotransplant parathyroid 4.45 NA 1.72 0.44 NA 6.61 ZZZ 60520 A Removal of thymus gland 16.81 NA 9.55 1.84 NA 28.20 090 60521 A Removal of thymus gland 18.87 NA 11.57 2.34 NA 32.78 090 60522 A Removal of thymus gland 23.09 NA 12.88 2.83 NA 38.80 090 60540 A Explore adrenal gland 17.03 NA 8.09 1.42 NA 26.54 090 60545 A Explore adrenal gland 19.88 NA 9.73 1.75 NA 31.36 090 60600 A Remove carotid body lesion 17.93 NA 13.43 1.87 NA 33.23 090 60605 A Remove carotid body lesion 20.24 NA 18.12 2.28 NA 40.64 090 60650 A Laparoscopy adrenalectomy 20.00 NA 8.34 1.98 NA 30.32 090 60659 C Laparo proc, endocrine 0.00 0.00 0.00 0.00 0.00 0.00 YYY 60699 C Endocrine surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 61000 A Remove cranial cavity fluid 1.58 1.79 1.53 0.13 3.50 3.24 000 61001 A Remove cranial cavity fluid 1.49 2.08 1.47 0.15 3.72 3.11 000 61020 A Remove brain cavity fluid 1.51 2.52 1.51 0.26 4.29 3.28 000 61026 A Injection into brain canal 1.69 2.28 1.73 0.21 4.18 3.63 000 61050 A Remove brain canal fluid 1.51 NA 1.56 0.13 NA 3.20 000 61055 A Injection into brain canal 2.10 NA 1.80 0.13 NA 4.03 000 61070 A Brain canal shunt procedure 0.89 7.33 1.22 0.09 8.31 2.20 000 61105 A Twist drill hole 5.14 NA 3.67 1.05 NA 9.86 090 61107 A Drill skull for implantation 5.00 NA 3.12 1.02 NA 9.14 000 61108 A Drill skull for drainage 10.19 NA 7.09 2.04 NA 19.32 090 61120 A Burr hole for puncture 8.76 NA 5.88 1.81 NA 16.45 090 61140 A Pierce skull for biopsy 15.90 NA 10.00 3.15 NA 29.05 090 61150 A Pierce skull for drainage 17.57 NA 10.74 3.52 NA 31.83 090 61151 A Pierce skull for drainage 12.42 NA 8.16 2.45 NA 23.03 090 61154 A Pierce skull & remove clot 14.99 NA 9.43 3.05 NA 27.47 090 61156 A Pierce skull for drainage 16.32 NA 10.30 3.42 NA 30.04 090 61210 A Pierce skull, implant device 5.84 NA 3.53 1.16 NA 10.53 000 61215 A Insert brain-fluid device 4.89 NA 4.24 0.99 NA 10.12 090 61250 A Pierce skull & explore 10.42 NA 6.73 2.02 NA 19.17 090 61253 A Pierce skull & explore 12.36 NA 7.65 2.26 NA 22.27 090 61304 A Open skull for exploration 21.96 NA 12.85 4.33 NA 39.14 090 61305 A Open skull for exploration 26.61 NA 15.31 5.25 NA 47.17 090 61312 A Open skull for drainage 24.57 NA 14.57 4.99 NA 44.13 090 61313 A Open skull for drainage 24.93 NA 14.76 5.07 NA 44.76 090 61314 A Open skull for drainage 24.23 NA 11.55 4.00 NA 39.78 090 61315 A Open skull for drainage 27.68 NA 16.22 5.62 NA 49.52 090 61320 A Open skull for drainage 25.62 NA 15.20 5.20 NA 46.02 090 61321 A Open skull for drainage 28.50 NA 16.09 5.35 NA 49.94 090 61330 A Decompress eye socket 23.32 NA 19.43 2.58 NA 45.33 090 61332 A Explore/biopsy eye socket 27.28 NA 20.43 4.15 NA 51.86 090Start Printed Page 55394 61333 A Explore orbit/remove lesion 27.95 NA 16.45 2.24 NA 46.64 090 61334 A Explore orbit/remove object 18.27 NA 10.08 3.02 NA 31.37 090 61340 A Relieve cranial pressure 18.66 NA 11.75 3.66 NA 34.07 090 61343 A Incise skull (press relief) 29.77 NA 17.96 6.04 NA 53.77 090 61345 A Relieve cranial pressure 27.20 NA 16.17 5.23 NA 48.60 090 61440 A Incise skull for surgery 26.63 NA 12.14 5.57 NA 44.34 090 61450 A Incise skull for surgery 25.95 NA 14.46 5.11 NA 45.52 090 61458 A Incise skull for brain wound 27.29 NA 15.89 5.28 NA 48.46 090 61460 A Incise skull for surgery 28.39 NA 16.77 5.13 NA 50.29 090 61470 A Incise skull for surgery 26.06 NA 13.74 4.65 NA 44.45 090 61480 A Incise skull for surgery 26.49 NA 12.34 5.54 NA 44.37 090 61490 A Incise skull for surgery 25.66 NA 15.18 5.37 NA 46.21 090 61500 A Removal of skull lesion 17.92 NA 11.03 3.26 NA 32.21 090 61501 A Remove infected skull bone 14.84 NA 9.62 2.63 NA 27.09 090 61510 A Removal of brain lesion 28.45 NA 16.60 5.77 NA 50.82 090 61512 A Remove brain lining lesion 35.09 NA 20.18 7.14 NA 62.41 090 61514 A Removal of brain abscess 25.26 NA 14.91 5.12 NA 45.29 090 61516 A Removal of brain lesion 24.61 NA 15.01 4.94 NA 44.56 090 61518 A Removal of brain lesion 37.32 NA 22.34 7.53 NA 67.19 090 61519 A Remove brain lining lesion 41.39 NA 24.42 8.15 NA 73.96 090 61520 A Removal of brain lesion 54.84 NA 31.93 10.10 NA 96.87 090 61521 A Removal of brain lesion 44.48 NA 26.22 8.85 NA 79.55 090 61522 A Removal of brain abscess 29.45 NA 17.20 5.30 NA 51.95 090 61524 A Removal of brain lesion 27.86 NA 16.83 5.01 NA 49.70 090 61526 A Removal of brain lesion 52.17 NA 31.55 6.72 NA 90.44 090 61530 A Removal of brain lesion 43.86 NA 27.43 6.17 NA 77.46 090 61531 A Implant brain electrodes 14.63 NA 9.56 2.84 NA 27.03 090 61533 A Implant brain electrodes 19.71 NA 12.21 3.80 NA 35.72 090 61534 A Removal of brain lesion 20.97 NA 13.30 4.15 NA 38.42 090 61535 A Remove brain electrodes 11.63 NA 8.16 2.29 NA 22.08 090 61536 A Removal of brain lesion 35.52 NA 21.18 6.68 NA 63.38 090 61538 A Removal of brain tissue 26.81 NA 16.30 5.38 NA 48.49 090 61539 A Removal of brain tissue 32.08 NA 18.91 6.62 NA 57.61 090 61541 A Incision of brain tissue 28.85 NA 16.89 5.50 NA 51.24 090 61542 A Removal of brain tissue 31.02 NA 18.00 6.49 NA 55.51 090 61543 A Removal of brain tissue 29.22 NA 17.42 6.11 NA 52.75 090 61544 A Remove & treat brain lesion 25.50 NA 15.21 4.91 NA 45.62 090 61545 A Excision of brain tumor 43.80 NA 25.09 8.88 NA 77.77 090 61546 A Removal of pituitary gland 31.30 NA 18.74 6.06 NA 56.10 090 61548 A Removal of pituitary gland 21.53 NA 13.74 3.63 NA 38.90 090 61550 A Release of skull seams 14.65 NA 4.89 1.14 NA 20.68 090 61552 A Release of skull seams 19.56 NA 9.87 0.88 NA 30.31 090 61556 A Incise skull/sutures 22.26 NA 11.74 3.57 NA 37.57 090 61557 A Incise skull/sutures 22.38 NA 13.41 4.68 NA 40.47 090 61558 A Excision of skull/sutures 25.58 NA 12.67 2.61 NA 40.86 090 61559 A Excision of skull/sutures 32.79 NA 18.89 6.86 NA 58.54 090 61563 A Excision of skull tumor 26.83 NA 16.25 4.46 NA 47.54 090 61564 A Excision of skull tumor 33.83 NA 18.73 7.08 NA 59.64 090 61570 A Remove foreign body, brain 24.60 NA 13.80 4.60 NA 43.00 090 61571 A Incise skull for brain wound 26.39 NA 15.43 5.23 NA 47.05 090 61575 A Skull base/brainstem surgery 34.36 NA 21.38 5.02 NA 60.76 090 61576 A Skull base/brainstem surgery 52.43 NA 28.89 4.68 NA 86.00 090 61580 A Craniofacial approach, skull 30.35 NA 19.96 2.75 NA 53.06 090 61581 A Craniofacial approach, skull 34.60 NA 22.57 3.37 NA 60.54 090 61582 A Craniofacial approach, skull 31.66 NA 19.56 6.30 NA 57.52 090 61583 A Craniofacial approach, skull 36.21 NA 22.71 6.94 NA 65.86 090 61584 A Orbitocranial approach/skull 34.65 NA 20.99 6.53 NA 62.17 090 61585 A Orbitocranial approach/skull 38.61 NA 22.21 6.19 NA 67.01 090 61586 A Resect nasopharynx, skull 25.10 NA 16.39 3.52 NA 45.01 090 61590 A Infratemporal approach/skull 41.78 NA 26.12 4.28 NA 72.18 090 61591 A Infratemporal approach/skull 43.68 NA 26.89 5.26 NA 75.83 090 61592 A Orbitocranial approach/skull 39.64 NA 23.59 7.55 NA 70.78 090 61595 A Transtemporal approach/skull 29.57 NA 19.74 3.05 NA 52.36 090 61596 A Transcochlear approach/skull 35.63 NA 21.88 4.25 NA 61.76 090 61597 A Transcondylar approach/skull 37.96 NA 22.41 6.65 NA 67.02 090 61598 A Transpetrosal approach/skull 33.41 NA 20.92 4.60 NA 58.93 090 61600 A Resect/excise cranial lesion 25.85 NA 15.01 3.12 NA 43.98 090 61601 A Resect/excise cranial lesion 27.89 NA 17.34 5.29 NA 50.52 090 61605 A Resect/excise cranial lesion 29.33 NA 18.97 2.51 NA 50.81 090 61606 A Resect/excise cranial lesion 38.83 NA 23.17 6.81 NA 68.81 090 61607 A Resect/excise cranial lesion 36.27 NA 22.17 5.69 NA 64.13 090 61608 A Resect/excise cranial lesion 42.10 NA 24.89 8.31 NA 75.30 090 61609 A Transect artery, sinus 9.89 NA 5.11 2.07 NA 17.07 ZZZStart Printed Page 55395 61610 A Transect artery, sinus 29.67 NA 14.38 3.52 NA 47.57 ZZZ 61611 A Transect artery, sinus 7.42 NA 2.96 1.55 NA 11.93 ZZZ 61612 A Transect artery, sinus 27.88 NA 14.30 3.55 NA 45.73 ZZZ 61613 A Remove aneurysm, sinus 40.86 NA 23.34 8.32 NA 72.52 090 61615 A Resect/excise lesion, skull 32.07 NA 20.81 4.64 NA 57.52 090 61616 A Resect/excise lesion, skull 43.33 NA 26.97 7.02 NA 77.32 090 61618 A Repair dura 16.99 NA 11.43 2.92 NA 31.34 090 61619 A Repair dura 20.71 NA 13.67 3.42 NA 37.80 090 61624 A Occlusion/embolization cath 20.15 NA 7.46 1.15 NA 28.76 000 61626 A Occlusion/embolization cath 16.62 NA 5.88 0.84 NA 23.34 000 61680 A Intracranial vessel surgery 30.71 NA 18.38 6.04 NA 55.13 090 61682 A Intracranial vessel surgery 61.57 NA 34.65 12.69 NA 108.91 090 61684 A Intracranial vessel surgery 39.81 NA 22.60 7.87 NA 70.28 090 61686 A Intracranial vessel surgery 64.49 NA 36.70 13.20 NA 114.39 090 61690 A Intracranial vessel surgery 29.31 NA 17.64 5.51 NA 52.46 090 61692 A Intracranial vessel surgery 51.87 NA 29.51 10.17 NA 91.55 090 61697 A Brain aneurysm repr, complx 50.52 NA 28.42 10.31 NA 89.25 090 61698 A Brain aneurysm repr, complx 48.41 NA 27.31 9.99 NA 85.71 090 61700 A Brain aneurysm repr , simple 50.52 NA 28.42 10.18 NA 89.12 090 61702 A Inner skull vessel surgery 48.41 NA 27.31 9.75 NA 85.47 090 61703 A Clamp neck artery 17.47 NA 11.13 3.62 NA 32.22 090 61705 A Revise circulation to head 36.20 NA 19.89 6.67 NA 62.76 090 61708 A Revise circulation to head 35.30 NA 16.52 2.18 NA 54.00 090 61710 A Revise circulation to head 29.67 NA 14.68 2.42 NA 46.77 090 61711 A Fusion of skull arteries 36.33 NA 20.68 7.39 NA 64.40 090 61720 A Incise skull/brain surgery 16.77 NA 10.90 3.51 NA 31.18 090 61735 A Incise skull/brain surgery 20.43 NA 12.77 4.16 NA 37.36 090 61750 A Incise skull/brain biopsy 18.20 NA 11.08 3.71 NA 32.99 090 61751 A Brain biopsy w/ ct/mr guide 17.62 NA 10.92 3.57 NA 32.11 090 61760 A Implant brain electrodes 22.27 NA 12.85 4.59 NA 39.71 090 61770 A Incise skull for treatment 21.44 NA 13.26 4.09 NA 38.79 090 61790 A Treat trigeminal nerve 10.86 NA 6.92 1.82 NA 19.60 090 61791 A Treat trigeminal tract 14.61 NA 9.39 3.03 NA 27.03 090 61793 A Focus radiation beam 17.24 NA 11.07 3.51 NA 31.82 090 61795 A Brain surgery using computer 4.04 NA 2.14 0.81 NA 6.99 ZZZ 61850 A Implant neuroelectrodes 12.39 NA 8.13 2.23 NA 22.75 090 61860 A Implant neuroelectrodes 20.87 NA 12.59 4.04 NA 37.50 090 61862 A Implant neurostimul, subcort 19.34 NA 12.16 3.97 NA 35.47 090 61870 A Implant neuroelectrodes 14.94 NA 9.97 1.70 NA 26.61 090 61875 A Implant neuroelectrodes 15.06 NA 7.39 2.42 NA 24.87 090 61880 A Revise/remove neuroelectrode 6.29 NA 5.26 1.31 NA 12.86 090 61885 A Implant neurostim one array 5.85 NA 4.36 1.22 NA 11.43 090 61886 A Implant neurostim arrays 8.00 NA 6.13 1.64 NA 15.77 090 61888 A Revise/remove neuroreceiver 5.07 NA 3.90 1.04 NA 10.01 010 62000 A Treat skull fracture 12.53 NA 6.19 0.87 NA 19.59 090 62005 A Treat skull fracture 16.17 NA 9.35 2.33 NA 27.85 090 62010 A Treatment of head injury 19.81 NA 11.83 4.05 NA 35.69 090 62100 A Repair brain fluid leakage 22.03 NA 13.97 4.07 NA 40.07 090 62115 A Reduction of skull defect 21.66 NA 11.03 4.53 NA 37.22 090 62116 A Reduction of skull defect 23.59 NA 14.04 4.85 NA 42.48 090 62117 A Reduction of skull defect 26.60 NA 12.68 5.56 NA 44.84 090 62120 A Repair skull cavity lesion 23.35 NA 15.14 3.07 NA 41.56 090 62121 A Incise skull repair 21.58 NA 13.52 2.47 NA 37.57 090 62140 A Repair of skull defect 13.51 NA 8.72 2.60 NA 24.83 090 62141 A Repair of skull defect 14.91 NA 9.89 2.85 NA 27.65 090 62142 A Remove skull plate/flap 10.79 NA 7.31 2.10 NA 20.20 090 62143 A Replace skull plate/flap 13.05 NA 8.81 2.55 NA 24.41 090 62145 A Repair of skull & brain 18.82 NA 11.77 3.81 NA 34.40 090 62146 A Repair of skull with graft 16.12 NA 10.63 2.94 NA 29.69 090 62147 A Repair of skull with graft 19.34 NA 12.38 3.64 NA 35.36 090 62180 A Establish brain cavity shunt 21.06 NA 13.08 4.32 NA 38.46 090 62190 A Establish brain cavity shunt 11.07 NA 7.77 2.18 NA 21.02 090 62192 A Establish brain cavity shunt 12.25 NA 8.25 2.46 NA 22.96 090 62194 A Replace/irrigate catheter 5.03 NA 2.25 0.50 NA 7.78 010 62200 A Establish brain cavity shunt 18.32 NA 11.72 3.70 NA 33.74 090 62201 A Establish brain cavity shunt 14.86 NA 9.76 2.52 NA 27.14 090 62220 A Establish brain cavity shunt 13.00 NA 8.60 2.53 NA 24.13 090 62223 A Establish brain cavity shunt 12.87 NA 8.54 2.58 NA 23.99 090 62225 A Replace/irrigate catheter 5.41 NA 4.11 1.09 NA 10.61 090 62230 A Replace/revise brain shunt 10.54 NA 6.42 2.10 NA 19.06 090 62252 A Csf shunt reprogram 0.74 1.35 NA 0.18 2.27 NA XXX 62252 26 A Csf shunt reprogram 0.74 0.30 0.30 0.16 1.20 1.20 XXX 62252 TC A Csf shunt reprogram 0.00 1.05 NA 0.02 1.07 NA XXXStart Printed Page 55396 62256 A Remove brain cavity shunt 6.60 NA 5.40 1.34 NA 13.34 090 62258 A Replace brain cavity shunt 14.54 NA 8.82 2.91 NA 26.27 090 62263 A Lysis epidural adhesions 6.14 5.15 2.07 0.42 11.71 8.63 010 62268 A Drain spinal cord cyst 4.74 NA 2.74 0.29 NA 7.77 000 62269 A Needle biopsy, spinal cord 5.02 NA 2.40 0.29 NA 7.71 000 62270 A Spinal fluid tap, diagnostic 1.13 4.08 0.48 0.06 5.27 1.67 000 62272 A Drain cerebro spinal fluid 1.35 3.38 0.62 0.13 4.86 2.10 000 62273 A Treat epidural spine lesion 2.15 1.57 1.27 0.14 3.86 3.56 000 62280 A Treat spinal cord lesion 2.63 3.79 0.70 0.17 6.59 3.50 010 62281 A Treat spinal cord lesion 2.66 4.50 0.62 0.16 7.32 3.44 010 62282 A Treat spinal canal lesion 2.33 5.57 0.62 0.14 8.04 3.09 010 62284 A Injection for myelogram 1.54 5.53 0.55 0.10 7.17 2.19 000 62287 A Percutaneous diskectomy 8.08 NA 5.05 0.66 NA 13.79 090 62290 A Inject for spine disk x-ray 3.00 5.68 1.30 0.20 8.88 4.50 000 62291 A Inject for spine disk x-ray 2.91 6.24 1.20 0.17 9.32 4.28 000 62292 A Injection into disk lesion 7.86 NA 5.34 0.65 NA 13.85 090 62294 A Injection into spinal artery 11.83 NA 7.37 0.85 NA 20.05 090 62310 A Inject spine c/t 1.91 3.71 0.43 0.11 5.73 2.45 000 62311 A Inject spine l/s (cd) 1.54 4.22 0.37 0.09 5.85 2.00 000 62318 A Inject spine w/cath, c/t 2.04 3.83 0.44 0.12 5.99 2.60 000 62319 A Inject spine w/cath l/s (cd) 1.87 3.67 0.40 0.11 5.65 2.38 000 62350 A Implant spinal canal cath 6.87 NA 3.79 0.64 NA 11.30 090 62351 A Implant spinal canal cath 10.00 NA 6.90 1.79 NA 18.69 090 62355 A Remove spinal canal catheter 5.45 NA 3.02 0.47 NA 8.94 090 62360 A Insert spine infusion device 2.62 NA 2.46 0.21 NA 5.29 090 62361 A Implant spine infusion pump 5.42 NA 3.67 0.50 NA 9.59 090 62362 A Implant spine infusion pump 7.04 NA 4.06 0.86 NA 11.96 090 62365 A Remove spine infusion device 5.42 NA 3.99 0.58 NA 9.99 090 62367 C Analyze spine infusion pump 0.00 0.00 0.00 0.00 0.00 0.00 XXX 62367 26 A Analyze spine infusion pump 0.48 0.14 0.14 0.03 0.65 0.65 XXX 62367 TC C Analyze spine infusion pump 0.00 0.00 0.00 0.00 0.00 0.00 XXX 62368 C Analyze spine infusion pump 0.00 0.00 0.00 0.00 0.00 0.00 XXX 62368 26 A Analyze spine infusion pump 0.75 0.20 0.20 0.05 1.00 1.00 XXX 62368 TC C Analyze spine infusion pump 0.00 0.00 0.00 0.00 0.00 0.00 XXX 63001 A Removal of spinal lamina 15.82 NA 11.68 3.03 NA 30.53 090 63003 A Removal of spinal lamina 15.95 NA 11.95 2.98 NA 30.88 090 63005 A Removal of spinal lamina 14.92 NA 11.49 2.62 NA 29.03 090 63011 A Removal of spinal lamina 14.52 NA 11.29 1.43 NA 27.24 090 63012 A Removal of spinal lamina 15.40 NA 10.34 2.71 NA 28.45 090 63015 A Removal of spinal lamina 19.35 NA 13.68 3.84 NA 36.87 090 63016 A Removal of spinal lamina 19.20 NA 13.66 3.62 NA 36.48 090 63017 A Removal of spinal lamina 15.94 NA 12.00 2.91 NA 30.85 090 63020 A Neck spine disk surgery 14.81 NA 11.33 2.89 NA 29.03 090 63030 A Low back disk surgery 12.00 NA 9.92 2.21 NA 24.13 090 63035 A Spinal disk surgery add-on 3.15 NA 1.67 0.57 NA 5.39 ZZZ 63040 A Laminotomy, single cervical 18.81 NA 13.39 3.36 NA 35.56 090 63042 A Laminotomy, single lumbar 17.47 NA 12.95 3.11 NA 33.53 090 63043 C Laminotomy, addl cervical 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 63044 C Laminotomy, addl lumbar 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 63045 A Removal of spinal lamina 16.50 NA 12.22 3.19 NA 31.91 090 63046 A Removal of spinal lamina 15.80 NA 12.02 2.89 NA 30.71 090 63047 A Removal of spinal lamina 14.61 NA 11.42 2.61 NA 28.64 090 63048 A Remove spinal lamina add-on 3.26 NA 1.75 0.58 NA 5.59 ZZZ 63055 A Decompress spinal cord 21.99 NA 15.11 4.09 NA 41.19 090 63056 A Decompress spinal cord 20.36 NA 14.44 3.34 NA 38.14 090 63057 A Decompress spine cord add-on 5.26 NA 2.82 0.81 NA 8.89 ZZZ 63064 A Decompress spinal cord 24.61 NA 17.12 4.72 NA 46.45 090 63066 A Decompress spine cord add-on 3.26 NA 1.76 0.63 NA 5.65 ZZZ 63075 A Neck spine disk surgery 19.41 NA 13.83 3.73 NA 36.97 090 63076 A Neck spine disk surgery 4.05 NA 2.16 0.78 NA 6.99 ZZZ 63077 A Spine disk surgery, thorax 21.44 NA 15.47 3.44 NA 40.35 090 63078 A Spine disk surgery, thorax 3.28 NA 1.72 0.50 NA 5.50 ZZZ 63081 A Removal of vertebral body 23.73 NA 16.68 4.46 NA 44.87 090 63082 A Remove vertebral body add-on 4.37 NA 2.34 0.82 NA 7.53 ZZZ 63085 A Removal of vertebral body 26.92 NA 17.89 4.70 NA 49.51 090 63086 A Remove vertebral body add-on 3.19 NA 1.66 0.55 NA 5.40 ZZZ 63087 A Removal of vertebral body 35.57 NA 22.45 5.87 NA 63.89 090 63088 A Remove vertebral body add-on 4.33 NA 2.30 0.77 NA 7.40 ZZZ 63090 A Removal of vertebral body 28.16 NA 18.12 4.27 NA 50.55 090 63091 A Remove vertebral body add-on 3.03 NA 1.48 0.45 NA 4.96 ZZZ 63170 A Incise spinal cord tract(s) 19.83 NA 13.54 3.89 NA 37.26 090 63172 A Drainage of spinal cyst 17.66 NA 13.37 3.46 NA 34.49 090 63173 A Drainage of spinal cyst 21.99 NA 15.54 4.14 NA 41.67 090Start Printed Page 55397 63180 A Revise spinal cord ligaments 18.27 NA 13.04 3.83 NA 35.14 090 63182 A Revise spinal cord ligaments 20.50 NA 13.61 3.48 NA 37.59 090 63185 A Incise spinal column/nerves 15.04 NA 9.70 2.08 NA 26.82 090 63190 A Incise spinal column/nerves 17.45 NA 11.68 2.88 NA 32.01 090 63191 A Incise spinal column/nerves 17.54 NA 10.65 3.50 NA 31.69 090 63194 A Incise spinal column & cord 19.19 NA 13.48 4.01 NA 36.68 090 63195 A Incise spinal column & cord 18.84 NA 13.02 3.44 NA 35.30 090 63196 A Incise spinal column & cord 22.30 NA 14.03 4.66 NA 40.99 090 63197 A Incise spinal column & cord 21.11 NA 13.49 4.42 NA 39.02 090 63198 A Incise spinal column & cord 25.38 NA 12.70 5.31 NA 43.39 090 63199 A Incise spinal column & cord 26.89 NA 14.38 5.62 NA 46.89 090 63200 A Release of spinal cord 19.18 NA 13.42 3.61 NA 36.21 090 63250 A Revise spinal cord vessels 40.76 NA 23.15 7.65 NA 71.56 090 63251 A Revise spinal cord vessels 41.20 NA 23.51 7.98 NA 72.69 090 63252 A Revise spinal cord vessels 41.19 NA 23.36 7.75 NA 72.30 090 63265 A Excise intraspinal lesion 21.56 NA 13.21 4.29 NA 39.06 090 63266 A Excise intraspinal lesion 22.30 NA 13.70 4.47 NA 40.47 090 63267 A Excise intraspinal lesion 17.95 NA 11.48 3.50 NA 32.93 090 63268 A Excise intraspinal lesion 18.52 NA 10.97 3.18 NA 32.67 090 63270 A Excise intraspinal lesion 26.80 NA 16.10 5.41 NA 48.31 090 63271 A Excise intraspinal lesion 26.92 NA 16.17 5.56 NA 48.65 090 63272 A Excise intraspinal lesion 25.32 NA 15.31 5.07 NA 45.70 090 63273 A Excise intraspinal lesion 24.29 NA 14.84 5.08 NA 44.21 090 63275 A Biopsy/excise spinal tumor 23.68 NA 14.47 4.68 NA 42.83 090 63276 A Biopsy/excise spinal tumor 23.45 NA 14.27 4.63 NA 42.35 090 63277 A Biopsy/excise spinal tumor 20.83 NA 12.99 4.03 NA 37.85 090 63278 A Biopsy/excise spinal tumor 20.56 NA 13.08 4.02 NA 37.66 090 63280 A Biopsy/excise spinal tumor 28.35 NA 16.76 5.80 NA 50.91 090 63281 A Biopsy/excise spinal tumor 28.05 NA 16.73 5.67 NA 50.45 090 63282 A Biopsy/excise spinal tumor 26.39 NA 15.79 5.33 NA 47.51 090 63283 A Biopsy/excise spinal tumor 25.00 NA 15.07 5.12 NA 45.19 090 63285 A Biopsy/excise spinal tumor 36.00 NA 20.82 7.31 NA 64.13 090 63286 A Biopsy/excise spinal tumor 35.63 NA 20.51 7.07 NA 63.21 090 63287 A Biopsy/excise spinal tumor 36.70 NA 21.03 7.48 NA 65.21 090 63290 A Biopsy/excise spinal tumor 37.38 NA 21.58 7.65 NA 66.61 090 63300 A Removal of vertebral body 24.43 NA 14.63 4.78 NA 43.84 090 63301 A Removal of vertebral body 27.60 NA 15.65 5.03 NA 48.28 090 63302 A Removal of vertebral body 27.81 NA 16.45 5.25 NA 49.51 090 63303 A Removal of vertebral body 30.50 NA 17.71 5.21 NA 53.42 090 63304 A Removal of vertebral body 30.33 NA 17.80 4.72 NA 52.85 090 63305 A Removal of vertebral body 32.03 NA 19.24 5.39 NA 56.66 090 63306 A Removal of vertebral body 32.22 NA 18.19 2.39 NA 52.80 090 63307 A Removal of vertebral body 31.63 NA 17.29 4.23 NA 53.15 090 63308 A Remove vertebral body add-on 5.25 NA 2.74 1.01 NA 9.00 ZZZ 63600 A Remove spinal cord lesion 14.02 NA 6.38 1.22 NA 21.62 090 63610 A Stimulation of spinal cord 8.73 NA 3.90 0.43 NA 13.06 000 63615 A Remove lesion of spinal cord 16.28 NA 9.50 2.85 NA 28.63 090 63650 A Implant neuroelectrodes 6.74 NA 2.97 0.48 NA 10.19 090 63655 A Implant neuroelectrodes 10.29 NA 7.26 1.85 NA 19.40 090 63660 A Revise/remove neuroelectrode 6.16 NA 3.67 0.65 NA 10.48 090 63685 A Implant neuroreceiver 7.04 NA 4.15 0.96 NA 12.15 090 63688 A Revise/remove neuroreceiver 5.39 NA 3.69 0.70 NA 9.78 090 63700 A Repair of spinal herniation 16.53 NA 10.47 2.69 NA 29.69 090 63702 A Repair of spinal herniation 18.48 NA 9.90 1.36 NA 29.74 090 63704 A Repair of spinal herniation 21.18 NA 12.37 3.84 NA 37.39 090 63706 A Repair of spinal herniation 24.11 NA 13.60 4.73 NA 42.44 090 63707 A Repair spinal fluid leakage 11.26 NA 8.06 1.96 NA 21.28 090 63709 A Repair spinal fluid leakage 14.32 NA 9.79 2.49 NA 26.60 090 63710 A Graft repair of spine defect 14.07 NA 9.54 2.61 NA 26.22 090 63740 A Install spinal shunt 11.36 NA 7.79 2.15 NA 21.30 090 63741 A Install spinal shunt 8.25 NA 4.72 1.05 NA 14.02 090 63744 A Revision of spinal shunt 8.10 NA 5.72 1.51 NA 15.33 090 63746 A Removal of spinal shunt 6.43 NA 4.96 1.15 NA 12.54 090 64400 A Injection for nerve block 1.11 2.70 0.29 0.06 3.87 1.46 000 64402 A Injection for nerve block 1.25 4.38 0.45 0.07 5.70 1.77 000 64405 A Injection for nerve block 1.32 1.34 0.37 0.08 2.74 1.77 000 64408 A Injection for nerve block 1.41 2.95 0.62 0.09 4.45 2.12 000 64410 A Injection for nerve block 1.43 3.27 0.35 0.08 4.78 1.86 000 64412 A Injection for nerve block 1.18 2.49 0.37 0.08 3.75 1.63 000 64413 A Injection for nerve block 1.40 2.81 0.34 0.09 4.30 1.83 000 64415 A Injection for nerve block 1.48 2.65 0.32 0.08 4.21 1.88 000 64417 A Injection for nerve block 1.44 3.21 0.38 0.09 4.74 1.91 000 64418 A Injection for nerve block 1.32 2.49 0.29 0.07 3.88 1.68 000Start Printed Page 55398 64420 A Injection for nerve block 1.18 2.37 0.27 0.07 3.62 1.52 000 64421 A Injection for nerve block 1.68 2.91 0.38 0.10 4.69 2.16 000 64425 A Injection for nerve block 1.75 2.33 0.41 0.11 4.19 2.27 000 64430 A Injection for nerve block 1.46 2.89 0.47 0.11 4.46 2.04 000 64435 A Injection for nerve block 1.45 2.96 0.60 0.15 4.56 2.20 000 64445 A Injection for nerve block 1.48 1.60 0.42 0.08 3.16 1.98 000 64450 A Injection for nerve block 1.27 1.79 0.33 0.08 3.14 1.68 000 64470 A Inj paravertebral c/t 1.85 4.02 0.48 0.12 5.99 2.45 000 64472 A Inj paravertebral c/t add-on 1.29 3.90 0.33 0.09 5.28 1.71 ZZZ 64475 A Inj paravertebral l/s 1.41 3.82 0.39 0.09 5.32 1.89 000 64476 A Inj paravertebral l/s add-on 0.98 3.86 0.26 0.06 4.90 1.30 ZZZ 64479 A Inj foramen epidural c/t 2.20 4.40 0.64 0.14 6.74 2.98 000 64480 A Inj foramen epidural add-on 1.54 4.07 0.50 0.09 5.70 2.13 ZZZ 64483 A Inj foramen epidural l/s 1.90 4.44 0.56 0.12 6.46 2.58 000 64484 A Inj foramen epidural add-on 1.33 4.05 0.40 0.08 5.46 1.81 ZZZ 64505 A Injection for nerve block 1.36 2.41 0.35 0.08 3.85 1.79 000 64508 A Injection for nerve block 1.12 2.32 0.48 0.06 3.50 1.66 000 64510 A Injection for nerve block 1.22 2.53 0.26 0.07 3.82 1.55 000 64520 A Injection for nerve block 1.35 3.49 0.31 0.08 4.92 1.74 000 64530 A Injection for nerve block 1.58 3.07 0.37 0.09 4.74 2.04 000 64550 A Apply neurostimulator 0.18 0.56 0.07 0.01 0.75 0.26 000 64553 A Implant neuroelectrodes 2.31 4.25 1.33 0.17 6.73 3.81 010 64555 A Implant neuroelectrodes 2.27 2.38 0.77 0.11 4.76 3.15 010 64560 A Implant neuroelectrodes 2.36 2.30 0.94 0.17 4.83 3.47 010 64561 A Implant neuroelectrodes 6.74 15.28 3.83 0.11 22.13 10.68 010 64565 A Implant neuroelectrodes 1.76 3.41 0.69 0.08 5.25 2.53 010 64573 A Implant neuroelectrodes 7.50 NA 5.40 1.48 NA 14.38 090 64575 A Implant neuroelectrodes 4.35 NA 3.03 0.37 NA 7.75 090 64577 A Implant neuroelectrodes 4.62 NA 3.44 0.50 NA 8.56 090 64580 A Implant neuroelectrodes 4.12 NA 3.94 0.21 NA 8.27 090 64581 A Implant neuroelectrodes 13.50 NA 6.72 0.37 NA 20.59 090 64585 A Revise/remove neuroelectrode 2.06 2.82 2.20 0.29 5.17 4.55 010 64590 A Implant neuroreceiver 2.40 NA 2.17 0.40 NA 4.97 010 64595 A Revise/remove neuroreceiver 1.73 NA 2.08 0.22 NA 4.03 010 64600 A Injection treatment of nerve 3.45 2.98 2.06 0.28 6.71 5.79 010 64605 A Injection treatment of nerve 5.61 3.62 2.90 0.53 9.76 9.04 010 64610 A Injection treatment of nerve 7.16 NA 4.18 1.12 NA 12.46 010 64612 A Destroy nerve, face muscle 1.96 3.00 1.65 0.09 5.05 3.70 010 64613 A Destroy nerve, spine muscle 1.96 1.82 1.48 0.10 3.88 3.54 010 64614 A Destroy nerve, extrem musc 2.20 3.23 0.82 0.09 5.52 3.11 010 64620 A Injection treatment of nerve 2.84 2.98 0.67 0.17 5.99 3.68 010 64622 A Destr paravertebrl nerve l/s 3.00 4.77 0.74 0.17 7.94 3.91 010 64623 A Destr paravertebral n add-on 0.99 3.85 0.24 0.06 4.90 1.29 ZZZ 64626 A Destr paravertebrl nerve c/t 3.28 4.34 0.80 0.22 7.84 4.30 010 64627 A Destr paravertebral n add-on 1.16 3.74 0.29 0.08 4.98 1.53 ZZZ 64630 A Injection treatment of nerve 3.00 3.66 0.88 0.16 6.82 4.04 010 64640 A Injection treatment of nerve 2.76 3.67 1.72 0.11 6.54 4.59 010 64680 A Injection treatment of nerve 2.62 2.89 0.76 0.15 5.66 3.53 010 64702 A Revise finger/toe nerve 4.23 NA 4.05 0.51 NA 8.79 090 64704 A Revise hand/foot nerve 4.57 NA 3.23 0.59 NA 8.39 090 64708 A Revise arm/leg nerve 6.12 NA 5.19 0.82 NA 12.13 090 64712 A Revision of sciatic nerve 7.75 NA 5.61 0.54 NA 13.90 090 64713 A Revision of arm nerve(s) 11.00 NA 6.66 1.01 NA 18.67 090 64714 A Revise low back nerve(s) 10.33 NA 4.25 0.64 NA 15.22 090 64716 A Revision of cranial nerve 6.31 NA 5.18 0.59 NA 12.08 090 64718 A Revise ulnar nerve at elbow 5.99 NA 5.29 0.87 NA 12.15 090 64719 A Revise ulnar nerve at wrist 4.85 NA 4.78 0.63 NA 10.26 090 64721 A Carpal tunnel surgery 4.29 6.59 6.14 0.59 11.47 11.02 090 64722 A Relieve pressure on nerve(s) 4.70 NA 3.49 0.32 NA 8.51 090 64726 A Release foot/toe nerve 4.18 NA 3.14 0.57 NA 7.89 090 64727 A Internal nerve revision 3.10 NA 1.68 0.40 NA 5.18 ZZZ 64732 A Incision of brow nerve 4.41 NA 3.69 0.77 NA 8.87 090 64734 A Incision of cheek nerve 4.92 NA 3.80 0.83 NA 9.55 090 64736 A Incision of chin nerve 4.60 NA 2.98 0.71 NA 8.29 090 64738 A Incision of jaw nerve 5.73 NA 3.92 0.84 NA 10.49 090 64740 A Incision of tongue nerve 5.59 NA 4.11 0.43 NA 10.13 090 64742 A Incision of facial nerve 6.22 NA 4.96 0.69 NA 11.87 090 64744 A Incise nerve, back of head 5.24 NA 3.94 0.98 NA 10.16 090 64746 A Incise diaphragm nerve 5.93 NA 4.58 0.75 NA 11.26 090 64752 A Incision of vagus nerve 7.06 NA 4.96 0.83 NA 12.85 090 64755 A Incision of stomach nerves 13.52 NA 6.40 1.16 NA 21.08 090 64760 A Incision of vagus nerve 6.96 NA 4.05 0.51 NA 11.52 090 64761 A Incision of pelvis nerve 6.41 NA 3.48 0.26 NA 10.15 090Start Printed Page 55399 64763 A Incise hip/thigh nerve 6.93 NA 6.21 0.77 NA 13.91 090 64766 A Incise hip/thigh nerve 8.67 NA 4.73 0.99 NA 14.39 090 64771 A Sever cranial nerve 7.35 NA 5.44 1.32 NA 14.11 090 64772 A Incision of spinal nerve 7.21 NA 4.88 1.20 NA 13.29 090 64774 A Remove skin nerve lesion 5.17 NA 3.92 0.60 NA 9.69 090 64776 A Remove digit nerve lesion 5.12 NA 3.89 0.63 NA 9.64 090 64778 A Digit nerve surgery add-on 3.11 NA 1.64 0.38 NA 5.13 ZZZ 64782 A Remove limb nerve lesion 6.23 NA 3.93 0.79 NA 10.95 090 64783 A Limb nerve surgery add-on 3.72 NA 1.95 0.48 NA 6.15 ZZZ 64784 A Remove nerve lesion 9.82 NA 6.99 1.17 NA 17.98 090 64786 A Remove sciatic nerve lesion 15.46 NA 10.41 2.22 NA 28.09 090 64787 A Implant nerve end 4.30 NA 2.28 0.56 NA 7.14 ZZZ 64788 A Remove skin nerve lesion 4.61 NA 3.50 0.54 NA 8.65 090 64790 A Removal of nerve lesion 11.31 NA 7.53 1.68 NA 20.52 090 64792 A Removal of nerve lesion 14.92 NA 9.13 1.88 NA 25.93 090 64795 A Biopsy of nerve 3.01 NA 1.81 0.40 NA 5.22 000 64802 A Remove sympathetic nerves 9.15 NA 5.17 0.87 NA 15.19 090 64804 A Remove sympathetic nerves 14.64 NA 6.83 1.79 NA 23.26 090 64809 A Remove sympathetic nerves 13.67 NA 6.04 0.96 NA 20.67 090 64818 A Remove sympathetic nerves 10.30 NA 5.76 1.08 NA 17.14 090 64820 A Remove sympathetic nerves 10.37 NA 6.48 1.17 NA 18.02 090 64821 A Remove sympathetic nerves 8.75 NA 7.09 0.99 NA 16.83 090 64822 A Remove sympathetic nerves 8.75 NA 7.09 0.99 NA 16.83 090 64823 A Remove sympathetic nerves 10.37 NA 7.89 1.17 NA 19.43 090 64831 A Repair of digit nerve 9.44 NA 7.44 1.14 NA 18.02 090 64832 A Repair nerve add-on 5.66 NA 3.11 0.68 NA 9.45 ZZZ 64834 A Repair of hand or foot nerve 10.19 NA 7.40 1.23 NA 18.82 090 64835 A Repair of hand or foot nerve 10.94 NA 8.06 1.36 NA 20.36 090 64836 A Repair of hand or foot nerve 10.94 NA 7.94 1.32 NA 20.20 090 64837 A Repair nerve add-on 6.26 NA 3.47 0.80 NA 10.53 ZZZ 64840 A Repair of leg nerve 13.02 NA 7.79 0.86 NA 21.67 090 64856 A Repair/transpose nerve 13.80 NA 9.66 1.71 NA 25.17 090 64857 A Repair arm/leg nerve 14.49 NA 10.21 1.76 NA 26.46 090 64858 A Repair sciatic nerve 16.49 NA 11.04 2.78 NA 30.31 090 64859 A Nerve surgery 4.26 NA 2.24 0.50 NA 7.00 ZZZ 64861 A Repair of arm nerves 19.24 NA 13.02 2.45 NA 34.71 090 64862 A Repair of low back nerves 19.44 NA 12.29 2.47 NA 34.20 090 64864 A Repair of facial nerve 12.55 NA 8.63 1.13 NA 22.31 090 64865 A Repair of facial nerve 15.24 NA 10.46 1.37 NA 27.07 090 64866 A Fusion of facial/other nerve 15.74 NA 9.84 1.06 NA 26.64 090 64868 A Fusion of facial/other nerve 14.04 NA 9.57 1.40 NA 25.01 090 64870 A Fusion of facial/other nerve 15.99 NA 9.65 1.08 NA 26.72 090 64872 A Subsequent repair of nerve 1.99 NA 1.08 0.24 NA 3.31 ZZZ 64874 A Repair & revise nerve add-on 2.98 NA 1.64 0.34 NA 4.96 ZZZ 64876 A Repair nerve/shorten bone 3.38 NA 1.35 0.39 NA 5.12 ZZZ 64885 A Nerve graft, head or neck 17.53 NA 11.66 1.51 NA 30.70 090 64886 A Nerve graft, head or neck 20.75 NA 13.60 1.73 NA 36.08 090 64890 A Nerve graft, hand or foot 15.15 NA 10.27 1.74 NA 27.16 090 64891 A Nerve graft, hand or foot 16.14 NA 5.75 1.38 NA 23.27 090 64892 A Nerve graft, arm or leg 14.65 NA 8.96 1.65 NA 25.26 090 64893 A Nerve graft, arm or leg 15.60 NA 10.75 1.77 NA 28.12 090 64895 A Nerve graft, hand or foot 19.25 NA 8.62 2.04 NA 29.91 090 64896 A Nerve graft, hand or foot 20.49 NA 11.75 1.85 NA 34.09 090 64897 A Nerve graft, arm or leg 18.24 NA 10.92 2.64 NA 31.80 090 64898 A Nerve graft, arm or leg 19.50 NA 10.75 2.71 NA 32.96 090 64901 A Nerve graft add-on 10.22 NA 5.75 0.99 NA 16.96 ZZZ 64902 A Nerve graft add-on 11.83 NA 6.32 1.10 NA 19.25 ZZZ 64905 A Nerve pedicle transfer 14.02 NA 8.93 1.52 NA 24.47 090 64907 A Nerve pedicle transfer 18.83 NA 12.07 1.79 NA 32.69 090 64999 C Nervous system surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY 65091 A Revise eye 6.46 NA 11.59 0.26 NA 18.31 090 65093 A Revise eye with implant 6.87 NA 11.83 0.28 NA 18.98 090 65101 A Removal of eye 7.03 NA 12.04 0.28 NA 19.35 090 65103 A Remove eye/insert implant 7.57 NA 12.17 0.30 NA 20.04 090 65105 A Remove eye/attach implant 8.49 NA 12.67 0.34 NA 21.50 090 65110 A Removal of eye 13.95 NA 15.90 0.68 NA 30.53 090 65112 A Remove eye/revise socket 16.38 NA 17.26 0.96 NA 34.60 090 65114 A Remove eye/revise socket 17.53 NA 18.54 0.94 NA 37.01 090 65125 A Revise ocular implant 3.12 6.23 1.48 0.15 9.50 4.75 090 65130 A Insert ocular implant 7.15 NA 11.46 0.28 NA 18.89 090 65135 A Insert ocular implant 7.33 NA 12.37 0.29 NA 19.99 090 65140 A Attach ocular implant 8.02 NA 12.36 0.31 NA 20.69 090 65150 A Revise ocular implant 6.26 NA 10.94 0.25 NA 17.45 090Start Printed Page 55400 65155 A Reinsert ocular implant 8.66 NA 12.59 0.40 NA 21.65 090 65175 A Removal of ocular implant 6.28 NA 11.35 0.26 NA 17.89 090 65205 A Remove foreign body from eye 0.71 0.63 0.20 0.03 1.37 0.94 000 65210 A Remove foreign body from eye 0.84 0.78 0.32 0.03 1.65 1.19 000 65220 A Remove foreign body from eye 0.71 8.23 0.19 0.05 8.99 0.95 000 65222 A Remove foreign body from eye 0.93 0.80 0.29 0.04 1.77 1.26 000 65235 A Remove foreign body from eye 7.57 NA 7.04 0.30 NA 14.91 090 65260 A Remove foreign body from eye 10.96 NA 12.66 0.43 NA 24.05 090 65265 A Remove foreign body from eye 12.59 NA 14.38 0.50 NA 27.47 090 65270 A Repair of eye wound 1.90 4.07 2.44 0.08 6.05 4.42 010 65272 A Repair of eye wound 3.82 5.76 4.75 0.16 9.74 8.73 090 65273 A Repair of eye wound 4.36 NA 5.15 0.17 NA 9.68 090 65275 A Repair of eye wound 5.34 5.50 5.32 0.27 11.11 10.93 090 65280 A Repair of eye wound 7.66 NA 7.88 0.30 NA 15.84 090 65285 A Repair of eye wound 12.90 NA 13.86 0.51 NA 27.27 090 65286 A Repair of eye wound 5.51 9.12 7.85 0.21 14.84 13.57 090 65290 A Repair of eye socket wound 5.41 NA 6.60 0.26 NA 12.27 090 65400 A Removal of eye lesion 6.06 8.61 7.13 0.24 14.91 13.43 090 65410 A Biopsy of cornea 1.47 1.76 0.71 0.06 3.29 2.24 000 65420 A Removal of eye lesion 4.17 8.36 7.22 0.17 12.70 11.56 090 65426 A Removal of eye lesion 5.25 8.01 6.75 0.20 13.46 12.20 090 65430 A Corneal smear 1.47 8.68 0.71 0.06 10.21 2.24 000 65435 A Curette/treat cornea 0.92 1.37 0.41 0.04 2.33 1.37 000 65436 A Curette/treat cornea 4.19 6.02 5.03 0.17 10.38 9.39 090 65450 A Treatment of corneal lesion 3.27 7.97 6.80 0.13 11.37 10.20 090 65600 A Revision of cornea 3.40 5.54 1.54 0.14 9.08 5.08 090 65710 A Corneal transplant 12.35 NA 13.25 0.49 NA 26.09 090 65730 A Corneal transplant 14.25 NA 12.16 0.56 NA 26.97 090 65750 A Corneal transplant 15.00 NA 14.54 0.59 NA 30.13 090 65755 A Corneal transplant 14.89 NA 14.48 0.58 NA 29.95 090 65760 N Revision of cornea 0.00 0.00 0.00 0.00 0.00 0.00 XXX 65765 N Revision of cornea 0.00 0.00 0.00 0.00 0.00 0.00 XXX 65767 N Corneal tissue transplant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 65770 A Revise cornea with implant 17.56 NA 15.48 0.69 NA 33.73 090 65771 N Radial keratotomy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 65772 A Correction of astigmatism 4.29 7.51 6.47 0.17 11.97 10.93 090 65775 A Correction of astigmatism 5.79 NA 8.63 0.22 NA 14.64 090 65800 A Drainage of eye 1.91 2.33 1.45 0.08 4.32 3.44 000 65805 A Drainage of eye 1.91 2.34 1.46 0.08 4.33 3.45 000 65810 A Drainage of eye 4.87 NA 8.95 0.19 NA 14.01 090 65815 A Drainage of eye 5.05 9.40 8.16 0.20 14.65 13.41 090 65820 A Relieve inner eye pressure 8.13 NA 10.99 0.32 NA 19.44 090 65850 A Incision of eye 10.52 NA 10.35 0.41 NA 21.28 090 65855 A Laser surgery of eye 3.85 5.17 3.70 0.17 9.19 7.72 010 65860 A Incise inner eye adhesions 3.55 4.15 3.18 0.14 7.84 6.87 090 65865 A Incise inner eye adhesions 5.60 NA 6.92 0.22 NA 12.74 090 65870 A Incise inner eye adhesions 6.27 NA 7.25 0.24 NA 13.76 090 65875 A Incise inner eye adhesions 6.54 NA 7.37 0.25 NA 14.16 090 65880 A Incise inner eye adhesions 7.09 NA 7.64 0.28 NA 15.01 090 65900 A Remove eye lesion 10.93 NA 12.75 0.46 NA 24.14 090 65920 A Remove implant of eye 8.40 NA 8.26 0.33 NA 16.99 090 65930 A Remove blood clot from eye 7.44 NA 8.83 0.29 NA 16.56 090 66020 A Injection treatment of eye 1.59 2.43 1.57 0.07 4.09 3.23 010 66030 A Injection treatment of eye 1.25 2.25 1.40 0.05 3.55 2.70 010 66130 A Remove eye lesion 7.69 7.63 6.71 0.31 15.63 14.71 090 66150 A Glaucoma surgery 8.30 NA 10.98 0.33 NA 19.61 090 66155 A Glaucoma surgery 8.29 NA 10.94 0.32 NA 19.55 090 66160 A Glaucoma surgery 10.17 NA 11.84 0.41 NA 22.42 090 66165 A Glaucoma surgery 8.01 NA 10.72 0.31 NA 19.04 090 66170 A Glaucoma surgery 12.16 NA 17.11 0.48 NA 29.75 090 66172 A Incision of eye 15.04 NA 15.67 0.59 NA 31.30 090 66180 A Implant eye shunt 14.55 NA 12.44 0.57 NA 27.56 090 66185 A Revise eye shunt 8.14 NA 8.47 0.32 NA 16.93 090 66220 A Repair eye lesion 7.77 NA 9.99 0.32 NA 18.08 090 66225 A Repair/graft eye lesion 11.05 NA 9.65 0.44 NA 21.14 090 66250 A Follow-up surgery of eye 5.98 8.08 6.48 0.23 14.29 12.69 090 66500 A Incision of iris 3.71 NA 4.82 0.15 NA 8.68 090 66505 A Incision of iris 4.08 NA 5.01 0.17 NA 9.26 090 66600 A Remove iris and lesion 8.68 NA 8.90 0.34 NA 17.92 090 66605 A Removal of iris 12.79 NA 12.54 0.61 NA 25.94 090 66625 A Removal of iris 5.13 7.90 6.81 0.20 13.23 12.14 090 66630 A Removal of iris 6.16 NA 7.76 0.24 NA 14.16 090 66635 A Removal of iris 6.25 NA 6.65 0.24 NA 13.14 090Start Printed Page 55401 66680 A Repair iris & ciliary body 5.44 NA 6.30 0.21 NA 11.95 090 66682 A Repair iris & ciliary body 6.21 NA 7.75 0.24 NA 14.20 090 66700 A Destruction, ciliary body 4.78 7.17 7.17 0.19 12.14 12.14 090 66710 A Destruction, ciliary body 4.78 8.92 7.53 0.18 13.88 12.49 090 66720 A Destruction, ciliary body 4.78 8.40 7.53 0.19 13.37 12.50 090 66740 A Destruction, ciliary body 4.78 NA 6.53 0.18 NA 11.49 090 66761 A Revision of iris 4.07 5.66 4.38 0.16 9.89 8.61 090 66762 A Revision of iris 4.58 5.65 4.45 0.18 10.41 9.21 090 66770 A Removal of inner eye lesion 5.18 5.94 4.68 0.20 11.32 10.06 090 66820 A Incision, secondary cataract 3.89 NA 8.50 0.16 NA 12.55 090 66821 A After cataract laser surgery 2.35 3.89 3.46 0.10 6.34 5.91 090 66825 A Reposition intraocular lens 8.23 NA 10.56 0.32 NA 19.11 090 66830 A Removal of lens lesion 8.20 NA 7.06 0.32 NA 15.58 090 66840 A Removal of lens material 7.91 NA 6.92 0.31 NA 15.14 090 66850 A Removal of lens material 9.11 NA 7.52 0.36 NA 16.99 090 66852 A Removal of lens material 9.97 NA 7.99 0.39 NA 18.35 090 66920 A Extraction of lens 8.86 NA 7.42 0.35 NA 16.63 090 66930 A Extraction of lens 10.18 NA 8.94 0.41 NA 19.53 090 66940 A Extraction of lens 8.93 NA 8.39 0.35 NA 17.67 090 66982 A Cataract surgery, complex 13.50 NA 9.31 0.56 NA 23.37 090 66983 A Cataract surg w/iol, 1 stage 8.99 NA 6.34 0.37 NA 15.70 090 66984 A Cataract surg w/iol, 1 stage 10.23 NA 7.85 0.41 NA 18.49 090 66985 A Insert lens prosthesis 8.39 NA 7.05 0.33 NA 15.77 090 66986 A Exchange lens prosthesis 12.28 NA 8.86 0.49 NA 21.63 090 66999 C Eye surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 67005 A Partial removal of eye fluid 5.70 NA 2.75 0.22 NA 8.67 090 67010 A Partial removal of eye fluid 6.87 NA 3.32 0.27 NA 10.46 090 67015 A Release of eye fluid 6.92 NA 8.38 0.27 NA 15.57 090 67025 A Replace eye fluid 6.84 18.23 7.77 0.27 25.34 14.88 090 67027 A Implant eye drug system 10.85 15.12 9.26 0.46 26.43 20.57 090 67028 A Injection eye drug 2.52 11.92 1.21 0.11 14.55 3.84 000 67030 A Incise inner eye strands 4.84 NA 6.96 0.19 NA 11.99 090 67031 A Laser surgery, eye strands 3.67 4.22 3.24 0.15 8.04 7.06 090 67036 A Removal of inner eye fluid 11.89 NA 9.30 0.47 NA 21.66 090 67038 A Strip retinal membrane 21.24 NA 16.01 0.84 NA 38.09 090 67039 A Laser treatment of retina 14.52 NA 12.74 0.57 NA 27.83 090 67040 A Laser treatment of retina 17.23 NA 14.08 0.68 NA 31.99 090 67101 A Repair detached retina 7.53 11.29 9.12 0.29 19.11 16.94 090 67105 A Repair detached retina 7.41 7.80 5.70 0.29 15.50 13.40 090 67107 A Repair detached retina 14.84 NA 13.63 0.58 NA 29.05 090 67108 A Repair detached retina 20.82 NA 18.30 0.82 NA 39.94 090 67110 A Repair detached retina 8.81 21.74 10.56 0.35 30.90 19.72 090 67112 A Rerepair detached retina 16.86 NA 15.66 0.66 NA 33.18 090 67115 A Release encircling material 4.99 NA 7.02 0.19 NA 12.20 090 67120 A Remove eye implant material 5.98 17.57 7.36 0.23 23.78 13.57 090 67121 A Remove eye implant material 10.67 NA 12.47 0.42 NA 23.56 090 67141 A Treatment of retina 5.20 8.29 7.16 0.20 13.69 12.56 090 67145 A Treatment of retina 5.37 5.43 4.28 0.21 11.01 9.86 090 67208 A Treatment of retinal lesion 6.70 8.62 7.26 0.26 15.58 14.22 090 67210 A Treatment of retinal lesion 8.82 7.49 5.93 0.35 16.66 15.10 090 67218 A Treatment of retinal lesion 18.53 NA 16.36 0.53 NA 35.42 090 67220 A Treatment of choroid lesion 13.13 11.18 9.94 0.51 24.82 23.58 090 67221 A Ocular photodynamic ther 4.01 4.80 1.95 0.16 8.97 6.12 000 67225 A Eye photodynamic ther add-on 0.47 0.24 0.19 0.50 1.21 1.16 ZZZ 67227 A Treatment of retinal lesion 6.58 9.29 7.40 0.26 16.13 14.24 090 67228 A Treatment of retinal lesion 12.74 10.17 7.47 0.50 23.41 20.71 090 67250 A Reinforce eye wall 8.66 NA 12.10 0.36 NA 21.12 090 67255 A Reinforce/graft eye wall 8.90 NA 12.11 0.35 NA 21.36 090 67299 C Eye surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 67311 A Revise eye muscle 6.65 NA 6.36 0.27 NA 13.28 090 67312 A Revise two eye muscles 8.54 NA 7.46 0.35 NA 16.35 090 67314 A Revise eye muscle 7.52 NA 6.94 0.30 NA 14.76 090 67316 A Revise two eye muscles 9.66 NA 7.99 0.40 NA 18.05 090 67318 A Revise eye muscle(s) 7.85 NA 7.37 0.31 NA 15.53 090 67320 A Revise eye muscle(s) add-on 4.33 NA 2.09 0.17 NA 6.59 ZZZ 67331 A Eye surgery follow-up add-on 4.06 NA 2.02 0.17 NA 6.25 ZZZ 67332 A Rerevise eye muscles add-on 4.49 NA 2.16 0.18 NA 6.83 ZZZ 67334 A Revise eye muscle w/suture 3.98 NA 1.90 0.16 NA 6.04 ZZZ 67335 A Eye suture during surgery 2.49 NA 1.20 0.10 NA 3.79 ZZZ 67340 A Revise eye muscle add-on 4.93 NA 2.41 0.19 NA 7.53 ZZZ 67343 A Release eye tissue 7.35 NA 7.26 0.30 NA 14.91 090 67345 A Destroy nerve of eye muscle 2.96 4.46 1.36 0.13 7.55 4.45 010 67350 A Biopsy eye muscle 2.87 NA 1.99 0.13 NA 4.99 000Start Printed Page 55402 67399 C Eye muscle surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 67400 A Explore/biopsy eye socket 9.76 NA 13.85 0.43 NA 24.04 090 67405 A Explore/drain eye socket 7.93 NA 12.56 0.36 NA 20.85 090 67412 A Explore/treat eye socket 9.50 NA 16.02 0.41 NA 25.93 090 67413 A Explore/treat eye socket 10.00 NA 13.80 0.43 NA 24.23 090 67414 A Explr/decompress eye socket 11.13 NA 16.90 0.48 NA 28.51 090 67415 A Aspiration, orbital contents 1.76 NA 0.80 0.09 NA 2.65 000 67420 A Explore/treat eye socket 20.06 NA 20.79 0.84 NA 41.69 090 67430 A Explore/treat eye socket 13.39 NA 18.38 0.97 NA 32.74 090 67440 A Explore/drain eye socket 13.09 NA 18.43 0.58 NA 32.10 090 67445 A Explr/decompress eye socket 14.42 NA 18.19 0.63 NA 33.24 090 67450 A Explore/biopsy eye socket 13.51 NA 17.51 0.56 NA 31.58 090 67500 A Inject/treat eye socket 0.79 0.95 0.20 0.04 1.78 1.03 000 67505 A Inject/treat eye socket 0.82 0.95 0.21 0.04 1.81 1.07 000 67515 A Inject/treat eye socket 0.61 0.86 0.29 0.02 1.49 0.92 000 67550 A Insert eye socket implant 10.19 NA 13.57 0.50 NA 24.26 090 67560 A Revise eye socket implant 10.60 NA 13.50 0.47 NA 24.57 090 67570 A Decompress optic nerve 13.58 NA 17.66 0.69 NA 31.93 090 67599 C Orbit surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 67700 A Drainage of eyelid abscess 1.35 7.80 0.60 0.06 9.21 2.01 010 67710 A Incision of eyelid 1.02 7.92 0.49 0.04 8.98 1.55 010 67715 A Incision of eyelid fold 1.22 NA 0.59 0.05 NA 1.86 010 67800 A Remove eyelid lesion 1.38 2.67 0.66 0.06 4.11 2.10 010 67801 A Remove eyelid lesions 1.88 8.23 0.91 0.08 10.19 2.87 010 67805 A Remove eyelid lesions 2.22 8.41 1.06 0.09 10.72 3.37 010 67808 A Remove eyelid lesion(s) 3.80 NA 4.34 0.17 NA 8.31 090 67810 A Biopsy of eyelid 1.48 5.26 0.72 0.06 6.80 2.26 000 67820 A Revise eyelashes 0.89 2.02 0.39 0.04 2.95 1.32 000 67825 A Revise eyelashes 1.38 5.70 1.07 0.06 7.14 2.51 010 67830 A Revise eyelashes 1.70 11.55 2.20 0.07 13.32 3.97 010 67835 A Revise eyelashes 5.56 NA 4.90 0.22 NA 10.68 090 67840 A Remove eyelid lesion 2.04 8.19 0.99 0.08 10.31 3.11 010 67850 A Treat eyelid lesion 1.69 8.79 2.07 0.07 10.55 3.83 010 67875 A Closure of eyelid by suture 1.35 11.62 2.16 0.06 13.03 3.57 000 67880 A Revision of eyelid 3.80 12.77 3.24 0.16 16.73 7.20 090 67882 A Revision of eyelid 5.07 15.42 4.84 0.21 20.70 10.12 090 67900 A Repair brow defect 6.14 11.29 6.69 0.30 17.73 13.13 090 67901 A Repair eyelid defect 6.97 NA 7.22 0.32 NA 14.51 090 67902 A Repair eyelid defect 7.03 NA 7.17 0.34 NA 14.54 090 67903 A Repair eyelid defect 6.37 10.72 6.80 0.39 17.48 13.56 090 67904 A Repair eyelid defect 6.26 14.97 8.57 0.26 21.49 15.09 090 67906 A Repair eyelid defect 6.79 9.91 6.30 0.42 17.12 13.51 090 67908 A Repair eyelid defect 5.13 9.65 6.36 0.20 14.98 11.69 090 67909 A Revise eyelid defect 5.40 10.20 6.87 0.25 15.85 12.52 090 67911 A Revise eyelid defect 5.27 NA 6.92 0.23 NA 12.42 090 67914 A Repair eyelid defect 3.68 13.22 3.70 0.16 17.06 7.54 090 67915 A Repair eyelid defect 3.18 11.73 1.52 0.13 15.04 4.83 090 67916 A Repair eyelid defect 5.31 17.26 5.52 0.22 22.79 11.05 090 67917 A Repair eyelid defect 6.02 10.63 6.86 0.25 16.90 13.13 090 67921 A Repair eyelid defect 3.40 12.94 3.47 0.14 16.48 7.01 090 67922 A Repair eyelid defect 3.06 11.73 3.31 0.13 14.92 6.50 090 67923 A Repair eyelid defect 5.88 16.33 5.62 0.24 22.45 11.74 090 67924 A Repair eyelid defect 5.79 9.97 6.20 0.23 15.99 12.22 090 67930 A Repair eyelid wound 3.61 12.50 3.15 0.17 16.28 6.93 010 67935 A Repair eyelid wound 6.22 16.12 5.60 0.29 22.63 12.11 090 67938 A Remove eyelid foreign body 1.33 9.65 0.53 0.06 11.04 1.92 010 67950 A Revision of eyelid 5.82 9.01 7.67 0.30 15.13 13.79 090 67961 A Revision of eyelid 5.69 9.39 6.03 0.26 15.34 11.98 090 67966 A Revision of eyelid 6.57 9.01 6.25 0.33 15.91 13.15 090 67971 A Reconstruction of eyelid 9.79 NA 7.85 0.42 NA 18.06 090 67973 A Reconstruction of eyelid 12.87 NA 9.95 0.59 NA 23.41 090 67974 A Reconstruction of eyelid 12.84 NA 9.87 0.54 NA 23.25 090 67975 A Reconstruction of eyelid 9.13 NA 7.51 0.38 NA 17.02 090 67999 C Revision of eyelid 0.00 0.00 0.00 0.00 0.00 0.00 YYY 68020 A Incise/drain eyelid lining 1.37 7.79 0.65 0.06 9.22 2.08 010 68040 A Treatment of eyelid lesions 0.85 7.68 0.41 0.03 8.56 1.29 000 68100 A Biopsy of eyelid lining 1.35 7.93 0.65 0.06 9.34 2.06 000 68110 A Remove eyelid lining lesion 1.77 8.98 1.41 0.07 10.82 3.25 010 68115 A Remove eyelid lining lesion 2.36 8.47 1.14 0.10 10.93 3.60 010 68130 A Remove eyelid lining lesion 4.93 NA 2.38 0.19 NA 7.50 090 68135 A Remove eyelid lining lesion 1.84 8.23 0.89 0.07 10.14 2.80 010 68200 A Treat eyelid by injection 0.49 0.76 0.24 0.02 1.27 0.75 000 68320 A Revise/graft eyelid lining 5.37 5.75 5.34 0.21 11.33 10.92 090Start Printed Page 55403 68325 A Revise/graft eyelid lining 7.36 NA 6.33 0.30 NA 13.99 090 68326 A Revise/graft eyelid lining 7.15 NA 6.26 0.30 NA 13.71 090 68328 A Revise/graft eyelid lining 8.18 NA 7.07 0.40 NA 15.65 090 68330 A Revise eyelid lining 4.83 7.34 5.82 0.19 12.36 10.84 090 68335 A Revise/graft eyelid lining 7.19 NA 5.68 0.29 NA 13.16 090 68340 A Separate eyelid adhesions 4.17 15.87 4.33 0.17 20.21 8.67 090 68360 A Revise eyelid lining 4.37 6.77 5.42 0.17 11.31 9.96 090 68362 A Revise eyelid lining 7.34 NA 8.02 0.29 NA 15.65 090 68399 C Eyelid lining surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY 68400 A Incise/drain tear gland 1.69 11.48 2.18 0.07 13.24 3.94 010 68420 A Incise/drain tear sac 2.30 11.89 2.52 0.10 14.29 4.92 010 68440 A Incise tear duct opening 0.94 7.86 0.45 0.04 8.84 1.43 010 68500 A Removal of tear gland 11.02 NA 9.13 0.60 NA 20.75 090 68505 A Partial removal, tear gland 10.94 NA 10.31 0.57 NA 21.82 090 68510 A Biopsy of tear gland 4.61 13.09 2.22 0.19 17.89 7.02 000 68520 A Removal of tear sac 7.51 NA 7.47 0.33 NA 15.31 090 68525 A Biopsy of tear sac 4.43 NA 2.15 0.18 NA 6.76 000 68530 A Clearance of tear duct 3.66 15.33 3.18 0.16 19.15 7.00 010 68540 A Remove tear gland lesion 10.60 NA 9.73 0.46 NA 20.79 090 68550 A Remove tear gland lesion 13.26 NA 10.50 0.66 NA 24.42 090 68700 A Repair tear ducts 6.60 NA 6.87 0.27 NA 13.74 090 68705 A Revise tear duct opening 2.06 8.33 1.00 0.08 10.47 3.14 010 68720 A Create tear sac drain 8.96 NA 8.04 0.38 NA 17.38 090 68745 A Create tear duct drain 8.63 NA 7.82 0.38 NA 16.83 090 68750 A Create tear duct drain 8.66 NA 8.46 0.37 NA 17.49 090 68760 A Close tear duct opening 1.73 6.77 1.25 0.07 8.57 3.05 010 68761 A Close tear duct opening 1.36 3.09 1.03 0.06 4.51 2.45 010 68770 A Close tear system fistula 7.02 17.74 6.15 0.28 25.04 13.45 090 68801 A Dilate tear duct opening 0.94 0.88 0.57 0.04 1.86 1.55 010 68810 A Probe nasolacrimal duct 1.90 2.48 0.91 0.08 4.46 2.89 010 68811 A Probe nasolacrimal duct 2.35 NA 2.46 0.10 NA 4.91 010 68815 A Probe nasolacrimal duct 3.20 14.08 2.92 0.14 17.42 6.26 010 68840 A Explore/irrigate tear ducts 1.25 1.62 1.00 0.05 2.92 2.30 010 68850 A Injection for tear sac x-ray 0.80 15.29 0.32 0.03 16.12 1.15 000 68899 C Tear duct system surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY 69000 A Drain external ear lesion 1.45 2.14 0.59 0.10 3.69 2.14 010 69005 A Drain external ear lesion 2.11 2.55 2.11 0.16 4.82 4.38 010 69020 A Drain outer ear canal lesion 1.48 2.25 0.71 0.11 3.84 2.30 010 69090 N Pierce earlobes 0.00 0.00 0.00 0.00 0.00 0.00 XXX 69100 A Biopsy of external ear 0.81 1.44 0.41 0.04 2.29 1.26 000 69105 A Biopsy of external ear canal 0.85 1.51 1.02 0.06 2.42 1.93 000 69110 A Remove external ear, partial 3.44 3.48 2.85 0.24 7.16 6.53 090 69120 A Removal of external ear 4.05 NA 4.68 0.31 NA 9.04 090 69140 A Remove ear canal lesion(s) 7.97 NA 8.24 0.56 NA 16.77 090 69145 A Remove ear canal lesion(s) 2.62 3.41 2.54 0.18 6.21 5.34 090 69150 A Extensive ear canal surgery 13.43 NA 11.38 1.07 NA 25.88 090 69155 A Extensive ear/neck surgery 20.80 NA 16.26 1.51 NA 38.57 090 69200 A Clear outer ear canal 0.77 1.45 0.77 0.05 2.27 1.59 000 69205 A Clear outer ear canal 1.20 NA 1.58 0.09 NA 2.87 010 69210 A Remove impacted ear wax 0.61 0.59 0.25 0.04 1.24 0.90 000 69220 A Clean out mastoid cavity 0.83 1.53 0.44 0.06 2.42 1.33 000 69222 A Clean out mastoid cavity 1.40 2.24 1.71 0.10 3.74 3.21 010 69300 R Revise external ear 6.36 NA 4.38 0.43 NA 11.17 YYY 69310 A Rebuild outer ear canal 10.79 NA 9.86 0.77 NA 21.42 090 69320 A Rebuild outer ear canal 16.96 NA 13.77 1.17 NA 31.90 090 69399 C Outer ear surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 69400 A Inflate middle ear canal 0.83 1.51 0.49 0.06 2.40 1.38 000 69401 A Inflate middle ear canal 0.63 1.41 0.34 0.04 2.08 1.01 000 69405 A Catheterize middle ear canal 2.63 3.09 1.50 0.18 5.90 4.31 010 69410 A Inset middle ear (baffle) 0.33 1.39 0.17 0.02 1.74 0.52 000 69420 A Incision of eardrum 1.33 2.35 0.75 0.10 3.78 2.18 010 69421 A Incision of eardrum 1.73 2.58 1.92 0.13 4.44 3.78 010 69424 A Remove ventilating tube 0.85 1.68 0.94 0.06 2.59 1.85 000 69433 A Create eardrum opening 1.52 2.32 0.88 0.11 3.95 2.51 010 69436 A Create eardrum opening 1.96 NA 2.05 0.14 NA 4.15 010 69440 A Exploration of middle ear 7.57 NA 7.41 0.53 NA 15.51 090 69450 A Eardrum revision 5.57 NA 6.18 0.39 NA 12.14 090 69501 A Mastoidectomy 9.07 NA 8.22 0.65 NA 17.94 090 69502 A Mastoidectomy 12.38 NA 10.80 0.86 NA 24.04 090 69505 A Remove mastoid structures 12.99 NA 10.94 0.92 NA 24.85 090 69511 A Extensive mastoid surgery 13.52 NA 11.45 0.96 NA 25.93 090 69530 A Extensive mastoid surgery 19.19 NA 15.06 1.32 NA 35.57 090 69535 A Remove part of temporal bone 36.14 NA 25.13 2.59 NA 63.86 090Start Printed Page 55404 69540 A Remove ear lesion 1.20 2.27 1.61 0.09 3.56 2.90 010 69550 A Remove ear lesion 10.99 NA 9.97 0.80 NA 21.76 090 69552 A Remove ear lesion 19.46 NA 14.81 1.36 NA 35.63 090 69554 A Remove ear lesion 33.16 NA 21.79 2.32 NA 57.27 090 69601 A Mastoid surgery revision 13.24 NA 11.97 0.92 NA 26.13 090 69602 A Mastoid surgery revision 13.58 NA 11.55 0.94 NA 26.07 090 69603 A Mastoid surgery revision 14.02 NA 11.80 1.00 NA 26.82 090 69604 A Mastoid surgery revision 14.02 NA 11.76 0.98 NA 26.76 090 69605 A Mastoid surgery revision 18.49 NA 14.37 1.29 NA 34.15 090 69610 A Repair of eardrum 4.43 4.27 3.47 0.31 9.01 8.21 010 69620 A Repair of eardrum 5.89 6.90 3.40 0.40 13.19 9.69 090 69631 A Repair eardrum structures 9.86 NA 9.38 0.69 NA 19.93 090 69632 A Rebuild eardrum structures 12.75 NA 11.73 0.89 NA 25.37 090 69633 A Rebuild eardrum structures 12.10 NA 11.36 0.84 NA 24.30 090 69635 A Repair eardrum structures 13.33 NA 11.41 0.87 NA 25.61 090 69636 A Rebuild eardrum structures 15.22 NA 13.23 1.07 NA 29.52 090 69637 A Rebuild eardrum structures 15.11 NA 13.16 1.06 NA 29.33 090 69641 A Revise middle ear & mastoid 12.71 NA 11.06 0.89 NA 24.66 090 69642 A Revise middle ear & mastoid 16.84 NA 14.16 1.18 NA 32.18 090 69643 A Revise middle ear & mastoid 15.32 NA 13.24 1.08 NA 29.64 090 69644 A Revise middle ear & mastoid 16.97 NA 14.22 1.19 NA 32.38 090 69645 A Revise middle ear & mastoid 16.38 NA 13.77 1.16 NA 31.31 090 69646 A Revise middle ear & mastoid 17.99 NA 14.83 1.26 NA 34.08 090 69650 A Release middle ear bone 9.66 NA 8.53 0.68 NA 18.87 090 69660 A Revise middle ear bone 11.90 NA 9.86 0.84 NA 22.60 090 69661 A Revise middle ear bone 15.74 NA 12.63 1.10 NA 29.47 090 69662 A Revise middle ear bone 15.44 NA 12.56 1.08 NA 29.08 090 69666 A Repair middle ear structures 9.75 NA 8.65 0.68 NA 19.08 090 69667 A Repair middle ear structures 9.76 NA 8.58 0.72 NA 19.06 090 69670 A Remove mastoid air cells 11.51 NA 10.36 0.78 NA 22.65 090 69676 A Remove middle ear nerve 9.52 NA 9.14 0.69 NA 19.35 090 69700 A Close mastoid fistula 8.23 NA 5.77 0.55 NA 14.55 090 69710 N Implant/replace hearing aid 0.00 0.00 0.00 0.00 0.00 0.00 XXX 69711 A Remove/repair hearing aid 10.44 NA 9.62 0.62 NA 20.68 090 69714 A Implant temple bone w/stimul 14.00 NA 11.53 1.01 NA 26.54 090 69715 A Temple bone implnt w/stimulat 18.25 NA 14.05 1.32 NA 33.62 090 69717 A Temple bone implant revision 14.98 NA 11.46 1.08 NA 27.52 090 69718 A Revise temple bone implant 18.50 NA 14.20 1.34 NA 34.04 090 69720 A Release facial nerve 14.38 NA 12.85 1.03 NA 28.26 090 69725 A Release facial nerve 25.38 NA 17.97 1.78 NA 45.13 090 69740 A Repair facial nerve 15.96 NA 10.90 1.13 NA 27.99 090 69745 A Repair facial nerve 16.69 NA 12.80 1.00 NA 30.49 090 69799 C Middle ear surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 69801 A Incise inner ear 8.56 NA 7.96 0.60 NA 17.12 090 69802 A Incise inner ear 13.10 NA 11.37 0.91 NA 25.38 090 69805 A Explore inner ear 13.82 NA 10.91 0.97 NA 25.70 090 69806 A Explore inner ear 12.35 NA 10.82 0.86 NA 24.03 090 69820 A Establish inner ear window 10.34 NA 8.78 0.66 NA 19.78 090 69840 A Revise inner ear window 10.26 NA 9.00 0.64 NA 19.90 090 69905 A Remove inner ear 11.10 NA 9.94 0.77 NA 21.81 090 69910 A Remove inner ear & mastoid 13.63 NA 11.42 0.94 NA 25.99 090 69915 A Incise inner ear nerve 21.23 NA 15.88 1.54 NA 38.65 090 69930 A Implant cochlear device 16.81 NA 12.94 1.19 NA 30.94 090 69949 C Inner ear surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY 69950 A Incise inner ear nerve 25.64 NA 16.71 2.90 NA 45.25 090 69955 A Release facial nerve 27.04 NA 18.39 1.89 NA 47.32 090 69960 A Release inner ear canal 27.04 NA 18.40 2.43 NA 47.87 090 69970 A Remove inner ear lesion 30.04 NA 19.12 2.34 NA 51.50 090 69979 C Temporal bone surgery 0.00 0.00 0.00 0.00 0.00 0.00 YYY 69990 R Microsurgery add-on 3.47 NA 1.87 0.56 NA 5.90 ZZZ 70010 A Contrast x-ray of brain 1.19 4.53 NA 0.24 5.96 NA XXX 70010 26 A Contrast x-ray of brain 1.19 0.42 0.42 0.06 1.67 1.67 XXX 70010 TC A Contrast x-ray of brain 0.00 4.11 NA 0.18 4.29 NA XXX 70015 A Contrast x-ray of brain 1.19 1.71 NA 0.12 3.02 NA XXX 70015 26 A Contrast x-ray of brain 1.19 0.42 0.42 0.05 1.66 1.66 XXX 70015 TC A Contrast x-ray of brain 0.00 1.29 NA 0.07 1.36 NA XXX 70030 A X-ray eye for foreign body 0.17 0.45 NA 0.03 0.65 NA XXX 70030 26 A X-ray eye for foreign body 0.17 0.06 0.06 0.01 0.24 0.24 XXX 70030 TC A X-ray eye for foreign body 0.00 0.39 NA 0.02 0.41 NA XXX 70100 A X-ray exam of jaw 0.18 0.56 NA 0.03 0.77 NA XXX 70100 26 A X-ray exam of jaw 0.18 0.06 0.06 0.01 0.25 0.25 XXX 70100 TC A X-ray exam of jaw 0.00 0.50 NA 0.02 0.52 NA XXX 70110 A X-ray exam of jaw 0.25 0.68 NA 0.04 0.97 NA XXXStart Printed Page 55405 70110 26 A X-ray exam of jaw 0.25 0.09 0.09 0.01 0.35 0.35 XXX 70110 TC A X-ray exam of jaw 0.00 0.59 NA 0.03 0.62 NA XXX 70120 A X-ray exam of mastoids 0.18 0.65 NA 0.04 0.87 NA XXX 70120 26 A X-ray exam of mastoids 0.18 0.06 0.06 0.01 0.25 0.25 XXX 70120 TC A X-ray exam of mastoids 0.00 0.59 NA 0.03 0.62 NA XXX 70130 A X-ray exam of mastoids 0.34 0.86 NA 0.05 1.25 NA XXX 70130 26 A X-ray exam of mastoids 0.34 0.12 0.12 0.01 0.47 0.47 XXX 70130 TC A X-ray exam of mastoids 0.00 0.74 NA 0.04 0.78 NA XXX 70134 A X-ray exam of middle ear 0.34 0.82 NA 0.05 1.21 NA XXX 70134 26 A X-ray exam of middle ear 0.34 0.12 0.12 0.01 0.47 0.47 XXX 70134 TC A X-ray exam of middle ear 0.00 0.70 NA 0.04 0.74 NA XXX 70140 A X-ray exam of facial bones 0.19 0.66 NA 0.04 0.89 NA XXX 70140 26 A X-ray exam of facial bones 0.19 0.07 0.07 0.01 0.27 0.27 XXX 70140 TC A X-ray exam of facial bones 0.00 0.59 NA 0.03 0.62 NA XXX 70150 A X-ray exam of facial bones 0.26 0.83 NA 0.05 1.14 NA XXX 70150 26 A X-ray exam of facial bones 0.26 0.09 0.09 0.01 0.36 0.36 XXX 70150 TC A X-ray exam of facial bones 0.00 0.74 NA 0.04 0.78 NA XXX 70160 A X-ray exam of nasal bones 0.17 0.56 NA 0.03 0.76 NA XXX 70160 26 A X-ray exam of nasal bones 0.17 0.06 0.06 0.01 0.24 0.24 XXX 70160 TC A X-ray exam of nasal bones 0.00 0.50 NA 0.02 0.52 NA XXX 70170 A X-ray exam of tear duct 0.30 1.01 NA 0.06 1.37 NA XXX 70170 26 A X-ray exam of tear duct 0.30 0.11 0.11 0.01 0.42 0.42 XXX 70170 TC A X-ray exam of tear duct 0.00 0.90 NA 0.05 0.95 NA XXX 70190 A X-ray exam of eye sockets 0.21 0.66 NA 0.04 0.91 NA XXX 70190 26 A X-ray exam of eye sockets 0.21 0.07 0.07 0.01 0.29 0.29 XXX 70190 TC A X-ray exam of eye sockets 0.00 0.59 NA 0.03 0.62 NA XXX 70200 A X-ray exam of eye sockets 0.28 0.84 NA 0.05 1.17 NA XXX 70200 26 A X-ray exam of eye sockets 0.28 0.10 0.10 0.01 0.39 0.39 XXX 70200 TC A X-ray exam of eye sockets 0.00 0.74 NA 0.04 0.78 NA XXX 70210 A X-ray exam of sinuses 0.17 0.65 NA 0.04 0.86 NA XXX 70210 26 A X-ray exam of sinuses 0.17 0.06 0.06 0.01 0.24 0.24 XXX 70210 TC A X-ray exam of sinuses 0.00 0.59 NA 0.03 0.62 NA XXX 70220 A X-ray exam of sinuses 0.25 0.83 NA 0.05 1.13 NA XXX 70220 26 A X-ray exam of sinuses 0.25 0.09 0.09 0.01 0.35 0.35 XXX 70220 TC A X-ray exam of sinuses 0.00 0.74 NA 0.04 0.78 NA XXX 70240 A X-ray exam, pituitary saddle 0.19 0.46 NA 0.03 0.68 NA XXX 70240 26 A X-ray exam, pituitary saddle 0.19 0.07 0.07 0.01 0.27 0.27 XXX 70240 TC A X-ray exam, pituitary saddle 0.00 0.39 NA 0.02 0.41 NA XXX 70250 A X-ray exam of skull 0.24 0.67 NA 0.04 0.95 NA XXX 70250 26 A X-ray exam of skull 0.24 0.08 0.08 0.01 0.33 0.33 XXX 70250 TC A X-ray exam of skull 0.00 0.59 NA 0.03 0.62 NA XXX 70260 A X-ray exam of skull 0.34 0.96 NA 0.06 1.36 NA XXX 70260 26 A X-ray exam of skull 0.34 0.12 0.12 0.01 0.47 0.47 XXX 70260 TC A X-ray exam of skull 0.00 0.84 NA 0.05 0.89 NA XXX 70300 A X-ray exam of teeth 0.10 0.29 NA 0.03 0.42 NA XXX 70300 26 A X-ray exam of teeth 0.10 0.04 0.04 0.01 0.15 0.15 XXX 70300 TC A X-ray exam of teeth 0.00 0.25 NA 0.02 0.27 NA XXX 70310 A X-ray exam of teeth 0.16 0.46 NA 0.03 0.65 NA XXX 70310 26 A X-ray exam of teeth 0.16 0.07 0.07 0.01 0.24 0.24 XXX 70310 TC A X-ray exam of teeth 0.00 0.39 NA 0.02 0.41 NA XXX 70320 A Full mouth x-ray of teeth 0.22 0.82 NA 0.05 1.09 NA XXX 70320 26 A Full mouth x-ray of teeth 0.22 0.08 0.08 0.01 0.31 0.31 XXX 70320 TC A Full mouth x-ray of teeth 0.00 0.74 NA 0.04 0.78 NA XXX 70328 A X-ray exam of jaw joint 0.18 0.53 NA 0.03 0.74 NA XXX 70328 26 A X-ray exam of jaw joint 0.18 0.06 0.06 0.01 0.25 0.25 XXX 70328 TC A X-ray exam of jaw joint 0.00 0.47 NA 0.02 0.49 NA XXX 70330 A X-ray exam of jaw joints 0.24 0.88 NA 0.05 1.17 NA XXX 70330 26 A X-ray exam of jaw joints 0.24 0.08 0.08 0.01 0.33 0.33 XXX 70330 TC A X-ray exam of jaw joints 0.00 0.80 NA 0.04 0.84 NA XXX 70332 A X-ray exam of jaw joint 0.54 2.18 NA 0.12 2.84 NA XXX 70332 26 A X-ray exam of jaw joint 0.54 0.19 0.19 0.02 0.75 0.75 XXX 70332 TC A X-ray exam of jaw joint 0.00 1.99 NA 0.10 2.09 NA XXX 70336 A Magnetic image, jaw joint 1.48 11.16 NA 0.56 13.20 NA XXX 70336 26 A Magnetic image, jaw joint 1.48 0.52 0.52 0.07 2.07 2.07 XXX 70336 TC A Magnetic image, jaw joint 0.00 10.64 NA 0.49 11.13 NA XXX 70350 A X-ray head for orthodontia 0.17 0.42 NA 0.03 0.62 NA XXX 70350 26 A X-ray head for orthodontia 0.17 0.06 0.06 0.01 0.24 0.24 XXX 70350 TC A X-ray head for orthodontia 0.00 0.36 NA 0.02 0.38 NA XXX 70355 A Panoramic x-ray of jaws 0.20 0.61 NA 0.04 0.85 NA XXX 70355 26 A Panoramic x-ray of jaws 0.20 0.07 0.07 0.01 0.28 0.28 XXX 70355 TC A Panoramic x-ray of jaws 0.00 0.54 NA 0.03 0.57 NA XXX 70360 A X-ray exam of neck 0.17 0.45 NA 0.03 0.65 NA XXX 70360 26 A X-ray exam of neck 0.17 0.06 0.06 0.01 0.24 0.24 XXXStart Printed Page 55406 70360 TC A X-ray exam of neck 0.00 0.39 NA 0.02 0.41 NA XXX 70370 A Throat x-ray & fluoroscopy 0.32 1.35 NA 0.07 1.74 NA XXX 70370 26 A Throat x-ray & fluoroscopy 0.32 0.11 0.11 0.01 0.44 0.44 XXX 70370 TC A Throat x-ray & fluoroscopy 0.00 1.24 NA 0.06 1.30 NA XXX 70371 A Speech evaluation, complex 0.84 2.29 NA 0.14 3.27 NA XXX 70371 26 A Speech evaluation, complex 0.84 0.30 0.30 0.04 1.18 1.18 XXX 70371 TC A Speech evaluation, complex 0.00 1.99 NA 0.10 2.09 NA XXX 70373 A Contrast x-ray of larynx 0.44 1.84 NA 0.11 2.39 NA XXX 70373 26 A Contrast x-ray of larynx 0.44 0.15 0.15 0.02 0.61 0.61 XXX 70373 TC A Contrast x-ray of larynx 0.00 1.69 NA 0.09 1.78 NA XXX 70380 A X-ray exam of salivary gland 0.17 0.69 NA 0.04 0.90 NA XXX 70380 26 A X-ray exam of salivary gland 0.17 0.06 0.06 0.01 0.24 0.24 XXX 70380 TC A X-ray exam of salivary gland 0.00 0.63 NA 0.03 0.66 NA XXX 70390 A X-ray exam of salivary duct 0.38 1.82 NA 0.11 2.31 NA XXX 70390 26 A X-ray exam of salivary duct 0.38 0.13 0.13 0.02 0.53 0.53 XXX 70390 TC A X-ray exam of salivary duct 0.00 1.69 NA 0.09 1.78 NA XXX 70450 A Ct head/brain w/o dye 0.85 4.78 NA 0.25 5.88 NA XXX 70450 26 A Ct head/brain w/o dye 0.85 0.30 0.30 0.04 1.19 1.19 XXX 70450 TC A Ct head/brain w/o dye 0.00 4.48 NA 0.21 4.69 NA XXX 70460 A Ct head/brain w/dye 1.13 5.77 NA 0.30 7.20 NA XXX 70460 26 A Ct head/brain w/dye 1.13 0.40 0.40 0.05 1.58 1.58 XXX 70460 TC A Ct head/brain w/dye 0.00 5.37 NA 0.25 5.62 NA XXX 70470 A Ct head/brain w/o&w dye 1.27 7.16 NA 0.37 8.80 NA XXX 70470 26 A Ct head/brain w/o&w dye 1.27 0.45 0.45 0.06 1.78 1.78 XXX 70470 TC A Ct head/brain w/o&w dye 0.00 6.71 NA 0.31 7.02 NA XXX 70480 A Ct orbit/ear/fossa w/o dye 1.28 4.93 NA 0.27 6.48 NA XXX 70480 26 A Ct orbit/ear/fossa w/o dye 1.28 0.45 0.45 0.06 1.79 1.79 XXX 70480 TC A Ct orbit/ear/fossa w/o dye 0.00 4.48 NA 0.21 4.69 NA XXX 70481 A Ct orbit/ear/fossa w/dye 1.38 5.85 NA 0.31 7.54 NA XXX 70481 26 A Ct orbit/ear/fossa w/dye 1.38 0.48 0.48 0.06 1.92 1.92 XXX 70481 TC A Ct orbit/ear/fossa w/dye 0.00 5.37 NA 0.25 5.62 NA XXX 70482 A Ct orbit/ear/fossa w/o&w dye 1.45 7.22 NA 0.37 9.04 NA XXX 70482 26 A Ct orbit/ear/fossa w/o&w dye 1.45 0.51 0.51 0.06 2.02 2.02 XXX 70482 TC A Ct orbit/ear/fossa w/o&w dye 0.00 6.71 NA 0.31 7.02 NA XXX 70486 A Ct maxillofacial w/o dye 1.14 4.88 NA 0.26 6.28 NA XXX 70486 26 A Ct maxillofacial w/o dye 1.14 0.40 0.40 0.05 1.59 1.59 XXX 70486 TC A Ct maxillofacial w/o dye 0.00 4.48 NA 0.21 4.69 NA XXX 70487 A Ct maxillofacial w/dye 1.30 5.83 NA 0.31 7.44 NA XXX 70487 26 A Ct maxillofacial w/dye 1.30 0.46 0.46 0.06 1.82 1.82 XXX 70487 TC A Ct maxillofacial w/dye 0.00 5.37 NA 0.25 5.62 NA XXX 70488 A Ct maxillofacial w/o&w dye 1.42 7.21 NA 0.37 9.00 NA XXX 70488 26 A Ct maxillofacial w/o&w dye 1.42 0.50 0.50 0.06 1.98 1.98 XXX 70488 TC A Ct maxillofacial w/o&w dye 0.00 6.71 NA 0.31 7.02 NA XXX 70490 A Ct soft tissue neck w/o dye 1.28 4.93 NA 0.27 6.48 NA XXX 70490 26 A Ct soft tissue neck w/o dye 1.28 0.45 0.45 0.06 1.79 1.79 XXX 70490 TC A Ct soft tissue neck w/o dye 0.00 4.48 NA 0.21 4.69 NA XXX 70491 A Ct soft tissue neck w/dye 1.38 5.85 NA 0.31 7.54 NA XXX 70491 26 A Ct soft tissue neck w/dye 1.38 0.48 0.48 0.06 1.92 1.92 XXX 70491 TC A Ct soft tissue neck w/dye 0.00 5.37 NA 0.25 5.62 NA XXX 70492 A Ct sft tsue nck w/o & w/dye 1.45 7.22 NA 0.37 9.04 NA XXX 70492 26 A Ct sft tsue nck w/o & w/dye 1.45 0.51 0.51 0.06 2.02 2.02 XXX 70492 TC A Ct sft tsue nck w/o & w/dye 0.00 6.71 NA 0.31 7.02 NA XXX 70496 A Ct angiography, head 1.75 7.41 NA 0.56 9.72 NA XXX 70496 26 A Ct angiography, head 1.75 0.70 0.70 0.08 2.53 2.53 XXX 70496 TC A Ct angiography, head 0.00 6.71 NA 0.48 7.19 NA XXX 70498 A Ct angiography, neck 1.75 7.41 NA 0.56 9.72 NA XXX 70498 26 A Ct angiography, neck 1.75 0.70 0.70 0.08 2.53 2.53 XXX 70498 TC A Ct angiography, neck 0.00 6.71 NA 0.48 7.19 NA XXX 70540 A Mri orbit/face/neck w/o dye 1.35 11.11 NA 0.36 12.82 NA XXX 70540 26 A Mri orbit/face/neck w/o dye 1.35 0.47 0.47 0.04 1.86 1.86 XXX 70540 TC A Mri orbit/face/neck w/o dye 0.00 10.64 NA 0.32 10.96 NA XXX 70542 A Mri orbit/face/neck w/dye 1.62 13.33 NA 0.44 15.39 NA XXX 70542 26 A Mri orbit/face/neck w/dye 1.62 0.57 0.57 0.05 2.24 2.24 XXX 70542 TC A Mri orbit/face/neck w/dye 0.00 12.76 NA 0.39 13.15 NA XXX 70543 A Mri orbt/fac/nck w/o&w dye 2.15 24.39 NA 0.77 27.31 NA XXX 70543 26 A Mri orbt/fac/nck w/o&w dye 2.15 0.75 0.75 0.07 2.97 2.97 XXX 70543 TC A Mri orbt/fac/nck w/o&w dye 0.00 23.64 NA 0.70 24.34 NA XXX 70544 A Mr angiography head w/o dye 1.20 11.06 NA 0.54 12.80 NA XXX 70544 26 A Mr angiography head w/o dye 1.20 0.42 0.42 0.05 1.67 1.67 XXX 70544 TC A Mr angiography head w/o dye 0.00 10.64 NA 0.49 11.13 NA XXX 70545 A Mr angiography head w/dye 1.20 11.06 NA 0.54 12.80 NA XXX 70545 26 A Mr angiography head w/dye 1.20 0.42 0.42 0.05 1.67 1.67 XXX 70545 TC A Mr angiography head w/dye 0.00 10.64 NA 0.49 11.13 NA XXXStart Printed Page 55407 70546 A Mr angiograph head w/o&w dye 1.80 21.92 NA 0.57 24.29 NA XXX 70546 26 A Mr angiograph head w/o&w dye 1.80 0.63 0.63 0.08 2.51 2.51 XXX 70546 TC A Mr angiograph head w/o&w dye 0.00 21.29 NA 0.49 21.78 NA XXX 70547 A Mr angiography neck w/o dye 1.20 11.06 NA 0.54 12.80 NA XXX 70547 26 A Mr angiography neck w/o dye 1.20 0.42 0.42 0.05 1.67 1.67 XXX 70547 TC A Mr angiography neck w/o dye 0.00 10.64 NA 0.49 11.13 NA XXX 70548 A Mr angiography neck w/dye 1.20 11.06 NA 0.54 12.80 NA XXX 70548 26 A Mr angiography neck w/dye 1.20 0.42 0.42 0.05 1.67 1.67 XXX 70548 TC A Mr angiography neck w/dye 0.00 10.64 NA 0.49 11.13 NA XXX 70549 A Mr angiograph neck w/o&w dye 1.80 21.92 NA 0.57 24.29 NA XXX 70549 26 A Mr angiograph neck w/o&w dye 1.80 0.63 0.63 0.08 2.51 2.51 XXX 70549 TC A Mr angiograph neck w/o&w dye 0.00 21.29 NA 0.49 21.78 NA XXX 70551 A Mri brain w/o dye 1.48 11.16 NA 0.56 13.20 NA XXX 70551 26 A Mri brain w/o dye 1.48 0.52 0.52 0.07 2.07 2.07 XXX 70551 TC A Mri brain w/o dye 0.00 10.64 NA 0.49 11.13 NA XXX 70552 A Mri brain w/dye 1.78 13.40 NA 0.66 15.84 NA XXX 70552 26 A Mri brain w/dye 1.78 0.64 0.64 0.08 2.50 2.50 XXX 70552 TC A Mri brain w/dye 0.00 12.76 NA 0.58 13.34 NA XXX 70553 A Mri brain w/o&w dye 2.36 24.47 NA 1.19 28.02 NA XXX 70553 26 A Mri brain w/o&w dye 2.36 0.83 0.83 0.10 3.29 3.29 XXX 70553 TC A Mri brain w/o&w dye 0.00 23.64 NA 1.09 24.73 NA XXX 71010 A Chest x-ray 0.18 0.51 NA 0.03 0.72 NA XXX 71010 26 A Chest x-ray 0.18 0.06 0.06 0.01 0.25 0.25 XXX 71010 TC A Chest x-ray 0.00 0.45 NA 0.02 0.47 NA XXX 71015 A Chest x-ray 0.21 0.57 NA 0.03 0.81 NA XXX 71015 26 A Chest x-ray 0.21 0.07 0.07 0.01 0.29 0.29 XXX 71015 TC A Chest x-ray 0.00 0.50 NA 0.02 0.52 NA XXX 71020 A Chest x-ray 0.22 0.67 NA 0.04 0.93 NA XXX 71020 26 A Chest x-ray 0.22 0.08 0.08 0.01 0.31 0.31 XXX 71020 TC A Chest x-ray 0.00 0.59 NA 0.03 0.62 NA XXX 71021 A Chest x-ray 0.27 0.79 NA 0.05 1.11 NA XXX 71021 26 A Chest x-ray 0.27 0.09 0.09 0.01 0.37 0.37 XXX 71021 TC A Chest x-ray 0.00 0.70 NA 0.04 0.74 NA XXX 71022 A Chest x-ray 0.31 0.81 NA 0.06 1.18 NA XXX 71022 26 A Chest x-ray 0.31 0.11 0.11 0.02 0.44 0.44 XXX 71022 TC A Chest x-ray 0.00 0.70 NA 0.04 0.74 NA XXX 71023 A Chest x-ray and fluoroscopy 0.38 0.88 NA 0.06 1.32 NA XXX 71023 26 A Chest x-ray and fluoroscopy 0.38 0.14 0.14 0.02 0.54 0.54 XXX 71023 TC A Chest x-ray and fluoroscopy 0.00 0.74 NA 0.04 0.78 NA XXX 71030 A Chest x-ray 0.31 0.85 NA 0.05 1.21 NA XXX 71030 26 A Chest x-ray 0.31 0.11 0.11 0.01 0.43 0.43 XXX 71030 TC A Chest x-ray 0.00 0.74 NA 0.04 0.78 NA XXX 71034 A Chest x-ray and fluoroscopy 0.46 1.54 NA 0.09 2.09 NA XXX 71034 26 A Chest x-ray and fluoroscopy 0.46 0.17 0.17 0.02 0.65 0.65 XXX 71034 TC A Chest x-ray and fluoroscopy 0.00 1.37 NA 0.07 1.44 NA XXX 71035 A Chest x-ray 0.18 0.56 NA 0.03 0.77 NA XXX 71035 26 A Chest x-ray 0.18 0.06 0.06 0.01 0.25 0.25 XXX 71035 TC A Chest x-ray 0.00 0.50 NA 0.02 0.52 NA XXX 71040 A Contrast x-ray of bronchi 0.58 1.59 NA 0.10 2.27 NA XXX 71040 26 A Contrast x-ray of bronchi 0.58 0.20 0.20 0.03 0.81 0.81 XXX 71040 TC A Contrast x-ray of bronchi 0.00 1.39 NA 0.07 1.46 NA XXX 71060 A Contrast x-ray of bronchi 0.74 2.35 NA 0.14 3.23 NA XXX 71060 26 A Contrast x-ray of bronchi 0.74 0.26 0.26 0.03 1.03 1.03 XXX 71060 TC A Contrast x-ray of bronchi 0.00 2.09 NA 0.11 2.20 NA XXX 71090 A X-ray & pacemaker insertion 0.54 1.82 NA 0.11 2.47 NA XXX 71090 26 A X-ray & pacemaker insertion 0.54 0.22 0.22 0.02 0.78 0.78 XXX 71090 TC A X-ray & pacemaker insertion 0.00 1.60 NA 0.09 1.69 NA XXX 71100 A X-ray exam of ribs 0.22 0.62 NA 0.04 0.88 NA XXX 71100 26 A X-ray exam of ribs 0.22 0.08 0.08 0.01 0.31 0.31 XXX 71100 TC A X-ray exam of ribs 0.00 0.54 NA 0.03 0.57 NA XXX 71101 A X-ray exam of ribs/chest 0.27 0.72 NA 0.04 1.03 NA XXX 71101 26 A X-ray exam of ribs/chest 0.27 0.09 0.09 0.01 0.37 0.37 XXX 71101 TC A X-ray exam of ribs/chest 0.00 0.63 NA 0.03 0.66 NA XXX 71110 A X-ray exam of ribs 0.27 0.83 NA 0.05 1.15 NA XXX 71110 26 A X-ray exam of ribs 0.27 0.09 0.09 0.01 0.37 0.37 XXX 71110 TC A X-ray exam of ribs 0.00 0.74 NA 0.04 0.78 NA XXX 71111 A X-ray exam of ribs/chest 0.32 0.95 NA 0.06 1.33 NA XXX 71111 26 A X-ray exam of ribs/chest 0.32 0.11 0.11 0.01 0.44 0.44 XXX 71111 TC A X-ray exam of ribs/chest 0.00 0.84 NA 0.05 0.89 NA XXX 71120 A X-ray exam of breastbone 0.20 0.69 NA 0.04 0.93 NA XXX 71120 26 A X-ray exam of breastbone 0.20 0.07 0.07 0.01 0.28 0.28 XXX 71120 TC A X-ray exam of breastbone 0.00 0.62 NA 0.03 0.65 NA XXX 71130 A X-ray exam of breastbone 0.22 0.75 NA 0.04 1.01 NA XXXStart Printed Page 55408 71130 26 A X-ray exam of breastbone 0.22 0.08 0.08 0.01 0.31 0.31 XXX 71130 TC A X-ray exam of breastbone 0.00 0.67 NA 0.03 0.70 NA XXX 71250 A Ct thorax w/o dye 1.16 6.02 NA 0.31 7.49 NA XXX 71250 26 A Ct thorax w/o dye 1.16 0.41 0.41 0.05 1.62 1.62 XXX 71250 TC A Ct thorax w/o dye 0.00 5.61 NA 0.26 5.87 NA XXX 71260 A Ct thorax w/dye 1.24 7.14 NA 0.36 8.74 NA XXX 71260 26 A Ct thorax w/dye 1.24 0.43 0.43 0.05 1.72 1.72 XXX 71260 TC A Ct thorax w/dye 0.00 6.71 NA 0.31 7.02 NA XXX 71270 A Ct thorax w/o&w dye 1.38 8.88 NA 0.44 10.70 NA XXX 71270 26 A Ct thorax w/o&w dye 1.38 0.48 0.48 0.06 1.92 1.92 XXX 71270 TC A Ct thorax w/o&w dye 0.00 8.40 NA 0.38 8.78 NA XXX 71275 A Ct angiography, chest 1.92 9.17 NA 0.38 11.47 NA XXX 71275 26 A Ct angiography, chest 1.92 0.77 0.77 0.06 2.75 2.75 XXX 71275 TC A Ct angiography, chest 0.00 8.40 NA 0.32 8.72 NA XXX 71550 A Mri chest w/o dye 1.46 11.15 NA 0.41 13.02 NA XXX 71550 26 A Mri chest w/o dye 1.46 0.51 0.51 0.04 2.01 2.01 XXX 71550 TC A Mri chest w/o dye 0.00 10.64 NA 0.37 11.01 NA XXX 71551 A Mri chest w/dye 1.73 13.36 NA 0.49 15.58 NA XXX 71551 26 A Mri chest w/dye 1.73 0.60 0.60 0.06 2.39 2.39 XXX 71551 TC A Mri chest w/dye 0.00 12.76 NA 0.43 13.19 NA XXX 71552 A Mri chest w/o&w dye 2.26 24.43 NA 0.64 27.33 NA XXX 71552 26 A Mri chest w/o&w dye 2.26 0.79 0.79 0.08 3.13 3.13 XXX 71552 TC A Mri chest w/o&w dye 0.00 23.64 NA 0.56 24.20 NA XXX 71555 R Mri angio chest w or w/o dye 1.81 11.28 NA 0.57 13.66 NA XXX 71555 26 R Mri angio chest w or w/o dye 1.81 0.64 0.64 0.08 2.53 2.53 XXX 71555 TC R Mri angio chest w or w/o dye 0.00 10.64 NA 0.49 11.13 NA XXX 72010 A X-ray exam of spine 0.45 1.13 NA 0.08 1.66 NA XXX 72010 26 A X-ray exam of spine 0.45 0.16 0.16 0.03 0.64 0.64 XXX 72010 TC A X-ray exam of spine 0.00 0.97 NA 0.05 1.02 NA XXX 72020 A X-ray exam of spine 0.15 0.44 NA 0.03 0.62 NA XXX 72020 26 A X-ray exam of spine 0.15 0.05 0.05 0.01 0.21 0.21 XXX 72020 TC A X-ray exam of spine 0.00 0.39 NA 0.02 0.41 NA XXX 72040 A X-ray exam of neck spine 0.22 0.65 NA 0.04 0.91 NA XXX 72040 26 A X-ray exam of neck spine 0.22 0.08 0.08 0.01 0.31 0.31 XXX 72040 TC A X-ray exam of neck spine 0.00 0.57 NA 0.03 0.60 NA XXX 72050 A X-ray exam of neck spine 0.31 0.95 NA 0.07 1.33 NA XXX 72050 26 A X-ray exam of neck spine 0.31 0.11 0.11 0.02 0.44 0.44 XXX 72050 TC A X-ray exam of neck spine 0.00 0.84 NA 0.05 0.89 NA XXX 72052 A X-ray exam of neck spine 0.36 1.20 NA 0.07 1.63 NA XXX 72052 26 A X-ray exam of neck spine 0.36 0.13 0.13 0.02 0.51 0.51 XXX 72052 TC A X-ray exam of neck spine 0.00 1.07 NA 0.05 1.12 NA XXX 72069 A X-ray exam of trunk spine 0.22 0.56 NA 0.04 0.82 NA XXX 72069 26 A X-ray exam of trunk spine 0.22 0.09 0.09 0.02 0.33 0.33 XXX 72069 TC A X-ray exam of trunk spine 0.00 0.47 NA 0.02 0.49 NA XXX 72070 A X-ray exam of thoracic spine 0.22 0.70 NA 0.04 0.96 NA XXX 72070 26 A X-ray exam of thoracic spine 0.22 0.08 0.08 0.01 0.31 0.31 XXX 72070 TC A X-ray exam of thoracic spine 0.00 0.62 NA 0.03 0.65 NA XXX 72072 A X-ray exam of thoracic spine 0.22 0.78 NA 0.05 1.05 NA XXX 72072 26 A X-ray exam of thoracic spine 0.22 0.08 0.08 0.01 0.31 0.31 XXX 72072 TC A X-ray exam of thoracic spine 0.00 0.70 NA 0.04 0.74 NA XXX 72074 A X-ray exam of thoracic spine 0.22 0.94 NA 0.06 1.22 NA XXX 72074 26 A X-ray exam of thoracic spine 0.22 0.08 0.08 0.01 0.31 0.31 XXX 72074 TC A X-ray exam of thoracic spine 0.00 0.86 NA 0.05 0.91 NA XXX 72080 A X-ray exam of trunk spine 0.22 0.71 NA 0.05 0.98 NA XXX 72080 26 A X-ray exam of trunk spine 0.22 0.08 0.08 0.02 0.32 0.32 XXX 72080 TC A X-ray exam of trunk spine 0.00 0.63 NA 0.03 0.66 NA XXX 72090 A X-ray exam of trunk spine 0.28 0.73 NA 0.05 1.06 NA XXX 72090 26 A X-ray exam of trunk spine 0.28 0.10 0.10 0.02 0.40 0.40 XXX 72090 TC A X-ray exam of trunk spine 0.00 0.63 NA 0.03 0.66 NA XXX 72100 A X-ray exam of lower spine 0.22 0.71 NA 0.05 0.98 NA XXX 72100 26 A X-ray exam of lower spine 0.22 0.08 0.08 0.02 0.32 0.32 XXX 72100 TC A X-ray exam of lower spine 0.00 0.63 NA 0.03 0.66 NA XXX 72110 A X-ray exam of lower spine 0.31 0.97 NA 0.07 1.35 NA XXX 72110 26 A X-ray exam of lower spine 0.31 0.11 0.11 0.02 0.44 0.44 XXX 72110 TC A X-ray exam of lower spine 0.00 0.86 NA 0.05 0.91 NA XXX 72114 A X-ray exam of lower spine 0.36 1.26 NA 0.08 1.70 NA XXX 72114 26 A X-ray exam of lower spine 0.36 0.13 0.13 0.03 0.52 0.52 XXX 72114 TC A X-ray exam of lower spine 0.00 1.13 NA 0.05 1.18 NA XXX 72120 A X-ray exam of lower spine 0.22 0.92 NA 0.07 1.21 NA XXX 72120 26 A X-ray exam of lower spine 0.22 0.08 0.08 0.02 0.32 0.32 XXX 72120 TC A X-ray exam of lower spine 0.00 0.84 NA 0.05 0.89 NA XXX 72125 A Ct neck spine w/o dye 1.16 6.02 NA 0.31 7.49 NA XXX 72125 26 A Ct neck spine w/o dye 1.16 0.41 0.41 0.05 1.62 1.62 XXXStart Printed Page 55409 72125 TC A Ct neck spine w/o dye 0.00 5.61 NA 0.26 5.87 NA XXX 72126 A Ct neck spine w/dye 1.22 7.14 NA 0.36 8.72 NA XXX 72126 26 A Ct neck spine w/dye 1.22 0.43 0.43 0.05 1.70 1.70 XXX 72126 TC A Ct neck spine w/dye 0.00 6.71 NA 0.31 7.02 NA XXX 72127 A Ct neck spine w/o&w dye 1.27 8.85 NA 0.44 10.56 NA XXX 72127 26 A Ct neck spine w/o&w dye 1.27 0.45 0.45 0.06 1.78 1.78 XXX 72127 TC A Ct neck spine w/o&w dye 0.00 8.40 NA 0.38 8.78 NA XXX 72128 A Ct chest spine w/o dye 1.16 6.02 NA 0.31 7.49 NA XXX 72128 26 A Ct chest spine w/o dye 1.16 0.41 0.41 0.05 1.62 1.62 XXX 72128 TC A Ct chest spine w/o dye 0.00 5.61 NA 0.26 5.87 NA XXX 72129 A Ct chest spine w/dye 1.22 7.14 NA 0.36 8.72 NA XXX 72129 26 A Ct chest spine w/dye 1.22 0.43 0.43 0.05 1.70 1.70 XXX 72129 TC A Ct chest spine w/dye 0.00 6.71 NA 0.31 7.02 NA XXX 72130 A Ct chest spine w/o&w dye 1.27 8.85 NA 0.44 10.56 NA XXX 72130 26 A Ct chest spine w/o&w dye 1.27 0.45 0.45 0.06 1.78 1.78 XXX 72130 TC A Ct chest spine w/o&w dye 0.00 8.40 NA 0.38 8.78 NA XXX 72131 A Ct lumbar spine w/o dye 1.16 6.02 NA 0.31 7.49 NA XXX 72131 26 A Ct lumbar spine w/o dye 1.16 0.41 0.41 0.05 1.62 1.62 XXX 72131 TC A Ct lumbar spine w/o dye 0.00 5.61 NA 0.26 5.87 NA XXX 72132 A Ct lumbar spine w/dye 1.22 7.14 NA 0.37 8.73 NA XXX 72132 26 A Ct lumbar spine w/dye 1.22 0.43 0.43 0.06 1.71 1.71 XXX 72132 TC A Ct lumbar spine w/dye 0.00 6.71 NA 0.31 7.02 NA XXX 72133 A Ct lumbar spine w/o&w dye 1.27 8.85 NA 0.44 10.56 NA XXX 72133 26 A Ct lumbar spine w/o&w dye 1.27 0.45 0.45 0.06 1.78 1.78 XXX 72133 TC A Ct lumbar spine w/o&w dye 0.00 8.40 NA 0.38 8.78 NA XXX 72141 A Mri neck spine w/o dye 1.60 11.20 NA 0.56 13.36 NA XXX 72141 26 A Mri neck spine w/o dye 1.60 0.56 0.56 0.07 2.23 2.23 XXX 72141 TC A Mri neck spine w/o dye 0.00 10.64 NA 0.49 11.13 NA XXX 72142 A Mri neck spine w/dye 1.92 13.45 NA 0.67 16.04 NA XXX 72142 26 A Mri neck spine w/dye 1.92 0.69 0.69 0.09 2.70 2.70 XXX 72142 TC A Mri neck spine w/dye 0.00 12.76 NA 0.58 13.34 NA XXX 72146 A Mri chest spine w/o dye 1.60 12.38 NA 0.60 14.58 NA XXX 72146 26 A Mri chest spine w/o dye 1.60 0.56 0.56 0.07 2.23 2.23 XXX 72146 TC A Mri chest spine w/o dye 0.00 11.82 NA 0.53 12.35 NA XXX 72147 A Mri chest spine w/dye 1.92 13.44 NA 0.67 16.03 NA XXX 72147 26 A Mri chest spine w/dye 1.92 0.68 0.68 0.09 2.69 2.69 XXX 72147 TC A Mri chest spine w/dye 0.00 12.76 NA 0.58 13.34 NA XXX 72148 A Mri lumbar spine w/o dye 1.48 12.34 NA 0.60 14.42 NA XXX 72148 26 A Mri lumbar spine w/o dye 1.48 0.52 0.52 0.07 2.07 2.07 XXX 72148 TC A Mri lumbar spine w/o dye 0.00 11.82 NA 0.53 12.35 NA XXX 72149 A Mri lumbar spine w/dye 1.78 13.40 NA 0.67 15.85 NA XXX 72149 26 A Mri lumbar spine w/dye 1.78 0.64 0.64 0.09 2.51 2.51 XXX 72149 TC A Mri lumbar spine w/dye 0.00 12.76 NA 0.58 13.34 NA XXX 72156 A Mri neck spine w/o&w dye 2.57 24.55 NA 1.20 28.32 NA XXX 72156 26 A Mri neck spine w/o&w dye 2.57 0.91 0.91 0.11 3.59 3.59 XXX 72156 TC A Mri neck spine w/o&w dye 0.00 23.64 NA 1.09 24.73 NA XXX 72157 A Mri chest spine w/o&w dye 2.57 24.54 NA 1.20 28.31 NA XXX 72157 26 A Mri chest spine w/o&w dye 2.57 0.90 0.90 0.11 3.58 3.58 XXX 72157 TC A Mri chest spine w/o&w dye 0.00 23.64 NA 1.09 24.73 NA XXX 72158 A Mri lumbar spine w/o&w dye 2.36 24.47 NA 1.20 28.03 NA XXX 72158 26 A Mri lumbar spine w/o&w dye 2.36 0.83 0.83 0.11 3.30 3.30 XXX 72158 TC A Mri lumbar spine w/o&w dye 0.00 23.64 NA 1.09 24.73 NA XXX 72159 N Mr angio spine w/o&w dye +1.80 12.54 NA 0.61 14.95 NA XXX 72159 26 N Mr angio spine w/o&w dye +1.80 0.72 0.72 0.08 2.60 2.60 XXX 72159 TC N Mr angio spine w/o&w dye +0.00 11.82 NA 0.53 12.35 NA XXX 72170 A X-ray exam of pelvis 0.17 0.56 NA 0.03 0.76 NA XXX 72170 26 A X-ray exam of pelvis 0.17 0.06 0.06 0.01 0.24 0.24 XXX 72170 TC A X-ray exam of pelvis 0.00 0.50 NA 0.02 0.52 NA XXX 72190 A X-ray exam of pelvis 0.21 0.70 NA 0.04 0.95 NA XXX 72190 26 A X-ray exam of pelvis 0.21 0.07 0.07 0.01 0.29 0.29 XXX 72190 TC A X-ray exam of pelvis 0.00 0.63 NA 0.03 0.66 NA XXX 72191 A Ct angiograph pelv w/o&w dye 1.81 8.78 NA 0.38 10.97 NA XXX 72191 26 A Ct angiograph pelv w/o&w dye 1.81 0.72 0.72 0.06 2.59 2.59 XXX 72191 TC A Ct angiograph pelv w/o&w dye 0.00 8.06 NA 0.32 8.38 NA XXX 72192 A Ct pelvis w/o dye 1.09 5.99 NA 0.31 7.39 NA XXX 72192 26 A Ct pelvis w/o dye 1.09 0.38 0.38 0.05 1.52 1.52 XXX 72192 TC A Ct pelvis w/o dye 0.00 5.61 NA 0.26 5.87 NA XXX 72193 A Ct pelvis w/dye 1.16 6.91 NA 0.35 8.42 NA XXX 72193 26 A Ct pelvis w/dye 1.16 0.41 0.41 0.05 1.62 1.62 XXX 72193 TC A Ct pelvis w/dye 0.00 6.50 NA 0.30 6.80 NA XXX 72194 A Ct pelvis w/o&w dye 1.22 8.49 NA 0.41 10.12 NA XXX 72194 26 A Ct pelvis w/o&w dye 1.22 0.43 0.43 0.05 1.70 1.70 XXX 72194 TC A Ct pelvis w/o&w dye 0.00 8.06 NA 0.36 8.42 NA XXXStart Printed Page 55410 72195 A Mri pelvis w/o dye 1.46 11.15 NA 0.42 13.03 NA XXX 72195 26 A Mri pelvis w/o dye 1.46 0.51 0.51 0.05 2.02 2.02 XXX 72195 TC A Mri pelvis w/o dye 0.00 10.64 NA 0.37 11.01 NA XXX 72196 A Mri pelvis w/dye 1.73 13.36 NA 0.48 15.57 NA XXX 72196 26 A Mri pelvis w/dye 1.73 0.60 0.60 0.05 2.38 2.38 XXX 72196 TC A Mri pelvis w/dye 0.00 12.76 NA 0.43 13.19 NA XXX 72197 A Mri pelvis w/o&w dye 2.26 24.43 NA 0.84 27.53 NA XXX 72197 26 A Mri pelvis w/o&w dye 2.26 0.79 0.79 0.08 3.13 3.13 XXX 72197 TC A Mri pelvis w/o&w dye 0.00 23.64 NA 0.76 24.40 NA XXX 72198 N Mr angio pelvis w/o&w dye +1.80 11.36 NA 0.57 13.73 NA XXX 72198 26 N Mr angio pelvis w/o&w dye +1.80 0.72 0.72 0.08 2.60 2.60 XXX 72198 TC N Mr angio pelvis w/o&w dye +0.00 10.64 NA 0.49 11.13 NA XXX 72200 A X-ray exam sacroiliac joints 0.17 0.56 NA 0.03 0.76 NA XXX 72200 26 A X-ray exam sacroiliac joints 0.17 0.06 0.06 0.01 0.24 0.24 XXX 72200 TC A X-ray exam sacroiliac joints 0.00 0.50 NA 0.02 0.52 NA XXX 72202 A X-ray exam sacroiliac joints 0.19 0.66 NA 0.04 0.89 NA XXX 72202 26 A X-ray exam sacroiliac joints 0.19 0.07 0.07 0.01 0.27 0.27 XXX 72202 TC A X-ray exam sacroiliac joints 0.00 0.59 NA 0.03 0.62 NA XXX 72220 A X-ray exam of tailbone 0.17 0.60 NA 0.04 0.81 NA XXX 72220 26 A X-ray exam of tailbone 0.17 0.06 0.06 0.01 0.24 0.24 XXX 72220 TC A X-ray exam of tailbone 0.00 0.54 NA 0.03 0.57 NA XXX 72240 A Contrast x-ray of neck spine 0.91 4.82 NA 0.25 5.98 NA XXX 72240 26 A Contrast x-ray of neck spine 0.91 0.31 0.31 0.04 1.26 1.26 XXX 72240 TC A Contrast x-ray of neck spine 0.00 4.51 NA 0.21 4.72 NA XXX 72255 A Contrast x-ray, thorax spine 0.91 4.41 NA 0.22 5.54 NA XXX 72255 26 A Contrast x-ray, thorax spine 0.91 0.30 0.30 0.04 1.25 1.25 XXX 72255 TC A Contrast x-ray, thorax spine 0.00 4.11 NA 0.18 4.29 NA XXX 72265 A Contrast x-ray, lower spine 0.83 4.15 NA 0.22 5.20 NA XXX 72265 26 A Contrast x-ray, lower spine 0.83 0.28 0.28 0.04 1.15 1.15 XXX 72265 TC A Contrast x-ray, lower spine 0.00 3.87 NA 0.18 4.05 NA XXX 72270 A Contrast x-ray of spine 1.33 6.25 NA 0.34 7.92 NA XXX 72270 26 A Contrast x-ray of spine 1.33 0.46 0.46 0.07 1.86 1.86 XXX 72270 TC A Contrast x-ray of spine 0.00 5.79 NA 0.27 6.06 NA XXX 72275 A Epidurography 0.76 2.20 NA 0.21 3.17 NA XXX 72275 26 A Epidurography 0.76 0.21 0.21 0.03 1.00 1.00 XXX 72275 TC A Epidurography 0.00 1.99 NA 0.18 2.17 NA XXX 72285 A X-ray c/t spine disk 1.16 8.35 NA 0.42 9.93 NA XXX 72285 26 A X-ray c/t spine disk 1.16 0.39 0.39 0.06 1.61 1.61 XXX 72285 TC A X-ray c/t spine disk 0.00 7.96 NA 0.36 8.32 NA XXX 72295 A X-ray of lower spine disk 0.83 7.76 NA 0.37 8.96 NA XXX 72295 26 A X-ray of lower spine disk 0.83 0.29 0.29 0.04 1.16 1.16 XXX 72295 TC A X-ray of lower spine disk 0.00 7.47 NA 0.33 7.80 NA XXX 73000 A X-ray exam of collar bone 0.16 0.56 NA 0.03 0.75 NA XXX 73000 26 A X-ray exam of collar bone 0.16 0.06 0.06 0.01 0.23 0.23 XXX 73000 TC A X-ray exam of collar bone 0.00 0.50 NA 0.02 0.52 NA XXX 73010 A X-ray exam of shoulder blade 0.17 0.56 NA 0.03 0.76 NA XXX 73010 26 A X-ray exam of shoulder blade 0.17 0.06 0.06 0.01 0.24 0.24 XXX 73010 TC A X-ray exam of shoulder blade 0.00 0.50 NA 0.02 0.52 NA XXX 73020 A X-ray exam of shoulder 0.15 0.50 NA 0.03 0.68 NA XXX 73020 26 A X-ray exam of shoulder 0.15 0.05 0.05 0.01 0.21 0.21 XXX 73020 TC A X-ray exam of shoulder 0.00 0.45 NA 0.02 0.47 NA XXX 73030 A X-ray exam of shoulder 0.18 0.60 NA 0.04 0.82 NA XXX 73030 26 A X-ray exam of shoulder 0.18 0.06 0.06 0.01 0.25 0.25 XXX 73030 TC A X-ray exam of shoulder 0.00 0.54 NA 0.03 0.57 NA XXX 73040 A Contrast x-ray of shoulder 0.54 2.18 NA 0.13 2.85 NA XXX 73040 26 A Contrast x-ray of shoulder 0.54 0.19 0.19 0.03 0.76 0.76 XXX 73040 TC A Contrast x-ray of shoulder 0.00 1.99 NA 0.10 2.09 NA XXX 73050 A X-ray exam of shoulders 0.20 0.70 NA 0.05 0.95 NA XXX 73050 26 A X-ray exam of shoulders 0.20 0.07 0.07 0.02 0.29 0.29 XXX 73050 TC A X-ray exam of shoulders 0.00 0.63 NA 0.03 0.66 NA XXX 73060 A X-ray exam of humerus 0.17 0.60 NA 0.04 0.81 NA XXX 73060 26 A X-ray exam of humerus 0.17 0.06 0.06 0.01 0.24 0.24 XXX 73060 TC A X-ray exam of humerus 0.00 0.54 NA 0.03 0.57 NA XXX 73070 A X-ray exam of elbow 0.15 0.55 NA 0.03 0.73 NA XXX 73070 26 A X-ray exam of elbow 0.15 0.05 0.05 0.01 0.21 0.21 XXX 73070 TC A X-ray exam of elbow 0.00 0.50 NA 0.02 0.52 NA XXX 73080 A X-ray exam of elbow 0.17 0.60 NA 0.04 0.81 NA XXX 73080 26 A X-ray exam of elbow 0.17 0.06 0.06 0.01 0.24 0.24 XXX 73080 TC A X-ray exam of elbow 0.00 0.54 NA 0.03 0.57 NA XXX 73085 A Contrast x-ray of elbow 0.54 2.19 NA 0.13 2.86 NA XXX 73085 26 A Contrast x-ray of elbow 0.54 0.20 0.20 0.03 0.77 0.77 XXX 73085 TC A Contrast x-ray of elbow 0.00 1.99 NA 0.10 2.09 NA XXX 73090 A X-ray exam of forearm 0.16 0.56 NA 0.03 0.75 NA XXXStart Printed Page 55411 73090 26 A X-ray exam of forearm 0.16 0.06 0.06 0.01 0.23 0.23 XXX 73090 TC A X-ray exam of forearm 0.00 0.50 NA 0.02 0.52 NA XXX 73092 A X-ray exam of arm, infant 0.16 0.53 NA 0.03 0.72 NA XXX 73092 26 A X-ray exam of arm, infant 0.16 0.06 0.06 0.01 0.23 0.23 XXX 73092 TC A X-ray exam of arm, infant 0.00 0.47 NA 0.02 0.49 NA XXX 73100 A X-ray exam of wrist 0.16 0.53 NA 0.04 0.73 NA XXX 73100 26 A X-ray exam of wrist 0.16 0.06 0.06 0.02 0.24 0.24 XXX 73100 TC A X-ray exam of wrist 0.00 0.47 NA 0.02 0.49 NA XXX 73110 A X-ray exam of wrist 0.17 0.57 NA 0.03 0.77 NA XXX 73110 26 A X-ray exam of wrist 0.17 0.06 0.06 0.01 0.24 0.24 XXX 73110 TC A X-ray exam of wrist 0.00 0.51 NA 0.02 0.53 NA XXX 73115 A Contrast x-ray of wrist 0.54 1.70 NA 0.11 2.35 NA XXX 73115 26 A Contrast x-ray of wrist 0.54 0.20 0.20 0.03 0.77 0.77 XXX 73115 TC A Contrast x-ray of wrist 0.00 1.50 NA 0.08 1.58 NA XXX 73120 A X-ray exam of hand 0.16 0.53 NA 0.03 0.72 NA XXX 73120 26 A X-ray exam of hand 0.16 0.06 0.06 0.01 0.23 0.23 XXX 73120 TC A X-ray exam of hand 0.00 0.47 NA 0.02 0.49 NA XXX 73130 A X-ray exam of hand 0.17 0.57 NA 0.03 0.77 NA XXX 73130 26 A X-ray exam of hand 0.17 0.06 0.06 0.01 0.24 0.24 XXX 73130 TC A X-ray exam of hand 0.00 0.51 NA 0.02 0.53 NA XXX 73140 A X-ray exam of finger(s) 0.13 0.44 NA 0.03 0.60 NA XXX 73140 26 A X-ray exam of finger(s) 0.13 0.05 0.05 0.01 0.19 0.19 XXX 73140 TC A X-ray exam of finger(s) 0.00 0.39 NA 0.02 0.41 NA XXX 73200 A Ct upper extremity w/o dye 1.09 5.09 NA 0.26 6.44 NA XXX 73200 26 A Ct upper extremity w/o dye 1.09 0.38 0.38 0.05 1.52 1.52 XXX 73200 TC A Ct upper extremity w/o dye 0.00 4.71 NA 0.21 4.92 NA XXX 73201 A Ct upper extremity w/dye 1.16 6.02 NA 0.31 7.49 NA XXX 73201 26 A Ct upper extremity w/dye 1.16 0.41 0.41 0.05 1.62 1.62 XXX 73201 TC A Ct upper extremity w/dye 0.00 5.61 NA 0.26 5.87 NA XXX 73202 A Ct uppr extremity w/o&w dye 1.22 7.48 NA 0.38 9.08 NA XXX 73202 26 A Ct uppr extremity w/o&w dye 1.22 0.43 0.43 0.06 1.71 1.71 XXX 73202 TC A Ct uppr extremity w/o&w dye 0.00 7.05 NA 0.32 7.37 NA XXX 73206 A Ct angio upr extrm w/o&w dye 1.81 7.77 NA 0.38 9.96 NA XXX 73206 26 A Ct angio upr extrm w/o&w dye 1.81 0.72 0.72 0.06 2.59 2.59 XXX 73206 TC A Ct angio upr extrm w/o&w dye 0.00 7.05 NA 0.32 7.37 NA XXX 73218 A Mri upper extremity w/o dye 1.35 11.11 NA 0.36 12.82 NA XXX 73218 26 A Mri upper extremity w/o dye 1.35 0.47 0.47 0.04 1.86 1.86 XXX 73218 TC A Mri upper extremity w/o dye 0.00 10.64 NA 0.32 10.96 NA XXX 73219 A Mri upper extremity w/dye 1.62 13.33 NA 0.44 15.39 NA XXX 73219 26 A Mri upper extremity w/dye 1.62 0.57 0.57 0.05 2.24 2.24 XXX 73219 TC A Mri upper extremity w/dye 0.00 12.76 NA 0.39 13.15 NA XXX 73220 A Mri uppr extremity w/o&w dye 2.15 24.39 NA 0.78 27.32 NA XXX 73220 26 A Mri uppr extremity w/o&w dye 2.15 0.75 0.75 0.08 2.98 2.98 XXX 73220 TC A Mri uppr extremity w/o&w dye 0.00 23.64 NA 0.70 24.34 NA XXX 73221 A Mri joint upr extrem w/o dye 1.35 11.11 NA 0.36 12.82 NA XXX 73221 26 A Mri joint upr extrem w/o dye 1.35 0.47 0.47 0.04 1.86 1.86 XXX 73221 TC A Mri joint upr extrem w/o dye 0.00 10.64 NA 0.32 10.96 NA XXX 73222 A Mri joint upr extrem w/dye 1.62 13.33 NA 0.44 15.39 NA XXX 73222 26 A Mri joint upr extrem w/dye 1.62 0.57 0.57 0.05 2.24 2.24 XXX 73222 TC A Mri joint upr extrem w/dye 0.00 12.76 NA 0.39 13.15 NA XXX 73223 A Mri joint upr extr w/o&w dye 2.15 24.39 NA 0.77 27.31 NA XXX 73223 26 A Mri joint upr extr w/o&w dye 2.15 0.75 0.75 0.07 2.97 2.97 XXX 73223 TC A Mri joint upr extr w/o&w dye 0.00 23.64 NA 0.70 24.34 NA XXX 73225 N Mr angio upr extr w/o&w dye +1.73 11.33 NA 0.57 13.63 NA XXX 73225 26 N Mr angio upr extr w/o&w dye +1.73 0.69 0.69 0.08 2.50 2.50 XXX 73225 TC N Mr angio upr extr w/o&w dye +0.00 10.64 NA 0.49 11.13 NA XXX 73500 A X-ray exam of hip 0.17 0.51 NA 0.03 0.71 NA XXX 73500 26 A X-ray exam of hip 0.17 0.06 0.06 0.01 0.24 0.24 XXX 73500 TC A X-ray exam of hip 0.00 0.45 NA 0.02 0.47 NA XXX 73510 A X-ray exam of hip 0.21 0.61 NA 0.05 0.87 NA XXX 73510 26 A X-ray exam of hip 0.21 0.07 0.07 0.02 0.30 0.30 XXX 73510 TC A X-ray exam of hip 0.00 0.54 NA 0.03 0.57 NA XXX 73520 A X-ray exam of hips 0.26 0.72 NA 0.05 1.03 NA XXX 73520 26 A X-ray exam of hips 0.26 0.09 0.09 0.02 0.37 0.37 XXX 73520 TC A X-ray exam of hips 0.00 0.63 NA 0.03 0.66 NA XXX 73525 A Contrast x-ray of hip 0.54 2.19 NA 0.13 2.86 NA XXX 73525 26 A Contrast x-ray of hip 0.54 0.20 0.20 0.03 0.77 0.77 XXX 73525 TC A Contrast x-ray of hip 0.00 1.99 NA 0.10 2.09 NA XXX 73530 A X-ray exam of hip 0.29 0.60 NA 0.03 0.92 NA XXX 73530 26 A X-ray exam of hip 0.29 0.10 0.10 0.01 0.40 0.40 XXX 73530 TC A X-ray exam of hip 0.00 0.50 NA 0.02 0.52 NA XXX 73540 A X-ray exam of pelvis & hips 0.20 0.61 NA 0.05 0.86 NA XXX 73540 26 A X-ray exam of pelvis & hips 0.20 0.07 0.07 0.02 0.29 0.29 XXXStart Printed Page 55412 73540 TC A X-ray exam of pelvis & hips 0.00 0.54 NA 0.03 0.57 NA XXX 73542 A X-ray exam, sacroiliac joint 0.59 2.16 NA 0.13 2.88 NA XXX 73542 26 A X-ray exam, sacroiliac joint 0.59 0.17 0.17 0.03 0.79 0.79 XXX 73542 TC A X-ray exam, sacroiliac joint 0.00 1.99 NA 0.10 2.09 NA XXX 73550 A X-ray exam of thigh 0.17 0.60 NA 0.04 0.81 NA XXX 73550 26 A X-ray exam of thigh 0.17 0.06 0.06 0.01 0.24 0.24 XXX 73550 TC A X-ray exam of thigh 0.00 0.54 NA 0.03 0.57 NA XXX 73560 A X-ray exam of knee, 1 or 2 0.17 0.56 NA 0.04 0.77 NA XXX 73560 26 A X-ray exam of knee, 1 or 2 0.17 0.06 0.06 0.02 0.25 0.25 XXX 73560 TC A X-ray exam of knee, 1 or 2 0.00 0.50 NA 0.02 0.52 NA XXX 73562 A X-ray exam of knee, 3 0.18 0.60 NA 0.05 0.83 NA XXX 73562 26 A X-ray exam of knee, 3 0.18 0.06 0.06 0.02 0.26 0.26 XXX 73562 TC A X-ray exam of knee, 3 0.00 0.54 NA 0.03 0.57 NA XXX 73564 A X-ray exam, knee, 4 or more 0.22 0.67 NA 0.05 0.94 NA XXX 73564 26 A X-ray exam, knee, 4 or more 0.22 0.08 0.08 0.02 0.32 0.32 XXX 73564 TC A X-ray exam, knee, 4 or more 0.00 0.59 NA 0.03 0.62 NA XXX 73565 A X-ray exam of knees 0.17 0.54 NA 0.04 0.75 NA XXX 73565 26 A X-ray exam of knees 0.17 0.07 0.07 0.02 0.26 0.26 XXX 73565 TC A X-ray exam of knees 0.00 0.47 NA 0.02 0.49 NA XXX 73580 A Contrast x-ray of knee joint 0.54 2.68 NA 0.15 3.37 NA XXX 73580 26 A Contrast x-ray of knee joint 0.54 0.19 0.19 0.03 0.76 0.76 XXX 73580 TC A Contrast x-ray of knee joint 0.00 2.49 NA 0.12 2.61 NA XXX 73590 A X-ray exam of lower leg 0.17 0.56 NA 0.03 0.76 NA XXX 73590 26 A X-ray exam of lower leg 0.17 0.06 0.06 0.01 0.24 0.24 XXX 73590 TC A X-ray exam of lower leg 0.00 0.50 NA 0.02 0.52 NA XXX 73592 A X-ray exam of leg, infant 0.16 0.53 NA 0.03 0.72 NA XXX 73592 26 A X-ray exam of leg, infant 0.16 0.06 0.06 0.01 0.23 0.23 XXX 73592 TC A X-ray exam of leg, infant 0.00 0.47 NA 0.02 0.49 NA XXX 73600 A X-ray exam of ankle 0.16 0.53 NA 0.03 0.72 NA XXX 73600 26 A X-ray exam of ankle 0.16 0.06 0.06 0.01 0.23 0.23 XXX 73600 TC A X-ray exam of ankle 0.00 0.47 NA 0.02 0.49 NA XXX 73610 A X-ray exam of ankle 0.17 0.57 NA 0.03 0.77 NA XXX 73610 26 A X-ray exam of ankle 0.17 0.06 0.06 0.01 0.24 0.24 XXX 73610 TC A X-ray exam of ankle 0.00 0.51 NA 0.02 0.53 NA XXX 73615 A Contrast x-ray of ankle 0.54 2.18 NA 0.13 2.85 NA XXX 73615 26 A Contrast x-ray of ankle 0.54 0.19 0.19 0.03 0.76 0.76 XXX 73615 TC A Contrast x-ray of ankle 0.00 1.99 NA 0.10 2.09 NA XXX 73620 A X-ray exam of foot 0.16 0.53 NA 0.03 0.72 NA XXX 73620 26 A X-ray exam of foot 0.16 0.06 0.06 0.01 0.23 0.23 XXX 73620 TC A X-ray exam of foot 0.00 0.47 NA 0.02 0.49 NA XXX 73630 A X-ray exam of foot 0.17 0.57 NA 0.03 0.77 NA XXX 73630 26 A X-ray exam of foot 0.17 0.06 0.06 0.01 0.24 0.24 XXX 73630 TC A X-ray exam of foot 0.00 0.51 NA 0.02 0.53 NA XXX 73650 A X-ray exam of heel 0.16 0.51 NA 0.03 0.70 NA XXX 73650 26 A X-ray exam of heel 0.16 0.06 0.06 0.01 0.23 0.23 XXX 73650 TC A X-ray exam of heel 0.00 0.45 NA 0.02 0.47 NA XXX 73660 A X-ray exam of toe(s) 0.13 0.44 NA 0.03 0.60 NA XXX 73660 26 A X-ray exam of toe(s) 0.13 0.05 0.05 0.01 0.19 0.19 XXX 73660 TC A X-ray exam of toe(s) 0.00 0.39 NA 0.02 0.41 NA XXX 73700 A Ct lower extremity w/o dye 1.09 5.09 NA 0.26 6.44 NA XXX 73700 26 A Ct lower extremity w/o dye 1.09 0.38 0.38 0.05 1.52 1.52 XXX 73700 TC A Ct lower extremity w/o dye 0.00 4.71 NA 0.21 4.92 NA XXX 73701 A Ct lower extremity w/dye 1.16 6.02 NA 0.31 7.49 NA XXX 73701 26 A Ct lower extremity w/dye 1.16 0.41 0.41 0.05 1.62 1.62 XXX 73701 TC A Ct lower extremity w/dye 0.00 5.61 NA 0.26 5.87 NA XXX 73702 A Ct lwr extremity w/o&w dye 1.22 7.48 NA 0.37 9.07 NA XXX 73702 26 A Ct lwr extremity w/o&w dye 1.22 0.43 0.43 0.05 1.70 1.70 XXX 73702 TC A Ct lwr extremity w/o&w dye 0.00 7.05 NA 0.32 7.37 NA XXX 73706 A Ct angio lwr extr w/o&w dye 1.90 7.81 NA 0.38 10.09 NA XXX 73706 26 A Ct angio lwr extr w/o&w dye 1.90 0.76 0.76 0.06 2.72 2.72 XXX 73706 TC A Ct angio lwr extr w/o&w dye 0.00 7.05 NA 0.32 7.37 NA XXX 73718 A Mri lower extremity w/o dye 1.35 11.11 NA 0.36 12.82 NA XXX 73718 26 A Mri lower extremity w/o dye 1.35 0.47 0.47 0.04 1.86 1.86 XXX 73718 TC A Mri lower extremity w/o dye 0.00 10.64 NA 0.32 10.96 NA XXX 73719 A Mri lower extremity w/dye 1.62 13.32 NA 0.44 15.38 NA XXX 73719 26 A Mri lower extremity w/dye 1.62 0.56 0.56 0.05 2.23 2.23 XXX 73719 TC A Mri lower extremity w/dye 0.00 12.76 NA 0.39 13.15 NA XXX 73720 A Mri lwr extremity w/o&w dye 2.15 24.39 NA 0.78 27.32 NA XXX 73720 26 A Mri lwr extremity w/o&w dye 2.15 0.75 0.75 0.08 2.98 2.98 XXX 73720 TC A Mri lwr extremity w/o&w dye 0.00 23.64 NA 0.70 24.34 NA XXX 73721 A Mri joint of lwr extre w/o d 1.35 11.11 NA 0.36 12.82 NA XXX 73721 26 A Mri joint of lwr extre w/o d 1.35 0.47 0.47 0.04 1.86 1.86 XXX 73721 TC A Mri joint of lwr extre w/o d 0.00 10.64 NA 0.32 10.96 NA XXX Start Printed Page 55413 73722 A Mri joint of lwr extr w/dye 1.62 13.33 NA 0.45 15.40 NA XXX 73722 26 A Mri joint of lwr extr w/dye 1.62 0.57 0.57 0.06 2.25 2.25 XXX 73722 TC A Mri joint of lwr extr w/dye 0.00 12.76 NA 0.39 13.15 NA XXX 73723 A Mri joint lwr extr w/o&w dye 2.15 24.39 NA 0.77 27.31 NA XXX 73723 26 A Mri joint lwr extr w/o&w dye 2.15 0.75 0.75 0.07 2.97 2.97 XXX 73723 TC A Mri joint lwr extr w/o&w dye 0.00 23.64 NA 0.70 24.34 NA XXX 73725 R Mr ang lwr ext w or w/o dye 1.82 11.28 NA 0.57 13.67 NA XXX 73725 26 R Mr ang lwr ext w or w/o dye 1.82 0.64 0.64 0.08 2.54 2.54 XXX 73725 TC R Mr ang lwr ext w or w/o dye 0.00 10.64 NA 0.49 11.13 NA XXX 74000 A X-ray exam of abdomen 0.18 0.56 NA 0.03 0.77 NA XXX 74000 26 A X-ray exam of abdomen 0.18 0.06 0.06 0.01 0.25 0.25 XXX 74000 TC A X-ray exam of abdomen 0.00 0.50 NA 0.02 0.52 NA XXX 74010 A X-ray exam of abdomen 0.23 0.62 NA 0.04 0.89 NA XXX 74010 26 A X-ray exam of abdomen 0.23 0.08 0.08 0.01 0.32 0.32 XXX 74010 TC A X-ray exam of abdomen 0.00 0.54 NA 0.03 0.57 NA XXX 74020 A X-ray exam of abdomen 0.27 0.68 NA 0.04 0.99 NA XXX 74020 26 A X-ray exam of abdomen 0.27 0.09 0.09 0.01 0.37 0.37 XXX 74020 TC A X-ray exam of abdomen 0.00 0.59 NA 0.03 0.62 NA XXX 74022 A X-ray exam series, abdomen 0.32 0.81 NA 0.05 1.18 NA XXX 74022 26 A X-ray exam series, abdomen 0.32 0.11 0.11 0.01 0.44 0.44 XXX 74022 TC A X-ray exam series, abdomen 0.00 0.70 NA 0.04 0.74 NA XXX 74150 A Ct abdomen w/o dye 1.19 5.79 NA 0.30 7.28 NA XXX 74150 26 A Ct abdomen w/o dye 1.19 0.42 0.42 0.05 1.66 1.66 XXX 74150 TC A Ct abdomen w/o dye 0.00 5.37 NA 0.25 5.62 NA XXX 74160 A Ct abdomen w/dye 1.27 6.94 NA 0.36 8.57 NA XXX 74160 26 A Ct abdomen w/dye 1.27 0.44 0.44 0.06 1.77 1.77 XXX 74160 TC A Ct abdomen w/dye 0.00 6.50 NA 0.30 6.80 NA XXX 74170 A Ct abdomen w/o&w dye 1.40 8.55 NA 0.42 10.37 NA XXX 74170 26 A Ct abdomen w/o&w dye 1.40 0.49 0.49 0.06 1.95 1.95 XXX 74170 TC A Ct abdomen w/o&w dye 0.00 8.06 NA 0.36 8.42 NA XXX 74175 A Ct angio abdom w/o&w dye 1.90 8.82 NA 0.38 11.10 NA XXX 74175 26 A Ct angio abdom w/o&w dye 1.90 0.76 0.76 0.06 2.72 2.72 XXX 74175 TC A Ct angio abdom w/o&w dye 0.00 8.06 NA 0.32 8.38 NA XXX 74181 A Mri abdomen w/o dye 1.46 11.15 NA 0.41 13.02 NA XXX 74181 26 A Mri abdomen w/o dye 1.46 0.51 0.51 0.04 2.01 2.01 XXX 74181 TC A Mri abdomen w/o dye 0.00 10.64 NA 0.37 11.01 NA XXX 74182 A Mri abdomen w/dye 1.73 13.36 NA 0.49 15.58 NA XXX 74182 26 A Mri abdomen w/dye 1.73 0.60 0.60 0.06 2.39 2.39 XXX 74182 TC A Mri abdomen w/dye 0.00 12.76 NA 0.43 13.19 NA XXX 74183 A Mri abdomen w/o&w dye 2.26 24.43 NA 0.84 27.53 NA XXX 74183 26 A Mri abdomen w/o&w dye 2.26 0.79 0.79 0.08 3.13 3.13 XXX 74183 TC A Mri abdomen w/o&w dye 0.00 23.64 NA 0.76 24.40 NA XXX 74185 R Mri angio, abdom w or w/o dy 1.80 11.27 NA 0.57 13.64 NA XXX 74185 26 R Mri angio, abdom w or w/o dy 1.80 0.63 0.63 0.08 2.51 2.51 XXX 74185 TC R Mri angio, abdom w or w/o dy 0.00 10.64 NA 0.49 11.13 NA XXX 74190 A X-ray exam of peritoneum 0.48 1.41 NA 0.08 1.97 NA XXX 74190 26 A X-ray exam of peritoneum 0.48 0.17 0.17 0.02 0.67 0.67 XXX 74190 TC A X-ray exam of peritoneum 0.00 1.24 NA 0.06 1.30 NA XXX 74210 A Contrst x-ray exam of throat 0.36 1.26 NA 0.07 1.69 NA XXX 74210 26 A Contrst x-ray exam of throat 0.36 0.13 0.13 0.02 0.51 0.51 XXX 74210 TC A Contrst x-ray exam of throat 0.00 1.13 NA 0.05 1.18 NA XXX 74220 A Contrast x-ray, esophagus 0.46 1.29 NA 0.07 1.82 NA XXX 74220 26 A Contrast x-ray, esophagus 0.46 0.16 0.16 0.02 0.64 0.64 XXX 74220 TC A Contrast x-ray, esophagus 0.00 1.13 NA 0.05 1.18 NA XXX 74230 A Cine/video x-ray, throat/eso 0.53 1.43 NA 0.08 2.04 NA XXX 74230 26 A Cine/video x-ray, throat/eso 0.53 0.19 0.19 0.02 0.74 0.74 XXX 74230 TC A Cine/video x-ray, throat/eso 0.00 1.24 NA 0.06 1.30 NA XXX 74235 A Remove esophagus obstruction 1.19 2.90 NA 0.17 4.26 NA XXX 74235 26 A Remove esophagus obstruction 1.19 0.41 0.41 0.05 1.65 1.65 XXX 74235 TC A Remove esophagus obstruction 0.00 2.49 NA 0.12 2.61 NA XXX 74240 A X-ray exam, upper gi tract 0.69 1.63 NA 0.10 2.42 NA XXX 74240 26 A X-ray exam, upper gi tract 0.69 0.24 0.24 0.03 0.96 0.96 XXX 74240 TC A X-ray exam, upper gi tract 0.00 1.39 NA 0.07 1.46 NA XXX 74241 A X-ray exam, upper gi tract 0.69 1.65 NA 0.10 2.44 NA XXX 74241 26 A X-ray exam, upper gi tract 0.69 0.24 0.24 0.03 0.96 0.96 XXX 74241 TC A X-ray exam, upper gi tract 0.00 1.41 NA 0.07 1.48 NA XXX 74245 A X-ray exam, upper gi tract 0.91 2.58 NA 0.15 3.64 NA XXX 74245 26 A X-ray exam, upper gi tract 0.91 0.32 0.32 0.04 1.27 1.27 XXX 74245 TC A X-ray exam, upper gi tract 0.00 2.26 NA 0.11 2.37 NA XXX 74246 A Contrst x-ray uppr gi tract 0.69 1.80 NA 0.11 2.60 NA XXX 74246 26 A Contrst x-ray uppr gi tract 0.69 0.24 0.24 0.03 0.96 0.96 XXX 74246 TC A Contrst x-ray uppr gi tract 0.00 1.56 NA 0.08 1.64 NA XXX 74247 A Contrst x-ray uppr gi tract 0.69 1.84 NA 0.12 2.65 NA XXX Start Printed Page 55414 74247 26 A Contrst x-ray uppr gi tract 0.69 0.24 0.24 0.03 0.96 0.96 XXX 74247 TC A Contrst x-ray uppr gi tract 0.00 1.60 NA 0.09 1.69 NA XXX 74249 A Contrst x-ray uppr gi tract 0.91 2.76 NA 0.16 3.83 NA XXX 74249 26 A Contrst x-ray uppr gi tract 0.91 0.32 0.32 0.04 1.27 1.27 XXX 74249 TC A Contrst x-ray uppr gi tract 0.00 2.44 NA 0.12 2.56 NA XXX 74250 A X-ray exam of small bowel 0.47 1.40 NA 0.08 1.95 NA XXX 74250 26 A X-ray exam of small bowel 0.47 0.16 0.16 0.02 0.65 0.65 XXX 74250 TC A X-ray exam of small bowel 0.00 1.24 NA 0.06 1.30 NA XXX 74251 A X-ray exam of small bowel 0.69 1.48 NA 0.09 2.26 NA XXX 74251 26 A X-ray exam of small bowel 0.69 0.24 0.24 0.03 0.96 0.96 XXX 74251 TC A X-ray exam of small bowel 0.00 1.24 NA 0.06 1.30 NA XXX 74260 A X-ray exam of small bowel 0.50 1.58 NA 0.09 2.17 NA XXX 74260 26 A X-ray exam of small bowel 0.50 0.17 0.17 0.02 0.69 0.69 XXX 74260 TC A X-ray exam of small bowel 0.00 1.41 NA 0.07 1.48 NA XXX 74270 A Contrast x-ray exam of colon 0.69 1.86 NA 0.12 2.67 NA XXX 74270 26 A Contrast x-ray exam of colon 0.69 0.24 0.24 0.03 0.96 0.96 XXX 74270 TC A Contrast x-ray exam of colon 0.00 1.62 NA 0.09 1.71 NA XXX 74280 A Contrast x-ray exam of colon 0.99 2.47 NA 0.15 3.61 NA XXX 74280 26 A Contrast x-ray exam of colon 0.99 0.35 0.35 0.04 1.38 1.38 XXX 74280 TC A Contrast x-ray exam of colon 0.00 2.12 NA 0.11 2.23 NA XXX 74283 A Contrast x-ray exam of colon 2.02 3.14 NA 0.21 5.37 NA XXX 74283 26 A Contrast x-ray exam of colon 2.02 0.71 0.71 0.09 2.82 2.82 XXX 74283 TC A Contrast x-ray exam of colon 0.00 2.43 NA 0.12 2.55 NA XXX 74290 A Contrast x-ray, gallbladder 0.32 0.81 NA 0.05 1.18 NA XXX 74290 26 A Contrast x-ray, gallbladder 0.32 0.11 0.11 0.01 0.44 0.44 XXX 74290 TC A Contrast x-ray, gallbladder 0.00 0.70 NA 0.04 0.74 NA XXX 74291 A Contrast x-rays, gallbladder 0.20 0.46 NA 0.03 0.69 NA XXX 74291 26 A Contrast x-rays, gallbladder 0.20 0.07 0.07 0.01 0.28 0.28 XXX 74291 TC A Contrast x-rays, gallbladder 0.00 0.39 NA 0.02 0.41 NA XXX 74300 C X-ray bile ducts/pancreas 0.00 0.00 0.00 0.00 0.00 0.00 XXX 74300 26 A X-ray bile ducts/pancreas 0.36 0.13 0.13 0.02 0.51 0.51 XXX 74300 TC C X-ray bile ducts/pancreas 0.00 0.00 0.00 0.00 0.00 0.00 XXX 74301 C X-rays at surgery add-on 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 74301 26 A X-rays at surgery add-on 0.21 0.07 0.07 0.01 0.29 0.29 ZZZ 74301 TC C X-rays at surgery add-on 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 74305 A X-ray bile ducts/pancreas 0.42 0.89 NA 0.06 1.37 NA XXX 74305 26 A X-ray bile ducts/pancreas 0.42 0.15 0.15 0.02 0.59 0.59 XXX 74305 TC A X-ray bile ducts/pancreas 0.00 0.74 NA 0.04 0.78 NA XXX 74320 A Contrast x-ray of bile ducts 0.54 3.18 NA 0.16 3.88 NA XXX 74320 26 A Contrast x-ray of bile ducts 0.54 0.19 0.19 0.02 0.75 0.75 XXX 74320 TC A Contrast x-ray of bile ducts 0.00 2.99 NA 0.14 3.13 NA XXX 74327 A X-ray bile stone removal 0.70 1.91 NA 0.12 2.73 NA XXX 74327 26 A X-ray bile stone removal 0.70 0.24 0.24 0.03 0.97 0.97 XXX 74327 TC A X-ray bile stone removal 0.00 1.67 NA 0.09 1.76 NA XXX 74328 A Xray bile duct endoscopy 0.70 3.24 NA 0.17 4.11 NA XXX 74328 26 A Xray bile duct endoscopy 0.70 0.25 0.25 0.03 0.98 0.98 XXX 74328 TC A Xray bile duct endoscopy 0.00 2.99 NA 0.14 3.13 NA XXX 74329 A X-ray for pancreas endoscopy 0.70 3.24 NA 0.17 4.11 NA XXX 74329 26 A X-ray for pancreas endoscopy 0.70 0.25 0.25 0.03 0.98 0.98 XXX 74329 TC A X-ray for pancreas endoscopy 0.00 2.99 NA 0.14 3.13 NA XXX 74330 A X-ray bile/panc endoscopy 0.90 3.31 NA 0.18 4.39 NA XXX 74330 26 A X-ray bile/panc endoscopy 0.90 0.32 0.32 0.04 1.26 1.26 XXX 74330 TC A X-ray bile/panc endoscopy 0.00 2.99 NA 0.14 3.13 NA XXX 74340 A X-ray guide for GI tube 0.54 2.68 NA 0.14 3.36 NA XXX 74340 26 A X-ray guide for GI tube 0.54 0.19 0.19 0.02 0.75 0.75 XXX 74340 TC A X-ray guide for GI tube 0.00 2.49 NA 0.12 2.61 NA XXX 74350 A X-ray guide, stomach tube 0.76 3.26 NA 0.17 4.19 NA XXX 74350 26 A X-ray guide, stomach tube 0.76 0.27 0.27 0.03 1.06 1.06 XXX 74350 TC A X-ray guide, stomach tube 0.00 2.99 NA 0.14 3.13 NA XXX 74355 A X-ray guide, intestinal tube 0.76 2.75 NA 0.15 3.66 NA XXX 74355 26 A X-ray guide, intestinal tube 0.76 0.26 0.26 0.03 1.05 1.05 XXX 74355 TC A X-ray guide, intestinal tube 0.00 2.49 NA 0.12 2.61 NA XXX 74360 A X-ray guide, GI dilation 0.54 3.18 NA 0.16 3.88 NA XXX 74360 26 A X-ray guide, GI dilation 0.54 0.19 0.19 0.02 0.75 0.75 XXX 74360 TC A X-ray guide, GI dilation 0.00 2.99 NA 0.14 3.13 NA XXX 74363 A X-ray, bile duct dilation 0.88 6.10 NA 0.31 7.29 NA XXX 74363 26 A X-ray, bile duct dilation 0.88 0.31 0.31 0.04 1.23 1.23 XXX 74363 TC A X-ray, bile duct dilation 0.00 5.79 NA 0.27 6.06 NA XXX 74400 A Contrst x-ray, urinary tract 0.49 1.77 NA 0.11 2.37 NA XXX 74400 26 A Contrst x-ray, urinary tract 0.49 0.17 0.17 0.02 0.68 0.68 XXX 74400 TC A Contrst x-ray, urinary tract 0.00 1.60 NA 0.09 1.69 NA XXX 74410 A Contrst x-ray, urinary tract 0.49 2.02 NA 0.11 2.62 NA XXX 74410 26 A Contrst x-ray, urinary tract 0.49 0.17 0.17 0.02 0.68 0.68 XXX Start Printed Page 55415 74410 TC A Contrst x-ray, urinary tract 0.00 1.85 NA 0.09 1.94 NA XXX 74415 A Contrst x-ray, urinary tract 0.49 2.18 NA 0.12 2.79 NA XXX 74415 26 A Contrst x-ray, urinary tract 0.49 0.17 0.17 0.02 0.68 0.68 XXX 74415 TC A Contrst x-ray, urinary tract 0.00 2.01 NA 0.10 2.11 NA XXX 74420 A Contrst x-ray, urinary tract 0.36 2.62 NA 0.14 3.12 NA XXX 74420 26 A Contrst x-ray, urinary tract 0.36 0.13 0.13 0.02 0.51 0.51 XXX 74420 TC A Contrst x-ray, urinary tract 0.00 2.49 NA 0.12 2.61 NA XXX 74425 A Contrst x-ray, urinary tract 0.36 1.37 NA 0.08 1.81 NA XXX 74425 26 A Contrst x-ray, urinary tract 0.36 0.13 0.13 0.02 0.51 0.51 XXX 74425 TC A Contrst x-ray, urinary tract 0.00 1.24 NA 0.06 1.30 NA XXX 74430 A Contrast x-ray, bladder 0.32 1.11 NA 0.07 1.50 NA XXX 74430 26 A Contrast x-ray, bladder 0.32 0.11 0.11 0.02 0.45 0.45 XXX 74430 TC A Contrast x-ray, bladder 0.00 1.00 NA 0.05 1.05 NA XXX 74440 A X-ray, male genital tract 0.38 1.20 NA 0.07 1.65 NA XXX 74440 26 A X-ray, male genital tract 0.38 0.13 0.13 0.02 0.53 0.53 XXX 74440 TC A X-ray, male genital tract 0.00 1.07 NA 0.05 1.12 NA XXX 74445 A X-ray exam of penis 1.14 1.46 NA 0.10 2.70 NA XXX 74445 26 A X-ray exam of penis 1.14 0.39 0.39 0.05 1.58 1.58 XXX 74445 TC A X-ray exam of penis 0.00 1.07 NA 0.05 1.12 NA XXX 74450 A X-ray, urethra/bladder 0.33 1.51 NA 0.09 1.93 NA XXX 74450 26 A X-ray, urethra/bladder 0.33 0.12 0.12 0.02 0.47 0.47 XXX 74450 TC A X-ray, urethra/bladder 0.00 1.39 NA 0.07 1.46 NA XXX 74455 A X-ray, urethra/bladder 0.33 1.61 NA 0.10 2.04 NA XXX 74455 26 A X-ray, urethra/bladder 0.33 0.11 0.11 0.02 0.46 0.46 XXX 74455 TC A X-ray, urethra/bladder 0.00 1.50 NA 0.08 1.58 NA XXX 74470 A X-ray exam of kidney lesion 0.54 1.37 NA 0.08 1.99 NA XXX 74470 26 A X-ray exam of kidney lesion 0.54 0.19 0.19 0.02 0.75 0.75 XXX 74470 TC A X-ray exam of kidney lesion 0.00 1.18 NA 0.06 1.24 NA XXX 74475 A X-ray control, cath insert 0.54 4.06 NA 0.20 4.80 NA XXX 74475 26 A X-ray control, cath insert 0.54 0.19 0.19 0.02 0.75 0.75 XXX 74475 TC A X-ray control, cath insert 0.00 3.87 NA 0.18 4.05 NA XXX 74480 A X-ray control, cath insert 0.54 4.06 NA 0.20 4.80 NA XXX 74480 26 A X-ray control, cath insert 0.54 0.19 0.19 0.02 0.75 0.75 XXX 74480 TC A X-ray control, cath insert 0.00 3.87 NA 0.18 4.05 NA XXX 74485 A X-ray guide, GU dilation 0.54 3.18 NA 0.17 3.89 NA XXX 74485 26 A X-ray guide, GU dilation 0.54 0.19 0.19 0.03 0.76 0.76 XXX 74485 TC A X-ray guide, GU dilation 0.00 2.99 NA 0.14 3.13 NA XXX 74710 A X-ray measurement of pelvis 0.34 1.12 NA 0.07 1.53 NA XXX 74710 26 A X-ray measurement of pelvis 0.34 0.12 0.12 0.02 0.48 0.48 XXX 74710 TC A X-ray measurement of pelvis 0.00 1.00 NA 0.05 1.05 NA XXX 74740 A X-ray, female genital tract 0.38 1.37 NA 0.08 1.83 NA XXX 74740 26 A X-ray, female genital tract 0.38 0.13 0.13 0.02 0.53 0.53 XXX 74740 TC A X-ray, female genital tract 0.00 1.24 NA 0.06 1.30 NA XXX 74742 A X-ray, fallopian tube 0.61 3.23 NA 0.16 4.00 NA XXX 74742 26 A X-ray, fallopian tube 0.61 0.24 0.24 0.02 0.87 0.87 XXX 74742 TC A X-ray, fallopian tube 0.00 2.99 NA 0.14 3.13 NA XXX 74775 A X-ray exam of perineum 0.62 1.62 NA 0.10 2.34 NA XXX 74775 26 A X-ray exam of perineum 0.62 0.23 0.23 0.03 0.88 0.88 XXX 74775 TC A X-ray exam of perineum 0.00 1.39 NA 0.07 1.46 NA XXX 75552 A Heart mri for morph w/o dye 1.60 11.20 NA 0.56 13.36 NA XXX 75552 26 A Heart mri for morph w/o dye 1.60 0.56 0.56 0.07 2.23 2.23 XXX 75552 TC A Heart mri for morph w/o dye 0.00 10.64 NA 0.49 11.13 NA XXX 75553 A Heart mri for morph w/dye 2.00 11.35 NA 0.58 13.93 NA XXX 75553 26 A Heart mri for morph w/dye 2.00 0.71 0.71 0.09 2.80 2.80 XXX 75553 TC A Heart mri for morph w/dye 0.00 10.64 NA 0.49 11.13 NA XXX 75554 A Cardiac MRI/function 1.83 11.33 NA 0.56 13.72 NA XXX 75554 26 A Cardiac MRI/function 1.83 0.69 0.69 0.07 2.59 2.59 XXX 75554 TC A Cardiac MRI/function 0.00 10.64 NA 0.49 11.13 NA XXX 75555 A Cardiac MRI/limited study 1.74 11.32 NA 0.56 13.62 NA XXX 75555 26 A Cardiac MRI/limited study 1.74 0.68 0.68 0.07 2.49 2.49 XXX 75555 TC A Cardiac MRI/limited study 0.00 10.64 NA 0.49 11.13 NA XXX 75556 N Cardiac MRI/flow mapping 0.00 0.00 0.00 0.00 0.00 0.00 XXX 75600 A Contrast x-ray exam of aorta 0.49 12.16 NA 0.56 13.21 NA XXX 75600 26 A Contrast x-ray exam of aorta 0.49 0.20 0.20 0.02 0.71 0.71 XXX 75600 TC A Contrast x-ray exam of aorta 0.00 11.96 NA 0.54 12.50 NA XXX 75605 A Contrast x-ray exam of aorta 1.14 12.39 NA 0.59 14.12 NA XXX 75605 26 A Contrast x-ray exam of aorta 1.14 0.43 0.43 0.05 1.62 1.62 XXX 75605 TC A Contrast x-ray exam of aorta 0.00 11.96 NA 0.54 12.50 NA XXX 75625 A Contrast x-ray exam of aorta 1.14 12.37 NA 0.59 14.10 NA XXX 75625 26 A Contrast x-ray exam of aorta 1.14 0.41 0.41 0.05 1.60 1.60 XXX 75625 TC A Contrast x-ray exam of aorta 0.00 11.96 NA 0.54 12.50 NA XXX 75630 A X-ray aorta, leg arteries 1.79 13.14 NA 0.65 15.58 NA XXX 75630 26 A X-ray aorta, leg arteries 1.79 0.67 0.67 0.08 2.54 2.54 XXX Start Printed Page 55416 75630 TC A X-ray aorta, leg arteries 0.00 12.47 NA 0.57 13.04 NA XXX 75635 A Ct angio abdominal arteries 2.40 9.02 NA 0.41 11.83 NA XXX 75635 26 A Ct angio abdominal arteries 2.40 0.96 0.96 0.09 3.45 3.45 XXX 75635 TC A Ct angio abdominal arteries 0.00 8.06 NA 0.32 8.38 NA XXX 75650 A Artery x-rays, head & neck 1.49 12.49 NA 0.61 14.59 NA XXX 75650 26 A Artery x-rays, head & neck 1.49 0.53 0.53 0.07 2.09 2.09 XXX 75650 TC A Artery x-rays, head & neck 0.00 11.96 NA 0.54 12.50 NA XXX 75658 A Artery x-rays, arm 1.31 12.44 NA 0.60 14.35 NA XXX 75658 26 A Artery x-rays, arm 1.31 0.48 0.48 0.06 1.85 1.85 XXX 75658 TC A Artery x-rays, arm 0.00 11.96 NA 0.54 12.50 NA XXX 75660 A Artery x-rays, head & neck 1.31 12.44 NA 0.60 14.35 NA XXX 75660 26 A Artery x-rays, head & neck 1.31 0.48 0.48 0.06 1.85 1.85 XXX 75660 TC A Artery x-rays, head & neck 0.00 11.96 NA 0.54 12.50 NA XXX 75662 A Artery x-rays, head & neck 1.66 12.60 NA 0.62 14.88 NA XXX 75662 26 A Artery x-rays, head & neck 1.66 0.64 0.64 0.08 2.38 2.38 XXX 75662 TC A Artery x-rays, head & neck 0.00 11.96 NA 0.54 12.50 NA XXX 75665 A Artery x-rays, head & neck 1.31 12.43 NA 0.61 14.35 NA XXX 75665 26 A Artery x-rays, head & neck 1.31 0.47 0.47 0.07 1.85 1.85 XXX 75665 TC A Artery x-rays, head & neck 0.00 11.96 NA 0.54 12.50 NA XXX 75671 A Artery x-rays, head & neck 1.66 12.55 NA 0.62 14.83 NA XXX 75671 26 A Artery x-rays, head & neck 1.66 0.59 0.59 0.08 2.33 2.33 XXX 75671 TC A Artery x-rays, head & neck 0.00 11.96 NA 0.54 12.50 NA XXX 75676 A Artery x-rays, neck 1.31 12.43 NA 0.61 14.35 NA XXX 75676 26 A Artery x-rays, neck 1.31 0.47 0.47 0.07 1.85 1.85 XXX 75676 TC A Artery x-rays, neck 0.00 11.96 NA 0.54 12.50 NA XXX 75680 A Artery x-rays, neck 1.66 12.55 NA 0.62 14.83 NA XXX 75680 26 A Artery x-rays, neck 1.66 0.59 0.59 0.08 2.33 2.33 XXX 75680 TC A Artery x-rays, neck 0.00 11.96 NA 0.54 12.50 NA XXX 75685 A Artery x-rays, spine 1.31 12.43 NA 0.60 14.34 NA XXX 75685 26 A Artery x-rays, spine 1.31 0.47 0.47 0.06 1.84 1.84 XXX 75685 TC A Artery x-rays, spine 0.00 11.96 NA 0.54 12.50 NA XXX 75705 A Artery x-rays, spine 2.18 12.75 NA 0.65 15.58 NA XXX 75705 26 A Artery x-rays, spine 2.18 0.79 0.79 0.11 3.08 3.08 XXX 75705 TC A Artery x-rays, spine 0.00 11.96 NA 0.54 12.50 NA XXX 75710 A Artery x-rays, arm/leg 1.14 12.38 NA 0.60 14.12 NA XXX 75710 26 A Artery x-rays, arm/leg 1.14 0.42 0.42 0.06 1.62 1.62 XXX 75710 TC A Artery x-rays, arm/leg 0.00 11.96 NA 0.54 12.50 NA XXX 75716 A Artery x-rays, arms/legs 1.31 12.43 NA 0.60 14.34 NA XXX 75716 26 A Artery x-rays, arms/legs 1.31 0.47 0.47 0.06 1.84 1.84 XXX 75716 TC A Artery x-rays, arms/legs 0.00 11.96 NA 0.54 12.50 NA XXX 75722 A Artery x-rays, kidney 1.14 12.39 NA 0.59 14.12 NA XXX 75722 26 A Artery x-rays, kidney 1.14 0.43 0.43 0.05 1.62 1.62 XXX 75722 TC A Artery x-rays, kidney 0.00 11.96 NA 0.54 12.50 NA XXX 75724 A Artery x-rays, kidneys 1.49 12.56 NA 0.59 14.64 NA XXX 75724 26 A Artery x-rays, kidneys 1.49 0.60 0.60 0.05 2.14 2.14 XXX 75724 TC A Artery x-rays, kidneys 0.00 11.96 NA 0.54 12.50 NA XXX 75726 A Artery x-rays, abdomen 1.14 12.36 NA 0.59 14.09 NA XXX 75726 26 A Artery x-rays, abdomen 1.14 0.40 0.40 0.05 1.59 1.59 XXX 75726 TC A Artery x-rays, abdomen 0.00 11.96 NA 0.54 12.50 NA XXX 75731 A Artery x-rays, adrenal gland 1.14 12.36 NA 0.59 14.09 NA XXX 75731 26 A Artery x-rays, adrenal gland 1.14 0.40 0.40 0.05 1.59 1.59 XXX 75731 TC A Artery x-rays, adrenal gland 0.00 11.96 NA 0.54 12.50 NA XXX 75733 A Artery x-rays, adrenals 1.31 12.43 NA 0.60 14.34 NA XXX 75733 26 A Artery x-rays, adrenals 1.31 0.47 0.47 0.06 1.84 1.84 XXX 75733 TC A Artery x-rays, adrenals 0.00 11.96 NA 0.54 12.50 NA XXX 75736 A Artery x-rays, pelvis 1.14 12.37 NA 0.59 14.10 NA XXX 75736 26 A Artery x-rays, pelvis 1.14 0.41 0.41 0.05 1.60 1.60 XXX 75736 TC A Artery x-rays, pelvis 0.00 11.96 NA 0.54 12.50 NA XXX 75741 A Artery x-rays, lung 1.31 12.42 NA 0.60 14.33 NA XXX 75741 26 A Artery x-rays, lung 1.31 0.46 0.46 0.06 1.83 1.83 XXX 75741 TC A Artery x-rays, lung 0.00 11.96 NA 0.54 12.50 NA XXX 75743 A Artery x-rays, lungs 1.66 12.54 NA 0.61 14.81 NA XXX 75743 26 A Artery x-rays, lungs 1.66 0.58 0.58 0.07 2.31 2.31 XXX 75743 TC A Artery x-rays, lungs 0.00 11.96 NA 0.54 12.50 NA XXX 75746 A Artery x-rays, lung 1.14 12.36 NA 0.59 14.09 NA XXX 75746 26 A Artery x-rays, lung 1.14 0.40 0.40 0.05 1.59 1.59 XXX 75746 TC A Artery x-rays, lung 0.00 11.96 NA 0.54 12.50 NA XXX 75756 A Artery x-rays, chest 1.14 12.44 NA 0.58 14.16 NA XXX 75756 26 A Artery x-rays, chest 1.14 0.48 0.48 0.04 1.66 1.66 XXX 75756 TC A Artery x-rays, chest 0.00 11.96 NA 0.54 12.50 NA XXX 75774 A Artery x-ray, each vessel 0.36 12.09 NA 0.56 13.01 NA ZZZ 75774 26 A Artery x-ray, each vessel 0.36 0.13 0.13 0.02 0.51 0.51 ZZZ 75774 TC A Artery x-ray, each vessel 0.00 11.96 NA 0.54 12.50 NA ZZZ Start Printed Page 55417 75790 A Visualize A-V shunt 1.84 1.93 NA 0.16 3.93 NA XXX 75790 26 A Visualize A-V shunt 1.84 0.64 0.64 0.09 2.57 2.57 XXX 75790 TC A Visualize A-V shunt 0.00 1.29 NA 0.07 1.36 NA XXX 75801 A Lymph vessel x-ray, arm/leg 0.81 5.42 NA 0.29 6.52 NA XXX 75801 26 A Lymph vessel x-ray, arm/leg 0.81 0.28 0.28 0.05 1.14 1.14 XXX 75801 TC A Lymph vessel x-ray, arm/leg 0.00 5.14 NA 0.24 5.38 NA XXX 75803 A Lymph vessel x-ray,arms/legs 1.17 5.55 NA 0.29 7.01 NA XXX 75803 26 A Lymph vessel x-ray,arms/legs 1.17 0.41 0.41 0.05 1.63 1.63 XXX 75803 TC A Lymph vessel x-ray,arms/legs 0.00 5.14 NA 0.24 5.38 NA XXX 75805 A Lymph vessel x-ray, trunk 0.81 6.08 NA 0.31 7.20 NA XXX 75805 26 A Lymph vessel x-ray, trunk 0.81 0.29 0.29 0.04 1.14 1.14 XXX 75805 TC A Lymph vessel x-ray, trunk 0.00 5.79 NA 0.27 6.06 NA XXX 75807 A Lymph vessel x-ray, trunk 1.17 6.20 NA 0.32 7.69 NA XXX 75807 26 A Lymph vessel x-ray, trunk 1.17 0.41 0.41 0.05 1.63 1.63 XXX 75807 TC A Lymph vessel x-ray, trunk 0.00 5.79 NA 0.27 6.06 NA XXX 75809 A Nonvascular shunt, x-ray 0.47 0.91 NA 0.06 1.44 NA XXX 75809 26 A Nonvascular shunt, x-ray 0.47 0.17 0.17 0.02 0.66 0.66 XXX 75809 TC A Nonvascular shunt, x-ray 0.00 0.74 NA 0.04 0.78 NA XXX 75810 A Vein x-ray, spleen/liver 1.14 12.36 NA 0.60 14.10 NA XXX 75810 26 A Vein x-ray, spleen/liver 1.14 0.40 0.40 0.06 1.60 1.60 XXX 75810 TC A Vein x-ray, spleen/liver 0.00 11.96 NA 0.54 12.50 NA XXX 75820 A Vein x-ray, arm/leg 0.70 1.15 NA 0.08 1.93 NA XXX 75820 26 A Vein x-ray, arm/leg 0.70 0.25 0.25 0.03 0.98 0.98 XXX 75820 TC A Vein x-ray, arm/leg 0.00 0.90 NA 0.05 0.95 NA XXX 75822 A Vein x-ray, arms/legs 1.06 1.77 NA 0.12 2.95 NA XXX 75822 26 A Vein x-ray, arms/legs 1.06 0.37 0.37 0.05 1.48 1.48 XXX 75822 TC A Vein x-ray, arms/legs 0.00 1.40 NA 0.07 1.47 NA XXX 75825 A Vein x-ray, trunk 1.14 12.36 NA 0.60 14.10 NA XXX 75825 26 A Vein x-ray, trunk 1.14 0.40 0.40 0.06 1.60 1.60 XXX 75825 TC A Vein x-ray, trunk 0.00 11.96 NA 0.54 12.50 NA XXX 75827 A Vein x-ray, chest 1.14 12.36 NA 0.59 14.09 NA XXX 75827 26 A Vein x-ray, chest 1.14 0.40 0.40 0.05 1.59 1.59 XXX 75827 TC A Vein x-ray, chest 0.00 11.96 NA 0.54 12.50 NA XXX 75831 A Vein x-ray, kidney 1.14 12.36 NA 0.59 14.09 NA XXX 75831 26 A Vein x-ray, kidney 1.14 0.40 0.40 0.05 1.59 1.59 XXX 75831 TC A Vein x-ray, kidney 0.00 11.96 NA 0.54 12.50 NA XXX 75833 A Vein x-ray, kidneys 1.49 12.49 NA 0.61 14.59 NA XXX 75833 26 A Vein x-ray, kidneys 1.49 0.53 0.53 0.07 2.09 2.09 XXX 75833 TC A Vein x-ray, kidneys 0.00 11.96 NA 0.54 12.50 NA XXX 75840 A Vein x-ray, adrenal gland 1.14 12.38 NA 0.61 14.13 NA XXX 75840 26 A Vein x-ray, adrenal gland 1.14 0.42 0.42 0.07 1.63 1.63 XXX 75840 TC A Vein x-ray, adrenal gland 0.00 11.96 NA 0.54 12.50 NA XXX 75842 A Vein x-ray, adrenal glands 1.49 12.48 NA 0.61 14.58 NA XXX 75842 26 A Vein x-ray, adrenal glands 1.49 0.52 0.52 0.07 2.08 2.08 XXX 75842 TC A Vein x-ray, adrenal glands 0.00 11.96 NA 0.54 12.50 NA XXX 75860 A Vein x-ray, neck 1.14 12.39 NA 0.60 14.13 NA XXX 75860 26 A Vein x-ray, neck 1.14 0.43 0.43 0.06 1.63 1.63 XXX 75860 TC A Vein x-ray, neck 0.00 11.96 NA 0.54 12.50 NA XXX 75870 A Vein x-ray, skull 1.14 12.38 NA 0.60 14.12 NA XXX 75870 26 A Vein x-ray, skull 1.14 0.42 0.42 0.06 1.62 1.62 XXX 75870 TC A Vein x-ray, skull 0.00 11.96 NA 0.54 12.50 NA XXX 75872 A Vein x-ray, skull 1.14 12.36 NA 0.59 14.09 NA XXX 75872 26 A Vein x-ray, skull 1.14 0.40 0.40 0.05 1.59 1.59 XXX 75872 TC A Vein x-ray, skull 0.00 11.96 NA 0.54 12.50 NA XXX 75880 A Vein x-ray, eye socket 0.70 1.17 NA 0.08 1.95 NA XXX 75880 26 A Vein x-ray, eye socket 0.70 0.27 0.27 0.03 1.00 1.00 XXX 75880 TC A Vein x-ray, eye socket 0.00 0.90 NA 0.05 0.95 NA XXX 75885 A Vein x-ray, liver 1.44 12.46 NA 0.60 14.50 NA XXX 75885 26 A Vein x-ray, liver 1.44 0.50 0.50 0.06 2.00 2.00 XXX 75885 TC A Vein x-ray, liver 0.00 11.96 NA 0.54 12.50 NA XXX 75887 A Vein x-ray, liver 1.44 12.46 NA 0.60 14.50 NA XXX 75887 26 A Vein x-ray, liver 1.44 0.50 0.50 0.06 2.00 2.00 XXX 75887 TC A Vein x-ray, liver 0.00 11.96 NA 0.54 12.50 NA XXX 75889 A Vein x-ray, liver 1.14 12.36 NA 0.59 14.09 NA XXX 75889 26 A Vein x-ray, liver 1.14 0.40 0.40 0.05 1.59 1.59 XXX 75889 TC A Vein x-ray, liver 0.00 11.96 NA 0.54 12.50 NA XXX 75891 A Vein x-ray, liver 1.14 12.36 NA 0.59 14.09 NA XXX 75891 26 A Vein x-ray, liver 1.14 0.40 0.40 0.05 1.59 1.59 XXX 75891 TC A Vein x-ray, liver 0.00 11.96 NA 0.54 12.50 NA XXX 75893 A Venous sampling by catheter 0.54 12.15 NA 0.56 13.25 NA XXX 75893 26 A Venous sampling by catheter 0.54 0.19 0.19 0.02 0.75 0.75 XXX 75893 TC A Venous sampling by catheter 0.00 11.96 NA 0.54 12.50 NA XXX 75894 A X-rays, transcath therapy 1.31 23.38 NA 1.12 25.81 NA XXX Start Printed Page 55418 75894 26 A X-rays, transcath therapy 1.31 0.46 0.46 0.07 1.84 1.84 XXX 75894 TC A X-rays, transcath therapy 0.00 22.92 NA 1.05 23.97 NA XXX 75896 A X-rays, transcath therapy 1.31 20.42 NA 0.97 22.70 NA XXX 75896 26 A X-rays, transcath therapy 1.31 0.48 0.48 0.06 1.85 1.85 XXX 75896 TC A X-rays, transcath therapy 0.00 19.94 NA 0.91 20.85 NA XXX 75898 A Follow-up angiography 1.65 1.60 NA 0.12 3.37 NA XXX 75898 26 A Follow-up angiography 1.65 0.60 0.60 0.07 2.32 2.32 XXX 75898 TC A Follow-up angiography 0.00 1.00 NA 0.05 1.05 NA XXX 75900 A Arterial catheter exchange 0.49 20.09 NA 0.94 21.52 NA XXX 75900 26 A Arterial catheter exchange 0.49 0.17 0.17 0.02 0.68 0.68 XXX 75900 TC A Arterial catheter exchange 0.00 19.92 NA 0.92 20.84 NA XXX 75940 A X-ray placement, vein filter 0.54 12.15 NA 0.57 13.26 NA XXX 75940 26 A X-ray placement, vein filter 0.54 0.19 0.19 0.03 0.76 0.76 XXX 75940 TC A X-ray placement, vein filter 0.00 11.96 NA 0.54 12.50 NA XXX 75945 A Intravascular us 0.40 4.48 NA 0.23 5.11 NA XXX 75945 26 A Intravascular us 0.40 0.15 0.15 0.03 0.58 0.58 XXX 75945 TC A Intravascular us 0.00 4.33 NA 0.20 4.53 NA XXX 75946 A Intravascular us add-on 0.40 2.32 NA 0.14 2.86 NA ZZZ 75946 26 A Intravascular us add-on 0.40 0.14 0.14 0.03 0.57 0.57 ZZZ 75946 TC A Intravascular us add-on 0.00 2.18 NA 0.11 2.29 NA ZZZ 75952 C Endovasc repair abdom aorta +0.00 0.00 0.00 0.00 0.00 0.00 XXX 75952 26 A Endovasc repair abdom aorta 4.50 1.80 1.80 0.68 6.98 6.98 XXX 75952 TC C Endovasc repair abdom aorta 0.00 0.00 0.00 0.00 0.00 0.00 XXX 75953 C Abdom aneurysm endovas rpr +0.00 0.00 0.00 0.00 0.00 0.00 XXX 75953 26 A Abdom aneurysm endovas rpr 1.36 0.54 0.54 0.68 2.58 2.58 XXX 75953 TC C Abdom aneurysm endovas rpr 0.00 0.00 0.00 0.00 0.00 0.00 XXX 75960 A Transcatheter intro, stent 0.82 14.45 NA 0.68 15.95 NA XXX 75960 26 A Transcatheter intro, stent 0.82 0.30 0.30 0.04 1.16 1.16 XXX 75960 TC A Transcatheter intro, stent 0.00 14.15 NA 0.64 14.79 NA XXX 75961 A Retrieval, broken catheter 4.25 11.46 NA 0.64 16.35 NA XXX 75961 26 A Retrieval, broken catheter 4.25 1.49 1.49 0.18 5.92 5.92 XXX 75961 TC A Retrieval, broken catheter 0.00 9.97 NA 0.46 10.43 NA XXX 75962 A Repair arterial blockage 0.54 15.15 NA 0.72 16.41 NA XXX 75962 26 A Repair arterial blockage 0.54 0.20 0.20 0.03 0.77 0.77 XXX 75962 TC A Repair arterial blockage 0.00 14.95 NA 0.69 15.64 NA XXX 75964 A Repair artery blockage, each 0.36 8.10 NA 0.38 8.84 NA ZZZ 75964 26 A Repair artery blockage, each 0.36 0.13 0.13 0.02 0.51 0.51 ZZZ 75964 TC A Repair artery blockage, each 0.00 7.97 NA 0.36 8.33 NA ZZZ 75966 A Repair arterial blockage 1.31 15.45 NA 0.75 17.51 NA XXX 75966 26 A Repair arterial blockage 1.31 0.50 0.50 0.06 1.87 1.87 XXX 75966 TC A Repair arterial blockage 0.00 14.95 NA 0.69 15.64 NA XXX 75968 A Repair artery blockage, each 0.36 8.11 NA 0.37 8.84 NA ZZZ 75968 26 A Repair artery blockage, each 0.36 0.14 0.14 0.01 0.51 0.51 ZZZ 75968 TC A Repair artery blockage, each 0.00 7.97 NA 0.36 8.33 NA ZZZ 75970 A Vascular biopsy 0.83 11.26 NA 0.54 12.63 NA XXX 75970 26 A Vascular biopsy 0.83 0.30 0.30 0.04 1.17 1.17 XXX 75970 TC A Vascular biopsy 0.00 10.96 NA 0.50 11.46 NA XXX 75978 A Repair venous blockage 0.54 15.14 NA 0.71 16.39 NA XXX 75978 26 A Repair venous blockage 0.54 0.19 0.19 0.02 0.75 0.75 XXX 75978 TC A Repair venous blockage 0.00 14.95 NA 0.69 15.64 NA XXX 75980 A Contrast xray exam bile duct 1.44 5.64 NA 0.30 7.38 NA XXX 75980 26 A Contrast xray exam bile duct 1.44 0.50 0.50 0.06 2.00 2.00 XXX 75980 TC A Contrast xray exam bile duct 0.00 5.14 NA 0.24 5.38 NA XXX 75982 A Contrast xray exam bile duct 1.44 6.29 NA 0.33 8.06 NA XXX 75982 26 A Contrast xray exam bile duct 1.44 0.50 0.50 0.06 2.00 2.00 XXX 75982 TC A Contrast xray exam bile duct 0.00 5.79 NA 0.27 6.06 NA XXX 75984 A Xray control catheter change 0.72 2.10 NA 0.12 2.94 NA XXX 75984 26 A Xray control catheter change 0.72 0.25 0.25 0.03 1.00 1.00 XXX 75984 TC A Xray control catheter change 0.00 1.85 NA 0.09 1.94 NA XXX 75989 A Abscess drainage under x-ray 1.19 3.41 NA 0.19 4.79 NA XXX 75989 26 A Abscess drainage under x-ray 1.19 0.42 0.42 0.05 1.66 1.66 XXX 75989 TC A Abscess drainage under x-ray 0.00 2.99 NA 0.14 3.13 NA XXX 75992 A Atherectomy, x-ray exam 0.54 15.15 NA 0.71 16.40 NA XXX 75992 26 A Atherectomy, x-ray exam 0.54 0.20 0.20 0.02 0.76 0.76 XXX 75992 TC A Atherectomy, x-ray exam 0.00 14.95 NA 0.69 15.64 NA XXX 75993 A Atherectomy, x-ray exam 0.36 8.11 NA 0.37 8.84 NA ZZZ 75993 26 A Atherectomy, x-ray exam 0.36 0.14 0.14 0.01 0.51 0.51 ZZZ 75993 TC A Atherectomy, x-ray exam 0.00 7.97 NA 0.36 8.33 NA ZZZ 75994 A Atherectomy, x-ray exam 1.31 15.45 NA 0.75 17.51 NA XXX 75994 26 A Atherectomy, x-ray exam 1.31 0.50 0.50 0.06 1.87 1.87 XXX 75994 TC A Atherectomy, x-ray exam 0.00 14.95 NA 0.69 15.64 NA XXX 75995 A Atherectomy, x-ray exam 1.31 15.42 NA 0.75 17.48 NA XXX 75995 26 A Atherectomy, x-ray exam 1.31 0.47 0.47 0.06 1.84 1.84 XXX Start Printed Page 55419 75995 TC A Atherectomy, x-ray exam 0.00 14.95 NA 0.69 15.64 NA XXX 75996 A Atherectomy, x-ray exam 0.36 8.09 NA 0.37 8.82 NA ZZZ 75996 26 A Atherectomy, x-ray exam 0.36 0.12 0.12 0.01 0.49 0.49 ZZZ 75996 TC A Atherectomy, x-ray exam 0.00 7.97 NA 0.36 8.33 NA ZZZ 76000 A Fluoroscope examination 0.17 1.31 NA 0.07 1.55 NA XXX 76000 26 A Fluoroscope examination 0.17 0.07 0.07 0.01 0.25 0.25 XXX 76000 TC A Fluoroscope examination 0.00 1.24 NA 0.06 1.30 NA XXX 76001 A Fluoroscope exam, extensive 0.67 2.73 NA 0.15 3.55 NA XXX 76001 26 A Fluoroscope exam, extensive 0.67 0.24 0.24 0.03 0.94 0.94 XXX 76001 TC A Fluoroscope exam, extensive 0.00 2.49 NA 0.12 2.61 NA XXX 76003 A Needle localization by x-ray 0.54 1.43 NA 0.09 2.06 NA XXX 76003 26 A Needle localization by x-ray 0.54 0.19 0.19 0.03 0.76 0.76 XXX 76003 TC A Needle localization by x-ray 0.00 1.24 NA 0.06 1.30 NA XXX 76005 A Fluoroguide for spine inject 0.60 1.41 NA 0.09 2.10 NA XXX 76005 26 A Fluoroguide for spine inject 0.60 0.17 0.17 0.03 0.80 0.80 XXX 76005 TC A Fluoroguide for spine inject 0.00 1.24 NA 0.06 1.30 NA XXX 76006 A X-ray stress view 0.41 0.20 0.20 0.04 0.65 0.65 XXX 76010 A X-ray, nose to rectum 0.18 0.56 NA 0.03 0.77 NA XXX 76010 26 A X-ray, nose to rectum 0.18 0.06 0.06 0.01 0.25 0.25 XXX 76010 TC A X-ray, nose to rectum 0.00 0.50 NA 0.02 0.52 NA XXX 76012 C Percut vertebroplasty fluor +0.00 0.00 0.00 0.00 0.00 0.00 XXX 76012 26 A Percut vertebroplasty fluor 1.31 0.52 0.52 0.23 2.06 2.06 XXX 76012 TC C Percut vertebroplasty fluor 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76013 C Percut vertebroplasty, ct +0.00 0.00 0.00 0.00 0.00 0.00 XXX 76013 26 A Percut vertebroplasty, ct 1.38 0.55 0.55 0.48 2.41 2.41 XXX 76013 TC C Percut vertebroplasty, ct 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76020 A X-rays for bone age 0.19 0.57 NA 0.03 0.79 NA XXX 76020 26 A X-rays for bone age 0.19 0.07 0.07 0.01 0.27 0.27 XXX 76020 TC A X-rays for bone age 0.00 0.50 NA 0.02 0.52 NA XXX 76040 A X-rays, bone evaluation 0.27 0.84 NA 0.07 1.18 NA XXX 76040 26 A X-rays, bone evaluation 0.27 0.10 0.10 0.03 0.40 0.40 XXX 76040 TC A X-rays, bone evaluation 0.00 0.74 NA 0.04 0.78 NA XXX 76061 A X-rays, bone survey 0.45 1.11 NA 0.07 1.63 NA XXX 76061 26 A X-rays, bone survey 0.45 0.16 0.16 0.02 0.63 0.63 XXX 76061 TC A X-rays, bone survey 0.00 0.95 NA 0.05 1.00 NA XXX 76062 A X-rays, bone survey 0.54 1.56 NA 0.09 2.19 NA XXX 76062 26 A X-rays, bone survey 0.54 0.19 0.19 0.02 0.75 0.75 XXX 76062 TC A X-rays, bone survey 0.00 1.37 NA 0.07 1.44 NA XXX 76065 A X-rays, bone evaluation 0.70 0.95 NA 0.05 1.70 NA XXX 76065 26 A X-rays, bone evaluation 0.70 0.25 0.25 0.01 0.96 0.96 XXX 76065 TC A X-rays, bone evaluation 0.00 0.70 NA 0.04 0.74 NA XXX 76066 A Joint survey, single view 0.31 1.17 NA 0.07 1.55 NA XXX 76066 26 A Joint survey, single view 0.31 0.11 0.11 0.02 0.44 0.44 XXX 76066 TC A Joint survey, single view 0.00 1.06 NA 0.05 1.11 NA XXX 76070 I CT scan, bone density study +0.25 2.90 NA 0.14 3.29 NA XXX 76070 26 I CT scan, bone density study +0.25 0.10 0.10 0.01 0.36 0.36 XXX 76070 TC I CT scan, bone density study +0.00 2.80 NA 0.13 2.93 NA XXX 76075 A Us exam, abdom, limited 0.30 3.05 NA 0.15 3.50 NA XXX 76075 26 A Us exam, abdom, limited 0.30 0.11 0.11 0.01 0.42 0.42 XXX 76075 TC A Us exam, abdom, limited 0.00 2.94 NA 0.14 3.08 NA XXX 76076 A Dual energy x-ray study 0.22 0.80 NA 0.05 1.07 NA XXX 76076 26 A Dual energy x-ray study 0.22 0.08 0.08 0.01 0.31 0.31 XXX 76076 TC A Dual energy x-ray study 0.00 0.72 NA 0.04 0.76 NA XXX 76078 A Radiographic absorptiometry 0.20 0.80 NA 0.05 1.05 NA XXX 76078 26 A Radiographic absorptiometry 0.20 0.08 0.08 0.01 0.29 0.29 XXX 76078 TC A Radiographic absorptiometry 0.00 0.72 NA 0.04 0.76 NA XXX 76080 A X-ray exam of fistula 0.54 1.19 NA 0.07 1.80 NA XXX 76080 26 A X-ray exam of fistula 0.54 0.19 0.19 0.02 0.75 0.75 XXX 76080 TC A X-ray exam of fistula 0.00 1.00 NA 0.05 1.05 NA XXX 76085 A Computer mammogram add-on 0.06 0.31 NA 0.02 0.39 NA ZZZ 76085 26 A Computer mammogram add-on 0.06 0.02 0.02 0.01 0.09 0.09 ZZZ 76085 TC A Computer mammogram add-on 0.00 0.29 NA 0.01 0.30 NA XXX 76086 A X-ray of mammary duct 0.36 2.62 NA 0.14 3.12 NA XXX 76086 26 A X-ray of mammary duct 0.36 0.13 0.13 0.02 0.51 0.51 XXX 76086 TC A X-ray of mammary duct 0.00 2.49 NA 0.12 2.61 NA XXX 76088 A X-ray of mammary ducts 0.45 3.64 NA 0.18 4.27 NA XXX 76088 26 A X-ray of mammary ducts 0.45 0.16 0.16 0.02 0.63 0.63 XXX 76088 TC A X-ray of mammary ducts 0.00 3.48 NA 0.16 3.64 NA XXX 76090 A Mammogram, one breast 0.70 1.25 NA 0.08 2.03 NA XXX 76090 26 A Mammogram, one breast 0.70 0.25 0.25 0.03 0.98 0.98 XXX 76090 TC A Mammogram, one breast 0.00 1.00 NA 0.05 1.05 NA XXX 76091 A Mammogram, both breasts 0.87 1.54 NA 0.09 2.50 NA XXX 76091 26 A Mammogram, both breasts 0.87 0.30 0.30 0.03 1.20 1.20 XXX Start Printed Page 55420 76091 TC A Mammogram, both breasts 0.00 1.24 NA 0.06 1.30 NA XXX 76092 A Mammogram, screening 0.70 1.44 NA 0.09 2.23 NA XXX 76092 26 A Mammogram, screening 0.70 0.25 0.25 0.03 0.98 0.98 XXX 76092 TC A Mammogram, screening 0.00 1.19 NA 0.06 1.25 NA XXX 76093 A Magnetic image, breast 1.63 17.31 NA 0.83 19.77 NA XXX 76093 26 A Magnetic image, breast 1.63 0.57 0.57 0.07 2.27 2.27 XXX 76093 TC A Magnetic image, breast 0.00 16.74 NA 0.76 17.50 NA XXX 76094 A Magnetic image, both breasts 1.63 23.28 NA 1.10 26.01 NA XXX 76094 26 A Magnetic image, both breasts 1.63 0.57 0.57 0.07 2.27 2.27 XXX 76094 TC A Magnetic image, both breasts 0.00 22.71 NA 1.03 23.74 NA XXX 76095 A Stereotactic breast biopsy 1.59 7.36 NA 0.40 9.35 NA XXX 76095 26 A Stereotactic breast biopsy 1.59 0.56 0.56 0.09 2.24 2.24 XXX 76095 TC A Stereotactic breast biopsy 0.00 6.80 NA 0.31 7.11 NA XXX 76096 A X-ray of needle wire, breast 0.56 1.44 NA 0.09 2.09 NA XXX 76096 26 A X-ray of needle wire, breast 0.56 0.20 0.20 0.03 0.79 0.79 XXX 76096 TC A X-ray of needle wire, breast 0.00 1.24 NA 0.06 1.30 NA XXX 76098 A X-ray exam, breast specimen 0.16 0.45 NA 0.03 0.64 NA XXX 76098 26 A X-ray exam, breast specimen 0.16 0.06 0.06 0.01 0.23 0.23 XXX 76098 TC A X-ray exam, breast specimen 0.00 0.39 NA 0.02 0.41 NA XXX 76100 A X-ray exam of body section 0.58 1.38 NA 0.09 2.05 NA XXX 76100 26 A X-ray exam of body section 0.58 0.20 0.20 0.03 0.81 0.81 XXX 76100 TC A X-ray exam of body section 0.00 1.18 NA 0.06 1.24 NA XXX 76101 A Complex body section x-ray 0.58 1.55 NA 0.10 2.23 NA XXX 76101 26 A Complex body section x-ray 0.58 0.20 0.20 0.03 0.81 0.81 XXX 76101 TC A Complex body section x-ray 0.00 1.35 NA 0.07 1.42 NA XXX 76102 A Complex body section x-rays 0.58 1.84 NA 0.12 2.54 NA XXX 76102 26 A Complex body section x-rays 0.58 0.20 0.20 0.03 0.81 0.81 XXX 76102 TC A Complex body section x-rays 0.00 1.64 NA 0.09 1.73 NA XXX 76120 A Cine/video x-rays 0.38 1.14 NA 0.07 1.59 NA XXX 76120 26 A Cine/video x-rays 0.38 0.14 0.14 0.02 0.54 0.54 XXX 76120 TC A Cine/video x-rays 0.00 1.00 NA 0.05 1.05 NA XXX 76125 A Cine/ video x-rays add-on 0.27 0.84 NA 0.05 1.16 NA ZZZ 76125 26 A Cine/ video x-rays add-on 0.27 0.10 0.10 0.01 0.38 0.38 ZZZ 76125 TC A Cine/ video x-rays add-on 0.00 0.74 NA 0.04 0.78 NA ZZZ 76140 I X-ray consultation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76150 A X-ray exam, dry process 0.00 0.39 NA 0.02 0.41 NA XXX 76350 C Special x-ray contrast study 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76355 A CAT scan for localization 1.21 8.28 NA 0.41 9.90 NA XXX 76355 26 A CAT scan for localization 1.21 0.44 0.44 0.06 1.71 1.71 XXX 76355 TC A CAT scan for localization 0.00 7.84 NA 0.35 8.19 NA XXX 76360 A CAT scan for needle biopsy 1.16 8.24 NA 0.40 9.80 NA XXX 76360 26 A CAT scan for needle biopsy 1.16 0.40 0.40 0.05 1.61 1.61 XXX 76360 TC A CAT scan for needle biopsy 0.00 7.84 NA 0.35 8.19 NA XXX 76362 A Cat scan for tissue ablation 4.00 9.24 NA 1.38 14.62 NA XXX 76362 26 A Cat scan for tissue ablation 4.00 1.40 1.40 0.17 5.57 5.57 XXX 76362 TC A Cat scan for tissue ablation 0.00 7.84 NA 1.21 9.05 NA XXX 76370 A CAT scan for therapy guide 0.85 3.10 NA 0.17 4.12 NA XXX 76370 26 A CAT scan for therapy guide 0.85 0.30 0.30 0.04 1.19 1.19 XXX 76370 TC A CAT scan for therapy guide 0.00 2.80 NA 0.13 2.93 NA XXX 76375 A 3d/holograph reconstr add-on 0.16 3.42 NA 0.16 3.74 NA XXX 76375 26 A 3d/holograph reconstr add-on 0.16 0.06 0.06 0.01 0.23 0.23 XXX 76375 TC A 3d/holograph reconstr add-on 0.00 3.36 NA 0.15 3.51 NA XXX 76380 A CAT scan follow-up study 0.98 3.66 NA 0.19 4.83 NA XXX 76380 26 A CAT scan follow-up study 0.98 0.34 0.34 0.04 1.36 1.36 XXX 76380 TC A CAT scan follow-up study 0.00 3.32 NA 0.15 3.47 NA XXX 76390 A Mr spectroscopy 1.40 11.14 NA 0.55 13.09 NA XXX 76390 26 A Mr spectroscopy 1.40 0.50 0.50 0.06 1.96 1.96 XXX 76390 TC A Mr spectroscopy 0.00 10.64 NA 0.49 11.13 NA XXX 76393 A Mr guidance for needle place 1.50 11.16 NA 0.53 13.19 NA XXX 76393 26 A Mr guidance for needle place 1.50 0.52 0.52 0.07 2.09 2.09 XXX 76393 TC A Mr guidance for needle place 0.00 10.64 NA 0.46 11.10 NA XXX 76394 A Mri for tissue ablation 4.25 12.13 NA 1.43 17.81 NA XXX 76394 26 A Mri for tissue ablation 4.25 1.49 1.49 0.14 5.88 5.88 XXX 76394 TC A Mri for tissue ablation 0.00 10.64 NA 1.29 11.93 NA XXX 76400 A Magnetic image, bone marrow 1.60 11.20 NA 0.56 13.36 NA XXX 76400 26 A Magnetic image, bone marrow 1.60 0.56 0.56 0.07 2.23 2.23 XXX 76400 TC A Magnetic image, bone marrow 0.00 10.64 NA 0.49 11.13 NA XXX 76490 A Us for tissue ablation 2.00 2.13 NA 0.36 4.49 NA XXX 76490 26 A Us for tissue ablation 2.00 0.69 0.69 0.12 2.81 2.81 XXX 76490 TC A Us for tissue ablation 0.00 1.44 NA 0.24 1.68 NA XXX 76499 C Radiographic procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76499 26 C Radiographic procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76499 TC C Radiographic procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55421 76506 A Echo exam of head 0.63 1.61 NA 0.10 2.34 NA XXX 76506 26 A Echo exam of head 0.63 0.26 0.26 0.03 0.92 0.92 XXX 76506 TC A Echo exam of head 0.00 1.35 NA 0.07 1.42 NA XXX 76511 A Echo exam of eye 0.94 2.37 NA 0.08 3.39 NA XXX 76511 26 A Echo exam of eye 0.94 0.45 0.45 0.02 1.41 1.41 XXX 76511 TC A Echo exam of eye 0.00 1.92 NA 0.06 1.98 NA XXX 76512 A Echo exam of eye 0.66 2.49 NA 0.09 3.24 NA XXX 76512 26 A Echo exam of eye 0.66 0.31 0.31 0.01 0.98 0.98 XXX 76512 TC A Echo exam of eye 0.00 2.18 NA 0.08 2.26 NA XXX 76513 A Echo exam of eye, water bath 0.66 2.90 NA 0.09 3.65 NA XXX 76513 26 A Echo exam of eye, water bath 0.66 0.32 0.32 0.01 0.99 0.99 XXX 76513 TC A Echo exam of eye, water bath 0.00 2.58 NA 0.08 2.66 NA XXX 76516 A Echo exam of eye 0.54 2.04 NA 0.07 2.65 NA XXX 76516 26 A Echo exam of eye 0.54 0.26 0.26 0.01 0.81 0.81 XXX 76516 TC A Echo exam of eye 0.00 1.78 NA 0.06 1.84 NA XXX 76519 A Echo exam of eye 0.54 1.91 NA 0.07 2.52 NA XXX 76519 26 A Echo exam of eye 0.54 0.26 0.26 0.01 0.81 0.81 XXX 76519 TC A Echo exam of eye 0.00 1.65 NA 0.06 1.71 NA XXX 76529 A Echo exam of eye 0.57 2.70 NA 0.08 3.35 NA XXX 76529 26 A Echo exam of eye 0.57 0.27 0.27 0.01 0.85 0.85 XXX 76529 TC A Echo exam of eye 0.00 2.43 NA 0.07 2.50 NA XXX 76536 A Us exam of head and neck 0.56 1.55 NA 0.09 2.20 NA XXX 76536 26 A Us exam of head and neck 0.56 0.20 0.20 0.02 0.78 0.78 XXX 76536 TC A Us exam of head and neck 0.00 1.35 NA 0.07 1.42 NA XXX 76604 A Us exam, chest, b-scan 0.55 1.43 NA 0.08 2.06 NA XXX 76604 26 A Us exam, chest, b-scan 0.55 0.19 0.19 0.02 0.76 0.76 XXX 76604 TC A Us exam, chest, b-scan 0.00 1.24 NA 0.06 1.30 NA XXX 76645 A Us exam, breast(s) 0.54 1.19 NA 0.08 1.81 NA XXX 76645 26 A Us exam, breast(s) 0.54 0.19 0.19 0.03 0.76 0.76 XXX 76645 TC A Us exam, breast(s) 0.00 1.00 NA 0.05 1.05 NA XXX 76700 A Us exam, abdom, complete 0.81 2.15 NA 0.13 3.09 NA XXX 76700 26 A Us exam, abdom, complete 0.81 0.28 0.28 0.04 1.13 1.13 XXX 76700 TC A Us exam, abdom, complete 0.00 1.87 NA 0.09 1.96 NA XXX 76705 A Us exam, abdom, limited 0.59 1.56 NA 0.10 2.25 NA XXX 76705 26 A Us exam, abdom, limited 0.59 0.21 0.21 0.03 0.83 0.83 XXX 76705 TC A Us exam, abdom, limited 0.00 1.35 NA 0.07 1.42 NA XXX 76770 A Us exam abdo back wall, comp 0.74 2.13 NA 0.12 2.99 NA XXX 76770 26 A Us exam abdo back wall, comp 0.74 0.26 0.26 0.03 1.03 1.03 XXX 76770 TC A Us exam abdo back wall, comp 0.00 1.87 NA 0.09 1.96 NA XXX 76775 A Us exam abdo back wall, lim 0.58 1.55 NA 0.10 2.23 NA XXX 76775 26 A Us exam abdo back wall, lim 0.58 0.20 0.20 0.03 0.81 0.81 XXX 76775 TC A Us exam abdo back wall, lim 0.00 1.35 NA 0.07 1.42 NA XXX 76778 A Us exam kidney transplant 0.74 2.13 NA 0.12 2.99 NA XXX 76778 26 A Us exam kidney transplant 0.74 0.26 0.26 0.03 1.03 1.03 XXX 76778 TC A Us exam kidney transplant 0.00 1.87 NA 0.09 1.96 NA XXX 76800 A Us exam, spinal canal 1.13 1.73 NA 0.11 2.97 NA XXX 76800 26 A Us exam, spinal canal 1.13 0.38 0.38 0.04 1.55 1.55 XXX 76800 TC A Us exam, spinal canal 0.00 1.35 NA 0.07 1.42 NA XXX 76805 A Us exam, pg uterus, compl 0.99 2.35 NA 0.14 3.48 NA XXX 76805 26 A Us exam, pg uterus, compl 0.99 0.36 0.36 0.04 1.39 1.39 XXX 76805 TC A Us exam, pg uterus, compl 0.00 1.99 NA 0.10 2.09 NA XXX 76810 A Us exam, pg uterus, mult 1.97 4.74 NA 0.25 6.96 NA XXX 76810 26 A Us exam, pg uterus, mult 1.97 0.75 0.75 0.07 2.79 2.79 XXX 76810 TC A Us exam, pg uterus, mult 0.00 3.99 NA 0.18 4.17 NA XXX 76815 A Us exam, pg uterus limit 0.65 1.60 NA 0.09 2.34 NA XXX 76815 26 A Us exam, pg uterus limit 0.65 0.25 0.25 0.02 0.92 0.92 XXX 76815 TC A Us exam, pg uterus limit 0.00 1.35 NA 0.07 1.42 NA XXX 76816 A Us exam pg uterus repeat 0.57 1.28 NA 0.07 1.92 NA XXX 76816 26 A Us exam pg uterus repeat 0.57 0.22 0.22 0.02 0.81 0.81 XXX 76816 TC A Us exam pg uterus repeat 0.00 1.06 NA 0.05 1.11 NA XXX 76818 A Fetal biophy profile w/nst 1.05 1.94 NA 0.12 3.11 NA XXX 76818 26 A Fetal biophy profile w/nst 1.05 0.41 0.41 0.04 1.50 1.50 XXX 76818 TC A Fetal biophy profile w/nst 0.00 1.53 NA 0.08 1.61 NA XXX 76819 A Fetal biophys profil w/o nst 0.77 1.83 NA 0.10 2.70 NA XXX 76819 26 A Fetal biophys profil w/o nst 0.77 0.30 0.30 0.02 1.09 1.09 XXX 76819 TC A Fetal biophys profil w/o nst 0.00 1.53 NA 0.08 1.61 NA XXX 76825 A Echo exam of fetal heart 1.67 2.50 NA 0.15 4.32 NA XXX 76825 26 A Echo exam of fetal heart 1.67 0.63 0.63 0.06 2.36 2.36 XXX 76825 TC A Echo exam of fetal heart 0.00 1.87 NA 0.09 1.96 NA XXX 76826 A Echo exam of fetal heart 0.83 0.97 NA 0.07 1.87 NA XXX 76826 26 A Echo exam of fetal heart 0.83 0.30 0.30 0.03 1.16 1.16 XXX 76826 TC A Echo exam of fetal heart 0.00 0.67 NA 0.04 0.71 NA XXX 76827 A Echo exam of fetal heart 0.58 1.85 NA 0.12 2.55 NA XXX Start Printed Page 55422 76827 26 A Echo exam of fetal heart 0.58 0.22 0.22 0.02 0.82 0.82 XXX 76827 TC A Echo exam of fetal heart 0.00 1.63 NA 0.10 1.73 NA XXX 76828 A Echo exam of fetal heart 0.56 1.29 NA 0.09 1.94 NA XXX 76828 26 A Echo exam of fetal heart 0.56 0.23 0.23 0.02 0.81 0.81 XXX 76828 TC A Echo exam of fetal heart 0.00 1.06 NA 0.07 1.13 NA XXX 76830 A Us exam, transvaginal 0.69 1.68 NA 0.11 2.48 NA XXX 76830 26 A Us exam, transvaginal 0.69 0.24 0.24 0.03 0.96 0.96 XXX 76830 TC A Us exam, transvaginal 0.00 1.44 NA 0.08 1.52 NA XXX 76831 A Echo exam, uterus 0.72 1.71 NA 0.10 2.53 NA XXX 76831 26 A Echo exam, uterus 0.72 0.27 0.27 0.02 1.01 1.01 XXX 76831 TC A Echo exam, uterus 0.00 1.44 NA 0.08 1.52 NA XXX 76856 A Us exam, pelvic, complete 0.69 1.68 NA 0.11 2.48 NA XXX 76856 26 A Us exam, pelvic, complete 0.69 0.24 0.24 0.03 0.96 0.96 XXX 76856 TC A Us exam, pelvic, complete 0.00 1.44 NA 0.08 1.52 NA XXX 76857 A Us exam, pelvic, limited 0.38 1.13 NA 0.07 1.58 NA XXX 76857 26 A Us exam, pelvic, limited 0.38 0.13 0.13 0.02 0.53 0.53 XXX 76857 TC A Us exam, pelvic, limited 0.00 1.00 NA 0.05 1.05 NA XXX 76870 A Us exam, scrotum 0.64 1.66 NA 0.11 2.41 NA XXX 76870 26 A Us exam, scrotum 0.64 0.22 0.22 0.03 0.89 0.89 XXX 76870 TC A Us exam, scrotum 0.00 1.44 NA 0.08 1.52 NA XXX 76872 A Echo exam, transrectal 0.69 1.68 NA 0.12 2.49 NA XXX 76872 26 A Echo exam, transrectal 0.69 0.24 0.24 0.04 0.97 0.97 XXX 76872 TC A Echo exam, transrectal 0.00 1.44 NA 0.08 1.52 NA XXX 76873 A Echograp trans r, pros study 1.55 2.53 NA 0.21 4.29 NA XXX 76873 26 A Echograp trans r, pros study 1.55 0.54 0.54 0.08 2.17 2.17 XXX 76873 TC A Echograp trans r, pros study 0.00 1.99 NA 0.13 2.12 NA XXX 76880 A Us exam, extremity 0.59 1.56 NA 0.10 2.25 NA XXX 76880 26 A Us exam, extremity 0.59 0.21 0.21 0.03 0.83 0.83 XXX 76880 TC A Us exam, extremity 0.00 1.35 NA 0.07 1.42 NA XXX 76885 A Us exam infant hips, dynamic 0.74 1.70 NA 0.11 2.55 NA XXX 6885 26 A Us exam infant hips, dynamic 0.74 0.26 0.26 0.03 1.03 1.03 XXX 76885 TC A Us exam infant hips, dynamic 0.00 1.44 NA 0.08 1.52 NA XXX 76886 A Us exam infant hips, static 0.62 1.57 NA 0.10 2.29 NA XXX 76886 26 A Us exam infant hips, static 0.62 0.22 0.22 0.03 0.87 0.87 XXX 76886 TC A Us exam infant hips, static 0.00 1.35 NA 0.07 1.42 NA XXX 76930 A Echo guide, cardiocentesis 0.67 1.71 NA 0.10 2.48 NA XXX 76930 26 A Echo guide, cardiocentesis 0.67 0.27 0.27 0.02 0.96 0.96 XXX 76930 TC A Echo guide, cardiocentesis 0.00 1.44 NA 0.08 1.52 NA XXX 76932 A Echo guide for heart biopsy 0.67 1.71 NA 0.10 2.48 NA XXX 76932 26 A Echo guide for heart biopsy 0.67 0.27 0.27 0.02 0.96 0.96 XXX 76932 TC A Echo guide for heart biopsy 0.00 1.44 NA 0.08 1.52 NA XXX 76936 A Echo guide for artery repair 1.99 6.68 NA 0.39 9.06 NA XXX 76936 26 A Echo guide for artery repair 1.99 0.70 0.70 0.11 2.80 2.80 XXX 76936 TC A Echo guide for artery repair 0.00 5.98 NA 0.28 6.26 NA XXX 76941 A Echo guide for transfusion 1.34 1.98 NA 0.13 3.45 NA XXX 76941 26 A Echo guide for transfusion 1.34 0.53 0.53 0.06 1.93 1.93 XXX 76941 TC A Echo guide for transfusion 0.00 1.45 NA 0.07 1.52 NA XXX 76942 A Echo guide for biopsy 0.67 1.67 NA 0.12 2.46 NA XXX 76942 26 A Echo guide for biopsy 0.67 0.23 0.23 0.04 0.94 0.94 XXX 76942 TC A Echo guide for biopsy 0.00 1.44 NA 0.08 1.52 NA XXX 76945 A Echo guide, villus sampling 0.67 1.69 NA 0.10 2.46 NA XXX 76945 26 A Echo guide, villus sampling 0.67 0.24 0.24 0.03 0.94 0.94 XXX 76945 TC A Echo guide, villus sampling 0.00 1.45 NA 0.07 1.52 NA XXX 76946 A Echo guide for amniocentesis 0.38 1.59 NA 0.09 2.06 NA XXX 76946 26 A Echo guide for amniocentesis 0.38 0.15 0.15 0.01 0.54 0.54 XXX 76946 TC A Echo guide for amniocentesis 0.00 1.44 NA 0.08 1.52 NA XXX 76948 A Echo guide, ova aspiration 0.38 1.57 NA 0.10 2.05 NA XXX 76948 26 A Echo guide, ova aspiration 0.38 0.13 0.13 0.02 0.53 0.53 XXX 76948 TC A Echo guide, ova aspiration 0.00 1.44 NA 0.08 1.52 NA XXX 76950 A Echo guidance radiotherapy 0.58 1.45 NA 0.09 2.12 NA XXX 76950 26 A Echo guidance radiotherapy 0.58 0.21 0.21 0.03 0.82 0.82 XXX 76950 TC A Echo guidance radiotherapy 0.00 1.24 NA 0.06 1.30 NA XXX 76965 A Echo guidance radiotherapy 1.34 5.75 NA 0.31 7.40 NA XXX 76965 26 A Echo guidance radiotherapy 1.34 0.46 0.46 0.07 1.87 1.87 XXX 76965 TC A Echo guidance radiotherapy 0.00 5.29 NA 0.24 5.53 NA XXX 76970 A Ultrasound exam follow-up 0.40 1.14 NA 0.07 1.61 NA XXX 76970 26 A Ultrasound exam follow-up 0.40 0.14 0.14 0.02 0.56 0.56 XXX 76970 TC A Ultrasound exam follow-up 0.00 1.00 NA 0.05 1.05 NA XXX 76975 A GI endoscopic ultrasound 0.81 1.73 NA 0.11 2.65 NA XXX 76975 26 A GI endoscopic ultrasound 0.81 0.29 0.29 0.03 1.13 1.13 XXX 76975 TC A GI endoscopic ultrasound 0.00 1.44 NA 0.08 1.52 NA XXX 76977 A Us bone density measure 0.05 0.80 NA 0.05 0.90 NA XXX 76977 26 A Us bone density measure 0.05 0.02 0.02 0.01 0.08 0.08 XXX Start Printed Page 55423 76977 TC A Us bone density measure 0.00 0.78 NA 0.04 0.82 NA XXX 76986 A Ultrasound guide intraoper 1.20 2.91 NA 0.19 4.30 NA XXX 76986 26 A Ultrasound guide intraoper 1.20 0.42 0.42 0.07 1.69 1.69 XXX 76986 TC A Ultrasound guide intraoper 0.00 2.49 NA 0.12 2.61 NA XXX 76999 C Echo examination procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76999 26 C Echo examination procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76999 TC C Echo examination procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77261 A Radiation therapy planning 1.39 0.56 0.56 0.06 2.01 2.01 XXX 77262 A Radiation therapy planning 2.11 0.82 0.82 0.09 3.02 3.02 XXX 77263 A Radiation therapy planning 3.14 1.23 1.23 0.13 4.50 4.50 XXX 77280 A Set radiation therapy field 0.70 3.55 NA 0.18 4.43 NA XXX 77280 26 A Set radiation therapy field 0.70 0.25 0.25 0.03 0.98 0.98 XXX 77280 TC A Set radiation therapy field 0.00 3.30 NA 0.15 3.45 NA XXX 77285 A Set radiation therapy field 1.05 5.67 NA 0.29 7.01 NA XXX 77285 26 A Set radiation therapy field 1.05 0.38 0.38 0.04 1.47 1.47 XXX 77285 TC A Set radiation therapy field 0.00 5.29 NA 0.25 5.54 NA XXX 77290 A Set radiation therapy field 1.56 6.74 NA 0.35 8.65 NA XXX 77290 26 A Set radiation therapy field 1.56 0.56 0.56 0.06 2.18 2.18 XXX 77290 TC A Set radiation therapy field 0.00 6.18 NA 0.29 6.47 NA XXX 77295 A Set radiation therapy field 4.57 28.18 NA 1.41 34.16 NA XXX 77295 26 A Set radiation therapy field 4.57 1.65 1.65 0.18 6.40 6.40 XXX 77295 TC A Set radiation therapy field 0.00 26.53 NA 1.23 27.76 NA XXX 77299 C Radiation therapy planning 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77299 26 C Radiation therapy planning 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77299 TC C Radiation therapy planning 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77300 A Radiation therapy dose plan 0.62 1.50 NA 0.09 2.21 NA XXX 77300 26 A Radiation therapy dose plan 0.62 0.22 0.22 0.03 0.87 0.87 XXX 77300 TC A Radiation therapy dose plan 0.00 1.28 NA 0.06 1.34 NA XXX 77301 A Radioltherapy dos plan, imrt 8.00 29.72 NA 1.41 39.13 NA XXX 77301 26 A Radioltherapy dos plan, imrt 8.00 3.19 3.19 0.18 11.37 11.37 XXX 77301 TC A Radioltherapy dos plan, imrt 0.00 26.53 NA 1.23 27.76 NA XXX 77305 A Radiation therapy dose plan 0.70 2.01 NA 0.12 2.83 NA XXX 77305 26 A Radiation therapy dose plan 0.70 0.25 0.25 0.03 0.98 0.98 XXX 77305 TC A Radiation therapy dose plan 0.00 1.76 NA 0.09 1.85 NA XXX 77310 A Radiation therapy dose plan 1.05 2.59 NA 0.15 3.79 NA XXX 77310 26 A Radiation therapy dose plan 1.05 0.38 0.38 0.04 1.47 1.47 XXX 77310 TC A Radiation therapy dose plan 0.00 2.21 NA 0.11 2.32 NA XXX 77315 A Radiation therapy dose plan 1.56 3.09 NA 0.18 4.83 NA XXX 77315 26 A Radiation therapy dose plan 1.56 0.56 0.56 0.06 2.18 2.18 XXX 77315 TC A Radiation therapy dose plan 0.00 2.53 NA 0.12 2.65 NA XXX 77321 A Radiation therapy port plan 0.95 4.18 NA 0.21 5.34 NA XXX 77321 26 A Radiation therapy port plan 0.95 0.34 0.34 0.04 1.33 1.33 XXX 77321 TC A Radiation therapy port plan 0.00 3.84 NA 0.17 4.01 NA XXX 77326 A Radiation therapy dose plan 0.93 2.58 NA 0.15 3.66 NA XXX 77326 26 A Radiation therapy dose plan 0.93 0.34 0.34 0.04 1.31 1.31 XXX 77326 TC A Radiation therapy dose plan 0.00 2.24 NA 0.11 2.35 NA XXX 77327 A Radiation therapy dose plan 1.39 3.80 NA 0.21 5.40 NA XXX 77327 26 A Radiation therapy dose plan 1.39 0.50 0.50 0.06 1.95 1.95 XXX 77327 TC A Radiation therapy dose plan 0.00 3.30 NA 0.15 3.45 NA XXX 77328 A Radiation therapy dose plan 2.09 5.46 NA 0.30 7.85 NA XXX 77328 26 A Radiation therapy dose plan 2.09 0.75 0.75 0.09 2.93 2.93 XXX 77328 TC A Radiation therapy dose plan 0.00 4.71 NA 0.21 4.92 NA XXX 77331 A Special radiation dosimetry 0.87 0.79 NA 0.06 1.72 NA XXX 77331 26 A Special radiation dosimetry 0.87 0.31 0.31 0.04 1.22 1.22 XXX 77331 TC A Special radiation dosimetry 0.00 0.48 NA 0.02 0.50 NA XXX 77332 A Radiation treatment aid(s) 0.54 1.47 NA 0.08 2.09 NA XXX 77332 26 A Radiation treatment aid(s) 0.54 0.19 0.19 0.02 0.75 0.75 XXX 77332 TC A Radiation treatment aid(s) 0.00 1.28 NA 0.06 1.34 NA XXX 77333 A Radiation treatment aid(s) 0.84 2.10 NA 0.13 3.07 NA XXX 77333 26 A Radiation treatment aid(s) 0.84 0.30 0.30 0.04 1.18 1.18 XXX 77333 TC A Radiation treatment aid(s) 0.00 1.80 NA 0.09 1.89 NA XXX 77334 A Radiation treatment aid(s) 1.24 3.54 NA 0.19 4.97 NA XXX 77334 26 A Radiation treatment aid(s) 1.24 0.45 0.45 0.05 1.74 1.74 XXX 77334 TC A Radiation treatment aid(s) 0.00 3.09 NA 0.14 3.23 NA XXX 77336 A Radiation physics consult 0.00 2.83 NA 0.13 2.96 NA XXX 77370 A Radiation physics consult 0.00 3.31 NA 0.15 3.46 NA XXX 77399 C External radiation dosimetry 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77399 26 C External radiation dosimetry 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77399 TC C External radiation dosimetry 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77401 A Radiation treatment delivery 0.00 1.68 NA 0.09 1.77 NA XXX 77402 A Radiation treatment delivery 0.00 1.68 NA 0.09 1.77 NA XXX 77403 A Radiation treatment delivery 0.00 1.68 NA 0.09 1.77 NA XXX 77404 A Radiation treatment delivery 0.00 1.68 NA 0.09 1.77 NA XXX Start Printed Page 55424 77406 A Radiation treatment delivery 0.00 1.68 NA 0.09 1.77 NA XXX 77407 A Radiation treatment delivery 0.00 1.98 NA 0.10 2.08 NA XXX 77408 A Radiation treatment delivery 0.00 1.98 NA 0.10 2.08 NA XXX 77409 A Radiation treatment delivery 0.00 1.98 NA 0.10 2.08 NA XXX 77411 A Radiation treatment delivery 0.00 1.98 NA 0.10 2.08 NA XXX 77412 A Radiation treatment delivery 0.00 2.21 NA 0.11 2.32 NA XXX 77413 A Radiation treatment delivery 0.00 2.21 NA 0.11 2.32 NA XXX 77414 A Radiation treatment delivery 0.00 2.21 NA 0.11 2.32 NA XXX 77416 A Radiation treatment delivery 0.00 2.21 NA 0.11 2.32 NA XXX 77417 A Radiology port film(s) 0.00 0.56 NA 0.03 0.59 NA XXX 77418 A Radiation tx delivery, imrt 0.00 16.07 NA 0.11 16.18 NA XXX 77427 A Radiation tx management, x5 3.31 1.19 1.19 0.14 4.64 4.64 XXX 77431 A Radiation therapy management 1.81 0.73 0.73 0.07 2.61 2.61 XXX 77432 A Stereotactic radiation trmt 7.93 3.25 3.25 0.33 11.51 11.51 XXX 77470 A Special radiation treatment 2.09 11.34 NA 0.58 14.01 NA XXX 77470 26 A Special radiation treatment 2.09 0.75 0.75 0.09 2.93 2.93 XXX 77470 TC A Special radiation treatment 0.00 10.59 NA 0.49 11.08 NA XXX 77499 C Radiation therapy management 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77499 26 C Radiation therapy management 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77499 TC C Radiation therapy management 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77520 C Proton trmt, simple w/o comp 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77522 C Proton trmt, simple w/comp 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77523 C Proton trmt, intermediate 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77525 C Proton treatment, complex 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77600 R Hyperthermia treatment 1.56 3.44 NA 0.21 5.21 NA XXX 77600 26 R Hyperthermia treatment 1.56 0.55 0.55 0.08 2.19 2.19 XXX 77600 TC R Hyperthermia treatment 0.00 2.89 NA 0.13 3.02 NA XXX 77605 R Hyperthermia treatment 2.09 4.62 NA 0.31 7.02 NA XXX 77605 26 R Hyperthermia treatment 2.09 0.76 0.76 0.13 2.98 2.98 XXX 77605 TC R Hyperthermia treatment 0.00 3.86 NA 0.18 4.04 NA XXX 77610 R Hyperthermia treatment 1.56 3.44 NA 0.20 5.20 NA XXX 77610 26 R Hyperthermia treatment 1.56 0.55 0.55 0.07 2.18 2.18 XXX 77610 TC R Hyperthermia treatment 0.00 2.89 NA 0.13 3.02 NA XXX 77615 R Hyperthermia treatment 2.09 4.60 NA 0.27 6.96 NA XXX 77615 26 R Hyperthermia treatment 2.09 0.74 0.74 0.09 2.92 2.92 XXX 77615 TC R Hyperthermia treatment 0.00 3.86 NA 0.18 4.04 NA XXX 77620 R Hyperthermia treatment 1.56 3.47 NA 0.19 5.22 NA XXX 77620 26 R Hyperthermia treatment 1.56 0.58 0.58 0.06 2.20 2.20 XXX 77620 TC R Hyperthermia treatment 0.00 2.89 NA 0.13 3.02 NA XXX 77750 A Infuse radioactive materials 4.91 3.04 NA 0.23 8.18 NA 090 77750 26 A Infuse radioactive materials 4.91 1.77 1.77 0.17 6.85 6.85 090 77750 TC A Infuse radioactive materials 0.00 1.27 NA 0.06 1.33 NA 090 77761 A Apply intrcav radiat simple 3.81 3.51 NA 0.28 7.60 NA 090 77761 26 A Apply intrcav radiat simple 3.81 1.13 1.13 0.16 5.10 5.10 090 77761 TC A Apply intrcav radiat simple 0.00 2.38 NA 0.12 2.50 NA 090 77762 A Apply intrcav radiat interm 5.72 5.42 NA 0.38 11.52 NA 090 77762 26 A Apply intrcav radiat interm 5.72 1.99 1.99 0.22 7.93 7.93 090 77762 TC A Apply intrcav radiat interm 0.00 3.43 NA 0.16 3.59 NA 090 77763 A Apply intrcav radiat compl 8.57 7.38 NA 0.53 16.48 NA 090 77763 26 A Apply intrcav radiat compl 8.57 3.12 3.12 0.34 12.03 12.03 090 77763 TC A Apply intrcav radiat compl 0.00 4.26 NA 0.19 4.45 NA 090 77776 A Apply interstit radiat simpl 4.66 3.72 NA 0.35 8.73 NA 090 77776 26 A Apply interstit radiat simpl 4.66 1.65 1.65 0.24 6.55 6.55 090 77776 TC A Apply interstit radiat simpl 0.00 2.07 NA 0.11 2.18 NA 090 77777 A Apply interstit radiat inter 7.48 6.37 NA 0.50 14.35 NA 090 77777 26 A Apply interstit radiat inter 7.48 2.35 2.35 0.32 10.15 10.15 090 77777 TC A Apply interstit radiat inter 0.00 4.02 NA 0.18 4.20 NA 090 77778 A Apply iterstit radiat compl 11.19 8.90 NA 0.69 20.78 NA 090 77778 26 A Apply iterstit radiat compl 11.19 4.02 4.02 0.47 15.68 15.68 090 77778 TC A Apply iterstit radiat compl 0.00 4.88 NA 0.22 5.10 NA 090 77781 A High intensity brachytherapy 1.66 19.88 NA 0.95 22.49 NA 090 77781 26 A High intensity brachytherapy 1.66 0.60 0.60 0.07 2.33 2.33 090 77781 TC A High intensity brachytherapy 0.00 19.28 NA 0.88 20.16 NA 090 77782 A High intensity brachytherapy 2.49 20.18 NA 0.98 23.65 NA 090 77782 26 A High intensity brachytherapy 2.49 0.90 0.90 0.10 3.49 3.49 090 77782 TC A High intensity brachytherapy 0.00 19.28 NA 0.88 20.16 NA 090 77783 A High intensity brachytherapy 3.73 20.62 NA 1.03 25.38 NA 090 77783 26 A High intensity brachytherapy 3.73 1.34 1.34 0.15 5.22 5.22 090 77783 TC A High intensity brachytherapy 0.00 19.28 NA 0.88 20.16 NA 090 77784 A High intensity brachytherapy 5.61 21.30 NA 1.10 28.01 NA 090 77784 26 A High intensity brachytherapy 5.61 2.02 2.02 0.22 7.85 7.85 090 77784 TC A High intensity brachytherapy 0.00 19.28 NA 0.88 20.16 NA 090 77789 A Apply surface radiation 1.12 0.84 NA 0.05 2.01 NA 090 Start Printed Page 55425 77789 26 A Apply surface radiation 1.12 0.41 0.41 0.03 1.56 1.56 090 77789 TC A Apply surface radiation 0.00 0.43 NA 0.02 0.45 NA 090 77790 A Radiation handling 1.05 0.86 NA 0.06 1.97 NA XXX 77790 26 A Radiation handling 1.05 0.38 0.38 0.04 1.47 1.47 XXX 77790 TC A Radiation handling 0.00 0.48 NA 0.02 0.50 NA XXX 77799 C Radium/radioisotope therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77799 26 C Radium/radioisotope therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77799 TC C Radium/radioisotope therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78000 A Thyroid, single uptake 0.19 0.99 NA 0.06 1.24 NA XXX 78000 26 A Thyroid, single uptake 0.19 0.07 0.07 0.01 0.27 0.27 XXX 78000 TC A Thyroid, single uptake 0.00 0.92 NA 0.05 0.97 NA XXX 78001 A Thyroid, multiple uptakes 0.26 1.33 NA 0.07 1.66 NA XXX 78001 26 A Thyroid, multiple uptakes 0.26 0.09 0.09 0.01 0.36 0.36 XXX 78001 TC A Thyroid, multiple uptakes 0.00 1.24 NA 0.06 1.30 NA XXX 78003 A Thyroid suppress/stimul 0.33 1.04 NA 0.06 1.43 NA XXX 78003 26 A Thyroid suppress/stimul 0.33 0.12 0.12 0.01 0.46 0.46 XXX 78003 TC A Thyroid suppress/stimul 0.00 0.92 NA 0.05 0.97 NA XXX 78006 A Thyroid imaging with uptake 0.49 2.44 NA 0.13 3.06 NA XXX 78006 26 A Thyroid imaging with uptake 0.49 0.18 0.18 0.02 0.69 0.69 XXX 78006 TC A Thyroid imaging with uptake 0.00 2.26 NA 0.11 2.37 NA XXX 78007 A Thyroid image, mult uptakes 0.50 2.62 NA 0.14 3.26 NA XXX 78007 26 A Thyroid image, mult uptakes 0.50 0.18 0.18 0.02 0.70 0.70 XXX 78007 TC A Thyroid image, mult uptakes 0.00 2.44 NA 0.12 2.56 NA XXX 78010 A Thyroid imaging 0.39 1.87 NA 0.11 2.37 NA XXX 78010 26 A Thyroid imaging 0.39 0.14 0.14 0.02 0.55 0.55 XXX 78010 TC A Thyroid imaging 0.00 1.73 NA 0.09 1.82 NA XXX 78011 A Thyroid imaging with flow 0.45 2.45 NA 0.13 3.03 NA XXX 78011 26 A Thyroid imaging with flow 0.45 0.16 0.16 0.02 0.63 0.63 XXX 78011 TC A Thyroid imaging with flow 0.00 2.29 NA 0.11 2.40 NA XXX 78015 A Thyroid met imaging 0.67 2.68 NA 0.15 3.50 NA XXX 78015 26 A Thyroid met imaging 0.67 0.24 0.24 0.03 0.94 0.94 XXX 78015 TC A Thyroid met imaging 0.00 2.44 NA 0.12 2.56 NA XXX 78016 A Thyroid met imaging/studies 0.82 3.62 NA 0.18 4.62 NA XXX 78016 26 A Thyroid met imaging/studies 0.82 0.31 0.31 0.03 1.16 1.16 XXX 78016 TC A Thyroid met imaging/studies 0.00 3.31 NA 0.15 3.46 NA XXX 78018 A Thyroid met imaging, body 0.86 5.47 NA 0.27 6.60 NA XXX 78018 26 A Thyroid met imaging, body 0.86 0.32 0.32 0.03 1.21 1.21 XXX 78018 TC A Thyroid met imaging, body 0.00 5.15 NA 0.24 5.39 NA XXX 78020 A Thyroid met uptake 0.60 1.47 NA 0.14 2.21 NA ZZZ 78020 26 A Thyroid met uptake 0.60 0.23 0.23 0.02 0.85 0.85 ZZZ 78020 TC A Thyroid met uptake 0.00 1.24 NA 0.12 1.36 NA ZZZ 78070 A Parathyroid nuclear imaging 0.82 2.03 NA 0.12 2.97 NA XXX 78070 26 A Parathyroid nuclear imaging 0.82 0.30 0.30 0.03 1.15 1.15 XXX 78070 TC A Parathyroid nuclear imaging 0.00 1.73 NA 0.09 1.82 NA XXX 78075 A Adrenal nuclear imaging 0.74 5.44 NA 0.27 6.45 NA XXX 78075 26 A Adrenal nuclear imaging 0.74 0.29 0.29 0.03 1.06 1.06 XXX 78075 TC A Adrenal nuclear imaging 0.00 5.15 NA 0.24 5.39 NA XXX 78099 C Endocrine nuclear procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78099 26 C Endocrine nuclear procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78099 TC C Endocrine nuclear procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78102 A Bone marrow imaging, ltd 0.55 2.15 NA 0.12 2.82 NA XXX 78102 26 A Bone marrow imaging, ltd 0.55 0.21 0.21 0.02 0.78 0.78 XXX 78102 TC A Bone marrow imaging, ltd 0.00 1.94 NA 0.10 2.04 NA XXX 78103 A Bone marrow imaging, mult 0.75 3.28 NA 0.17 4.20 NA XXX 78103 26 A Bone marrow imaging, mult 0.75 0.27 0.27 0.03 1.05 1.05 XXX 78103 TC A Bone marrow imaging, mult 0.00 3.01 NA 0.14 3.15 NA XXX 78104 A Bone marrow imaging, body 0.80 4.16 NA 0.21 5.17 NA XXX 78104 26 A Bone marrow imaging, body 0.80 0.29 0.29 0.03 1.12 1.12 XXX 78104 TC A Bone marrow imaging, body 0.00 3.87 NA 0.18 4.05 NA XXX 78110 A Plasma volume, single 0.19 0.97 NA 0.06 1.22 NA XXX 78110 26 A Plasma volume, single 0.19 0.07 0.07 0.01 0.27 0.27 XXX 78110 TC A Plasma volume, single 0.00 0.90 NA 0.05 0.95 NA XXX 78111 A Plasma volume, multiple 0.22 2.52 NA 0.13 2.87 NA XXX 78111 26 A Plasma volume, multiple 0.22 0.08 0.08 0.01 0.31 0.31 XXX 78111 TC A Plasma volume, multiple 0.00 2.44 NA 0.12 2.56 NA XXX 78120 A Red cell mass, single 0.23 1.73 NA 0.10 2.06 NA XXX 78120 26 A Red cell mass, single 0.23 0.09 0.09 0.01 0.33 0.33 XXX 78120 TC A Red cell mass, single 0.00 1.64 NA 0.09 1.73 NA XXX 78121 A Red cell mass, multiple 0.32 2.88 NA 0.13 3.33 NA XXX 78121 26 A Red cell mass, multiple 0.32 0.12 0.12 0.01 0.45 0.45 XXX 78121 TC A Red cell mass, multiple 0.00 2.76 NA 0.12 2.88 NA XXX 78122 A Blood volume 0.45 4.54 NA 0.22 5.21 NA XXX 78122 26 A Blood volume 0.45 0.17 0.17 0.02 0.64 0.64 XXX Start Printed Page 55426 78122 TC A Blood volume 0.00 4.37 NA 0.20 4.57 NA XXX 78130 A Red cell survival study 0.61 2.93 NA 0.15 3.69 NA XXX 78130 26 A Red cell survival study 0.61 0.22 0.22 0.03 0.86 0.86 XXX 78130 TC A Red cell survival study 0.00 2.71 NA 0.12 2.83 NA XXX 78135 A Red cell survival kinetics 0.64 4.86 NA 0.24 5.74 NA XXX 78135 26 A Red cell survival kinetics 0.64 0.23 0.23 0.03 0.90 0.90 XXX 78135 TC A Red cell survival kinetics 0.00 4.63 NA 0.21 4.84 NA XXX 78140 A Red cell sequestration 0.61 3.95 NA 0.20 4.76 NA XXX 78140 26 A Red cell sequestration 0.61 0.21 0.21 0.03 0.85 0.85 XXX 78140 TC A Red cell sequestration 0.00 3.74 NA 0.17 3.91 NA XXX 78160 A Plasma iron turnover 0.33 3.60 NA 0.19 4.12 NA XXX 78160 26 A Plasma iron turnover 0.33 0.12 0.12 0.03 0.48 0.48 XXX 78160 TC A Plasma iron turnover 0.00 3.48 NA 0.16 3.64 NA XXX 78162 A Iron absorption exam 0.45 3.22 NA 0.15 3.82 NA XXX 78162 26 A Iron absorption exam 0.45 0.18 0.18 0.01 0.64 0.64 XXX 78162 TC A Iron absorption exam 0.00 3.04 NA 0.14 3.18 NA XXX 78170 A Red cell iron utilization 0.41 5.19 NA 0.27 5.87 NA XXX 78170 26 A Red cell iron utilization 0.41 0.15 0.15 0.04 0.60 0.60 XXX 78170 TC A Red cell iron utilization 0.00 5.04 NA 0.23 5.27 NA XXX 78172 C Total body iron estimation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78172 26 A Total body iron estimation 0.53 0.20 0.20 0.02 0.75 0.75 XXX 78172 TC C Total body iron estimation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78185 A Spleen imaging 0.40 2.39 NA 0.13 2.92 NA XXX 78185 26 A Spleen imaging 0.40 0.15 0.15 0.02 0.57 0.57 XXX 78185 TC A Spleen imaging 0.00 2.24 NA 0.11 2.35 NA XXX 78190 A Platelet survival, kinetics 1.09 5.83 NA 0.31 7.23 NA XXX 78190 26 A Platelet survival, kinetics 1.09 0.40 0.40 0.06 1.55 1.55 XXX 78190 TC A Platelet survival, kinetics 0.00 5.43 NA 0.25 5.68 NA XXX 78191 A Platelet survival 0.61 7.19 NA 0.34 8.14 NA XXX 78191 26 A Platelet survival 0.61 0.22 0.22 0.03 0.86 0.86 XXX 78191 TC A Platelet survival 0.00 6.97 NA 0.31 7.28 NA XXX 78195 A Lymph system imaging 1.20 4.31 NA 0.23 5.74 NA XXX 78195 26 A Lymph system imaging 1.20 0.44 0.44 0.05 1.69 1.69 XXX 78195 TC A Lymph system imaging 0.00 3.87 NA 0.18 4.05 NA XXX 78199 C Blood/lymph nuclear exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78199 26 C Blood/lymph nuclear exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78199 TC C Blood/lymph nuclear exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78201 A Liver imaging 0.44 2.40 NA 0.13 2.97 NA XXX 78201 26 A Liver imaging 0.44 0.16 0.16 0.02 0.62 0.62 XXX 78201 TC A Liver imaging 0.00 2.24 NA 0.11 2.35 NA XXX 78202 A Liver imaging with flow 0.51 2.93 NA 0.14 3.58 NA XXX 78202 26 A Liver imaging with flow 0.51 0.19 0.19 0.02 0.72 0.72 XXX 78202 TC A Liver imaging with flow 0.00 2.74 NA 0.12 2.86 NA XXX 78205 A Liver imaging (3D) 0.71 5.87 NA 0.29 6.87 NA XXX 78205 26 A Liver imaging (3D) 0.71 0.26 0.26 0.03 1.00 1.00 XXX 78205 TC A Liver imaging (3D) 0.00 5.61 NA 0.26 5.87 NA XXX 78206 A Liver image (3d) w/flow 0.96 5.96 NA 0.13 7.05 NA XXX 78206 26 A Liver image (3d) w/flow 0.96 0.35 0.35 0.04 1.35 1.35 XXX 78206 TC A Liver image (3d) w/flow 0.00 5.61 NA 0.09 5.70 NA XXX 78215 A Liver and spleen imaging 0.49 2.97 NA 0.14 3.60 NA XXX 78215 26 A Liver and spleen imaging 0.49 0.18 0.18 0.02 0.69 0.69 XXX 78215 TC A Liver and spleen imaging 0.00 2.79 NA 0.12 2.91 NA XXX 78216 A Liver & spleen image/flow 0.57 3.52 NA 0.17 4.26 NA XXX 78216 26 A Liver & spleen image/flow 0.57 0.21 0.21 0.02 0.80 0.80 XXX 78216 TC A Liver & spleen image/flow 0.00 3.31 NA 0.15 3.46 NA XXX 78220 A Liver function study 0.49 3.72 NA 0.18 4.39 NA XXX 78220 26 A Liver function study 0.49 0.18 0.18 0.02 0.69 0.69 XXX 78220 TC A Liver function study 0.00 3.54 NA 0.16 3.70 NA XXX 78223 A Hepatobiliary imaging 0.84 3.78 NA 0.20 4.82 NA XXX 78223 26 A Hepatobiliary imaging 0.84 0.30 0.30 0.04 1.18 1.18 XXX 78223 TC A Hepatobiliary imaging 0.00 3.48 NA 0.16 3.64 NA XXX 78230 A Salivary gland imaging 0.45 2.23 NA 0.13 2.81 NA XXX 78230 26 A Salivary gland imaging 0.45 0.16 0.16 0.02 0.63 0.63 XXX 78230 TC A Salivary gland imaging 0.00 2.07 NA 0.11 2.18 NA XXX 78231 A Serial salivary imaging 0.52 3.21 NA 0.16 3.89 NA XXX 78231 26 A Serial salivary imaging 0.52 0.20 0.20 0.02 0.74 0.74 XXX 78231 TC A Serial salivary imaging 0.00 3.01 NA 0.14 3.15 NA XXX 78232 A Salivary gland function exam 0.47 3.54 NA 0.16 4.17 NA XXX 78232 26 A Salivary gland function exam 0.47 0.18 0.18 0.01 0.66 0.66 XXX 78232 TC A Salivary gland function exam 0.00 3.36 NA 0.15 3.51 NA XXX 78258 A Esophageal motility study 0.74 3.01 NA 0.15 3.90 NA XXX 78258 26 A Esophageal motility study 0.74 0.27 0.27 0.03 1.04 1.04 XXX 78258 TC A Esophageal motility study 0.00 2.74 NA 0.12 2.86 NA XXX Start Printed Page 55427 78261 A Gastric mucosa imaging 0.69 4.15 NA 0.21 5.05 NA XXX 78261 26 A Gastric mucosa imaging 0.69 0.26 0.26 0.03 0.98 0.98 XXX 78261 TC A Gastric mucosa imaging 0.00 3.89 NA 0.18 4.07 NA XXX 78262 A Gastroesophageal reflux exam 0.68 4.29 NA 0.21 5.18 NA XXX 78262 26 A Gastroesophageal reflux exam 0.68 0.25 0.25 0.03 0.96 0.96 XXX 78262 TC A Gastroesophageal reflux exam 0.00 4.04 NA 0.18 4.22 NA XXX 78264 A Gastric emptying study 0.78 4.20 NA 0.21 5.19 NA XXX 78264 26 A Gastric emptying study 0.78 0.28 0.28 0.03 1.09 1.09 XXX 78264 TC A Gastric emptying study 0.00 3.92 NA 0.18 4.10 NA XXX 78267 X Breath tst attain/anal c-14 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78268 X Breath test analysis, c-14 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78270 A Vit B-12 absorption exam 0.20 1.54 NA 0.09 1.83 NA XXX 78270 26 A Vit B-12 absorption exam 0.20 0.07 0.07 0.01 0.28 0.28 XXX 78270 TC A Vit B-12 absorption exam 0.00 1.47 NA 0.08 1.55 NA XXX 78271 A Vit B-12 absorp exam, IF 0.20 1.63 NA 0.09 1.92 NA XXX 78271 26 A Vit B-12 absorp exam, IF 0.20 0.07 0.07 0.01 0.28 0.28 XXX 78271 TC A Vit B-12 absorp exam, IF 0.00 1.56 NA 0.08 1.64 NA XXX 78272 A Vit B-12 absorp, combined 0.27 2.30 NA 0.12 2.69 NA XXX 78272 26 A Vit B-12 absorp, combined 0.27 0.10 0.10 0.01 0.38 0.38 XXX 78272 TC A Vit B-12 absorp, combined 0.00 2.20 NA 0.11 2.31 NA XXX 78278 A Acute GI blood loss imaging 0.99 4.98 NA 0.25 6.22 NA XXX 78278 26 A Acute GI blood loss imaging 0.99 0.35 0.35 0.04 1.38 1.38 XXX 78278 TC A Acute GI blood loss imaging 0.00 4.63 NA 0.21 4.84 NA XXX 78282 C GI protein loss exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78282 26 A GI protein loss exam 0.38 0.13 0.13 0.02 0.53 0.53 XXX 78282 TC C GI protein loss exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78290 A Meckel's divert exam 0.68 3.13 NA 0.16 3.97 NA XXX 78290 26 A Meckel's divert exam 0.68 0.24 0.24 0.03 0.95 0.95 XXX 78290 TC A Meckel's divert exam 0.00 2.89 NA 0.13 3.02 NA XXX 78291 A Leveen/shunt patency exam 0.88 3.23 NA 0.17 4.28 NA XXX 78291 26 A Leveen/shunt patency exam 0.88 0.32 0.32 0.04 1.24 1.24 XXX 78291 TC A Leveen/shunt patency exam 0.00 2.91 NA 0.13 3.04 NA XXX 78299 C GI nuclear procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78299 26 C GI nuclear procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78299 TC C GI nuclear procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78300 A Bone imaging, limited area 0.62 2.58 NA 0.15 3.35 NA XXX 78300 26 A Bone imaging, limited area 0.62 0.22 0.22 0.03 0.87 0.87 XXX 78300 TC A Bone imaging, limited area 0.00 2.36 NA 0.12 2.48 NA XXX 78305 A Bone imaging, multiple areas 0.83 3.78 NA 0.19 4.80 NA XXX 78305 26 A Bone imaging, multiple areas 0.83 0.30 0.30 0.03 1.16 1.16 XXX 78305 TC A Bone imaging, multiple areas 0.00 3.48 NA 0.16 3.64 NA XXX 78306 A Bone imaging, whole body 0.86 4.37 NA 0.22 5.45 NA XXX 78306 26 A Bone imaging, whole body 0.86 0.31 0.31 0.04 1.21 1.21 XXX 78306 TC A Bone imaging, whole body 0.00 4.06 NA 0.18 4.24 NA XXX 78315 A Bone imaging, 3 phase 1.02 4.91 NA 0.25 6.18 NA XXX 78315 26 A Bone imaging, 3 phase 1.02 0.37 0.37 0.04 1.43 1.43 XXX 78315 TC A Bone imaging, 3 phase 0.00 4.54 NA 0.21 4.75 NA XXX 78320 A Bone imaging (3D) 1.04 6.00 NA 0.30 7.34 NA XXX 78320 26 A Bone imaging (3D) 1.04 0.39 0.39 0.04 1.47 1.47 XXX 78320 TC A Bone imaging (3D) 0.00 5.61 NA 0.26 5.87 NA XXX 78350 A Bone mineral, single photon 0.22 0.80 NA 0.05 1.07 NA XXX 78350 26 A Bone mineral, single photon 0.22 0.08 0.08 0.01 0.31 0.31 XXX 78350 TC A Bone mineral, single photon 0.00 0.72 NA 0.04 0.76 NA XXX 78351 N Bone mineral, dual photon +0.30 1.64 0.12 0.01 1.95 0.43 XXX 78399 C Musculoskeletal nuclear exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78399 26 C Musculoskeletal nuclear exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78399 TC C Musculoskeletal nuclear exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78414 C Non-imaging heart function 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78414 26 A Non-imaging heart function 0.45 0.16 0.16 0.02 0.63 0.63 XXX 78414 TC C Non-imaging heart function 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78428 A Cardiac shunt imaging 0.78 2.46 NA 0.14 3.38 NA XXX 78428 26 A Cardiac shunt imaging 0.78 0.32 0.32 0.03 1.13 1.13 XXX 78428 TC A Cardiac shunt imaging 0.00 2.14 NA 0.11 2.25 NA XXX 78445 A Vascular flow imaging 0.49 1.94 NA 0.11 2.54 NA XXX 78445 26 A Vascular flow imaging 0.49 0.18 0.18 0.02 0.69 0.69 XXX 78445 TC A Vascular flow imaging 0.00 1.76 NA 0.09 1.85 NA XXX 78455 A Venous thrombosis study 0.73 4.04 NA 0.20 4.97 NA XXX 78455 26 A Venous thrombosis study 0.73 0.26 0.26 0.03 1.02 1.02 XXX 78455 TC A Venous thrombosis study 0.00 3.78 NA 0.17 3.95 NA XXX 78456 A Acute venous thrombus image 1.00 4.15 NA 0.28 5.43 NA XXX 78456 26 A Acute venous thrombus image 1.00 0.37 0.37 0.04 1.41 1.41 XXX 78456 TC A Acute venous thrombus image 0.00 3.78 NA 0.24 4.02 NA XXX 78457 A Venous thrombosis imaging 0.77 2.81 NA 0.15 3.73 NA XXX Start Printed Page 55428 78457 26 A Venous thrombosis imaging 0.77 0.28 0.28 0.03 1.08 1.08 XXX 78457 TC A Venous thrombosis imaging 0.00 2.53 NA 0.12 2.65 NA XXX 78458 A Ven thrombosis images, bilat 0.90 4.17 NA 0.20 5.27 NA XXX 78458 26 A Ven thrombosis images, bilat 0.90 0.35 0.35 0.03 1.28 1.28 XXX 78458 TC A Ven thrombosis images, bilat 0.00 3.82 NA 0.17 3.99 NA XXX 78459 I Heart muscle imaging (PET) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78459 26 I Heart muscle imaging (PET) +1.88 0.75 0.75 0.08 2.71 2.71 XXX 78459 TC I Heart muscle imaging (PET) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78460 A Heart muscle blood, single 0.86 2.55 NA 0.14 3.55 NA XXX 78460 26 A Heart muscle blood, single 0.86 0.31 0.31 0.03 1.20 1.20 XXX 78460 TC A Heart muscle blood, single 0.00 2.24 NA 0.11 2.35 NA XXX 78461 A Heart muscle blood, multiple 1.23 4.94 NA 0.26 6.43 NA XXX 78461 26 A Heart muscle blood, multiple 1.23 0.46 0.46 0.05 1.74 1.74 XXX 78461 TC A Heart muscle blood, multiple 0.00 4.48 NA 0.21 4.69 NA XXX 78464 A Heart image (3d), single 1.09 7.12 NA 0.35 8.56 NA XXX 78464 26 A Heart image (3d), single 1.09 0.41 0.41 0.04 1.54 1.54 XXX 78464 TC A Heart image (3d), single 0.00 6.71 NA 0.31 7.02 NA XXX 78465 A Heart image (3d), multiple 1.46 11.76 NA 0.56 13.78 NA XXX 78465 26 A Heart image (3d), multiple 1.46 0.56 0.56 0.05 2.07 2.07 XXX 78465 TC A Heart image (3d), multiple 0.00 11.20 NA 0.51 11.71 NA XXX 78466 A Heart infarct image 0.69 2.75 NA 0.15 3.59 NA XXX 78466 26 A Heart infarct image 0.69 0.26 0.26 0.03 0.98 0.98 XXX 78466 TC A Heart infarct image 0.00 2.49 NA 0.12 2.61 NA XXX 78468 A Heart infarct image (ef) 0.80 3.78 NA 0.19 4.77 NA XXX 78468 26 A Heart infarct image (ef) 0.80 0.30 0.30 0.03 1.13 1.13 XXX 78468 TC A Heart infarct image (ef) 0.00 3.48 NA 0.16 3.64 NA XXX 78469 A Heart infarct image (3D) 0.92 5.31 NA 0.26 6.49 NA XXX 78469 26 A Heart infarct image (3D) 0.92 0.35 0.35 0.03 1.30 1.30 XXX 78469 TC A Heart infarct image (3D) 0.00 4.96 NA 0.23 5.19 NA XXX 78472 A Gated heart, planar, single 0.98 5.60 NA 0.29 6.87 NA XXX 78472 26 A Gated heart, planar, single 0.98 0.37 0.37 0.04 1.39 1.39 XXX 78472 TC A Gated heart, planar, single 0.00 5.23 NA 0.25 5.48 NA XXX 78473 A Gated heart, multiple 1.47 8.40 NA 0.40 10.27 NA XXX 78473 26 A Gated heart, multiple 1.47 0.56 0.56 0.05 2.08 2.08 XXX 78473 TC A Gated heart, multiple 0.00 7.84 NA 0.35 8.19 NA XXX 78478 A Heart wall motion add-on 0.62 1.72 NA 0.10 2.44 NA ZZZ 78478 26 A Heart wall motion add-on 0.62 0.24 0.24 0.02 0.88 0.88 ZZZ 78478 TC A Heart wall motion add-on 0.00 1.48 NA 0.08 1.56 NA ZZZ 78480 A Heart function add-on 0.62 1.72 NA 0.10 2.44 NA ZZZ 78480 26 A Heart function add-on 0.62 0.24 0.24 0.02 0.88 0.88 ZZZ 78480 TC A Heart function add-on 0.00 1.48 NA 0.08 1.56 NA ZZZ 78481 A Heart first pass, single 0.98 5.35 NA 0.26 6.59 NA XXX 78481 26 A Heart first pass, single 0.98 0.39 0.39 0.03 1.40 1.40 XXX 78481 TC A Heart first pass, single 0.00 4.96 NA 0.23 5.19 NA XXX 78483 A Heart first pass, multiple 1.47 8.05 NA 0.39 9.91 NA XXX 78483 26 A Heart first pass, multiple 1.47 0.58 0.58 0.05 2.10 2.10 XXX 78483 TC A Heart first pass, multiple 0.00 7.47 NA 0.34 7.81 NA XXX 78491 I Heart image (pet), single 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78491 26 I Heart image (pet), single +1.50 0.60 0.60 0.05 2.15 2.15 XXX 78491 TC I Heart image (pet), single 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78492 I Heart image (pet), multiple 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78492 26 I Heart image (pet), multiple +1.87 0.75 0.75 0.06 2.68 2.68 XXX 78492 TC I Heart image (pet), multiple 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78494 A Heart image, spect 1.19 7.15 NA 0.29 8.63 NA XXX 78494 26 A Heart image, spect 1.19 0.44 0.44 0.04 1.67 1.67 XXX 78494 TC A Heart image, spect 0.00 6.71 NA 0.25 6.96 NA XXX 78496 A Heart first pass add-on 0.50 6.91 NA 0.27 7.68 NA ZZZ 78496 26 A Heart first pass add-on 0.50 0.20 0.20 0.02 0.72 0.72 ZZZ 78496 TC A Heart first pass add-on 0.00 6.71 NA 0.25 6.96 NA ZZZ 78499 C Cardiovascular nuclear exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78499 26 C Cardiovascular nuclear exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78499 TC C Cardiovascular nuclear exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78580 A Lung perfusion imaging 0.74 3.53 NA 0.18 4.45 NA XXX 78580 26 A Lung perfusion imaging 0.74 0.27 0.27 0.03 1.04 1.04 XXX 78580 TC A Lung perfusion imaging 0.00 3.26 NA 0.15 3.41 NA XXX 78584 A Lung V/Q image single breath 0.99 3.39 NA 0.18 4.56 NA XXX 78584 26 A Lung V/Q image single breath 0.99 0.35 0.35 0.04 1.38 1.38 XXX 78584 TC A Lung V/Q image single breath 0.00 3.04 NA 0.14 3.18 NA XXX 78585 A Lung V/Q imaging 1.09 5.74 NA 0.30 7.13 NA XXX 78585 26 A Lung V/Q imaging 1.09 0.39 0.39 0.05 1.53 1.53 XXX 78585 TC A Lung V/Q imaging 0.00 5.35 NA 0.25 5.60 NA XXX 78586 A Aerosol lung image, single 0.40 2.60 NA 0.14 3.14 NA XXX 78586 26 A Aerosol lung image, single 0.40 0.14 0.14 0.02 0.56 0.56 XXX Start Printed Page 55429 78586 TC A Aerosol lung image, single 0.00 2.46 NA 0.12 2.58 NA XXX 78587 A Aerosol lung image, multiple 0.49 2.84 NA 0.14 3.47 NA XXX 78587 26 A Aerosol lung image, multiple 0.49 0.18 0.18 0.02 0.69 0.69 XXX 78587 TC A Aerosol lung image, multiple 0.00 2.66 NA 0.12 2.78 NA XXX 78588 A Perfusion lung image 1.09 3.43 NA 0.20 4.72 NA XXX 78588 26 A Perfusion lung image 1.09 0.39 0.39 0.05 1.53 1.53 XXX 78588 TC A Perfusion lung image 0.00 3.04 NA 0.15 3.19 NA XXX 78591 A Vent image, 1 breath, 1 proj 0.40 2.86 NA 0.14 3.40 NA XXX 78591 26 A Vent image, 1 breath, 1 proj 0.40 0.15 0.15 0.02 0.57 0.57 XXX 78591 TC A Vent image, 1 breath, 1 proj 0.00 2.71 NA 0.12 2.83 NA XXX 78593 A Vent image, 1 proj, gas 0.49 3.46 NA 0.17 4.12 NA XXX 78593 26 A Vent image, 1 proj, gas 0.49 0.18 0.18 0.02 0.69 0.69 XXX 78593 TC A Vent image, 1 proj, gas 0.00 3.28 NA 0.15 3.43 NA XXX 78594 A Vent image, mult proj, gas 0.53 4.92 NA 0.23 5.68 NA XXX 78594 26 A Vent image, mult proj, gas 0.53 0.19 0.19 0.02 0.74 0.74 XXX 78594 TC A Vent image, mult proj, gas 0.00 4.73 NA 0.21 4.94 NA XXX 78596 A Lung differential function 1.27 7.17 NA 0.36 8.80 NA XXX 78596 26 A Lung differential function 1.27 0.46 0.46 0.05 1.78 1.78 XXX 78596 TC A Lung differential function 0.00 6.71 NA 0.31 7.02 NA XXX 78599 C Respiratory nuclear exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78599 26 C Respiratory nuclear exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78599 TC C Respiratory nuclear exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78600 A Brain imaging, ltd static 0.44 2.90 NA 0.14 3.48 NA XXX 78600 26 A Brain imaging, ltd static 0.44 0.16 0.16 0.02 0.62 0.62 XXX 78600 TC A Brain imaging, ltd static 0.00 2.74 NA 0.12 2.86 NA XXX 78601 A Brain imaging, ltd w/flow 0.51 3.41 NA 0.17 4.09 NA XXX 78601 26 A Brain imaging, ltd w/flow 0.51 0.18 0.18 0.02 0.71 0.71 XXX 78601 TC A Brain imaging, ltd w/flow 0.00 3.23 NA 0.15 3.38 NA XXX 78605 A Brain imaging, complete 0.53 3.42 NA 0.17 4.12 NA XXX 78605 26 A Brain imaging, complete 0.53 0.19 0.19 0.02 0.74 0.74 XXX 78605 TC A Brain imaging, complete 0.00 3.23 NA 0.15 3.38 NA XXX 78606 A Brain imaging, compl w/flow 0.64 3.90 NA 0.20 4.74 NA XXX 78606 26 A Brain imaging, compl w/flow 0.64 0.23 0.23 0.03 0.90 0.90 XXX 78606 TC A Brain imaging, compl w/flow 0.00 3.67 NA 0.17 3.84 NA XXX 78607 A Brain imaging (3D) 1.23 6.70 NA 0.34 8.27 NA XXX 78607 26 A Brain imaging (3D) 1.23 0.47 0.47 0.05 1.75 1.75 XXX 78607 TC A Brain imaging (3D) 0.00 6.23 NA 0.29 6.52 NA XXX 78608 N Brain imaging (PET) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78609 N Brain imaging (PET) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78610 A Brain flow imaging only 0.30 1.61 NA 0.09 2.00 NA XXX 78610 26 A Brain flow imaging only 0.30 0.11 0.11 0.01 0.42 0.42 XXX 78610 TC A Brain flow imaging only 0.00 1.50 NA 0.08 1.58 NA XXX 78615 A Cerebral vascular flow image 0.42 3.81 NA 0.19 4.42 NA XXX 78615 26 A Cerebral vascular flow image 0.42 0.16 0.16 0.02 0.60 0.60 XXX 78615 TC A Cerebral vascular flow image 0.00 3.65 NA 0.17 3.82 NA XXX 78630 A Cerebrospinal fluid scan 0.68 5.02 NA 0.25 5.95 NA XXX 78630 26 A Cerebrospinal fluid scan 0.68 0.24 0.24 0.03 0.95 0.95 XXX 78630 TC A Cerebrospinal fluid scan 0.00 4.78 NA 0.22 5.00 NA XXX 78635 A CSF ventriculography 0.61 2.67 NA 0.14 3.42 NA XXX 78635 26 A CSF ventriculography 0.61 0.25 0.25 0.02 0.88 0.88 XXX 78635 TC A CSF ventriculography 0.00 2.42 NA 0.12 2.54 NA XXX 78645 A CSF shunt evaluation 0.57 3.47 NA 0.17 4.21 NA XXX 78645 26 A CSF shunt evaluation 0.57 0.21 0.21 0.02 0.80 0.80 XXX 78645 TC A CSF shunt evaluation 0.00 3.26 NA 0.15 3.41 NA XXX 78647 A Cerebrospinal fluid scan 0.90 5.94 NA 0.29 7.13 NA XXX 78647 26 A Cerebrospinal fluid scan 0.90 0.33 0.33 0.03 1.26 1.26 XXX 78647 TC A Cerebrospinal fluid scan 0.00 5.61 NA 0.26 5.87 NA XXX 78650 A CSF leakage imaging 0.61 4.63 NA 0.22 5.46 NA XXX 78650 26 A CSF leakage imaging 0.61 0.22 0.22 0.02 0.85 0.85 XXX 78650 TC A CSF leakage imaging 0.00 4.41 NA 0.20 4.61 NA XXX 78660 A Nuclear exam of tear flow 0.53 2.20 NA 0.12 2.85 NA XXX 78660 26 A Nuclear exam of tear flow 0.53 0.19 0.19 0.02 0.74 0.74 XXX 78660 TC A Nuclear exam of tear flow 0.00 2.01 NA 0.10 2.11 NA XXX 78699 C Nervous system nuclear exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78699 26 C Nervous system nuclear exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78699 TC C Nervous system nuclear exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78700 A Kidney imaging, static 0.45 3.05 NA 0.15 3.65 NA XXX 78700 26 A Kidney imaging, static 0.45 0.16 0.16 0.02 0.63 0.63 XXX 78700 TC A Kidney imaging, static 0.00 2.89 NA 0.13 3.02 NA XXX 78701 A Kidney imaging with flow 0.49 3.55 NA 0.17 4.21 NA XXX 78701 26 A Kidney imaging with flow 0.49 0.17 0.17 0.02 0.68 0.68 XXX 78701 TC A Kidney imaging with flow 0.00 3.38 NA 0.15 3.53 NA XXX 78704 A Imaging renogram 0.74 4.03 NA 0.20 4.97 NA XXX Start Printed Page 55430 78704 26 A Imaging renogram 0.74 0.27 0.27 0.03 1.04 1.04 XXX 78704 TC A Imaging renogram 0.00 3.76 NA 0.17 3.93 NA XXX 78707 A Kidney flow/function image 0.96 4.59 NA 0.23 5.78 NA XXX 78707 26 A Kidney flow/function image 0.96 0.35 0.35 0.04 1.35 1.35 XXX 78707 TC A Kidney flow/function image 0.00 4.24 NA 0.19 4.43 NA XXX 78708 A Kidney flow/function image 1.21 4.68 NA 0.24 6.13 NA XXX 78708 26 A Kidney flow/function image 1.21 0.44 0.44 0.05 1.70 1.70 XXX 78708 TC A Kidney flow/function image 0.00 4.24 NA 0.19 4.43 NA XXX 78709 A Kidney flow/function image 1.41 4.75 NA 0.25 6.41 NA XXX 78709 26 A Kidney flow/function image 1.41 0.51 0.51 0.06 1.98 1.98 XXX 78709 TC A Kidney flow/function image 0.00 4.24 NA 0.19 4.43 NA XXX 78710 A Kidney imaging (3D) 0.66 5.84 NA 0.29 6.79 NA XXX 78710 26 A Kidney imaging (3D) 0.66 0.23 0.23 0.03 0.92 0.92 XXX 78710 TC A Kidney imaging (3D) 0.00 5.61 NA 0.26 5.87 NA XXX 78715 A Renal vascular flow exam 0.30 1.61 NA 0.09 2.00 NA XXX 78715 26 A Renal vascular flow exam 0.30 0.11 0.11 0.01 0.42 0.42 XXX 78715 TC A Renal vascular flow exam 0.00 1.50 NA 0.08 1.58 NA XXX 78725 A Kidney function study 0.38 1.83 NA 0.10 2.31 NA XXX 78725 26 A Kidney function study 0.38 0.14 0.14 0.01 0.53 0.53 XXX 78725 TC A Kidney function study 0.00 1.69 NA 0.09 1.78 NA XXX 78730 A Urinary bladder retention 0.36 1.52 NA 0.09 1.97 NA XXX 78730 26 A Urinary bladder retention 0.36 0.13 0.13 0.02 0.51 0.51 XXX 78730 TC A Urinary bladder retention 0.00 1.39 NA 0.07 1.46 NA XXX 78740 A Ureteral reflux study 0.57 2.22 NA 0.12 2.91 NA XXX 78740 26 A Ureteral reflux study 0.57 0.21 0.21 0.02 0.80 0.80 XXX 78740 TC A Ureteral reflux study 0.00 2.01 NA 0.10 2.11 NA XXX 78760 A Testicular imaging 0.66 2.77 NA 0.15 3.58 NA XXX 78760 26 A Testicular imaging 0.66 0.23 0.23 0.03 0.92 0.92 XXX 78760 TC A Testicular imaging 0.00 2.54 NA 0.12 2.66 NA XXX 78761 A Testicular imaging/flow 0.71 3.30 NA 0.17 4.18 NA XXX 78761 26 A Testicular imaging/flow 0.71 0.26 0.26 0.03 1.00 1.00 XXX 78761 TC A Testicular imaging/flow 0.00 3.04 NA 0.14 3.18 NA XXX 78799 C Genitourinary nuclear exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78799 26 C Genitourinary nuclear exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78799 TC C Genitourinary nuclear exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78800 A Tumor imaging, limited area 0.66 3.46 NA 0.18 4.30 NA XXX 78800 26 A Tumor imaging, limited area 0.66 0.23 0.23 0.03 0.92 0.92 XXX 78800 TC A Tumor imaging, limited area 0.00 3.23 NA 0.15 3.38 NA XXX 78801 A Tumor imaging, mult areas 0.79 4.30 NA 0.21 5.30 NA XXX 78801 26 A Tumor imaging, mult areas 0.79 0.29 0.29 0.03 1.11 1.11 XXX 78801 TC A Tumor imaging, mult areas 0.00 4.01 NA 0.18 4.19 NA XXX 78802 A Tumor imaging, whole body 0.86 5.57 NA 0.28 6.71 NA XXX 78802 26 A Tumor imaging, whole body 0.86 0.32 0.32 0.03 1.21 1.21 XXX 78802 TC A Tumor imaging, whole body 0.00 5.25 NA 0.25 5.50 NA XXX 78803 A Tumor imaging (3D) 1.09 6.64 NA 0.33 8.06 NA XXX 78803 26 A Tumor imaging (3D) 1.09 0.41 0.41 0.04 1.54 1.54 XXX 78803 TC A Tumor imaging (3D) 0.00 6.23 NA 0.29 6.52 NA XXX 78805 A Abscess imaging, ltd area 0.73 3.50 NA 0.18 4.41 NA XXX 78805 26 A Abscess imaging, ltd area 0.73 0.27 0.27 0.03 1.03 1.03 XXX 78805 TC A Abscess imaging, ltd area 0.00 3.23 NA 0.15 3.38 NA XXX 78806 A Abscess imaging, whole body 0.86 6.43 NA 0.32 7.61 NA XXX 78806 26 A Abscess imaging, whole body 0.86 0.32 0.32 0.03 1.21 1.21 XXX 78806 TC A Abscess imaging, whole body 0.00 6.11 NA 0.29 6.40 NA XXX 78807 A Nuclear localization/abscess 1.09 6.66 NA 0.33 8.08 NA XXX 78807 26 A Nuclear localization/abscess 1.09 0.43 0.43 0.04 1.56 1.56 XXX 78807 TC A Nuclear localization/abscess 0.00 6.23 NA 0.29 6.52 NA XXX 78810 N Tumor imaging (PET) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78810 26 N Tumor imaging (PET) +1.93 0.77 0.77 0.09 2.79 2.79 XXX 78810 TC N Tumor imaging (PET) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78890 B Nuclear medicine data proc +0.05 1.26 NA 0.06 1.37 NA XXX 78890 26 B Nuclear medicine data proc +0.05 0.02 0.02 0.01 0.08 0.08 XXX 78890 TC B Nuclear medicine data proc +0.00 1.24 NA 0.05 1.29 NA XXX 78891 B Nuclear med data proc +0.10 2.53 NA 0.12 2.75 NA XXX 78891 26 B Nuclear med data proc +0.10 0.04 0.04 0.01 0.15 0.15 XXX 78891 TC B Nuclear med data proc +0.00 2.49 NA 0.11 2.60 NA XXX 78990 I Provide diag radionuclide(s) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78999 C Nuclear diagnostic exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78999 26 C Nuclear diagnostic exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78999 TC C Nuclear diagnostic exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 79000 A Init hyperthyroid therapy 1.80 3.14 NA 0.19 5.13 NA XXX 79000 26 A Init hyperthyroid therapy 1.80 0.65 0.65 0.07 2.52 2.52 XXX 79000 TC A Init hyperthyroid therapy 0.00 2.49 NA 0.12 2.61 NA XXX 79001 A Repeat hyperthyroid therapy 1.05 1.63 NA 0.10 2.78 NA XXX Start Printed Page 55431 79001 26 A Repeat hyperthyroid therapy 1.05 0.39 0.39 0.04 1.48 1.48 XXX 79001 TC A Repeat hyperthyroid therapy 0.00 1.24 NA 0.06 1.30 NA XXX 79020 A Thyroid ablation 1.81 3.13 NA 0.19 5.13 NA XXX 79020 26 A Thyroid ablation 1.81 0.64 0.64 0.07 2.52 2.52 XXX 79020 TC A Thyroid ablation 0.00 2.49 NA 0.12 2.61 NA XXX 79030 A Thyroid ablation, carcinoma 2.10 3.26 NA 0.20 5.56 NA XXX 79030 26 A Thyroid ablation, carcinoma 2.10 0.77 0.77 0.08 2.95 2.95 XXX 79030 TC A Thyroid ablation, carcinoma 0.00 2.49 NA 0.12 2.61 NA XXX 79035 A Thyroid metastatic therapy 2.52 3.43 NA 0.21 6.16 NA XXX 79035 26 A Thyroid metastatic therapy 2.52 0.94 0.94 0.09 3.55 3.55 XXX 79035 TC A Thyroid metastatic therapy 0.00 2.49 NA 0.12 2.61 NA XXX 79100 A Hematopoetic nuclear therapy 1.32 3.00 NA 0.17 4.49 NA XXX 79100 26 A Hematopoetic nuclear therapy 1.32 0.51 0.51 0.05 1.88 1.88 XXX 79100 TC A Hematopoetic nuclear therapy 0.00 2.49 NA 0.12 2.61 NA XXX 79200 A Intracavitary nuclear trmt 1.99 3.23 NA 0.19 5.41 NA XXX 79200 26 A Intracavitary nuclear trmt 1.99 0.74 0.74 0.07 2.80 2.80 XXX 79200 TC A Intracavitary nuclear trmt 0.00 2.49 NA 0.12 2.61 NA XXX 79300 C Interstitial nuclear therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 79300 26 A Interstitial nuclear therapy 1.60 0.68 0.68 0.07 2.35 2.35 XXX 79300 TC C Interstitial nuclear therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 79400 A Nonhemato nuclear therapy 1.96 3.22 NA 0.20 5.38 NA XXX 79400 26 A Nonhemato nuclear therapy 1.96 0.73 0.73 0.08 2.77 2.77 XXX 79400 TC A Nonhemato nuclear therapy 0.00 2.49 NA 0.12 2.61 NA XXX 79420 C Intravascular nuclear ther 0.00 0.00 0.00 0.00 0.00 0.00 XXX 79420 26 A Intravascular nuclear ther 1.51 0.54 0.54 0.06 2.11 2.11 XXX 79420 TC C Intravascular nuclear ther 0.00 0.00 0.00 0.00 0.00 0.00 XXX 79440 A Nuclear joint therapy 1.99 3.29 NA 0.20 5.48 NA XXX 79440 26 A Nuclear joint therapy 1.99 0.80 0.80 0.08 2.87 2.87 XXX 79440 TC A Nuclear joint therapy 0.00 2.49 NA 0.12 2.61 NA XXX 79900 C Provide ther radiopharm(s) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 79999 C Nuclear medicine therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 79999 26 C Nuclear medicine therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 79999 TC C Nuclear medicine therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80048 X Basic metabolic panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80050 N General health panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80051 X Electrolyte panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80053 X Comprehen metabolic panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80055 I Obstetric panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80061 X Lipid panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80069 X Renal function panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80072 D Arthritis panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80074 X Acute hepatitis panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80076 X Hepatic function panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80090 X Torch antibody panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80100 X Drug screen, qualitate/multi 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80101 X Drug screen, single 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80102 X Drug confirmation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80103 X Drug analysis, tissue prep 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80150 X Assay of amikacin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80152 X Assay of amitriptyline 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80154 X Assay of benzodiazepines 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80156 X Assay, carbamazepine, total 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80157 X Assay, carbamazepine, free 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80158 X Assay of cyclosporine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80160 X Assay of desipramine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80162 X Assay of digoxin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80164 X Assay, dipropylacetic acid 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80166 X Assay of doxepin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80168 X Assay of ethosuximide 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80170 X Assay of gentamicin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80172 X Assay of gold 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80173 X Assay of haloperidol 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80174 X Assay of imipramine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80176 X Assay of lidocaine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80178 X Assay of lithium 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80182 X Assay of nortriptyline 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80184 X Assay of phenobarbital 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80185 X Assay of phenytoin, total 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80186 X Assay of phenytoin, free 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80188 X Assay of primidone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80190 X Assay of procainamide 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80192 X Assay of procainamide 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80194 X Assay of quinidine 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55432 80196 X Assay of salicylate 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80197 X Assay of tacrolimus 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80198 X Assay of theophylline 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80200 X Assay of tobramycin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80201 X Assay of topiramate 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80202 X Assay of vancomycin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80299 X Quantitative assay, drug 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80400 X Acth stimulation panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80402 X Acth stimulation panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80406 X Acth stimulation panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80408 X Aldosterone suppression eval 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80410 X Calcitonin stimul panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80412 X CRH stimulation panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80414 X Testosterone response 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80415 X Estradiol response panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80416 X Renin stimulation panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80417 X Renin stimulation panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80418 X Pituitary evaluation panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80420 X Dexamethasone panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80422 X Glucagon tolerance panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80424 X Glucagon tolerance panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80426 X Gonadotropin hormone panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80428 X Growth hormone panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80430 X Growth hormone panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80432 X Insulin suppression panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80434 X Insulin tolerance panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80435 X Insulin tolerance panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80436 X Metyrapone panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80438 X TRH stimulation panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80439 X TRH stimulation panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80440 X TRH stimulation panel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80500 A Lab pathology consultation 0.37 0.21 0.17 0.01 0.59 0.55 XXX 80502 A Lab pathology consultation 1.33 0.63 0.61 0.05 2.01 1.99 XXX 81000 X Urinalysis, nonauto w/scope 0.00 0.00 0.00 0.00 0.00 0.00 XXX 81001 X Urinalysis, auto w/scope 0.00 0.00 0.00 0.00 0.00 0.00 XXX 81002 X Urinalysis nonauto w/o scope 0.00 0.00 0.00 0.00 0.00 0.00 XXX 81003 X Urinalysis, auto, w/o scope 0.00 0.00 0.00 0.00 0.00 0.00 XXX 81005 X Urinalysis 0.00 0.00 0.00 0.00 0.00 0.00 XXX 81007 X Urine screen for bacteria 0.00 0.00 0.00 0.00 0.00 0.00 XXX 81015 X Microscopic exam of urine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 81020 X Urinalysis, glass test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 81025 X Urine pregnancy test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 81050 X Urinalysis, volume measure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 81099 X Urinalysis test procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82000 X Assay of blood acetaldehyde 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82003 X Assay of acetaminophen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82009 X Test for acetone/ketones 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82010 X Acetone assay 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82013 X Acetylcholinesterase assay 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82016 X Acylcarnitines, qual 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82017 X Acylcarnitines, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82024 X Assay of acth 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82030 X Assay of adp & amp 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82040 X Assay of serum albumin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82042 X Assay of urine albumin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82043 X Microalbumin, quantitative 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82044 X Microalbumin, semiquant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82055 X Assay of ethanol 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82075 X Assay of breath ethanol 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82085 X Assay of aldolase 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82088 X Assay of aldosterone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82101 X Assay of urine alkaloids 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82103 X Alpha-1-antitrypsin, total 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82104 X Alpha-1-antitrypsin, pheno 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82105 X Alpha-fetoprotein, serum 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82106 X Alpha-fetoprotein, amniotic 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82108 X Assay of aluminum 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82120 X Amines, vaginal fluid qual 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82127 X Amino acid, single qual 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82128 X Amino acids, mult qual 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82131 X Amino acids, single quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82135 X Assay, aminolevulinic acid 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82136 X Amino acids, quant, 2-5 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55433 82139 X Amino acids, quan, 6 or more 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82140 X Assay of ammonia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82143 X Amniotic fluid scan 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82145 X Assay of amphetamines 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82150 X Assay of amylase 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82154 X Androstanediol glucuronide 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82157 X Assay of androstenedione 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82160 X Assay of androsterone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82163 X Assay of angiotensin II 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82164 X Angiotensin I enzyme test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82172 X Assay of apolipoprotein 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82175 X Assay of arsenic 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82180 X Assay of ascorbic acid 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82190 X Atomic absorption 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82205 X Assay of barbiturates 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82232 X Assay of beta-2 protein 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82239 X Bile acids, total 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82240 X Bile acids, cholylglycine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82247 X Bilirubin, total 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82248 X Bilirubin, direct 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82252 X Fecal bilirubin test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82261 X Assay of biotinidase 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82270 X Test for blood, feces 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82273 X Test for blood, other source 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82274 X Assay test for blood, fecal 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82286 X Assay of bradykinin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82300 X Assay of cadmium 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82306 X Assay of vitamin D 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82307 X Assay of vitamin D 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82308 X Assay of calcitonin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82310 X Assay of calcium 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82330 X Assay of calcium 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82331 X Calcium infusion test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82340 X Assay of calcium in urine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82355 X Calculus analysis, qual 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82360 X Calculus assay, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82365 X Calculus spectroscopy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82370 X X-ray assay, calculus 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82373 X Assay, c-d transfer measure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82374 X Assay, blood carbon dioxide 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82375 X Assay, blood carbon monoxide 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82376 X Test for carbon monoxide 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82378 X Carcinoembryonic antigen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82379 X Assay of carnitine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82380 X Assay of carotene 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82382 X Assay, urine catecholamines 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82383 X Assay, blood catecholamines 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82384 X Assay, three catecholamines 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82387 X Assay of cathepsin-d 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82390 X Assay of ceruloplasmin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82397 X Chemiluminescent assay 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82415 X Assay of chloramphenicol 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82435 X Assay of blood chloride 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82436 X Assay of urine chloride 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82438 X Assay, other fluid chlorides 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82441 X Test for chlorohydrocarbons 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82465 X Assay, bld/serum cholesterol 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82480 X Assay, serum cholinesterase 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82482 X Assay, rbc cholinesterase 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82485 X Assay, chondroitin sulfate 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82486 X Gas/liquid chromatography 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82487 X Paper chromatography 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82488 X Paper chromatography 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82489 X Thin layer chromatography 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82491 X Chromotography, quant, sing 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82492 X Chromotography, quant, mult 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82495 X Assay of chromium 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82507 X Assay of citrate 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82520 X Assay of cocaine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82523 X Collagen crosslinks 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82525 X Assay of copper 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82528 X Assay of corticosterone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82530 X Cortisol, free 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55434 82533 X Total cortisol 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82540 X Assay of creatine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82541 X Column chromotography, qual 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82542 X Column chromotography, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82543 X Column chromotograph/isotope 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82544 X Column chromotograph/isotope 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82550 X Assay of ck (cpk) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82552 X Assay of cpk in blood 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82553 X Creatine, MB fraction 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82554 X Creatine, isoforms 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82565 X Assay of creatinine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82570 X Assay of urine creatinine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82575 X Creatinine clearance test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82585 X Assay of cryofibrinogen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82595 X Assay of cryoglobulin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82600 X Assay of cyanide 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82607 X Vitamin B-12 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82608 X B-12 binding capacity 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82615 X Test for urine cystines 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82626 X Dehydroepiandrosterone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82627 X Dehydroepiandrosterone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82633 X Desoxycorticosterone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82634 X Deoxycortisol 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82638 X Assay of dibucaine number 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82646 X Assay of dihydrocodeinone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82649 X Assay of dihydromorphinone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82651 X Assay of dihydrotestosterone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82652 X Assay of dihydroxyvitamin d 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82654 X Assay of dimethadione 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82657 X Enzyme cell activity 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82658 X Enzyme cell activity, ra 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82664 X Electrophoretic test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82666 X Assay of epiandrosterone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82668 X Assay of erythropoietin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82670 X Assay of estradiol 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82671 X Assay of estrogens 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82672 X Assay of estrogen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82677 X Assay of estriol 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82679 X Assay of estrone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82690 X Assay of ethchlorvynol 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82693 X Assay of ethylene glycol 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82696 X Assay of etiocholanolone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82705 X Fats/lipids, feces, qual 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82710 X Fats/lipids, feces, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82715 X Assay of fecal fat 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82725 X Assay of blood fatty acids 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82726 X Long chain fatty acids 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82728 X Assay of ferritin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82731 X Assay of fetal fibronectin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82735 X Assay of fluoride 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82742 X Assay of flurazepam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82746 X Blood folic acid serum 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82747 X Assay of folic acid, rbc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82757 X Assay of semen fructose 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82759 X Assay of rbc galactokinase 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82760 X Assay of galactose 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82775 X Assay galactose transferase 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82776 X Galactose transferase test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82784 X Assay of gammaglobulin igm 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82785 X Assay of gammaglobulin ige 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82787 X Igg 1, 2, 3 or 4, each 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82800 X Blood pH 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82803 X Blood gases: pH, pO2 & pCO2 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82805 X Blood gases W/02 saturation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82810 X Blood gases, O2 sat only 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82820 X Hemoglobin-oxygen affinity 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82926 X Assay of gastric acid 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82928 X Assay of gastric acid 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82938 X Gastrin test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82941 X Assay of gastrin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82943 X Assay of glucagon 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82945 X Glucose other fluid 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82946 X Glucagon tolerance test 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55435 82947 X Assay, glucose, blood quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82948 X Reagent strip/blood glucose 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82950 X Glucose test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82951 X Glucose tolerance test (GTT) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82952 X GTT-added samples 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82953 X Glucose-tolbutamide test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82955 X Assay of g6pd enzyme 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82960 X Test for G6PD enzyme 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82962 X Glucose blood test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82963 X Assay of glucosidase 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82965 X Assay of gdh enzyme 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82975 X Assay of glutamine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82977 X Assay of GGT 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82978 X Assay of glutathione 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82979 X Assay, rbc glutathione 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82980 X Assay of glutethimide 0.00 0.00 0.00 0.00 0.00 0.00 XXX 82985 X Glycated protein 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83001 X Gonadotropin (FSH) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83002 X Gonadotropin (LH) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83003 X Assay, growth hormone (hgh) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83008 X Assay of guanosine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83010 X Assay of haptoglobin, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83012 X Assay of haptoglobins 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83013 X H pylori analysis 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83014 X H pylori drug admin/collect 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83015 X Heavy metal screen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83018 X Quantitative screen, metals 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83020 X Hemoglobin electrophoresis 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83020 26 A Hemoglobin electrophoresis 0.37 0.17 0.17 0.01 0.55 0.55 XXX 83021 X Hemoglobin chromotography 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83026 X Hemoglobin, copper sulfate 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83030 X Fetal hemoglobin, chemical 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83033 X Fetal hemoglobin assay, qual 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83036 X Glycated hemoglobin test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83045 X Blood methemoglobin test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83050 X Blood methemoglobin assay 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83051 X Assay of plasma hemoglobin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83055 X Blood sulfhemoglobin test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83060 X Blood sulfhemoglobin assay 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83065 X Assay of hemoglobin heat 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83068 X Hemoglobin stability screen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83069 X Assay of urine hemoglobin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83070 X Assay of hemosiderin, qual 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83071 X Assay of hemosiderin, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83080 X Assay of b hexosaminidase 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83088 X Assay of histamine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83090 X Assay of homocystine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83150 X Assay of for hva 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83491 X Assay of corticosteroids 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83497 X Assay of 5-hiaa 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83498 X Assay of progesterone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83499 X Assay of progesterone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83500 X Assay, free hydroxyproline 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83505 X Assay, total hydroxyproline 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83516 X Immunoassay, nonantibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83518 X Immunoassay, dipstick 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83519 X Immunoassay, nonantibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83520 X Immunoassay, RIA 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83525 X Assay of insulin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83527 X Assay of insulin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83528 X Assay of intrinsic factor 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83540 X Assay of iron 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83550 X Iron binding test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83570 X Assay of idh enzyme 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83582 X Assay of ketogenic steroids 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83586 X Assay 17- ketosteroids 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83593 X Fractionation, ketosteroids 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83605 X Assay of lactic acid 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83615 X Lactate (LD) (LDH) enzyme 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83625 X Assay of ldh enzymes 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83632 X Placental lactogen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83633 X Test urine for lactose 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83634 X Assay of urine for lactose 0.00 0.00 0.00 0.00 0.00 0.00 XXXStart Printed Page 55436 83655 X Assay of lead 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83661 X L/s ratio, fetal lung 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83662 X Foam stability, fetal lung 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83663 X Fluoro polarize, fetal lung 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83664 X Lamellar bdy, fetal lung 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83670 X Assay of lap enzyme 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83690 X Assay of lipase 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83715 X Assay of blood lipoproteins 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83716 X Assay of blood lipoproteins 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83718 X Assay of lipoprotein 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83719 X Assay of blood lipoprotein 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83721 X Assay of blood lipoprotein 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83727 X Assay of lrh hormone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83735 X Assay of magnesium 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83775 X Assay of md enzyme 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83785 X Assay of manganese 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83788 X Mass spectrometry qual 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83789 X Mass spectrometry quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83805 X Assay of meprobamate 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83825 X Assay of mercury 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83835 X Assay of metanephrines 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83840 X Assay of methadone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83857 X Assay of methemalbumin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83858 X Assay of methsuximide 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83864 X Mucopolysaccharides 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83866 X Mucopolysaccharides screen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83872 X Assay synovial fluid mucin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83873 X Assay of csf protein 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83874 X Assay of myoglobin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83883 X Assay, nephelometry not spec 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83885 X Assay of nickel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83887 X Assay of nicotine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83890 X Molecule isolate 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83891 X Molecule isolate nucleic 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83892 X Molecular diagnostics 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83893 X Molecule dot/slot/blot 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83894 X Molecule gel electrophor 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83896 X Molecular diagnostics 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83897 X Molecule nucleic transfer 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83898 X Molecule nucleic ampli 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83901 X Molecule nucleic ampli 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83902 X Molecular diagnostics 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83903 X Molecule mutation scan 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83904 X Molecule mutation identify 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83905 X Molecule mutation identify 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83906 X Molecule mutation identify 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83912 X Genetic examination 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83912 26 A Genetic examination 0.37 0.17 0.17 0.01 0.55 0.55 XXX 83915 X Assay of nucleotidase 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83916 X Oligoclonal bands 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83918 X Organic acids, total, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83919 X Organic acids, qual, each 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83921 X Organic acid, single, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83925 X Assay of opiates 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83930 X Assay of blood osmolality 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83935 X Assay of urine osmolality 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83937 X Assay of osteocalcin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83945 X Assay of oxalate 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83950 X Oncorprotein, her-2/neu 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83970 X Assay of parathormone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83986 X Assay of body fluid acidity 0.00 0.00 0.00 0.00 0.00 0.00 XXX 83992 X Assay for phencyclidine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84022 X Assay of phenothiazine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84030 X Assay of blood pku 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84035 X Assay of phenylketones 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84060 X Assay acid phosphatase 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84061 X Phosphatase, forensic exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84066 X Assay prostate phosphatase 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84075 X Assay alkaline phosphatase 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84078 X Assay alkaline phosphatase 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84080 X Assay alkaline phosphatases 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84081 X Amniotic fluid enzyme test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84085 X Assay of rbc pg6d enzyme 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55437 84087 X Assay phosphohexose enzymes 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84100 X Assay of phosphorus 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84105 X Assay of urine phosphorus 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84106 X Test for porphobilinogen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84110 X Assay of porphobilinogen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84119 X Test urine for porphyrins 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84120 X Assay of urine porphyrins 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84126 X Assay of feces porphyrins 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84127 X Assay of feces porphyrins 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84132 X Assay of serum potassium 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84133 X Assay of urine potassium 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84134 X Assay of prealbumin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84135 X Assay of pregnanediol 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84138 X Assay of pregnanetriol 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84140 X Assay of pregnenolone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84143 X Assay of 17-hydroxypregneno 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84144 X Assay of progesterone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84146 X Assay of prolactin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84150 X Assay of prostaglandin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84152 X Assay of psa, complexed 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84153 X Assay of psa, total 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84154 X Assay of psa, free 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84155 X Assay of protein 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84160 X Assay of serum protein 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84165 X Assay of serum proteins 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84165 26 A Assay of serum proteins 0.37 0.17 0.17 0.01 0.55 0.55 XXX 84181 X Western blot test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84181 26 A Western blot test 0.37 0.15 0.15 0.01 0.53 0.53 XXX 84182 X Protein, western blot test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84182 26 A Protein, western blot test 0.37 0.15 0.15 0.01 0.53 0.53 XXX 84202 X Assay RBC protoporphyrin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84203 X Test RBC protoporphyrin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84206 X Assay of proinsulin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84207 X Assay of vitamin b-6 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84210 X Assay of pyruvate 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84220 X Assay of pyruvate kinase 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84228 X Assay of quinine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84233 X Assay of estrogen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84234 X Assay of progesterone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84235 X Assay of endocrine hormone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84238 X Assay, nonendocrine receptor 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84244 X Assay of renin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84252 X Assay of vitamin b-2 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84255 X Assay of selenium 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84260 X Assay of serotonin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84270 X Assay of sex hormone globul 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84275 X Assay of sialic acid 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84285 X Assay of silica 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84295 X Assay of serum sodium 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84300 X Assay of urine sodium 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84305 X Assay of somatomedin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84307 X Assay of somatostatin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84311 X Spectrophotometry 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84315 X Body fluid specific gravity 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84375 X Chromatogram assay, sugars 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84376 X Sugars, single, qual 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84377 X Sugars, multiple, qual 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84378 X Sugars single quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84379 X Sugars multiple quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84392 X Assay of urine sulfate 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84402 X Assay of testosterone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84403 X Assay of total testosterone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84425 X Assay of vitamin b-1 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84430 X Assay of thiocyanate 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84432 X Assay of thyroglobulin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84436 X Assay of total thyroxine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84437 X Assay of neonatal thyroxine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84439 X Assay of free thyroxine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84442 X Assay of thyroid activity 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84443 X Assay thyroid stim hormone 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84445 X Assay of tsi 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84446 X Assay of vitamin e 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84449 X Assay of transcortin 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55438 84450 X Transferase (AST) (SGOT) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84460 X Alanine amino (ALT) (SGPT) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84466 X Assay of transferrin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84478 X Assay of triglycerides 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84479 X Assay of thyroid (t3 or t4) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84480 X Assay, triiodothyronine (t3) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84481 X Free assay (FT-3) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84482 X Reverse assay (t3) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84484 X Assay of troponin, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84485 X Assay duodenal fluid trypsin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84488 X Test feces for trypsin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84490 X Assay of feces for trypsin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84510 X Assay of tyrosine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84512 X Assay of troponin, qual 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84520 X Assay of urea nitrogen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84525 X Urea nitrogen semi-quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84540 X Assay of urine/urea-n 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84545 X Urea-N clearance test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84550 X Assay of blood/uric acid 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84560 X Assay of urine/uric acid 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84577 X Assay of feces/urobilinogen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84578 X Test urine urobilinogen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84580 X Assay of urine urobilinogen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84583 X Assay of urine urobilinogen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84585 X Assay of urine vma 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84586 X Assay of vip 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84588 X Assay of vasopressin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84590 X Assay of vitamin a 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84591 X Assay of nos vitamin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84597 X Assay of vitamin k 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84600 X Assay of volatiles 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84620 X Xylose tolerance test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84630 X Assay of zinc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84681 X Assay of c-peptide 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84702 X Chorionic gonadotropin test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84703 X Chorionic gonadotropin assay 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84830 X Ovulation tests 0.00 0.00 0.00 0.00 0.00 0.00 XXX 84999 X Clinical chemistry test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85002 X Bleeding time test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85007 X Differential WBC count 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85008 X Nondifferential WBC count 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85009 X Differential WBC count 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85013 X Hematocrit 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85014 X Hematocrit 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85018 X Hemoglobin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85021 X Automated hemogram 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85022 X Automated hemogram 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85023 X Automated hemogram 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85024 X Automated hemogram 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85025 X Automated hemogram 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85027 X Automated hemogram 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85031 X Manual hemogram, cbc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85041 X Red blood cell (RBC) count 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85044 X Reticulocyte count 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85045 X Reticulocyte count 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85046 X Reticyte/hgb concentrate 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85048 X White blood cell (WBC) count 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85060 A Blood smear interpretation 0.45 0.19 0.19 0.02 0.66 0.66 XXX 85095 D Bone marrow aspiration 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85097 A Bone marrow interpretation 0.94 1.75 0.43 0.03 2.72 1.40 XXX 85102 D Bone marrow biopsy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85130 X Chromogenic substrate assay 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85170 X Blood clot retraction 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85175 X Blood clot lysis time 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85210 X Blood clot factor II test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85220 X Blood clot factor V test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85230 X Blood clot factor VII test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85240 X Blood clot factor VIII test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85244 X Blood clot factor VIII test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85245 X Blood clot factor VIII test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85246 X Blood clot factor VIII test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85247 X Blood clot factor VIII test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85250 X Blood clot factor IX test 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55439 85260 X Blood clot factor X test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85270 X Blood clot factor XI test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85280 X Blood clot factor XII test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85290 X Blood clot factor XIII test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85291 X Blood clot factor XIII test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85292 X Blood clot factor assay 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85293 X Blood clot factor assay 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85300 X Antithrombin III test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85301 X Antithrombin III test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85302 X Blood clot inhibitor antigen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85303 X Blood clot inhibitor test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85305 X Blood clot inhibitor assay 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85306 X Blood clot inhibitor test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85307 X Assay activated protein c 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85335 X Factor inhibitor test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85337 X Thrombomodulin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85345 X Coagulation time 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85347 X Coagulation time 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85348 X Coagulation time 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85360 X Euglobulin lysis 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85362 X Fibrin degradation products 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85366 X Fibrinogen test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85370 X Fibrinogen test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85378 X Fibrin degradation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85379 X Fibrin degradation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85384 X Fibrinogen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85385 X Fibrinogen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85390 X Fibrinolysins screen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85390 26 A Fibrinolysins screen 0.37 0.12 0.12 0.01 0.50 0.50 XXX 85400 X Fibrinolytic plasmin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85410 X Fibrinolytic antiplasmin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85415 X Fibrinolytic plasminogen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85420 X Fibrinolytic plasminogen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85421 X Fibrinolytic plasminogen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85441 X Heinz bodies, direct 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85445 X Heinz bodies, induced 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85460 X Hemoglobin, fetal 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85461 X Hemoglobin, fetal 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85475 X Hemolysin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85520 X Heparin assay 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85525 X Heparin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85530 X Heparin-protamine tolerance 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85535 D Iron stain, blood cells 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85536 X Iron stain peripheral blood 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85540 X Wbc alkaline phosphatase 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85547 X RBC mechanical fragility 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85549 X Muramidase 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85555 X RBC osmotic fragility 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85557 X RBC osmotic fragility 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85576 X Blood platelet aggregation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85576 26 A Blood platelet aggregation 0.37 0.16 0.16 0.01 0.54 0.54 XXX 85585 X Blood platelet estimation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85590 X Platelet count, manual 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85595 X Platelet count, automated 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85597 X Platelet neutralization 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85610 X Prothrombin time 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85611 X Prothrombin test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85612 X Viper venom prothrombin time 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85613 X Russell viper venom, diluted 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85635 X Reptilase test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85651 X Rbc sed rate, nonautomated 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85652 X Rbc sed rate, automated 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85660 X RBC sickle cell test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85670 X Thrombin time, plasma 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85675 X Thrombin time, titer 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85705 X Thromboplastin inhibition 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85730 X Thromboplastin time, partial 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85732 X Thromboplastin time, partial 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85810 X Blood viscosity examination 0.00 0.00 0.00 0.00 0.00 0.00 XXX 85999 X Hematology procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86000 X Agglutinins, febrile 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86001 X Allergen specific igg 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86003 X Allergen specific IgE 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55440 86005 X Allergen specific IgE 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86021 X WBC antibody identification 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86022 X Platelet antibodies 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86023 X Immunoglobulin assay 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86038 X Antinuclear antibodies 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86039 X Antinuclear antibodies (ANA) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86060 X Antistreptolysin o, titer 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86063 X Antistreptolysin o, screen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86077 A Physician blood bank service 0.94 0.48 0.43 0.03 1.45 1.40 XXX 86078 A Physician blood bank service 0.94 0.51 0.43 0.03 1.48 1.40 XXX 86079 A Physician blood bank service 0.94 0.50 0.44 0.03 1.47 1.41 XXX 86140 X C-reactive protein 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86141 X C-reactive protein, hs 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86146 X Glycoprotein antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86147 X Cardiolipin antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86148 X Phospholipid antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86155 X Chemotaxis assay 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86156 X Cold agglutinin, screen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86157 X Cold agglutinin, titer 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86160 X Complement, antigen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86161 X Complement/function activity 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86162 X Complement, total (CH50) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86171 X Complement fixation, each 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86185 X Counterimmunoelectrophoresis 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86215 X Deoxyribonuclease, antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86225 X DNA antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86226 X DNA antibody, single strand 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86235 X Nuclear antigen antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86243 X Fc receptor 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86255 X Fluorescent antibody, screen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86255 26 A Fluorescent antibody, screen 0.37 0.17 0.17 0.01 0.55 0.55 XXX 86256 X Fluorescent antibody, titer 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86256 26 A Fluorescent antibody, titer 0.37 0.17 0.17 0.01 0.55 0.55 XXX 86277 X Growth hormone antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86280 X Hemagglutination inhibition 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86294 X Immunoassay, tumor qual 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86300 X Immunoassay, tumor ca 15-3 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86301 X Immunoassay, tumor ca 19-9 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86304 X Immunoassay, tumor, ca 125 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86308 X Heterophile antibodies 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86309 X Heterophile antibodies 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86310 X Heterophile antibodies 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86316 X Immunoassay, tumor other 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86317 X Immunoassay, infectious agent 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86318 X Immunoassay, infectious agent 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86320 X Serum immunoelectrophoresis 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86320 26 A Serum immunoelectrophoresis 0.37 0.17 0.17 0.01 0.55 0.55 XXX 86325 X Other immunoelectrophoresis 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86325 26 A Other immunoelectrophoresis 0.37 0.17 0.17 0.01 0.55 0.55 XXX 86327 X Immunoelectrophoresis assay 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86327 26 A Immunoelectrophoresis assay 0.42 0.20 0.20 0.01 0.63 0.63 XXX 86329 X Immunodiffusion 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86331 X Immunodiffusion ouchterlony 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86332 X Immune complex assay 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86334 X Immunofixation procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86334 26 A Immunofixation procedure 0.37 0.17 0.17 0.01 0.55 0.55 XXX 86336 X Inhibin A 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86337 X Insulin antibodies 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86340 X Intrinsic factor antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86341 X Islet cell antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86343 X Leukocyte histamine release 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86344 X Leukocyte phagocytosis 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86353 X Lymphocyte transformation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86359 X T cells, total count 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86360 X T cell, absolute count/ratio 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86361 X T cell, absolute count 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86376 X Microsomal antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86378 X Migration inhibitory factor 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86382 X Neutralization test, viral 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86384 X Nitroblue tetrazolium dye 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86403 X Particle agglutination test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86406 X Particle agglutination test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86430 X Rheumatoid factor test 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55441 86431 X Rheumatoid factor, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86485 C Skin test, candida 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86490 A Coccidioidomycosis skin test 0.00 0.28 NA 0.02 0.30 NA XXX 86510 A Histoplasmosis skin test 0.00 0.30 NA 0.02 0.32 NA XXX 86580 A TB intradermal test 0.00 0.24 NA 0.02 0.26 NA XXX 86585 A TB tine test 0.00 0.19 NA 0.01 0.20 NA XXX 86586 C Skin test, unlisted 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86590 X Streptokinase, antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86592 X Blood serology, qualitative 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86593 X Blood serology, quantitative 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86602 X Antinomyces antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86603 X Adenovirus antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86606 X Aspergillus antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86609 X Bacterium antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86611 X Bartonella antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86612 X Blastomyces antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86615 X Bordetella antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86617 X Lyme disease antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86618 X Lyme disease antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86619 X Borrelia antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86622 X Brucella antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86625 X Campylobacter antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86628 X Candida antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86631 X Chlamydia antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86632 X Chlamydia igm antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86635 X Coccidioides antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86638 X Q fever antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86641 X Cryptococcus antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86644 X CMV antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86645 X CMV antibody, IgM 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86648 X Diphtheria antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86651 X Encephalitis antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86652 X Encephalitis antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86653 X Encephalitis antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86654 X Encephalitis antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86658 X Enterovirus antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86663 X Epstein-barr antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86664 X Epstein-barr antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86665 X Epstein-barr antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86666 X Ehrlichia antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86668 X Francisella tularensis 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86671 X Fungus antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86674 X Giardia lamblia antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86677 X Helicobacter pylori 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86682 X Helminth antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86683 D Hemoglobin, fecal antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86684 X Hemophilus influenza 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86687 X Htlv-i antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86688 X Htlv-ii antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86689 X HTLV/HIV confirmatory test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86692 X Hepatitis, delta agent 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86694 X Herpes simplex test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86695 X Herpes simplex test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86696 X Herpes simplex type 2 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86698 X Histoplasma 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86701 X HIV-1 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86702 X HIV-2 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86703 X HIV-1/HIV-2, single assay 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86704 X Hep b core antibody, total 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86705 X Hep b core antibody, igm 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86706 X Hep b surface antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86707 X Hep be antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86708 X Hep a antibody, total 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86709 X Hep a antibody, igm 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86710 X Influenza virus antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86713 X Legionella antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86717 X Leishmania antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86720 X Leptospira antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86723 X Listeria monocytogenes ab 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86727 X Lymph choriomeningitis ab 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86729 X Lympho venereum antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86732 X Mucormycosis antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86735 X Mumps antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55442 86738 X Mycoplasma antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86741 X Neisseria meningitidis 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86744 X Nocardia antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86747 X Parvovirus antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86750 X Malaria antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86753 X Protozoa antibody nos 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86756 X Respiratory virus antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86757 X Rickettsia antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86759 X Rotavirus antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86762 X Rubella antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86765 X Rubeola antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86768 X Salmonella antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86771 X Shigella antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86774 X Tetanus antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86777 X Toxoplasma antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86778 X Toxoplasma antibody, igm 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86781 X Treponema pallidum, confirm 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86784 X Trichinella antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86787 X Varicella-zoster antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86790 X Virus antibody nos 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86793 X Yersinia antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86800 X Thyroglobulin antibody 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86803 X Hepatitis c ab test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86804 X Hep c ab test, confirm 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86805 X Lymphocytotoxicity assay 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86806 X Lymphocytotoxicity assay 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86807 X Cytotoxic antibody screening 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86808 X Cytotoxic antibody screening 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86812 X HLA typing, A, B, or C 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86813 X HLA typing, A, B, or C 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86816 X HLA typing, DR/DQ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86817 X HLA typing, DR/DQ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86821 X Lymphocyte culture, mixed 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86822 X Lymphocyte culture, primed 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86849 X Immunology procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86850 X RBC antibody screen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86860 X RBC antibody elution 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86870 X RBC antibody identification 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86880 X Coombs test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86885 X Coombs test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86886 X Coombs test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86890 X Autologous blood process 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86891 X Autologous blood, op salvage 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86900 X Blood typing, ABO 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86901 X Blood typing, Rh (D) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86903 X Blood typing, antigen screen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86904 X Blood typing, patient serum 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86905 X Blood typing, RBC antigens 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86906 X Blood typing, Rh phenotype 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86910 N Blood typing, paternity test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86911 N Blood typing, antigen system 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86915 X Bone marrow/stem cell prep 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86920 X Compatibility test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86921 X Compatibility test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86922 X Compatibility test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86927 X Plasma, fresh frozen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86930 X Frozen blood prep 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86931 X Frozen blood thaw 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86932 X Frozen blood freeze/thaw 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86940 X Hemolysins/agglutinins, auto 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86941 X Hemolysins/agglutinins 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86945 X Blood product/irradiation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86950 X Leukacyte transfusion 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86965 X Pooling blood platelets 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86970 X RBC pretreatment 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86971 X RBC pretreatment 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86972 X RBC pretreatment 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86975 X RBC pretreatment, serum 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86976 X RBC pretreatment, serum 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86977 X RBC pretreatment, serum 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86978 X RBC pretreatment, serum 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86985 X Split blood or products 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86999 X Transfusion procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55443 87001 X Small animal inoculation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87003 X Small animal inoculation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87015 X Specimen concentration 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87040 X Blood culture for bacteria 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87045 X Feces culture, bacteria 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87046 X Stool cultr, bacteria, each 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87070 X Culture, bacteria, other 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87071 X Culture bacteri aerobic othr 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87073 X Culture bacteria anaerobic 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87075 X Culture bacteria anaerobic 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87076 X Culture anaerobe ident, each 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87077 X Culture aerobic identify 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87081 X Culture screen only 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87084 X Culture of specimen by kit 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87086 X Urine culture/colony count 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87088 X Urine bacteria culture 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87101 X Skin fungi culture 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87102 X Fungus isolation culture 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87103 X Blood fungus culture 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87106 X Fungi identification, yeast 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87107 X Fungi identification, mold 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87109 X Mycoplasma 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87110 X Chlamydia culture 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87116 X Mycobacteria culture 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87118 X Mycobacteric identification 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87140 X Culture type immunofluoresc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87143 X Culture typing, glc/hplc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87147 X Culture type, immunologic 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87149 X Culture type, nucleic acid 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87152 X Culture type pulse field gel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87158 X Culture typing, added method 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87164 X Dark field examination 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87164 26 A Dark field examination 0.37 0.12 0.11 0.01 0.50 0.49 XXX 87166 X Dark field examination 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87168 X Macroscopic exam arthropod 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87169 X Macacroscopic exam parasite 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87172 X Pinworm exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87176 X Tissue homogenization, cultr 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87177 X Ova and parasites smears 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87181 X Microbe susceptible, diffuse 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87184 X Microbe susceptible, disk 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87185 X Microbe susceptible, enzyme 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87186 X Microbe susceptible, mic 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87187 X Microbe susceptible, mlc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87188 X Microbe suscept, macrobroth 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87190 X Microbe suscept, mycobacteri 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87197 X Bactericidal level, serum 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87198 X Cytomegalovirus antibody dfa 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87199 X Enterovirus antibody, dfa 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87205 X Smear, gram stain 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87206 X Smear, fluorescent/acid stai 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87207 X Smear, special stain 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87207 26 A Smear, special stain 0.37 0.18 0.17 0.01 0.56 0.55 XXX 87210 X Smear, wet mount, saline/ink 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87220 X Tissue exam for fungi 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87230 X Assay, toxin or antitoxin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87250 X Virus inoculate, eggs/animal 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87252 X Virus inoculation, tissue 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87253 X Virus inoculate tissue, addl 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87254 X Virus inoculation, shell via 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87260 X Adenovirus ag, if 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87265 X Pertussis ag, if 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87270 X Chlamydia trachomatis ag, if 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87272 X Cryptosporidum/gardia ag, if 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87273 X Herpes simplex 2, ag, if 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87274 X Herpes simplex 1, ag, if 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87275 X Influenza b, ag, if 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87276 X Influenza a, ag, if 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87277 X Legionella micdadei, ag, if 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87278 X Legion pneumophilia ag, if 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87279 X Parainfluenza, ag, if 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87280 X Respiratory syncytial ag, if 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87281 X Pneumocystis carinii, ag, if 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55444 87283 X Rubeola, ag, if 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87285 X Treponema pallidum, ag, if 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87290 X Varicella zoster, ag, if 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87299 X Antibody detection, nos, if 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87300 X Ag detection, polyval, if 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87301 X Adenovirus ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87320 X Chylmd trach ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87324 X Clostridium ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87327 X Cryptococcus neoform ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87328 X Cryptospor ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87332 X Cytomegalovirus ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87335 X E coli 0157 ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87336 X Entamoeb hist dispr, ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87337 X Entamoeb hist group, ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87338 X Hpylori, stool, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87339 X H pylori ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87340 X Hepatitis b surface ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87341 X Hepatitis b surface, ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87350 X Hepatitis be ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87380 X Hepatitis delta ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87385 X Histoplasma capsul ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87390 X Hiv-1 ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87391 X Hiv-2 ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87400 X Influenza a/b, ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87420 X Resp syncytial ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87425 X Rotavirus ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87427 X Shiga-like toxin ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87430 X Strep a ag, eia 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87449 X Ag detect nos, eia, mult 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87450 X Ag detect nos, eia, single 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87451 X Ag detect polyval, eia, mult 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87470 X Bartonella, dna, dir probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87471 X Bartonella, dna, amp probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87472 X Bartonella, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87475 X Lyme dis, dna, dir probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87476 X Lyme dis, dna, amp probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87477 X Lyme dis, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87480 X Candida, dna, dir probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87481 X Candida, dna, amp probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87482 X Candida, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87485 X Chylmd pneum, dna, dir probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87486 X Chylmd pneum, dna, amp probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87487 X Chylmd pneum, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87490 X Chylmd trach, dna, dir probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87491 X Chylmd trach, dna, amp probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87492 X Chylmd trach, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87495 X Cytomeg, dna, dir probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87496 X Cytomeg, dna, amp probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87497 X Cytomeg, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87510 X Gardner vag, dna, dir probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87511 X Gardner vag, dna, amp probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87512 X Gardner vag, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87515 X Hepatitis b, dna, dir probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87516 X Hepatitis b, dna, amp probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87517 X Hepatitis b, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87520 X Hepatitis c, rna, dir probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87521 X Hepatitis c, rna, amp probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87522 X Hepatitis c, rna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87525 X Hepatitis g, dna, dir probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87526 X Hepatitis g, dna, amp probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87527 X Hepatitis g, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87528 X Hsv, dna, dir probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87529 X Hsv, dna, amp probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87530 X Hsv, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87531 X Hhv-6, dna, dir probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87532 X Hhv-6, dna, amp probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87533 X Hhv-6, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87534 X Hiv-1, dna, dir probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87535 X Hiv-1, dna, amp probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87536 X Hiv-1, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87537 X Hiv-2, dna, dir probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87538 X Hiv-2, dna, amp probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87539 X Hiv-2, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55445 87540 X Legion pneumo, dna, dir prob 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87541 X Legion pneumo, dna, amp prob 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87542 X Legion pneumo, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87550 X Mycobacteria, dna, dir probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87551 X Mycobacteria, dna, amp probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87552 X Mycobacteria, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87555 X M.tuberculo, dna, dir probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87556 X M.tuberculo, dna, amp probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87557 X M.tuberculo, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87560 X M.avium-intra, dna, dir prob 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87561 X M.avium-intra, dna, amp prob 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87562 X M.avium-intra, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87580 X M.pneumon, dna, dir probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87581 X M.pneumon, dna, amp probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87582 X M.pneumon, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87590 X N.gonorrhoeae, dna, dir prob 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87591 X N.gonorrhoeae, dna, amp prob 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87592 X N.gonorrhoeae, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87620 X Hpv, dna, dir probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87621 X Hpv, dna, amp probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87622 X Hpv, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87650 X Strep a, dna, dir probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87651 X Strep a, dna, amp probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87652 X Strep a, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87797 X Detect agent nos, dna, dir 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87798 X Detect agent nos, dna, amp 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87799 X Detect agent nos, dna, quant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87800 X Detect agnt mult, dna, direc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87801 X Detect agnt mult, dna, ampli 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87802 X Strep b assay w/optic 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87803 X Clostridium toxin a w/optic 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87804 X Influenza assay w/optic 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87810 X Chylmd trach assay w/optic 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87850 X N. gonorrhoeae assay w/optic 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87880 X Strep a assay w/optic 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87899 X Agent nos assay w/optic 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87901 X Genotype, dna, hiv reverse t 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87902 X Genotype, dna, hepatitis C 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87903 X Phenotype, dna hiv w/culture 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87904 X Phenotype, dna hiv w/clt add 0.00 0.00 0.00 0.00 0.00 0.00 XXX 87999 X Microbiology procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88000 N Autopsy (necropsy), gross 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88005 N Autopsy (necropsy), gross 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88007 N Autopsy (necropsy), gross 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88012 N Autopsy (necropsy), gross 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88014 N Autopsy (necropsy), gross 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88016 N Autopsy (necropsy), gross 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88020 N Autopsy (necropsy), complete 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88025 N Autopsy (necropsy), complete 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88027 N Autopsy (necropsy), complete 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88028 N Autopsy (necropsy), complete 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88029 N Autopsy (necropsy), complete 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88036 N Limited autopsy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88037 N Limited autopsy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88040 N Forensic autopsy (necropsy) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88045 N Coroner's autopsy (necropsy) 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88099 N Necropsy (autopsy) procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88104 A Cytopathology, fluids 0.56 0.72 NA 0.04 1.32 NA XXX 88104 26 A Cytopathology, fluids 0.56 0.26 0.26 0.02 0.84 0.84 XXX 88104 TC A Cytopathology, fluids 0.00 0.46 NA 0.02 0.48 NA XXX 88106 A Cytopathology, fluids 0.56 0.72 NA 0.04 1.32 NA XXX 88106 26 A Cytopathology, fluids 0.56 0.26 0.26 0.02 0.84 0.84 XXX 88106 TC A Cytopathology, fluids 0.00 0.46 NA 0.02 0.48 NA XXX 88107 A Cytopathology, fluids 0.76 1.01 NA 0.05 1.82 NA XXX 88107 26 A Cytopathology, fluids 0.76 0.35 0.35 0.03 1.14 1.14 XXX 88107 TC A Cytopathology, fluids 0.00 0.66 NA 0.02 0.68 NA XXX 88108 A Cytopath, concentrate tech 0.56 0.94 NA 0.04 1.54 NA XXX 88108 26 A Cytopath, concentrate tech 0.56 0.26 0.26 0.02 0.84 0.84 XXX 88108 TC A Cytopath, concentrate tech 0.00 0.68 NA 0.02 0.70 NA XXX 88125 A Forensic cytopathology 0.26 0.30 NA 0.02 0.58 NA XXX 88125 26 A Forensic cytopathology 0.26 0.12 0.12 0.01 0.39 0.39 XXX 88125 TC A Forensic cytopathology 0.00 0.18 NA 0.01 0.19 NA XXX 88130 X Sex chromatin identification 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55446 88140 X Sex chromatin identification 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88141 A Cytopath, c/v, interpret 0.42 0.19 0.19 0.01 0.62 0.62 XXX 88142 X Cytopath, c/v, thin layer 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88143 X Cytopath, c/v, thin lyr redo 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88144 X Cytopath, c/v, thin lyr redo 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88145 X Cytopath, c/v, thin lyr sel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88147 X Cytopath, c/v, automated 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88148 X Cytopath, c/v, auto rescreen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88150 X Cytopath, c/v, manual 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88152 X Cytopath, c/v, auto redo 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88153 X Cytopath, c/v, redo 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88154 X Cytopath, c/v, select 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88155 X Cytopath, c/v, index add-on 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88160 A Cytopath smear, other source 0.50 1.01 NA 0.04 1.55 NA XXX 88160 26 A Cytopath smear, other source 0.50 0.23 0.23 0.02 0.75 0.75 XXX 88160 TC A Cytopath smear, other source 0.00 0.78 NA 0.02 0.80 NA XXX 88161 A Cytopath smear, other source 0.50 1.22 NA 0.04 1.76 NA XXX 88161 26 A Cytopath smear, other source 0.50 0.23 0.23 0.02 0.75 0.75 XXX 88161 TC A Cytopath smear, other source 0.00 0.99 NA 0.02 1.01 NA XXX 88162 A Cytopath smear, other source 0.76 0.73 NA 0.05 1.54 NA XXX 88162 26 A Cytopath smear, other source 0.76 0.35 0.35 0.03 1.14 1.14 XXX 88162 TC A Cytopath smear, other source 0.00 0.38 NA 0.02 0.40 NA XXX 88164 X Cytopath tbs, c/v, manual 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88165 X Cytopath tbs, c/v, redo 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88166 X Cytopath tbs, c/v, auto redo 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88167 X Cytopath tbs, c/v, select 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88170 D Fine needle aspiration 0.00 0.00 NA 0.00 0.00 NA XXX 88170 26 D Fine needle aspiration 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88170 TC D Fine needle aspiration 0.00 0.00 NA 0.00 0.00 NA XXX 88171 D Fine needle aspiration 0.00 0.00 NA 0.00 0.00 NA XXX 88171 26 D Fine needle aspiration 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88171 TC D Fine needle aspiration 0.00 0.00 NA 0.00 0.00 NA XXX 88172 A Cytopathology eval of fna 0.60 0.68 NA 0.04 1.32 NA XXX 88172 26 A Cytopathology eval of fna 0.60 0.28 0.28 0.02 0.90 0.90 XXX 88172 TC A Cytopathology eval of fna 0.00 0.40 NA 0.02 0.42 NA XXX 88173 A Cytopath eval, fna, report 1.39 1.80 NA 0.07 3.26 NA XXX 88173 26 A Cytopath eval, fna, report 1.39 0.64 0.64 0.05 2.08 2.08 XXX 88173 TC A Cytopath eval, fna, report 0.00 1.16 NA 0.02 1.18 NA XXX 88180 A Cell marker study 0.36 0.60 NA 0.03 0.99 NA XXX 88180 26 A Cell marker study 0.36 0.17 0.17 0.01 0.54 0.54 XXX 88180 TC A Cell marker study 0.00 0.43 NA 0.02 0.45 NA XXX 88182 A Cell marker study 0.77 1.81 NA 0.06 2.64 NA XXX 88182 26 A Cell marker study 0.77 0.36 0.36 0.03 1.16 1.16 XXX 88182 TC A Cell marker study 0.00 1.45 NA 0.03 1.48 NA XXX 88199 C Cytopathology procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88199 26 C Cytopathology procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88199 TC C Cytopathology procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88230 X Tissue culture, lymphocyte 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88233 X Tissue culture, skin/biopsy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88235 X Tissue culture, placenta 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88237 X Tissue culture, bone marrow 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88239 X Tissue culture, tumor 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88240 X Cell cryopreserve/storage 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88241 X Frozen cell preparation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88245 X Chromosome analysis, 20-25 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88248 X Chromosome analysis, 50-100 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88249 X Chromosome analysis, 100 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88261 X Chromosome analysis, 5 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88262 X Chromosome analysis, 15-20 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88263 X Chromosome analysis, 45 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88264 X Chromosome analysis, 20-25 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88267 X Chromosome analys, placenta 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88269 X Chromosome analys, amniotic 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88271 X Cytogenetics, dna probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88272 X Cytogenetics, 3-5 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88273 X Cytogenetics, 10-30 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88274 X Cytogenetics, 25-99 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88275 X Cytogenetics, 100-300 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88280 X Chromosome karyotype study 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88283 X Chromosome banding study 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88285 X Chromosome count, additional 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88289 X Chromosome study, additional 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88291 A Cyto/molecular report 0.52 0.23 0.23 0.02 0.77 0.77 XXX Start Printed Page 55447 88299 C Cytogenetic study 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88300 A Surgical path, gross 0.08 0.34 NA 0.02 0.44 NA XXX 88300 26 A Surgical path, gross 0.08 0.04 0.04 0.01 0.13 0.13 XXX 88300 TC A Surgical path, gross 0.00 0.30 NA 0.01 0.31 NA XXX 88302 A Tissue exam by pathologist 0.13 0.73 NA 0.03 0.89 NA XXX 88302 26 A Tissue exam by pathologist 0.13 0.06 0.06 0.01 0.20 0.20 XXX 88302 TC A Tissue exam by pathologist 0.00 0.67 NA 0.02 0.69 NA XXX 88304 A Tissue exam by pathologist 0.22 0.95 NA 0.03 1.20 NA XXX 88304 26 A Tissue exam by pathologist 0.22 0.10 0.10 0.01 0.33 0.33 XXX 88304 TC A Tissue exam by pathologist 0.00 0.85 NA 0.02 0.87 NA XXX 88305 A Tissue exam by pathologist 0.75 1.78 NA 0.05 2.58 NA XXX 88305 26 A Tissue exam by pathologist 0.75 0.35 0.35 0.02 1.12 1.12 XXX 88305 TC A Tissue exam by pathologist 0.00 1.43 NA 0.03 1.46 NA XXX 88307 A Tissue exam by pathologist 1.59 2.71 NA 0.11 4.41 NA XXX 88307 26 A Tissue exam by pathologist 1.59 0.74 0.74 0.06 2.39 2.39 XXX 88307 TC A Tissue exam by pathologist 0.00 1.97 NA 0.05 2.02 NA XXX 88309 A Tissue exam by pathologist 2.28 3.40 NA 0.13 5.81 NA XXX 88309 26 A Tissue exam by pathologist 2.28 1.05 1.05 0.08 3.41 3.41 XXX 88309 TC A Tissue exam by pathologist 0.00 2.35 NA 0.05 2.40 NA XXX 88311 A Decalcify tissue 0.24 0.21 NA 0.02 0.47 NA XXX 88311 26 A Decalcify tissue 0.24 0.11 0.11 0.01 0.36 0.36 XXX 88311 TC A Decalcify tissue 0.00 0.10 NA 0.01 0.11 NA XXX 88312 A Special stains 0.54 1.69 NA 0.03 2.26 NA XXX 88312 26 A Special stains 0.54 0.25 0.25 0.02 0.81 0.81 XXX 88312 TC A Special stains 0.00 1.44 NA 0.01 1.45 NA XXX 88313 A Special stains 0.24 1.47 NA 0.02 1.73 NA XXX 88313 26 A Special stains 0.24 0.11 0.11 0.01 0.36 0.36 XXX 88313 TC A Special stains 0.00 1.36 NA 0.01 1.37 NA XXX 88314 A Histochemical stain 0.45 0.86 NA 0.04 1.35 NA XXX 88314 26 A Histochemical stain 0.45 0.20 0.20 0.02 0.67 0.67 XXX 88314 TC A Histochemical stain 0.00 0.66 NA 0.02 0.68 NA XXX 88318 A Chemical histochemistry 0.42 0.59 NA 0.02 1.03 NA XXX 88318 26 A Chemical histochemistry 0.42 0.20 0.20 0.01 0.63 0.63 XXX 88318 TC A Chemical histochemistry 0.00 0.39 NA 0.01 0.40 NA XXX 88319 A Enzyme histochemistry 0.53 2.45 NA 0.04 3.02 NA XXX 88319 26 A Enzyme histochemistry 0.53 0.24 0.24 0.02 0.79 0.79 XXX 88319 TC A Enzyme histochemistry 0.00 2.21 NA 0.02 2.23 NA XXX 88321 A Microslide consultation 1.30 0.62 0.60 0.04 1.96 1.94 XXX 88323 A Microslide consultation 1.35 1.37 NA 0.07 2.79 NA XXX 88323 26 A Microslide consultation 1.35 0.63 0.63 0.05 2.03 2.03 XXX 88323 TC A Microslide consultation 0.00 0.74 NA 0.02 0.76 NA XXX 88325 A Comprehensive review of data 2.22 0.98 0.98 0.08 3.28 3.28 XXX 88329 A Path consult introp 0.67 0.39 0.31 0.02 1.08 1.00 XXX 88331 A Path consult intraop, 1 bloc 1.19 0.87 NA 0.07 2.13 NA XXX 88331 26 A Path consult intraop, 1 bloc 1.19 0.55 0.55 0.04 1.78 1.78 XXX 88331 TC A Path consult intraop, 1 bloc 0.00 0.32 NA 0.03 0.35 NA XXX 88332 A Path consult intraop, addl 0.59 0.47 NA 0.04 1.10 NA XXX 88332 26 A Path consult intraop, addl 0.59 0.27 0.27 0.02 0.88 0.88 XXX 88332 TC A Path consult intraop, addl 0.00 0.20 NA 0.02 0.22 NA XXX 88342 A Immunocytochemistry 0.85 1.43 NA 0.05 2.33 NA XXX 88342 26 A Immunocytochemistry 0.85 0.39 0.39 0.03 1.27 1.27 XXX 88342 TC A Immunocytochemistry 0.00 1.04 NA 0.02 1.06 NA XXX 88346 A Immunofluorescent study 0.86 1.20 NA 0.05 2.11 NA XXX 88346 26 A Immunofluorescent study 0.86 0.39 0.39 0.03 1.28 1.28 XXX 88346 TC A Immunofluorescent study 0.00 0.81 NA 0.02 0.83 NA XXX 88347 A Immunofluorescent study 0.86 1.90 NA 0.05 2.81 NA XXX 88347 26 A Immunofluorescent study 0.86 0.38 0.38 0.03 1.27 1.27 XXX 88347 TC A Immunofluorescent study 0.00 1.52 NA 0.02 1.54 NA XXX 88348 A Electron microscopy 1.51 6.96 NA 0.11 8.58 NA XXX 88348 26 A Electron microscopy 1.51 0.69 0.69 0.05 2.25 2.25 XXX 88348 TC A Electron microscopy 0.00 6.27 NA 0.06 6.33 NA XXX 88349 A Scanning electron microscopy 0.76 8.51 NA 0.08 9.35 NA XXX 88349 26 A Scanning electron microscopy 0.76 0.35 0.35 0.03 1.14 1.14 XXX 88349 TC A Scanning electron microscopy 0.00 8.16 NA 0.05 8.21 NA XXX 88355 A Analysis, skeletal muscle 1.85 2.41 NA 0.12 4.38 NA XXX 88355 26 A Analysis, skeletal muscle 1.85 0.86 0.86 0.07 2.78 2.78 XXX 88355 TC A Analysis, skeletal muscle 0.00 1.55 NA 0.05 1.60 NA XXX 88356 A Analysis, nerve 3.02 4.96 NA 0.16 8.14 NA XXX 88356 26 A Analysis, nerve 3.02 1.37 1.37 0.10 4.49 4.49 XXX 88356 TC A Analysis, nerve 0.00 3.59 NA 0.06 3.65 NA XXX 88358 A Analysis, tumor 2.82 1.76 NA 0.16 4.74 NA XXX 88358 26 A Analysis, tumor 2.82 1.30 1.30 0.10 4.22 4.22 XXX 88358 TC A Analysis, tumor 0.00 0.46 NA 0.06 0.52 NA XXX Start Printed Page 55448 88362 A Nerve teasing preparations 2.17 3.36 NA 0.12 5.65 NA XXX 88362 26 A Nerve teasing preparations 2.17 0.99 0.99 0.07 3.23 3.23 XXX 88362 TC A Nerve teasing preparations 0.00 2.37 NA 0.05 2.42 NA XXX 88365 A Tissue hybridization 0.93 2.03 NA 0.05 3.01 NA XXX 88365 26 A Tissue hybridization 0.93 0.43 0.43 0.03 1.39 1.39 XXX 88365 TC A Tissue hybridization 0.00 1.60 NA 0.02 1.62 NA XXX 88371 X Protein, western blot tissue 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88371 26 A Protein, western blot tissue 0.37 0.15 0.14 0.01 0.53 0.52 XXX 88372 X Protein analysis w/probe 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88372 26 A Protein analysis w/probe 0.37 0.17 0.17 0.01 0.55 0.55 XXX 88380 C Microdissection 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88380 26 C Microdissection 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88380 TC C Microdissection 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88399 C Surgical pathology procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88399 26 C Surgical pathology procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88399 TC C Surgical pathology procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88400 X Bilirubin total transcut 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89050 X Body fluid cell count 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89051 X Body fluid cell count 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89060 X Exam synovial fluid crystals 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89060 26 A Exam synovial fluid crystals 0.37 0.18 0.17 0.01 0.56 0.55 XXX 89100 A Sample intestinal contents 0.60 2.29 0.23 0.02 2.91 0.85 XXX 89105 A Sample intestinal contents 0.50 2.25 0.18 0.02 2.77 0.70 XXX 89125 X Specimen fat stain 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89130 A Sample stomach contents 0.45 2.21 0.13 0.02 2.68 0.60 XXX 89132 A Sample stomach contents 0.19 1.15 0.05 0.01 1.35 0.25 XXX 89135 A Sample stomach contents 0.79 2.53 0.25 0.03 3.35 1.07 XXX 89136 A Sample stomach contents 0.21 2.05 0.08 0.01 2.27 0.30 XXX 89140 A Sample stomach contents 0.94 2.36 0.19 0.03 3.33 1.16 XXX 89141 A Sample stomach contents 0.85 3.14 0.40 0.03 4.02 1.28 XXX 89160 X Exam feces for meat fibers 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89190 X Nasal smear for eosinophils 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89250 X Fertilization of oocyte 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89251 X Culture oocyte w/embryos 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89252 X Assist oocyte fertilization 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89253 X Embryo hatching 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89254 X Oocyte identification 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89255 X Prepare embryo for transfer 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89256 X Prepare cryopreserved embryo 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89257 X Sperm identification 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89258 X Cryopreservation, embryo 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89259 X Cryopreservation, sperm 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89260 X Sperm isolation, simple 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89261 X Sperm isolation, complex 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89264 X Identify sperm tissue 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89300 X Semen analysis 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89310 X Semen analysis 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89320 X Semen analysis 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89321 X Semen analysis 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89325 X Sperm antibody test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89329 X Sperm evaluation test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89330 X Evaluation, cervical mucus 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89350 A Sputum specimen collection 0.00 0.39 NA 0.02 0.41 NA XXX 89355 X Exam feces for starch 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89360 A Collect sweat for test 0.00 0.43 NA 0.02 0.45 NA XXX 89365 X Water load test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89399 C Pathology lab procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89399 26 C Pathology lab procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89399 TC C Pathology lab procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90281 I Human ig, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90283 I Human ig, iv 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90287 I Botulinum antitoxin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90288 I Botulism ig, iv 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90291 I Cmv ig, iv 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90296 E Diphtheria antitoxin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90371 E Hep b ig, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90375 E Rabies ig, im/sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90376 E Rabies ig, heat treated 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90378 X Rsv ig, im, 50mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90379 I Rsv ig, iv 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90384 I Rh ig, full-dose, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90385 E Rh ig, minidose, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90386 I Rh ig, iv 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55449 90389 I Tetanus ig, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90393 E Vaccina ig, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90396 E Varicella-zoster ig, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90399 I Immune globulin 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90471 A Immunization admin 0.00 0.10 NA 0.01 0.11 NA XXX 90472 A Immunization admin, each add 0.00 0.10 NA 0.01 0.11 NA ZZZ 90473 N Immune admin oral/nasal 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90474 N Immune admin oral/nasal addl 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 90476 E Adenovirus vaccine, type 4 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90477 E Adenovirus vaccine, type 7 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90581 E Anthrax vaccine, sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90585 E Bcg vaccine, percut 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90586 E Bcg vaccine, intravesical 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90632 E Hep a vaccine, adult im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90633 E Hep a vacc, ped/adol, 2 dose 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90634 E Hep a vacc, ped/adol, 3 dose 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90636 E Hep a/hep b vacc, adult im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90645 E Hib vaccine, hboc, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90646 E Hib vaccine, prp-d, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90647 E Hib vaccine, prp-omp, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90648 E Hib vaccine, prp-t, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90657 X Flu vaccine, 6-35 mo, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90658 X Flu vaccine, 3 yrs, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90659 X Flu vaccine, whole, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90660 X Flu vaccine, nasal 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90665 E Lyme disease vaccine, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90669 N Pneumococcal vacc, ped<5 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90675 E Rabies vaccine, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90676 E Rabies vaccine, id 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90680 E Rotovirus vaccine, oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90690 E Typhoid vaccine, oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90691 E Typhoid vaccine, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90692 E Typhoid vaccine, h-p, sc/id 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90693 E Typhoid vaccine, akd, sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90700 E Dtap vaccine, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90701 E Dtp vaccine, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90702 E Dt vaccine < 7, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90703 E Tetanus vaccine, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90704 E Mumps vaccine, sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90705 E Measles vaccine, sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90706 E Rubella vaccine, sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90707 E Mmr vaccine, sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90708 E Measles-rubella vaccine, sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90709 E Rubella & mumps vaccine, sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90710 E Mmrv vaccine, sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90712 E Oral poliovirus vaccine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90713 E Poliovirus, ipv, sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90716 E Chicken pox vaccine, sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90717 E Yellow fever vaccine, sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90718 E Td vaccine > 7, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90719 E Diphtheria vaccine, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90720 E Dtp/hib vaccine, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90721 E Dtap/hib vaccine, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90723 X Dtap-hep b-ipv vaccine, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90725 E Cholera vaccine, injectable 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90727 E Plague vaccine, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90732 X Pneumococcal vaccine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90733 E Meningococcal vaccine, sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90735 E Encephalitis vaccine, sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90740 X Hepb vacc, ill pat 3 dose im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90743 X Hep b vacc, adol, 2 dose, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90744 X Hepb vacc ped/adol 3 dose im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90746 X Hep b vaccine, adult, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90747 X Hepb vacc, ill pat 4 dose im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90748 E Hep b/hib vaccine, im 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90749 E Vaccine toxoid 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90780 A IV infusion therapy, 1 hour 0.00 1.06 NA 0.06 1.12 NA XXX 90781 A IV infusion, additional hour 0.00 0.53 NA 0.03 0.56 NA ZZZ 90782 T Injection, sc/im 0.00 0.10 NA 0.01 0.11 NA XXX 90783 T Injection, ia 0.00 0.39 NA 0.02 0.41 NA XXX 90784 T Injection, iv 0.00 0.45 NA 0.03 0.48 NA XXX 90788 T Injection of antibiotic 0.00 0.11 NA 0.01 0.12 NA XXX 90799 C Ther/prophylactic/dx inject 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55450 90801 A Psy dx interview 2.80 1.14 0.93 0.06 4.00 3.79 XXX 90802 A Intac psy dx interview 3.01 1.17 0.99 0.07 4.25 4.07 XXX 90804 A Psytx, office, 20-30 min 1.21 0.53 0.40 0.03 1.77 1.64 XXX 90805 A Psytx, off, 20-30 min w/e&m 1.37 0.59 0.44 0.03 1.99 1.84 XXX 90806 A Psytx, off, 45-50 min 1.86 0.75 0.62 0.04 2.65 2.52 XXX 90807 A Psytx, off, 45-50 min w/e&m 2.02 0.79 0.66 0.05 2.86 2.73 XXX 90808 A Psytx, office, 75-80 min 2.79 1.06 0.93 0.07 3.92 3.79 XXX 90809 A Psytx, off, 75-80, w/e&m 2.95 1.11 0.97 0.07 4.13 3.99 XXX 90810 A Intac psytx, off, 20-30 min 1.32 0.56 0.44 0.03 1.91 1.79 XXX 90811 A Intac psytx, 20-30, w/e&m 1.48 0.63 0.48 0.03 2.14 1.99 XXX 90812 A Intac psytx, off, 45-50 min 1.97 0.80 0.69 0.05 2.82 2.71 XXX 90813 A Intac psytx, 45-50 min w/e&m 2.13 0.87 0.71 0.05 3.05 2.89 XXX 90814 A Intac psytx, off, 75-80 min 2.90 1.15 1.01 0.07 4.12 3.98 XXX 90815 A Intac psytx, 75-80 w/e&m 3.06 1.15 1.02 0.07 4.28 4.15 XXX 90816 A Psytx, hosp, 20-30 min 1.25 0.57 0.43 0.03 1.85 1.71 XXX 90817 A Psytx, hosp, 20-30 min w/e&m 1.41 0.62 0.45 0.03 2.06 1.89 XXX 90818 A Psytx, hosp, 45-50 min 1.89 0.80 0.65 0.04 2.73 2.58 XXX 90819 A Psytx, hosp, 45-50 min w/e&m 2.05 0.83 0.66 0.05 2.93 2.76 XXX 90821 A Psytx, hosp, 75-80 min 2.83 1.11 0.97 0.06 4.00 3.86 XXX 90822 A Psytx, hosp, 75-80 min w/e&m 2.99 1.30 0.97 0.07 4.36 4.03 XXX 90823 A Intac psytx, hosp, 20-30 min 1.36 0.65 0.45 0.03 2.04 1.84 XXX 90824 A Intac psytx, hsp 20-30 w/e&m 1.52 0.70 0.50 0.03 2.25 2.05 XXX 90826 A Intac psytx, hosp, 45-50 min 2.01 0.89 0.68 0.04 2.94 2.73 XXX 90827 A Intac psytx, hsp 45-50 w/e&m 2.16 0.91 0.70 0.05 3.12 2.91 XXX 90828 A Intac psytx, hosp, 75-80 min 2.94 1.90 1.02 0.07 4.91 4.03 XXX 90829 A Intac psytx, hsp 75-80 w/e&m 3.10 1.23 1.02 0.07 4.40 4.19 XXX 90845 A Psychoanalysis 1.79 0.71 0.57 0.04 2.54 2.40 XXX 90846 R Family psytx w/o patient 1.83 0.73 0.62 0.04 2.60 2.49 XXX 90847 R Family psytx w/patient 2.21 0.86 0.75 0.05 3.12 3.01 XXX 90849 R Multiple family group psytx 0.59 0.31 0.20 0.01 0.91 0.80 XXX 90853 A Group psychotherapy 0.59 0.35 0.20 0.01 0.95 0.80 XXX 90857 A Intac group psytx 0.63 0.37 0.21 0.02 1.02 0.86 XXX 90862 A Medication management 0.95 0.44 0.31 0.02 1.41 1.28 XXX 90865 A Narcosynthesis 2.84 1.70 0.94 0.07 4.61 3.85 XXX 90870 A Electroconvulsive therapy 1.88 0.74 0.74 0.04 2.66 2.66 000 90871 A Electroconvulsive therapy 2.72 NA 1.04 0.06 NA 3.82 000 90875 N Psychophysiological therapy +1.20 0.90 0.48 0.03 2.13 1.71 XXX 90876 N Psychophysiological therapy +1.90 1.18 0.76 0.04 3.12 2.70 XXX 90880 A Hypnotherapy 2.19 0.91 0.71 0.05 3.15 2.95 XXX 90882 N Environmental manipulation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90885 B Psy evaluation of records +0.97 0.39 0.39 0.02 1.38 1.38 XXX 90887 B Consultation with family +1.48 0.83 0.59 0.03 2.34 2.10 XXX 90889 B Preparation of report 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90899 C Psychiatric service/therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90901 A Biofeedback train, any meth 0.41 0.82 0.17 0.02 1.25 0.60 000 90911 A Biofeedback peri/uro/rectal 0.89 0.87 0.39 0.04 1.80 1.32 000 90918 A ESRD related services, month 11.18 5.53 5.53 0.30 17.01 17.01 XXX 90919 A ESRD related services, month 8.54 4.53 4.53 0.24 13.31 13.31 XXX 90920 A ESRD related services, month 7.27 4.02 4.02 0.19 11.48 11.48 XXX 90921 A ESRD related services, month 4.47 2.96 2.96 0.12 7.55 7.55 XXX 90922 A ESRD related services, day 0.37 0.17 0.17 0.01 0.55 0.55 XXX 90923 A ESRD related services, day 0.28 0.15 0.15 0.01 0.44 0.44 XXX 90924 A ESRD related services, day 0.24 0.13 0.13 0.01 0.38 0.38 XXX 90925 A ESRD related services, day 0.15 0.10 0.10 0.01 0.26 0.26 XXX 90935 A Hemodialysis, one evaluation 1.22 NA 0.86 0.03 NA 2.11 000 90937 A Hemodialysis, repeated eval 2.11 NA 1.20 0.06 NA 3.37 000 90939 X Hemodialysis study, transcut 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90940 X Hemodialysis access study 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90945 A Dialysis, one evaluation 1.28 NA 0.89 0.04 NA 2.21 000 90947 A Dialysis, repeated eval 2.16 NA 1.24 0.06 NA 3.46 000 90989 X Dialysis training, complete 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90993 X Dialysis training, incompl 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90997 A Hemoperfusion 1.84 NA 1.10 0.05 NA 2.99 000 90999 C Dialysis procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 91000 A Esophageal intubation 0.73 0.32 NA 0.04 1.09 NA 000 91000 26 A Esophageal intubation 0.73 0.25 0.25 0.03 1.01 1.01 000 91000 TC A Esophageal intubation 0.00 0.07 NA 0.01 0.08 NA 000 91010 A Esophagus motility study 1.25 2.60 NA 0.10 3.95 NA 000 91010 26 A Esophagus motility study 1.25 0.46 0.46 0.05 1.76 1.76 000 91010 TC A Esophagus motility study 0.00 2.14 NA 0.05 2.19 NA 000 91011 A Esophagus motility study 1.50 2.71 NA 0.10 4.31 NA 000 91011 26 A Esophagus motility study 1.50 0.55 0.55 0.05 2.10 2.10 000 91011 TC A Esophagus motility study 0.00 2.16 NA 0.05 2.21 NA 000 Start Printed Page 55451 91012 A Esophagus motility study 1.46 2.35 NA 0.12 3.93 NA 000 91012 26 A Esophagus motility study 1.46 0.54 0.54 0.06 2.06 2.06 000 91012 TC A Esophagus motility study 0.00 1.81 NA 0.06 1.87 NA 000 91020 A Gastric motility 1.44 2.96 NA 0.11 4.51 NA 000 91020 26 A Gastric motility 1.44 0.51 0.51 0.06 2.01 2.01 000 91020 TC A Gastric motility 0.00 2.45 NA 0.05 2.50 NA 000 91030 A Acid perfusion of esophagus 0.91 2.27 NA 0.05 3.23 NA 000 91030 26 A Acid perfusion of esophagus 0.91 0.34 0.34 0.03 1.28 1.28 000 91030 TC A Acid perfusion of esophagus 0.00 1.93 NA 0.02 1.95 NA 000 91032 A Esophagus, acid reflux test 1.21 2.26 NA 0.10 3.57 NA 000 91032 26 A Esophagus, acid reflux test 1.21 0.44 0.44 0.05 1.70 1.70 000 91032 TC A Esophagus, acid reflux test 0.00 1.82 NA 0.05 1.87 NA 000 91033 A Prolonged acid reflux test 1.30 2.64 NA 0.14 4.08 NA 000 91033 26 A Prolonged acid reflux test 1.30 0.48 0.48 0.05 1.83 1.83 000 91033 TC A Prolonged acid reflux test 0.00 2.16 NA 0.09 2.25 NA 000 91052 A Gastric analysis test 0.79 2.19 NA 0.05 3.03 NA 000 91052 26 A Gastric analysis test 0.79 0.29 0.29 0.03 1.11 1.11 000 91052 TC A Gastric analysis test 0.00 1.90 NA 0.02 1.92 NA 000 91055 A Gastric intubation for smear 0.94 2.22 NA 0.06 3.22 NA 000 91055 26 A Gastric intubation for smear 0.94 0.28 0.28 0.04 1.26 1.26 000 91055 TC A Gastric intubation for smear 0.00 1.94 NA 0.02 1.96 NA 000 91060 A Gastric saline load test 0.45 0.28 NA 0.04 0.77 NA 000 91060 26 A Gastric saline load test 0.45 0.15 0.15 0.02 0.62 0.62 000 91060 TC A Gastric saline load test 0.00 0.13 NA 0.02 0.15 NA 000 91065 A Breath hydrogen test 0.20 4.55 NA 0.03 4.78 NA 000 91065 26 A Breath hydrogen test 0.20 0.07 0.07 0.01 0.28 0.28 000 91065 TC A Breath hydrogen test 0.00 4.48 NA 0.02 4.50 NA 000 91100 A Pass intestine bleeding tube 1.08 NA 0.48 0.06 NA 1.62 000 91105 A Gastric intubation treatment 0.37 NA 0.21 0.02 NA 0.60 000 91122 A Anal pressure record 1.77 2.77 NA 0.17 4.71 NA 000 91122 26 A Anal pressure record 1.77 0.63 0.63 0.10 2.50 2.50 000 91122 TC A Anal pressure record 0.00 2.14 NA 0.07 2.21 NA 000 91123 B Irrigate fecal impaction 0.00 0.00 0.00 0.00 0.00 0.00 XXX 91132 C Electrogastrography 0.00 0.00 0.00 0.00 0.00 0.00 XXX 91132 26 A Electrogastrography 0.52 0.21 NA 0.03 0.76 NA XXX 91132 TC C Electrogastrography 0.00 0.00 0.00 0.00 0.00 0.00 XXX 91133 C Electrogastrography w/test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 91133 26 A Electrogastrography w/test 0.66 0.26 NA 0.03 0.95 NA XXX 91133 TC C Electrogastrography w/test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 91299 C Gastroenterology procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 91299 26 C Gastroenterology procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 91299 TC C Gastroenterology procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92002 A Eye exam, new patient 0.88 0.96 0.38 0.02 1.86 1.28 XXX 92004 A Eye exam, new patient 1.67 1.71 0.73 0.03 3.41 2.43 XXX 92012 A Eye exam established pat 0.67 1.01 0.31 0.01 1.69 0.99 XXX 92014 A Eye exam & treatment 1.10 1.40 0.50 0.02 2.52 1.62 XXX 92015 N Refraction +0.38 1.51 0.15 0.01 1.90 0.54 XXX 92018 A New eye exam & treatment 2.50 NA 1.14 0.03 NA 3.67 XXX 92019 A Eye exam & treatment 1.31 NA 0.61 0.03 NA 1.95 XXX 92020 A Special eye evaluation 0.37 0.95 0.17 0.01 1.33 0.55 XXX 92060 A Special eye evaluation 0.69 0.74 NA 0.02 1.45 NA XXX 92060 26 A Special eye evaluation 0.69 0.31 0.31 0.01 1.01 1.01 XXX 92060 TC A Special eye evaluation 0.00 0.43 NA 0.01 0.44 NA XXX 92065 A Orthoptic/pleoptic training 0.37 1.19 NA 0.02 1.58 NA XXX 92065 26 A Orthoptic/pleoptic training 0.37 0.15 0.15 0.01 0.53 0.53 XXX 92065 TC A Orthoptic/pleoptic training 0.00 1.04 NA 0.01 1.05 NA XXX 92070 A Fitting of contact lens 0.70 1.12 0.34 0.01 1.83 1.05 XXX 92081 A Visual field examination(s) 0.36 1.84 NA 0.02 2.22 NA XXX 92081 26 A Visual field examination(s) 0.36 0.16 0.16 0.01 0.53 0.53 XXX 92081 TC A Visual field examination(s) 0.00 1.68 NA 0.01 1.69 NA XXX 92082 A Visual field examination(s) 0.44 0.85 NA 0.02 1.31 NA XXX 92082 26 A Visual field examination(s) 0.44 0.20 0.20 0.01 0.65 0.65 XXX 92082 TC A Visual field examination(s) 0.00 0.65 NA 0.01 0.66 NA XXX 92083 A Visual field examination(s) 0.50 1.51 NA 0.02 2.03 NA XXX 92083 26 A Visual field examination(s) 0.50 0.23 0.23 0.01 0.74 0.74 XXX 92083 TC A Visual field examination(s) 0.00 1.28 NA 0.01 1.29 NA XXX 92100 A Serial tonometry exam(s) 0.92 0.75 0.40 0.02 1.69 1.34 XXX 92120 A Tonography & eye evaluation 0.81 0.81 0.31 0.02 1.64 1.14 XXX 92130 A Water provocation tonography 0.81 0.92 0.32 0.02 1.75 1.15 XXX 92135 A Ophthalmic dx imaging 0.35 1.48 NA 0.02 1.85 NA XXX 92135 26 A Ophthalmic dx imaging 0.35 0.17 0.17 0.01 0.53 0.53 XXX 92135 TC A Ophthalmic dx imaging 0.00 1.31 NA 0.01 1.32 NA XXX 92136 A Ophthalmic biometry 0.54 1.52 NA 0.07 2.13 NA XXX Start Printed Page 55452 92136 26 A Ophthalmic biometry 0.54 0.22 0.22 0.01 0.77 0.77 XXX 92136 TC A Ophthalmic biometry 0.00 1.30 NA 0.06 1.36 NA XXX 92140 A Glaucoma provocative tests 0.50 1.01 0.22 0.01 1.52 0.73 XXX 92225 A Special eye exam, initial 0.38 0.23 0.17 0.01 0.62 0.56 XXX 92226 A Special eye exam, subsequent 0.33 0.22 0.15 0.01 0.56 0.49 XXX 92230 A Eye exam with photos 0.60 1.73 0.21 0.02 2.35 0.83 XXX 92235 A Eye exam with photos 0.81 2.62 NA 0.07 3.50 NA XXX 92235 26 A Eye exam with photos 0.81 0.39 0.39 0.02 1.22 1.22 XXX 92235 TC A Eye exam with photos 0.00 2.23 NA 0.05 2.28 NA XXX 92240 A Icg angiography 1.10 5.24 NA 0.07 6.41 NA XXX 92240 26 A Icg angiography 1.10 0.53 0.53 0.02 1.65 1.65 XXX 92240 TC A Icg angiography 0.00 4.71 NA 0.05 4.76 NA XXX 92250 A Eye exam with photos 0.44 1.37 NA 0.02 1.83 NA XXX 92250 26 A Eye exam with photos 0.44 0.20 0.20 0.01 0.65 0.65 XXX 92250 TC A Eye exam with photos 0.00 1.17 NA 0.01 1.18 NA XXX 92260 A Ophthalmoscopy/dynamometry 0.20 0.24 0.10 0.01 0.45 0.31 XXX 92265 A Eye muscle evaluation 0.81 1.23 NA 0.04 2.08 NA XXX 92265 26 A Eye muscle evaluation 0.81 0.38 0.38 0.02 1.21 1.21 XXX 92265 TC A Eye muscle evaluation 0.00 0.85 NA 0.02 0.87 NA XXX 92270 A Electro-oculography 0.81 1.15 NA 0.05 2.01 NA XXX 92270 26 A Electro-oculography 0.81 0.37 0.37 0.03 1.21 1.21 XXX 92270 TC A Electro-oculography 0.00 0.78 NA 0.02 0.80 NA XXX 92275 A Electroretinography 1.01 1.25 NA 0.04 2.30 NA XXX 92275 26 A Electroretinography 1.01 0.46 0.46 0.02 1.49 1.49 XXX 92275 TC A Electroretinography 0.00 0.79 NA 0.02 0.81 NA XXX 92283 A Color vision examination 0.17 0.74 NA 0.02 0.93 NA XXX 92283 26 A Color vision examination 0.17 0.07 0.07 0.01 0.25 0.25 XXX 92283 TC A Color vision examination 0.00 0.67 NA 0.01 0.68 NA XXX 92284 A Dark adaptation eye exam 0.24 1.75 NA 0.02 2.01 NA XXX 92284 26 A Dark adaptation eye exam 0.24 0.09 0.09 0.01 0.34 0.34 XXX 92284 TC A Dark adaptation eye exam 0.00 1.66 NA 0.01 1.67 NA XXX 92285 A Eye photography 0.20 0.80 NA 0.02 1.02 NA XXX 92285 26 A Eye photography 0.20 0.09 0.09 0.01 0.30 0.30 XXX 92285 TC A Eye photography 0.00 0.71 NA 0.01 0.72 NA XXX 92286 A Internal eye photography 0.66 3.00 NA 0.03 3.69 NA XXX 92286 26 A Internal eye photography 0.66 0.32 0.32 0.01 0.99 0.99 XXX 92286 TC A Internal eye photography 0.00 2.68 NA 0.02 2.70 NA XXX 92287 A Internal eye photography 0.81 3.16 0.31 0.02 3.99 1.14 XXX 92310 N Contact lens fitting +1.17 1.10 0.47 0.03 2.30 1.67 XXX 92311 A Contact lens fitting 1.08 1.17 0.31 0.03 2.28 1.42 XXX 92312 A Contact lens fitting 1.26 1.17 0.45 0.03 2.46 1.74 XXX 92313 A Contact lens fitting 0.92 1.21 0.33 0.02 2.15 1.27 XXX 92314 N Prescription of contact lens +0.69 0.91 0.28 0.01 1.61 0.98 XXX 92315 A Prescription of contact lens 0.45 0.95 0.17 0.01 1.41 0.63 XXX 92316 A Prescription of contact lens 0.68 1.03 0.30 0.01 1.72 0.99 XXX 92317 A Prescription of contact lens 0.45 0.97 0.18 0.01 1.43 0.64 XXX 92325 A Modification of contact lens 0.00 0.38 NA 0.01 0.39 NA XXX 92326 A Replacement of contact lens 0.00 1.55 NA 0.05 1.60 NA XXX 92330 A Fitting of artificial eye 1.08 1.01 0.38 0.04 2.13 1.50 XXX 92335 A Fitting of artificial eye 0.45 0.99 0.17 0.01 1.45 0.63 XXX 92340 N Fitting of spectacles +0.37 0.68 0.15 0.01 1.06 0.53 XXX 92341 N Fitting of spectacles +0.47 0.72 0.19 0.01 1.20 0.67 XXX 92342 N Fitting of spectacles +0.53 0.74 0.21 0.01 1.28 0.75 XXX 92352 B Special spectacles fitting +0.37 0.68 0.15 0.01 1.06 0.53 XXX 92353 B Special spectacles fitting +0.50 0.73 0.20 0.02 1.25 0.72 XXX 92354 B Special spectacles fitting +0.00 8.41 NA 0.08 8.49 NA XXX 92355 B Special spectacles fitting +0.00 4.11 NA 0.01 4.12 NA XXX 92358 B Eye prosthesis service +0.00 0.92 NA 0.04 0.96 NA XXX 92370 N Repair & adjust spectacles +0.32 0.54 0.13 0.02 0.88 0.47 XXX 92371 B Repair & adjust spectacles +0.00 0.59 NA 0.02 0.61 NA XXX 92390 N Supply of spectacles 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92391 N Supply of contact lenses 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92392 I Supply of low vision aids +0.00 3.84 NA 0.02 3.86 NA XXX 92393 I Supply of artificial eye +0.00 11.92 NA 0.47 12.39 NA XXX 92395 I Supply of spectacles +0.00 1.30 NA 0.08 1.38 NA XXX 92396 I Supply of contact lenses +0.00 2.19 NA 0.06 2.25 NA XXX 92499 C Eye service or procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92499 26 C Eye service or procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92499 TC C Eye service or procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92502 A Ear and throat examination 1.51 NA 1.28 0.06 NA 2.85 000 92504 A Ear microscopy examination 0.18 1.10 0.09 0.01 1.29 0.28 XXX 92506 A Speech/hearing evaluation 0.86 1.72 0.43 0.04 2.62 1.33 XXX 92507 A Speech/hearing therapy 0.52 1.54 0.28 0.02 2.08 0.82 XXX Start Printed Page 55453 92508 A Speech/hearing therapy 0.26 1.77 0.15 0.01 2.04 0.42 XXX 92510 A Rehab for ear implant 1.50 2.11 0.83 0.06 3.67 2.39 XXX 92511 A Nasopharyngoscopy 0.84 1.36 0.42 0.03 2.23 1.29 000 92512 A Nasal function studies 0.55 1.13 0.17 0.02 1.70 0.74 XXX 92516 A Facial nerve function test 0.43 0.94 0.24 0.02 1.39 0.69 XXX 92520 A Laryngeal function studies 0.76 0.52 0.43 0.03 1.31 1.22 XXX 92525 I Oral function evaluation +1.50 1.69 0.60 0.07 3.26 2.17 XXX 92526 A Oral function therapy 0.55 1.55 0.27 0.02 2.12 0.84 XXX 92531 B Spontaneous nystagmus study 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92532 B Positional nystagmus test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92533 B Caloric vestibular test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92534 B Optokinetic nystagmus test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92541 A Spontaneous nystagmus test 0.40 1.45 NA 0.04 1.89 NA XXX 92541 26 A Spontaneous nystagmus test 0.40 0.20 0.20 0.02 0.62 0.62 XXX 92541 TC A Spontaneous nystagmus test 0.00 1.25 NA 0.02 1.27 NA XXX 92542 A Positional nystagmus test 0.33 1.39 NA 0.03 1.75 NA XXX 92542 26 A Positional nystagmus test 0.33 0.17 0.17 0.01 0.51 0.51 XXX 92542 TC A Positional nystagmus test 0.00 1.22 NA 0.02 1.24 NA XXX 92543 A Caloric vestibular test 0.10 0.39 NA 0.02 0.51 NA XXX 92543 26 A Caloric vestibular test 0.10 0.05 0.05 0.01 0.16 0.16 XXX 92543 TC A Caloric vestibular test 0.00 0.34 NA 0.01 0.35 NA XXX 92544 A Optokinetic nystagmus test 0.26 1.35 NA 0.03 1.64 NA XXX 92544 26 A Optokinetic nystagmus test 0.26 0.13 0.13 0.01 0.40 0.40 XXX 92544 TC A Optokinetic nystagmus test 0.00 1.22 NA 0.02 1.24 NA XXX 92545 A Oscillating tracking test 0.23 1.32 NA 0.03 1.58 NA XXX 92545 26 A Oscillating tracking test 0.23 0.12 0.12 0.01 0.36 0.36 XXX 92545 TC A Oscillating tracking test 0.00 1.20 NA 0.02 1.22 NA XXX 92546 A Sinusoidal rotational test 0.29 2.22 NA 0.03 2.54 NA XXX 92546 26 A Sinusoidal rotational test 0.29 0.14 0.14 0.01 0.44 0.44 XXX 92546 TC A Sinusoidal rotational test 0.00 2.08 NA 0.02 2.10 NA XXX 92547 A Supplemental electrical test 0.00 1.21 NA 0.05 1.26 NA ZZZ 92548 A Posturography 0.50 2.09 NA 0.13 2.72 NA XXX 92548 26 A Posturography 0.50 0.28 0.28 0.02 0.80 0.80 XXX 92548 TC A Posturography 0.00 1.81 NA 0.11 1.92 NA XXX 92551 N Pure tone hearing test, air 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92552 A Pure tone audiometry, air 0.00 0.42 NA 0.03 0.45 NA XXX 92553 A Audiometry, air & bone 0.00 0.62 NA 0.05 0.67 NA XXX 92555 A Speech threshold audiometry 0.00 0.36 NA 0.03 0.39 NA XXX 92556 A Speech audiometry, complete 0.00 0.54 NA 0.05 0.59 NA XXX 92557 A Comprehensive hearing test 0.00 1.13 NA 0.10 1.23 NA XXX 92559 N Group audiometric testing 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92560 N Bekesy audiometry, screen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92561 A Bekesy audiometry, diagnosis 0.00 0.68 NA 0.05 0.73 NA XXX 92562 A Loudness balance test 0.00 0.39 NA 0.03 0.42 NA XXX 92563 A Tone decay hearing test 0.00 0.36 NA 0.03 0.39 NA XXX 92564 A Sisi hearing test 0.00 0.45 NA 0.04 0.49 NA XXX 92565 A Stenger test, pure tone 0.00 0.38 NA 0.03 0.41 NA XXX 92567 A Tympanometry 0.00 0.50 NA 0.05 0.55 NA XXX 92568 A Acoustic reflex testing 0.00 0.36 NA 0.03 0.39 NA XXX 92569 A Acoustic reflex decay test 0.00 0.39 NA 0.03 0.42 NA XXX 92571 A Filtered speech hearing test 0.00 0.37 NA 0.03 0.40 NA XXX 92572 A Staggered spondaic word test 0.00 0.08 NA 0.01 0.09 NA XXX 92573 A Lombard test 0.00 0.33 NA 0.03 0.36 NA XXX 92575 A Sensorineural acuity test 0.00 0.28 NA 0.02 0.30 NA XXX 92576 A Synthetic sentence test 0.00 0.42 NA 0.04 0.46 NA XXX 92577 A Stenger test, speech 0.00 0.68 NA 0.06 0.74 NA XXX 92579 A Visual audiometry (vra) 0.00 0.69 NA 0.05 0.74 NA XXX 92582 A Conditioning play audiometry 0.00 0.69 NA 0.05 0.74 NA XXX 92583 A Select picture audiometry 0.00 0.84 NA 0.07 0.91 NA XXX 92584 A Electrocochleography 0.00 2.35 NA 0.17 2.52 NA XXX 92585 A Auditor evoke potent, compre 0.50 1.98 NA 0.14 2.62 NA XXX 92585 26 A Auditor evoke potent, compre 0.50 0.23 0.23 0.02 0.75 0.75 XXX 92585 TC A Auditor evoke potent, compre 0.00 1.75 NA 0.12 1.87 NA XXX 92586 A Auditor evoke potent, limit 0.00 1.75 NA 0.12 1.87 NA XXX 92587 A Evoked auditory test 0.13 1.31 NA 0.10 1.54 NA XXX 92587 26 A Evoked auditory test 0.13 0.07 0.07 0.01 0.21 0.21 XXX 92587 TC A Evoked auditory test 0.00 1.24 NA 0.09 1.33 NA XXX 92588 A Evoked auditory test 0.36 1.58 NA 0.12 2.06 NA XXX 92588 26 A Evoked auditory test 0.36 0.18 0.18 0.01 0.55 0.55 XXX 92588 TC A Evoked auditory test 0.00 1.40 NA 0.11 1.51 NA XXX 92589 A Auditory function test(s) 0.00 0.51 NA 0.05 0.56 NA XXX 92590 N Hearing aid exam, one ear 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92591 N Hearing aid exam, both ears 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55454 92592 N Hearing aid check, one ear 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92593 N Hearing aid check, both ears 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92594 N Electro hearng aid test, one 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92595 N Electro hearng aid tst, both 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92596 A Ear protector evaluation 0.00 0.56 NA 0.05 0.61 NA XXX 92599 C ENT procedure/service 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92599 26 C ENT procedure/service 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92599 TC C ENT procedure/service 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92950 A Heart/lung resuscitation cpr 3.80 1.59 1.18 0.21 5.60 5.19 000 92953 A Temporary external pacing 0.23 NA 0.23 0.01 NA 0.47 000 92960 A Cardioversion electric, ext 2.25 2.23 0.91 0.08 4.56 3.24 000 92961 A Cardioversion, electric, int 4.60 NA 1.85 0.17 NA 6.62 000 92970 A Cardioassist, internal 3.52 NA 1.27 0.17 NA 4.96 000 92971 A Cardioassist, external 1.77 NA 0.86 0.06 NA 2.69 000 92973 A Percut coronary thrombectomy 3.28 NA 1.37 0.17 NA 4.82 ZZZ 92974 A Cath place, cardio brachytx 3.00 NA 1.26 1.18 NA 5.44 ZZZ 92975 A Dissolve clot, heart vessel 7.25 NA 3.01 0.22 NA 10.48 000 92977 A Dissolve clot, heart vessel 0.00 7.65 NA 0.38 8.03 NA XXX 92978 A Intravasc us, heart add-on 1.80 5.09 NA 0.26 7.15 NA ZZZ 92978 26 A Intravasc us, heart add-on 1.80 0.76 0.76 0.06 2.62 2.62 ZZZ 92978 TC A Intravasc us, heart add-on 0.00 4.33 NA 0.20 4.53 NA ZZZ 92979 A Intravasc us, heart add-on 1.44 2.76 NA 0.15 4.35 NA ZZZ 92979 26 A Intravasc us, heart add-on 1.44 0.58 0.58 0.04 2.06 2.06 ZZZ 92979 TC A Intravasc us, heart add-on 0.00 2.18 NA 0.11 2.29 NA ZZZ 92980 A Insert intracoronary stent 14.84 NA 6.22 0.78 NA 21.84 000 92981 A Insert intracoronary stent 4.17 NA 1.75 0.21 NA 6.13 ZZZ 92982 A Coronary artery dilation 10.98 NA 4.59 0.57 NA 16.14 000 92984 A Coronary artery dilation 2.97 NA 1.24 0.16 NA 4.37 ZZZ 92986 A Revision of aortic valve 21.80 NA 10.43 1.14 NA 33.37 090 92987 A Revision of mitral valve 22.70 NA 10.85 1.18 NA 34.73 090 92990 A Revision of pulmonary valve 17.34 NA 8.41 0.90 NA 26.65 090 92992 C Revision of heart chamber 0.00 0.00 0.00 0.00 0.00 0.00 090 92993 C Revision of heart chamber 0.00 0.00 0.00 0.00 0.00 0.00 090 92995 A Coronary atherectomy 12.09 NA 5.06 0.63 NA 17.78 000 92996 A Coronary atherectomy add-on 3.26 NA 1.37 0.17 NA 4.80 ZZZ 92997 A Pul art balloon repr, percut 12.00 NA 4.55 0.63 NA 17.18 000 92998 A Pul art balloon repr, percut 6.00 NA 2.06 0.31 NA 8.37 ZZZ 93000 A Electrocardiogram, complete 0.17 0.50 NA 0.03 0.70 NA XXX 93005 A Electrocardiogram, tracing 0.00 0.43 NA 0.02 0.45 NA XXX 93010 A Electrocardiogram report 0.17 0.07 0.07 0.01 0.25 0.25 XXX 93012 A Transmission of ecg 0.00 2.24 NA 0.15 2.39 NA XXX 93014 A Report on transmitted ecg 0.52 0.19 0.19 0.02 0.73 0.73 XXX 93015 A Cardiovascular stress test 0.75 1.90 NA 0.11 2.76 NA XXX 93016 A Cardiovascular stress test 0.45 0.18 0.18 0.01 0.64 0.64 XXX 93017 A Cardiovascular stress test 0.00 1.60 NA 0.09 1.69 NA XXX 93018 A Cardiovascular stress test 0.30 0.12 0.12 0.01 0.43 0.43 XXX 93024 A Cardiac drug stress test 1.17 1.55 NA 0.11 2.83 NA XXX 93024 26 A Cardiac drug stress test 1.17 0.48 0.48 0.04 1.69 1.69 XXX 93024 TC A Cardiac drug stress test 0.00 1.07 NA 0.07 1.14 NA XXX 93025 A Microvolt t-wave assess 0.75 6.42 NA 0.11 7.28 NA XXX 93040 A Rhythm ECG with report 0.16 0.19 NA 0.02 0.37 NA XXX 93041 A Rhythm ECG, tracing 0.00 0.14 NA 0.01 0.15 NA XXX 93042 A Rhythm ECG, report 0.16 0.05 0.05 0.01 0.22 0.22 XXX 93224 A ECG monitor/report, 24 hrs 0.52 3.47 NA 0.21 4.20 NA XXX 93225 A ECG monitor/record, 24 hrs 0.00 1.18 NA 0.07 1.25 NA XXX 93226 A ECG monitor/report, 24 hrs 0.00 2.08 NA 0.12 2.20 NA XXX 93227 A ECG monitor/review, 24 hrs 0.52 0.21 0.21 0.02 0.75 0.75 XXX 93230 A ECG monitor/report, 24 hrs 0.52 3.72 NA 0.22 4.46 NA XXX 93231 A Ecg monitor/record, 24 hrs 0.00 1.44 NA 0.09 1.53 NA XXX 93232 A ECG monitor/report, 24 hrs 0.00 2.07 NA 0.11 2.18 NA XXX 93233 A ECG monitor/review, 24 hrs 0.52 0.21 0.21 0.02 0.75 0.75 XXX 93235 A ECG monitor/report, 24 hrs 0.45 2.66 NA 0.13 3.24 NA XXX 93236 A ECG monitor/report, 24 hrs 0.00 2.49 NA 0.12 2.61 NA XXX 93237 A ECG monitor/review, 24 hrs 0.45 0.17 0.17 0.01 0.63 0.63 XXX 93268 A ECG record/review 0.52 3.62 NA 0.24 4.38 NA XXX 93270 A ECG recording 0.00 1.18 NA 0.07 1.25 NA XXX 93271 A Ecg/monitoring and analysis 0.00 2.24 NA 0.15 2.39 NA XXX 93272 A Ecg/review, interpret only 0.52 0.20 0.20 0.02 0.74 0.74 XXX 93278 A ECG/signal-averaged 0.25 1.19 NA 0.10 1.54 NA XXX 93278 26 A ECG/signal-averaged 0.25 0.10 0.10 0.01 0.36 0.36 XXX 93278 TC A ECG/signal-averaged 0.00 1.09 NA 0.09 1.18 NA XXX 93303 A Echo transthoracic 1.30 4.16 NA 0.23 5.69 NA XXX 93303 26 A Echo transthoracic 1.30 0.50 0.50 0.04 1.84 1.84 XXX Start Printed Page 55455 93303 TC A Echo transthoracic 0.00 3.66 NA 0.19 3.85 NA XXX 93304 A Echo transthoracic 0.75 2.15 NA 0.13 3.03 NA XXX 93304 26 A Echo transthoracic 0.75 0.30 0.30 0.02 1.07 1.07 XXX 93304 TC A Echo transthoracic 0.00 1.85 NA 0.11 1.96 NA XXX 93307 A Echo exam of heart 0.92 4.04 NA 0.22 5.18 NA XXX 93307 26 A Echo exam of heart 0.92 0.38 0.38 0.03 1.33 1.33 XXX 93307 TC A Echo exam of heart 0.00 3.66 NA 0.19 3.85 NA XXX 93308 A Echo exam of heart 0.53 2.07 NA 0.13 2.73 NA XXX 93308 26 A Echo exam of heart 0.53 0.22 0.22 0.02 0.77 0.77 XXX 93308 TC A Echo exam of heart 0.00 1.85 NA 0.11 1.96 NA XXX 93312 A Echo transesophageal 2.20 4.45 NA 0.32 6.97 NA XXX 93312 26 A Echo transesophageal 2.20 0.86 0.86 0.08 3.14 3.14 XXX 93312 TC A Echo transesophageal 0.00 3.59 NA 0.24 3.83 NA XXX 93313 A Echo transesophageal 0.95 5.29 0.22 0.05 6.29 1.22 XXX 93314 A Echo transesophageal 1.25 4.10 NA 0.28 5.63 NA XXX 93314 26 A Echo transesophageal 1.25 0.51 0.51 0.04 1.80 1.80 XXX 93314 TC A Echo transesophageal 0.00 3.59 NA 0.24 3.83 NA XXX 93315 A Echo transesophageal 2.78 4.70 NA 0.34 7.82 NA XXX 93315 26 A Echo transesophageal 2.78 1.11 1.11 0.10 3.99 3.99 XXX 93315 TC A Echo transesophageal 0.00 3.59 NA 0.24 3.83 NA XXX 93316 A Echo transesophageal 0.95 6.39 0.25 0.05 7.39 1.25 XXX 93317 A Echo transesophageal 1.83 4.31 NA 0.30 6.44 NA XXX 93317 26 A Echo transesophageal 1.83 0.72 0.72 0.06 2.61 2.61 XXX 93317 TC A Echo transesophageal 0.00 3.59 NA 0.24 3.83 NA XXX 93318 C Echo transesophageal intraop 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93318 26 A Echo transesophageal intraop 2.20 0.88 NA 0.06 3.14 NA XXX 93318 TC C Echo transesophageal intraop 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93320 A Doppler echo exam, heart 0.38 1.79 NA 0.11 2.28 NA ZZZ 93320 26 A Doppler echo exam, heart 0.38 0.16 0.16 0.01 0.55 0.55 ZZZ 93320 TC A Doppler echo exam, heart 0.00 1.63 NA 0.10 1.73 NA ZZZ 93321 A Doppler echo exam, heart 0.15 1.12 NA 0.08 1.35 NA ZZZ 93321 26 A Doppler echo exam, heart 0.15 0.06 0.06 0.01 0.22 0.22 ZZZ 93321 TC A Doppler echo exam, heart 0.00 1.06 NA 0.07 1.13 NA ZZZ 93325 A Doppler color flow add-on 0.07 2.78 NA 0.18 3.03 NA ZZZ 93325 26 A Doppler color flow add-on 0.07 0.03 0.03 0.01 0.11 0.11 ZZZ 93325 TC A Doppler color flow add-on 0.00 2.75 NA 0.17 2.92 NA ZZZ 93350 A Echo transthoracic 1.48 2.28 NA 0.13 3.89 NA XXX 93350 26 A Echo transthoracic 1.48 0.61 0.61 0.02 2.11 2.11 XXX 93350 TC A Echo transthoracic 0.00 1.67 NA 0.11 1.78 NA XXX 93501 A Right heart catheterization 3.02 17.23 NA 1.03 21.28 NA 000 93501 26 A Right heart catheterization 3.02 1.24 1.24 0.16 4.42 4.42 000 93501 TC A Right heart catheterization 0.00 15.99 NA 0.87 16.86 NA 000 93503 A Insert/place heart catheter 2.91 NA 0.71 0.16 NA 3.78 000 93505 A Biopsy of heart lining 4.38 3.67 NA 0.36 8.41 NA 000 93505 26 A Biopsy of heart lining 4.38 1.80 1.80 0.23 6.41 6.41 000 93505 TC A Biopsy of heart lining 0.00 1.87 NA 0.13 2.00 NA 000 93508 A Cath placement, angiography 4.10 13.64 NA 0.75 18.49 NA 000 93508 26 A Cath placement, angiography 4.10 1.71 1.71 0.21 6.02 6.02 000 93508 TC A Cath placement, angiography 0.00 11.93 NA 0.54 12.47 NA 000 93510 A Left heart catheterization 4.33 36.77 NA 2.13 43.23 NA 000 93510 26 A Left heart catheterization 4.33 1.82 1.82 0.22 6.37 6.37 000 93510 TC A Left heart catheterization 0.00 34.95 NA 1.91 36.86 NA 000 93511 A Left heart catheterization 5.03 36.12 NA 2.11 43.26 NA 000 93511 26 A Left heart catheterization 5.03 2.10 2.10 0.26 7.39 7.39 000 93511 TC A Left heart catheterization 0.00 34.02 NA 1.85 35.87 NA 000 93514 A Left heart catheterization 7.05 36.79 NA 2.22 46.06 NA 000 93514 26 A Left heart catheterization 7.05 2.77 2.77 0.37 10.19 10.19 000 93514 TC A Left heart catheterization 0.00 34.02 NA 1.85 35.87 NA 000 93524 A Left heart catheterization 6.95 47.32 NA 2.79 57.06 NA 000 93524 26 A Left heart catheterization 6.95 2.86 2.86 0.36 10.17 10.17 000 93524 TC A Left heart catheterization 0.00 44.46 NA 2.43 46.89 NA 000 93526 A Rt & Lt heart catheters 5.99 48.18 NA 2.81 56.98 NA 000 93526 26 A Rt & Lt heart catheters 5.99 2.50 2.50 0.31 8.80 8.80 000 93526 TC A Rt & Lt heart catheters 0.00 45.68 NA 2.50 48.18 NA 000 93527 A Rt & Lt heart catheters 7.28 47.49 NA 2.81 57.58 NA 000 93527 26 A Rt & Lt heart catheters 7.28 3.03 3.03 0.38 10.69 10.69 000 93527 TC A Rt & Lt heart catheters 0.00 44.46 NA 2.43 46.89 NA 000 93528 A Rt & Lt heart catheters 9.00 48.27 NA 2.90 60.17 NA 000 93528 26 A Rt & Lt heart catheters 9.00 3.81 3.81 0.47 13.28 13.28 000 93528 TC A Rt & Lt heart catheters 0.00 44.46 NA 2.43 46.89 NA 000 93529 A Rt< heart catheterization 4.80 46.46 NA 2.68 53.94 NA 000 93529 26 A Rt< heart catheterization 4.80 2.00 2.00 0.25 7.05 7.05 000 93529 TC A Rt< heart catheterization 0.00 44.46 NA 2.43 46.89 NA 000 Start Printed Page 55456 93530 A Rt heart cath, congenital 4.23 17.59 NA 1.11 22.93 NA 000 93530 26 A Rt heart cath, congenital 4.23 1.60 1.60 0.24 6.07 6.07 000 93530 TC A Rt heart cath, congenital 0.00 15.99 NA 0.87 16.86 NA 000 93531 A R & l heart cath, congenital 8.35 48.92 NA 2.96 60.23 NA 000 93531 26 A R & l heart cath, congenital 8.35 3.24 3.24 0.46 12.05 12.05 000 93531 TC A R & l heart cath, congenital 0.00 45.68 NA 2.50 48.18 NA 000 93532 A R & l heart cath, congenital 10.00 48.58 NA 2.95 61.53 NA 000 93532 26 A R & l heart cath, congenital 10.00 4.12 4.12 0.52 14.64 14.64 000 93532 TC A R & l heart cath, congenital 0.00 44.46 NA 2.43 46.89 NA 000 93533 A R & l heart cath, congenital 6.70 47.01 NA 2.86 56.57 NA 000 93533 26 A R & l heart cath, congenital 6.70 2.55 2.55 0.43 9.68 9.68 000 93533 TC A R & l heart cath, congenital 0.00 44.46 NA 2.43 46.89 NA 000 93536 D Insert circulation assi 0.00 NA 0.00 0.00 NA 0.00 000 93539 A Injection, cardiac cath 0.40 0.84 0.17 0.01 1.25 0.58 000 93540 A Injection, cardiac cath 0.43 0.86 0.18 0.01 1.30 0.62 000 93541 A Injection for lung angiogram 0.29 NA 0.12 0.01 NA 0.42 000 93542 A Injection for heart x-rays 0.29 NA 0.12 0.01 NA 0.42 000 93543 A Injection for heart x-rays 0.29 0.55 0.12 0.01 0.85 0.42 000 93544 A Injection for aortography 0.25 0.53 0.10 0.01 0.79 0.36 000 93545 A Inject for coronary x-rays 0.40 0.85 0.17 0.01 1.26 0.58 000 93555 A Imaging, cardiac cath 0.81 6.27 NA 0.31 7.39 NA XXX 93555 26 A Imaging, cardiac cath 0.81 0.34 0.34 0.03 1.18 1.18 XXX 93555 TC A Imaging, cardiac cath 0.00 5.93 NA 0.28 6.21 NA XXX 93556 A Imaging, cardiac cath 0.83 9.71 NA 0.45 10.99 NA XXX 93556 26 A Imaging, cardiac cath 0.83 0.35 0.35 0.03 1.21 1.21 XXX 93556 TC A Imaging, cardiac cath 0.00 9.36 NA 0.42 9.78 NA XXX 93561 A Cardiac output measurement 0.50 0.67 NA 0.07 1.24 NA 000 93561 26 A Cardiac output measurement 0.50 0.16 0.16 0.02 0.68 0.68 000 93561 TC A Cardiac output measurement 0.00 0.51 NA 0.05 0.56 NA 000 93562 A Cardiac output measurement 0.16 0.34 NA 0.04 0.54 NA 000 93562 26 A Cardiac output measurement 0.16 0.05 0.05 0.01 0.22 0.22 000 93562 TC A Cardiac output measurement 0.00 0.29 NA 0.03 0.32 NA 000 93571 A Heart flow reserve measure 1.80 5.06 NA 0.31 7.17 NA ZZZ 93571 26 A Heart flow reserve measure 1.80 0.73 0.73 0.11 2.64 2.64 ZZZ 93571 TC A Heart flow reserve measure 0.00 4.33 NA 0.20 4.53 NA ZZZ 93572 A Heart flow reserve measure 1.44 2.70 NA 0.28 4.42 NA ZZZ 93572 26 A Heart flow reserve measure 1.44 0.52 0.52 0.17 2.13 2.13 ZZZ 93572 TC A Heart flow reserve measure 0.00 2.18 NA 0.11 2.29 NA ZZZ 93600 A Bundle of His recording 2.12 2.74 NA 0.22 5.08 NA 000 93600 26 A Bundle of His recording 2.12 0.89 0.89 0.11 3.12 3.12 000 93600 TC A Bundle of His recording 0.00 1.85 NA 0.11 1.96 NA 000 93602 A Intra-atrial recording 2.12 1.94 NA 0.18 4.24 NA 000 93602 26 A Intra-atrial recording 2.12 0.88 0.88 0.12 3.12 3.12 000 93602 TC A Intra-atrial recording 0.00 1.06 NA 0.06 1.12 NA 000 93603 A Right ventricular recording 2.12 2.46 NA 0.20 4.78 NA 000 93603 26 A Right ventricular recording 2.12 0.86 0.86 0.11 3.09 3.09 000 93603 TC A Right ventricular recording 0.00 1.60 NA 0.09 1.69 NA 000 93607 D Left ventricular recording 0.00 0.00 0.00 0.00 0.00 0.00 000 93607 26 D Left ventricular recording 0.00 0.00 0.00 0.00 0.00 0.00 000 93607 TC D Left ventricular recording 0.00 0.00 0.00 0.00 0.00 0.00 000 93609 A Map tachycardia, add-on 4.81 4.59 NA 0.66 10.06 NA ZZZ 93609 26 A Map tachycardia, add-on 4.81 2.01 2.01 0.52 7.34 7.34 ZZZ 93609 TC A Map tachycardia, add-on 0.00 2.58 NA 0.14 2.72 NA ZZZ 93610 A Intra-atrial pacing 3.02 2.52 NA 0.25 5.79 NA 000 93610 26 A Intra-atrial pacing 3.02 1.23 1.23 0.17 4.42 4.42 000 93610 TC A Intra-atrial pacing 0.00 1.29 NA 0.08 1.37 NA 000 93612 A Intraventricular pacing 3.02 2.76 NA 0.26 6.04 NA 000 93612 26 A Intraventricular pacing 3.02 1.23 1.23 0.17 4.42 4.42 000 93612 TC A Intraventricular pacing 0.00 1.53 NA 0.09 1.62 NA 000 93613 C Electrophys map, 3d, add-on 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93613 26 A Electrophys map, 3d, add-on 7.00 2.79 2.79 0.52 10.31 10.31 XXX 93613 TC C Electrophys map, 3d, add-on 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93615 A Esophageal recording 0.99 0.66 NA 0.05 1.70 NA 000 93615 26 A Esophageal recording 0.99 0.36 0.36 0.03 1.38 1.38 000 93615 TC A Esophageal recording 0.00 0.30 NA 0.02 0.32 NA 000 93616 A Esophageal recording 1.49 0.80 NA 0.08 2.37 NA 000 93616 26 A Esophageal recording 1.49 0.50 0.50 0.06 2.05 2.05 000 93616 TC A Esophageal recording 0.00 0.30 NA 0.02 0.32 NA 000 93618 A Heart rhythm pacing 4.26 5.54 NA 0.42 10.22 NA 000 93618 26 A Heart rhythm pacing 4.26 1.78 1.78 0.22 6.26 6.26 000 93618 TC A Heart rhythm pacing 0.00 3.76 NA 0.20 3.96 NA 000 93619 A Electrophysiology evaluation 7.32 10.32 NA 0.77 18.41 NA 000 93619 26 A Electrophysiology evaluation 7.32 3.00 3.00 0.38 10.70 10.70 000 Start Printed Page 55457 93619 TC A Electrophysiology evaluation 0.00 7.32 NA 0.39 7.71 NA 000 93620 A Electrophysiology evaluation 11.59 13.33 NA 1.04 25.96 NA 000 93620 26 A Electrophysiology evaluation 11.59 4.82 4.82 0.60 17.01 17.01 000 93620 TC A Electrophysiology evaluation 0.00 8.51 NA 0.44 8.95 NA 000 93621 C Electrophysiology evaluation 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 93621 26 A Electrophysiology evaluation 2.10 0.88 0.88 0.15 3.13 3.13 ZZZ 93621 TC C Electrophysiology evaluation 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 93622 C Electrophysiology evaluation 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 93622 26 A Electrophysiology evaluation 3.10 1.30 1.30 0.67 5.07 5.07 ZZZ 93622 TC C Electrophysiology evaluation 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 93623 C Stimulation, pacing heart 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 93623 26 A Stimulation, pacing heart 2.85 1.19 1.19 0.15 4.19 4.19 ZZZ 93623 TC C Stimulation, pacing heart 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 93624 A Electrophysiologic study 4.81 3.87 NA 0.36 9.04 NA 000 93624 26 A Electrophysiologic study 4.81 1.99 1.99 0.25 7.05 7.05 000 93624 TC A Electrophysiologic study 0.00 1.88 NA 0.11 1.99 NA 000 93631 A Heart pacing, mapping 7.60 8.65 NA 1.17 17.42 NA 000 93631 26 A Heart pacing, mapping 7.60 2.81 2.81 0.66 11.07 11.07 000 93631 TC A Heart pacing, mapping 0.00 5.84 NA 0.51 6.35 NA 000 93640 A Evaluation heart device 3.52 8.27 NA 0.53 12.32 NA 000 93640 26 A Evaluation heart device 3.52 1.46 1.46 0.18 5.16 5.16 000 93640 TC A Evaluation heart device 0.00 6.81 NA 0.35 7.16 NA 000 93641 A Electrophysiology evaluation 5.93 9.28 NA 0.66 15.87 NA 000 93641 26 A Electrophysiology evaluation 5.93 2.47 2.47 0.31 8.71 8.71 000 93641 TC A Electrophysiology evaluation 0.00 6.81 NA 0.35 7.16 NA 000 93642 A Electrophysiology evaluation 4.89 8.85 NA 0.51 14.25 NA 000 93642 26 A Electrophysiology evaluation 4.89 2.04 2.04 0.16 7.09 7.09 000 93642 TC A Electrophysiology evaluation 0.00 6.81 NA 0.35 7.16 NA 000 93650 A Ablate heart dysrhythm focus 10.51 NA 4.32 0.55 NA 15.38 000 93651 A Ablate heart dysrhythm focus 16.25 NA 6.78 0.85 NA 23.88 000 93652 A Ablate heart dysrhythm focus 17.68 NA 7.36 0.92 NA 25.96 000 93660 A Tilt table evaluation 1.89 2.39 NA 0.08 4.36 NA 000 93660 26 A Tilt table evaluation 1.89 0.79 0.79 0.06 2.74 2.74 000 93660 TC A Tilt table evaluation 0.00 1.60 NA 0.02 1.62 NA 000 93662 C Intracardiac ecg (ice) +0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 93662 26 A Intracardiac ecg (ice) 2.80 1.12 1.12 0.41 4.33 4.33 ZZZ 93662 TC C Intracardiac ecg (ice) +0.00 0.00 NA 0.00 0.00 NA XXX 93668 N Peripheral vascular rehab 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93701 A Bioimpedance, thoracic 0.17 0.78 NA 0.02 0.97 NA XXX 93701 26 A Bioimpedance, thoracic 0.17 0.07 0.07 0.01 0.25 0.25 XXX 93701 TC A Bioimpedance, thoracic 0.00 0.71 NA 0.01 0.72 NA XXX 93720 A Total body plethysmography 0.17 0.73 NA 0.06 0.96 NA XXX 93721 A Plethysmography tracing 0.00 0.67 NA 0.05 0.72 NA XXX 93722 A Plethysmography report 0.17 0.06 0.06 0.01 0.24 0.24 XXX 93724 A Analyze pacemaker system 4.89 5.80 NA 0.38 11.07 NA 000 93724 26 A Analyze pacemaker system 4.89 2.04 2.04 0.18 7.11 7.11 000 93724 TC A Analyze pacemaker system 0.00 3.76 NA 0.20 3.96 NA 000 93727 A Analyze ilr system 0.52 0.21 0.21 0.05 0.78 0.78 XXX 93731 A Analyze pacemaker system 0.45 0.66 NA 0.05 1.16 NA XXX 93731 26 A Analyze pacemaker system 0.45 0.19 0.19 0.02 0.66 0.66 XXX 93731 TC A Analyze pacemaker system 0.00 0.47 NA 0.03 0.50 NA XXX 93732 A Analyze pacemaker system 0.92 0.87 NA 0.06 1.85 NA XXX 93732 26 A Analyze pacemaker system 0.92 0.38 0.38 0.03 1.33 1.33 XXX 93732 TC A Analyze pacemaker system 0.00 0.49 NA 0.03 0.52 NA XXX 93733 A Telephone analy, pacemaker 0.17 0.76 NA 0.06 0.99 NA XXX 93733 26 A Telephone analy, pacemaker 0.17 0.07 0.07 0.01 0.25 0.25 XXX 93733 TC A Telephone analy, pacemaker 0.00 0.69 NA 0.05 0.74 NA XXX 93734 A Analyze pacemaker system 0.38 0.49 NA 0.03 0.90 NA XXX 93734 26 A Analyze pacemaker system 0.38 0.16 0.16 0.01 0.55 0.55 XXX 93734 TC A Analyze pacemaker system 0.00 0.33 NA 0.02 0.35 NA XXX 93735 A Analyze pacemaker system 0.74 0.72 NA 0.06 1.52 NA XXX 93735 26 A Analyze pacemaker system 0.74 0.30 0.30 0.03 1.07 1.07 XXX 93735 TC A Analyze pacemaker system 0.00 0.42 NA 0.03 0.45 NA XXX 93736 A Telephone analy, pacemaker 0.15 0.66 NA 0.06 0.87 NA XXX 93736 26 A Telephone analy, pacemaker 0.15 0.06 0.06 0.01 0.22 0.22 XXX 93736 TC A Telephone analy, pacemaker 0.00 0.60 NA 0.05 0.65 NA XXX 93737 D Analyze cardio/defibrillator 0.00 0.00 NA 0.00 0.00 NA XXX 93737 26 D Analyze cardio/defibrillator 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93737 TC D Analyze cardio/defibrillator 0.00 0.00 NA 0.00 0.00 NA XXX 93738 D Analyze cardio/defibrillator 0.00 0.00 NA 0.00 0.00 NA XXX 93738 26 D Analyze cardio/defibrillator 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93738 TC D Analyze cardio/defibrillator 0.00 0.00 NA 0.00 0.00 NA XXX 93740 B Temperature gradient studies +0.16 0.21 NA 0.02 0.39 NA XXX Start Printed Page 55458 93740 26 B Temperature gradient studies +0.16 0.06 0.06 0.01 0.23 0.23 XXX 93740 TC B Temperature gradient studies +0.00 0.15 NA 0.01 0.16 NA XXX 93741 A Analyze ht pace device sngl 0.80 0.96 NA 0.05 1.81 NA XXX 93741 26 A Analyze ht pace device sngl 0.80 0.33 0.33 0.02 1.15 1.15 XXX 93741 TC A Analyze ht pace device sngl 0.00 0.63 NA 0.03 0.66 NA XXX 93742 A Analyze ht pace device sngl 0.91 1.01 NA 0.05 1.97 NA XXX 93742 26 A Analyze ht pace device sngl 0.91 0.38 0.38 0.02 1.31 1.31 XXX 93742 TC A Analyze ht pace device sngl 0.00 0.63 NA 0.03 0.66 NA XXX 93743 A Analyze ht pace device dual 1.03 1.13 NA 0.06 2.22 NA XXX 93743 26 A Analyze ht pace device dual 1.03 0.43 0.43 0.03 1.49 1.49 XXX 93743 TC A Analyze ht pace device dual 0.00 0.70 NA 0.03 0.73 NA XXX 93744 A Analyze ht pace device dual 1.18 1.12 NA 0.06 2.36 NA XXX 93744 26 A Analyze ht pace device dual 1.18 0.49 0.49 0.03 1.70 1.70 XXX 93744 TC A Analyze ht pace device dual 0.00 0.63 NA 0.03 0.66 NA XXX 93760 N Cephalic thermogram 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93762 N Peripheral thermogram 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93770 B Measure venous pressure +0.16 0.09 NA 0.02 0.27 NA XXX 93770 26 B Measure venous pressure +0.16 0.06 0.06 0.01 0.23 0.23 XXX 93770 TC B Measure venous pressure +0.00 0.03 NA 0.01 0.04 NA XXX 93784 N Ambulatory BP monitoring 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93786 N Ambulatory BP recording 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93788 N Ambulatory BP analysis 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93790 N Review/report BP recording 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93797 A Cardiac rehab 0.18 0.33 0.07 0.01 0.52 0.26 000 93798 A Cardiac rehab/monitor 0.28 0.44 0.11 0.01 0.73 0.40 000 93799 C Cardiovascular procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93799 26 C Cardiovascular procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93799 TC C Cardiovascular procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93875 A Extracranial study 0.22 1.13 NA 0.10 1.45 NA XXX 93875 26 A Extracranial study 0.22 0.08 0.08 0.01 0.31 0.31 XXX 93875 TC A Extracranial study 0.00 1.05 NA 0.09 1.14 NA XXX 93880 A Extracranial study 0.60 3.76 NA 0.33 4.69 NA XXX 93880 26 A Extracranial study 0.60 0.22 0.22 0.04 0.86 0.86 XXX 93880 TC A Extracranial study 0.00 3.54 NA 0.29 3.83 NA XXX 93882 A Extracranial study 0.40 2.50 NA 0.22 3.12 NA XXX 93882 26 A Extracranial study 0.40 0.15 0.15 0.04 0.59 0.59 XXX 93882 TC A Extracranial study 0.00 2.35 NA 0.18 2.53 NA XXX 93886 A Intracranial study 0.94 4.40 NA 0.37 5.71 NA XXX 93886 26 A Intracranial study 0.94 0.40 0.40 0.05 1.39 1.39 XXX 93886 TC A Intracranial study 0.00 4.00 NA 0.32 4.32 NA XXX 93888 A Intracranial study 0.62 2.91 NA 0.26 3.79 NA XXX 93888 26 A Intracranial study 0.62 0.24 0.24 0.04 0.90 0.90 XXX 93888 TC A Intracranial study 0.00 2.67 NA 0.22 2.89 NA XXX 93922 A Extremity study 0.25 1.18 NA 0.13 1.56 NA XXX 93922 26 A Extremity study 0.25 0.09 0.09 0.02 0.36 0.36 XXX 93922 TC A Extremity study 0.00 1.09 NA 0.11 1.20 NA XXX 93923 A Extremity study 0.45 2.24 NA 0.22 2.91 NA XXX 93923 26 A Extremity study 0.45 0.16 0.16 0.04 0.65 0.65 XXX 93923 TC A Extremity study 0.00 2.08 NA 0.18 2.26 NA XXX 93924 A Extremity study 0.50 2.43 NA 0.26 3.19 NA XXX 93924 26 A Extremity study 0.50 0.18 0.18 0.05 0.73 0.73 XXX 93924 TC A Extremity study 0.00 2.25 NA 0.21 2.46 NA XXX 93925 A Lower extremity study 0.58 3.76 NA 0.33 4.67 NA XXX 93925 26 A Lower extremity study 0.58 0.21 0.21 0.04 0.83 0.83 XXX 93925 TC A Lower extremity study 0.00 3.55 NA 0.29 3.84 NA XXX 93926 A Lower extremity study 0.39 2.51 NA 0.22 3.12 NA XXX 93926 26 A Lower extremity study 0.39 0.14 0.14 0.03 0.56 0.56 XXX 93926 TC A Lower extremity study 0.00 2.37 NA 0.19 2.56 NA XXX 93930 A Upper extremity study 0.46 3.93 NA 0.34 4.73 NA XXX 93930 26 A Upper extremity study 0.46 0.16 0.16 0.03 0.65 0.65 XXX 93930 TC A Upper extremity study 0.00 3.77 NA 0.31 4.08 NA XXX 93931 A Upper extremity study 0.31 2.62 NA 0.22 3.15 NA XXX 93931 26 A Upper extremity study 0.31 0.11 0.11 0.02 0.44 0.44 XXX 93931 TC A Upper extremity study 0.00 2.51 NA 0.20 2.71 NA XXX 93965 A Extremity study 0.35 1.17 NA 0.12 1.64 NA XXX 93965 26 A Extremity study 0.35 0.13 0.13 0.02 0.50 0.50 XXX 93965 TC A Extremity study 0.00 1.04 NA 0.10 1.14 NA XXX 93970 A Extremity study 0.68 4.16 NA 0.38 5.22 NA XXX 93970 26 A Extremity study 0.68 0.24 0.24 0.05 0.97 0.97 XXX 93970 TC A Extremity study 0.00 3.92 NA 0.33 4.25 NA XXX 93971 A Extremity study 0.45 2.77 NA 0.25 3.47 NA XXX 93971 26 A Extremity study 0.45 0.16 0.16 0.03 0.64 0.64 XXX 93971 TC A Extremity study 0.00 2.61 NA 0.22 2.83 NA XXX Start Printed Page 55459 93975 A Vascular study 1.80 5.10 NA 0.47 7.37 NA XXX 93975 26 A Vascular study 1.80 0.64 0.64 0.11 2.55 2.55 XXX 93975 TC A Vascular study 0.00 4.46 NA 0.36 4.82 NA XXX 93976 A Vascular study 1.21 3.41 NA 0.31 4.93 NA XXX 93976 26 A Vascular study 1.21 0.43 0.43 0.06 1.70 1.70 XXX 93976 TC A Vascular study 0.00 2.98 NA 0.25 3.23 NA XXX 93978 A Vascular study 0.65 3.88 NA 0.36 4.89 NA XXX 93978 26 A Vascular study 0.65 0.23 0.23 0.05 0.93 0.93 XXX 93978 TC A Vascular study 0.00 3.65 NA 0.31 3.96 NA XXX 93979 A Vascular study 0.44 2.59 NA 0.24 3.27 NA XXX 93979 26 A Vascular study 0.44 0.16 0.16 0.04 0.64 0.64 XXX 93979 TC A Vascular study 0.00 2.43 NA 0.20 2.63 NA XXX 93980 A Penile vascular study 1.25 3.75 NA 0.35 5.35 NA XXX 93980 26 A Penile vascular study 1.25 0.44 0.44 0.07 1.76 1.76 XXX 93980 TC A Penile vascular study 0.00 3.31 NA 0.28 3.59 NA XXX 93981 A Penile vascular study 0.44 3.21 NA 0.28 3.93 NA XXX 93981 26 A Penile vascular study 0.44 0.15 0.15 0.02 0.61 0.61 XXX 93981 TC A Penile vascular study 0.00 3.06 NA 0.26 3.32 NA XXX 93990 A Doppler flow testing 0.25 2.46 NA 0.21 2.92 NA XXX 93990 26 A Doppler flow testing 0.25 0.09 0.09 0.02 0.36 0.36 XXX 93990 TC A Doppler flow testing 0.00 2.37 NA 0.19 2.56 NA XXX 94010 A Breathing capacity test 0.17 0.82 NA 0.03 1.02 NA XXX 94010 26 A Breathing capacity test 0.17 0.06 0.06 0.01 0.24 0.24 XXX 94010 TC A Breathing capacity test 0.00 0.76 NA 0.02 0.78 NA XXX 94014 A Patient recorded spirometry 0.52 0.46 NA 0.03 1.01 NA XXX 94015 A Patient recorded spirometry 0.00 0.29 NA 0.01 0.30 NA XXX 94016 A Review patient spirometry 0.52 0.17 0.17 0.02 0.71 0.71 XXX 94060 A Evaluation of wheezing 0.31 1.36 NA 0.06 1.73 NA XXX 94060 26 A Evaluation of wheezing 0.31 0.10 0.10 0.01 0.42 0.42 XXX 94060 TC A Evaluation of wheezing 0.00 1.26 NA 0.05 1.31 NA XXX 94070 A Evaluation of wheezing 0.60 3.38 NA 0.10 4.08 NA XXX 94070 26 A Evaluation of wheezing 0.60 0.19 0.19 0.02 0.81 0.81 XXX 94070 TC A Evaluation of wheezing 0.00 3.19 NA 0.08 3.27 NA XXX 94150 B Vital capacity test +0.07 0.63 NA 0.02 0.72 NA XXX 94150 26 B Vital capacity test +0.07 0.03 0.03 0.01 0.11 0.11 XXX 94150 TC B Vital capacity test +0.00 0.60 NA 0.01 0.61 NA XXX 94200 A Lung function test (MBC/MVV) 0.11 0.33 NA 0.03 0.47 NA XXX 94200 26 A Lung function test (MBC/MVV) 0.11 0.04 0.04 0.01 0.16 0.16 XXX 94200 TC A Lung function test (MBC/MVV) 0.00 0.29 NA 0.02 0.31 NA XXX 94240 A Residual lung capacity 0.26 1.26 NA 0.05 1.57 NA XXX 94240 26 A Residual lung capacity 0.26 0.08 0.08 0.01 0.35 0.35 XXX 94240 TC A Residual lung capacity 0.00 1.18 NA 0.04 1.22 NA XXX 94250 A Expired gas collection 0.11 0.61 NA 0.02 0.74 NA XXX 94250 26 A Expired gas collection 0.11 0.04 0.04 0.01 0.16 0.16 XXX 94250 TC A Expired gas collection 0.00 0.57 NA 0.01 0.58 NA XXX 94260 A Thoracic gas volume 0.13 0.38 NA 0.04 0.55 NA XXX 94260 26 A Thoracic gas volume 0.13 0.04 0.04 0.01 0.18 0.18 XXX 94260 TC A Thoracic gas volume 0.00 0.34 NA 0.03 0.37 NA XXX 94350 A Lung nitrogen washout curve 0.26 1.01 NA 0.04 1.31 NA XXX 94350 26 A Lung nitrogen washout curve 0.26 0.08 0.08 0.01 0.35 0.35 XXX 94350 TC A Lung nitrogen washout curve 0.00 0.93 NA 0.03 0.96 NA XXX 94360 A Measure airflow resistance 0.26 0.50 NA 0.06 0.82 NA XXX 94360 26 A Measure airflow resistance 0.26 0.08 0.08 0.01 0.35 0.35 XXX 94360 TC A Measure airflow resistance 0.00 0.42 NA 0.05 0.47 NA XXX 94370 A Breath airway closing volume 0.26 2.03 NA 0.03 2.32 NA XXX 94370 26 A Breath airway closing volume 0.26 0.08 0.08 0.01 0.35 0.35 XXX 94370 TC A Breath airway closing volume 0.00 1.95 NA 0.02 1.97 NA XXX 94375 A Respiratory flow volume loop 0.31 0.46 NA 0.03 0.80 NA XXX 94375 26 A Respiratory flow volume loop 0.31 0.10 0.10 0.01 0.42 0.42 XXX 94375 TC A Respiratory flow volume loop 0.00 0.36 NA 0.02 0.38 NA XXX 94400 A CO2 breathing response curve 0.40 0.70 NA 0.06 1.16 NA XXX 94400 26 A CO2 breathing response curve 0.40 0.13 0.13 0.01 0.54 0.54 XXX 94400 TC A CO2 breathing response curve 0.00 0.57 NA 0.05 0.62 NA XXX 94450 A Hypoxia response curve 0.40 0.85 NA 0.04 1.29 NA XXX 94450 26 A Hypoxia response curve 0.40 0.12 0.12 0.02 0.54 0.54 XXX 94450 TC A Hypoxia response curve 0.00 0.73 NA 0.02 0.75 NA XXX 94620 A Pulmonary stress test/simple 0.64 1.66 NA 0.10 2.40 NA XXX 94620 26 A Pulmonary stress test/simple 0.64 0.21 0.21 0.02 0.87 0.87 XXX 94620 TC A Pulmonary stress test/simple 0.00 1.45 NA 0.08 1.53 NA XXX 94621 A Pulm stress test/complex 1.42 1.25 NA 0.13 2.80 NA XXX 94621 26 A Pulm stress test/complex 1.42 0.47 0.47 0.05 1.94 1.94 XXX 94621 TC A Pulm stress test/complex 0.00 0.78 NA 0.08 0.86 NA XXX 94640 A Airway inhalation treatment 0.00 0.74 NA 0.02 0.76 NA XXX Start Printed Page 55460 94642 C Aerosol inhalation treatment 0.00 0.00 0.00 0.00 0.00 0.00 XXX 94650 A Pressure breathing (IPPB) 0.00 0.67 NA 0.02 0.69 NA XXX 94651 A Pressure breathing (IPPB) 0.00 0.62 NA 0.02 0.64 NA XXX 94652 A Pressure breathing (IPPB) 0.00 0.77 NA 0.06 0.83 NA XXX 94656 A Initial ventilator mgmt 1.22 NA 0.33 0.06 NA 1.61 XXX 94657 A Continued ventilator mgmt 0.83 NA 0.26 0.03 NA 1.12 XXX 94660 A Pos airway pressure, CPAP 0.76 0.67 0.24 0.03 1.46 1.03 XXX 94662 A Neg press ventilation, cnp 0.76 NA 0.24 0.02 NA 1.02 XXX 94664 A Aerosol or vapor inhalations 0.00 0.53 NA 0.03 0.56 NA XXX 94665 A Aerosol or vapor inhalations 0.00 0.53 NA 0.04 0.57 NA XXX 94667 A Chest wall manipulation 0.00 1.01 NA 0.04 1.05 NA XXX 94668 A Chest wall manipulation 0.00 0.75 NA 0.02 0.77 NA XXX 94680 A Exhaled air analysis, o2 0.26 1.17 NA 0.06 1.49 NA XXX 94680 26 A Exhaled air analysis, o2 0.26 0.09 0.09 0.01 0.36 0.36 XXX 94680 TC A Exhaled air analysis, o2 0.00 1.08 NA 0.05 1.13 NA XXX 94681 A Exhaled air analysis, o2/co2 0.20 1.32 NA 0.11 1.63 NA XXX 94681 26 A Exhaled air analysis, o2/co2 0.20 0.07 0.07 0.01 0.28 0.28 XXX 94681 TC A Exhaled air analysis, o2/co2 0.00 1.25 NA 0.10 1.35 NA XXX 94690 A Exhaled air analysis 0.07 1.59 NA 0.04 1.70 NA XXX 94690 26 A Exhaled air analysis 0.07 0.02 0.02 0.01 0.10 0.10 XXX 94690 TC A Exhaled air analysis 0.00 1.57 NA 0.03 1.60 NA XXX 94720 A Monoxide diffusing capacity 0.26 1.32 NA 0.06 1.64 NA XXX 94720 26 A Monoxide diffusing capacity 0.26 0.08 0.08 0.01 0.35 0.35 XXX 94720 TC A Monoxide diffusing capacity 0.00 1.24 NA 0.05 1.29 NA XXX 94725 A Membrane diffusion capacity 0.26 0.71 NA 0.11 1.08 NA XXX 94725 26 A Membrane diffusion capacity 0.26 0.08 0.08 0.01 0.35 0.35 XXX 94725 TC A Membrane diffusion capacity 0.00 0.63 NA 0.10 0.73 NA XXX 94750 A Pulmonary compliance study 0.23 1.06 NA 0.04 1.33 NA XXX 94750 26 A Pulmonary compliance study 0.23 0.07 0.07 0.01 0.31 0.31 XXX 94750 TC A Pulmonary compliance study 0.00 0.99 NA 0.03 1.02 NA XXX 94760 T Measure blood oxygen level 0.00 0.10 NA 0.02 0.12 NA XXX 94761 T Measure blood oxygen level 0.00 0.14 NA 0.05 0.19 NA XXX 94762 A Measure blood oxygen level 0.00 0.74 NA 0.08 0.82 NA XXX 94770 A Exhaled carbon dioxide test 0.15 0.91 NA 0.07 1.13 NA XXX 94770 26 A Exhaled carbon dioxide test 0.15 0.04 0.04 0.01 0.20 0.20 XXX 94770 TC A Exhaled carbon dioxide test 0.00 0.87 NA 0.06 0.93 NA XXX 94772 C Breath recording, infant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 94772 26 C Breath recording, infant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 94772 TC C Breath recording, infant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 94799 C Pulmonary service/procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 94799 26 C Pulmonary service/procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 94799 TC C Pulmonary service/procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95004 A Allergy skin tests 0.00 0.09 NA 0.01 0.10 NA XXX 95010 A Sensitivity skin tests 0.15 0.45 0.07 0.01 0.61 0.23 XXX 95015 A Sensitivity skin tests 0.15 0.39 0.06 0.01 0.55 0.22 XXX 95024 A Allergy skin tests 0.00 0.14 NA 0.01 0.15 NA XXX 95027 A Skin end point titration 0.00 0.14 NA 0.01 0.15 NA XXX 95028 A Allergy skin tests 0.00 0.22 NA 0.01 0.23 NA XXX 95044 A Allergy patch tests 0.00 0.19 NA 0.01 0.20 NA XXX 95052 A Photo patch test 0.00 0.24 NA 0.01 0.25 NA XXX 95056 A Photosensitivity tests 0.00 0.17 NA 0.01 0.18 NA XXX 95060 A Eye allergy tests 0.00 0.33 NA 0.02 0.35 NA XXX 95065 A Nose allergy test 0.00 0.19 NA 0.01 0.20 NA XXX 95070 A Bronchial allergy tests 0.00 2.17 NA 0.02 2.19 NA XXX 95071 A Bronchial allergy tests 0.00 2.77 NA 0.02 2.79 NA XXX 95075 A Ingestion challenge test 0.95 0.80 0.43 0.03 1.78 1.41 XXX 95078 A Provocative testing 0.00 0.24 NA 0.02 0.26 NA XXX 95115 A Immunotherapy, one injection 0.00 0.37 NA 0.02 0.39 NA 000 95117 A Immunotherapy injections 0.00 0.48 NA 0.02 0.50 NA 000 95120 I Immunotherapy, one injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95125 I Immunotherapy, many antigens 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95130 I Immunotherapy, insect venom 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95131 I Immunotherapy, insect venoms 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95132 I Immunotherapy, insect venoms 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95133 I Immunotherapy, insect venoms 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95134 I Immunotherapy, insect venoms 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95144 A Antigen therapy services 0.06 0.25 0.03 0.01 0.32 0.10 000 95145 A Antigen therapy services 0.06 0.47 0.03 0.01 0.54 0.10 000 95146 A Antigen therapy services 0.06 0.62 0.03 0.01 0.69 0.10 000 95147 A Antigen therapy services 0.06 0.91 0.03 0.01 0.98 0.10 000 95148 A Antigen therapy services 0.06 0.81 0.03 0.01 0.88 0.10 000 95149 A Antigen therapy services 0.06 1.04 0.03 0.01 1.11 0.10 000 95165 A Antigen therapy services 0.06 0.21 0.02 0.01 0.28 0.09 000 Start Printed Page 55461 95170 A Antigen therapy services 0.06 0.26 0.02 0.01 0.33 0.09 000 95180 A Rapid desensitization 2.01 1.66 0.85 0.04 3.71 2.90 000 95199 C Allergy immunology services 0.00 0.00 0.00 0.00 0.00 0.00 000 95250 A Glucose monitoring, cont 0.00 1.44 NA 0.01 1.45 NA XXX 95805 A Multiple sleep latency test 1.88 5.89 NA 0.34 8.11 NA XXX 95805 26 A Multiple sleep latency test 1.88 0.70 0.70 0.06 2.64 2.64 XXX 95805 TC A Multiple sleep latency test 0.00 5.19 NA 0.28 5.47 NA XXX 95806 A Sleep study, unattended 1.66 4.31 NA 0.32 6.29 NA XXX 95806 26 A Sleep study, unattended 1.66 0.57 0.57 0.06 2.29 2.29 XXX 95806 TC A Sleep study, unattended 0.00 3.74 NA 0.26 4.00 NA XXX 95807 A Sleep study, attended 1.66 10.70 NA 0.40 12.76 NA XXX 95807 26 A Sleep study, attended 1.66 0.56 0.56 0.05 2.27 2.27 XXX 95807 TC A Sleep study, attended 0.00 10.14 NA 0.35 10.49 NA XXX 95808 A Polysomnography, 1-3 2.65 3.86 NA 0.44 6.95 NA XXX 95808 26 A Polysomnography, 1-3 2.65 0.99 0.99 0.09 3.73 3.73 XXX 95808 TC A Polysomnography, 1-3 0.00 2.87 NA 0.35 3.22 NA XXX 95810 A Polysomnography, 4 or more 3.53 15.66 NA 0.47 19.66 NA XXX 95810 26 A Polysomnography, 4 or more 3.53 1.26 1.26 0.12 4.91 4.91 XXX 95810 TC A Polysomnography, 4 or more 0.00 14.40 NA 0.35 14.75 NA XXX 95811 A Polysomnography w/cpap 3.80 13.63 NA 0.49 17.92 NA XXX 95811 26 A Polysomnography w/cpap 3.80 1.34 1.34 0.13 5.27 5.27 XXX 95811 TC A Polysomnography w/cpap 0.00 12.29 NA 0.36 12.65 NA XXX 95812 A Electroencephalogram (EEG) 1.08 3.96 NA 0.13 5.17 NA XXX 95812 26 A Electroencephalogram (EEG) 1.08 0.48 0.48 0.04 1.60 1.60 XXX 95812 TC A Electroencephalogram (EEG) 0.00 3.48 NA 0.09 3.57 NA XXX 95813 A Electroencephalogram (EEG) 1.73 5.53 NA 0.15 7.41 NA XXX 95813 26 A Electroencephalogram (EEG) 1.73 0.73 0.73 0.06 2.52 2.52 XXX 95813 TC A Electroencephalogram (EEG) 0.00 4.80 NA 0.09 4.89 NA XXX 95816 A Electroencephalogram (EEG) 1.08 3.42 NA 0.12 4.62 NA XXX 95816 26 A Electroencephalogram (EEG) 1.08 0.49 0.49 0.04 1.61 1.61 XXX 95816 TC A Electroencephalogram (EEG) 0.00 2.93 NA 0.08 3.01 NA XXX 95819 A Electroencephalogram (EEG) 1.08 4.34 NA 0.12 5.54 NA XXX 95819 26 A Electroencephalogram (EEG) 1.08 0.49 0.49 0.04 1.61 1.61 XXX 95819 TC A Electroencephalogram (EEG) 0.00 3.85 NA 0.08 3.93 NA XXX 95822 A Sleep electroencephalogram 1.08 1.78 NA 0.15 3.01 NA XXX 95822 26 A Sleep electroencephalogram 1.08 0.49 0.49 0.04 1.61 1.61 XXX 95822 TC A Sleep electroencephalogram 0.00 1.29 NA 0.11 1.40 NA XXX 95824 C Electroencephalography +0.00 0.00 0.00 0.00 0.00 0.00 XXX 95824 26 A Electroencephalography 0.74 0.30 0.30 0.05 1.09 1.09 ZZZ 95824 TC C Electroencephalography +0.00 0.00 NA 0.00 0.00 NA XXX 95827 A Night electroencephalogram 1.08 2.64 NA 0.15 3.87 NA XXX 95827 26 A Night electroencephalogram 1.08 0.46 0.46 0.03 1.57 1.57 XXX 95827 TC A Night electroencephalogram 0.00 2.18 NA 0.12 2.30 NA XXX 95829 A Surgery electrocorticogram 6.21 31.39 NA 0.33 37.93 NA XXX 95829 26 A Surgery electrocorticogram 6.21 2.90 2.90 0.31 9.42 9.42 XXX 95829 TC A Surgery electrocorticogram 0.00 28.49 NA 0.02 28.51 NA XXX 95830 A Insert electrodes for EEG 1.70 3.76 0.78 0.07 5.53 2.55 XXX 95831 A Limb muscle testing, manual 0.28 0.52 0.12 0.01 0.81 0.41 XXX 95832 A Hand muscle testing, manual 0.29 0.48 0.11 0.01 0.78 0.41 XXX 95833 A Body muscle testing, manual 0.47 0.54 0.24 0.01 1.02 0.72 XXX 95834 A Body muscle testing, manual 0.60 0.59 0.28 0.02 1.21 0.90 XXX 95851 A Range of motion measurements 0.16 0.55 0.08 0.01 0.72 0.25 XXX 95852 A Range of motion measurements 0.11 0.49 0.05 0.01 0.61 0.17 XXX 95857 A Tensilon test 0.53 0.66 0.24 0.02 1.21 0.79 XXX 95858 A Tensilon test & myogram 1.56 1.10 NA 0.07 2.73 NA XXX 95858 26 A Tensilon test & myogram 1.56 0.72 0.72 0.04 2.32 2.32 XXX 95858 TC A Tensilon test & myogram 0.00 0.38 NA 0.03 0.41 NA XXX 95860 A Muscle test, one limb 0.96 1.18 NA 0.05 2.19 NA XXX 95860 26 A Muscle test, one limb 0.96 0.45 0.45 0.03 1.44 1.44 XXX 95860 TC A Muscle test, one limb 0.00 0.73 NA 0.02 0.75 NA XXX 95861 A Muscle test, two limbs 1.54 1.42 NA 0.10 3.06 NA XXX 95861 26 A Muscle test, two limbs 1.54 0.72 0.72 0.05 2.31 2.31 XXX 95861 TC A Muscle test, two limbs 0.00 0.70 NA 0.05 0.75 NA XXX 95863 A Muscle test, 3 limbs 1.87 1.76 NA 0.11 3.74 NA XXX 95863 26 A Muscle test, 3 limbs 1.87 0.87 0.87 0.06 2.80 2.80 XXX 95863 TC A Muscle test, 3 limbs 0.00 0.89 NA 0.05 0.94 NA XXX 95864 A Muscle test, 4 limbs 1.99 2.62 NA 0.16 4.77 NA XXX 95864 26 A Muscle test, 4 limbs 1.99 0.93 0.93 0.06 2.98 2.98 XXX 95864 TC A Muscle test, 4 limbs 0.00 1.69 NA 0.10 1.79 NA XXX 95867 A Muscle test, head or neck 0.79 0.92 NA 0.06 1.77 NA XXX 95867 26 A Muscle test, head or neck 0.79 0.37 0.37 0.03 1.19 1.19 XXX 95867 TC A Muscle test, head or neck 0.00 0.55 NA 0.03 0.58 NA XXX 95868 A Muscle test, head or neck 1.18 1.23 NA 0.08 2.49 NA XXX Start Printed Page 55462 95868 26 A Muscle test, head or neck 1.18 0.57 0.57 0.04 1.79 1.79 XXX 95868 TC A Muscle test, head or neck 0.00 0.66 NA 0.04 0.70 NA XXX 95869 A Muscle test, thor paraspinal 0.37 0.37 NA 0.03 0.77 NA XXX 95869 26 A Muscle test, thor paraspinal 0.37 0.17 0.17 0.01 0.55 0.55 XXX 95869 TC A Muscle test, thor paraspinal 0.00 0.20 NA 0.02 0.22 NA XXX 95870 A Muscle test, nonparaspinal 0.37 0.37 NA 0.03 0.77 NA XXX 95870 26 A Muscle test, nonparaspinal 0.37 0.17 0.17 0.01 0.55 0.55 XXX 95870 TC A Muscle test, nonparaspinal 0.00 0.20 NA 0.02 0.22 NA XXX 95872 A Muscle test, one fiber 1.50 1.25 NA 0.08 2.83 NA XXX 95872 26 A Muscle test, one fiber 1.50 0.68 0.68 0.04 2.22 2.22 XXX 95872 TC A Muscle test, one fiber 0.00 0.57 NA 0.04 0.61 NA XXX 95875 A Limb exercise test 1.10 1.38 NA 0.09 2.57 NA XXX 95875 26 A Limb exercise test 1.10 0.49 0.49 0.04 1.63 1.63 XXX 95875 TC A Limb exercise test 0.00 0.89 NA 0.05 0.94 NA XXX 95900 A Motor nerve conduction test 0.42 0.73 NA 0.03 1.18 NA XXX 95900 26 A Motor nerve conduction test 0.42 0.20 0.20 0.01 0.63 0.63 XXX 95900 TC A Motor nerve conduction test 0.00 0.53 NA 0.02 0.55 NA XXX 95903 A Motor nerve conduction test 0.60 0.51 NA 0.04 1.15 NA XXX 95903 26 A Motor nerve conduction test 0.60 0.27 0.27 0.02 0.89 0.89 XXX 95903 TC A Motor nerve conduction test 0.00 0.24 NA 0.02 0.26 NA XXX 95904 A Sense nerve conduction test 0.34 0.64 NA 0.03 1.01 NA XXX 95904 26 A Sense nerve conduction test 0.34 0.16 0.16 0.01 0.51 0.51 XXX 95904 TC A Sense nerve conduction test 0.00 0.48 NA 0.02 0.50 NA XXX 95920 A Intraop nerve test add-on 2.11 2.23 NA 0.20 4.54 NA ZZZ 95920 26 A Intraop nerve test add-on 2.11 0.99 0.99 0.14 3.24 3.24 ZZZ 95920 TC A Intraop nerve test add-on 0.00 1.24 NA 0.06 1.30 NA ZZZ 95921 A Autonomic nerv function test 0.90 0.70 NA 0.05 1.65 NA XXX 95921 26 A Autonomic nerv function test 0.90 0.34 0.34 0.03 1.27 1.27 XXX 95921 TC A Autonomic nerv function test 0.00 0.36 NA 0.02 0.38 NA XXX 95922 A Autonomic nerv function test 0.96 0.79 NA 0.05 1.80 NA XXX 95922 26 A Autonomic nerv function test 0.96 0.43 0.43 0.03 1.42 1.42 XXX 95922 TC A Autonomic nerv function test 0.00 0.36 NA 0.02 0.38 NA XXX 95923 A Autonomic nerv function test 0.90 2.57 NA 0.05 3.52 NA XXX 95923 26 A Autonomic nerv function test 0.90 0.40 0.40 0.03 1.33 1.33 XXX 95923 TC A Autonomic nerv function test 0.00 2.17 NA 0.02 2.19 NA XXX 95925 A Somatosensory testing 0.54 1.10 NA 0.07 1.71 NA XXX 95925 26 A Somatosensory testing 0.54 0.24 0.24 0.02 0.80 0.80 XXX 95925 TC A Somatosensory testing 0.00 0.86 NA 0.05 0.91 NA XXX 95926 A Somatosensory testing 0.54 1.11 NA 0.07 1.72 NA XXX 95926 26 A Somatosensory testing 0.54 0.25 0.25 0.02 0.81 0.81 XXX 95926 TC A Somatosensory testing 0.00 0.86 NA 0.05 0.91 NA XXX 95927 A Somatosensory testing 0.54 1.13 NA 0.08 1.75 NA XXX 95927 26 A Somatosensory testing 0.54 0.27 0.27 0.03 0.84 0.84 XXX 95927 TC A Somatosensory testing 0.00 0.86 NA 0.05 0.91 NA XXX 95930 A Visual evoked potential test 0.35 0.84 NA 0.02 1.21 NA XXX 95930 26 A Visual evoked potential test 0.35 0.16 0.16 0.01 0.52 0.52 XXX 95930 TC A Visual evoked potential test 0.00 0.68 NA 0.01 0.69 NA XXX 95933 A Blink reflex test 0.59 1.01 NA 0.07 1.67 NA XXX 95933 26 A Blink reflex test 0.59 0.27 0.27 0.02 0.88 0.88 XXX 95933 TC A Blink reflex test 0.00 0.74 NA 0.05 0.79 NA XXX 95934 A H-reflex test 0.51 0.44 NA 0.04 0.99 NA XXX 95934 26 A H-reflex test 0.51 0.24 0.24 0.02 0.77 0.77 XXX 95934 TC A H-reflex test 0.00 0.20 NA 0.02 0.22 NA XXX 95936 A H-reflex test 0.55 0.45 NA 0.04 1.04 NA XXX 95936 26 A H-reflex test 0.55 0.25 0.25 0.02 0.82 0.82 XXX 95936 TC A H-reflex test 0.00 0.20 NA 0.02 0.22 NA XXX 95937 A Neuromuscular junction test 0.65 0.60 NA 0.04 1.29 NA XXX 95937 26 A Neuromuscular junction test 0.65 0.28 0.28 0.02 0.95 0.95 XXX 95937 TC A Neuromuscular junction test 0.00 0.32 NA 0.02 0.34 NA XXX 95950 A Ambulatory eeg monitoring 1.51 4.93 NA 0.44 6.88 NA XXX 95950 26 A Ambulatory eeg monitoring 1.51 0.70 0.70 0.08 2.29 2.29 XXX 95950 TC A Ambulatory eeg monitoring 0.00 4.23 NA 0.36 4.59 NA XXX 95951 A EEG monitoring/videorecord 6.00 16.38 NA 0.58 22.96 NA XXX 95951 26 A EEG monitoring/videorecord 6.00 2.72 2.72 0.20 8.92 8.92 XXX 95951 TC A EEG monitoring/videorecord 0.00 13.66 NA 0.38 14.04 NA XXX 95953 A EEG monitoring/computer 3.08 7.39 NA 0.46 10.93 NA XXX 95953 26 A EEG monitoring/computer 3.08 1.38 1.38 0.10 4.56 4.56 XXX 95953 TC A EEG monitoring/computer 0.00 6.01 NA 0.36 6.37 NA XXX 95954 A EEG monitoring/giving drugs 2.45 4.43 NA 0.15 7.03 NA XXX 95954 26 A EEG monitoring/giving drugs 2.45 1.07 1.07 0.10 3.62 3.62 XXX 95954 TC A EEG monitoring/giving drugs 0.00 3.36 NA 0.05 3.41 NA XXX 95955 A EEG during surgery 1.01 2.26 NA 0.19 3.46 NA XXX 95955 26 A EEG during surgery 1.01 0.40 0.40 0.05 1.46 1.46 XXX Start Printed Page 55463 95955 TC A EEG during surgery 0.00 1.86 NA 0.14 2.00 NA XXX 95956 A Eeg monitoring, cable/radio 3.08 7.43 NA 0.47 10.98 NA XXX 95956 26 A Eeg monitoring, cable/radio 3.08 1.35 1.35 0.11 4.54 4.54 XXX 95956 TC A Eeg monitoring, cable/radio 0.00 6.08 NA 0.36 6.44 NA XXX 95957 A EEG digital analysis 1.98 2.52 NA 0.17 4.67 NA XXX 95957 26 A EEG digital analysis 1.98 0.90 0.90 0.07 2.95 2.95 XXX 95957 TC A EEG digital analysis 0.00 1.62 NA 0.10 1.72 NA XXX 95958 A EEG monitoring/function test 4.25 3.51 NA 0.29 8.05 NA XXX 95958 26 A EEG monitoring/function test 4.25 1.86 1.86 0.18 6.29 6.29 XXX 95958 TC A EEG monitoring/function test 0.00 1.65 NA 0.11 1.76 NA XXX 95961 A Electrode stimulation, brain 2.97 2.67 NA 0.24 5.88 NA XXX 95961 26 A Electrode stimulation, brain 2.97 1.43 1.43 0.18 4.58 4.58 XXX 95961 TC A Electrode stimulation, brain 0.00 1.24 NA 0.06 1.30 NA XXX 95962 A Electrode stim, brain add-on 3.21 2.72 NA 0.23 6.16 NA ZZZ 95962 26 A Electrode stim, brain add-on 3.21 1.48 1.48 0.17 4.86 4.86 ZZZ 95962 TC A Electrode stim, brain add-on 0.00 1.24 NA 0.06 1.30 NA ZZZ 95965 C Meg, spontaneous 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95965 26 A Meg, spontaneous 8.00 3.19 3.19 0.20 11.39 11.39 XXX 95965 TC C Meg, spontaneous 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95966 C Meg, evoked, single 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95966 26 A Meg, evoked, single 4.00 1.60 1.60 0.18 5.78 5.78 XXX 95966 TC C Meg, evoked, single 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95967 C Meg, evoked, each addl 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 95967 26 A Meg, evoked, each addl 3.50 1.40 1.40 0.17 5.07 5.07 ZZZ 95967 TC C Meg, evoked, each addl 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 95970 A Analyze neurostim, no prog 0.45 0.18 0.16 0.03 0.66 0.64 XXX 95971 A Analyze neurostim, simple 0.78 0.28 0.24 0.06 1.12 1.08 XXX 95972 A Analyze neurostim, complex 1.50 0.62 0.51 0.17 2.29 2.18 XXX 95973 A Analyze neurostim, complex 0.92 0.42 0.36 0.07 1.41 1.35 ZZZ 95974 A Cranial neurostim, complex 3.00 1.37 1.37 0.15 4.52 4.52 XXX 95975 A Cranial neurostim, complex 1.70 0.78 0.78 0.07 2.55 2.55 ZZZ 95999 C Neurological procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 96000 A Motion analysis, video/3d 1.80 NA 0.72 0.02 NA 2.54 XXX 96001 A Motion test w/ft press meas 2.15 NA 0.86 0.02 NA 3.03 XXX 96002 A Dynamic surface emg 0.41 NA 0.16 0.02 NA 0.59 XXX 96003 A Dynamic fine wire emg 0.37 NA 0.15 0.03 NA 0.55 XXX 96004 A Phys review of motion tests 1.80 0.72 0.72 0.08 2.60 2.60 XXX 96100 A Psychological testing 0.00 1.67 NA 0.15 1.82 NA XXX 96105 A Assessment of aphasia 0.00 1.67 NA 0.15 1.82 NA XXX 96110 C Developmental test, lim 0.00 0.00 0.00 0.00 0.00 0.00 XXX 96111 A Developmental test, extend 0.00 1.67 NA 0.15 1.82 NA XXX 96115 A Neurobehavior status exam 0.00 1.67 NA 0.15 1.82 NA XXX 96117 A Neuropsych test battery 0.00 1.67 NA 0.15 1.82 NA XXX 96150 A Assess hlth/behave, init 0.50 0.21 0.20 0.02 0.73 0.72 XXX 96151 A Assess hlth/behave, subseq 0.48 0.21 0.19 0.02 0.71 0.69 XXX 96152 A Intervene hlth/behave, indiv 0.46 0.20 0.18 0.02 0.68 0.66 XXX 96153 A Intervene hlth/behave, group 0.10 0.04 0.04 0.01 0.15 0.15 XXX 96154 A Interv hlth/behav, fam w/pt 0.45 0.19 0.18 0.02 0.66 0.65 XXX 96155 A Interv hlth/behav fam no pt 0.44 0.18 0.18 0.02 0.64 0.64 XXX 96400 A Chemotherapy, sc/im 0.00 0.13 NA 0.01 0.14 NA XXX 96405 A Intralesional chemo admin 0.52 1.88 0.24 0.02 2.42 0.78 000 96406 A Intralesional chemo admin 0.80 2.94 0.41 0.02 3.76 1.23 000 96408 A Chemotherapy, push technique 0.00 0.92 NA 0.05 0.97 NA XXX 96410 A Chemotherapy infusion method 0.00 1.47 NA 0.07 1.54 NA XXX 96412 A Chemo, infuse method add-on 0.00 1.09 NA 0.06 1.15 NA ZZZ 96414 A Chemo, infuse method add-on 0.00 1.27 NA 0.07 1.34 NA XXX 96420 A Chemotherapy, push technique 0.00 1.18 NA 0.07 1.25 NA XXX 96422 A Chemotherapy infusion method 0.00 1.17 NA 0.07 1.24 NA XXX 96423 A Chemo, infuse method add-on 0.00 0.46 NA 0.02 0.48 NA ZZZ 96425 A Chemotherapy infusion method 0.00 1.36 NA 0.07 1.43 NA XXX 96440 A Chemotherapy, intracavitary 2.37 7.99 1.06 0.12 10.48 3.55 000 96445 A Chemotherapy, intracavitary 2.20 8.74 1.08 0.07 11.01 3.35 000 96450 A Chemotherapy, into CNS 1.89 6.79 0.95 0.06 8.74 2.90 000 96520 A Pump refilling, maintenance 0.00 0.84 NA 0.05 0.89 NA XXX 96530 A Pump refilling, maintenance 0.00 1.01 NA 0.05 1.06 NA XXX 96542 A Chemotherapy injection 1.42 4.70 0.55 0.05 6.17 2.02 XXX 96545 B Provide chemotherapy agent 0.00 0.00 0.00 0.00 0.00 0.00 XXX 96549 C Chemotherapy, unspecified 0.00 0.00 0.00 0.00 0.00 0.00 XXX 96567 A Photodynamic tx, skin 0.00 1.63 NA 0.03 1.66 NA XXX 96570 A Photodynamic tx, 30 min 1.10 0.46 0.38 0.04 1.60 1.52 ZZZ 96571 A Photodynamic tx, addl 15 min 0.55 0.22 0.20 0.02 0.79 0.77 ZZZ 96900 A Ultraviolet light therapy 0.00 0.45 NA 0.02 0.47 NA XXX 96902 B Trichogram +0.41 0.25 0.16 0.01 0.67 0.58 XXX Start Printed Page 55464 96910 A Photochemotherapy with UV-B 0.00 1.37 NA 0.03 1.40 NA XXX 96912 A Photochemotherapy with UV-A 0.00 1.54 NA 0.04 1.58 NA XXX 96913 A Photochemotherapy, UV-A or B 0.00 2.26 NA 0.08 2.34 NA XXX 96999 C Dermatological procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 97001 A Pt evaluation 1.20 0.56 0.37 0.10 1.86 1.67 XXX 97002 A Pt re-evaluation 0.60 0.35 0.27 0.04 0.99 0.91 XXX 97003 A Ot evaluation 1.20 0.69 0.32 0.05 1.94 1.57 XXX 97004 A Ot re-evaluation 0.60 0.69 0.12 0.02 1.31 0.74 XXX 97005 I Athletic train eval 0.00 0.00 0.00 0.00 0.00 0.00 XXX 97006 I Athletic train reeval 0.00 0.00 0.00 0.00 0.00 0.00 XXX 97010 B Hot or cold packs therapy +0.06 0.04 0.04 0.01 0.11 0.11 XXX 97012 A Mechanical traction therapy 0.25 0.11 0.11 0.01 0.37 0.37 XXX 97014 A Electric stimulation therapy 0.18 0.19 0.19 0.01 0.38 0.38 XXX 97016 A Vasopneumatic device therapy 0.18 0.14 0.14 0.01 0.33 0.33 XXX 97018 A Paraffin bath therapy 0.06 0.12 0.12 0.01 0.19 0.19 XXX 97020 A Microwave therapy 0.06 0.05 0.05 0.01 0.12 0.12 XXX 97022 A Whirlpool therapy 0.17 0.26 0.26 0.01 0.44 0.44 XXX 97024 A Diathermy treatment 0.06 0.05 0.05 0.01 0.12 0.12 XXX 97026 A Infrared therapy 0.06 0.05 0.05 0.01 0.12 0.12 XXX 97028 A Ultraviolet therapy 0.08 0.06 0.06 0.01 0.15 0.15 XXX 97032 A Electrical stimulation 0.25 0.21 0.21 0.01 0.47 0.47 XXX 97033 A Electric current therapy 0.26 0.12 0.12 0.02 0.40 0.40 XXX 97034 A Contrast bath therapy 0.21 0.14 0.14 0.01 0.36 0.36 XXX 97035 A Ultrasound therapy 0.21 0.08 0.08 0.01 0.30 0.30 XXX 97036 A Hydrotherapy 0.28 0.34 0.34 0.01 0.63 0.63 XXX 97039 A Physical therapy treatment 0.20 0.07 0.07 0.01 0.28 0.28 XXX 97110 A Therapeutic exercises 0.45 0.25 0.25 0.03 0.73 0.73 XXX 97112 A Neuromuscular reeducation 0.45 0.29 0.29 0.02 0.76 0.76 XXX 97113 A Aquatic therapy/exercises 0.44 0.33 0.33 0.03 0.80 0.80 XXX 97116 A Gait training therapy 0.40 0.21 0.21 0.02 0.63 0.63 XXX 97124 A Massage therapy 0.35 0.21 0.21 0.01 0.57 0.57 XXX 97139 A Physical medicine procedure 0.21 0.21 0.21 0.01 0.43 0.43 XXX 97140 A Manual therapy 0.43 0.23 0.23 0.02 0.68 0.68 XXX 97150 A Group therapeutic procedures 0.27 0.20 0.20 0.02 0.49 0.49 XXX 97504 A Orthotic training 0.45 0.25 0.25 0.03 0.73 0.73 XXX 97520 A Prosthetic training 0.45 0.21 0.21 0.02 0.68 0.68 XXX 97530 A Therapeutic activities 0.44 0.45 0.45 0.02 0.91 0.91 XXX 97532 A Cognitive skills development 0.44 0.17 0.17 0.01 0.62 0.62 XXX 97533 A Sensory integration 0.44 0.21 0.21 0.01 0.66 0.66 XXX 97535 A Self care mngment training 0.45 0.35 0.35 0.02 0.82 0.82 XXX 97537 A Community/work reintegration 0.45 0.20 0.20 0.01 0.66 0.66 XXX 97542 A Wheelchair mngment training 0.45 0.22 0.22 0.01 0.68 0.68 XXX 97545 R Work hardening 0.00 0.00 0.00 0.00 0.00 0.00 XXX 97546 R Work hardening add-on 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 97601 A Wound(s) care, selective 0.50 1.90 1.90 0.04 2.44 2.44 XXX 97602 B Wound(s) care non-selective 0.00 0.00 0.00 0.00 0.00 0.00 XXX 97703 A Prosthetic checkout 0.25 0.44 0.44 0.02 0.71 0.71 XXX 97750 A Physical performance test 0.45 0.24 0.24 0.02 0.71 0.71 XXX 97780 N Acupuncture w/o stimul 0.00 0.00 0.00 0.00 0.00 0.00 XXX 97781 N Acupuncture w/stimul 0.00 0.00 0.00 0.00 0.00 0.00 XXX 97799 C Physical medicine procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX 97802 A Medical nutrition, indiv, in 0.00 0.45 0.45 0.01 0.46 0.46 XXX 97803 A Med nutrition, indiv, subseq 0.00 0.45 0.45 0.01 0.46 0.46 XXX 97804 A Medical nutrition, group 0.00 0.17 0.17 0.01 0.18 0.18 XXX 98925 A Osteopathic manipulation 0.45 0.38 0.14 0.01 0.84 0.60 000 98926 A Osteopathic manipulation 0.65 0.44 0.25 0.02 1.11 0.92 000 98927 A Osteopathic manipulation 0.87 0.52 0.31 0.03 1.42 1.21 000 98928 A Osteopathic manipulation 1.03 0.59 0.38 0.03 1.65 1.44 000 98929 A Osteopathic manipulation 1.19 0.65 0.39 0.04 1.88 1.62 000 98940 A Chiropractic manipulation 0.45 0.25 0.13 0.01 0.71 0.59 000 98941 A Chiropractic manipulation 0.65 0.31 0.19 0.02 0.98 0.86 000 98942 A Chiropractic manipulation 0.87 0.37 0.25 0.03 1.27 1.15 000 98943 N Chiropractic manipulation +0.40 0.34 0.16 0.01 0.75 0.57 XXX 99000 B Specimen handling 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99001 B Specimen handling 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99002 B Device handling 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99024 B Postop follow-up visit 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99025 B Initial surgical evaluation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99050 B Medical services after hrs 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99052 B Medical services at night 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99054 B Medical servcs, unusual hrs 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99056 B Non-office medical services 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99058 B Office emergency care 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55465 99070 B Special supplies 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99071 B Patient education materials 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99075 N Medical testimony 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99078 B Group health education 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99080 B Special reports or forms 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99082 C Unusual physician travel 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99090 B Computer data analysis 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99091 B Collect/review data from pt 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99100 B Special anesthesia service 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 99116 B Anesthesia with hypothermia 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 99135 B Special anesthesia procedure 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 99140 B Emergency anesthesia 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 99141 B Sedation, iv/im or inhalant +0.80 2.12 0.39 0.04 2.96 1.23 XXX 99142 B Sedation, oral/rectal/nasal +0.60 1.24 0.31 0.03 1.87 0.94 XXX 99170 A Anogenital exam, child 1.75 2.02 0.55 0.07 3.84 2.37 000 99172 N Ocular function screen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99173 N Visual acuity screen 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99175 A Induction of vomiting 0.00 1.32 NA 0.08 1.40 NA XXX 99183 A Hyperbaric oxygen therapy 2.34 NA 0.77 0.12 NA 3.23 XXX 99185 A Regional hypothermia 0.00 0.61 NA 0.03 0.64 NA XXX 99186 A Total body hypothermia 0.00 1.69 NA 0.37 2.06 NA XXX 99190 X Special pump services 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99191 X Special pump services 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99192 X Special pump services 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99195 A Phlebotomy 0.00 0.42 NA 0.02 0.44 NA XXX 99199 C Special service/proc/report 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99201 A Office/outpatient visit, new 0.45 0.47 0.16 0.02 0.94 0.63 XXX 99202 A Office/outpatient visit, new 0.88 0.77 0.33 0.05 1.70 1.26 XXX 99203 A Office/outpatient visit, new 1.34 1.12 0.50 0.08 2.54 1.92 XXX 99204 A Office/outpatient visit, new 2.00 1.51 0.74 0.10 3.61 2.84 XXX 99205 A Office/outpatient visit, new 2.67 1.80 0.98 0.12 4.59 3.77 XXX 99211 A Office/outpatient visit, est 0.17 0.38 0.06 0.01 0.56 0.24 XXX 99212 A Office/outpatient visit, est 0.45 0.53 0.17 0.02 1.00 0.64 XXX 99213 A Office/outpatient visit, est 0.67 0.69 0.24 0.03 1.39 0.94 XXX 99214 A Office/outpatient visit, est 1.10 1.04 0.41 0.04 2.18 1.55 XXX 99215 A Office/outpatient visit, est 1.77 1.36 0.66 0.07 3.20 2.50 XXX 99217 A Observation care discharge 1.28 NA 0.45 0.05 NA 1.78 XXX 99218 A Observation care 1.28 NA 0.45 0.05 NA 1.78 XXX 99219 A Observation care 2.14 NA 0.75 0.08 NA 2.97 XXX 99220 A Observation care 2.99 NA 1.06 0.11 NA 4.16 XXX 99221 A Initial hospital care 1.28 NA 0.47 0.05 NA 1.80 XXX 99222 A Initial hospital care 2.14 NA 0.77 0.08 NA 2.99 XXX 99223 A Initial hospital care 2.99 NA 1.08 0.10 NA 4.17 XXX 99231 A Subsequent hospital care 0.64 NA 0.24 0.02 NA 0.90 XXX 99232 A Subsequent hospital care 1.06 NA 0.39 0.03 NA 1.48 XXX 99233 A Subsequent hospital care 1.51 NA 0.55 0.05 NA 2.11 XXX 99234 A Observ/hosp same date 2.56 NA 0.93 0.11 NA 3.60 XXX 99235 A Observ/hosp same date 3.42 NA 1.21 0.13 NA 4.76 XXX 99236 A Observ/hosp same date 4.27 NA 1.49 0.17 NA 5.93 XXX 99238 A Hospital discharge day 1.28 NA 0.51 0.04 NA 1.83 XXX 99239 A Hospital discharge day 1.75 NA 0.71 0.05 NA 2.51 XXX 99241 A Office consultation 0.64 0.62 0.24 0.04 1.30 0.92 XXX 99242 A Office consultation 1.29 1.03 0.50 0.09 2.41 1.88 XXX 99243 A Office consultation 1.72 1.38 0.67 0.10 3.20 2.49 XXX 99244 A Office consultation 2.58 1.83 0.98 0.13 4.54 3.69 XXX 99245 A Office consultation 3.43 2.29 1.30 0.16 5.88 4.89 XXX 99251 A Initial inpatient consult 0.66 NA 0.26 0.04 NA 0.96 XXX 99252 A Initial inpatient consult 1.32 NA 0.53 0.08 NA 1.93 XXX 99253 A Initial inpatient consult 1.82 NA 0.72 0.09 NA 2.63 XXX 99254 A Initial inpatient consult 2.64 NA 1.03 0.11 NA 3.78 XXX 99255 A Initial inpatient consult 3.65 NA 1.41 0.15 NA 5.21 XXX 99261 A Follow-up inpatient consult 0.42 NA 0.16 0.02 NA 0.60 XXX 99262 A Follow-up inpatient consult 0.85 NA 0.32 0.03 NA 1.20 XXX 99263 A Follow-up inpatient consult 1.27 NA 0.48 0.04 NA 1.79 XXX 99271 A Confirmatory consultation 0.45 0.67 0.17 0.03 1.15 0.65 XXX 99272 A Confirmatory consultation 0.84 0.89 0.32 0.06 1.79 1.22 XXX 99273 A Confirmatory consultation 1.19 1.13 0.47 0.07 2.39 1.73 XXX 99274 A Confirmatory consultation 1.73 1.41 0.68 0.09 3.23 2.50 XXX 99275 A Confirmatory consultation 2.31 1.68 0.88 0.10 4.09 3.29 XXX 99281 A Emergency dept visit 0.33 NA 0.09 0.02 NA 0.44 XXX 99282 A Emergency dept visit 0.55 NA 0.15 0.03 NA 0.73 XXX 99283 A Emergency dept visit 1.24 NA 0.32 0.08 NA 1.64 XXX 99284 A Emergency dept visit 1.95 NA 0.49 0.12 NA 2.56 XXX Start Printed Page 55466 99285 A Emergency dept visit 3.06 NA 0.75 0.19 NA 4.00 XXX 99288 B Direct advanced life support 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99289 I Pt transport, 30-74 min 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99290 I Pt transport, addl 30 min 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 99291 A Critical care, first hour 4.00 1.63 1.34 0.14 5.77 5.48 XXX 99292 A Critical care, addl 30 min 2.00 0.92 0.66 0.07 2.99 2.73 ZZZ 99295 A Neonatal critical care 16.00 NA 4.53 0.70 NA 21.23 XXX 99296 A Neonatal critical care 8.00 NA 2.58 0.23 NA 10.81 XXX 99297 A Neonatal critical care 4.00 NA 1.32 0.12 NA 5.44 XXX 99298 A Neonatal critical care 2.75 NA 0.97 0.10 NA 3.82 XXX 99301 A Nursing facility care 1.20 0.70 0.42 0.04 1.94 1.66 XXX 99302 A Nursing facility care 1.61 0.98 0.57 0.05 2.64 2.23 XXX 99303 A Nursing facility care 2.01 1.21 0.70 0.06 3.28 2.77 XXX 99311 A Nursing fac care, subseq 0.60 0.49 0.21 0.02 1.11 0.83 XXX 99312 A Nursing fac care, subseq 1.00 0.68 0.35 0.03 1.71 1.38 XXX 99313 A Nursing fac care, subseq 1.42 0.87 0.50 0.04 2.33 1.96 XXX 99315 A Nursing fac discharge day 1.13 0.74 0.40 0.04 1.91 1.57 XXX 99316 A Nursing fac discharge day 1.50 0.95 0.53 0.05 2.50 2.08 XXX 99321 A Rest home visit, new patient 0.71 0.49 NA 0.02 1.22 NA XXX 99322 A Rest home visit, new patient 1.01 0.70 NA 0.03 1.74 NA XXX 99323 A Rest home visit, new patient 1.28 0.93 NA 0.04 2.25 NA XXX 99331 A Rest home visit, est pat 0.60 0.47 NA 0.02 1.09 NA XXX 99332 A Rest home visit, est pat 0.80 0.59 NA 0.03 1.42 NA XXX 99333 A Rest home visit, est pat 1.00 0.73 NA 0.03 1.76 NA XXX 99341 A Home visit, new patient 1.01 0.56 NA 0.05 1.62 NA XXX 99342 A Home visit, new patient 1.52 0.87 NA 0.05 2.44 NA XXX 99343 A Home visit, new patient 2.27 1.29 NA 0.07 3.63 NA XXX 99344 A Home visit, new patient 3.03 1.57 NA 0.10 4.70 NA XXX 99345 A Home visit, new patient 3.79 1.86 NA 0.12 5.77 NA XXX 99347 A Home visit, est patient 0.76 0.49 NA 0.03 1.28 NA XXX 99348 A Home visit, est patient 1.26 0.74 NA 0.04 2.04 NA XXX 99349 A Home visit, est patient 2.02 1.08 NA 0.06 3.16 NA XXX 99350 A Home visit, est patient 3.03 1.47 NA 0.10 4.60 NA XXX 99354 A Prolonged service, office 1.77 1.46 0.66 0.06 3.29 2.49 ZZZ 99355 A Prolonged service, office 1.77 1.24 0.65 0.06 3.07 2.48 ZZZ 99356 A Prolonged service, inpatient 1.71 NA 0.61 0.06 NA 2.38 ZZZ 99357 A Prolonged service, inpatient 1.71 NA 0.63 0.06 NA 2.40 ZZZ 99358 B Prolonged serv, w/o contact 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 99359 B Prolonged serv, w/o contact 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 99360 X Physician standby services 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99361 B Physician/team conference 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99362 B Physician/team conference 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99371 B Physician phone consultation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99372 B Physician phone consultation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99373 B Physician phone consultation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99374 B Home health care supervision +1.10 1.47 0.44 0.04 2.61 1.58 XXX 99377 B Hospice care supervision +1.10 1.47 0.44 0.04 2.61 1.58 XXX 99379 B Nursing fac care supervision +1.10 1.47 0.44 0.03 2.60 1.57 XXX 99380 B Nursing fac care supervision +1.73 1.72 0.69 0.05 3.50 2.47 XXX 99381 N Prev visit, new, infant +1.19 1.50 0.48 0.04 2.73 1.71 XXX 99382 N Prev visit, new, age 1-4 +1.36 1.54 0.54 0.04 2.94 1.94 XXX 99383 N Prev visit, new, age 5-11 +1.36 1.48 0.54 0.04 2.88 1.94 XXX 99384 N Prev visit, new, age 12-17 +1.53 1.55 0.61 0.05 3.13 2.19 XXX 99385 N Prev visit, new, age 18-39 +1.53 1.55 0.61 0.05 3.13 2.19 XXX 99386 N Prev visit, new, age 40-64 +1.88 1.74 0.75 0.06 3.68 2.69 XXX 99387 N Prev visit, new, 65 & over +2.06 1.87 0.82 0.06 3.99 2.94 XXX 99391 N Prev visit, est, infant +1.02 1.02 0.41 0.03 2.07 1.46 XXX 99392 N Prev visit, est, age 1-4 +1.19 1.09 0.48 0.04 2.32 1.71 XXX 99393 N Prev visit, est, age 5-11 +1.19 1.06 0.48 0.04 2.29 1.71 XXX 99394 N Prev visit, est, age 12-17 +1.36 1.15 0.54 0.04 2.55 1.94 XXX 99395 N Prev visit, est, age 18-39 +1.36 1.18 0.54 0.04 2.58 1.94 XXX 99396 N Prev visit, est, age 40-64 +1.53 1.27 0.61 0.05 2.85 2.19 XXX 99397 N Prev visit, est, 65 & over +1.71 1.37 0.68 0.05 3.13 2.44 XXX 99401 N Preventive counseling, indiv +0.48 0.62 0.19 0.01 1.11 0.68 XXX 99402 N Preventive counseling, indiv +0.98 0.86 0.39 0.02 1.86 1.39 XXX 99403 N Preventive counseling, indiv +1.46 1.10 0.58 0.03 2.59 2.07 XXX 99404 N Preventive counseling, indiv +1.95 1.35 0.78 0.04 3.34 2.77 XXX 99411 N Preventive counseling, group +0.15 0.18 0.06 0.01 0.34 0.22 XXX 99412 N Preventive counseling, group +0.25 0.24 0.10 0.01 0.50 0.36 XXX 99420 N Health risk assessment test 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99429 N Unlisted preventive service 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99431 A Initial care, normal newborn 1.17 NA 0.39 0.04 NA 1.60 XXX 99432 A Newborn care, not in hosp 1.26 1.12 0.50 0.06 2.44 1.82 XXX Start Printed Page 55467 99433 A Normal newborn care/hospital 0.62 NA 0.21 0.02 NA 0.85 XXX 99435 A Newborn discharge day hosp 1.50 NA 0.54 0.05 NA 2.09 XXX 99436 A Attendance, birth 1.50 0.50 0.50 0.05 2.05 2.05 XXX 99440 A Newborn resuscitation 2.93 NA 1.17 0.11 NA 4.21 XXX 99450 N Life/disability evaluation 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99455 R Disability examination 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99456 R Disability examination 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99499 C Unlisted e&m service 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99500 I Home visit, prenatal 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99501 I Home visit, postnatal 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99502 I Home visit, nb care 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99503 I Home visit, resp therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99504 I Home visit, mech ventilator 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99505 I Home visit, stoma care 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99506 I Home visit, im injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99507 I Home visit, cath maintain 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99508 I Home visit, sleep studies 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99509 I Home visit, day life activity 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99510 I Home visit, sing/m/fam couns 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99511 I Home visit, fecal/enema mgmt 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99512 I Home visit, hemodialysis 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99539 I Home visit, nos 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99551 I Home infuse, pain mgmt, iv/sc 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99552 I Home infuse pain mgmt, epid/ith 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99553 I Home infuse, tocolytic tx 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99554 I Home infuse, hormone/platelet 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99555 I Home infuse, chemotheraphy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99556 I Home infuse, antibio/fung/vir 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99557 I Home infuse, anticoagulant 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99558 I Home infuse, immunotherapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99559 I Home infuse, periton dialysis 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99560 I Home infuse, entero nutrition 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99561 I Home infuse, hydration tx 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99562 I Home infuse, parent nutrition 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99563 I Home admin, pentamidine 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99564 I Home infuse, antihemophil agnt 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99565 I Home infuse, proteinase inhib 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99566 I Home infuse, iv therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99567 I Home infuse, sympath agent 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99568 I Home infuse, misc drug, daily 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99569 I Home infuse, each addl tx 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0021 I Outside state ambulance serv 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0080 I Noninterest escort in non er 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0090 I Interest escort in non er 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0100 I Nonemergency transport taxi 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0110 I Nonemergency transport bus 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0120 I Noner transport mini-bus 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0130 I Noner transport wheelch van 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0140 I Nonemergency transport air 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0160 I Noner transport case worker 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0170 I Noner transport parking fees 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0180 I Noner transport lodgng recip 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0190 I Noner transport meals recip 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0200 I Noner transport lodgng escrt 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0210 I Noner transport meals escort 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0380 X Basic life support mileage 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0382 X Basic support routine suppls 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0384 X Bls defibrillation supplies 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0390 X Advanced life support mileag 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0392 X Als defibrillation supplies 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0394 X Als IV drug therapy supplies 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0396 X Als esophageal intub suppls 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0398 X Als routine disposble suppls 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0420 X Ambulance waiting 1/2 hr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0422 X Ambulance 02 life sustaining 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0424 X Extra ambulance attendant 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0425 X Ground mileage 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0426 X Als 1 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0427 X ALS1-emergency 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0428 X bls 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0429 X BLS-emergency 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0430 X Fixed wing air transport 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0431 X Rotary wing air transport 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55468 A0432 X PI volunteer ambulance co 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0433 X als 2 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0434 X Specialty care transport 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0435 X Fixed wing air mileage 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0436 X Rotary wing air mileage 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0888 N Noncovered ambulance mileage 0.00 0.00 0.00 0.00 0.00 0.00 XXX A0999 X Unlisted ambulance service 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4206 I 1 CC sterile syringe&needle 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4207 I 2 CC sterile syringe&needle 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4208 I 3 CC sterile syringe&needle 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4209 I 5+ CC sterile syringe&needle 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4210 N Nonneedle injection device 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4211 P Supp for self-adm injections 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4212 P Non coring needle or stylet 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4213 I 20+ CC syringe only 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4214 P 30 CC sterile water/saline 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4215 I Sterile needle 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4220 P Infusion pump refill kit 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4221 X Maint drug infus cath per wk 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4222 X Drug infusion pump supplies 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4230 X Infus insulin pump non needl 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4231 X Infusion insulin pump needle 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4232 X Syringe w/needle insulin 3cc 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4244 I Alcohol or peroxide per pint 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4245 I Alcohol wipes per box 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4246 I Betadine/phisohex solution 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4247 I Betadine/iodine swabs/wipes 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4250 N Urine reagent strips/tablets 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4253 P Blood glucose/reagent strips 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4254 X Battery for glucose monitor 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4255 X Glucose monitor platforms 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4256 P Calibrator solution/chips 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4257 X Replace Lensshield Cartridge 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4258 P Lancet device each 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4259 P Lancets per box 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4260 N Levonorgestrel implant 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4261 N Cervical cap contraceptive 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4262 B Temporary tear duct plug 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4263 I Permanent tear duct plug 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4265 P Paraffin 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4270 B Disposable endoscope sheath 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4280 X Brst prsths adhsv attchmnt 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4290 X Sacral nerve stim test lead 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4300 B Cath impl vasc access portal 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4301 P Implantable access syst perc 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4305 P Drug delivery system >=50 ML 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4306 P Drug delivery system <=5 ML 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4310 P Insert tray w/o bag/cath 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4311 P Catheter w/o bag 2-way latex 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4312 P Cath w/o bag 2-way silicone 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4313 P Catheter w/bag 3-way 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4314 P Cath w/drainage 2-way latex 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4315 P Cath w/drainage 2-way silcne 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4316 P Cath w/drainage 3-way 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4319 X Sterile H2 O irrigation solut 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4320 P Irrigation tray 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4321 X Cath therapeutic irrig agent 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4322 P Irrigation syringe 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4323 P Saline irrigation solution 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4324 X Male ext cath w/adh coating 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4325 X Male ext cath w/adh strip 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4326 P Male external catheter 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4327 P Fem urinary collect dev cup 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4328 P Fem urinary collect pouch 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4329 D External catheter start set 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4330 P Stool collection pouch 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4331 X Extension drainage tubing 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4332 X Lubricant for cath insertion 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4333 X Urinary cath anchor device 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4334 X Urinary cath leg strap 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4335 P Incontinence supply 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4338 P Indwelling catheter latex 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4340 P Indwelling catheter special 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55469 A4344 P Cath indw foley 2 way silicn 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4346 P Cath indw foley 3 way 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4347 P Male external catheter 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4348 X Male ext cath extended wear 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4351 P Straight tip urine catheter 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4352 P Coude tip urinary catheter 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4353 X Intermittent urinary cath 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4354 P Cath insertion tray w/bag 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4355 P Bladder irrigation tubing 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4356 P Ext ureth clmp or compr dvc 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4357 P Bedside drainage bag 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4358 P Urinary leg or abdomen bag 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4359 P Urinary suspensory w/o leg b 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4360 N Adult incontinence garment 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4361 P Ostomy face plate 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4362 P Solid skin barrier 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4364 P Adhesive, liquid or equal 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4365 X Adhesive remover wipes 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4367 P Ostomy belt 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4368 X Ostomy filter 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4369 X Skin barrier liquid per oz 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4370 X Skin barrier paste per oz 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4371 X Skin barrier powder per oz 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4372 X Skin barrier solid 4x4 equiv 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4373 X Skin barrier with flange 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4374 X Skin barrier extended wear 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4375 X Drainable plastic pch w fcpl 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4376 X Drainable rubber pch w fcplt 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4377 X Drainable plstic pch w/o fp 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4378 X Drainable rubber pch w/o fp 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4379 X Urinary plastic pouch w fcpl 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4380 X Urinary rubber pouch w fcplt 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4381 X Urinary plastic pouch w/o fp 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4382 X Urinary hvy plstc pch w/o fp 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4383 X Urinary rubber pouch w/o fp 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4384 X Ostomy faceplt/silicone ring 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4385 X Ost skn barrier sld ext wear 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4386 X Ost skn barrier w flng ex wr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4387 X Ost clsd pouch w att st barr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4388 X Drainable pch w ex wear barr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4389 X Drainable pch w st wear barr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4390 X Drainable pch ex wear convex 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4391 X Urinary pouch w ex wear barr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4392 X Urinary pouch w st wear barr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4393 X Urine pch w ex wear bar conv 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4394 X Ostomy pouch liq deodorant 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4395 X Ostomy pouch solid deodorant 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4396 X Peristomal hernia supprt blt 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4397 P Irrigation supply sleeve 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4398 P Ostomy irrigation bag 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4399 P Ostomy irrig cone/cath w brs 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4400 P Ostomy irrigation set 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4402 P Lubricant per ounce 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4404 P Ostomy ring each 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4421 P Ostomy supply misc 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4454 P Tape all types all sizes 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4455 P Adhesive remover per ounce 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4460 P Elastic compression bandage 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4462 X Abdmnl drssng holder/binder 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4464 N Joint support device/garment 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4465 P Non-elastic extremity binder 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4470 P Gravlee jet washer 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4480 P Vabra aspirator 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4481 X Tracheostoma filter 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4483 X Moisture exchanger 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4490 N Above knee surgical stocking 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4495 N Thigh length surg stocking 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4500 N Below knee surgical stocking 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4510 N Full length surg stocking 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4550 I Surgical trays 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4554 N Disposable underpads 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4556 P Electrodes, pair 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4557 P Lead wires, pair 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55470 A4558 P Conductive paste or gel 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4561 X Pessary rubber, any type 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4562 X Pessary, non rubber, any type 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4565 X Slings 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4570 I Splint 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4572 X Rib belt 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4575 N Hyperbaric o2 chamber disps 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4580 I Cast supplies (plaster) 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4590 I Special casting material 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4595 X TENS suppl 2 lead per month 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4608 X Transtracheal oxygen cath 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4611 X Heavy duty battery 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4612 X Battery cables 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4613 X Battery charger 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4614 X Hand-held PEFR meter 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4615 X Cannula nasal 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4616 X Tubing (oxygen) per foot 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4617 X Mouth piece 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4618 X Breathing circuits 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4619 X Face tent 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4620 X Variable concentration mask 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4621 X Tracheotomy mask or collar 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4622 X Tracheostomy or larngectomy 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4623 X Tracheostomy inner cannula 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4624 X Tracheal suction tube 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4625 X Trach care kit for new trach 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4626 X Tracheostomy cleaning brush 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4627 N Spacer bag/reservoir 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4628 X Oropharyngeal suction cath 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4629 X Tracheostomy care kit 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4630 X Repl bat t.e.n.s. own by pt 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4631 X Wheelchair battery 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4635 X Underarm crutch pad 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4636 X Handgrip for cane etc 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4637 X Repl tip cane/crutch/walker 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4640 X Alternating pressure pad 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4641 E Diagnostic imaging agent 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4642 E Satumomab pendetide per dose 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4643 E High dose contrast MRI 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4644 E Contrast 100-199 MGs iodine 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4645 E Contrast 200-299 MGs iodine 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4646 E Contrast 300-399 MGs iodine 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4647 B Supp- paramagnetic contr mat 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4649 P Surgical supplies 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4650 D Supp esrd centrifuge 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4651 X Calibrated microcap tube 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4652 X Microcapillary tube sealant 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4655 D Esrd syringe/needle 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4656 X Dialysis needle 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4657 X Dialysis syringe w/wo needle 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4660 X Sphyg/bp app w cuff and stet 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4663 X Dialysis blood pressure cuff 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4670 N Automatic bp monitor, dial 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4680 X Actificial carbon filter, ea 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4690 X Dialyzer, each 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4700 D Standard dialysate solution 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4705 D Bicarb dialysate solution 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4706 X Bicarbonate conc sol per gal 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4707 X Bicarbonate conc pow per pac 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4708 X Acetate conc sol per gallon 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4709 X Acid conc sol per gallon 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4712 X Sterile water inj per 10 ml 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4714 X Treated water per gallon 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4719 X “Y set” tubing 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4720 X Dialysat sol fld vol > 249cc 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4721 X Dialysat sol fld vol > 999cc 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4722 X Dialys sol fld vol > 1999cc 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4723 X Dialys sol fld vol > 2999cc 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4724 X Dialys sol fld vol > 3999cc 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4725 X Dialys sol fld vol > 4999cc 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4726 X Dialys sol fld vol > 5999cc 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4730 X Fistula cannulation set, ea 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4735 D Local/topical anesthetics 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55471 A4736 X Topical anesthetic, per gram 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4737 X Inj anesthetic per 10 ml 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4740 X Shunt accessory 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4750 X Art or venous blood tubing 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4755 X Comb art/venous blood tubing 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4760 X Dialysate sol test kit, each 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4765 X Dialysate conc pow per pack 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4766 X Dialysate conc sol add 10 ml 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4770 X Blood collection tube/vacuum 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4771 X Serum clotting time tube 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4772 X Blood glucose test strips 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4773 X Occult blood test strips 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4774 X Ammonia test strips 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4780 D Esrd sterilizing agent 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4790 D Esrd cleansing agents 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4800 D Heparin/antidote dialysis 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4801 X Heparin per 1000 units 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4802 X Protamine sulfate per 50 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4820 D Supplies hemodialysis kit 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4850 D Rubber tipped hemostats 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4860 X Disposable catheter tips 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4870 X Plumb/elec wk hm hemo equip 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4880 D Water storage tanks 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4890 R Repair/maint cont hemo equip 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4900 D Capd supply kit 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4901 D Ccpd supply kit 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4905 D Ipd supply kit 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4910 D Esrd nonmedical supplies 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4911 X Drain bag/bottle 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4912 D Gomco drain bottle 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4913 X Misc dialysis supplies noc 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4914 D Preparation kit 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4918 X Venous pressure clamp 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4919 D Supp dialysis dialyzer holde 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4920 D Harvard pressure clamp 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4921 D Measuring cylinder 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4927 X Non-sterile gloves 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4928 X Surgical mask 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4929 X Tourniquet for dialysis, ea 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5051 P Pouch clsd w barr attached 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5052 P Clsd ostomy pouch w/o barr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5053 P Clsd ostomy pouch faceplate 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5054 P Clsd ostomy pouch w/flange 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5055 P Stoma cap 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5061 P Pouch drainable w barrier at 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5062 P Drnble ostomy pouch w/o barr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5063 P Drain ostomy pouch w/flange 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5064 D Drain ostomy pouch w/fceplte 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5071 P Urinary pouch w/barrier 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5072 P Urinary pouch w/o barrier 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5073 P Urinary pouch on barr w/flng 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5074 D Urinary pouch w/faceplate 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5075 D Urinary pouch on faceplate 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5081 P Continent stoma plug 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5082 P Continent stoma catheter 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5093 P Ostomy accessory convex inse 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5102 P Bedside drain btl w/wo tube 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5105 P Urinary suspensory 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5112 P Urinary leg bag 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5113 P Latex leg strap 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5114 P Foam/fabric leg strap 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5119 P Skin barrier wipes box pr 50 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5121 P Solid skin barrier 6x6 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5122 P Solid skin barrier 8x8 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5123 P Skin barrier with flange 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5126 P Disk/foam pad + or − adhesive 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5131 P Appliance cleaner 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5200 X Percutaneous catheter anchor 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5500 X Diab shoe for density insert 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5501 X Diabetic custom molded shoe 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5502 D Diabetic shoe density insert 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5503 X Diabetic shoe w/roller/rockr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5504 X Diabetic shoe with wedge 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55472 A5505 X Diab shoe w/metatarsal bar 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5506 X Diabetic shoe w/off set heel 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5507 X Modification diabetic shoe 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5508 X Diabetic deluxe shoe 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5509 X Direct heat form shoe insert 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5510 X Compression form shoe insert 0.00 0.00 0.00 0.00 0.00 0.00 XXX A5511 X Custom fab molded shoe inser 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6000 X Wound warming wound cover 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6010 X Collagen based wound filler 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6020 D Collagen wound dressing 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6021 X Collagen dressing <=16 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6022 X Collagen drsg>6<=48 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6023 X Collagen dressing >48 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6024 X Collagen dsg wound filler 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6025 I Silicone gel sheet, each 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6154 P Wound pouch each 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6196 P Alginate dressing <=16 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6197 P Alginate drsg >16 <=48 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6198 P alginate dressing >48 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6199 P Alginate drsg wound filler 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6200 X Compos drsg <=16 no border 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6201 X Compos drsg >16<=48 no bdr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6202 X Compos drsg >48 no border 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6203 P Composite drsg <=16 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6204 P Composite drsg >16<=48 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6205 P Composite drsg >48 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6206 P Contact layer <=16 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6207 P Contact layer >16<=48 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6208 P Contact layer >48 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6209 P Foam drsg <=16 sq in w/o bdr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6210 P Foam drg >16<=48 sq in w/o b 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6211 P Foam drg >48 sq in w/o brdr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6212 P Foam drg <=16 sq in w/border 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6213 P Foam drg >16<=48 sq in w/bdr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6214 P Foam drg >48 sq in w/border 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6215 P Foam dressing wound filler 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6216 P Non-sterile gauze <=16 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6217 P Non-sterile gauze >16<=48 sq 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6218 P Non-sterile gauze >48 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6219 P Gauze <=16 sq in w/border 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6220 P Gauze >16 <=48 sq in w/bordr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6221 P Gauze >48 sq in w/border 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6222 P Gauze <=16 in no w/sal w/o b 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6223 P Gauze >16<=48 no w/sal w/o b 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6224 P Gauze >48 in no w/sal w/o b 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6228 P Gauze <=16 sq in water/sal 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6229 P Gauze >16<=48 sq in watr/sal 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6230 P Gauze >48 sq in water/salne 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6231 X Hydrogel dsg <=16 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6232 X Hydrogel dsg >16<=48 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6233 X Hydrogel dressing >48 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6234 P Hydrocolld drg <=16 w/o bdr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6235 P Hydrocolld drg >16<=48 w/o b 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6236 P Hydrocolld drg >48 in w/o b 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6237 P Hydrocolld drg <=16 in w/bdr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6238 P Hydrocolld drg >16<=48 w/bdr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6239 P Hydrocolld drg >48 in w/bdr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6240 P Hydrocolld drg filler paste 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6241 P Hydrocolloid drg filler dry 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6242 P Hydrogel drg <=16 in w/o bdr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6243 P Hydrogel drg >16<=48 w/o bdr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6244 P Hydrogel drg >48 in w/o bdr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6245 P Hydrogel drg <=16 in w/bdr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6246 P Hydrogel drg >16<=48 in w/b 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6247 P Hydrogel drg >48 sq in w/b 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6248 P Hydrogel drsg gel filler 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6250 P Skin seal protect moisturizr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6251 P Absorpt drg <=16 sq in w/o b 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6252 P Absorpt drg >16<=48 w/o bdr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6253 P Absorpt drg >48 sq in w/o b 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6254 P Absorpt drg <=16 sq in w/bdr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6255 P Absorpt drg >16<=48 in w/bdr 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6256 P Absorpt drg >48 sq in w/bdr 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55473 A6257 P Transparent film <=16 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6258 P Transparent film >16<=48 in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6259 P Transparent film >48 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6260 P Wound cleanser any type/size 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6261 P Wound filler gel/paste/oz 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6262 P Wound filler dry form/gram 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6263 P Non-sterile elastic gauze/yd 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6264 P Non-sterile no elastic gauze 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6265 P Tape per 18 sq inches 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6266 P Impreg gauze no h20/sal/yard 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6402 P Sterile gauze <=16 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6403 P Sterile gauze >16<=48 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6404 P Sterile gauze >48 sq in 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6405 P Sterile elastic gauze/yd 0.00 0.00 0.00 0.00 0.00 0.00 XXX A6406 P Sterile non-elastic gauze/yd 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7000 X Disposable canister for pump 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7001 X Nondisposable pump canister 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7002 X Tubing used w suction pump 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7003 X Nebulizer administration set 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7004 X Disposable nebulizer sml vol 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7005 X Nondisposable nebulizer set 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7006 X Filtered nebulizer admin set 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7007 X Lg vol nebulizer disposable 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7008 X Disposable nebulizer prefill 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7009 X Nebulizer reservoir bottle 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7010 X Disposable corrugated tubing 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7011 X Nondispos corrugated tubing 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7012 X Nebulizer water collec devic 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7013 X Disposable compressor filter 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7014 X Compressor nondispos filter 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7015 X Aerosol mask used w nebulize 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7016 X Nebulizer dome & mouthpiece 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7017 X Nebulizer not used w oxygen 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7018 X Water distilled w/nebulizer 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7019 X Saline solution dispenser 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7020 X Sterile H2 O or NSS w lgv neb 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7501 X Tracheostoma valve w diaphra 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7502 X Replacement diaphragm/fplate 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7503 X HMES filter holder or cap 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7504 X Tracheostoma HMES filter 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7505 X HMES or trach valve housing 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7506 X HMES/trachvalve adhesive disk 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7507 X Integrated filter & holder 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7508 X Housing & Integrated Adhesiv 0.00 0.00 0.00 0.00 0.00 0.00 XXX A7509 X Heat & moisture exchange sys 0.00 0.00 0.00 0.00 0.00 0.00 XXX A9150 E Misc/exper non-prescript dru 0.00 0.00 0.00 0.00 0.00 0.00 XXX A9160 D Podiatrist non-covered servi 0.00 0.00 0.00 0.00 0.00 0.00 XXX A9170 D Chiropractor non-covered ser 0.00 0.00 0.00 0.00 0.00 0.00 XXX A9190 D Misc/expe personal comfort i 0.00 0.00 0.00 0.00 0.00 0.00 XXX A9270 N Non-covered item or service 0.00 0.00 0.00 0.00 0.00 0.00 XXX A9300 N Exercise equipment 0.00 0.00 0.00 0.00 0.00 0.00 XXX A9500 E Technetium TC 99m sestamibi 0.00 0.00 0.00 0.00 0.00 0.00 XXX A9502 X Technetium TC 99M tetrofosmin 0.00 0.00 0.00 0.00 0.00 0.00 XXX A9503 E Technetium TC 99m medronate 0.00 0.00 0.00 0.00 0.00 0.00 XXX A9504 X Technetium tc 99m apcitide 0.00 0.00 0.00 0.00 0.00 0.00 XXX A9505 E Thallous chloride TL 201/mci 0.00 0.00 0.00 0.00 0.00 0.00 XXX A9507 X Indium/111 capromab pendetid 0.00 0.00 0.00 0.00 0.00 0.00 XXX A9508 X Iobenguane sulfate I-131 0.00 0.00 0.00 0.00 0.00 0.00 XXX A9510 X Technetium TC99m Disofenin 0.00 0.00 0.00 0.00 0.00 0.00 XXX A9511 X Technetium TC 99m depreotide 0.00 0.00 0.00 0.00 0.00 0.00 XXX A9600 X Strontium-89 chloride 0.00 0.00 0.00 0.00 0.00 0.00 XXX A9605 X Samarium sm153 lexidronamm 0.00 0.00 0.00 0.00 0.00 0.00 XXX A9700 X Echocardiography Contrast 0.00 0.00 0.00 0.00 0.00 0.00 XXX A9900 X Supply/accessory/service 0.00 0.00 0.00 0.00 0.00 0.00 XXX A9901 X Delivery/set up/dispensing 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0120 N Periodic oral evaluation 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0140 N Limit oral eval problm focus 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0150 R Comprehensve oral evaluation 0.00 0.00 0.00 0.00 0.00 0.00 YYY D0160 N Extensv oral eval prob focus 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0170 N Re-eval,est pt,problem focus 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0210 I Intraor complete film series 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0220 I Intraoral periapical first f 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0230 I Intraoral periapical ea add 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55474 D0240 R Intraoral occlusal film 0.00 0.00 0.00 0.00 0.00 0.00 YYY D0250 R Extraoral first film 0.00 0.00 0.00 0.00 0.00 0.00 YYY D0260 R Extraoral ea additional film 0.00 0.00 0.00 0.00 0.00 0.00 YYY D0270 R Dental bitewing single film 0.00 0.00 0.00 0.00 0.00 0.00 YYY D0272 R Dental bitewings two films 0.00 0.00 0.00 0.00 0.00 0.00 YYY D0274 R Dental bitewings four films 0.00 0.00 0.00 0.00 0.00 0.00 YYY D0277 R Vert bitewings-sev to eight 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0290 I Dental film skull/facial bon 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0310 I Dental saliography 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0320 I Dental tmj arthrogram incl i 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0321 I Dental other tmj films 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0322 I Dental tomographic survey 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0330 I Dental panoramic film 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0340 I Dental cephalometric film 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0350 I Oral/facial images 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0415 N Bacteriologic study 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0425 N Caries susceptibility test 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0460 R Pulp vitality test 0.00 0.00 0.00 0.00 0.00 0.00 YYY D0470 N Diagnostic casts 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0472 R Gross exam, prep & report 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0473 R Micro exam, prep & report 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0474 R Micro w/exam of surg margins 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0480 R Cytopath smear prep & report 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0501 R Histopathologic examinations 0.00 0.00 0.00 0.00 0.00 0.00 YYY D0502 R Other oral pathology procedu 0.00 0.00 0.00 0.00 0.00 0.00 YYY D0999 R Unspecified diagnostic proce 0.00 0.00 0.00 0.00 0.00 0.00 YYY D1110 N Dental prophylaxis adult 0.00 0.00 0.00 0.00 0.00 0.00 XXX D1120 N Dental prophylaxis child 0.00 0.00 0.00 0.00 0.00 0.00 XXX D1201 N Topical fluor w/prophy child 0.00 0.00 0.00 0.00 0.00 0.00 XXX D1203 N Topical fluor w/o prophy chi 0.00 0.00 0.00 0.00 0.00 0.00 XXX D1204 N Topical fluor w/o prophy adu 0.00 0.00 0.00 0.00 0.00 0.00 XXX D1205 N Topical fluoride w/ prophy a 0.00 0.00 0.00 0.00 0.00 0.00 XXX D1310 N Nutri counsel-control caries 0.00 0.00 0.00 0.00 0.00 0.00 XXX D1320 N Tobacco counseling 0.00 0.00 0.00 0.00 0.00 0.00 XXX D1330 N Oral hygiene instruction 0.00 0.00 0.00 0.00 0.00 0.00 XXX D1351 N Dental sealant per tooth 0.00 0.00 0.00 0.00 0.00 0.00 XXX D1510 R Space maintainer fxd unilat 0.00 0.00 0.00 0.00 0.00 0.00 YYY D1515 R Fixed bilat space maintainer 0.00 0.00 0.00 0.00 0.00 0.00 YYY D1520 R Remove unilat space maintain 0.00 0.00 0.00 0.00 0.00 0.00 YYY D1525 R Remove bilat space maintain 0.00 0.00 0.00 0.00 0.00 0.00 YYY D1550 R Recement space maintainer 0.00 0.00 0.00 0.00 0.00 0.00 YYY D2110 N Amalgam one surface primary 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2120 N Amalgam two surfaces primary 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2130 N Amalgam three surfaces prima 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2131 N Amalgam four/more surf prima 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2140 N Amalgam one surface permanen 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2150 N Amalgam two surfaces permane 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2160 N Amalgam three surfaces perma 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2161 N Amalgam 4 or > surfaces perm 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2330 N Resin one surface-anterior 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2331 N Resin two surfaces-anterior 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2332 N Resin three surfaces-anterio 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2335 N Resin 4/> surf or w/incis an 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2336 N Composite resin crown 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2337 N Compo resin crown ant-perm 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2380 N Resin one surf poster primar 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2381 N Resin two surf poster primar 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2382 N Resin three/more surf post p 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2385 N Resin one surf poster perman 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2386 N Resin two surf poster perman 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2387 N Resin three/more surf post p 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2388 N Resin four/more, post perm 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2410 N Dental gold foil one surface 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2420 N Dental gold foil two surface 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2430 N Dental gold foil three surfa 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2510 N Dental inlay metalic 1 surf 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2520 N Dental inlay metallic 2 surf 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2530 N Dental inlay metl 3/more sur 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2542 N Dental onlay metallic 2 surf 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2543 N Dental onlay metallic 3 surf 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2544 N Dental onlay metl 4/more sur 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2610 N Inlay porcelain/ceramic 1 su 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2620 N Inlay porcelain/ceramic 2 su 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55475 D2630 N Dental onlay porc 3/more sur 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2642 N Dental onlay porcelin 2 surf 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2643 N Dental onlay porcelin 3 surf 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2644 N Dental onlay porc 4/more sur 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2650 N Inlay composite/resin one su 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2651 N Inlay composite/resin two su 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2652 N Dental inlay resin 3/mre sur 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2662 N Dental onlay resin 2 surface 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2663 N Dental onlay resin 3 surface 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2664 N Dental onlay resin 4/more sur 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2710 N Crown resin laboratory 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2720 N Crown resin w/high noble me 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2721 N Crown resin w/base metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2722 N Crown resin w/noble metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2740 N Crown porcelain/ceramic subs 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2750 N Crown porcelain w/h noble m 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2751 N Crown porcelain fused base m 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2752 N Crown porcelain w/noble met 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2780 N Crown 3/4 cast hi noble met 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2781 N Crown 3/4 cast base metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2782 N Crown 3/4 cast noble metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2783 N Crown 3/4 porcelain/ceramic 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2790 N Crown full cast high noble m 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2791 N Crown full cast base metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2792 N Crown full cast noble metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2799 N Provisional crown 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2910 N Dental recement inlay 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2920 N Dental recement crown 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2930 N Prefab stnlss steel crwn pri 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2931 N Prefab stnlss steel crown pe 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2932 N Prefabricated resin crown 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2933 N Prefab stainless steel crown 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2940 N Dental sedative filling 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2950 N Core build-up incl any pins 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2951 N Tooth pin retention 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2952 N Post and core cast + crown 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2953 N Each addtnl cast post 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2954 N Prefab post/core + crown 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2955 N Post removal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2957 N Each addtnl prefab post 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2960 N Laminate labial veneer 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2961 N Lab labial veneer resin 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2962 N Lab labial veneer porcelain 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2970 R Temporary-fractured tooth 0.00 0.00 0.00 0.00 0.00 0.00 YYY D2980 N Crown repair 0.00 0.00 0.00 0.00 0.00 0.00 XXX D2999 R Dental unspec restorative pr 0.00 0.00 0.00 0.00 0.00 0.00 YYY D3110 N Pulp cap direct 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3120 N Pulp cap indirect 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3220 N Therapeutic pulpotomy 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3221 N Gross pulpal debridement 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3230 N Pulpal therapy anterior prim 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3240 N Pulpal therapy posterior pri 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3310 N Anterior 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3320 N Root canal therapy 2 canals 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3330 N Root canal therapy 3 canals 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3331 N Non-surg tx root canal obs 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3332 N Incomplete endodontic tx 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3333 N Internal root repair 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3346 N Retreat root canal anterior 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3347 N Retreat root canal bicuspid 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3348 N Retreat root canal molar 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3351 N Apexification/recalc initial 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3352 N Apexification/recalc interim 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3353 N Apexification/recalc final 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3410 N Apicoect/perirad surg anter 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3421 N Root surgery bicuspid 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3425 N Root surgery molar 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3426 N Root surgery ea add root 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3430 N Retrograde filling 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3450 N Root amputation 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3460 R Endodontic endosseous implan 0.00 0.00 0.00 0.00 0.00 0.00 YYY D3470 N Intentional replantation 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3910 N Isolation-tooth w/rubb dam 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55476 D3920 N Tooth splitting 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3950 N Canal prep/fitting of dowel 0.00 0.00 0.00 0.00 0.00 0.00 XXX D3999 R Endodontic procedure 0.00 0.00 0.00 0.00 0.00 0.00 YYY D4210 I Gingivectomy/plasty per quad 0.00 0.00 0.00 0.00 0.00 0.00 XXX D4211 I Gingivectomy/plasty per toot 0.00 0.00 0.00 0.00 0.00 0.00 XXX D4220 N Gingival curettage per quadr 0.00 0.00 0.00 0.00 0.00 0.00 XXX D4240 N Gingival flap proc w/planin 0.00 0.00 0.00 0.00 0.00 0.00 XXX D4245 N Apically positioned flap 0.00 0.00 0.00 0.00 0.00 0.00 XXX D4249 N Crown lengthen hard tissue 0.00 0.00 0.00 0.00 0.00 0.00 XXX D4260 R Osseous surgery per quadrant 0.00 0.00 0.00 0.00 0.00 0.00 YYY D4263 R Bone replce graft first site 0.00 0.00 0.00 0.00 0.00 0.00 YYY D4264 R Bone replce graft each add 0.00 0.00 0.00 0.00 0.00 0.00 YYY D4266 N Guided tiss regen resorble 0.00 0.00 0.00 0.00 0.00 0.00 XXX D4267 N Guided tiss regen nonresorb 0.00 0.00 0.00 0.00 0.00 0.00 XXX D4268 R Surgical revision procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX D4270 R Pedicle soft tissue graft pr 0.00 0.00 0.00 0.00 0.00 0.00 YYY D4271 R Free soft tissue graft proc 0.00 0.00 0.00 0.00 0.00 0.00 YYY D4273 R Subepithelial tissue graft 0.00 0.00 0.00 0.00 0.00 0.00 YYY D4274 N Distal/proximal wedge proc 0.00 0.00 0.00 0.00 0.00 0.00 XXX D4320 N Provision splnt intracoronal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D4321 N Provisional splint extracoro 0.00 0.00 0.00 0.00 0.00 0.00 XXX D4341 N Periodontal scaling & root 0.00 0.00 0.00 0.00 0.00 0.00 XXX D4355 R Full mouth debridement 0.00 0.00 0.00 0.00 0.00 0.00 YYY D4381 R Localized chemo delivery 0.00 0.00 0.00 0.00 0.00 0.00 YYY D4910 N Periodontal maint procedures 0.00 0.00 0.00 0.00 0.00 0.00 XXX D4920 N Unscheduled dressing change 0.00 0.00 0.00 0.00 0.00 0.00 XXX D4999 N Unspecified periodontal proc 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5110 N Dentures complete maxillary 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5120 N Dentures complete mandible 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5130 N Dentures immediat maxillary 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5140 N Dentures immediat mandible 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5211 N Dentures maxill part resin 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5212 N Dentures mand part resin 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5213 N Dentures maxill part metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5214 N Dentures mandibl part metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5281 N Removable partial denture 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5410 N Dentures adjust cmplt maxil 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5411 N Dentures adjust cmplt mand 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5421 N Dentures adjust part maxill 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5422 N Dentures adjust part mandbl 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5510 N Dentur repr broken compl bas 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5520 N Replace denture teeth complt 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5610 N Dentures repair resin base 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5620 N Rep part denture cast frame 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5630 N Rep partial denture clasp 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5640 N Replace part denture teeth 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5650 N Add tooth to partial denture 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5660 N Add clasp to partial denture 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5710 N Dentures rebase cmplt maxil 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5711 N Dentures rebase cmplt mand 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5720 N Dentures rebase part maxill 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5721 N Dentures rebase part mandbl 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5730 N Denture reln cmplt maxil ch 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5731 N Denture reln cmplt mand chr 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5740 N Denture reln part maxil chr 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5741 N Denture reln part mand chr 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5750 N Denture reln cmplt max lab 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5751 N Denture reln cmplt mand lab 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5760 N Denture reln part maxil lab 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5761 N Denture reln part mand lab 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5810 N Denture interm cmplt maxill 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5811 N Denture interm cmplt mandbl 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5820 N Denture interm part maxill 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5821 N Denture interm part mandbl 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5850 N Denture tiss conditn maxill 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5851 N Denture tiss condtin mandbl 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5860 N Overdenture complete 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5861 N Overdenture partial 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5862 N Precision attachment 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5867 N Replacement of precision att 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5875 N Prosthesis modification 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5899 N Removable prosthodontic proc 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5911 R Facial moulage sectional 0.00 0.00 0.00 0.00 0.00 0.00 YYY Start Printed Page 55477 D5912 R Facial moulage complete 0.00 0.00 0.00 0.00 0.00 0.00 YYY D5913 I Nasal prosthesis 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5914 I Auricular prosthesis 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5915 I Orbital prosthesis 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5916 I Ocular prosthesis 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5919 I Facial prosthesis 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5922 I Nasal septal prosthesis 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5923 I Ocular prosthesis interim 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5924 I Cranial prosthesis 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5925 I Facial augmentation implant 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5926 I Replacement nasal prosthesis 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5927 I Auricular replacement 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5928 I Orbital replacement 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5929 I Facial replacement 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5931 I Surgical obturator 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5932 I Postsurgical obturator 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5933 I Refitting of obturator 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5934 I Mandibular flange prosthesis 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5935 I Mandibular denture prosth 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5936 I Temp obturator prosthesis 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5937 I Trismus appliance 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5951 R Feeding aid 0.00 0.00 0.00 0.00 0.00 0.00 YYY D5952 I Pediatric speech aid 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5953 I Adult speech aid 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5954 I Superimposed prosthesis 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5955 I Palatal lift prosthesis 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5958 I Intraoral con def inter plt 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5959 I Intraoral con def mod palat 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5960 I Modify speech aid prosthesis 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5982 I Surgical stent 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5983 R Radiation applicator 0.00 0.00 0.00 0.00 0.00 0.00 YYY D5984 R Radiation shield 0.00 0.00 0.00 0.00 0.00 0.00 YYY D5985 R Radiation cone locator 0.00 0.00 0.00 0.00 0.00 0.00 YYY D5986 N Fluoride applicator 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5987 R Commissure splint 0.00 0.00 0.00 0.00 0.00 0.00 YYY D5988 I Surgical splint 0.00 0.00 0.00 0.00 0.00 0.00 XXX D5999 I Maxillofacial prosthesis 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6010 I Odontics endosteal implant 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6020 I Odontics abutment placement 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6040 I Odontics eposteal implant 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6050 I Odontics transosteal implnt 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6055 I Implant connecting bar 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6056 N Prefabricated abutment 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6057 N Custom abutment 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6058 N Abutment supported crown 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6059 N Abutment supported mtl crown 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6060 N Abutment supported mtl crown 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6061 N Abutment supported mtl crown 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6062 N Abutment supported mtl crown 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6063 N Abutment supported mtl crown 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6064 N Abutment supported mtl crown 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6065 N Implant supported crown 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6066 N Implant supported mtl crown 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6067 N Implant supported mtl crown 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6068 N Abutment supported retainer 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6069 N Abutment supported retainer 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6070 N Abutment supported retainer 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6071 N Abutment supported retainer 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6072 N Abutment supported retainer 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6073 N Abutment supported retainer 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6074 N Abutment supported retainer 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6075 N Implant supported retainer 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6076 N Implant supported retainer 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6077 N Implant supported retainer 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6078 N Implnt/abut suprtd fixd dent 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6079 N Implnt/abut suprtd fixd dent 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6080 I Implant maintenance 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6090 I Repair implant 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6095 I Odontics repr abutment 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6100 I Removal of implant 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6199 I Implant procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6210 N Prosthodont high noble metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6211 N Bridge base metal cast 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55478 D6212 N Bridge noble metal cast 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6240 N Bridge porcelain high noble 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6241 N Bridge porcelain base metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6242 N Bridge porcelain nobel metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6245 N Bridge porcelain/ceramic 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6250 N Bridge resin w/high noble 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6251 N Bridge resin base metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6252 N Bridge resin w/noble metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6519 N Inlay/onlay porce/ceramic 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6520 N Dental retainer two surfaces 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6530 N Retainer metallic 3+ surface 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6543 N Dental retainr onlay 3 surf 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6544 N Dental retainr onlay 4/more 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6545 N Dental retainr cast metl 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6548 N Porcelain/ceramic retainer 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6720 N Retain crown resin w/hi nble 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6721 N Crown resin w/base metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6722 N Crown resin w/noble metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6740 N Crown porcelain/ceramic 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6750 N Crown porcelain high noble 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6751 N Crown porcelain base metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6752 N Crown porcelain noble metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6780 N Crown 3/4 high noble metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6781 N Crown 3/4 cast based metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6782 N Crown 3/4 cast noble metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6783 N Crown 3/4 porcelain/ceramic 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6790 N Crown full high noble metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6791 N Crown full base metal cast 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6792 N Crown full noble metal cast 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6920 R Dental connector bar 0.00 0.00 0.00 0.00 0.00 0.00 YYY D6930 N Dental recement bridge 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6940 N Stress breaker 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6950 N Precision attachment 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6970 N Post & core plus retainer 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6971 N Cast post bridge retainer 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6972 N Prefab post & core plus reta 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6973 N Core build up for retainer 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6975 N Coping metal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6976 N Each addtnl cast post 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6977 N Each addtl prefab post 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6980 N Bridge repair 0.00 0.00 0.00 0.00 0.00 0.00 XXX D6999 N Fixed prosthodontic proc 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7110 R Oral surgery single tooth 0.00 0.00 0.00 0.00 0.00 0.00 YYY D7120 R Each add tooth extraction 0.00 0.00 0.00 0.00 0.00 0.00 YYY D7130 R Tooth root removal 0.00 0.00 0.00 0.00 0.00 0.00 YYY D7210 R Rem imp tooth w/mucoper flp 0.00 0.00 0.00 0.00 0.00 0.00 YYY D7220 R Impact tooth remov soft tiss 0.00 0.00 0.00 0.00 0.00 0.00 YYY D7230 R Impact tooth remov part bony 0.00 0.00 0.00 0.00 0.00 0.00 YYY D7240 R Impact tooth remov comp bony 0.00 0.00 0.00 0.00 0.00 0.00 YYY D7241 R Impact tooth rem bony w/comp 0.00 0.00 0.00 0.00 0.00 0.00 YYY D7250 R Tooth root removal 0.00 0.00 0.00 0.00 0.00 0.00 YYY D7260 R Oral antral fistula closure 0.00 0.00 0.00 0.00 0.00 0.00 YYY D7270 N Tooth reimplantation 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7272 N Tooth transplantation 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7280 N Exposure impact tooth orthod 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7281 N Exposure tooth aid eruption 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7285 I Biopsy of oral tissue hard 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7286 I Biopsy of oral tissue soft 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7290 N Repositioning of teeth 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7291 R Transseptal fiberotomy 0.00 0.00 0.00 0.00 0.00 0.00 YYY D7310 I Alveoplasty w/ extraction 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7320 I Alveoplasty w/o extraction 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7340 I Vestibuloplasty ridge extens 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7350 I Vestibuloplasty exten graft 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7410 I Rad exc lesion up to 1.25 cm 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7420 I Lesion > 1.25 cm 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7430 I Exc benign tumor to 1.25 cm 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7431 I Benign tumor exc > 1.25 cm 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7440 I Malig tumor exc to 1.25 cm 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7441 I Malig tumor > 1.25 cm 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7450 I Rem odontogen cyst to 1.25 cm 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7451 I Rem odontogen cyst > 1.25 cm 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7460 I Rem nonodonto cyst to 1.25 cm 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55479 D7461 I Rem nonodonto cyst > 1.25 cm 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7465 I Lesion destruction 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7471 I Rem exostosis any site 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7480 I Partial ostectomy 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7490 I Mandible resection 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7510 I I&d absc intraoral soft tiss 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7520 I I&d abscess extraoral 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7530 I Removal fb skin/areolar tiss 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7540 I Removal of fb reaction 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7550 I Removal of sloughed off bone 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7560 I Maxillary sinusotomy 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7610 I Maxilla open reduct simple 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7620 I Clsd reduct simpl maxilla fx 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7630 I Open red simpl mandible fx 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7640 I Clsd red simpl mandible fx 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7650 I Open red simp malar/zygom fx 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7660 I Clsd red simp malar/zygom fx 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7670 I Closd rductn splint alveolus 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7680 I Reduct simple facial bone fx 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7710 I Maxilla open reduct compound 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7720 I Clsd reduct compd maxilla fx 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7730 I Open reduct compd mandble fx 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7740 I Clsd reduct compd mandble fx 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7750 I Open red comp malar/zygma fx 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7760 I Clsd red comp malar/zygma fx 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7770 I Open reduc compd alveolus fx 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7780 I Reduct compnd facial bone fx 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7810 I Tmj open reduct-dislocation 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7820 I Closed tmp manipulation 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7830 I Tmj manipulation under anest 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7840 I Removal of tmj condyle 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7850 I Tmj meniscectomy 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7852 I Tmj repair of joint disc 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7854 I Tmj excisn of joint membrane 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7856 I Tmj cutting of a muscle 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7858 I Tmj reconstruction 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7860 I Tmj cutting into joint 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7865 I Tmj reshaping components 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7870 I Tmj aspiration joint fluid 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7871 N Lysis + lavage w catheters 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7872 I Tmj diagnostic arthroscopy 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7873 I Tmj arthroscopy lysis adhesn 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7874 I Tmj arthroscopy disc reposit 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7875 I Tmj arthroscopy synovectomy 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7876 I Tmj arthroscopy discectomy 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7877 I Tmj arthroscopy debridement 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7880 I Occlusal orthotic appliance 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7899 I Tmj unspecified therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7910 I Dent sutur recent wnd to 5 cm 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7911 I Dental suture wound to 5 cm 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7912 I Suture complicate wnd > 5 cm 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7920 I Dental skin graft 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7940 R Reshaping bone orthognathic 0.00 0.00 0.00 0.00 0.00 0.00 YYY D7941 I Bone cutting ramus closed 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7943 I Cutting ramus open w/graft 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7944 I Bone cutting segmented 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7945 I Bone cutting body mandible 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7946 I Reconstruction maxilla total 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7947 I Reconstruct maxilla segment 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7948 I Reconstruct midface no graft 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7949 I Reconstruct midface w/graft 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7950 I Mandible graft 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7955 I Repair maxillofacial defects 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7960 I Frenulectomy/frenulotomy 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7970 I Excision hyperplastic tissue 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7971 I Excision pericoronal gingiva 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7980 I Sialolithotomy 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7981 I Excision of salivary gland 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7982 I Sialodochoplasty 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7983 I Closure of salivary fistula 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7990 I Emergency tracheotomy 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7991 I Dental coronoidectomy 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7995 I Synthetic graft facial bones 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55480 D7996 I Implant mandible for augment 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7997 N Appliance removal 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7999 I Oral surgery procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX D8010 N Limited dental tx primary 0.00 0.00 0.00 0.00 0.00 0.00 XXX D8020 N Limited dental tx transition 0.00 0.00 0.00 0.00 0.00 0.00 XXX D8030 N Limited dental tx adolescent 0.00 0.00 0.00 0.00 0.00 0.00 XXX D8040 N Limited dental tx adult 0.00 0.00 0.00 0.00 0.00 0.00 XXX D8050 N Intercep dental tx primary 0.00 0.00 0.00 0.00 0.00 0.00 XXX D8060 N Intercep dental tx transitn 0.00 0.00 0.00 0.00 0.00 0.00 XXX D8070 N Compre dental tx transition 0.00 0.00 0.00 0.00 0.00 0.00 XXX D8080 N Compre dental tx adolescent 0.00 0.00 0.00 0.00 0.00 0.00 XXX D8090 N Compre dental tx adult 0.00 0.00 0.00 0.00 0.00 0.00 XXX D8210 N Orthodontic rem appliance tx 0.00 0.00 0.00 0.00 0.00 0.00 XXX D8220 N Fixed appliance therapy habt 0.00 0.00 0.00 0.00 0.00 0.00 XXX D8660 N Preorthodontic tx visit 0.00 0.00 0.00 0.00 0.00 0.00 XXX D8670 N Periodic orthodontc tx visit 0.00 0.00 0.00 0.00 0.00 0.00 XXX D8680 N Orthodontic retention 0.00 0.00 0.00 0.00 0.00 0.00 XXX D8690 N Orthodontic treatment 0.00 0.00 0.00 0.00 0.00 0.00 XXX D8691 N Repair ortho appliance 0.00 0.00 0.00 0.00 0.00 0.00 XXX D8692 N Replacement retainer 0.00 0.00 0.00 0.00 0.00 0.00 XXX D8999 N Orthodontic procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9110 R Tx dental pain minor proc 0.00 0.00 0.00 0.00 0.00 0.00 YYY D9210 I Dent anesthesia w/o surgery 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9211 I Regional block anesthesia 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9212 I Trigeminal block anesthesia 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9215 I Local anesthesia 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9220 I General anesthesia 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9221 I General anesthesia ea ad 15m 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9230 R Analgesia 0.00 0.00 0.00 0.00 0.00 0.00 YYY D9241 I Intravenous sedation 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9242 I IV sedation ea ad 30 m 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9248 R Sedation (non-iv) 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9310 I Dental consultation 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9410 I Dental house call 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9420 I Hospital call 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9430 I Office visit during hours 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9440 I Office visit after hours 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9610 I Dent therapeutic drug inject 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9630 R Other drugs/medicaments 0.00 0.00 0.00 0.00 0.00 0.00 YYY D9910 N Dent appl desensitizing med 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9911 N Appl desensitizing resin 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9920 N Behavior management 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9930 R Treatment of complications 0.00 0.00 0.00 0.00 0.00 0.00 YYY D9940 R Dental occlusal guard 0.00 0.00 0.00 0.00 0.00 0.00 YYY D9941 N Fabrication athletic guard 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9950 R Occlusion analysis 0.00 0.00 0.00 0.00 0.00 0.00 YYY D9951 R Limited occlusal adjustment 0.00 0.00 0.00 0.00 0.00 0.00 YYY D9952 R Complete occlusal adjustment 0.00 0.00 0.00 0.00 0.00 0.00 YYY D9970 N Enamel microabrasion 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9971 N Odontoplasty 1-2 teeth 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9972 N Extrnl bleaching per arch 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9973 N Extrnl bleaching per tooth 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9974 N Intrnl bleaching per tooth 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9999 I Adjunctive procedure 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0001 X Drawing blood for specimen 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0002 A Temporary urinary catheter 0.50 3.32 0.17 0.03 3.85 0.70 000 G0004 A ECG transm phys review & int 0.52 7.10 NA 0.45 8.07 NA XXX G0005 A ECG 24 hour recording 0.00 1.18 NA 0.07 1.25 NA XXX G0006 A ECG transmission & analysis 0.00 5.71 NA 0.36 6.07 NA XXX G0007 A ECG phy review & interpret 0.52 0.21 0.21 0.02 0.75 0.75 XXX G0008 X Admin influenza virus vac 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0009 X Admin pneumococcal vaccine 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0010 X Admin hepatitis b vaccine 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0015 A Post symptom ECG tracing 0.00 5.71 NA 0.36 6.07 NA XXX G0016 D Post symptom ECG md review 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0025 I Collagen skin test kit 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0026 X Fecal leukocyte examination 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0027 X Semen analysis 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0030 C PET imaging prev PET single 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0030 26 A PET imaging prev PET single 1.50 0.52 0.52 0.04 2.06 2.06 XXX G0030 TC C PET imaging prev PET single 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0031 C PET imaging prev PET multple 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0031 26 A PET imaging prev PET multple 1.87 0.70 0.70 0.06 2.63 2.63 XXX Start Printed Page 55481 G0031 TC C PET imaging prev PET multple 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0032 C PET follow SPECT 78464 singl 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0032 26 A PET follow SPECT 78464 singl 1.50 0.52 0.52 0.05 2.07 2.07 XXX G0032 TC C PET follow SPECT 78464 singl 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0033 C PET follow SPECT 78464 mult 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0033 26 A PET follow SPECT 78464 mult 1.87 0.70 0.70 0.06 2.63 2.63 XXX G0033 TC C PET follow SPECT 78464 mult 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0034 C PET follow SPECT 76865 singl 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0034 26 A PET follow SPECT 76865 singl 1.50 0.52 0.52 0.05 2.07 2.07 XXX G0034 TC C PET follow SPECT 76865 singl 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0035 C PET follow SPECT 78465 mult 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0035 26 A PET follow SPECT 78465 mult 1.87 0.70 0.70 0.06 2.63 2.63 XXX G0035 TC C PET follow SPECT 78465 mult 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0036 C PET follow cornry angio sing 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0036 26 A PET follow cornry angio sing 1.50 0.52 0.52 0.04 2.06 2.06 XXX G0036 TC C PET follow cornry angio sing 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0037 C PET follow cornry angio mult 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0037 26 A PET follow cornry angio mult 1.87 0.70 0.70 0.06 2.63 2.63 XXX G0037 TC C PET follow cornry angio mult 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0038 C PET follow myocard perf sing 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0038 26 A PET follow myocard perf sing 1.50 0.52 0.52 0.04 2.06 2.06 XXX G0038 TC C PET follow myocard perf sing 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0039 C PET follow myocard perf mult 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0039 26 A PET follow myocard perf mult 1.87 0.70 0.70 0.07 2.64 2.64 XXX G0039 TC C PET follow myocard perf mult 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0040 C PET follow stress echo singl 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0040 26 A PET follow stress echo singl 1.50 0.52 0.52 0.04 2.06 2.06 XXX G0040 TC C PET follow stress echo singl 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0041 C PET follow stress echo mult 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0041 26 A PET follow stress echo mult 1.87 0.70 0.70 0.05 2.62 2.62 XXX G0041 TC C PET follow stress echo mult 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0042 C PET follow ventriculogm sing 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0042 26 A PET follow ventriculogm sing 1.50 0.52 0.52 0.04 2.06 2.06 XXX G0042 TC C PET follow ventriculogm sing 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0043 C PET follow ventriculogm mult 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0043 26 A PET follow ventriculogm mult 1.87 0.70 0.70 0.06 2.63 2.63 XXX G0043 TC C PET follow ventriculogm mult 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0044 C PET following rest ECG singl 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0044 26 A PET following rest ECG singl 1.50 0.52 0.52 0.04 2.06 2.06 XXX G0044 TC C PET following rest ECG singl 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0045 C PET following rest ECG mult 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0045 26 A PET following rest ECG mult 1.87 0.70 0.70 0.06 2.63 2.63 XXX G0045 TC C PET following rest ECG mult 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0046 C PET follow stress ECG singl 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0046 26 A PET follow stress ECG singl 1.50 0.52 0.52 0.04 2.06 2.06 XXX G0046 TC C PET follow stress ECG singl 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0047 C PET follow stress ECG mult 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0047 26 A PET follow stress ECG mult 1.87 0.70 0.70 0.06 2.63 2.63 XXX G0047 TC C PET follow stress ECG mult 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0050 A Residual urine by ultrasound 0.00 0.81 NA 0.04 0.85 NA XXX G0101 A CA screen; pelvic/breast exam 0.45 0.52 0.18 0.01 0.98 0.64 XXX G0102 A Prostate ca screening; dre 0.17 0.38 0.06 0.01 0.56 0.24 XXX G0103 X Psa, total screening 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0104 A CA screen; flexi sigmoidscope 0.96 1.92 0.53 0.05 2.93 1.54 000 G0105 A Colorectal scrn; hi risk ind 3.70 8.79 1.77 0.20 12.69 5.67 000 G0106 A Colon CA screen; barium enema 0.99 2.47 NA 0.15 3.61 NA XXX G0106 26 A Colon CA screen; barium enema 0.99 0.35 0.35 0.04 1.38 1.38 XXX G0106 TC A Colon CA screen; barium enema 0.00 2.12 NA 0.11 2.23 NA XXX G0107 X CA screen; fecal blood test 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0108 A Diab manage trn per indiv 0.00 1.64 NA 0.01 1.65 NA XXX G0109 A Diab manage trn ind/group 0.00 0.96 NA 0.01 0.97 NA XXX G0110 R Nett pulm-rehab educ; ind 0.90 0.67 0.36 0.03 1.60 1.29 XXX G0111 R Nett pulm-rehab educ; group 0.27 0.29 0.11 0.01 0.57 0.39 XXX G0112 R Nett; nutrition guid, initial 1.72 1.24 0.69 0.05 3.01 2.46 XXX G0113 R Nett; nutrition guid, subseqnt 1.29 0.97 0.51 0.04 2.30 1.84 XXX G0114 R Nett; psychosocial consult 1.20 0.49 0.48 0.03 1.72 1.71 XXX G0115 R Nett; psychological testing 1.20 0.57 0.48 0.04 1.81 1.72 XXX G0116 R Nett; psychosocial counsel 1.11 0.69 0.44 0.04 1.84 1.59 XXX G0117 T Glaucoma scrn hgh risk direc 0.45 0.97 0.22 0.02 1.44 0.69 XXX G0118 T Glaucoma scrn hgh risk direc 0.17 0.84 0.08 0.01 1.02 0.26 XXX G0120 A Colon ca scrn; barium enema 0.99 2.47 NA 0.15 3.61 NA XXX G0120 26 A Colon ca scrn; barium enema 0.99 0.35 0.35 0.04 1.38 1.38 XXX G0120 TC A Colon ca scrn; barium enema 0.00 2.12 NA 0.11 2.23 NA XXX Start Printed Page 55482 G0121 A Colon ca scrn not hi rsk ind 3.70 8.79 1.77 0.20 12.69 5.67 000 G0122 N Colon ca scrn; barium enema +0.99 2.52 NA 0.15 3.66 NA XXX G0122 26 N Colon ca scrn; barium enema +0.99 0.40 0.40 0.04 1.43 1.43 XXX G0122 TC N Colon ca scrn; barium enema +0.00 2.12 NA 0.11 2.23 NA XXX G0123 X Screen cerv/vag thin layer 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0124 A Screen c/v thin layer by MD 0.42 0.19 0.19 0.01 0.62 0.62 XXX G0125 A PET img WhBD sgl pulm ring 1.50 56.10 NA 2.00 59.60 NA XXX G0125 26 A PET img WhBD sgl pulm ring 1.50 0.52 0.52 0.05 2.07 2.07 XXX G0125 TC A PET img WhBD sgl pulm ring 0.00 55.58 NA 1.95 57.53 NA XXX G0126 D Lung image (PET) staging 0.00 0.00 NA 0.00 0.00 NA XXX G0126 26 D Lung image (PET) staging 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0126 TC D Lung image (PET) staging 0.00 0.00 NA 0.00 0.00 NA XXX G0127 R Trim nail(s) 0.17 0.26 0.07 0.01 0.44 0.25 000 G0128 R CORF skilled nursing service 0.08 0.03 0.03 0.01 0.12 0.12 XXX G0130 A Single energy x-ray study 0.22 0.90 NA 0.05 1.17 NA XXX G0130 26 A Single energy x-ray study 0.22 0.11 0.11 0.01 0.34 0.34 XXX G0130 TC A Single energy x-ray study 0.00 0.79 NA 0.04 0.83 NA XXX G0131 A CT scan, bone density study 0.25 3.18 NA 0.14 3.57 NA XXX G0131 26 A CT scan, bone density study 0.25 0.13 0.13 0.01 0.39 0.39 XXX G0131 TC A CT scan, bone density study 0.00 3.05 NA 0.13 3.18 NA XXX G0132 A CT scan, bone density study 0.22 0.90 NA 0.05 1.17 NA XXX G0132 26 A CT scan, bone density study 0.22 0.11 0.11 0.01 0.34 0.34 XXX G0132 TC A CT scan, bone density study 0.00 0.79 NA 0.04 0.83 NA XXX G0141 A Scr c/v cyto, autosys and md 0.42 0.19 0.19 0.01 0.62 0.62 XXX G0143 X Scr c/v cyto, thinlayer,rescr 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0144 X Scr c/v cyto, thinlayer,rescr 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0145 X Scr c/v cyto, thinlayer,rescr 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0147 X Scr c/v cyto, automated sys 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0148 X Scr c/v cyto, autosys, rescr 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0163 D Pet for rec of colorectal ca 0.00 0.00 NA 0.00 0.00 NA XXX G0163 26 D Pet for rec of colorectal ca 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0163 TC D Pet for rec of colorectal ca 0.00 0.00 NA 0.00 0.00 NA XXX G0164 D Pet for lymphoma staging 0.00 0.00 NA 0.00 0.00 NA XXX G0164 26 D Pet for lymphoma staging 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0164 TC D Pet for lymphoma staging 0.00 0.00 NA 0.00 0.00 NA XXX G0165 D Pet, rec of melanoma/met ca 0.00 0.00 NA 0.00 0.00 NA XXX G0165 26 D Pet, rec of melanoma/met ca 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0165 TC D Pet, rec of melanoma/met ca 0.00 0.00 NA 0.00 0.00 NA XXX G0166 A Extrnl counterpulse, per tx 0.07 4.17 0.03 0.01 4.25 0.11 XXX G0167 C Hyperbaric oz tx; no md reqrd 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0168 A Wound closure by adhesive 0.45 2.33 0.19 0.01 2.79 0.65 000 G0173 X Stereo radoisurgery, complete 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0174 D Intensitymodulatedradiation 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0175 X OPPS Service, sched team conf 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0176 X OPPS/PHP; activity therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0177 X OPPS/PHP; train & educ serv 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0178 D Intensitymodulatedradiation 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0179 A MD recertification HHA PT 0.45 1.21 NA 0.01 1.67 NA XXX G0180 A MD certification HHA patient 0.67 1.29 NA 0.02 1.98 NA XXX G0181 A Home health care supervision 1.73 1.57 NA 0.06 3.36 NA XXX G0182 A Hospice care supervision 1.73 1.97 NA 0.06 3.76 NA XXX G0184 D Ocular photdynamicTx 2nd eye 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ G0185 C Transpuppillary thermotx 0.00 0.00 0.00 0.00 0.00 0.00 YYY G0186 C Dstry eye lesn, fdr vssl tech 0.00 0.00 0.00 0.00 0.00 0.00 YYY G0187 C Dstry mclr drusen, photocoag 0.00 0.00 0.00 0.00 0.00 0.00 YYY G0188 D Xray lwr extrmty-full lngth 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0188 26 D Xray lwr extrmty-full lngth 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0188 TC D Xray lwr extrmty-full lngth 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0190 D Immunization administration 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0191 D Immunization admin, each add 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0192 N Immunization oral/intranasal 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0193 C Endoscopicstudyswallowfunctn 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0194 C Sensorytestingendoscopicstud 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0195 A Clinicalevalswallowingfunct 1.50 1.95 0.76 0.07 3.52 2.33 XXX G0196 A Eval of swallowing with radio opa 1.50 1.95 0.76 0.07 3.52 2.33 XXX G0197 A Eval of pt for prescip speech devi 1.35 2.11 0.75 0.04 3.50 2.14 XXX G0198 A Patient adapation & train for spe 0.99 1.14 0.58 0.03 2.16 1.60 XXX G0199 A Reevaluation of patient uses pec 1.01 1.92 0.56 0.03 2.96 1.60 XXX G0200 A Eval of patient prescip of voice p 1.35 2.11 0.75 0.04 3.50 2.14 XXX G0201 A Modi for training in use voice pro 0.99 1.14 0.58 0.03 2.16 1.60 XXX G0202 A Screening mammographydigital 0.70 2.70 NA 0.09 3.49 NA XXX G0202 26 A Screening mammographydigital 0.70 0.28 0.28 0.03 1.01 1.01 XXX G0202 TC A Screening mammographydigital 0.00 2.42 NA 0.06 2.48 NA XXX Start Printed Page 55483 G0203 D Screen mammographyfilmdigital 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0204 A Diagnostic mammographydigital 0.87 2.73 NA 0.09 3.69 NA XXX G0204 26 A Diagnostic mammographydigital 0.87 0.35 0.35 0.03 1.25 1.25 XXX G0204 TC A Diagnostic mammographydigital 0.00 2.38 NA 0.06 2.44 NA XXX G0205 D Diagnostic mammographyfilmpro 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0205 26 D Diagnostic mammographyfilmpro 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0205 TC D Diagnostic mammographyfilmpro 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0206 A Diagnostic mammographydigital 0.70 2.20 NA 0.08 2.98 NA XXX G0206 26 A Diagnostic mammographydigital 0.70 0.28 0.28 0.03 1.01 1.01 XXX G0206 TC A Diagnostic mammographydigital 0.00 1.92 NA 0.05 1.97 NA XXX G0207 D Diagnostic mammography film 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0207 26 D Diagnostic mammography film 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0207 TC D Diagnostic mammography film 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0210 C PET img WhBD ring dxlung ca 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0210 26 A PET img WhBD ring dxlung ca 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0210 TC C PET img WhBD ring dxlung ca 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0211 C PET img WhBD ring init lung 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0211 26 A PET img WhBD ring init lung 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0211 TC C PET img WhBD ring init lung 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0212 C PET img WhBD ring restag lun 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0212 26 A PET img WhBD ring restag lun 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0212 TC C PET img WhBD ring restag lun 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0213 C PET img WhBD ring dx colorec 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0213 26 A PET img WhBD ring dx colorec 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0213 TC C PET img WhBD ring dx colorec 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0214 C PET img WhBD ring init colre 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0214 26 A PET img WhBD ring init colre 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0214 TC C PET img WhBD ring init colre 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0215 C PET img WhBD restag col 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0215 26 A PET img WhBD restag col 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0215 TC C PET img WhBD restag col 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0216 C PET img WhBD ring dx melanom 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0216 26 A PET img WhBD ring dx melanom 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0216 TC C PET img WhBD ring dx melanom 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0217 C PET img WhBD ring init melan 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0217 26 A PET img WhBD ring init melan 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0217 TC C PET img WhBD ring init melan 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0218 C PET img WhBD ring restag mel 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0218 26 A PET img WhBD ring restag mel 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0218 TC C PET img WhBD ring restag mel 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0219 N PET img WhBD ring noncov ind +1.50 0.60 0.60 0.04 2.14 2.14 XXX G0219 26 N PET img WhBD ring noncov ind +1.50 0.60 0.60 0.04 2.14 2.14 XXX G0219 TC N PET img WhBD ring noncov ind 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0220 C PET img WhBD ring dx lymphom 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0220 26 A PET img WhBD ring dx lymphom 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0220 TC C PET img WhBD ring dx lymphom 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0221 C PET img WhBD ring init lymph 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0221 26 A PET img WhBD ring init lymph 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0221 TC C PET img WhBD ring init lymph 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0222 C PET img WhBD ring resta lymp 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0222 26 A PET img WhBD ring resta lymp 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0222 TC C PET img WhBD ring resta lymp 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0223 C PET img WhBD reg ring dx hea 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0223 26 A PET img WhBD reg ring dx hea 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0223 TC C PET img WhBD reg ring dx hea 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0224 C PET img WhBD reg ring ini hea 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0224 26 A PET img WhBD reg ring ini hea 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0224 TC C PET img WhBD reg ring ini hea 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0225 C PET img WhBD ring restag hea 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0225 26 A PET img WhBD ring restag hea 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0225 TC C PET img WhBD ring restag hea 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0226 C PET img WhBD dx esophag 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0226 26 A PET img WhBD dx esophag 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0226 TC C PET img WhBD dx esophag 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0227 C PET img WhBD ini esopha 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0227 26 A PET img WhBD ini esopha 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0227 TC C PET img WhBD ini esopha 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0228 C PET img WhBD ring restg esop 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0228 26 A PET img WhBD ring restg esop 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0228 TC C PET img WhBD ring restg esop 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0229 C PET img metabolic brain ring 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0229 26 A PET img metabolic brain ring 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0229 TC C PET img metabolic brain ring 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55484 G0230 C PET myocard viability ring 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0230 26 A PET myocard viability ring 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0230 TC C PET myocard viability ring 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0231 C PET WhBD colorec; gamma cam 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0231 26 A PET WhBD colorec; gamma cam 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0231 TC C PET WhBD colorec; gamma cam 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0232 C PET WhBD lymphoma; gamma cam 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0232 26 A PET WhBD lymphoma; gamma cam 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0232 TC C PET WhBD lymphoma; gamma cam 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0233 C PET WhBD melanoma; gamma cam 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0233 26 A PET WhBD melanoma; gamma cam 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0233 TC C PET WhBD melanoma; gamma cam 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0234 C PET WhBD pulm nod; gamma cam 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0234 26 A PET WhBD pulm nod; gamma cam 1.50 0.60 0.60 0.04 2.14 2.14 XXX G0234 TC C PET WhBD pulm nod; gamma cam 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0236 A digital film convert diag ma 0.06 0.31 NA 0.02 0.39 NA ZZZ G0236 26 A digital film convert diag ma 0.06 0.02 0.02 0.01 0.09 0.09 ZZZ G0236 TC A digital film convert diag ma 0.00 0.29 NA 0.01 0.30 NA ZZZ G0237 A Therapeutic procd strg endur 0.00 0.45 NA 0.02 0.47 NA XXX G0238 C Oth resp proc, indiv 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0239 C Oth resp proc, group 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0240 A Critic care by MD transport 4.00 1.60 1.60 0.14 5.74 5.74 XXX G0241 A Each additional 30 minutes 2.00 0.80 0.80 0.07 2.87 2.87 ZZZ G0242 X Multisource photon ster plan 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0243 X Multisour photon stero treat 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0244 X Observ care by facility topt 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9001 X MCCD, initial rate 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9002 X MCCD, maintenance rate 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9003 X MCCD, risk adj hi, initial 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9004 X MCCD, risk adj lo, initial 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9005 X MCCD, risk adj, maintenance 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9006 X MCCD, Home monitoring 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9007 X MCCD, sch team conf 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9008 X MCCD, phys coor-care ovrsght 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9009 X MCCD, risk adj, level 3 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9010 X MCCD, risk adj, level 4 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9011 X MCCD, risk adj, level 5 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9012 X Other Specified Case Mgmt 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9016 N Demo-smoking cessation coun 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0001 I Alcohol and/or drug assess 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0002 I Alcohol and/or drug screenin 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0003 I Alcohol and/or drug screenin 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0004 I Alcohol and/or drug services 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0005 I Alcohol and/or drug services 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0006 I Alcohol and/or drug services 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0007 I Alcohol and/or drug services 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0008 I Alcohol and/or drug services 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0009 I Alcohol and/or drug services 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0010 I Alcohol and/or drug services 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0011 I Alcohol and/or drug services 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0012 I Alcohol and/or drug services 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0013 I Alcohol and/or drug services 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0014 I Alcohol and/or drug services 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0015 I Alcohol and/or drug services 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0016 I Alcohol and/or drug services 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0017 I Alcohol and/or drug services 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0018 I Alcohol and/or drug services 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0019 I Alcohol and/or drug services 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0020 I Alcohol and/or drug services 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0021 I Alcohol and/or drug training 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0022 I Alcohol and/or drug interven 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0023 I Alcohol and/or drug outreach 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0024 I Alcohol and/or drug preventi 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0025 I Alcohol and/or drug preventi 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0026 I Alcohol and/or drug preventi 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0027 I Alcohol and/or drug preventi 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0028 I Alcohol and/or drug preventi 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0029 I Alcohol and/or drug preventi 0.00 0.00 0.00 0.00 0.00 0.00 XXX H0030 I Alcohol and/or drug hotline 0.00 0.00 0.00 0.00 0.00 0.00 XXX H1000 I Prenatal care atrisk assessm 0.00 0.00 0.00 0.00 0.00 0.00 XXX H1001 I Antepartum management 0.00 0.00 0.00 0.00 0.00 0.00 XXX H1002 I Care coordination prenatal 0.00 0.00 0.00 0.00 0.00 0.00 XXX H1003 I Prenatal at risk education 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55485 H1004 I Follow up home visit/prental 0.00 0.00 0.00 0.00 0.00 0.00 XXX H1005 I Prenatal care enhanced srv pk 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0120 E Tetracyclin injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0130 E Abciximab injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0150 E Injection adenosine 6 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0151 E Adenosine injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0170 E Adrenalin epinephrin inject 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0190 E Inj biperiden lactate/5 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0200 E Alatrofloxacin mesylate 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0205 E Alglucerase injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0207 E Amifostine 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0210 E Methyldopate hcl injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0256 E Alpha 1 proteinase inhibitor 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0270 E Alprostadil for injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0275 E Alprostadil urethral suppos 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0280 E Aminophyllin 250 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0282 E Amiodarone HCl 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0285 E Amphotericin B 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0286 E Amphotericin B lipid complex 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0290 E Ampicillin 500 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0295 E Ampicillin sodium per 1.5 gm 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0300 E Amobarbital 125 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0330 E Succinycholine chloride inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0340 D Nandrolon phenpropionate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0350 E Injection anistreplase 30 u 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0360 E Hydralazine hcl injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0380 E Inj metaraminol bitartrate 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0390 E Chloroquine injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0395 E Arbutamine HCl injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0400 D Inj trimethaphan camsylate 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0456 E Azithromycin 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0460 E Atropine sulfate injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0470 E Dimecaprol injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0475 E Baclofen 10 MG injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0476 E Baclofen intrathecal trial 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0500 E Dicyclomine injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0510 D Benzquinamide injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0515 E Inj benztropine mesylate 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0520 E Bethanechol chloride inject 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0530 E Penicillin g benzathine inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0540 E Penicillin g benzathine inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0550 E Penicillin g benzathine inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0560 E Penicillin g benzathine inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0570 E Penicillin g benzathine inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0580 E Penicillin g benzathine inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0585 E Botulinum toxin a per unit 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0587 E Botulinum toxin type B 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0590 D Ethylnorepinephrine hcl inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0600 E Edetate calcium disodium inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0610 E Calcium gluconate injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0620 E Calcium glycer & lact/10 ML 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0630 E Calcitonin salmon injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0635 E Calcitriol injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0640 E Leucovorin calcium injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0670 E Inj mepivacaine HCL/10 ml 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0690 E Cefazolin sodium injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0692 E Cefepime HCl for injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0694 E Cefoxitin sodium injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0695 D Cefonocid sodium injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0696 E Ceftriaxone sodium injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0697 E Sterile cefuroxime injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0698 E Cefotaxime sodium injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0702 E Betamethasone acet&sod phosp 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0704 E Betamethasone sod phosp/4 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0706 E Caffeine citrate injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0710 E Cephapirin sodium injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0713 E Inj ceftazidime per 500 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0715 E Ceftizoxime sodium/500 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0720 E Chloramphenicol sodium injec 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0725 E Chorionic gonadotropin/1000u 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0730 D Chlorpheniramin maleate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0735 E Clonidine hydrochloride 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0740 E Cidofovir injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55486 J0743 E Cilastatin sodium injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0744 E Ciprofloxacin iv 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0745 E Inj codeine phosphate/30 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0760 E Colchicine injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0770 E Colistimethate sodium inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0780 E Prochlorperazine injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0800 E Corticotropin injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0810 D Cortisone injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0835 E Inj cosyntropin per 0.25 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0850 E Cytomegalovirus imm IV /vial 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0895 E Deferoxamine mesylate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0900 E Testosterone enanthate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0945 E Brompheniramine maleate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J0970 E Estradiol valerate injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1000 E Depo-estradiol cypionate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1020 E Methylprednisolone 20 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1030 E Methylprednisolone 40 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1040 E Methylprednisolone 80 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1050 E Medroxyprogesterone inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1055 N Medroxyprogester acetate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1056 E MA/EC contraceptive injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1060 E Testosterone cypionate 1 ML 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1070 E Testosterone cypionate 100 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1080 E Testosterone cypionate 200 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1090 D Testosterone cypionate 50 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1095 E Inj dexamethasone acetate 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1100 E Dexamethasone sodium phos 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1110 E Inj dihydroergotamine mesylt 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1120 E Acetazolamid sodium injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1160 E Digoxin injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1165 E Phenytoin sodium injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1170 E Hydromorphone injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1180 E Dyphylline injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1190 E Dexrazoxane HCl injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1200 E Diphenhydramine hcl injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1205 E Chlorothiazide sodium inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1212 E Dimethyl sulfoxide 50% 50 ML 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1230 E Methadone injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1240 E Dimenhydrinate injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1245 E Dipyridamole injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1250 E Inj dobutamine HCL/250 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1260 E Dolasetron mesylate 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1270 E Injection, doxercalciferol 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1320 E Amitriptyline injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1325 E Epoprostenol injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1327 E Eptifibatide injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1330 E Ergonovine maleate injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1362 D Erythromycin glucep/250 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1364 E Erythro lactobionate/500 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1380 E Estradiol valerate 10 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1390 E Estradiol valerate 20 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1410 E Inj estrogen conjugate 25 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1435 E Injection estrone per 1 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1436 E Etidronate disodium inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1438 E Etanercept injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1440 E Filgrastim 300 mcg injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1441 E Filgrastim 480 mcg injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1450 E Fluconazole 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1452 E Intraocular Fomivirsen na 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1455 E Foscarnet sodium injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1460 E Gamma globulin 1 CC inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1470 E Gamma globulin 2 CC inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1480 E Gamma globulin 3 CC inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1490 E Gamma globulin 4 CC inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1500 E Gamma globulin 5 CC inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1510 E Gamma globulin 6 CC inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1520 E Gamma globulin 7 CC inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1530 E Gamma globulin 8 CC inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1540 E Gamma globulin 9 CC inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1550 E Gamma globulin 10 CC inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1560 E Gamma globulin > 10 CC inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1561 E Immune globulin 500 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1563 E IV immune globulin 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55487 J1565 E RSV-ivig 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1570 E Ganciclovir sodium injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1580 E Garamycin gentamicin inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1590 E Gatifloxacin injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1600 E Gold sodium thiomaleate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1610 E Glucagon hydrochloride/1 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1620 E Gonadorelin hydroch/ 100 mcg 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1626 E Granisetron HCl injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1630 E Haloperidol injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1631 E Haloperidol decanoate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1642 E Inj heparin sodium per 10 u 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1644 E Inj heparin sodium per 1000u 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1645 E Dalteparin sodium 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1650 E Inj enoxaparin sodium 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1655 E Tinzaparin sodium injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1670 E Tetanus immune globulin inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1690 D Prednisolone tebutate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1700 E Hydrocortisone acetate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1710 E Hydrocortisone sodium ph inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1720 E Hydrocortisone sodium succ i 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1730 E Diazoxide injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1739 D Hydroxyprogesterone cap 125 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1741 D Hydroxyprogesterone cap 250 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1742 E Ibutilide fumarate injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1745 E Infliximab injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1750 E Iron dextran 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1755 E Iron sucrose injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1785 E Injection imiglucerase /unit 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1790 E Droperidol injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1800 E Propranolol injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1810 E Droperidol/fentanyl inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1820 E Insulin injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1825 E Interferon beta-1a 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1830 E Interferon beta-1b/.25 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1835 E Intraconazole injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1840 E Kanamycin sulfate 500 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1850 E Kanamycin sulfate 75 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1885 E Ketorolac tromethamine inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1890 E Cephalothin sodium injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1910 E Kutapressin injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1930 D Propiomazine injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1940 E Furosemide injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1950 E Leuprolide acetate/3.75 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1955 E Inj levocarnitine per 1 gm 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1956 E Levofloxacin injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1960 E Levorphanol tartrate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1970 D Methotrimeprazine injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1980 E Hyoscyamine sulfate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J1990 E Chlordiazepoxide injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2000 E Lidocaine injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2010 E Lincomycin injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2020 E Linezolid injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2060 E Lorazepam injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2150 E Mannitol injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2175 E Meperidine hydrochl/100 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2180 E Meperidine/promethazine inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2210 E Methylergonovin maleate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2240 D Metocurine iodide injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2250 E Inj midazolam hydrochloride 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2260 E Inj milrinone lactate/5 ML 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2270 E Morphine sulfate injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2271 E Morphine so4 injection 100mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2275 E Morphine sulfate injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2300 E Inj nalbuphine hydrochloride 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2310 E Inj naloxone hydrochloride 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2320 E Nandrolone decanoate 50 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2321 E Nandrolone decanoate 100 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2322 E Nandrolone decanoate 200 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2330 D Thiothixene injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2350 D Niacinamide/niacin injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2352 E Octreotide acetate injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2355 E Oprelvekin injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2360 E Orphenadrine injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55488 J2370 E Phenylephrine hcl injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2400 E Chloroprocaine hcl injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2405 E Ondansetron hcl injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2410 E Oxymorphone hcl injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2430 E Pamidronate disodium/30 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2440 E Papaverin hcl injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2460 E Oxytetracycline injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2480 D Hydrochlorides of opium inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2500 E Paricalcitol 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2510 E Penicillin g procaine inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2512 D Inj pentagastrin per 2 ML 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2515 E Pentobarbital sodium inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2540 E Penicillin g potassium inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2543 E Piperacillin/tazobactam 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2545 E Pentamidine isethionte/300mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2550 E Promethazine hcl injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2560 E Phenobarbital sodium inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2590 E Oxytocin injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2597 E Inj desmopressin acetate 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2640 D Prednisolone sodium ph inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2650 E Prednisolone acetate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2670 E Totazoline hcl injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2675 D Inj progesterone per 50 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2680 E Fluphenazine decanoate 25 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2690 E Procainamide hcl injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2700 E Oxacillin sodium injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2710 E Neostigmine methylslfte inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2720 E Inj protamine sulfate/10 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2725 E Inj protirelin per 250 mcg 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2730 E Pralidoxime chloride inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2760 E Phentolaine mesylate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2765 E Metoclopramide hcl injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2770 E Quinupristin/dalfopristin 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2780 E Ranitidine hydrochloride inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2790 E Rho (D) immune globulin inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2792 E Rho(D) immune globulin h, sd 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2795 E Ropivacaine HCl injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2800 E Methocarbamol injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2810 E Inj theophylline per 40 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2820 E Sargramostim injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2860 D Secobarbital sodium inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2910 E Aurothioglucose injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2912 E Sodium chloride injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2915 E NA Ferric Gluconate Complex 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2920 E Methylprednisolone injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2930 E Methylprednisolone injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2940 E Somatrem injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2941 E Somatropin injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2950 E Promazine hcl injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2970 D Methicillin sodium injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2993 E Reteplase injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2995 E Inj streptokinase/250,000 IU 0.00 0.00 0.00 0.00 0.00 0.00 XXX J2997 E Alteplase recombinant 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3000 E Streptomycin injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3010 E Fentanyl citrate injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3030 E Sumatriptan succinate/6 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3070 E Pentazocine hcl injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3080 D Chlorprothixene injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3100 E Tenecteplase injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3105 E Terbutaline sulfate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3120 E Testosterone enanthate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3130 E Testosterone enanthate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3140 E Testosterone suspension inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3150 E Testosteron propionate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3230 E Chlorpromazine hcl injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3240 E Thyrotropin injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3245 E Tirofiban hydrochloride 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3250 E Trimethobenzamide hcl inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3260 E Tobramycin sulfate injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3265 E Injection torsemide 10 mg/ml 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3270 D Imipramine hcl injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3280 E Thiethylperazine maleate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3301 E Triamcinolone acetonide inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55489 J3302 E Triamcinolone diacetate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3303 E Triamcinolone hexacetonl inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3305 E Inj trimetrexate glucoronate 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3310 E Perphenazine injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3320 E Spectinomycn di-hcl inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3350 E Urea injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3360 E Diazepam injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3364 E Urokinase 5,000 IU injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3365 E Urokinase 250,000 IU inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3370 R Vancomycin hcl injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3390 D Methoxamine injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3395 E Verteporfin injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3400 E Triflupromazine hcl inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3410 E Hydroxyzine hcl injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3420 E Vitamin b12 injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3430 E Vitamin k phytonadione inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3450 D Mephentermine sulfate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3470 E Hyaluronidase injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3475 E Inj magnesium sulfate 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3480 E Inj potassium chloride 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3485 E Zidovudine 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3490 E Drugs unclassified injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3520 N Edetate disodium per 150 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3530 E Nasal vaccine inhalation 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3535 N Metered dose inhaler drug 0.00 0.00 0.00 0.00 0.00 0.00 XXX J3570 N Laetrile amygdalin vit B17 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7030 E Normal saline solution infus 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7040 E Normal saline solution infus 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7042 E 5% dextrose/normal saline 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7050 E Normal saline solution infus 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7051 E Sterile saline/water 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7060 E 5% dextrose/water 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7070 E D5w infusion 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7100 E Dextran 40 infusion 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7110 E Dextran 75 infusion 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7120 E Ringers lactate infusion 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7130 E Hypertonic saline solution 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7190 X Factor viii 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7191 X Factor VIII (porcine) 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7192 X Factor viii recombinant 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7193 E Factor IX non-recombinant 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7194 X Factor ix complex 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7195 E Factor IX recombinant 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7197 X Antithrombin iii injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7198 E Anti-inhibitor 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7199 E Hemophilia clot factor noc 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7300 N Intraut copper contraceptive 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7302 N Levonorgestrel iu contracept 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7308 E Aminolevulinic acid hcl top 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7310 E Ganciclovir long act implant 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7315 D Sodium hyaluronate injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7316 E Sodium hyaluronate injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7320 E Hylan G-F 20 injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7330 E Cultured chondrocytes implnt 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7340 E Metabolic active D/E tissue 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7500 X Azathioprine oral 50 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7501 X Azathioprine parenteral 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7502 E Cyclosporine oral 100 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7504 X Lymphocyte immune globulin 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7505 X Monoclonal antibodies 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7506 X Prednisone oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7507 E Tacrolimus oral per 1 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7508 E Tacrolimus oral per 5 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7509 X Methylprednisolone oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7510 X Prednisolone oral per 5 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7511 E Antithymocyte globuln rabbit 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7513 E Daclizumab, parenteral 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7515 E Cyclosporine oral 25 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7516 E Cyclosporin parenteral 250 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7517 E Mycophenolate mofetil oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7520 E Sirolimus, oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7525 E Tacrolimus injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7599 X Immunosuppressive drug noc 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55490 J7608 E Acetylcysteine inh sol u d 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7618 E Albuterol inh sol con 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7619 E Albuterol inh sol u d 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7622 E Beclomethasome inhalatn sol 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7624 E Betamethasome inhalation sol 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7626 E Budesonide inhalation sol 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7628 E Bitolterol mes inhal sol con 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7629 E Bitolterol mes inh sol u d 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7631 E Cromolyn sodium inh sol u d 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7635 E Atropine inhal sol con 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7636 E Atropine inhal sol unit dose 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7637 E Dexamethasone inhal sol con 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7638 E Dexamethasone inhal sol u d 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7639 E Dornase alpha inhal sol u d 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7641 E Flunisolide, inhalation sol 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7642 E Glycopyrrolate inhal sol con 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7643 E Glycopyrrolate inhal sol u d 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7644 E Ipratropium brom inh sol u d 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7648 E Isoetharine hcl inh sol con 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7649 E Isoetharine hcl inh sol u d 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7658 E Isoproterenolhcl inh sol con 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7659 E Isoproterenol hcl inh sol ud 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7668 E Metaproterenol inh sol con 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7669 E Metaproterenol inh sol u d 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7680 E Terbutaline so4 inh sol con 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7681 E Terbutaline so4 inh sol u d 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7682 E Tobramycin inhalation sol 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7683 E Triamcinolone inh sol con 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7684 E Triamcinolone inh sol u d 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7699 E Inhalation solution for DME 0.00 0.00 0.00 0.00 0.00 0.00 XXX J7799 E Non-inhalation drug for DME 0.00 0.00 0.00 0.00 0.00 0.00 XXX J8499 N Oral prescrip drug non chemo 0.00 0.00 0.00 0.00 0.00 0.00 XXX J8510 E Oral busulfan 0.00 0.00 0.00 0.00 0.00 0.00 XXX J8520 E Capecitabine, oral, 150 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX J8521 E Capecitabine, oral, 500 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX J8530 E Cyclophosphamide oral 25 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J8560 E Etoposide oral 50 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J8600 E Melphalan oral 2 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J8610 E Methotrexate oral 2.5 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J8700 E Temozolmide 0.00 0.00 0.00 0.00 0.00 0.00 XXX J8999 E Oral prescription drug chemo 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9000 E Doxorubic hcl 10 MG vl chemo 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9001 E Doxorubicin hcl liposome inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9015 E Aldesleukin/single use vial 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9017 E Arsenic trioxide 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9020 E Asparaginase injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9031 E Bcg live intravesical vac 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9040 E Bleomycin sulfate injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9045 E Carboplatin injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9050 E Carmus bischl nitro inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9060 E Cisplatin 10 MG injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9062 E Cisplatin 50 MG injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9065 E Inj cladribine per 1 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9070 E Cyclophosphamide 100 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9080 E Cyclophosphamide 200 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9090 E Cyclophosphamide 500 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9091 E Cyclophosphamide 1.0 grm inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9092 E Cyclophosphamide 2.0 grm inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9093 E Cyclophosphamide lyophilized 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9094 E Cyclophosphamide lyophilized 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9095 E Cyclophosphamide lyophilized 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9096 E Cyclophosphamide lyophilized 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9097 E Cyclophosphamide lyophilized 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9100 E Cytarabine hcl 100 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9110 E Cytarabine hcl 500 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9120 E Dactinomycin actinomycin d 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9130 E Dacarbazine 10 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9140 E Dacarbazine 200 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9150 E Daunorubicin 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9151 E Daunorubicin citrate liposom 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9160 E Denileukin diftitox, 300 mcg 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9165 E Diethylstilbestrol injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9170 E Docetaxel 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55491 J9180 E Epirubicin HCl injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9181 E Etoposide 10 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9182 E Etoposide 100 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9185 E Fludarabine phosphate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9190 E Fluorouracil injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9200 E Floxuridine injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9201 E Gemcitabine HCl 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9202 E Goserelin acetate implant 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9206 E Irinotecan injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9208 E Ifosfomide injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9209 E Mesna injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9211 E Idarubicin hcl injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9212 E Interferon alfacon-1 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9213 E Interferon alfa-2a inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9214 E Interferon alfa-2b inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9215 E Interferon alfa-n3 inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9216 E Interferon gamma 1-b inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9217 E Leuprolide acetate suspnsion 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9218 E Leuprolide acetate injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9219 E Leuprolide acetate implant 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9230 E Mechlorethamine hcl inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9245 E Inj melphalan hydrochl 50 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9250 E Methotrexate sodium inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9260 E Methotrexate sodium inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9265 E Paclitaxel injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9266 E Pegaspargase/singl dose vial 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9268 E Pentostatin injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9270 E Plicamycin (mithramycin) inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9280 E Mitomycin 5 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9290 E Mitomycin 20 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9291 E Mitomycin 40 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9293 E Mitoxantrone hydrochl/5 MG 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9300 E Gemtuzumab ozogamicin 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9310 E Rituximab cancer treatment 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9320 E Streptozocin injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9340 E Thiotepa injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9350 E Topotecan 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9355 E Trastuzumab 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9357 E Valrubicin, 200 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9360 E Vinblastine sulfate inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9370 E Vincristine sulfate 1 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9375 E Vincristine sulfate 2 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9380 E Vincristine sulfate 5 MG inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9390 E Vinorelbine tartrate/10 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9600 E Porfimer sodium 0.00 0.00 0.00 0.00 0.00 0.00 XXX J9999 E Chemotherapy drug 0.00 0.00 0.00 0.00 0.00 0.00 XXX M0064 A Visit for drug monitoring 0.37 0.25 0.12 0.01 0.63 0.50 XXX M0075 N Cellular therapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX M0076 N Prolotherapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX M0100 N Intragastric hypothermia 0.00 0.00 0.00 0.00 0.00 0.00 XXX M0300 N IV chelationtherapy 0.00 0.00 0.00 0.00 0.00 0.00 XXX M0301 N Fabric wrapping of aneurysm 0.00 0.00 0.00 0.00 0.00 0.00 XXX M0302 D Assessment of cardiac output 0.00 0.00 NA 0.00 0.00 NA XXX M0302 26 D Assessment of cardiac output 0.00 0.00 0.00 0.00 0.00 0.00 XXX M0302 TC D Assessment of cardiac output 0.00 0.00 NA 0.00 0.00 NA XXX P2028 X Cephalin floculation test 0.00 0.00 0.00 0.00 0.00 0.00 XXX P2029 X Congo red blood test 0.00 0.00 0.00 0.00 0.00 0.00 XXX P2031 N Hair analysis 0.00 0.00 0.00 0.00 0.00 0.00 XXX P2033 X Blood thymol turbidity 0.00 0.00 0.00 0.00 0.00 0.00 XXX P2038 X Blood mucoprotein 0.00 0.00 0.00 0.00 0.00 0.00 XXX P3000 X Screen pap by tech w md supv 0.00 0.00 0.00 0.00 0.00 0.00 XXX P3001 A Screening pap smear by phys 0.42 0.19 0.19 0.01 0.62 0.62 XXX P7001 I Culture bacterial urine 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9010 E Whole blood for transfusion 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9011 E Blood split unit 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9012 E Cryoprecipitate each unit 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9016 E RBC leukocytes reduced 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9017 E One donor fresh frozn plasma 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9019 E Platelets, each unit 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9020 E Plaelet rich plasma unit 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9021 E Red blood cells unit 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9022 E Washed red blood cells unit 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9023 X Frozen plasma, pooled, sd 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55492 P9031 X Platelets leukocytes reduced 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9032 X Platelets, irradiated 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9033 X Platelets leukoreduced irrad 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9034 X Platelets, pheresis 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9035 X Platelet pheres leukoreduced 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9036 X Platelet pheresis irradiated 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9037 X Plate pheres leukoredu irrad 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9038 X RBC irradiated 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9039 X RBC deglycerolized 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9040 X RBC leukoreduced irradiated 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9041 X Albumin (human), 5%, 50 ml 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9042 D Albumin (human), 25% 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9043 X Plasma protein fract,t5%,50 ml 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9044 X Cryoprecipitatereducedplasma 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9045 X Albumin (human), 5%, 250 ml 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9046 X Albumin (human), 25%, 20 ml 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9047 X Albumin (human), 25%, 50 ml 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9048 X Plasmaprotein fract, 5%, 250 ml 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9050 X Granulocytes, pheresis unit 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9603 X One-way allow prorated miles 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9604 X One-way allow prorated trip 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9612 X Catheterize for urine spec 0.00 0.00 0.00 0.00 0.00 0.00 XXX P9615 X Urine specimen collect mult 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0035 A Cardiokymography 0.17 0.44 NA 0.03 0.64 NA XXX Q0035 26 A Cardiokymography 0.17 0.07 0.07 0.01 0.25 0.25 XXX Q0035 TC A Cardiokymography 0.00 0.37 NA 0.02 0.39 NA XXX Q0091 A Obtaining screen pap smear 0.37 0.68 0.15 0.01 1.06 0.53 XXX Q0092 A Set up port x-ray equipment 0.00 0.30 NA 0.01 0.31 NA XXX Q0111 X Wet mounts/w preparations 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0112 X Potassium hydroxide preps 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0113 X Pinworm examinations 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0114 X Fern test 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0115 X Post-coital mucous exam 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0136 E Non esrd epoetin alpha inj 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0144 D Azithromycin dihydrate, oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0160 D Factor IX non-recombinant 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0161 D Factor IX recombinant 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0163 X Diphenhydramine HCl 50 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0164 X Prochlorperazine maleate 5 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0165 X Prochlorperazine maleate 10 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0166 X Granisetron HCl 1 mg oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0167 X Dronabinol 2.5 mg oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0168 X Dronabinol 5 mg oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0169 X Promethazine HCl 12.5 mg oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0170 X Promethazine HCl 25 mg oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0171 X Chlorpromazine HCl 10 mg oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0172 X Chlorpromazine HCl 25 mg oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0173 X Trimethobenzamide HCl 250 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0174 X Thiethylperazine maleate 10 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0175 X Perphenazine 4 mg oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0176 X Perphenazine 8 mg oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0177 X Hydroxyzine pamoate 25 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0178 X Hydroxyzine pamoate 50 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0179 X Ondansetron HCl 8 mg oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0180 X Dolasetron mesylate oral 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0181 X Unspecified oral anti-emetic 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0183 X Nonmetabolic active tissue 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0184 X Metabolically active tissue 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0185 D Metabolic active D/E tissue 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q0187 E Factor viia recombinant 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q1001 X Ntiol category 1 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q1002 X Ntiol category 2 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q1003 X Ntiol category 3 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q1004 X Ntiol category 4 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q1005 X Ntiol category 5 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q2001 N Oral cabergoline 0.5 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q2002 E Elliotts b solution per ml 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q2003 E Aprotinin, 10,000 kiu 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q2004 E Bladder calculi irrig sol 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q2005 E Corticorelin ovine triflutat 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q2006 E Digoxin immune fab (ovine) 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q2007 E Ethanolamine oleate 100 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q2008 E Fomepizole, 15 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55493 Q2009 E Fosphenytoin, 50 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q2010 E Glatiramer acetate, per dose 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q2011 E Hemin, per 1 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q2012 E Pegademase bovine, 25 iu 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q2013 E Pentastarch 10% solution 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q2014 E Sermorelin acetate, 0.5 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q2015 D Somatrem, 5 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q2016 D Somatropin, 1 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q2017 E Teniposide, 50 mg 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q2018 E Urofollitropin, 75 iu 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q2019 E Basiliximab 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q2020 E Histrelin acetate 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q2021 E Lepirudin 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q2022 E VonWillebrandFactrCmplxperIU 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q3001 E Brachytherapy Radioelements 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q3002 E Gallium ga 67 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q3003 E Technetium tc99m bicisate 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q3004 E Xenon xe 133 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q3005 E Technetium tc99m mertiatide 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q3006 E Technetium tc99m glucepatate 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q3007 E Sodium phosphate p32 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q3008 E Indium 111-in pentetreotide 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q3009 E Technetium tc99m oxidronate 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q3010 E Technetium tc99mlabeledrbcs 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q3011 E Chromic phosphate p32 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q3012 E Cyanocobalamin cobalt co57 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q3013 D Verteporfin injection 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q3014 E Telehealth facility fee 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q3017 E ALS assessment 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4001 X Cast sup body cast plaster 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4002 X Cast sup body cast fiberglas 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4003 X Cast sup shoulder cast plstr 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4004 X Cast sup shoulder cast fbrgl 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4005 X Cast sup long arm adult plst 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4006 X Cast sup long arm adult fbrg 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4007 X Cast sup long arm ped plster 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4008 X Cast sup long arm ped fbrgls 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4009 X Cast sup sht arm adult plstr 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4010 X Cast sup sht arm adult fbrgl 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4011 X Cast sup sht arm ped plaster 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4012 X Cast sup sht arm ped fbrglas 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4013 X Cast sup gauntlet plaster 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4014 X Cast sup gauntlet fiberglass 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4015 X Cast sup gauntlet ped plster 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4016 X Cast sup gauntlet ped fbrgls 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4017 X Cast sup lng arm splint plst 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4018 X Cast sup lng arm splint fbrg 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4019 X Cast sup lng arm splnt ped p 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4020 X Cast sup lng arm splnt ped f 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4021 X Cast sup sht arm splint plst 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4022 X Cast sup sht arm splint fbrg 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4023 X Cast sup sht arm splnt ped p 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4024 X Cast sup sht arm splnt ped f 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4025 X Cast sup hip spica plaster 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4026 X Cast sup hip spica fiberglas 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4027 X Cast sup hip spica ped plstr 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4028 X Cast sup hip spica ped fbrgl 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4029 X Cast sup long leg plaster 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4030 X Cast sup long leg fiberglass 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4031 X Cast sup lng leg ped plaster 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4032 X Cast sup lng leg ped fbrgls 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4033 X Cast sup lng leg cylinder pl 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4034 X Cast sup lng leg cylinder fb 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4035 X Cast sup lng leg cylndr ped p 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4036 X Cast sup lng leg cylndr ped f 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4037 X Cast sup shrt leg plaster 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4038 X Cast sup shrt leg fiberglass 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4039 X Cast sup shrt leg ped plster 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4040 X Cast sup shrt leg ped fbrgls 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4041 X Cast sup lng leg splnt plstr 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4042 X Cast sup lng leg splnt fbrgl 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4043 X Cast sup lng leg splnt ped p 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4044 X Cast sup lng leg splnt ped f 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55494 Q4045 X Cast sup sht leg splnt plstr 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4046 X Cast sup sht leg splnt fbrgl 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4047 X Cast sup sht leg splnt ped p 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4048 X Cast sup sht leg splnt ped f 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4049 X Finger splint, static 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4050 X Cast supplies unlisted 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q4051 X Splint supplies misc 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q9920 E Epoetin with hct <= 20 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q9921 E Epoetin with hct = 21 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q9922 E Epoetin with hct = 22 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q9923 E Epoetin with hct = 23 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q9924 E Epoetin with hct = 24 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q9925 E Epoetin with hct = 25 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q9926 E Epoetin with hct = 26 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q9927 E Epoetin with hct = 27 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q9928 E Epoetin with hct = 28 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q9929 E Epoetin with hct = 29 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q9930 E Epoetin with hct = 30 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q9931 E Epoetin with hct = 31 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q9932 E Epoetin with hct = 32 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q9933 E Epoetin with hct = 33 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q9934 E Epoetin with hct = 34 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q9935 E Epoetin with hct = 35 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q9936 E Epoetin with hct = 36 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q9937 E Epoetin with hct = 37 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q9938 E Epoetin with hct = 38 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q9939 E Epoetin with hct = 39 0.00 0.00 0.00 0.00 0.00 0.00 XXX Q9940 E Epoetin with hct >= 40 0.00 0.00 0.00 0.00 0.00 0.00 XXX R0070 C Transport portable x-ray 0.00 0.00 0.00 0.00 0.00 0.00 XXX R0075 C Transport port x-ray multipl 0.00 0.00 0.00 0.00 0.00 0.00 XXX R0076 B Transport portable EKG 0.00 0.00 0.00 0.00 0.00 0.00 XXX T1000 I Private duty/independent nsg 0.00 0.00 0.00 0.00 0.00 0.00 XXX T1001 I Nursing assessment/evaluatn 0.00 0.00 0.00 0.00 0.00 0.00 XXX T1002 I RN services up to 15 minutes 0.00 0.00 0.00 0.00 0.00 0.00 XXX T1003 I LPN/LVN services up to 15 min 0.00 0.00 0.00 0.00 0.00 0.00 XXX T1004 I Nsg aide service up to 15 min 0.00 0.00 0.00 0.00 0.00 0.00 XXX T1005 I Respite care service 15 min 0.00 0.00 0.00 0.00 0.00 0.00 XXX T1006 I Family/Couple Counseling 0.00 0.00 0.00 0.00 0.00 0.00 XXX T1007 I Treatment Plan Development 0.00 0.00 0.00 0.00 0.00 0.00 XXX T1008 I Day Treatment for Individual 0.00 0.00 0.00 0.00 0.00 0.00 XXX T1009 I Child Sitting Services 0.00 0.00 0.00 0.00 0.00 0.00 XXX T1010 I Meals when Receive Services 0.00 0.00 0.00 0.00 0.00 0.00 XXX T1011 I Alcohol/Substance Abuse NOC 0.00 0.00 0.00 0.00 0.00 0.00 XXX T1012 I Alcohol/Substance Abuse Skil 0.00 0.00 0.00 0.00 0.00 0.00 XXX T1013 I Sign Lang/Oral Interpreter 0.00 0.00 0.00 0.00 0.00 0.00 XXX T1014 I Telehealth transmit, per min 0.00 0.00 0.00 0.00 0.00 0.00 XXX T1015 I Clinic service 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2020 X Vision svcs frames purchases 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2025 N Eyeglasses delux frames 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2100 X Lens spher single plano 4.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2101 X Single visn sphere 4.12-7.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2102 X Singl visn sphere 7.12-20.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2103 X Spherocylindr 4.00d/12-2.00d 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2104 X Spherocylindr 4.00d/2.12-4d 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2105 X Spherocylinder 4.00d/4.25-6d 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2106 X Spherocylinder 4.00d/>6.00d 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2107 X Spherocylinder 4.25d/12-2d 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2108 X Spherocylinder 4.25d/2.12-4d 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2109 X Spherocylinder 4.25d/4.25-6d 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2110 X Spherocylinder 4.25d/over 6d 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2111 X Spherocylindr 7.25d/.25-2.25 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2112 X Spherocylindr 7.25d/2.25-4d 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2113 X Spherocylindr 7.25d/4.25-6d 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2114 X Spherocylinder over 12.00d 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2115 X Lens lenticular bifocal 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2116 X Nonaspheric lens bifocal 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2117 X Aspheric lens bifocal 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2118 X Lens aniseikonic single 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2199 X Lens single vision not oth c 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2200 X Lens spher bifoc plano 4.00d 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2201 X Lens sphere bifocal 4.12-7.0 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2202 X Lens sphere bifocal 7.12-20 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2203 X Lens sphcyl bifocal 4.00d/.1 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55495 V2204 X Lens sphcy bifocal 4.00d/2.1 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2205 X Lens sphcy bifocal 4.00d/4.2 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2206 X Lens sphcy bifocal 4.00d/ove 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2207 X Lens sphcy bifocal 4.25-7d/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2208 X Lens sphcy bifocal 4.25-7/2 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2209 X Lens sphcy bifocal 4.25-7/4 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2210 X Lens sphcy bifocal 4.25-7/ov 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2211 X Lens sphcy bifo 7.25-12/.25- 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2212 X Lens sphcyl bifo 7.25-12/2.2 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2213 X Lens sphcyl bifo 7.25-12/4.2 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2214 X Lens sphcyl bifocal over 12 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2215 X Lens lenticular bifocal 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2216 X Lens lenticular nonaspheric 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2217 X Lens lenticular aspheric bif 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2218 X Lens aniseikonic bifocal 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2219 X Lens bifocal seg width over 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2220 X Lens bifocal add over 3.25d 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2299 X Lens bifocal speciality 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2300 X Lens sphere trifocal 4.00d 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2301 X Lens sphere trifocal 4.12-7 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2302 X Lens sphere trifocal 7.12-20 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2303 X Lens sphcy trifocal 4.0/.12- 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2304 X Lens sphcy trifocal 4.0/2.25 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2305 X Lens sphcy trifocal 4.0/4.25 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2306 X Lens sphcyl trifocal 4.00/>6 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2307 X Lens sphcy trifocal 4.25-7/ 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2308 X Lens sphc trifocal 4.25-7/2 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2309 X Lens sphc trifocal 4.25-7/4 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2310 X Lens sphc trifocal 4.25-7/>6 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2311 X Lens sphc trifo 7.25-12/.25- 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2312 X Lens sphc trifo 7.25-12/2.25 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2313 X Lens sphc trifo 7.25-12/4.25 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2314 X Lens sphcyl trifocal over 12 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2315 X Lens lenticular trifocal 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2316 X Lens lenticular nonaspheric 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2317 X Lens lenticular aspheric tri 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2318 X Lens aniseikonic trifocal 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2319 X Lens trifocal seg width > 28 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2320 X Lens trifocal add over 3.25d 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2399 X Lens trifocal speciality 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2410 X Lens variab asphericity sing 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2430 X Lens variable asphericity bi 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2499 X Variable asphericity lens 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2500 X Contact lens pmma spherical 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2501 X Cntct lens pmma-toric/prism 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2502 X Contact lens pmma bifocal 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2503 X Cntct lens pmma color vision 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2510 X Cntct gas permeable sphericl 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2511 X Cntct toric prism ballast 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2512 X Cntct lens gas permbl bifocl 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2513 X Contact lens extended wear 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2520 P Contact lens hydrophilic 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2521 X Cntct lens hydrophilic toric 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2522 X Cntct lens hydrophil bifocl 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2523 X Cntct lens hydrophil extend 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2530 X Contact lens gas impermeable 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2531 X Contact lens gas permeable 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2599 X Contact lens/es other type 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2600 X Hand held low vision aids 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2610 X Single lens spectacle mount 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2615 X Telescop/othr compound lens 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2623 X Plastic eye prosth custom 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2624 X Polishing artifical eye 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2625 X Enlargemnt of eye prosthesis 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2626 X Reduction of eye prosthesis 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2627 X Scleral cover shell 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2628 X Fabrication & fitting 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2629 X Prosthetic eye other type 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2630 X Anter chamber intraocul lens 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2631 X Iris support intraoclr lens 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2632 X Post chmbr intraocular lens 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2700 X Balance lens 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2710 X Glass/plastic slab off prism 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55496 V2715 X Prism lens/es 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2718 X Fresnell prism press-on lens 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2730 X Special base curve 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2740 X Rose tint plastic 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2741 X Non-rose tint plastic 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2742 X Rose tint glass 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2743 X Non-rose tint glass 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2744 X Tint photochromatic lens/es 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2750 X Anti-reflective coating 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2755 X UV lens/es 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2760 X Scratch resistant coating 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2770 X Occluder lens/es 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2780 X Oversize lens/es 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2781 X Progressive lens per lens 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2785 X Corneal tissue processing 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2790 X Amniotic membrane 0.00 0.00 0.00 0.00 0.00 0.00 XXX V2799 X Miscellaneous vision service 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5008 N Hearing screening 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5010 N Assessment for hearing aid 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5011 N Hearing aid fitting/checking 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5014 N Hearing aid repair/modifying 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5020 N Conformity evaluation 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5030 N Body-worn hearing aid air 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5040 N Body-worn hearing aid bone 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5050 N Hearing aid monaural in ear 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5060 N Behind ear hearing aid 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5070 N Glasses air conduction 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5080 N Glasses bone conduction 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5090 N Hearing aid dispensing fee 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5100 N Body-worn bilat hearing aid 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5110 N Hearing aid dispensing fee 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5120 N Body-worn binaur hearing aid 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5130 N In ear binaural hearing aid 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5140 N Behind ear binaur hearing ai 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5150 N Glasses binaural hearing aid 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5160 N Dispensing fee binaural 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5170 N Within ear cros hearing aid 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5180 N Behind ear cros hearing aid 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5190 N Glasses cros hearing aid 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5200 N Cros hearing aid dispens fee 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5210 N In ear bicros hearing aid 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5220 N Behind ear bicros hearing ai 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5230 N Glasses bicros hearing aid 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5240 N Dispensing fee bicros 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5241 N Dispensing fee, monaural 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5242 N Hearing aid, monaural, cic 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5243 N Hearing aid, monaural, itc 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5244 N Hearing aid, prog, mon, cic 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5245 N Hearing aid, prog, mon, itc 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5246 N Hearing aid, prog, mon, ite 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5247 N Hearing aid, prog, mon, bte 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5248 N Hearing aid, binaural, cic 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5249 N Hearing aid, binaural, itc 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5250 N Hearing aid, prog, bin, cic 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5251 N Hearing aid, prog, bin, itc 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5252 N Hearing aid, prog, bin, ite 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5253 N Hearing aid, prog, bin, bte 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5254 N Hearing aid, digit, mon, cic 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5255 N Hearing aid, digit, mon, itc 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5256 N Hearing aid, digit, mon, ite 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5257 N Hearing aid, digit, mon, bte 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5258 N Hearing aid, digit, bin, cic 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5259 N Hearing aid, digit, bin, itc 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5260 N Hearing aid, digit, bin, ite 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5261 N Hearing aid, digit, bin, bte 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5262 N Hearing aid, disp, monaural 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5263 N Hearing aid, disp, binaural 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5264 N Ear mold/insert 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5265 N Ear mold/insert, disp 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5266 N Battery for hearing device 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5267 N Hearing aid supply/accessory 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5268 N ALD Telephone Amplifier 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5269 N Alerting device, any type 0.00 0.00 0.00 0.00 0.00 0.00 XXX Start Printed Page 55497 V5270 N ALD, TV amplifier, any type 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5271 N ALD, TV caption decoder 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5272 N Tdd 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5273 N ALD for cochlear implant 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5274 N ALD unspecified 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5275 N Ear impression 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5299 R Hearing service 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5336 N Repair communication device 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5362 R Speech screening 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5363 R Language screening 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5364 R Dysphagia screening 0.00 0.00 0.00 0.00 0.00 0.00 XXX 1 CPT codes and descriptions only are copyright 2001 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved. 3 +Indicates RVUs are not used for Medicare payment. Addendum C.—Codes With Interim RVUs
CPT 1/HCPCS 2 MOD Status Description Physician Work RVUs 3 Fully implemented non-facility PE RVUs Fully implemented facility PE RVUs Mal- practice RVUs Fully implemented non-facility total Fully implemented facility total Global 11981 A Insert drug implant device 1.48 1.58 0.59 0.14 3.20 2.21 XXX 11982 A Remove drug implant device 1.78 1.70 0.71 0.17 3.65 2.66 XXX 11983 A Remove/insert drug implant 3.30 2.31 1.32 0.31 5.92 4.93 XXX 20526 A Ther injection carpal tunnel 0.86 0.78 0.39 0.06 1.70 1.31 000 20551 A Inject tendon origin/insert 0.86 0.78 0.39 0.06 1.70 1.31 000 20552 A Inject trigger point, 1 or 2 0.86 0.78 0.39 0.06 1.70 1.31 000 20553 A Inject trigger points, > 3 0.86 0.78 0.39 0.06 1.70 1.31 000 24300 A Manipulate elbow w/anesth 3.75 NA 5.46 0.52 NA 9.73 090 24332 A Tenolysis, triceps 7.45 NA 5.23 0.77 NA 13.45 090 24343 A Repr elbow lat ligmnt w/tiss 8.65 NA 7.91 1.21 NA 17.77 090 24344 A Reconstruct elbow lat ligmnt 14.00 NA 10.87 1.95 NA 26.82 090 24345 A Repr elbw med ligmnt w/tiss 8.65 NA 7.91 1.21 NA 17.77 090 24346 A Reconstruct elbow med ligmnt 14.00 NA 10.87 1.95 NA 26.82 090 25001 A Incise flexor carpi radialis 3.38 NA 4.30 0.45 NA 8.13 090 25024 A Decompress forearm 2 spaces 9.50 NA 8.17 1.20 NA 18.87 090 25025 A Decompress forearm 2 spaces 16.54 NA 12.05 1.91 NA 30.50 090 25259 A Manipulate wrist w/anesthes 3.75 NA 5.35 0.52 NA 9.62 090 25275 A Repair forearm tendon sheath 8.50 NA 7.53 1.11 NA 17.14 090 25394 A Repair carpal bone, shorten 10.40 NA 8.43 1.15 NA 19.98 090 25430 A Vasc graft into carpal bone 9.25 NA 7.82 0.56 NA 17.63 090 25431 A Repair nonunion carpal bone 10.44 NA 6.42 0.56 NA 17.42 090 25651 A Pin ulnar styloid fracture 5.36 NA 4.39 0.73 NA 10.48 090 25652 A Treat fracture ulnar styloid 7.60 NA 6.90 0.97 NA 15.47 090 25671 A Pin radioulnar dislocation 6.00 NA 6.02 0.75 NA 12.77 090 26340 A Manipulate finger w/anesth 2.50 NA 4.53 0.32 NA 7.35 090 26587 A Reconstruct extra finger 14.05 4.67 NA 1.08 19.80 NA 090 28299 A Correction of bunion 10.58 11.55 9.21 1.24 23.37 21.03 090 29086 A Apply finger cast 0.62 0.81 0.50 0.07 1.50 1.19 000 29805 A Shoulder arthroscopy, dx 5.89 3.23 3.23 0.83 9.95 9.95 090 29806 A Shoulder arthroscopy/surgery 14.37 NA 11.33 2.01 NA 27.71 090 29807 A Shoulder arthroscopy/surgery 13.90 NA 11.06 2.01 NA 26.97 090 29824 A Shoulder arthroscopy/surgery 8.25 NA 7.48 1.16 NA 16.89 090 29900 A Mcp joint arthroscopy, dx 5.42 NA 5.88 0.69 NA 11.99 090 29901 A Mcp joint arthroscopy, surg 6.13 NA 6.28 0.81 NA 13.22 090 29902 A Mcp joint arthroscopy, surg 6.70 NA 6.60 0.89 NA 14.19 090 33967 A Insert ia percut device 4.85 2.01 1.96 0.27 7.13 7.08 000 33979 C Insert intracorporeal device 0.00 0.00 0.00 0.00 0.00 0.00 XXX 33980 C Remove intracorporeal device 0.00 0.00 0.00 0.00 0.00 0.00 090 35646 A Artery bypass graft 31.00 NA 13.26 2.98 NA 47.24 090 35647 A Artery bypass graft 28.00 NA 11.97 2.98 NA 42.95 090 35685 A Bypass graft patency/patch 4.05 NA 1.50 0.41 NA 5.96 ZZZ 35686 A Bypass graft/av fist patency 3.35 NA 1.24 0.34 NA 4.93 ZZZ 36002 A Pseudoaneurysm injection trt 1.96 2.95 1.03 0.08 4.99 3.07 000 36400 A Drawing blood 0.38 0.72 0.10 0.01 1.11 0.49 XXX 36820 A Av fusion/forearm vein 14.00 NA 6.56 1.53 NA 22.09 090 43239 A Upper GI endoscopy, biopsy 2.87 6.79 1.27 0.14 9.80 4.28 000 43313 A Esophagoplasty congential 45.28 NA 22.01 5.43 NA 72.72 090 43314 A Tracheo-esophagoplasty cong 50.27 NA 24.07 5.53 NA 79.87 090 44120 A Removal of small intestine 17.00 NA 7.67 1.46 NA 26.13 090 44126 A Enterectomy w/taper, cong 35.50 NA 18.03 0.36 NA 53.89 090 44127 A Enterectomy w/o taper, cong 41.00 NA 20.56 0.41 NA 61.97 090 44128 A Enterectomy cong, add-on 4.45 NA 1.78 0.45 NA 6.68 ZZZ Start Printed Page 55498 44160 A Removal of colon 18.62 NA 8.65 1.55 NA 28.82 090 44203 A Lap resect s/intestine, addl 4.45 NA 1.60 0.45 NA 6.50 ZZZ 44204 A Laparo partial colectomy 25.08 NA 10.46 1.83 NA 37.37 090 44205 A Lap colectomy part w/ileum 22.23 NA 9.31 1.55 NA 33.09 090 45136 A Excise ileoanal reservoir 27.30 NA 12.66 2.19 NA 42.15 090 45380 A Colonoscopy and biopsy 4.44 9.28 2.05 0.21 13.93 6.70 000 46020 A Placement of seton 2.90 3.09 2.36 0.22 6.21 5.48 010 47370 A Laparo ablate liver tumor rf 18.00 7.19 7.19 0.85 26.04 26.04 090 47371 A Laparo ablate liver cryosug 16.94 6.76 6.76 0.85 24.55 24.55 090 47380 A Open ablate liver tumor rf 21.25 8.48 8.48 0.85 30.58 30.58 090 47381 A Open ablate liver tumor cryo 21.00 8.38 8.38 0.85 30.23 30.23 090 47382 A Percut ablate liver rf 12.00 NA 5.37 0.85 NA 18.22 010 49491 A Repairing hern premie reduc 11.13 NA 5.65 1.00 NA 17.78 090 49492 A Rpr ing hern premie, blocked 14.03 NA 6.40 1.42 NA 21.85 090 52001 A Cystoscopy, removal of clots 2.37 NA 0.98 0.32 NA 3.67 000 52347 A Cystoscopy, resect ducts 5.28 NA 2.14 0.33 NA 7.75 000 53431 A Reconstruct urethra/bladder 19.89 7.94 7.94 1.25 29.08 29.08 090 53444 A Insert tandem cuff 13.40 NA 6.66 0.79 NA 20.85 090 53446 A Remove uro sphincter 10.23 NA 8.46 0.61 NA 19.30 090 53447 A Remove/replace ur sphincter 13.49 NA 7.90 0.79 NA 22.18 090 53448 A Remov/replc ur sphinctr comp 21.15 NA 12.35 1.27 NA 34.77 090 53853 A Prostatic water thermother 4.14 52.75 2.55 0.38 57.27 7.07 090 54162 A Lysis penil circumcis lesion 3.00 NA 2.91 0.18 NA 6.09 010 54163 A Repair of circumcision 3.00 NA 2.54 0.18 NA 5.72 010 54164 A Frenulotomy of penis 2.50 NA 2.37 0.15 NA 5.02 010 54406 A Remove multi-comp penis pros 12.10 NA 6.09 0.80 NA 18.99 090 54408 A Repair multi-comp penis pros 12.75 NA 6.46 0.80 NA 20.01 090 54410 A Remove/replace penis prosth 15.50 NA 7.36 0.80 NA 23.66 090 54411 A Remv/replc penis pros, comp 16.00 NA 8.98 0.80 NA 25.78 090 54415 A Remove self-contd penis pros 8.20 NA 5.35 0.55 NA 14.10 090 54416 A Remv/repl penis contain pros 10.87 NA 6.94 0.55 NA 18.36 090 54417 A Remv/replc penis pros, compl 14.19 NA 7.89 0.55 NA 22.63 090 56605 A Biopsy of vulva/perineum 1.10 1.90 0.50 0.11 3.11 1.71 000 56810 A Repair of perineum 4.13 NA 2.91 0.41 NA 7.45 010 57155 A Insert uteri tandems/ovoids 6.27 NA 3.67 0.63 NA 10.57 090 58100 A Biopsy of uterus lining 1.53 1.56 0.76 0.07 3.16 2.36 000 58346 A Insert heyman uteri capsule 6.75 NA 3.84 0.68 NA 11.27 090 58953 A Tah, rad dissect for debulk 32.00 NA 15.59 3.20 NA 50.79 090 58954 A Tah, rad debulk/lymph remove 35.00 NA 16.71 3.50 NA 55.21 090 59001 A Amniocentesis, therapeutic 3.00 NA 1.37 0.23 NA 4.60 000 64561 A Implant neuroelectrodes 6.74 15.28 3.83 0.11 22.13 10.68 010 64581 A Implant neuroelectrodes 13.50 NA 6.72 0.37 NA 20.59 090 64821 A Remove sympathetic nerves 8.75 NA 7.09 0.99 NA 16.83 090 64822 A Remove sympathetic nerves 8.75 NA 7.09 0.99 NA 16.83 090 64823 A Remove sympathetic nerves 10.37 NA 7.89 1.17 NA 19.43 090 67225 A Eye photodynamic ther add-on 0.47 0.24 0.19 0.50 1.21 1.16 ZZZ 76085 A Computer mammogram add-on 0.06 0.31 NA 0.02 0.39 NA ZZZ 76092 A Mammogram, screening 0.70 1.44 NA 0.09 2.23 NA XXX 76362 A Cat scan for tissue ablation 4.00 9.24 NA 1.38 14.62 NA XXX 76394 A Mri for tissue ablation 4.25 12.13 NA 1.43 17.81 NA XXX 76490 A Us for tissue ablation 2.00 2.13 NA 0.36 4.49 NA XXX 76819 A Fetal biophys profil w/o nst 0.77 1.83 NA 0.10 2.70 NA XXX 77301 A Radioltherapy dos plan, imrt 8.00 29.72 NA 1.41 39.13 NA XXX 77418 A Radiation tx delivery, imrt 0.00 16.07 NA 0.11 16.18 NA XXX 88380 C Microdissection 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90471 A Immunization admin 0.00 0.10 NA 0.01 0.11 NA XXX 90472 A Immunization admin, each add 0.00 0.10 NA 0.01 0.11 NA ZZZ 90473 N Immune admin oral/nasal 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90474 N Immune admin oral/nasal addl 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 90939 X Hemodialysis study, transcut 0.00 0.00 0.00 0.00 0.00 0.00 XXX 91123 B Irrigate fecal impaction 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92136 A Ophthalmic biometry 0.54 1.52 NA 0.07 2.13 NA XXX 92973 A Percut coronary thrombectomy 3.28 NA 1.37 0.17 NA 4.82 ZZZ 92974 A Cath place, cardio brachytx 3.00 NA 1.26 1.18 NA 5.44 ZZZ 93025 A Microvolt t-wave assess 0.75 6.42 NA 0.11 7.28 NA XXX 93609 A Map tachycardia, add-on 4.81 4.59 NA 0.66 10.06 NA ZZZ 93613 C Electrophys map, 3d, add-on 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93621 C Electrophysiology evaluation 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 93622 C Electrophysiology evaluation 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 93701 A Bioimpedance, thoracic 0.17 0.78 NA 0.02 0.97 NA XXX 95250 A Glucose monitoring, cont 0.00 1.44 NA 0.01 1.45 NA XXX 95875 A Limb exercise test 1.10 1.38 NA 0.09 2.57 NA XXX 95965 C Meg, spontaneous 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95966 C Meg, evoked, single 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95967 C Meg, evoked, each addl 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 96000 A Motion analysis, video/3d 1.80 NA 0.72 0.02 NA 2.54 XXX 96001 A Motion test w/ft press meas 2.15 NA 0.86 0.02 NA 3.03 XXX 96002 A Dynamic surface emg 0.41 NA 0.16 0.02 NA 0.59 XXX Start Printed Page 55499 96003 A Dynamic fine wire emg 0.37 NA 0.15 0.03 NA 0.55 XXX 96004 A Phys review of motion tests 1.80 0.72 0.72 0.08 2.60 2.60 XXX 96150 A Assess hlth/behave, init 0.50 0.21 0.20 0.02 0.73 0.72 XXX 96151 A Assess hlth/behave, subseq 0.48 0.21 0.19 0.02 0.71 0.69 XXX 96152 A Intervene hlth/behave, indiv 0.46 0.20 0.18 0.02 0.68 0.66 XXX 96153 A Intervene hlth/behave, group 0.10 0.04 0.04 0.01 0.15 0.15 XXX 96154 A Interv hlth/behav, fam w/pt 0.45 0.19 0.18 0.02 0.66 0.65 XXX 96155 A Interv hlth/behav fam no pt 0.44 0.18 0.18 0.02 0.64 0.64 XXX 96567 A Photodynamic tx, skin 0.00 1.63 NA 0.03 1.66 NA XXX 97602 B Wound(s) care non-selective 0.00 0.00 0.00 0.00 0.00 0.00 XXX 97802 A Medical nutrition, indiv, in 0.00 0.45 0.45 0.01 0.46 0.46 XXX 97803 A Med nutrition, indiv, subseq 0.00 0.45 0.45 0.01 0.46 0.46 XXX 97804 A Medical nutrition, group 0.00 0.17 0.17 0.01 0.18 0.18 XXX 99091 B Collect/review data from pt 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99289 I Pt transport, 30-74 min 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99290 I Pt transport, addl 30 min 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ G0117 T Glaucoma scrn hgh risk direc 0.45 0.97 0.22 0.02 1.44 0.69 XXX G0118 T Glaucoma scrn hgh risk direc 0.17 0.84 0.08 0.01 1.02 0.26 XXX G0202 26 A Screeningmammographydigital 0.70 0.28 0.28 0.03 1.01 1.01 XXX G0204 26 A Diagnosticmammographydigital 0.87 0.35 0.35 0.03 1.25 1.25 XXX G0206 26 A Diagnosticmammographydigital 0.70 0.28 0.28 0.03 1.01 1.01 XXX G0236 26 A digital film convert diag ma 0.06 0.02 0.02 0.01 0.09 0.09 ZZZ 1 CPT codes and descriptions only are copyright 2001 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. 2 Copyright 1994 American Dental Association. All rights reserved. 3+ Indicates RVUs are not used for Medicare payment. Addendum D.—2002 Geographic Practice Cost Indices by Medicare Carrier and Locality
Carrier No. Locality No. Locality name Work Practice expense Malpractice 00510 00 ALABAMA 0.978 0.870 0.807 00831 01 ALASKA 1.064 1.172 1.223 00832 00 ARIZONA 0.994 0.978 1.111 00520 13 ARKANSAS 0.953 0.847 0.340 31146 26 ANAHEIM/SANTA ANA, CA 1.037 1.184 0.955 31146 18 LOS ANGELES, CA 1.056 1.139 0.955 31140 03 MARIN/NAPA/SOLANO, CA 1.015 1.248 0.687 31140 07 OAKLAND/BERKELEY, CA 1.041 1.235 0.687 31140 05 SAN FRANCISCO, CA 1.068 1.458 0.687 31140 06 SAN MATEO, CA 1.048 1.432 0.687 31140 09 SANTA CLARA, CA 1.063 1.380 0.639 31146 17 VENTURA, CA 1.028 1.125 0.783 31146 99 REST OF CALIFORNIA* 1.007 1.034 0.748 31140 99 REST OF CALIFORNIA* 1.007 1.034 0.748 00824 01 COLORADO 0.985 0.992 0.840 00591 00 CONNECTICUT 1.050 1.156 0.966 00902 01 DELAWARE 1.019 1.035 0.712 00903 01 DC + MD/VA SUBURBS 1.050 1.166 0.909 00590 03 FORT LAUDERDALE, FL 0.996 1.018 1.877 00590 04 MIAMI, FL 1.015 1.052 2.528 00590 99 REST OF FLORIDA 0.975 0.946 1.265 00511 01 ATLANTA, GA 1.006 1.059 0.935 00511 99 REST OF GEORGIA 0.970 0.892 0.935 00833 01 HAWAII/GUAM 0.997 1.124 0.834 05130 00 IDAHO 0.960 0.881 0.497 00952 16 CHICAGO, IL 1.028 1.092 1.797 00952 12 EAST ST. LOUIS, IL 0.988 0.924 1.691 00952 15 SUBURBAN CHICAGO, IL 1.006 1.071 1.645 00952 99 REST OF ILLINOIS 0.964 0.889 1.157 00630 00 INDIANA 0.981 0.922 0.481 00826 00 IOWA 0.959 0.876 0.596 00650 00 KANSAS* 0.963 0.895 0.756 00740 04 KANSAS* 0.963 0.895 0.756 00660 00 KENTUCKY 0.970 0.866 0.877 00528 01 NEW ORLEANS, LA 0.998 0.945 1.283 00528 99 REST OF LOUISIANA 0.968 0.870 1.073 31142 03 SOUTHERN MAINE 0.979 0.999 0.666 31142 99 REST OF MAINE 0.961 0.910 0.666 00901 01 BALTIMORE/SURR. CNTYS, MD 1.021 1.038 0.916 00901 99 REST OF MARYLAND 0.984 0.972 0.774 31143 01 METROPOLITAN BOSTON 1.041 1.239 0.784 31143 99 REST OF MASSACHUSETTS 1.010 1.129 0.784 00953 01 DETROIT, MI 1.043 1.038 2.738 00953 99 REST OF MICHIGAN 0.997 0.938 1.571 00954 00 MINNESOTA 0.990 0.974 0.452 00512 00 MISSISSIPPI 0.957 0.837 0.779 Start Printed Page 55500 00740 02 METROPOLITAN KANSAS CITY, MO 0.988 0.967 0.846 00523 01 METROPOLITAN ST. LOUIS, MO 0.994 0.938 0.846 00740 99 REST OF MISSOURI* 0.946 0.825 0.793 00523 99 REST OF MISSOURI* 0.946 0.825 0.793 00751 01 MONTANA 0.950 0.876 0.727 00655 00 NEBRASKA 0.948 0.877 0.430 00834 00 NEVADA 1.005 1.039 1.209 31144 40 NEW HAMPSHIRE 0.986 1.030 0.825 00805 01 NORTHERN NJ 1.058 1.193 0.860 00805 99 REST OF NEW JERSEY 1.029 1.110 0.860 00521 05 NEW MEXICO 0.973 0.900 0.902 00803 01 MANHATTAN, NY 1.094 1.351 1.668 00803 02 NYC SUBURBS/LONG I., NY 1.068 1.251 1.952 00803 03 POUGHKPSIE/N NYC SUBURBS, NY 1.011 1.075 1.275 14330 04 QUEENS, NY 1.058 1.228 1.871 00801 99 REST OF NEW YORK 0.998 0.944 0.764 05535 00 NORTH CAROLINA 0.970 0.931 0.595 00820 01 NORTH DAKOTA 0.950 0.880 0.657 16360 00 OHIO 0.988 0.944 0.957 00522 00 OKLAHOMA 0.968 0.876 0.444 00835 01 PORTLAND, OR 0.996 1.049 0.436 00835 99 REST OF OREGON 0.961 0.933 0.436 00865 01 METROPOLITAN PHILADELPHIA, PA 1.023 1.092 1.413 00865 99 REST OF PENNSYLVANIA 0.989 0.929 0.774 00973 20 PUERTO RICO 0.881 0.712 0.275 00870 01 RHODE ISLAND 1.017 1.065 0.883 00880 01 SOUTH CAROLINA 0.974 0.904 0.279 00820 02 SOUTH DAKOTA 0.935 0.878 0.406 05440 35 TENNESSEE 0.975 0.900 0.592 00900 31 AUSTIN, TX 0.986 0.996 0.859 00900 20 BEAUMONT, TX 0.992 0.890 1.338 00900 09 BRAZORIA, TX 0.992 0.978 1.338 00900 11 DALLAS, TX 1.010 1.065 0.931 00900 28 FORT WORTH, TX 0.987 0.981 0.931 00900 15 GALVESTON, TX 0.988 0.969 1.338 00900 18 HOUSTON, TX 1.020 1.007 1.336 00900 99 REST OF TEXAS 0.966 0.880 0.956 00910 09 UTAH 0.976 0.941 0.644 31145 50 VERMONT 0.973 0.986 0.539 00973 50 VIRGIN ISLANDS 0.965 1.023 1.002 00904 00 VIRGINIA 0.984 0.938 0.500 00836 02 SEATTLE (KING CNTY), WA 1.005 1.100 0.788 00836 99 REST OF WASHINGTON 0.981 0.972 0.788 16510 16 WEST VIRGINIA 0.963 0.850 1.378 00951 00 WISCONSIN 0.981 0.929 0.939 00825 21 WYOMING 0.967 0.895 1.005 * Payment locality is serviced by two carriers. Note: Work GPCI reflects only 1/4 work GPCI in accordance with section 1848(e)(1)(A)(iii) of the Social Security Act. GPCIs rescaled by the following factors for budget neutrality: Work = 0.99699; Practice Expense = 0.99235; Malpractice Expense = 1.00215. End Supplemental InformationAddendum E.—Updated List of CPT 1/HCPCS Codes Used To Describe Certain Designated Health Services Under the Physician Referral Provisions
[Section 1877 of the Social Security Act]
CLINICAL LABORATORY SERVICES INCLUDE CPT codes for all clinical laboratory services in the 80000 series, except EXCLUDE CPT codes for the following blood component collection services: 86890 Autologous blood process 86891 Autologous blood, op salvage 86915 Bone marrow/stem cell prep 86927 Plasma, fresh frozen 86930 Frozen blood prep 86931 Frozen blood thaw 86932 Frozen blood freeze/thaw 86945 Blood product/irradiation 86950 Leukacyte transfusion 86965 Pooling blood platelets 86985 Split blood or products INCLUDE the following HCPCS level 2 codes for other clinical laboratory services: G0001 Drawing blood for specimen G0026 Fecal leukocyte examination G0027 Semen analysis G0103 Psa, total screening G0107 CA screen; fecal blood test G0123 Screen cerv/vag thin layer G0124 Screen c/v thin layer by MD G0141 Scr c/v cyto,autosys and md G0143-G0145 Scr c/v cyto,thinlayer, rescr G0147 Scr c/v cyto, automated sys G0148 Scr c/v cyto, autosys, rescr P2028 Cephalin floculation test P2029 Congo red blood test P2031 Hair analysis P2033 Blood thymol turbidity P2038 Blood mucoprotein P3000 Screen pap by tech w md supv P3001 Screening pap smear by phys P7001 Culture bacterial urine P9612 Catheterize for urine spec P9615 Urine specimen collect mult Q0111 Wet mounts/w preparations Q0112 Potassium hydroxide preps Q0113 Pinworm examinations Q0114 Fern test Q0115 Post-coital mucous exam PHYSICAL THERAPY/OCCUPATIONAL THERAPY/SPEECH-LANGUAGE PATHOLOGY INCLUDE the following CPT codes for the physical therapy/occupational therapy/speech-language pathology services in the 97000 series: 97001 Pt evaluation 97002 Pt re-evaluation 97003 Ot evaluation 97004 Ot re-evaluation 97010 Hot or cold packs therapy 97012 Mechanical traction therapy 97014 Electric stimulation therapy 97016 Vasopneumatic device therapy 97018 Paraffin bath therapy Start Printed Page 55501 97020 Microwave therapy 97022 Whirlpool therapy 97024 Diathermy treatment 97026 Infrared therapy 97028 Ultraviolet therapy 97032 Electrical stimulation 97033 Electric current therapy 97034 Contrast bath therapy 97035 Ultrasound therapy 97036 Hydrotherapy 97039 Physical therapy treatment 97110 Therapeutic exercises 97112 Neuromuscular reeducation 97113 Aquatic therapy/exercises 97116 Gait training therapy 97124 Massage therapy 97139 Physical medicine procedure 97140 Manual therapy 97150 Group therapeutic procedures 97504 Orthotic training 97520 Prosthetic training 97530 Therapeutic activities 97532 Cognitive skills development 97533 Sensory integration 97535 Self care mngment training 97537 Community/work reintegration 97542 Wheelchair mngment training 97545 Work hardening 97546 Work hardening add-on 97703 Prosthetic checkout 97750 Physical performance test 97799 Physical medicine procedure INCLUDE CPT codes for physical therapy/occupational therapy/speech-language pathology services not in the 97000 series: 64550 Apply neurostimulator 90901 Biofeedback train, any meth 90911 Biofeedback peri/uro/rectal 92506 Speech/hearing evaluation 92507-92508 Speech/hearing therapy 92510 Rehab for ear implant 92526 Oral function therapy 93797 Cardiac rehab 93798 Cardiac rehab/monitor 94667-94668 Chest wall manipulation 94762 Measure blood oxygen level 95831 Limb muscle testing, manual 95832 Hand muscle testing, manual 95833-95834 Body muscle testing, manual 95851-95852 Range of motion measurements 96000 Motion analysis, video/3d 96001 Motion test w/ft press meas 96002 Dynamic surface emg 96003 Dynamic fine wire emg 96105 Assessment of aphasia 96110 Developmental test, lim 96111 Developmental test, extend 96115 Neurobehavior status exam INCLUDE HCPCS level 2 codes for the following physical therapy/occupational therapy/speech-language pathology services: G0193 Endoscopic study swallow functn G0194 Sensory testing endoscopic stud G0195 Clinical eval swallowing funct G0196 Eval of swallowing with radioopa G0197 Eval of pt for prescip speech devi G0198 Patient adapation & train for spe G0199 Reevaluation of patient use spec G0200 Eval of patient prescip of voice p G0201 Modi for training in use voice pro Q0086 Physical therapy evaluation/ RADIOLOGY INCLUDE the following radiology and certain other imaging services in the CPT 70000 series: 70100-70110 X-ray exam of jaw 70120-70130 X-ray exam of mastoids 70134 X-ray exam of middle ear 70140-70150 X-ray exam of facial bones 70160 X-ray exam of nasal bones 70190-70200 X-ray exam of eye sockets 70210-70220 X-ray exam of sinuses 70240 X-ray exam, pituitary saddle 70250-70260 X-ray exam of skull 70300-70310 X-ray exam of teeth 70320 Full mouth x-ray of teeth 70328 X-ray exam of jaw joint 70330 X-ray exam of jaw joints 70336 Magnetic image, jaw joint 70350 X-ray head for orthodontia 70355 Panoramic x-ray of jaws 70360 X-ray exam of neck 70370 Throat x-ray & fluoroscopy 70371 Speech evaluation, complex 70380 X-ray exam of salivary gland 70450 Ct head/brain w/o dye 70460 Ct head/brain w/dye 70470 Ct head/brain w/o&w dye 70480 Ct orbit/ear/fossa w/o dye 70481 Ct orbit/ear/fossa w/dye 70482 Ct orbit/ear/fossa w/o&w dye 70486 Ct maxillofacial w/o dye 70487 Ct maxillofacial w/dye 70488 Ct maxillofacial w/o&w dye 70490 Ct soft tissue neck w/o dye 70491 Ct soft tissue neck w/dye 70492 Ct sft tsue nck w/o & w/dye 70496 Ct angiography, head 70498 Ct angiography, neck 70540 Mri orbit/face/neck w/o dye 70542 Mri orbit/face/neck w/dye 70543 Mri orbt/fac/nck w/o&w dye 70544 Mr angiography head w/o dye 70545 Mr angiography head w/dye 70546 Mr angiograph head w/o&w dye 70547 Mr angiography neck w/o dye 70548 Mr angiography neck w/dye 70549 Mr angiograph neck w/o&w dye 70551 Mri brain w/o dye 70552 Mri brain w/dye 70553 Mri brain w/o&w dye 71010-71022 Chest x-ray 71023 Chest x-ray and fluoroscopy 71030 Chest x-ray 71034 Chest x-ray and fluoroscopy 71035 Chest x-ray 71100 X-ray exam of ribs 71101 X-ray exam of ribs/chest 71110 X-ray exam of ribs 71111 X-ray exam of ribs/ chest 71120-71130 X-ray exam of breastbone 71250 Ct thorax w/o dye 71260 Ct thorax w/dye 71270 Ct thorax w/o&w dye 71275 Ct angiography, chest 71550 Mri chest w/o dye 71551 Mri chest w/dye 71552 Mri chest w/o&w dye 71555 Mri angio chest w or w/o dye 72010-72020 X-ray exam of spine 72040-72052 X-ray exam of neck spine 72069 X-ray exam of trunk spine 72070-72074 X-ray exam of thoracic spine 72080-72090 X-ray exam of trunk spine 72100-72120 X-ray exam of lower spine 72125 Ct neck spine w/o dye 72126 Ct neck spine w/dye 72127 Ct neck spine w/o&w dye 72128 Ct chest spine w/o dye 72129 Ct chest spine w/dye 72130 Ct chest spine w/o&w dye 72131 Ct lumbar spine w/o dye 72132 Ct lumbar spine w/dye 72133 Ct lumbar spine w/o&w dye 72141 Mri neck spine w/o dye 72142 Mri neck spine w/dye 72146 Mri chest spine w/o dye 72147 Mri chest spine w/dye 72148 Mri lumbar spine w/o dye 72149 Mri lumbar spine w/dye 72156 Mri neck spine w/o&w dye 72157 Mri chest spine w/o&w dye 72158 Mri lumbar spine w/o&w dye 72170-72190 X-ray exam of pelvis 72191 Ct angiograph pelv w/o&w dye 72192 Ct pelvis w/o dye 72193 Ct pelvis w/dye 72194 Ct pelvis w/o&w dye 72195 Mri pelvis w/o dye 72196 Mri pelvis w/dye 72197 Mri pelvis w/o & w dye 72200-72202 X-ray exam sacroiliac joints 72220 X-ray exam of tailbone 73000 X-ray exam of collar bone 73010 X-ray exam of shoulder blade 73020-73030 X-ray exam of shoulder 73050 X-ray exam of shoulders 73060 X-ray exam of humerus 73070-73080 X-ray exam of elbow 73090 X-ray exam of forearm 73092 X-ray exam of arm, infant 73100-73110 X-ray exam of wrist 73120-73130 X-ray exam of hand 73140 X-ray exam of finger(s) 73200 Ct upper extremity w/o dye 73201 Ct upper extremity w/dye 73202 Ct uppr extremity w/o&w dye 73206 Ct angio upr extrm w/o&w dye 73218 Mri upper extremity w/o dye 73219 Mri upper extremity w/dye 73220 Mri uppr extremity w/o&w dye 73221 Mri joint upr extrem w/o dye 73222 Mri joint upr extrem w/ dye 73223 Mri joint upr extr w/o&w dye 73500-73510 X-ray exam of hip 73520 X-ray exam of hips 73540 X-ray exam of pelvis & hips 73550 X-ray exam of thigh 73560 X-ray exam of knee, 1 or 2 73562 X-ray exam of knee, 3 73564 X-ray exam, knee, 4 or more 73565 X-ray exam of knees 73590 X-ray exam of lower leg 73592 X-ray exam of leg, infant 73600-73610 X-ray exam of ankle 73620-73630 X-ray exam of foot 73650 X-ray exam of heel 73660 X-ray exam of toe(s) 73700 Ct lower extremity w/o dye 73701 Ct lower extremity w/dye 73702 Ct lwr extremity w/o&w dye 73706 Ct angio lwr extr w/o&w dye 73718 Mri lower extremity w/o dye 73719 Mri lower extremity w/dye 73720 Mri lwr extremity w/o&w dye 73721 Mri joint of lwr extre w/o d 73722 Mri joint of lwr extr w/dye Start Printed Page 55502 73723 Mri joint lwr extr w/o&w dye 73725 Mr ang lwr ext w or w/o dye 74000-74020 X-ray exam of abdomen 74022 X-ray exam series, abdomen 74150 Ct abdomen w/o dye 74160 Ct abdomen w/dye 74170 Ct abdomen w/o&w dye 74175 Ct angio abdom w/o&w dye 74181 Mri abdomen w/o dye 74182 Mri abdomen w/dye 74183 Mri abdomen w/o&w dye 74185 Mri angio, abdom w or w/o dy 74210 Contrst x-ray exam of throat 74220 Contrast x-ray, esophagus 74230 Cine/video x-ray, throat/eso 74240-74245 X-ray exam, upper gi tract 74246-74249 Contrst x-ray uppr gi tract 74250 X-ray exam of small bowel 74290 Contrast x-ray, gallbladder 74291 Contrast x-rays, gallbladder 74710 X-ray measurement of pelvis 75552 Heart mri for morph w/o dye 75553 Heart mri for morph w/dye 75554 Cardiac MRI/function 75555 Cardiac MRI/limited study 75635 Ct angio abdominal arteries 76000 Fluoroscope examination 76006 X-ray stress view 76010 X-ray, nose to rectum 76020 X-rays for bone age 76040 X-rays, bone evaluation 76061-76062 X-rays, bone survey 76065 X-rays, bone evaluation 76066 Joint survey, single view 76085 Computer mammogram add-on 76090 Mammogram, one breast 76091 Mammogram, both breasts 76092 Mammogram, screening 76093 Magnetic image, breast 76094 Magnetic image, both breasts 76100 X-ray exam of body section 76101 Complex body section x-ray 76102 Complex body section x-rays 76120 Cine/video x-rays 76125 Cine/ video x-rays add-on 76150 X-ray exam, dry process 76370 CAT scan for therapy guide 76375 3d/holograph reconstr add-on 76380 CAT scan follow-up study 76390 Mr spectroscopy 76400 Magnetic image, bone marrow 76499 Radiographic procedure 76506 Echo exam of head 76511-76512 Echo exam of eye 76513 Echo exam of eye, water bath 76516-76519 Echo exam of eye 76536 Us exam of head and neck 76604 Us exam, chest, b-scan 76645 Us exam, breast(s) 76700 Us exam, abdom, complete 76705 Us exam, abdom, limited 76770 Us exam abdo back wall, comp 76775 Us exam abdo back wall, lim 76778 Us exam kidney transplant 76800 Us exam, spinal canal 76805 Us exam, pg uterus, compl 76810 Us exam, pg uterus, mult 76815 Us exam, pg uterus limit 76816 Us exam pg uterus repeat 76818 Fetal biophy profile w/nst 76819 Fetal biophys profil w/o nst 76825-76828 Echo exam of fetal heart 76830 Us exam, transvaginal 76831 Echo exam, uterus 76856 Us exam, pelvic, complete 76857 Us exam, pelvic, limited 76870 Us exam, scrotum 76872 Echo exam, transrectal 76873 Echograp trans r, pros study 76880 Us exam, extremity 76885 Us exam infant hips, dynamic 76886 Us exam infant hips, static 76970 Ultrasound exam follow-up 76977 Us bone density measure 76999 Echo examination procedure INCLUDE the following CPT codes for echocardiography and vascular ultrasound: 93303-93304 Echo transthoracic 93307-93308 Echo exam of heart 93320-93321 Doppler echo exam, heart, if used in conjunction with 93303-93308 93325 Doppler color flow add-on, if used in conjunction with 93303-93308 93875-93882 Extracranial study 93886-93888 Intracranial study 93922-93924 Extremity study 93925-93926 Lower extremity study 93930-93931 Upper extremity study 93965-93971 Extremity study 93975-93979 Vascular study 93980-93981 Penile vascular study 93990 Doppler flow testing INCLUDE miscellaneous other HCPCS level 2 codes for radiology and certain other imaging services: G0050 Residual urine by ultrasound G0131-132 CT scan, bone density study G0188 Xray lwr extrmty-full lngth G0202 Screening mammography digital G0204 Diagnostic mammography digital G0206 Diagnostic mammography digital G0236 digital film convert diag ma R0070 Transport portable x-ray R0075 Transport port x-ray multipl RADIATION THERAPY SERVICES AND SUPPLIES INCLUDE CPT codes for all radiation therapy services and supplies in the CPT 70000 series: 77261-77263 Radiation therapy planning 77280-77295 Set radiation therapy field 77299 Radiation therapy planning 77300 Radiation therapy dose plan 77301 Radioltherapy dos plan, imrt 77305-77315 Radiation therapy dose plan 77321 Radiation therapy port plan 77326-77328 Radiation therapy dose plan 77331 Special radiation dosimetry 77332-77334 Radiation treatment aid(s) 77336-77370 Radiation physics consult 77399 External radiation dosimetry 77401-77416 Radiation treatment delivery 77417 Radiology port film(s) 77418 Radiation tx delivery, imrt 77427 Radiation tx management, x5 77431 Radiation therapy management 77432 Stereotactic radiation trmt 77470 Special radiation treatment 77499 Radiation therapy management 77520 Proton trmt, simple w/o comp 77522 Proton trmt, simple w/comp 77523 Proton trmt, intermediate 77525 Proton treatment, complex 77600-77620 Hyperthermia treatment 77750 Infuse radioactive materials 77761 Apply intrcav radiat simple 77762 Apply intrcav radiat interm 77763 Apply intrcav radiat compl 77776 Apply interstit radiat simpl 77777 Apply interstit radiat inter 77778 Apply iterstit radiat compl 77781-77784 High intensity brachytherapy 77789 Apply surface radiation 77790 Radiation handling 77799 Radium/radioisotope therapy INCLUDE CPT codes for radiation therapy classified elsewhere: 31643 Diag bronchoscope/catheter 50559 Renal endoscopy/radiotracer 55859 Percut/needle insert, pros 61770 Incise skull for treatment 61793 Focus radiation beam 92974 Cath place, cardio brachytx PREVENTIVE SCREENING TESTS, IMMUNIZATIONS AND VACCINES The following CPT and HCPCS codes are excluded under § 411.355(h) as screening tests: 76085 Computer mammogram add-on 76092 Mammogram, screening 76977 Us bone density measure G0103 Psa, total screening G0107 CA screen; fecal blood test G0123 Screen cerv/vag thin layer G0124 Screen c/v thin layer by MD G0141 Scr c/v cyto, autosys and md G0143-G0145 Scr c/v cyto, thinlayer, rescr G0147 Scr c/v cyto, automated sys G0148 Scr c/v cyto, autosys, rescr G0202 Screening mammography digital P3000 Screen pap by tech w md supv P3001 Screening pap smear by phys The following CPT and HCPCS codes are excluded under § 411.355(h) as vaccines: 90657 Flu vaccine, 6-35 mo, im 90658 Flu vaccine, 3 yrs, im 90659 Flu vacine, whole, im 90732 Pneumococcal vaccine 90748 Hep b/hib vaccine, im Q3018 Hepatitis B vaccine DRUGS USED BY PATIENTS UNDERGOING DIALYSIS The following HCPCS codes are excluded under § 411.355(g) as EPO and other dialysis related outpatient prescription drugs furnished in or by an ESRD facility: J0635 Calcitriol injection J0895 Deferoxamine mesylate inj J1270 Injection, doxercalciferol J1750 Iron dextran J1755 Iron sucrose injection J2915 NA Ferric Gluconate Complex J2997 Alteplase recombinant Q9920 Epoetin with hct <=20 Q9921 Epoetin with hct = 21 Q9922 Epoetin with hct = 22 Q9923 Epoetin with hct = 23 Q9924 Epoetin with hct = 24 Q9925 Epoetin with hct = 25 Q9926 Epoetin with hct = 26 Q9927 Epoetin with hct = 27 Q9928 Epoetin with hct = 28 Q9929 Epoetin with hct = 29 Q9930 Epoetin with hct = 30 Q9931 Epoetin with hct = 31 Q9932 Epoetin with hct = 32 Q9933 Epoetin with hct = 33 Q9934 Epoetin with hct = 34 Q9935 Epoetin with hct = 35 Start Printed Page 55503 Q9936 Epoetin with hct = 36 Q9937 Epoetin with hct = 37 Q9938 Epoetin with hct = 38 Q9939 Epoetin with hct = 39 Q9940 Epoetin with hct >= 40 1 CPT codes and descriptions only are copyright 2001 American Medical Association. All rights are reserved and applicable FARS/DFARS clauses apply. [FR Doc. 01-27275 Filed 10-31-01; 8:45 am]
BILLING CODE 4120-01-P
Document Information
- Published:
- 11/01/2001
- Department:
- Centers for Medicare & Medicaid Services
- Entry Type:
- Rule
- Action:
- Final rule with comment period.
- Document Number:
- 01-27275
- Pages:
- 55245-55503 (259 pages)
- Docket Numbers:
- CMS-1169-FC
- RINs:
- 0938-AK57
- Topics:
- Administrative practice and procedure, Health facilities, Health professions, Kidney diseases, Laboratories, Medicare, Reporting and recordkeeping requirements, Rural areas, X-rays
- PDF File:
- 01-27275.pdf
- CFR: (18)
- 42 CFR 405.534
- 42 CFR 405.535
- 42 CFR 410.3
- 42 CFR 410.10
- 42 CFR 410.23
- More ...