01-29621. Medicare Program; Changes to the Hospital Outpatient Prospective Payment System for Calendar Year 2002  

  • Start Preamble Start Printed Page 59856

    AGENCY:

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

    ACTION:

    Final rule.

    SUMMARY:

    This final rule revises the Medicare hospital outpatient prospective payment system to implement applicable statutory requirements, including relevant provisions of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000, and changes arising from our continuing experience with this system. In addition, it describes changes to the amounts and factors used to determine the payment rates for Medicare hospital outpatient services paid under the prospective payment system. This final rule also announces a uniform reduction of 68.9 percent to be applied to each of the transitional pass-through payments. These changes are applicable to services furnished on or after January 1, 2002.

    EFFECTIVE DATE:

    This final rule is effective January 1, 2002 and is applicable to services furnished on or after January 1, 2002.

    Start Further Info

    FOR FURTHER INFORMATION CONTACT:

    George Morey (410) 786-4653, for provider-based issues; and Nancy Edwards (410) 786-0378, for all other issues.

    End Further Info End Preamble Start Supplemental Information

    SUPPLEMENTARY INFORMATION:

    Availability of Copies and Electronic Access

    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 document at most libraries designated as Federal Depository Libraries and at many other public and academic libraries throughout the country that receive the Federal Register.

    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 Web site address is: http://www.access.gpo.gov/​nara/​index.html.

    Information on the outpatient prospective payment system can be found on our homepage. You can access these data by using the following directions:

    1. Go to 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 Hospital Outpatient Prospective Payment System.

    Or, you can go directly to the Hospital Outpatient Prospective Payment System page by typing the following: http://www.hcfa.gov/​medicare/​hopsmain.htm.

    To assist readers in referencing sections contained in this document, we are providing the following table of contents.

    Outline of Contents

    I. Background

    A. Authority

    B. Summary of Rulemaking

    C. Summary of Changes in the August 24, 2001 Proposed Rule

    1. Changes Required by BIPA 2000

    2. Additional Changes

    3. Provider-Based Changes

    D. Public Comments and Responses to the August 24, 2001 Proposed Rule

    II. Changes to the Ambulatory Payment Classification (APC) Groups and Relative Weights

    A. Recommendations of the Advisory Panel on APC Groups

    1. Establishment of the Advisory Panel

    2. Specific Recommendations of the Advisory Panel and Our Responses

    B. Additional APC Changes Resulting from BIPA Provisions

    1. Coverage of Glaucoma Screening

    2. APCs for Contrast Enhanced Diagnostic Procedures

    3. Coding and Payment for Mammography Services

    a. Screening Mammography

    b. Diagnostic Mammography

    c. Coding and Payment for New Technology Mammography Services

    C. Other Changes Affecting the APCs

    1. Changes in Revenue Code Packaging

    2. Special Revenue Code Packaging for Specific Types of Procedures

    3. Limit on Variation of Costs of Services Classified Within a Group

    4. Observation Services

    5. List of Procedures That Will Be Paid Only As Inpatient Procedures

    6. Additional New Technology APC Groups

    D. Recalibration of APC Weights for CY 2002

    III. Wage Index Changes

    IV. Copayment Changes

    A. BIPA 2000 Coinsurance Limit

    B. Impact of BIPA 2000 Payment Rate Increase on Coinsurance

    C. Coinsurance and Copayment Changes Resulting from Change in an APC Group

    V. Outlier Policy Changes

    VI. Other Policy Decisions and Changes

    A. Change in Services Covered Within the Scope of the OPPS

    B. Categories of Hospitals Subject To and Excluded from the OPPS

    C. Conforming Changes: Additional Payments on a Reasonable Cost Basis

    D. Hospital Coding for Evaluation and Management Services

    E. Annual Drug Pricing Update

    F. Definition of Single-Use Devices

    G. Criteria for New Technology APCs

    1. Background

    2. Modifications to the Criteria and Process for Assigning Services to New Technology APCs

    a. Services Paid Under New Technology APCs

    b. Criteria for Assignment to New Technology APC

    c. Revision of Application for New Technology Status

    d. Length of Time in a New Technology APC

    VII. Transitional Pass-Through Payment Issues

    A. Background

    B. Discussion of Pro-Rata Reduction

    C. Reducing Transitional Pass-Through Payments to Offset Costs Packaged into APC Groups

    VIII. Conversion Factor Update for CY 2002

    IX. Summary of and Responses to MedPAC Recommendations

    X. Provider-Based Issues

    A. Background and April 7, 2000 Regulations

    B. Provider-Based Issues/Frequently Asked Questions

    C. Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000

    1. Two-Year “Grandfathering”

    2. Geographic Location Criteria

    3. Criteria for Temporary Treatment as Provider-Based

    D. Commitment to Re-examine EMTALA Applicability to Off-Campus Locations, and to Further Revise Provider-Based Regulations

    E. Changes to Provider-Based Regulations

    1. Clarification of Requirements for Adequate Cost Data and Cost Finding

    2. Scope and Definitions

    3. BIPA Provisions on Grandfathering and Temporary Treatment as Provider-Based

    4. Reporting

    5. Geographic Location Criteria

    6. Notice to Beneficiaries of Coinsurance Liability

    7. Clarification of Protocols for Off-Campus Departments

    8. Other Changes

    F. Comments on Other Issues

    XI. Provisions of the Final Rule Start Printed Page 59857

    A. Changes Required by BIPA

    B. Additional Changes

    C. Technical Corrections

    XII. Collection of Information Requirements

    XIII. Regulatory Impact Analysis Regulations Text

    Addenda

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

    Addendum B—Payment Status by HCPCS Code, and Related Information

    Addendum C—Hospital Outpatient Payment for Procedures by APC: Displayed on Website Only

    Addendum D—Payment Status Indicators for the Hospital Outpatient Prospective Payment System

    Addendum E—CPT Codes Which Would Be Paid Only As Inpatient Procedures

    Addendum G—Service Mix Indices by Hospital: Displayed on Website only

    Addendum H—Wage Index for Urban Areas

    Addendum I—Wage Index for Rural Areas

    Addendum J—Wage Index for Hospitals That Are Reclassified

    Alphabetical List of Acronyms Appearing in the Proposed Rule

    APC Ambulatory payment classification

    APG Ambulatory patient group

    ASC Ambulatory surgical center

    AWP Average wholesale price

    BBA 1997 Balanced Budget Act of 1997

    BBRA 1999 Balanced Budget Refinement Act of 1999

    BIPA 2000 Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000

    CAH Critical access hospital

    CAT Computerized axial tomography

    CCI Correct Coding Initiative

    CCR Cost-to-charge ratio

    CMHC Community mental health center

    CMS Centers for Medicare & Medicaid Services (Formerly known as the Health Care Financing Administration)

    CORF Comprehensive outpatient rehabilitation facility

    CPI Consumer Price Index

    CPT (Physician's) Current Procedural Terminology, Fourth Edition, 2001, copyrighted by the American Medical Association

    DME Durable medical equipment

    DMEPOS DME, prosthetics (which include prosthetic devices and implants), orthotics, and supplies

    DRG Diagnosis-related group

    EMTALA Emergency Medical Treatment and Active Labor Act

    FDA Food and Drug Administration

    FQHC Federally qualified health center

    HCPCS Healthcare Common Procedure Coding System

    HHA Home health agency

    ICD-9-CM International Classification of Diseases, Ninth Edition, Clinical Modification

    IME Indirect medical education

    JCAHO Joint Commission on Accreditation of Healthcare Organizations

    MRI Magnetic resonance imaging

    MSA Metropolitan statistical area

    NECMA New England County Metropolitan Area

    OPPS Hospital outpatient prospective payment system

    PPS Prospective payment system

    RFA Regulatory Flexibility Act

    RHC Rural health clinic

    RRC Rural referral center

    SCH Sole community hospital

    SNF Skilled nursing facility

    I. Background

    A. Authority

    When the Medicare statute was originally enacted, Medicare payment for hospital outpatient services was based on hospital-specific costs. In an effort to ensure that Medicare and its beneficiaries pay appropriately for services and to encourage more efficient delivery of care, the Congress mandated replacement of the cost-based payment methodology with a prospective payment system (PPS). The Balanced Budget Act of 1997 (BBA) (Pub. L. 105-33), enacted on August 5, 1997, added section 1833(t) to the Social Security Act (the Act) authorizing implementation of a PPS for hospital outpatient services. The Balanced Budget Refinement Act of 1999 (BBRA) (Pub. L. 106-113), enacted on November 29, 1999, made major changes that affected the hospital outpatient PPS (OPPS). The Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA) (Pub. L. 106-554), enacted on December 21, 2000, made further changes in the OPPS. The BIPA provisions that affect the OPPS are summarized below, in section I.C. The OPPS was first implemented for services furnished on or after August 1, 2000.

    B. Summary of Rulemaking

    • On September 8, 1998, we published a proposed rule (63 FR 47552) to establish in regulations a PPS for hospital outpatient services, to eliminate the formula-driven overpayment for certain hospital outpatient services, and to extend reductions in payment for costs of hospital outpatient services. On June 30, 1999, we published a correction notice (64 FR 35258) to correct a number of technical and typographic errors in the September 1998 proposed rule including the proposed amounts and factors used to determine the payment rates.
    • On April 7, 2000, we published a final rule with comment period (65 FR 18438) that addressed the provisions of the PPS for hospital outpatient services scheduled to be effective for services furnished on or after July 1, 2000. Under this system, Medicare payment for hospital outpatient services included in the PPS is made at a predetermined, specific rate. These outpatient services are classified according to a list of ambulatory payment classifications (APCs). The April 7 final rule with comment period also established requirements for provider departments and provider-based entities and prohibited Medicare payment for nonphysician services furnished to a hospital outpatient by a provider or supplier other than a hospital unless the services are furnished under arrangement. In addition, this rule extended reductions in payment for costs of hospital outpatient services as required by the BBA of 1997 and amended by the BBRA of 1999. Medicare regulations governing the hospital OPPS are set forth at 42 CFR 419.
    • On June 30, 2000, we published a notice (65 FR 40535) announcing a delay in implementation of the OPPS from July 1, 2000 to August 1, 2000.
    • On August 3, 2000, we published an interim final rule with comment period (65 FR 47670) that modified criteria that we use to determine which medical devices are eligible for transitional pass-through payments. The August 3, 2000 rule also corrected and clarified certain provider-based provisions included in the April 7, 2000 rule.
    • On November 13, 2000, we published an interim final rule with comment period (65 FR 67798). This rule provided for the annual update to the amounts and factors for OPPS payment rates effective for services furnished on or after January 1, 2001. We also responded to public comments on those portions of the April 7, 2000 final rule that implemented related provisions of the BBRA and public comments on the August 3, 2000 rule.
    • On August 24, 2001, we published a proposed rule (66 FR 44672) that set forth proposed changes to the Medicare hospital OPPS and calendar year (CY) 2002 payment rates. It also set forth proposed changes to the amounts and factors used to determine these payment rates.

    C. Summary of Changes in the August 24, 2001 Proposed Rule

    On August 24, 2001, we published a proposed rule (66 FR 44672) that set forth proposed changes to the Medicare hospital OPPS and CY 2002 payment rates including changes to the amounts and factors used to determine these payment rates.

    The following is a summary of the major changes that we proposed and the Start Printed Page 59858issues we addressed in the August 24, 2001 proposed rule.

    1. Changes Required by BIPA 2000

    We proposed the following changes to the OPPS, to implement the provisions of BIPA 2000:

    • Limit coinsurance to a specified percentage of APC payment amounts.
    • Provide hold-harmless payments to children's hospitals.
    • Provide separate APCs for services that use contrast agents and those that do not.
    • Payment for glaucoma screening as a covered service.
    • Payment for certain new technology used in diagnostic mammograms.

    2. Additional Changes

    We proposed the following additional changes to the OPPS:

    • Add APCs, delete APCs, and modify the composition of services within some existing APCs.
    • Add an APC group that would provide separate payment for observation services in limited circumstances to patients having specific diagnoses.
    • Recalibrate the relative payment weights of the APCs.
    • Update the conversion factor and wage index.
    • Revise the APC payment amounts to reflect the APC reclassifications, the recalibration of payment weights and the other required updates and adjustments.
    • Make reductions in pass-through payments for specific drugs and categories of devices to account for the drug and device costs that are included in the APC payment for associated procedures and services.
    • Apply a standard procedure to calculate copayment amounts when new APCs are created or when APC payment rates are increased or decreased as a result of recalibrated relative weights.
    • Calculate outlier payments on a service-by-service basis beginning in 2002. We also proposed a methodology for allocating packaged services to individual APCs in determining costs of a service and we proposed to use a hospital's overall outpatient cost-to-charge ratio to convert charges to costs.
    • Set the threshold for outlier payments to require costs to exceed 3 times the APC payment amount and payment at 50 percent of any excess costs above the threshold.
    • Exclude hospitals located outside the 50 states, the District of Columbia and Puerto Rico from the OPPS.
    • Exclude from payment under the OPPS certain services that are furnished to inpatients of hospitals that do not submit claims for outpatient services under Medicare Part B.
    • Make conforming changes to regulations text to reflect the exclusion from the OPPS of certain items and services (for example, bad debts, direct medical education and certain certified registered nurse anesthetists services) that are paid on a cost basis.
    • Update the payments for pass-through radiopharmaceuticals, drugs, and biologicals on a calendar year basis to reflect increases in AWP.
    • Allow reprocessed single use devices to be considered eligible for pass-through payments if the reprocessing process for single use devices meets the FDA's most recent criteria.
    • Revise the criteria we will use to determine whether a procedure or service is eligible to be assigned to a new technology APC.
    • Revise the list of information that must be submitted to request assignment of a service or procedure to a new technology APC.
    • Provide more flexibility in the amount of time a service may be paid under a new technology APC.
    • A description of the Secretary's estimate of the total amount of pass-through payments for CY 2002 and the need for a pro rata reduction to those payments in that year.

    3. Provider-Based Changes

    We proposed to make changes to the provider-based regulations to reflect the provisions of section 404 of BIPA and to codify certain clarifications on provider-based status that were posted on the CMS Web site.

    D. Public Comments Received in Response to the August 24, 2001 Proposed Rule

    We received approximately 400 timely items of correspondence containing multiple comments on the proposed rule. Major issues addressed by the commenters included the following:

    • The implementation of a uniform reduction in the transitional pass-through payments for CY 2002.
    • Changes to APC classifications and weights for certain outpatient services including mammography, stereotactic radiosurgery and intensity modulated radiation therapy, and positive emission tomography (PET) scans.
    • Changes to the eligibility criteria for payment as a new technology service.

    On November 2, 2001, we published a final rule (66 FR 55857) that responded to the comments on the Secretary's estimate of the total amount of transitional pass-through payments for CY 2002 and the need for a uniform reduction in the pass-through payments for that year as well as comments on the proposed conversion factor for CY 2002. That final rule announced that the conversion factor for CY 2002 is $50.904 and that the Secretary is implementing a pro rata reduction in 2002 (expected to be between 65 and 70 percent) to each pass-through payment (we stated that we would announce the exact amount of the reduction before the beginning of 2002).

    Summaries of the remaining public comments received and our responses to those comments are set forth below under the appropriate heading. In addition, we are announcing that the pro rata reduction is 68.9 percent.

    II. Changes to the APC Groups and Relative Weights

    Under the OPPS, we pay for hospital outpatient services on a rate per service basis that varies according to the APC group to which the service is assigned. Each APC weight represents the median hospital cost of the services included in that APC relative to the median hospital cost of the services included in APC 0601, Mid-Level Clinic Visits. As described in the April 7, 2000 final rule (65 FR 18484), the APC weights are scaled to APC 0601 because a mid-level clinic visit is one of the most frequently performed services in the outpatient setting.

    Section 1833(t)(9)(A) of the Act requires the Secretary to review the components of the OPPS not less often than annually and to revise the groups and related payment adjustment factors to take into account changes in medical practice, changes in technology, and the addition of the new services, new cost data, and other relevant information. Section 1833(t)(9)(A) of the Act requires the Secretary, beginning in 2001, to consult with an outside panel of experts when annually reviewing and updating the APC groups and the relative weights.

    Finally, section 1833(t)(2) of the Act provides that, subject to certain exceptions, the items and services within an APC group cannot be considered comparable with respect to the use of resources if the highest median or mean cost item or service in the group is more than 2 times greater than the lowest median or mean cost item or service within the same group (referred to as the “2 times rule”). We use the median cost of the item or service in implementing this provision. The statute authorizes the Secretary to make exceptions to the 2 times rule “in Start Printed Page 59859unusual cases, such as low volume items and services.”

    For the proposed rule and for this final rule, we analyzed the APC groups within this statutory framework.

    A. Recommendations of the Advisory Panel on APC Groups

    1. Establishment of the Advisory Panel

    Section 1833(t)(9)(A) of the Act, which requires that we consult with an outside panel of experts when annually reviewing and updating the APC groups and the relative weights, specifies that the panel will act in an advisory capacity. The expert panel, which is to be composed of representatives of providers, is to review and advise us about the clinical integrity of the APC groups and their weights. The Panel is not restricted to using our data and may use data collected or developed by organizations outside the Department in conducting its review.

    On November 21, 2000, the Secretary signed the charter establishing an “Advisory Panel on APC Groups” (the Panel). The Panel is technical in nature and is governed by the provisions of the Federal Advisory Committee Act (FACA) as amended (Public Law 92-463). To establish the Panel, we solicited members in a notice published in the Federal Register on December 5, 2000 (65 FR 75943). We received applications from more than 115 individuals nominating either themselves or a colleague. After carefully reviewing the applications, CMS chose 15 highly qualified individuals to serve on the Panel. The Panel was convened for the first time on February 27, February 28, and March 1, 2001. We published a notice in the Federal Register on February 12, 2001 (66 FR 9857) to announce the location and time of the Panel meeting, a list of agenda items, and that the meeting was open to the public. We also provided additional information through a press release and our website.

    2. Specific Recommendations of the Advisory Panel and Our Responses

    In the proposed rule, we summarized the issues considered by the Panel, the Panel's APC recommendations, and our subsequent action with regard to the Panel's recommendations. The data used by the Panel in making its recommendation are the 1996 claims that were used to set the APC weights and payment rates for CY 2000 and 2001. In the proposed rule, we provided a detailed summary of the Panel discussion and recommendations (66 FR 44675-44686). See the proposed rule for more details regarding these discussions.

    As discussed below, the Panel sometimes declined to recommend a change in an APC even though the APC violated the 2 times rule. In section II.C.3 of this preamble, we discuss our policies regarding the 2 times rule based on the data we are using to recalibrate the 2002 APC relative weights (that is, claims for services furnished on or after July 1, 1999 and before July 1, 2000). That section also details the criteria we use in deciding to make an exception to the 2 times rule. We asked the Panel to review many of the exceptions we implemented in 2000 and 2001. The exceptions are referred to as “violations of the 2 times” rule in the following discussion.

    We did not receive comments on the APC changes we proposed based on the recommendations of the Panel except for our proposal regarding stereotactic radiosurgery (APCs 0300 and 0302). We discuss that proposal in detail below along with the comments and our responses. For all other APC Panel proposed changes, we briefly discuss the Panel's recommendation, our proposal, and the final changes we have made. We also received comments on APCs and the assignment of codes to APCs for which we made no specific proposal in the proposed rule. We address those comments below in section II.A.3. of this preamble.

    APC 0016: Level V Debridement & Destruction

    APC 0017: Level VI Debridement & Destruction

    We asked the Panel to review the current placement of CPT code 56501, Destruction of lesion(s), vulva; simple, any method, in APC 0016 because the APC violates the 2 times rule. Because the procedure is a simple destruction of skin and superficial subcutaneous tissues, we will not expect it to have a median cost of $500. Thus, we believe that the higher costs associated with this code were the result of incorrect coding. To ensure that procedures in APC 0016 comply with the 2 times rule, we asked the Panel to consider one of the following clinical options:

    • Move CPT code 56501 to APC 0017.
    • Retain CPT code 56501 in APC 0016 but split APC 0016 into three APCs to distinguish simple destruction lesions from extensive destruction lesions.

    The Panel recommended the following:

    • Move CPT code 56501 from APC 0016 to APC 0017.
    • Move CPT code 46917 from APC 0014 to APC 0017.

    After considerable discussion the Panel recommended these changes to achieve clinical coherence and resource similarity among the procedures assigned to these APCs. Because CPT code 46917 is performed using laser equipment and requires anesthesia, the Panel believed it appropriate to move this procedure to APC 0017. Although the Panel considered the reassignment of CPT code 54055 to APC 0017, it did not recommend this change. The Panel's recommended changes will group in APC 0017 simple destruction of lesion procedures that use laser or surgical techniques with extensive destruction of lesion procedures.

    We proposed to accept the Panel's recommendation regarding CPT code 56501 and to revise the APC accordingly. We are adopting these changes in final; however, as shown below in Table 3, we are making additional changes to these APCs because of the 2 times rule.

    APC 0024: Level I Skin Repair

    APC 0025: Level II Skin Repair

    APC 0026: Level III Skin Repair

    APC 0027: Level IV Skin Repair

    The composition of procedures in APCs 0025 and 0027 results in these APCs violating the 2 times rule. Therefore, we requested the Panel's advice in exploring other clinical options for reconfiguring the four skin repair APCs to achieve clinical and resource homogeneity among the procedures assigned to APCs 0025 and 0027 while retaining clinical and resource homogeneity for APCs 0024 and 0026. We asked the Panel to consider the following clinical options to achieve this result:

    • Rearrange the procedures assigned to APCs 0024 through 0027 based on the size or the length of the skin incision.
    • Rearrange the procedures assigned to APCs 0024 through 0027 based on the complexity of the repair, such as distinguishing repairs that involve layers of skin, flaps, or grafts from those that do not.

    The Panel reviewed the various options presented, which were modeled based on the 1996 claims data used in constructing the current APC groups and payment rates. The Panel recommended the following:

    • Make no changes to APCs 0024 and 0027.
    • Reevaluate these APCs with new data when the Panel meets in 2002.
    • The Panel, in preparation for the 2002 meeting, will discuss options with and gather clinical and utilization information from their respective hospitals regarding these procedures. Start Printed Page 59860

    We proposed to accept the Panel's recommendations. We are adopting these recommendations as final; however, as discussed below in section II.C., we are making additional changes to these APCs based on the use of new data and application of the 2 times rule.

    APC 0058: Level I Strapping and Casting Application

    APC 0059: Level II Strapping and Casting Application

    APC 0058 (which consists of the simpler casting, splinting, and strapping procedures) violates the 2 times rule. The median costs for high volume procedures in APC 0058 vary widely, ranging from $27 to $83. The median costs associated with presumably more resource-intensive procedures in APC 0059 are fairly uniform, ranging from $69 to $119. To limit the cost variation in APC 0058, we asked the Panel to consider the following options:

    • Move the following four codes from APC 0058 to APC 0059: CPT code 29515, Application of short splint (calf to foot); CPT code 29520, Strapping; hip; CPT code 29530, Strapping; knee; and CPT code 29590, Denis-Brown splint strapping.
    • Create a new APC to include a third level of strapping and casting application procedures by regrouping all procedures assigned to both APCs 0058 and 0059 based on the following clinical distinctions: removal/revision, strapping/splinting, and casting.
    • Package certain CPT codes assigned to APC 0058 with relevant procedures.

    The Panel recommended that we do the following:

    • Make no changes to APC 0058.
    • Provide appropriate education and guidance to hospitals regarding appropriate use and billing of codes in APC 0058.
    • Resubmit APC 0058 to the Panel for reevaluation when later data are available.

    We proposed to accept the Panel's recommendations except that we proposed to move CPT code 29515 to APC 0059 due to the 2 times rule and the newer data we are using for this rule. These changes have been adopted as final in this document.

    APC 0079: Ventilation Initiation and Management

    The codes in APC 0079 represent respiratory treatment and support provided in the outpatient setting. The cost variation among the assigned procedures in this APC raises concern about hospital coding practices. The median costs for these procedures range from $40 to $315. We asked the Panel to clarify whether these procedures are performed on outpatients or if they are performed on patients who come to the emergency room and are later admitted to the hospital as inpatients.

    The Panel recommended the following:

    • Remove CPT code 94660 from APC 0079 and create a new APC for this one procedure.

    We proposed to accept the Panel's recommendation by creating a new APC 0065, CPAP Initiation. We have adopted this change in this final rule.

    APC 0094: Resuscitation and Cardioversion

    We requested the Panel's assistance in determining whether it is clinically appropriate to remove the cardioversion procedures from APC 0094 because the rest of the procedures assigned to APC 0094 are emergency procedures rather than elective. We proposed that the Panel consider the creation of a new APC for the cardioversion procedures or reassignment of the procedures to another APC that would be more appropriate in terms of clinical coherence and resource similarity. Splitting APC 0094 into two distinct groups, one for resuscitation procedures and the other for internal and external electrical cardioversion procedures, would not result in a significant difference in the APC payment rate for either of the new APCs.

    The Panel recommended that the only action we take would be to move CPT code 92961, Cardioversion, elective, electrical conversion of arrhythmia; internal (separate procedure) from APC 0094 to APC 0087, Cardiac Electrophysiology Recording/Mapping.

    We proposed to accept the APC Panel recommendation. We are adopting this change as final.

    APC 0102: Electronic Analysis of Pacemakers/Other Devices

    The neurologic procedures included in APC 0102 (CPT codes 95970 through 95975), are significantly more complex than the routine cardiac pacemaker programming codes also assigned to this APC. Because we believe these codes are clinically different, we asked the Panel to consider the following:

    • Create a new APC for the neurologic codes.
    • Move the neurologic codes to APC 0215, Level I Nerve and Muscle Tests.

    The Panel recommended the following reorganization of APC 0102 to better reflect clinical coherence:

    • Split APC 0102 into four new APCs: one APC for analysis and programming of infusion pumps and CSF shunts; a second for analysis and programming of neurostimulators; a third for analysis and programming of pacemakers and internal loop recorders; and a fourth for analysis and programming of cardioverter-defibrillators.

    We proposed to accept the Panel's recommendations and proposed to create four new APCs as follows:

    APC 0689: Electronic Analysis of Cardioverter-Defibrillator

    APC 0690: Electronic Analysis of Pacemakers and Other Cardiac Devices

    APC 0691: Electronic Analysis of Programmable Shunts/Pumps

    APC 0692: Electronic Analysis of Neurostimulator Pulse Generators.

    We have made these changes final in this rule.

    APC 0110: Transfusion

    APC 0111: Blood Product Exchange

    APC 0112: Extracorporeal Photopheresis

    The procedures included in APC 0110 are those related only to the services associated with performing the blood transfusion and monitoring the patient during the transfusion; the costs associated with the blood products themselves are not included in APC 0110. We advised the Panel that we were not certain that cost data for blood transfusions excluded the costs of the blood products because the APC 0110 median cost of $289 seemed excessive. We expressed concern about hospital coding and billing practices for blood products, blood processing, storage, and transportation charges as represented in the 1996 data. We asked the Panel to advise us on how to clarify hospital billing and coding practices for blood transfusions; we also asked if the Panel members believe that the median costs for transfusion procedures include the costs for blood products and, if so, how the procedures should be adjusted to eliminate these costs.

    After considerable discussion, the Panel recommended the following:

    • Take no action on APC 0110.
    • Move CPT code 36521 from APC 0111 to APC 0112 to achieve clinical coherence and resource similarity with photopheresis procedures included in APC 0112. However, the Panel cautioned that the payment for APC 0112 captured the cost of the entire procedure including the cost of the adsorption column. For this reason, any additional payment for the adsorption column through the transitional pass-through payment mechanism will be a duplicate payment. Therefore, the Panel asked that CMS address this problem when considering their recommendation. Start Printed Page 59861

    We proposed to accept the Panel's recommendations. We noted that effective April 1, 2001, the Prosorba column is no longer eligible for a transitional pass-through payment (see PMA-01-40 issued on March 27, 2001).

    We have adopted the proposed changes in final in this document.

    APC 0116: Chemotherapy Administration by Other Technique Except Infusion

    APC 0117: Chemotherapy Administration by Infusion Only

    APC 0118: Chemotherapy Administration by Both Infusion and Other Technique

    Based on previous comments we had received, we asked the Panel to review whether oral delivery of chemotherapy and delivery of chemotherapy by infusion pumps and reservoirs should be recognized for payment under the OPPS.

    In summary, the Panel recommended the following:

    • Allow hospitals to bill for patient education on the administration of oral anticancer agents under the appropriate clinic codes.
    • Assign CPT codes 96520 and 96530 to a new APC.
    • Continue to use the current HCPCS Level II Q codes for chemotherapy administration.
    • There is no need to develop a new HCPCS code for “extended chemotherapy infusions.”
    • CMS should consider developing a new HCPCS code for flushing of ports and reservoirs.

    We proposed to accept all the Panel's recommendations except for the recommendation regarding flushing of ports and reservoirs. Flushing is performed in conjunction with either a chemotherapy administration service or an outpatient clinic visit. In the first case, flushing is part of the chemotherapy administration and its costs are adequately captured in the costs of the chemotherapy administration code. In the second case, we believe that the costs of flushing are adequately captured in the costs of the clinic visit and need not be paid separately. We proposed to create a new APC 0125, Refilling of Infusion Pump.

    We are adopting these changes as final in this rule.

    APC 0123: Bone Marrow Harvesting and Bone Marrow/Stem Cell Transplant

    In APC 0123, the 1996 median cost for CPT code 38230, Bone marrow harvesting for transplantation, was only $15. We believe that this cost is lower than the actual cost of the procedure. Further, we do not have sufficient data to determine how often bone marrow and stem cell transplant procedures are performed on an outpatient basis. For these reasons, we requested the Panel's advice in clarifying the resources used in performing the procedures assigned to APC 0123, and the extent to which these procedures are performed on an outpatient basis.

    The Panel recommended the following:

    • Make no changes in the procedures assigned to APC 0123 in the absence of sufficient data to support such modifications.
    • The two presenters on this APC issue should submit cost data for the Panel to use in reevaluating this issue at its 2002 meeting.

    We noted in the proposed rule that our analysis of the more recent claims data we are using to reclassify and recalibrate the APCs reveals a significant increase in costs for this APC resulting in a payment rate that is double the current rate. However, very few procedures (fewer than 20) were billed on an outpatient basis. As we indicated in the proposed rule, we will have the Panel review this APC again at their next meeting.

    APC 0142: Small Intestine Endoscopy

    APC 0143: Lower GI Endoscopy

    APC 0145: Therapeutic Anoscopy

    APC 0147: Level II Sigmoidoscopy

    APC 0148: Level I Anal/Rectal Procedures

    APC 0149: Level II Anal/Rectal Procedures

    APC 0150: Level III Anal/Rectal Procedures

    We presented these seven APCs to the Panel because of the inconsistencies in the median costs for some procedures included in APCs 0142, 0143, 0145, and 0147. We advised the Panel that our cost data do not show a progression of median costs proportional to increases in clinical complexity as we would expect. For example, the data indicate that a therapeutic anoscopy assigned to APC 0145 costs more than twice as much as a flexible or rigid sigmoidoscopy assigned to APC 0147. We stated our concern that cost disparity could provide incentives to use inappropriate procedures. Because of these concerns, we asked the Panel's advice in determining whether one of the following actions should be taken:

    • Divide the codes in APC 0142 into separate APCs representing ileoscopy and small intestine procedures.
    • Combine diagnostic anoscopy and Level I sigmoidoscopy.
    • Merge APCs 0143, 0145, and 0147 into one APC.

    We also asked the Panel whether the costs associated with codes in APC 0145 appeared to be valid.

    The Panel recommended that we do the following:

    • Make no changes to APCs 0142, 0143, 0145, and 0147.
    • Provide information and guidance to better assist hospitals in understanding how to bill appropriately for services included in APCs 0142, 0143, 0145, and 0147.
    • Resubmit these APCs to the Panel for review when newer data are available.

    We proposed to accept the Panel's recommendations.

    We have adopted these recommendations in this final rule.

    APC 0151: Endoscopic Retrograde Cholangio-Pancreatography (ERCP)

    We advised the Panel that we have received comments that indicate that it is inappropriate to assign both diagnostic and therapeutic ERCP procedures to the same APC. The commenters allege that virtually every hospital performs diagnostic ERCPs but only teaching hospitals perform therapeutic ERCPs. Based on our current data, if we created two APCs for ERCP procedures, the APC payment rate for therapeutic ERCPs would be lower than that for diagnostic ERCPs (approximately $526 and $535, respectively). Therefore, we requested the Panel's advice to help us determine whether to create separate APCs for diagnostic and therapeutic ERCP procedures.

    The Panel recommended that we do the following:

    • Do not reconfigure the ERCP procedures in APC 0151.
    • Resubmit this issue to the Panel for review when more recent data are available.
    • Explore the feasibility of using multiple claims rather than single claims to calculate appropriate APC payment rates for ERCP procedures.

    We proposed to accept the Panel's recommendations. As we stated in the proposed rule, we are reviewing the potential for using multiple claims data for determining payment rates for ERCP procedures. As a first step in the process, in the proposed rule, we determined a payment rate for ERCP procedures based on both single claims for ERCP procedures and, because ERCP procedures are typically done under radiologic guidance, on claims that included both an ERCP procedure and a radiologic supervision or guidance procedure in this APC. We Start Printed Page 59862accomplished this by changing the status indicator for radiologic guidance and supervision codes to “N”, which results in these codes being packaged. Using these additional claims resulted in significantly increasing the number of claims used to determine the payment rate for this APC and in a much higher payment rate (about $780 in this final rule).

    We will be presenting this issue again to the APC Panel at their next meeting.

    APC 0160: Level I Cystourethroscopy and other Genitourinary Procedures

    APC 0161: Level II Cystourethroscopy and other Genitourinary Procedures

    APC 0162: Level III Cystourethroscopy and Other Genitourinary Procedures

    APC 0163: Level IV Cystourethroscopy and Other Genitourinary Procedures APC 0169: Lithotripsy

    We advised the Panel that we had previously received a number of comments that advocated moving CPT code 52337, Cystoscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included), from APC 0162 to APC 0163. (We note that CPT code 52337 was deleted for 2001 and replaced with an identical CPT code, 52353. We will use the new code in the following discussion.) Because of these comments, we sought the Panel's advice in examining the clinical and resource distinctions between CPT code 52353 and other procedures assigned to APC 0162. Other information shared with the Panel noted that most of the procedures included in APC 0162 are complicated cystourethroscopies while those assigned to APC 0163 are largely prostate procedures.

    The Panel recommended that we move CPT code 52353 from APC 0162 to APC 0169 because both codes 52353 and 50590 are lithotripsy procedures.

    We reviewed the Panel discussion very carefully and noted the close vote. After careful consideration, we proposed to disagree with the Panel's recommendation and move code 52353 to APC 0163. The 1999-2000 cost data used for the proposed rule, which contained over 400 single claims for code 52353 (reported under code 52337) and over 6,000 single claims for code 50590, showed that the median cost for code 52353 is much more similar to the median cost of other procedures in APC 0163 than it is to the median cost of APC 0169. Although both codes involve lithotripsy, the type of equipment used in the two procedures is very different. Clinically, the surgical approach used for code 52353 and the resources used (e.g., anesthesia and operating room costs) are much more similar to other procedures in APC 0163 than to those for code 50590. Additionally, the median cost for code 50590, which was $700 higher than that of code 52353, is dependent on the widely variable arrangements hospitals make for use of the extracorporeal lithotriptor. Therefore, we believe that placing code 52353 in APC 0163 maintains its clinical coherence and similar use of resources.

    Based on the updated 1999-2000 data base available for the final rule, we find that the cost relationship between codes 52353 and 50590 continues to reflect a difference. There are now almost 500 single claims for code 52353 and almost 7,000 single claims for code 50590. The median cost for 50590 remains about $700 higher than the median cost for code 52353. Therefore, we are adopting as final our proposal to move code 52353 to APC 0163.

    APC 0191: Level I Female Reproductive Procedures

    APC 0192: Level II Female Reproductive Procedures

    APC 0193: Level III Female Reproductive Procedures

    APC 0194: Level IV Female Reproductive Procedures

    APC 0195: Level V Female Reproductive Procedures

    This group of APCs was presented to the Panel because APC 0195 violates the 2 times rule. To facilitate the Panel's review of this issue, we distributed cost data on all the female reproductive procedures assigned to these five APCs. These data showed that the median costs for procedures assigned to APC 0195 ranged from a low of $365 to a high of $1,817. The CPT code 57288, Sling operation for stress incontinence (e.g., fascia or synthetic), which is assigned to APC 0195, has the highest median cost of the procedures in this group. We discussed with the Panel two clinical options for rearranging the procedures assigned to APC 0195 to comply with the 2 times rule. The first option would split APC 0195 into two separate APCs by separating vaginal procedures from abdominal procedures. The second option would split APC 0195 into three distinct APCs by retaining the separate APCs for abdominal and vaginal procedures and further distinguishing vaginal procedures based on whether they are simple or complex.

    The Panel closely reviewed the four APCs for female reproductive procedures (APCs 0191, 0192, 0193, and 0194) to ensure each was clinically homogeneous. As a result of this review, the Panel recommended a number of changes for these APCs. These recommendations and those for APC 0195 are as follows:

    • Move CPT codes 56350, Hysteroscopy, diagnostic, and 58555, Hysterosocopy, diagnostic/separate procedure, from APC 0191 to APC 0194 (In 2001, CPT code 56350 was replaced with CPT code 58555.)
    • Divide APC 0195 into two APCs to distinguish vaginal procedures from abdominal procedures.
    • Retain the following vaginal procedures in APC 0195:
    CPT codeDescriptor
    57555Excision of cervical stump, vaginal approach: with anterior and/or posterior repair.
    58800Drainage of ovarian cyst(s), unilateral or bilateral, (separate procedure); vaginal approach.
    58820Drainage of ovarian abscess; vaginal approach, open.
    57310Closure of urethrovaginal fistula;
    57320Closure of vesicovaginal fistula; vaginal approach
    57530Trachelectomy (cervicectomy), amputation of cervix (separate procedure).
    57291Construction of artificial vagina; without graft.
    57220Plastic operation on urethral sphincter, vaginal approach (e.g., Kelly urethral plication).
    57550Excision of cervical stump, vaginal approach.
    57556Excision of cervical stump, vaginal approach; with repair of enterocele.
    57289Pereyra procedure, including anterior colporrhapy.
    57300Closure of rectovaginal fistula; vaginal or transanal approach.
    Start Printed Page 59863
    57284Paravaginal defect repair (including repair of cystocele, stress urinary incontinence, and/or incomplete vaginal prolapse).
    57265Combined anteroposterior colporrhaphy; with enterocele repair.
    57268Repair of enterocele vaginal approach (separate procedure).
    56625Vulvectomy simple; complete.
    58145Myomectomy excision of fibroid tumor of uterus, single or multiple (separate procedure); vaginal approach.
    57260Combined anteroposterior colporrhaphy;
    57240Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele.
    57250Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy.
    56620Vulvectomy simple; partial.
    57522Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; loop electrode excision.
    • Include the following abdominal procedures in a new APC titled “Level VI Female Reproductive Procedures.”
    CPT codeDescriptor
    58920Wedge resection or bisection of ovary, unilateral or bilateral.
    58900Biopsy of ovary, unilateral or bilateral (separate procedure).
    58925Ovarian cystectomy, unilateral or bilateral.
    57288Sling operation for stress incontinence (e.g., fascia or synthetic).
    57287Removal or revision of sling for stress incontinence (e.g., fascia or synthetic).
    • Move CPT code 57107 from APC 0194 to APC 0195, Level V Female Reproductive Procedures.
    • Move CPT code 57109, Vaginectomy with removal of paravaginal tissue (radical vaginectomy) with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), from APC 0194 to the new APC, Level VI Female Reproductive Procedures.

    We proposed to accept all of these Panel recommendations. These APCs would be reconfigured and renumbered as APCs 0188 to 0194. We also proposed to add new APCs for Level VII and Level VIII Female Reproductive Procedures (APCs 0195 and 0202, respectively) based on the 1999-2000 claims data and the 2 times rule. These proposed changes have been adopted as final in this document.

    APC 0210: Spinal Tap

    APC 0211: Level I Nervous System Injections

    APC 0212: Level II Nervous System Injections

    The Panel heard testimony from two presenters regarding the merits of modifying these three APCs. The first presenter, speaking on behalf of a manufacturer, discussed a new code for 2001, CPT code 64614, Chemodenervation of muscles; extremities and/or trunk muscles (e.g., for dystonia, cerebral palsy, multiple sclerosis).

    The second presenter, representing a specialty society, proposed regrouping the procedures assigned to APCs 0210, 0211, and 0212 based on similar levels of complexity and median costs. The presenter's proposal also included reassignment to these APCs of interventional pain procedures currently assigned to APCs 040, Arthrocentesis and Ligament/Tendon Injection, 0105, Revision/Removal of Pacemakers, AICD, or Vascular Device, and 0971. The presenter proposed establishing the following five levels of interventional pain procedures by regrouping the procedures into new APCs as stated below:

    • Level I Nerve Injections (to include Trigger Point, Joint, Other Injections, and Lower Complexity Nerve Blocks):
    CPT codeReassigned from APC
    20550040
    20600040
    20605040
    20610040
    646120211
    646130211
    646140971
    64400-644180211
    644250211
    644300211
    644350211
    644450211
    644500211
    645050211
    645080211
    • Level II Nerve Injections (to include Moderate Complexity Nerve Blocks and Epidurals):
    CPT CodeReassigned from APC
    270960210
    622700210
    622720210
    622730212
    62310-623190212
    • Level III Nerve Injections (to include Moderately High Complexity Epidurals, Facet Blocks, and Disk Injections):
    CPT CodeReassigned from APC
    62280-622820212
    62290(1)
    62291(1)
    64420-644210211
    644700211
    644720211
    64475-644760211
    644790211
    644800211
    64483-644840211
    645100211
    645200211
    645300211
    646300211
    646400211
    1 Currently packaged.
    • Level IV Nerve Injections (to include High Complexity Lysis of Adhesions, Neurolytic Procedures, Removal of Implantable Pumps and Stimulators):
    CPT CodeReassigned from APC
    622630212
    646000211
    646050211
    646100211
    646200211
    64622-646230211
    64626-646270211
    646800211
    623550105
    623650105
    • Level V Nerve Injections (to include Highest Complexity Disk and Spinal Endoscopies): CPT code 62287, Aspiration or decompression procedure, percutaneous, of nucleus pulposus of invertebral disk, any method, single or multiple levels, lumbar (e.g., manual or automated percutaneous diskectomy, percutaneous laser diskectomy), reassigned from APC 0220, Level I Nerve Procedures.

    The Panel recommended reassignment of CPT code 64614 from APC 0971 to APC 0211.

    Concerning the suggested regrouping of interventional pain procedures, the Panel agreed that the recommended division of these procedures by clinical complexity would reflect resource use and was a reasonable approach to take. It was pointed out to the Panel that the costs for CPT codes 62290, Injection procedure for diskography, each level; lumbar, and 62291, Injection procedure for diskography, each level; cervical or thoracic, were packaged into the procedures with which they were billed. Therefore, the Panel concurred with the regrouping of procedures to establish Start Printed Page 59864Levels I, II, III, and IV with the following exceptions:

    • The Panel recommended that we not include CPT codes 62290 and 62291 in Level III because they are packaged injections and should not be unpackaged and paid separately.
    • The Panel opposed moving CPT codes 62355, Removal of previously implanted intrathecal or epidural catheter, and 62365, Removal of subcutaneous reservoir or pump, previously implanted for intrathecal or epidural infusion, from APC 0105 to Level IV Nerve Injections because they were neither clinically similar nor similar in resource use to the other codes assigned to this APC.
    • The Panel opposed the creation of Level V Nerve Tests as it included only one code and recommended that CPT code 62287 remain in APC 220.
    • We proposed to accept the Panel's recommendations for these services and we proposed to create new APCs 0203, 0204, 0206, and 0207 to accommodate these changes. We are adopting these proposed changes as final.

    APC 0215: Level I Nerve and Muscle Tests

    APC 0216: Level II Nerve and Muscle Tests

    APC 0217: Level III Nerve and Muscle Tests

    We advised the Panel that we had received a comment contending that assignment of CPT code 95863, Needle electromyography, three extremities with or without related paraspinal areas, to APC 0216 created an inappropriate incentive to perform tests on three extremities rather than two or four extremities. The payment of about $144 for APC 0216 is greater than the payment of about $58 for the same tests when performed on one, two, or four extremities. This is because CPT codes 95860, 95861, and 95864, Needle electromyography, one, two, and four extremities with or without related paraspinal areas, respectively, are assigned to APC 0215. We distributed data to the Panel that showed a median cost of about $141 for CPT code 95863, which is more than 3 times that of the median cost of $41 for CPT code 95864. We asked the Panel to consider the reassignment of CPT code 95863 from APC 0216 to APC 0215 and advised the Panel that, based on cost data available at the time of our meeting, this change could potentially reduce the payment for APC 0216. It was also noted that this change could result in a payment increase for APC 0215.

    The Panel reviewed the cost data for APCs 0215 and 0216 and noted that the median costs for both CPT codes 95863 and 95864 appeared aberrant. Based on the information presented, the Panel recommended that we move CPT code 95863 from APC 0216 to APC 0215. We proposed to accept the Panel's recommendation with one exception. We proposed to revise these APCs based on the 1999-2000 cost data and the 2 times rule, and CPT code 95863 would be assigned to a reconfigured APC for Level II Nerve and Muscle Tests (APC 0218).

    The changes we proposed to APCs 0215, 0216, and 0217 have been adopted as final in this document.

    APC 0237: Level III Posterior Segment Eye Procedures

    We advised the Panel that procedures assigned to APC 0237 are high volume procedures and rank among the top outpatient procedures billed under Medicare. We have received a number of comments disagreeing with the assignment of CPT code 67027, Implantation of intravitreal drug delivery system (e.g., ganciclovir implant), includes concomitant removal of vitreous, to APC 0237. This procedure was added to the CPT coding system after 1996 and, therefore, was not included in the 1996 data. We advised the Panel that ganciclovir, the drug implanted during this procedure, is paid separately as a transitional pass-through item. Because the drug is paid separately, it should not be included in determining whether the resources associated with the surgical procedure are similar to the resources required to perform the other procedures assigned to APC 0237. We advised the Panel that, of the procedures assigned to APC 0237, we believe that CPT code 67027 is related to codes 65260, 65265, and 67005, all of which involve removal of foreign bodies and vitreous from the eye. To ensure that CPT code 67027 is assigned to the appropriate APC, we asked the Panel to consider creation of a new APC, Level IV Posterior Segment Eye Procedures, for CPT codes 65260, 65265, 67005, and 67027. Based on the APC rates effective January 1, 2001, the suggested change could lower the APC rate for the four procedures by $400.

    The Panel reviewed the data and did not believe it was sufficient to support the creation of a new APC for these four procedures. Therefore, the Panel recommended that APC 0237 remain intact and that more recent claims data be analyzed to determine whether CPT code 67027 is similar to the other procedures assigned to APC 0237.

    Based on the 1999-2000 claims data, we have determined that the resources used for code 67027 are similar to other procedures in APC 0237. However, we will present APCs 0235, 0236, and 0237 to the Panel at their next meeting to determine whether any further changes should be made. We proposed to make various other changes to these APCs based on the new data and the 2 times rule, which we are incorporating as final in this document.

    APC 0251: Level I ENT Procedures

    This APC violates the 2 times rule because it consists of a wide variety of minor ENT procedures, many of which are low volume services or codes for nonspecific procedures. In order to correct this problem, we recommended to the Panel that this APC be split by surgical site (for example, nasal and oral). After reviewing cost data, the Panel agreed that the APC should be split but that current data were insufficient to determine how that split should be made. Therefore, the Panel asked that this APC, along with more recent cost data, be placed on the agenda at the next meeting.

    We agree that this APC should be reviewed by the Panel at its next meeting. However, our review of the more recent cost data indicates that significant violations of the 2 times rule still exist. In order to correct this problem, but keep the APC as intact as possible, we proposed to move CPT codes 30300, Remove foreign body, intranasal; office type procedure, 40804, Removal of embedded foreign body, vestibule of mouth; simple, and 42809, Removal of foreign body from pharynx, to APC 0340, Minor Ancillary Procedures. This APC consists of procedures such as removal of earwax that require similar resources. Based on the latest 1999-2000 data, we find that the reasons for our proposed revision are still valid, therefore, we have incorporated those changes as final in this rule.

    APC 0264: Level II Miscellaneous Radiology Procedures

    We asked the Panel to review this APC because it violated the 2 times rule and consisted of a wide variety of unrelated procedures. Specifically, we believe that the costs associated with CPT codes 74740, Hysterosalpingography, radiological supervision and interpretation, and 76102, Radiologic examination, complex motion (e.g., hypercycloidal) body section (e.g., mastoid polytomography), other than with urography; bilateral, were aberrant and that we would significantly underpay these procedures if we moved them into a lower paying APC. We also asked the Panel to determine whether this APC Start Printed Page 59865and APC 0263, Level I Miscellaneous Radiology Procedures, should be reconfigured by body system.

    After considerable discussion, the Panel agreed that the procedures in these APCs were not clinically homogeneous; however, it recommended that we leave these APCs intact because the data do not support any more coherent reorganization. The Panel requested that this APC be placed on the agenda for the 2002 meeting.

    We stated in the proposed rule that we agreed with the Panel's recommendations with the following revisions. First, BIPA requires us to assign procedures requiring contrast into different APCs from procedures not requiring contrast. This required changes to a number of radiologic APCs including APCs 0263 and 0264. In addition, we proposed to move CPT code 75940, Percutaneous Placement of IVC filter, radiologic supervision and interpretation, to a new APC 0187, Placement/Reposition Miscellaneous Catheters, because its costs were significantly higher than the costs of the procedures remaining in APC 0264.

    We are adopting the changes discussed in the proposed rule as final. However, as discussed in a comment and response below in section II.A.3 of this preamble, we are revising the title and status indicator for APC 0187.

    APC 0269: Echocardiogram Except Transesophageal

    APC 0270: Transesophageal Echocardiogram

    We asked the Panel to consider splitting these APCs based on whether or not 2D imaging is employed. After review of the data, the Panel recommended that we leave these APCs intact.

    We proposed to leave APC 0270 intact except for the addition of two new codes for transesophageal echocardiography. We also proposed to split APC 0269 into two APCs, APC 0269, Level I Echocardiogram Except Transesophageal and APC 0697, Level II Echocardiogram Except Transesophageal. One APC (0269) would include comprehensive echocardiograms and the other APC (0697) would include limited/follow-up echocardiograms and doppler add-on procedures.

    We have included these proposed changes in the APCs set forth in this final rule.

    APC 0274: Myelography

    We advised the Panel that APC 0274 is clinically homogeneous but that it violates the 2 times rule. Procedures assigned to this APC include radiological supervision and interpretation of diagnostic studies of central nervous system structures (e.g., spinal cord and spinal nerves) performed after injection of contrast material. We shared data with the Panel that showed the median costs for the procedures assigned to this APC ranged from a low of about $109 to a high of about $295. We asked the Panel's recommendation for reconfiguring APC 0274 to comply with the 2 times rule.

    We informed the Panel members that we packaged the costs associated with radiologic injection codes into the radiological supervision and interpretation codes with which they were reported. The reason for doing this is that hospitals incur expenses for providing both services and they typically perform both an injection and a supervision and interpretation procedure on the same patient. Therefore, since neither an injection code nor a supervision and interpretation code should be billed alone, it would not be appropriate for us to use single claims data to determine the costs of performing these procedures. However, we are using single claims data in order to accurately determine the costs of performing procedures. Therefore, in order to accurately determine the costs of a complete radiologic procedure, we had to package the costs of the injection component into the cost of the supervision and interpretation component with which it was billed.

    The Panel recommended the following:

    • Make no changes to APC 0274.
    • Review new cost data to determine whether payment would increase for APC 0274.

    We proposed to accept the Panel's recommendation. We have made no further changes in this APC.

    APC 0279: Level I Diagnostic Angiography and Venography

    APC 0280: Level II Diagnostic Angiography and Venography

    We presented these codes to the Panel for several reasons. APC 0279 violates the 2 times rule, there are numerous codes in these APCs with no cost data, there are numerous “add on” codes in these APCs, and many of these procedures were performed infrequently in the outpatient setting in 1996.

    The Panel recommended the following:

    • Create a new APC (APC 0287, Complex Venography) with the following CPT codes: 75831, 75840, 75842, 75860, 75870, 75872, and 75880.
    • Move CPT codes 75960, 75961, 75964, 75968, 75970, 75978, 75992, and 75995 from APC 0279 to APC 0280.

    We proposed to accept the Panel's recommendations. We noted that, as proposed, APC 0279 violated the 2 times rule because of the low cost data for CPT code 75660, Angiography, external carotid, unilateral selective, radiological supervision and interpretation. We believe that, for these procedures, these cost data are aberrant. This code is clinically similar to the other codes in APC 0279 and moving code 75660 to an APC with a lower weight could be an inappropriate APC assignment. Therefore, we stated in the proposed rule that we believe that an exception to the 2 times rule is warranted.

    We are adopting the proposed changes as final. We note that APC 0279 continues to violate the 2 times rule due to the median cost of CPT code 75660. However, we continue to believe an exception is warranted.

    APC 0300: Level I Radiation Therapy

    APC 0302: Level III Radiation Therapy

    As discussed in the proposed rule, we presented this APC to the technical advisory Panel because we had received comments that the assignment of CPT code 61793, Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator), one or more sessions, to APC 0302 would result in inappropriate payment for this service. Many commenters wrote that stereotactic radiosurgery and intensity modulated radiation therapy (IMRT) required significantly more staff time, treatment time, and resources than other types of radiation therapy. Other commenters disagreed with our decision, effective January 1, 2001, to discontinue recognizing CPT code 61793, and to create two HCPCS level 2 codes, G0173, Stereotactic radiosurgery, complete course of therapy in one session, and G0174, Intensity modulated radiation therapy (IMRT) plan, per session, to report both stereotactic radiosurgery and IMRT.

    We reported to the Panel that the APC assignment of these G codes and their payment rate was based on our understanding that stereotactic radiosurgery was generally performed on an inpatient basis and delivered a complete course of treatment in a single session, while IMRT was performed on an outpatient basis and required several sessions to deliver a complete course of treatment. We also explained to the Panel that it was our understanding that multiple CPT codes were billed for each session of stereotactic radiosurgery and Start Printed Page 59866IMRT. Therefore, we believed that the payment for APC 0302 was only a fraction of the total payment a hospital received for performing stereotactic radiosurgery or IMRT on an outpatient basis.

    Radiosurgery equipment manufacturers, physician groups, and patient advocacy groups submitted comments and provided testimony to the APC Panel on these issues. These comments convinced us that we did not clearly understand either the relationship of IMRT to stereotactic radiosurgery or the various types of equipment used to perform these services.

    We proposed a new coding structure to more accurately reflect the clinical use of these services and the resources required to perform them. In the proposed rule, we stated that there are essentially two services required to deliver stereotactic radiosurgery and IMRT. First, there is “treatment planning,” which includes such activities as determining the location of all normal and abnormal tissues, determining the amount of radiation to be delivered to the abnormal tissue, determining the dose tolerances of normal tissues, and determining how to deliver the required dose to abnormal tissue while delivering a dose to adjacent normal tissues within their range of tolerance. We noted that planning activities include the ability to manufacture various treatment devices for protection of normal tissue as well as the ability to ensure that the plan will deliver the intended doses to normal and abnormal tissue by simulating the treatment. Second, there is “treatment delivery,” which is the actual delivery of radiation to the patient in accordance with the treatment plan and includes such activities as adjusting the collimator (a device that filters the radiation beams), doing setup and verification images, treating one or more areas, and performing quality control.

    We noted that treatment planning for IMRT requires specialized equipment including a duplicate of the actual equipment used to deliver the treatment, the ability to perform a CT scan, various disposable supplies, and involvement of various staff such as the physician, the physicist, the dosimetrist, and the radiation technologist. Treatment delivery requires specialized equipment to deliver the treatment and the involvement of the radiation technologist. The physician and physicist provide general oversight of this process.

    Our proposal stated that although there are several types of equipment, produced by several manufacturers, used to accomplish this treatment, it was the consensus of the commenters and the Panel that the most useful way to categorize stereotactic radiosurgery and IMRT is by the source of radiation used for the treatment and not by the type of equipment used. One reason for this is that the clinical indications for stereotactic radiosurgery and IMRT overlap. Therefore, a single disease process can be treated by either modality but the cost of treatment varies by source of radiation used for the treatment. Second, while both stereotactic radiosurgery and IMRT can deliver a complete course of treatment in either one or multiple sessions, the cost of treatment delivery per session is relatively fixed, and is closely related to the source of radiation used for the treatment. On the basis of this understanding we made the following proposal: Appropriate APC assignment and payment were to be made by creating four HCPCS codes to describe these services.

    The proposed codes are as follows:

    • GXXX1 Multi-source photon stereotactic radiosurgery (Cobalt 60 multi-source converging beams) plan, including dose volume histograms for target and critical structure tolerances, plan optimization performed for highly conformal distributions, plan positional accuracy and dose verification, all lesions treated, per course of treatment.
    • GXXX2 Multi-source photon stereotactic radiosurgery, delivery including collimator changes and custom plugging, complete course of treatment, per lesion.
    • G0174 Intensity modulated radiation therapy (IMRT) delivery to one or more treatment areas, multiple couch angles/fields/arcs custom collimated pencil-beams with treatment setup and verification images, complete course of therapy requiring more than one session, per session.
    • G0178 Intensity modulated radiation therapy (IMRT) plan, including dose volume histograms for target and critical structure partial tolerances, inverse plan optimization performed for highly conformal distributions, plan positional accuracy and dose verification, per course of treatment.

    We also proposed that HCPCS codes GXXX1, G0174, and G0178 have status indicators of S, while GXXX2 has a status indicator of T. We believe these are the correct status indicators because G0178 has a “per session” designation, while GXXX2 has a “per lesion” designation. This was based on our understanding that GXXX1 would not be billed on a “per lesion” basis as the planning process would take into account all lesions being treated and it would be extremely difficult to determine resource utilization for planning on a “per lesion” basis. Because the costs of performing GXXX1 will vary based on the number of lesions treated, payment would reflect a weighted average.

    We based our proposal on our understanding that single-source photon stereotactic radiosurgery (or linear accelerator) planning and delivery are similar to IMRT planning and delivery in terms of clinical use and resource requirements. Therefore, we proposed to require coding for single-source photon stereotactic radiosurgery under HCPCS codes G0174 and G0178.

    We also noted that the AMA is establishing codes for IMRT planning and treatment delivery for 2002 and we proposed to retire G0174 and G0178 (with the usual 90-day phase out) and recognize the applicable CPT codes when they are established in January 2002.

    Because all activities required to perform stereotactic radiosurgery and IMRT were to be included in the codes described above, we proposed to discontinue the use of any other radiation therapy codes for activities involved with planning and delivery of stereotactic radiosurgery and IMRT for purposes of hospital billing in OPPS. Therefore, we also proposed continuing to not recognize CPT code 61793 for hospital billing purposes.

    We believed that our proposal would not only simplify the reporting process for hospitals, but also appropriately recognize the clinical practice and resource requirements for stereotactic radiosurgery and IMRT.

    We sought comments on our proposal, including the code titles, descriptors, and coding requirements discussed above. We also requested information regarding appropriate APC assignment and payment rates to inform our decision-making. We specifically asked for information regarding the costs of treatment delivery including any differences between the cost of a complete treatment in single versus multiple sessions.

    Finally, we noted that several commenters had requested placement of the stereotactic delivery codes in surgical APCs, therefore, we requested clarification and support for these comments within the context of our coding proposal. Specifically, we were concerned that appropriate payment be made for GXXX2, which has a “per lesion” descriptor.

    We received numerous comments on our proposal. These comments concerned our proposed coding scheme Start Printed Page 59867and payment amounts as well as the need for separate codes recognizing linear accelerator-based radiosurgery. Many of the comments were part of a write-in campaign asking us to categorize radiosurgery as a surgical procedure and not a radiologic procedure. These letters also asserted that our payment amount for stereotactic radiosurgery should be $15,000. Below, we address each major issue raised by the commenters.

    Comment: We received several comments regarding our coding proposal. The commenters indicated the following:

    • Our proposed codes are duplicative of currently existing codes.
    • We should recognize CPT code 61793 in the APC system.
    • Our proposed codes would not allow billing for single session and fractionated linear accelerator-based radiosurgery.
    • We incorrectly believe that multisession radiosurgery is similar in resource use to IMRT.
    • We should delete our proposed codes for stereotactic radiosurgery planning and recognize CPT code 77295 for this purpose.
    • CMS should clarify the other codes that would be billable with our proposed codes.
    • Conflicting comments on whether the proposed code for stereotactic radiosurgery delivery should be “per lesion” or “per session” or “per course of treatment.”

    Commenters were also concerned about our ability to establish APC weights using claims that contained two significant procedures (e.g., stereotactic radiosurgery planning and stereotactic radiosurgery delivery).

    Response: We reviewed all these comments very carefully. After completing our review, we have decided to make the following modifications to our proposed coding scheme:

    • IMRT—We are not making any changes to our proposal for IMRT coding. We will delete the applicable G codes (G0174 and G0178) and recognize the new CPT codes for IMRT planning (code 77301) and IMRT delivery (code 77418) as established by the AMA.
    • GXXX1—Under our proposal, GXXX1 (now G0242) would have been used only for Cobalt-based radiosurgery. After review of the comments, we believe that the planning for Cobalt-based and linear accelerator-based radiosurgery is similar both clinically and in terms of resource consumption. Therefore, at the next coding update, we will change the descriptor for this code to include linear accelerator-based radiosurgery planning. We do not know whether radiosurgery planning is similar clinically and in terms of resource consumption to CPT code 77295 (therapeutic radiology simulation-added field setting; three-dimensional). Use of G0242 will allow us to collect claims data and cost information that will aid us in determining whether G0242 is similar in resource use to 77295. However, we believe that tracking the utilization of G0242 as well as the codes with which it is submitted is very important for future APC reclassification and recalibration purposes, therefore, at this time, we do not intend to discontinue use of this code.
    • GXXX2—Most of the comments concerned whether this code (now G0243) should be “per lesion.” After extensive review of the comments, we have determined that it is more appropriate for this code to be used “per session” or “per course of treatment.” We have concluded that the resource consumption for stereotactic treatment delivery varies significantly depending on the size, shape, and depth of the lesion(s) being treated. It is quite possible for the treatment of two superficial, spherical lesions to be less resource intensive than the treatment of a single, large, irregular lesion deep within the brain. Furthermore, the method of treatment and the manner in which the resources are used make a “per lesion” description inappropriate. For example, in Cobalt-based treatment, patients are administered “spheres of dose” and moved in and out of the machine after each “sphere of dose.” The number of “spheres of dose” per lesion varies widely so therefore “per sphere of dose” might be an alternative description for this service. However, we have concluded that any descriptor other than “per session” or “per course of treatment” will result in, or create the incentive to bill for, inappropriate payments for this service. Furthermore, it is our understanding that hospitals usually have a single charge for this service and that charge is based on the average resource use for all patients undergoing the procedure whether those patients have one, two, or more lesions treated. Because of the variability of treatment delivery per lesion, hospitals would be overpaid for multi-lesion patients if their charge is based on the average resource use over all patients. Finally, a “per session” description is more consistent with a prospective payment system. Because a “per session” payment reflects an average that includes all patients, unless a hospital specializes in treatment of multi-lesion patients, the OPPS payment is likely to be appropriate across all patient types. That is, the payment will be slightly higher than costs for single lesion treatments, and slightly lower than costs for multiple lesion treatments, averaging out over all patients.
    • Linear accelerator-based radiosurgery—This treatment poses an especially difficult problem because linear accelerator-based radiosurgery can be delivered in a single dose like Cobalt-based treatment, or it can be delivered in fractions, with a maximum of five fractions. We do not have any cost information concerning the resource use of linear accelerator-based treatment delivery, but we do understand that there are two types of linear accelerator-based delivery of radiosurgery: “gantry-based” and “image-directed.” We do not know if the resource use of these two subtypes of linear accelerator based-radiosurgery is similar. Furthermore, we do not know whether the total resource consumption of fractionated radiosurgery delivered from a linear accelerator is different from the resource consumption of single dose radiosurgery delivered by a linear accelerator.

    Therefore, in order to collect data on this procedure, we will designate current code G0173 for reporting single session radiosurgery delivered by a linear accelerator, either gantry-based or image-directed. At the next coding update, we will revise the descriptor for G0173 to reflect this change. Additionally, at the next coding update, we will create a new G code for use by facilities for fractionated radiosurgery delivered by a linear accelerator (either gantry-based or image-directed). The number of fractions will be limited to no more than five. Both G0173 and the new code for fractionated linear accelerator-based radiosurgery will be temporary while we collect cost and utilization data for these services. Once we have collected these data, we will determine whether permanent codes are needed.

    In general, we have tried to strike a balance between recognizing clinically dissimilar treatments with individual codes and avoiding the creation of equipment-specific codes for purposes of the OPPS. We believe that the codes established in this final rule reflect this balance.

    For multiple procedure claims, we do not believe there is a problem recognizing claims with more than one significant procedure to assist us in determining appropriate APC weights. We have analyzed all the claims in the 1999-2000 data base for CPT code 61793 to determine the codes with which it was billed and in what Start Printed Page 59868frequencies. We have developed coding edits based on this claims analysis and, as discussed below, the payments for stereotactic radiosurgery reflect the median costs for all services that will be included in the payment for stereotactic radiosurgery planning and delivery. We have discussed these coding edits in great detail with the American Society for Therapeutic Radiology and Oncology (ASTRO) and they concur with the edits.

    Comment: Many commenters asked us to place stereotactic radiosurgery in a “surgical” APC.

    Response: We do not understand these comments. We realize that a neurosurgeon is present during stereotactic radiosurgery but, unlike the hospital inpatient PPS, we have no APC designation of “surgical.” We have interpreted this comment to mean that commenters do not want stereotactic radiosurgery to be in the same APC as IMRT or fractionated stereotactic radiosurgery. As discussed below, our new assignments of the codes to APCs will effectively create this change.

    Comment: We received numerous comments concerning the status indicators we had proposed for the various radiosurgery procedures.

    Response: In view of the change in the descriptor for G0243, we will be changing the status indicator for G0243 to “S.” This is because there will not be multiple units of this service billed and the costs for providing single dose stereotactic radiosurgery is relatively fixed and it would be inappropriate to give this procedure, as finalized, a “T” designation (that is, the multiple procedure reduction is not applicable).

    Comment: Many comments addressed the payment rate for stereotactic radiosurgery and IMRT. Suggested amounts for payment of IMRT treatment planning and delivery varied from less than $300 to over $2,000 and suggested amounts for radiosurgery planning and treatment ranged from less than $1,000 to $15,000.

    Response: We have no cost data specifically associated with IMRT upon which to base payment for IMRT. Therefore, we used information that provided the basis for IMRT payment under the physician fee schedule and we have established APC assignments that result in payment rates for IMRT planning and treatment delivery similar to payment under the physician fee schedule. We believe this is appropriate because the resource use for these procedures is similar in freestanding facilities and in hospitals. Because we have no claims data on the costs of IMRT, these procedures will be assigned to new technology APCs. As cost data are incorporated in the OPPS claims data base, they will be used to recalibrate the payment for these services and determine their future APC assignment. We would note that payment for IMRT planning includes payment for the following CPT codes: 77300, 77280-77295, 77305-77321. The only CPT codes that may be billed in addition to G0242 (IMRT planning) are the CPT codes 72332-72334 for treatment devices. We plan to incorporate the costs of those codes into IMRT planning when we have collected the cost data. The APC assignment for G0242 is APC 0714, New Technology—IX ($1250-$1500).

    In order to determine appropriate payment amounts for both planning and treatment of stereotactic radiosurgery, we did an extensive analysis of our claims data base for code 61793 because that was the code used for stereotactic radiosurgery during 1999-2000. We collected all claims for 61793 and determined which CPT codes were billed with 61793 and the frequency with which each of those codes was billed with 61793. Within the subset of claims including CPT code 61793, we determined the median costs for 61793 and for each CPT code billed with 61793. In analyzing these claims, it was clear that 61793 was generally used to bill for treatment delivery and other codes were used, in combination, to bill for treatment planning. For example, 61793 was billed with 77300 on 57 percent of the claims, with either 77295 or 77290 on 62 percent of the claims, with either 77370 or 77336 on 77 percent of the claims (occasionally both of these codes were on the same claim), and with either 77305, 77315, or 77321 on 59 percent of the claims.

    Based on these data, we have determined the total cost for stereotactic radiosurgery as follows: For stereotactic radiosurgery planning, we added the median costs (when billed with 61793) of 77295 (the most typical simulation code billed with 61793), 77300, 77370 (the most common physics consult billed with 61793), and 77315 (the most common dose plan billed with 61793) and will use the sum of these medians as the basis for our APC assignment for 2002. The medians of these codes are: $134.06 for 77300; $146.97 for 77370; $955.88 for 77295; and $206.56 for 77315. The total median cost for these codes is $1,443.47. Effective for services furnished on or after January 1, 2002, we will no longer allow these codes to be billed with stereotactic radiosurgery. No other codes were billed frequently enough with 61793 to justify including their costs in our stereotactic radiosurgery planning code. However, treatment device codes (77332-77334) were billed with 61793 on 42 percent of the claims, so we will allow one of those codes to be billed with each claim for stereotactic radiosurgery. We will consider incorporating their costs into the payment for stereotactic radiosurgery in the future. We note that the median cost of 77334 (the most common treatment device code billed with 61793) was $174.27 when it was billed with 61793.

    CPT Code 20660, application of cranial tongs, caliper, or stereotactic frame, including removal (separate procedure), was billed with 61793 on only 23 percent of the claims. Because 20660 is required in order to perform stereotactic radiosurgery treatment, we will package the costs associated with 20660 into G0243, the radiosurgery treatment delivery code. We also note that 61793 was billed with an MRI of the brain on 71 percent of the claims. We will allow CTs and MRIs to be billed in addition to stereotactic radiosurgery planning.

    For stereotactic radiosurgery delivery, we determined that the median cost of 61793 (using all claims) was $5,734.22 and will use that amount as the basis for our APC assignment for stereotactic radiosurgery for 2002. No other radiotherapy treatment code was billed frequently enough with 61793 to justify incorporation of its cost into our payment (that is, the treatment code most commonly billed with 61793 was 77470 (33 percent of the claims) and the next most common was 77412 (6 percent of the claims)). We will not allow billing of any other radiation treatment delivery codes with stereotactic radiosurgery treatment.

    Therefore, we are assigning G0243 to APC 0721, New Technology—XVI ($5,000 to $6,000).

    We will pay the same amount for linear accelerator-based stereotactic radiosurgery as for multiple source-based radiosurgery. For fractionated linear accelerator-based radiosurgery, we will divide the payment for single session radiosurgery by five and allow up to five payments. This will make total payment for fractionated linear accelerator based radiosurgery similar to linear accelerator-based single dose radiosurgery while allowing us to collect cost and utilization data for setting payments in 2003. Note that because application of a stereotactic frame is not required for linear accelerator-based radiosurgery, we will not be packaging the costs of code 20660 into the costs for linear accelerator-based radiosurgery.

    Linear accelerator-based radiosurgery planning will be coded with the same Start Printed Page 59869code as multiple source-based radiosurgery; therefore, the APC assignment will be the same as well. We note that all of these codes associated with radiosurgery are assigned to new technology APCs as we have no claim data on the procedures. Once we have collected data, the procedures will be assigned to other APCs.

    The final APC assignments are as follows:

    • 77301 is assigned to APC 0712
    • 77418 is assigned to APC 0710
    • G0173 is assigned to APC 0721
    • G0242 is assigned to APC 0714
    • G0243 is assigned to APC 0721.

    APC 0311: Radiation Physics Services

    APC 0312: Radio Element Application

    APC 0313: Brachytherapy

    We presented APC 0311 to the Panel because we believed our cost data for CPT codes 77336, Continuing medical physics consultation, including assessment of treatment parameters, quality assurance of dose delivery, and review of patient treatment documentation in support of the radiation oncologist, reported per week of therapy; 77370, Special medical radiation physics consultation; and 77399, Unlisted procedure, medical radiation physics, dosimetry, and treatment devices, and special services, were inaccurate. We were concerned that these procedures, particularly code 77370, were not being paid appropriately in APC 0311.

    Presenters pointed out that, as with all radiation oncology services, the usual practice is to bill multiple CPT codes on the same date of service. Therefore, single claims were likely to be inaccurate bills and did not represent the true costs of the procedure. For this reason, presenters believed that using single claims to set payment rates for radiation oncology procedures was inappropriate and that we needed to develop a methodology that allowed the use of multiple claims data to set payment rates for these services.

    For radiation physics consultation, presenters stated that the staff costs associated with CPT code 77370 were significantly greater than the costs of CPT codes 77336 and 77399. Therefore, they recommended that CPT codes 77336 and 77399 be moved from APC 0311 to APC 0304, Level I Therapeutic Radiation Treatment Preparation, and CPT code 77370 be moved from APC 0311 to APC 0305, Level II Therapeutic Radiation Treatment Preparation. The Panel agreed with this recommendation and we proposed to accept the Panel's recommendation. We also agreed that we should review the use of single claims to set payment rates for radiation oncology services. We plan to present this issue again at the 2002 Panel meeting.

    We presented APCs 0312 and 0313 to the Panel because commenters were concerned that the payment rates were too low for the procedures assigned to the APCs and that there were insufficient data to set payment rates for these APCs. The Panel agreed that the issue regarding the use of single claim data affected the payment rates for these services. However, there were insufficient data for the Panel to make any recommendations regarding these APCs. The Panel did request to look at the issue of radiation oncology at its 2002 meeting.

    Therefore, we proposed to make no changes to APCs 0312 and 0313 but will address radiation oncology issues at the Panel's 2002 meeting. We note that our updated claims data show very few single claims for procedures in these APCs. However, moving any of these procedures into other radiation oncology APCs would lower their payment rates. We are making no further changes to these APCs.

    APC 0371: Allergy Injections

    We presented this APC to the Panel because it violates the 2 times rule. The median costs for CPT codes 95115, Professional services for allergen immunotherapy not including provision of allergenic extracts; single injection, and 95117, Professional services for allergen immunotherapy not including provision of allergenic extracts; two or more injections, were lower than the median costs for the other services in this APC.

    The Panel agreed that because codes 95115 and 95117 included administration of an injection only, the resource utilization for these services was lower than for the other services. The other services involve preparation of antigen and require more staff time and hospital resources to perform.

    In order to create clinical and resource homogeneity, the Panel recommended that we create a new APC for codes 95115 and 95117 and that we leave the other services in APC 0371. We proposed to accept the Panel recommendation and create a new APC 0353, Level II Allergy Injections, and revise the title of APC 0371 to Level I Allergy Injections. These proposed changes are incorporated as final in this rule.

    Observation Services

    See the discussion on observation services in section II.C.4 of this preamble for the Panel's recommendations and our proposal as well as a discussion of the comments we received.

    Inpatient Procedure List

    See the discussion of the inpatient procedures list in section II.C.5 of this preamble for the Panel's recommendations and our proposal and a discussion of the comments we received on the list.

    3. Other APC Issues

    APC 0285: Positron Emission Tomography (PET)

    Comment: Commenters expressed concern about the calculation of the payment rate for APC 0285, Positron Emission Tomography (PET), which includes PET for myocardial perfusion imaging. One specific concern is that single service claims are used to calculate relative weights although the applicable procedure codes for these studies are always linked to another diagnostic study and, therefore, they should not appear on single service claims. Second, the commenters are concerned that it is not appropriate to place both single study and multiple study PET procedures in the same APC.

    Response: While the PET procedures are linked with a previous diagnostic procedure, the latter need not have been performed on the same day or in the same facility. Upon review of our claims data base, we find that nearly 50 percent of all claims for PET myocardial perfusion imaging studies are single service claims. We believe this to be a sufficient frequency for setting payment rates consistent with the overall methodology for setting rates in the OPPS. With regard to the second concern, after further analysis of claims, we concluded that there is not sufficient variation in the cost among the relevant codes, whether single or multiple studies, to warrant a change in the APC structure.

    PET Scans Assigned to APC 0976: New Technology—Level VII ($750-$1000)

    In the April 7, 2000 final rule, we assigned PET scans that use 18-flurodeoxyglucose (FDG) to APC 0980, New Technology—Level XII ($2000-$2500) because there were no claims for these procedures in the 1996 data used to establish the APC relative weights for 2000. However, based on the data from over 4,000 claims for services furnished between July 1, 1999 through June 30, 2000, the data base that was used to set the proposed APC weights, we found that the reported median costs for these procedures was closer to $900. Therefore, in the proposed rule, we Start Printed Page 59870assigned the FDG PET scans to APC 0976, New Technology—Level VII ($750-$1000). We received a large number of comments on this proposed change.

    Comment: Commenters expressed concern that the proposed APC assignment resulted in a much reduced payment rate for FDG PET scans. Many of these commenters expressed particular concern that the proposed rate of about $850 would not cover the cost of purchasing FDG in addition to the direct and indirect costs of a PET scan. The commenters requested that we review our data and the data they submitted and assign these procedures to a higher level new technology APC.

    Response: As we discussed in detail in the April 7, 2002 final rule (65 FR 18476-78), the purpose of assigning a service to a new technology APC is to pay for a new technology based on its expected costs (as evidenced by data collected by us from various external sources) while we collect claims data that would allow assignment of the service to a clinically appropriate APC based on the actual resource use of the service. Our current policy is that a service remains in a new technology APC for 2 to 3 years while we collect the necessary claims data. (See section VI.G of this preamble for a discussion of changes we are making to this policy effective CY 2002.) Because FDG PET scans were assigned to a new technology APC at the implementation of the OPPS in August 2000, they will continue to be assigned to a new technology APC through 2002. However, when we reviewed the claims data in our 1999-2000 data base, there were about 5,000 single claims for these PET scans, with a median cost of about $900. Therefore, we proposed to move these procedures from APC 0980 to APC 0976.

    As requested by the commenters and consistent with our policy on pricing services for assignment to new technology APCs, we reviewed the external data provided by the commenters as well as our claims data. These data suggest that our claims cost data may not have accurately captured the entire costs of the procedure, particularly the cost of the FDG. Based on our analysis, we believe that the cost of an FDG PET scan is between $1,200 and $1,800, with a midpoint of $1,500. According to our methodology for pricing new technology services, these services will be reassigned to APC 0978, New Technology—Level IX ($1250-$1500), which results in a payment rate of $1,375.

    Cryoablation of the Prostate

    Comment: We received several comments concerning our proposal to place CPT code 55873, cryosurgical ablation of the prostate, into APC 0163, Level IV Cystourethroscopy and other Genitourinary Procedures. Commenters believe that we had insufficient cost data to justify moving this code from its current assignment, APC 0980, New Technology—XI ($1750-$2000). They also believe that cryoablation of the prostate is not clinically similar to other procedures in APC 0163. One commenter requested moving code 55873 into either APC 0984, New Technology—XV ($3500-$5000) or 0132, Level III Laparoscopy.

    Response: We have reviewed our 1999-2000 cost data for code 55873, and have 4 claims that show a median cost of just over $4,000, which includes the cost of the procedure as well as the associated devices. The devices associated with this procedure are eligible for transitional pass-through payments. After subtracting the estimated cost of the pass-through devices, we believe that the approximate expected cost of this procedure warrants its assignment to APC 0982 New Technology—XIII ($2500-$3000), with a status indicator of “T.” The devices associated with this procedure remain eligible for transitional pass-through payments in 2002 in addition to the APC payment amount.

    Water-Induced Thermotherapy

    Comment: We received a comment from the manufacturer of the equipment used for water-induced thermotherapy (a treatment for benign prostatic hyperplasia), CPT code 53853, that our proposal to assign this procedure in new technology APC 0977, New Technology—VIII ($1000-$1250) did not accurately reflect the costs and resources required to furnish this procedure. The commenter believes that 53853 should be placed in APC 0982, New Technology—XIII ($2500-$3000) with other minimally invasive thermotherapy treatments for benign prostatic hyperplasia.

    Response: We disagree with the commenter and are finalizing our proposal. Based on the information provided by the commenters and our own clinical knowledge, we understand that the resources required to deliver water-induced thermotherapy are less than the resources required for the procedures assigned to APC 0982 (CPT codes 53850, transurethral destruction of prostate tissue; by microwave thermotherapy, and 53852, transurethral destruction of prostate tissue; by radiofrequency thermotherapy). Less intraoperative staff time and less equipment resources are required for 53853 than for the other procedures. In addition, unlike codes 53850 and 53852, which require sedation or regional anesthesia, code 53853 requires only local anesthesia. Finally, recovery time is shorter (in part because of the local anesthesia) and requires fewer facility resources. Therefore, we believe code 53853 is appropriately assigned to APC 0977.

    Ultrasound Radiologic Guidance Codes

    Comment: Several commenters inquired about a change in the proposed rule that resulted in the packaging of certain ultrasound and radiologic guidance codes. The commenters urged us to publish the data and rationale for these changes and recommended that the proposed changes not be made final, pending further review and a fuller discussion of the proposed changes. The commenters recommended separate rather than packaged payment for the guidance codes.

    Response: As we explain above in section II.A.2 of this preamble under the discussion for APC 0151, we accepted the APC Panel's recommendation to consider the use of multiple claims data to determine payment rates for endoscopic retrograde cholangio-pancreatography (ERCP). The payment rate that we proposed for ERCP was based on both single claims for ERCP procedures and on claims that included both an ERCP procedure and a radiologic supervision or guidance procedure. That is, rather than making separate payment for the radiologic supervision and guidance furnished in connection with ERCP, we packaged those costs into the proposed rate for APC 0151.

    Our experience using multiple procedure claims to price ERCP in accordance with the Panel's recommendation led us to consider other services that could be priced similarly. We believe that the following procedures assigned to APC 0268, Guidance Under Ultrasound, would never be performed alone, but would always be performed in connection with and be considered integral to the performance of another procedure: 76930, 76932, 76934, 76938, 76941, 76942, 76945, 76946, 76948, 76950, 76960, 76965, G0161. Therefore, if a claim listed one of the procedures in APC 0268 in addition to another procedure, we retained that claim in the pool of single-procedure bills used to calculate median costs for services within the various APCs. Costs Start Printed Page 59871associated with the codes in APC 0268 were therefore packaged into the APCs of procedures with which they were billed between July 1, 1999 through June 30, 2000.

    We continue to believe that the most appropriate way to pay for ultrasound guidance is to package its costs as part of the cost of performing the procedure for which the guidance is needed. Therefore, in the proposed rule, we assigned status indicator “N” to still active codes that had previously been in APC 0268. We applied the same principle to several radiologic guidance codes (76393, 19290, 19291, and 19295). We assigned status indicator “N” to these codes because they represent services that are always furnished in connection with another procedure. That is, they are integral to performing another procedure and would never be performed alone, as a single service. Therefore, costs associated with such radiologic guidance codes are more appropriately packaged than paid for separately.

    It is crucial that hospitals bill charges for codes with status indicator “N” to ensure that costs for packaged services are appropriately captured in the APCs with which they are associated. For the 2003 OPPS update, we will consider proposing to package additional guidance services with whichever procedures they are billed, including the following:

    76095, Stereotactic localization guidance for breast biopsy or needle placement.

    76355, Computerized tomography guidance for stereotactic localization.

    76360, Computerized tomography guidance for needle placement.

    We will report to the Panel on our progress in treating bills with certain packaged services as single procedure claims. We will also include on the agenda of the next Panel meeting a follow-up discussion to review the services that we have packaged thus far and to consider other codes that would also be more appropriately paid as packaged rather than separate services. To identify all the procedures with which the ultrasound and radiologic guidance services are packaged would require a review of the raw outpatient claims that make up the 1999-2000 data that we are using to recalibrate the 2002 APC weights because we have previously packaged the guidance costs with whatever procedure they are billed in preparing the claims data base used for recalibration.

    Breast Biopsy

    Comment: A few commenters, including the manufacturer of a minimally invasive breast biopsy system, expressed concern that the higher APC relative weight for surgical breast biopsy procedures would discourage Medicare beneficiary access to less invasive procedures. The commenters were also concerned that the proposed payment for less invasive breast biopsy procedures was inadequate.

    Response: As we discuss below in section II.D. of this preamble, the APC weights reflect hospital median costs (as determined from the charges reflected on claims submitted by hospitals) for a given procedure relative to the costs for other procedures. We expect that the costs for an open surgical procedure will be higher than those for less invasive procedures because open surgery is more resource intensive, especially in terms of recovery time, anesthesia, and nursing care. We do not agree that the higher relative weight for open surgical biopsy will serve as an incentive to perform this procedure rather than the less costly, less invasive options. The payment rate for the less invasive options are based on the costs of those procedures as reported by hospitals. We note that the payment rate for the breast biopsy procedure assigned to APC 0974, New Technology—Level V ($300-$500) (CPT code 19103, Percutaneous, automated vacuum assisted or rotating biopsy device, using imaging guidance) is higher in this final rule relative to the proposed rule (see the discussion in section II.D. of this preamble, below).

    Comment: Several commenters questioned why the proposed rule indicated that CPT code 76095, Stereotactic localization guidance for breast biopsy, would be moved from APC 0264, Level II Miscellaneous Radiology Procedures, with a status indicator of “X” (ancillary service) to APC 0187, Placement/Repositioning Miscellaneous Catheters, with a status indicator of “T” (significant procedure, multiple procedure reduction applies). The commenters were concerned that the “T” status indicator would result in a lower payment for the procedure when it is billed with other procedures.

    Response: We agree with commenters that the title for APC 0187 in the proposed rule is misleading given the procedures that are included within the APC. Therefore, in the final rule, we are changing the name of APC 0187 to “Miscellaneous Placement/Repositioning”. We are also changing the status indicator for APC 0187 from “T” to “X”. We created APC 0187 to pay more appropriately for certain guidance codes, including code 76095.

    Status Indicators

    Comment: A commenter asserted that some hospitals believe that procedure codes designated with status indicators of “S,” “T,” “V,” and “X” mean that the procedure must be performed in the outpatient setting.

    Response: This is not the case. These status indicators were developed to assist us with our pricing policy in OPPS, not to dictate where the procedures could be performed. Although a status indicator of “C” means that the procedure will not be paid if performed in the outpatient setting, the status indicators paid under the OPPS do not dictate where that service or procedure is covered. We pay for any covered service or procedure performed in the inpatient setting as an inpatient service as long as the patient's condition merits admission to the hospital as an inpatient.

    B. Additional APC Changes Resulting from BIPA Provisions

    1. Coverage of Glaucoma Screening

    Section 102 of the BIPA amended section 1861(s)(2) of the Act to provide payment for glaucoma screening for eligible Medicare beneficiaries, specifically, those with diabetes mellitus or a family history of glaucoma, and certain other individuals found to be at high risk for glaucoma as specified by our rulemaking. The implementation of this provision is discussed in detail in a separate final rule concerning the revisions in the physician fee schedule payment policy for CY 2002, published in the Federal Register on November 1, 2001 (66 FR 55272).

    In order to implement section 102 of BIPA, we have established two new HCPCS codes for glaucoma screening:

    • G0117—Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist.
    • G0118—Glaucoma screening for high risk patients furnished under the direct supervision of an optometrist or ophthalmologist.

    We proposed to assign the glaucoma screening codes to APC 0230, Level I Eye Tests. We further proposed to instruct our fiscal intermediaries to make payment for glaucoma screening only if it is the sole ophthalmologic service for which the hospital submits a bill for a visit. That is, the services included in glaucoma screening (a dilated eye examination with an intraocular pressure measurement and direct opthalmoscopy or slit-lamp biomicroscopy) would generally be performed during the delivery of another opthalmologic service that is furnished on the same day. If the Start Printed Page 59872beneficiary receives only a screening service, however, we would pay for it under APC 0230.

    2. APCs for Contrast Enhanced Diagnostic Procedures

    Section 430 of the BIPA amended section 1833(t)(2) of the Act to require the Secretary to create additional APC groups to classify procedures that utilize contrast agents separately from those that do not, effective for items and services furnished on or after July 1, 2001. On June 1, 2001, we issued a Program Memorandum, Transmittal A-01-73, in which we made numerous coding and grouping changes to implement this provision. (This transmittal can be found at www.hcfa.gov/​pubforms/​transmit/​AO173.pdf) We removed the radiological procedures whose descriptors included either “without contrast material” or “without contrast material followed by contrast material” from APC groups 0282, Level I, Computerized Axial Tomography; APC 0283, Level II, Computerized Axial Tomography; and APC 0284, Magnetic Resonance Imaging. As a result, APCs 0283 and 0284 now include only imaging procedures that are performed with contrast materials. Additionally, reconfigured APC 0282 no longer includes radiological procedures that use contrast agents.

    Effective for items or services furnished on or after July 1, 2001, we created six new APC groups for the procedures removed from APCs 0282, 0283, and 0284, as shown below. (Effective October 1, 2001, we eliminated APC 0338. Refer to Transmittal A-01-73 for a detailed description of this change.) For services furnished on or after July 1, 2001 and before January 1, 2002, the payment rates for the new imaging APCs are the same as those associated with the APCs from which the procedures were moved. For the proposed rule, we calculated separate weights for the new APCs based on the data available at the time for recalibration. In this final rule, we are establishing separate weights for the new APCs based on the final data used to recalibrate the weights for 2002.

    Table 1.—APC Groups Reconfigured To Separate Imaging Procedures That Use Contrast Material From Procedures That Do Not Use Contrast Material

    APCSIAPC title
    0282SMiscellaneous Computerized Axial Tomography.
    0283SComputerized Axial Tomography with Contrast.
    0284SMagnetic Resonance Imaging and Angiography with Contrast.
    0332SComputerized Axial Tomography w/o Contrast.
    0333SCT Angio and Computerized Axial Tomography w/o Contrast followed by with Contrast.
    0335SMagnetic Resonance Imaging, Temporomandibular Joint.
    0336SMagnetic Resonance Angiography and Imaging without Contrast.
    0337SMagnetic Resonance Imaging and Angiography w/o Contrast followed by with Contrast.

    The HCPCS codes that are reassigned to the new imaging APCs in this final rule are as follows:

    APCHCPCSSIShort descriptor
    028276370SCAT scan for therapy guide.
    76375S3d/holograph reconstr add-on.
    76380SCAT scan for follow-up study.
    G0131SCt scan, bone density study.
    G0132SCt scan, bone density study.
    028370460SCt head/brain w/dye.
    70481SCt orbit/ear/fossa w/dye.
    70487SCt maxillofacial w/dye.
    70491SCt soft tissue neck w/dye.
    71260SCt thorax w/dye.
    72126SCt neck spine w/dye.
    72129SCt chest spine w/dye.
    72132SCt lumbar spine w/dye.
    72193SCt pelvis w/dye.
    73201SCt upper extremity w/dye.
    73701SCt lower extremity w/dye.
    74160SCt abdomen w/dye.
    76355SCAT scan for localization
    76360SCAT scan for needle biopsy.
    028470542SMRI orbit/face/neck w/dye.
    70545SMr angiography head w/dye.
    70548SMr angiography neck w/dye.
    70552SMRI brain w/dye.
    71551SMRI chest w/dye.
    72142SMRI neck spine w/dye.
    72147SMRI chest spine w/dye.
    72149SMRI lumbar spine w/dye.
    72196SMRI pelvis w/dye.
    73219SMRI upper extremity w/dye.
    73222SMRI joint upr extrem w/dye.
    73719SMRI lower extremity w/dye.
    73722SMRI joint of lwr extr w/dye.
    Start Printed Page 59873
    74182SMRI abdomen w/dye.
    75553SHeart MRI for morph w/dye.
    C8900SMRA w/cont, abd.
    C8903SMRI w/cont, breast,uni.
    C8906SMRI w/cont, breast, bi.
    C8909SMRA w/cont, chest.
    C8912SMRA w/cont, lwr ext.
    033270450SCAT scan of head or brain.
    70480SCt orbit/ear/fossa w/o dye.
    70486SCt maxillofacial w/o dye.
    70490SCt soft tissue neck w/o dye.
    71250SCt thorax w/o dye.
    72125SCt neck spine w/o dye.
    72128SCt chest spine w/o dye.
    72131SCt lumbar spine w/o dye.
    72192SCt pelvis w/o dye.
    73200SCt upper extremity w/o dye.
    73700SCt lower extremity w/o dye.
    74150SCt abdomen w/o dye.
    033370470SCt head/brain w/o&w dye.
    70482SCt orbit/ear/fossa w/o&w dye.
    70488SCt maxillofacial w/o&w dye.
    70492SCt sft tsue nck w/o & w/dye.
    70496SCt angiography, head.
    70498SCt angiography, neck.
    71270SCt thorax w/o&w dye.
    71275SCt angiography, chest.
    72127SCt neck spine w/o&w dye.
    72130SCt chest spine w/o&w dye.
    72133SCt lumbar spine w/o&w dye.
    72191SCt angiograph pelv w/o&w dye.
    72194SCt pelvis w/o&w dye.
    73202SCt uppr extremity w/o&w dye.
    73206SCt angio upr extrm w/o&w dye.
    73702SCt lwr extremity w/o&w dye.
    73706SCt angio lwr extr w/o&w dye.
    74170SCt abdomen w/o&w dye.
    74175SCt angio abdom w/o&w dye.
    75635SCt angio abdominal arteries.
    033570336SMagnetic image, jaw joint.
    75554SCardiac mri/function.
    75555SCardiac mri/limited study.
    76390SMr spectroscopy.
    76400SMagnetic image, bone marrow.
    033670540SMRI orbit/face/neck w/o dye.
    70544SMr angiography head w/o dye.
    70547SMr angiography neck w/o dye.
    70551SMRI brain w/o dye.
    71550SMRI chest w/o dye.
    72141SMRI neck spine w/o dye.
    72146SMRI chest spine w/o dye.
    72148SMRI lumbar spine w/o dye.
    72195SMRI pelvis w/o dye.
    73218SMRI upper extremity w/o dye.
    73221SMRI joint upr extrem w/o dye.
    73718SMRI lower extremity w/o dye.
    73721SMRI joint of lwr extre w/o d.
    74181SMRI abdomen w/o dye.
    75552SHeart MRI for morph w/o dye.
    C8901SMRA w/o cont, abd.
    C8904SMRI w/o cont, breast, uni.
    C8910SMRA w/o cont, chest.
    C8913SMRA w/o cont, lwr ext.
    033770543SMRI orbt/fac/nck w/o&w dye.
    70546SMr angiograph head w/o&w dye.
    70549SMr angiograph neck w/o&w dye.
    70553SMRI brain w/o&w dye.
    71552SMRI chest w/o&w dye.
    72156SMRI neck spine w/o&w dye.
    72157SMRI chest spine w/o&w dye.
    72158SMRI lumbar spine w/o&w dye.
    72197SMRI pelvis w/o&w dye.
    73220SMRI uppr extremity w/o&w dye.
    73223SMRI joint upr extr w/o&w dye.
    Start Printed Page 59874
    73720SMRI lwr extremity w/o&w dye.
    73723SMRI joint lwr extr w/o&w dye.
    74183SMRI abdomen w/o&w dye.
    C8902SMRA w/o fol w/cont, abd.
    C8905SMRI w/o fol w/cont, brst, uni.
    C8908SMRI w/o fol w/cont, breast, bi.
    C8911SMRA w/o fol w/cont, chest.
    C8914SMRA w/o fol w/cont, lwr ext.

    Refer to Addendum A or Addendum B of this final rule for the updated weights, payment rates, national unadjusted copayment, and minimum unadjusted copayment for all of the procedures listed above.

    3. Coding and Payment for Mammography Services

    a. Screening Mammography. Screening mammography means a radiologic procedure provided to a woman without signs or symptoms of breast disease for the purpose of early detection of breast cancer. Under Medicare, screening mammography services can be billed in three ways: (1) For the physician's interpretation of the results of the screening mammogram (that is, the professional component of mammography services); (2) for all services other than the physician's interpretation (that is, the technical component); or (3) for both the professional and technical components (global billing), although global billing is not permitted for services furnished in the hospital outpatient setting.

    Section 4163 of the Omnibus Budget Reconciliation Act of 1990 (Pub. L. 101-508) added section 1834(c) of the Act to provide for Part B coverage of screening mammography performed on or after January 1, 1991. Section 1834(c) of the Act governing those screenings did not include screening mammography under the physician fee schedule; it provided for payment under a separate statutory methodology. Payment for screening mammography services furnished in the hospital outpatient setting before January 1, 2002 is subject to the payment method set by the statute at section 1834(c) of the Act. When Medicare implemented the OPPS for services furnished beginning August 1, 2000, payment for screening mammography services continued to be based on the payment method set by the statute at section 1834(c) (the lower of hospital charges or the national payment limitation) of the Act and was not made under the OPPS.

    Section 104 of BIPA amended section 1848(j)(3) of the Act to include screening mammography as a physician service. As a result of this amendment, the payment limit that is currently the basis for payment is replaced beginning January 1, 2002 by payment under the Medicare physician fee schedule. Payments for all services under the physician fee schedule are resource-based and have geographic adjustments that reflect cost differences among areas. A discussion of how payment for screening mammography services is determined under the physician fee schedule can be found in the final rule, “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,” published in the November 1, 2001 Federal Register (66 FR 55246). Beginning January 1, 2002, Medicare payment for screening mammography services furnished in a hospital outpatient setting is no longer the lower of hospital charges or the national payment limitation; however, payment will continue to be excluded from the OPPS. For screening mammography furnished in the outpatient setting, Medicare will pay hospitals the technical component amount established under the Medicare physician fee schedule.

    Comment: A few commenters questioned why we had not established an APC or a payment rate for screening mammography in the proposed rule. One commenter expressed grave concern that our failure to include an APC for screening mammography in the proposed rule meant that Medicare beneficiaries would not be able to receive screening mammography services in the hospital outpatient setting. These commenters urged that we establish an APC for screening mammography services and that the payment rate be consistent with the cost of taking a screening mammogram in the hospital outpatient setting rather than the payment rate proposed for diagnostic mammograms in APC 0271, Mammography. One commenter, citing a survey conducted by a professional society, reported the average cost of doing a screening mammogram in a hospital to be about $97. Several commenters supported the physician fee schedule payment rate for screening mammography services as a more reasonable recognition of associated costs than the payment rate proposed for diagnostic mammography under APC 0271.

    Response: The fact that we have not assigned the HCPCS codes for screening mammography services to an APC does not mean that Medicare does not pay hospitals for these services when they are furnished in the outpatient setting. Rather, as we explain in the April 7, 2000 final rule, we excluded screening mammography services from payment under the OPPS because they were already subject to an existing fee schedule or other prospectively determined payment rate (65 FR 18442). When the OPPS was implemented on August 1, 2000, screening mammography services were assigned payment status indicator “A” to specify that payment would be the “lower of charge or national rate,” consistent with section 1834(c)(3) of the Act (65 FR 18445).

    As a result of section 104 of BIPA, which amended section 1848(j)(3) of the Act to define screening mammography as a physician service, Medicare payment for screening mammography services furnished on or after January 1, 2002 is no longer subject to the payment methodology established under section 1834(c) of the Act. Therefore, payment for both the professional and technical components of screening mammography services furnished on or after January 1, 2002 is made under the physician fee schedule. This means that, effective for services furnished on or after January 1, 2002, the payment amount to hospitals for screening mammography services furnished in the outpatient setting will be based on the amount established for the technical component of screening mammography under the physician fee schedule.

    Hospitals are to use the following codes to bill for screening mammography services effective January 1, 2002:

    • CPT code 76092, Screening mammography, bilateral (two view film study of each breast) Start Printed Page 59875
    • HCPCS code G0202, Screening mammography, direct digital image, bilateral, all views
    • CPT code 76085, Computer-aided detection add-on code for screening mammography (can only be billed with CPT code 76092)

    We further discuss in section II.B.3.c, below, coding and payment for screening and diagnostic mammograms that use advanced new technologies.

    Payment for screening mammography services furnished in a hospital outpatient department beginning January 1, 2002 is equal to 80 percent of the lower of the hospital's actual charge or the locality specific technical component payment amount under the physician fee schedule. Coinsurance equals 20 percent of the lower of the actual charge or the physician fee schedule amount. The Medicare Part B deductible does not apply to screening mammography. The November 1 physician fee schedule final rule lists the relative value units for screening mammography services and the physician fee schedule conversion factor for CY 2002 (66 FR 55334). In addition to the technical component payment made to the hospital, physicians are paid an additional amount for professional services furnished in connection with these procedures.

    In this final rule, we are changing the descriptor of payment status indicator “A” for the screening mammography codes to “Physician Fee Schedule” to conform with the BIPA change.

    b. Diagnostic Mammography. Medicare covers a radiological mammogram as a diagnostic test under the following conditions:

    • A patient has distinct signs and symptoms for which a mammogram is indicated;
    • A patient has a history of breast cancer; or
    • A patient is asymptomatic, but on the basis of the patient's history and other factors the physician considers significant, the physician's judgment is that a mammogram is appropriate.

    Payment for a diagnostic mammogram furnished in a hospital outpatient setting is made under the OPPS. The following codes are used to report diagnostic mammography: CPT code 76090, Mammography; unilateral, and CPT code 76091, Mammography, bilateral are used to report a diagnostic mammogram. These two codes are assigned to APC 0271, Mammography, and we proposed no changes to the assignment of these codes in the proposed rule. (We discuss in section III.B.3.c, below, coding changes for the CY 2002 related to new technology mammography.)

    In the proposed rule, the relative weight for APC 0271 was equal to 0.64. We recalibrated all the APC relative weights, including that for APC 0271, using claims data for services furnished beginning July 1, 1999 through June 30, 2000 in accordance with the process explained in the proposed rule (66 FR 44695).

    Comment: We received numerous comments, many of which were the product of a “write-in” campaign, regarding the relative weight and payment rate proposed for APC 0271. The commenters asserted that the current payment rate for APC 0271 is inadequate to support the provision of mammography services in the hospital outpatient setting, and they expressed disbelief that the proposed payment rate for 2002 is lower than the current rate. Commenters expressed grave concern that the proposed payment rate for diagnostic mammography would have a generally negative impact on beneficiary access to mammography services. Many commenters cited a practice cost survey conducted by the American College of Radiology that indicated the average cost for performing a screening mammogram in a hospital outpatient setting to be $97. The commenters argued that diagnostic mammography is more complex technically and more resource intensive, requiring more than double the clinical labor, supply, and equipment inputs than those required for screening mammography. One commenter stated that the technical cost of providing screening mammography in the hospital setting is nearly twice the cost of providing the same service in a physician office setting.

    Other commenters recommended that payment for all mammography services furnished in the outpatient setting, both screening and diagnostic, be paid under the physician fee schedule to eliminate the significant payment disparity that will result if the proposed OPPS rates for diagnostic mammography are implemented in 2002. Several commenters complained that we provided no rationale or data to show how the proposed payment rate for APC 0271 was calculated nor did we explain why the proposed payment for these services is lower than the current payment. Commenters urged that we recalculate the payment rate for APC 0271 to represent a payment rate that is reflective of the resources used to perform the procedure.

    Response: We calculated the relative weight for APC 0271 in the April 7, 2000 final rule in accordance with the process we described in that rule (65 FR 18482), using, as required by the statute, claims from 1996 and data from the most recent available hospital cost reports. Because we did not recalibrate the relative weights for any APC groups in the November 13, 2000 final rule, the relative weight (0.70) for APC 0271 as well as the relative weights for the other APC groups have not changed since August 1, 2000.

    Using 1999-2000 claims data, we recalibrated all the APC weights in the proposed rule in accordance with the process that we explained in that rule (66 FR 44695). The relative weight for every APC group changed for two reasons: the use of more recent claims data, and the statutory requirements for budget neutrality. Section 1833(t)(9)(B) of the Act requires that estimated spending for services covered under the OPPS be neither greater nor less than it would have been had the recalibration and reclassification changes not been made. Because of this, the weights and, therefore, the payment rates for a specific service may increase or decrease depending on the change in charges hospitals report for that service relative to the change in charges hospitals report for other outpatient services. The decrease in the relative weight for diagnostic mammography proposed for 2002 can be attributed to a decrease in the relative level of charges for diagnostic mammography that hospitals reported for services furnished from July 1, 1999 through June 30, 2000 compared to the relative level of charges hospitals reported for all other outpatient services furnished during the same period. However, that weight does reflect the hospital resources used to perform mammograms. We note that the weight for APC 0271 in both the proposed and final rules is calculated from the median cost of almost 900,000 single-procedure claims.

    The weight for APC 0271 in this final rule is 0.60. This weight was recalibrated, like all of the APC weights in this final rule, in accordance with the methodology described in section II.D. of this preamble. We note that the weight for APC 0271, like the weights for all of the nondevice-related APCs, has decreased from the proposed weight. This decrease is the result of our incorporating a portion of the cost of pass-through devices into the base costs of the APCs with which the devices are associated. As we explained in the final rule published on November 2, 2001, the additional pass-through device costs that were incorporated into the base APC costs are not evenly distributed among the APCs, but rather are concentrated in a relatively small Start Printed Page 59876number of APCs that include the procedures that use pass-through devices (66 FR 55862). Whereas the weights of these APCs increased as a result of the added device costs, in general, the weights for APCs that do not include device costs, such as APC 0271, decreased by approximately 8 percent. For a more detailed discussion of how the incorporation of device costs into the base APCs affects the relative weights, see sections II.D. and VII, below.

    Unlike screening mammography, the statute makes no specific designation for the technical component of diagnostic mammography services furnished in the hospital outpatient setting to be defined as a physicians' service. Therefore, we believe that the payment for diagnostic mammography should be included in the OPPS.

    Comment: Several commenters expressed concern that the reduced payment rate for diagnostic mammography would have an especially onerous and negative impact on small, low volume hospitals, most of which are located in rural areas. The commenters noted that although these small rural hospitals are generally the sole providers of mammography and radiology services to the surrounding communities, volume in these hospitals is nonetheless too low to offset the fixed costs incurred for certified staff and equipment.

    Response: In order to limit potential reductions in payment to hospitals under the OPPS, section 1833(t)(7) of the Act requires us to provide transitional payment adjustments for hospitals whose OPPS payments are less than our estimate of the hospital's pre-BBA payments. Section 1833(t)(7)(D)(i) of the Act includes a special “hold harmless” provision, which applies to hospital outpatient services furnished before 2004 by hospitals that are located in a rural area and that have no more than 100 beds. Under section 1833(t)(7)(D)(i) of the Act, small rural hospitals will be paid a predetermined pre-BBA amount for services covered under the OPPS if payment under the OPPS would be less than the pre-BBA amount. This hold harmless provision establishes a payment floor until January 1, 2004 for small rural hospitals. These provisions should provide some measure of protection to small hospitals in rural areas to the extent that the reduced payment for diagnostic mammography services results in overall payment reductions.

    c. Coding and Payment for New Technology Mammography Services. Section 104(d) of BIPA prescribes a payment methodology for both diagnostic and screening mammography furnished during the period April 1, 2001 through December 31, 2001 that use a new technology, as defined in section 104(d)(3) of BIPA. Section 104(d)(2) of BIPA directs the Secretary to determine, for mammography performed after 2001, whether the assignment of a new HCPCS code is appropriate for mammography that uses a new technology. The following codes have been established to identify the new technology mammography services and will be used effective January 1, 2002:

    • HCPCS code G0202, Screening mammography producing direct digital image, bilateral, all views.
    • CPT code 76085, Digitization of film radiographic images with computer analysis for lesion detection and further physician review for interpretation, screening mammography. (This code can only be billed with CPT code 76092, Screening mammography, bilateral.)
    • HCPCS code G0204, Diagnostic mammography, direct digital image, bilateral, all views.
    • HCPCS code G0206, Diagnostic mammography, direct digital image, unilateral, all views.
    • HCPCS code G0236, Digitization of film radiographic images with computer analysis for lesion detection and further physician review for interpretation, diagnostic mammography. (This code can only be billed with code CPT code 76090, Diagnostic mammography, unilateral, or CPT code 76091, Diagnostic mammography, bilateral.)

    In the proposed rule, we assigned computer-aided detection (CAD) and full field digital mammography (FFDM) services used for diagnostic mammography to APC 0271. We proposed to assign payment status indicator “A,” designating that payment would be “lower of charges or national rate,” to the CAD and FFDM codes for screening mammography. Numerous commenters addressed our proposed payment for CAD and FFDM new technology mammography services. Their comments are summarized below.

    Comment: One commenter recommended that CAD used in conjunction with film screening mammography be assigned to a new technology APC under the OPPS rather than being paid under the physician fee schedule. The commenter argued that although section 104(a) of BIPA provided for payment for screening mammography under the physician fee schedule, payment for a new technology such as CAD is provided under a separate BIPA provision, section 104(d)(3), and therefore is not linked to the physician fee schedule.

    Response: We do not agree with the commenter's recommendation that CPT code 76085 for CAD used with screening mammography be assigned for payment to a new technology APC under the OPPS. Because CPT code 76085 is an add-on code that can be paid only when it is billed with CPT code 76092 for screening mammography, we believe it is more appropriate to pay for both CPT codes 76085 and 76092 under the physician fee schedule than to pay for them separately under two different payment systems.

    Comment: Most commenters recommended assignment of CAD and FFDM services used with diagnostic mammography to a new technology APC on the grounds that no existing APC would be appropriate both clinically and in terms of payment for these services. Commenters were unanimous in opposing assignment of the CAD and FFDM services used for diagnostic mammography to APC 0271. Several commenters were concerned that payment for these services under the physician fee schedule was so much higher than that proposed under the OPPS.

    Response: We agree that the new technology procedures associated with diagnostic mammography should be assigned to a new technology APC until we have collected cost data to make a more clinically and resource use appropriate APC assignment. Therefore, effective for services furnished on or after January 1, 2002, HCPCS codes G0204 and G0206 will be assigned to APC 0971 and HCPCS code G0236 will be assigned to APC 0970.

    The difference in payment amounts for the new technology mammography services between the physician fee schedule and the OPPS is attributable to differences in the payment methodology required under the statute.

    Final Action: See section II.B.3.a. for the codes used to bill for new technology screening mammography services. The following codes and APC groups are effective for new technology services used for diagnostic mammography beginning January 1, 2002:

    HCPCS codes G0205 and G0207 are deleted.

    Use HCPCS codes G0204 and G0206 for full field digital diagnostic mammography services; assigned to APC 0707.

    Use HCPCS code G0236 for computer-assisted detection with CPT code 76090 and CPT code 76091 for diagnostic mammography; assigned to APC 0706. Start Printed Page 59877

    C. Other Changes Affecting the APCs

    1. Changes in Revenue Code Packaging

    In the April 7, 2000 final rule, we described how, in calculating the per procedure and per visit costs to determine the median cost of an APC (and therefore its relative weight), we used the charges billed using the revenue codes that contained items that were integral to performing the procedure or visit (65 FR 18483). The complete list of the revenue centers by type of APC group was printed in the April 7, 2000 rule (65 FR 18484).

    In the November 13, 2000 interim final rule, we made some changes to the list of revenue codes to reflect the charges associated with implantable devices (65 FR 67806 and 67825). We were later able to incorporate revenue codes 274 (prosthetic/orthotic devices), 275 (pacemaker), and 278 (other implants) in our database, and effective January 1, 2001, we updated the APC payment rates to reflect inclusion of this information.

    As discussed in the proposed rule, we have continued to review and revise the list of revenue codes to be included in the database and we proposed several changes to the list of revenue codes that are packaged with the costs used to calculate the proposed APC rates. Some of these changes reflect the addition of revenue codes and others are a further refinement of our methodology. The following are the specific changes we proposed:

    • Package additional revenue centers that may be used to bill for implantable devices (including durable medical equipment (DME) and brachytherapy seeds) with surgical procedures. These additional centers are revenue codes 280 (oncology), 289 (other oncology), 290 (DME), and 624 (investigational devices).
    • Package revenue codes 280, 289, and 624 with other diagnostic and radiology services.
    • Package the revenue codes for medical social services, 560 (medical social services) and 569 (other medical social services). These services are not paid separately in the hospital outpatient setting but often constitute discharge-planning services if provided with an outpatient service.
    • Package revenue code 637 (self-administered drug (insulin administered in an emergency diabetic coma)) with medical visits. Although this is a self-administrable drug, it is covered when administered as described.
    • Remove revenue code 723 (circumcision) from the list of packaged revenue codes because circumcision is a payable procedure under OPPS and should not be packaged.
    • Package revenue code 942 (education/training) with medical visits and the category of “All Other APC Groups.” Patient training and education are generally not paid as a separate service under Medicare, but may be included as part of an otherwise payable service such as a medical visit. We believe that training and education services generally occur as part of a medical visit or psychiatric service.
    • Remove the revenue codes in the range of 890 through 899 (donor bank), as these are no longer valid revenue codes.

    Comment: One commenter disagreed with our proposal to package revenue code 942 (education/training). The commenter stated that such a policy would be inappropriate because revenue code 942 is the proper revenue code to use when billing diabetes training with HCPCS codes G0108 and G0109. If CMS does package that revenue code, the commenter wanted to know what revenue code should be billed for diabetes education.

    Response: Although under OPPS we will package charges for education and training when billed with revenue code 942, training and education associated with diabetes management, identified by HCPCS codes G0108 and G0109, is not paid under the OPPS and, therefore, is not a packaged service. The list of packaged revenue codes contained in the proposed rule represents revenue codes that are packaged when they appear on a bill with an OPPS service and are not billed with a HCPCS code for a service, like diabetes education, which is paid by Medicare but paid outside of the OPPS.

    Comment: One commenter questioned our proposal to package additional revenue centers that may be used to bill for implantable devices (including brachytherapy seeds) with surgical procedures. The commenter asked for details on how such packaging would be accomplished and specifically how we would account for the varying number of costly brachytherapy seeds used in each procedure.

    Response: In determining the median cost of a procedure or service, we take into account the costs associated with any packaged revenue center that appears on a bill as well as the cost associated with the specific line item that reflects the HCPCS code for the procedure or service. Thus, when a hospital bills a charge for brachytherapy seeds using one of the revenue codes that are identified as a packaged revenue code, we convert that charge to a cost by multiplying the billed charge by the hospital-specific cost-to-charge ratio for the related cost center. The cost of the brachytherapy seeds is then added to all other costs on the bill that are attributable to the procedure to arrive at the cost of the bill. Under this methodology, the varying numbers of brachytherapy seeds used and the varying costs of the seeds are accurately captured in the median cost data we use to calculate median cost for the APC. That is, we would expect that the cost associated with a bill would reflect the number of seeds used in a particular procedure and the median cost for that procedure overall would be an average of the varying numbers of seeds used by hospitals.

    2. Special Revenue Code Packaging for Specific Types of Procedures

    We proposed that the same packaging used for surgical procedures be used for corneal tissue implant procedures in APC 0244, Corneal Transplant, except that organ acquisition revenue codes and the revenue codes used to bill implantable devices are not packaged with corneal implants.

    There are certain other diagnostic procedures with CPT codes that are similar to surgical procedures. The cost of these procedures (HCPCS codes 92980-92996, 93501-93505, and 93510-93536) reflects both the revenue code packaging for ambulatory surgical center (ASC) and other surgery, as well as the revenue code packaging for other diagnostic services.

    A complete listing of the revenue codes that we used for purposes of calculating median costs of services are shown below in Table 2.

    Table 2.—Packaged Services by Revenue Code

    Surgery

    250 Pharmacy

    251 Generic

    252 Nongeneric

    257 Nonprescription Drugs

    258 IV Solutions

    259 Other Pharmacy

    260 IV Therapy, general class

    262 IV Therapy/pharmacy services

    263 IV Therapy/drug supply/delivery

    264 IV Therapy/supplies

    269 Other IV Therapy

    270 M&S supplies

    271 Nonsterile supplies

    272 Sterile supplies

    274 Prosthetic/orthotic devices

    275 Pacemaker drug

    276 Intraocular lens source drug

    278 Other implants

    279 Other M&S supplies

    280 Oncology

    289 Other oncologyStart Printed Page 59878

    762 Observation room

    810 Organ acquisition

    290 Durable medical equipment

    370 Anesthesia

    379 Other anesthesia

    390 Blood storage and processing

    399 Other blood storage and processing

    560 Medical social services

    569 Other medical social services

    624 Investigational device (IDE)

    630 Drugs requiring specific identification, general class

    631 Single source

    632 Multiple

    633 Restrictive prescription

    700 Cast room

    709 Other cast room

    710 Recovery room

    719 Other recovery room

    720 Labor room

    721 Labor

    819 Other organ acquisition

    Medical Visit

    250 Pharmacy

    251 Generic

    252 Nongeneric

    257 Nonprescription drugs

    258 IV solutions

    259 Other pharmacy

    270 M&S supplies

    271 Nonsterile supplies

    272 Sterile supplies

    279 Other M&S supplies

    560 Medical social services

    569 Other medical social services

    630 Drugs requiring specific identification, general class

    631 Single source drug

    632 Multiple source drug

    633 Restrictive prescription

    637 Self-administered drug (insulin admin. in emergency diabetic coma)

    700 Cast room

    709 Other cast room

    762 Observation room

    942 Education/training

    Other Diagnostic

    254 Pharmacy incident to other diagnostic

    280 Oncology

    289 Other oncology

    372 Anesthesia incident to other diagnostic

    560 Medical social services

    569 Other medical social services

    622 Supplies incident to other diagnostic

    624 Investigational device (IDE)

    710 Recovery room

    719 Other recovery room

    762 Observation room

    Radiology

    255 Pharmacy incident to radiology

    280 Oncology

    289 Other oncology

    371 Anesthesia incident to radiology

    560 Medical social services

    569 Other medical social services

    621 Supplies incident to radiology

    624 Investigational device (IDE)

    710 Recovery room

    719 Other recovery room

    762 Observation room

    All Other APC Groups

    250 Pharmacy

    251 Generic

    252 Nongeneric

    257 Nonprescription drugs

    258 IV Solutions

    259 Other pharmacy

    260 IV Therapy, general class

    262 IV Therapy pharmacy services

    263 IV Therapy drug/supply/delivery

    264 IV Therapy supplies

    269 Other IV therapy

    270 M&S supplies

    271 Nonsterile supplies

    272 Sterile supplies

    279 Other M&S supplies

    560 Medical social services

    569 Other medical social services

    630 Drugs requiring specific identification, general class

    631 Single source drug

    632 Multiple source drug

    633 Restrictive prescription

    762 Observation room

    942 Education/training

    3. Limit on Variation of Costs of Services Classified Within a Group

    Section 1833(t)(2) of the Act provides that the items and services within an APC group cannot be considered comparable with respect to the use of resources if the highest cost item or service within a group is more than 2 times greater than the lowest cost item or service within the same group. However, the Secretary may make exceptions to this limit on the variation of costs within each group in unusual cases such as low volume items and services. No exception may be made, however, in the case of a drug or biological that has been designated as an orphan drug under section 526 of the Federal Food, Drug, and Cosmetic Act.

    Based on the APC changes discussed above in this section of this preamble and our use of more current data to calculate the median cost of procedures classified to APCs, we reviewed all the APCs to determine which of them would not meet the 2 times limit. We use the following criteria when deciding whether to make exceptions to the 2 times rule for affected APCs:

    • Resource homogeneity.
    • Clinical homogeneity.
    • Hospital concentration.
    • Frequency of service (volume).
    • Opportunity for upcoding and code fragmentation.

    For a detailed discussion of these criteria, refer to the April 7, 2000 final rule (65 FR 18457).

    The proposed rule set forth a list of APCs that we proposed to exempt from the 2 times rule based on the criteria cited above (66 FR 44690). In cases in which compliance with the 2 times rule appeared to conflict with a recommendation of the APC Advisory Panel, we generally proposed to accept the Panel recommendation. This was because Panel recommendations were based on explicit consideration of resource use, clinical homogeneity, hospital specialization, and the quality of the data used to determine payment rates.

    We received no comments on our proposal. The following is the final list of APCs we exempted from the 2 times rule. This list reflects the final APCs as recalibrated based on the updated 1999-2000 data base as well as the incorporation of 75 percent of the estimated cost of the pass-through devices (See section II.D).

    List of APCs exempted from the “two times” requirement:

    0001 Photochemotherapy

    0004 Level I Needle Biopsy/Aspiration Except Bone Marrow

    0043 Closed Treatment Fracture Finger/Toe/Trunk

    0044 Closed Treatment Fracture/Dislocation Except Finger

    0047 Arthroscopy without Prosthesis

    0058 Level I Strapping and Cast Application

    0060 Manipulation Therapy

    0077 Level I Pulmonary Treatment

    0093 Vascular Repair/Fistula Construction

    0096 Non-Invasive Vascular Studies

    0097 Cardiac Monitoring for 30 Days

    0115 Cannula/Access Device Procedures

    0121 Level I Tube Changes and Repositioning

    0140 Esophageal Dilation without Endoscopy

    0141 Upper GI Procedures

    0142 Small Intestine Endoscopy

    0147 Level II Sigmoidoscopy

    0164 Level I Urinary and Anal Procedures

    0165 Level III Urinary and Anal Procedures

    0182 Insertion of Penile Prosthesis

    0187 Placement/Repositioning Misc Catheters

    0198 Pregnancy and Neonatal Care Procedures

    0203 Level V Nerve Injections

    0204 Level VI Nerve Injections

    0207 Level IV Nerve Injections

    0213 Extended EEG Studies and Sleep Studies, Level I Start Printed Page 59879

    0215 Level I Nerve and Muscle Tests

    0218 Level II Nerve and Muscle Tests

    0233 Level II Anterior Segment Eye Procedures

    0234 Level III Anterior Segment Eye Procedures

    0237 Level III Posterior Segment Eye Procedures

    0247 Laser Eye Procedures Except Retinal

    0251 Level I ENT Procedures

    0252 Level II ENT Procedures

    0260 Level I Plain Film Except Teeth

    0263 Level I Miscellaneous Radiology Procedures

    0264 Level II Miscellaneous Radiology Procedures

    0265 Level I Diagnostic Ultrasound Except Vascular

    0279 Level I Angiography and Venography Except Extremity

    0285 Positron Emission Tomography (PET)

    0294 Level I Therapeutic Nuclear Medicine

    0296 Level I Therapeutic Radiologic Procedures

    0305 Level II Therapeutic Radiation Treatment Preparation

    0322 Brief Individual Psychotherapy

    0345 Level I Transfusion Laboratory Procedures

    0354 Administration of Influenza/Pneumonia Vaccine

    0355 Level I Immunizations

    0356 Level II Immunizations

    0363 Otorhyinolaryngologic Function Tests

    0364 Level I Audiometry

    0373 Neuropsychological Testing

    0600 Low Level Clinic Visits

    0601 Mid Level Clinic Visits

    0602 High Level Clinic Visits

    0694 Level III Excision/Biopsy

    4. Observation Services

    Frequently, beneficiaries are placed in “observation status” in order to receive treatment or be monitored before making a decision concerning their next placement (that is, admit to the hospital or discharge to home). This occurs most frequently after surgery or a visit to the emergency department. In the proposed rule, we discussed the clinical and payment history of observation services. We also discussed at length the issues we considered in determining whether to make separate payment for observation services. For a more detailed discussion of our deliberations, see 66 FR 44690-91. After careful consideration, we proposed the following:

    • To continue to package observation services into surgical procedures and most clinic and emergency visits.
    • To create a single APC, APC 0339, Observation, to make separate payment for observation services for three medical conditions, chest pain, asthma, and congestive heart failure, when certain criteria (as described below) are met.

    We also proposed to instruct hospitals that payment under APC 0339 for observation services would be subject to the following billing requirements and conditions:

    • An emergency department visit (APC 0610, 0611, or 0612) or a clinic visit (APC 0600, 0601, or 0602) is billed in conjunction with each bill for observation services.
    • Observation care is billed hourly for a minimum of 8 hours up to a maximum of 48 hours. We would not pay separately for any hours a beneficiary spends in observation over 24 hours, but all costs beyond 24 hours would be packaged into the APC payment for observation services.
    • Observation time begins at the clock time appearing on the nurse's observation admission note. (We note that this coincides with the initiation of observation care or with the time of the patient's arrival in the observation unit.)
    • Observation time ends at the clock time documented in the physician's discharge orders, or, in the absence of such a documented time, the clock time when the nurse or other appropriate person signs off on the physician's discharge order. (This time coincides with the end of the patient's period of monitoring or treatment in observation.)
    • The beneficiary is under the care of a physician during the period of observation, as documented in the medical record by admission, discharge, and other appropriate progress notes, timed, written, and signed by the physician.
    • The medical record includes documentation that the physician used risk stratification criteria to determine that the beneficiary would benefit from observation care. (These criteria may be either published generally accepted medical standards or established hospital-specific standards.)
    • The hospital furnishes certain other diagnostic services along with observation services to ensure that separate payment is made only for those beneficiaries truly requiring observation care. We believe that these tests are typically performed on beneficiaries requiring observation care for the three specified conditions and they are medically necessary to determine whether a beneficiary will benefit from being admitted to observation care and the appropriate disposition of a patient in observation care. The diagnostic tests are as follows:
    • For chest pain, at least two sets of cardiac enzymes and two sequential electrocardiograms.
    • For asthma, a peak expiratory flow rate (PEFR) (CPT code 94010) and nebulizer treatments.
    • For congestive heart failure, a chest x-ray, an electrocardiogram, and pulse oximetry.

    We proposed to make payment for APC 0339 only if the tests described above are billed on the same claim as the observation service. (We did not propose to require telemetry and other ongoing monitoring services as criteria to make separate payment for observation services. Although these services are often medically necessary to ensure prompt diagnosis of cardiac arrhythmias and other disorders, we do not believe they are necessary to support separate payment for observation services.) In the proposed rule, we listed the following ICD-9-CM diagnosis codes that hospitals would be required to bill to receive payment for APC 0339:

    For Chest Pain:

    411.1 Intermediate coronary syndrome

    411.81 Coronary occlusion without myocardial infarction

    411.0 Postmyocardial infarction syndrome

    411.89 Other acute ischemic heart disease

    413.0 Angina decubitus

    413.1 Prinzmetal angina

    413.9 Other and unspecified angina pectoris

    786.05 Shortness of breath

    786.50 Chest pain, unspecified

    786.51 Precordial pain

    786.52 Painful respiration

    786.59 Other chest pain

    For Asthma:

    493.01 Extrinsic asthma with status asthmaticus

    493.02 Extrinsic asthma with acute exacerbation

    493.11 Intrinsic asthma with status asthmaticus

    493.12 Intrinsic asthma with acute exacerbation

    493.21 Chronic obstructive asthma with status asthmaticus

    493.22 Chronic obstructive asthma with acute exacerbation

    493.91 Asthma, unspecified with status asthmaticus

    493.92 Asthma, unspecified with acute exacerbation

    For Congestive Heart Failure:

    428.0 Congestive heart failure

    428.1 Left heart failure

    428.9 Heart failure, unspecified

    Start Printed Page 59880

    In the proposed rule, we specified the following process to identify the appropriate median cost for APC 0339 (66 FR 44692). First, we identified in the 1999-2000 claims data all hospital outpatient claims for observation using revenue codes 760, 761, 762, and 769. We then selected the subset of these claims that were billed for patients with chest pain, asthma, and congestive heart failure. Because no standard method for coding these claims was in place in 1996, we identified all diagnosis codes that could reasonably have been used to classify beneficiaries as having chest pain, asthma, and congestive heart failure. We then verified that these beneficiaries received appropriate observation care for chest pain, asthma, or congestive heart failure by identifying the claims in which one or more of the tests identified above were performed. The median costs of these claims were used to establish the median costs of APC 0339.

    Finally, we stated that we would consider medical research submitted to support the benefits of observation services for conditions other than those we had proposed. This information will assist us in determining whether these other conditions meet the criteria we used to select the three conditions we proposed to include in APC 0339.

    We received a large number of comments on this proposal. Many commenters commended our proposal to pay separately for observation services. However, other commenters either had questions about or suggestions on revising our proposal. Those comments and our responses appear below.

    Comment: We received comments requesting that we expand the list of conditions for which we would make a separate payment for observation services. Some commenters listed specific conditions that should be added to the list (for example, abdominal pain, atrial fibrillation, or pyelonephritis) while others asserted that any condition a physician thought required observation should qualify for separate payment. One commenter submitted medical literature as supportive evidence that we should expand our list of conditions. One commenter argued that developing a restrictive list of conditions for which separate payment would be made is inconsistent with the medical literature and with InterQual, which publishes the criteria used by Peer Review Organizations to assess whether admission to the hospital as an inpatient is necessary.

    Response: We wish to clarify that our proposal merely specified a list of conditions for which we would make separate payment for observation services. For all other conditions, payment for observation services would be packaged into the APC in which those services were provided. For example, if a patient with syncope goes to the emergency room and receives emergency services and observation services, the payment to the hospital for the emergency visit includes payment for the observation service. The payment rate calculated for clinic and emergency visits includes the packaged costs of observation services to the extent that those costs were included on the visit bills.

    We have reviewed the commenters' suggestions for additional conditions and the medical literature that they submitted in support of their requests. At this time, we are finalizing our proposal without expanding the list of conditions for which separate observation payment will be made. As noted in the proposed rule, we believe that chest pain, asthma, and congestive heart failure are the only conditions that require a well-defined set of hospital services that are distinctly different from the services provided in a clinic or emergency service. Thus, they are the services for which a separately payable observation period is clinically appropriate. Given the clinically improper use of observation care by hospitals in the recent past, we want to minimize the risk of future improper use while ensuring a valid medical benefit to the patient for appropriate medical care. Therefore, we believe it is premature to expand the conditions for which we will separately pay for observation services. We want to observe the effect of separate payment for this limited set of conditions to determine what clinical and payment issues arise before expanding the list of conditions. Furthermore, an essential issue for Medicare is that separate payment for observation be made only when those services are clearly distinct and separate from prolonged clinic or emergency department care and when observation provides a distinct clinical benefit that cannot be obtained by sending the patient home or admitting the patient to the hospital. We believe that the medical literature demonstrates such a benefit exists for patients with chest pain, congestive heart failure, and asthma.

    We will continue to review this issue and any information that is provided to us. If we believe an expansion of the list of conditions is appropriate, we will include such a proposal in a future proposed rule.

    Comment: An association of hospitals provided an explanation of their concept of “rapid treatment,” which they distinguished from observation. They defined observation as a service required by managed care contracts that involves only physiologic monitoring, frequent nursing assessment, and the patient's routine daily medication.

    Response: This level of care would not qualify as an observation service, either packaged or separately paid, under Medicare. We require that during observation, patients be actively assessed and, if necessary, treated in order to determine if they should be admitted or may be safely discharged.

    Comment: Several commenters pointed out that correct coding guidelines allow hospitals to code the reason for a patient's visit in any one of several fields on the claim including the principal diagnosis field, the secondary diagnosis field, and the admitting diagnosis field. These commenters suggested that facilities be allowed to report the appropriate diagnosis code supporting the provision of observation services in the admitting, principal, or secondary diagnosis field.

    Response: We agree with the commenters and will ensure that our software is designed to allow this.

    Comment: Commenters argued that additional ICD-9-CM diagnosis codes for chest pain, congestive heart failure, and asthma be added to the proposed list of diagnoses qualifying observation care for separate payment. These included: for asthma: 493.00, 493.10, 493.20, 493.90; for congestive heart failure: 391.8, 398.91, 402.01, 402.11, 402.91, 404.01, 404.03, 404.11, 404.13, 404.91, 404.93; for chest pain: codes for weakness, shortness of breath, palpitations, rapid heart beat, and syncope. One commenter asked that we include codes for chronic obstructive pulmonary disease (COPD) on the list of qualifying diagnoses. One commenter believes that 428.1 and 428.9 are not to be used for congestive heart failure and should be deleted from the list.

    Response: With regard to the comments to add diagnosis codes for asthma, our proposal included codes for status asthmaticus and acute exacerbations of asthma. The codes suggested by the commenters are used for chronic, stable asthma, or unspecified asthma. Our clinical judgment is that these patients do not require active observation care that meets our definition and, thus, a separate payment is not warranted. Therefore, we have not revised our list of qualifying diagnoses for asthma.

    With regard to the suggested codes to be added for congestive heart failure, we agree with the commenters and are adding the codes to the list. Start Printed Page 59881

    With regard to the suggested codes for chest pain, we note that 786.05, Shortness of breath, was included on our proposed list of qualifying codes. If a patient has one of the other suggested symptoms (weakness, palpitations, rapid heartbeat, and syncope), it would be appropriate to use one of the proposed codes as the diagnosis (for example, 413.9, other and unspecified angina). Therefore, we believe the list we proposed covers the additions suggested by the commenter.

    With regard to the requested deletions of codes 428.1 and 428.9, we disagree. Code 428.1 is specified for use in patients with acute pulmonary edema and 428.9 is used for patients with congestive heart failure without a specific diagnosis and both codes are therefore appropriately included on the list.

    Comment: Several commenters believe that dedicated observation units would not be financially viable if only three conditions qualified for payment.

    Response: We want to emphasize that we are making payment for all observation services provided in the outpatient setting. Payment for observation services not meeting the requirements for separate payment in APC 0339 is included in the payment for the clinic or emergency department visit. That is, the payment for each clinic or emergency department visit contains a payment for packaged observation services. This means that hospitals are being paid for observation every time a clinic or emergency visit is billed.

    Our policy of separate payment for certain observation services is not intended to increase the total amount of money paid for observation services. Instead, our policy redistributes payments into a separate APC; the relative weight of the new APC for observation services reflects costs that would otherwise be reflected in the relative weights for other relevant APCs. Thus, the payments for clinic and emergency visits are slightly lower than would have been the case had we not created a separate payment for observation. The only hospitals that could be disadvantaged are those that provided observation care for packaged conditions to an unusually large number of patients. Hospitals with large numbers of observation cases for chest pain, asthma, and congestive heart failure will benefit from our new policy. Hospitals with an average number of observation cases will be neither advantaged nor disadvantaged by our new policy.

    Comment: Some commenters believe it is inappropriate “not to pay for observation” for other conditions. Others argued that because pulse oximetry, one of the diagnostic tests we identified as a condition of separate payment for congestive heart failure, is a packaged service, it is not paid for and therefore cannot be reported on the bill. This would place hospitals in a “Catch-22” situation because they would be required to report pulse oximetry to be paid separately for observation but could not report pulse oximetry because it is packaged.

    Response: These comments reflect a misunderstanding of what it means for a service to be “packaged.” The concept is perhaps most clearly understood in terms of the anesthesia used during surgery. The costs of the anesthesia drugs and administration are associated with the surgery with which they were billed, and become part of the payment for the surgery. It is understood that anesthesia is paid for, but not paid for separately from the surgical procedure. Similarly, we packaged the cost of observation whenever it was billed. It is packaged into surgical procedures as well as clinic and emergency visits. Each time a hospital bills for a procedure or visit, any associated observation cost is recognized. Because, according to the literature, observation is billed in fewer than 6 percent of emergency room visits, the cost is not always readily identifiable. However, we wish to emphasize that it is important for hospital bills to show that observation was provided and the charges associated with it. This is because the charges for packaged services might affect outlier and transitional corridor payments, and are used to update the APC weights. Thus, hospitals should report pulse oximetry on the bill even though it is not separately payable.

    Comment: Surgeons reported that hospitals, believing that observation is not payable, would not allow postoperative observation for patients such as those who have undergone mastectomy or thyroidectomy.

    Response: Surgery performed in the outpatient setting should not, as a rule, require a period of postoperative observation. As provided in section 230.6E of the Medicare Hospital Manual, standing orders for observation following outpatient surgery is not a covered service. In addition, that section states that the availability of an outpatient observation unit at a hospital is not a reason to perform, on an outpatient basis, surgeries for which an overnight stay is anticipated.

    Although an occasional surgical case may require a longer recovery period, as a rule, surgical outpatients should not require observation. We note, however, that to the extent that observation care is provided to surgical patients, the cost of that care is packaged into the payment for the surgical APC.

    Comment: There were many comments on the list of diagnostic tests required for separate payment for observation services. Several commenters pointed out that nebulizer treatments, by definition, are not diagnostic. These commenters also noted that observation of asthma patients need not involve nebulizer treatments (that is, some patients are treated with intravenous steroids or inhalers). Others indicated that pulse oximetry is a routine test and is not usually coded. Other commenters were concerned that the required tests would not all be performed within the period of observation; that is, some tests might be performed in the emergency department before admission to observation status.

    Response: The requirement that certain diagnostic tests be performed in order to receive separate payment for observation services reflects our concern that observation not be considered a way to keep a patient in a “holding pattern.” We are aware that some patients are considered to be in observation overnight when they are placed in a bed on a nursing unit, with vital signs taken every 4 hours. This is not the service we recognize as observation, which we define as an active treatment to determine if a patient's condition is going to require that he or she be admitted as an inpatient, or if it resolves itself so that the patient may be discharged. The services we included on the list of required treatment were designed to indicate that an active assessment of the patient was being undertaken. We believe this is consistent with the clinical practice of observation.

    We agree that nebulizer treatments are not diagnostic, and, although, based on the experience of our clinical staff, are frequently used in acute asthma, they need not be used for every asthma patient receiving observation services. We agree that occasionally patients may use their own inhaler or be given intravenous medications without nebulizer treatments. Thus, we are not including this treatment on the final list of services required for separate payment of observation. As discussed above, pulse oximetry, although packaged, should be reported on the bill when furnished.

    We agree that some of the required diagnostic testing (for example, cardiac enzymes) may be performed as part of the emergency or clinic visit before the Start Printed Page 59882beneficiary is admitted to observation status. We will ensure that our software identifies when the required diagnostic tests were performed in the clinic or emergency department as well as diagnostic tests performed during the period of observation.

    Comment: Several commenters claimed that requiring specific clinical interventions for observation care was an intrusion into the practice of medicine.

    Response: We disagree with the commenters. We are setting conditions only for separate payment for observation. All observation care that does not meet the criteria for classification into APC 0339 will continue to be paid as part of the service into which it is packaged. In order to ensure that we are making separate payment only when it is warranted, we are providing as a condition for separate payment that a minimal number of appropriate diagnostic tests must be performed. The hospital will continue to receive packaged payment for observation care for beneficiaries who require such care but for whom the required tests were not performed.

    As stated above, we are withdrawing the proposed condition of administering nebulizer treatments. We will allow either pulse oximetry or peak expiratory flow rate to be performed as a requirement to receive separate payment for observation of asthma patients. We are finalizing our requirements for chest pain and congestive heart failure. We note that none of the commenters had any clinical disagreement with the designation of these specific tests. Their only concern stemmed from the misconception that these tests would be required to be performed in order to receive payment for observation care. We will closely follow the impact of these requirements and, if we believe that changes are necessary, we will propose them in a future rule.

    Comment: Several commenters argued that packaging the first 8 hours of observation was arbitrary and would be difficult to document. We also received comments that we should eliminate our minimum time requirement for observation or reduce it to 6 hours. The following reasons were given for these comments: asthma patients do not require 8 hours of observation; no evaluation and management (E/M) service lasts for more than 1 hour and 45 minutes; and emergency visits typically last 3-4 hours so any potential for abuse of observation would be reduced with a minimum time requirement of 6 hours because 6 hours does not overlap with the length of a typical emergency visit.

    Response: We believe it is important to ensure that payment for clinic and emergency department services does not duplicate payments for observation. We also want to make clear that we do not consider a long emergency room visit to be “observation.” We believe that observation is a specific type of service that should be specifically ordered by a physician and should involve specific goals and a plan of care that is distinct from the goals and plan of care for an emergency or clinic visit. We believe that requiring 8 hours of care as a condition for separate payment of observation is reasonable and will minimize confusion for hospitals. We will be including the first 8 hours of observation care as a packaged service and make payment as part of the clinic or emergency visit with which it occurs. Therefore, the payment rate for emergency and clinic visit will reflect the extent to which patients are observed for less than 8 hours. Although occasionally patients with asthma may require less than 8 hours of observation, we believe that intensity and variety of services provided to patients with an acute asthma exacerbation or status asthmaticus who require 8 or more hours of observation is different from the service provided when they require less than 8 hours of observation. The less intensive services provided to asthma patients who require less than 8 hours of observation is appropriately paid for as part of an emergency or clinic visit. We note that we received no comments disagreeing with our minimum time requirement for patients with chest pain and congestive heart failure. Finally, we believe that a clear requirement of 8 hours will allow hospitals to prospectively develop clinical protocols and plans of care facilitating the appropriate use of observation services. However, we will closely monitor the impact of the 8-hour time requirement and, if appropriate, consider changes for a future proposed rule.

    Comment: Commenters raised concerns about our requirement that physicians write progress notes in the medical record. They believe that admission and discharge notes are generally sufficient to document observation care. The commenters also raised questions about determining when observation starts and ends, with one commenter describing the proposed documentation requirement as “rigid and inflexible.” Others expected documentation to be difficult in hospitals without emergency department staff or house staff. One commenter stated that specific requirements for determining the time observation stops would not reflect the variety of methods hospitals and physicians have to document time in the medical record. Commenters asserted that the period of treatment and monitoring can continue beyond the time that a discharge order is written by the physician or taken off by the nurse.

    One commenter discussed the difficulty in determining when a patient is “moved to observation status” and the need for physicians to be able to write orders specifying discharge at a “future time.” Several commenters expressed concerns about requiring documentation that the physician used risk stratification criteria to determine that the beneficiary would benefit from observation care because documenting use of risk stratification criteria would be burdensome and is not required for any other services.

    Response: We appreciate these concerns and, although we are finalizing our proposal, we wish to clarify several aspects of these requirements to reassure commenters. With regard to writing progress notes, we wish to emphasize that the requirement is only to write “appropriate” progress notes. We understand that, in many cases, writing a progress note is unnecessary (because the admission and discharge notes are sufficient), while in other cases it is necessary to write progress notes because of the length and complexity of care provided or because of a change in the patient's condition. We wish to clarify that progress notes are not required in every case but only in those cases in which the physician deems it appropriate to write a progress note.

    With regard to documenting the times that observation starts and ends, we have to balance the potential for improper billing of observation status against creating burdens for hospitals that will have to support their claims for observation treatment in the medical record. We believe that our policy strikes this balance appropriately. Typically both physicians' orders and nurses' removal of those orders are timed; therefore, we do not believe this requirement places a significant burden on physicians or hospitals because no change in the processes of care will be required. We do not believe that for chest pain, congestive heart failure, and asthma, orders are written for a future discharge time because those patients may not be discharged until treatment goals are met, and determining this requires current (not future) physician intervention (for example, to review lab tests or examine the patient). Start Printed Page 59883

    An important reason we are requiring clocked time to determine the period of observation is because we want to minimize confusion and separate observation care from prolonged emergency or clinic visits. Our requirements will assist hospitals to prospectively ensure that observation is appropriately billed. Although it is possible that treatment and monitoring may continue for a significant period of time after a discharge order is written or taken off, we believe such an occurrence is the exception rather than the rule; additionally, it is frequently difficult to determine exactly when facility services are discontinued. One problem is that it is typical for those patients to remain in the observation area for a significant period of time after treatment is finished, most commonly because the patient is waiting for transportation home. As stated above, we need a bright line rule with regard to the stop time for observation.

    With regard to documenting the use of risk stratification, we did not mean to require any extra documentation in the medical record. We just wish to put physicians and hospitals on notice as to what type of medical record evidence reviewers will use when reviewing claims for observation. We believe that a well-documented observation record will satisfy this requirement without any extra documentation. Therefore, we are clarifying that the manner in which documentation of risk stratification is made is at the discretion of the physician. As with all the criteria we are establishing for payment of APC 0339, we will monitor the effects of these requirements on the provision of observation care and consider making changes if appropriate.

    Comment: We received a variety of comments asking for clarification as to how observation services should be reported; whether notes may be written by house staff or fellows; whether orders may be phoned in; whether additional diagnostic tests during observation would be paid for; how observation would be treated by local medical review policies; whether short inpatient stays for congestive heart failure and asthma would no longer be allowed; how billing would occur for patients who are admitted directly to a chest pain center without being seen in the emergency department; and whether payment for observation is made per hour or per day.

    Response: Observation services should be tracked by the hour. If the number of hours is less than 8, then payment is packaged into the associated clinic or emergency visit. If more than 24 hours of observation are billed, payment for any time over 24 hours is packaged into the payment for 8 to 24 hours of observation. Therefore, the payment rate for observation will reflect those cases in which observation actually occurs for more than 24 hours. That is, just as the payment for emergency visits reflects payment for observation of up to 8 hours, so will payment for APC 0339 reflect payment for observation care up to 48 hours. Effective for services furnished on or after January 1, 2001, we have created a new HCPCS code for use with our new APC 0339 to help distinguish packaged observation form separately payable observation. The code is G0224, Observation care provided by a facility to a patient with CHF, chest pain, or asthma, minimum eight hours, maximum forty-eight hours. The previously available CPT codes for observation, 99234-99236, should continue to be used for packaged observation services.

    With regard to house staff writing notes and orders, teaching physician rules apply to Part B payments for observation care. With regard to facility payments, observation may be billed if the notes are written by house staff. Physicians may phone in orders but if those orders are for admission or discharge to observation, they must be timed. Moreover, the physician must write admission and discharge notes in the medical record.

    We note that we will pay separately for all nonpackaged diagnostic tests furnished to observation patients.

    We will continue pay for inpatient admissions for chest pain, asthma, and congestive heart failure when appropriate and our observation payment policy is subject to local medical review policies.

    With regard to direct admissions from physician offices, separate payment for observation will not be made unless a physician is present to order the initiation of observation services and to monitor the patient as clinically appropriate.

    The following are the final requirements for billing G0244 and assignment to APC 0339.

    The acceptable diagnosis codes are:

    For Chest Pain

    • 391.8 Other acute rheumatic heart disease
    • 398.91 Rheumatic heart failure (congestive)
    • 402.01 Malignant hypertensive heart disease with congestive heart failure
    • 402.11 Benign hypertensive heart disease with congestive heart failure
    • 402.91 Unspecified hypertensive heart disease with congestive heart failure
    • 404.01 Malignant hypertensive heart and renal disease with congestive heart failure
    • 404.03 Malignant hypertensive heart and renal disease with congestive heart and renal failure
    • 404.11 Benign hypertensive heart and renal disease with congestive heart failure
    • 404.13 Benign hypertensive heart and renal disease with congestive heart and renal failure
    • 404.91 Unspecified hypertensive heart and renal disease with congestive heart failure
    • 404.93 Unspecified hypertensive heart and renal disease with congestive heart and renal failure
    • 411.1 Intermediate coronary syndrome
    • 411.81 Coronary occlusion without myocardial infarction
    • 411.0 Postmyocardial infarction syndrome
    • 411.89 Other acute ischemic heart disease
    • 413.0  Angina decubitus
    • 413.1 Prinzmetal angina
    • 413.9 Other and unspecified angina pectoris
    • 786.05 Shortness of breath
    • 786.50 Chest pain, unspecified
    • 786.51 Precordial pain
    • 786.52 Painful respiration
    • 786.59 Other chest pain

    For Asthma

    • 493.01 Extrinsic asthma with status asthmaticus
    • 493.02 Extrinsic asthma with acute exacerbation
    • 493.11 Intrinsic asthma with status asthmaticus
    • 493.12 Intrinsic asthma with acute exacerbation
    • 493.21 Chronic obstructive asthma with status asthmaticus
    • 493.22 Chronic obstructive asthma with acute exacerbation
    • 493.91 Asthma, unspecified with status asthmaticus
    • 493.92 Asthma, unspecified with acute exacerbation

    For Congestive Heart Failure

    • 428.0 Congestive heart failure
    • 428.1 Left heart failure
    • 428.9 Heart failure, unspecified

    The required tests are as follows:

    For chest pain, at least two sets of cardiac enzymes and two sequential electrocardiograms.

    For asthma, a peak expiratory flow rate (PEFR) (CPT code 94010).

    For congestive heart failure, a chest x-ray, an electrocardiogram, and pulse oximetry. Start Printed Page 59884

    5. List of Procedures That Will Be Paid Only As Inpatient Procedures

    Section 1833(t)(1)(B)(i) of the Act gives the Secretary broad authority to determine the services to be covered and paid for under OPPS. In the April 7, 2000 final rule, we defined a set of services that are typically provided only in an inpatient setting and, hence, would not be paid by Medicare under the OPPS (65 FR 18455). This set of services is referred to as the “inpatient list.” The inpatient list specifies those services that are appropriate to provide only in an inpatient setting and that, therefore, are only paid when provided in an inpatient setting. These are services that require inpatient care because of the invasive nature of the procedure, the need for at least 24 hours of postoperative recovery time or monitoring before the patient can be safely discharged, or the underlying physical condition of the patient.

    At its February 2001 meeting, the APC Advisory Panel generally favored the elimination of the inpatient list. In the proposed rule, we stated that we disagreed with the position taken by the Panel and we proposed to continue the current policy of reviewing the HCPCS codes on the inpatient list and eliminating procedures from the list if they can be appropriately performed on the Medicare population in the outpatient setting. Our medical and policy staff, supplemented as appropriate by the APC Advisory Panel, would review comments submitted by the public and consider advances in medical practice in making decisions to remove codes from the list. We stated that we would continue to use the following criteria, which we discussed in the April 7, 2000 final rule, when deciding to remove codes from the list:

    • Most outpatient departments are equipped to provide the services to the Medicare population.
    • The simplest procedure described by the code may be performed in most outpatient departments.
    • The procedure is related to codes we have already moved off the inpatient list (for example, the radiologic part of an interventional cardiology procedure).

    In the proposed rule, we indicated that we would continue to update the list in response to comments as often as quarterly through program memoranda to reflect current advances in medical practice. We proposed no further changes to the inpatient list, which we set forth in Addendum E to the proposed rule.

    Comment: Several specialty organizations, hospitals, and device manufacturers recommended that we remove certain procedures from the inpatient only list and assign them to APCs.

    Response: We reviewed these requests in accordance with our previously published criteria and moved several of the procedures from the list. However, in our clinical judgment, the remainder of the procedures should not be moved. We are referring some of them to the APC Advisory Panel for review and further discussion at the next meeting. As noted in the proposed rule, we plan to continue updating the list on a quarterly basis, as needed. Set forth below is the list of procedures that commenters requested be moved off the inpatient list and the final action that we are taking in this rule.

    Procedures That Remain Inpatient

    • 34800—Endovascular repair of infrarenal abdominal aortic aneurysm or dissection
    • 34802—Endovascular repair of infrarenal abdominal aortic aneurysm or dissection
    • 34804—Endovascular repair of infrarenal abdominal aortic aneurysm or dissection
    • 34808—Endovascular placement of iliac artery occlusion device
    • 34812—Open femoral artery exposure for delivery of aortic endovascular prosthesis
    • 34813—Placement of femoral-femoral prosthetic graft
    • 34820—Occlusion during endovascular therapy
    • 34825—Placement of proximal or distal extension prosthesis
    • 34826—Infrarenal abdominal aortic aneurysm
    • 33968—Removal of intra-aortic balloon assist device, percutaneous
    • 44901—Incision and drainage of appendiceal abscess; percutaneous
    • 49021—Drainage of peritoneal abscess or localized peritonitis; percutaneous
    • 49041—Drainage of subdiaphragmatic or subphrenic abscess; percutaneous
    • 49061—Drainage of retroperitoneal abscess; percutaneous
    • 61624—Transcatheter occlusion or embolization (e.g., for tumor destruction, to achieve hemostasis, to occlude a vascular malformation), percutaneous, any method; central nervous system (intracranial, spinal cord)

    Procedures Referred to the APC Advisory Panel

    • 21390—Open treatment of orbital floor blowout fracture
    • 27216—Percutaneous skeletal fixation of posterior pelvic ring fracture and/or dislocation
    • 27235—Percutaneous skeletal fixation of femoral fracture, proximal end, neck
    • 32201—Pneumonostomy; with percutaneous drainage of abscess or cyst
    • 47490—Percutaneous cholecystostomy
    • 64820—Sympathectomy, digital arteries, with magnification, each digit
    • 92986—Percutaneous balloon valvuloplasty; aortic valve
    • 92987—Percutaneous balloon valvuloplasty; mitral valve
    • 92990—Percutaneous balloon valvuloplasty; pulmonary valve
    • 92997—Percutaneous transluminal pulmonary artery balloon angioplasty; single vessel
    • 92998—Percutaneous transluminal pulmonary artery balloon angioplasty; each additional vessel (list separately in addition to code for primary procedure)

    Procedures Moved to APCs

    • 23440—Resection or transplantation of long tendon of biceps (APC 0052)
    • 23470—Arthroplasty, glenohumeral joint; hemiarthroplasty (APC 0048)
    • 47011—Hepatotomy; for percutaneous drainage of abscess or cyst, one or two stages (APC 0005)
    • 48511—External drainage, pseudocyst of pancreas; percutaneous (APC 0005)
    • 49200—Excision or destruction by any method of intra-abdominal or retroperitoneal tumors or cysts or endometriomas (APC 0130)
    • 50021—Drainage of perirenal or renal abscess; percutaneous (APC 0005)
    • 58823—Drainage of pelvic abscess, transvaginal or transrectal approach, percutaneous (APC 0193)
    • 61626—Transcatheter occlusion or embolization (e.g., for tumor destruction, to achieve hemostasis, to occlude a vascular malformation), percutaneous, any method; non-central nervous system, head or neck extracranial, brachiocephalic branch) (APC 0081)
    • 61791—Creation of lesion by stereotactic method, percutaneous, by neurolytic agent (e.g., alcohol, thermal, electrical, radiofrequency); trigeminal medullary tract (APC 0204)
    • 63655—Laminectomy for implantation of neurostimulator electrodes, plate/paddle, epidural (APC 0225)

    6. Additional New Technology APC Groups

    In the April 7, 2000 final rule, we created 15 new technology APC groups to pay for new technologies that do not meet the statutory requirements for Start Printed Page 59885transitional pass-through payments and for which we have little or no data upon which to base assignment to an appropriate APC. APC groups 0970 through 0984 are the current new technology APCs. We currently assign services to a new technology APC for 2 to 3 years based solely on costs, without regard to clinical factors. This method of paying for new technologies allows us to gather data on their use for subsequent assignment to a clinically-based APC. Payment rates for the new technology APCs are based on the midpoint of ranges of possible costs.

    After evaluating the costs of services in the new technology APCs, we proposed that APC 0982, which covers a range of costs from $2500 to $3500, be split into two APCs, as follows: APC 0982, which would encompass services whose costs fall between $2500 and $3000, and APC 0983, which would encompass those services whose costs fall between $3000 and $3500. APC 0984 would then encompass services whose costs fall between $3500 and $5000 and we would create a new APC, 0985, for services whose costs fall between $5000 and $6000. We believe that subdividing the current range of costs within APC 0982 would allow us to pay more accurately for the services in that cost range.

    In section VI.G of this preamble, we describe several modifications and refinements to the criteria and process for assigning services to new technology APCs that we are implementing in this final rule.

    We received no comments on adding a new technology APC group and have included this change in the final APCs. However, we note that in this final rule, we are making additional changes to the new technology APCs to improve our ability to pay appropriately for new technology services.

    We are designating 16 additional APC groups, APCs 0706 through 0721, as new technology APCs and reassigning some services currently assigned to APC groups 0970 through 0985 so that, beginning with services furnished on or after January 1, 2002, there will be two parallel sets of new technology APCs. This is an administrative adjustment to distinguish between those new technology services designated with a status indicator of “S” and those designated “T.” The new APCs will allow us to assign to the same APC group procedures that are appropriately subject to a multiple procedure payment reduction (T) with those that should not be so discounted (S). Each set of new technology APC groups will have identical group titles, payment rates, and minimum unadjusted copayments, but a different status indicator. That is, the new technology APC groups 0970 through 0985 will, effective January 1, 2002, be assigned status indicator “T” and all services grouped in APCs 970 through 985 will be subject to the multiple procedure reduction. Each of the new technology APC groups 0706 through 0721 will be assigned status indicator “S.” Therefore, effective January 1, 2002, new technology services currently grouped under APC 0971, 0974, 0976, and 0981 are reassigned to APC 0707, 0710, 0712, and 0717, respectively, in order to retain the payment status indicator “S.”

    D. Recalibration of APC Weights for CY 2002

    Section 1833(t)(9)(A) of the Act requires that the Secretary review and revise the relative payment weights for APCs at least annually beginning in 2001 for application in 2002. In the April 7, 2000 final rule (65 FR 18482), we explained in detail how we calculated the relative payment weights that were implemented on August 1, 2000 for each APC group. Except for some reweighting due to APC changes, these relative weights continued to be in effect for 2001. (See the November 13, 2000 interim final rule (65 FR 67824-67827).)

    To recalibrate the relative APC weights for services furnished on or after January 1, 2002 and before January 1, 2003, we proposed to use the same basic methodology that we described in the April 7, 2000 final rule to recalibrate the relative weights for 2002. That is, we would recalibrate the weights based on claims and cost report data for outpatient services. We proposed to use the most recent available data to construct the database for calculating APC group weights. For the purpose of recalibrating the proposed APC relative weights for 2002, the most recent available claims data are the approximately 98 million final action claims for hospital outpatient department services furnished on or after July 1, 1999 and before July 1, 2000. We matched these claims to the most recent cost report filed by the individual hospitals represented in our claims data. The APC relative weights would continue to be based on the median hospital costs for services in the APC groups.

    The methodology we followed to calculate the final APC relative weights for CY 2002 is similar to the proposed except that there are now over 107 million final action claims and as discussed below in section VII of this preamble, we have incorporated a portion of pass-through device costs into device-related procedures. That action has increased the median costs for those procedures. The methodology for calculating the final APC relative weights is as follows:

    • We excluded from the data approximately 16.2 million claims for those bill and claim types that would not be paid under the OPPS (for example, bill type 72X for dialysis services for patients with ESRD).
    • Using the most recent available cost report from each hospital, we converted billed charges to costs and aggregated them to the procedure or visit level first by identifying the cost-to-charge ratio specific to each hospital's cost centers (“cost center specific cost-to-charge ratios” or CCRs) and then by matching the CCRs to revenue centers used on the hospital's 1999-2000 outpatient bills. The CCRs included operating and capital costs but excluded costs paid on a reasonable cost basis that are described elsewhere in this preamble.
    • We eliminated from the hospital CCR data 283 hospitals that we identified as having reported charges on their cost reports that were not actual charges (for example, they make uniform charges for all services).
    • We calculated the geometric mean of the total operating CCRs of hospitals remaining in the CCR data. We removed from the CCR data 67 hospitals whose total operating CCR exceeded the geometric mean by more than 3 standard deviations.
    • We excluded from our data approximately 2.1 million claims from the hospitals that we removed or trimmed from the hospital CCR data.
    • We matched revenue centers from the remaining universe of approximately 89.1 million claims to CCRs of 5,672 hospitals.
    • We separated the 89.1 million claims that we had matched with a cost report into two distinct groups: single-procedure claims and multiple-procedure claims. Single-procedure claims were those that included only one HCPCS code (other than laboratory and incidentals such as packaged drugs and venipuncture) that could be grouped to an APC. Multiple-procedure claims included more than one HCPCS code that could be mapped to an APC. There were approximately 39.9 million single-procedure claims and 49.2 million multiple-procedure claims.
    • To calculate median costs for services within an APC, we used only single-procedure bills. We did not use multiple-procedure claims because we are not able to specifically allocate charges or costs for packaged items and services such as anesthesia, recovery room, drugs, or supplies to a particular Start Printed Page 59886procedure when more than one significant procedure or medical visit is billed on a claim. Use of the single-procedure bills minimizes the risk of improperly assigning costs to the wrong procedure or visit.
    • For each single-procedure claim, we calculated a cost for every billed line item charge by multiplying each revenue center charge by the appropriate hospital-specific CCR. If the appropriate cost center did not exist for a given hospital, we crosswalked the revenue center to a secondary cost center when possible, or to the hospital's overall cost-to-charge ratio for outpatient department services. We excluded from this calculation all charges associated with HCPCS codes previously defined as not paid under the OPPS (for example, laboratory, ambulance, and therapy services).
    • To calculate the per-service costs, we used the charges shown in the revenue centers that contained items integral to performing the service. These included those items that we previously discussed as being subject to our proposed packaging provision. For instance, in calculating the surgical procedure cost, we included charges for the operating room, treatment rooms, recovery, observation, medical and surgical supplies, pharmacy, anesthesia, and donor tissue, bone, and organ. For medical visit cost estimates, we included charges for items such as medical and surgical supplies, drugs, and observation in those instances in which it is still packaged. See sections II.C.1 and II.C.2 of this preamble for a discussion and complete listing of the revenue centers that we used to calculate per-service costs. In addition, for device-related procedures, we incorporated 75 percent of the estimated cost of the pass-through device into the per-service costs.
    • We standardized costs for geographic wage variation by dividing the labor-related portion of the operating and capital costs for each billed item by the current FY 2002 hospital inpatient prospective payment system wage index published in the Federal Register on August 1, 2001 (65 FR 40038). We used 60 percent to represent our estimate of that portion of costs attributable, on average, to labor. A more detailed discussion of wage index adjustments is found in section III of this preamble.
    • We summed the standardized labor-related cost and the nonlabor-related cost component for each billed item to derive the total standardized cost for each procedure or medical visit.
    • We removed extremely unusual costs that appeared to be errors in the data using a trimming methodology analogous to what we use in calculating the DRG weights for the hospital inpatient PPS. That is, we eliminated any bills with costs outside of 3 standard deviations from the geometric mean.
    • After trimming the procedure and visit level costs, we mapped each procedure or visit cost to its assigned APC, including, to the extent possible, the proposed APC changes described elsewhere in this preamble.
    • We calculated the median cost, weighted by procedure volume, for each APC.
    • Using the weighted median APC costs, we calculated the relative payment weights for each APC. We scaled all the relative payment weights to APC 0601, Mid-level clinic visit, because it is one of the most frequently performed services in the hospital outpatient setting. This approach is consistent with that used in developing relative value units for the Medicare physician fee schedule. We assigned APC 0601 a relative payment weight of 1.00 and divided the median cost for each APC by the median cost for APC 0601, to derive the relative payment weight for each APC. The median cost for APC 0601 is $54.00.

    Section 1833(t)(9)(B) of the Act requires that APC reclassification and recalibration changes and wage index changes be made in a manner that ensures that aggregate payments under the OPPS for 2002 are neither greater than nor less than the aggregate payments that would have been made without the changes. To comply with this requirement concerning the APC changes, we compared aggregate payments using the CY 2001 relative weights to aggregate payments using the CY 2002 final weights. Based on this comparison, in this final rule we are making an adjustment of 0.945 to the weights; that is, each weight is reduced by this factor (the scaler). The final weights for 2002, which incorporate the recalibration adjustments explained in this section, are listed in Addendum A and Addendum B of the final rule.

    We note that in the proposed rule, we inadvertently applied the weight adjustment factor of 1.022 to the relative weights of the new technology APCs. This was incorrect. The payment rates for the new technology APCs are based on the mid-point of the cost range represented by the APC. Therefore the payment rates should be static from year to year. In this final rule, the payment rates for APCs 0970-0985 correctly reflect no adjustment.

    Comment: We received numerous comments regarding HCPCS codes and APC groups for which the payment rate proposed for 2002 is lower than the current payment rate. Commenters expressed concern that the proposed decrease in payment would have adverse effects both on beneficiary access to services and hospital solvency. Many commenters suggested that a lower rate was a data or a calculation error and requested that a particular weight be confirmed. Many commenters stated that because the lower proposed payment rate was inadequate to pay hospital costs for the service, we should adjust the rate to a more appropriate level.

    Response: As explained above, the methodology we used to recalibrate the final 2002 relative weights is essentially the same methodology that we followed to recalibrate the weights in the August 24, 2001 proposed rule, with the exception of the additional step of folding pass-through device costs into certain base APC costs. (We discuss the reason for this additional step in the November 2, 2001 OPPS final rule (66 FR 55857).)

    In both the proposed rule and this final rule, the relative weights for the APC groups change for two reasons: The use of more recent claims data, and the statutory requirements governing how payment for all services under the OPPS must be determined.

    The use of more recent claims data: We calibrated the relative weights published in the April 7, 2000 final rule using, as required by the statute, claims from 1996 and data from the most recent available hospital cost reports. These relative payment weights were implemented on August 1, 2000 and they have remained largely unchanged throughout 2001. In the August 24 proposed rule, we proposed to use the same basic methodology to recalibrate the weights that we described in the April 7, 2000 final rule (65 FR 18482). But we also proposed to use the most recent available data, rather than 1996 data, to construct the database for calculating APC group weights. For 2002, the most recent data are from final action claims for hospital outpatient services furnished beginning July 1, 1999 through June 30, 2000. In recalibrating the final weights for 2002, we had the benefit of data from additional claims that had not been received when we recalibrated the relative payment weights for the August 24, 2001 proposed rule. We matched these claims to the most recent cost report filed by the various hospitals represented in the claims data. Hospital costs reflected in claims for the period July 1, 1999 through June 30, 2000 have Start Printed Page 59887changed from those taken from 1996 claims.

    Statutory requirements governing how payment for OPPS services is to be determined. Section 1833(t)(9)(B) of the Act requires that estimated spending for services covered under the OPPS be neither greater nor less than it would have been had we not recalibrated the APC weights nor made changes in the APC groups. Because of this, the weights and, therefore, the payment rates for a specific service may increase or decrease depending on the change in charges hospitals report for that service relative to the change in charges hospitals report for other outpatient services.

    Under any prospective payment system or fee schedule that bases rates on a system of relative weights within limits imposed by a budget neutrality requirement, some weights will increase and others will decrease from year to year. A decrease in the relative weight for an APC is the result of a decrease in the relative level of charges for the services in that APC that hospitals reported for the period from July 1, 1999 through June 30, 2000, compared to the relative level of charges the same hospitals reported for all other outpatient services furnished during the same period. In addition, the application of the budget neutrality adjustment required by section 1833(t)(9)(B) of the Act will further decrease a relative weight if the adjustment is less than 1.000.

    In this final rule, some weights are lower than what we had proposed. The further lowering of weights for some APCs is the result of our incorporating a portion of the cost of pass-through devices into the basic costs of the APCs with which the devices are associated. As we explained in the final rule published on November 2, 2001 (66 FR 55857), the portion of the pass-through device costs that were incorporated into APC costs are not evenly distributed among the APCs, but rather are concentrated in a relatively small number of APCs that include the procedures that use pass-through devices. Whereas the weights of these APCs have increased as a result of the added device costs, the weights for all APCs that do not include device costs have decreased.

    In preparing the weights for this final rule, we were particularly attentive to APCs such as APC 0169, Lithotripsy, APC 0245, Level I Cataract Procedures without IOL Insert, and APC 0246, Cataract Procedures with IOL Insert, about which commenters had expressed concern. As a result, we have a high level of confidence in the appropriateness of the weights that are in this final rule. Therefore, we are not increasing the relative weight or payment rate for an APC group simply because its payment is lower in 2002 than it was in 2001 nor are we reducing the relative weight or payment rate for an APC group simply because its payment is higher in 2002 than it was in 2001.

    III. Wage Index Changes

    Under section 1833(t)(2)(D) of the Act, we are required to determine a wage adjustment factor to adjust for geographic wage differences, in a budget neutral manner, that portion of the OPPS payment rate and copayment amount that is attributable to labor and labor-related costs.

    We used the May 4, 2001 proposed Federal fiscal year (FY) 2002 hospital inpatient PPS wage index (66 FR 22646) to make wage adjustments in determining the proposed payment rates set forth in the proposed rule. We also proposed to use the final FY 2002 hospital inpatient wage index to calculate the final CY 2002 payment rates and coinsurance amounts for OPPS. We received no comments on this issue and are implementing our proposed policy in final.

    The final FY 2002 hospital inpatient wage index published in the August 1, 2001 Federal Register (66 FR 39828) is reprinted in this final rule as Addendum H, Wage Index for Urban Areas; Addendum I, Wage Index for Rural Areas; and Addendum J, Wage Index for Hospitals That Are Reclassified. Those wage index values will be used to calculate the OPPS payment rates and coinsurance amounts for calendar year (CY) 2002.

    IV. Copayment Changes

    We note that in section 1833(t) of the Act, the terms “copayment” and “coinsurance” appear to be used interchangeably. To be consistent with CMS usage, we make a distinction between the two terms throughout this preamble. We are making conforming changes to part 419 of the regulations to reflect the following usage:

    • Coinsurance” means the percent of the Medicare-approved amount that beneficiaries pay for a service furnished in the hospital outpatient department (after they meet the Part B deductible).
    • Copayment” means the set dollar amount that beneficiaries pay under the OPPS. For example, if the payment rate for an APC is $200 and the beneficiary is responsible for paying $50, the copayment is $50 and the coinsurance is 25 percent.

    A. BIPA 2000 Coinsurance Limit

    As discussed in section I.C of this preamble, certain provisions of BIPA 2000 affect beneficiary copayment amounts under the OPPS. Section 111 of the BIPA added section 1833(t)(8)(C)(ii) of the Act, to accelerate the reduction of beneficiary copayment amounts, providing that, for services furnished on or after April 1, 2001 and before January 1, 2002, the national unadjusted coinsurance for an APC cannot exceed 57 percent of the APC payment rate. The statute provides for further reductions in future years so that the national unadjusted coinsurance for an APC cannot exceed 55 percent in 2002 and 2003, 50 percent in 2004, 45 percent in 2005, and 40 percent in 2006 and thereafter.

    We implemented the reduction in beneficiary copayments for 2001 effective April 1, 2001 through changes to the OPPS PRICER software used to calculate OPPS payments to hospitals from the Medicare Program and beneficiary copayments.

    We proposed to revise § 419.41 to conform the regulations text to this provision.

    We received no comments on this proposal and are implementing the required 55 percent limit on the national unadjusted coinsurance rate of the final APCs. We are also adopting as final the proposed changes to the regulations text.

    B. Impact of BIPA 2000 Payment Rate Increase on Coinsurance

    Under the statute as enacted by BBA 1997, APC payment rates for 2001 were to be based on the payment rates for 2000 increased by the inpatient hospital market basket percentage increase minus 1 percentage point; however, section 401 of the BIPA 2000 increased APC payment rates for 2001 to reflect an update based on the full market basket percentage increase. The Congress intended for the increased payment to be in effect for the entire calendar year 2001; however, to provide us sufficient time to make the change, the Congress adopted a special payment rule for 2001. Under section 401(c) of the BIPA, the payment rates in effect for services furnished on or after January 1, 2001 and before April 1, 2001 are the rates as determined under the statute prior to the enactment of BIPA. For services furnished on or after April 1, 2001 and before January 1, 2002 the payment rates reflect the full market basket update and are further increased by 0.32 percent to account for the timing delay in implementing the full market basket update for 2001. The 0.32 percent Start Printed Page 59888increase is a temporary increase that applies only to the period April 1 through December 31, 2001 and is not considered in updating the OPPS conversion factor for 2002. The increase in APC payment rates for 2001 was implemented effective April 1, 2001 through changes to the OPPS PRICER software. We proposed to revise § 419.32 to conform to the statute.

    The section 401 increase to the APC payment rates affected beneficiary copayments in several ways. In cases for which the beneficiary coinsurance was already based on 20 percent of the APC payment rate, the increase in the APC payment rate caused a corresponding increase in the copayment for the APC. For all other APCs, the copayment amount remained at the same level. In addition, because the minimum copayment amount for an APC, which is the lowest amount a provider may elect to charge if it chooses to reduce copayments for an APC, is based on 20 percent of the APC amount, the increase to an APC payment rate under section 401 of BIPA resulted in an increase to the minimum copayment amount for each APC.

    We received no comments on this issue, and we are implementing the changes to the regulations text in final.

    C. Coinsurance and Copayment Changes Resulting From Change in an APC Group

    National unadjusted copayment amounts for the original APCs that went into effect on August 1, 2000 were, by statute, based on 20 percent of the national median charge billed for services in the APC group during calendar year 1996, trended forward to 1999, but could be no lower than 20 percent of the APC payment rate. Although the BBA 1997 specified how copayments were to be determined initially, the statute does not specify how copayments are to be determined in the future as the APC groups are recalibrated or as individual services are reclassified from one APC group to another. In the proposed rule, we provided the method we intend to apply in determining copayments for new APCs (that is, those created after 2001) and for APCs that are revised because of recalibration and reclassification. We also discussed the issues we considered in developing a proposed approach to be used in determining copayments for new or revised APCs.

    The following describes how we proposed to determine copayment amounts for new and revised APCs for 2002 and subsequent years:

    1. If a newly created APC group consists of services that were not included in the 1996 data base or whose charges were not separately calculated in that data base (that is, the services were excluded or packaged) the unadjusted copayment amount would be 20 percent of the APC payment rate.

    2. If recalibrating the relative payment weights results in an APC having a decrease in its payment rate for a subsequent year, the unadjusted copayment amount will be calculated so that the coinsurance percentage for the APC remains the same as it was before the payment rate decrease. For example, assume the APC had a payment rate of $100 and an unadjusted copayment amount of $50, resulting in a coinsurance percentage of 50 percent. If the new payment rate for the APC is lowered to $80, the copayment amount is calculated using the prior coinsurance percentage of 50 percent; therefore, the new copayment amount would be 50 percent of $80 or $40.

    3. If recalibrating the relative payment weights results in an APC having an increase in its payment rate for a subsequent year, the unadjusted copayment amount would be calculated so that the copayment dollar amount for the APC remains the same as it was before the payment rate increase. That is, the unadjusted copayment amount would not change. For example, assume the APC had a payment rate of $100 and an unadjusted copayment amount of $60 (a coinsurance percentage of 60 percent). If the new payment rate for the APC is increased to $150, the unadjusted copayment amount would remain at $60 (a coinsurance percentage of 40 percent).

    4. If a newly created APC group consists of services from two or more existing APCs, the unadjusted copayment amount would be calculated based on the lowest coinsurance percentage of the contributing APCs. For example, a new APC is created by moving some or all of the services from two existing APCs into the new APC. Assume that one contributing APC had a payment rate of $100 and an unadjusted copayment amount of $40, a coinsurance percentage of 40 percent. Assume the other contributing APC had a payment rate of $150 and an unadjusted copayment amount of $75, a coinsurance percentage of 50 percent. If the new APC had a payment rate of $130, the unadjusted copayment amount for the new APC would be based on a coinsurance percentage of 40. The unadjusted copayment amount for the new APC would be 40 percent of $130, or $52.

    These changes will in general reduce beneficiary copayment for services in affected APCs. For 2002, we believe the size of these changes will be modest. If in the future the size of such changes appears likely to be large, we may revisit this policy.

    5. If an APC payment rate is increased due to a conversion factor update, the unadjusted copayment amount for the APC would not change.

    We received no comments on this proposal. Therefore, we are implementing the proposed methodology for calculating copayment amounts in this final rule.

    V. Outlier Policy Changes

    For OPPS services furnished before January 1, 2002, section 1833(t)(5)(D) of the Act explicitly authorizes the Secretary to apply the outlier payment provision based upon all of the OPPS services on a bill. We exercised that authority and, since the beginning of the OPPS on August 1, 2000, we have calculated outlier payments in the aggregate for all OPPS services that appear on a bill. However, beginning January 1, 2002, we proposed to calculate outlier payments based on each individual OPPS service. That is, we proposed to revise the aggregate method that we are currently using to calculate outlier payments and begin to determine outliers on a service-by-service basis for OPPS services furnished on or after January 1, 2002.

    In the proposed rule, we discussed in detail the difficulties we faced with calculating outliers based on individual services. We also discussed possible solutions to those problems including requiring hospitals to submit separate bills for each OPPS service and allocating the charges for any packaged service among the individual OPPS services that appear on the bill. We stated that we prefer using one of the approaches that would allocate packaged charges among the APCs on a bill to avoid disruptive billing changes. We proposed that charges be allocated to each OPPS service based on the percent the APC payment rate for that service bears to the total APC rates for all OPPS services on the bill.

    We also proposed to convert charges to costs for calculating outlier payments by continuing to apply a single overall hospital-specific cost-to-charge ratio instead of applying hospital-specific departmental cost-to-charge ratios. In the proposed rule, we explained that, for purposes of calculating outlier payments under the OPPS, the use of departmental cost-to-charge ratios is not feasible given currently available information because we do not have a way of defining, in a uniform manner that is accurate for all hospitals, which departmental cost-to charge ratio to Start Printed Page 59889apply to a revenue code billed by a hospital. We also explained that collecting the data necessary to make it feasible to use departmental cost-to-charge ratios would impose significant burden and administrative costs on hospitals and our contractors. We then stated that given that outliers represent only 2 to 3 percent of total OPPS expenditures, we believe that the increased accuracy in calculating outlier payments that we could gain would not be sufficient to justify the significant additional administrative burden and cost that would be required. For this reason, we proposed to continue to apply a single hospital-specific outpatient cost-to-charge ratio to convert billed charges to costs for calculating outlier payments.

    As explained in the April 7, 2000 final rule (65 FR 18498), we set a target for outlier payments at 2.0 percent of total payments. We also explained that, for purposes of simulating payments to calculate outlier thresholds, we set the parameters for determining outlier payments as if the target were 2.5 percent. We believed that it would be likely that using simulation 1996 claims data would overstate the percentage of payments that would be made. Based on the simulations, we set a threshold for outlier payments at 2.5 times the claim cost and a payment percent of 75 percent of the cost above the threshold for both 2000 and 2001.

    In setting the proposed CY 2002 outlier threshold and payment percentage, we accounted for the change to service level rather than claim level outlier calculation. We proposed to set the target for outlier payment at 2.0 percent as we had for CY 2001. We believe that the claims data we are using to set the 2002 payment rates reflect much better coding of services than did the 1996 data so we set the proposed threshold and proposed payment percentage based on simulations of payments so that the percentage of outlier payments under the simulations was 2.0 percent, rather than 2.5 percent as we did in simulating payments to set the outlier criteria for the April 7, 2000 final rule. Based on our simulations, the proposed threshold for 2002 is 3 times the service costs and the proposed payment percentage for costs above that threshold is set at 50 percent. Based on the simulations using the updated claims data from July 1, 1999 to June 30, 2000, the final threshold for 2002 is 3 times the service costs and the final payment percentage for costs above that threshold is set at 50 percent (the same as the proposed thresholds).

    We received many comments on our proposed changes to the outlier policy, which are summarized below along with our responses.

    Comment: Several commenters expressed concern that we proposed to increase the outlier threshold while lowering the payment percentage without providing sufficient analysis in the proposed rule to document and justify these changes. A number of commenters contended that the quality of the data is not sufficient to justify these dramatic changes and urged us to maintain the current threshold and payment percentage until better data become available. One commenter recommended that we either furnish hospitals with the information that explains the significant changes, providing an additional opportunity to comment, or maintain the current threshold and payment percentage amounts. Another commenter stated that, in the annual proposed and final rules for hospital inpatient PPS, the data to support any modifications to outlier payments are presented in detail and the commenter believes we should include similar information in the annual proposed and final OPPS rules.

    Response: In the April 7, 2000 final rule (65 FR 18498), we described the general methodology that we use to set the outlier threshold and payment percentage. We use historical claims data and simulate payments for those claims by applying the payment rates and policies for the upcoming year. We calibrate the threshold and payment percentage by applying an iterative process in which we try different combinations of thresholds and payment percentages until an appropriate combination results in outlier payments under the simulation equal to the target percentage (for purposes of the simulation) of total OPPS payments under the simulation.

    There are two major sources of the changes between the threshold and payment percentage for 2001 and these proposed 2002. First, the outlier payment simulations for the proposed rule reflected the proposed change in the outlier payment policy from a bill-level calculation to service-level calculation. Second, the outlier payment simulations for the proposed rule were based on updated claims data which were considerably more recent than the 1996 claims we used previously. We believe that the updated data reflect more accurate coding of the outpatient services hospitals furnished compared to the 1996 data.

    When updated data or a change in policy (or, as in this case, both) dictate a significant change in the outlier parameters, we believe it is, in general, a better policy to adjust both the threshold and the outlier payment percentage. For 2002, an adjustment made only to the threshold amount would greatly limit the number of services that would qualify for an outlier payment. Conversely, an adjustment only to the outlier payment percentage would have significantly decreased the amount of the outlier payment made for the services that do qualify. By adjusting both of the parameters, we hope to strike a balance. That is, for 2002 as compared to 2001, we do not wish to drastically lower the number of services qualifying for outlier payment nor do we wish to significantly decrease the amount of payment hospitals may receive for services that qualify as outliers. Based on this premise, we both raised the outlier threshold and decreased the payment percentage in order to prevent, to the extent possible, large changes in the outlier payments made to hospitals.

    Comment: One commenter stated that, because we provided no data to demonstrate that the target for CY 2001 would be exceeded, we should provide that if the proposed changes are put into place and actual outlier payments in 2002 are significantly less than the 2002 outlier target, the “shortfall” from 2001 and 2002 will be made up by increased outlier payments in subsequent years.

    Response: The outlier threshold and payment percentage are determined each year based on our best estimate of what threshold and payment percentage are needed to achieve a certain level of outlier payments. For example, for CY 2002, we set the threshold and payment percentage based on estimates so that outlier payments are projected to equal 2.0 percent of total OPPS payments.

    Section 1833(t)(5)(C) of the Act requires that the outlier payment estimate for a year be made by the Secretary before the beginning of the year. Consistent with our outlier policies in other prospective payment systems, we will not adjust outlier payments in subsequent years to account for an underestimation (or overestimation) of outlier payments in a previous year. The statute does not provide for such an adjustment. We set the outlier policies prospectively, using the best available data. Outlier payments, like many aspects of a prospective payment system, reflect estimates, and we believe it would be inappropriate to adjust the outlier payments (upward or downward) for a given year simply because an estimate for a previous year ultimately turned out to be inaccurate. If we underestimate or overestimate the percentage of outlier payments, the divergence of our estimate from actual experience may Start Printed Page 59890provide information that might help us improve future estimates, but it would have no direct effect on the amount of outlier payments for any following year.

    Comment: One commenter suggested that we lack reliable data on actual claims experience that are critical in determining which hospitals are receiving outlier payments and for which specific services. The commenter believes that once such data become available, they can be used to improve the APC system, reducing the overall need for outliers and to refine the outlier methodology to target outlier payments as most appropriate.

    Response: As coding on outpatient claims improves, the median costs we use to calculate APC weights and, ultimately, APC payment rates will also more accurately reflect the resources associated with furnishing the services within each APC. It is possible that this may reduce the incidence of outlier payments for specific services as well as decrease the need for outlier payments across all services.

    Comment: One commenter pointed out that the increase in the outlier threshold and the decrease in the percent of the excess costs that will be paid as an outlier payment are based on an outlier target of 2.0 percent of estimated total OPPS payments. In order to not penalize hospitals that treat high cost cases, the commenter recommended that the outlier target be set at 3.0 percent of estimated total OPPS payments.

    Response: Section 1833(t)(5)(C) of the Act limits projected outlier payments for years prior to 2004 to no more than 2.5 percent of projected total OPPS payments. For CY 2002, we proposed to set the target for outlier payments at 2.0 percent. Although we could increase that amount to 2.5 percent, we have chosen not to do so because increasing the outlier target percentage would require a corresponding decrease to APC payment amounts due to budget neutrality. Given the decrease in many of the APC payment rates that results from the incorporation of 75 percent of device pass-through costs into the APCs (see section II.D. of this preamble), we believe it is appropriate not to increase the outlier target percentage so that there is no additional reduction in the APC payments. Once we have claims data that reflect payments made under the OPPS, our analysis of those data may lead us to revise our policy of setting the outlier target below the limit allowed.

    Comment: One commenter estimated that the proposed changes in the threshold and the payment percentage would reduce outlier payments by as much as 50 percent. Several other commenters claimed that the proposed changes would result in drastic cuts in outlier payments to certain community mental health centers (CMHCs) in Louisiana and Mississippi. These commenters contended that the payment reductions would be so severe that CMHCs would be forced to close, thereby eliminating services for the seriously and persistently mentally ill. These commenters requested that the CY 2002 outlier payments for CMHCs continue to be calculated using the CY 2001 outlier threshold and payment percentage.

    Another commenter asked that we provide data on outlier payments made since the implementation of the OPPS to provide greater information about the impact of outliers on cancer care. The commenter stated that, in the area of cancer care, hospital outpatient departments often provide the only access point for patients needing complex therapies or new therapies not yet specifically recognized by the coding system and outlier payments provide an important safeguard against any adverse impact of providing this care. The commenter specifically requested information on how the outlier payments have been applied to cancer patients across the country. If actual outlier payments are less than the 2.0 percent target, the commenter urged us to direct more of the outlier monies to cancer care or apply any difference between projected and actual outlier amounts to the transitional pass-through payments for drugs and devices.

    Response: As discussed above, the difference between the 2001 and proposed 2002 outlier threshold and payment percentage arises from the use of newer claims data and the change to a service-level rather than claim-level outlier payment calculation. In accordance with section 1833(t)(5) of the act, we set a “fixed” threshold that applies to all OPPS services. Thus, we apply a uniform threshold to all OPPS services in a given calendar year; the statute does not provide for different thresholds for different classes of providers or different types of OPPS services. Similarly, we set the payment percentage prospectively before the beginning of each year and apply it to all OPPS services qualifying for outlier payments in that year.

    Currently, we do not have adequate data for OPPS claims to perform a useful analysis of actual outlier payments under the OPPS, but we expect to discuss information on actual outlier payments in future regulation documents after sufficient information becomes available.

    For the suggestion concerning the redistribution of outlier payments to pass-through drugs and devices, we note that the statute provides for both the outlier and transitional pass-through payments and establishes the 2.5 percent limits on those payments for the years before 2004 (when the limit for outliers increases to 3.0 percent and the limit for transitional pass-throughs decreases to 2.0 percent). Thus, we do not have the administrative authority to make the change that this commenter has recommended. Rather, legislative action would be required to make any of these changes.

    Comment: Although some commenters were in favor of calculating outlier payments on an individual service basis, several commenters requested that we reconsider our proposal and recommended that we continue to use the aggregate bill method. Another commenter believes that the increased specificity gained under the proposed outlier methodology would not offset the additional costs and administrative burden to hospitals of making information system changes necessary to calculate and verify outlier payments. One commenter asserted that multiple service claims are not used in calculating the APC relative weights because we are unable to accurately allocate packaged items and services when more than one service is billed on a claim. The commenter is concerned that the same problem would occur with the proposed methodology for paying outliers and recommends that, to avoid inappropriate outlier payments, we should continue to calculate outliers on a claim-level basis until an equitable method of assigning packaged costs is developed.

    Another commenter believes that the current methodology more accurately meets the intent of outlier payments, which is to pay facilities for unusual expenses incurred on behalf of patients, not specific line items or individual services. The commenter stated that the allocation of charges to develop service-by-service outliers presents an administrative problem to those hospitals that must significantly alter their systems in order to monitor and audit their payments.

    Several commenters expressed concern that the proposed service-level approach could result in very few services qualifying for additional payment and asked for a delay in the policy. One hospital association requested a delay so it would have an opportunity to evaluate CYs 2000 and 2001 data to better understand the impact the change would have on its member hospitals. Another hospital Start Printed Page 59891association believes that the data that are currently available (that is, data for services furnished prior to implementation of the OPPS) may not accurately reflect the financial impact of the proposed change and asked for a delay in calculating service-level outliers until OPPS data are available and can be provided to the hospital industry for analysis. Several commenters urged us to delay implementation of service-level outlier calculations until hospitals and fiscal intermediaries had adequate time to perform systems testing related to the change.

    Response: We believe that calculating outliers on a service-by-service basis is the most appropriate way to calculate outliers for outpatient services. Outliers on a bill basis requires both the aggregation of costs and the aggregation of OPPS payments thereby introducing some degree of offset among services; that is, the aggregation of low cost services and high cost services on a bill may result in no outlier payment being made. While service-based outliers are somewhat more complex to administer, under this method, outlier payments will be more appropriately directed to those specific services for which a hospital incurs significantly increased costs. We are revising the outpatient PRICER program to calculate outliers on a service-by-service basis, and we do not anticipate that our contractors will have any significant problems being able to calculate outlier payments under this revised policy.

    Comment: Two commenters requested clarification concerning how outlier payments would be calculated on a service-by-service basis in the case of multiple surgical procedures appearing on the same claim when all of the surgical charges are combined into a single line on the claim. One commenter stated that if hospitals will be required to change the practice of combining surgical charges for all procedures on a single line item, they may require significant resources to comply with such a change.

    Response: The commenters raise a valid concern. When a hospital performs several surgical procedures during the same operative session, it is an acceptable billing practice to show the entire charge for use of the operating room or treatment room on the line with one of the surgical HCPCS codes and zero charges on the lines with the remaining surgical HCPCS codes. We do not intend to require that hospitals change this practice. Hospitals will continue to have the option of splitting out the charges among the individual surgical procedures based on the resources that are attributable to each procedure or they may show a single combined charge with one of the surgical HCPCS codes and zero charges with the others. If the hospital chooses the latter option, in calculating outliers on a service-by-service basis, we will allocate the combined operating or treatment room charge among all of the surgical procedures on the bill. The charges will be allocated to each surgical procedure based on the proportion that the APC payment for the procedure bears to the total APC payments for all surgical procedures performed on that day.

    Comment: One commenter supported calculating outliers on a service-by-service basis and agreed with using an overall cost-to-charge ratio, but disagreed with the proposal to allocate packaged services. Several commenters asserted that while it is not possible to directly assign packaged services to a payable procedure in all cases, it is possible in some cases. As an example, the commenters stated that on a claim with a surgical procedure and a visit or diagnostic service, it would be logical and reasonable to assign anesthesia, recovery room, and device charges completely to the surgical procedure, instead of allocating a portion to the visit or diagnostic service.

    Another commenter recommended that we modify our proposal for allocating packaged services and develop a set of rules to directly assign the packaged services for those obvious situations when there is a clear relationship of the packaged item or service to the payable service or procedure.

    Response: We believe that the policy the commenters are recommending is problematic. For example, anesthesia and recovery room services are not limited to surgical procedures but may also be billed with certain diagnostic procedures. Although we agree that we may in the future be able to improve the allocation of packaged services for a service-level outlier calculation, we also must be careful that the calculation does not become so complex that hospitals are unable to understand how their outlier payments have been determined. Therefore, we are not adopting the commenter's suggestion. We will however continue to analyze possible refinements to this policy.

    Comment: One commenter acknowledged the complexities we would face in using a cost report line-specific method of calculating the cost-to-charge ratios (CCRs) for outlier payments but believes the issue warrants further study. The commenter contends that using line-specific CCRs is the only way to ensure that outlier payments are equitable on a service level.

    Response: We agree with the commenter that applying appropriate departmental cost-to-charge ratios (CCRs) would generally be more accurate than using an overall outpatient CCR. However, as discussed above and in the proposed rule, it is currently unfeasible to use departmental cost-to-charge ratios for purposes of outlier payments under the OPPS because we currently do not have the necessary information. We continue to believe that the increased accuracy that would be achieved by use of departmental CCRs would not justify the significant administrative burden that would be placed on both hospitals and fiscal intermediaries.

    Comment: A number of commenters raised concerns about the hospital-specific CCRs we have used since the beginning of OPPS to calculate outlier payments as well as transitional pass-through payments and interim transitional corridor payments. The commenters raised issues relating to the accuracy of CCR calculations, the basis of future CCR updates, and the timing of CCR updates.

    Response: We are working on instructions to our fiscal intermediaries that will address both how and when the CCRs will be revised and updated and those instructions will be published in a forthcoming program memorandum.

    VI. Other Policy Decisions and Proposed Changes

    A. Change in Services Covered Within the Scope of the OPPS

    Section 1833(t)(1)(B) of the Act defines the term “covered OPD services” that are to be paid under the OPPS. “Covered OPD services” are “hospital outpatient services designated by the Secretary” and include “inpatient hospital services designated by the Secretary that are covered under this part and furnished to a hospital inpatient who (1) is entitled to benefits under Part A but has exhausted benefits for inpatient hospital services during a spell of illness, or (2) is not so entitled” (that is, “Part B-only” services). “Part B-only” services are certain ancillary services furnished to inpatients for which the hospital receives payment under Medicare Part B. These services, which are specified in section 3110 of the Medicare Intermediary Manual and section 2255C of the Medicare Carriers Manual include diagnostic tests; X-ray and radioactive isotope therapy; surgical dressings, splints and casts; prosthetic Start Printed Page 59892devices; and limb braces and trusses and artificial limbs and eyes.

    In the April 7, 2000 final rule, we included inpatient “Part B-only” services within the definition of services payable under the OPPS (68 FR 18543). In the proposed rule, we discussed some hospitals' concerns about the administrative burden and prohibitive costs they would incur if they were to change their billing systems to accommodate OPPS requirements solely to receive payment for “Part B-only” services. We proposed to revise § 419.22 by adding paragraph (r) to exclude Part B-only services that are furnished to inpatients of hospitals that do no other billing for hospital outpatient services under Part B from payment under the OPPS.

    We noted that under this proposed revision of the regulations, hospitals with outpatient departments would continue to bill under the OPPS for Part B-only services that they furnish to their inpatients. However, a hospital that does not have an outpatient department would be unable to bill under the OPPS for any Part B-only service the hospital furnished to its inpatients because those services would not fall within the scope of covered OPD services. If a hospital with no outpatient department is currently billing under the OPPS, the hospital would have to revert to its previous payment methodology for services furnished on or after January 1, 2002. That methodology would be an all-inclusive rate for hospitals paid that way prior to the implementation of OPPS and reasonable cost for other hospitals.

    We received several comments on this proposal, which are summarized below.

    Comment: Several commenters requested that the proposed change be made retroactive to the implementation of OPPS on August 1, 2000. These commenters observed that, without retroactive effect, the hospitals would be unable to bill for inpatient ancillary services provided to beneficiaries with Part B-only coverage during the period from August 1, 2000 until January 1, 2002. Another commenter contended that the proposed policy should have retroactive effect. The commenter raised two alternative reasons for this contention. One was that section 1833(t)(1)(B)(ii) of the Act should not have been interpreted to apply to inpatients who have exhausted their Part A coverage because of the 190-day lifetime limit on inpatient psychiatric days, because the statutory language refers only to hospital inpatients who have “exhausted benefits for inpatient hospital services during a spell of illness.” The other was that, allegedly, CMS had never designated through formal regulations those Part B services that are subject to the OPPS. Until such a rule is adopted, the commenter contended, no service provided on an inpatient basis to beneficiaries with Part B-only coverage can be subject to OPPS.

    Response: Contrary to the assertion of the commenter, we have in fact designated those Part B services to be covered under the OPPS through formal regulations. In the April 7, 2000, final rule, we specifically included services furnished to inpatients who have exhausted their Part A benefits in the list of “Services Included Within the Scope of the Hospital Outpatient PPS,” and provided examples of those services (65 FR 18444). The statutory language gives the agency broad authority to define the services that are to be included under the OPPS. The statute broadly includes both “hospital outpatient services designated by the Secretary” and “inpatient hospital services designated by the Secretary that are covered under this part and furnished to a hospital inpatient who (1) is entitled to benefits under Part A but has exhausted benefits for inpatient hospital services during a spell of illness, or (2) is not so entitled” within the definition.

    We designated Part B-only services as OPPS services through notice and comment rulemaking, and the policy has been in effect since the inception of OPPS. As discussed in the proposed rule, representatives of hospitals approached us after publication of the April 7, 2000 final rule to express concerns about the policy. We have considered those concerns, and we are changing the policy prospectively. We believe not only that applying the policy change on a prospective basis only is fair (particularly given that the current policy was established through notice and comment rulemaking) but also that applying the policy change on a retroactive basis would constitute impermissible retroactive rulemaking.

    Comment: Several commenters requested that CMS clarify that those hospitals to which this change applies may resume billing under the per diem based methodology that they employed prior to the implementation of OPPS.

    Response: As we stated in the proposed rule (66 FR 44699), “If a hospital with no outpatient department is currently billing under the OPPS, the hospital would have to revert to its previous payment methodology for services furnished on or after January 1, 2002. That methodology would be an all-inclusive rate for hospitals paid that way prior to the implementation of OPPS and reasonable cost for other hospitals.” The hospitals to which this change applies may therefore resume billing under the per diem or reasonable cost methodology that was applicable to them prior to the implementation of the OPPS.

    Comment: One commenter asked that we recognize the situation of two other classes of hospitals. Some hospitals that have outpatient departments submit claims for only a limited range of outpatient services under Part B. Other hospitals have outpatient departments (for example, for children's psychiatric services) but submit no claims under Medicare Part B. The commenter contended that these hospitals do not have the capacity to bill for the full range of inpatient ancillary services under the OPPS.

    Response: We believe that it is very important to restrict this exception to those hospitals that do not provide Medicare Part B services through an outpatient department. As stated in the April 7, 2000 final rule, in developing a hospital OPPS, we “wanted to ensure that all services furnished in a hospital outpatient setting will be paid on a prospective basis.” (65 FR 18442.) We believe that hospitals that have outpatient departments and that bill for some outpatient services under Part B should also be paid for the services in question under the OPPS. Therefore, those hospitals will not be excluded from billing under the OPPS. On the other hand, the exception will apply to those hospitals that do not bill under Medicare Part B, even if they have outpatient departments; that is, they do not treat Medicare beneficiaries in their outpatient departments.

    Comment: Several commenters requested that CMS clarify whether the proposed provision in § 419.22(r) of the regulations would include therapy services (for example, physical therapy) so that the State psychiatric hospitals included in the exception could resume billing therapies at the per diem all-inclusive rate. The commenters pointed out that these services are currently included in the list of ancillary services under section 3110 of the Medicare Intermediary Manual and section 2255C of the Medicare Carrier Manual. In the proposed rule, CMS specified that the Part B-only services to which the proposed exception would apply were ancillary services listed in those manual sections, but did not specifically list the therapy services in the proposed rule. Some of these commenters raised the same question about diagnostic laboratory services, which CMS had also not specifically listed in the preamble text, but which are included in the list of ancillary services under section 3110 Start Printed Page 59893of the Medicare Intermediary Manual and section 2255C of the Medicare Carrier Manual.

    Response: Section 1833(t)(1)(B)(iv) of the Act specifically excludes outpatient physical therapy, outpatient speech-language pathology, and outpatient occupational therapy from the definition of services payable under the OPPS. Therefore, we specifically did not include them in the list of Part-B only services to which the exception would apply in the proposed rule. These services are subject to fee schedules that were established prior to the OPPS.

    We agree with the commenters that diagnostic laboratory services are included in the list of ancillary services that are excluded from the OPPS under this policy.

    B. Categories of Hospitals Subject To and Excluded from the OPPS

    Under § 419.20(b), certain hospitals in Maryland that qualify under section 1814(b)(3) of the Act for payment under the State's payment system are excluded from the OPPS. Critical access hospitals (CAHs), which are paid under a reasonable cost-based system as required under section 1834(g) of the Act, are also excluded. In addition, we stated in the April 7, 2000 final rule that the outpatient services provided by the hospitals of the Indian Health Services (IHS) will continue to be paid under separately established rates. We also noted that we intended to consult with the IHS and develop a plan to transition these hospitals into OPPS. With these exceptions, the OPPS applies to all other hospitals that participate in the Medicare program.

    In the proposed rule, we noted that under the statute, hospitals located in Guam, Saipan, American Samoa, and the Virgin Islands are excluded from the hospital inpatient PPS. We proposed to revise § 419.20 of the regulations by adding paragraph (b)(3) to exclude these hospitals from OPPS consistent with their treatment under inpatient PPS. In addition, we proposed to revise paragraph (b)(4) of that section to include the hospitals of the IHS to clarify that they are excluded from OPPS until we develop a plan to include them. We noted that it might also be possible to include the hospitals in the territories in the OPPS in the future.

    We received one comment on this proposal, as set forth below.

    Comment: A commenter asked for clarification about the meaning of “hospital of the Indian Health Service” in the context of our proposal. The commenter requested that CMS define the term to include several classes of hospitals, not only those owned and operated by the IHS, but also those that are operated by Tribes and Tribal organizations, but owned or leased by the IHS.

    Response: We agree with the commenter that clarification of the term “hospital of the Indian Health Service” is appropriate, and we are taking this opportunity to do so. Specifically, we will use here the definition at 42 CFR 413.65(l), where the term is defined to include facilities and organizations that, on or before April 7, 2000, furnished only services that were billed as if they were furnished by a hospital operated by the IHS or by a Tribe and that are: owned and operated by the Indian Health Service; owned by a Tribe or Tribal organization but leased from the Tribe or Tribal organization by the IHS under the Indian Self-Determination Act (Pub. L. 93-638) in accordance with applicable regulations and policies of the Indian Health Service in consultation with Tribes; or owned by the Indian Health Service but leased and operated by the Tribe or Tribal organization under the Indian Self-Determination Act (Pub. L. 93-638) in accordance with applicable regulations and policies of the Indian Health Service in consultation with Tribes.

    C. Conforming Changes: Additional Payments on a Reasonable Cost Basis

    Hospitals subject to the OPPS are paid for certain items and services that are outside the scope of the OPPS on a reasonable cost or other basis. Payments for the following services are made on a reasonable cost basis or otherwise applicable methodology:

    a. The direct costs of medical education as described in § 413.86.

    b. The costs of nursing and allied health programs as described in § 413.85.

    c. The costs associated with interns and residents not in approved teaching programs as described in § 415.202.

    d. The costs of teaching physicians attributable to Part B services for hospitals that elect cost-based payment for teaching physicians under § 415.160.

    e. The costs of anesthesia services furnished to hospital outpatients by qualified nonphysician anesthetists (certified registered nurse anesthetists and anesthesiologists' assistants) employed by the hospital or obtained under arrangements, for hospitals that meet the requirements under § 412.113(c).

    f. Bad debts for uncollectible deductible and coinsurance amounts as described in § 413.80(b).

    g. Organ acquisition costs paid under Part B.

    Interim payments for these services are made on a biweekly basis and final payments are determined at cost report settlement.

    We proposed to revise § 419.2(c) to make conforming changes that reflect the exclusion of these costs from the OPPS rates.

    We received one comment on this proposal, as follows.

    Comment: The commenter supported the clarification, but requested a statement concerning how CMS will ensure that the appropriate interim biweekly payments for these services are made.

    Response: We are working on appropriate operating instructions to our intermediaries with directions to ensure that the appropriate interim payments for these items and services are made.

    D. Hospital Coding for Evaluation and Management Services

    In the April 7, 2000 final rule, we emphasized the importance of each facility accurately assessing the intensity, resource use, and charges for evaluation and management (E/M) services, in order to ensure proper reporting of the service provided. In the proposed rule, we stated that we understand that facilities have developed several different systems for determining resource consumption to assign proper E/M codes. Some of these systems are based on clinical (“condition”) criteria, and others are based on weighted scoring criteria. We continue to believe that proper facility coding of E/M services is critical for assuring appropriate payments. In order to achieve this, we are interested in developing and implementing a standardized coding process for facility reporting of E/M services. This process could include the use of current HCPCS codes or the establishment of new HCPCS codes in conjunction with guidelines for facility coding.

    In the proposed rule, we solicited comments from hospitals and other interested parties on this issue. We stated that we would submit these comments to the APC Advisory Panel and ask for the Panel's recommendations regarding the development and implementation of a facility coding process for E/M services. We will review both the public comments and the recommendations from the Panel and propose a coding process in the proposed rule for 2003.

    E. Annual Drug Pricing Update

    1. Payment for Drugs and Biologicals

    Under the OPPS, we pay for drugs and biologicals in one of three ways.Start Printed Page 59894

    a. Packaged Payment. As we explained in the April 7, 2000 final rule, we generally package the cost of drugs, biologicals, and pharmaceuticals into the APC payment rate for the primary procedure or treatment with which the drugs are usually furnished (65 FR 18450). No separate payment is made under the OPPS for drugs, biologicals, and pharmaceuticals whose costs are packaged into the APCs with which they are associated.

    b. Transitional Pass-Through Payments for Eligible Drugs and Biologicals. As we also explained in the April 7, 2000 final rule and in section VII of this preamble, the BBRA 1999 provided for special transitional pass-through payments for a period of 2 to 3 years for the following drugs and biologicals:

    • Current orphan drugs, as designated under section 526 of the Federal Food, Drug, and Cosmetic Act;
    • Current drugs and biologic agents used for treatment of cancer;
    • Current radiopharmaceutical drugs and biological products; and
    • New drugs and biologic agents in instances where the item was not being paid for as a hospital outpatient service as of December 31, 1996, and where the cost of the item is “not insignificant” in relation to the hospital outpatient PPS payment amount.

    In this context, “current” refers to those items for which hospital outpatient payment was being made on August 1, 2000, the date on which the OPPS was implemented. A “new” drug or biological is a product that was not paid as a hospital outpatient service before January 1, 1997 and for which the cost is not insignificant in relation to the payment for the APC to which it is assigned. In the proposed rule, we discussed in detail the statutory basis and payment methodology for transitional pass-through payments for drugs and biologicals. In addition, we included an illustration of the payment methodology.

    Section 1833(t)(6)(D)(i) of the Act sets the payment rate for pass-through eligible drugs (assuming that no pro rata reduction in pass-through payment is necessary) as the amount determined under section 1842(o) of the Act, that is, 95 percent of the applicable average wholesale price (AWP). Section 1833(t)(6)(D)(i) of the Act also sets the amount of additional payment for pass-through-eligible drugs and biologicals (the pass-through payment amount). The pass-through payment amount is the difference between 95 percent of the applicable AWP and the portion of the otherwise applicable fee schedule amount (that is, the APC payment rate) that the Secretary determines is associated with the drug or biological. Therefore, as we explained in the April 7, 2000 final rule (65 FR 18481), in order to determine the correct pass-through payment amount, we first had to determine the cost that was packaged for the drug or biological within its related APC. In order to determine this amount, we used the following methodology, which we also explained in the April 7, 2000 final rule.

    When we implemented the OPPS on August 1, 2000, costs for drugs and biologicals eligible for transitional pass-through payment were, to the extent possible, not included in the payment rates for the APC groups into which they had been packaged prior to enactment of the BBRA 1999. That is, to the extent feasible, we removed from the APC groups into which they were packaged, the costs of as many of the pass-through eligible drugs and biologicals as we could identify in the 1996 claims data. Then, we assigned each drug and biological eligible for a pass-through payment to its own, separate APC group, the total payment rate for which was set at 95 percent of the applicable AWP.

    Next, in order to establish the applicable beneficiary copayment amount and pass-through payment amount, we had to determine the cost of the pass-through eligible drug or biological that would have been included in the payment rate for its associated APC had the drug or biological been packaged. We used hospital acquisition costs as a proxy for the amount that would have been packaged, based on data taken from an external survey of hospital drug costs. (See the April 7, 2000 final rule (65 FR 18481).) We imputed the acquisition cost for the various drugs and biologicals in pass-through APCs by multiplying their applicable AWP by one of the following ratios. The following ratios are based on the survey data, and they represent, on average, hospital drug acquisition cost relative to AWP:

    • For drugs with one manufacturer (sole-source), the ratio of acquisition cost to AWP equals 0.68.
    • For drugs with more than one manufacturer (multi-source), the ratio of acquisition cost to AWP equals 0.61.
    • For drugs with more than one manufacturer and with generic competitors, the ratio of acquisition cost to AWP equals 0.43.

    In accordance with section 1833(t)(7) of the Act, we base beneficiary copayment amounts for pass-through drugs only on that portion of the drug's cost that would have been included in the payment amount for an associated APC had the drug been packaged. Therefore, having determined the hospital acquisition cost of the drug based on the ratios described above, we multiply the acquisition cost by 20 percent to calculate the beneficiary copayment for the pass-through drug or biological APCs. Finally, to calculate the actual pass-through payment amount, we subtract the hospital acquisition cost from the applicable 95 percent of AWP. The Medicare program payment is the sum of the acquisition cost and the pass-through amount, less the beneficiary copayment amount.

    To illustrate this payment methodology, consider a current sole source drug with an average wholesale price (AWP) of $100 per dose. Under section 1842(o) of the Act, the total allowed payment for the drug is $95, that is, 95 percent of AWP. We impute the cost of the drug based on survey data, which indicate hospital acquisition costs for this type of drug on average to be 68 percent of its AWP (or $68). In the absence of the pass-through provisions, this cost would be packaged into the APC payment for the procedure or service with which the drug or biological is furnished. Therefore, we define the beneficiary coinsurance as 20 percent of the imputed cost of $68, resulting in a copayment amount of $13.60. The pass-through payment amount is $27 (the difference between 95 percent of AWP ($95) and the portion of the APC payment that is based on the cost of the drug ($68)). The total Medicare program payment in this example equals $81.40 (cost of the drug in the APC ($68) less beneficiary copayment ($13.60), plus pass-through payment ($27)). In the proposed rule, we clarified that, for purposes of calculating transitional pass-through payment amounts, we make no distinction between new and current drugs and biologicals. Rather, we assume that drugs and biologicals defined as “new” under section 1833(t)(6)(A)(iv)(I) of the Act, that is, for which payment was not being made as of December 31, 1996, nonetheless replace or are alternatives to drugs, biologicals, or therapies whose costs would have been reflected in our 1996 claims data and, thus, have been packaged into an associated APC. Therefore, we assume that our imputed acquisition cost, based on the external survey data, represents that portion of the APC payment attributable to new as well as current drugs and biologicals. For that reason, we are discontinuing use of the payment status indicator “J” that we introduced in the November 13, Start Printed Page 598952000 final rule to designate a “new” drug/biological pass-through. Instead, we stated that we would assign payment status indicator “G” to both current and new drugs that are eligible for pass-through payment under the OPPS. (Addendum D of this final rule lists the definition of the OPPS payment status indicators.)

    c. Separate APCs for Drugs Not Eligible for Transitional Pass-Through Payment. There are some drugs and biologicals for which we did not yet have adequate cost data that are not eligible for transitional pass-through payments. Beginning with the April 7, 2000 final rule, we created separate APCs for these drugs and biologicals to allow separate payment so as not to discourage their use where appropriate.

    We based the payment rate for these APCs on median hospital acquisition costs. To determine the hospital acquisition cost for the drugs, we imputed a cost using the same ratios of drug acquisition cost to AWP used in connection with calculating acquisition costs for transitional pass-through drug payments. That is, we multiplied the AWP for the drug by the applicable ratio (sole, multi, or generic source) based on data collected in an external survey of hospital drug acquisition costs.

    We set beneficiary copayment amounts for these drugs APCs at 20 percent of the imputed acquisition cost. We use status indicator “K” to denote the APCs for drugs, biologicals, and pharmaceuticals that are paid separately from and in addition to the procedure or treatment with which they are associated yet are not eligible for transitional pass-through payment. Refer to Addendum A of this final rule to identify these APCs.

    2. Annual Drug Pricing Update

    a. Drugs Eligible for Pass-Through Payments. We used the AWPs reported in the Drug Topics Red Book to determine the payment rates for the pass-through drugs and biologicals. In the proposed rule we referred to a discussion in the November 13, 2000 interim final rule. When we developed that interim final rule, it was our understanding that, although there are quarterly updates to the AWPs in the Red Book, the annual update is published in April of each year. It was our intention to update the AWPs for drugs each July 1, the quarter following the annual publication, and we did use the April 2001 version of the Red Book to update the APC rates for drugs eligible for pass-through payments. The pass-through payment rates for drugs and biologicals updated for 2001 went into effect July 1, 2001 (Program Memorandum A-01-73, issued on June 1, 2001).

    We found that doing an update for all the pass-through drugs and biologicals at mid-year was disruptive to both our computer systems and pricing software. Thus, we proposed to update the APC rates for drugs that are eligible for pass-through payments in 2002 using the July 2001 or October 2001 version of Red Book. The updated rates effective January 1, 2002 would remain in effect until we implement the next annual update in 2003, when we would again update the AWPs based on the latest quarterly version of the Red Book. This would place the update of pass-through drug prices on the same calendar year schedule as the other annual OPPS updates.

    b. Drugs in Separate APCs Not Eligible for Pass-Through Payments. We used the conversion factor published in the November 13, 2000 final rule (65 FR 67827) to update, effective January 1, 2001, the APC rates for the drugs that are not eligible for pass-through payments that are in separate APCs. We also made payment adjustments to these APC groups effective April 1, 2001, as required by section 401(c) of the BIPA, which sets forth a special payment rule that had the effect of providing a full market basket update in 2001.

    For 2002, we proposed to recalibrate the weights for the APCs for drugs that are not pass-through items and make the other adjustments applicable to the APC groups that we discuss in sections III, IV, and VIII of this preamble.

    We received several comments on our discussion of the payment for drugs under the OPPS. These comments are summarized below.

    Comment: One commenter expressed concern that the “three methodologies for drug payment reductions in the proposed rule” may not take into account the most recent data. The commenter requested an estimate of the magnitude of the expected reduction, and the data used to develop the estimate.

    Response: We did not propose three methodologies for drug payment reductions in the proposed rule. Rather we described, in greater detail than we have previously, the three methods by which drug costs are paid under the OPPS. In the final rule that we published on November 2, 2001 (66 FR 55857), we announced that we would be implementing a reduction in the payments made for one category of drugs, namely those drugs that qualify for transitional pass-through payments. As we described in that final rule, this reduction is applied on a uniform basis to all pass-through payments (including payments for devices) and is required to enforce a statutory limit on the size of those estimated payments relative to the estimate of all spending under the OPPS.

    Comment: One commenter was confused by an apparent discrepancy between our description of how the pass-through payment amount for a drug is calculated and our example of how the amount is calculated. The description indicated that the beneficiary coinsurance is subtracted from the applicable 95 percent of AWP and imputed acquisition cost, but the example did not include this subtraction.

    Response: We regret that the written description was not entirely clear. The example was accurate. The pass-through payment is the difference between 95 percent of AWP and imputed acquisition cost. The beneficiary coinsurance is 20 percent of the imputed acquisition cost. The Medicare program payment is the pass-through amount, plus the imputed acquisition cost, minus the beneficiary copayment. Total payment to the hospital is the pass-through amount, plus the imputed acquisition cost, plus the beneficiary copayment. In our example (see above), the AWP for the drug was $100, and 95 percent of AWP was thus $95. The imputed acquisition cost for the drug was 68 percent of AWP, or $68. Beneficiary coinsurance was 20 percent of $68, or $13.60. The Medicare program payment is $27 (the pass-through amount), plus $68 (the imputed acquisition cost), minus $13.60 (the beneficiary copayment), for a total of $81.40. Total payment to the hospital is $81.40 (the Medicare program payment) plus $13.60 (the beneficiary copayment), for a total of $95.

    Comment: Several commenters objected that our drug pricing is based on annual updates using 6-month old data and on ratios of drug acquisition costs to AWP that derive from outdated and limited data. Some of these commenters objected to the use of the acquisition cost study to establish the ratios of drug acquisition costs to AWP. One commenter asked that CMS clarify why the new system is too complex to undertake quarterly updates of drug prices.

    Response: We are placing the updates for the drugs that are eligible for pass-through payments on the same annual update schedule as the rest of the OPPS. We will always use the most recent available version of the Red Book in doing this update. Assuming that the October Red Book becomes available in time for use in the final rule establishing the annual OPPS updates, our drug Start Printed Page 59896pricing may be based on data that are only 3 months old when it becomes effective. In any event, it is not unusual for updates to prospective payment systems to reflect data that are 6 months old or older. We have always considered the use of the study-derived ratios of drug costs to AWP to be an interim measure until we are able to obtain data on hospitals' actual costs for drugs from claims. We anticipate having this data available for use in setting payment rates for 2003. Revisions to our payment systems require a long lead-time, and thus it would be very difficult to implement more than one update in a year. We note that rate-based payment systems are commonly updated annually, and we see no compelling reason why the update of drug prices under the OPPS should be updated more frequently than the other payment rates under the system.

    Comment: Several commenters requested more information about the methodology that CMS uses to compute payment rates for drugs, radiopharmaceuticals, and biologicals, particularly those that are not sole source.

    Response: We employ the methodology provided in 42 CFR § 405.517(c) to determine the payment rates. Specifically, we compute the median price of each drug, radiopharmaceutical, or biological, using the median price of the generic versions or the lowest of the prices of the brand versions from the Red Book. (For drugs with both generic and brand manufacturers, we use the lower cost of the two.) For the denominator, we employ measures of dosage and concentration that are compatible with the HCPCS code descriptor. We also consider route of administration (for example, intravenous or perenteral) and dose. As an example, if drug A has a descriptor of 10 mg As the dose, we usually utilize the AWP for 5 mg and 10 mg doses, but not for 25 mg or 50 mg doses. This is because the latter two doses could not be administered to provide a 10 mg dose. If drug B has a descriptor for 25 mg injection and the drug is manufactured in 5 mg per ml, 25 mg per ml, and 50 mg per ml concentrations, we would utilize the AWP for the 25 and 50 mg per ml concentrations, but not the 5 mg per ml concentration. This is because we would not expect a beneficiary to receive a 5 ml injection, which would be necessary to utilize the lowest concentration dose to provide 25 mg of the drug at the 5 mg per ml concentration.

    However, we lack precise information for many drugs in the Red Book concerning the size of vials/ampules and the numbers of vials/ampules per packaging. In these cases, we are unable to employ this methodology, and we simply use the list price. We are continuously seeking further information on these drugs, and we will revise the pricing as we obtain additional information.

    Comment: Several commenters called our attention to instances in which the Medicare payment is higher than the cost for certain drugs, especially radiopharmaceuticals.

    Response: We thank the commenters for bringing these cases to our attention. We have experienced some difficulty in determining appropriate payment rates for radiopharmaceuticals due to several factors. First, the Red Book lacks information concerning the dosage per vial after the elements are compounded to create the radioactive substance, the numbers of doses that can be obtained per vial, and the cost per vial when more than one dose may be given from the vial. Nuclear medicine experts have informed us that multiple doses for multiple patients can often be obtained with one vial and that we have often unnecessarily assumed the cost for the entire vial. At the same time, there are circumstances in which an entire vial is appropriately charged for one patient. We have made the appropriate modifications for those agents that have been identified to us. We welcome any additional information that would help us to ensure that payment rates reflect as accurately as possible the cost and usage of these agents.

    Comment: One commenter requested that CMS clarify whether repackaged products are included in its calculations.

    Response: There is no separate calculation for any repackaging process. We use only AWPs to calculate drugs and biological prices.

    Comment: One commenter asked us to clarify how we pay for the pharmacy overhead costs associated with administering drugs. The commenter expressed concern that the data in the survey of drug costs did not capture these costs.

    Response: For the drugs paid for under the OPPS, hospitals can bill both for the drug and for the administration of the drug. The overhead cost is captured in the administration codes, along with the costs of all drugs that are not paid for separately. Each time a drug is billed with an administration code, the total payment thus includes the acquisition cost for the billed drug, the packaged cost of all other drugs, and the overhead costs.

    F. Definition of Single-Use Devices

    Our definition of a device eligible for pass-through payment includes a criterion whereby eligible devices are used for one patient only and are single use (65 FR 47674, August 3, 2000). In the November 13, 2000 interim final rule, we stated, in response to a comment, that additional pass-through payments would not be made for devices that are reprocessed or reused because they are not single-use items. We further indicated that hospitals submitting pass-through claims for these devices might be considered to be engaging in fraudulent billing practices (65 FR 67822).

    In the proposed rule, we discussed issues that have come to our attention regarding reprocessed single-use devices. We noted that the FDA published guidance for the reprocessing of single-use devices (FDA's “Enforcement Priorities for Single-Use Devices Reprocessed by Third Parties and Hospitals,” issued August 14, 2000). This document presents a phased-in regulatory scheme for reprocessed devices. We proposed to follow FDA's guidance on reprocessed single-use devices. We stated that we would consider reprocessed single-use devices that are otherwise eligible for pass-through payment as part of a category of devices to be eligible for that payment if they meet FDA's most recent regulatory criteria on single-use devices. Also, reprocessed devices must meet any FDA guidance or other regulatory requirements in the future regarding single use. We proposed to consider reprocessed devices adhering to these guidelines as having met our criterion of approval or clearance by the FDA. We have met with and will continue to meet and coordinate with the FDA concerning that Federal agency's definition and regulation of single-use devices. We also stated our expectation that hospital charges on claims submitted for pass-through payments for reprocessed single-use devices would reflect the lower cost of these devices.

    We received several comments on this proposal, which are summarized below.

    Comment: One commenter expressed agreement with our decision to allow hospitals to submit claims for pass-through payment for reprocessed devices, as long as the device is reprocessed in accordance with FDA policy on reprocessing.

    Response: We appreciate the comment. It is important to emphasize that, in order to qualify for pass-through payment, a reprocessed device must clearly fit into one of the currently open device categories established for pass-Start Printed Page 59897through payment. We also expect that the charges for the reprocessed device will accurately reflect any lower cost of reprocessed devices.

    Comment: One commenter recommended that CMS not expect hospitals to charge less for reprocessed devices, claiming that paying hospitals less for reprocessed devices would perpetuate an incentive to use new devices instead of reprocessed devices.

    Response: We disagree. Hospitals would not necessarily have a greater incentive to use new devices if their charges for reprocessed devices are in accordance with their costs. If the charges reflect the lower costs of the reprocessed devices to the hospital, the margins for reprocessed versus new devices should remain relatively constant. This would not create an incentive for hospitals to use either new or reprocessed devices. On the other hand, if hospitals to charge the same amount for reprocessed and original devices, this would inflate the margins of pass-through payment for reprocessed devices and create an incentive to use reprocessed over new devices.

    Comment: Several commenters asked that CMS clarify how we will implement and enforce our pass-through payment policy for reprocessed single-use devices. A device manufacturer pointed out that Pre-Market Approval and 510k submissions for approval of reprocessed single-use devices are still pending with the FDA, awaiting final decisions. These commenters also asked how CMS would prohibit noncompliant single-use devices from receiving Medicare payment.

    Response: As we indicated in the proposed rule, we will follow the most recent FDA guidance or regulatory criteria on the issue of reprocessed single-use devices. When the FDA requires reprocessors, including hospitals, to have FDA approval or clearance regarding safety and effectiveness, prior to use in a health setting. Hospitals must adhere to these requirements, and will not be entitled to receive a pass-though payment if they do not comply. We will employ our standard procedures for claims reviews to enforce these requirements.

    Comment: One commenter recommended that CMS develop and implement a tracking mechanism to differentiate and collect data on reprocessed versus original device costs and use. This commenter also recommended either creating a modifier or establishing pairs of categories for original and reprocessed devices.

    Response: Reprocessed devices will be subsumed under the same categories as the original devices, and the average cost for the category will accurately reflect the cost of reprocessed and new devices. We do not believe that it is practical or advisable to create special modifiers or categories for items that will be receiving pass-though payments for only a limited period of time.

    Comment: One commenter recommended that CMS provide hospitals with guidance on how to adjust their charges for reprocessed devices eligible for pass-through payment, taking into account the costs of reprocessing and amortization of the initial cost of the device.

    Response: We expect those hospitals' charges for reprocessed single-use devices will reflect their costs, just as in the case of the first-use devices. The device's full cost to the hospital is reflected in the payment the first time it is used for a Medicare patient. The cost of the reprocessed device to the hospital will already include the cost of reprocessing. No amortization of the initial cost of the device will apply for single use devices, since they are intended for one time use only.

    G. Criteria for New Technology APCs

    1. Background

    In the April 7, 2000 final rule (68 FR 18477), we created a set of new technology APCs to pay for certain new technology services under the OPPS. New technology APCs are intended to pay for new technology services that are not addressed by the transitional pass-through provisions of the BBRA 1999 and BIPA 2000. New technology APCs are defined on the basis of costs and not the clinical characteristics of a service. The payment rate for each new technology APC is based on the midpoint of a range of costs.

    The new technology APCs that were implemented on August 1, 2000 were populated with 11 new technology services. We stated in the April 7, 2000 rule that we will pay for an item or service under a new technology APC for at least 2 years but no more than 3 years, consistent with the term of transitional pass-through payments. After that period of time, during the annual APC update cycle, we stated that we will move the item or service into the existing APC structure based on its clinical attributes and, based on claims data, its resource costs. For a new technology APC, the beneficiary coinsurance is 20 percent of the APC payment rate.

    In the April 7, 2000 rule, we specified an application process and the information that must be supplied for us to consider a request for payment under the new technology APCs (65 FR 18478). We also described the five criteria we would use to determine whether a service is eligible for assignment to a new technology APC group. These criteria, which we are currently using, are as follows:

    • The item or service is one that could not have been billed to the Medicare program in 1996 or, if it was available in 1996, the costs of the service could not have been adequately represented in 1996 data.
    • The item or service does not qualify for an additional payment under the transitional pass-through payments provided for by section 1833(t)(6) of the Act as a current orphan drug, as a current cancer therapy drug or biological or brachytherapy, as a current radiopharmaceutical drug or biological product, or as a new medical device, drug, or biological.
    • The item or service has a HCPCS code.
    • The item or service falls within the scope of Medicare benefits under section 1832(a) of the Act.
    • The item or service is determined to be reasonable and necessary in accordance with section 1862(a)(1)(A) of the Act.

    2. Modifications to the Criteria and Process for Assigning Services to New Technology APCs

    Based on the experience we have gained and data we have collected since publication of the April 7, 2000 final rule, we proposed in the August 24 proposed rule to revise—(1) the definition of what is appropriately paid for under the new technology APCs; (2) the criteria for determining whether a service may be paid under the new technology APCs; (3) the information that we will require to determine eligibility for assignment to a new technology APC; and 4) the length of time we will pay for a service in a new technology APC.

    We invited comment on the changes to the definition, criteria, application process, and timeframe that we proposed for services and procedures that may qualify for assignment to a new technology APC under the OPPS. We received numerous comments on the proposed changes, primarily from drug and device manufacturers and their trade associations, but also from medical specialty societies and hospital associations. Although several commenters supported the changes that we proposed, most commenters expressed concern that the new requirements might make it extremely difficult or virtually impossible for any new technology to qualify for Start Printed Page 59898assignment to a new technology APC. Many commenters urged us to maintain flexibility in approving services and products for new technology APCs rather than adhering to rigid criteria. The comments are summarized below.

    a. Services Paid Under New Technology APCs. We proposed to limit eligibility for placement in new technology APCs to complete services or procedures. That is, items, materials, supplies, apparatuses, instruments, implements, or equipment that are used to accomplish a more comprehensive service or procedure would not be eligible for placement in a new technology APC. Devices or any drug, biologic, radiopharmaceutical, product, or commodity for which payment could be made under the transitional pass-through provisions would continue to be excluded from assignment to a new technology APC. We proposed to limit new technology APCs to comprehensive services or procedures that are truly new. In addition, we clarified that we do not consider a different approach to an existing treatment or procedure to qualify a service for assignment to a new technology APC.

    A few commenters supported our proposal to limit eligibility to complete services and procedures, and to exclude changes to an existing service or procedure from new technology APCs. They cited this approach as a means of better controlling and managing payment and improving the predictability of cost estimates for new services or procedures under the OPPS. However, most commenters were opposed to these proposals. (In our responses to comments in this section VI.G., we use “HCPCS code” to mean a Level II HCPCS/National Code and “CPT code” to mean a Level I HCPCS code.)

    Comment: One commenter was concerned that the new criteria for identifying devices that will be eligible for assignment to a new technology APC will make it more difficult for new devices to qualify.

    Response: The commenter is correct. The changes that we proposed are intended to clarify, sharpen, and refine the scope of what we assign and pay for under a new technology APC. We want to clarify that new technology APCs are not meant to be the payment vehicle for items that can be paid under a transitional pass-through device category. Nor are new technology APCs meant to be a means of paying for drugs, biologicals, or radiopharmaceutical drugs that are otherwise eligible for transitional pass-through payments. The cost of a device that is not eligible for transitional pass-through payment and that is not associated with a comprehensive service or treatment eligible for assignment to a new technology APC will become incorporated into the weight of the APC or APCs associated with its use as hospitals begin to use it. The same is true for other items, supplies, and equipment that are furnished incident to a service or procedure and are used as a tool or serve as an aid in performing a variety of procedures.

    Comment: A number of commenters were opposed to limiting new technology APCs to services and procedures that are “truly new” because what constitutes “truly new” is vague and difficult to define and does not reflect the significant advances in medical technology that are incremental and build on existing technology or procedures. One commenter argued that transformational technology often changes significantly the way that a procedure is done, for example, changing a traditionally human resource (for example, labor) or time intensive procedure to one that is technology intensive. Commenters were concerned that the requirement that a new technology be “truly new” could result in lack of adequate payment for important new therapies and severely limit patient access to such therapies. For example, a new interventional radiology or other minimally invasive procedure such as the recent advances in endovascular techniques and device technology that replace traditional open surgery could be viewed as a “different approach to an existing treatment” and therefore not qualify for assignment to a new technology APC. One commenter concluded that this requirement would limit new technology APCs to inpatient procedures that move to an outpatient setting or procedures that are fundamentally different enough to qualify for a new CPT code. Many commenters recommended that innovation that improves current procedures be recognized and paid for in addition to “truly new” services. Several commenters stated that we should publish the definition of “truly new” in the Federal Register for public comment before implementing this criterion.

    Response: In fact, we do want to limit new technology APCs to those services that would be eligible for a new HCPCS code. For example, there are existing codes for wound repair which hospitals have been using to bill for Medicare services for many years. The use of a new, expensive instrument for tissue debridement or a new, expensive wound dressing does not in and of itself warrant creation of a new HCPCS code to describe the instrument or dressing; rather, the existing wound repair code appropriately describes the service that is being furnished, that is, the service is a wound repair, regardless of whether or not a new instrument or a new wound dressing is involved. We would consider it inappropriate to pay for the wound repair performed with the new, expensive dressing or instrument under a new technology APC because an APC group that includes the wound repair procedure already exists. (However, we note that the dressing or instrument could qualify for transitional pass-through payments.) Similarly, the invention of a new endoscope or new suturing material would not qualify for a new technology APC unless the procedure in which it is used cannot be appropriately billed under an existing code.

    By contrast, new services such as cryosurgery of the prostate, coronary artery brachytherapy, and 3-D electrophysiologic mapping of the heart are not adequately described with current codes, and they do not fit appropriately within an existing APC group. The new technology APCs are intended to address appropriate payment for these latter types of services, which cannot be accurately described by existing codes and are not similar either clinically or in terms of resource use with an existing APC group.

    We want to ensure appropriate allocation of Medicare expenditures and access for our beneficiaries to breakthrough technologies. The appropriate method of reflecting changes in the costs of supplies and equipment used to provide existing services is to incorporate those changes into the payment for such services during the yearly reclassification and recalibration of the APCs. We believe it is appropriate for those new technologies that can be appropriately reported by existing codes and do not qualify for transitional pass-through payments to be grouped with older technologies, and have their costs gradually incorporated into APCs when APC weights are adjusted.

    In summary, the most important criterion that will determine whether a technology is “truly new” and appropriate for a new technology APC is the inability to appropriately, and without redundancy, describe the new, complete (or comprehensive) service with any combination of existing HCPCS and CPT codes. We acknowledge the need to critically evaluate, on an ongoing basis, our criteria for new technology APCs. We remind interested parties that eligibility Start Printed Page 59899of a procedure for a temporary HCPCS code and assignment to a new technology APC does not guarantee that a permanent code will ultimately be approved for the service or procedure. Conversely, the fact that a new CPT or HCPCS code has been assigned to a service or procedure does not automatically qualify it for placement in a new technology APC unless it meets the criteria we have established for this purpose.

    Comment: A few commenters indicated that we need to better define “complete services or procedures” and “a more comprehensive service” with a clearer explanation of the underlying intent and examples to clarify when assignment to a new technology APC would be appropriate and when it would not. A couple of commenters stated that our proposal to permit only “complete” or “comprehensive” services or procedures to qualify for assignment to a new technology APC is contrary to the underlying concepts of the OPPS. These commenters argued that hospital outpatient departments, in order to provide a “complete” or “comprehensive” service, are allowed and expected to bill the appropriate set of CPT and HCPCS codes that combine to describe a particular service, often resulting in claims with multiple codes matched to multiple APCs. The same commenters asserted that a new technology or procedure will likely consist of multiple codes and multiple APCs and that this can be most effectively evaluated as part of the data collection during the period that the technology or procedure is assigned to a new technology APC. One commenter stated that medical technologies, even when considered transformational, are not usually “complete services and procedures.”

    Response: These comments focus on our concept of the type of services appropriate for assignment to new technology APCs under the OPPS. A service that qualifies for a new technology APC may be a complete, stand-alone service (for example, water-induced thermotherapy of the prostate or cryosurgery of the prostate) or it may be a service that would always be billed in combination with other services (for example, coronary artery brachytherapy). In the latter case, the new technology procedure, even though billed in combination with other, previously existing procedures, describes a distinct procedure with a beginning, middle, and end. Drugs, supplies, devices, and equipment in and of themselves are not a distinct procedure with a beginning, middle, and end. Rather, drugs, supplies, devices, and equipment are used in the performance of a procedure. Therefore, taken individually and apart from the procedure or service with which they are used, these items will not be eligible for new technology APCs. (As noted above, these items may qualify for transitional pass-through payments.) Furthermore, unbundled components that are integral to a service or procedure (for example, preparing a patient for surgery or preparation and application of a wound dressing for wound care) are not eligible for consideration for a new technology APC.

    We understand that hospitals frequently bill multiple codes to describe multiple services furnished to a given patient. Therefore, we are not making eligibility for new technology APCs contingent on whether hospitals would bill other HCPCS codes in conjunction with a proposed new technology procedure. However, we reiterate that the inability to describe appropriately, and without redundancy, a complete (or comprehensive) service with any combination of current CPT or HCPCS codes is crucial to determining eligibility for a new technology APC. It is possible that a procedure for which assignment to a new technology APC is sought can only be described by several current codes and the applicant believes it is important to establish a single HCPCS code to describe the procedure in a more comprehensive manner (for example, stereotactic radiosurgery or intensity modulated radiotherapy). We agree with this and will consider creating such new HCPCS codes if reporting a combination of current codes does not adequately describe the service or does not properly account for the resources used to deliver the comprehensive service.

    In short, we consider that a “truly new” service is one that cannot be appropriately described by existing HCPCS codes and that a new HCPCS code needs to be established in order to describe the new procedure.

    Claims for services assigned to new technology APCs should include, in addition to other HCPCS codes billed, the appropriate revenue codes and charges for the resources required to deliver the service. We evaluate these data to identify the complete package of resources required to perform the new technology service, the cost of this package of services, and, subsequently, the extent to which the new technology service is, or is not, consistent with services in an existing APC. If, over time, our claims data indicate that the package of resources and the clinical components of the new technology are unique and bear no similarity to services in any existing APC, we may create a separate APC for the new technology service when it is reassigned from a new technology APC. Examples of services that are currently in new technology APCs due to lack of data include water-induced thermotherapy, coronary artery thrombectomy, and coronary artery brachytherapy.

    Comment: Several commenters stated that we should eliminate the proposed criteria for defining services eligible for new technology APCs and suggested, instead, that we be flexible and work closely with manufacturers, providers, the APC Panel, and other experts “to consider circumstances unique to the individual technology” when determining whether a new technology APC is appropriate.

    Response: We will continue to work with manufacturers and their representative associations, with hospitals, with the APC Panel, with other experts, and with applicants as we evaluate requests for new technology APC assignments and determine which are appropriate for new technology APCs. The review of an application for new technology APC assignment by our medical officers and clinical experts is a dynamic, interactive process that involves ongoing consultation with the applicant, with hospitals and physicians who are furnishing the service or who participated in clinical trials, with the manufacturers of the new technology, and with other agencies such as the FDA that may have pertinent information. We believe that the criteria that we proposed serve to inform, guide, and expedite the review process and help to guard against inappropriate assignment of services to a new technology APC simply on the basis of those services being characterized as “new.”

    Comment: One commenter recommended that an applicant be the one to determine whether to seek pass-through payment for a drug used as part of the service or new technology APC status for the entire service, including the drug.

    Response: We agree. Application for pass-through payment or new technology APC status is voluntary and the determination of which application(s) to submit is left solely to the interested party. However, as part of the review process, we would expect to work with the applicant to arrive at the most appropriate classification for the service under consideration.

    Comment: Several commenters recommended that we further clarify the proposed criteria to ensure that all new technologies and services that do not Start Printed Page 59900qualify for pass-through status and that would not be adequately paid under existing APCs can be assigned to new technology APCs. These commenters also recommended that, when a pass-through category expires, we consider reclassifying medical devices in the expired category into a new technology APC to give beneficiaries seamless access to expensive new medical technology.

    Response: As we discussed above, devices eligible for pass-through payments fall outside the scope of services appropriate for new technology APCs. As data associated with pass-through items are collected and incorporated into the APCs with which they are associated, they will be reflected in the weight of the APC. The services assigned to the new technology APCs are those for which we do not have adequate data to make an appropriate APC assignment. Thus, it would not be appropriate to assign a pass-through device for which we have collected data to a new technology APC.

    b. Criteria for Assignment to New Technology APC. In the proposed rule, we proposed that the following criteria be used to determine whether a service be assigned to a new technology APC. These proposals represent modifications to criteria that are based on changes in data (we are no longer using 1996 data to set payment rates) and our continuing experience with the system of assigning new technology APCs.

    • The service is one that could not have been adequately represented in the claims data being used for the most current annual payment update. (Current criterion based on 1996 data.)
    • The service does not qualify for an additional payment under the transitional pass-through provisions. (This criterion is unchanged.)
    • The service cannot reasonably be placed in an existing APC group that is appropriate in terms of clinical characteristics and resource costs. We believe it is unnecessary to assign a new service to a new technology APC if it may be appropriately placed in a current APC. (This criterion for assignment to a new technology APC is implied but not explicitly stated in the April 7, 2000 final rule.)
    • The service falls within the scope of Medicare benefits under section 1832(a) of the Act. (This criterion is unchanged.)
    • The service is determined to be reasonable and necessary in accordance with section 1862(a)(1)(A) of the Act. (This criterion is unchanged.)

    We further proposed to delete the criterion that the service must have a HCPCS code in order to be assigned to a new technology APC. We wish to clarify that our proposal to delete the criterion that a service must have a HCPCS code refers to the discussion in the April 7, 2000 final rule which implied that assignment of a HCPCS code through the annual HCPCS cycle is required. On the contrary, as we state throughout this section, in order to be considered for a new technology APC, a truly new service cannot be adequately described by existing codes. Therefore, in the absence of an appropriate HCPCS code, we would consider creating a HCPCS code that describes the new technology service. These HCPCS codes would be solely for hospitals to use when billing under the OPPS.

    Most commenters supported the proposal not to require a HCPCS code for products or services in order to be considered for assignment to a new technology APC. The few commenters that addressed the proposed criterion that would define a new technology APC service as one that could not have been adequately represented in the claims data being used for the most current annual payment update (rather than on 1996 claims data) concurred with the proposed change; no one opposed the change. The remaining comments on these proposed criteria are summarized below.

    Comment: One commenter wanted to confirm our intention to assign a new service or procedure to an existing APC only in those instances where a clinically similar APC exists and the associated APC payment rate meets or exceeds the cost of furnishing the new technology service as itemized in the application for a new technology APC.

    Response: Our experience to date in evaluating requests for new technology APC classification prompted us to propose changes regarding the information that would be required in an application. One of the principal reasons that we proposed to require submission of a clinical vignette, including a detailed description of the resources used to furnish the service, was to enable us to determine whether a clinically similar APC exists and whether the APC payment rate adequately addresses the costs associated with the nominated new technology service. However, we will not limit our determination of the cost of the procedure to information submitted by the applicant. Our staff will obtain information on cost from other appropriate sources before making a determination of the cost of the procedure to hospitals.

    Comment: A number of commenters strongly opposed the criterion excluding any service involving a new drug or biological that qualifies for transitional pass-through payment from possible eligibility as a new technology APC. Commenters stated that continuing to exclude drugs or biologicals eligible for pass-through payments from being eligible for a new technology APC seems to suggest that an entirely new service that includes a new drug would only be eligible for pass-through payments for the drug, rather than the entire service being eligible for payment under a new technology APC. Under this criterion, novel treatments such as those in the growing field of radioimmunotherapy that involve both a new drug and new procedures for both calculating appropriate dosages and administering treatment would not be paid as a new technology APC. Instead, the hospital would be paid for the cost of the drug through the applicable pass-through payment, which may result in underpaying hospitals for the total package of items and services associated with the treatment.

    Commenters requested that we clarify that a brand new service in which a pass-through drug or device is used could be eligible for either a pass-through payment for the drug or device or for a new technology APC for the entire service and that we permit a new technology that includes the provision of a new drug or biological to be eligible for payments under a new technology APC. A few commenters recommended that we eliminate this requirement altogether and allow new medical device technology to be included in new tech APCs.

    Response: In the April 7, 2000 final rule we adopted a criterion that provided that an item or service that qualifies as a transitional pass-through item would not be considered for assignment to a new technology APC. We proposed to retain that criterion without modification. We have never intended new technology APCs to be a substitute payment vehicle for individual items that qualify for payment under a transitional pass-through device category. Nor are new technology APCs meant to be the means of payment for drugs, biologicals, or radiopharmaceutical drugs that are otherwise eligible for transitional pass-through payments. From the outset of the OPPS, our policy regarding payment for devices, drugs, and biologicals that do not qualify for transitional pass-through payment has been to package payment with the items' associated APCs, with the exception of a few drugs for which we had insufficient data.

    Many commenters expressed concern and disagreement with this criterion. We believe the commenters misunderstood our explanation of this Start Printed Page 59901criterion. Therefore, we reiterate that we have never intended to disqualify from assignment to a new technology APC a truly new, comprehensive service, procedure, or therapy that involves the use of a drug or device which, on its own, might also qualify for a transitional pass-through payment. That is, a truly new, comprehensive service could qualify for assignment to a new technology APC even if it involves a device or drug that could, on its own, qualify for a pass-through payment.

    Take, for example, a case in which a drug that qualifies for a pass-through payment is integral to a service that may be considered a new, comprehensive procedure or service appropriate for a new technology APC. In this case, an interested party has several options. The first option is to simply submit a request for the drug pass-through payment. Under this option, the therapy or procedure or service associated with administration of the drug would be paid through an existing APC that most closely approximates the service clinically and in terms of resources. (In this option, if the new service associated with the drug can be appropriately described by one or more existing HCPCS codes, it is possible that the new service might not qualify for a new technology APC.) A second option would be for the interested party to apply for a pass-through payment for the drug and submit a separate application for assignment of the therapy or procedure associated with administration of the drug to a new technology APC. A third option is to submit an application to have the entire service, including the potential pass-through drug, which is an integral part of the service, assigned to a new technology APC. In that case, the cost of the drug would be taken into account and packaged with the other costs associated with the service so that the drug cost is reflected and accounted for within the new technology APC payment rate for the service. We believe the third option represents a simple, unburdensome approach that would ensure timely and appropriate payment in a new technology APC for a new service that includes administration of a new drug or biological and that meets the other criteria for a new technology APC. For both options two and three, we would first consider whether assigning a new HCPCS code is appropriate and, if it is, we would then determine whether the new code should be assigned to an existing APC. If not, we would assign it to a new technology APC.

    c. Revision of Application for New Technology Status. In the August 24 proposed rule we proposed to change the information that interested parties must submit to have a service or procedure considered for assignment to a new technology APC. Specifically, to be considered, we proposed to require that requests include the following information:

    • The name by which the service is most commonly known. We currently require only the trade/brand name.
    • A clinical vignette, including patient diagnoses that the service is intended to treat, the typical patient, and a description of what resources are used to furnish the service by both the facility and the physician. For example, for a surgical procedure this would include staff, operating room, and recovery room services as well as equipment, supplies, and devices, etc. This criterion would replace the criterion that requires a detailed description of the clinical application of the service.
    • A list of any drugs or devices used as part of the service that require approval from the Food and Drug Administration (FDA) and information to document receipt of FDA approval/clearances and the date obtained.
    • A description of where the service is currently being performed (by location) and the approximate number of patients receiving the service in each location.
    • An estimate of the number of physicians who are furnishing the service nationally and the specialties they represent.
    • Information about the clinical use and efficacy of the service such as peer-reviewed articles.
    • The CPT or HCPCS Level II code(s) that are currently being used to report the service and an explanation of why use of these HCPCS codes is inadequate to report the service under the OPPS.
    • A list of the CPT or HCPCS Level II codes for all items and procedures that are an integral part of the service. This list should include codes for all procedures and services that, if coded in addition to the code for the service under consideration for new technology status, would represent unbundling.
    • A list of all CPT and HCPCS Level II codes that would typically be reported in addition to the service.
    • A proposal for a new HCPCS code, including a descriptor and rationale for why the descriptor is appropriate. The proposal should include the reason why the service does not have a CPT or HCPCS Level II code, and why the CPT or HCPCS Level II code or codes currently used to describe the service are inadequate.
    • An itemized list of the costs incurred by a hospital to furnish the new technology service, including labor, equipment, supplies, overhead, etc. (This criterion is unchanged.)
    • The name, address, and telephone number of the party making the request. (This criterion is unchanged.)
    • Other information as CMS may require to evaluate specific requests. (This criterion is unchanged.)

    One commenter stated that, on the whole, the proposed changes to the information that interested parties must submit to have a service or procedures considered for assignment to a new technology APC seem reasonable and designed to minimize the need for time-consuming requests for supplemental information from applicants. Other comments on the proposed changes are summarized below.

    Comment: A few commenters stated that the significant amount of additional data required to file an application is unnecessarily burdensome, and, in some cases, may not be available when new products are launched. In particular, one commenter was concerned that the information needed to provide a clinical vignette (patient diagnoses that the service is intended to treat, the typical patient, a description of resources used to furnish the service such as staff, equipment, supplies, and similar facility and professional resources) may not always be available when a new product is launched. The commenter was also concerned that upcoming implementation of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) will make providers reluctant to furnish necessary data to manufacturers. The need for consent releases and storage retention required by the HIPAA regulations are added administrative costs that will have to be incurred. Instead, the commenter recommended that we request a detailed description of the service which, if possible, includes the resources used during the procedure.

    Response: Our experience with new technology applications has revealed the critical need for the information on clinical factors and resource utilization that is described as part of a “clinical vignette.” Without this information, it is difficult to understand what the nominated service involves in both clinical and resource terms. We need the fullest possible description of every aspect of the service to help us understand how it is being furnished in hospitals and the costs associated with the service. This information is indispensable in assessing the appropriate payment rate for the Start Printed Page 59902nominated service. We believe that those seeking to apply for new technology APC status for a service will have sufficient expertise and experience with the service to enable them to furnish the full and detailed description of the service that is required as part of the clinical vignette. Based on our experience to date in reviewing applications for new technology APCs, there is strong evidence that close cooperative working relationships exist among manufacturers, hospitals, and clinicians who seek to have a service assigned to a new technology APC. When we have had to ask for additional information of the type we proposed to require for future applications, this information has been readily available and promptly supplied.

    Comment: One commenter stated that the requirement for “a description of where the service is currently being performed (by location) and the approximate number of patients receiving the service in each location” appears excessive if all that is sought through this requirement is the identification of medical contacts. A commenter expressed concern that having to identify all facilities or physicians performing the procedure would in many cases appear to be administratively excessive and a potential breach of confidentiality. A commenter recommended that, if medical contacts are desired, the requirement should be for the names, contact information and approximate number of patients treated for a “representative” sample of facilities and/or physicians performing the procedure or service who are willing to serve as such contacts.

    Response: While this requirement would furnish us with medical contacts, it also provides us with other significant information. For example, knowing the locations where the service is being performed and the approximate number of patients receiving the service provides insight into the extent to which the service is being performed (rarely, occasionally, or frequently); the types of hospitals where it is being performed (small rural or suburban hospitals, large urban teaching hospitals); and a geographic profile of where the service is currently available. We believe it is crucial to our evaluation of nominated procedures that we have a detailed understanding of, among other things, the indications and contraindications for the procedure, the current utilization of the procedure, the patient populations for which the procedure is performed, the types of hospitals where it is performed, the sites (for example, inpatient hospital, physician office) and locations (for example, teaching hospitals, community hospitals) where the procedure is performed. Without such information, we cannot make an appropriate determination as to whether the procedure is “truly new”. This information, along with information about the specialties of physicians performing the service, assists our medical advisors and clinicians in their evaluation of whether or not the service should be assigned to a new technology APC.

    Comment: One commenter wanted assurance that “information about the clinical use and efficacy of the service such as peer-reviewed articles' would be referred to the Office of Clinical Standards and Quality if the intent of this new requirement were to determine whether the new technology should be “covered.”

    Response: The purpose of this requirement is to help us better understand the clinical dimensions of the service. Neither assignment of one or more new HCPCS code(s) to a procedure or assignment of a procedure to a new technology APC assures that Medicare will cover the procedure. In order for a procedure to be covered by Medicare, it must be determined, either locally, or nationally, that the procedure is medically reasonable and necessary. Information about how to obtain a national coverage decision is posted on the CMS website at http://www.hcfa.gov/​coverage. To receive Medicare payment, services must be considered reasonable and necessary and each use of a service is subject to medical review for determination of whether its use was reasonable and necessary.

    d. Length of Time in a New Technology APC. We proposed to change the period of time during which a service may be paid under a new technology APC. We noted that although section 1833(t)(6)(B) of the Act, as amended by section 201 of BBRA 1999, sets a 2 to 3 year period of payment for transitional pass-through payments, this requirement does not extend to new technology APCs. We proposed to modify the time frame that we established for new technology APCs in the April 7, 2000 final rule and to retain a service within a new technology APC group until we have acquired adequate data that allow us to assign the service to a clinically appropriate APC. This policy would allow us to move a service from a new technology APC in less than 2 years if sufficient data were available and would also allow us to retain a service in a new technology APC for more than 3 years if sufficient data upon which to base a decision had not been collected.

    Comment: One commenter supported eliminating the 2 to 3 year assignment to a new tech APC, which would give CMS greater flexibility to base future payment on adequate pricing data that could take less than 2 or more than 3 years to collect.

    Several commenters stated that we should clarify at the time of the assignment to the new technology APC how the decision will be made to move it into a permanent APC. Specifically, these commenters indicated that we should publish the methodology used to reassign services from new technology APCs into existing APC categories, including how we will evaluate clinical and cost data to determine whether or not a service in a new technology APC should be reassigned to an existing APC.

    Most commenters supported keeping a procedure in a new technology APC for a minimum of 2 years of data collection to ensure that an adequate claims database is available to make appropriate decisions about ultimate APC assignment, structuring, packaging, and payment. These commenters noted that limited procedure volume and coding confusion immediately following market release of a new technology could limit the amount of useful data that would be available in the first year.

    Response: We agree with commenters that adequate claims data is more important than completion of a fixed time span for determining when to reassign a new technology APC service. We expect that, practically speaking, we will need a full year of available claims data. We use the same methodology to reassign services from a new technology APC to an existing APC group, or to a new APC group if that is indicated, that we use in our annual review of all APC weights and assignments. That is, we review claims-based charge and utilization data and the most recent available cost report data. This process may include consulting the APC Advisory Panel for its recommendations regarding appropriate APC assignments.

    Comment: Several commenters urged us not to reassign new medical procedures from one new technology APC to another during the yearly updates to the APC system absent current and complete data. These commenters asserted that during the period when a new procedure is assigned to a new technology APC, there may be reasons why claims data used for the annual updates to the APC system are not representative of actual hospital experience in providing the service. Therefore, we should recognize that the reasons that support a multi-Start Printed Page 59903year assignment to a new technology APC, that is, the need to gather data, also argue for caution in moving services from one new technology APC (and payment rate) to another.

    Response: In general, we agree that once a device has been assigned to a new technology APC, it will remain there until we have collected the data necessary to move it to a clinically appropriate APC. However, we have on occasion, made an assignment to a new technology APC based on information that later was found to have been inaccurate. In those cases, we believe that it is appropriate to move the service to the new technology APC that better reflects the cost. We note that when we have made these changes in the past, services were moved to higher-paying APCs as well as lower-paying APCs.

    Comment: One commenter urged that any new criteria that we adopt be applied prospectively to those applications submitted after the effective date of the final rules.

    Response: Changes in the criteria and application process for assigning services to a new technology APC will be made prospectively, effective upon implementation of this final rule.

    Comment: Although the new technology APCs and pass-through device categories were to be updated on a quarterly basis, many applications have taken much longer to process. CMS should establish a mechanism to process applications in a timely manner. One commenter suggested monthly updates.

    Response: The volume of applications and changes we have had to make in the OPPS following enactment of BIPA have combined to stretch our resources to the maximum. Also, the need to seek additional information to enable us to complete a thorough and rigorous evaluation of applications for new technology APC assignments has often caused delays in making a final determination. We believe the additional information that we proposed to require in an application for new technology APC status will assist us in completing our reviews and making final determinations in a timely manner. CMS and our fiscal intermediaries' systems constraints preclude making updates more frequently than quarterly.

    Comment: One commenter stated that the amount of information provided in the proposed rule does not satisfy the requirement of the Administrative Procedures Act that the public be informed and allowed to comment on major regulatory changes. The commenter requested full disclosure of data, methodology and options considered prior to implementation of the methodology with a suitable time of at least 60 days for public comment. The commenter requested that we retain the criteria established in the April 2000 final rule but that we eliminate the need for a HCPCS code.

    Response: We believe that our description of the proposed changes to the criteria and application process for new technology APCs allowed ample opportunity for substantive comment, and we did receive numerous substantive comments on the proposed changes. In addition, changes in the process and information required to apply for new technology APC status under the OPPS are subject to provisions of the Paperwork Reduction Act (PRA) of 1995, as further explained in section XII of this final rule.

    Final Action: We are making final the changes we proposed regarding the definition of what is appropriately paid for under a new technology APC, the criteria for determining assignment to a new APC, the information that must be supplied for a request to be considered, and the period of time during which payment in a new technology APC can be made. The schedule for submission of applications and the process and information required for a new technology APC designation is posted on the CMS website at http://www.hcfa.gov/​medlearn.

    VII. Transitional Pass-Through Payment Issues

    A. Background

    Section 1833(t)(6) of the Act provides for temporary additional payments or “transitional pass-through payments” for certain innovative medical devices, drugs, and biologicals. As originally enacted by the BBRA, this provision required the Secretary to make additional payments to hospitals for current orphan drugs, as designated under section 526 of the Federal Food, Drug, and Cosmetic Act; current drugs, biologic agents, and brachytherapy devices used for the treatment of cancer; and current radiopharmaceutical drugs and biological products. Transitional pass-through payments are also required for new medical devices, drugs, and biologic agents that were not being paid for as a hospital outpatient service as of December 31, 1996 and whose cost is “not insignificant” in relation to the OPPS payment for the procedures or services associated with the new device, drug, or biological. Under the statute, transitional pass-through payments are to be made for at least 2 years but not more than 3 years.

    Section 402 of BIPA, which was enacted on December 21, 2000, made several changes to section 1833(t)(6) of the Act. First, section 1833(t)(6)(B)(i) of the Act, as amended, requires us to establish by April 1, 2001, initial categories to be used for purposes of determining which medical devices are eligible for transitional pass-through payments. We fulfilled this requirement through the issuance on March 22, 2001 of two Program Memoranda, Transmittals A-01-40 and A-01-41. These Program Memoranda can be found on the CMS homepage at www.hcfa.gov/​pubforms/​transmit/​A0140.pdf and www.hcfa.gov/​pubforms/​transmit/​A0141.pdf,, respectively. We note that section 1833(t)(6)(B)(i)(II) of the Act explicitly authorizes the Secretary to establish initial categories by program memorandum.

    Transmittal A-01-41 includes a list of the initial device categories and a crosswalk of all the item-specific C-codes for individual devices that were approved for transitional pass-through payments as of January 20, 2001 to the initial category code by which the device is to be billed beginning April 1, 2001.

    Section 1833(t)(6)(B)(ii) of the Act also requires us to establish, through rulemaking, criteria that will be used to create additional categories, other than those established initially. On November 2, 2001, we published an interim final rule with comment that established the criteria for new categories (66 FR 55850).

    Transitional pass-through categories are for devices only; they do not apply to drugs or biologicals. The regulations governing transitional pass-through payments for eligible drugs and biologicals remain unchanged. The process to apply for transitional pass-through payment for eligible drugs and biological agents, including radiopharmaceuticals, can be found in the April 7, 2000 Federal Register (65 FR 18481) and on the CMS web site at http://www.hcfa.gov/​medlearn/​appdead.htm. If we revise the application instructions in any way, we will post the revisions on our web site and submit the changes for the Office of Management and Budget (OMB) review under the Paperwork Reduction Act. The application process for new categories can be found on the CMS web site at http://www.hcfa.gov/​/medicare/​newcatapp1030f.rtf.

    B. Discussion of Pro Rata Reduction

    Section 1833(t)(6)(E) of the Act limits the total projected amount of transitional pass-through payments for a given year to an “applicable percentage” of projected total payments under the hospital OPPS. For a year before 2004, Start Printed Page 59904the applicable percentage is 2.5 percent; for 2004 and subsequent years, the applicable percentage is specified by the Secretary up to 2.0 percent. If the Secretary estimates before the beginning of the calendar year that the total amount of pass-through payments in that year would exceed the applicable percentage, section 1833(t)(6)(E)(iii) of the Act requires a (prospective) uniform reduction in the amount of each of the transitional pass-through payments made in that year to ensure that the limit is not exceeded.

    As discussed above, on November 2, 2001, we published a final rule that announced the implementation of a pro rata reduction for CY 2002. That document describes the methodology for estimating pass-through payments and indicates that we expected the reduction would be between 65 and 70 percent. Based on the final APC weights, which incorporate 75 percent of the estimated device pass-through costs, the final pro rata reduction is 68.9 percent.

    C. Reducing Transitional Pass-Through Payments To Offset Costs Packaged Into APC Groups

    As discussed in the proposed rule, in the November 13, 2000 interim final rule (65 FR 67806 and 67825), we had excluded costs in revenue codes 274 (Prosthetic/orthotic devices), 275 (Pacemaker), and 278 (Other implants) from the calculation of APC payment rates. This was because, before enactment of the BBRA 1999, we had proposed to pay for implantable devices outside of the OPPS. After the enactment of the BBRA, it was not feasible to revise our database to include these revenue codes in developing the April 7, 2000 final rule. We were able to make the necessary revisions and adjustments in time for implementation on January 1, 2001. When we packaged costs from these revenue codes to recalculate APC rates for 2001, to comply with the BBRA 1999 requirement, the median costs for a handful of procedures related to pacemakers and neurostimulators significantly increased. Therefore, we restructured the affected APCs to account for these changes in procedure level median costs.

    Under section 1833(t)(6)(D)(ii) of the Act, as added by the BBRA 1999 and redesignated by BIPA, the amount of additional payment for an eligible device is the amount by which the hospital's cost exceeds the portion of the otherwise applicable APC payment amount that the Secretary determines is associated with the device. Thus, beginning January 1, 2001, for eligible devices, we deducted from transitional pass-through payments the dollar increase in the rates for the new APCs for procedures associated with the devices. Effective April 1, 2001, we revised our policy to subtract the dollar amount from the otherwise applicable pass-through payment for each category of device. The dollar amount subtracted in 2001 from transitional pass-through payments for affected categories of devices is as follows:

    Table 4.—CY 2001 Reductions To Pass-Through Payments to Offset Device-Related Costs Packaged in Associated APC Groups

    For item billed under HCPCS code. * * *Subtract from the pass- through payment the following amount:
    C1767 Generator, neurostimulator (implantable)$643.73
    C1778 Lead, neurostimulator (implantable)501.27
    C1785 Pacemaker, dual chamber, rate-responsive (implantable)2,843.00
    C1786 Pacemaker, single chamber, rate-responsive (implantable)2,843.00
    C1816 Receiver and/or transmitter, neurostimulator (implantable)537.83
    C2619 Pacemaker, dual chamber, non rate-responsive (implantable)2,843.00
    C2620 Pacemaker, single chamber, non rate-responsive (implantable)2,843.00

    The increase in certain APC rates for device costs on January 1, 2001 was offset by the simultaneous reduction of the associated pass-through payments. Payments for the procedures in the affected APCs that did not include a pass-through device increased for 2001 and for procedures that did include devices, total payment for the procedure plus the device or devices did not change.

    For 2002, we estimated in the proposed rule the portion of each APC rate that could reasonably be attributed to the cost of associated devices that are eligible for pass-through payments. This amount will be deducted from the pass-through payments for those devices as required by the statute. Since the deductions to the pass-through payments for costs included in APCs for 2002 are included in the recalibration of the weights and the “fixed pool” of dollars for outpatient services, the total payment for the procedure plus device or devices will be reduced rather than remain constant as they did in 2001.

    We described our methodology for calculating these reductions for the proposed rule. First, we reviewed the APCs to determine which of them contained services that are associated with a category of devices eligible for a transitional pass-through payment. We then estimated the portion of the costs in those APCs that could reasonably be attributed to the cost of pass-through devices as follows:

    • For each procedure associated with a pass-through device or devices, we examined all single-service bills (that is, bills that include services payable only under one APC) to determine utilization patterns for specific revenue centers that would reasonably be used for device-related charges in revenue codes 272 (sterile supplies), 275 (pacemakers), and 278 (other implants).
    • We removed the costs in those revenue codes to calculate a cost for the bill net of device-related costs (reduced cost). For example, the average bill cost (in 1999-2000 dollars) for insertion of a cardiac pacemaker (CPT 33208) was $5,733. The average cost associated with revenue code 275 was $4,163, so the reduced cost for the procedure was $1,570. We calculated the ratio of the reduced cost ($1,570) to the full bill costs ($5,733), and we applied that ratio to the costs on any bills for CPT 33208 that did not use revenue code 275 to establish reduced cost at the procedure code level across all claims.
    • To determine the reduced cost at the APC level and that portion of the APC payment rate associated with device costs, we calculated the median cost of the reduced cost bills for each relevant APC. For this calculation of the median, we allowed the full costs of bills for services in the APC that were not associated with pass-through devices.
    • We calculated, for the APC, the percentage difference between the APC median of full cost or unreduced bills and the APC median where some or all of the bills had reduced costs. We applied this percent difference to the proposed APC payment rate in order to calculate the share of that rate attributable to the device or devices associated with procedures in the APC.

    In column 3 of Table 5, we show the amount of the offset that we have computed with this methodology for each of the 25 APCs that we determined to have device costs represented in their rates. We note that the list of 25 APCs with device costs in their rates has changed slightly since the publication of the proposed rule. Specifically, APC 0185, Removal or Repair of Penile Start Printed Page 59905Prosthesis, is no longer on the list, and APC 0259, Level VI ENT Procedures, has been added to the list. These changes result from the application of the limit on the variation of costs of services classified within a group (the “two-times” rule). APC 0185 has been deleted due to the application of this rule. The device-related procedures that had been included with APC 0185 have been incorporated into APC 0259. As a result, APC 0259 has been added to the list of APCs with device costs reflected in their rates, on the basis of the same costs that had been included in APC 0185.

    We received several comments on this proposal, which are summarized below.

    Comment: Several commenters asked for clarification of the methodology used in selecting the 25 APCs for which we calculated reductions.

    Response: We described our methodology for selecting the 25 APCs in some detail in the proposed rule (66 FR 44706). As we stated there, we reviewed the APCs to determine which of them contained services that are associated with a category of devices eligible for a transitional pass-through payment. We carefully examined those APCs with a high frequency of claims in the data, and those that were associated with high-cost devices. We selected those APCs with patterns of billing that could be reasonably associated with devices, that is, with charges in revenue centers that are likely to be used for devices (revenue codes 272 (sterile supplies), 275 (pacemakers), and 278 (other implants)).

    Comment: Several commenters noted that for 11 of the 25 APCs for which we have identified offsets, the amount of the proposed APC payment for 2002 has either decreased or increased by less than the amount of the offset. For these 11 APCs, Medicare's combined payments for the device and procedure would thus be reduced effective January 1, 2002.

    Response: The estimate of the offset did not affect the APC rates. Any changes in the APC rates were due to the recalibration of the relative weights using the 1999-2000 data. The offset amount will be subtracted from the pass-through payment amount that would have been made otherwise. Thus, the combined payment for the device and procedure is necessarily reduced for all 25 APCs relative to what the payment would have been in 2002 without the offset. In other words, payments for all 25 device/procedure combinations would have been higher in 2002 by the amount of the offset if we had not identified the packaged costs and applied the offset. We assume, however, that the commenter means that payments for the device/procedure combinations associated with 11 of the 25 APCs will decrease in 2002 relative to the combined payments in 2001. Relative to the payments for 2001, the combined payment for the device and procedure could increase or decrease due to a number of factors affecting the relative weights for the APCs and the costs of the devices themselves. In the cases identified by the commenter, these factors decreased the proposed rates, or increased those rates by less than the amount of the offset, and thus decreased the payment in 2002 for the device/procedure combination relative to the payment for the combination in 2001.

    Comment: One commenter endorsed the idea of making a reduction in pass-through payments for the costs already represented in the APC rates. However, the commenter expressed concern that reducing the pass-through payment will likely result in underpayments to hospitals that are using the associated devices with procedures, and overpayments to hospitals performing procedures without using the associated devices.

    Response: We are not certain that the commenter understands how the pass-through offset works. The purpose of this measure is to ensure that the Medicare program pays only for the incremental costs of the new technology, over and above what is already represented in the APC rate for the associated procedure. The offset is applied only when a hospital bills for a device or other pass-through item in conjunction with billing for a procedure in an associated APC. When a hospital bills for a pass-through item along with a procedure, the hospital receives the full APC payment for the procedure. The offset is subtracted from the cost of the pass-through item. The hospital thus receives payment for the cost of the pass-through item over and above the offset amount. Without applying the offset, hospitals would be paid twice for the same costs. There is thus no underpayment for hospitals that are using pass-through items. When a hospital does not bill for a pass-through item with an APC, the hospital receives the full APC payment but no pass-through payment. The offset is not applied in the absence of a bill for a pass-through item. There is thus no overpayment for hospitals that are not using pass-through items. The hospital is paid only for the technology costs incorporated into the base APC rate, not for the incremental costs of new technologies.

    Comment: One commenter raised a question about a possible consequence of applying predetermined amounts to subtract from pass-through payments as offsets for the device-related costs already included in the APC rates. The commenter observed that use of a hospital-wide cost-to-charge ratio in determining the amount of a pass-through payment makes it possible for the predetermined offset amount to exceed the calculated cost of a device to the hospital. The commenter therefore recommended that the reduction for the costs included in the APC rates never exceed the amount of the pass-through payment.

    Response: We agree that the application of the pass-through offset should never result in a negative payment amount to the hospital. Our systems do not in fact compute pass-through payment amounts of less than zero.

    Comment: One commenter recommended that, if we implement a pro rata reduction in the transitional pass-through payments, the same percentage reduction should be applied to the offsets for the technology costs already represented in the APCs associated with pass-through items. Such a reduction in the offset would help hospitals to maintain beneficiary access to new technology services in the event of a substantial pro rata reduction.

    Response: The statute provides for applying a pro rata reduction only to the pass-through payments themselves, not to the offsets that are required to account for the costs that are represented in the payment rates for associated APCs. Reducing the offset would also increase the estimate of pass-through spending and require a larger pro rata reduction. We are therefore unable to accept the commenter's recommendation. We note, however, that the pro rata reduction is applied to the pass-through payment amount only after the offset.

    Comment: One commenter endorsed the concept of incorporating pass-through device costs into their associated APCs, but raised a specific question about the device costs associated with APC 0182, Insertion of Penile Prosthesis. The commenter contended that a review of the median cost files suggests that numerous claims could not have included device costs, even though the whole point of the procedure is to implant a device. As a result, the commenter contended that both the pass-through offset for the device and any upward adjustment to incorporate device costs into the APC can only be understated. Two commenters inquired about APC 0108, Insertion/Replacement/Repair of Cardioverter-Defibrillator Leads. The Start Printed Page 59906commenter contended that the $5,768 that we have determined as representing device costs in that APC is far too low, since the average device costs between $22,000 and $23,000 in 1996.

    Response: The first commenter is mistaken in thinking that we published a methodology for incorporating device costs into the APCs in the proposed rule. Rather, we published a methodology for identifying device costs that are already represented in the rates. (We published a methodology for incorporating device costs into the APCs in the November 2, 2001 final rule announcing the CY 2002 conversion factor and the pro rata reduction of transitional pass-through payments (66 FR 55857).) In developing our estimate of the device costs included in the APC rates, we used that portion of hospital costs that were allocated to those revenue centers in which device charges were likely to be billed. Hospitals have considerable flexibility in determining which revenue centers to assign charges, and we believe that in many cases they have allocated device charges to general supply centers. We are unable to separate the device charges from the other charges assigned to those revenue centers. We were thus unable to use costs from those centers in developing our estimates of the device costs associated with the APC rates. As a result, our estimate of the device costs in the APC rates might conceivably be understated. We believe that it does represent, however, a reasonably conservative estimate. We do not know the source of the other commenter's information about the cost for a specific device, but we believe that our offsets accurately capture the costs for device costs that are included in the current APC rates, net of all discounts, rebates, etc.

    Comment: Several commenters questioned whether we would deduct from pass-through payments the full amount of the offset for the device costs reflected in associated APCs in cases where the payment for the associated APC is reduced due to the multiple procedures discount. Some of these commenters also recommended a methodology for making an appropriate adjustment. Specifically, they recommended that the multiple procedure discount be applied only to the nondevice-related portion of the APC payment amount.

    Response: We agree with the commenters that the full pass-through offset should not be applied when the APC associated with the use of the device is subject to the multiple procedure discount of 50 percent. The purpose of the offset is to ensure that the program is not making double payment for any portion of the cost associated with the use of a pass-through item. The offset should therefore reflect that portion of the cost for the pass-through item actually reflected in the payment that is received for the associated APC. We believe that the most straightforward methodology for applying this principle is simply to reduce the offset amount by 50 percent whenever the multiple procedure discount applies to the associated APC.

    Comment: One commenter asked how the offset is applied when one pass-through device is billed with more than one of the 25 APCs in which we have identified costs associated with pass-through items. And conversely, the commenter wondered what happens when two or more devices are billed with only one of the 25 APCs with offsets.

    Response: The purpose of the offset is to avoid paying twice for costs that are represented both in the APC rates and in the costs of pass-through items. When one pass-through device is billed with two or more APCs with device-related costs, we would be double paying for some costs if we applied only one offset to the pass-through payment. We therefore apply all the offsets for the APCs on a bill when only one device is billed. As we have discussed above, however, the offset for the second APC would be reduced by 50 percent when the multiple service discount applies to that APC. Conversely, the offset is applied only once when one APC is billed, no matter how many devices are billed along with the APC. To apply the offset more than once would be to double-count the pass-through costs represented in that APC.

    We employed the following methodology in incorporating 75 percent of the device pass-through costs into the costs that are used to establish the APC relative weights. We used a crosswalk that we developed as part of the methodology for estimating total pass-through spending as the basis for determining the device costs that are to be included in setting the relative weight for each APC. This crosswalk matches devices to the primary procedures in which they are used. In developing the total pass-through estimate, we used this crosswalk to produce a device package for each APC associated with device use, based on the one or more devices used in the procedures included in the APC. We then adjusted the costs of each package by subtracting the costs already represented in the payment amount for the APC. (These are the costs that are shown in column 3 of Table 5 below.) In order to account for these costs in determining the new relative weights, we added 75 percent of the costs in this adjusted package to the costs at the claim level for each procedure that uses the package of devices in the APC. At this point, we determined a revised median cost for the APC. That new median cost in turn was used as the basis for calculating the APC's new relative weight.

    It is important to note that the median cost of an APC will not necessarily increase by the same amount as the costs that are folded into the APC. The middle number (that is, the median) in the ordered sequence of the costs for services in an APC would only vary by the same amount as the folded-in costs if every number in the sequence were increased by the amount of those folded-in costs. However, as we explained in the November 2, 2001 final rule concerning the pro rata reduction on transitional pass-through payments (FR 66 55862-5863), the device costs folded into an APC will not be uniformly distributed among the procedures in that APC. This is because procedures in an APC may require different types or numbers of devices, and some procedures may not require devices at all. Therefore, the increase in median cost for an APC is unlikely to exactly equal the amount of the costs folded into the APC. In the November 2, 2001 final rule, we also discuss in detail how the increase in APC rates due to the incorporation of these pass-through costs will be offset against the 2002 pass-through payments.

    Table 5 shows the amount of the offsets that we will apply for each APC that contains device costs. Column 4 of Table 5 shows the amount of the offset for each APC into which costs have been folded employing the methodology we have just described. Column 5 then shows the total offset that is to be applied for each APC. For the 25 APCs in which we had previously identified device costs, the amount of the offset in column 5 is the sum of the amount in column 3 (the amount of the offset due to the device costs that we had previously identified in the APC) and the amount in column 4 (the amount of the offset due to the costs that have just been folded in). For all the other APCs listed in the table, the amounts in column 4 and column 5 are identical (and there is no entry in column 3). This is because we had not previously identified device costs that were already represented in the payment amounts for these APCs. Start Printed Page 59907

    Table 5.—Offsets To Be Applied for Each APC That Contains Device Costs

    APCDescriptionDevice costs already reflected in APC rateAdditional device costs folded into APC rateTotal office for device costs
    12345
    0032Insertion of Central Venous/Arterial Catheter$73.79$276.41$350.20
    0046Open/Percutaneous Treatment Fracture or DislocationNA91.6391.63
    0048Arthroplasty with ProsthesisNA501.91501.91
    0057Bunion ProceduresNA155.76155.76
    0070Thoracentesis/Lavage ProceduresNA24.9424.94
    0080Diagnostic Cardiac Catheterization164.27124.21288.48
    0081Non-Coronary Angioplasty or Atherectomy307.06353.78660.84
    0082Coronary Atherectomy242.951,187.081,430.03
    0083Coronary Angioplasty528.64365.49894.13
    0084Level I Electrophysiologic EvaluationNA9,783.249,783.24
    0085Level II Electrophysiologic EvaluationNA580.82580.82
    0086Ablate Heart Dysrhythm FocusNA1,299.581,299.58
    0087Cardiac Electrophysiologic Recording/MappingNA1,964.381,964.38
    0088Thrombectomy162.72251.47414.19
    0089Insertion/Replacement of Permanent Pacemaker and Electrodes3,175.703,242.086,417.78
    0090Insertion/Replacement of Pacemaker Pulse Generator2,921.062,196.005,117.06
    0094Resuscitation and CardioversionNA17.3117.31
    0103Miscellaneous Vascular ProceduresNA202.60202.60
    0104Transcatheter Placement of Intracoronary Stents428.16798.681,226.84
    0106Insertion/Replacement/Repair of Pacemaker and/or Electrodes657.591,038.441,696.03
    0107Insertion of Cardioverter-Defibrillator6,803.8510,987.6317,791.48
    0108Insertion/Replacement/Repair of Cardioverter-Defibrillator Leads6,940.2719,438.2026,378.47
    0111Blood Product ExchangeNA203.11203.11
    0115Cannula/Access Device ProceduresNA121.15121.15
    0117Chemotherapy Administration by Infusion OnlyNA29.0229.02
    0118Chemotherapy Administration by Both Infusion and Other TechniqueNA27.4927.49
    0119Implantation of DevicesNA3,325.053,325.05
    0120Infusion Therapy Except ChemotherapyNA34.1034.10
    0121Level I Tube Changes and RepositioningNA5.095.09
    0122Level II Tube Changes and Repositioning72.55212.27284.82
    0124Revision of Implanted Infusion PumpNA3,282.803,282.80
    0144Diagnostic AnoscopyNA126.75126.75
    0151Endoscopic Retrograde Cholangio-Pancreatography (ERCP)60.920.0060.92
    0152Percutaneous Biliary Endoscopic Procedures107.610.00107.61
    0153Peritoneal and Abdominal ProceduresNA33.6033.60
    0154Hernia/Hydrocele Procedures108.11369.57477.68
    0161Level II Cystourethroscopy and other Genitourinary ProceduresNA7.127.12
    0162Level III Cystourethroscopy and other Genitourinary ProceduresNA312.55312.55
    0163Level IV Cystourethroscopy and other Genitourinary ProceduresNA889.80889.80
    0179Urinary Incontinence ProceduresNA3,359.663,359.66
    0182Insertion of Penile Prosthesis2,238.90543.662,782.56
    0202Level VIII Female Reproductive Proc505.321,215.081,720.40
    0203Level V Nerve InjectionsNA416.39416.39
    0207Level IV Nerve InjectionsNA61.6061.60
    0222Implantation of Neurological Device4,458.579,510.4013,968.97
    0223Implantation of Pain Management Device421.333,307.743,729.07
    0225Implantation of Neurostimulator Electrodes1,182.0011,862.1513,044.15
    0226Implantation of Drug Infusion ReservoirNA3,341.853,341.85
    0227Implantation of Drug Infusion Device3,810.462,354.316,164.77
    0229Transcatherter Placement of Intravascular Shunts1,074.41391.451,465.86
    0237Level III Posterior Segment Eye ProceduresNA138.46138.46
    0246Cataract Procedures with IOL Insert146.820.00146.82
    0248Laser Retinal ProceduresNA1,262.931,262.93
    0259Level VI ENT Procedures12,407.523,724.6516,132.17
    0264Level II Miscellaneous Radiology ProceduresNA60.0660.06
    0312Radioelement ApplicationsNA1,201.841,201.84
    0685Level III Needle Biopsy/Aspiration Except Bone MarrowNA208.20208.20
    0686Level V Skin RepairNA458.65458.65
    0687Revision/Removal of Neurostimulator ElectrodesNA1,432.441,432.44
    0688Revision/Removal of Neurostimulator Pulse Generator ReceiverNA6,195.526,195.52
    0692Electronic Analysis of Neurostimulator Pulse GeneratorsNA639.86639.86
    Start Printed Page 59908

    VIII. Conversion Factor Update for CY 2002

    Section 1833(t)(3)(C)(ii) of the Act requires us to update the conversion factor used to determine payment rates under the OPPS on an annual basis. Section 1833(t)(3)(C)(iv) of the Act, as redesignated by section 401 of the BIPA, provides that for 2002, the update is equal to the hospital inpatient market basket percentage increase applicable to hospital discharges under section 1886(b)(3)(B)(iii) of the Act, reduced by one percentage point. Further, section 401 of the BIPA increased the conversion factor for 2001 to reflect an update equal to the full market basket percentage increase amount.

    In the November 2, 2001 final rule, we announced that the conversion factor for CY 2002 is $50.904 (66 FR 55864) based on an increase factor of 2.3 percent for 2002 and a wage index budget neutrality adjustment of 0.9936.

    IX. Summary of and Responses to MedPAC Recommendations

    On March 1, 2001 the Medicare Payment Advisory Commission (MedPAC) issued its annual report to Congress, including several recommendations related to the OPPS. In the August 24, 2001 proposed rule, we responded to these recommendations (66 FR 44707-44708).

    MedPAC Recommendation: MedPAC has offered two recommendations regarding the update to the conversion factor in the OPPS. The first recommendation is that the Secretary should not use an expenditure target to update the conversion factor. The second recommendation is that Congress should require an annual update of the conversion factor in the OPPS that is based on the relevant factors influencing the costs of efficiently providing hospital outpatient care, and not just the change in input prices.

    Response: Section 1833(t)(3)(C)(ii) of the Act requires the Secretary to update the conversion factor annually. Under section 1833(t)(3)(C)(iv) of the Act the update is equal to the hospital market basket percentage increase applicable under the hospital inpatient PPS, minus one percentage point for the years 2000 and 2002. The Secretary has the authority under section 1833(t)(3)(C)(iv) of the Act to substitute a market basket that is specific to hospital outpatient services. Finally, section 1833(t)(2)(F) of the Act requires the Secretary to develop a method for controlling unnecessary increases in the volume of covered hospital outpatient services, and section 1833(t)(9)(C) of the Act authorizes the Secretary to adjust the update to the conversion factor if the volume of services increased beyond the amount established under section 1833(t)(2)(F) of the Act.

    In the September 8, 1998 proposed rule on the OPPS, we indicated that we were considering the option of developing an outpatient-specific market basket and invited comments on possible sources of data suitable for constructing one (63 FR 47579). We received no comments in response to this invitation, and we therefore announced in the April 7, 2000 final rule that we would update the conversion factor by the hospital inpatient market basket increase, minus one percentage point, for the years 2000, 2001, and 2002 (65 FR 18502). As required by section 401(c) of the BIPA, we made payment adjustments effective April 1, 2001 under a special payment rule that has had the effect of providing a full market basket update in 2001. We are, however, working with a contractor to study the option of developing an outpatient-specific market basket and would welcome comments and recommendations regarding appropriate data sources. We will also study the feasibility of developing appropriate adjustments for factors that influence the costs of efficiently providing hospital outpatient care, such as productivity increases and the introduction of new technologies, and the availability of appropriate sources of data for calculating the factors.

    In the September 8, 1998 proposed rule on the OPPS, we proposed employing a modified version of the physicians' sustainable growth rate system (SGR) as an adjustment in the update framework to control for excess increases in the volume of covered outpatient services (63 FR 47586-47587). In response to comments on this proposal, we announced in the April 7, 2000 final rule that we had decided to delay implementation of a volume control mechanism, and to continue to study the options with a contractor (65 FR 18503). We will take MedPAC's recommendation into consideration in making a decision, and before implementing volume control mechanism we will publish a proposed rule with an opportunity for public comment.

    MedPAC Recommendation: MedPAC recommends that the Secretary should develop formalized procedures in the OPPS for expeditiously assigning codes, updating relative weights, and investigating the need for service classification changes to recognize the costs of new and substantially improved technologies.

    Response: Beginning with the April 7, 2000 final rule implementing the OPPS, we have outlined a comprehensive process to recognize the costs of new technology in the new system. One component of this process is the provision for pass-through payments for devices, drugs, and biologicals (see the discussion in conjunction with the next MedPAC recommendation). The other component is the creation of new APC groups to accommodate payment for new technology services that are not eligible for transitional pass-through payments. We assign new technology services that cannot be appropriately placed within existing APC groups to new technology APC groups, using costs alone (rather than costs plus clinical coherence) as the basis for the assignment. We describe revised criteria for assignment to a new technology group in section VI.G. of this preamble. When it is necessary, creation of new technology APC groups involves establishment of new codes. New codes are established through a well-ordered process that operates on an annual cycle. The cycle starts with submission of information by interested parties no later than April 1 of each year and ends with the announcement of new codes in October. As we stated previously, in the absence of an appropriate HCPCS code, we would consider creating a HCPCS code that describes the procedure or service. These codes would be solely for hospitals to use when billing under the OPPS.

    We have also provided a mechanism for moving these services from the new technology APCs to clinically related APCs as part of the annual update of the APC groups. As described in section VI of this preamble, a service is retained within a new technology APC group until we have acquired adequate data that allow us to assign the service to an appropriate APC. We use the annual APC update cycle to assign the service to an existing APC that is similar both clinically and in terms of resource costs. If no such APC exists, we create a new APC for the service.

    MedPAC Recommendation: MedPAC recommends that pass-through payments for specific technologies should be made in the OPPS only when a technology is new or substantially improved and adds substantially to the cost of care in an APC. MedPAC believes that the definition of “new” should not include items whose costs were included in the 1996 data used to set the OPPS payment rates.

    Response: The statute requires that, under the OPPS, transitional pass-through payments are made for certain drugs, devices, and biologicals. The Start Printed Page 59909items designated by the statute to receive these pass-through payments include the following:

    • Current orphan drugs, as designated under section 526 of the Federal Food, Drug, and Cosmetic Act.
    • Current drugs and biologicals used for the treatment of cancer, and brachytherapy and temperature monitored cryoablation devices used for the treatment of cancer.
    • Current radiopharmaceutical drugs and biologicals.
    • New drugs and biologicals in instances in which the item was not being paid as a hospital outpatient service as of December 31, 1996, and when the cost of the item is “not insignificant” in relation to the OPPS payment amount.
    • Effective April 1, 2001, categories of Medical devices when the cost of the category is “not insignificant” in relation to the OPPS payment amount.

    We are publishing a separate interim final rule in which we lay out the criteria for establishing categories of devices eligible for pass-through payments.

    Section 1833(t)(6) of the Act provides that once a category is established, a specific device may receive a pass-through payment for 2 to 3 years if the device is described by an existing category, regardless of whether it was being paid as a hospital outpatient service as of December 31, 1996 or its cost meets the “not insignificant” criterion. Thus, the statute allows for certain devices that do not meet MedPAC's recommended limitation on a “new” device to receive transitional pass-through payments. However, no categories are created on the basis of devices that were paid for on or before December 31, 1996. That is, while devices paid for on or before December 31, 1996 can be included in a category, we would establish a category only on the basis of devices that were not being paid as hospital outpatient services as of December 31, 1996.

    MedPAC Recommendation: MedPAC recommends that pass-through payments for specific technologies in the OPPS should be made on a budget-neutral basis and that the costs of new or substantially improved technologies should be factored into the update of the outpatient conversion factor.

    Response: The statute requires that the transitional pass-through payments for drugs, devices, and biologicals be made on a budget neutral basis. Estimated pass-through payments are limited under the statute to 2.5 percent (and up to 2.0 percent for 2004 and thereafter) of estimated total program payments for covered hospital outpatient services. We adjust the conversion factor to account for the proportion of total program payments for covered hospital outpatient services, up to the statutory limit, that we estimate will be made in pass-through payments. As we have discussed in response to MedPAC's recommendation concerning an update framework for the OPPS conversion factor, we will study the feasibility of including appropriate adjustments for factors, including introduction of new technologies, that influence the costs of efficiently providing hospital outpatient care within such a framework.

    MedPAC Recommendation: MedPAC recommends that the Congress should continue the reduction in outpatient coinsurance to achieve a 20 percent coinsurance rate by 2010.

    Response: For most services that Medicare covers, the program is responsible for 80 percent of the total payment amount, and beneficiaries pay 20 percent. However, under the cost-based payment system in place for outpatient services before the OPPS, beneficiaries paid 20 percent of the hospital's charges for these services. As a result, coinsurance was often more than 20 percent of the total payment amount for the services.

    The BBA established a formula under the OPPS that was designed to reduce coinsurance gradually to 20 percent of the total payment amount. Under this formula, a national copayment amount was set for each service category, and that amount is to remain frozen as payment rates increase until the coinsurance percentage falls to 20 percent for all services. On average, beneficiaries paid about 16 percent less in copayments for hospital outpatient services during 2000 under the OPPS than they would have paid under the previous system. However, it is true that the coinsurance remains higher than 20 percent of the Medicare payment amount for many services.

    Subsequent legislation has placed caps on the coinsurance percentages to speed up this process. Specifically, section 111 of BIPA amended section 1833(t)(8)(C)(ii) of the Act to reduce beneficiary coinsurance liability by phasing in a cap on the coinsurance percentage for each service. Starting on April 1, 2001, coinsurance for a single service furnished in 2001 cannot exceed 57 percent of the total payment amount for the service. The cap will be 55 percent in 2002 and 2003, and will be reduced by 5 percentage points each year from 2004 to 2006 until coinsurance is limited to 40 percent of the total payment for each service. The underlying process for decreasing coinsurance will also continue during this period (see discussion in section IV.A. of this preamble). However, MedPAC projects that under current law, it would take until 2029 to reach the goal of 20 percent coinsurance for all services.

    We agree with MedPAC's goal of continuing the reduction in outpatient coinsurance, and we would welcome enactment of a practical measure to do so.

    We received no comments on our responses to the MedPAC recommendations.

    X. Provider-Based Issues

    A. Background and April 7, 2000 Regulations

    On April 7, 2000, we published a final rule specifying the criteria that must be met for a determination regarding provider-based status (65 FR 18504). Since the beginning of the Medicare program, some providers, which we refer to as “main providers,” have functioned as a single entity while owning and operating multiple departments, locations, and facilities. Having clear criteria for provider-based status is important because this designation can result in additional Medicare payments for services furnished at the provider-based facility, and may also increase the coinsurance liability of Medicare for those services.

    The regulations at § 413.65 define provider-based status as “the relationship between a main provider and a provider-based entity or a department of a provider, remote location of a hospital, or satellite facility, that complies with the provisions of this section.” Section 413.65(b)(2) states that before a main provider may bill for services of a facility as if the facility is provider-based, or before it includes costs of those services on its cost report, the facility must meet the criteria listed in the regulations at § 413.65(d). Among these criteria are the requirements that the main provider and the facility must have common licensure (when appropriate), the facility must operate under the ownership and control of the main provider, and the facility must be located in the immediate vicinity of the main provider.

    The effective date of these regulations was originally set at October 10, 2000, but was subsequently delayed and is now in effect for cost reporting periods beginning on or after January 10, 2001. Program instructions on provider-based status issued before that date, found in Section 2446 of the Provider Reimbursement Manual—Part 1 (PRM-Start Printed Page 599101), Section 2004 of the Medicare State Operations Manual (SOM), and CMS Program Memorandum (PM) A-99-24, will apply to any facility for periods before the new regulations become applicable to it. (Some of these instructions will not be applied because they have been superseded by specific legislation on provider-based status, as described in item X.C below).

    B. Provider-Based Issues/Frequently Asked Questions

    Following publication of the April 7, 2000 final rule, we received many requests for clarification of policies on specific issues related to provider-based status. In response, we published a list of “Frequently Asked Questions” and the answers to them on the CMS web site at www.hcfa.gov/​medlearn/​provqa.htm. (This document can also be obtained by contacting the CMS (formerly, HCFA) Regional Office.) These Qs and As did not revise the regulatory criteria, but do provide subregulatory guidance for their implementation.

    C. Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (Pub. L. 106-554)

    On December 21, 2000, the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act (BIPA) of 2000 (Pub. L. 106-554) was enacted. Section 404 of BIPA contains provisions that significantly affect the provider-based regulations at § 413.65. Section 404 includes a grandfathering provision for facilities treated as provider-based on October 1, 2000; alternative criteria for meeting the geographic location requirement; and criteria for temporary treatment as provider-based.

    1. Two-Year “Grandfathering”

    Under section 404(a) of BIPA, any facilities or organizations that were “treated” as provider-based in relation to any hospital or CAH on October 1, 2000 will continue to be treated as such until October 1, 2002. For the purpose of this provision, we interpret “treated as provider-based” to include those facilities with formal CMS determinations, as well as those facilities without formal CMS determinations that were being paid as provider-based as of October 1, 2000. As a result, existing provider-based facilities and organizations may retain that status without meeting the criteria in the regulations under §§ 413.65(d), (e), (f), and (h) until October 1, 2002. These provisions concern provider-based status requirements, joint ventures, management contracts, and services under arrangement. Thus, the provider-based facilities and organizations affected under section 404(a) of BIPA are not required to submit an application for or obtain a provider-based status determination in order to continue receiving reimbursement as provider-based during this period.

    These provider-based facilities and organizations will not be exempt from the Emergency Medical Treatment and Active Labor Act (EMTALA) responsibilities of provider-based facilities and organizations (revised § 489.24(b) and new § 489.24(i)) or from the obligations of hospital outpatient departments and hospital-based entities in § 413.65(g), such as the responsibility of off-campus facilities provide written notices to Medicare beneficiaries of coinsurance liability. These rules are not pre-empted by the grandfather provisions of BIPA section 404 because they do not set forth criteria that must be met for provider-based status as a department of a hospital, but instead identify responsibilities that flow from that status. These responsibilities become effective for hospitals on the first day of the hospital's cost reporting period beginning on or after January 10, 2001.

    2. Geographic Location Criteria

    Section 404(b) of BIPA provides that those facilities or organizations that are not included in the grandfathering provision at section 404(a) are deemed to comply with the “immediate vicinity” requirements of the new regulations under § 413.65(d)(7) if they are located not more than 35 miles from the main campus of the hospital or critical access hospital. Therefore, those facilities located within 35 miles of the main provider satisfy the immediate vicinity requirement as an alternative to meeting the “75/75 test” under § 413.65(d)(7).

    In addition, BIPA provides that certain facilities or organizations are deemed to comply with the requirements for geographic proximity (either the “75/75 test” or the “35-mile test”) if they are owned and operated by a main provider that is a hospital with a disproportionate share adjustment percentage greater than 11.75 percent and is (1) owned or operated by a unit of State or local government, (2) a public or private nonprofit corporation that is formally granted governmental powers by a unit of State or local government, or (3) a private hospital that has a contract with a State or local government that includes the operation of clinics of the hospital to ensure access in a well-defined service area to health care services for low-income individuals who are not entitled to benefits under Medicare or Medicaid.

    These geographic location criteria are permanent. While those facilities or organizations treated as provider-based on October 1, 2000 are covered by the 2-year grandfathering provision noted above, the geographic location criteria at section 404(b) of BIPA and the regulations at § 413.65(d)(7) will apply to facilities or organizations not treated as provider-based as of that date, effective with the hospital's cost reporting period beginning on or after January 10, 2001. Beginning October 1, 2002, these criteria will also apply to the grandfathered facilities.

    3. Criteria for Temporary Treatment as Provider-Based

    Section 404(c) of BIPA also provides that a facility or organization that seeks a determination of provider-based status on or after October 1, 2000 and before October 1, 2002 shall be treated as having provider-based status for any period before a determination is made. Thus, recovery for overpayments will not be made retroactively for noncompliance with the provider-based criteria once a request for a determination during that time period has been made. For hospitals that do not qualify for grandfathering under section 404(a) of BIPA, a request for provider-based status should be submitted to the appropriate CMS Regional Office (RO). Until a uniform application is available, at a minimum, the request should include the identity of the main provider and the facility or organization for which provider-based status is being sought and supporting documentation to demonstrate compliance with the provider-based status criteria in effect at the time the application is submitted. Once such a request has been submitted on or after October 1, 2000, and before October 1, 2002, CMS will treat the facility or organization as being provider-based from the date it began operating as provider-based (as long as that date is on or after October 1, 2000) until the effective date of a CMS determination that the facility or organization is not provider-based.

    Facilities requesting a provider-based status determination on or after October 1, 2002 will not be covered by the provision concerning temporary treatment as provider-based in section 404(c) of BIPA. Thus, as stated in § 413.65(n), CMS ROs will make provider-based status effective as of the earliest date on which a request for determination has been made and all requirements for provider-based status in effect as of the date of the request are shown to have been met, not on the date Start Printed Page 59911of the formal CMS determination. If a facility or organization does not qualify for provider-based status and CMS learns that the provider has treated the facility or organization as provider-based without having obtained a provider-based determination under applicable regulations, CMS will review all payments and may seek recovery for overpayments in accordance with the regulations at § 413.65(j), including overpayments made for the period of time between submission of the request or application for provider-based status and the issuance of a formal CMS determination.

    D. Commitment To Re-Examine EMTALA Applicability to Off-Campus Hospital Locations, and to Further Revise Provider-Based Regulations

    As explained in the proposed rule published on August 24, 2001, (p. 44709) we are aware that many hospitals and physicians continue to have significant concerns with our policy on the applicability of EMTALA to provider-based facilities and organizations. We intend to re-examine these regulations and, in particular, reconsider the appropriateness of applying EMTALA to off-campus locations. We plan to review these regulations with a view toward ensuring that these locations are treated in ways that are appropriate to the responsibility for EMTALA compliance of the hospital as a whole. At the same time, we want to ensure that those departments that Medicare pays as hospital-based departments are appropriately integrated with the hospital as a whole. Because of these considerations, we stated in the preamble to our August 24, 2001 proposals that we intend to publish a proposed rule to address these issues more fully.

    In response to our statements, we received several comments, which are summarized below.

    Comment: Several commenters expressed approval of the statement, in the preamble to the August 24, 2001 proposed rule, that CMS plans to reconsider the appropriateness of applying EMTALA to off-campus hospital locations. The commenters offered to work with CMS in establishing further policy in this area.

    Response: We appreciate the commenters' support, and look forward to working with them on these important issues.

    Comment: One commenter stated that since CMS is planning to reconsider the appropriateness of applying EMTALA to off-campus hospital locations it should, while the review is taking place, either withdraw the regulations requiring EMTALA compliance at off-campus hospital facilities, or not implement those regulations.

    Response: We agree that the issues need to be reviewed carefully. EMTALA affords important protections to individuals who come to hospitals to seek care for possible emergency medical conditions. Thus, any change in the scope of the EMTALA regulations must be considered very thoroughly before it is undertaken. At the same time, we are well aware that many hospitals continue to be concerned about what they view as the excessive financial and administrative burden of complying with EMTALA at off-campus locations. In view of the complexity of the issues under view, and in consideration of the very significant impact that any change could have on the health and safety of hospital patients, we remain convinced that it would not be appropriate to anticipate the conclusion of that review by withdrawing or rescinding the regulations at this time. For the same reason, we are not adopting the suggestion that we suspend implementation of the current regulations.

    Comment: Several commenters recommended that CMS publish additional regulations clarifying various issues related to the criteria for provider-based status. The commenters offered to work with CMS in establishing further policy in this area.

    Response: We appreciate the commenters' support, and look forward to working with them on these important issues.

    E. Changes to Provider-Based Regulations

    To fully implement the provisions of section 404 of BIPA and to codify the clarifications currently stated only in the Qs and As on provider-based status, as described above, we proposed to revise the regulations as follows.

    1. Clarification of Requirements for Adequate Cost Data and Cost Finding (§ 413.24(d))

    As part of the April 7, 2000, final rule implementing the prospective payment system for hospital outpatient services to Medicare beneficiaries, under § 413.24, Adequate Cost Data and Cost Finding, we added a new paragraph (d)(6), entitled “Management Contracts.” Since publication of the final rule, we have received several questions concerning the new paragraph.

    In response to these questions, we proposed to revise that paragraph to clarify its meaning. In addition, for further clarity, we proposed to revise the coding and title of that material. We proposed to redesignate § 413.24(d)(6)(i) as § 413.24(d)(6) and § 413.24(d)(6)(ii) as § 413.24(d)(7). As revised, paragraph (d)(6) would address the situation when the main provider in a provider-based complex purchases services for a provider-based entity or for a department of the provider through a contract for services (for example, a management contract), directly assigning the costs to the provider-based entity or department and reporting the costs directly in the cost center for that entity or department. In any situation in which costs are directly assigned to a cost center, there is a risk of excess cost in that cost center resulting from the directly assigned costs plus a share of overhead improperly allocated to the cost center that duplicates the directly assigned costs. This duplication could result in improper Medicare payment to the provider. Therefore, when a provider has purchased services for a provider-based entity or for a provider department, like general service costs of the provider (for example, like costs in the administrative and general cost center) must be separately identified to ensure that they are not improperly allocated to the entity or the department. If the like costs of the provider cannot be separately identified, the costs of the services purchased through a contract for the provider-based entity or provider department must be reclassified to the main provider and allocated among the main provider's benefiting cost centers.

    For costs of services furnished to free-standing entities, we proposed to clarify in revised § 413.24(d)(7), that the costs that a provider incurs to furnish services to free-standing entities with which it is associated are not allowable costs of that provider. Any costs of services furnished to a free-standing entity must be identified and eliminated from the allowable costs of the servicing provider, to prevent Medicare payment to that provider for those costs. This may be done by including the free-standing entity on the cost report as a nonreimbursable cost center for the purpose of allocating overhead costs to that entity. If this method would not result in an accurate allocation of costs to the entity, the provider must develop detailed work papers showing how the cost of services furnished by the provider to the entity were determined. These costs are removed from the applicable cost centers of the servicing provider.

    This revision is not a change in the policy, but instead is a clarification to the policy set forth in the April 7, 2000 Start Printed Page 59912final rule. We received no comments on this proposal and are adopting it without change.

    2. Scope and Definitions (§ 413.65(a))

    In Q/A 9 published on the CMS (formerly, HCFA) web site at www.hcfa.gov/​medlearn/​provqa.htm,, we identified specific types of facilities for which provider-based determinations would not be made, since their status would not affect either Medicare payment levels or beneficiary liability. (This document may also be obtained by contacting the CMS (formerly, HCFA) Regional Office.) The facilities identified in Q/A 9 are ambulatory surgical centers (ASCs); comprehensive outpatient rehabilitation facilities (CORFs); home health agencies (HHAs); skilled nursing facilities (SNFs); hospices; inpatient rehabilitation units that are excluded from the inpatient PPS for acute hospital services; independent diagnostic testing facilities and any other facilities that furnish only clinical diagnostic laboratory tests; facilities furnishing only physical, occupational or speech therapy to ambulatory patients, for as long as the $1500 annual cap on coverage of physical, occupational, and speech therapy, as described in section 1833(g)(2) of the Act, remains suspended by the action of subsequent legislation; and end-stage renal disease (ESRD) facilities. Determinations for ESRD facilities are made under § 413.174.

    We proposed to revise the regulations at § 413.65(a) to clarify that these facilities are not subject to the provider-based requirements and that provider-based determinations will not be made for them.

    We received a few comments on this proposal, which are summarized below.

    Comment: One commenter expressed approval of the proposed revision, but suggested that we expand the list of facilities or organizations for which provider-based status is not required to include specific types of neonatal intensive care units and outpatient departments providing specialty pediatric care. The commenter believed such a change would permit these facilities to be treated as provider-based after the grandfather provisions of BIPA section 404 expire, even though they do not meet all criteria in 42 CFR 413.65(d).

    Response: In Q/A 9 published on the CMS web site at www.hcfa.gov/​medlearn/​provqa.htm we identified specific types of facilities for which provider-based determinations will not be made because any determinations regarding their status would not affect either Medicare payment levels or beneficiary liability. In the August 24, 2001 proposed rule, we proposed to codify this list of facilities. Because the comment was submitted in response to this part of our proposal, we considered it in that context. However, the commenter did not succeed in establishing that the units and specialized outpatient departments meet the criteria for inclusion on a list of facilities for which a determination about provider-based status would not affect either Medicare payment levels or beneficiary liability. (On the contrary, the commenter argued that if determinations were made on such units and departments, payments would be reduced significantly.) Moreover, the primary focus of the comment is not to ask that no determinations be made for these units and departments, but instead that those facilities be treated as provider-based even though they do not meet some or all of the provider-based criteria in § 413.65(d). We did not propose to extend provider-based status to such facilities (except insofar as BIPA section 404 requires us to do so), nor can such a proposal be logically inferred from the provisions included in the proposed rule. Thus, while we reviewed this comment with interest, we did not adopt it. We received no other comments on this proposed revision and are adopting it without change.

    3. BIPA Provisions on Grandfathering and Temporary Treatment as Provider-Based (§§ 413.65(b)(2) and (b)(5))

    Currently, § 413.65(b)(2) states that a main provider or a facility must contact CMS (formerly, HCFA), and CMS must determine that the facility is provider-based before the main provider bills for services of the facility as if the facility were provider-based, or before it includes costs of those services on its cost report. However, as explained earlier, sections 404(a) and (c) of BIPA require that certain facilities be grandfathered for a 2-year period, and that facilities applying between October 1, 2000 and October 1, 2002 for provider-based status with respect to a hospital be given provider-based status on a temporary basis, pending a decision on their applications. To implement these provisions, we proposed to revise the regulations in § 413.65(b)(2) to state that if a facility was treated as provider-based in relation to a hospital or CAH on October 1, 2000, it will continue to be considered provider-based in relation to that hospital or CAH until October 1, 2002, and the requirements, limitations, and exclusions specified in paragraphs (d), (e), (f), and (h) of § 413.65 will not apply to that hospital or CAH with respect to that facility until October 1, 2002. We further proposed that for purposes of paragraph (b)(2), a facility would be considered to have been treated as provider-based on October 1, 2000, if on that date it either had a written determination from CMS (formerly, HCFA) that it was provider-based as of that date, or was billing and being paid as a provider-based department or entity of the hospital.

    In addition, we proposed to add a new § 413.65(b)(2) to state that a facility for which a determination of provider-based status in relation to a hospital or CAH is requested on or after October 1, 2000 and before October 1, 2002 will be treated as provider-based in relation to the hospital or CAH from the first date on or after October 1, 2000 on which the facility was licensed (to the extent required by the State), staffed and equipped to treat patients until the date on which CMS (formerly, HCFA) determines that the facility does not qualify for provider-based status.

    We received one comment on this proposal, which is summarized below.

    Comment: One commenter stated that our proposed revision to these sections does not adequately implement section 404(c) of BIPA, in that it would require temporary treatment as provider-based for a facility or organization for which such status is requested on or before October 1, 2000 only from October 1, 2000 forward. The commenter believes this is inappropriate because section 404(c) of BIPA provides that such a facility or organization is to be treated as provider-based for “any period before a determination is made.” Under the commenter's recommended interpretation of the provision, such temporary treatment would also be available for any period before October 1, 2000.

    Response: We believe this interpretation of the provision is overly literal, and does not accurately reflect the role of paragraph (c) in the total statutory scheme established by section 404 of BIPA. Section 404(a)(1) describes the treatment to be accorded to facilities treated as provider-based on October 1, 2000, by providing that such facilities will continue to be treated as provider-based until October 1, 2002. Thus, paragraph (a) of section 404 addresses the situation of facilities that existed and were treated as provider based on October 1, 2000. Section 404(c) of BIPA complements this provision by mandating a grace period for those facilities seeking provider-based status determinations on or after October 1, 2000 that either (i) existed on October 1, 2000 but were not treated as provider-based, or (ii) did not exist as of October Start Printed Page 599131, 2000 (that is, were opened after that date). Taken together, paragraphs (a) and (c) specify the treatment to be given to facilities treated as provider-based on the reference date of October 1, 2000 and to those facilities for which provider-based status is sought within 2 years after the reference date. However, we find no indication that the statute was intended to extend provider-based status for any period before the reference date. Such an extension would not be necessary to protect a provider from possible retroactive liability based on possible delay in considering a provider-based application, and could inappropriately prevent collection of overpayments incurred well before October 1, 2000. Thus, we did not adopt this comment.

    We received no other comments on this proposal and we are adopting it without change.

    4. Reporting (§ 413.65(c)(1))

    Currently, § 413.65(c) states that a main provider that creates or acquires a facility or organization for which it wishes to claim provider-based status, including any physician offices that a hospital wishes to operate as a hospital outpatient department or clinic, must report its acquisition of the facility or organization to CMS (formerly, HCFA) if the facility or organization is located off the campus of the provider, or inclusion of the costs of the facility or organization in the provider's cost report would increase the total costs on the provider's cost report by at least 5 percent, and must furnish all information needed for a determination as to whether the facility or organization meets the requirements in paragraph (d) of this section for provider-based status. Concern has been expressed that such reporting would duplicate the requirement for obtaining approval of a facility as provider-based before billing its services that way or including its costs on the cost report of the main provider (current § 413.65(b)(2)). To prevent any unnecessary duplicate reporting, we proposed to delete the current requirement from § 413.65(c)(1). We proposed, however, to retain the requirement that a main provider that has had one or more facilities considered provider-based also report to CMS (formerly, HCFA) any material change in the relationship between it and any provider-based facility, such as a change in ownership of the facility or entry into a new or different management contract that could affect the provider-based status of the facility.

    We received one comment on this proposal, which is summarized below.

    Comment: A commenter stated that more guidance is needed on the rules regarding reporting to CMS any significant changes in the relationship between a main provider and its provider-based facilities. The commenter asked that we explain the meaning of “significant changes,” prescribe the format of such reporting, and specify to whom such reports are to be made.

    Response: Although the commenter refers to reporting any significant changes, the regulations at § 413.65(c)(1) speak of reporting any “material” changes in the relationship between it and any provider-based facility. As explained in the August 24, 2001 proposed rule, we would consider a “material” change to be anything that may interfere with compliance with the provider-based rules. The August 24, 2001 document further explains that such a change may include but is not limited to a change of ownership, entry into a new or different management contract, or change in the financial operations of the facility or the main provider. The main provider may report such material changes in the form of a letter submitted to its CMS Regional Office with a copy to its fiscal intermediary. While we are responding in this preamble to the commenter's questions and hope that this information is helpful, we do not believe it is essential to include this level of detail in the Code of Federal Regulations. Therefore, we did not revise the regulations based on this comment.

    We received no other comments on the proposal and are adopting it without change.

    5. Geographic Location Criteria (§ 413.65(d)(7))

    As explained earlier in X.C.2 of this preamble, section 404(b) of BIPA mandates that facilities seeking provider-based status be considered to meet any geographic location criteria if they are located not more than 35 miles from the main campus of the hospital or CAH to which they wish to be based, or meet other specific criteria relating to their ownership and operation. To implement this provision, we proposed to revise § 413.65(d)(7) to state that a facility will meet provider-based location criteria if it and the main provider are located on the same campus, or if one of the following three criteria are met:

    • The facility or organization is located within a 35-mile radius of the main campus of the hospital or CAH that is the potential main provider.
    • The facility or organization is owned and operated by a hospital or CAH that—

    (A) Is owned or operated by a unit of State or local government;

    (B) Is a public or nonprofit corporation that is formally granted governmental powers by a unit of State or local government; or

    (C) Is a private hospital that has a contract with a State or local government that includes the operation of clinics located off the main campus of the hospital to ensure access in a well-defined service area to health care services to low-income individuals who are not entitled to benefits under Medicare (or medical assistance under a Medicaid State plan); and

    (D) Has a disproportionate share adjustment (as determined under § 412.106 of this chapter) greater than 11.75 percent or is described in § 412.106(c)(2) of this chapter implementing section 1886(d)(5)(F)(i)(II) of the Act.

    • The facility meets the criteria currently set forth in § 413.65(d)(7)(i) for service to the same patient population as the main provider.

    We received no comments on this proposal and we are adopting it without change.

    6. Notice to Beneficiaries of Coinsurance Liability (§ 413.65(g)(7))

    Currently § 413.65(g)(7) states that when a Medicare beneficiary is treated in a hospital outpatient department or hospital-based entity (other than an RHC) that is not located on the main provider's campus, the hospital has a duty to provide written notice to the beneficiary, before the delivery of services, of the amount of the beneficiary's potential financial liability (that is, of the fact that the beneficiary will incur a coinsurance liability for an outpatient visit to the hospital as well as for the physician service, and of the amount of that liability). The notice must be one that the beneficiary can read and understand.

    We clarified in the preamble to an interim final rule with comment period published on August 3, 2000 (65 FR 47670) that if the exact type and extent of care needed is not known, the hospital may furnish a written notice to the patient that explains the fact that the beneficiary will incur a coinsurance liability to the hospital that they would not incur if the facility were not provider-based. The interim final rule further explained that the hospital may furnish an estimate based on typical or average charges for visits to the facility, while stating that the patient's actual liability will depend upon the actual Start Printed Page 59914services furnished by the hospital if the beneficiary is unconscious, under great duress, or for any other reason unable to read a written notice and understand and act on his or her own rights, the notice must be provided, before the delivery of services, to the beneficiary's authorized representative.

    We proposed to amend § 413.65(g)(7) to include this clarifying language. We received no comments on this proposal, and we are adopting it without change.

    7. Clarification of Protocols for Off-Campus Departments (§ 489.24(i)(2)(ii))

    Currently, § 489.24(i) specifies the anti-dumping obligations that hospitals have for individuals who come to off-campus hospital departments for the examination or treatment of a potential emergency medical condition. These obligations are sometimes known as EMTALA obligations, after the Emergency Medical Treatment and Labor Act, which is the legislation that first imposed the obligations. Currently, hospitals are responsible for ensuring that personnel at their off-campus departments are trained and given appropriate protocols for the handling of emergency cases.

    In the case of off-campus departments not routinely staffed with physicians, RNs, or LPNs, the department's personnel must be given protocols that direct them to contact emergency personnel at the main hospital campus before arranging an appropriate transfer to a medical facility other than the main hospital.

    Some concern had been expressed that taking the time needed to make such contacts might inappropriately delay the appropriate transfer of emergency patients in cases in which the patient's condition was deteriorating rapidly. In response to this concern, we clarified in the preamble to the interim final rule with comment period published on August 3, 2000 cited above (65 FR 47670) that in any case of the kind described in § 489.24(i)(2)(ii), the contact with emergency personnel at the main hospital campus should be made either concurrently with or after the actions needed to arrange an appropriate transfer, if, prior to transfer, contacting the main hospital campus would significantly jeopardize the individual's life or health. This does not relieve the off-campus department of the responsibility for making the contact, but only clarifies that the contact may be delayed in specific cases in which doing otherwise would endanger a patient subject to EMTALA protection.

    We proposed to amend § 489.24(i)(2)(ii) to include this clarifying language. We received two comments on this proposal, which are summarized below.

    Comment: Two commenters expressed approval of the change and recommended that it be adopted in the final rule. However, the commenter recommended that we further clarify the rule by spelling out the circumstances under which personnel at off-campus locations would be expected to call EMS before seeking guidance from the emergency department staff at the main campus delay.

    Response: As noted above, we plan to reconsider the general issue of the appropriateness of applying EMTALA to off-campus hospital locations. We will consider the commenter's specific suggestion in the course of that more general review. Therefore, we have not made any change in the final rule based on this comment.

    Comment: One commenter expressed approval of the proposed clarification at § 489.24(i)(2)(ii), under which personnel in off-campus departments that are not routinely staffed with physicians, RNs, or LPNs, may delay contacting the main hospital's emergency department according to protocols if, prior to transfer, contacting the main hospital campus would significantly jeopardize the individual's life or health. However, the commenter pointed out that the introductory paragraph of § 489.24(i)(2) applies the protocol requirement to all off-campus departments (whether or not staffed by physicians and nurses). Therefore, the commenter suggested that we move this provision to the introductory paragraph of § 489.24(i)(2), and so that it will apply to all off-campus departments. The commenter believes that this change would be consistent with the policy stated by CMS on its website (CMS EMTALA guidance, 7/20/01, Q/A ##7 and 13-16).

    Response: We agree that it would be appropriate, and consistent with our policy in this area, to apply this provision concerning the delay of contact in certain situations to all off-campus departments. As the commeter suggested, we are amending § 489.24(i)(2) to include the clarifying language that had been proposed at § 489.24(i)(2)(ii).

    8. Other Changes

    In addition to the changes cited previously, we proposed to make the following conforming and clarifying changes:

    • Correcting date references in §§ 413.65(i)(1)(i) and (i)(2), in order to take into account the effective date of the current regulations.
    • Substituting “CMS” for “HCFA” throughout the revised sections of part 413, to reflect the renaming of the Health Care Financing Administration (HCFA) as the Centers for Medicare & Medicaid Services (CMS).

    We received no comments on these proposals and are adopting them without change.

    F. Comments on Other Issues

    We also received a number of comments recommending various changes in the provider-based regulations that were not in our August 24, proposed rule and cannot logically be inferred from those proposals. While we read these comments with interest, we have not made any changes in the final rule based on them.

    XI. Summary of the Final Rule

    This final rule revises the Medicare hospital outpatient prospective payment system to implement applicable statutory requirements, including relevant provisions of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000, and changes arising from our continuing experience with this system. In addition, it describes changes to the amounts and factors used to determine the payment rates for Medicare hospital outpatient services paid under the prospective payment system. This final rule also announces a uniform reduction of 68.9 percent to be applied to each of the transitional pass-through payments.

    This final rule finalizes a number of policies discussed in the August 24, 2001 proposed rule as follows:

    • We are implementing BIPA provisions that affect the OPPS in 2002, including the following:

    + The national coinsurance rate for OPPS services is limited to 55 percent of the APC payment rate established for a procedure or service.

    + Children s hospitals receive the same hold-harmless protection accorded to cancer hospitals under BBRA.

    + Special payment provisions for certain services, including screening for glaucoma, payment for contrast agents, and new technology diagnostic mammography.

    • We adjust payments to hospitals for geographic wage differences, as required by the statute, using the FY 2002 hospital inpatient PPS wage index. We have recalibrated the APC weights, also as required by the statute, using median costs drawn from claims data for hospital services furnished on or after July 1, 1999 through June 30, 2000.
    • The methodology that we followed to calculate the final APC relative weights for CY 2002 is similar to the proposed methodology except that we have incorporated pass-through device Start Printed Page 59915costs in device-related procedures. Specifically, we have incorporated 75 percent of the estimated cost for pass-through devices into the base APC costs.
    • We have revised and updated the APC groups in accordance with several factors. These changes would affect more than half of the approximately 340 existing APC groups.
    • As a result of consultations with the advisory panel on APC groups, we have reviewed and are accepting a number of the Panel's recommendations. In some cases, we have made additional changes to the APCs based on the use of new data and application of the 2 times rule.
    • We have received recommendations from commenters and interested parties to establish separate APCs for observation services. As proposed, we are creating a new APC to make separate payment for observation services for patients with chest pain, asthma, and congestive heart failure, when certain clinical criteria are met. We have made some minor changes based on public comment.
    • Based on public comment, we made several modifications to our proposed coding scheme for stereotactic radiosurgery.
    • We have revised the criteria for the new technology APC groups that we created to allow payment at an appropriate level for new technologies that do not meet the statutory requirements for pass-through payments. These changes are intended to allow us to reserve these special new technology APC groups for services that are a new, “complete” procedure and not just modifications of existing technologies.
    • We are changing the aggregate method currently used for calculating outlier payments and will begin determining outliers on an APC-by-APC basis rather than the entire bill. To do this, we allocate packaged items on a bill to APCs based on their relative weight.
    • We are excluding from the OPPS the Part B-only services furnished to inpatients of hospitals that do no other billing for hospital outpatient services under Part B. This is in response to complaints we received from State psychiatric hospitals that did not have outpatient departments and, therefore, bill under OPPS only for inpatients. This policy would exempt them from having to make costly revisions to their billing systems.
    • We are excluding from the OPPS hospitals that are located outside the 50 States or the District of Columbia or Puerto Rico, that is, hospitals in Guam, Saipan, American Samoa, and the Virgin Islands. This policy is consistent with their current exclusion from the inpatient PPS and will also save these hospitals from billing system revisions.
    • We will continue to use a list of certain procedures that are designated as inpatient procedures and therefore are not paid by Medicare under the OPPS. Based on comments, we have made minor changes to this list.
    • We are revising the regulations affecting provider-based entities to implement technical BIPA provisions on grandfathering, temporary treatment as provider-based, and certain geographic location criteria; and to clarify requirements for adequate cost data and cost finding, certain reporting requirements, requirements regarding notice to beneficiaries of coinsurance liability, and clarification of anti-patient dumping rules (EMTALA obligations) in off-campus departments.
    • In response to public comments regarding provider-based issues, we are moving the provision concerning the delay of contact in certain situations to the introductory paragraph of § 489.24(i)(2) so that it will apply to all off-campus departments.
    • In addition, we are making editorial and technical revisions to our regulations. We made minor editorial changes in paragraphs (b)(2), (b)(4), (b)(5), (c), (d)(7)(iv), and (g)(7) of § 413.65. In § 413.65(i)(2), we modified the presentation of our language to more clearly present our policy.

    XII. Collection of Information Requirements

    Under the Paperwork Reduction Act 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.

    Sections 413.65 and 419.42 of this final rule contain information collection requirements that are subject to review by OMB under the Paperwork Reduction Act of 1995. However, §§ 413.65 and 419.42 have been approved by OMB under approval number 0938-0798, with a current expiration date of August 31, 2003 and OMB approval number 0938-0802, with a current expiration date of December 31, 2001.

    Process and Information Required To Apply for Transitional Pass-through Payment for Eligible Drugs and Biological Agents, Including Radiopharmaceuticals, Under the Hospital Outpatient Prospective Payment System

    The application itself for Transitional Pass-Through Payment for Eligible Drugs and Biological Agents, Including Radiopharmaceuticals, may be found at <www.hcfa.gov>. Transitional pass-through categories are for devices only; they do not apply to drugs or biologicals. The regulations governing transitional pass-through payments for eligible drugs and biologicals remain unchanged. The process to apply for transitional pass-through payment for eligible drugs and biological agents, including radiopharmaceuticals, can be found in the April 7, 2000 Federal Register (65 FR 18481) and on the CMS web site at http://www.hcfa.gov/​medlearn/​appdead.htm. If we revise the application instructions in any way, we will post the revisions on our web site and submit the changes for the Office of Management and Budget (OMB) review under the Paperwork Reduction Act. The application process for new categories can be found on the CMS web site at http://www.hcfa.gov/​/medicare/​newcatapp1030f.rtf.

    We estimate that approximately 100 entities will file an application yearly. We believe it will take each of these entities around 16 hours to gather the necessary information and fill out the application.

    We have submitted a copy of this final rule to OMB for its review of the information collection requirement described above. The requirement is not effective until it has been approved by OMB.

    XIV. Regulatory Impact Analysis

    A. General

    We have examined the impacts of this final rule as required by Executive Order 12866 (September 1993; Regulatory Planning and Review) and the Regulatory Flexibility Act (RFA) (September 19, 1980; Public Law 96-354). Executive Order 12866 directs agencies to assess all costs and benefits of available regulatory alternatives and, if regulation is necessary, to select regulatory approaches that maximize Start Printed Page 59916net 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).

    The provisions of this final rule do not result in impacts that exceed $100 million per year. The effects of the changes in this rule are redistributional and do not result in additional expenditures. The impacts discussed below reflect the effects of the final rule published on November 2, 2001. Therefore, this final rule is not an economically significant rule under Executive Order 12866, nor a major rule under 5 U.S.C. 804(2).

    We note, however, that on November 2, 2001, we published a final rule that announced the updated conversion factor for payments under the OPPS (66 FR 55857). As discussed in more detail in that document, we estimated that the total impact of the changes for CY 2002 payments compared to CY 2001 payments as set forth in the November 2 rule would be approximately a $450 million increase (66 FR 55864).

    The RFA requires agencies to determine whether a rule will have a significant economic impact on a substantial number of small entities. For purposes of the RFA, small entities include small businesses, nonprofit organizations and government agencies. Most hospitals and most other providers and suppliers are small entities, either by nonprofit status or by having revenues of $5 to $25 million or less annually (see 65 FR 69432). For purposes of the RFA, all providers of hospital outpatient services are considered small entities. Individuals and States are not included in the definition of a small entity.

    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. With the exception of hospitals located in certain New England counties, 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 (MSA) and has fewer than 100 beds, or New England County Metropolitan Area (NECMA). Section 601(g) of the Social Security Amendments of 1983 (Pub. L. 98-21) designated hospitals in certain New England counties as belonging to the adjacent NECMA. Thus, for purposes of the OPPS, we classify these hospitals as urban hospitals.

    It is clear that the changes in this final rule affect both a substantial number of rural hospitals as well as other classes of hospitals, and the effects on some may be significant. Therefore, the discussion below, in combination with the rest of this final rule, constitutes a regulatory impact analysis.

    Section 202 of the Unfunded Mandate Reform Act of 1995 (Pub. L. 104-4) also requires that agencies assess anticipated costs and benefits before issuing any rule that may result in an expenditure in any one year by State, local, or tribal governments, in the aggregate, or by the private sector, of $110 million. This final rule does not mandate any requirements for State, local, or tribal governments.

    Executive Order 13132 establishes certain requirements that an agency must meet when it publishes a proposed rule (and subsequent final rule) that imposes substantial direct costs on State and local governments, preempts State law, or otherwise has Federalism implications. We have examined this final rule in accordance with Executive Order 13132, Federalism, and have determined that it will not have any negative impact on the rights, roles, and responsibilities of State, local or tribal governments.

    B. Changes in This Final Rule

    In this final rule, we are making several changes to the OPPS that are required by the statute. We are required under section 1833(t)(9)(A) of the Act to revise, not less often than annually, the wage index and other adjustments used to determine the APC payment rates. In addition, we must review the clinical integrity of payment groups and the relative weights at least annually. Accordingly, in this final rule, we are updating the wage index adjustment for hospital outpatient services furnished beginning January 1, 2002. We are also revising the relative APC payment weights based on claims data from July 1, 1999 through June 30, 2000. Finally, we are beginning to calculate outlier payments on an APC-specific basis rather than the current method of calculating outlier payments for each claim. In addition, as an administrative action, we have incorporated 75 percent of the estimated cost of the pass-through devices into the base APC rates.

    As described in the preamble, budget neutrality adjustments are made to the weights to assure that the revisions in the wage index, APC groups, and relative weights do not affect aggregate payments. In addition, the parameters for outlier payments have been modified so that outlier payments for 2002 are projected to equal the established policy target of 2.0 percent of total payments. Because we are not revising the target percentage, there is no estimated aggregate impact from modifying the method of determining outlier payments.

    The impact of the wage index, APC reclassification and recalibration, and outlier changes do vary somewhat by hospital group. Estimates of these impacts are displayed on Table 6.

    We received no specific comments on the impact analysis. However, in commenting on certain proposed policies, commenters sometimes referred to the impact of a policy on hospitals or a specific group of hospitals. We have addressed these comments elsewhere in the preamble to this final rule. The following is a discussion of how the final policies set forth in this rule affect hospitals and beneficiaries. As an informational matter, the impact of changes set forth in Table 6 include the impact of the update to the conversion factor, which was implemented in the November 2 final rule.

    C. Limitations of Our Analysis

    The distributional impacts represent the projected effects of the policy changes as well as statutory changes effective for 2002, on various hospital groups. We estimate the effects of individual policy changes by estimating payments per service while holding all other payment policies constant. We use the best data available but do not attempt to predict behavioral responses to our policy changes. In addition, we do not make adjustments for future changes in variables such as service volume, service mix, or number of encounters. Finally, we do not model the impact of the transitional corridor payments, which protect hospitals from losses in 2002 compared to their 1996 payments. We are unable to model this impact because we do not yet have filed cost reports from hospitals for the services furnished under the PPS. The raw cost report data are generally not available until at least 7 months after the end of the cost reporting period.

    D. Estimated Impacts of This Final Rule on Hospital Payments

    Column 5 in Table 6 represents the full impact on each hospital group of all the changes for 2002. Columns 2 through 4 in the table reflect the independent effects of the change in the wage index, the APC reclassification and recalibration changes (including the incorporation of pass-through device Start Printed Page 59917costs), and the change in outlier method, respectively.

    In general, the wage index changes favor rural hospitals, particularly the largest in bed size and volume. The only rural hospitals that would experience a negative impact due to wage index changes are those in the Pacific Region, a decrease of 0.1 percent. Conversely, the urban hospitals are generally negatively affected by these changes, with the largest effect on those with 500 or more beds (a 0.5 percent decrease) and those in the Middle Atlantic (a 0.5 percent decrease) and West South Central (a 0.9 percent decrease) Regions.

    We estimate that the APC reclassification and recalibration changes have generally an opposite impact from the wage index, causing increases in payments for all urban hospitals except those with fewer than 200 beds and volumes of fewer than 21,000 services per year and those located in the New England (a 0.6 percent decrease), Middle Atlantic (a 0.8 percent decrease), and Puerto Rico (an 8.1 percent decrease) Regions.

    The incorporation of 75 percent of the estimated costs of pass-through devices into the base APC rates has a relatively large negative effect on rural hospitals. In the proposed rule, the estimated impact of the APC reclassification and recalibration changes on rural hospitals was a 1.5 percent decrease in payments. With the incorporation of the device costs, the impact is now estimated to be a 3.8 percent decrease. This impact does not include the effects of any additional transitional corridor payments to rural hospitals. The negative effect is particularly pronounced for rural hospitals with fewer than 100 beds (a decrease of 5.6 percent for hospitals with fewer than 50 beds and a 4.9 percent decrease for hospitals with 50-99 beds). This impact is due to the large increase in payment rates for device-related APCs and the corresponding decrease in nondevice-related APCs, as discussed in more detail above in section II.C. of this preamble. The decrease in the payment rates for clinic visits and diagnostic and preventive services affect rural hospitals disproportionately because they perform far more of these services as compared to the device-related APCs for which payment rates have increased. These impact estimates do not reflect the effects of the hold harmless transitional corridor payments in 2002 for the smallest rural hospitals.

    We also note that it is not the large academic medical centers that are most positively affected by the incorporation of pass-through device costs. While the group of hospitals that receives the largest increase in payments is hospitals with 500 or more beds (a 3.4 percent increase), minor teaching hospitals will receive an increase of only 2.0 percent and major teaching hospitals, an increase of 0.5 percent.

    Although teaching hospitals perform many device-related procedures, they also provide a very large number of clinic and emergency room visits, both of which will experience a projected decrease in payment rates of approximately 8 percent. In fact, teaching hospitals that do not also receive disproportionate share payments will experience a projected decrease of 2.1 percent. The largest negative impact for urban hospitals is for those with no teaching adjustment that also do not serve a disproportionate share of low-income patients. Even though this is a relatively small group of hospitals, their payments are projected to decrease by 15.5 percent.

    The change in outlier policy to an APC-specific payment has a slight negative effect on rural hospitals as a group (a 0.1 percent decrease), no effect on urban hospitals as a group, and slight negative effects on all small hospitals (fewer than 100 beds) as well as those with lower volumes of services. For urban hospitals, other than a projected increase in payments of 0.3 percent for hospitals in the Middle Atlantic Region, no geographic group of hospitals is affected by more than 0.1 percent. For rural hospitals, the Middle Atlantic Region will also experience a positive impact, a 0.2 percent increase. For the rest of the regions, rural hospitals will experience no more than a 0.2 percent decrease, except for hospitals in the Pacific Region, where there is no impact.

    The overall projected increase in payments for urban hospitals (3.0 percent) is greater than the average increase for all hospitals (2.3 percent). However, due to the large decrease in payments attributable to the APC changes, rural hospitals will experience an average decrease in payments of 0.7 percent. While rural hospitals gain 1.0 percent from the wage index change, they lose a combined 3.9 percent from the APC changes (-3.8 percent) and the change in method of determining outlier payments (a slight decrease of 0.1 percent). These impacts do not include the effects of any additional transitional corridor payments to rural hospitals. Rural hospitals with 100 or more beds will experience an overall increase in payments, however, those with fewer than 100 beds are projected to receive large decreases in payments (-3.5 percent for hospitals with fewer than 50 beds and -2.4 percent for those with 50 to 99 beds). We note that these smallest rural hospitals will be protected by the hold harmless transitional corridor payments for 2002. That is, their Medicare payment margin for services furnished under the OPPS cannot be less than their margin for the services in 1996.

    In both urban and rural areas, hospitals that provide a higher volume of outpatient services are projected to receive a larger increase in payments than lower volume hospitals. In rural areas, hospitals with volumes of fewer than 5,000 services are projected to experience a relatively large decline in payments (-3.6 percent). The less favorable impact for the low volume hospitals is attributable to the APC changes and the change in outlier method. For example, rural hospitals providing fewer than 5000 services are projected to lose a combined 6 percent due to these changes.

    Urban hospitals in all regions except Puerto Rico (with a decrease of 5.1 percent) receive an increase on overall payments. The lowest increase is in the Middle Atlantic Region, where hospitals are projected to receive a 1.2 percent increase in payments. Except for increases for hospitals in the South Atlantic (0.3 percent) and West South Central (0.5) Regions and no change in the Mountain Region, rural hospitals experience an overall loss in payments. Again, this is due to the decrease in payments as a result of the APC changes.

    Major teaching hospitals are projected to experience a smaller increase in overall payments (2.4 percent) than do hospitals with the less intensive teaching programs due to the negative impacts of the wage index (-0.4 percent), a relatively small increase due to the APC recalibration (0.5 percent), and outlier changes (-0.2 percent). Among hospitals with varying shares of low-income patients, those with a DSH patient percentage of zero experience a large decrease in payments because of the APC changes (-7.6 percent) and the outlier changes (-0.3 percent). For hospitals with a greater than 0 percent of low-income patients, the impact on all hospitals is positive, with the lowest increase of 0.3 percent attributable to hospitals with the highest share.

    E. Estimated Impacts of This Final Rule on Beneficiary Copayments

    In general, the increase in the APC rates for procedures that use pass-through devices results in increased copayments for beneficiaries who receive those procedures. Many of the device-related APC rates (approximately 50 APCs) have increased by over 100 Start Printed Page 59918percent and a small number by over 750 percent. Under the statute, the copayment amount for an APC cannot be less than 20 percent of the payment rate. Therefore, beneficiaries will experience an increase in copayments for most of the device-related APCs. This increase is countered by small decreases in the copayments for some other APCs, particularly clinic and emergency room visits.

    One important thing to note is that beneficiaries receive far more clinic and emergency visits in a year than they do device-related procedures. For example, in the 1999-2000 claims data base, there are almost 7 million low-level clinic visits, over 3 million mid-level clinic visits, and almost 2 million high-level clinic visits. However, for APC 0084, Level I Electrophysiologic Evaluation (the device-related APC with the largest increase), there were only about 7,000 procedures performed. Thus, the number of services received by beneficiaries with small decreases in copayments far outweighs the number of services for which they will incur some incremental costs.

    In addition, we note that section 1833(t)(8)(C)(i) of the Act places a limit on the copayment amount for any procedure; that is, the copayment may not be more than the applicable inpatient hospital deductible for the year in which the procedure is performed. For CY 2002, the inpatient deductible is $812. We further note that the complete incorporation of the costs of the current pass-through devices into the base APCs must be done in CY 2003. Therefore, any increase in copayments that occur in 2002 are a transition to increases that must, by statute, occur in 2003. Finally, as discussed in section IV. C above, we have minimized the effects of changes in APC groupings on beneficiary coinsurance and copayments.

    Table 6.—Impact of Changes for CY 2002 Hospital Outpatient Prospective Payment System

    [Percent change in total payment to hospitals (program and beneficiary); does not include the effects of additional transitional corridors payments]

    Number of hosps 1New wage index 2APC/WGTS/75% fold in 3New outlier policy 4All CY2002 changes 5
    (1)(2)(3)(4)(5)
    All Hospitals5,0840.00.00.02.3
    Non-Tefra Hospitals4,6710.00.00.02.3
    Urban Hosps2,550-0.21.00.03.0
    Large Urban (GT 1 Mill.)1,459-0.40.80.12.7
    Other Urban (LE 1 Mill.)1,0910.01.30.03.5
    Rural Hosps2,1211.0-3.8-0.1-0.7
    Beds (Urban):
    0-99 Beds646-0.1-3.2-0.1-1.2
    100-199 Beds908-0.2-1.20.00.9
    200-299 Beds490-0.20.80.02.8
    300-499 Beds363-0.22.90.05.0
    500 + Beds143-0.53.40.15.3
    Beds (Rural):
    0-49 Beds1,2780.2-5.6-0.2-3.5
    50-99 Beds5080.4-4.9-0.1-2.4
    100-149 Beds1961.5-3.0-0.10.6
    150-199 Beds731.5-1.6-0.12.0
    200 + Beds662.3-1.70.02.8
    Volume (Urban)
    LT 5,000307-0.40.7-0.22.3
    5,000-10,999445-0.3-2.40.0-0.5
    11,000-20,999570-0.3-0.90.01.1
    21,000-42,999739-0.31.00.03.0
    GT 42,999489-0.21.80.04.0
    Volume (Rural):
    LT 5,0009450.3-5.6-0.4-3.6
    5,000-10,9996020.2-5.7-0.2-3.5
    11,000-20,9993320.7-3.9-0.1-1.2
    21,000-42,9991981.4-2.50.01.1
    GT 42,999442.3-2.20.02.3
    Region (Urban):
    New England1350.6-0.60.02.2
    Middle Atlantic379-0.5-0.80.31.2
    South Atlantic386-0.12.80.05.0
    East North Cent441-0.40.10.01.9
    East South Cent1541.22.1-0.15.5
    West North Cent181-0.41.50.03.3
    West South Cent321-0.92.1-0.13.4
    Mountain128-0.12.40.04.5
    Pacific386-0.41.6-0.13.5
    Puerto Rico391.0-8.1-0.1-5.1
    Region (Rural):
    New England520.0-4.1-0.1-2.1
    Middle Atlantic740.5-4.90.2-2.0
    South Atlantic2701.4-3.2-0.10.3
    East North Cent2791.1-4.6-0.1-1.5
    East South Cent2501.3-3.8-0.1-0.4
    Start Printed Page 59919
    West North Cent5061.2-3.9-0.2-0.9
    West South Cent3281.5-3.0-0.10.5
    Mountain2151.3-3.2-0.20.0
    Pacific142-0.8-2.80.0-1.5
    Puerto Rico54.5-6.8-0.1-0.5
    Teaching Status:
    Non-Teaching3,5760.2-1.40.00.9
    Minor8030.02.00.04.4
    Major291-0.40.50.02.4
    DSH Patient Percent:
    0320.7-7.6-1.3-6.4
    GT 0-0.101,2610.00.20.02.5
    0.10-0.161,0350.1-0.10.12.4
    0.16-0.23869-0.10.60.02.7
    0.23-0.357860.10.3-0.12.6
    GE 0.35688-0.2-1.6-0.10.3
    Urban IME/DSH:
    IME & DSH1,000-0.31.80.13.8
    IME/No DSH30.0-2.1-2.0-2.3
    No IME/DSH1,531-0.2-0.10.02.0
    No IME/No DSH160.8-15.5-0.3-13.2
    Rural Hosp. Types:
    No Special Status7940.2-4.8-0.1-2.6
    RRC1722.1-2.00.02.3
    SCH/Each6660.4-4.8-0.1-2.4
    MDH3290.2-6.2-0.3-4.2
    SCH and RRC712.0-2.1-0.12.0
    Type of Ownership:
    Voluntary2,7740.00.20.02.4
    Proprietary7570.01.00.03.3
    Government1,1400.3-1.7-0.10.6
    Specialty Hospitals:
    Eye and Ear120.8-4.80.0-1.8
    Trauma151-0.11.50.03.7
    Cancer10-1.3-0.40.40.7
    Tefra Hospitals (Not Included on Other Lines):
    Rehab1690.37.5-0.39.2
    Psych103-0.7-7.4-1.7-7.8
    LTC99-0.7-4.3-0.4-3.3
    Children42-0.6-0.9-1.0-0.5
    Note: For CY 2002, under the OPPS transitional corridor policy cancer, children's, and rural hospitals with 100 or fewer beds are held harmless compared to their 1996 payment margin for these services. All other hospitals are protected to some extent when their payment margins are less than they were in 1996 (see § 419.70(b)). These additional payments are not reflected below.
    1 Some data necessary to classify hospitals by category were missing; thus, the total number of hospitals in each category may not equal the national total.
    2 This column shows the impact of updating the wage index used to calculate payment using the final FY 2002 hospital inpatient wage index after geographic reclassification by the Medicare Geographic Classification Review Board. The hospital inpatient final rule for FY 2002 was published in the Federal Register on September 1, 2001.
    3 This column shows the impact of recalibrating the APC weights based on the 1999-2000 hospital claims data and on the reassignment of some HCPCs to APCs as well as the incorporation of the device costs discussed in this rule.
    4 This column shows the difference in calculating outliers on an APC-specific rather than bill basis and with the final thresholds.
    5 This column shows changes in total payment from CY2001 to CY 2002. It incorporates all of the changes reflected in columns 2, 3, and 4. In addition, it shows the impact of the CY 2002 payment update. The sum of the columns may be different from the percentage changes shown here due to rounding.

    In accordance with the provisions of Executive Order 12866, this final rule was reviewed by the Office of Management and Budget.

    Start List of Subjects

    List of Subjects

    42 CFR Part 413

    • Health facilities
    • Kidney diseases
    • Medicare
    • Puerto Rico
    • Reporting and recordkeeping requirements

    42 CFR Part 419

    • Hospitals
    • Medicare
    • Reporting and recordkeeping requirements

    42 CFR Part 489

    • Health facilities
    • Medicare
    • Reporting and recordkeeping requirements
    End List of Subjects Start Amendment Part

    For the reasons set forth in the preamble, the Centers for Medicare & Start Printed Page 59920Medicaid Services amends 42 CFR chapter IV as follows:

    End Amendment Part Start Part

    PART 413—PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES; PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES

    End Part Start Amendment Part

    A. Part 413 is amended as set forth below:

    End Amendment Part Start Amendment Part

    1. The authority citation for part 413 continues to read as follows:

    End Amendment Part Start Authority

    Authority: Secs. 1102, 1812(d), 1814(b), 1815, 1833(a), (i), and (n), 1871, 1881, 1883, and 1886 of the Social Security Act (42 U.S.C. 1302, 1395f(b), 1395g, 1395l, 1395l(a), (i), and (n), 1395x(v), 1395hh, 1395rr, 1395tt, and 1395ww).

    End Authority

    Subpart B—Accounting Records and Reports

    Start Amendment Part

    2. In § 413.24, the heading to paragraph (d) is republished, paragraph (d)(6) is revised, and a new paragraph (d)(7) is added, to read as follows:

    End Amendment Part
    Adequate cost data and cost finding.
    * * * * *

    (d) Cost finding methods. * * *

    (6) Provider-based entities and departments: Preventing duplication of cost. In some situations, the main provider in a provider-based complex may purchase services for a provider-based entity or for a department of the provider through a contract for services (for example, a management contract), directly assigning the costs to the provider-based entity or department and reporting the costs directly in the cost center for that entity or department. In any situation in which costs are directly assigned to a cost center, there is a risk of excess cost in that cost center resulting from the directly assigned costs plus a share of overhead improperly allocated to the cost center which duplicates the directly assigned costs. This duplication could result in improper Medicare payment to the provider. Where a provider has purchased services for a provider-based entity or for a provider department, like general service costs of the provider (for example, like costs in the administrative and general cost center) must be separately identified to ensure that they are not improperly allocated to the entity or the department. If the like costs of the main provider cannot be separately identified, the costs of the services purchased through a contract must be reclassified to the main provider and allocated among the main provider's benefiting cost centers.

    Example:

    A provider-based complex is composed of a hospital and a hospital-based rural health clinic (RHC). The hospital furnishes the entirety of its own administrative and general costs internally. The RHC, however, is managed by an independent contractor through a management contract. The management contract provides a full array of administrative and general services, with the exception of patient billing. The hospital directly assigns the costs of the RHC's management contract to the RHC cost center (for example, Form HCFA 2552-96, Worksheet A, Line 71). A full allocation of the hospital's administrative and general costs to the RHC cost center would duplicate most of the RHC's administrative and general costs. However, an allocation of the hospital's cost (included in hospital administrative and general costs) of its patient billing function to the RHC would be appropriate. Therefore, the hospital must include the costs of the patient billing function in a separate cost center to be allocated to the benefiting cost centers, including the RHC cost center. The remaining hospital administrative and general costs would be allocated to all cost centers, excluding the RHC cost center. If the hospital is unable to isolate the costs of the patient billing function, the costs of the RHC's management contract must be reclassified to the hospital administrative and general cost center to be allocated among all cost centers, as appropriate.

    (7) Costs of services furnished to free-standing entities. The costs that a provider incurs to furnish services to free-standing entities with which it is associated are not allowable costs of that provider. Any costs of services furnished to a free-standing entity must be identified and eliminated from the allowable costs of the servicing provider, to prevent Medicare payment to that provider for those costs. This may be done by including the free-standing entity on the cost report as a nonreimbursable cost center for the purpose of allocating overhead costs to that entity. If this method would not result in an accurate allocation of costs to the entity, the provider must develop detailed work papers showing how the cost of services furnished by the provider to the entity were determined. These costs are removed from the applicable cost centers of the servicing provider.

    * * * * *

    Subpart E—Payments to Providers

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    3. Section 413.65 is amended as follows:

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    A. Revising paragraph (a)(1).

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    B. Revising the definition of “Provider-based entity” in paragraph (a)(2).

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    C. Revising paragraph (b).

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    D. Revising paragraph (c).

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    E. Revising the introductory text to paragraph (d).

    End Amendment Part Start Amendment Part

    F. Revising paragraph (d)(7).

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    G. Revising paragraph (g)(7).

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    H. Revising the introductory text to paragraph (i)(1).

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    I. Revising paragraph (i)(1)(ii).

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    J. Revising paragraph (i)(2).

    End Amendment Part Start Amendment Part

    The revisions read as follows:

    End Amendment Part
    Requirements for a determination that a facility or an organization has provider-based status.

    (a) Scope and definitions. (1) Scope. (i) This section applies to all facilities for which provider-based status is sought, including remote locations of hospitals, as defined in paragraph (a)(2) of this section and satellite facilities as defined in § 412.22(h)(1) and § 412.25(e)(1) of this chapter, other than facilities described in paragraph (a)(1)(ii) of this section.

    (ii) This section does not apply to the following facilities:

    (A) Ambulatory surgical centers (ASCs).

    (B) Comprehensive outpatient rehabilitation facilities (CORFs).

    (C) Home health agencies (HHAs).

    (D) Skilled nursing facilities (SNFs).

    (E) Hospices.

    (F) Inpatient rehabilitation units that are excluded from the inpatient PPS for acute hospital services.

    (G) Independent diagnostic testing facilities and any other facilities that furnish only clinical diagnostic laboratory tests.

    (H) Facilities furnishing only physical, occupational, or speech therapy to ambulatory patients, for as long as the $1,500 annual cap on coverage of physical, occupational, and speech therapy, as described in section 1833(g)(2) of the Act, remains suspended by the action of subsequent legislation.

    (I) ESRD facilities (determinations for ESRD facilities are made under § 413.174 of this chapter).

    (2) Definitions. * * *

    * * * * *

    Provider-based entity means a provider of health care services, or an RHC as defined in § 405.2401(b) of this chapter, that is either created by, or acquired by, a main provider for the purpose of furnishing health care services of a different type from those of the main provider under the name, ownership, and administrative and financial control of the main provider, in accordance with the provisions of this section.

    * * * * *

    (b) Provider-based determinations. (1) A facility or organization is not entitled to be treated as provider-based simply Start Printed Page 59921because it or the main provider believe it is provider-based.

    (2) If a facility was treated as provider-based in relation to a hospital or CAH on October 1, 2000, it will continue to be considered provider-based in relation to that hospital or CAH until October 1, 2002. The requirements, limitations, and exclusions specified in paragraphs (d), (e), (f), and (h) of this section will not apply to that hospital or CAH for that facility until October 1, 2002. For purposes of this paragraph, a facility is considered as provider-based on October 1, 2000, if on that date it either had a written determination from CMS that it was provider-based, or was billing and being paid as a provider-based department or entity of the hospital.

    (3) Except as specified in paragraphs (b)(2) and (b)(5) of this section, a main provider or a facility must contact CMS, and the facility must be determined by CMS to be provider-based, before the main provider bills for services of the facility as if the facility were provider based, or before it includes costs of those services on its cost report.

    (4) A facility that is not located on the campus of a hospital and that is used as a site where physician services of the kind ordinarily furnished in physician offices are furnished is presumed as a free-standing facility, unless CMS determines the facility has provider-based status.

    (5) A facility that has requested provider-based status in relation to a hospital or CAH on or after October 1, 2000 and before October 1, 2002 will be treated as provider-based in relation to the hospital or CAH from the first date on or after October 1, 2000 on which the facility was licensed (to the extent required by the State), staffed and equipped to treat patients until the date on which CMS determines that the facility does not qualify for provider-based status.

    (c) Reporting. A main provider that has had one or more facilities considered provider-based also must report to CMS any material change in the relationship between it and any provider-based facility, such as a change in ownership of the facility or entry into a new or different management contract that would affect the provider-based status of the facility.

    (d) Requirements. An entity must meet all of the following requirements to be determined by CMS to have provider-based status.

    * * * * *

    (7) Location in immediate vicinity. The facility or organization and the main provider are located on the same campus, except when the requirements in paragraphs (d)(7)(i), (d)(7)(ii), or (d)(7)(iii) of this section are met:

    (i) The facility or organization is located within a 35-mile radius of the main campus of the hospital or CAH that is the potential main provider;

    (ii) The facility or organization is owned and operated by a hospital or CAH that has a disproportionate share adjustment (as determined under § 412.106 of this chapter) greater than 11.75 percent or is described in § 412.106(c)(2) of this chapter implementing section 1886(d)(5)(F)(i)(II) of the Act and is—

    (A) Owned or operated by a unit of State or local government;

    (B) A public or nonprofit corporation that is formally granted governmental powers by a unit of State or local government; or

    (C) A private hospital that has a contract with a State or local government that includes the operation of clinics located off the main campus of the hospital to assure access in a well-defined service area to health care services to low-income individuals who are not entitled to benefits under Medicare (or medical assistance under a Medicaid State plan).

    (iii) The facility or organization demonstrates a high level of integration with the main provider by showing that it meets all of the other provider-based criteria and demonstrates that it serves the same patient population as the main provider, by submitting records showing that, during the 12-month period immediately preceding the first day of the month in which the application for provider-based status is filed with CMS, and for each subsequent 12-month period—

    (A) At least 75 percent of the patients served by the facility or organization reside in the same zip code areas as at least 75 percent of the patients served by the main provider;

    (B) At least 75 percent of the patients served by the facility or organization who required the type of care furnished by the main provider received that care from that provider (for example, at least 75 percent of the patients of an RHC seeking provider-based status received inpatient hospital services from the hospital that is the main provider); or

    (C) If the facility or organization is unable to meet the criteria in paragraph (d)(7)(i)(A) or (d)(7)(i)(B) of this section because it was not in operation during all of the 12-month period described in the previous sentence, the facility or organization is located in a zip code area included among those that, during all of the 12-month period described in the previous sentence, accounted for at least 75 percent of the patients served by the main provider.

    (iv) A facility or organization is not considered in the “immediate vicinity” of the main provider unless the facility or organization and the main provider are located in the same State or, when consistent with the laws of both States, or adjacent States.

    (v) An RHC that is otherwise qualified as a provider-based entity of a hospital that is located in a rural area, as defined in § 412.62(f)(1)(iii) of this chapter, and has fewer than 50 beds, as determined under § 412.105(b) of this chapter, is not subject to the criteria in paragraphs (d)(7)(i) through (d)(7)(iv) of this section.

    * * * * *

    (g) Obligations of hospital outpatient departments and hospital-based entities. * * *

    * * * * *

    (7) When a Medicare beneficiary is treated in a hospital outpatient department or hospital-based entity (other than an RHC) that is not located on the main provider's campus, the hospital must provide written notice to the beneficiary, before the delivery of services, of the amount of the beneficiary's potential financial liability (that is, that the beneficiary will incur a coinsurance liability for an outpatient visit to the hospital as well as for the physician service, and of the amount of that liability). The notice must be one that the beneficiary can read and understand. If the exact type and extent of care needed is not known, the hospital may furnish a written notice to the patient that explains that the beneficiary will incur a coinsurance liability to the hospital that he or she would not incur if the facility were not provider-based. The hospital may furnish an estimate based on typical or average charges for visits to the facility, while stating that the patient's actual liability will depend upon the actual services furnished by the hospital. If the beneficiary is unconscious, under great duress, or for any other reason unable to read a written notice and understand and act on his or her own rights, the notice must be provided, before the delivery of services, to the beneficiary's authorized representative.

    * * * * *

    (i) Inappropriate treatment of a facility or organization as provider-based—(1) Determination and review. If CMS learns that a provider has treated a facility or organization as provider-based and the provider had not obtained a determination of provider-based status under this section, CMS will—

    * * * * *
    Start Printed Page 59922

    (ii) Investigate and determine whether the requirements in paragraph (d) of this section (or, for periods before the beginning of the hospital's first cost reporting period beginning or or after January 10, 2001, the requirements in applicable program instructions) were met; and

    * * * * *

    (2) Recovery of overpayments. If CMS finds that payments for services at the facility or organization were made as if the facility or organization were provider-based, even though CMS had not previously determined that the facility or organization qualified for provider-based status—

    (i) CMS will recover the difference between the amount of payments that actually were made and the amount of payments that CMS estimates would have been made in the absence of a determination of provider-based status.

    (ii) CMS will not make recovery payments for any period before the beginning of the hospital's first cost reporting period beginning on or after January 10, 2001 if during all of that period the management of the entity made a good faith effort to operate it as a provider-based facility or organization, as described in paragraph (h)(3) of this section.

    * * * * *
    Start Part

    PART 419—PROSPECTIVE PAYMENT SYSTEM FOR HOSPITAL OUTPATIENT DEPARTMENT SERVICES

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    B. Part 419 is amended as set forth below:

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    1. The authority citation for part 419 continues to read as follows:

    End Amendment Part Start Authority

    Authority: Secs. 1102, 1833(t), and 1871 of the Social Security Act (42 U.S.C. 1302, 1395l(t), and 1395hh).

    End Authority

    Subpart A—General Provisions

    Start Amendment Part

    2. In § 419.2, paragraph (c) is revised to read as follows:

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    Basis of payment.
    * * * * *

    (c) Determination of hospital outpatient prospective payment rates: Excluded costs. The following costs are excluded from the hospital outpatient prospective payment system.

    (1) The costs of direct graduate medical education activities as described in § 413.86 of this chapter.

    (2) The costs of nursing and allied health programs as described in § 413.85 of this chapter.

    (3) The costs associated with interns and residents not in approved teaching programs as described in § 415.202 of this chapter.

    (4) The costs of teaching physicians attributable to Part B services for hospitals that elect cost-based reimbursement for teaching physicians under § 415.160.

    (5) The reasonable costs of anesthesia services furnished to hospital outpatients by qualified nonphysician anesthetists (certified registered nurse anesthetists and anesthesiologists' assistants) employed by the hospital or obtained under arrangements, for hospitals that meet the requirements under § 412.113(c) of this chapter.

    (6) Bad debts for uncollectible deductibles and coinsurances as described in § 413.80(b) of this chapter.

    (7) Organ acquisition costs paid under Part B.

    (8) Corneal tissue acquisition costs.

    Subpart B—Categories of Hospitals and Services Subject to and Excluded from the Hospital Outpatient Prospective Payment System

    Start Amendment Part

    3. In § 419.20, paragraph (a) is revised, and paragraphs (b)(3) and (b)(4) are added to read as follows:

    End Amendment Part
    Hospitals subject to the hospital outpatient prospective payment system.

    (a) Applicability. The hospital outpatient prospective payment system is applicable to any hospital participating in the Medicare program, except those specified in paragraph (b) of this section, for services furnished on or after August 1, 2000.

    (b) Hospitals excluded from the outpatient prospective payment system.

    * * * * *

    (3) A hospital located outside one of the 50 States, the District of Columbia, and Puerto Rico is excluded from the hospital outpatient prospective payment system.

    (4) A hospital of the Indian Health Service.

    Start Amendment Part

    4. In § 419.22, the introductory text is republished, and paragraph (r) is added to read as follows:

    End Amendment Part
    Hospital outpatient services excluded from payment under the hospital outpatient prospective payment system.

    The following services are not paid for under the hospital outpatient prospective payment system:

    * * * * *

    (r) Services defined in § 419.21(b) that are furnished to inpatients of hospitals that do not submit claims for outpatient services under Medicare Part B.

    Subpart C—Basic Methodology for Determining Prospective Payment Rates for Hospital Outpatient Services

    Start Amendment Part

    5. In § 419.32, paragraph (b)(1) is revised to read as follows:

    End Amendment Part
    Calculation of prospective payment rates for hospital outpatient services.
    * * * * *

    (b) Conversion factor for calendar year 2000 and subsequent years. (1) Subject to paragraph (b)(2) of this section, the conversion factor for a calendar year is equal to the conversion factor calculated for the previous year adjusted as follows:

    (i) For calendar year 2000, by the hospital inpatient market basket percentage increase applicable under section 1886(b)(3)(B)(iii) of the Act reduced by one percentage point.

    (ii) For calendar year 2001—

    (A) For services furnished on or after January 1, 2001 and before April 1, 2001, by the hospital inpatient market basket percentage increase applicable under section 1886(b)(3)(B)(iii) of the Act reduced by one percentage point; and

    (B) For services furnished on or after April 1, 2001 and before January 1, 2002, by the hospital inpatient market basket percentage increase applicable under section 1886(b)(3)(B)(iii) of the Act, and increased by a transitional percentage allowance equal to 0.32 percent.

    (iii) For calendar year 2002, by the hospital inpatient market basket percentage increase applicable under section 1886(b)(3)(B)(iii) of the Act reduced by one percentage point, without taking into account the transitional percentage allowance referenced in § 419.32(b)(ii)(B).

    (iv) For calendar year 2003 and subsequent years, by the hospital inpatient market basket percentage increase applicable under section 1886(b)(3)(B)(iii) of the Act.

    * * * * *

    Subpart D—Payments to Hospitals

    Start Amendment Part

    6. In § 419.40, the word “coinsurance” is removed and the word “copayment” is added in its place as follows. As revised, § 419.40 reads as follows:

    End Amendment Part
    Payment concepts.

    (a) In addition to the payment rate described in § 419.32, for each APC group there is a predetermined beneficiary copayment amount as described in § 419.41(a). The Medicare program payment amount for each APC group is calculated by applying the Start Printed Page 59923program payment percentage as described in § 419.41(b).

    (b) For purposes of this section—

    (1) Coinsurance percentage is calculated as the difference between the program payment percentage and 100 percent. The coinsurance percentage in any year is thus defined for each APC group as the greater of the following: the ratio of the APC group unadjusted copayment amount to the annual APC group payment rate, or 20 percent.

    (2) Program payment percentage is calculated as the lower of the following: the ratio of the APC group payment rate minus the APC group unadjusted copayment amount, to the APC group payment rate, or 80 percent.

    (3) Unadjusted copayment amount is calculated as 20 percent of the wage-adjusted national median of charges for services within an APC group furnished during 1996, updated to 1999 using an actuarial projection of charge increases for hospital outpatient department services during the period 1996 to 1999.

    (c) Limitation of copayment amount to inpatient hospital deductible amount. The copayment amount for a procedure performed in a year cannot exceed the amount of the inpatient hospital deductible established under section 1813(b) of the Act for that year.

    Start Amendment Part

    7. Amend § 419.41 as follows:

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    A. The section heading is revised.

    End Amendment Part Start Amendment Part

    B. The word “coinsurance” is removed each time it appears, and the word “copayment” is added in its place.

    End Amendment Part Start Amendment Part

    C. Paragraph (c)(4)(ii) is redesignated as paragraph (c)(4)(iv).

    End Amendment Part Start Amendment Part

    D. Paragraphs (c)(4)(ii) and (c)(4)(iii) are added as follows:

    End Amendment Part
    Calculation of national beneficiary copayment amounts and national Medicare program payment amounts.
    * * * * *

    (c) * * *

    (4) * * *

    (ii) Effective for services furnished from April 1, 2001 through December 31, 2001, the national unadjusted coinsurance rate for an APC cannot exceed 57 percent of the prospective payment rate for that APC.

    (iii) The national unadjusted coinsurance rate for an APC cannot exceed 55 percent in calendar years 2002 and 2003; 50 percent in calendar year 2004; 45 percent in calendar year 2005; and 40 percent in calendar year 2006 and thereafter.

    * * * * *
    Start Amendment Part

    8. In § 419.42 paragraph (a), (c), and (e) are revised to read as follows:

    End Amendment Part
    Hospital election to reduce coinsurance.

    (a) A hospital may elect to reduce coinsurance for any or all APC groups on a calendar year basis. A hospital may not elect to reduce copayment amounts for some, but not all, services within the same group.

    * * * * *

    (c) The hospital's election must be properly documented. It must specifically identify the APCs to which it applies and the copayment amount (within the limits identified below) that the hospital has selected for each group.

    * * * * *

    (e) In electing reduced coinsurance, a hospital may elect a copayment amount that is less than that year's wage-adjusted copayment amount for the group but not less than 20 percent of the APC payment rate as determined in § 419.32.

    * * * * *
    [Amended]
    Start Amendment Part

    9. Section 419.43 is amended by removing the word “coinsurance” from the section heading and from paragraph (a), and adding the word “copayment” in its place.

    End Amendment Part

    Subpart H—Transitional Corridors

    Start Amendment Part

    10. In § 419.70, paragraph (d)(2) is revised to read as follows:

    End Amendment Part
    Transitional adjustment to limit decline in payment.
    * * * * *

    (d) Hold harmless provisions * * *

    * * * * *

    (2) Permanent treatment for cancer hospitals and children's hospitals. In the case of a hospital described in § 412.23(d) or § 412.23(f) of this chapter for which the prospective payment system amount is less than the pre-BBA amount for covered hospital outpatient services, the amount of payment under this part is increased by the amount of this difference.

    * * * * *
    Start Part

    PART 489—PROVIDER AGREEMENTS AND SUPPLIER APPROVAL

    End Part Start Amendment Part

    C. Part 489 is amended as set forth below:

    End Amendment Part Start Amendment Part

    1. The authority citation to part 489 continues to read as follows:

    End Amendment Part Start Authority

    Authority: Secs. 1102 and 1871 of the Social Security Act (42 U.S.C. 1302 and 1395hh).

    End Authority

    Subpart B—Essentials of Provider Agreements

    Start Amendment Part

    2. In § 489.24, paragraphs (i)(2) introductory text and (i)(2)(ii) are revised to read as follows:

    End Amendment Part
    Special responsibilities of Medicare hospitals in emergency cases.
    * * * * *

    (i) Off-campus departments. * * *

    (2) Protocols for off-campus departments. The hospital must establish protocols for the handling of individuals with potential emergency conditions at off-campus departments. These protocols must provide for direct contact between personnel at the off-campus department and emergency personnel at the main hospital campus and may provide for dispatch of practitioners, when appropriate, from the main hospital campus to the off-campus department to provide screening or stabilization services. Any contact with emergency personnel at the main hospital campus should either be made after or concurrently with the actions needed to arrange an appropriate transfer under paragraph (i)(3)(ii) of this section if contacting the main hospital campus prior to transfer would significantly jeopardize the life or health of the individual.

    * * * * *

    (ii) If the off-campus department is a physical therapy, radiology, or other facility not routinely staffed with physicians, RNs, or LPNs, the department's personnel must be given protocols that direct them to contact emergency personnel at the main hospital campus for direction. Under this direction, and in accordance with protocols established in advance by the hospital, the personnel at the off-campus department must describe patient appearance and report symptoms and, if appropriate, either arrange transportation of the individual to the main hospital campus in accordance with paragraph (i)(3)(i) of this section or assist in an appropriate transfer as described in paragraphs (i)(3)(ii) and (d)(2) of this section.

    * * * * *
    Start Signature

    (Catalog of Federal Domestic Assistance Program No. 93.773, Medicare—Hospital Insurance; and Program No. 93.774, Medicare—Supplementary Medical Insurance Program)

    Start Printed Page 59924

    Dated: November 20, 2001.

    Thomas A. Scully,

    Administrator, Centers for Medicare & Medicaid Services.

    Approved: November 23, 2001.

    Tommy G. Thompson,

    Secretary.

    End Signature

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

    [Calendar Year 2002]

    APCGroup TitleStatus IndicatorRelative WeightPayment RateNational Unadjusted CopaymentMinimum Unadjusted Copayment
    0001PhotochemotherapyS0.43$21.89$7.88$4.38
    0002Fine needle Biopsy/AspirationT0.42$21.38$11.76$4.28
    0003Bone Marrow Biopsy/AspirationT1.03$52.43$27.99$10.49
    0004Level I Needle Biopsy/ Aspiration Except Bone MarrowT2.47$125.73$32.57$25.15
    0005Level II Needle Biopsy /Aspiration Except Bone MarrowT4.03$205.14$90.26$41.03
    0006Level I Incision & DrainageT2.18$110.97$33.95$22.19
    0007Level II Incision & DrainageT6.75$343.60$72.03$68.72
    0008Level III Incision and DrainageT10.93$556.38$113.67$111.28
    0009Nail ProceduresT0.63$32.07$8.34$6.41
    0010Level I Destruction of LesionT0.66$33.60$9.86$6.72
    0011Level II Destruction of LesionT1.47$74.83$27.69$14.97
    0012Level I Debridement & DestructionT0.66$33.60$9.18$6.72
    0013Level II Debridement & DestructionT1.36$69.23$17.66$13.85
    0015Level IV Debridement & DestructionT2.07$105.37$31.20$21.07
    0016Level V Debridement & DestructionT3.02$153.73$64.57$30.75
    0017Level VI Debridement & DestructionT9.68$492.75$226.67$98.55
    0018Biopsy of Skin/Puncture of LesionT1.05$53.45$17.66$10.69
    0019Level I Excision/ BiopsyT4.22$214.81$78.91$42.96
    0020Level II Excision/ BiopsyT8.44$429.63$130.53$85.93
    0021Level IV Excision/ BiopsyT11.82$601.69$236.51$120.34
    0022Level V Excision/ BiopsyT13.91$708.07$292.94$141.61
    0023Exploration Penetrating WoundT2.08$105.88$40.37$21.18
    0024Level I Skin RepairT2.28$116.06$41.78$23.21
    0025Level II Skin RepairT3.39$172.56$65.57$34.51
    0026Level III Skin RepairT12.62$642.41$277.92$128.48
    0027Level IV Skin RepairT18.02$917.29$383.10$183.46
    0028Level I Breast SurgeryT14.00$712.66$303.74$142.53
    0029Level II Breast SurgeryT23.76$1,209.48$628.93$241.90
    0030Level III Breast SurgeryT34.20$1,740.92$763.55$348.18
    0032Insertion of Central Venous/Arterial CatheterT12.64$643.43$128.69
    0033Partial HospitalizationP4.17$212.27$48.17$42.45
    0035Placement of Arterial or Central Venous CatheterT0.12$6.11$2.69$1.22
    0041Level I ArthroscopyT23.61$1,201.84$576.88$240.37
    0042Level II ArthroscopyT35.76$1,820.33$804.74$364.07
    0043Closed Treatment Fracture Finger/Toe/TrunkT4.05$206.16$41.23
    0044Closed Treatment Fracture/Dislocation Except Finger/Toe/TrunkT2.52$128.28$38.08$25.66
    0045Bone/Joint Manipulation Under AnesthesiaT11.67$594.05$277.12$118.81
    0046Open/Percutaneous Treatment Fracture or DislocationT27.69$1,409.53$535.76$281.91
    0047Arthroplasty without ProsthesisT26.36$1,341.83$537.03$268.37
    0048Arthroplasty with ProsthesisT43.19$2,198.54$725.94$439.71
    0049Level I Musculoskeletal Procedures Except Hand and FootT15.84$806.32$356.95$161.26
    0050Level II Musculoskeletal Procedures Except Hand and FootT20.63$1,050.15$504.07$210.03
    0051Level III Musculoskeletal Procedures Except Hand and FootT28.56$1,453.82$675.24$290.76
    0052Level IV Musculoskeletal Procedures Except Hand and FootT35.94$1,829.49$930.91$365.90
    0053Level I Hand Musculoskeletal ProceduresT11.69$595.07$253.49$119.01
    0054Level II Hand Musculoskeletal ProceduresT19.83$1,009.43$472.33$201.89
    0055Level I Foot Musculoskeletal ProceduresT15.44$785.96$355.34$157.19
    0056Level II Foot Musculoskeletal ProceduresT18.85$959.54$405.81$191.91
    0057Bunion ProceduresT24.35$1,239.51$496.65$247.90
    0058Level I Strapping and Cast ApplicationS1.28$65.16$19.27$13.03
    0059Level II Strapping and Cast ApplicationS2.22$113.01$29.59$22.60
    0060Manipulation TherapyS0.23$11.71$2.34
    0068CPAP InitiationS3.02$153.73$84.55$30.75
    0069ThoracoscopyT23.57$1,199.81$239.96
    0070Thoracentesis/Lavage ProceduresT4.58$233.14$79.60$46.63
    0071Level I Endoscopy Upper AirwayT1.03$52.43$14.22$10.49
    0072Level II Endoscopy Upper AirwayT1.21$61.59$33.87$12.32
    0073Level III Endoscopy Upper AirwayT3.29$167.47$73.69$33.49
    0074Level IV Endoscopy Upper AirwayT11.32$576.23$293.88$115.25
    0075Level V Endoscopy Upper AirwayT17.42$886.75$443.38$177.35
    0076Endoscopy Lower AirwayT7.56$384.83$188.57$76.97
    0077Level I Pulmonary TreatmentS0.39$19.85$10.92$3.97
    0078Level II Pulmonary TreatmentS0.86$43.78$18.83$8.76
    0079Ventilation Initiation and ManagementS0.60$30.54$16.80$6.11
    0080Diagnostic Cardiac CatheterizationT34.73$1,767.90$838.92$353.58
    0081Non-Coronary Angioplasty or AtherectomyT29.24$1,488.43$710.91$297.69
    0082Coronary AtherectomyT92.00$4,683.17$1,351.74$936.63
    Start Printed Page 59925
    0083Coronary AngioplastyT59.49$3,028.28$794.30$605.66
    0084Level I Electrophysiologic EvaluationS199.65$10,162.98$2,032.60
    0085Level II Electrophysiologic EvaluationT38.69$1,969.48$654.48$393.90
    0086Ablate Heart Dysrhythm FocusT72.72$3,701.74$1,265.37$740.35
    0087Cardiac Electrophysiologic Recording/MappingT52.46$2,670.42$534.08
    0088ThrombectomyT34.38$1,750.08$678.68$350.02
    0089Insertion/Replacement of Permanent Pacemaker and ElectrodesT149.52$7,611.17$2,246.59$1,522.23
    0090Insertion/Replacement of Pacemaker Pulse GeneratorT117.54$5,983.26$2,133.88$1,196.65
    0091Level I Vascular LigationT20.34$1,035.39$348.23$207.08
    0092Level II Vascular LigationT19.91$1,013.50$503.71$202.70
    0093Vascular Repair/Fistula ConstructionT14.16$720.80$277.34$144.16
    0094Resuscitation and CardioversionS6.08$309.50$105.29$61.90
    0095Cardiac RehabilitationS0.61$31.05$16.46$6.21
    0096Non-Invasive Vascular StudiesS1.71$87.05$47.88$17.41
    0097Cardiac Monitoring for 30 daysX0.84$42.76$23.52$8.55
    0098Injection of Sclerosing SolutionT1.24$63.12$20.88$12.62
    0099ElectrocardiogramsS0.35$17.82$9.80$3.56
    0100Stress Tests and Continuous ECGX1.47$74.83$41.16$14.97
    0101Tilt Table EvaluationS3.74$190.38$104.71$38.08
    0103Miscellaneous Vascular ProceduresT15.95$811.92$295.70$162.38
    0104Transcatheter Placement of Intracoronary StentsT87.98$4,478.53$895.71
    0105Revision/Removal of Pacemakers, AICD, or VascularT14.76$751.34$368.16$150.27
    0106Insertion/Replacement/Repair of Pacemaker and/or ElectrodesT36.64$1,865.12$503.07$373.02
    0107Insertion of Cardioverter-DefibrillatorT379.46$19,316.03$4,224.27$3,863.21
    0108Insertion/Replacement/Repair of Cardioverter-Defibrillator LeadsT573.46$29,191.41$5,838.28
    0109Removal of Implanted DevicesT6.27$319.17$130.86$63.83
    0110TransfusionS5.30$269.79$113.31$53.96
    0111Blood Product ExchangeS21.08$1,073.06$300.74$214.61
    0112Apheresis, Photopheresis, and PlasmapheresisS36.25$1,845.27$608.94$369.05
    0113Excision Lymphatic SystemT15.53$790.54$326.55$158.11
    0114Thyroid/Lymphadenectomy ProceduresT29.28$1,490.47$493.78$298.09
    0115Cannula/Access Device ProceduresT21.35$1,086.80$506.74$217.36
    0116Chemotherapy Administration by Other Technique Except InfusionS0.91$46.32$9.26
    0117Chemotherapy Administration by Infusion OnlyS4.01$204.13$52.69$40.83
    0118Chemotherapy Administration by Both Infusion and Other TechniqueS4.20$213.80$72.03$42.76
    0119Implantation of DevicesT79.67$4,055.52$811.10
    0120Infusion Therapy Except ChemotherapyT3.08$156.78$42.67$31.36
    0121Level I Tube changes and RepositioningT2.54$129.30$52.53$25.86
    0122Level II Tube changes and RepositioningT9.89$503.44$114.93$100.69
    0123Bone Marrow Harvesting and Bone Marrow/Stem Cell TransplantS8.56$435.74$87.15
    0124Revision of Implanted Infusion PumpT89.07$4,534.02$906.80
    0125Refilling of Infusion PumpT3.00$152.71$30.54
    0130Level I LaparoscopyT25.91$1,318.92$659.53$263.78
    0131Level II LaparoscopyT37.63$1,915.52$996.07$383.10
    0132Level III LaparoscopyT56.06$2,853.68$1,239.22$570.74
    0140Esophageal Dilation without EndoscopyT5.65$287.61$107.24$57.52
    0141Upper GI ProceduresT7.21$367.02$184.67$73.40
    0142Small Intestine EndoscopyT6.94$353.27$151.91$70.65
    0143Lower GI EndoscopyT7.27$370.07$185.04$74.01
    0144Diagnostic AnoscopyT4.43$225.50$49.32$45.10
    0145Therapeutic AnoscopyT10.81$550.27$179.39$110.05
    0146Level I SigmoidoscopyT2.73$138.97$63.93$27.79
    0147Level II SigmoidoscopyT5.71$290.66$136.61$58.13
    0148Level I Anal/Rectal ProcedureT2.40$122.17$43.59$24.43
    0149Level III Anal/Rectal ProcedureT13.53$688.73$293.06$137.75
    0150Level IV Anal/Rectal ProcedureT18.08$920.34$437.12$184.07
    0151Endoscopic Retrograde Cholangio-Pancreatography (ERCP)T15.29$778.32$245.46$155.66
    0152Percutaneous Biliary Endoscopic ProceduresT16.13$821.08$207.38$164.22
    0153Peritoneal and Abdominal ProceduresT23.55$1,198.79$496.31$239.76
    0154Hernia/Hydrocele ProceduresT31.40$1,598.39$556.98$319.68
    0155Level II Anal/Rectal ProcedureT5.26$267.76$53.55
    0156Level II Urinary and Anal ProceduresT2.45$124.71$37.41$24.94
    0157Colorectal Cancer Screening: Barium EnemaS1.98$100.79$22.19$20.16
    0158Colorectal Cancer Screening: ColonoscopyT6.55$333.42$83.36$66.68
    0159Colorectal Cancer Screening: Flexible SigmoidoscopyS2.33$118.61$29.65$23.72
    0160Level I Cystourethroscopy and other Genitourinary ProceduresT5.13$261.14$104.46$52.23
    0161Level II Cystourethroscopy and other Genitourinary ProceduresT13.72$698.40$249.36$139.68
    0162Level III Cystourethroscopy and other Genitourinary ProceduresT25.09$1,277.18$427.49$255.44
    0163Level IV Cystourethroscopy and other Genitourinary ProceduresT40.40$2,056.52$792.58$411.30
    0164Level I Urinary and Anal ProceduresT1.01$51.41$15.42$10.28
    0165Level III Urinary and Anal ProceduresT5.22$265.72$91.76$53.14
    0166Level I Urethral ProceduresT12.20$621.03$218.73$124.21
    0167Level II Urethral ProceduresT22.28$1,134.14$555.84$226.83
    0168Level III Urethral ProceduresT18.42$937.65$403.19$187.53
    0169LithotripsyT39.62$2,016.82$1,109.25$403.36
    0170Dialysis for Other Than ESRD PatientsS0.28$14.25$3.14$2.85
    0179Urinary Incontinence ProceduresT139.33$7,092.45$2,340.51$1,418.49
    Start Printed Page 59926
    0180CircumcisionT15.02$764.58$304.87$152.92
    0181Penile ProceduresT22.09$1,124.47$618.46$224.89
    0182Insertion of Penile ProsthesisT87.54$4,456.14$1,492.28$891.23
    0183Testes/Epididymis ProceduresT18.87$960.56$448.94$192.11
    0184Prostate BiopsyT4.83$245.87$122.94$49.17
    0187Miscellaneous Placement/RepositioningX4.22$214.81$42.96
    0188Level II Female Reproductive ProcT0.80$40.72$11.81$8.14
    0189Level III Female Reproductive ProcT1.26$64.14$17.96$12.83
    0190Surgical HysteroscopyT16.91$860.79$421.79$172.16
    0191Level I Female Reproductive ProcT0.23$11.71$3.40$2.34
    0192Level IV Female Reproductive ProcT2.50$127.26$35.33$25.45
    0193Level V Female Reproductive ProcT11.16$568.09$171.13$113.62
    0194Level VI Female Reproductive ProcT15.86$807.34$395.60$161.47
    0195Level VII Female Reproductive ProcT20.62$1,049.64$483.80$209.93
    0196Dilation and CurettageT13.48$686.19$336.23$137.24
    0197Infertility ProceduresT2.40$122.17$49.55$24.43
    0198Pregnancy and Neonatal Care ProceduresT1.31$66.68$32.67$13.34
    0199Vaginal DeliveryT5.09$259.10$72.55$51.82
    0200Therapeutic AbortionT11.34$577.25$305.94$115.45
    0201Spontaneous AbortionT14.33$729.45$329.65$145.89
    0202Level VIII Female Reproductive ProcT63.54$3,234.44$1,487.84$646.89
    0203Level V Nerve InjectionsT15.79$803.77$369.73$160.75
    0204Level VI Nerve InjectionsT2.24$114.02$43.33$22.80
    0206Level III Nerve InjectionsT3.59$182.75$74.93$36.55
    0207Level IV Nerve InjectionsT5.36$272.85$122.78$54.57
    0208Laminotomies and LaminectomiesT29.12$1,482.32$296.46
    0209Extended EEG Studies and Sleep Studies, Level IIS10.54$536.53$279.00$107.31
    0212Level II Nervous System InjectionsT3.77$191.91$88.78$38.38
    0213Extended EEG Studies and Sleep Studies, Level IS2.65$134.90$70.15$26.98
    0214ElectroencephalogramS2.10$106.90$53.45$21.38
    0215Level I Nerve and Muscle TestsS0.66$33.60$17.47$6.72
    0216Level III Nerve and Muscle TestsS2.61$132.86$59.79$26.57
    0218Level II Nerve and Muscle TestsS1.03$52.43$23.59$10.49
    0220Level I Nerve ProceduresT13.60$692.29$325.38$138.46
    0221Level II Nerve ProceduresT21.43$1,090.87$463.62$218.17
    0222Implantation of Neurological DeviceT302.53$15,399.99$3,080.00
    0223Implantation of Pain Management DeviceT75.39$3,837.65$767.53
    0224Implantation of Reservoir/Pump/ShuntT28.48$1,449.75$453.41$289.95
    0225Implantation of Neurostimulator ElectrodesT267.56$13,619.87$2,723.97
    0226Implantation of Drug Infusion ReservoirT75.81$3,859.03$771.81
    0227Implantation of Drug Infusion DeviceT139.55$7,103.65$1,420.73
    0228Creation of Lumbar Subarachnoid ShuntT53.77$2,737.11$696.46$547.42
    0229Transcatherter Placement of Intravascular ShuntsT67.22$3,421.77$996.86$684.35
    0230Level I Eye Tests & TreatmentsS0.61$31.05$14.28$6.21
    0231Level III Eye Tests & TreatmentsS2.03$103.34$46.50$20.67
    0232Level I Anterior Segment Eye ProceduresT3.50$178.16$78.39$35.63
    0233Level II Anterior Segment Eye ProceduresT10.83$551.29$264.62$110.26
    0234Level III Anterior Segment Eye ProceduresT19.08$971.25$466.20$194.25
    0235Level I Posterior Segment Eye ProceduresT5.57$283.54$78.91$56.71
    0236Level II Posterior Segment Eye ProceduresT16.21$825.15$165.03
    0237Level III Posterior Segment Eye ProceduresT36.32$1,848.83$369.77
    0238Level I Repair and Plastic Eye ProceduresT3.01$153.22$58.96$30.64
    0239Level II Repair and Plastic Eye ProceduresT5.80$295.24$115.14$59.05
    0240Level III Repair and Plastic Eye ProceduresT13.83$704.00$315.34$140.80
    0241Level IV Repair and Plastic Eye ProceduresT18.12$922.38$384.47$184.48
    0242Level V Repair and Plastic Eye ProceduresT23.72$1,207.44$597.36$241.49
    0243Strabismus/Muscle ProceduresT17.70$901.00$429.78$180.20
    0244Corneal TransplantT38.46$1,957.77$851.42$391.55
    0245Level I Cataract Procedures without IOL InsertT10.44$531.44$249.78$106.29
    0246Cataract Procedures with IOL InsertT21.20$1,079.16$507.21$215.83
    0247Laser Eye Procedures Except RetinalT4.03$205.14$94.36$41.03
    0248Laser Retinal ProceduresT29.51$1,502.18$300.44
    0249Level II Cataract Procedures without IOL InsertT21.80$1,109.71$521.56$221.94
    0250Nasal Cauterization/PackingT2.10$106.90$37.42$21.38
    0251Level I ENT ProceduresT2.43$123.70$27.99$24.74
    0252Level II ENT ProceduresT5.95$302.88$114.24$60.58
    0253Level III ENT ProceduresT12.33$627.65$284.00$125.53
    0254Level IV ENT ProceduresT17.37$884.20$272.41$176.84
    0256Level V ENT ProceduresT26.61$1,354.56$623.05$270.91
    0258Tonsil and Adenoid ProceduresT17.43$887.26$434.76$177.45
    0259Level VI ENT ProceduresT376.56$19,168.41$8,798.30$3,833.68
    0260Level I Plain Film Except TeethX0.70$35.63$19.60$7.13
    0261Level II Plain Film Except Teeth Including Bone Density MeasurementX1.21$61.59$33.87$12.32
    0262Plain Film of TeethX0.65$33.09$10.90$6.62
    0263Level I Miscellaneous Radiology ProceduresX1.61$81.96$44.26$16.39
    0264Level II Miscellaneous Radiology ProceduresX3.71$188.85$103.87$37.77
    0265Level I Diagnostic Ultrasound Except VascularS0.95$48.36$26.60$9.67
    Start Printed Page 59927
    0266Level II Diagnostic Ultrasound Except VascularS1.54$78.39$43.11$15.68
    0267Vascular UltrasoundS2.33$118.61$65.24$23.72
    0269Level I Echocardiogram Except TransesophagealS3.85$195.98$101.91$39.20
    0270Transesophageal EchocardiogramS5.30$269.79$145.69$53.96
    0271MammographyS0.60$30.54$16.80$6.11
    0272Level I FluoroscopyX1.38$70.25$38.64$14.05
    0274MyelographyS5.24$266.74$128.12$53.35
    0275ArthrographyS2.59$131.84$68.56$26.37
    0276Level I Digestive RadiologyS1.48$75.34$41.44$15.07
    0277Level II Digestive RadiologyS2.16$109.95$60.47$21.99
    0278Diagnostic UrographyS2.34$119.12$65.52$23.82
    0279Level I Angiography and Venography except ExtremityS7.72$392.98$174.57$78.60
    0280Level II Angiography and Venography except ExtremityS13.54$689.24$351.51$137.85
    0281Venography of ExtremityS4.32$219.91$114.35$43.98
    0282Miscellaneous Computerized Axial TomographyS1.58$80.43$44.24$16.09
    0283Computerized Axial Tomography with Contrast MaterialS4.48$228.05$125.43$45.61
    0284Magnetic Resonance Imaging and Magnetic Resonance Angiography with Contrast MaterialS7.15$363.96$200.18$72.79
    0285Positron Emission Tomography (PET)S18.72$952.92$415.21$190.58
    0286Myocardial ScansS5.41$275.39$151.46$55.08
    0287Complex VenographyS4.06$206.67$90.93$41.33
    0288CT, Bone DensityS1.17$59.56$32.76$11.91
    0289Needle Localization for Breast BiopsyX1.63$82.97$44.80$16.59
    0290Standard Non-Imaging Nuclear MedicineS1.75$89.08$48.99$17.82
    0291Level I Diagnostic Nuclear Medicine Excluding Myocardial ScansS3.50$178.16$90.20$35.63
    0292Level II Diagnostic Nuclear Medicine Excluding Myocardial ScansS4.20$213.80$117.59$42.76
    0294Level I Therapeutic Nuclear MedicineS5.01$255.03$140.27$51.01
    0295Level II Therapeutic Nuclear MedicineS12.10$615.94$338.77$123.19
    0296Level I Therapeutic Radiologic ProceduresS3.39$172.56$94.91$34.51
    0297Level II Therapeutic Radiologic ProceduresS7.07$359.89$172.51$71.98
    0299Miscellaneous Radiation TreatmentS0.21$10.69$4.06$2.14
    0300Level I Radiation TherapyS2.07$105.37$47.72$21.07
    0301Level II Radiation TherapyS5.15$262.16$52.53$52.43
    0302Level III Radiation TherapyS11.16$568.09$216.55$113.62
    0303Treatment Device ConstructionX3.00$152.71$69.28$30.54
    0304Level I Therapeutic Radiation Treatment PreparationX1.63$82.97$41.52$16.59
    0305Level II Therapeutic Radiation Treatment PreparationX3.71$188.85$90.65$37.77
    0310Level III Therapeutic Radiation Treatment PreparationX14.51$738.62$339.05$147.72
    0312Radioelement ApplicationsS32.40$1,649.29$329.86
    0313BrachytherapyS14.84$755.42$164.02$151.08
    0314Hyperthermic TherapiesS3.90$198.53$101.25$39.71
    0320Electroconvulsive TherapyS3.88$197.51$80.06$39.50
    0321Biofeedback and Other TrainingS0.93$47.34$21.78$9.47
    0322Brief Individual PsychotherapyS1.15$58.54$12.29$11.71
    0323Extended Individual PsychotherapyS1.73$88.06$21.13$17.61
    0324Family PsychotherapyS2.69$136.93$20.19$27.39
    0325Group PsychotherapyS1.38$70.25$18.27$14.05
    0330Dental ProceduresS10.97$558.42$111.68
    0332Computerized Axial Tomography and Computerized Angiography without Contrast MaterialS3.24$164.93$90.71$32.99
    0333Computerized Axial Tomography and Computerized Angio w/o Contrast Material followed by ContrastS5.22$265.72$146.15$53.14
    0335Magnetic Resonance Imaging, MiscellaneousS5.39$274.37$150.90$54.87
    0336Magnetic Resonance Imaging and Magnetic Resonance Angiography without ContrastS6.29$320.19$176.10$64.04
    0337MRI and Magnetic Resonance Angiography without Contrast Material followed by Contrast MaterialS8.54$434.72$239.10$86.94
    0339ObservationX6.85$348.69$69.74
    0340Minor Ancillary ProceduresX0.84$42.76$10.69$8.55
    0341Skin Tests and Miscellaneous Red Blood Cell TestsX0.10$5.09$2.80$1.02
    0342Level I PathologyX0.21$10.69$5.88$2.14
    0343Level II PathologyX0.39$19.85$10.72$3.97
    0344Level III PathologyX0.56$28.51$15.68$5.70
    0345Level I Transfusion Laboratory ProceduresX0.26$13.24$5.37$2.65
    0346Level II Transfusion Laboratory ProceduresX0.77$39.20$12.03$7.84
    0347Level III Transfusion Laboratory ProceduresX1.56$79.41$20.13$15.88
    0348Fertility Laboratory ProceduresX0.77$39.20$7.84
    0352Level II InjectionsX0.41$20.87$4.17
    0353Level II Allergy InjectionsX0.25$12.73$2.55
    0354Administration of Influenza/Pneumonia VaccineK0.10$5.09
    0355Level I ImmunizationsK0.19$9.67$1.93
    0356Level II ImmunizationsK1.11$56.50$11.30
    0359Level II InjectionsX1.79$91.12$18.22
    0360Level I Alimentary TestsX1.35$68.72$34.36$13.74
    0361Level II Alimentary TestsX3.25$165.44$82.72$33.09
    0362Fitting of Vision AidsX0.86$43.78$9.63$8.76
    0363Otorhinolaryngologic Function TestsX1.73$88.06$32.58$17.61
    Start Printed Page 59928
    0364Level I AudiometryX0.58$29.52$11.51$5.90
    0365Level II AudiometryX1.31$66.68$20.00$13.34
    0367Level I Pulmonary TestX0.70$35.63$17.82$7.13
    0368Level II Pulmonary TestsX1.47$74.83$38.16$14.97
    0369Level III Pulmonary TestsX3.49$177.65$58.50$35.53
    0370Allergy TestsX0.80$40.72$11.81$8.14
    0371Level I Allergy InjectionsX0.70$35.63$7.13
    0372Therapeutic PhlebotomyX0.53$26.98$10.09$5.40
    0373Neuropsychological TestingX1.00$50.90$14.25$10.18
    0374Monitoring Psychiatric DrugsX0.89$45.30$9.97$9.06
    0600Low Level Clinic VisitsV0.86$43.78$8.76
    0601Mid Level Clinic VisitsV0.95$48.36$9.67
    0602High Level Clinic VisitsV1.38$70.25$14.05
    0610Low Level Emergency VisitsV1.23$62.61$19.41$12.52
    0611Mid Level Emergency VisitsV2.16$109.95$36.47$21.99
    0612High Level Emergency VisitsV3.49$177.65$54.14$35.53
    0620Critical CareS8.40$427.59$149.66$85.52
    0685Level III Needle Biopsy/Aspiration Except Bone MarrowT9.16$466.28$205.16$93.26
    0686Level V Skin RepairT24.01$1,222.21$277.92$244.44
    0687Revision/Removal of Neurostimulator ElectrodesT42.34$2,155.28$431.06
    0688Revision/Removal of Neurostimulator Pulse Generator ReceiverT145.27$7,394.82$1,478.96
    0689Electronic Analysis of Cardioverter-defibrillatorsS0.43$21.89$12.04$4.38
    0690Electronic Analysis of Pacemakers and other Cardiac DevicesS0.37$18.83$10.36$3.77
    0691Electronic Analysis of Programmable Shunts/PumpsS3.17$161.37$88.75$32.27
    0692Electronic Analysis of Neurostimulator Pulse GeneratorsS14.34$729.96$401.48$145.99
    0693Level II Breast ReconstructionT31.81$1,619.26$712.47$323.85
    0694Level III Excision/BiopsyT3.99$203.11$60.93$40.62
    0695Level VII Debridement & DestructionT15.78$803.27$369.50$160.65
    0697Level II Echocardiogram Except TransesophagealS2.08$105.88$55.06$21.18
    0698Level II Eye Tests & TreatmentsS1.03$52.43$19.92$10.49
    0699Level IV Eye Tests & TreatmentT6.46$328.84$147.98$65.77
    0701SR 89 chloride, per mCiG$963.42$137.92
    0702SM 153 lexidronam, 50 mCiG$1,020.00$146.02
    0704IN 111 Satumomab pendetide per doseG$1,591.25$227.80
    0705TC 99M tetrofosmin, per doseG$114.00$16.32
    0706New Technology—Level I ($0-$50)S$25.00$5.00
    0707New Technology—Level II ($50-$100)S$75.00$15.00
    0708New Technology—Level III ($100-$200)S$150.00$30.00
    0709New Technology—Level IV ($200-$300)S$250.00$50.00
    0710New Technology—Level V ($300-$500)S$400.00$80.00
    0711New Technology—Level VI ($500-$750)S$625.00$125.00
    0712New Technology—Level VII ($750-$1000)S$875.00$175.00
    0713New Technology—Level VIII ($1000-$1250)S$1,125.00$225.00
    0714New Technology—Level IX ($1250-$1500)S$1,375.00$275.00
    0715New Technology—Level X ($1500-$1750)S$1,625.00$325.00
    0716New Technology—Level XI ($1750-$2000)S$1,875.00$375.00
    0717New Technology—Level XII ($2000-$2500)S$2,250.00$450.00
    0718New Technology—Level XIII ($2500-$3000)S$2,750.00$550.00
    0719New Technology—Level XIV ($3000-$3500)S$3,250.00$650.00
    0720New Technology—Level XV ($3500-$5000)S$4,250.00$850.00
    0721New Technology—Level XVI ($5000-$6000)S$5,500.00$1,100.00
    0725Leucovorin calcium inj, 50 mgG$4.15$.38
    0726Dexrazoxane hcl injection, 250 mgG$194.52$24.98
    0727Etidronate disodium inj 300 mgG$63.65$9.11
    0728Filgrastim 300 mcg injectionG$179.08$23.00
    0730Pamidronate disodium , 30 mgG$265.87$38.06
    0731Sargramostim injection 50 mcgG$29.06$4.16
    0732Mesna injection 200 mgG$36.48$3.30
    0733Non esrd epoetin alpha inj, 1000 uG$12.26$1.57
    0750Dolasetron mesylate, 10 mgG$16.45$2.11
    0754Metoclopramide hcl injection up to 10 mgG$1.17$.11
    0755Thiethylperazine maleate inj up to 10 mgG$4.60$.66
    0762Dronabinol 2.5mg oralG$3.28$.42
    0763Dolasetron mesylate oral, 100 mgG$69.64$8.94
    0764Granisetron hcl injection 10 mcgG$18.54$2.65
    0765Granisetron hcl 1 mg oralG$44.69$6.40
    0768Ondansetron hcl injection 1 mgG$6.09$.78
    0769Ondansetron hcl 8mg oralG$26.41$3.39
    0800Leuprolide acetate, 3.75 mgG$93.47$12.00
    0801Cyclophosphamide oral 25 mgG$2.03$.18
    0802Etoposide oral 50 mgG$52.43$6.73
    0803Melphalan oral 2 mgG$2.29$.33
    0807Aldesleukin/single use vialG$672.60$96.29
    0809Bcg live intravesical vacG$166.49$21.38
    0810Goserelin acetate implant 3.6 mgG$446.49$63.92
    0811Carboplatin injection 50 mgG$114.46$16.39
    0812Carmus bischl nitro inj 100 mgG$117.84$16.87
    Start Printed Page 59929
    0813Cisplatin 10 mg injectionG$42.18$3.82
    0814Asparaginase injection 10,000 uG$62.61$8.96
    0815Cyclophosphamide 100 mg injG$5.82$.75
    0816Cyclophosphamide lyophilized 100 mgG$4.89$.63
    0817Cytarabine hcl 100 mg injG$6.10$.55
    0818Dactinomycin 0.5 mgG$13.87$1.99
    0819Dacarbazine 100 mg injG$12.68$1.15
    0820Daunorubicin 10 mgG$76.62$6.94
    0821Daunorubicin citrate liposom 10 mgG$64.60$9.25
    0822Diethylstilbestrol injection 250 mgG$14.41$1.30
    0823Docetaxel, 20 mgG$297.83$42.64
    0824Etoposide 10 mg injG$10.45$.95
    0826Methotrexate Oral 2.5 mgG$3.45$.31
    0827Floxuridine injection 500 mgG$129.56$16.64
    0828Gemcitabine HCL 200 mgG$106.72$15.28
    0830Irinotecan injection 20 mgG$134.25$19.22
    0831Ifosfomide injection 1 gmG$156.64$22.42
    0832Idarubicin hcl injection 5 mgG$412.21$59.01
    0833Interferon alfacon-1, 1 mcgG$4.10$.59
    0834Interferon alfa-2a inj recombinant 3 million uG$34.86$4.99
    0836Interferon alfa-2b inj recombinant, 1 millionG$11.28$1.45
    0838Interferon gamma 1-b inj, 3 million uG$285.65$40.89
    0839Mechlorethamine hcl inj 10 mgG$12.01$1.72
    0840Melphalan hydrochl 50 mgG$400.74$57.37
    0841Methotrexate sodium inj 5 mgG$.45$.04
    0842Fludarabine phosphate inj 50 mgG$271.82$38.91
    0844Pentostatin injection, 10 mgG$1,654.14$236.80
    0847Doxorubicin hcl 10 mg vl chemoG$37.46$4.81
    0849Rituximab, 100 mgG$454.55$65.07
    0850Streptozocin injection, 1 gmG$117.64$16.84
    0851Thiotepa injection, 15 mgG$116.97$10.59
    0852Topotecan, 4 mgG$664.19$95.08
    0853Vinblastine sulfate inj, 1 mgG$4.11$.37
    0854Vincristine sulfate 1 mg injG$30.16$3.87
    0855Vinorelbine tartrate, 10 mgG$88.83$12.72
    0856Porfimer sodium, 75 mgG$2,603.67$372.74
    0857Bleomycin sulfate injection 15 uG$289.37$37.16
    0858Cladribine, 1mgG$53.39$4.83
    0859Fluorouracil injection 500 mgG$2.73$.25
    0860Plicamycin (mithramycin) inj 2.5 mgG$93.80$13.43
    0861Leuprolide acetate injection 1 mgG$69.79$6.32
    0862Mitomycin 5 mg injG$121.65$11.01
    0863Paclitaxel injection, 30 mgG$173.50$22.28
    0864Mitoxantrone hcl, 5 mgG$244.21$34.96
    0865Interferon alfa-n3 inj, human leukocyte derived, 2G$7.86$1.12
    0884Rho d immune globulin inj, 1 dose pkgG$34.11$4.38
    0886Azathioprine oral 50mgG$1.25$.11
    0887Azathioprine parenteral 100 mgG$1.06$.10
    0888Cyclosporine oral 100 mgG$5.22$.67
    0889Cyclosporin parenteral 250mgG$25.08$3.22
    0890Lymphocyte immune globulin 250 mgG$269.06$38.52
    0891Tacrolimus oral per 1 mgG$2.91$.42
    0900Alglucerase injection, per 10 uG$37.53$5.37
    0901Alpha 1 proteinase inhibitor, 10 mgG$2.09$.30
    0902Botulinum toxin a, per unitG$4.39$.63
    0903Cytomegalovirus imm IV/vialG$370.50$47.58
    0905Immune globulin 500 mgG$35.63$3.23
    0906RSV-ivig, 50 mgG$15.51$1.99
    0907Ganciclovir Sodium 500 mg injectionK0.42$21.38$4.28
    0908Tetanus immune globulin inj up to 250 uG$102.60$13.18
    0909Interferon beta-1a, 33 mcgG$225.22$32.24
    0910Interferon beta-1b /0.25 mgG$68.40$9.79
    0911Streptokinase per 250,000 iuK1.66$84.50$16.90
    0913Ganciclovir long act implant 4.5 mgG$4,750.00$680.00
    0916Injection imiglucerase /unitG$3.75$.54
    0917Pharmacologic stressorsK0.34$17.31$3.46
    0925Factor viii per iuG$.87$.08
    0926Factor VIII (porcine) per iuG$2.09$.30
    0927Factor viii recombinant per iuG$1.12$.14
    0928Factor ix complex per iuG$.48$.04
    0929Anti-inhibitor per iuG$1.43$.18
    0930Antithrombin iii injection per iuG$1.05$.15
    0931Factor IX non-recombinant, per iuG$26.13$3.74
    0932Factor IX recombinant, per iuG$1.12$.16
    0949Plasma, Pooled Multiple Donor, Solvent/Detergent TK2.78$141.51$28.30
    0950Blood (Whole) For TransfusionK1.97$100.28$20.06
    0952CryoprecipitateK0.66$33.60$6.72
    Start Printed Page 59930
    0954RBC leukocytes reducedK2.67$135.91$27.18
    0955Plasma, Fresh FrozenK2.13$108.43$21.69
    0956Plasma Protein FractionK1.19$60.58$12.12
    0957Platelet ConcentrateK0.93$47.34$9.47
    0958Platelet Rich PlasmaK1.10$55.99$11.20
    0959Red Blood CellsK1.93$98.24$19.65
    0960Washed Red Blood CellsK3.60$183.25$36.65
    0961Infusion, Albumin (Human) 5%, 50 mlK2.07$105.37$21.07
    0962Infusion, Albumin (Human) 25%, 50 mlK1.04$52.94$10.59
    0963Albumin (human), 5%, 250 mlK10.35$526.86$105.37
    0964Albumin (human), 25%, 20 mlK2.08$105.88$21.18
    0965Albumin (human), 25%, 50mlK5.20$264.70$52.94
    0966Plasmaprotein fract,5%,250mlK5.95$302.88$60.58
    0970New Technology—Level I ($0-$50)T$25.00$5.00
    0971New Technology—Level II ($50-$100)T$75.00$15.00
    0972New Technology—Level III ($100-$200)T$150.00$30.00
    0973New Technology—Level IV ($200-$300)T$250.00$50.00
    0974New Technology—Level V ($300-$500)T$400.00$80.00
    0975New Technology—Level VI ($500-$750)T$625.00$125.00
    0976New Technology—Level VII ($750-$1000)T$875.00$175.00
    0977New Technology—Level VIII ($1000-$1250)T$1,125.00$225.00
    0978New Technology—Level IX ($1250-$1500)T$1,375.00$275.00
    0979New Technology—Level X ($1500-$1750)T$1,625.00$325.00
    0980New Technology—Level XI ($1750-$2000)T$1,875.00$375.00
    0981New Technology—Level XII ($2000-$2500)T$2,250.00$450.00
    0982New Technology—Level XIII ($2500-$3000)T$2,750.00$550.00
    0983New Technology—Level XIV ($3000- $3500)T$3,250.00$650.00
    0984New Technology—Level XV ($3500-$5000)T$4,250.00$850.00
    0985New Technology—Level XVI ($5000-$6000)T$5,500.00$1,100.00
    1009Cryoprecip reduced plasmaK0.82$41.74$8.35
    1010Blood, L/R, CMV-negK2.72$138.46$27.69
    1011Platelets, HLA-m, L/R, unitK11.21$570.63$114.13
    1012Platelet concentrate, L/R, irradiated, unitK1.81$92.14$18.43
    1013Platelet concentrate, L/R, unitK1.11$56.50$11.30
    1014Platelets, aph/pher, L/R, unitK8.45$430.14$86.03
    1016Blood, L/R, froz/deglycerol/washedK6.76$344.11$68.82
    1017Platelets, aph/pher, L/R, CMV-neg, unitK8.82$448.97$89.79
    1018Blood, L/R, irradiatedK2.96$150.68$30.14
    1019Platelets, aph/pher, L/R, irradiated, unitK9.11$463.74$92.75
    1024Quinupristin/dalfopristin 500 mg (150/350)G$102.05$13.11
    1045Iobenguane sulfate I-131G$495.65$70.96
    1058TC 99M oxidronate, per vialG$36.74$5.26
    1059Cultured chondrocytes implntG$14,250.00$2,040.00
    1064I-131 cap, each add mCiG$5.86$.75
    1065I-131 sol, each add mCiG$15.81$2.03
    1066IN 111 satumomab pendetideG$1,591.25$227.80
    1079CO 57/58 0.5 mCiG$253.84$36.34
    1084Denileukin diftitox, 300 MCGG$999.88$143.14
    1086Temozolomide,oral 5 mgG$6.05$.87
    1087I-123 per 100 uciG$.65$.06
    1089Coo 57, 0.5 MciG$81.10$10.41
    1091IN 111 Oxyquinoline, per .5 mCiG$427.50$61.20
    1092IN 111 Pentetate, per 0.5 mCiG$256.50$23.22
    1094TC 99M Albumin aggr,1.0 cmCiG$33.09$4.25
    1095Technetium TC 99M DepreotideG$38.00$5.44
    1096TC 99M Exametazime, per doseG$445.31$63.75
    1097TC 99M Mebrofenin, per vialG$51.44$7.36
    1098TC 99M Pentetate, per vialG$22.43$2.88
    1099TC 99M Pyrophosphate, per vialG$39.11$5.60
    1122TC 99M arcitumomab, per vialG$1,235.00$176.80
    1166Cytarabine liposomal, 10 mgG$371.45$53.18
    1167Epirubicin hcl, 2 mgG$24.94$3.57
    1178Busulfan IV, 6 mgG$26.48$3.79
    1188I-131 cap, per 1-5 mCiG$117.25$15.06
    1200TC 99M Sodium GlucoheptonateG$22.61$3.24
    1201TC 99M succimer, per vialG$135.66$19.42
    1202TC 99M Sulfur Colloid, per doseG$76.00$9.76
    1203Verteporfin for injectionG$1,458.25$208.76
    1205Technetium Tc 99m disofeninG$79.17$11.33
    1207Octreotide acetate depot 1mgG$138.08$19.77
    1305ApligrafG$1,157.81$165.75
    1348I-131 sol, per 1-6 mCiG$146.57$18.82
    1400Diphenhydramine hcl 50mgG$.23$.02
    1401Prochlorperazine maleate 5mgG$.65$.06
    1402Promethazine hcl 12.5mg oralG$.01$.00
    1403Chlorpromazine hcl 10mg oralG$.27$.02
    1404Trimethobenzamide hcl 250mgG$.38$.03
    Start Printed Page 59931
    1405Thiethylperazine maleate10mgG$.56$.08
    1406Perphenazine 4mg oralG$.62$.06
    1407Hydroxyzine pamoate 25mgG$.28$.03
    1409Factor viia recombinant, per 1.2 mgG$1,596.00$228.48
    1600Technetium TC 99M sestamibiG$121.70$17.42
    1601Technetium TC 99M medronateG$42.18$5.42
    1602Technetium TC 99M apcitideG$475.00$68.00
    1603Thallous chloride TL 201, per mCiG$78.16$7.08
    1604IN 111 capromab pendetide, per doseG$2,192.13$313.82
    1605Abciximab injection, 10 mgG$513.02$73.44
    1606Anistreplase, 30 uG$2,693.80$385.64
    1607Eptifibatide injection, 5 mgG$11.31$1.45
    1608Etanercept injection, 25 mgG$141.01$20.19
    1609Rho(D) immune globulin h, sd, 100 iuG$20.55$2.64
    1611Hylan G-F 20 injection, 16 mgG$213.87$27.47
    1612Daclizumab, parenteral, 25 mgG$397.29$56.88
    1613Trastuzumab, 10 mgG$52.83$7.56
    1614Valrubicin, 200 mgG$423.23$60.59
    1615Basiliximab, 20 mgG$1,437.78$205.83
    1617LepirudinG$131.96$18.89
    1618Vonwillebrandfactrcmplx, per iuG$.95$.14
    1619Ga 67, per mCiG$25.62$2.32
    1620Technetium tc99m bicisateG$403.99$57.83
    1621Xenin xe 133G$29.93$2.71
    1622Technetium tc99m mertiatideG$137.75$19.72
    1623Technetium tc99m glucepatateG$22.61$3.24
    1624Sodium phosphate p32G$54.34$7.78
    1625Indium 111-in pentetreotideG$935.75$133.96
    1626Technetium tc99m oxidronateG$1.47$.21
    1627Technetium tc99mlabeled rbcsG$40.90$5.85
    1628Chromic phosphate p32G$150.86$21.60
    1713Anchor/screw bn/bn,tis/bnH
    1714Cath, trans atherectomy, dirH
    1715Brachytherapy needleH
    1716Brachytx seed, Gold 198H
    1717Brachytx seed, HDR Ir-192H
    1718Brachytx seed, Iodine 125H
    1719Brachytxseed, Non-HDR Ir-192H
    1720Brachytx seed, Palladium 103H
    1721AICD, dual chamberH
    1722AICD, single chamberH
    1724Cath, trans atherec,rotationH
    1725Cath, translumin non-laserH
    1726Cath, bal dil, non-vascularH
    1727Cath, bal tis dis, non-vasH
    1728Cath, brachytx seed admH
    1729Cath, drainageH
    1730Cath, EP, 19 or fewer electH
    1731Cath, EP, 20 or more elecH
    1732Cath, EP, diag/abl, 3D/vectH
    1733Cath, EP, othr than cool-tipH
    1750Cath, hemodialysis,long-termH
    1751Cath, inf, per/cent/midlineH
    1752Cath, hemodialysis,short-termH
    1753Cath, intravas ultrasoundH
    1754Catheter, intradiscalH
    1755Catheter, intraspinalH
    1756Cath, pacing, transesophH
    1757Cath, thrombectomy/embolectH
    1758Cath, ureteralH
    1759Cath, intra echocardiographyH
    1760Closure dev, vasc, imp/insertH
    1762Conn tiss, human (inc fascia)H
    1763Conn tiss, non-humanH
    1764Event recorder, cardiacH
    1765Adhesion barrierH
    1766Intro/sheath,strble,non-peelH
    1767Generator, neurostim, impH
    1768Graft, vascularH
    1769Guide wireH
    1770Imaging coil, MR, insertableH
    1771Rep dev, urinary, w/slingH
    1772Infusion pump, programmableH
    1773Retrieval dev, insertH
    1776Joint device (implantable)H
    1777Lead, AICD, endo single coilH
    1778Lead, neurostimulatorH
    Start Printed Page 59932
    1779Lead, pmkr, transvenous VDDH
    1780Lens, intraocularH
    1781Mesh (implantable)H
    1782MorcellatorH
    1784Ocular dev, intraop, det retH
    1785Pmkr, dual, rate-respH
    1786Pmkr, single, rate-respH
    1787Patient progr, neurostimH
    1788Port, indwelling, impH
    1789Prosthesis, breast, impH
    1813Prosthesis, penile, inflatabH
    1815Pros, urinary sph, impH
    1816Receiver/transmitter, neuroH
    1817Septal defect imp sysH
    1874Stent, coated/cov w/del sysH
    1875Stent, coated/cov w/o del syH
    1876Stent, non-coa/no-cov w/delH
    1877Stent, non-coat/cov w/o delH
    1878Matrl for vocal cordH
    1879Tissue marker, impH
    1880Vena cava filterH
    1881Dialysis access systemH
    1882AICD, other than sing/dualH
    1883Adapt/ext, pacing/neuro leadH
    1885Cath, translumin angio laserH
    1887Catheter, guidingH
    1891Infusion pump,non-prog,permH
    1892Intro/sheath,fixed,peel-awayH
    1893Intro/sheath,fixed,non-peelH
    1894Intro/sheath, non-laserH
    1895Lead, AICD, endo dual coilH
    1896Lead, AICD, non sing/dualH
    1897Lead, neurostim test kitH
    1898Lead, pmkr, other than transH
    1899Lead, pmkr/AICD combinationH
    2615Sealant, pulmonary, liquidH
    2616Brachytx seed, Yttrium-90H
    2617Stent, non-cor, tem w/o delH
    2618Probe, cryoablationH
    2619Pmkr, dual, non rate-respH
    2620Pmkr, single, non rate-respH
    2621Pmkr, other than sing/dualH
    2622Prosthesis, penile, non-infH
    2625Stent, non-cor, tem w/del sysH
    2626Infusion pump, non-prog,tempH
    2627Cath, suprapubic/cystoscopicH
    2628Catheter, occlusionH
    2629Intro/sheath, laserH
    2630Cath, EP, cool-tipH
    2631Rep dev, urinary, w/o slingH
    7000Amifostine, 500 mgG$392.06$56.13
    7001Amphotericin B lipid complex, 50 mgG$109.25$15.64
    7003Epoprostenol injection 0.5 mgG$12.04$1.72
    7005Gonadorelin hydroch, 100 mcgG$192.37$27.54
    7007Milrinone lactate, per 5 ml, injK0.44$22.40$4.48
    7010Morphine sulfate (preservative free) 10 mgG$1.02$.09
    7011Oprelvekin injection, 5 mgG$245.81$35.19
    7014Fentanyl citrate injectionG$1.23$.11
    7015Busulfan, oral, 2 mgG$1.91$.27
    7019Aprotinin, 10,000 kiuG$2.16$.31
    7022Elliot's B solution, per mlG$1.43$.20
    7023Bladder calculi irrig solG$24.70$3.54
    7024Corticorelin ovine triflutatG$368.03$52.69
    7025Digoxin immune FAB (ovine)G$551.66$78.97
    7026Ethanolamine oleate, 100 mgG$39.73$5.69
    7027Fomepizole, 15 mgG$10.93$1.56
    7028Fosphenytoin, 50 mgG$5.73$.82
    7029Glatiramer acetate, per doseG$30.07$4.30
    7030Hemin, per 1 mgG$.99$.14
    7031Octreotide acetate injectionG$138.08$19.77
    7032Sermorelin acetate, 0.5 mgG$13.60$1.95
    7033Somatrem, 5mgG$209.48$29.99
    7034Somatropin injectionG$39.90$5.12
    7035Teniposide, 50 mgG$222.80$31.90
    7036Urokinase 250,000 iu injK6.41$326.29$65.26
    7037Urofollitropin, 75 iuG$73.29$10.49
    7038Muromonab-CD3, 5 mgG$269.06$38.52
    Start Printed Page 59933
    7039Pegademase bovine inj 25 I.UG$139.33$19.95
    7040Pentastarch 10% solutionG$15.11$2.16
    7041Tirofiban hydrochloride 12.5 mgG$436.41$62.48
    7042Capecitabine, oral, 150 mgG$2.43$.35
    7043Infliximab injection 10 mgG$63.24$9.05
    7045Trimetrexate glucoronateG$118.75$17.00
    7046Doxorubicin hcl liposome inj 10 mgG$358.95$51.39
    7048Alteplase recombinantK0.36$18.33$3.67
    7049Filgrastim 480 mcg injectionG$285.38$36.65
    7050Prednisone oralG$.07$.01
    7051Leuprolide acetate implant, 65 mgG$5,399.80$773.02
    7315Sodium hyaluronate injection, 5mgG$26.13$3.74
    9000Na chromate Cr51, per 0.25mCiG$.52$.07
    9001Linezolid inj, 200mgG$24.13$3.45
    9002Tenecteplase, 50mg/vialG$2,612.50$374.00
    9003Palivizumab, per 50mgG$664.49$95.13
    9004Gemtuzumab ozogamicin inj,5mgG$1,929.69$276.25
    9005Reteplase injectionG$1,306.25$187.00
    9006Tacrolimus injG$113.15$16.20
    9007Baclofen Intrathecal kit-1ampG$79.80$11.42
    9008Baclofen refill kit—per 500 mcgG$11.69$1.67
    9009Baclofen refill kit—per 2000 mcgG$49.12$7.03
    9010Baclofen refill kit—per 4000 mcgG$43.08$6.17
    9011Caffeine Citrate, inj,G$3.05$.44
    9012Arsenic TrioxideG$23.75$3.40
    9013Co 57 Cobaltous CIG$81.10$10.41
    9015Mycophenolate mofetil oral 250 mgG$2.40$.34
    9016Echocardiography contrastG$118.75$17.00
    9018Botulinum tox B, per 100 uG$8.79$1.26
    9019Caspofungin acetate, 5 mgG$34.20$4.90
    9020Sirolimus tablet, 1 mgG$6.51$.93
    9100Iodinated I-131 albuminG$10.34$1.48
    910251 na chromate, per 50mCiG$64.84$9.28
    9103Na iothalamate I-125, per 10 uciG$17.18$2.46
    9104Anti-thymocycte globulin rabbitG$325.09$46.54
    9105Hep B imm glob, per 1 mlG$133.00$17.08
    9106Sirolimus, 1 mgG$6.51$.93
    9108Thyrotropin alfa, per 1.1 mgG$531.05$76.02
    9109Tirofliban hcl, per 6.25 mgG$207.81$29.75
    9110Alemtuzumab, per mlG$486.88$69.70
    9111Inj, bivalirudin, per 250mg vialG$397.81$56.95
    9112Perflutren lipid micro, per 2mlG$148.20$21.22
    9113Inj pantoprazole sodium, vialG$22.80$3.26
    9114Nesiritide, per 1.5 mg vialG$433.20$62.02
    9115Inj, zoledronic acid, per 2 mgG$406.78$58.23
    9200Orcel, per 36 cm2G$1,135.25$162.52
    9201Dermagraft, per 37.5 sq cmG$577.60$82.69
    9217Leuprolide acetate suspnsion, 7.5 mgG$592.60$84.84
    9500Platelets, irradiatedK1.68$85.52$17.10
    9501Platelets, pheresisK9.16$466.28$93.26
    9502Platelet pheresis irradiatedK9.94$505.99$101.20
    9503Fresh frozen plasma, ea unitK1.56$79.41$15.88
    9504RBC deglycerolizedK4.11$209.22$41.84
    9505RBC irradiatedK2.44$124.21$24.84
    9506Granulocytes, pheresisK27.75$1,412.59$282.52
    —————————— CPT codes and descriptions only are copyright American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. Copyright American Dental Association. All rights reserved. * Code is new in 2002. Start Printed Page 59933

    Addendum B.—Payment Status by HCPCS Code and Related Information Calender Year 2002------

    CPT/HCPCSStatus IndicatorDescriptionAPCRelative WeightPayment RateNational Unadjusted CopaymentMinimum Unadjusted Copayment
    *0001TCEndovas repr abdo ao aneurys
    *0002TCEndovas repr abdo ao aneurys
    *0003TNCervicography
    *0005TCPerc cath stent/brain cv art
    *0006TCPerc cath stent/brain cv art
    *0007TCPerc cath stent/brain cv art
    *0008TEUpper gi endoscopy w/suture
    *0009TTEndometrial cryoablation019311.16$568.09$171.13$113.62
    Start Printed Page 59934
    00100NAnesth, salivary gland
    00102NAnesth, repair of cleft lip
    00103NAnesth, blepharoplasty
    00104NAnesth, electroshock
    *0010TATb test, gamma interferon
    00120NAnesth, ear surgery
    00124NAnesth, ear exam
    00126NAnesth, tympanotomy
    *0012TTOsteochondral knee autograft004123.61$1,201.84$576.88$240.37
    *0013TTOsteochondral knee allograft004123.61$1,201.84$576.88$240.37
    00140NAnesth, procedures on eye
    00142NAnesth, lens surgery
    00144NAnesth, corneal transplant
    00145NAnesth, vitreoretinal surg
    00147NAnesth, iridectomy
    00148NAnesth, eye exam
    *0014TTMeniscal transplant, knee004123.61$1,201.84$576.88$240.37
    00160NAnesth, nose/sinus surgery
    00162NAnesth, nose/sinus surgery
    00164NAnesth, biopsy of nose
    *0016TEThermotx choroid vasc lesion
    00170NAnesth, procedure on mouth
    00172NAnesth, cleft palate repair
    00174CAnesth, pharyngeal surgery
    00176CAnesth, pharyngeal surgery
    *0017TEPhotocoagulat macular drusen
    *0018TSTranscranial magnetic stimul02150.66$33.60$17.47$6.72
    00190NAnesth, face/skull bone surg
    00192CAnesth, facial bone surgery
    *0019TAExtracorp shock wave tx, ms
    *0020TAExtracorp shock wave tx, ft
    00210NAnesth, open head surgery
    00212NAnesth, skull drainage
    00214CAnesth, skull drainage
    00215CAnesth, skull repair/fract
    00216NAnesth, head vessel surgery
    00218NAnesth, special head surgery
    *0021TCFetal oximetry, trnsvag/cerv
    00220NAnesth, spinal fluid shunt
    00222NAnesth, head nerve surgery
    *0023TAPhenotype drug test, hiv 1
    *0024TCTranscath cardiac reduction
    *0025TSUltrasonic pachymetry02300.61$31.05$14.28$6.21
    *0026TAMeasure remnant lipoproteins
    00300NAnesth, head/neck/ptrunk
    00320NAnesth, neck organ surgery
    00322NAnesth, biopsy of thyroid
    00350NAnesth, neck vessel surgery
    00352NAnesth, neck vessel surgery
    00400NAnesth, skin, ext/per/atrunk
    00402NAnesth, surgery of breast
    00404CAnesth, surgery of breast
    00406CAnesth, surgery of breast
    00410NAnesth, correct heart rhythm
    00450NAnesth, surgery of shoulder
    00452CAnesth, surgery of shoulder
    00454NAnesth, collar bone biopsy
    00470NAnesth, removal of rib
    00472NAnesth, chest wall repair
    00474CAnesth, surgery of rib(s)
    00500NAnesth, esophageal surgery
    00520NAnesth, chest procedure
    00522NAnesth, chest lining biopsy
    00524CAnesth, chest drainage
    00528NAnesth, chest partition view
    00530NAnesth, pacemaker insertion
    00532NAnesth, vascular access
    00534NAnesth, cardioverter/defib
    00537NAnesth, cardiac electrophys
    00540CAnesth, chest surgery
    00542CAnesth, release of lung
    00544CAnesth, chest lining removal
    00546CAnesth, lung,chest wall surg
    00548NAnesth, trachea,bronchi surg
    00550NAnesth, sternal debridement
    Start Printed Page 59935
    00560CAnesth, open heart surgery
    00562CAnesth, open heart surgery
    00563NAnesth, heart proc w/pump
    00566NAnesth, cabg w/o pump
    00580CAnesth heart/lung transplant
    00600NAnesth, spine, cord surgery
    00604CAnesth, sitting procedure
    00620NAnesth, spine, cord surgery
    00622CAnesth, removal of nerves
    00630NAnesth, spine, cord surgery
    00632CAnesth, removal of nerves
    00634CAnesth for chemonucleolysis
    00635NAnesth, lumbar puncture
    00670CAnesth, spine, cord surgery
    00700NAnesth, abdominal wall surg
    00702NAnesth, for liver biopsy
    00730NAnesth, abdominal wall surg
    00740NAnesth, upper gi visualize
    00750NAnesth, repair of hernia
    00752NAnesth, repair of hernia
    00754NAnesth, repair of hernia
    00756NAnesth, repair of hernia
    00770NAnesth, blood vessel repair
    00790NAnesth, surg upper abdomen
    00792CAnesth, hemorr/excise liver
    00794CAnesth, pancreas removal
    00796CAnesth, for liver transplant
    *00797NAnesth, surgery for obesity
    00800NAnesth, abdominal wall surg
    00802CAnesth, fat layer removal
    00810NAnesth, low intestine scope
    00820NAnesth, abdominal wall surg
    00830NAnesth, repair of hernia
    00832NAnesth, repair of hernia
    00840NAnesth, surg lower abdomen
    00842NAnesth, amniocentesis
    00844CAnesth, pelvis surgery
    00846CAnesth, hysterectomy
    00848CAnesth, pelvic organ surg
    00850DAnesth, cesarean section
    *00851NAnesth, tubal ligation
    00855DAnesth, hysterectomy
    00857DAnalgesia, labor & c-section
    00860NAnesth, surgery of abdomen
    00862NAnesth, kidney/ureter surg
    00864CAnesth, removal of bladder
    00865CAnesth, removal of prostate
    00866CAnesth, removal of adrenal
    00868CAnesth, kidney transplant
    *00869NAnesth, vasectomy
    00870NAnesth, bladder stone surg
    00872NAnesth kidney stone destruct
    00873NAnesth kidney stone destruct
    00880NAnesth, abdomen vessel surg
    00882CAnesth, major vein ligation
    00884DAnesth, major vein revision
    00902NAnesth, anorectal surgery
    00904CAnesth, perineal surgery
    00906NAnesth, removal of vulva
    00908CAnesth, removal of prostate
    00910NAnesth, bladder surgery
    00912NAnesth, bladder tumor surg
    00914NAnesth, removal of prostate
    00916NAnesth, bleeding control
    00918NAnesth, stone removal
    00920NAnesth, genitalia surgery
    00922NAnesth, sperm duct surgery
    00924NAnesth, testis exploration
    00926NAnesth, removal of testis
    00928CAnesth, removal of testis
    00930NAnesth, testis suspension
    00932CAnesth, amputation of penis
    00934CAnesth, penis, nodes removal
    00936CAnesth, penis, nodes removal
    00938NAnesth, insert penis device
    Start Printed Page 59936
    00940NAnesth, vaginal procedures
    00942NAnesth, surg on vag/urethal
    00944CAnesth, vaginal hysterectomy
    00946DAnesth, vaginal delivery
    00948NAnesth, repair of cervix
    00950NAnesth, vaginal endoscopy
    00952NAnesth, hysteroscope/graph
    00955DAnalgesia, vaginal delivery
    01112NAnesth, bone aspirate/bx
    01120NAnesth, pelvis surgery
    01130NAnesth, body cast procedure
    01140CAnesth, amputation at pelvis
    01150CAnesth, pelvic tumor surgery
    01160NAnesth, pelvis procedure
    01170NAnesth, pelvis surgery
    01180NAnesth, pelvis nerve removal
    01190CAnesth, pelvis nerve removal
    01200NAnesth, hip joint procedure
    01202NAnesth, arthroscopy of hip
    01210NAnesth, hip joint surgery
    01212CAnesth, hip disarticulation
    01214CAnesth, replacement of hip
    01215NAnesth, revise hip repair
    01220NAnesth, procedure on femur
    01230NAnesth, surgery of femur
    01232CAnesth, amputation of femur
    01234CAnesth, radical femur surg
    01250NAnesth, upper leg surgery
    01260NAnesth, upper leg veins surg
    01270NAnesth, thigh arteries surg
    01272CAnesth, femoral artery surg
    01274CAnesth, femoral embolectomy
    01320NAnesth, knee area surgery
    01340NAnesth, knee area procedure
    01360NAnesth, knee area surgery
    01380NAnesth, knee joint procedure
    01382NAnesth, knee arthroscopy
    01390NAnesth, knee area procedure
    01392NAnesth, knee area surgery
    01400NAnesth, knee joint surgery
    01402CAnesth, replacement of knee
    01404CAnesth, amputation at knee
    01420NAnesth, knee joint casting
    01430NAnesth, knee veins surgery
    01432NAnesth, knee vessel surg
    01440NAnesth, knee arteries surg
    01442CAnesth, knee artery surg
    01444CAnesth, knee artery repair
    01462NAnesth, lower leg procedure
    01464NAnesth, ankle arthroscopy
    01470NAnesth, lower leg surgery
    01472NAnesth, achilles tendon surg
    01474NAnesth, lower leg surgery
    01480NAnesth, lower leg bone surg
    01482NAnesth, radical leg surgery
    01484NAnesth, lower leg revision
    01486CAnesth, ankle replacement
    01490NAnesth, lower leg casting
    01500NAnesth, leg arteries surg
    01502CAnesth, lwr leg embolectomy
    01520NAnesth, lower leg vein surg
    01522NAnesth, lower leg vein surg
    01610NAnesth, surgery of shoulder
    01620NAnesth, shoulder procedure
    01622NAnesth, shoulder arthroscopy
    01630NAnesth, surgery of shoulder
    01632CAnesth, surgery of shoulder
    01634CAnesth, shoulder joint amput
    01636CAnesth, forequarter amput
    01638CAnesth, shoulder replacement
    01650NAnesth, shoulder artery surg
    01652CAnesth, shoulder vessel surg
    01654CAnesth, shoulder vessel surg
    01656CAnesth, arm-leg vessel surg
    01670NAnesth, shoulder vein surg
    Start Printed Page 59937
    01680NAnesth, shoulder casting
    01682NAnesth, airplane cast
    01710NAnesth, elbow area surgery
    01712NAnesth, uppr arm tendon surg
    01714NAnesth, uppr arm tendon surg
    01716NAnesth, biceps tendon repair
    01730NAnesth, uppr arm procedure
    01732NAnesth, elbow arthroscopy
    01740NAnesth, upper arm surgery
    01742NAnesth, humerus surgery
    01744NAnesth, humerus repair
    01756CAnesth, radical humerus surg
    01758NAnesth, humeral lesion surg
    01760NAnesth, elbow replacement
    01770NAnesth, uppr arm artery surg
    01772NAnesth, uppr arm embolectomy
    01780NAnesth, upper arm vein surg
    01782NAnesth, uppr arm vein repair
    01810NAnesth, lower arm surgery
    01820NAnesth, lower arm procedure
    01830NAnesth, lower arm surgery
    01832NAnesth, wrist replacement
    01840NAnesth, lwr arm artery surg
    01842NAnesth, lwr arm embolectomy
    01844NAnesth, vascular shunt surg
    01850NAnesth, lower arm vein surg
    01852NAnesth, lwr arm vein repair
    01860NAnesth, lower arm casting
    01904DAnesth, skull x-ray inject
    *01905NAnes, spine inject, x-ray/re
    01906DAnesth, lumbar myelography
    01908DAnesth, cervical myelography
    01910DAnesth, skull myelography
    01912DAnesth, lumbar diskography
    01914DAnesth, cervical diskography
    01916NAnesth, head arteriogram
    01918DAnesth, limb arteriogram
    01920NAnesth, catheterize heart
    01921DAnesth, vessel surgery
    01922NAnesth, cat or MRI scan
    *01924NAnes, ther interven rad, art
    *01925NAnes, ther interven rad, car
    *01926NAnes, tx interv rad hrt/cran
    *01930NAnes, ther interven rad, vei
    *01931NAnes, ther interven rad, tip
    *01932NAnes, tx interv rad, th vein
    *01933NAnes, tx interv rad, cran v
    01951NAnesth, burn, less 1 percent
    01952NAnesth, burn, 1-9 percent
    01953NAnesth, burn, each 9 percent
    *01960NAnesth, vaginal delivery
    *01961NAnesth, cs delivery
    *01962NAnesth, emer hysterectomy
    *01963NAnesth, cs hysterectomy
    *01964NAnesth, abortion procedures
    *01967NAnesth/analg, vag delivery
    *01968NAnes/analg cs deliver add-on
    *01969NAnesth/analg cs hyst add-on
    01990CSupport for organ donor
    01995NRegional anesthesia, limb
    01996NManage daily drug therapy
    01999NUnlisted anesth procedure
    *10021TFna w/o image00020.42$21.38$11.75$4.28
    *10022TFna w/image00020.42$21.38$11.75$4.28
    10040TAcne surgery of skin abscess00062.18$110.97$33.95$22.19
    10060TDrainage of skin abscess00062.18$110.97$33.95$22.19
    10061TDrainage of skin abscess00062.18$110.97$33.95$22.19
    10080TDrainage of pilonidal cyst00062.18$110.97$33.95$22.19
    10081TDrainage of pilonidal cyst00076.75$343.60$72.03$68.72
    10120TRemove foreign body00062.18$110.97$33.95$22.19
    10121TRemove foreign body00208.44$429.63$130.53$85.93
    10140TDrainage of hematoma/fluid00076.75$343.60$72.03$68.72
    10160TPuncture drainage of lesion00181.05$53.45$17.66$10.69
    10180TComplex drainage, wound00076.75$343.60$72.03$68.72
    11000TDebride infected skin00152.07$105.37$31.20$21.07
    Start Printed Page 59938
    11001TDebride infected skin add-on00131.36$69.23$17.66$13.85
    11010TDebride skin, fx002213.91$708.07$292.94$141.61
    11011TDebride skin/muscle, fx002213.91$708.07$292.94$141.61
    11012TDebride skin/muscle/bone, fx002213.91$708.07$292.94$141.61
    11040TDebride skin, partial00152.07$105.37$31.20$21.07
    11041TDebride skin, full00152.07$105.37$31.20$21.07
    11042TDebride skin/tissue00163.02$153.73$64.57$30.75
    11043TDebride tissue/muscle00163.02$153.73$64.57$30.75
    11044TDebride tissue/muscle/bone00179.68$492.75$226.67$98.55
    11055TTrim skin lesion00120.66$33.60$9.18$6.72
    11056TTrim skin lesions, 2 to 400120.66$33.60$9.18$6.72
    11057TTrim skin lesions, over 400120.66$33.60$9.18$6.72
    11100TBiopsy of skin lesion00181.05$53.45$17.66$10.69
    11101TBiopsy, skin add-on00181.05$53.45$17.66$10.69
    11200TRemoval of skin tags00131.36$69.23$17.66$13.85
    11201TRemove skin tags add-on00152.07$105.37$31.20$21.07
    11300TShave skin lesion00120.66$33.60$9.18$6.72
    11301TShave skin lesion00120.66$33.60$9.18$6.72
    11302TShave skin lesion00131.36$69.23$17.66$13.85
    11303TShave skin lesion00152.07$105.37$31.20$21.07
    11305TShave skin lesion00131.36$69.23$17.66$13.85
    11306TShave skin lesion00131.36$69.23$17.66$13.85
    11307TShave skin lesion00131.36$69.23$17.66$13.85
    11308TShave skin lesion00131.36$69.23$17.66$13.85
    11310TShave skin lesion00131.36$69.23$17.66$13.85
    11311TShave skin lesion00131.36$69.23$17.66$13.85
    11312TShave skin lesion00131.36$69.23$17.66$13.85
    11313TShave skin lesion00163.02$153.73$64.57$30.75
    11400TRemoval of skin lesion00194.22$214.81$78.91$42.96
    11401TRemoval of skin lesion00194.22$214.81$78.91$42.96
    11402TRemoval of skin lesion00194.22$214.81$78.91$42.96
    11403TRemoval of skin lesion00194.22$214.81$78.91$42.96
    11404TRemoval of skin lesion00208.44$429.63$130.53$85.93
    11406TRemoval of skin lesion002111.82$601.69$236.51$120.34
    11420TRemoval of skin lesion00194.22$214.81$78.91$42.96
    11421TRemoval of skin lesion00194.22$214.81$78.91$42.96
    11422TRemoval of skin lesion00194.22$214.81$78.91$42.96
    11423TRemoval of skin lesion00208.44$429.63$130.53$85.93
    11424TRemoval of skin lesion00208.44$429.63$130.53$85.93
    11426TRemoval of skin lesion002213.91$708.07$292.94$141.61
    11440TRemoval of skin lesion00194.22$214.81$78.91$42.96
    11441TRemoval of skin lesion00194.22$214.81$78.91$42.96
    11442TRemoval of skin lesion00194.22$214.81$78.91$42.96
    11443TRemoval of skin lesion00208.44$429.63$130.53$85.93
    11444TRemoval of skin lesion00208.44$429.63$130.53$85.93
    11446TRemoval of skin lesion002213.91$708.07$292.94$141.61
    11450TRemoval, sweat gland lesion002213.91$708.07$292.94$141.61
    11451TRemoval, sweat gland lesion002213.91$708.07$292.94$141.61
    11462TRemoval, sweat gland lesion002213.91$708.07$292.94$141.61
    11463TRemoval, sweat gland lesion002213.91$708.07$292.94$141.61
    11470TRemoval, sweat gland lesion002213.91$708.07$292.94$141.61
    11471TRemoval, sweat gland lesion002213.91$708.07$292.94$141.61
    11600TRemoval of skin lesion00194.22$214.81$78.91$42.96
    11601TRemoval of skin lesion00194.22$214.81$78.91$42.96
    11602TRemoval of skin lesion00194.22$214.81$78.91$42.96
    11603TRemoval of skin lesion00208.44$429.63$130.53$85.93
    11604TRemoval of skin lesion00208.44$429.63$130.53$85.93
    11606TRemoval of skin lesion002111.82$601.69$236.51$120.34
    11620TRemoval of skin lesion00194.22$214.81$78.91$42.96
    11621TRemoval of skin lesion00194.22$214.81$78.91$42.96
    11622TRemoval of skin lesion00194.22$214.81$78.91$42.96
    11623TRemoval of skin lesion00208.44$429.63$130.53$85.93
    11624TRemoval of skin lesion00208.44$429.63$130.53$85.93
    11626TRemoval of skin lesion002213.91$708.07$292.94$141.61
    11640TRemoval of skin lesion00194.22$214.81$78.91$42.96
    11641TRemoval of skin lesion00194.22$214.81$78.91$42.96
    11642TRemoval of skin lesion00194.22$214.81$78.91$42.96
    11643TRemoval of skin lesion00208.44$429.63$130.53$85.93
    11644TRemoval of skin lesion00208.44$429.63$130.53$85.93
    11646TRemoval of skin lesion002213.91$708.07$292.94$141.61
    11719TTrim nail(s)00090.63$32.07$8.34$6.41
    11720TDebride nail, 1-500090.63$32.07$8.34$6.41
    11721TDebride nail, 6 or more00090.63$32.07$8.34$6.41
    11730TRemoval of nail plate00131.36$69.23$17.66$13.85
    11732TRemove nail plate, add-on00120.66$33.60$9.18$6.72
    Start Printed Page 59939
    11740TDrain blood from under nail00090.63$32.07$8.34$6.41
    11750TRemoval of nail bed00194.22$214.81$78.91$42.96
    11752TRemove nail bed/finger tip002213.91$708.07$292.94$141.61
    11755TBiopsy, nail unit00194.22$214.81$78.91$42.96
    11760TRepair of nail bed00242.28$116.06$41.78$23.21
    11762TReconstruction of nail bed00242.28$116.06$41.78$23.21
    11765TExcision of nail fold, toe00152.07$105.37$31.20$21.07
    11770TRemoval of pilonidal lesion002111.82$601.69$236.51$120.34
    11771TRemoval of pilonidal lesion002213.91$708.07$292.94$141.61
    11772TRemoval of pilonidal lesion002213.91$708.07$292.94$141.61
    11900TInjection into skin lesions00120.66$33.60$9.18$6.72
    11901TAdded skin lesions injection00120.66$33.60$9.18$6.72
    11920TCorrect skin color defects00242.28$116.06$41.78$23.21
    11921TCorrect skin color defects00242.28$116.06$41.78$23.21
    11922TCorrect skin color defects00242.28$116.06$41.78$23.21
    11950TTherapy for contour defects00242.28$116.06$41.78$23.21
    11951TTherapy for contour defects00242.28$116.06$41.78$23.21
    11952TTherapy for contour defects00242.28$116.06$41.78$23.21
    11954TTherapy for contour defects00242.28$116.06$41.78$23.21
    11960TInsert tissue expander(s)002612.62$642.41$277.92$128.48
    11970TReplace tissue expander002612.62$642.41$277.92$128.48
    11971TRemove tissue expander(s)002213.91$708.07$292.94$141.61
    11975EInsert contraceptive cap
    11976TRemoval of contraceptive cap00194.22$214.81$78.91$42.96
    11977ERemoval/reinsert contra cap
    11980XImplant hormone pellet(s)03400.84$42.76$10.69$8.55
    *11981XInsert drug implant device03400.84$42.76$10.69$8.55
    *11982XRemove drug implant device03400.84$42.76$10.69$8.55
    *11983XRemove/insert drug implant03400.84$42.76$10.69$8.55
    12001TRepair superficial wound(s)00242.28$116.06$41.78$23.21
    12002TRepair superficial wound(s)00242.28$116.06$41.78$23.21
    12004TRepair superficial wound(s)00242.28$116.06$41.78$23.21
    12005TRepair superficial wound(s)00242.28$116.06$41.78$23.21
    12006TRepair superficial wound(s)00242.28$116.06$41.78$23.21
    12007TRepair superficial wound(s)00242.28$116.06$41.78$23.21
    12011TRepair superficial wound(s)00242.28$116.06$41.78$23.21
    12013TRepair superficial wound(s)00242.28$116.06$41.78$23.21
    12014TRepair superficial wound(s)00242.28$116.06$41.78$23.21
    12015TRepair superficial wound(s)00242.28$116.06$41.78$23.21
    12016TRepair superficial wound(s)00242.28$116.06$41.78$23.21
    12017TRepair superficial wound(s)00242.28$116.06$41.78$23.21
    12018TRepair superficial wound(s)00242.28$116.06$41.78$23.21
    12020TClosure of split wound00242.28$116.06$41.78$23.21
    12021TClosure of split wound00242.28$116.06$41.78$23.21
    12031TLayer closure of wound(s)00242.28$116.06$41.78$23.21
    12032TLayer closure of wound(s)00242.28$116.06$41.78$23.21
    12034TLayer closure of wound(s)00242.28$116.06$41.78$23.21
    12035TLayer closure of wound(s)00242.28$116.06$41.78$23.21
    12036TLayer closure of wound(s)00242.28$116.06$41.78$23.21
    12037TLayer closure of wound(s)002612.62$642.41$277.92$128.48
    12041TLayer closure of wound(s)00242.28$116.06$41.78$23.21
    12042TLayer closure of wound(s)00242.28$116.06$41.78$23.21
    12044TLayer closure of wound(s)00242.28$116.06$41.78$23.21
    12045TLayer closure of wound(s)00242.28$116.06$41.78$23.21
    12046TLayer closure of wound(s)00242.28$116.06$41.78$23.21
    12047TLayer closure of wound(s)002612.62$642.41$277.92$128.48
    12051TLayer closure of wound(s)00242.28$116.06$41.78$23.21
    12052TLayer closure of wound(s)00242.28$116.06$41.78$23.21
    12053TLayer closure of wound(s)00242.28$116.06$41.78$23.21
    12054TLayer closure of wound(s)00242.28$116.06$41.78$23.21
    12055TLayer closure of wound(s)00242.28$116.06$41.78$23.21
    12056TLayer closure of wound(s)00242.28$116.06$41.78$23.21
    12057TLayer closure of wound(s)002612.62$642.41$277.92$128.48
    13100TRepair of wound or lesion00253.39$172.56$65.57$34.51
    13101TRepair of wound or lesion00253.39$172.56$65.57$34.51
    13102TRepair wound/lesion add-on00253.39$172.56$65.57$34.51
    13120TRepair of wound or lesion00253.39$172.56$65.57$34.51
    13121TRepair of wound or lesion00253.39$172.56$65.57$34.51
    13122TRepair wound/lesion add-on00253.39$172.56$65.57$34.51
    13131TRepair of wound or lesion00253.39$172.56$65.57$34.51
    13132TRepair of wound or lesion00253.39$172.56$65.57$34.51
    13133TRepair wound/lesion add-on00253.39$172.56$65.57$34.51
    13150TRepair of wound or lesion002612.62$642.41$277.92$128.48
    13151TRepair of wound or lesion00253.39$172.56$65.57$34.51
    13152TRepair of wound or lesion00253.39$172.56$65.57$34.51
    Start Printed Page 59940
    13153TRepair wound/lesion add-on00253.39$172.56$65.57$34.51
    13160TLate closure of wound002612.62$642.41$277.92$128.48
    14000TSkin tissue rearrangement002612.62$642.41$277.92$128.48
    14001TSkin tissue rearrangement002612.62$642.41$277.92$128.48
    14020TSkin tissue rearrangement002612.62$642.41$277.92$128.48
    14021TSkin tissue rearrangement002612.62$642.41$277.92$128.48
    14040TSkin tissue rearrangement002612.62$642.41$277.92$128.48
    14041TSkin tissue rearrangement002612.62$642.41$277.92$128.48
    14060TSkin tissue rearrangement002612.62$642.41$277.92$128.48
    14061TSkin tissue rearrangement002612.62$642.41$277.92$128.48
    14300TSkin tissue rearrangement002612.62$642.41$277.92$128.48
    14350TSkin tissue rearrangement002612.62$642.41$277.92$128.48
    15000TSkin graft002612.62$642.41$277.92$128.48
    15001TSkin graft add-on002612.62$642.41$277.92$128.48
    15050TSkin pinch graft002612.62$642.41$277.92$128.48
    15100TSkin split graft002612.62$642.41$277.92$128.48
    15101TSkin split graft add-on002612.62$642.41$277.92$128.48
    15120TSkin split graft002612.62$642.41$277.92$128.48
    15121TSkin split graft add-on002612.62$642.41$277.92$128.48
    15200TSkin full graft002612.62$642.41$277.92$128.48
    15201TSkin full graft add-on002612.62$642.41$277.92$128.48
    15220TSkin full graft002612.62$642.41$277.92$128.48
    15221TSkin full graft add-on002612.62$642.41$277.92$128.48
    15240TSkin full graft002612.62$642.41$277.92$128.48
    15241TSkin full graft add-on002612.62$642.41$277.92$128.48
    15260TSkin full graft002612.62$642.41$277.92$128.48
    15261TSkin full graft add-on002612.62$642.41$277.92$128.48
    15342TCultured skin graft, 25 cm00253.39$172.56$65.57$34.51
    15343TCulture skn graft addl 25 cm00253.39$172.56$65.57$34.51
    15350TSkin homograft068624.01$1,222.21$277.92$244.44
    15351TSkin homograft add-on002612.62$642.41$277.92$128.48
    15400TSkin heterograft002612.62$642.41$277.92$128.48
    15401TSkin heterograft add-on002612.62$642.41$277.92$128.48
    15570TForm skin pedicle flap002612.62$642.41$277.92$128.48
    15572TForm skin pedicle flap002612.62$642.41$277.92$128.48
    15574TForm skin pedicle flap002612.62$642.41$277.92$128.48
    15576TForm skin pedicle flap002612.62$642.41$277.92$128.48
    15600TSkin graft002612.62$642.41$277.92$128.48
    15610TSkin graft002612.62$642.41$277.92$128.48
    15620TSkin graft002612.62$642.41$277.92$128.48
    15630TSkin graft002612.62$642.41$277.92$128.48
    15650TTransfer skin pedicle flap002612.62$642.41$277.92$128.48
    15732TMuscle-skin graft, head/neck002718.02$917.29$383.10$183.46
    15734TMuscle-skin graft, trunk002718.02$917.29$383.10$183.46
    15736TMuscle-skin graft, arm002718.02$917.29$383.10$183.46
    15738TMuscle-skin graft, leg002718.02$917.29$383.10$183.46
    15740TIsland pedicle flap graft002718.02$917.29$383.10$183.46
    15750TNeurovascular pedicle graft002718.02$917.29$383.10$183.46
    15756CFree muscle flap, microvasc
    15757CFree skin flap, microvasc
    15758CFree fascial flap, microvasc
    15760TComposite skin graft002718.02$917.29$383.10$183.46
    15770TDerma-fat-fascia graft002718.02$917.29$383.10$183.46
    15775THair transplant punch grafts002612.62$642.41$277.92$128.48
    15776THair transplant punch grafts002612.62$642.41$277.92$128.48
    15780TAbrasion treatment of skin002213.91$708.07$292.94$141.61
    15781TAbrasion treatment of skin002213.91$708.07$292.94$141.61
    15782TAbrasion treatment of skin002213.91$708.07$292.94$141.61
    15783TAbrasion treatment of skin00163.02$153.73$64.57$30.75
    15786TAbrasion, lesion, single00131.36$69.23$17.66$13.85
    15787TAbrasion, lesions, add-on00131.36$69.23$17.66$13.85
    15788TChemical peel, face, epiderm00120.66$33.60$9.18$6.72
    15789TChemical peel, face, dermal00152.07$105.37$31.20$21.07
    15792TChemical peel, nonfacial00120.66$33.60$9.18$6.72
    15793TChemical peel, nonfacial00131.36$69.23$17.66$13.85
    15810TSalabrasion00163.02$153.73$64.57$30.75
    15811TSalabrasion00163.02$153.73$64.57$30.75
    15819TPlastic surgery, neck002612.62$642.41$277.92$128.48
    15820TRevision of lower eyelid002612.62$642.41$277.92$128.48
    15821TRevision of lower eyelid002612.62$642.41$277.92$128.48
    15822TRevision of upper eyelid002612.62$642.41$277.92$128.48
    15823TRevision of upper eyelid002612.62$642.41$277.92$128.48
    15824TRemoval of forehead wrinkles002718.02$917.29$383.10$183.46
    15825TRemoval of neck wrinkles002612.62$642.41$277.92$128.48
    15826TRemoval of brow wrinkles002612.62$642.41$277.92$128.48
    Start Printed Page 59941
    15828TRemoval of face wrinkles002718.02$917.29$383.10$183.46
    15829TRemoval of skin wrinkles002612.62$642.41$277.92$128.48
    15831TExcise excessive skin tissue002213.91$708.07$292.94$141.61
    15832TExcise excessive skin tissue002213.91$708.07$292.94$141.61
    15833TExcise excessive skin tissue002213.91$708.07$292.94$141.61
    15834TExcise excessive skin tissue002213.91$708.07$292.94$141.61
    15835TExcise excessive skin tissue002612.62$642.41$277.92$128.48
    15836TExcise excessive skin tissue00194.22$214.81$78.91$42.96
    15837TExcise excessive skin tissue00194.22$214.81$78.91$42.96
    15838TExcise excessive skin tissue00194.22$214.81$78.91$42.96
    15839TExcise excessive skin tissue00194.22$214.81$78.91$42.96
    15840TGraft for face nerve palsy002718.02$917.29$383.10$183.46
    15841TGraft for face nerve palsy002718.02$917.29$383.10$183.46
    15842TFlap for face nerve palsy002718.02$917.29$383.10$183.46
    15845TSkin and muscle repair, face002718.02$917.29$383.10$183.46
    15850TRemoval of sutures00163.02$153.73$64.57$30.75
    15851TRemoval of sutures00131.36$69.23$17.66$13.85
    15852TDressing change, not for burn00131.36$69.23$17.66$13.85
    15860NTest for blood flow in graft
    15876TSuction assisted lipectomy002718.02$917.29$383.10$183.46
    15877TSuction assisted lipectomy002718.02$917.29$383.10$183.46
    15878TSuction assisted lipectomy002718.02$917.29$383.10$183.46
    15879TSuction assisted lipectomy002718.02$917.29$383.10$183.46
    15920TRemoval of tail bone ulcer002213.91$708.07$292.94$141.61
    15922TRemoval of tail bone ulcer002718.02$917.29$383.10$183.46
    15931TRemove sacrum pressure sore002213.91$708.07$292.94$141.61
    15933TRemove sacrum pressure sore002213.91$708.07$292.94$141.61
    15934TRemove sacrum pressure sore002718.02$917.29$383.10$183.46
    15935TRemove sacrum pressure sore002718.02$917.29$383.10$183.46
    15936TRemove sacrum pressure sore002718.02$917.29$383.10$183.46
    15937TRemove sacrum pressure sore002718.02$917.29$383.10$183.46
    15940TRemove hip pressure sore002213.91$708.07$292.94$141.61
    15941TRemove hip pressure sore002213.91$708.07$292.94$141.61
    15944TRemove hip pressure sore002718.02$917.29$383.10$183.46
    15945TRemove hip pressure sore002718.02$917.29$383.10$183.46
    15946TRemove hip pressure sore002718.02$917.29$383.10$183.46
    15950TRemove thigh pressure sore002213.91$708.07$292.94$141.61
    15951TRemove thigh pressure sore002213.91$708.07$292.94$141.61
    15952TRemove thigh pressure sore002718.02$917.29$383.10$183.46
    15953TRemove thigh pressure sore002718.02$917.29$383.10$183.46
    15956TRemove thigh pressure sore002718.02$917.29$383.10$183.46
    15958TRemove thigh pressure sore002718.02$917.29$383.10$183.46
    15999TRemoval of pressure sore002213.91$708.07$292.94$141.61
    16000TInitial treatment of burn(s)00131.36$69.23$17.66$13.85
    16010TTreatment of burn(s)00163.02$153.73$64.57$30.75
    16015TTreatment of burn(s)00179.68$492.75$226.67$98.55
    16020TTreatment of burn(s)00131.36$69.23$17.66$13.85
    16025TTreatment of burn(s)00131.36$69.23$17.66$13.85
    16030TTreatment of burn(s)00152.07$105.37$31.20$21.07
    16035CIncision of burn scab, initi
    16036CIncise burn scab, addl incis
    17000TDestroy benign/premal lesion00100.66$33.60$9.86$6.72
    17003TDestroy lesions, 2-1400100.66$33.60$9.86$6.72
    17004TDestroy lesions, 15 or more00111.47$74.83$27.69$14.97
    17106TDestruction of skin lesions00111.47$74.83$27.69$14.97
    17107TDestruction of skin lesions00111.47$74.83$27.69$14.97
    17108TDestruction of skin lesions00111.47$74.83$27.69$14.97
    17110TDestruct lesion, 1-1400100.66$33.60$9.86$6.72
    17111TDestruct lesion, 15 or more00111.47$74.83$27.69$14.97
    17250TChemical cautery, tissue00131.36$69.23$17.66$13.85
    17260TDestruction of skin lesions00131.36$69.23$17.66$13.85
    17261TDestruction of skin lesions00131.36$69.23$17.66$13.85
    17262TDestruction of skin lesions00131.36$69.23$17.66$13.85
    17263TDestruction of skin lesions00131.36$69.23$17.66$13.85
    17264TDestruction of skin lesions00131.36$69.23$17.66$13.85
    17266TDestruction of skin lesions00163.02$153.73$64.57$30.75
    17270TDestruction of skin lesions00131.36$69.23$17.66$13.85
    17271TDestruction of skin lesions00120.66$33.60$9.18$6.72
    17272TDestruction of skin lesions00131.36$69.23$17.66$13.85
    17273TDestruction of skin lesions00152.07$105.37$31.20$21.07
    17274TDestruction of skin lesions00163.02$153.73$64.57$30.75
    17276TDestruction of skin lesions00163.02$153.73$64.57$30.75
    17280TDestruction of skin lesions00131.36$69.23$17.66$13.85
    17281TDestruction of skin lesions00131.36$69.23$17.66$13.85
    17282TDestruction of skin lesions00152.07$105.37$31.20$21.07
    Start Printed Page 59942
    17283TDestruction of skin lesions00152.07$105.37$31.20$21.07
    17284TDestruction of skin lesions00163.02$153.73$64.57$30.75
    17286TDestruction of skin lesions00131.36$69.23$17.66$13.85
    17304TChemosurgery of skin lesion06943.99$203.11$60.93$40.62
    17305T2nd stage chemosurgery06943.99$203.11$60.93$40.62
    17306T3rd stage chemosurgery06943.99$203.11$60.93$40.62
    17307TFollowup skin lesion therapy06943.99$203.11$60.93$40.62
    17310TExtensive skin chemosurgery06943.99$203.11$60.93$40.62
    17340TCryotherapy of skin00120.66$33.60$9.18$6.72
    17360TSkin peel therapy00120.66$33.60$9.18$6.72
    17380THair removal by electrolysis00179.68$492.75$226.67$98.55
    17999TSkin tissue procedure00042.47$125.73$32.57$25.15
    19000TDrainage of breast lesion00042.47$125.73$32.57$25.15
    19001TDrain breast lesion add-on00042.47$125.73$32.57$25.15
    19020TIncision of breast lesion000810.93$556.38$113.67$111.28
    19030NInjection for breast x-ray
    19100TBx breast percut w/o image00054.03$205.14$90.26$41.03
    19101TBiopsy of breast, open002814.00$712.66$303.74$142.53
    19102TBx breast percut w/image00054.03$205.14$90.26$41.03
    19103SBx breast percut w/device0710$400.00$80.00
    19110TNipple exploration002814.00$712.66$303.74$142.53
    19112TExcise breast duct fistula002814.00$712.66$303.74$142.53
    19120TRemoval of breast lesion002814.00$712.66$303.74$142.53
    19125TExcision, breast lesion002814.00$712.66$303.74$142.53
    19126TExcision, addl breast lesion002814.00$712.66$303.74$142.53
    19140TRemoval of breast tissue002814.00$712.66$303.74$142.53
    19160TRemoval of breast tissue002814.00$712.66$303.74$142.53
    19162TRemove breast tissue, nodes069331.81$1,619.26$712.47$323.85
    19180TRemoval of breast002923.76$1,209.48$628.93$241.90
    19182TRemoval of breast002923.76$1,209.48$628.93$241.90
    19200CRemoval of breast
    19220CRemoval of breast
    19240TRemoval of breast003034.20$1,740.92$763.55$348.18
    19260TRemoval of chest wall lesion002111.82$601.69$236.51$120.34
    19271CRevision of chest wall
    19272CExtensive chest wall surgery
    19290NPlace needle wire, breast
    19291NPlace needle wire, breast
    19295NPlace breast clip, percut
    19316TSuspension of breast002923.76$1,209.48$628.93$241.90
    19318TReduction of large breast069331.81$1,619.26$712.47$323.85
    19324TEnlarge breast069331.81$1,619.26$712.47$323.85
    19325TEnlarge breast with implant069331.81$1,619.26$712.47$323.85
    19328TRemoval of breast implant002923.76$1,209.48$628.93$241.90
    19330TRemoval of implant material002923.76$1,209.48$628.93$241.90
    19340TImmediate breast prosthesis003034.20$1,740.92$763.55$348.18
    19342TDelayed breast prosthesis069331.81$1,619.26$712.47$323.85
    19350TBreast reconstruction002923.76$1,209.48$628.93$241.90
    19355TCorrect inverted nipple(s)002923.76$1,209.48$628.93$241.90
    19357TBreast reconstruction069331.81$1,619.26$712.47$323.85
    19361CBreast reconstruction
    19364CBreast reconstruction
    19366TBreast reconstruction002923.76$1,209.48$628.93$241.90
    19367CBreast reconstruction
    19368CBreast reconstruction
    19369CBreast reconstruction
    19370TSurgery of breast capsule002923.76$1,209.48$628.93$241.90
    19371TRemoval of breast capsule002923.76$1,209.48$628.93$241.90
    19380TRevise breast reconstruction003034.20$1,740.92$763.55$348.18
    19396TDesign custom breast implant002923.76$1,209.48$628.93$241.90
    19499TBreast surgery procedure002814.00$712.66$303.74$142.53
    20000TIncision of abscess00062.18$110.97$33.95$22.19
    20005TIncision of deep abscess004915.84$806.32$356.95$161.26
    20100TExplore wound, neck00232.08$105.88$40.37$21.18
    20101TExplore wound, chest002612.62$642.41$277.92$128.48
    20102TExplore wound, abdomen002612.62$642.41$277.92$128.48
    20103TExplore wound, extremity00232.08$105.88$40.37$21.18
    20150TExcise epiphyseal bar005128.56$1,453.82$675.24$290.76
    20200TMuscle biopsy00208.44$429.63$130.53$85.93
    20205TDeep muscle biopsy002111.82$601.69$236.51$120.34
    20206TNeedle biopsy, muscle00054.03$205.14$90.26$41.03
    20220TBone biopsy, trocar/needle00194.22$214.81$78.91$42.96
    20225TBone biopsy, trocar/needle00194.22$214.81$78.91$42.96
    20240TBone biopsy, excisional002213.91$708.07$292.94$141.61
    20245TBone biopsy, excisional002213.91$708.07$292.94$141.61
    Start Printed Page 59943
    20250TOpen bone biopsy004915.84$806.32$356.95$161.26
    20251TOpen bone biopsy004915.84$806.32$356.95$161.26
    20500TInjection of sinus tract02512.43$123.70$27.99$24.74
    20501NInject sinus tract for x-ray
    20520TRemoval of foreign body00194.22$214.81$78.91$42.96
    20525TRemoval of foreign body002213.91$708.07$292.94$141.61
    *20526TTher injection carpal tunnel02042.24$114.02$43.33$22.80
    20550TInject tendon/ligament/cyst02042.24$114.02$43.33$22.80
    *20551TInject tendon origin/insert02042.24$114.02$43.33$22.80
    *20552TInject trigger point, 1 or 202042.24$114.02$43.33$22.80
    *20553TInject trigger points, > 302042.24$114.02$43.33$22.80
    20600TDrain/inject, joint/bursa02042.24$114.02$43.33$22.80
    20605TDrain/inject, joint/bursa02042.24$114.02$43.33$22.80
    20610TDrain/inject, joint/bursa02042.24$114.02$43.33$22.80
    20615TTreatment of bone cyst00042.47$125.73$32.57$25.15
    20650TInsert and remove bone pin004915.84$806.32$356.95$161.26
    20660CApply,remove fixation device
    20661CApplication of head brace
    20662CApplication of pelvis brace
    20663CApplication of thigh brace
    20664CHalo brace application
    20665NRemoval of fixation device
    20670TRemoval of support implant002111.82$601.69$236.51$120.34
    20680TRemoval of support implant002213.91$708.07$292.94$141.61
    20690TApply bone fixation device005020.63$1,050.15$504.07$210.03
    20692TApply bone fixation device005020.63$1,050.15$504.07$210.03
    20693TAdjust bone fixation device004915.84$806.32$356.95$161.26
    20694TRemove bone fixation device004915.84$806.32$356.95$161.26
    20802CReplantation, arm, complete
    20805CReplant, forearm, complete
    20808CReplantation hand, complete
    20816CReplantation digit, complete
    20822CReplantation digit, complete
    20824CReplantation thumb, complete
    20827CReplantation thumb, complete
    20838CReplantation foot, complete
    20900TRemoval of bone for graft005020.63$1,050.15$504.07$210.03
    20902TRemoval of bone for graft005020.63$1,050.15$504.07$210.03
    20910TRemove cartilage for graft002612.62$642.41$277.92$128.48
    20912TRemove cartilage for graft002612.62$642.41$277.92$128.48
    20920TRemoval of fascia for graft002612.62$642.41$277.92$128.48
    20922TRemoval of fascia for graft002612.62$642.41$277.92$128.48
    20924TRemoval of tendon for graft005020.63$1,050.15$504.07$210.03
    20926TRemoval of tissue for graft002612.62$642.41$277.92$128.48
    20930CSpinal bone allograft
    20931CSpinal bone allograft
    20936CSpinal bone autograft
    20937CSpinal bone autograft
    20938CSpinal bone autograft
    20950TFluid pressure, muscle00062.18$110.97$33.95$22.19
    20955CFibula bone graft, microvasc
    20956CIliac bone graft, microvasc
    20957CMt bone graft, microvasc
    20962COther bone graft, microvasc
    20969CBone/skin graft, microvasc
    20970CBone/skin graft, iliac crest
    20972CBone/skin graft, metatarsal
    20973CBone/skin graft, great toe
    20974AElectrical bone stimulation
    20975TElectrical bone stimulation004915.84$806.32$356.95$161.26
    20979AUs bone stimulation
    20999NMusculoskeletal surgery
    21010TIncision of jaw joint025417.37$884.20$272.41$176.84
    21015TResection of facial tumor02525.95$302.88$114.24$60.58
    21025TExcision of bone, lower jaw025626.61$1,354.56$623.05$270.91
    21026TExcision of facial bone(s)025626.61$1,354.56$623.05$270.91
    21029TContour of face bone lesion025626.61$1,354.56$623.05$270.91
    21030TRemoval of face bone lesion025417.37$884.20$272.41$176.84
    21031TRemove exostosis, mandible025417.37$884.20$272.41$176.84
    21032TRemove exostosis, maxilla025417.37$884.20$272.41$176.84
    21034TRemoval of face bone lesion025626.61$1,354.56$623.05$270.91
    21040TRemoval of jaw bone lesion025417.37$884.20$272.41$176.84
    21041TRemoval of jaw bone lesion025626.61$1,354.56$623.05$270.91
    21044TRemoval of jaw bone lesion025626.61$1,354.56$623.05$270.91
    21045CExtensive jaw surgery
    Start Printed Page 59944
    21050TRemoval of jaw joint025626.61$1,354.56$623.05$270.91
    21060TRemove jaw joint cartilage025626.61$1,354.56$623.05$270.91
    21070TRemove coronoid process025626.61$1,354.56$623.05$270.91
    21076TPrepare face/oral prosthesis025417.37$884.20$272.41$176.84
    21077TPrepare face/oral prosthesis025626.61$1,354.56$623.05$270.91
    21079TPrepare face/oral prosthesis025626.61$1,354.56$623.05$270.91
    21080TPrepare face/oral prosthesis025626.61$1,354.56$623.05$270.91
    21081TPrepare face/oral prosthesis025626.61$1,354.56$623.05$270.91
    21082TPrepare face/oral prosthesis025626.61$1,354.56$623.05$270.91
    21083TPrepare face/oral prosthesis025626.61$1,354.56$623.05$270.91
    21084TPrepare face/oral prosthesis025626.61$1,354.56$623.05$270.91
    21085TPrepare face/oral prosthesis025312.33$627.65$284.00$125.53
    21086TPrepare face/oral prosthesis025626.61$1,354.56$623.05$270.91
    21087TPrepare face/oral prosthesis025626.61$1,354.56$623.05$270.91
    21088TPrepare face/oral prosthesis025626.61$1,354.56$623.05$270.91
    21089TPrepare face/oral prosthesis025312.33$627.65$284.00$125.53
    21100TMaxillofacial fixation025626.61$1,354.56$623.05$270.91
    21110TInterdental fixation02525.95$302.88$114.24$60.58
    21116NInjection, jaw joint x-ray
    21120TReconstruction of chin025417.37$884.20$272.41$176.84
    21121TReconstruction of chin025417.37$884.20$272.41$176.84
    21122TReconstruction of chin025417.37$884.20$272.41$176.84
    21123TReconstruction of chin025417.37$884.20$272.41$176.84
    21125TAugmentation, lower jaw bone025417.37$884.20$272.41$176.84
    21127TAugmentation, lower jaw bone025626.61$1,354.56$623.05$270.91
    21137TReduction of forehead025417.37$884.20$272.41$176.84
    21138TReduction of forehead025626.61$1,354.56$623.05$270.91
    21139TReduction of forehead025626.61$1,354.56$623.05$270.91
    21141CReconstruct midface, lefort
    21142CReconstruct midface, lefort
    21143CReconstruct midface, lefort
    21145CReconstruct midface, lefort
    21146CReconstruct midface, lefort
    21147CReconstruct midface, lefort
    21150CReconstruct midface, lefort
    21151CReconstruct midface, lefort
    21154CReconstruct midface, lefort
    21155CReconstruct midface, lefort
    21159CReconstruct midface, lefort
    21160CReconstruct midface, lefort
    21172CReconstruct orbit/forehead
    21175CReconstruct orbit/forehead
    21179CReconstruct entire forehead
    21180CReconstruct entire forehead
    21181TContour cranial bone lesion025417.37$884.20$272.41$176.84
    21182CReconstruct cranial bone
    21183CReconstruct cranial bone
    21184CReconstruct cranial bone
    21188CReconstruction of midface
    21193CReconst lwr jaw w/o graft
    21194CReconst lwr jaw w/graft
    21195CReconst lwr jaw w/o fixation
    21196CReconst lwr jaw w/fixation
    21198TReconstr lwr jaw segment025626.61$1,354.56$623.05$270.91
    21199TReconstr lwr jaw w/advance025626.61$1,354.56$623.05$270.91
    21206TReconstruct upper jaw bone025626.61$1,354.56$623.05$270.91
    21208TAugmentation of facial bones025626.61$1,354.56$623.05$270.91
    21209TReduction of facial bones025626.61$1,354.56$623.05$270.91
    21210TFace bone graft025626.61$1,354.56$623.05$270.91
    21215TLower jaw bone graft025626.61$1,354.56$623.05$270.91
    21230TRib cartilage graft025626.61$1,354.56$623.05$270.91
    21235TEar cartilage graft025417.37$884.20$272.41$176.84
    21240TReconstruction of jaw joint025626.61$1,354.56$623.05$270.91
    21242TReconstruction of jaw joint025626.61$1,354.56$623.05$270.91
    21243TReconstruction of jaw joint025626.61$1,354.56$623.05$270.91
    21244TReconstruction of lower jaw025626.61$1,354.56$623.05$270.91
    21245TReconstruction of jaw025626.61$1,354.56$623.05$270.91
    21246TReconstruction of jaw025626.61$1,354.56$623.05$270.91
    21247CReconstruct lower jaw bone
    21248TReconstruction of jaw025626.61$1,354.56$623.05$270.91
    21249TReconstruction of jaw025626.61$1,354.56$623.05$270.91
    21255CReconstruct lower jaw bone
    21256CReconstruction of orbit
    21260TRevise eye sockets025626.61$1,354.56$623.05$270.91
    21261TRevise eye sockets025626.61$1,354.56$623.05$270.91
    Start Printed Page 59945
    21263TRevise eye sockets025626.61$1,354.56$623.05$270.91
    21267TRevise eye sockets025626.61$1,354.56$623.05$270.91
    21268CRevise eye sockets
    21270TAugmentation, cheek bone025626.61$1,354.56$623.05$270.91
    21275TRevision, orbitofacial bones025626.61$1,354.56$623.05$270.91
    21280TRevision of eyelid025626.61$1,354.56$623.05$270.91
    21282TRevision of eyelid025312.33$627.65$284.00$125.53
    21295TRevision of jaw muscle/bone02525.95$302.88$114.24$60.58
    21296TRevision of jaw muscle/bone025417.37$884.20$272.41$176.84
    21299TCranio/maxillofacial surgery025312.33$627.65$284.00$125.53
    21300TTreatment of skull fracture025312.33$627.65$284.00$125.53
    21310XTreatment of nose fracture03400.84$42.76$10.69$8.55
    21315XTreatment of nose fracture03400.84$42.76$10.69$8.55
    21320XTreatment of nose fracture03400.84$42.76$10.69$8.55
    21325TTreatment of nose fracture025417.37$884.20$272.41$176.84
    21330TTreatment of nose fracture025417.37$884.20$272.41$176.84
    21335TTreatment of nose fracture025417.37$884.20$272.41$176.84
    21336TTreat nasal septal fracture004627.69$1,409.53$535.76$281.91
    21337TTreat nasal septal fracture025312.33$627.65$284.00$125.53
    21338TTreat nasoethmoid fracture025417.37$884.20$272.41$176.84
    21339TTreat nasoethmoid fracture025417.37$884.20$272.41$176.84
    21340TTreatment of nose fracture025626.61$1,354.56$623.05$270.91
    21343CTreatment of sinus fracture
    21344CTreatment of sinus fracture
    21345TTreat nose/jaw fracture025417.37$884.20$272.41$176.84
    21346CTreat nose/jaw fracture
    21347CTreat nose/jaw fracture
    21348CTreat nose/jaw fracture
    21355TTreat cheek bone fracture025626.61$1,354.56$623.05$270.91
    21356CTreat cheek bone fracture
    21360CTreat cheek bone fracture
    21365CTreat cheek bone fracture
    21366CTreat cheek bone fracture
    21385CTreat eye socket fracture
    21386CTreat eye socket fracture
    21387CTreat eye socket fracture
    21390CTreat eye socket fracture
    21395CTreat eye socket fracture
    21400TTreat eye socket fracture02525.95$302.88$114.24$60.58
    21401TTreat eye socket fracture025312.33$627.65$284.00$125.53
    21406TTreat eye socket fracture025626.61$1,354.56$623.05$270.91
    21407TTreat eye socket fracture025626.61$1,354.56$623.05$270.91
    21408CTreat eye socket fracture
    21421TTreat mouth roof fracture025417.37$884.20$272.41$176.84
    21422CTreat mouth roof fracture
    21423CTreat mouth roof fracture
    21431CTreat craniofacial fracture
    21432CTreat craniofacial fracture
    21433CTreat craniofacial fracture
    21435CTreat craniofacial fracture
    21436CTreat craniofacial fracture
    21440TTreat dental ridge fracture025417.37$884.20$272.41$176.84
    21445TTreat dental ridge fracture025417.37$884.20$272.41$176.84
    21450TTreat lower jaw fracture02512.43$123.70$27.99$24.74
    21451TTreat lower jaw fracture02525.95$302.88$114.24$60.58
    21452TTreat lower jaw fracture025312.33$627.65$284.00$125.53
    21453TTreat lower jaw fracture025626.61$1,354.56$623.05$270.91
    21454TTreat lower jaw fracture025417.37$884.20$272.41$176.84
    21461TTreat lower jaw fracture025626.61$1,354.56$623.05$270.91
    21462TTreat lower jaw fracture025626.61$1,354.56$623.05$270.91
    21465TTreat lower jaw fracture025626.61$1,354.56$623.05$270.91
    21470TTreat lower jaw fracture025626.61$1,354.56$623.05$270.91
    21480TReset dislocated jaw02512.43$123.70$27.99$24.74
    21485TReset dislocated jaw025312.33$627.65$284.00$125.53
    21490TRepair dislocated jaw025626.61$1,354.56$623.05$270.91
    21493TTreat hyoid bone fracture02525.95$302.88$114.24$60.58
    21494TTreat hyoid bone fracture02525.95$302.88$114.24$60.58
    21495CTreat hyoid bone fracture
    21497TInterdental wiring025312.33$627.65$284.00$125.53
    21499THead surgery procedure025312.33$627.65$284.00$125.53
    21501TDrain neck/chest lesion000810.93$556.38$113.67$111.28
    21502TDrain chest lesion004915.84$806.32$356.95$161.26
    21510CDrainage of bone lesion
    21550TBiopsy of neck/chest00194.22$214.81$78.91$42.96
    21555TRemove lesion, neck/chest002213.91$708.07$292.94$141.61
    Start Printed Page 59946
    21556TRemove lesion, neck/chest002213.91$708.07$292.94$141.61
    21557CRemove tumor, neck/chest
    21600TPartial removal of rib005020.63$1,050.15$504.07$210.03
    21610TPartial removal of rib005020.63$1,050.15$504.07$210.03
    21615CRemoval of rib
    21616CRemoval of rib and nerves
    21620CPartial removal of sternum
    21627CSternal debridement
    21630CExtensive sternum surgery
    21632CExtensive sternum surgery
    21700TRevision of neck muscle00062.18$110.97$33.95$22.19
    21705CRevision of neck muscle/rib
    21720TRevision of neck muscle000810.93$556.38$113.67$111.28
    21725TRevision of neck muscle00062.18$110.97$33.95$22.19
    21740CReconstruction of sternum
    21750CRepair of sternum separation
    21800TTreatment of rib fracture00434.05$206.16$41.23
    21805TTreatment of rib fracture004627.69$1,409.53$535.76$281.91
    21810CTreatment of rib fracture(s)
    21820TTreat sternum fracture00442.52$128.28$38.08$25.66
    21825CTreat sternum fracture
    21899TNeck/chest surgery procedure02525.95$302.88$114.24$60.58
    21920TBiopsy soft tissue of back00194.22$214.81$78.91$42.96
    21925TBiopsy soft tissue of back002213.91$708.07$292.94$141.61
    21930TRemove lesion, back or flank002213.91$708.07$292.94$141.61
    21935TRemove tumor, back002213.91$708.07$292.94$141.61
    22100CRemove part of neck vertebra
    22101CRemove part, thorax vertebra
    22102CRemove part, lumbar vertebra
    22103CRemove extra spine segment
    22110CRemove part of neck vertebra
    22112CRemove part, thorax vertebra
    22114CRemove part, lumbar vertebra
    22116CRemove extra spine segment
    22210CRevision of neck spine
    22212CRevision of thorax spine
    22214CRevision of lumbar spine
    22216CRevise, extra spine segment
    22220CRevision of neck spine
    22222CRevision of thorax spine
    22224CRevision of lumbar spine
    22226CRevise, extra spine segment
    22305TTreat spine process fracture00434.05$206.16$41.23
    22310TTreat spine fracture00434.05$206.16$41.23
    22315TTreat spine fracture00434.05$206.16$41.23
    22318CTreat odontoid fx w/o graft
    22319CTreat odontoid fx w/graft
    22325CTreat spine fracture
    22326CTreat neck spine fracture
    22327CTreat thorax spine fracture
    22328CTreat each add spine fx
    22505TManipulation of spine004511.67$594.05$277.12$118.81
    22520TPercut vertebroplasty thor005020.63$1,050.15$504.07$210.03
    22521TPercut vertebroplasty lumb005020.63$1,050.15$504.07$210.03
    22522TPercut vertebroplasty addl005020.63$1,050.15$504.07$210.03
    22548CNeck spine fusion
    22554CNeck spine fusion
    22556CThorax spine fusion
    22558CLumbar spine fusion
    22585CAdditional spinal fusion
    22590CSpine & skull spinal fusion
    22595CNeck spinal fusion
    22600CNeck spine fusion
    22610CThorax spine fusion
    22612CLumbar spine fusion
    22614CSpine fusion, extra segment
    22630CLumbar spine fusion
    22632CSpine fusion, extra segment
    22800CFusion of spine
    22802CFusion of spine
    22804CFusion of spine
    22808CFusion of spine
    22810CFusion of spine
    22812CFusion of spine
    22818CKyphectomy, 1-2 segments
    Start Printed Page 59947
    22819CKyphectomy, 3 or more
    22830CExploration of spinal fusion
    22840CInsert spine fixation device
    22841CInsert spine fixation device
    22842CInsert spine fixation device
    22843CInsert spine fixation device
    22844CInsert spine fixation device
    22845CInsert spine fixation device
    22846CInsert spine fixation device
    22847CInsert spine fixation device
    22848CInsert pelv fixation device
    22849CReinsert spinal fixation
    22850CRemove spine fixation device
    22851CApply spine prosth device
    22852CRemove spine fixation device
    22855CRemove spine fixation device
    22899TSpine surgery procedure00434.05$206.16$41.23
    22900TRemove abdominal wall lesion002213.91$708.07$292.94$141.61
    22999TAbdomen surgery procedure002213.91$708.07$292.94$141.61
    23000TRemoval of calcium deposits002111.82$601.69$236.51$120.34
    23020TRelease shoulder joint005128.56$1,453.82$675.24$290.76
    23030TDrain shoulder lesion000810.93$556.38$113.67$111.28
    23031TDrain shoulder bursa000810.93$556.38$113.67$111.28
    23035CDrain shoulder bone lesion
    23040TExploratory shoulder surgery005020.63$1,050.15$504.07$210.03
    23044TExploratory shoulder surgery005020.63$1,050.15$504.07$210.03
    23065TBiopsy shoulder tissues002111.82$601.69$236.51$120.34
    23066TBiopsy shoulder tissues002213.91$708.07$292.94$141.61
    23075TRemoval of shoulder lesion002111.82$601.69$236.51$120.34
    23076TRemoval of shoulder lesion002213.91$708.07$292.94$141.61
    23077TRemove tumor of shoulder002213.91$708.07$292.94$141.61
    23100TBiopsy of shoulder joint004915.84$806.32$356.95$161.26
    23101TShoulder joint surgery005020.63$1,050.15$504.07$210.03
    23105TRemove shoulder joint lining005020.63$1,050.15$504.07$210.03
    23106TIncision of collarbone joint005020.63$1,050.15$504.07$210.03
    23107TExplore treat shoulder joint005020.63$1,050.15$504.07$210.03
    23120TPartial removal, collar bone005128.56$1,453.82$675.24$290.76
    23125CRemoval of collar bone
    23130TRemove shoulder bone, part005128.56$1,453.82$675.24$290.76
    23140TRemoval of bone lesion004915.84$806.32$356.95$161.26
    23145TRemoval of bone lesion005020.63$1,050.15$504.07$210.03
    23146TRemoval of bone lesion005020.63$1,050.15$504.07$210.03
    23150TRemoval of humerus lesion005020.63$1,050.15$504.07$210.03
    23155TRemoval of humerus lesion005020.63$1,050.15$504.07$210.03
    23156TRemoval of humerus lesion005020.63$1,050.15$504.07$210.03
    23170TRemove collar bone lesion005020.63$1,050.15$504.07$210.03
    23172TRemove shoulder blade lesion005020.63$1,050.15$504.07$210.03
    23174TRemove humerus lesion005020.63$1,050.15$504.07$210.03
    23180TRemove collar bone lesion005020.63$1,050.15$504.07$210.03
    23182TRemove shoulder blade lesion005020.63$1,050.15$504.07$210.03
    23184TRemove humerus lesion005020.63$1,050.15$504.07$210.03
    23190TPartial removal of scapula005020.63$1,050.15$504.07$210.03
    23195CRemoval of head of humerus
    23200CRemoval of collar bone
    23210CRemoval of shoulder blade
    23220CPartial removal of humerus
    23221CPartial removal of humerus
    23222CPartial removal of humerus
    23330TRemove shoulder foreign body00194.22$214.81$78.91$42.96
    23331TRemove shoulder foreign body002213.91$708.07$292.94$141.61
    23332CRemove shoulder foreign body
    23350NInjection for shoulder x-ray
    23395CMuscle transfer,shoulder/arm
    23397CMuscle transfers
    23400CFixation of shoulder blade
    23405TIncision of tendon & muscle005020.63$1,050.15$504.07$210.03
    23406TIncise tendon(s) & muscle(s)005020.63$1,050.15$504.07$210.03
    23410TRepair of tendon(s)005235.94$1,829.49$930.91$365.90
    23412TRepair of tendon(s)005235.94$1,829.49$930.91$365.90
    23415TRelease of shoulder ligament005128.56$1,453.82$675.24$290.76
    23420TRepair of shoulder005235.94$1,829.49$930.91$365.90
    23430TRepair biceps tendon005235.94$1,829.49$930.91$365.90
    23440TRemove/transplant tendon005235.94$1,829.49$930.91$365.90
    23450TRepair shoulder capsule005235.94$1,829.49$930.91$365.90
    23455TRepair shoulder capsule005235.94$1,829.49$930.91$365.90
    Start Printed Page 59948
    23460TRepair shoulder capsule005235.94$1,829.49$930.91$365.90
    23462TRepair shoulder capsule005235.94$1,829.49$930.91$365.90
    23465TRepair shoulder capsule005235.94$1,829.49$930.91$365.90
    23466TRepair shoulder capsule005235.94$1,829.49$930.91$365.90
    23470TReconstruct shoulder joint004843.19$2,198.54$725.94$439.71
    23472CReconstruct shoulder joint
    23480TRevision of collar bone005128.56$1,453.82$675.24$290.76
    23485TRevision of collar bone005128.56$1,453.82$675.24$290.76
    23490TReinforce clavicle005128.56$1,453.82$675.24$290.76
    23491TReinforce shoulder bones005128.56$1,453.82$675.24$290.76
    23500TTreat clavicle fracture00434.05$206.16$41.23
    23505TTreat clavicle fracture00434.05$206.16$41.23
    23515TTreat clavicle fracture004627.69$1,409.53$535.76$281.91
    23520TTreat clavicle dislocation00442.52$128.28$38.08$25.66
    23525TTreat clavicle dislocation00434.05$206.16$41.23
    23530TTreat clavicle dislocation004627.69$1,409.53$535.76$281.91
    23532TTreat clavicle dislocation004627.69$1,409.53$535.76$281.91
    23540TTreat clavicle dislocation00442.52$128.28$38.08$25.66
    23545TTreat clavicle dislocation00434.05$206.16$41.23
    23550TTreat clavicle dislocation004627.69$1,409.53$535.76$281.91
    23552TTreat clavicle dislocation004627.69$1,409.53$535.76$281.91
    23570TTreat shoulder blade fx00434.05$206.16$41.23
    23575TTreat shoulder blade fx00442.52$128.28$38.08$25.66
    23585TTreat scapula fracture004627.69$1,409.53$535.76$281.91
    23600TTreat humerus fracture00442.52$128.28$38.08$25.66
    23605TTreat humerus fracture00442.52$128.28$38.08$25.66
    23615TTreat humerus fracture004627.69$1,409.53$535.76$281.91
    23616TTreat humerus fracture004627.69$1,409.53$535.76$281.91
    23620TTreat humerus fracture00442.52$128.28$38.08$25.66
    23625TTreat humerus fracture00442.52$128.28$38.08$25.66
    23630TTreat humerus fracture004627.69$1,409.53$535.76$281.91
    23650TTreat shoulder dislocation00434.05$206.16$41.23
    23655TTreat shoulder dislocation004511.67$594.05$277.12$118.81
    23660TTreat shoulder dislocation004627.69$1,409.53$535.76$281.91
    23665TTreat dislocation/fracture00442.52$128.28$38.08$25.66
    23670TTreat dislocation/fracture004627.69$1,409.53$535.76$281.91
    23675TTreat dislocation/fracture00442.52$128.28$38.08$25.66
    23680TTreat dislocation/fracture004627.69$1,409.53$535.76$281.91
    23700TFixation of shoulder004511.67$594.05$277.12$118.81
    23800TFusion of shoulder joint005128.56$1,453.82$675.24$290.76
    23802TFusion of shoulder joint005128.56$1,453.82$675.24$290.76
    23900CAmputation of arm & girdle
    23920CAmputation at shoulder joint
    23921TAmputation follow-up surgery002612.62$642.41$277.92$128.48
    23929TShoulder surgery procedure00434.05$206.16$41.23
    23930TDrainage of arm lesion000810.93$556.38$113.67$111.28
    23931TDrainage of arm bursa00062.18$110.97$33.95$22.19
    23935TDrain arm/elbow bone lesion004915.84$806.32$356.95$161.26
    24000TExploratory elbow surgery005020.63$1,050.15$504.07$210.03
    24006TRelease elbow joint005020.63$1,050.15$504.07$210.03
    24065TBiopsy arm/elbow soft tissue00208.44$429.63$130.53$85.93
    24066TBiopsy arm/elbow soft tissue002111.82$601.69$236.51$120.34
    24075TRemove arm/elbow lesion002111.82$601.69$236.51$120.34
    24076TRemove arm/elbow lesion002213.91$708.07$292.94$141.61
    24077TRemove tumor of arm/elbow002213.91$708.07$292.94$141.61
    24100TBiopsy elbow joint lining004915.84$806.32$356.95$161.26
    24101TExplore/treat elbow joint005020.63$1,050.15$504.07$210.03
    24102TRemove elbow joint lining005020.63$1,050.15$504.07$210.03
    24105TRemoval of elbow bursa004915.84$806.32$356.95$161.26
    24110TRemove humerus lesion004915.84$806.32$356.95$161.26
    24115TRemove/graft bone lesion005020.63$1,050.15$504.07$210.03
    24116TRemove/graft bone lesion005020.63$1,050.15$504.07$210.03
    24120TRemove elbow lesion004915.84$806.32$356.95$161.26
    24125TRemove/graft bone lesion005020.63$1,050.15$504.07$210.03
    24126TRemove/graft bone lesion005020.63$1,050.15$504.07$210.03
    24130TRemoval of head of radius005020.63$1,050.15$504.07$210.03
    24134TRemoval of arm bone lesion005020.63$1,050.15$504.07$210.03
    24136TRemove radius bone lesion005020.63$1,050.15$504.07$210.03
    24138TRemove elbow bone lesion005020.63$1,050.15$504.07$210.03
    24140TPartial removal of arm bone005020.63$1,050.15$504.07$210.03
    24145TPartial removal of radius005020.63$1,050.15$504.07$210.03
    24147TPartial removal of elbow005020.63$1,050.15$504.07$210.03
    24149CRadical resection of elbow
    24150CExtensive humerus surgery
    24151CExtensive humerus surgery
    Start Printed Page 59949
    24152CExtensive radius surgery
    24153CExtensive radius surgery
    24155TRemoval of elbow joint005128.56$1,453.82$675.24$290.76
    24160TRemove elbow joint implant005020.63$1,050.15$504.07$210.03
    24164TRemove radius head implant005020.63$1,050.15$504.07$210.03
    24200TRemoval of arm foreign body00194.22$214.81$78.91$42.96
    24201TRemoval of arm foreign body002111.82$601.69$236.51$120.34
    24220NInjection for elbow x-ray
    *24300TManipulate elbow w/anesth004511.67$594.05$277.12$118.81
    24301TMuscle/tendon transfer005020.63$1,050.15$504.07$210.03
    24305TArm tendon lengthening005020.63$1,050.15$504.07$210.03
    24310TRevision of arm tendon004915.84$806.32$356.95$161.26
    24320TRepair of arm tendon005128.56$1,453.82$675.24$290.76
    24330TRevision of arm muscles005128.56$1,453.82$675.24$290.76
    24331TRevision of arm muscles005128.56$1,453.82$675.24$290.76
    *24332TTenolysis, triceps004915.84$806.32$356.95$161.26
    24340TRepair of biceps tendon005128.56$1,453.82$675.24$290.76
    24341TRepair arm tendon/muscle005128.56$1,453.82$675.24$290.76
    24342TRepair of ruptured tendon005128.56$1,453.82$675.24$290.76
    *24343TRepr elbow lat ligmnt w/tiss005020.63$1,050.15$504.07$210.03
    *24344TReconstruct elbow lat ligmnt005128.56$1,453.82$675.24$290.76
    *24345TRepr elbw med ligmnt w/tiss005020.63$1,050.15$504.07$210.03
    *24346TReconstruct elbow med ligmnt005128.56$1,453.82$675.24$290.76
    24350TRepair of tennis elbow005020.63$1,050.15$504.07$210.03
    24351TRepair of tennis elbow005020.63$1,050.15$504.07$210.03
    24352TRepair of tennis elbow005020.63$1,050.15$504.07$210.03
    24354TRepair of tennis elbow005020.63$1,050.15$504.07$210.03
    24356TRevision of tennis elbow005020.63$1,050.15$504.07$210.03
    24360TReconstruct elbow joint004726.36$1,341.83$537.03$268.37
    24361TReconstruct elbow joint004843.19$2,198.54$725.94$439.71
    24362TReconstruct elbow joint004843.19$2,198.54$725.94$439.71
    24363TReplace elbow joint004843.19$2,198.54$725.94$439.71
    24365TReconstruct head of radius004726.36$1,341.83$537.03$268.37
    24366TReconstruct head of radius004843.19$2,198.54$725.94$439.71
    24400TRevision of humerus005020.63$1,050.15$504.07$210.03
    24410TRevision of humerus005020.63$1,050.15$504.07$210.03
    24420TRevision of humerus005128.56$1,453.82$675.24$290.76
    24430TRepair of humerus005128.56$1,453.82$675.24$290.76
    24435TRepair humerus with graft005128.56$1,453.82$675.24$290.76
    24470TRevision of elbow joint005128.56$1,453.82$675.24$290.76
    24495TDecompression of forearm005020.63$1,050.15$504.07$210.03
    24498TReinforce humerus005128.56$1,453.82$675.24$290.76
    24500TTreat humerus fracture00442.52$128.28$38.08$25.66
    24505TTreat humerus fracture00442.52$128.28$38.08$25.66
    24515TTreat humerus fracture004627.69$1,409.53$535.76$281.91
    24516TTreat humerus fracture004627.69$1,409.53$535.76$281.91
    24530TTreat humerus fracture00442.52$128.28$38.08$25.66
    24535TTreat humerus fracture00442.52$128.28$38.08$25.66
    24538TTreat humerus fracture004627.69$1,409.53$535.76$281.91
    24545TTreat humerus fracture004627.69$1,409.53$535.76$281.91
    24546TTreat humerus fracture004627.69$1,409.53$535.76$281.91
    24560TTreat humerus fracture00442.52$128.28$38.08$25.66
    24565TTreat humerus fracture00442.52$128.28$38.08$25.66
    24566TTreat humerus fracture004627.69$1,409.53$535.76$281.91
    24575TTreat humerus fracture004627.69$1,409.53$535.76$281.91
    24576TTreat humerus fracture00442.52$128.28$38.08$25.66
    24577TTreat humerus fracture00442.52$128.28$38.08$25.66
    24579TTreat humerus fracture004627.69$1,409.53$535.76$281.91
    24582TTreat humerus fracture004627.69$1,409.53$535.76$281.91
    24586TTreat elbow fracture004627.69$1,409.53$535.76$281.91
    24587TTreat elbow fracture004627.69$1,409.53$535.76$281.91
    24600TTreat elbow dislocation00442.52$128.28$38.08$25.66
    24605TTreat elbow dislocation004511.67$594.05$277.12$118.81
    24615TTreat elbow dislocation004627.69$1,409.53$535.76$281.91
    24620TTreat elbow fracture00442.52$128.28$38.08$25.66
    24635TTreat elbow fracture004627.69$1,409.53$535.76$281.91
    24640TTreat elbow dislocation00442.52$128.28$38.08$25.66
    24650TTreat radius fracture00442.52$128.28$38.08$25.66
    24655TTreat radius fracture00442.52$128.28$38.08$25.66
    24665TTreat radius fracture004627.69$1,409.53$535.76$281.91
    24666TTreat radius fracture004627.69$1,409.53$535.76$281.91
    24670TTreat ulnar fracture00442.52$128.28$38.08$25.66
    24675TTreat ulnar fracture00442.52$128.28$38.08$25.66
    24685TTreat ulnar fracture004627.69$1,409.53$535.76$281.91
    24800TFusion of elbow joint005128.56$1,453.82$675.24$290.76
    Start Printed Page 59950
    24802TFusion/graft of elbow joint005128.56$1,453.82$675.24$290.76
    24900CAmputation of upper arm
    24920CAmputation of upper arm
    24925TAmputation follow-up surgery004915.84$806.32$356.95$161.26
    24930CAmputation follow-up surgery
    24931CAmputate upper arm & implant
    24935TRevision of amputation005235.94$1,829.49$930.91$365.90
    24940CRevision of upper arm
    24999TUpper arm/elbow surgery00442.52$128.28$38.08$25.66
    25000TIncision of tendon sheath004915.84$806.32$356.95$161.26
    *25001TIncise flexor carpi radialis004915.84$806.32$356.95$161.26
    25020TDecompression of forearm004915.84$806.32$356.95$161.26
    25023TDecompression of forearm005020.63$1,050.15$504.07$210.03
    *25024TDecompress forearm 2 spaces005020.63$1,050.15$504.07$210.03
    *25025TDecompress forarm 2 spaces005020.63$1,050.15$504.07$210.03
    25028TDrainage of forearm lesion004915.84$806.32$356.95$161.26
    25031TDrainage of forearm bursa004915.84$806.32$356.95$161.26
    25035TTreat forearm bone lesion004915.84$806.32$356.95$161.26
    25040TExplore/treat wrist joint005020.63$1,050.15$504.07$210.03
    25065TBiopsy forearm soft tissues002111.82$601.69$236.51$120.34
    25066TBiopsy forearm soft tissues002213.91$708.07$292.94$141.61
    25075TRemoval of forearm lesion00208.44$429.63$130.53$85.93
    25076TRemoval of forearm lesion002213.91$708.07$292.94$141.61
    25077TRemove tumor, forearm/wrist002213.91$708.07$292.94$141.61
    25085TIncision of wrist capsule004915.84$806.32$356.95$161.26
    25100TBiopsy of wrist joint004915.84$806.32$356.95$161.26
    25101TExplore/treat wrist joint005020.63$1,050.15$504.07$210.03
    25105TRemove wrist joint lining005020.63$1,050.15$504.07$210.03
    25107TRemove wrist joint cartilage005020.63$1,050.15$504.07$210.03
    25110TRemove wrist tendon lesion004915.84$806.32$356.95$161.26
    25111TRemove wrist tendon lesion005311.69$595.07$253.49$119.01
    25112TReremove wrist tendon lesion005311.69$595.07$253.49$119.01
    25115TRemove wrist/forearm lesion004915.84$806.32$356.95$161.26
    25116TRemove wrist/forearm lesion004915.84$806.32$356.95$161.26
    25118TExcise wrist tendon sheath005020.63$1,050.15$504.07$210.03
    25119TPartial removal of ulna005020.63$1,050.15$504.07$210.03
    25120TRemoval of forearm lesion005020.63$1,050.15$504.07$210.03
    25125TRemove/graft forearm lesion005020.63$1,050.15$504.07$210.03
    25126TRemove/graft forearm lesion005020.63$1,050.15$504.07$210.03
    25130TRemoval of wrist lesion005020.63$1,050.15$504.07$210.03
    25135TRemove & graft wrist lesion005020.63$1,050.15$504.07$210.03
    25136TRemove & graft wrist lesion005020.63$1,050.15$504.07$210.03
    25145TRemove forearm bone lesion005020.63$1,050.15$504.07$210.03
    25150TPartial removal of ulna005020.63$1,050.15$504.07$210.03
    25151TPartial removal of radius005020.63$1,050.15$504.07$210.03
    25170CExtensive forearm surgery
    25210TRemoval of wrist bone005419.83$1,009.43$472.33$201.89
    25215TRemoval of wrist bones005419.83$1,009.43$472.33$201.89
    25230TPartial removal of radius005020.63$1,050.15$504.07$210.03
    25240TPartial removal of ulna005020.63$1,050.15$504.07$210.03
    25246NInjection for wrist x-ray
    25248TRemove forearm foreign body004915.84$806.32$356.95$161.26
    25250TRemoval of wrist prosthesis005020.63$1,050.15$504.07$210.03
    25251TRemoval of wrist prosthesis005020.63$1,050.15$504.07$210.03
    *25259TManipulate wrist w/anesthes00442.52$128.28$38.08$25.66
    25260TRepair forearm tendon/muscle005020.63$1,050.15$504.07$210.03
    25263TRepair forearm tendon/muscle005020.63$1,050.15$504.07$210.03
    25265TRepair forearm tendon/muscle005020.63$1,050.15$504.07$210.03
    25270TRepair forearm tendon/muscle005020.63$1,050.15$504.07$210.03
    25272TRepair forearm tendon/muscle005020.63$1,050.15$504.07$210.03
    25274TRepair forearm tendon/muscle005020.63$1,050.15$504.07$210.03
    *25275TRepair forearm tendon sheath005020.63$1,050.15$504.07$210.03
    25280TRevise wrist/forearm tendon005020.63$1,050.15$504.07$210.03
    25290TIncise wrist/forearm tendon005020.63$1,050.15$504.07$210.03
    25295TRelease wrist/forearm tendon004915.84$806.32$356.95$161.26
    25300TFusion of tendons at wrist005020.63$1,050.15$504.07$210.03
    25301TFusion of tendons at wrist005020.63$1,050.15$504.07$210.03
    25310TTransplant forearm tendon005128.56$1,453.82$675.24$290.76
    25312TTransplant forearm tendon005128.56$1,453.82$675.24$290.76
    25315TRevise palsy hand tendon(s)005128.56$1,453.82$675.24$290.76
    25316TRevise palsy hand tendon(s)005128.56$1,453.82$675.24$290.76
    25320TRepair/revise wrist joint005128.56$1,453.82$675.24$290.76
    25332TRevise wrist joint004726.36$1,341.83$537.03$268.37
    25335TRealignment of hand005128.56$1,453.82$675.24$290.76
    25337TReconstruct ulna/radioulnar005128.56$1,453.82$675.24$290.76
    Start Printed Page 59951
    25350TRevision of radius005128.56$1,453.82$675.24$290.76
    25355TRevision of radius005128.56$1,453.82$675.24$290.76
    25360TRevision of ulna005020.63$1,050.15$504.07$210.03
    25365TRevise radius & ulna005020.63$1,050.15$504.07$210.03
    25370TRevise radius or ulna005128.56$1,453.82$675.24$290.76
    25375TRevise radius & ulna005128.56$1,453.82$675.24$290.76
    25390CShorten radius or ulna
    25391CLengthen radius or ulna
    25392CShorten radius & ulna
    25393CLengthen radius & ulna
    *25394TRepair carpal bone, shorten005311.69$595.07$253.49$119.01
    25400TRepair radius or ulna005020.63$1,050.15$504.07$210.03
    25405TRepair/graft radius or ulna005020.63$1,050.15$504.07$210.03
    25415TRepair radius & ulna005020.63$1,050.15$504.07$210.03
    25420CRepair/graft radius & ulna
    25425TRepair/graft radius or ulna005128.56$1,453.82$675.24$290.76
    25426TRepair/graft radius & ulna005128.56$1,453.82$675.24$290.76
    *25430TVasc graft into carpal bone005419.83$1,009.43$472.33$201.89
    *25431TRepair nonunion carpal bone005419.83$1,009.43$472.33$201.89
    25440TRepair/graft wrist bone005128.56$1,453.82$675.24$290.76
    25441TReconstruct wrist joint004843.19$2,198.54$725.94$439.71
    25442TReconstruct wrist joint004843.19$2,198.54$725.94$439.71
    25443TReconstruct wrist joint004843.19$2,198.54$725.94$439.71
    25444TReconstruct wrist joint004843.19$2,198.54$725.94$439.71
    25445TReconstruct wrist joint004843.19$2,198.54$725.94$439.71
    25446TWrist replacement004843.19$2,198.54$725.94$439.71
    25447TRepair wrist joint(s)004726.36$1,341.83$537.03$268.37
    25449TRemove wrist joint implant004726.36$1,341.83$537.03$268.37
    25450TRevision of wrist joint005128.56$1,453.82$675.24$290.76
    25455TRevision of wrist joint005128.56$1,453.82$675.24$290.76
    25490TReinforce radius005128.56$1,453.82$675.24$290.76
    25491TReinforce ulna005128.56$1,453.82$675.24$290.76
    25492TReinforce radius and ulna005128.56$1,453.82$675.24$290.76
    25500TTreat fracture of radius00442.52$128.28$38.08$25.66
    25505TTreat fracture of radius00442.52$128.28$38.08$25.66
    25515TTreat fracture of radius004627.69$1,409.53$535.76$281.91
    25520TTreat fracture of radius00442.52$128.28$38.08$25.66
    25525TTreat fracture of radius004627.69$1,409.53$535.76$281.91
    25526TTreat fracture of radius004627.69$1,409.53$535.76$281.91
    25530TTreat fracture of ulna00442.52$128.28$38.08$25.66
    25535TTreat fracture of ulna00442.52$128.28$38.08$25.66
    25545TTreat fracture of ulna004627.69$1,409.53$535.76$281.91
    25560TTreat fracture radius & ulna00442.52$128.28$38.08$25.66
    25565TTreat fracture radius & ulna00442.52$128.28$38.08$25.66
    25574TTreat fracture radius & ulna004627.69$1,409.53$535.76$281.91
    25575TTreat fracture radius/ulna004627.69$1,409.53$535.76$281.91
    25600TTreat fracture radius/ulna00442.52$128.28$38.08$25.66
    25605TTreat fracture radius/ulna00442.52$128.28$38.08$25.66
    25611TTreat fracture radius/ulna004627.69$1,409.53$535.76$281.91
    25620TTreat fracture radius/ulna004627.69$1,409.53$535.76$281.91
    25622TTreat wrist bone fracture00442.52$128.28$38.08$25.66
    25624TTreat wrist bone fracture00442.52$128.28$38.08$25.66
    25628TTreat wrist bone fracture004627.69$1,409.53$535.76$281.91
    25630TTreat wrist bone fracture00442.52$128.28$38.08$25.66
    25635TTreat wrist bone fracture00442.52$128.28$38.08$25.66
    25645TTreat wrist bone fracture004627.69$1,409.53$535.76$281.91
    25650TTreat wrist bone fracture00442.52$128.28$38.08$25.66
    *25651TPin ulnar styloid fracture004627.69$1,409.53$535.76$281.91
    *25652TTreat fracture ulnar styloid004627.69$1,409.53$535.76$281.91
    25660TTreat wrist dislocation00442.52$128.28$38.08$25.66
    25670TTreat wrist dislocation004627.69$1,409.53$535.76$281.91
    *25671TPin radioulnar dislocation004627.69$1,409.53$535.76$281.91
    25675TTreat wrist dislocation00442.52$128.28$38.08$25.66
    25676TTreat wrist dislocation004627.69$1,409.53$535.76$281.91
    25680TTreat wrist fracture00442.52$128.28$38.08$25.66
    25685TTreat wrist fracture004627.69$1,409.53$535.76$281.91
    25690TTreat wrist dislocation00442.52$128.28$38.08$25.66
    25695TTreat wrist dislocation004627.69$1,409.53$535.76$281.91
    25800TFusion of wrist joint005128.56$1,453.82$675.24$290.76
    25805TFusion/graft of wrist joint005128.56$1,453.82$675.24$290.76
    25810TFusion/graft of wrist joint005128.56$1,453.82$675.24$290.76
    25820TFusion of hand bones005311.69$595.07$253.49$119.01
    25825TFuse hand bones with graft005419.83$1,009.43$472.33$201.89
    25830TFusion, radioulnar jnt/ulna005128.56$1,453.82$675.24$290.76
    25900CAmputation of forearm
    Start Printed Page 59952
    25905CAmputation of forearm
    25907TAmputation follow-up surgery004915.84$806.32$356.95$161.26
    25909CAmputation follow-up surgery
    25915CAmputation of forearm
    25920CAmputate hand at wrist
    25922TAmputate hand at wrist004915.84$806.32$356.95$161.26
    25924CAmputation follow-up surgery
    25927CAmputation of hand
    25929TAmputation follow-up surgery002612.62$642.41$277.92$128.48
    25931CAmputation follow-up surgery
    25999TForearm or wrist surgery00442.52$128.28$38.08$25.66
    26010TDrainage of finger abscess00062.18$110.97$33.95$22.19
    26011TDrainage of finger abscess00076.75$343.60$72.03$68.72
    26020TDrain hand tendon sheath005311.69$595.07$253.49$119.01
    26025TDrainage of palm bursa005311.69$595.07$253.49$119.01
    26030TDrainage of palm bursa(s)005311.69$595.07$253.49$119.01
    26034TTreat hand bone lesion005311.69$595.07$253.49$119.01
    26035TDecompress fingers/hand005311.69$595.07$253.49$119.01
    26037TDecompress fingers/hand005311.69$595.07$253.49$119.01
    26040TRelease palm contracture005419.83$1,009.43$472.33$201.89
    26045TRelease palm contracture005419.83$1,009.43$472.33$201.89
    26055TIncise finger tendon sheath005311.69$595.07$253.49$119.01
    26060TIncision of finger tendon005311.69$595.07$253.49$119.01
    26070TExplore/treat hand joint005311.69$595.07$253.49$119.01
    26075TExplore/treat finger joint005311.69$595.07$253.49$119.01
    26080TExplore/treat finger joint005311.69$595.07$253.49$119.01
    26100TBiopsy hand joint lining005311.69$595.07$253.49$119.01
    26105TBiopsy finger joint lining005311.69$595.07$253.49$119.01
    26110TBiopsy finger joint lining005311.69$595.07$253.49$119.01
    26115TRemoval of hand lesion002213.91$708.07$292.94$141.61
    26116TRemoval of hand lesion002213.91$708.07$292.94$141.61
    26117TRemove tumor, hand/finger002213.91$708.07$292.94$141.61
    26121TRelease palm contracture005419.83$1,009.43$472.33$201.89
    26123TRelease palm contracture005419.83$1,009.43$472.33$201.89
    26125TRelease palm contracture005419.83$1,009.43$472.33$201.89
    26130TRemove wrist joint lining005311.69$595.07$253.49$119.01
    26135TRevise finger joint, each005419.83$1,009.43$472.33$201.89
    26140TRevise finger joint, each005311.69$595.07$253.49$119.01
    26145TTendon excision, palm/finger005311.69$595.07$253.49$119.01
    26160TRemove tendon sheath lesion005311.69$595.07$253.49$119.01
    26170TRemoval of palm tendon, each005311.69$595.07$253.49$119.01
    26180TRemoval of finger tendon005311.69$595.07$253.49$119.01
    26185TRemove finger bone005311.69$595.07$253.49$119.01
    26200TRemove hand bone lesion005311.69$595.07$253.49$119.01
    26205TRemove/graft bone lesion005419.83$1,009.43$472.33$201.89
    26210TRemoval of finger lesion005311.69$595.07$253.49$119.01
    26215TRemove/graft finger lesion005311.69$595.07$253.49$119.01
    26230TPartial removal of hand bone005311.69$595.07$253.49$119.01
    26235TPartial removal, finger bone005311.69$595.07$253.49$119.01
    26236TPartial removal, finger bone005311.69$595.07$253.49$119.01
    26250TExtensive hand surgery005311.69$595.07$253.49$119.01
    26255TExtensive hand surgery005419.83$1,009.43$472.33$201.89
    26260TExtensive finger surgery005311.69$595.07$253.49$119.01
    26261TExtensive finger surgery005311.69$595.07$253.49$119.01
    26262TPartial removal of finger005311.69$595.07$253.49$119.01
    26320TRemoval of implant from hand00208.44$429.63$130.53$85.93
    *26340TManipulate finger w/anesth00434.05$206.16$41.23
    26350TRepair finger/hand tendon005419.83$1,009.43$472.33$201.89
    26352TRepair/graft hand tendon005419.83$1,009.43$472.33$201.89
    26356TRepair finger/hand tendon005419.83$1,009.43$472.33$201.89
    26357TRepair finger/hand tendon005419.83$1,009.43$472.33$201.89
    26358TRepair/graft hand tendon005419.83$1,009.43$472.33$201.89
    26370TRepair finger/hand tendon005419.83$1,009.43$472.33$201.89
    26372TRepair/graft hand tendon005419.83$1,009.43$472.33$201.89
    26373TRepair finger/hand tendon005419.83$1,009.43$472.33$201.89
    26390TRevise hand/finger tendon005419.83$1,009.43$472.33$201.89
    26392TRepair/graft hand tendon005419.83$1,009.43$472.33$201.89
    26410TRepair hand tendon005311.69$595.07$253.49$119.01
    26412TRepair/graft hand tendon005419.83$1,009.43$472.33$201.89
    26415TExcision, hand/finger tendon005419.83$1,009.43$472.33$201.89
    26416TGraft hand or finger tendon005419.83$1,009.43$472.33$201.89
    26418TRepair finger tendon005311.69$595.07$253.49$119.01
    26420TRepair/graft finger tendon005419.83$1,009.43$472.33$201.89
    26426TRepair finger/hand tendon005419.83$1,009.43$472.33$201.89
    26428TRepair/graft finger tendon005419.83$1,009.43$472.33$201.89
    Start Printed Page 59953
    26432TRepair finger tendon005311.69$595.07$253.49$119.01
    26433TRepair finger tendon005311.69$595.07$253.49$119.01
    26434TRepair/graft finger tendon005419.83$1,009.43$472.33$201.89
    26437TRealignment of tendons005311.69$595.07$253.49$119.01
    26440TRelease palm/finger tendon005311.69$595.07$253.49$119.01
    26442TRelease palm & finger tendon005419.83$1,009.43$472.33$201.89
    26445TRelease hand/finger tendon005311.69$595.07$253.49$119.01
    26449TRelease forearm/hand tendon005419.83$1,009.43$472.33$201.89
    26450TIncision of palm tendon005311.69$595.07$253.49$119.01
    26455TIncision of finger tendon005311.69$595.07$253.49$119.01
    26460TIncise hand/finger tendon005311.69$595.07$253.49$119.01
    26471TFusion of finger tendons005311.69$595.07$253.49$119.01
    26474TFusion of finger tendons005311.69$595.07$253.49$119.01
    26476TTendon lengthening005311.69$595.07$253.49$119.01
    26477TTendon shortening005311.69$595.07$253.49$119.01
    26478TLengthening of hand tendon005311.69$595.07$253.49$119.01
    26479TShortening of hand tendon005311.69$595.07$253.49$119.01
    26480TTransplant hand tendon005419.83$1,009.43$472.33$201.89
    26483TTransplant/graft hand tendon005419.83$1,009.43$472.33$201.89
    26485TTransplant palm tendon005419.83$1,009.43$472.33$201.89
    26489TTransplant/graft palm tendon005419.83$1,009.43$472.33$201.89
    26490TRevise thumb tendon005419.83$1,009.43$472.33$201.89
    26492TTendon transfer with graft005419.83$1,009.43$472.33$201.89
    26494THand tendon/muscle transfer005419.83$1,009.43$472.33$201.89
    26496TRevise thumb tendon005419.83$1,009.43$472.33$201.89
    26497TFinger tendon transfer005419.83$1,009.43$472.33$201.89
    26498TFinger tendon transfer005419.83$1,009.43$472.33$201.89
    26499TRevision of finger005419.83$1,009.43$472.33$201.89
    26500THand tendon reconstruction005311.69$595.07$253.49$119.01
    26502THand tendon reconstruction005419.83$1,009.43$472.33$201.89
    26504THand tendon reconstruction005419.83$1,009.43$472.33$201.89
    26508TRelease thumb contracture005311.69$595.07$253.49$119.01
    26510TThumb tendon transfer005419.83$1,009.43$472.33$201.89
    26516TFusion of knuckle joint005419.83$1,009.43$472.33$201.89
    26517TFusion of knuckle joints005419.83$1,009.43$472.33$201.89
    26518TFusion of knuckle joints005419.83$1,009.43$472.33$201.89
    26520TRelease knuckle contracture005311.69$595.07$253.49$119.01
    26525TRelease finger contracture005311.69$595.07$253.49$119.01
    26530TRevise knuckle joint004726.36$1,341.83$537.03$268.37
    26531TRevise knuckle with implant004843.19$2,198.54$725.94$439.71
    26535TRevise finger joint004726.36$1,341.83$537.03$268.37
    26536TRevise/implant finger joint004843.19$2,198.54$725.94$439.71
    26540TRepair hand joint005311.69$595.07$253.49$119.01
    26541TRepair hand joint with graft005419.83$1,009.43$472.33$201.89
    26542TRepair hand joint with graft005311.69$595.07$253.49$119.01
    26545TReconstruct finger joint005419.83$1,009.43$472.33$201.89
    26546TRepair nonunion hand005419.83$1,009.43$472.33$201.89
    26548TReconstruct finger joint005419.83$1,009.43$472.33$201.89
    26550TConstruct thumb replacement005419.83$1,009.43$472.33$201.89
    26551CGreat toe-hand transfer
    26553CSingle transfer, toe-hand
    26554CDouble transfer, toe-hand
    26555TPositional change of finger005419.83$1,009.43$472.33$201.89
    26556CToe joint transfer
    26560TRepair of web finger005311.69$595.07$253.49$119.01
    26561TRepair of web finger005419.83$1,009.43$472.33$201.89
    26562TRepair of web finger005419.83$1,009.43$472.33$201.89
    26565TCorrect metacarpal flaw005419.83$1,009.43$472.33$201.89
    26567TCorrect finger deformity005419.83$1,009.43$472.33$201.89
    26568TLengthen metacarpal/finger005419.83$1,009.43$472.33$201.89
    26580TRepair hand deformity005419.83$1,009.43$472.33$201.89
    26585DRepair finger deformity005419.83$1,009.43$472.33$201.89
    26587TReconstruct extra finger005311.69$595.07$253.49$119.01
    26590TRepair finger deformity005419.83$1,009.43$472.33$201.89
    26591TRepair muscles of hand005419.83$1,009.43$472.33$201.89
    26593TRelease muscles of hand005311.69$595.07$253.49$119.01
    26596TExcision constricting tissue005419.83$1,009.43$472.33$201.89
    26597DRelease of scar contracture005419.83$1,009.43$472.33$201.89
    26600TTreat metacarpal fracture00442.52$128.28$38.08$25.66
    26605TTreat metacarpal fracture00442.52$128.28$38.08$25.66
    26607TTreat metacarpal fracture00442.52$128.28$38.08$25.66
    26608TTreat metacarpal fracture004627.69$1,409.53$535.76$281.91
    26615TTreat metacarpal fracture004627.69$1,409.53$535.76$281.91
    26641TTreat thumb dislocation00442.52$128.28$38.08$25.66
    26645TTreat thumb fracture00442.52$128.28$38.08$25.66
    Start Printed Page 59954
    26650TTreat thumb fracture004627.69$1,409.53$535.76$281.91
    26665TTreat thumb fracture004627.69$1,409.53$535.76$281.91
    26670TTreat hand dislocation00442.52$128.28$38.08$25.66
    26675TTreat hand dislocation00442.52$128.28$38.08$25.66
    26676TPin hand dislocation004627.69$1,409.53$535.76$281.91
    26685TTreat hand dislocation004627.69$1,409.53$535.76$281.91
    26686TTreat hand dislocation004627.69$1,409.53$535.76$281.91
    26700TTreat knuckle dislocation00434.05$206.16$41.23
    26705TTreat knuckle dislocation00442.52$128.28$38.08$25.66
    26706TPin knuckle dislocation00442.52$128.28$38.08$25.66
    26715TTreat knuckle dislocation004627.69$1,409.53$535.76$281.91
    26720TTreat finger fracture, each00434.05$206.16$41.23
    26725TTreat finger fracture, each00434.05$206.16$41.23
    26727TTreat finger fracture, each004627.69$1,409.53$535.76$281.91
    26735TTreat finger fracture, each004627.69$1,409.53$535.76$281.91
    26740TTreat finger fracture, each00434.05$206.16$41.23
    26742TTreat finger fracture, each00442.52$128.28$38.08$25.66
    26746TTreat finger fracture, each004627.69$1,409.53$535.76$281.91
    26750TTreat finger fracture, each00434.05$206.16$41.23
    26755TTreat finger fracture, each00434.05$206.16$41.23
    26756TPin finger fracture, each004627.69$1,409.53$535.76$281.91
    26765TTreat finger fracture, each004627.69$1,409.53$535.76$281.91
    26770TTreat finger dislocation00434.05$206.16$41.23
    26775TTreat finger dislocation004511.67$594.05$277.12$118.81
    26776TPin finger dislocation004627.69$1,409.53$535.76$281.91
    26785TTreat finger dislocation004627.69$1,409.53$535.76$281.91
    26820TThumb fusion with graft005419.83$1,009.43$472.33$201.89
    26841TFusion of thumb005419.83$1,009.43$472.33$201.89
    26842TThumb fusion with graft005419.83$1,009.43$472.33$201.89
    26843TFusion of hand joint005419.83$1,009.43$472.33$201.89
    26844TFusion/graft of hand joint005419.83$1,009.43$472.33$201.89
    26850TFusion of knuckle005419.83$1,009.43$472.33$201.89
    26852TFusion of knuckle with graft005419.83$1,009.43$472.33$201.89
    26860TFusion of finger joint005419.83$1,009.43$472.33$201.89
    26861TFusion of finger jnt, add-on005419.83$1,009.43$472.33$201.89
    26862TFusion/graft of finger joint005419.83$1,009.43$472.33$201.89
    26863TFuse/graft added joint005419.83$1,009.43$472.33$201.89
    26910TAmputate metacarpal bone005419.83$1,009.43$472.33$201.89
    26951TAmputation of finger/thumb005311.69$595.07$253.49$119.01
    26952TAmputation of finger/thumb005311.69$595.07$253.49$119.01
    26989THand/finger surgery00434.05$206.16$41.23
    26990TDrainage of pelvis lesion004915.84$806.32$356.95$161.26
    26991TDrainage of pelvis bursa004915.84$806.32$356.95$161.26
    26992CDrainage of bone lesion
    27000TIncision of hip tendon004915.84$806.32$356.95$161.26
    27001TIncision of hip tendon005020.63$1,050.15$504.07$210.03
    27003TIncision of hip tendon005020.63$1,050.15$504.07$210.03
    27005CIncision of hip tendon
    27006CIncision of hip tendons
    27025CIncision of hip/thigh fascia
    27030CDrainage of hip joint
    27033TExploration of hip joint005128.56$1,453.82$675.24$290.76
    27035CDenervation of hip joint
    27036CExcision of hip joint/muscle
    27040TBiopsy of soft tissues002111.82$601.69$236.51$120.34
    27041TBiopsy of soft tissues002213.91$708.07$292.94$141.61
    27047TRemove hip/pelvis lesion002213.91$708.07$292.94$141.61
    27048TRemove hip/pelvis lesion002213.91$708.07$292.94$141.61
    27049TRemove tumor, hip/pelvis002213.91$708.07$292.94$141.61
    27050TBiopsy of sacroiliac joint004915.84$806.32$356.95$161.26
    27052TBiopsy of hip joint004915.84$806.32$356.95$161.26
    27054CRemoval of hip joint lining
    27060TRemoval of ischial bursa004915.84$806.32$356.95$161.26
    27062TRemove femur lesion/bursa004915.84$806.32$356.95$161.26
    27065TRemoval of hip bone lesion004915.84$806.32$356.95$161.26
    27066TRemoval of hip bone lesion005020.63$1,050.15$504.07$210.03
    27067TRemove/graft hip bone lesion005020.63$1,050.15$504.07$210.03
    27070CPartial removal of hip bone
    27071CPartial removal of hip bone
    27075CExtensive hip surgery
    27076CExtensive hip surgery
    27077CExtensive hip surgery
    27078CExtensive hip surgery
    27079CExtensive hip surgery
    27080TRemoval of tail bone005020.63$1,050.15$504.07$210.03
    Start Printed Page 59955
    27086TRemove hip foreign body00194.22$214.81$78.91$42.96
    27087TRemove hip foreign body004915.84$806.32$356.95$161.26
    27090CRemoval of hip prosthesis
    27091CRemoval of hip prosthesis
    27093NInjection for hip x-ray
    27095NInjection for hip x-ray
    27096NInject sacroiliac joint
    27097TRevision of hip tendon005020.63$1,050.15$504.07$210.03
    27098TTransfer tendon to pelvis005020.63$1,050.15$504.07$210.03
    27100TTransfer of abdominal muscle005128.56$1,453.82$675.24$290.76
    27105TTransfer of spinal muscle005128.56$1,453.82$675.24$290.76
    27110TTransfer of iliopsoas muscle005128.56$1,453.82$675.24$290.76
    27111TTransfer of iliopsoas muscle005128.56$1,453.82$675.24$290.76
    27120CReconstruction of hip socket
    27122CReconstruction of hip socket
    27125CPartial hip replacement
    27130CTotal hip replacement
    27132CTotal hip replacement
    27134CRevise hip joint replacement
    27137CRevise hip joint replacement
    27138CRevise hip joint replacement
    27140CTransplant femur ridge
    27146CIncision of hip bone
    27147CRevision of hip bone
    27151CIncision of hip bones
    27156CRevision of hip bones
    27158CRevision of pelvis
    27161CIncision of neck of femur
    27165CIncision/fixation of femur
    27170CRepair/graft femur head/neck
    27175CTreat slipped epiphysis
    27176CTreat slipped epiphysis
    27177CTreat slipped epiphysis
    27178CTreat slipped epiphysis
    27179CRevise head/neck of femur
    27181CTreat slipped epiphysis
    27185CRevision of femur epiphysis
    27187CReinforce hip bones
    27193TTreat pelvic ring fracture00442.52$128.28$38.08$25.66
    27194TTreat pelvic ring fracture004511.67$594.05$277.12$118.81
    27200TTreat tail bone fracture00442.52$128.28$38.08$25.66
    27202TTreat tail bone fracture004627.69$1,409.53$535.76$281.91
    27215CTreat pelvic fracture(s)
    27216CTreat pelvic ring fracture
    27217CTreat pelvic ring fracture
    27218CTreat pelvic ring fracture
    27220TTreat hip socket fracture00442.52$128.28$38.08$25.66
    27222CTreat hip socket fracture
    27226CTreat hip wall fracture
    27227CTreat hip fracture(s)
    27228CTreat hip fracture(s)
    27230TTreat thigh fracture00442.52$128.28$38.08$25.66
    27232CTreat thigh fracture
    27235CTreat thigh fracture
    27236CTreat thigh fracture
    27238TTreat thigh fracture00442.52$128.28$38.08$25.66
    27240CTreat thigh fracture
    27244CTreat thigh fracture
    27245CTreat thigh fracture
    27246TTreat thigh fracture00434.05$206.16$41.23
    27248CTreat thigh fracture
    27250TTreat hip dislocation00442.52$128.28$38.08$25.66
    27252TTreat hip dislocation004511.67$594.05$277.12$118.81
    27253CTreat hip dislocation
    27254CTreat hip dislocation
    27256TTreat hip dislocation00434.05$206.16$41.23
    27257TTreat hip dislocation004511.67$594.05$277.12$118.81
    27258CTreat hip dislocation
    27259CTreat hip dislocation
    27265TTreat hip dislocation00442.52$128.28$38.08$25.66
    27266TTreat hip dislocation004726.36$1,341.83$537.03$268.37
    27275TManipulation of hip joint004511.67$594.05$277.12$118.81
    27280CFusion of sacroiliac joint
    27282CFusion of pubic bones
    27284CFusion of hip joint
    Start Printed Page 59956
    27286CFusion of hip joint
    27290CAmputation of leg at hip
    27295CAmputation of leg at hip
    27299TPelvis/hip joint surgery00434.05$206.16$41.23
    27301TDrain thigh/knee lesion000810.93$556.38$113.67$111.28
    27303CDrainage of bone lesion
    27305TIncise thigh tendon & fascia004915.84$806.32$356.95$161.26
    27306TIncision of thigh tendon004915.84$806.32$356.95$161.26
    27307TIncision of thigh tendons004915.84$806.32$356.95$161.26
    27310TExploration of knee joint005020.63$1,050.15$504.07$210.03
    27315TPartial removal, thigh nerve022013.60$692.29$325.38$138.46
    27320TPartial removal, thigh nerve022013.60$692.29$325.38$138.46
    27323TBiopsy, thigh soft tissues002111.82$601.69$236.51$120.34
    27324TBiopsy, thigh soft tissues002213.91$708.07$292.94$141.61
    27327TRemoval of thigh lesion002213.91$708.07$292.94$141.61
    27328TRemoval of thigh lesion002213.91$708.07$292.94$141.61
    27329TRemove tumor, thigh/knee002213.91$708.07$292.94$141.61
    27330TBiopsy, knee joint lining005020.63$1,050.15$504.07$210.03
    27331TExplore/treat knee joint005020.63$1,050.15$504.07$210.03
    27332TRemoval of knee cartilage005020.63$1,050.15$504.07$210.03
    27333TRemoval of knee cartilage005020.63$1,050.15$504.07$210.03
    27334TRemove knee joint lining005020.63$1,050.15$504.07$210.03
    27335TRemove knee joint lining005020.63$1,050.15$504.07$210.03
    27340TRemoval of kneecap bursa004915.84$806.32$356.95$161.26
    27345TRemoval of knee cyst004915.84$806.32$356.95$161.26
    27347TRemove knee cyst004915.84$806.32$356.95$161.26
    27350TRemoval of kneecap005020.63$1,050.15$504.07$210.03
    27355TRemove femur lesion005020.63$1,050.15$504.07$210.03
    27356TRemove femur lesion/graft005020.63$1,050.15$504.07$210.03
    27357TRemove femur lesion/graft005020.63$1,050.15$504.07$210.03
    27358TRemove femur lesion/fixation005020.63$1,050.15$504.07$210.03
    27360TPartial removal, leg bone(s)005020.63$1,050.15$504.07$210.03
    27365CExtensive leg surgery
    27370NInjection for knee x-ray
    27372TRemoval of foreign body002213.91$708.07$292.94$141.61
    27380TRepair of kneecap tendon004915.84$806.32$356.95$161.26
    27381TRepair/graft kneecap tendon004915.84$806.32$356.95$161.26
    27385TRepair of thigh muscle004915.84$806.32$356.95$161.26
    27386TRepair/graft of thigh muscle004915.84$806.32$356.95$161.26
    27390TIncision of thigh tendon004915.84$806.32$356.95$161.26
    27391TIncision of thigh tendons004915.84$806.32$356.95$161.26
    27392TIncision of thigh tendons004915.84$806.32$356.95$161.26
    27393TLengthening of thigh tendon005020.63$1,050.15$504.07$210.03
    27394TLengthening of thigh tendons005020.63$1,050.15$504.07$210.03
    27395TLengthening of thigh tendons005128.56$1,453.82$675.24$290.76
    27396TTransplant of thigh tendon005020.63$1,050.15$504.07$210.03
    27397TTransplants of thigh tendons005128.56$1,453.82$675.24$290.76
    27400TRevise thigh muscles/tendons005128.56$1,453.82$675.24$290.76
    27403TRepair of knee cartilage005020.63$1,050.15$504.07$210.03
    27405TRepair of knee ligament005128.56$1,453.82$675.24$290.76
    27407TRepair of knee ligament005128.56$1,453.82$675.24$290.76
    27409TRepair of knee ligaments005128.56$1,453.82$675.24$290.76
    27418TRepair degenerated kneecap005128.56$1,453.82$675.24$290.76
    27420TRevision of unstable kneecap005128.56$1,453.82$675.24$290.76
    27422TRevision of unstable kneecap005128.56$1,453.82$675.24$290.76
    27424TRevision/removal of kneecap005128.56$1,453.82$675.24$290.76
    27425TLateral retinacular release005020.63$1,050.15$504.07$210.03
    27427TReconstruction, knee005235.94$1,829.49$930.91$365.90
    27428TReconstruction, knee005235.94$1,829.49$930.91$365.90
    27429TReconstruction, knee005235.94$1,829.49$930.91$365.90
    27430TRevision of thigh muscles005128.56$1,453.82$675.24$290.76
    27435TIncision of knee joint005128.56$1,453.82$675.24$290.76
    27437TRevise kneecap004726.36$1,341.83$537.03$268.37
    27438TRevise kneecap with implant004843.19$2,198.54$725.94$439.71
    27440TRevision of knee joint004726.36$1,341.83$537.03$268.37
    27441TRevision of knee joint004726.36$1,341.83$537.03$268.37
    27442TRevision of knee joint004726.36$1,341.83$537.03$268.37
    27443TRevision of knee joint004726.36$1,341.83$537.03$268.37
    27445CRevision of knee joint
    27446TRevision of knee joint004726.36$1,341.83$537.03$268.37
    27447CTotal knee replacement
    27448CIncision of thigh
    27450CIncision of thigh
    27454CRealignment of thigh bone
    27455CRealignment of knee
    Start Printed Page 59957
    27457CRealignment of knee
    27465CShortening of thigh bone
    27466CLengthening of thigh bone
    27468CShorten/lengthen thighs
    27470CRepair of thigh
    27472CRepair/graft of thigh
    27475CSurgery to stop leg growth
    27477CSurgery to stop leg growth
    27479CSurgery to stop leg growth
    27485CSurgery to stop leg growth
    27486CRevise/replace knee joint
    27487CRevise/replace knee joint
    27488CRemoval of knee prosthesis
    27495CReinforce thigh
    27496TDecompression of thigh/knee004915.84$806.32$356.95$161.26
    27497TDecompression of thigh/knee004915.84$806.32$356.95$161.26
    27498TDecompression of thigh/knee004915.84$806.32$356.95$161.26
    27499TDecompression of thigh/knee004915.84$806.32$356.95$161.26
    27500TTreatment of thigh fracture00442.52$128.28$38.08$25.66
    27501TTreatment of thigh fracture00442.52$128.28$38.08$25.66
    27502TTreatment of thigh fracture00442.52$128.28$38.08$25.66
    27503TTreatment of thigh fracture00442.52$128.28$38.08$25.66
    27506CTreatment of thigh fracture
    27507CTreatment of thigh fracture
    27508TTreatment of thigh fracture00442.52$128.28$38.08$25.66
    27509TTreatment of thigh fracture004627.69$1,409.53$535.76$281.91
    27510TTreatment of thigh fracture00442.52$128.28$38.08$25.66
    27511CTreatment of thigh fracture
    27513CTreatment of thigh fracture
    27514CTreatment of thigh fracture
    27516TTreat thigh fx growth plate00442.52$128.28$38.08$25.66
    27517TTreat thigh fx growth plate00434.05$206.16$41.23
    27519CTreat thigh fx growth plate
    27520TTreat kneecap fracture00442.52$128.28$38.08$25.66
    27524TTreat kneecap fracture004627.69$1,409.53$535.76$281.91
    27530TTreat knee fracture00442.52$128.28$38.08$25.66
    27532TTreat knee fracture00442.52$128.28$38.08$25.66
    27535CTreat knee fracture
    27536CTreat knee fracture
    27538TTreat knee fracture(s)00434.05$206.16$41.23
    27540CTreat knee fracture
    27550TTreat knee dislocation00442.52$128.28$38.08$25.66
    27552TTreat knee dislocation004511.67$594.05$277.12$118.81
    27556CTreat knee dislocation
    27557CTreat knee dislocation
    27558CTreat knee dislocation
    27560TTreat kneecap dislocation00442.52$128.28$38.08$25.66
    27562TTreat kneecap dislocation004511.67$594.05$277.12$118.81
    27566TTreat kneecap dislocation004627.69$1,409.53$535.76$281.91
    27570TFixation of knee joint004511.67$594.05$277.12$118.81
    27580CFusion of knee
    27590CAmputate leg at thigh
    27591CAmputate leg at thigh
    27592CAmputate leg at thigh
    27594TAmputation follow-up surgery004915.84$806.32$356.95$161.26
    27596CAmputation follow-up surgery
    27598CAmputate lower leg at knee
    27599TLeg surgery procedure00442.52$128.28$38.08$25.66
    27600TDecompression of lower leg004915.84$806.32$356.95$161.26
    27601TDecompression of lower leg004915.84$806.32$356.95$161.26
    27602TDecompression of lower leg004915.84$806.32$356.95$161.26
    27603TDrain lower leg lesion000810.93$556.38$113.67$111.28
    27604TDrain lower leg bursa004915.84$806.32$356.95$161.26
    27605TIncision of achilles tendon005515.44$785.96$355.34$157.19
    27606TIncision of achilles tendon004915.84$806.32$356.95$161.26
    27607TTreat lower leg bone lesion004915.84$806.32$356.95$161.26
    27610TExplore/treat ankle joint005020.63$1,050.15$504.07$210.03
    27612TExploration of ankle joint005020.63$1,050.15$504.07$210.03
    27613TBiopsy lower leg soft tissue00194.22$214.81$78.91$42.96
    27614TBiopsy lower leg soft tissue002213.91$708.07$292.94$141.61
    27615TRemove tumor, lower leg004627.69$1,409.53$535.76$281.91
    27618TRemove lower leg lesion002111.82$601.69$236.51$120.34
    27619TRemove lower leg lesion002213.91$708.07$292.94$141.61
    27620TExplore/treat ankle joint005020.63$1,050.15$504.07$210.03
    27625TRemove ankle joint lining005020.63$1,050.15$504.07$210.03
    Start Printed Page 59958
    27626TRemove ankle joint lining005020.63$1,050.15$504.07$210.03
    27630TRemoval of tendon lesion004915.84$806.32$356.95$161.26
    27635TRemove lower leg bone lesion005020.63$1,050.15$504.07$210.03
    27637TRemove/graft leg bone lesion005020.63$1,050.15$504.07$210.03
    27638TRemove/graft leg bone lesion005020.63$1,050.15$504.07$210.03
    27640TPartial removal of tibia005128.56$1,453.82$675.24$290.76
    27641TPartial removal of fibula005020.63$1,050.15$504.07$210.03
    27645CExtensive lower leg surgery
    27646CExtensive lower leg surgery
    27647TExtensive ankle/heel surgery005128.56$1,453.82$675.24$290.76
    27648NInjection for ankle x-ray
    27650TRepair achilles tendon005128.56$1,453.82$675.24$290.76
    27652TRepair/graft achilles tendon005128.56$1,453.82$675.24$290.76
    27654TRepair of achilles tendon005128.56$1,453.82$675.24$290.76
    27656TRepair leg fascia defect004915.84$806.32$356.95$161.26
    27658TRepair of leg tendon, each004915.84$806.32$356.95$161.26
    27659TRepair of leg tendon, each004915.84$806.32$356.95$161.26
    27664TRepair of leg tendon, each004915.84$806.32$356.95$161.26
    27665TRepair of leg tendon, each005020.63$1,050.15$504.07$210.03
    27675TRepair lower leg tendons004915.84$806.32$356.95$161.26
    27676TRepair lower leg tendons005020.63$1,050.15$504.07$210.03
    27680TRelease of lower leg tendon005020.63$1,050.15$504.07$210.03
    27681TRelease of lower leg tendons005020.63$1,050.15$504.07$210.03
    27685TRevision of lower leg tendon005020.63$1,050.15$504.07$210.03
    27686TRevise lower leg tendons005020.63$1,050.15$504.07$210.03
    27687TRevision of calf tendon005020.63$1,050.15$504.07$210.03
    27690TRevise lower leg tendon005128.56$1,453.82$675.24$290.76
    27691TRevise lower leg tendon005128.56$1,453.82$675.24$290.76
    27692TRevise additional leg tendon005128.56$1,453.82$675.24$290.76
    27695TRepair of ankle ligament005020.63$1,050.15$504.07$210.03
    27696TRepair of ankle ligaments005020.63$1,050.15$504.07$210.03
    27698TRepair of ankle ligament005020.63$1,050.15$504.07$210.03
    27700TRevision of ankle joint004726.36$1,341.83$537.03$268.37
    27702CReconstruct ankle joint
    27703CReconstruction, ankle joint
    27704TRemoval of ankle implant004915.84$806.32$356.95$161.26
    27705TIncision of tibia005128.56$1,453.82$675.24$290.76
    27707TIncision of fibula004915.84$806.32$356.95$161.26
    27709TIncision of tibia & fibula005020.63$1,050.15$504.07$210.03
    27712CRealignment of lower leg
    27715CRevision of lower leg
    27720CRepair of tibia
    27722CRepair/graft of tibia
    27724CRepair/graft of tibia
    27725CRepair of lower leg
    27727CRepair of lower leg
    27730TRepair of tibia epiphysis005020.63$1,050.15$504.07$210.03
    27732TRepair of fibula epiphysis005020.63$1,050.15$504.07$210.03
    27734TRepair lower leg epiphyses005020.63$1,050.15$504.07$210.03
    27740TRepair of leg epiphyses005020.63$1,050.15$504.07$210.03
    27742TRepair of leg epiphyses005128.56$1,453.82$675.24$290.76
    27745TReinforce tibia005128.56$1,453.82$675.24$290.76
    27750TTreatment of tibia fracture00442.52$128.28$38.08$25.66
    27752TTreatment of tibia fracture00442.52$128.28$38.08$25.66
    27756TTreatment of tibia fracture004627.69$1,409.53$535.76$281.91
    27758TTreatment of tibia fracture004627.69$1,409.53$535.76$281.91
    27759TTreatment of tibia fracture004627.69$1,409.53$535.76$281.91
    27760TTreatment of ankle fracture00442.52$128.28$38.08$25.66
    27762TTreatment of ankle fracture00442.52$128.28$38.08$25.66
    27766TTreatment of ankle fracture004627.69$1,409.53$535.76$281.91
    27780TTreatment of fibula fracture00442.52$128.28$38.08$25.66
    27781TTreatment of fibula fracture00442.52$128.28$38.08$25.66
    27784TTreatment of fibula fracture004627.69$1,409.53$535.76$281.91
    27786TTreatment of ankle fracture00442.52$128.28$38.08$25.66
    27788TTreatment of ankle fracture00442.52$128.28$38.08$25.66
    27792TTreatment of ankle fracture004627.69$1,409.53$535.76$281.91
    27808TTreatment of ankle fracture00442.52$128.28$38.08$25.66
    27810TTreatment of ankle fracture00442.52$128.28$38.08$25.66
    27814TTreatment of ankle fracture004627.69$1,409.53$535.76$281.91
    27816TTreatment of ankle fracture00442.52$128.28$38.08$25.66
    27818TTreatment of ankle fracture00442.52$128.28$38.08$25.66
    27822TTreatment of ankle fracture004627.69$1,409.53$535.76$281.91
    27823TTreatment of ankle fracture004627.69$1,409.53$535.76$281.91
    27824TTreat lower leg fracture00442.52$128.28$38.08$25.66
    27825TTreat lower leg fracture00442.52$128.28$38.08$25.66
    Start Printed Page 59959
    27826TTreat lower leg fracture004627.69$1,409.53$535.76$281.91
    27827TTreat lower leg fracture004627.69$1,409.53$535.76$281.91
    27828TTreat lower leg fracture004627.69$1,409.53$535.76$281.91
    27829TTreat lower leg joint004627.69$1,409.53$535.76$281.91
    27830TTreat lower leg dislocation00442.52$128.28$38.08$25.66
    27831TTreat lower leg dislocation00442.52$128.28$38.08$25.66
    27832TTreat lower leg dislocation004627.69$1,409.53$535.76$281.91
    27840TTreat ankle dislocation00442.52$128.28$38.08$25.66
    27842TTreat ankle dislocation004511.67$594.05$277.12$118.81
    27846TTreat ankle dislocation004627.69$1,409.53$535.76$281.91
    27848TTreat ankle dislocation004627.69$1,409.53$535.76$281.91
    27860TFixation of ankle joint004511.67$594.05$277.12$118.81
    27870TFusion of ankle joint005128.56$1,453.82$675.24$290.76
    27871TFusion of tibiofibular joint005128.56$1,453.82$675.24$290.76
    27880CAmputation of lower leg
    27881CAmputation of lower leg
    27882CAmputation of lower leg
    27884TAmputation follow-up surgery004915.84$806.32$356.95$161.26
    27886CAmputation follow-up surgery
    27888CAmputation of foot at ankle
    27889TAmputation of foot at ankle005020.63$1,050.15$504.07$210.03
    27892TDecompression of leg004915.84$806.32$356.95$161.26
    27893TDecompression of leg004915.84$806.32$356.95$161.26
    27894TDecompression of leg004915.84$806.32$356.95$161.26
    27899TLeg/ankle surgery procedure00442.52$128.28$38.08$25.66
    28001TDrainage of bursa of foot000810.93$556.38$113.67$111.28
    28002TTreatment of foot infection004915.84$806.32$356.95$161.26
    28003TTreatment of foot infection004915.84$806.32$356.95$161.26
    28005TTreat foot bone lesion005515.44$785.96$355.34$157.19
    28008TIncision of foot fascia005515.44$785.96$355.34$157.19
    28010TIncision of toe tendon005515.44$785.96$355.34$157.19
    28011TIncision of toe tendons005515.44$785.96$355.34$157.19
    28020TExploration of foot joint005515.44$785.96$355.34$157.19
    28022TExploration of foot joint005515.44$785.96$355.34$157.19
    28024TExploration of toe joint005515.44$785.96$355.34$157.19
    28030TRemoval of foot nerve022013.60$692.29$325.38$138.46
    28035TDecompression of tibia nerve022013.60$692.29$325.38$138.46
    28043TExcision of foot lesion002111.82$601.69$236.51$120.34
    28045TExcision of foot lesion005515.44$785.96$355.34$157.19
    28046TResection of tumor, foot005515.44$785.96$355.34$157.19
    28050TBiopsy of foot joint lining005515.44$785.96$355.34$157.19
    28052TBiopsy of foot joint lining005515.44$785.96$355.34$157.19
    28054TBiopsy of toe joint lining005515.44$785.96$355.34$157.19
    28060TPartial removal, foot fascia005618.85$959.54$405.81$191.91
    28062TRemoval of foot fascia005618.85$959.54$405.81$191.91
    28070TRemoval of foot joint lining005618.85$959.54$405.81$191.91
    28072TRemoval of foot joint lining005618.85$959.54$405.81$191.91
    28080TRemoval of foot lesion005515.44$785.96$355.34$157.19
    28086TExcise foot tendon sheath005515.44$785.96$355.34$157.19
    28088TExcise foot tendon sheath005515.44$785.96$355.34$157.19
    28090TRemoval of foot lesion005515.44$785.96$355.34$157.19
    28092TRemoval of toe lesions005515.44$785.96$355.34$157.19
    28100TRemoval of ankle/heel lesion005515.44$785.96$355.34$157.19
    28102TRemove/graft foot lesion005618.85$959.54$405.81$191.91
    28103TRemove/graft foot lesion005618.85$959.54$405.81$191.91
    28104TRemoval of foot lesion005515.44$785.96$355.34$157.19
    28106TRemove/graft foot lesion005618.85$959.54$405.81$191.91
    28107TRemove/graft foot lesion005618.85$959.54$405.81$191.91
    28108TRemoval of toe lesions005515.44$785.96$355.34$157.19
    28110TPart removal of metatarsal005618.85$959.54$405.81$191.91
    28111TPart removal of metatarsal005515.44$785.96$355.34$157.19
    28112TPart removal of metatarsal005515.44$785.96$355.34$157.19
    28113TPart removal of metatarsal005515.44$785.96$355.34$157.19
    28114TRemoval of metatarsal heads005515.44$785.96$355.34$157.19
    28116TRevision of foot005515.44$785.96$355.34$157.19
    28118TRemoval of heel bone005515.44$785.96$355.34$157.19
    28119TRemoval of heel spur005515.44$785.96$355.34$157.19
    28120TPart removal of ankle/heel005515.44$785.96$355.34$157.19
    28122TPartial removal of foot bone005515.44$785.96$355.34$157.19
    28124TPartial removal of toe005515.44$785.96$355.34$157.19
    28126TPartial removal of toe005515.44$785.96$355.34$157.19
    28130TRemoval of ankle bone005515.44$785.96$355.34$157.19
    28140TRemoval of metatarsal005515.44$785.96$355.34$157.19
    28150TRemoval of toe005515.44$785.96$355.34$157.19
    28153TPartial removal of toe005515.44$785.96$355.34$157.19
    Start Printed Page 59960
    28160TPartial removal of toe005515.44$785.96$355.34$157.19
    28171TExtensive foot surgery005515.44$785.96$355.34$157.19
    28173TExtensive foot surgery005515.44$785.96$355.34$157.19
    28175TExtensive foot surgery005515.44$785.96$355.34$157.19
    28190TRemoval of foot foreign body00194.22$214.81$78.91$42.96
    28192TRemoval of foot foreign body002111.82$601.69$236.51$120.34
    28193TRemoval of foot foreign body002111.82$601.69$236.51$120.34
    28200TRepair of foot tendon005515.44$785.96$355.34$157.19
    28202TRepair/graft of foot tendon005618.85$959.54$405.81$191.91
    28208TRepair of foot tendon005515.44$785.96$355.34$157.19
    28210TRepair/graft of foot tendon005515.44$785.96$355.34$157.19
    28220TRelease of foot tendon005515.44$785.96$355.34$157.19
    28222TRelease of foot tendons005515.44$785.96$355.34$157.19
    28225TRelease of foot tendon005515.44$785.96$355.34$157.19
    28226TRelease of foot tendons005515.44$785.96$355.34$157.19
    28230TIncision of foot tendon(s)005515.44$785.96$355.34$157.19
    28232TIncision of toe tendon005515.44$785.96$355.34$157.19
    28234TIncision of foot tendon005515.44$785.96$355.34$157.19
    28238TRevision of foot tendon005618.85$959.54$405.81$191.91
    28240TRelease of big toe005515.44$785.96$355.34$157.19
    28250TRevision of foot fascia005618.85$959.54$405.81$191.91
    28260TRelease of midfoot joint005618.85$959.54$405.81$191.91
    28261TRevision of foot tendon005618.85$959.54$405.81$191.91
    28262TRevision of foot and ankle005618.85$959.54$405.81$191.91
    28264TRelease of midfoot joint005618.85$959.54$405.81$191.91
    28270TRelease of foot contracture005515.44$785.96$355.34$157.19
    28272TRelease of toe joint, each005515.44$785.96$355.34$157.19
    28280TFusion of toes005515.44$785.96$355.34$157.19
    28285TRepair of hammertoe005515.44$785.96$355.34$157.19
    28286TRepair of hammertoe005515.44$785.96$355.34$157.19
    28288TPartial removal of foot bone005618.85$959.54$405.81$191.91
    28289TRepair hallux rigidus005618.85$959.54$405.81$191.91
    28290TCorrection of bunion005618.85$959.54$405.81$191.91
    28292TCorrection of bunion005724.35$1,239.51$496.65$247.90
    28293TCorrection of bunion005724.35$1,239.51$496.65$247.90
    28294TCorrection of bunion005618.85$959.54$405.81$191.91
    28296TCorrection of bunion005618.85$959.54$405.81$191.91
    28297TCorrection of bunion005724.35$1,239.51$496.65$247.90
    28298TCorrection of bunion005618.85$959.54$405.81$191.91
    28299TCorrection of bunion005724.35$1,239.51$496.65$247.90
    28300TIncision of heel bone005618.85$959.54$405.81$191.91
    28302TIncision of ankle bone005618.85$959.54$405.81$191.91
    28304TIncision of midfoot bones005618.85$959.54$405.81$191.91
    28305TIncise/graft midfoot bones005618.85$959.54$405.81$191.91
    28306TIncision of metatarsal005618.85$959.54$405.81$191.91
    28307TIncision of metatarsal005618.85$959.54$405.81$191.91
    28308TIncision of metatarsal005618.85$959.54$405.81$191.91
    28309TIncision of metatarsals005618.85$959.54$405.81$191.91
    28310TRevision of big toe005515.44$785.96$355.34$157.19
    28312TRevision of toe005515.44$785.96$355.34$157.19
    28313TRepair deformity of toe005515.44$785.96$355.34$157.19
    28315TRemoval of sesamoid bone005515.44$785.96$355.34$157.19
    28320TRepair of foot bones005618.85$959.54$405.81$191.91
    28322TRepair of metatarsals005618.85$959.54$405.81$191.91
    28340TResect enlarged toe tissue005515.44$785.96$355.34$157.19
    28341TResect enlarged toe005515.44$785.96$355.34$157.19
    28344TRepair extra toe(s)005618.85$959.54$405.81$191.91
    28345TRepair webbed toe(s)005618.85$959.54$405.81$191.91
    28360TReconstruct cleft foot005618.85$959.54$405.81$191.91
    28400TTreatment of heel fracture00442.52$128.28$38.08$25.66
    28405TTreatment of heel fracture00442.52$128.28$38.08$25.66
    28406TTreatment of heel fracture004627.69$1,409.53$535.76$281.91
    28415TTreat heel fracture004627.69$1,409.53$535.76$281.91
    28420TTreat/graft heel fracture004627.69$1,409.53$535.76$281.91
    28430TTreatment of ankle fracture00442.52$128.28$38.08$25.66
    28435TTreatment of ankle fracture00442.52$128.28$38.08$25.66
    28436TTreatment of ankle fracture004627.69$1,409.53$535.76$281.91
    28445TTreat ankle fracture004627.69$1,409.53$535.76$281.91
    28450TTreat midfoot fracture, each00442.52$128.28$38.08$25.66
    28455TTreat midfoot fracture, each00442.52$128.28$38.08$25.66
    28456TTreat midfoot fracture004627.69$1,409.53$535.76$281.91
    28465TTreat midfoot fracture, each004627.69$1,409.53$535.76$281.91
    28470TTreat metatarsal fracture00442.52$128.28$38.08$25.66
    28475TTreat metatarsal fracture00442.52$128.28$38.08$25.66
    28476TTreat metatarsal fracture004627.69$1,409.53$535.76$281.91
    Start Printed Page 59961
    28485TTreat metatarsal fracture004627.69$1,409.53$535.76$281.91
    28490TTreat big toe fracture00442.52$128.28$38.08$25.66
    28495TTreat big toe fracture00442.52$128.28$38.08$25.66
    28496TTreat big toe fracture004627.69$1,409.53$535.76$281.91
    28505TTreat big toe fracture004627.69$1,409.53$535.76$281.91
    28510TTreatment of toe fracture00434.05$206.16$41.23
    28515TTreatment of toe fracture00434.05$206.16$41.23
    28525TTreat toe fracture004627.69$1,409.53$535.76$281.91
    28530TTreat sesamoid bone fracture00442.52$128.28$38.08$25.66
    28531TTreat sesamoid bone fracture004627.69$1,409.53$535.76$281.91
    28540TTreat foot dislocation00442.52$128.28$38.08$25.66
    28545TTreat foot dislocation004511.67$594.05$277.12$118.81
    28546TTreat foot dislocation004627.69$1,409.53$535.76$281.91
    28555TRepair foot dislocation004627.69$1,409.53$535.76$281.91
    28570TTreat foot dislocation00442.52$128.28$38.08$25.66
    28575TTreat foot dislocation00434.05$206.16$41.23
    28576TTreat foot dislocation004627.69$1,409.53$535.76$281.91
    28585TRepair foot dislocation004627.69$1,409.53$535.76$281.91
    28600TTreat foot dislocation00442.52$128.28$38.08$25.66
    28605TTreat foot dislocation00434.05$206.16$41.23
    28606TTreat foot dislocation004627.69$1,409.53$535.76$281.91
    28615TRepair foot dislocation004627.69$1,409.53$535.76$281.91
    28630TTreat toe dislocation00442.52$128.28$38.08$25.66
    28635TTreat toe dislocation004511.67$594.05$277.12$118.81
    28636TTreat toe dislocation004627.69$1,409.53$535.76$281.91
    28645TRepair toe dislocation004627.69$1,409.53$535.76$281.91
    28660TTreat toe dislocation00434.05$206.16$41.23
    28665TTreat toe dislocation004511.67$594.05$277.12$118.81
    28666TTreat toe dislocation004627.69$1,409.53$535.76$281.91
    28675TRepair of toe dislocation004627.69$1,409.53$535.76$281.91
    28705TFusion of foot bones005618.85$959.54$405.81$191.91
    28715TFusion of foot bones005618.85$959.54$405.81$191.91
    28725TFusion of foot bones005618.85$959.54$405.81$191.91
    28730TFusion of foot bones005618.85$959.54$405.81$191.91
    28735TFusion of foot bones005618.85$959.54$405.81$191.91
    28737TRevision of foot bones005515.44$785.96$355.34$157.19
    28740TFusion of foot bones005618.85$959.54$405.81$191.91
    28750TFusion of big toe joint005515.44$785.96$355.34$157.19
    28755TFusion of big toe joint005515.44$785.96$355.34$157.19
    28760TFusion of big toe joint005618.85$959.54$405.81$191.91
    28800CAmputation of midfoot
    28805CAmputation thru metatarsal
    28810TAmputation toe & metatarsal005515.44$785.96$355.34$157.19
    28820TAmputation of toe005515.44$785.96$355.34$157.19
    28825TPartial amputation of toe005515.44$785.96$355.34$157.19
    28899TFoot/toes surgery procedure00434.05$206.16$41.23
    29000SApplication of body cast00592.22$113.01$29.59$22.60
    29010SApplication of body cast00592.22$113.01$29.59$22.60
    29015SApplication of body cast00592.22$113.01$29.59$22.60
    29020SApplication of body cast00592.22$113.01$29.59$22.60
    29025SApplication of body cast00592.22$113.01$29.59$22.60
    29035SApplication of body cast00581.28$65.16$19.27$13.03
    29040SApplication of body cast00592.22$113.01$29.59$22.60
    29044SApplication of body cast00592.22$113.01$29.59$22.60
    29046SApplication of body cast00592.22$113.01$29.59$22.60
    29049SApplication of figure eight00592.22$113.01$29.59$22.60
    29055SApplication of shoulder cast00592.22$113.01$29.59$22.60
    29058SApplication of shoulder cast00592.22$113.01$29.59$22.60
    29065SApplication of long arm cast00592.22$113.01$29.59$22.60
    29075SApplication of forearm cast00581.28$65.16$19.27$13.03
    29085SApply hand/wrist cast00581.28$65.16$19.27$13.03
    *29086SApply finger cast00581.28$65.16$19.27$13.03
    29105SApply long arm splint00581.28$65.16$19.27$13.03
    29125SApply forearm splint00581.28$65.16$19.27$13.03
    29126SApply forearm splint00581.28$65.16$19.27$13.03
    29130SApplication of finger splint00581.28$65.16$19.27$13.03
    29131SApplication of finger splint00581.28$65.16$19.27$13.03
    29200SStrapping of chest00581.28$65.16$19.27$13.03
    29220SStrapping of low back00592.22$113.01$29.59$22.60
    29240SStrapping of shoulder00581.28$65.16$19.27$13.03
    29260SStrapping of elbow or wrist00581.28$65.16$19.27$13.03
    29280SStrapping of hand or finger00581.28$65.16$19.27$13.03
    29305SApplication of hip cast00581.28$65.16$19.27$13.03
    29325SApplication of hip casts00592.22$113.01$29.59$22.60
    29345SApplication of long leg cast00592.22$113.01$29.59$22.60
    Start Printed Page 59962
    29355SApplication of long leg cast00592.22$113.01$29.59$22.60
    29358SApply long leg cast brace00592.22$113.01$29.59$22.60
    29365SApplication of long leg cast00592.22$113.01$29.59$22.60
    29405SApply short leg cast00581.28$65.16$19.27$13.03
    29425SApply short leg cast00592.22$113.01$29.59$22.60
    29435SApply short leg cast00581.28$65.16$19.27$13.03
    29440SAddition of walker to cast00592.22$113.01$29.59$22.60
    29445SApply rigid leg cast00592.22$113.01$29.59$22.60
    29450SApplication of leg cast00592.22$113.01$29.59$22.60
    29505SApplication, long leg splint00592.22$113.01$29.59$22.60
    29515SApplication lower leg splint00592.22$113.01$29.59$22.60
    29520SStrapping of hip00581.28$65.16$19.27$13.03
    29530SStrapping of knee00581.28$65.16$19.27$13.03
    29540SStrapping of ankle00581.28$65.16$19.27$13.03
    29550SStrapping of toes00581.28$65.16$19.27$13.03
    29580SApplication of paste boot00581.28$65.16$19.27$13.03
    29590SApplication of foot splint00581.28$65.16$19.27$13.03
    29700SRemoval/revision of cast00581.28$65.16$19.27$13.03
    29705SRemoval/revision of cast00581.28$65.16$19.27$13.03
    29710SRemoval/revision of cast00581.28$65.16$19.27$13.03
    29715SRemoval/revision of cast00581.28$65.16$19.27$13.03
    29720SRepair of body cast00581.28$65.16$19.27$13.03
    29730SWindowing of cast00581.28$65.16$19.27$13.03
    29740SWedging of cast00581.28$65.16$19.27$13.03
    29750SWedging of clubfoot cast00581.28$65.16$19.27$13.03
    29799NCasting/strapping procedure
    29800TJaw arthroscopy/surgery004123.61$1,201.84$576.88$240.37
    29804TJaw arthroscopy/surgery004123.61$1,201.84$576.88$240.37
    *29805TShoulder arthroscopy, dx004123.61$1,201.84$576.88$240.37
    *29806TShoulder arthroscopy/surgery004123.61$1,201.84$576.88$240.37
    *29807TShoulder arthroscopy/surgery004123.61$1,201.84$576.88$240.37
    29815DShoulder arthroscopy004123.61$1,201.84$576.88$240.37
    29819TShoulder arthroscopy/surgery004123.61$1,201.84$576.88$240.37
    29820TShoulder arthroscopy/surgery004123.61$1,201.84$576.88$240.37
    29821TShoulder arthroscopy/surgery004123.61$1,201.84$576.88$240.37
    29822TShoulder arthroscopy/surgery004123.61$1,201.84$576.88$240.37
    29823TShoulder arthroscopy/surgery004123.61$1,201.84$576.88$240.37
    *29824TShoulder arthroscopy/surgery004123.61$1,201.84$576.88$240.37
    29825TShoulder arthroscopy/surgery004123.61$1,201.84$576.88$240.37
    29826TShoulder arthroscopy/surgery004235.76$1,820.33$804.74$364.07
    29830TElbow arthroscopy004123.61$1,201.84$576.88$240.37
    29834TElbow arthroscopy/surgery004123.61$1,201.84$576.88$240.37
    29835TElbow arthroscopy/surgery004235.76$1,820.33$804.74$364.07
    29836TElbow arthroscopy/surgery004235.76$1,820.33$804.74$364.07
    29837TElbow arthroscopy/surgery004123.61$1,201.84$576.88$240.37
    29838TElbow arthroscopy/surgery004123.61$1,201.84$576.88$240.37
    29840TWrist arthroscopy004123.61$1,201.84$576.88$240.37
    29843TWrist arthroscopy/surgery004123.61$1,201.84$576.88$240.37
    29844TWrist arthroscopy/surgery004123.61$1,201.84$576.88$240.37
    29845TWrist arthroscopy/surgery004123.61$1,201.84$576.88$240.37
    29846TWrist arthroscopy/surgery004123.61$1,201.84$576.88$240.37
    29847TWrist arthroscopy/surgery004123.61$1,201.84$576.88$240.37
    29848TWrist endoscopy/surgery004123.61$1,201.84$576.88$240.37
    29850TKnee arthroscopy/surgery004123.61$1,201.84$576.88$240.37
    29851TKnee arthroscopy/surgery004123.61$1,201.84$576.88$240.37
    29855TTibial arthroscopy/surgery004235.76$1,820.33$804.74$364.07
    29856TTibial arthroscopy/surgery004123.61$1,201.84$576.88$240.37
    29860THip arthroscopy, dx004123.61$1,201.84$576.88$240.37
    29861THip arthroscopy/surgery004123.61$1,201.84$576.88$240.37
    29862THip arthroscopy/surgery004235.76$1,820.33$804.74$364.07
    29863THip arthroscopy/surgery004235.76$1,820.33$804.74$364.07
    29870TKnee arthroscopy, dx004123.61$1,201.84$576.88$240.37
    29871TKnee arthroscopy/drainage004123.61$1,201.84$576.88$240.37
    29874TKnee arthroscopy/surgery004123.61$1,201.84$576.88$240.37
    29875TKnee arthroscopy/surgery004123.61$1,201.84$576.88$240.37
    29876TKnee arthroscopy/surgery004123.61$1,201.84$576.88$240.37
    29877TKnee arthroscopy/surgery004123.61$1,201.84$576.88$240.37
    29879TKnee arthroscopy/surgery004123.61$1,201.84$576.88$240.37
    29880TKnee arthroscopy/surgery004123.61$1,201.84$576.88$240.37
    29881TKnee arthroscopy/surgery004123.61$1,201.84$576.88$240.37
    29882TKnee arthroscopy/surgery004123.61$1,201.84$576.88$240.37
    29883TKnee arthroscopy/surgery004123.61$1,201.84$576.88$240.37
    29884TKnee arthroscopy/surgery004123.61$1,201.84$576.88$240.37
    29885TKnee arthroscopy/surgery004123.61$1,201.84$576.88$240.37
    29886TKnee arthroscopy/surgery004123.61$1,201.84$576.88$240.37
    Start Printed Page 59963
    29887TKnee arthroscopy/surgery004123.61$1,201.84$576.88$240.37
    29888TKnee arthroscopy/surgery004235.76$1,820.33$804.74$364.07
    29889TKnee arthroscopy/surgery004235.76$1,820.33$804.74$364.07
    29891TAnkle arthroscopy/surgery004123.61$1,201.84$576.88$240.37
    29892TAnkle arthroscopy/surgery004123.61$1,201.84$576.88$240.37
    29893TScope, plantar fasciotomy005515.44$785.96$355.34$157.19
    29894TAnkle arthroscopy/surgery004123.61$1,201.84$576.88$240.37
    29895TAnkle arthroscopy/surgery004123.61$1,201.84$576.88$240.37
    29897TAnkle arthroscopy/surgery004123.61$1,201.84$576.88$240.37
    29898TAnkle arthroscopy/surgery004123.61$1,201.84$576.88$240.37
    *29900TMcp joint arthroscopy, dx005311.69$595.07$253.49$119.01
    *29901TMcp joint arthroscopy, surg005311.69$595.07$253.49$119.01
    *29902TMcp joint arthroscopy, surg005311.69$595.07$253.49$119.01
    29909DArthroscopy of joint004123.61$1,201.84$576.88$240.37
    *29999TArthroscopy of joint004123.61$1,201.84$576.88$240.37
    30000TDrainage of nose lesion02512.43$123.70$27.99$24.74
    30020TDrainage of nose lesion02512.43$123.70$27.99$24.74
    30100TIntranasal biopsy02525.95$302.88$114.24$60.58
    30110TRemoval of nose polyp(s)025312.33$627.65$284.00$125.53
    30115TRemoval of nose polyp(s)025312.33$627.65$284.00$125.53
    30117TRemoval of intranasal lesion025312.33$627.65$284.00$125.53
    30118TRemoval of intranasal lesion025417.37$884.20$272.41$176.84
    30120TRevision of nose025312.33$627.65$284.00$125.53
    30124TRemoval of nose lesion02525.95$302.88$114.24$60.58
    30125TRemoval of nose lesion025626.61$1,354.56$623.05$270.91
    30130TRemoval of turbinate bones025312.33$627.65$284.00$125.53
    30140TRemoval of turbinate bones025417.37$884.20$272.41$176.84
    30150TPartial removal of nose025626.61$1,354.56$623.05$270.91
    30160TRemoval of nose025626.61$1,354.56$623.05$270.91
    30200TInjection treatment of nose025312.33$627.65$284.00$125.53
    30210TNasal sinus therapy02525.95$302.88$114.24$60.58
    30220TInsert nasal septal button02525.95$302.88$114.24$60.58
    30300XRemove nasal foreign body03400.84$42.76$10.69$8.55
    30310TRemove nasal foreign body025312.33$627.65$284.00$125.53
    30320TRemove nasal foreign body025312.33$627.65$284.00$125.53
    30400TReconstruction of nose025626.61$1,354.56$623.05$270.91
    30410TReconstruction of nose025626.61$1,354.56$623.05$270.91
    30420TReconstruction of nose025626.61$1,354.56$623.05$270.91
    30430TRevision of nose025417.37$884.20$272.41$176.84
    30435TRevision of nose025626.61$1,354.56$623.05$270.91
    30450TRevision of nose025626.61$1,354.56$623.05$270.91
    30460TRevision of nose025626.61$1,354.56$623.05$270.91
    30462TRevision of nose025626.61$1,354.56$623.05$270.91
    30465TRepair nasal stenosis025626.61$1,354.56$623.05$270.91
    30520TRepair of nasal septum025626.61$1,354.56$623.05$270.91
    30540TRepair nasal defect025626.61$1,354.56$623.05$270.91
    30545TRepair nasal defect025626.61$1,354.56$623.05$270.91
    30560TRelease of nasal adhesions02512.43$123.70$27.99$24.74
    30580TRepair upper jaw fistula025626.61$1,354.56$623.05$270.91
    30600TRepair mouth/nose fistula025626.61$1,354.56$623.05$270.91
    30620TIntranasal reconstruction025626.61$1,354.56$623.05$270.91
    30630TRepair nasal septum defect025417.37$884.20$272.41$176.84
    30801TCauterization, inner nose02525.95$302.88$114.24$60.58
    30802TCauterization, inner nose025312.33$627.65$284.00$125.53
    30901TControl of nosebleed02502.10$106.90$37.42$21.38
    30903TControl of nosebleed02502.10$106.90$37.42$21.38
    30905TControl of nosebleed02502.10$106.90$37.42$21.38
    30906TRepeat control of nosebleed02502.10$106.90$37.42$21.38
    30915TLigation, nasal sinus artery009120.34$1,035.39$348.23$207.08
    30920TLigation, upper jaw artery009219.91$1,013.50$503.71$202.70
    30930TTherapy, fracture of nose025312.33$627.65$284.00$125.53
    30999TNasal surgery procedure02512.43$123.70$27.99$24.74
    31000TIrrigation, maxillary sinus02512.43$123.70$27.99$24.74
    31002TIrrigation, sphenoid sinus02525.95$302.88$114.24$60.58
    31020TExploration, maxillary sinus025417.37$884.20$272.41$176.84
    31030TExploration, maxillary sinus025626.61$1,354.56$623.05$270.91
    31032TExplore sinus,remove polyps025626.61$1,354.56$623.05$270.91
    31040TExploration behind upper jaw025417.37$884.20$272.41$176.84
    31050TExploration, sphenoid sinus025626.61$1,354.56$623.05$270.91
    31051TSphenoid sinus surgery025626.61$1,354.56$623.05$270.91
    31070TExploration of frontal sinus025417.37$884.20$272.41$176.84
    31075TExploration of frontal sinus025626.61$1,354.56$623.05$270.91
    31080TRemoval of frontal sinus025626.61$1,354.56$623.05$270.91
    31081TRemoval of frontal sinus025626.61$1,354.56$623.05$270.91
    31084TRemoval of frontal sinus025626.61$1,354.56$623.05$270.91
    Start Printed Page 59964
    31085TRemoval of frontal sinus025626.61$1,354.56$623.05$270.91
    31086TRemoval of frontal sinus025626.61$1,354.56$623.05$270.91
    31087TRemoval of frontal sinus025626.61$1,354.56$623.05$270.91
    31090TExploration of sinuses025626.61$1,354.56$623.05$270.91
    31200TRemoval of ethmoid sinus025626.61$1,354.56$623.05$270.91
    31201TRemoval of ethmoid sinus025626.61$1,354.56$623.05$270.91
    31205TRemoval of ethmoid sinus025626.61$1,354.56$623.05$270.91
    31225CRemoval of upper jaw
    31230CRemoval of upper jaw
    31231TNasal endoscopy, dx00711.03$52.43$14.22$10.49
    31233TNasal/sinus endoscopy, dx00721.21$61.59$33.87$12.32
    31235TNasal/sinus endoscopy, dx007411.32$576.23$293.88$115.25
    31237TNasal/sinus endoscopy, surg007517.42$886.75$443.38$177.35
    31238TNasal/sinus endoscopy, surg007411.32$576.23$293.88$115.25
    31239TNasal/sinus endoscopy, surg007517.42$886.75$443.38$177.35
    31240TNasal/sinus endoscopy, surg007411.32$576.23$293.88$115.25
    31254TRevision of ethmoid sinus007517.42$886.75$443.38$177.35
    31255TRemoval of ethmoid sinus007517.42$886.75$443.38$177.35
    31256TExploration maxillary sinus007517.42$886.75$443.38$177.35
    31267TEndoscopy, maxillary sinus007517.42$886.75$443.38$177.35
    31276TSinus endoscopy, surgical007517.42$886.75$443.38$177.35
    31287TNasal/sinus endoscopy, surg007517.42$886.75$443.38$177.35
    31288TNasal/sinus endoscopy, surg007517.42$886.75$443.38$177.35
    31290CNasal/sinus endoscopy, surg
    31291CNasal/sinus endoscopy, surg
    31292CNasal/sinus endoscopy, surg
    31293CNasal/sinus endoscopy, surg
    31294CNasal/sinus endoscopy, surg
    31299TSinus surgery procedure02525.95$302.88$114.24$60.58
    31300TRemoval of larynx lesion025626.61$1,354.56$623.05$270.91
    31320TDiagnostic incision, larynx025626.61$1,354.56$623.05$270.91
    31360CRemoval of larynx
    31365CRemoval of larynx
    31367CPartial removal of larynx
    31368CPartial removal of larynx
    31370CPartial removal of larynx
    31375CPartial removal of larynx
    31380CPartial removal of larynx
    31382CPartial removal of larynx
    31390CRemoval of larynx & pharynx
    31395CReconstruct larynx & pharynx
    31400TRevision of larynx025626.61$1,354.56$623.05$270.91
    31420TRemoval of epiglottis025626.61$1,354.56$623.05$270.91
    31500SInsert emergency airway00946.08$309.50$105.29$61.90
    31502TChange of windpipe airway01212.54$129.30$52.53$25.86
    31505TDiagnostic laryngoscopy00721.21$61.59$33.87$12.32
    31510TLaryngoscopy with biopsy007411.32$576.23$293.88$115.25
    31511TRemove foreign body, larynx00721.21$61.59$33.87$12.32
    31512TRemoval of larynx lesion007411.32$576.23$293.88$115.25
    31513TInjection into vocal cord00733.29$167.47$73.69$33.49
    31515TLaryngoscopy for aspiration007411.32$576.23$293.88$115.25
    31520TDiagnostic laryngoscopy00721.21$61.59$33.87$12.32
    31525TDiagnostic laryngoscopy007411.32$576.23$293.88$115.25
    31526TDiagnostic laryngoscopy007517.42$886.75$443.38$177.35
    31527TLaryngoscopy for treatment007517.42$886.75$443.38$177.35
    31528TLaryngoscopy and dilatation007411.32$576.23$293.88$115.25
    31529TLaryngoscopy and dilatation007411.32$576.23$293.88$115.25
    31530TOperative laryngoscopy007517.42$886.75$443.38$177.35
    31531TOperative laryngoscopy007517.42$886.75$443.38$177.35
    31535TOperative laryngoscopy007517.42$886.75$443.38$177.35
    31536TOperative laryngoscopy007517.42$886.75$443.38$177.35
    31540TOperative laryngoscopy007517.42$886.75$443.38$177.35
    31541TOperative laryngoscopy007517.42$886.75$443.38$177.35
    31560TOperative laryngoscopy007517.42$886.75$443.38$177.35
    31561TOperative laryngoscopy007517.42$886.75$443.38$177.35
    31570TLaryngoscopy with injection007411.32$576.23$293.88$115.25
    31571TLaryngoscopy with injection007517.42$886.75$443.38$177.35
    31575TDiagnostic laryngoscopy00711.03$52.43$14.22$10.49
    31576TLaryngoscopy with biopsy007517.42$886.75$443.38$177.35
    31577TRemove foreign body, larynx00733.29$167.47$73.69$33.49
    31578TRemoval of larynx lesion007517.42$886.75$443.38$177.35
    31579TDiagnostic laryngoscopy00733.29$167.47$73.69$33.49
    31580TRevision of larynx025626.61$1,354.56$623.05$270.91
    31582CRevision of larynx
    31584CTreat larynx fracture
    Start Printed Page 59965
    31585TTreat larynx fracture025312.33$627.65$284.00$125.53
    31586TTreat larynx fracture025626.61$1,354.56$623.05$270.91
    31587CRevision of larynx
    31588TRevision of larynx025626.61$1,354.56$623.05$270.91
    31590TReinnervate larynx025626.61$1,354.56$623.05$270.91
    31595TLarynx nerve surgery025626.61$1,354.56$623.05$270.91
    31599TLarynx surgery procedure025417.37$884.20$272.41$176.84
    31600TIncision of windpipe025417.37$884.20$272.41$176.84
    31601TIncision of windpipe025417.37$884.20$272.41$176.84
    31603TIncision of windpipe02525.95$302.88$114.24$60.58
    31605TIncision of windpipe025312.33$627.65$284.00$125.53
    31610TIncision of windpipe025417.37$884.20$272.41$176.84
    31611TSurgery/speech prosthesis025417.37$884.20$272.41$176.84
    31612TPuncture/clear windpipe025417.37$884.20$272.41$176.84
    31613TRepair windpipe opening025417.37$884.20$272.41$176.84
    31614TRepair windpipe opening025626.61$1,354.56$623.05$270.91
    31615TVisualization of windpipe00767.56$384.83$188.57$76.97
    31622TDx bronchoscope/wash00767.56$384.83$188.57$76.97
    31623TDx bronchoscope/brush00767.56$384.83$188.57$76.97
    31624TDx bronchoscope/lavage00767.56$384.83$188.57$76.97
    31625TBronchoscopy with biopsy00767.56$384.83$188.57$76.97
    31628TBronchoscopy with biopsy00767.56$384.83$188.57$76.97
    31629TBronchoscopy with biopsy00767.56$384.83$188.57$76.97
    31630TBronchoscopy with repair00767.56$384.83$188.57$76.97
    31631TBronchoscopy with dilation00767.56$384.83$188.57$76.97
    31635TRemove foreign body, airway00767.56$384.83$188.57$76.97
    31640TBronchoscopy & remove lesion00767.56$384.83$188.57$76.97
    31641TBronchoscopy, treat blockage00767.56$384.83$188.57$76.97
    31643TDiag bronchoscope/catheter00767.56$384.83$188.57$76.97
    31645TBronchoscopy, clear airways00767.56$384.83$188.57$76.97
    31646TBronchoscopy, reclear airway00767.56$384.83$188.57$76.97
    31656TBronchoscopy, inj for xray00767.56$384.83$188.57$76.97
    31700TInsertion of airway catheter00721.21$61.59$33.87$12.32
    31708NInstill airway contrast dye
    31710NInsertion of airway catheter
    31715NInjection for bronchus x-ray
    31717TBronchial brush biopsy00733.29$167.47$73.69$33.49
    31720TClearance of airways00721.21$61.59$33.87$12.32
    31725CClearance of airways
    31730TIntro, windpipe wire/tube00733.29$167.47$73.69$33.49
    31750TRepair of windpipe025626.61$1,354.56$623.05$270.91
    31755TRepair of windpipe025626.61$1,354.56$623.05$270.91
    31760CRepair of windpipe
    31766CReconstruction of windpipe
    31770CRepair/graft of bronchus
    31775CReconstruct bronchus
    31780CReconstruct windpipe
    31781CReconstruct windpipe
    31785CRemove windpipe lesion
    31786CRemove windpipe lesion
    31800CRepair of windpipe injury
    31805CRepair of windpipe injury
    31820TClosure of windpipe lesion025312.33$627.65$284.00$125.53
    31825TRepair of windpipe defect025417.37$884.20$272.41$176.84
    31830TRevise windpipe scar025417.37$884.20$272.41$176.84
    31899TAirways surgical procedure00767.56$384.83$188.57$76.97
    32000TDrainage of chest00704.58$233.14$79.60$46.63
    32002TTreatment of collapsed lung00704.58$233.14$79.60$46.63
    32005TTreat lung lining chemically00704.58$233.14$79.60$46.63
    32020TInsertion of chest tube00704.58$233.14$79.60$46.63
    32035CExploration of chest
    32036CExploration of chest
    32095CBiopsy through chest wall
    32100CExploration/biopsy of chest
    32110CExplore/repair chest
    32120CRe-exploration of chest
    32124CExplore chest free adhesions
    32140CRemoval of lung lesion(s)
    32141CRemove/treat lung lesions
    32150CRemoval of lung lesion(s)
    32151CRemove lung foreign body
    32160COpen chest heart massage
    32200CDrain, open, lung lesion
    32201CDrain, percut, lung lesion
    32215CTreat chest lining
    Start Printed Page 59966
    32220CRelease of lung
    32225CPartial release of lung
    32310CRemoval of chest lining
    32320CFree/remove chest lining
    32400TNeedle biopsy chest lining00054.03$205.14$90.26$41.03
    32402COpen biopsy chest lining
    32405TBiopsy, lung or mediastinum06859.16$466.28$205.16$93.26
    32420TPuncture/clear lung00704.58$233.14$79.60$46.63
    32440CRemoval of lung
    32442CSleeve pneumonectomy
    32445CRemoval of lung
    32480CPartial removal of lung
    32482CBilobectomy
    32484CSegmentectomy
    32486CSleeve lobectomy
    32488CCompletion pneumonectomy
    32491CLung volume reduction
    32500CPartial removal of lung
    32501CRepair bronchus add-on
    32520CRemove lung & revise chest
    32522CRemove lung & revise chest
    32525CRemove lung & revise chest
    32540CRemoval of lung lesion
    32601TThoracoscopy, diagnostic006923.57$1,199.81$239.96
    32602TThoracoscopy, diagnostic006923.57$1,199.81$239.96
    32603TThoracoscopy, diagnostic006923.57$1,199.81$239.96
    32604TThoracoscopy, diagnostic006923.57$1,199.81$239.96
    32605TThoracoscopy, diagnostic006923.57$1,199.81$239.96
    32606TThoracoscopy, diagnostic006923.57$1,199.81$239.96
    32650CThoracoscopy, surgical
    32651CThoracoscopy, surgical
    32652CThoracoscopy, surgical
    32653CThoracoscopy, surgical
    32654CThoracoscopy, surgical
    32655CThoracoscopy, surgical
    32656CThoracoscopy, surgical
    32657CThoracoscopy, surgical
    32658CThoracoscopy, surgical
    32659CThoracoscopy, surgical
    32660CThoracoscopy, surgical
    32661CThoracoscopy, surgical
    32662CThoracoscopy, surgical
    32663CThoracoscopy, surgical
    32664CThoracoscopy, surgical
    32665CThoracoscopy, surgical
    32800CRepair lung hernia
    32810CClose chest after drainage
    32815CClose bronchial fistula
    32820CReconstruct injured chest
    32850CDonor pneumonectomy
    32851CLung transplant, single
    32852CLung transplant with bypass
    32853CLung transplant, double
    32854CLung transplant with bypass
    32900CRemoval of rib(s)
    32905CRevise & repair chest wall
    32906CRevise & repair chest wall
    32940CRevision of lung
    32960TTherapeutic pneumothorax00704.58$233.14$79.60$46.63
    32997CTotal lung lavage
    32999TChest surgery procedure00704.58$233.14$79.60$46.63
    33010TDrainage of heart sac00704.58$233.14$79.60$46.63
    33011TRepeat drainage of heart sac00704.58$233.14$79.60$46.63
    33015CIncision of heart sac
    33020CIncision of heart sac
    33025CIncision of heart sac
    33030CPartial removal of heart sac
    33031CPartial removal of heart sac
    33050CRemoval of heart sac lesion
    33120CRemoval of heart lesion
    33130CRemoval of heart lesion
    33140CHeart revascularize (tmr)
    33141CHeart tmr w/other procedure
    33200CInsertion of heart pacemaker
    33201CInsertion of heart pacemaker
    Start Printed Page 59967
    33206TInsertion of heart pacemaker0089149.52$7,611.17$2,246.59$1,522.23
    33207TInsertion of heart pacemaker0089149.52$7,611.17$2,246.59$1,522.23
    33208TInsertion of heart pacemaker0089149.52$7,611.17$2,246.59$1,522.23
    33210TInsertion of heart electrode010636.64$1,865.12$503.07$373.02
    33211TInsertion of heart electrode010636.64$1,865.12$503.07$373.02
    33212TInsertion of pulse generator0090117.54$5,983.26$2,133.88$1,196.65
    33213TInsertion of pulse generator0090117.54$5,983.26$2,133.88$1,196.65
    33214TUpgrade of pacemaker system0089149.52$7,611.17$2,246.59$1,522.23
    33216TRevise eltrd pacing-defib010636.64$1,865.12$503.07$373.02
    33217TRevise eltrd pacing-defib010636.64$1,865.12$503.07$373.02
    33218TRevise eltrd pacing-defib010636.64$1,865.12$503.07$373.02
    33220TRevise eltrd pacing-defib010636.64$1,865.12$503.07$373.02
    33222TRevise pocket, pacemaker002612.62$642.41$277.92$128.48
    33223TRevise pocket, pacing-defib002612.62$642.41$277.92$128.48
    33233TRemoval of pacemaker system010514.76$751.34$368.16$150.27
    33234TRemoval of pacemaker system010514.76$751.34$368.16$150.27
    33235TRemoval pacemaker electrode010514.76$751.34$368.16$150.27
    33236CRemove electrode/thoracotomy
    33237CRemove electrode/thoracotomy
    33238CRemove electrode/thoracotomy
    33240TInsert pulse generator0107379.46$19,316.03$4,224.27$3,863.21
    33241TRemove pulse generator010514.76$751.34$368.16$150.27
    33243CRemove eltrd/thoracotomy
    33244TRemove eltrd, transven010514.76$751.34$368.16$150.27
    33245CInsert epic eltrd pace-defib
    33246CInsert epic eltrd/generator
    33249TEltrd/insert pace-defib0108573.46$29,191.41$5,838.28
    33250CAblate heart dysrhythm focus
    33251CAblate heart dysrhythm focus
    33253CReconstruct atria
    33261CAblate heart dysrhythm focus
    33282SImplant pat-active ht record0710$400.00$80.00
    33284TRemove pat-active ht record01096.27$319.17$130.86$63.83
    33300CRepair of heart wound
    33305CRepair of heart wound
    33310CExploratory heart surgery
    33315CExploratory heart surgery
    33320CRepair major blood vessel(s)
    33321CRepair major vessel
    33322CRepair major blood vessel(s)
    33330CInsert major vessel graft
    33332CInsert major vessel graft
    33335CInsert major vessel graft
    33400CRepair of aortic valve
    33401CValvuloplasty, open
    33403CValvuloplasty, w/cp bypass
    33404CPrepare heart-aorta conduit
    33405CReplacement of aortic valve
    33406CReplacement of aortic valve
    33410CReplacement of aortic valve
    33411CReplacement of aortic valve
    33412CReplacement of aortic valve
    33413CReplacement of aortic valve
    33414CRepair of aortic valve
    33415CRevision, subvalvular tissue
    33416CRevise ventricle muscle
    33417CRepair of aortic valve
    33420CRevision of mitral valve
    33422CRevision of mitral valve
    33425CRepair of mitral valve
    33426CRepair of mitral valve
    33427CRepair of mitral valve
    33430CReplacement of mitral valve
    33460CRevision of tricuspid valve
    33463CValvuloplasty, tricuspid
    33464CValvuloplasty, tricuspid
    33465CReplace tricuspid valve
    33468CRevision of tricuspid valve
    33470CRevision of pulmonary valve
    33471CValvotomy, pulmonary valve
    33472CRevision of pulmonary valve
    33474CRevision of pulmonary valve
    33475CReplacement, pulmonary valve
    33476CRevision of heart chamber
    33478CRevision of heart chamber
    Start Printed Page 59968
    33496CRepair, prosth valve clot
    33500CRepair heart vessel fistula
    33501CRepair heart vessel fistula
    33502CCoronary artery correction
    33503CCoronary artery graft
    33504CCoronary artery graft
    33505CRepair artery w/tunnel
    33506CRepair artery, translocation
    33510CCABG, vein, single
    33511CCABG, vein, two
    33512CCABG, vein, three
    33513CCABG, vein, four
    33514CCABG, vein, five
    33516CCabg, vein, six or more
    33517CCABG, artery-vein, single
    33518CCABG, artery-vein, two
    33519CCABG, artery-vein, three
    33521CCABG, artery-vein, four
    33522CCABG, artery-vein, five
    33523CCabg, art-vein, six or more
    33530CCoronary artery, bypass/reop
    33533CCABG, arterial, single
    33534CCABG, arterial, two
    33535CCABG, arterial, three
    33536CCabg, arterial, four or more
    33542CRemoval of heart lesion
    33545CRepair of heart damage
    33572COpen coronary endarterectomy
    33600CClosure of valve
    33602CClosure of valve
    33606CAnastomosis/artery-aorta
    33608CRepair anomaly w/conduit
    33610CRepair by enlargement
    33611CRepair double ventricle
    33612CRepair double ventricle
    33615CRepair, modified fontan
    33617CRepair single ventricle
    33619CRepair single ventricle
    33641CRepair heart septum defect
    33645CRevision of heart veins
    33647CRepair heart septum defects
    33660CRepair of heart defects
    33665CRepair of heart defects
    33670CRepair of heart chambers
    33681CRepair heart septum defect
    33684CRepair heart septum defect
    33688CRepair heart septum defect
    33690CReinforce pulmonary artery
    33692CRepair of heart defects
    33694CRepair of heart defects
    33697CRepair of heart defects
    33702CRepair of heart defects
    33710CRepair of heart defects
    33720CRepair of heart defect
    33722CRepair of heart defect
    33730CRepair heart-vein defect(s)
    33732CRepair heart-vein defect
    33735CRevision of heart chamber
    33736CRevision of heart chamber
    33737CRevision of heart chamber
    33750CMajor vessel shunt
    33755CMajor vessel shunt
    33762CMajor vessel shunt
    33764CMajor vessel shunt & graft
    33766CMajor vessel shunt
    33767CMajor vessel shunt
    33770CRepair great vessels defect
    33771CRepair great vessels defect
    33774CRepair great vessels defect
    33775CRepair great vessels defect
    33776CRepair great vessels defect
    33777CRepair great vessels defect
    33778CRepair great vessels defect
    33779CRepair great vessels defect
    33780CRepair great vessels defect
    Start Printed Page 59969
    33781CRepair great vessels defect
    33786CRepair arterial trunk
    33788CRevision of pulmonary artery
    33800CAortic suspension
    33802CRepair vessel defect
    33803CRepair vessel defect
    33813CRepair septal defect
    33814CRepair septal defect
    33820CRevise major vessel
    33822CRevise major vessel
    33824CRevise major vessel
    33840CRemove aorta constriction
    33845CRemove aorta constriction
    33851CRemove aorta constriction
    33852CRepair septal defect
    33853CRepair septal defect
    33860CAscending aortic graft
    33861CAscending aortic graft
    33863CAscending aortic graft
    33870CTransverse aortic arch graft
    33875CThoracic aortic graft
    33877CThoracoabdominal graft
    33910CRemove lung artery emboli
    33915CRemove lung artery emboli
    33916CSurgery of great vessel
    33917CRepair pulmonary artery
    33918CRepair pulmonary atresia
    33919CRepair pulmonary atresia
    33920CRepair pulmonary atresia
    33922CTransect pulmonary artery
    33924CRemove pulmonary shunt
    33930CRemoval of donor heart/lung
    33935CTransplantation, heart/lung
    33940CRemoval of donor heart
    33945CTransplantation of heart
    33960CExternal circulation assist
    33961CExternal circulation assist
    *33967CInsert ia percut device
    33968CRemove aortic assist device
    33970CAortic circulation assist
    33971CAortic circulation assist
    33973CInsert balloon device
    33974CRemove intra-aortic balloon
    33975CImplant ventricular device
    33976CImplant ventricular device
    33977CRemove ventricular device
    33978CRemove ventricular device
    *33979CInsert intracorporeal device
    *33980CRemove intracorporeal device
    33999TCardiac surgery procedure00704.58$233.14$79.60$46.63
    34001CRemoval of artery clot
    34051CRemoval of artery clot
    34101TRemoval of artery clot008834.38$1,750.08$678.68$350.02
    34111TRemoval of arm artery clot008834.38$1,750.08$678.68$350.02
    34151CRemoval of artery clot
    34201TRemoval of artery clot008834.38$1,750.08$678.68$350.02
    34203TRemoval of leg artery clot008834.38$1,750.08$678.68$350.02
    34401CRemoval of vein clot
    34421TRemoval of vein clot008834.38$1,750.08$678.68$350.02
    34451CRemoval of vein clot
    34471TRemoval of vein clot008834.38$1,750.08$678.68$350.02
    34490TRemoval of vein clot008834.38$1,750.08$678.68$350.02
    34501TRepair valve, femoral vein008834.38$1,750.08$678.68$350.02
    34502CReconstruct vena cava
    34510TTransposition of vein valve008834.38$1,750.08$678.68$350.02
    34520TCross-over vein graft008834.38$1,750.08$678.68$350.02
    34530TLeg vein fusion008834.38$1,750.08$678.68$350.02
    34800CEndovasc abdo repair w/tube
    34802CEndovasc abdo repr w/device
    34804CEndovasc abdo repr w/device
    34808CEndovasc abdo occlud device
    34812CXpose for endoprosth, aortic
    34813CXpose for endoprosth, femorl
    34820CXpose for endoprosth, iliac
    34825CEndovasc extend prosth, init
    Start Printed Page 59970
    34826CEndovasc exten prosth, addl
    34830COpen aortic tube prosth repr
    34831COpen aortoiliac prosth repr
    34832COpen aortofemor prosth repr
    35001CRepair defect of artery
    35002CRepair artery rupture, neck
    35005CRepair defect of artery
    35011TRepair defect of artery009314.16$720.80$277.34$144.16
    35013CRepair artery rupture, arm
    35021CRepair defect of artery
    35022CRepair artery rupture, chest
    35045CRepair defect of arm artery
    35081CRepair defect of artery
    35082CRepair artery rupture, aorta
    35091CRepair defect of artery
    35092CRepair artery rupture, aorta
    35102CRepair defect of artery
    35103CRepair artery rupture, groin
    35111CRepair defect of artery
    35112CRepair artery rupture,spleen
    35121CRepair defect of artery
    35122CRepair artery rupture, belly
    35131CRepair defect of artery
    35132CRepair artery rupture, groin
    35141CRepair defect of artery
    35142CRepair artery rupture, thigh
    35151CRepair defect of artery
    35152CRepair artery rupture, knee
    35161CRepair defect of artery
    35162CRepair artery rupture
    35180TRepair blood vessel lesion009314.16$720.80$277.34$144.16
    35182CRepair blood vessel lesion
    35184TRepair blood vessel lesion009314.16$720.80$277.34$144.16
    35188TRepair blood vessel lesion008834.38$1,750.08$678.68$350.02
    35189CRepair blood vessel lesion
    35190TRepair blood vessel lesion009314.16$720.80$277.34$144.16
    35201TRepair blood vessel lesion009314.16$720.80$277.34$144.16
    35206TRepair blood vessel lesion009314.16$720.80$277.34$144.16
    35207TRepair blood vessel lesion008834.38$1,750.08$678.68$350.02
    35211CRepair blood vessel lesion
    35216CRepair blood vessel lesion
    35221CRepair blood vessel lesion
    35226TRepair blood vessel lesion009314.16$720.80$277.34$144.16
    35231TRepair blood vessel lesion009314.16$720.80$277.34$144.16
    35236TRepair blood vessel lesion009314.16$720.80$277.34$144.16
    35241CRepair blood vessel lesion
    35246CRepair blood vessel lesion
    35251CRepair blood vessel lesion
    35256TRepair blood vessel lesion009314.16$720.80$277.34$144.16
    35261TRepair blood vessel lesion009314.16$720.80$277.34$144.16
    35266TRepair blood vessel lesion009314.16$720.80$277.34$144.16
    35271CRepair blood vessel lesion
    35276CRepair blood vessel lesion
    35281CRepair blood vessel lesion
    35286TRepair blood vessel lesion009314.16$720.80$277.34$144.16
    35301CRechanneling of artery
    35311CRechanneling of artery
    35321TRechanneling of artery009314.16$720.80$277.34$144.16
    35331CRechanneling of artery
    35341CRechanneling of artery
    35351CRechanneling of artery
    35355CRechanneling of artery
    35361CRechanneling of artery
    35363CRechanneling of artery
    35371CRechanneling of artery
    35372CRechanneling of artery
    35381CRechanneling of artery
    35390CReoperation, carotid add-on
    35400CAngioscopy
    35450CRepair arterial blockage
    35452CRepair arterial blockage
    35454CRepair arterial blockage
    35456CRepair arterial blockage
    35458TRepair arterial blockage008129.24$1,488.43$710.91$297.69
    35459TRepair arterial blockage008129.24$1,488.43$710.91$297.69
    Start Printed Page 59971
    35460TRepair venous blockage008129.24$1,488.43$710.91$297.69
    35470TRepair arterial blockage008129.24$1,488.43$710.91$297.69
    35471TRepair arterial blockage008129.24$1,488.43$710.91$297.69
    35472TRepair arterial blockage008129.24$1,488.43$710.91$297.69
    35473TRepair arterial blockage008129.24$1,488.43$710.91$297.69
    35474TRepair arterial blockage008129.24$1,488.43$710.91$297.69
    35475TRepair arterial blockage008129.24$1,488.43$710.91$297.69
    35476TRepair venous blockage008129.24$1,488.43$710.91$297.69
    35480CAtherectomy, open
    35481CAtherectomy, open
    35482CAtherectomy, open
    35483CAtherectomy, open
    35484TAtherectomy, open008129.24$1,488.43$710.91$297.69
    35485TAtherectomy, open008129.24$1,488.43$710.91$297.69
    35490TAtherectomy, percutaneous008129.24$1,488.43$710.91$297.69
    35491TAtherectomy, percutaneous008129.24$1,488.43$710.91$297.69
    35492TAtherectomy, percutaneous008129.24$1,488.43$710.91$297.69
    35493TAtherectomy, percutaneous008129.24$1,488.43$710.91$297.69
    35494TAtherectomy, percutaneous008129.24$1,488.43$710.91$297.69
    35495TAtherectomy, percutaneous008129.24$1,488.43$710.91$297.69
    35500THarvest vein for bypass008129.24$1,488.43$710.91$297.69
    35501CArtery bypass graft
    35506CArtery bypass graft
    35507CArtery bypass graft
    35508CArtery bypass graft
    35509CArtery bypass graft
    35511CArtery bypass graft
    35515CArtery bypass graft
    35516CArtery bypass graft
    35518CArtery bypass graft
    35521CArtery bypass graft
    35526CArtery bypass graft
    35531CArtery bypass graft
    35533CArtery bypass graft
    35536CArtery bypass graft
    35541CArtery bypass graft
    35546CArtery bypass graft
    35548CArtery bypass graft
    35549CArtery bypass graft
    35551CArtery bypass graft
    35556CArtery bypass graft
    35558CArtery bypass graft
    35560CArtery bypass graft
    35563CArtery bypass graft
    35565CArtery bypass graft
    35566CArtery bypass graft
    35571CArtery bypass graft
    35582CVein bypass graft
    35583CVein bypass graft
    35585CVein bypass graft
    35587CVein bypass graft
    35600CHarvest artery for cabg
    35601CArtery bypass graft
    35606CArtery bypass graft
    35612CArtery bypass graft
    35616CArtery bypass graft
    35621CArtery bypass graft
    35623CBypass graft, not vein
    35626CArtery bypass graft
    35631CArtery bypass graft
    35636CArtery bypass graft
    35641CArtery bypass graft
    35642CArtery bypass graft
    35645CArtery bypass graft
    35646CArtery bypass graft
    *35647CArtery bypass graft
    35650CArtery bypass graft
    35651CArtery bypass graft
    35654CArtery bypass graft
    35656CArtery bypass graft
    35661CArtery bypass graft
    35663CArtery bypass graft
    35665CArtery bypass graft
    35666CArtery bypass graft
    35671CArtery bypass graft
    Start Printed Page 59972
    35681CComposite bypass graft
    35682CComposite bypass graft
    35683CComposite bypass graft
    *35685TBypass graft patency/patch009314.16$720.80$277.34$144.16
    *35686TBypass graft/av fist patency009314.16$720.80$277.34$144.16
    35691CArterial transposition
    35693CArterial transposition
    35694CArterial transposition
    35695CArterial transposition
    35700CReoperation, bypass graft
    35701CExploration, carotid artery
    35721CExploration, femoral artery
    35741CExploration popliteal artery
    35761TExploration of artery/vein011521.35$1,086.80$506.74$217.36
    35800CExplore neck vessels
    35820CExplore chest vessels
    35840CExplore abdominal vessels
    35860TExplore limb vessels009314.16$720.80$277.34$144.16
    35870CRepair vessel graft defect
    35875TRemoval of clot in graft008834.38$1,750.08$678.68$350.02
    35876TRemoval of clot in graft008834.38$1,750.08$678.68$350.02
    35879TRevise graft w/vein008834.38$1,750.08$678.68$350.02
    35881TRevise graft w/vein008834.38$1,750.08$678.68$350.02
    35901CExcision, graft, neck
    35903TExcision, graft, extremity011521.35$1,086.80$506.74$217.36
    35905CExcision, graft, thorax
    35907CExcision, graft, abdomen
    36000NPlace needle in vein
    *36002SPseudoaneurysm injection trt02672.33$118.61$65.23$23.72
    36005NInjection, venography
    36010NPlace catheter in vein
    36011NPlace catheter in vein
    36012NPlace catheter in vein
    36013NPlace catheter in artery
    36014NPlace catheter in artery
    36015NPlace catheter in artery
    36100NEstablish access to artery
    36120NEstablish access to artery
    36140NEstablish access to artery
    36145NArtery to vein shunt
    36160NEstablish access to aorta
    36200NPlace catheter in aorta
    36215NPlace catheter in artery
    36216NPlace catheter in artery
    36217NPlace catheter in artery
    36218NPlace catheter in artery
    36245NPlace catheter in artery
    36246NPlace catheter in artery
    36247NPlace catheter in artery
    36248NPlace catheter in artery
    36260TInsertion of infusion pump011979.67$4,055.52$811.10
    36261TRevision of infusion pump012489.07$4,534.02$906.80
    36262TRemoval of infusion pump01096.27$319.17$130.86$63.83
    36299NVessel injection procedure
    36400NDrawing blood
    36405NDrawing blood
    36406NDrawing blood
    36410NDrawing blood
    36415EDrawing blood
    36420TEstablish access to vein00350.12$6.11$2.69$1.22
    36425TEstablish access to vein00350.12$6.11$2.69$1.22
    36430SBlood transfusion service01105.30$269.79$113.31$53.96
    36440SBlood transfusion service01105.30$269.79$113.31$53.96
    36450SExchange transfusion service01105.30$269.79$113.31$53.96
    36455SExchange transfusion service01105.30$269.79$113.31$53.96
    36460STransfusion service, fetal01105.30$269.79$113.31$53.96
    36468TInjection(s), spider veins00981.24$63.12$20.88$12.62
    36469TInjection(s), spider veins00981.24$63.12$20.88$12.62
    36470TInjection therapy of vein00981.24$63.12$20.88$12.62
    36471TInjection therapy of veins00981.24$63.12$20.88$12.62
    36481NInsertion of catheter, vein
    36488TInsertion of catheter, vein003212.64$643.43$128.69
    36489TInsertion of catheter, vein003212.64$643.43$128.69
    36490TInsertion of catheter, vein003212.64$643.43$128.69
    36491TInsertion of catheter, vein003212.64$643.43$128.69
    Start Printed Page 59973
    36493XRepositioning of cvc01874.22$214.81$42.96
    36500NInsertion of catheter, vein
    36510CInsertion of catheter, vein
    36520SPlasma and/or cell exchange011121.08$1,073.06$300.74$214.61
    36521SApheresis w/ adsorp/reinfuse011236.25$1,845.27$608.94$369.05
    36522SPhotopheresis011236.25$1,845.27$608.94$369.05
    36530TInsertion of infusion pump011979.67$4,055.52$811.10
    36531TRevision of infusion pump012489.07$4,534.02$906.80
    36532TRemoval of infusion pump01096.27$319.17$130.86$63.83
    36533TInsertion of access device011521.35$1,086.80$506.74$217.36
    36534TRevision of access device01096.27$319.17$130.86$63.83
    36535TRemoval of access device01096.27$319.17$130.86$63.83
    36540NCollect blood venous device
    36550TDeclot vascular device0972$150.00$30.00
    36600NWithdrawal of arterial blood
    36620NInsertion catheter, artery
    36625NInsertion catheter, artery
    36640TInsertion catheter, artery003212.64$643.43$128.69
    36660CInsertion catheter, artery
    36680TInsert needle, bone cavity01203.08$156.78$42.67$31.36
    36800TInsertion of cannula011521.35$1,086.80$506.74$217.36
    36810TInsertion of cannula011521.35$1,086.80$506.74$217.36
    36815TInsertion of cannula011521.35$1,086.80$506.74$217.36
    36819TAv fusion by basilic vein008834.38$1,750.08$678.68$350.02
    *36820TAv fusion/forearm vein008834.38$1,750.08$678.68$350.02
    36821TAv fusion direct any site008834.38$1,750.08$678.68$350.02
    36822CInsertion of cannula(s)
    36823CInsertion of cannula(s)
    36825TArtery-vein graft008834.38$1,750.08$678.68$350.02
    36830TArtery-vein graft008834.38$1,750.08$678.68$350.02
    36831TAv fistula excision, open008834.38$1,750.08$678.68$350.02
    36832TAv fistula revision, open008834.38$1,750.08$678.68$350.02
    36833TAv fistula revision008834.38$1,750.08$678.68$350.02
    36834TRepair A-V aneurysm008834.38$1,750.08$678.68$350.02
    36835TArtery to vein shunt011521.35$1,086.80$506.74$217.36
    36860TExternal cannula declotting011521.35$1,086.80$506.74$217.36
    36861TCannula declotting011521.35$1,086.80$506.74$217.36
    36870TAv fistula revision, open009314.16$720.80$277.34$144.16
    37140CRevision of circulation
    37145CRevision of circulation
    37160CRevision of circulation
    37180CRevision of circulation
    37181CSplice spleen/kidney veins
    37195CThrombolytic therapy, stroke
    37200TTranscatheter biopsy06859.16$466.28$205.16$93.26
    37201TTranscatheter therapy infuse01203.08$156.78$42.67$31.36
    37202TTranscatheter therapy infuse01203.08$156.78$42.67$31.36
    37203TTranscatheter retrieval010315.95$811.92$295.70$162.38
    37204TTranscatheter occlusion010315.95$811.92$295.70$162.38
    37205TTranscatheter stent022967.22$3,421.77$996.86$684.35
    37206TTranscatheter stent add-on022967.22$3,421.77$996.86$684.35
    37207TTranscatheter stent022967.22$3,421.77$996.86$684.35
    37208TTranscatheter stent add-on022967.22$3,421.77$996.86$684.35
    37209TExchange arterial catheter010315.95$811.92$295.70$162.38
    37250TIv us first vessel add-on010315.95$811.92$295.70$162.38
    37251TIv us each add vessel add-on010315.95$811.92$295.70$162.38
    37565TLigation of neck vein009314.16$720.80$277.34$144.16
    37600TLigation of neck artery009314.16$720.80$277.34$144.16
    37605TLigation of neck artery009120.34$1,035.39$348.23$207.08
    37606TLigation of neck artery009120.34$1,035.39$348.23$207.08
    37607TLigation of a-v fistula009219.91$1,013.50$503.71$202.70
    37609TTemporal artery procedure00208.44$429.63$130.53$85.93
    37615TLigation of neck artery009120.34$1,035.39$348.23$207.08
    37616CLigation of chest artery
    37617CLigation of abdomen artery
    37618CLigation of extremity artery
    37620TRevision of major vein009120.34$1,035.39$348.23$207.08
    37650TRevision of major vein009120.34$1,035.39$348.23$207.08
    37660CRevision of major vein
    37700TRevise leg vein009120.34$1,035.39$348.23$207.08
    37720TRemoval of leg vein009219.91$1,013.50$503.71$202.70
    37730TRemoval of leg veins009219.91$1,013.50$503.71$202.70
    37735TRemoval of leg veins/lesion009219.91$1,013.50$503.71$202.70
    37760TRevision of leg veins009120.34$1,035.39$348.23$207.08
    37780TRevision of leg vein009120.34$1,035.39$348.23$207.08
    Start Printed Page 59974
    37785TRevise secondary varicosity009120.34$1,035.39$348.23$207.08
    37788CRevascularization, penis
    37790TPenile venous occlusion018122.09$1,124.47$618.45$224.89
    37799TVascular surgery procedure00208.44$429.63$130.53$85.93
    38100CRemoval of spleen, total
    38101CRemoval of spleen, partial
    38102CRemoval of spleen, total
    38115CRepair of ruptured spleen
    38120TLaparoscopy, splenectomy013137.63$1,915.52$996.07$383.10
    38129TLaparoscope proc, spleen013025.91$1,318.92$659.53$263.78
    38200NInjection for spleen x-ray
    *38220TBone marrow aspiration00031.03$52.43$27.99$10.49
    *38221TBone marrow biopsy00031.03$52.43$27.99$10.49
    38230SBone marrow collection01238.56$435.74$87.15
    38231SStem cell collection011121.08$1,073.06$300.74$214.61
    38240SBone marrow/stem transplant01238.56$435.74$87.15
    38241SBone marrow/stem transplant01238.56$435.74$87.15
    38300TDrainage, lymph node lesion000810.93$556.38$113.67$111.28
    38305TDrainage, lymph node lesion000810.93$556.38$113.67$111.28
    38308TIncision of lymph channels011315.53$790.54$326.55$158.11
    38380CThoracic duct procedure
    38381CThoracic duct procedure
    38382CThoracic duct procedure
    38500TBiopsy/removal, lymph nodes011315.53$790.54$326.55$158.11
    38505TNeedle biopsy, lymph nodes00054.03$205.14$90.26$41.03
    38510TBiopsy/removal, lymph nodes011315.53$790.54$326.55$158.11
    38520TBiopsy/removal, lymph nodes011315.53$790.54$326.55$158.11
    38525TBiopsy/removal, lymph nodes011315.53$790.54$326.55$158.11
    38530TBiopsy/removal, lymph nodes011315.53$790.54$326.55$158.11
    38542TExplore deep node(s), neck011429.28$1,490.47$493.78$298.09
    38550TRemoval, neck/armpit lesion011315.53$790.54$326.55$158.11
    38555TRemoval, neck/armpit lesion011315.53$790.54$326.55$158.11
    38562CRemoval, pelvic lymph nodes
    38564CRemoval, abdomen lymph nodes
    38570TLaparoscopy, lymph node biop013137.63$1,915.52$996.07$383.10
    38571TLaparoscopy, lymphadenectomy013256.06$2,853.68$1,239.22$570.74
    38572TLaparoscopy, lymphadenectomy013137.63$1,915.52$996.07$383.10
    38589TLaparoscope proc, lymphatic013025.91$1,318.92$659.53$263.78
    38700CRemoval of lymph nodes, neck
    38720TRemoval of lymph nodes, neck011315.53$790.54$326.55$158.11
    38724CRemoval of lymph nodes, neck
    38740TRemove armpit lymph nodes011429.28$1,490.47$493.78$298.09
    38745TRemove armpit lymph nodes011429.28$1,490.47$493.78$298.09
    38746CRemove thoracic lymph nodes
    38747CRemove abdominal lymph nodes
    38760TRemove groin lymph nodes011315.53$790.54$326.55$158.11
    38765CRemove groin lymph nodes
    38770CRemove pelvis lymph nodes
    38780CRemove abdomen lymph nodes
    38790NInject for lymphatic x-ray
    38792NIdentify sentinel node
    38794NAccess thoracic lymph duct
    38999TBlood/lymph system procedure000810.93$556.38$113.67$111.28
    39000CExploration of chest
    39010CExploration of chest
    39200CRemoval chest lesion
    39220CRemoval chest lesion
    39400TVisualization of chest006923.57$1,199.81$239.96
    39499CChest procedure
    39501CRepair diaphragm laceration
    39502CRepair paraesophageal hernia
    39503CRepair of diaphragm hernia
    39520CRepair of diaphragm hernia
    39530CRepair of diaphragm hernia
    39531CRepair of diaphragm hernia
    39540CRepair of diaphragm hernia
    39541CRepair of diaphragm hernia
    39545CRevision of diaphragm
    39560CResect diaphragm, simple
    39561CResect diaphragm, complex
    39599CDiaphragm surgery procedure
    40490TBiopsy of lip02512.43$123.70$27.99$24.74
    40500TPartial excision of lip025312.33$627.65$284.00$125.53
    40510TPartial excision of lip025417.37$884.20$272.41$176.84
    40520TPartial excision of lip025312.33$627.65$284.00$125.53
    Start Printed Page 59975
    40525TReconstruct lip with flap025417.37$884.20$272.41$176.84
    40527TReconstruct lip with flap025417.37$884.20$272.41$176.84
    40530TPartial removal of lip025417.37$884.20$272.41$176.84
    40650TRepair lip02525.95$302.88$114.24$60.58
    40652TRepair lip02525.95$302.88$114.24$60.58
    40654TRepair lip02525.95$302.88$114.24$60.58
    40700TRepair cleft lip/nasal025626.61$1,354.56$623.05$270.91
    40701TRepair cleft lip/nasal025626.61$1,354.56$623.05$270.91
    40702TRepair cleft lip/nasal025626.61$1,354.56$623.05$270.91
    40720TRepair cleft lip/nasal025626.61$1,354.56$623.05$270.91
    40761TRepair cleft lip/nasal025626.61$1,354.56$623.05$270.91
    40799TLip surgery procedure025312.33$627.65$284.00$125.53
    40800TDrainage of mouth lesion02512.43$123.70$27.99$24.74
    40801TDrainage of mouth lesion02525.95$302.88$114.24$60.58
    40804XRemoval, foreign body, mouth03400.84$42.76$10.69$8.55
    40805TRemoval, foreign body, mouth02525.95$302.88$114.24$60.58
    40806TIncision of lip fold02512.43$123.70$27.99$24.74
    40808TBiopsy of mouth lesion02512.43$123.70$27.99$24.74
    40810TExcision of mouth lesion025312.33$627.65$284.00$125.53
    40812TExcise/repair mouth lesion02525.95$302.88$114.24$60.58
    40814TExcise/repair mouth lesion025312.33$627.65$284.00$125.53
    40816TExcision of mouth lesion025417.37$884.20$272.41$176.84
    40818TExcise oral mucosa for graft02512.43$123.70$27.99$24.74
    40819TExcise lip or cheek fold02525.95$302.88$114.24$60.58
    40820TTreatment of mouth lesion025312.33$627.65$284.00$125.53
    40830TRepair mouth laceration02512.43$123.70$27.99$24.74
    40831TRepair mouth laceration02525.95$302.88$114.24$60.58
    40840TReconstruction of mouth025417.37$884.20$272.41$176.84
    40842TReconstruction of mouth025417.37$884.20$272.41$176.84
    40843TReconstruction of mouth025417.37$884.20$272.41$176.84
    40844TReconstruction of mouth025626.61$1,354.56$623.05$270.91
    40845TReconstruction of mouth025626.61$1,354.56$623.05$270.91
    40899TMouth surgery procedure02525.95$302.88$114.24$60.58
    41000TDrainage of mouth lesion025312.33$627.65$284.00$125.53
    41005TDrainage of mouth lesion02512.43$123.70$27.99$24.74
    41006TDrainage of mouth lesion025417.37$884.20$272.41$176.84
    41007TDrainage of mouth lesion025312.33$627.65$284.00$125.53
    41008TDrainage of mouth lesion025312.33$627.65$284.00$125.53
    41009TDrainage of mouth lesion02512.43$123.70$27.99$24.74
    41010TIncision of tongue fold025312.33$627.65$284.00$125.53
    41015TDrainage of mouth lesion02512.43$123.70$27.99$24.74
    41016TDrainage of mouth lesion02525.95$302.88$114.24$60.58
    41017TDrainage of mouth lesion02525.95$302.88$114.24$60.58
    41018TDrainage of mouth lesion02525.95$302.88$114.24$60.58
    41100TBiopsy of tongue02525.95$302.88$114.24$60.58
    41105TBiopsy of tongue025312.33$627.65$284.00$125.53
    41108TBiopsy of floor of mouth02525.95$302.88$114.24$60.58
    41110TExcision of tongue lesion025312.33$627.65$284.00$125.53
    41112TExcision of tongue lesion025312.33$627.65$284.00$125.53
    41113TExcision of tongue lesion025312.33$627.65$284.00$125.53
    41114TExcision of tongue lesion025417.37$884.20$272.41$176.84
    41115TExcision of tongue fold02525.95$302.88$114.24$60.58
    41116TExcision of mouth lesion025312.33$627.65$284.00$125.53
    41120TPartial removal of tongue025626.61$1,354.56$623.05$270.91
    41130CPartial removal of tongue
    41135CTongue and neck surgery
    41140CRemoval of tongue
    41145CTongue removal, neck surgery
    41150CTongue, mouth, jaw surgery
    41153CTongue, mouth, neck surgery
    41155CTongue, jaw, & neck surgery
    41250TRepair tongue laceration02512.43$123.70$27.99$24.74
    41251TRepair tongue laceration02525.95$302.88$114.24$60.58
    41252TRepair tongue laceration02525.95$302.88$114.24$60.58
    41500TFixation of tongue025417.37$884.20$272.41$176.84
    41510TTongue to lip surgery025312.33$627.65$284.00$125.53
    41520TReconstruction, tongue fold02525.95$302.88$114.24$60.58
    41599TTongue and mouth surgery02512.43$123.70$27.99$24.74
    41800TDrainage of gum lesion02512.43$123.70$27.99$24.74
    41805TRemoval foreign body, gum025417.37$884.20$272.41$176.84
    41806TRemoval foreign body, jawbone025312.33$627.65$284.00$125.53
    41820TExcision, gum, each quadrant02525.95$302.88$114.24$60.58
    41821TExcision of gum flap02525.95$302.88$114.24$60.58
    41822TExcision of gum lesion025312.33$627.65$284.00$125.53
    41823TExcision of gum lesion025417.37$884.20$272.41$176.84
    Start Printed Page 59976
    41825TExcision of gum lesion025312.33$627.65$284.00$125.53
    41826TExcision of gum lesion025312.33$627.65$284.00$125.53
    41827TExcision of gum lesion025417.37$884.20$272.41$176.84
    41828TExcision of gum lesion025312.33$627.65$284.00$125.53
    41830TRemoval of gum tissue025312.33$627.65$284.00$125.53
    41850TTreatment of gum lesion025312.33$627.65$284.00$125.53
    41870TGum graft025417.37$884.20$272.41$176.84
    41872TRepair gum025312.33$627.65$284.00$125.53
    41874TRepair tooth socket025417.37$884.20$272.41$176.84
    41899TDental surgery procedure025312.33$627.65$284.00$125.53
    42000TDrainage mouth roof lesion02512.43$123.70$27.99$24.74
    42100TBiopsy roof of mouth02525.95$302.88$114.24$60.58
    42104TExcision lesion, mouth roof025312.33$627.65$284.00$125.53
    42106TExcision lesion, mouth roof025312.33$627.65$284.00$125.53
    42107TExcision lesion, mouth roof025417.37$884.20$272.41$176.84
    42120TRemove palate/lesion025626.61$1,354.56$623.05$270.91
    42140TExcision of uvula02525.95$302.88$114.24$60.58
    42145TRepair palate, pharynx/uvula025417.37$884.20$272.41$176.84
    42160TTreatment mouth roof lesion025312.33$627.65$284.00$125.53
    42180TRepair palate02512.43$123.70$27.99$24.74
    42182TRepair palate025626.61$1,354.56$623.05$270.91
    42200TReconstruct cleft palate025626.61$1,354.56$623.05$270.91
    42205TReconstruct cleft palate025626.61$1,354.56$623.05$270.91
    42210TReconstruct cleft palate025626.61$1,354.56$623.05$270.91
    42215TReconstruct cleft palate025626.61$1,354.56$623.05$270.91
    42220TReconstruct cleft palate025626.61$1,354.56$623.05$270.91
    42225TReconstruct cleft palate025626.61$1,354.56$623.05$270.91
    42226TLengthening of palate025626.61$1,354.56$623.05$270.91
    42227TLengthening of palate025626.61$1,354.56$623.05$270.91
    42235TRepair palate025312.33$627.65$284.00$125.53
    42260TRepair nose to lip fistula025417.37$884.20$272.41$176.84
    42280TPreparation, palate mold02512.43$123.70$27.99$24.74
    42281TInsertion, palate prosthesis025312.33$627.65$284.00$125.53
    42299TPalate/uvula surgery02512.43$123.70$27.99$24.74
    42300TDrainage of salivary gland025312.33$627.65$284.00$125.53
    42305TDrainage of salivary gland025312.33$627.65$284.00$125.53
    42310TDrainage of salivary gland02512.43$123.70$27.99$24.74
    42320TDrainage of salivary gland02512.43$123.70$27.99$24.74
    42325TCreate salivary cyst drain02512.43$123.70$27.99$24.74
    42326TCreate salivary cyst drain02525.95$302.88$114.24$60.58
    42330TRemoval of salivary stone02525.95$302.88$114.24$60.58
    42335TRemoval of salivary stone025312.33$627.65$284.00$125.53
    42340TRemoval of salivary stone025312.33$627.65$284.00$125.53
    42400TBiopsy of salivary gland00042.47$125.73$32.57$25.15
    42405TBiopsy of salivary gland025312.33$627.65$284.00$125.53
    42408TExcision of salivary cyst025312.33$627.65$284.00$125.53
    42409TDrainage of salivary cyst025312.33$627.65$284.00$125.53
    42410TExcise parotid gland/lesion025626.61$1,354.56$623.05$270.91
    42415TExcise parotid gland/lesion025626.61$1,354.56$623.05$270.91
    42420TExcise parotid gland/lesion025626.61$1,354.56$623.05$270.91
    42425TExcise parotid gland/lesion025626.61$1,354.56$623.05$270.91
    42426CExcise parotid gland/lesion
    42440TExcise submaxillary gland025626.61$1,354.56$623.05$270.91
    42450TExcise sublingual gland025417.37$884.20$272.41$176.84
    42500TRepair salivary duct025417.37$884.20$272.41$176.84
    42505TRepair salivary duct025626.61$1,354.56$623.05$270.91
    42507TParotid duct diversion025626.61$1,354.56$623.05$270.91
    42508TParotid duct diversion025626.61$1,354.56$623.05$270.91
    42509TParotid duct diversion025626.61$1,354.56$623.05$270.91
    42510TParotid duct diversion025626.61$1,354.56$623.05$270.91
    42550NInjection for salivary x-ray
    42600TClosure of salivary fistula025312.33$627.65$284.00$125.53
    42650TDilation of salivary duct02525.95$302.88$114.24$60.58
    42660TDilation of salivary duct02525.95$302.88$114.24$60.58
    42665TLigation of salivary duct025417.37$884.20$272.41$176.84
    42699TSalivary surgery procedure025312.33$627.65$284.00$125.53
    42700TDrainage of tonsil abscess02512.43$123.70$27.99$24.74
    42720TDrainage of throat abscess025312.33$627.65$284.00$125.53
    42725TDrainage of throat abscess025626.61$1,354.56$623.05$270.91
    42800TBiopsy of throat02525.95$302.88$114.24$60.58
    42802TBiopsy of throat025312.33$627.65$284.00$125.53
    42804TBiopsy of upper nose/throat025312.33$627.65$284.00$125.53
    42806TBiopsy of upper nose/throat025417.37$884.20$272.41$176.84
    42808TExcise pharynx lesion025312.33$627.65$284.00$125.53
    42809XRemove pharynx foreign body03400.84$42.76$10.69$8.55
    Start Printed Page 59977
    42810TExcision of neck cyst025417.37$884.20$272.41$176.84
    42815TExcision of neck cyst025626.61$1,354.56$623.05$270.91
    42820TRemove tonsils and adenoids025817.43$887.26$434.76$177.45
    42821TRemove tonsils and adenoids025817.43$887.26$434.76$177.45
    42825TRemoval of tonsils025817.43$887.26$434.76$177.45
    42826TRemoval of tonsils025817.43$887.26$434.76$177.45
    42830TRemoval of adenoids025817.43$887.26$434.76$177.45
    42831TRemoval of adenoids025817.43$887.26$434.76$177.45
    42835TRemoval of adenoids025817.43$887.26$434.76$177.45
    42836TRemoval of adenoids025817.43$887.26$434.76$177.45
    42842CExtensive surgery of throat
    42844TExtensive surgery of throat025626.61$1,354.56$623.05$270.91
    42845CExtensive surgery of throat
    42860TExcision of tonsil tags025817.43$887.26$434.76$177.45
    42870TExcision of lingual tonsil025817.43$887.26$434.76$177.45
    42890TPartial removal of pharynx025626.61$1,354.56$623.05$270.91
    42892TRevision of pharyngeal walls025626.61$1,354.56$623.05$270.91
    42894CRevision of pharyngeal walls
    42900TRepair throat wound02525.95$302.88$114.24$60.58
    42950TReconstruction of throat025417.37$884.20$272.41$176.84
    42953CRepair throat, esophagus
    42955TSurgical opening of throat025417.37$884.20$272.41$176.84
    42960TControl throat bleeding02502.10$106.90$37.42$21.38
    42961CControl throat bleeding
    42962TControl throat bleeding025626.61$1,354.56$623.05$270.91
    42970TControl nose/throat bleeding02502.10$106.90$37.42$21.38
    42971CControl nose/throat bleeding
    42972TControl nose/throat bleeding025312.33$627.65$284.00$125.53
    42999TThroat surgery procedure02525.95$302.88$114.24$60.58
    43020TIncision of esophagus02525.95$302.88$114.24$60.58
    43030CThroat muscle surgery
    43045CIncision of esophagus
    43100CExcision of esophagus lesion
    43101CExcision of esophagus lesion
    43107CRemoval of esophagus
    43108CRemoval of esophagus
    43112CRemoval of esophagus
    43113CRemoval of esophagus
    43116CPartial removal of esophagus
    43117CPartial removal of esophagus
    43118CPartial removal of esophagus
    43121CPartial removal of esophagus
    43122CParital removal of esophagus
    43123CPartial removal of esophagus
    43124CRemoval of esophagus
    43130TRemoval of esophagus pouch025417.37$884.20$272.41$176.84
    43135CRemoval of esophagus pouch
    43200TEsophagus endoscopy01417.21$367.02$184.67$73.40
    43202TEsophagus endoscopy, biopsy01417.21$367.02$184.67$73.40
    43204TEsophagus endoscopy & inject01417.21$367.02$184.67$73.40
    43205TEsophagus endoscopy/ligation01417.21$367.02$184.67$73.40
    43215TEsophagus endoscopy01417.21$367.02$184.67$73.40
    43216TEsophagus endoscopy/lesion01417.21$367.02$184.67$73.40
    43217TEsophagus endoscopy01417.21$367.02$184.67$73.40
    43219TEsophagus endoscopy01417.21$367.02$184.67$73.40
    43220TEsoph endoscopy, dilation01417.21$367.02$184.67$73.40
    43226TEsoph endoscopy, dilation01417.21$367.02$184.67$73.40
    43227TEsoph endoscopy, repair01417.21$367.02$184.67$73.40
    43228TEsoph endoscopy, ablation01417.21$367.02$184.67$73.40
    43231TEsoph endoscopy w/us exam01417.21$367.02$184.67$73.40
    43232TEsoph endoscopy w/us fn bx01417.21$367.02$184.67$73.40
    43234TUpper GI endoscopy, exam01417.21$367.02$184.67$73.40
    43235TUppr gi endoscopy, diagnosis01417.21$367.02$184.67$73.40
    43239TUpper GI endoscopy, biopsy01417.21$367.02$184.67$73.40
    43240TEsoph endoscope w/drain cyst01417.21$367.02$184.67$73.40
    43241TUpper GI endoscopy with tube01417.21$367.02$184.67$73.40
    43242TUppr gi endoscopy w/us fn bx01417.21$367.02$184.67$73.40
    43243TUpper gi endoscopy & inject01417.21$367.02$184.67$73.40
    43244TUpper GI endoscopy/ligation01417.21$367.02$184.67$73.40
    43245TOperative upper GI endoscopy01417.21$367.02$184.67$73.40
    43246TPlace gastrostomy tube01417.21$367.02$184.67$73.40
    43247TOperative upper GI endoscopy01417.21$367.02$184.67$73.40
    43248TUppr gi endoscopy/guide wire01417.21$367.02$184.67$73.40
    43249TEsoph endoscopy, dilation01417.21$367.02$184.67$73.40
    43250TUpper GI endoscopy/tumor01417.21$367.02$184.67$73.40
    Start Printed Page 59978
    43251TOperative upper GI endoscopy01417.21$367.02$184.67$73.40
    43255TOperative upper GI endoscopy01417.21$367.02$184.67$73.40
    43256TUppr gi endoscopy w stent01417.21$367.02$184.67$73.40
    43258TOperative upper GI endoscopy01417.21$367.02$184.67$73.40
    43259TEndoscopic ultrasound exam01417.21$367.02$184.67$73.40
    43260TEndo cholangiopancreatograph015115.29$778.32$245.46$155.66
    43261TEndo cholangiopancreatograph015115.29$778.32$245.46$155.66
    43262TEndo cholangiopancreatograph015115.29$778.32$245.46$155.66
    43263TEndo cholangiopancreatograph015115.29$778.32$245.46$155.66
    43264TEndo cholangiopancreatograph015115.29$778.32$245.46$155.66
    43265TEndo cholangiopancreatograph015115.29$778.32$245.46$155.66
    43267TEndo cholangiopancreatograph015115.29$778.32$245.46$155.66
    43268TEndo cholangiopancreatograph015115.29$778.32$245.46$155.66
    43269TEndo cholangiopancreatograph015115.29$778.32$245.46$155.66
    43271TEndo cholangiopancreatograph015115.29$778.32$245.46$155.66
    43272TEndo cholangiopancreatograph015115.29$778.32$245.46$155.66
    43280TLaparoscopy, fundoplasty013256.06$2,853.68$1,239.22$570.74
    43289TLaparoscope proc, esoph013025.91$1,318.92$659.53$263.78
    43300CRepair of esophagus
    43305CRepair esophagus and fistula
    43310CRepair of esophagus
    43312CRepair esophagus and fistula
    *43313CEsophagoplasty congential
    *43314CTracheo-esophagoplasty cong
    43320CFuse esophagus & stomach
    43324CRevise esophagus & stomach
    43325CRevise esophagus & stomach
    43326CRevise esophagus & stomach
    43330CRepair of esophagus
    43331CRepair of esophagus
    43340CFuse esophagus & intestine
    43341CFuse esophagus & intestine
    43350CSurgical opening, esophagus
    43351CSurgical opening, esophagus
    43352CSurgical opening, esophagus
    43360CGastrointestinal repair
    43361CGastrointestinal repair
    43400CLigate esophagus veins
    43401CEsophagus surgery for veins
    43405CLigate/staple esophagus
    43410CRepair esophagus wound
    43415CRepair esophagus wound
    43420CRepair esophagus opening
    43425CRepair esophagus opening
    43450TDilate esophagus01405.65$287.61$107.24$57.52
    43453TDilate esophagus01405.65$287.61$107.24$57.52
    43456TDilate esophagus01405.65$287.61$107.24$57.52
    43458TDilate esophagus01405.65$287.61$107.24$57.52
    43460CPressure treatment esophagus
    43496CFree jejunum flap, microvasc
    43499TEsophagus surgery procedure01405.65$287.61$107.24$57.52
    43500CSurgical opening of stomach
    43501CSurgical repair of stomach
    43502CSurgical repair of stomach
    43510CSurgical opening of stomach
    43520CIncision of pyloric muscle
    43600TBiopsy of stomach01417.21$367.02$184.67$73.40
    43605CBiopsy of stomach
    43610CExcision of stomach lesion
    43611CExcision of stomach lesion
    43620CRemoval of stomach
    43621CRemoval of stomach
    43622CRemoval of stomach
    43631CRemoval of stomach, partial
    43632CRemoval of stomach, partial
    43633CRemoval of stomach, partial
    43634CRemoval of stomach, partial
    43635CRemoval of stomach, partial
    43638CRemoval of stomach, partial
    43639CRemoval of stomach, partial
    43640CVagotomy & pylorus repair
    43641CVagotomy & pylorus repair
    43651TLaparoscopy, vagus nerve013256.06$2,853.68$1,239.22$570.74
    43652TLaparoscopy, vagus nerve013256.06$2,853.68$1,239.22$570.74
    43653TLaparoscopy, gastrostomy013137.63$1,915.52$996.07$383.10
    Start Printed Page 59979
    43659TLaparoscope proc, stom013025.91$1,318.92$659.53$263.78
    43750TPlace gastrostomy tube01417.21$367.02$184.67$73.40
    43752ENasal/orogastric w/stent
    43760TChange gastrostomy tube01212.54$129.30$52.53$25.86
    43761TReposition gastrostomy tube01212.54$129.30$52.53$25.86
    43800CReconstruction of pylorus
    43810CFusion of stomach and bowel
    43820CFusion of stomach and bowel
    43825CFusion of stomach and bowel
    43830TPlace gastrostomy tube01417.21$367.02$184.67$73.40
    43831TPlace gastrostomy tube01417.21$367.02$184.67$73.40
    43832CPlace gastrostomy tube
    43840CRepair of stomach lesion
    43842CGastroplasty for obesity
    43843CGastroplasty for obesity
    43846CGastric bypass for obesity
    43847CGastric bypass for obesity
    43848CRevision gastroplasty
    43850CRevise stomach-bowel fusion
    43855CRevise stomach-bowel fusion
    43860CRevise stomach-bowel fusion
    43865CRevise stomach-bowel fusion
    43870TRepair stomach opening00253.39$172.56$65.57$34.51
    43880CRepair stomach-bowel fistula
    43999TStomach surgery procedure01212.54$129.30$52.53$25.86
    44005CFreeing of bowel adhesion
    44010CIncision of small bowel
    44015CInsert needle cath bowel
    44020CExploration of small bowel
    44021CDecompress small bowel
    44025CIncision of large bowel
    44050CReduce bowel obstruction
    44055CCorrect malrotation of bowel
    44100TBiopsy of bowel01417.21$367.02$184.67$73.40
    44110CExcision of bowel lesion(s)
    44111CExcision of bowel lesion(s)
    44120CRemoval of small intestine
    44121CRemoval of small intestine
    44125CRemoval of small intestine
    *44126CEnterectomy w/taper, cong
    *44127CEnterectomy w/o taper, cong
    *44128CEnterectomy cong, add-on
    44130CBowel to bowel fusion
    44132CEnterectomy, cadaver donor
    44133CEnterectomy, live donor
    44135CIntestine transplnt, cadaver
    44136CIntestine transplant, live
    44139CMobilization of colon
    44140CPartial removal of colon
    44141CPartial removal of colon
    44143CPartial removal of colon
    44144CPartial removal of colon
    44145CPartial removal of colon
    44146CPartial removal of colon
    44147CPartial removal of colon
    44150CRemoval of colon
    44151CRemoval of colon/ileostomy
    44152CRemoval of colon/ileostomy
    44153CRemoval of colon/ileostomy
    44155CRemoval of colon/ileostomy
    44156CRemoval of colon/ileostomy
    44160CRemoval of colon
    44200TLaparoscopy, enterolysis013137.63$1,915.52$996.07$383.10
    44201TLaparoscopy, jejunostomy013137.63$1,915.52$996.07$383.10
    44202CLaparo, resect intestine
    *44203CLap resect s/intestine, addl
    *44204CLaparo partial colectomy
    *44205CLap colectomy part w/ileum
    44209TLaparoscope proc, intestine013025.91$1,318.92$659.53$263.78
    44300COpen bowel to skin
    44310CIleostomy/jejunostomy
    44312TRevision of ileostomy002612.62$642.41$277.92$128.48
    44314CRevision of ileostomy
    44316CDevise bowel pouch
    44320CColostomy
    Start Printed Page 59980
    44322CColostomy with biopsies
    44340TRevision of colostomy002612.62$642.41$277.92$128.48
    44345CRevision of colostomy
    44346CRevision of colostomy
    44360TSmall bowel endoscopy01426.94$353.27$151.91$70.65
    44361TSmall bowel endoscopy/biopsy01426.94$353.27$151.91$70.65
    44363TSmall bowel endoscopy01426.94$353.27$151.91$70.65
    44364TSmall bowel endoscopy01426.94$353.27$151.91$70.65
    44365TSmall bowel endoscopy01426.94$353.27$151.91$70.65
    44366TSmall bowel endoscopy01426.94$353.27$151.91$70.65
    44369TSmall bowel endoscopy01426.94$353.27$151.91$70.65
    44370TSmall bowel endoscopy/stent01426.94$353.27$151.91$70.65
    44372TSmall bowel endoscopy01426.94$353.27$151.91$70.65
    44373TSmall bowel endoscopy01426.94$353.27$151.91$70.65
    44376TSmall bowel endoscopy01426.94$353.27$151.91$70.65
    44377TSmall bowel endoscopy/biopsy01426.94$353.27$151.91$70.65
    44378TSmall bowel endoscopy01426.94$353.27$151.91$70.65
    44379TS bowel endoscope w/stent01426.94$353.27$151.91$70.65
    44380TSmall bowel endoscopy01426.94$353.27$151.91$70.65
    44382TSmall bowel endoscopy01426.94$353.27$151.91$70.65
    44383TIleoscopy w/stent01426.94$353.27$151.91$70.65
    44385TEndoscopy of bowel pouch01437.27$370.07$185.04$74.01
    44386TEndoscopy, bowel pouch/biop01437.27$370.07$185.04$74.01
    44388TColon endoscopy01437.27$370.07$185.04$74.01
    44389TColonoscopy with biopsy01437.27$370.07$185.04$74.01
    44390TColonoscopy for foreign body01437.27$370.07$185.04$74.01
    44391TColonoscopy for bleeding01437.27$370.07$185.04$74.01
    44392TColonoscopy & polypectomy01437.27$370.07$185.04$74.01
    44393TColonoscopy, lesion removal01437.27$370.07$185.04$74.01
    44394TColonoscopy w/snare01437.27$370.07$185.04$74.01
    44397TColonoscopy w stent01437.27$370.07$185.04$74.01
    44500TIntro, gastrointestinal tube01212.54$129.30$52.53$25.86
    44602CSuture, small intestine
    44603CSuture, small intestine
    44604CSuture, large intestine
    44605CRepair of bowel lesion
    44615CIntestinal stricturoplasty
    44620CRepair bowel opening
    44625CRepair bowel opening
    44626CRepair bowel opening
    44640CRepair bowel-skin fistula
    44650CRepair bowel fistula
    44660CRepair bowel-bladder fistula
    44661CRepair bowel-bladder fistula
    44680CSurgical revision, intestine
    44700CSuspend bowel w/prosthesis
    44799TIntestine surgery procedure01426.94$353.27$151.91$70.65
    44800CExcision of bowel pouch
    44820CExcision of mesentery lesion
    44850CRepair of mesentery
    44899CBowel surgery procedure
    44900CDrain app abscess, open
    44901CDrain app abscess, percut
    44950CAppendectomy
    44955CAppendectomy add-on
    44960CAppendectomy
    44970TLaparoscopy, appendectomy013025.91$1,318.92$659.53$263.78
    44979TLaparoscope proc, app013025.91$1,318.92$659.53$263.78
    45000TDrainage of pelvic abscess014913.53$688.73$293.06$137.75
    45005TDrainage of rectal abscess01482.40$122.17$43.59$24.43
    45020TDrainage of rectal abscess014913.53$688.73$293.06$137.75
    45100TBiopsy of rectum014913.53$688.73$293.06$137.75
    45108TRemoval of anorectal lesion015018.08$920.34$437.12$184.07
    45110CRemoval of rectum
    45111CPartial removal of rectum
    45112CRemoval of rectum
    45113CPartial proctectomy
    45114CPartial removal of rectum
    45116CPartial removal of rectum
    45119CRemove rectum w/reservoir
    45120CRemoval of rectum
    45121CRemoval of rectum and colon
    45123CPartial proctectomy
    45126CPelvic exenteration
    45130CExcision of rectal prolapse
    Start Printed Page 59981
    45135CExcision of rectal prolapse
    *45136CExcise ileoanal reservoir
    45150TExcision of rectal stricture015018.08$920.34$437.12$184.07
    45160TExcision of rectal lesion015018.08$920.34$437.12$184.07
    45170TExcision of rectal lesion015018.08$920.34$437.12$184.07
    45190TDestruction, rectal tumor015018.08$920.34$437.12$184.07
    45300TProctosigmoidoscopy dx01462.73$138.97$63.93$27.79
    45303TProctosigmoidoscopy dilate01462.73$138.97$63.93$27.79
    45305TProtosigmoidoscopy w/bx01462.73$138.97$63.93$27.79
    45307TProtosigmoidoscopy fb01462.73$138.97$63.93$27.79
    45308TProtosigmoidoscopy removal01475.71$290.66$136.61$58.13
    45309TProtosigmoidoscopy removal01475.71$290.66$136.61$58.13
    45315TProtosigmoidoscopy removal01475.71$290.66$136.61$58.13
    45317TProtosigmoidoscopy bleed01462.73$138.97$63.93$27.79
    45320TProtosigmoidoscopy ablate01475.71$290.66$136.61$58.13
    45321TProtosigmoidoscopy volvul01475.71$290.66$136.61$58.13
    45327TProctosigmoidoscopy w/stent01475.71$290.66$136.61$58.13
    45330TDiagnostic sigmoidoscopy01462.73$138.97$63.93$27.79
    45331TSigmoidoscopy and biopsy01462.73$138.97$63.93$27.79
    45332TSigmoidoscopy w/fb removal01462.73$138.97$63.93$27.79
    45333TSigmoidoscopy & polypectomy01475.71$290.66$136.61$58.13
    45334TSigmoidoscopy for bleeding01475.71$290.66$136.61$58.13
    45337TSigmoidoscopy & decompress01475.71$290.66$136.61$58.13
    45338TSigmoidoscpy w/tumr remove01475.71$290.66$136.61$58.13
    45339TSigmoidoscopy w/ablate tumr01475.71$290.66$136.61$58.13
    45341TSigmoidoscopy w/ultrasound01475.71$290.66$136.61$58.13
    45342TSigmoidoscopy w/us guide bx01475.71$290.66$136.61$58.13
    45345TSigmodoscopy w/stent01475.71$290.66$136.61$58.13
    45355TSurgical colonoscopy01437.27$370.07$185.04$74.01
    45378TDiagnostic colonoscopy01437.27$370.07$185.04$74.01
    45379TColonoscopy w/fb removal01437.27$370.07$185.04$74.01
    45380TColonoscopy and biopsy01437.27$370.07$185.04$74.01
    45382TColonoscopy/control bleeding01437.27$370.07$185.04$74.01
    45383TLesion removal colonoscopy01437.27$370.07$185.04$74.01
    45384TLesion remove colonoscopy01437.27$370.07$185.04$74.01
    45385TLesion removal colonoscopy01437.27$370.07$185.04$74.01
    45387TColonoscopy w/stent01437.27$370.07$185.04$74.01
    45500TRepair of rectum015018.08$920.34$437.12$184.07
    45505TRepair of rectum015018.08$920.34$437.12$184.07
    45520TTreatment of rectal prolapse00981.24$63.12$20.88$12.62
    45540CCorrect rectal prolapse
    45541CCorrect rectal prolapse
    45550CRepair rectum/remove sigmoid
    45560TRepair of rectocele015018.08$920.34$437.12$184.07
    45562CExploration/repair of rectum
    45563CExploration/repair of rectum
    45800CRepair rect/bladder fistula
    45805CRepair fistula w/colostomy
    45820CRepair rectourethral fistula
    45825CRepair fistula w/colostomy
    45900TReduction of rectal prolapse01482.40$122.17$43.59$24.43
    45905TDilation of anal sphincter014913.53$688.73$293.06$137.75
    45910TDilation of rectal narrowing014913.53$688.73$293.06$137.75
    45915TRemove rectal obstruction01482.40$122.17$43.59$24.43
    45999TRectum surgery procedure01482.40$122.17$43.59$24.43
    *46020TPlacement of seton01482.40$122.17$43.59$24.43
    46030NRemoval of rectal marker
    46040TIncision of rectal abscess01555.26$267.76$53.55
    46045TIncision of rectal abscess015018.08$920.34$437.12$184.07
    46050TIncision of anal abscess01482.40$122.17$43.59$24.43
    46060TIncision of rectal abscess015018.08$920.34$437.12$184.07
    46070TIncision of anal septum01555.26$267.76$53.55
    46080TIncision of anal sphincter014913.53$688.73$293.06$137.75
    46083TIncise external hemorrhoid01482.40$122.17$43.59$24.43
    46200TRemoval of anal fissure015018.08$920.34$437.12$184.07
    46210TRemoval of anal crypt014913.53$688.73$293.06$137.75
    46211TRemoval of anal crypts015018.08$920.34$437.12$184.07
    46220TRemoval of anal tab014913.53$688.73$293.06$137.75
    46221TLigation of hemorrhoid(s)01555.26$267.76$53.55
    46230TRemoval of anal tabs014913.53$688.73$293.06$137.75
    46250THemorrhoidectomy015018.08$920.34$437.12$184.07
    46255THemorrhoidectomy015018.08$920.34$437.12$184.07
    46257TRemove hemorrhoids & fissure015018.08$920.34$437.12$184.07
    46258TRemove hemorrhoids & fistula015018.08$920.34$437.12$184.07
    46260THemorrhoidectomy015018.08$920.34$437.12$184.07
    Start Printed Page 59982
    46261TRemove hemorrhoids & fissure015018.08$920.34$437.12$184.07
    46262TRemove hemorrhoids & fistula015018.08$920.34$437.12$184.07
    46270TRemoval of anal fistula015018.08$920.34$437.12$184.07
    46275TRemoval of anal fistula015018.08$920.34$437.12$184.07
    46280TRemoval of anal fistula015018.08$920.34$437.12$184.07
    46285TRemoval of anal fistula015018.08$920.34$437.12$184.07
    46288TRepair anal fistula015018.08$920.34$437.12$184.07
    46320TRemoval of hemorrhoid clot01555.26$267.76$53.55
    46500TInjection into hemorrhoids01555.26$267.76$53.55
    46600NDiagnostic anoscopy
    46604TAnoscopy and dilation01444.43$225.50$49.32$45.10
    46606TAnoscopy and biopsy014510.81$550.27$179.39$110.05
    46608TAnoscopy/ remove for body01444.43$225.50$49.32$45.10
    46610TAnoscopy/remove lesion014510.81$550.27$179.39$110.05
    46611TAnoscopy014510.81$550.27$179.39$110.05
    46612TAnoscopy/ remove lesions014510.81$550.27$179.39$110.05
    46614TAnoscopy/control bleeding014510.81$550.27$179.39$110.05
    46615TAnoscopy014510.81$550.27$179.39$110.05
    46700TRepair of anal stricture015018.08$920.34$437.12$184.07
    46705CRepair of anal stricture
    46715CRepair of anovaginal fistula
    46716CRepair of anovaginal fistula
    46730CConstruction of absent anus
    46735CConstruction of absent anus
    46740CConstruction of absent anus
    46742CRepair of imperforated anus
    46744CRepair of cloacal anomaly
    46746CRepair of cloacal anomaly
    46748CRepair of cloacal anomaly
    46750TRepair of anal sphincter015018.08$920.34$437.12$184.07
    46751CRepair of anal sphincter
    46753TReconstruction of anus015018.08$920.34$437.12$184.07
    46754TRemoval of suture from anus014913.53$688.73$293.06$137.75
    46760TRepair of anal sphincter015018.08$920.34$437.12$184.07
    46761TRepair of anal sphincter015018.08$920.34$437.12$184.07
    46762TImplant artificial sphincter015018.08$920.34$437.12$184.07
    46900TDestruction, anal lesion(s)00163.02$153.73$64.57$30.75
    46910TDestruction, anal lesion(s)00179.68$492.75$226.67$98.55
    46916TCryosurgery, anal lesion(s)00131.36$69.23$17.66$13.85
    46917TLaser surgery, anal lesions069515.78$803.27$369.50$160.65
    46922TExcision of anal lesion(s)069515.78$803.27$369.50$160.65
    46924TDestruction, anal lesion(s)069515.78$803.27$369.50$160.65
    46934TDestruction of hemorrhoids01555.26$267.76$53.55
    46935TDestruction of hemorrhoids01555.26$267.76$53.55
    46936TDestruction of hemorrhoids014913.53$688.73$293.06$137.75
    46937TCryotherapy of rectal lesion014913.53$688.73$293.06$137.75
    46938TCryotherapy of rectal lesion015018.08$920.34$437.12$184.07
    46940TTreatment of anal fissure014913.53$688.73$293.06$137.75
    46942TTreatment of anal fissure014913.53$688.73$293.06$137.75
    46945TLigation of hemorrhoids01555.26$267.76$53.55
    46946TLigation of hemorrhoids01555.26$267.76$53.55
    46999TAnus surgery procedure014913.53$688.73$293.06$137.75
    47000TNeedle biopsy of liver06859.16$466.28$205.16$93.26
    47001CNeedle biopsy, liver add-on
    47010COpen drainage, liver lesion
    47011TPercut drain, liver lesion00054.03$205.14$90.26$41.03
    47015CInject/aspirate liver cyst
    47100CWedge biopsy of liver
    47120CPartial removal of liver
    47122CExtensive removal of liver
    47125CPartial removal of liver
    47130CPartial removal of liver
    47133CRemoval of donor liver
    47134CPartial removal, donor liver
    47135CTransplantation of liver
    47136CTransplantation of liver
    47300CSurgery for liver lesion
    47350CRepair liver wound
    47360CRepair liver wound
    47361CRepair liver wound
    47362CRepair liver wound
    *47370TLaparo ablate liver tumor rf013025.91$1,318.92$659.53$263.78
    *47371TLaparo ablate liver cryosug013025.91$1,318.92$659.53$263.78
    47379TLaparoscope procedure, liver013025.91$1,318.92$659.53$263.78
    *47380COpen ablate liver tumor rf
    Start Printed Page 59983
    *47381COpen ablate liver tumor cryo
    *47382TPercut ablate liver rf015216.13$821.08$207.38$164.22
    47399TLiver surgery procedure00054.03$205.14$90.26$41.03
    47400CIncision of liver duct
    47420CIncision of bile duct
    47425CIncision of bile duct
    47460CIncise bile duct sphincter
    47480CIncision of gallbladder
    47490CIncision of gallbladder
    47500NInjection for liver x-rays
    47505NInjection for liver x-rays
    47510TInsert catheter, bile duct015216.13$821.08$207.38$164.22
    47511TInsert bile duct drain015216.13$821.08$207.38$164.22
    47525TChange bile duct catheter01229.89$503.44$114.93$100.69
    47530TRevise/reinsert bile tube01212.54$129.30$52.53$25.86
    47550CBile duct endoscopy add-on
    47552TBiliary endoscopy thru skin015216.13$821.08$207.38$164.22
    47553TBiliary endoscopy thru skin015216.13$821.08$207.38$164.22
    47554TBiliary endoscopy thru skin015216.13$821.08$207.38$164.22
    47555TBiliary endoscopy thru skin015216.13$821.08$207.38$164.22
    47556TBiliary endoscopy thru skin015216.13$821.08$207.38$164.22
    47560TLaparoscopy w/cholangio013025.91$1,318.92$659.53$263.78
    47561TLaparo w/cholangio/biopsy013025.91$1,318.92$659.53$263.78
    47562TLaparoscopic cholecystectomy013137.63$1,915.52$996.07$383.10
    47563TLaparo cholecystectomy/graph013137.63$1,915.52$996.07$383.10
    47564TLaparo cholecystectomy/explr013137.63$1,915.52$996.07$383.10
    47570CLaparo cholecystoenterostomy
    47579TLaparoscope proc, biliary013025.91$1,318.92$659.53$263.78
    47600CRemoval of gallbladder
    47605CRemoval of gallbladder
    47610CRemoval of gallbladder
    47612CRemoval of gallbladder
    47620CRemoval of gallbladder
    47630TRemove bile duct stone015216.13$821.08$207.38$164.22
    47700CExploration of bile ducts
    47701CBile duct revision
    47711CExcision of bile duct tumor
    47712CExcision of bile duct tumor
    47715CExcision of bile duct cyst
    47716CFusion of bile duct cyst
    47720CFuse gallbladder & bowel
    47721CFuse upper gi structures
    47740CFuse gallbladder & bowel
    47741CFuse gallbladder & bowel
    47760CFuse bile ducts and bowel
    47765CFuse liver ducts & bowel
    47780CFuse bile ducts and bowel
    47785CFuse bile ducts and bowel
    47800CReconstruction of bile ducts
    47801CPlacement, bile duct support
    47802CFuse liver duct & intestine
    47900CSuture bile duct injury
    47999TBile tract surgery procedure01212.54$129.30$52.53$25.86
    48000CDrainage of abdomen
    48001CPlacement of drain, pancreas
    48005CResect/debride pancreas
    48020CRemoval of pancreatic stone
    48100CBiopsy of pancreas
    48102TNeedle biopsy, pancreas06859.16$466.28$205.16$93.26
    48120CRemoval of pancreas lesion
    48140CPartial removal of pancreas
    48145CPartial removal of pancreas
    48146CPancreatectomy
    48148CRemoval of pancreatic duct
    48150CPartial removal of pancreas
    48152CPancreatectomy
    48153CPancreatectomy
    48154CPancreatectomy
    48155CRemoval of pancreas
    48160EPancreas removal/transplant
    48180CFuse pancreas and bowel
    48400CInjection, intraop add-on
    48500CSurgery of pancreas cyst
    48510CDrain pancreatic pseudocyst
    48511SDrain pancreatic pseudocyst00054.03$205.14$90.26$41.03
    Start Printed Page 59984
    48520CFuse pancreas cyst and bowel
    48540CFuse pancreas cyst and bowel
    48545CPancreatorrhaphy
    48547CDuodenal exclusion
    48550EDonor pancreatectomy
    48554ETranspl allograft pancreas
    48556CRemoval, allograft pancreas
    48999TPancreas surgery procedure00054.03$205.14$90.26$41.03
    49000CExploration of abdomen
    49002CReopening of abdomen
    49010CExploration behind abdomen
    49020CDrain abdominal abscess
    49021CDrain abdominal abscess
    49040CDrain, open, abdom abscess
    49041CDrain, percut, abdom abscess
    49060CDrain, open, retrop abscess
    49061CDrain, percut, retroper absc
    49062CDrain to peritoneal cavity
    49080TPuncture, peritoneal cavity00704.58$233.14$79.60$46.63
    49081TRemoval of abdominal fluid00704.58$233.14$79.60$46.63
    49085TRemove abdomen foreign body015323.55$1,198.79$496.31$239.76
    49180TBiopsy, abdominal mass06859.16$466.28$205.16$93.26
    49200TRemoval of abdominal lesion013025.91$1,318.92$659.53$263.78
    49201CRemoval of abdominal lesion
    49215CExcise sacral spine tumor
    49220CMultiple surgery, abdomen
    49250TExcision of umbilicus015323.55$1,198.79$496.31$239.76
    49255CRemoval of omentum
    49320TDiag laparo separate proc013025.91$1,318.92$659.53$263.78
    49321TLaparoscopy, biopsy013025.91$1,318.92$659.53$263.78
    49322TLaparoscopy, aspiration013025.91$1,318.92$659.53$263.78
    49323TLaparo drain lymphocele013025.91$1,318.92$659.53$263.78
    49329TLaparo proc, abdm/per/oment013025.91$1,318.92$659.53$263.78
    49400NAir injection into abdomen
    49420TInsert abdominal drain015323.55$1,198.79$496.31$239.76
    49421TInsert abdominal drain015323.55$1,198.79$496.31$239.76
    49422TRemove perm cannula/catheter010514.76$751.34$368.16$150.27
    49423TExchange drainage catheter015323.55$1,198.79$496.31$239.76
    49424NAssess cyst, contrast inject
    49425CInsert abdomen-venous drain
    49426TRevise abdomen-venous shunt015323.55$1,198.79$496.31$239.76
    49427NInjection, abdominal shunt
    49428CLigation of shunt
    49429TRemoval of shunt010514.76$751.34$368.16$150.27
    *49491TRepairing hern premie reduc015431.40$1,598.39$556.98$319.68
    *49492TRpr ing hern premie, blocked015431.40$1,598.39$556.98$319.68
    49495TRepair inguinal hernia, init015431.40$1,598.39$556.98$319.68
    49496TRepair inguinal hernia, init015431.40$1,598.39$556.98$319.68
    49500TRepair inguinal hernia015431.40$1,598.39$556.98$319.68
    49501TRepair inguinal hernia, init015431.40$1,598.39$556.98$319.68
    49505TRepair inguinal hernia015431.40$1,598.39$556.98$319.68
    49507TRepair inguinal hernia015431.40$1,598.39$556.98$319.68
    49520TRerepair inguinal hernia015431.40$1,598.39$556.98$319.68
    49521TRepair inguinal hernia, rec015431.40$1,598.39$556.98$319.68
    49525TRepair inguinal hernia015431.40$1,598.39$556.98$319.68
    49540TRepair lumbar hernia015431.40$1,598.39$556.98$319.68
    49550TRepair femoral hernia015431.40$1,598.39$556.98$319.68
    49553TRepair femoral hernia, init015431.40$1,598.39$556.98$319.68
    49555TRepair femoral hernia015431.40$1,598.39$556.98$319.68
    49557TRepair femoral hernia, recur015431.40$1,598.39$556.98$319.68
    49560TRepair abdominal hernia015431.40$1,598.39$556.98$319.68
    49561TRepair incisional hernia015431.40$1,598.39$556.98$319.68
    49565TRerepair abdominal hernia015431.40$1,598.39$556.98$319.68
    49566TRepair incisional hernia015431.40$1,598.39$556.98$319.68
    49568THernia repair w/mesh015431.40$1,598.39$556.98$319.68
    49570TRepair epigastric hernia015431.40$1,598.39$556.98$319.68
    49572TRepair epigastric hernia015431.40$1,598.39$556.98$319.68
    49580TRepair umbilical hernia015431.40$1,598.39$556.98$319.68
    49582TRepair umbilical hernia015431.40$1,598.39$556.98$319.68
    49585TRepair umbilical hernia015431.40$1,598.39$556.98$319.68
    49587TRepair umbilical hernia015431.40$1,598.39$556.98$319.68
    49590TRepair abdominal hernia015431.40$1,598.39$556.98$319.68
    49600TRepair umbilical lesion015431.40$1,598.39$556.98$319.68
    49605CRepair umbilical lesion
    49606CRepair umbilical lesion
    Start Printed Page 59985
    49610CRepair umbilical lesion
    49611CRepair umbilical lesion
    49650TLaparo hernia repair initial013137.63$1,915.52$996.07$383.10
    49651TLaparo hernia repair recur013137.63$1,915.52$996.07$383.10
    49659TLaparo proc, hernia repair013137.63$1,915.52$996.07$383.10
    49900CRepair of abdominal wall
    49905COmental flap
    49906CFree omental flap, microvasc
    49999TAbdomen surgery procedure01212.54$129.30$52.53$25.86
    50010CExploration of kidney
    50020CRenal abscess, open drain
    50021SRenal abscess, percut drain00054.03$205.14$90.26$41.03
    50040CDrainage of kidney
    50045CExploration of kidney
    50060CRemoval of kidney stone
    50065CIncision of kidney
    50070CIncision of kidney
    50075CRemoval of kidney stone
    50080TRemoval of kidney stone016340.40$2,056.52$792.58$411.30
    50081TRemoval of kidney stone016340.40$2,056.52$792.58$411.30
    50100CRevise kidney blood vessels
    50120CExploration of kidney
    50125CExplore and drain kidney
    50130CRemoval of kidney stone
    50135CExploration of kidney
    50200TBiopsy of kidney06859.16$466.28$205.16$93.26
    50205CBiopsy of kidney
    50220CRemoval of kidney
    50225CRemoval of kidney
    50230CRemoval of kidney
    50234CRemoval of kidney & ureter
    50236CRemoval of kidney & ureter
    50240CPartial removal of kidney
    50280CRemoval of kidney lesion
    50290CRemoval of kidney lesion
    50300CRemoval of donor kidney
    50320CRemoval of donor kidney
    50340CRemoval of kidney
    50360CTransplantation of kidney
    50365CTransplantation of kidney
    50370CRemove transplanted kidney
    50380CReimplantation of kidney
    50390TDrainage of kidney lesion06859.16$466.28$205.16$93.26
    50392TInsert kidney drain016113.72$698.40$249.36$139.68
    50393TInsert ureteral tube016113.72$698.40$249.36$139.68
    50394NInjection for kidney x-ray
    50395TCreate passage to kidney016113.72$698.40$249.36$139.68
    50396TMeasure kidney pressure01641.01$51.41$15.42$10.28
    50398TChange kidney tube01229.89$503.44$114.93$100.69
    50400CRevision of kidney/ureter
    50405CRevision of kidney/ureter
    50500CRepair of kidney wound
    50520CClose kidney-skin fistula
    50525CRepair renal-abdomen fistula
    50526CRepair renal-abdomen fistula
    50540CRevision of horseshoe kidney
    50541TLaparo ablate renal cyst013025.91$1,318.92$659.53$263.78
    50544TLaparoscopy, pyeloplasty013025.91$1,318.92$659.53$263.78
    50545CLaparo radical nephrectomy
    50546CLaparoscopic nephrectomy
    50547CLaparo removal donor kidney
    50548CLaparo remove k/ureter
    50549TLaparoscope proc, renal013025.91$1,318.92$659.53$263.78
    50551TKidney endoscopy01605.13$261.14$104.46$52.23
    50553TKidney endoscopy016113.72$698.40$249.36$139.68
    50555TKidney endoscopy & biopsy01605.13$261.14$104.46$52.23
    50557TKidney endoscopy & treatment016225.09$1,277.18$427.49$255.44
    50559TRenal endoscopy/radiotracer01605.13$261.14$104.46$52.23
    50561TKidney endoscopy & treatment016113.72$698.40$249.36$139.68
    50570CKidney endoscopy
    50572CKidney endoscopy
    50574CKidney endoscopy & biopsy
    50575CKidney endoscopy
    50576CKidney endoscopy & treatment
    50578CRenal endoscopy/radiotracer
    Start Printed Page 59986
    50580CKidney endoscopy & treatment
    50590TFragmenting of kidney stone016939.62$2,016.82$1,109.25$403.36
    50600CExploration of ureter
    50605CInsert ureteral support
    50610CRemoval of ureter stone
    50620CRemoval of ureter stone
    50630CRemoval of ureter stone
    50650CRemoval of ureter
    50660CRemoval of ureter
    50684NInjection for ureter x-ray
    50686TMeasure ureter pressure01641.01$51.41$15.42$10.28
    50688TChange of ureter tube01212.54$129.30$52.53$25.86
    50690NInjection for ureter x-ray
    50700CRevision of ureter
    50715CRelease of ureter
    50722CRelease of ureter
    50725CRelease/revise ureter
    50727CRevise ureter
    50728CRevise ureter
    50740CFusion of ureter & kidney
    50750CFusion of ureter & kidney
    50760CFusion of ureters
    50770CSplicing of ureters
    50780CReimplant ureter in bladder
    50782CReimplant ureter in bladder
    50783CReimplant ureter in bladder
    50785CReimplant ureter in bladder
    50800CImplant ureter in bowel
    50810CFusion of ureter & bowel
    50815CUrine shunt to bowel
    50820CConstruct bowel bladder
    50825CConstruct bowel bladder
    50830CRevise urine flow
    50840CReplace ureter by bowel
    50845CAppendico-vesicostomy
    50860CTransplant ureter to skin
    50900CRepair of ureter
    50920CClosure ureter/skin fistula
    50930CClosure ureter/bowel fistula
    50940CRelease of ureter
    50945TLaparoscopy ureterolithotomy013137.63$1,915.52$996.07$383.10
    50947TLaparo new ureter/bladder013137.63$1,915.52$996.07$383.10
    50948TLaparo new ureter/bladder013137.63$1,915.52$996.07$383.10
    50949TLaparoscope proc, ureter013025.91$1,318.92$659.53$263.78
    50951TEndoscopy of ureter01605.13$261.14$104.46$52.23
    50953TEndoscopy of ureter01605.13$261.14$104.46$52.23
    50955TUreter endoscopy & biopsy016113.72$698.40$249.36$139.68
    50957TUreter endoscopy & treatment016113.72$698.40$249.36$139.68
    50959TUreter endoscopy & tracer016113.72$698.40$249.36$139.68
    50961TUreter endoscopy & treatment016113.72$698.40$249.36$139.68
    50970TUreter endoscopy01605.13$261.14$104.46$52.23
    50972TUreter endoscopy & catheter01605.13$261.14$104.46$52.23
    50974TUreter endoscopy & biopsy016113.72$698.40$249.36$139.68
    50976TUreter endoscopy & treatment016113.72$698.40$249.36$139.68
    50978TUreter endoscopy & tracer016113.72$698.40$249.36$139.68
    50980TUreter endoscopy & treatment016113.72$698.40$249.36$139.68
    51000TDrainage of bladder01655.22$265.72$91.76$53.14
    51005TDrainage of bladder01562.45$124.71$37.41$24.94
    51010TDrainage of bladder01655.22$265.72$91.76$53.14
    51020TIncise & treat bladder016225.09$1,277.18$427.49$255.44
    51030TIncise & treat bladder016225.09$1,277.18$427.49$255.44
    51040TIncise & drain bladder016225.09$1,277.18$427.49$255.44
    51045TIncise bladder/drain ureter01605.13$261.14$104.46$52.23
    51050TRemoval of bladder stone016225.09$1,277.18$427.49$255.44
    51060CRemoval of ureter stone
    51065TRemoval of ureter stone016225.09$1,277.18$427.49$255.44
    51080TDrainage of bladder abscess00076.75$343.60$72.03$68.72
    51500TRemoval of bladder cyst015431.40$1,598.39$556.98$319.68
    51520TRemoval of bladder lesion016225.09$1,277.18$427.49$255.44
    51525CRemoval of bladder lesion
    51530CRemoval of bladder lesion
    51535CRepair of ureter lesion
    51550CPartial removal of bladder
    51555CPartial removal of bladder
    51565CRevise bladder & ureter(s)
    Start Printed Page 59987
    51570CRemoval of bladder
    51575CRemoval of bladder & nodes
    51580CRemove bladder/revise tract
    51585CRemoval of bladder & nodes
    51590CRemove bladder/revise tract
    51595CRemove bladder/revise tract
    51596CRemove bladder/create pouch
    51597CRemoval of pelvic structures
    51600NInjection for bladder x-ray
    51605NPreparation for bladder xray
    51610NInjection for bladder x-ray
    51700TIrrigation of bladder01562.45$124.71$37.41$24.94
    51705TChange of bladder tube01212.54$129.30$52.53$25.86
    51710TChange of bladder tube01212.54$129.30$52.53$25.86
    51715TEndoscopic injection/implant016722.28$1,134.14$555.84$226.83
    51720TTreatment of bladder lesion01562.45$124.71$37.41$24.94
    51725TSimple cystometrogram01655.22$265.72$91.76$53.14
    51726TComplex cystometrogram01655.22$265.72$91.76$53.14
    51736TUrine flow measurement01641.01$51.41$15.42$10.28
    51741TElectro-uroflowmetry, first01641.01$51.41$15.42$10.28
    51772TUrethra pressure profile01655.22$265.72$91.76$53.14
    51784TAnal/urinary muscle study01641.01$51.41$15.42$10.28
    51785TAnal/urinary muscle study01562.45$124.71$37.41$24.94
    51792TUrinary reflex study01562.45$124.71$37.41$24.94
    51795TUrine voiding pressure study01655.22$265.72$91.76$53.14
    51797TIntraabdominal pressure test01655.22$265.72$91.76$53.14
    51800CRevision of bladder/urethra
    51820CRevision of urinary tract
    51840CAttach bladder/urethra
    51841CAttach bladder/urethra
    51845CRepair bladder neck
    51860CRepair of bladder wound
    51865CRepair of bladder wound
    51880TRepair of bladder opening016225.09$1,277.18$427.49$255.44
    51900CRepair bladder/vagina lesion
    51920CClose bladder-uterus fistula
    51925CHysterectomy/bladder repair
    51940CCorrection of bladder defect
    51960CRevision of bladder & bowel
    51980CConstruct bladder opening
    51990TLaparo urethral suspension013137.63$1,915.52$996.07$383.10
    51992TLaparo sling operation013256.06$2,853.68$1,239.22$570.74
    52000TCystoscopy01605.13$261.14$104.46$52.23
    *52001TCystoscopy, removal of clots01605.13$261.14$104.46$52.23
    52005TCystoscopy & ureter catheter016113.72$698.40$249.36$139.68
    52007TCystoscopy and biopsy016113.72$698.40$249.36$139.68
    52010TCystoscopy & duct catheter01605.13$261.14$104.46$52.23
    52204TCystoscopy016113.72$698.40$249.36$139.68
    52214TCystoscopy and treatment016225.09$1,277.18$427.49$255.44
    52224TCystoscopy and treatment016225.09$1,277.18$427.49$255.44
    52234TCystoscopy and treatment016340.40$2,056.52$792.58$411.30
    52235TCystoscopy and treatment016340.40$2,056.52$792.58$411.30
    52240TCystoscopy and treatment016225.09$1,277.18$427.49$255.44
    52250TCystoscopy and radiotracer016225.09$1,277.18$427.49$255.44
    52260TCystoscopy and treatment016113.72$698.40$249.36$139.68
    52265TCystoscopy and treatment01605.13$261.14$104.46$52.23
    52270TCystoscopy & revise urethra016113.72$698.40$249.36$139.68
    52275TCystoscopy & revise urethra016113.72$698.40$249.36$139.68
    52276TCystoscopy and treatment016113.72$698.40$249.36$139.68
    52277TCystoscopy and treatment016225.09$1,277.18$427.49$255.44
    52281TCystoscopy and treatment016113.72$698.40$249.36$139.68
    52282TCystoscopy, implant stent016340.40$2,056.52$792.58$411.30
    52283TCystoscopy and treatment016113.72$698.40$249.36$139.68
    52285TCystoscopy and treatment016113.72$698.40$249.36$139.68
    52290TCystoscopy and treatment016113.72$698.40$249.36$139.68
    52300TCystoscopy and treatment016113.72$698.40$249.36$139.68
    52301TCystoscopy and treatment016113.72$698.40$249.36$139.68
    52305TCystoscopy and treatment016113.72$698.40$249.36$139.68
    52310TCystoscopy and treatment01605.13$261.14$104.46$52.23
    52315TCystoscopy and treatment016113.72$698.40$249.36$139.68
    52317TRemove bladder stone016225.09$1,277.18$427.49$255.44
    52318TRemove bladder stone016225.09$1,277.18$427.49$255.44
    52320TCystoscopy and treatment016225.09$1,277.18$427.49$255.44
    52325TCystoscopy, stone removal016225.09$1,277.18$427.49$255.44
    52327TCystoscopy, inject material016225.09$1,277.18$427.49$255.44
    Start Printed Page 59988
    52330TCystoscopy and treatment016225.09$1,277.18$427.49$255.44
    52332TCystoscopy and treatment016225.09$1,277.18$427.49$255.44
    52334TCreate passage to kidney016225.09$1,277.18$427.49$255.44
    52341TCysto w/ureter stricture tx016225.09$1,277.18$427.49$255.44
    52342TCysto w/up stricture tx016225.09$1,277.18$427.49$255.44
    52343TCysto w/renal stricture tx016225.09$1,277.18$427.49$255.44
    52344TCysto/uretero, stone remove016225.09$1,277.18$427.49$255.44
    52345TCysto/uretero w/up stricture016225.09$1,277.18$427.49$255.44
    52346TCystouretero w/renal strict016225.09$1,277.18$427.49$255.44
    *52347TCystoscopy, resect ducts01605.13$261.14$104.46$52.23
    52351TCystouretro & or pyeloscope01605.13$261.14$104.46$52.23
    52352TCystouretro w/stone remove016225.09$1,277.18$427.49$255.44
    52353TCystouretero w/lithotripsy016340.40$2,056.52$792.58$411.30
    52354TCystouretero w/biopsy016225.09$1,277.18$427.49$255.44
    52355TCystouretero w/excise tumor016225.09$1,277.18$427.49$255.44
    52400TCystouretero w/congen repr016225.09$1,277.18$427.49$255.44
    52450TIncision of prostate016225.09$1,277.18$427.49$255.44
    52500TRevision of bladder neck016225.09$1,277.18$427.49$255.44
    52510TDilation prostatic urethra016113.72$698.40$249.36$139.68
    52601TProstatectomy (TURP)016340.40$2,056.52$792.58$411.30
    52606TControl postop bleeding016225.09$1,277.18$427.49$255.44
    52612TProstatectomy, first stage016340.40$2,056.52$792.58$411.30
    52614TProstatectomy, second stage016340.40$2,056.52$792.58$411.30
    52620TRemove residual prostate016340.40$2,056.52$792.58$411.30
    52630TRemove prostate regrowth016340.40$2,056.52$792.58$411.30
    52640TRelieve bladder contracture016225.09$1,277.18$427.49$255.44
    52647TLaser surgery of prostate016340.40$2,056.52$792.58$411.30
    52648TLaser surgery of prostate016340.40$2,056.52$792.58$411.30
    52700TDrainage of prostate abscess016225.09$1,277.18$427.49$255.44
    53000TIncision of urethra016612.20$621.03$218.73$124.21
    53010TIncision of urethra016612.20$621.03$218.73$124.21
    53020TIncision of urethra016612.20$621.03$218.73$124.21
    53025TIncision of urethra016612.20$621.03$218.73$124.21
    53040TDrainage of urethra abscess016612.20$621.03$218.73$124.21
    53060TDrainage of urethra abscess016612.20$621.03$218.73$124.21
    53080TDrainage of urinary leakage016612.20$621.03$218.73$124.21
    53085CDrainage of urinary leakage
    53200TBiopsy of urethra016612.20$621.03$218.73$124.21
    53210TRemoval of urethra016818.42$937.65$403.19$187.53
    53215TRemoval of urethra016818.42$937.65$403.19$187.53
    53220TTreatment of urethra lesion016818.42$937.65$403.19$187.53
    53230TRemoval of urethra lesion016818.42$937.65$403.19$187.53
    53235TRemoval of urethra lesion016818.42$937.65$403.19$187.53
    53240TSurgery for urethra pouch016818.42$937.65$403.19$187.53
    53250TRemoval of urethra gland016612.20$621.03$218.73$124.21
    53260TTreatment of urethra lesion016612.20$621.03$218.73$124.21
    53265TTreatment of urethra lesion016612.20$621.03$218.73$124.21
    53270TRemoval of urethra gland016722.28$1,134.14$555.84$226.83
    53275TRepair of urethra defect016612.20$621.03$218.73$124.21
    53400TRevise urethra, stage 1016818.42$937.65$403.19$187.53
    53405TRevise urethra, stage 2016818.42$937.65$403.19$187.53
    53410TReconstruction of urethra016818.42$937.65$403.19$187.53
    53415CReconstruction of urethra
    53420TReconstruct urethra, stage 1016818.42$937.65$403.19$187.53
    53425TReconstruct urethra, stage 2016818.42$937.65$403.19$187.53
    53430TReconstruction of urethra016818.42$937.65$403.19$187.53
    *53431TReconstruct urethra/bladder016818.42$937.65$403.19$187.53
    53440TCorrect bladder function0179139.33$7,092.45$2,340.51$1,418.49
    53442TRemove perineal prosthesis016612.20$621.03$218.73$124.21
    53443DReconstruction of urethra
    *53444TInsert tandem cuff0179139.33$7,092.45$2,340.51$1,418.49
    53445TCorrect urine flow control0179139.33$7,092.45$2,340.51$1,418.49
    *53446TRemove uro sphincter016818.42$937.65$403.19$187.53
    53447TRemove artificial sphincter0179139.33$7,092.45$2,340.51$1,418.49
    *53448CRemov/replc ur sphinctr comp
    53449TCorrect artificial sphincter016818.42$937.65$403.19$187.53
    53450TRevision of urethra016818.42$937.65$403.19$187.53
    53460TRevision of urethra016818.42$937.65$403.19$187.53
    53502TRepair of urethra injury016612.20$621.03$218.73$124.21
    53505TRepair of urethra injury016722.28$1,134.14$555.84$226.83
    53510TRepair of urethra injury016612.20$621.03$218.73$124.21
    53515TRepair of urethra injury016818.42$937.65$403.19$187.53
    53520TRepair of urethra defect016818.42$937.65$403.19$187.53
    53600TDilate urethra stricture01562.45$124.71$37.41$24.94
    53601TDilate urethra stricture01641.01$51.41$15.42$10.28
    Start Printed Page 59989
    53605TDilate urethra stricture016113.72$698.40$249.36$139.68
    53620TDilate urethra stricture01655.22$265.72$91.76$53.14
    53621TDilate urethra stricture01641.01$51.41$15.42$10.28
    53660TDilation of urethra01641.01$51.41$15.42$10.28
    53661TDilation of urethra01641.01$51.41$15.42$10.28
    53665TDilation of urethra016612.20$621.03$218.73$124.21
    53670NInsert urinary catheter
    53675TInsert urinary catheter01562.45$124.71$37.41$24.94
    53850TProstatic microwave thermotx0982$2,750.00$550.00
    53852TProstatic rf thermotx0982$2,750.00$550.00
    *53853TProstatic water thermother0977$1,125.00$225.00
    53899TUrology surgery procedure01655.22$265.72$91.76$53.14
    54000TSlitting of prepuce016612.20$621.03$218.73$124.21
    54001TSlitting of prepuce016612.20$621.03$218.73$124.21
    54015TDrain penis lesion00062.18$110.97$33.95$22.19
    54050TDestruction, penis lesion(s)00131.36$69.23$17.66$13.85
    54055TDestruction, penis lesion(s)00179.68$492.75$226.67$98.55
    54056TCryosurgery, penis lesion(s)00120.66$33.60$9.18$6.72
    54057TLaser surg, penis lesion(s)00179.68$492.75$226.67$98.55
    54060TExcision of penis lesion(s)00179.68$492.75$226.67$98.55
    54065TDestruction, penis lesion(s)069515.78$803.27$369.50$160.65
    54100TBiopsy of penis00208.44$429.63$130.53$85.93
    54105TBiopsy of penis002111.82$601.69$236.51$120.34
    54110TTreatment of penis lesion018122.09$1,124.47$618.45$224.89
    54111TTreat penis lesion, graft018122.09$1,124.47$618.45$224.89
    54112TTreat penis lesion, graft018122.09$1,124.47$618.45$224.89
    54115TTreatment of penis lesion000810.93$556.38$113.67$111.28
    54120TPartial removal of penis018122.09$1,124.47$618.45$224.89
    54125CRemoval of penis
    54130CRemove penis & nodes
    54135CRemove penis & nodes
    54150TCircumcision018015.02$764.58$304.87$152.92
    54152TCircumcision018015.02$764.58$304.87$152.92
    54160TCircumcision018015.02$764.58$304.87$152.92
    54161TCircumcision018015.02$764.58$304.87$152.92
    *54162TLysis penil circumcis lesion018015.02$764.58$304.87$152.92
    *54163TRepair of circumcision018015.02$764.58$304.87$152.92
    *54164TFrenulotomy of penis018015.02$764.58$304.87$152.92
    54200TTreatment of penis lesion01562.45$124.71$37.41$24.94
    54205TTreatment of penis lesion018122.09$1,124.47$618.45$224.89
    54220TTreatment of penis lesion01562.45$124.71$37.41$24.94
    54230NPrepare penis study
    54231TDynamic cavernosometry01655.22$265.72$91.76$53.14
    54235TPenile injection01641.01$51.41$15.42$10.28
    54240TPenis study01641.01$51.41$15.42$10.28
    54250TPenis study01655.22$265.72$91.76$53.14
    54300TRevision of penis018122.09$1,124.47$618.45$224.89
    54304TRevision of penis018122.09$1,124.47$618.45$224.89
    54308TReconstruction of urethra018122.09$1,124.47$618.45$224.89
    54312TReconstruction of urethra018122.09$1,124.47$618.45$224.89
    54316TReconstruction of urethra018122.09$1,124.47$618.45$224.89
    54318TReconstruction of urethra018122.09$1,124.47$618.45$224.89
    54322TReconstruction of urethra018122.09$1,124.47$618.45$224.89
    54324TReconstruction of urethra018122.09$1,124.47$618.45$224.89
    54326TReconstruction of urethra018122.09$1,124.47$618.45$224.89
    54328TRevise penis/urethra018122.09$1,124.47$618.45$224.89
    54332CRevise penis/urethra
    54336CRevise penis/urethra
    54340TSecondary urethral surgery018122.09$1,124.47$618.45$224.89
    54344TSecondary urethral surgery018122.09$1,124.47$618.45$224.89
    54348TSecondary urethral surgery018122.09$1,124.47$618.45$224.89
    54352TReconstruct urethra/penis018122.09$1,124.47$618.45$224.89
    54360TPenis plastic surgery018122.09$1,124.47$618.45$224.89
    54380TRepair penis018122.09$1,124.47$618.45$224.89
    54385TRepair penis018122.09$1,124.47$618.45$224.89
    54390CRepair penis and bladder
    54400TInsert semi-rigid prosthesis018287.54$4,456.14$1,492.28$891.23
    54401TInsert self-contd prosthesis018287.54$4,456.14$1,492.28$891.23
    54402DRemove penis prosthesis018287.54$4,456.14$1,492.28$891.23
    54405TInsert multi-comp prosthesis018287.54$4,456.14$1,492.28$891.23
    *54406TRemove multi-comp penis pros018122.09$1,124.47$618.45$224.89
    54407DRemove multi-comp prosthesis018287.54$4,456.14$1,492.28$891.23
    *54408TRepair multi-comp penis pros018122.09$1,124.47$618.45$224.89
    54409DRevise penis prosthesis018287.54$4,456.14$1,492.28$891.23
    *54410TRemove/replace penis prosth018287.54$4,456.14$1,492.28$891.23
    Start Printed Page 59990
    *54411CRemv/replc penis pros, comp
    *54415TRemove self-contd penis pros018122.09$1,124.47$618.45$224.89
    *54416TRemv/repl penis contain pros018287.54$4,456.14$1,492.28$891.23
    *54417CRemv/replc penis pros, compl
    54420TRevision of penis018122.09$1,124.47$618.45$224.89
    54430CRevision of penis
    54435TRevision of penis018122.09$1,124.47$618.45$224.89
    54440TRepair of penis018122.09$1,124.47$618.45$224.89
    54450TPreputial stretching01562.45$124.71$37.41$24.94
    54500TBiopsy of testis00054.03$205.14$90.26$41.03
    54505TBiopsy of testis018318.87$960.56$448.94$192.11
    54510DRemoval of testis lesion018318.87$960.56$448.94$192.11
    54512TExcise lesion testis018318.87$960.56$448.94$192.11
    54520TRemoval of testis018318.87$960.56$448.94$192.11
    54522TOrchiectomy, partial018318.87$960.56$448.94$192.11
    54530TRemoval of testis015431.40$1,598.39$556.98$319.68
    54535CExtensive testis surgery
    54550TExploration for testis015431.40$1,598.39$556.98$319.68
    54560CExploration for testis
    54600TReduce testis torsion018318.87$960.56$448.94$192.11
    54620TSuspension of testis018318.87$960.56$448.94$192.11
    54640TSuspension of testis015431.40$1,598.39$556.98$319.68
    54650COrchiopexy (Fowler-Stephens)
    54660TRevision of testis018318.87$960.56$448.94$192.11
    54670TRepair testis injury018318.87$960.56$448.94$192.11
    54680TRelocation of testis(es)018318.87$960.56$448.94$192.11
    54690TLaparoscopy, orchiectomy013137.63$1,915.52$996.07$383.10
    54692TLaparoscopy, orchiopexy013256.06$2,853.68$1,239.22$570.74
    54699TLaparoscope proc, testis013025.91$1,318.92$659.53$263.78
    54700TDrainage of scrotum018318.87$960.56$448.94$192.11
    54800TBiopsy of epididymis00042.47$125.73$32.57$25.15
    54820TExploration of epididymis018318.87$960.56$448.94$192.11
    54830TRemove epididymis lesion018318.87$960.56$448.94$192.11
    54840TRemove epididymis lesion018318.87$960.56$448.94$192.11
    54860TRemoval of epididymis018318.87$960.56$448.94$192.11
    54861TRemoval of epididymis018318.87$960.56$448.94$192.11
    54900TFusion of spermatic ducts018318.87$960.56$448.94$192.11
    54901TFusion of spermatic ducts018318.87$960.56$448.94$192.11
    55000TDrainage of hydrocele00042.47$125.73$32.57$25.15
    55040TRemoval of hydrocele015431.40$1,598.39$556.98$319.68
    55041TRemoval of hydroceles015431.40$1,598.39$556.98$319.68
    55060TRepair of hydrocele018318.87$960.56$448.94$192.11
    55100TDrainage of scrotum abscess00076.75$343.60$72.03$68.72
    55110TExplore scrotum018318.87$960.56$448.94$192.11
    55120TRemoval of scrotum lesion018318.87$960.56$448.94$192.11
    55150TRemoval of scrotum018318.87$960.56$448.94$192.11
    55175TRevision of scrotum018318.87$960.56$448.94$192.11
    55180TRevision of scrotum018318.87$960.56$448.94$192.11
    55200TIncision of sperm duct018318.87$960.56$448.94$192.11
    55250TRemoval of sperm duct(s)018318.87$960.56$448.94$192.11
    55300NPrepare, sperm duct x-ray
    55400TRepair of sperm duct018318.87$960.56$448.94$192.11
    55450TLigation of sperm duct018318.87$960.56$448.94$192.11
    55500TRemoval of hydrocele018318.87$960.56$448.94$192.11
    55520TRemoval of sperm cord lesion018318.87$960.56$448.94$192.11
    55530TRevise spermatic cord veins018318.87$960.56$448.94$192.11
    55535TRevise spermatic cord veins015431.40$1,598.39$556.98$319.68
    55540TRevise hernia & sperm veins015431.40$1,598.39$556.98$319.68
    55550TLaparo ligate spermatic vein013137.63$1,915.52$996.07$383.10
    55559TLaparo proc, spermatic cord013025.91$1,318.92$659.53$263.78
    55600CIncise sperm duct pouch
    55605CIncise sperm duct pouch
    55650CRemove sperm duct pouch
    55680TRemove sperm pouch lesion018318.87$960.56$448.94$192.11
    55700TBiopsy of prostate01844.83$245.87$122.94$49.17
    55705TBiopsy of prostate01844.83$245.87$122.94$49.17
    55720TDrainage of prostate abscess016225.09$1,277.18$427.49$255.44
    55725TDrainage of prostate abscess016225.09$1,277.18$427.49$255.44
    55801CRemoval of prostate
    55810CExtensive prostate surgery
    55812CExtensive prostate surgery
    55815CExtensive prostate surgery
    55821CRemoval of prostate
    55831CRemoval of prostate
    55840CExtensive prostate surgery
    Start Printed Page 59991
    55842CExtensive prostate surgery
    55845CExtensive prostate surgery
    55859TPercut/needle insert, pros016340.40$2,056.52$792.58$411.30
    55860TSurgical exposure, prostate01655.22$265.72$91.76$53.14
    55862CExtensive prostate surgery
    55865CExtensive prostate surgery
    55870TElectroejaculation01972.40$122.17$49.55$24.43
    55873TCryoablate prostate0982$2,750.00$550.00
    55899TGenital surgery procedure01641.01$51.41$15.42$10.28
    55970ESex transformation, M to F
    55980ESex transformation, F to M
    56405TI & D of vulva/perineum01922.50$127.26$35.33$25.45
    56420TDrainage of gland abscess01922.50$127.26$35.33$25.45
    56440TSurgery for vulva lesion019415.86$807.34$395.60$161.47
    56441TLysis of labial lesion(s)019311.16$568.09$171.13$113.62
    56501TDestruction, vulva lesion(s)00179.68$492.75$226.67$98.55
    56515TDestruction, vulva lesion(s)069515.78$803.27$369.50$160.65
    56605TBiopsy of vulva/perineum00194.22$214.81$78.91$42.96
    56606TBiopsy of vulva/perineum00194.22$214.81$78.91$42.96
    56620TPartial removal of vulva019520.62$1,049.64$483.80$209.93
    56625TComplete removal of vulva019520.62$1,049.64$483.80$209.93
    56630CExtensive vulva surgery
    56631CExtensive vulva surgery
    56632CExtensive vulva surgery
    56633CExtensive vulva surgery
    56634CExtensive vulva surgery
    56637CExtensive vulva surgery
    56640CExtensive vulva surgery
    56700TPartial removal of hymen019415.86$807.34$395.60$161.47
    56720TIncision of hymen019311.16$568.09$171.13$113.62
    56740TRemove vagina gland lesion019415.86$807.34$395.60$161.47
    56800TRepair of vagina019415.86$807.34$395.60$161.47
    56805TRepair clitoris019415.86$807.34$395.60$161.47
    56810TRepair of perineum019415.86$807.34$395.60$161.47
    57000TExploration of vagina019415.86$807.34$395.60$161.47
    57010TDrainage of pelvic abscess019415.86$807.34$395.60$161.47
    57020TDrainage of pelvic fluid019311.16$568.09$171.13$113.62
    57022TI &d vaginal hematoma, ob00076.75$343.60$72.03$68.72
    57023TI &d vag hematoma, trauma00076.75$343.60$72.03$68.72
    57061TDestruction vagina lesion(s)019415.86$807.34$395.60$161.47
    57065TDestruction vagina lesion(s)019415.86$807.34$395.60$161.47
    57100TBiopsy of vagina019311.16$568.09$171.13$113.62
    57105TBiopsy of vagina019415.86$807.34$395.60$161.47
    57106TRemove vagina wall, partial019415.86$807.34$395.60$161.47
    57107TRemove vagina tissue, part019520.62$1,049.64$483.80$209.93
    57109TVaginectomy partial w/nodes020263.54$3,234.44$1,487.84$646.89
    57110CRemove vagina wall, complete
    57111CRemove vagina tissue, compl
    57112CVaginectomy w/nodes, compl
    57120TClosure of vagina019415.86$807.34$395.60$161.47
    57130TRemove vagina lesion019415.86$807.34$395.60$161.47
    57135TRemove vagina lesion019415.86$807.34$395.60$161.47
    57150TTreat vagina infection01910.23$11.71$3.40$2.34
    *57155TInsert uteri tandems/ovoids01922.50$127.26$35.33$25.45
    57160TInsert pessary/other device01880.80$40.72$11.81$8.14
    57170TFitting of diaphragm/cap01910.23$11.71$3.40$2.34
    57180TTreat vaginal bleeding01922.50$127.26$35.33$25.45
    57200TRepair of vagina019415.86$807.34$395.60$161.47
    57210TRepair vagina/perineum019415.86$807.34$395.60$161.47
    57220TRevision of urethra019520.62$1,049.64$483.80$209.93
    57230TRepair of urethral lesion019415.86$807.34$395.60$161.47
    57240TRepair bladder & vagina019520.62$1,049.64$483.80$209.93
    57250TRepair rectum & vagina019520.62$1,049.64$483.80$209.93
    57260TRepair of vagina019520.62$1,049.64$483.80$209.93
    57265TExtensive repair of vagina019520.62$1,049.64$483.80$209.93
    57268TRepair of bowel bulge019520.62$1,049.64$483.80$209.93
    57270CRepair of bowel pouch
    57280CSuspension of vagina
    57282CRepair of vaginal prolapse
    57284TRepair paravaginal defect019520.62$1,049.64$483.80$209.93
    57287TRevise/remove sling repair020263.54$3,234.44$1,487.84$646.89
    57288TRepair bladder defect020263.54$3,234.44$1,487.84$646.89
    57289TRepair bladder & vagina019520.62$1,049.64$483.80$209.93
    57291TConstruction of vagina019520.62$1,049.64$483.80$209.93
    57292CConstruct vagina with graft
    Start Printed Page 59992
    57300TRepair rectum-vagina fistula019520.62$1,049.64$483.80$209.93
    57305CRepair rectum-vagina fistula
    57307CFistula repair & colostomy
    57308CFistula repair, transperine
    57310TRepair urethrovaginal lesion019520.62$1,049.64$483.80$209.93
    57311CRepair urethrovaginal lesion
    57320TRepair bladder-vagina lesion019520.62$1,049.64$483.80$209.93
    57330TRepair bladder-vagina lesion019520.62$1,049.64$483.80$209.93
    57335CRepair vagina
    57400TDilation of vagina019415.86$807.34$395.60$161.47
    57410TPelvic examination019415.86$807.34$395.60$161.47
    57415TRemove vaginal foreign body019415.86$807.34$395.60$161.47
    57452TExamination of vagina01891.26$64.14$17.96$12.83
    57454TVagina examination & biopsy01922.50$127.26$35.33$25.45
    57460TCervix excision019311.16$568.09$171.13$113.62
    57500TBiopsy of cervix01922.50$127.26$35.33$25.45
    57505TEndocervical curettage01922.50$127.26$35.33$25.45
    57510TCauterization of cervix019311.16$568.09$171.13$113.62
    57511TCryocautery of cervix01891.26$64.14$17.96$12.83
    57513TLaser surgery of cervix019311.16$568.09$171.13$113.62
    57520TConization of cervix019415.86$807.34$395.60$161.47
    57522TConization of cervix019520.62$1,049.64$483.80$209.93
    57530TRemoval of cervix019520.62$1,049.64$483.80$209.93
    57531CRemoval of cervix, radical
    57540CRemoval of residual cervix
    57545CRemove cervix/repair pelvis
    57550TRemoval of residual cervix019520.62$1,049.64$483.80$209.93
    57555TRemove cervix/repair vagina019520.62$1,049.64$483.80$209.93
    57556TRemove cervix, repair bowel019520.62$1,049.64$483.80$209.93
    57700TRevision of cervix019415.86$807.34$395.60$161.47
    57720TRevision of cervix019415.86$807.34$395.60$161.47
    57800TDilation of cervical canal01922.50$127.26$35.33$25.45
    57820TD & c of residual cervix019613.48$686.19$336.23$137.24
    58100TBiopsy of uterus lining01880.80$40.72$11.81$8.14
    58120TDilation and curettage019613.48$686.19$336.23$137.24
    58140CRemoval of uterus lesion
    58145TRemoval of uterus lesion019520.62$1,049.64$483.80$209.93
    58150CTotal hysterectomy
    58152CTotal hysterectomy
    58180CPartial hysterectomy
    58200CExtensive hysterectomy
    58210CExtensive hysterectomy
    58240CRemoval of pelvis contents
    58260CVaginal hysterectomy
    58262CVaginal hysterectomy
    58263CVaginal hysterectomy
    58267CHysterectomy & vagina repair
    58270CHysterectomy & vagina repair
    58275CHysterectomy/revise vagina
    58280CHysterectomy/revise vagina
    58285CExtensive hysterectomy
    58300EInsert intrauterine device
    58301TRemove intrauterine device01891.26$64.14$17.96$12.83
    58321TArtificial insemination01972.40$122.17$49.55$24.43
    58322TArtificial insemination01972.40$122.17$49.55$24.43
    58323TSperm washing01972.40$122.17$49.55$24.43
    58340NCatheter for hysterography
    58345TReopen fallopian tube019415.86$807.34$395.60$161.47
    *58346TInsert heyman uteri capsule01922.50$127.26$35.33$25.45
    58350TReopen fallopian tube019415.86$807.34$395.60$161.47
    58353TEndometr ablate, thermal019311.16$568.09$171.13$113.62
    58400CSuspension of uterus
    58410CSuspension of uterus
    58520CRepair of ruptured uterus
    58540CRevision of uterus
    58550TLaparo-asst vag hysterectomy013256.06$2,853.68$1,239.22$570.74
    58551TLaparoscopy, remove myoma013137.63$1,915.52$996.07$383.10
    58555THysteroscopy, dx, sep proc019415.86$807.34$395.60$161.47
    58558THysteroscopy, biopsy019016.91$860.79$421.79$172.16
    58559THysteroscopy, lysis019016.91$860.79$421.79$172.16
    58560THysteroscopy, resect septum019016.91$860.79$421.79$172.16
    58561THysteroscopy, remove myoma019016.91$860.79$421.79$172.16
    58562THysteroscopy, remove fb019016.91$860.79$421.79$172.16
    58563THysteroscopy, ablation019016.91$860.79$421.79$172.16
    58578TLaparo proc, uterus019016.91$860.79$421.79$172.16
    Start Printed Page 59993
    58579THysteroscope procedure019016.91$860.79$421.79$172.16
    58600TDivision of fallopian tube019415.86$807.34$395.60$161.47
    58605CDivision of fallopian tube
    58611CLigate oviduct(s) add-on
    58615TOcclude fallopian tube(s)019415.86$807.34$395.60$161.47
    58660TLaparoscopy, lysis013137.63$1,915.52$996.07$383.10
    58661TLaparoscopy, remove adnexa013137.63$1,915.52$996.07$383.10
    58662TLaparoscopy, excise lesions013137.63$1,915.52$996.07$383.10
    58670TLaparoscopy, tubal cautery013137.63$1,915.52$996.07$383.10
    58671TLaparoscopy, tubal block013137.63$1,915.52$996.07$383.10
    58672TLaparoscopy, fimbrioplasty013137.63$1,915.52$996.07$383.10
    58673TLaparoscopy, salpingostomy013137.63$1,915.52$996.07$383.10
    58679TLaparo proc, oviduct-ovary013025.91$1,318.92$659.53$263.78
    58700CRemoval of fallopian tube
    58720CRemoval of ovary/tube(s)
    58740CRevise fallopian tube(s)
    58750CRepair oviduct
    58752CRevise ovarian tube(s)
    58760CRemove tubal obstruction
    58770CCreate new tubal opening
    58800TDrainage of ovarian cyst(s)019520.62$1,049.64$483.80$209.93
    58805CDrainage of ovarian cyst(s)
    58820TDrain ovary abscess, open019520.62$1,049.64$483.80$209.93
    58822CDrain ovary abscess, percut
    58823TDrain pelvic abscess, percut019311.16$568.09$171.13$113.62
    58825CTransposition, ovary(s)
    58900TBiopsy of ovary(s)019520.62$1,049.64$483.80$209.93
    58920TPartial removal of ovary(s)020263.54$3,234.44$1,487.84$646.89
    58925TRemoval of ovarian cyst(s)020263.54$3,234.44$1,487.84$646.89
    58940CRemoval of ovary(s)
    58943CRemoval of ovary(s)
    58950CResect ovarian malignancy
    58951CResect ovarian malignancy
    58952CResect ovarian malignancy
    *58953CTah, rad dissect for debulk
    *58954CTah rad debulk/lymph remove
    58960CExploration of abdomen
    58970TRetrieval of oocyte019415.86$807.34$395.60$161.47
    58974TTransfer of embryo01972.40$122.17$49.55$24.43
    58976TTransfer of embryo01972.40$122.17$49.55$24.43
    58999TGenital surgery procedure00194.22$214.81$78.91$42.96
    59000TAmniocentesis01981.31$66.68$32.67$13.34
    *59001TAmniocentesis, therapeutic01981.31$66.68$32.67$13.34
    59012TFetal cord puncture,prenatal01981.31$66.68$32.67$13.34
    59015TChorion biopsy01981.31$66.68$32.67$13.34
    59020TFetal contract stress test01981.31$66.68$32.67$13.34
    59025TFetal non-stress test01981.31$66.68$32.67$13.34
    59030TFetal scalp blood sample01981.31$66.68$32.67$13.34
    59050TFetal monitor w/report01981.31$66.68$32.67$13.34
    59051EFetal monitor/interpret only
    59100CRemove uterus lesion
    59120CTreat ectopic pregnancy
    59121CTreat ectopic pregnancy
    59130CTreat ectopic pregnancy
    59135CTreat ectopic pregnancy
    59136CTreat ectopic pregnancy
    59140CTreat ectopic pregnancy
    59150TTreat ectopic pregnancy013137.63$1,915.52$996.07$383.10
    59151TTreat ectopic pregnancy013137.63$1,915.52$996.07$383.10
    59160TD & c after delivery019613.48$686.19$336.23$137.24
    59200TInsert cervical dilator01891.26$64.14$17.96$12.83
    59300TEpisiotomy or vaginal repair019311.16$568.09$171.13$113.62
    59320TRevision of cervix019415.86$807.34$395.60$161.47
    59325CRevision of cervix
    59350CRepair of uterus
    59400EObstetrical care
    59409TObstetrical care01995.09$259.10$72.55$51.82
    59410EObstetrical care
    59412TAntepartum manipulation01995.09$259.10$72.55$51.82
    59414TDeliver placenta01995.09$259.10$72.55$51.82
    59425EAntepartum care only
    59426EAntepartum care only
    59430ECare after delivery
    59510ECesarean delivery
    59514CCesarean delivery only
    Start Printed Page 59994
    59515ECesarean delivery
    59525CRemove uterus after cesarean
    59610EVbac delivery
    59612TVbac delivery only01995.09$259.10$72.55$51.82
    59614EVbac care after delivery
    59618EAttempted vbac delivery
    59620CAttempted vbac delivery only
    59622EAttempted vbac after care
    59812TTreatment of miscarriage020114.33$729.45$329.65$145.89
    59820TCare of miscarriage020114.33$729.45$329.65$145.89
    59821TTreatment of miscarriage020114.33$729.45$329.65$145.89
    59830CTreat uterus infection
    59840TAbortion020011.34$577.25$305.94$115.45
    59841TAbortion020011.34$577.25$305.94$115.45
    59850CAbortion
    59851CAbortion
    59852CAbortion
    59855CAbortion
    59856CAbortion
    59857CAbortion
    59866TAbortion (mpr)01981.31$66.68$32.67$13.34
    59870TEvacuate mole of uterus020114.33$729.45$329.65$145.89
    59871TRemove cerclage suture019415.86$807.34$395.60$161.47
    59898TLaparo proc, ob care/deliver013025.91$1,318.92$659.53$263.78
    59899TMaternity care procedure01981.31$66.68$32.67$13.34
    60000TDrain thyroid/tongue cyst02525.95$302.88$114.24$60.58
    60001TAspirate/inject thyriod cyst00042.47$125.73$32.57$25.15
    60100TBiopsy of thyroid00042.47$125.73$32.57$25.15
    60200TRemove thyroid lesion011429.28$1,490.47$493.78$298.09
    60210TPartial thyroid excision011429.28$1,490.47$493.78$298.09
    60212TParital thyroid excision011429.28$1,490.47$493.78$298.09
    60220TPartial removal of thyroid011429.28$1,490.47$493.78$298.09
    60225TPartial removal of thyroid011429.28$1,490.47$493.78$298.09
    60240TRemoval of thyroid011429.28$1,490.47$493.78$298.09
    60252TRemoval of thyroid025626.61$1,354.56$623.05$270.91
    60254CExtensive thyroid surgery
    60260TRepeat thyroid surgery025626.61$1,354.56$623.05$270.91
    60270CRemoval of thyroid
    60271CRemoval of thyroid
    60280TRemove thyroid duct lesion011429.28$1,490.47$493.78$298.09
    60281TRemove thyroid duct lesion011429.28$1,490.47$493.78$298.09
    60500TExplore parathyroid glands025626.61$1,354.56$623.05$270.91
    60502CRe-explore parathyroids
    60505CExplore parathyroid glands
    60512TAutotransplant parathyroid002111.82$601.69$236.51$120.34
    60520CRemoval of thymus gland
    60521CRemoval of thymus gland
    60522CRemoval of thymus gland
    60540CExplore adrenal gland
    60545CExplore adrenal gland
    60600CRemove carotid body lesion
    60605CRemove carotid body lesion
    60650CLaparoscopy adrenalectomy
    60659TLaparo proc, endocrine013025.91$1,318.92$659.53$263.78
    60699TEndocrine surgery procedure00042.47$125.73$32.57$25.15
    61000TRemove cranial cavity fluid02123.77$191.91$88.78$38.38
    61001TRemove cranial cavity fluid02123.77$191.91$88.78$38.38
    61020TRemove brain cavity fluid02123.77$191.91$88.78$38.38
    61026TInjection into brain canal02123.77$191.91$88.78$38.38
    61050TRemove brain canal fluid02123.77$191.91$88.78$38.38
    61055TInjection into brain canal02123.77$191.91$88.78$38.38
    61070TBrain canal shunt procedure02123.77$191.91$88.78$38.38
    61105CTwist drill hole
    61107CDrill skull for implantation
    61108CDrill skull for drainage
    61120CBurr hole for puncture
    61140CPierce skull for biopsy
    61150CPierce skull for drainage
    61151CPierce skull for drainage
    61154CPierce skull & remove clot
    61156CPierce skull for drainage
    61210CPierce skull, implant device
    61215TInsert brain-fluid device022428.48$1,449.75$453.41$289.95
    61250CPierce skull & explore
    61253CPierce skull & explore
    Start Printed Page 59995
    61304COpen skull for exploration
    61305COpen skull for exploration
    61312COpen skull for drainage
    61313COpen skull for drainage
    61314COpen skull for drainage
    61315COpen skull for drainage
    61320COpen skull for drainage
    61321COpen skull for drainage
    61330TDecompress eye socket025626.61$1,354.56$623.05$270.91
    61332CExplore/biopsy eye socket
    61333CExplore orbit/remove lesion
    61334CExplore orbit/remove object
    61340CRelieve cranial pressure
    61343CIncise skull (press relief)
    61345CRelieve cranial pressure
    61440CIncise skull for surgery
    61450CIncise skull for surgery
    61458CIncise skull for brain wound
    61460CIncise skull for surgery
    61470CIncise skull for surgery
    61480CIncise skull for surgery
    61490CIncise skull for surgery
    61500CRemoval of skull lesion
    61501CRemove infected skull bone
    61510CRemoval of brain lesion
    61512CRemove brain lining lesion
    61514CRemoval of brain abscess
    61516CRemoval of brain lesion
    61518CRemoval of brain lesion
    61519CRemove brain lining lesion
    61520CRemoval of brain lesion
    61521CRemoval of brain lesion
    61522CRemoval of brain abscess
    61524CRemoval of brain lesion
    61526CRemoval of brain lesion
    61530CRemoval of brain lesion
    61531CImplant brain electrodes
    61533CImplant brain electrodes
    61534CRemoval of brain lesion
    61535CRemove brain electrodes
    61536CRemoval of brain lesion
    61538CRemoval of brain tissue
    61539CRemoval of brain tissue
    61541CIncision of brain tissue
    61542CRemoval of brain tissue
    61543CRemoval of brain tissue
    61544CRemove & treat brain lesion
    61545CExcision of brain tumor
    61546CRemoval of pituitary gland
    61548CRemoval of pituitary gland
    61550CRelease of skull seams
    61552CRelease of skull seams
    61556CIncise skull/sutures
    61557CIncise skull/sutures
    61558CExcision of skull/sutures
    61559CExcision of skull/sutures
    61563CExcision of skull tumor
    61564CExcision of skull tumor
    61570CRemove foreign body, brain
    61571CIncise skull for brain wound
    61575CSkull base/brainstem surgery
    61576CSkull base/brainstem surgery
    61580CCraniofacial approach, skull
    61581CCraniofacial approach, skull
    61582CCraniofacial approach, skull
    61583CCraniofacial approach, skull
    61584COrbitocranial approach/skull
    61585COrbitocranial approach/skull
    61586CResect nasopharynx, skull
    61590CInfratemporal approach/skull
    61591CInfratemporal approach/skull
    61592COrbitocranial approach/skull
    61595CTranstemporal approach/skull
    61596CTranscochlear approach/skull
    61597CTranscondylar approach/skull
    Start Printed Page 59996
    61598CTranspetrosal approach/skull
    61600CResect/excise cranial lesion
    61601CResect/excise cranial lesion
    61605CResect/excise cranial lesion
    61606CResect/excise cranial lesion
    61607CResect/excise cranial lesion
    61608CResect/excise cranial lesion
    61609CTransect artery, sinus
    61610CTransect artery, sinus
    61611CTransect artery, sinus
    61612CTransect artery, sinus
    61613CRemove aneurysm, sinus
    61615CResect/excise lesion, skull
    61616CResect/excise lesion, skull
    61618CRepair dura
    61619CRepair dura
    61624COcclusion/embolization cath
    61626TOcclusion/embolization cath008129.24$1,488.43$710.91$297.69
    61680CIntracranial vessel surgery
    61682CIntracranial vessel surgery
    61684CIntracranial vessel surgery
    61686CIntracranial vessel surgery
    61690CIntracranial vessel surgery
    61692CIntracranial vessel surgery
    61697CBrain aneurysm repr, complx
    61698CBrain aneurysm repr, complx
    61700CBrain aneurysm repr , simple
    61702CInner skull vessel surgery
    61703CClamp neck artery
    61705CRevise circulation to head
    61708CRevise circulation to head
    61710CRevise circulation to head
    61711CFusion of skull arteries
    61720CIncise skull/brain surgery
    61735CIncise skull/brain surgery
    61750CIncise skull/brain biopsy
    61751CBrain biopsy w/ ct/mr guide
    61760CImplant brain electrodes
    61770CIncise skull for treatment
    61790TTreat trigeminal nerve022013.60$692.29$325.38$138.46
    61791TTreat trigeminal tract02042.24$114.02$43.33$22.80
    61793SFocus radiation beam030211.16$568.09$216.55$113.62
    61795SBrain surgery using computer030211.16$568.09$216.55$113.62
    61850CImplant neuroelectrodes
    61860CImplant neuroelectrodes
    61862CImplant neurostimul, subcort
    61870CImplant neuroelectrodes
    61875CImplant neuroelectrodes
    61880TRevise/remove neuroelectrode068742.34$2,155.28$431.06
    61885TImplant neurostim one array0222302.53$15,399.99$3,080.00
    61886TImplant neurostim arrays0222302.53$15,399.99$3,080.00
    61888TRevise/remove neuroreceiver0688145.27$7,394.82$1,478.96
    62000CTreat skull fracture
    62005CTreat skull fracture
    62010CTreatment of head injury
    62100CRepair brain fluid leakage
    62115CReduction of skull defect
    62116CReduction of skull defect
    62117CReduction of skull defect
    62120CRepair skull cavity lesion
    62121CIncise skull repair
    62140CRepair of skull defect
    62141CRepair of skull defect
    62142CRemove skull plate/flap
    62143CReplace skull plate/flap
    62145CRepair of skull & brain
    62146CRepair of skull with graft
    62147CRepair of skull with graft
    62180CEstablish brain cavity shunt
    62190CEstablish brain cavity shunt
    62192CEstablish brain cavity shunt
    62194TReplace/irrigate catheter01212.54$129.30$52.53$25.86
    62200CEstablish brain cavity shunt
    62201CEstablish brain cavity shunt
    62220CEstablish brain cavity shunt
    Start Printed Page 59997
    62223CEstablish brain cavity shunt
    62225TReplace/irrigate catheter01212.54$129.30$52.53$25.86
    62230TReplace/revise brain shunt022428.48$1,449.75$453.41$289.95
    62252SCsf shunt reprogram06913.17$161.37$88.75$32.27
    62256CRemove brain cavity shunt
    62258CReplace brain cavity shunt
    62263TLysis epidural adhesions020315.79$803.77$369.73$160.75
    62268TDrain spinal cord cyst02123.77$191.91$88.78$38.38
    62269TNeedle biopsy, spinal cord00054.03$205.14$90.26$41.03
    62270TSpinal fluid tap, diagnostic02063.59$182.75$74.93$36.55
    62272TDrain spinal fluid02063.59$182.75$74.93$36.55
    62273TTreat epidural spine lesion02063.59$182.75$74.93$36.55
    62280TTreat spinal cord lesion02075.36$272.85$122.78$54.57
    62281TTreat spinal cord lesion02075.36$272.85$122.78$54.57
    62282TTreat spinal canal lesion02075.36$272.85$122.78$54.57
    62284NInjection for myelogram
    62287TPercutaneous diskectomy022013.60$692.29$325.38$138.46
    62290NInject for spine disk x-ray
    62291NInject for spine disk x-ray
    62292TInjection into disk lesion02123.77$191.91$88.78$38.38
    62294TInjection into spinal artery02123.77$191.91$88.78$38.38
    62310TInject spine c/t02063.59$182.75$74.93$36.55
    62311TInject spine l/s (cd)02063.59$182.75$74.93$36.55
    62318TInject spine w/cath, c/t02063.59$182.75$74.93$36.55
    62319TInject spine w/cath l/s (cd)02063.59$182.75$74.93$36.55
    62350TImplant spinal canal cath022375.39$3,837.65$767.53
    62351CImplant spinal canal cath
    62355TRemove spinal canal catheter010514.76$751.34$368.16$150.27
    62360TInsert spine infusion device022675.81$3,859.03$771.81
    62361TImplant spine infusion pump0227139.55$7,103.65$1,420.73
    62362TImplant spine infusion pump0227139.55$7,103.65$1,420.73
    62365TRemove spine infusion device010514.76$751.34$368.16$150.27
    62367SAnalyze spine infusion pump06913.17$161.37$88.75$32.27
    62368SAnalyze spine infusion pump06913.17$161.37$88.75$32.27
    63001TRemoval of spinal lamina020829.12$1,482.32$296.46
    63003TRemoval of spinal lamina020829.12$1,482.32$296.46
    63005TRemoval of spinal lamina020829.12$1,482.32$296.46
    63011TRemoval of spinal lamina020829.12$1,482.32$296.46
    63012TRemoval of spinal lamina020829.12$1,482.32$296.46
    63015TRemoval of spinal lamina020829.12$1,482.32$296.46
    63016TRemoval of spinal lamina020829.12$1,482.32$296.46
    63017TRemoval of spinal lamina020829.12$1,482.32$296.46
    63020TNeck spine disk surgery020829.12$1,482.32$296.46
    63030TLow back disk surgery020829.12$1,482.32$296.46
    63035TSpinal disk surgery add-on020829.12$1,482.32$296.46
    63040TLaminotomy, single cervical020829.12$1,482.32$296.46
    63042TLaminotomy, single lumbar020829.12$1,482.32$296.46
    63043CLaminotomy, addl cervical
    63044CLaminotomy, addl lumbar
    63045TRemoval of spinal lamina020829.12$1,482.32$296.46
    63046TRemoval of spinal lamina020829.12$1,482.32$296.46
    63047TRemoval of spinal lamina020829.12$1,482.32$296.46
    63048TRemove spinal lamina add-on020829.12$1,482.32$296.46
    63055TDecompress spinal cord020829.12$1,482.32$296.46
    63056TDecompress spinal cord020829.12$1,482.32$296.46
    63057TDecompress spine cord add-on020829.12$1,482.32$296.46
    63064TDecompress spinal cord020829.12$1,482.32$296.46
    63066TDecompress spine cord add-on020829.12$1,482.32$296.46
    63075CNeck spine disk surgery
    63076CNeck spine disk surgery
    63077CSpine disk surgery, thorax
    63078CSpine disk surgery, thorax
    63081CRemoval of vertebral body
    63082CRemove vertebral body add-on
    63085CRemoval of vertebral body
    63086CRemove vertebral body add-on
    63087CRemoval of vertebral body
    63088CRemove vertebral body add-on
    63090CRemoval of vertebral body
    63091CRemove vertebral body add-on
    63170CIncise spinal cord tract(s)
    63172CDrainage of spinal cyst
    63173CDrainage of spinal cyst
    63180CRevise spinal cord ligaments
    63182CRevise spinal cord ligaments
    Start Printed Page 59998
    63185CIncise spinal column/nerves
    63190CIncise spinal column/nerves
    63191CIncise spinal column/nerves
    63194CIncise spinal column & cord
    63195CIncise spinal column & cord
    63196CIncise spinal column & cord
    63197CIncise spinal column & cord
    63198CIncise spinal column & cord
    63199CIncise spinal column & cord
    63200CRelease of spinal cord
    63250CRevise spinal cord vessels
    63251CRevise spinal cord vessels
    63252CRevise spinal cord vessels
    63265CExcise intraspinal lesion
    63266CExcise intraspinal lesion
    63267CExcise intraspinal lesion
    63268CExcise intraspinal lesion
    63270CExcise intraspinal lesion
    63271CExcise intraspinal lesion
    63272CExcise intraspinal lesion
    63273CExcise intraspinal lesion
    63275CBiopsy/excise spinal tumor
    63276CBiopsy/excise spinal tumor
    63277CBiopsy/excise spinal tumor
    63278CBiopsy/excise spinal tumor
    63280CBiopsy/excise spinal tumor
    63281CBiopsy/excise spinal tumor
    63282CBiopsy/excise spinal tumor
    63283CBiopsy/excise spinal tumor
    63285CBiopsy/excise spinal tumor
    63286CBiopsy/excise spinal tumor
    63287CBiopsy/excise spinal tumor
    63290CBiopsy/excise spinal tumor
    63300CRemoval of vertebral body
    63301CRemoval of vertebral body
    63302CRemoval of vertebral body
    63303CRemoval of vertebral body
    63304CRemoval of vertebral body
    63305CRemoval of vertebral body
    63306CRemoval of vertebral body
    63307CRemoval of vertebral body
    63308CRemove vertebral body add-on
    63600TRemove spinal cord lesion022013.60$692.29$325.38$138.46
    63610TStimulation of spinal cord022013.60$692.29$325.38$138.46
    63615TRemove lesion of spinal cord022013.60$692.29$325.38$138.46
    63650TImplant neuroelectrodes0225267.56$13,619.87$2,723.97
    63655TImplant neuroelectrodes0225267.56$13,619.87$2,723.97
    63660TRevise/remove neuroelectrode068742.34$2,155.28$431.06
    63685TImplant neuroreceiver0222302.53$15,399.99$3,080.00
    63688TRevise/remove neuroreceiver0688145.27$7,394.82$1,478.96
    63700CRepair of spinal herniation
    63702CRepair of spinal herniation
    63704CRepair of spinal herniation
    63706CRepair of spinal herniation
    63707CRepair spinal fluid leakage
    63709CRepair spinal fluid leakage
    63710CGraft repair of spine defect
    63740CInstall spinal shunt
    63741TInstall spinal shunt022853.77$2,737.11$696.46$547.42
    63744TRevision of spinal shunt022853.77$2,737.11$696.46$547.42
    63746TRemoval of spinal shunt01096.27$319.17$130.86$63.83
    64400TInjection for nerve block02042.24$114.02$43.33$22.80
    64402TInjection for nerve block02042.24$114.02$43.33$22.80
    64405TInjection for nerve block02042.24$114.02$43.33$22.80
    64408TInjection for nerve block02042.24$114.02$43.33$22.80
    64410TInjection for nerve block02042.24$114.02$43.33$22.80
    64412TInjection for nerve block02042.24$114.02$43.33$22.80
    64413TInjection for nerve block02042.24$114.02$43.33$22.80
    64415TInjection for nerve block02042.24$114.02$43.33$22.80
    64417TInjection for nerve block02042.24$114.02$43.33$22.80
    64418TInjection for nerve block02042.24$114.02$43.33$22.80
    64420TInjection for nerve block02075.36$272.85$122.78$54.57
    64421TInjection for nerve block02075.36$272.85$122.78$54.57
    64425TInjection for nerve block02042.24$114.02$43.33$22.80
    64430TInjection for nerve block02042.24$114.02$43.33$22.80
    Start Printed Page 59999
    64435TInjection for nerve block02042.24$114.02$43.33$22.80
    64445TInjection for nerve block02042.24$114.02$43.33$22.80
    64450TInjection for nerve block02042.24$114.02$43.33$22.80
    64470TInj paravertebral c/t02075.36$272.85$122.78$54.57
    64472TInj paravertebral c/t add-on02075.36$272.85$122.78$54.57
    64475TInj paravertebral l/s02075.36$272.85$122.78$54.57
    64476TInj paravertebral l/s add-on02075.36$272.85$122.78$54.57
    64479TInj foramen epidural c/t02075.36$272.85$122.78$54.57
    64480TInj foramen epidural add-on02075.36$272.85$122.78$54.57
    64483TInj foramen epidural l/s02075.36$272.85$122.78$54.57
    64484TInj foramen epidural add-on02075.36$272.85$122.78$54.57
    64505TInjection for nerve block02042.24$114.02$43.33$22.80
    64508TInjection for nerve block02042.24$114.02$43.33$22.80
    64510TInjection for nerve block02075.36$272.85$122.78$54.57
    64520TInjection for nerve block02075.36$272.85$122.78$54.57
    64530TInjection for nerve block02075.36$272.85$122.78$54.57
    64550AApply neurostimulator
    64553TImplant neuroelectrodes0225267.56$13,619.87$2,723.97
    64555TImplant neuroelectrodes0225267.56$13,619.87$2,723.97
    64560TImplant neuroelectrodes0225267.56$13,619.87$2,723.97
    *64561TImplant neuroelectrodes0225267.56$13,619.87$2,723.97
    64565TImplant neuroelectrodes0225267.56$13,619.87$2,723.97
    64573TImplant neuroelectrodes0225267.56$13,619.87$2,723.97
    64575TImplant neuroelectrodes0225267.56$13,619.87$2,723.97
    64577TImplant neuroelectrodes0225267.56$13,619.87$2,723.97
    64580TImplant neuroelectrodes0225267.56$13,619.87$2,723.97
    *64581TImplant neuroelectrodes0225267.56$13,619.87$2,723.97
    64585TRevise/remove neuroelectrode068742.34$2,155.28$431.06
    64590TImplant neuroreceiver0222302.53$15,399.99$3,080.00
    64595TRevise/remove neuroreceiver0688145.27$7,394.82$1,478.96
    64600TInjection treatment of nerve020315.79$803.77$369.73$160.75
    64605TInjection treatment of nerve020315.79$803.77$369.73$160.75
    64610TInjection treatment of nerve020315.79$803.77$369.73$160.75
    64612TDestroy nerve, face muscle02042.24$114.02$43.33$22.80
    64613TDestroy nerve, spine muscle02042.24$114.02$43.33$22.80
    64614TDestroy nerve, extrem musc02063.59$182.75$74.93$36.55
    64620TInjection treatment of nerve020315.79$803.77$369.73$160.75
    64622TDestr paravertebrl nerve l/s020315.79$803.77$369.73$160.75
    64623TDestr paravertebral n add-on020315.79$803.77$369.73$160.75
    64626TDestr paravertebrl nerve c/t020315.79$803.77$369.73$160.75
    64627TDestr paravertebral n add-on020315.79$803.77$369.73$160.75
    64630TInjection treatment of nerve02075.36$272.85$122.78$54.57
    64640TInjection treatment of nerve02075.36$272.85$122.78$54.57
    64680TInjection treatment of nerve020315.79$803.77$369.73$160.75
    64702TRevise finger/toe nerve022013.60$692.29$325.38$138.46
    64704TRevise hand/foot nerve022013.60$692.29$325.38$138.46
    64708TRevise arm/leg nerve022013.60$692.29$325.38$138.46
    64712TRevision of sciatic nerve022013.60$692.29$325.38$138.46
    64713TRevision of arm nerve(s)022013.60$692.29$325.38$138.46
    64714TRevise low back nerve(s)022013.60$692.29$325.38$138.46
    64716TRevision of cranial nerve022013.60$692.29$325.38$138.46
    64718TRevise ulnar nerve at elbow022013.60$692.29$325.38$138.46
    64719TRevise ulnar nerve at wrist022013.60$692.29$325.38$138.46
    64721TCarpal tunnel surgery022013.60$692.29$325.38$138.46
    64722TRelieve pressure on nerve(s)022013.60$692.29$325.38$138.46
    64726TRelease foot/toe nerve022013.60$692.29$325.38$138.46
    64727TInternal nerve revision022013.60$692.29$325.38$138.46
    64732TIncision of brow nerve022013.60$692.29$325.38$138.46
    64734TIncision of cheek nerve022013.60$692.29$325.38$138.46
    64736TIncision of chin nerve022013.60$692.29$325.38$138.46
    64738TIncision of jaw nerve022013.60$692.29$325.38$138.46
    64740TIncision of tongue nerve022013.60$692.29$325.38$138.46
    64742TIncision of facial nerve022013.60$692.29$325.38$138.46
    64744TIncise nerve, back of head022013.60$692.29$325.38$138.46
    64746TIncise diaphragm nerve022013.60$692.29$325.38$138.46
    64752CIncision of vagus nerve
    64755CIncision of stomach nerves
    64760CIncision of vagus nerve
    64761TIncision of pelvis nerve022013.60$692.29$325.38$138.46
    64763CIncise hip/thigh nerve
    64766CIncise hip/thigh nerve
    64771TSever cranial nerve022013.60$692.29$325.38$138.46
    64772TIncision of spinal nerve022013.60$692.29$325.38$138.46
    64774TRemove skin nerve lesion022013.60$692.29$325.38$138.46
    64776TRemove digit nerve lesion022013.60$692.29$325.38$138.46
    Start Printed Page 60000
    64778TDigit nerve surgery add-on022013.60$692.29$325.38$138.46
    64782TRemove limb nerve lesion022013.60$692.29$325.38$138.46
    64783TLimb nerve surgery add-on022013.60$692.29$325.38$138.46
    64784TRemove nerve lesion022013.60$692.29$325.38$138.46
    64786TRemove sciatic nerve lesion022121.43$1,090.87$463.62$218.17
    64787TImplant nerve end022013.60$692.29$325.38$138.46
    64788TRemove skin nerve lesion022013.60$692.29$325.38$138.46
    64790TRemoval of nerve lesion022013.60$692.29$325.38$138.46
    64792TRemoval of nerve lesion022121.43$1,090.87$463.62$218.17
    64795TBiopsy of nerve022013.60$692.29$325.38$138.46
    64802CRemove sympathetic nerves
    64804CRemove sympathetic nerves
    64809CRemove sympathetic nerves
    64818CRemove sympathetic nerves
    64820CRemove sympathetic nerves
    *64821TRemove sympathetic nerves005419.83$1,009.43$472.33$201.89
    *64822TRemove sympathetic nerves005419.83$1,009.43$472.33$201.89
    *64823TRemove sympathetic nerves005419.83$1,009.43$472.33$201.89
    64831TRepair of digit nerve022121.43$1,090.87$463.62$218.17
    64832TRepair nerve add-on022121.43$1,090.87$463.62$218.17
    64834TRepair of hand or foot nerve022121.43$1,090.87$463.62$218.17
    64835TRepair of hand or foot nerve022121.43$1,090.87$463.62$218.17
    64836TRepair of hand or foot nerve022121.43$1,090.87$463.62$218.17
    64837TRepair nerve add-on022121.43$1,090.87$463.62$218.17
    64840TRepair of leg nerve022121.43$1,090.87$463.62$218.17
    64856TRepair/transpose nerve022121.43$1,090.87$463.62$218.17
    64857TRepair arm/leg nerve022121.43$1,090.87$463.62$218.17
    64858TRepair sciatic nerve022121.43$1,090.87$463.62$218.17
    64859TNerve surgery022121.43$1,090.87$463.62$218.17
    64861TRepair of arm nerves022121.43$1,090.87$463.62$218.17
    64862TRepair of low back nerves022121.43$1,090.87$463.62$218.17
    64864TRepair of facial nerve022121.43$1,090.87$463.62$218.17
    64865TRepair of facial nerve022121.43$1,090.87$463.62$218.17
    64866CFusion of facial/other nerve
    64868CFusion of facial/other nerve
    64870TFusion of facial/other nerve022121.43$1,090.87$463.62$218.17
    64872TSubsequent repair of nerve022121.43$1,090.87$463.62$218.17
    64874TRepair & revise nerve add-on022121.43$1,090.87$463.62$218.17
    64876TRepair nerve/shorten bone022121.43$1,090.87$463.62$218.17
    64885TNerve graft, head or neck022121.43$1,090.87$463.62$218.17
    64886TNerve graft, head or neck022121.43$1,090.87$463.62$218.17
    64890TNerve graft, hand or foot022121.43$1,090.87$463.62$218.17
    64891TNerve graft, hand or foot022121.43$1,090.87$463.62$218.17
    64892TNerve graft, arm or leg022121.43$1,090.87$463.62$218.17
    64893TNerve graft, arm or leg022121.43$1,090.87$463.62$218.17
    64895TNerve graft, hand or foot022121.43$1,090.87$463.62$218.17
    64896TNerve graft, hand or foot022121.43$1,090.87$463.62$218.17
    64897TNerve graft, arm or leg022121.43$1,090.87$463.62$218.17
    64898TNerve graft, arm or leg022121.43$1,090.87$463.62$218.17
    64901TNerve graft add-on022121.43$1,090.87$463.62$218.17
    64902TNerve graft add-on022121.43$1,090.87$463.62$218.17
    64905TNerve pedicle transfer022121.43$1,090.87$463.62$218.17
    64907TNerve pedicle transfer022121.43$1,090.87$463.62$218.17
    64999TNervous system surgery02042.24$114.02$43.33$22.80
    65091TRevise eye024223.72$1,207.44$597.36$241.49
    65093TRevise eye with implant024118.12$922.38$384.47$184.48
    65101TRemoval of eye024223.72$1,207.44$597.36$241.49
    65103TRemove eye/insert implant024223.72$1,207.44$597.36$241.49
    65105TRemove eye/attach implant024223.72$1,207.44$597.36$241.49
    65110TRemoval of eye024223.72$1,207.44$597.36$241.49
    65112TRemove eye/revise socket024223.72$1,207.44$597.36$241.49
    65114TRemove eye/revise socket024223.72$1,207.44$597.36$241.49
    65125TRevise ocular implant024013.83$704.00$315.34$140.80
    65130TInsert ocular implant024118.12$922.38$384.47$184.48
    65135TInsert ocular implant024118.12$922.38$384.47$184.48
    65140TAttach ocular implant024223.72$1,207.44$597.36$241.49
    65150TRevise ocular implant024118.12$922.38$384.47$184.48
    65155TReinsert ocular implant024223.72$1,207.44$597.36$241.49
    65175TRemoval of ocular implant024013.83$704.00$315.34$140.80
    65205SRemove foreign body from eye02312.03$103.34$46.50$20.67
    65210SRemove foreign body from eye02312.03$103.34$46.50$20.67
    65220SRemove foreign body from eye02312.03$103.34$46.50$20.67
    65222SRemove foreign body from eye02312.03$103.34$46.50$20.67
    65235TRemove foreign body from eye023310.83$551.29$264.62$110.26
    65260TRemove foreign body from eye023736.32$1,848.83$369.77
    Start Printed Page 60001
    65265TRemove foreign body from eye023616.21$825.15$165.03
    65270TRepair of eye wound024013.83$704.00$315.34$140.80
    65272TRepair of eye wound023310.83$551.29$264.62$110.26
    65273CRepair of eye wound
    65275TRepair of eye wound023310.83$551.29$264.62$110.26
    65280TRepair of eye wound023419.08$971.25$466.20$194.25
    65285TRepair of eye wound023419.08$971.25$466.20$194.25
    65286TRepair of eye wound023310.83$551.29$264.62$110.26
    65290TRepair of eye socket wound024317.70$901.00$429.78$180.20
    65400TRemoval of eye lesion023310.83$551.29$264.62$110.26
    65410TBiopsy of cornea023310.83$551.29$264.62$110.26
    65420TRemoval of eye lesion023310.83$551.29$264.62$110.26
    65426TRemoval of eye lesion023419.08$971.25$466.20$194.25
    65430SCorneal smear02300.61$31.05$14.28$6.21
    65435TCurette/treat cornea02395.80$295.24$115.14$59.05
    65436TCurette/treat cornea023310.83$551.29$264.62$110.26
    65450STreatment of corneal lesion02312.03$103.34$46.50$20.67
    65600TRevision of cornea024013.83$704.00$315.34$140.80
    65710TCorneal transplant024438.46$1,957.77$851.42$391.55
    65730TCorneal transplant024438.46$1,957.77$851.42$391.55
    65750TCorneal transplant024438.46$1,957.77$851.42$391.55
    65755TCorneal transplant024438.46$1,957.77$851.42$391.55
    65760ERevision of cornea
    65765ERevision of cornea
    65767ECorneal tissue transplant
    65770TRevise cornea with implant024438.46$1,957.77$851.42$391.55
    65771ERadial keratotomy
    65772TCorrection of astigmatism023310.83$551.29$264.62$110.26
    65775TCorrection of astigmatism023310.83$551.29$264.62$110.26
    65800TDrainage of eye023310.83$551.29$264.62$110.26
    65805TDrainage of eye023310.83$551.29$264.62$110.26
    65810TDrainage of eye023310.83$551.29$264.62$110.26
    65815TDrainage of eye023419.08$971.25$466.20$194.25
    65820TRelieve inner eye pressure02323.50$178.16$78.39$35.63
    65850TIncision of eye023419.08$971.25$466.20$194.25
    65855TLaser surgery of eye024829.51$1,502.18$300.44
    65860TIncise inner eye adhesions02474.03$205.14$94.36$41.03
    65865TIncise inner eye adhesions023310.83$551.29$264.62$110.26
    65870TIncise inner eye adhesions023419.08$971.25$466.20$194.25
    65875TIncise inner eye adhesions023419.08$971.25$466.20$194.25
    65880TIncise inner eye adhesions023310.83$551.29$264.62$110.26
    65900TRemove eye lesion023310.83$551.29$264.62$110.26
    65920TRemove implant from eye023310.83$551.29$264.62$110.26
    65930TRemove blood clot from eye023419.08$971.25$466.20$194.25
    66020TInjection treatment of eye023310.83$551.29$264.62$110.26
    66030TInjection treatment of eye023310.83$551.29$264.62$110.26
    66130TRemove eye lesion023419.08$971.25$466.20$194.25
    66150TGlaucoma surgery023310.83$551.29$264.62$110.26
    66155TGlaucoma surgery023419.08$971.25$466.20$194.25
    66160TGlaucoma surgery023419.08$971.25$466.20$194.25
    66165TGlaucoma surgery023419.08$971.25$466.20$194.25
    66170TGlaucoma surgery023419.08$971.25$466.20$194.25
    66172TIncision of eye023419.08$971.25$466.20$194.25
    66180TImplant eye shunt023419.08$971.25$466.20$194.25
    66185TRevise eye shunt023419.08$971.25$466.20$194.25
    66220TRepair eye lesion023616.21$825.15$165.03
    66225TRepair/graft eye lesion023419.08$971.25$466.20$194.25
    66250TFollow-up surgery of eye023310.83$551.29$264.62$110.26
    66500TIncision of iris02323.50$178.16$78.39$35.63
    66505TIncision of iris02323.50$178.16$78.39$35.63
    66600TRemove iris and lesion023310.83$551.29$264.62$110.26
    66605TRemoval of iris023419.08$971.25$466.20$194.25
    66625TRemoval of iris023310.83$551.29$264.62$110.26
    66630TRemoval of iris023310.83$551.29$264.62$110.26
    66635TRemoval of iris023419.08$971.25$466.20$194.25
    66680TRepair iris & ciliary body023419.08$971.25$466.20$194.25
    66682TRepair iris & ciliary body023419.08$971.25$466.20$194.25
    66700TDestruction, ciliary body023310.83$551.29$264.62$110.26
    66710TDestruction, ciliary body023310.83$551.29$264.62$110.26
    66720TDestruction, ciliary body023310.83$551.29$264.62$110.26
    66740TDestruction, ciliary body023310.83$551.29$264.62$110.26
    66761TRevision of iris024829.51$1,502.18$300.44
    66762TRevision of iris02474.03$205.14$94.36$41.03
    66770TRemoval of inner eye lesion02474.03$205.14$94.36$41.03
    66820TIncision, secondary cataract02323.50$178.16$78.39$35.63
    Start Printed Page 60002
    66821TAfter cataract laser surgery024829.51$1,502.18$300.44
    66825TReposition intraocular lens023419.08$971.25$466.20$194.25
    66830TRemoval of lens lesion02323.50$178.16$78.39$35.63
    66840TRemoval of lens material024510.44$531.44$249.78$106.29
    66850TRemoval of lens material024921.80$1,109.71$521.56$221.94
    66852TRemoval of lens material024921.80$1,109.71$521.56$221.94
    66920TExtraction of lens024921.80$1,109.71$521.56$221.94
    66930TExtraction of lens024921.80$1,109.71$521.56$221.94
    66940TExtraction of lens024510.44$531.44$249.78$106.29
    66982TCataract surgery, complex024621.20$1,079.16$507.21$215.83
    66983TCataract surg w/iol, 1 stage024621.20$1,079.16$507.21$215.83
    66984TCataract surg w/iol, i stage024621.20$1,079.16$507.21$215.83
    66985TInsert lens prosthesis024621.20$1,079.16$507.21$215.83
    66986TExchange lens prosthesis024621.20$1,079.16$507.21$215.83
    66999TEye surgery procedure02474.03$205.14$94.36$41.03
    67005TPartial removal of eye fluid023736.32$1,848.83$369.77
    67010TPartial removal of eye fluid023736.32$1,848.83$369.77
    67015TRelease of eye fluid023736.32$1,848.83$369.77
    67025TReplace eye fluid023616.21$825.15$165.03
    67027TImplant eye drug system023736.32$1,848.83$369.77
    67028TInjection eye drug02355.57$283.54$78.91$56.71
    67030TIncise inner eye strands023616.21$825.15$165.03
    67031TLaser surgery, eye strands02474.03$205.14$94.36$41.03
    67036TRemoval of inner eye fluid023736.32$1,848.83$369.77
    67038TStrip retinal membrane023736.32$1,848.83$369.77
    67039TLaser treatment of retina023736.32$1,848.83$369.77
    67040TLaser treatment of retina023736.32$1,848.83$369.77
    67101TRepair detached retina02355.57$283.54$78.91$56.71
    67105TRepair detached retina02474.03$205.14$94.36$41.03
    67107TRepair detached retina023736.32$1,848.83$369.77
    67108TRepair detached retina023736.32$1,848.83$369.77
    67110TRepair detached retina02355.57$283.54$78.91$56.71
    67112TRerepair detached retina023736.32$1,848.83$369.77
    67115TRelease encircling material023616.21$825.15$165.03
    67120TRemove eye implant material023616.21$825.15$165.03
    67121TRemove eye implant material023736.32$1,848.83$369.77
    67141TTreatment of retina02355.57$283.54$78.91$56.71
    67145TTreatment of retina02474.03$205.14$94.36$41.03
    67208STreatment of retinal lesion02312.03$103.34$46.50$20.67
    67210TTreatment of retinal lesion02474.03$205.14$94.36$41.03
    67218TTreatment of retinal lesion023736.32$1,848.83$369.77
    67220TTreatment of choroid lesion02355.57$283.54$78.91$56.71
    67221TOcular photodynamic ther02355.57$283.54$78.91$56.71
    *67225TEye photodynamic ther add-on02355.57$283.54$78.91$56.71
    67227TTreatment of retinal lesion02355.57$283.54$78.91$56.71
    67228TTreatment of retinal lesion024829.51$1,502.18$300.44
    67250TReinforce eye wall024013.83$704.00$315.34$140.80
    67255TReinforce/graft eye wall023736.32$1,848.83$369.77
    67299TEye surgery procedure024829.51$1,502.18$300.44
    67311TRevise eye muscle024317.70$901.00$429.78$180.20
    67312TRevise two eye muscles024317.70$901.00$429.78$180.20
    67314TRevise eye muscle024317.70$901.00$429.78$180.20
    67316TRevise two eye muscles024317.70$901.00$429.78$180.20
    67318TRevise eye muscle(s)024317.70$901.00$429.78$180.20
    67320TRevise eye muscle(s) add-on024317.70$901.00$429.78$180.20
    67331TEye surgery follow-up add-on024317.70$901.00$429.78$180.20
    67332TRerevise eye muscles add-on024317.70$901.00$429.78$180.20
    67334TRevise eye muscle w/suture024317.70$901.00$429.78$180.20
    67335TEye suture during surgery024317.70$901.00$429.78$180.20
    67340TRevise eye muscle add-on024317.70$901.00$429.78$180.20
    67343TRelease eye tissue024317.70$901.00$429.78$180.20
    67345TDestroy nerve of eye muscle02383.01$153.22$58.96$30.64
    67350TBiopsy eye muscle06996.46$328.84$147.98$65.77
    67399TEye muscle surgery procedure024317.70$901.00$429.78$180.20
    67400TExplore/biopsy eye socket024118.12$922.38$384.47$184.48
    67405TExplore/drain eye socket024118.12$922.38$384.47$184.48
    67412TExplore/treat eye socket024118.12$922.38$384.47$184.48
    67413TExplore/treat eye socket024118.12$922.38$384.47$184.48
    67414TExplr/decompress eye socket024223.72$1,207.44$597.36$241.49
    67415TAspiration, orbital contents02395.80$295.24$115.14$59.05
    67420TExplore/treat eye socket024223.72$1,207.44$597.36$241.49
    67430TExplore/treat eye socket024223.72$1,207.44$597.36$241.49
    67440TExplore/drain eye socket024223.72$1,207.44$597.36$241.49
    67445TExplr/decompress eye socket024223.72$1,207.44$597.36$241.49
    67450TExplore/biopsy eye socket024223.72$1,207.44$597.36$241.49
    Start Printed Page 60003
    67500SInject/treat eye socket02312.03$103.34$46.50$20.67
    67505TInject/treat eye socket02383.01$153.22$58.96$30.64
    67515TInject/treat eye socket02395.80$295.24$115.14$59.05
    67550TInsert eye socket implant024223.72$1,207.44$597.36$241.49
    67560TRevise eye socket implant024118.12$922.38$384.47$184.48
    67570TDecompress optic nerve024223.72$1,207.44$597.36$241.49
    67599TOrbit surgery procedure02395.80$295.24$115.14$59.05
    67700TDrainage of eyelid abscess02383.01$153.22$58.96$30.64
    67710TIncision of eyelid02395.80$295.24$115.14$59.05
    67715TIncision of eyelid fold024013.83$704.00$315.34$140.80
    67800TRemove eyelid lesion02383.01$153.22$58.96$30.64
    67801TRemove eyelid lesions02395.80$295.24$115.14$59.05
    67805TRemove eyelid lesions02383.01$153.22$58.96$30.64
    67808TRemove eyelid lesion(s)024013.83$704.00$315.34$140.80
    67810TBiopsy of eyelid02383.01$153.22$58.96$30.64
    67820SRevise eyelashes06981.03$52.43$19.92$10.49
    67825TRevise eyelashes02383.01$153.22$58.96$30.64
    67830TRevise eyelashes02395.80$295.24$115.14$59.05
    67835TRevise eyelashes024013.83$704.00$315.34$140.80
    67840TRemove eyelid lesion02395.80$295.24$115.14$59.05
    67850TTreat eyelid lesion02395.80$295.24$115.14$59.05
    67875TClosure of eyelid by suture02395.80$295.24$115.14$59.05
    67880TRevision of eyelid023310.83$551.29$264.62$110.26
    67882TRevision of eyelid024013.83$704.00$315.34$140.80
    67900TRepair brow defect024013.83$704.00$315.34$140.80
    67901TRepair eyelid defect024013.83$704.00$315.34$140.80
    67902TRepair eyelid defect024013.83$704.00$315.34$140.80
    67903TRepair eyelid defect024013.83$704.00$315.34$140.80
    67904TRepair eyelid defect024013.83$704.00$315.34$140.80
    67906TRepair eyelid defect024013.83$704.00$315.34$140.80
    67908TRepair eyelid defect024013.83$704.00$315.34$140.80
    67909TRevise eyelid defect024013.83$704.00$315.34$140.80
    67911TRevise eyelid defect024013.83$704.00$315.34$140.80
    67914TRepair eyelid defect024013.83$704.00$315.34$140.80
    67915TRepair eyelid defect02395.80$295.24$115.14$59.05
    67916TRepair eyelid defect024013.83$704.00$315.34$140.80
    67917TRepair eyelid defect024013.83$704.00$315.34$140.80
    67921TRepair eyelid defect024013.83$704.00$315.34$140.80
    67922TRepair eyelid defect02395.80$295.24$115.14$59.05
    67923TRepair eyelid defect024013.83$704.00$315.34$140.80
    67924TRepair eyelid defect024013.83$704.00$315.34$140.80
    67930TRepair eyelid wound024013.83$704.00$315.34$140.80
    67935TRepair eyelid wound024013.83$704.00$315.34$140.80
    67938SRemove eyelid foreign body06981.03$52.43$19.92$10.49
    67950TRevision of eyelid024013.83$704.00$315.34$140.80
    67961TRevision of eyelid024013.83$704.00$315.34$140.80
    67966TRevision of eyelid024013.83$704.00$315.34$140.80
    67971TReconstruction of eyelid024118.12$922.38$384.47$184.48
    67973TReconstruction of eyelid024118.12$922.38$384.47$184.48
    67974TReconstruction of eyelid024118.12$922.38$384.47$184.48
    67975TReconstruction of eyelid024013.83$704.00$315.34$140.80
    67999TRevision of eyelid024013.83$704.00$315.34$140.80
    68020TIncise/drain eyelid lining024013.83$704.00$315.34$140.80
    68040STreatment of eyelid lesions06981.03$52.43$19.92$10.49
    68100TBiopsy of eyelid lining023310.83$551.29$264.62$110.26
    68110TRemove eyelid lining lesion06996.46$328.84$147.98$65.77
    68115TRemove eyelid lining lesion02395.80$295.24$115.14$59.05
    68130TRemove eyelid lining lesion023310.83$551.29$264.62$110.26
    68135TRemove eyelid lining lesion02395.80$295.24$115.14$59.05
    68200STreat eyelid by injection06981.03$52.43$19.92$10.49
    68320TRevise/graft eyelid lining024013.83$704.00$315.34$140.80
    68325TRevise/graft eyelid lining024223.72$1,207.44$597.36$241.49
    68326TRevise/graft eyelid lining024118.12$922.38$384.47$184.48
    68328TRevise/graft eyelid lining024118.12$922.38$384.47$184.48
    68330TRevise eyelid lining023310.83$551.29$264.62$110.26
    68335TRevise/graft eyelid lining024118.12$922.38$384.47$184.48
    68340TSeparate eyelid adhesions024013.83$704.00$315.34$140.80
    68360TRevise eyelid lining023419.08$971.25$466.20$194.25
    68362TRevise eyelid lining023419.08$971.25$466.20$194.25
    68399TEyelid lining surgery02395.80$295.24$115.14$59.05
    68400TIncise/drain tear gland02383.01$153.22$58.96$30.64
    68420TIncise/drain tear sac024013.83$704.00$315.34$140.80
    68440TIncise tear duct opening02383.01$153.22$58.96$30.64
    68500TRemoval of tear gland024118.12$922.38$384.47$184.48
    68505TPartial removal, tear gland024118.12$922.38$384.47$184.48
    Start Printed Page 60004
    68510TBiopsy of tear gland024013.83$704.00$315.34$140.80
    68520TRemoval of tear sac024118.12$922.38$384.47$184.48
    68525TBiopsy of tear sac024013.83$704.00$315.34$140.80
    68530TClearance of tear duct024013.83$704.00$315.34$140.80
    68540TRemove tear gland lesion024118.12$922.38$384.47$184.48
    68550TRemove tear gland lesion024223.72$1,207.44$597.36$241.49
    68700TRepair tear ducts024118.12$922.38$384.47$184.48
    68705TRevise tear duct opening02383.01$153.22$58.96$30.64
    68720TCreate tear sac drain024223.72$1,207.44$597.36$241.49
    68745TCreate tear duct drain024118.12$922.38$384.47$184.48
    68750TCreate tear duct drain024223.72$1,207.44$597.36$241.49
    68760SClose tear duct opening06981.03$52.43$19.92$10.49
    68761SClose tear duct opening02312.03$103.34$46.50$20.67
    68770TClose tear system fistula024013.83$704.00$315.34$140.80
    68801SDilate tear duct opening02312.03$103.34$46.50$20.67
    68810TProbe nasolacrimal duct06996.46$328.84$147.98$65.77
    68811TProbe nasolacrimal duct024013.83$704.00$315.34$140.80
    68815TProbe nasolacrimal duct024013.83$704.00$315.34$140.80
    68840TExplore/irrigate tear ducts06996.46$328.84$147.98$65.77
    68850NInjection for tear sac x-ray
    68899TTear duct system surgery06996.46$328.84$147.98$65.77
    69000TDrain external ear lesion00062.18$110.97$33.95$22.19
    69005TDrain external ear lesion00076.75$343.60$72.03$68.72
    69020TDrain outer ear canal lesion00062.18$110.97$33.95$22.19
    69090EPierce earlobes
    69100TBiopsy of external ear00194.22$214.81$78.91$42.96
    69105TBiopsy of external ear canal025312.33$627.65$284.00$125.53
    69110TRemove external ear, partial00208.44$429.63$130.53$85.93
    69120TRemoval of external ear025417.37$884.20$272.41$176.84
    69140TRemove ear canal lesion(s)025417.37$884.20$272.41$176.84
    69145TRemove ear canal lesion(s)00208.44$429.63$130.53$85.93
    69150CExtensive ear canal surgery
    69155CExtensive ear/neck surgery
    69200XClear outer ear canal03400.84$42.76$10.69$8.55
    69205TClear outer ear canal002213.91$708.07$292.94$141.61
    69210XRemove impacted ear wax03400.84$42.76$10.69$8.55
    69220TClean out mastoid cavity00120.66$33.60$9.18$6.72
    69222TClean out mastoid cavity025312.33$627.65$284.00$125.53
    69300TRevise external ear025417.37$884.20$272.41$176.84
    69310TRebuild outer ear canal025626.61$1,354.56$623.05$270.91
    69320TRebuild outer ear canal025626.61$1,354.56$623.05$270.91
    69399TOuter ear surgery procedure02512.43$123.70$27.99$24.74
    69400TInflate middle ear canal02512.43$123.70$27.99$24.74
    69401NInflate middle ear canal
    69405TCatheterize middle ear canal02525.95$302.88$114.24$60.58
    69410TInset middle ear (baffle)02525.95$302.88$114.24$60.58
    69420TIncision of eardrum02512.43$123.70$27.99$24.74
    69421TIncision of eardrum025312.33$627.65$284.00$125.53
    69424TRemove ventilating tube02525.95$302.88$114.24$60.58
    69433TCreate eardrum opening02525.95$302.88$114.24$60.58
    69436TCreate eardrum opening025312.33$627.65$284.00$125.53
    69440TExploration of middle ear025417.37$884.20$272.41$176.84
    69450TEardrum revision025626.61$1,354.56$623.05$270.91
    69501TMastoidectomy025626.61$1,354.56$623.05$270.91
    69502CMastoidectomy
    69505TRemove mastoid structures025626.61$1,354.56$623.05$270.91
    69511TExtensive mastoid surgery025626.61$1,354.56$623.05$270.91
    69530TExtensive mastoid surgery025626.61$1,354.56$623.05$270.91
    69535CRemove part of temporal bone
    69540TRemove ear lesion025312.33$627.65$284.00$125.53
    69550TRemove ear lesion025626.61$1,354.56$623.05$270.91
    69552TRemove ear lesion025626.61$1,354.56$623.05$270.91
    69554CRemove ear lesion
    69601TMastoid surgery revision025626.61$1,354.56$623.05$270.91
    69602TMastoid surgery revision025626.61$1,354.56$623.05$270.91
    69603TMastoid surgery revision025626.61$1,354.56$623.05$270.91
    69604TMastoid surgery revision025626.61$1,354.56$623.05$270.91
    69605TMastoid surgery revision025626.61$1,354.56$623.05$270.91
    69610TRepair of eardrum025417.37$884.20$272.41$176.84
    69620TRepair of eardrum025417.37$884.20$272.41$176.84
    69631TRepair eardrum structures025626.61$1,354.56$623.05$270.91
    69632TRebuild eardrum structures025626.61$1,354.56$623.05$270.91
    69633TRebuild eardrum structures025626.61$1,354.56$623.05$270.91
    69635TRepair eardrum structures025626.61$1,354.56$623.05$270.91
    69636TRebuild eardrum structures025626.61$1,354.56$623.05$270.91
    Start Printed Page 60005
    69637TRebuild eardrum structures025626.61$1,354.56$623.05$270.91
    69641TRevise middle ear & mastoid025626.61$1,354.56$623.05$270.91
    69642TRevise middle ear & mastoid025626.61$1,354.56$623.05$270.91
    69643TRevise middle ear & mastoid025626.61$1,354.56$623.05$270.91
    69644TRevise middle ear & mastoid025626.61$1,354.56$623.05$270.91
    69645TRevise middle ear & mastoid025626.61$1,354.56$623.05$270.91
    69646TRevise middle ear & mastoid025626.61$1,354.56$623.05$270.91
    69650TRelease middle ear bone025417.37$884.20$272.41$176.84
    69660TRevise middle ear bone025626.61$1,354.56$623.05$270.91
    69661TRevise middle ear bone025626.61$1,354.56$623.05$270.91
    69662TRevise middle ear bone025626.61$1,354.56$623.05$270.91
    69666TRepair middle ear structures025626.61$1,354.56$623.05$270.91
    69667TRepair middle ear structures025626.61$1,354.56$623.05$270.91
    69670TRemove mastoid air cells025626.61$1,354.56$623.05$270.91
    69676TRemove middle ear nerve025626.61$1,354.56$623.05$270.91
    69700TClose mastoid fistula025626.61$1,354.56$623.05$270.91
    69710EImplant/replace hearing aid
    69711TRemove/repair hearing aid025626.61$1,354.56$623.05$270.91
    69714TImplant temple bone w/stimul025626.61$1,354.56$623.05$270.91
    69715TTemple bne implnt w/stimulat025626.61$1,354.56$623.05$270.91
    69717TTemple bone implant revision025626.61$1,354.56$623.05$270.91
    69718TRevise temple bone implant025626.61$1,354.56$623.05$270.91
    69720TRelease facial nerve025626.61$1,354.56$623.05$270.91
    69725TRelease facial nerve025626.61$1,354.56$623.05$270.91
    69740TRepair facial nerve025626.61$1,354.56$623.05$270.91
    69745TRepair facial nerve025626.61$1,354.56$623.05$270.91
    69799TMiddle ear surgery procedure025312.33$627.65$284.00$125.53
    69801TIncise inner ear025626.61$1,354.56$623.05$270.91
    69802TIncise inner ear025626.61$1,354.56$623.05$270.91
    69805TExplore inner ear025626.61$1,354.56$623.05$270.91
    69806TExplore inner ear025626.61$1,354.56$623.05$270.91
    69820TEstablish inner ear window025626.61$1,354.56$623.05$270.91
    69840TRevise inner ear window025626.61$1,354.56$623.05$270.91
    69905TRemove inner ear025626.61$1,354.56$623.05$270.91
    69910TRemove inner ear & mastoid025626.61$1,354.56$623.05$270.91
    69915TIncise inner ear nerve025626.61$1,354.56$623.05$270.91
    69930TImplant cochlear device0259376.56$19,168.41$8,798.30$3,833.68
    69949TInner ear surgery procedure025312.33$627.65$284.00$125.53
    69950CIncise inner ear nerve
    69955TRelease facial nerve025626.61$1,354.56$623.05$270.91
    69960TRelease inner ear canal025626.61$1,354.56$623.05$270.91
    69970CRemove inner ear lesion
    69979TTemporal bone surgery02512.43$123.70$27.99$24.74
    69990NMicrosurgery add-on
    70010SContrast x-ray of brain02745.24$266.74$128.12$53.35
    70015SContrast x-ray of brain02745.24$266.74$128.12$53.35
    70030XX-ray eye for foreign body02600.70$35.63$19.59$7.13
    70100XX-ray exam of jaw02600.70$35.63$19.59$7.13
    70110XX-ray exam of jaw02600.70$35.63$19.59$7.13
    70120XX-ray exam of mastoids02600.70$35.63$19.59$7.13
    70130XX-ray exam of mastoids02600.70$35.63$19.59$7.13
    70134XX-ray exam of middle ear02611.21$61.59$33.87$12.32
    70140XX-ray exam of facial bones02600.70$35.63$19.59$7.13
    70150XX-ray exam of facial bones02600.70$35.63$19.59$7.13
    70160XX-ray exam of nasal bones02600.70$35.63$19.59$7.13
    70170XX-ray exam of tear duct02631.61$81.96$44.26$16.39
    70190XX-ray exam of eye sockets02600.70$35.63$19.59$7.13
    70200XX-ray exam of eye sockets02600.70$35.63$19.59$7.13
    70210XX-ray exam of sinuses02600.70$35.63$19.59$7.13
    70220XX-ray exam of sinuses02600.70$35.63$19.59$7.13
    70240XX-ray exam, pituitary saddle02600.70$35.63$19.59$7.13
    70250XX-ray exam of skull02600.70$35.63$19.59$7.13
    70260XX-ray exam of skull02611.21$61.59$33.87$12.32
    70300XX-ray exam of teeth02620.65$33.09$10.90$6.62
    70310XX-ray exam of teeth02620.65$33.09$10.90$6.62
    70320XFull mouth x-ray of teeth02620.65$33.09$10.90$6.62
    70328XX-ray exam of jaw joint02600.70$35.63$19.59$7.13
    70330XX-ray exam of jaw joints02600.70$35.63$19.59$7.13
    70332SX-ray exam of jaw joint02752.59$131.84$68.56$26.37
    70336SMagnetic image, jaw joint03355.39$274.37$150.90$54.87
    70350XX-ray head for orthodontia02600.70$35.63$19.59$7.13
    70355XPanoramic x-ray of jaws02600.70$35.63$19.59$7.13
    70360XX-ray exam of neck02600.70$35.63$19.59$7.13
    70370XThroat x-ray & fluoroscopy02721.38$70.25$38.63$14.05
    70371XSpeech evaluation, complex02721.38$70.25$38.63$14.05
    Start Printed Page 60006
    70373XContrast x-ray of larynx02631.61$81.96$44.26$16.39
    70380XX-ray exam of salivary gland02600.70$35.63$19.59$7.13
    70390XX-ray exam of salivary duct02631.61$81.96$44.26$16.39
    70450SCt head/brain w/o dye03323.24$164.93$90.71$32.99
    70460SCt head/brain w/dye02834.48$228.05$125.42$45.61
    70470SCt head/brain w/o&w dye03335.22$265.72$146.14$53.14
    70480SCt orbit/ear/fossa w/o dye03323.24$164.93$90.71$32.99
    70481SCt orbit/ear/fossa w/dye02834.48$228.05$125.42$45.61
    70482SCt orbit/ear/fossa w/o&w dye03335.22$265.72$146.14$53.14
    70486SCt maxillofacial w/o dye03323.24$164.93$90.71$32.99
    70487SCt maxillofacial w/dye02834.48$228.05$125.42$45.61
    70488SCt maxillofacial w/o&w dye03335.22$265.72$146.14$53.14
    70490SCt soft tissue neck w/o dye03323.24$164.93$90.71$32.99
    70491SCt soft tissue neck w/dye02834.48$228.05$125.42$45.61
    70492SCt sft tsue nck w/o & w/dye03335.22$265.72$146.14$53.14
    70496SCt angiography, head03335.22$265.72$146.14$53.14
    70498SCt angiography, neck03335.22$265.72$146.14$53.14
    70540SMri orbit/face/neck w/o dye03366.29$320.19$176.10$64.04
    70542SMri orbit/face/neck w/dye02847.15$363.96$200.17$72.79
    70543SMri orbt/fac/nck w/o&w dye03378.54$434.72$239.09$86.94
    70544SMr angiography head w/o dye03366.29$320.19$176.10$64.04
    70545SMr angiography head w/dye02847.15$363.96$200.17$72.79
    70546SMr angiograph head w/o&w dye03378.54$434.72$239.09$86.94
    70547SMr angiography neck w/o dye03366.29$320.19$176.10$64.04
    70548SMr angiography neck w/dye02847.15$363.96$200.17$72.79
    70549SMr angiograph neck w/o&w dye03378.54$434.72$239.09$86.94
    70551SMri brain w/o dye03366.29$320.19$176.10$64.04
    70552SMri brain w/dye02847.15$363.96$200.17$72.79
    70553SMri brain w/o&w dye03378.54$434.72$239.09$86.94
    71010XChest x-ray02600.70$35.63$19.59$7.13
    71015XChest x-ray02600.70$35.63$19.59$7.13
    71020XChest x-ray02600.70$35.63$19.59$7.13
    71021XChest x-ray02600.70$35.63$19.59$7.13
    71022XChest x-ray02600.70$35.63$19.59$7.13
    71023XChest x-ray and fluoroscopy02721.38$70.25$38.63$14.05
    71030XChest x-ray02600.70$35.63$19.59$7.13
    71034XChest x-ray and fluoroscopy02721.38$70.25$38.63$14.05
    71035XChest x-ray02600.70$35.63$19.59$7.13
    71040XContrast x-ray of bronchi02631.61$81.96$44.26$16.39
    71060XContrast x-ray of bronchi02631.61$81.96$44.26$16.39
    71090XX-ray & pacemaker insertion02721.38$70.25$38.63$14.05
    71100XX-ray exam of ribs02600.70$35.63$19.59$7.13
    71101XX-ray exam of ribs/chest02600.70$35.63$19.59$7.13
    71110XX-ray exam of ribs02600.70$35.63$19.59$7.13
    71111XX-ray exam of ribs/ chest02611.21$61.59$33.87$12.32
    71120XX-ray exam of breastbone02600.70$35.63$19.59$7.13
    71130XX-ray exam of breastbone02600.70$35.63$19.59$7.13
    71250SCt thorax w/o dye03323.24$164.93$90.71$32.99
    71260SCt thorax w/dye02834.48$228.05$125.42$45.61
    71270SCt thorax w/o&w dye03335.22$265.72$146.14$53.14
    71275SCt angiography, chest03335.22$265.72$146.14$53.14
    71550SMri chest w/o dye03366.29$320.19$176.10$64.04
    71551SMri chest w/dye02847.15$363.96$200.17$72.79
    71552SMri chest w/o&w dye03378.54$434.72$239.09$86.94
    71555EMri angio chest w or w/o dye
    72010XX-ray exam of spine02611.21$61.59$33.87$12.32
    72020XX-ray exam of spine02600.70$35.63$19.59$7.13
    72040XX-ray exam of neck spine02600.70$35.63$19.59$7.13
    72050XX-ray exam of neck spine02611.21$61.59$33.87$12.32
    72052XX-ray exam of neck spine02611.21$61.59$33.87$12.32
    72069XX-ray exam of trunk spine02600.70$35.63$19.59$7.13
    72070XX-ray exam of thoracic spine02600.70$35.63$19.59$7.13
    72072XX-ray exam of thoracic spine02600.70$35.63$19.59$7.13
    72074XX-ray exam of thoracic spine02600.70$35.63$19.59$7.13
    72080XX-ray exam of trunk spine02600.70$35.63$19.59$7.13
    72090XX-ray exam of trunk spine02611.21$61.59$33.87$12.32
    72100XX-ray exam of lower spine02600.70$35.63$19.59$7.13
    72110XX-ray exam of lower spine02611.21$61.59$33.87$12.32
    72114XX-ray exam of lower spine02611.21$61.59$33.87$12.32
    72120XX-ray exam of lower spine02600.70$35.63$19.59$7.13
    72125SCt neck spine w/o dye03323.24$164.93$90.71$32.99
    72126SCt neck spine w/dye02834.48$228.05$125.42$45.61
    72127SCt neck spine w/o&w dye03335.22$265.72$146.14$53.14
    72128SCt chest spine w/o dye03323.24$164.93$90.71$32.99
    72129SCt chest spine w/dye02834.48$228.05$125.42$45.61
    Start Printed Page 60007
    72130SCt chest spine w/o&w dye03335.22$265.72$146.14$53.14
    72131SCt lumbar spine w/o dye03323.24$164.93$90.71$32.99
    72132SCt lumbar spine w/dye02834.48$228.05$125.42$45.61
    72133SCt lumbar spine w/o&w dye03335.22$265.72$146.14$53.14
    72141SMri neck spine w/o dye03366.29$320.19$176.10$64.04
    72142SMri neck spine w/dye02847.15$363.96$200.17$72.79
    72146SMri chest spine w/o dye03366.29$320.19$176.10$64.04
    72147SMri chest spine w/dye02847.15$363.96$200.17$72.79
    72148SMri lumbar spine w/o dye03366.29$320.19$176.10$64.04
    72149SMri lumbar spine w/dye02847.15$363.96$200.17$72.79
    72156SMri neck spine w/o&w dye03378.54$434.72$239.09$86.94
    72157SMri chest spine w/o&w dye03378.54$434.72$239.09$86.94
    72158SMri lumbar spine w/o&w dye03378.54$434.72$239.09$86.94
    72159EMr angio spine w/o&w dye
    72170XX-ray exam of pelvis02600.70$35.63$19.59$7.13
    72190XX-ray exam of pelvis02600.70$35.63$19.59$7.13
    72191SCt angiograph pelv w/o&w dye03335.22$265.72$146.14$53.14
    72192SCt pelvis w/o dye03323.24$164.93$90.71$32.99
    72193SCt pelvis w/dye02834.48$228.05$125.42$45.61
    72194SCt pelvis w/o&w dye03335.22$265.72$146.14$53.14
    72195SMri pelvis w/o dye03366.29$320.19$176.10$64.04
    72196SMri pelvis w/dye02847.15$363.96$200.17$72.79
    72197SMri pelvis w/o & w dye03378.54$434.72$239.09$86.94
    72198EMr angio pelvis w/o&w dye
    72200XX-ray exam sacroiliac joints02600.70$35.63$19.59$7.13
    72202XX-ray exam sacroiliac joints02600.70$35.63$19.59$7.13
    72220XX-ray exam of tailbone02600.70$35.63$19.59$7.13
    72240SContrast x-ray of neck spine02745.24$266.74$128.12$53.35
    72255SContrast x-ray, thorax spine02745.24$266.74$128.12$53.35
    72265SContrast x-ray, lower spine02745.24$266.74$128.12$53.35
    72270SContrast x-ray of spine02745.24$266.74$128.12$53.35
    72275SEpidurography02745.24$266.74$128.12$53.35
    72285SX-ray c/t spine disk02745.24$266.74$128.12$53.35
    72295SX-ray of lower spine disk02745.24$266.74$128.12$53.35
    73000XX-ray exam of collar bone02600.70$35.63$19.59$7.13
    73010XX-ray exam of shoulder blade02600.70$35.63$19.59$7.13
    73020XX-ray exam of shoulder02600.70$35.63$19.59$7.13
    73030XX-ray exam of shoulder02600.70$35.63$19.59$7.13
    73040SContrast x-ray of shoulder02752.59$131.84$68.56$26.37
    73050XX-ray exam of shoulders02600.70$35.63$19.59$7.13
    73060XX-ray exam of humerus02600.70$35.63$19.59$7.13
    73070XX-ray exam of elbow02600.70$35.63$19.59$7.13
    73080XX-ray exam of elbow02600.70$35.63$19.59$7.13
    73085SContrast x-ray of elbow02752.59$131.84$68.56$26.37
    73090XX-ray exam of forearm02600.70$35.63$19.59$7.13
    73092XX-ray exam of arm, infant02600.70$35.63$19.59$7.13
    73100XX-ray exam of wrist02600.70$35.63$19.59$7.13
    73110XX-ray exam of wrist02600.70$35.63$19.59$7.13
    73115SContrast x-ray of wrist02752.59$131.84$68.56$26.37
    73120XX-ray exam of hand02600.70$35.63$19.59$7.13
    73130XX-ray exam of hand02600.70$35.63$19.59$7.13
    73140XX-ray exam of finger(s)02600.70$35.63$19.59$7.13
    73200SCt upper extremity w/o dye03323.24$164.93$90.71$32.99
    73201SCt upper extremity w/dye02834.48$228.05$125.42$45.61
    73202SCt uppr extremity w/o&w dye03335.22$265.72$146.14$53.14
    73206SCt angio upr extrm w/o&w dye03335.22$265.72$146.14$53.14
    73218SMri upper extremity w/o dye03366.29$320.19$176.10$64.04
    73219SMri upper extremity w/dye02847.15$363.96$200.17$72.79
    73220SMri uppr extremity w/o&w dye03378.54$434.72$239.09$86.94
    73221SMri joint upr extrem w/o dye03366.29$320.19$176.10$64.04
    73222SMri joint upr extrem w/ dye02847.15$363.96$200.17$72.79
    73223SMri joint upr extr w/o&w dye03378.54$434.72$239.09$86.94
    73225EMr angio upr extr w/o&w dye
    73500XX-ray exam of hip02600.70$35.63$19.59$7.13
    73510XX-ray exam of hip02600.70$35.63$19.59$7.13
    73520XX-ray exam of hips02600.70$35.63$19.59$7.13
    73525SContrast x-ray of hip02752.59$131.84$68.56$26.37
    73530XX-ray exam of hip02611.21$61.59$33.87$12.32
    73540XX-ray exam of pelvis & hips02600.70$35.63$19.59$7.13
    73542SX-ray exam, sacroiliac joint02752.59$131.84$68.56$26.37
    73550XX-ray exam of thigh02600.70$35.63$19.59$7.13
    73560XX-ray exam of knee, 1 or 202600.70$35.63$19.59$7.13
    73562XX-ray exam of knee, 302600.70$35.63$19.59$7.13
    73564XX-ray exam, knee, 4 or more02600.70$35.63$19.59$7.13
    73565XX-ray exam of knees02600.70$35.63$19.59$7.13
    Start Printed Page 60008
    73580SContrast x-ray of knee joint02752.59$131.84$68.56$26.37
    73590XX-ray exam of lower leg02600.70$35.63$19.59$7.13
    73592XX-ray exam of leg, infant02611.21$61.59$33.87$12.32
    73600XX-ray exam of ankle02600.70$35.63$19.59$7.13
    73610XX-ray exam of ankle02600.70$35.63$19.59$7.13
    73615SContrast x-ray of ankle02752.59$131.84$68.56$26.37
    73620XX-ray exam of foot02600.70$35.63$19.59$7.13
    73630XX-ray exam of foot02600.70$35.63$19.59$7.13
    73650XX-ray exam of heel02600.70$35.63$19.59$7.13
    73660XX-ray exam of toe(s)02600.70$35.63$19.59$7.13
    73700SCt lower extremity w/o dye03323.24$164.93$90.71$32.99
    73701SCt lower extremity w/dye02834.48$228.05$125.42$45.61
    73702SCt lwr extremity w/o&w dye03335.22$265.72$146.14$53.14
    73706SCt angio lwr extr w/o&w dye03335.22$265.72$146.14$53.14
    73718SMri lower extremity w/o dye03366.29$320.19$176.10$64.04
    73719SMri lower extremity w/dye02847.15$363.96$200.17$72.79
    73720SMri lwr extremity w/o&w dye03378.54$434.72$239.09$86.94
    73721SMri joint of lwr extre w/o d03366.29$320.19$176.10$64.04
    73722SMri joint of lwr extr w/dye02847.15$363.96$200.17$72.79
    73723SMri joint lwr extr w/o&w dye03378.54$434.72$239.09$86.94
    73725EMr ang lwr ext w or w/o dye
    74000XX-ray exam of abdomen02600.70$35.63$19.59$7.13
    74010XX-ray exam of abdomen02600.70$35.63$19.59$7.13
    74020XX-ray exam of abdomen02600.70$35.63$19.59$7.13
    74022XX-ray exam series, abdomen02611.21$61.59$33.87$12.32
    74150SCt abdomen w/o dye03323.24$164.93$90.71$32.99
    74160SCt abdomen w/dye02834.48$228.05$125.42$45.61
    74170SCt abdomen w/o&w dye03335.22$265.72$146.14$53.14
    74175SCt angio abdom w/o&w dye03335.22$265.72$146.14$53.14
    74181SMri abdomen w/o dye03366.29$320.19$176.10$64.04
    74182SMri abdomen w/dye02847.15$363.96$200.17$72.79
    74183SMri abdomen w/o&w dye03378.54$434.72$239.09$86.94
    74185EMri angio, abdom w or w/o dy
    74190XX-ray exam of peritoneum02631.61$81.96$44.26$16.39
    74210SContrst x-ray exam of throat02761.48$75.34$41.43$15.07
    74220SContrast x-ray, esophagus02761.48$75.34$41.43$15.07
    74230SCinema x-ray, throat/esoph02761.48$75.34$41.43$15.07
    74235SRemove esophagus obstruction02963.39$172.56$94.90$34.51
    74240SX-ray exam, upper gi tract02761.48$75.34$41.43$15.07
    74241SX-ray exam, upper gi tract02761.48$75.34$41.43$15.07
    74245SX-ray exam, upper gi tract02772.16$109.95$60.47$21.99
    74246SContrst x-ray uppr gi tract02761.48$75.34$41.43$15.07
    74247SContrst x-ray uppr gi tract02761.48$75.34$41.43$15.07
    74249SContrst x-ray uppr gi tract02772.16$109.95$60.47$21.99
    74250SX-ray exam of small bowel02761.48$75.34$41.43$15.07
    74251SX-ray exam of small bowel02772.16$109.95$60.47$21.99
    74260SX-ray exam of small bowel02772.16$109.95$60.47$21.99
    74270SContrast x-ray exam of colon02761.48$75.34$41.43$15.07
    74280SContrast x-ray exam of colon02772.16$109.95$60.47$21.99
    74283SContrast x-ray exam of colon02761.48$75.34$41.43$15.07
    74290SContrast x-ray, gallbladder02761.48$75.34$41.43$15.07
    74291SContrast x-rays, gallbladder02761.48$75.34$41.43$15.07
    74300XX-ray bile ducts/pancreas02631.61$81.96$44.26$16.39
    74301XX-rays at surgery add-on02631.61$81.96$44.26$16.39
    74305XX-ray bile ducts/pancreas02631.61$81.96$44.26$16.39
    74320XContrast x-ray of bile ducts02643.71$188.85$103.86$37.77
    74327SX-ray bile stone removal02963.39$172.56$94.90$34.51
    74328NXray bile duct endoscopy
    74329NX-ray for pancreas endoscopy
    74330NX-ray bile/panc endoscopy
    74340XX-ray guide for GI tube02721.38$70.25$38.63$14.05
    74350XX-ray guide, stomach tube01874.22$214.81$42.96
    74355XX-ray guide, intestinal tube01874.22$214.81$42.96
    74360SX-ray guide, GI dilation02963.39$172.56$94.90$34.51
    74363SX-ray, bile duct dilation02977.07$359.89$172.51$71.98
    74400SContrst x-ray, urinary tract02782.34$119.12$65.51$23.82
    74410SContrst x-ray, urinary tract02782.34$119.12$65.51$23.82
    74415SContrst x-ray, urinary tract02782.34$119.12$65.51$23.82
    74420SContrst x-ray, urinary tract02782.34$119.12$65.51$23.82
    74425SContrst x-ray, urinary tract02782.34$119.12$65.51$23.82
    74430SContrast x-ray, bladder02782.34$119.12$65.51$23.82
    74440SX-ray, male genital tract02782.34$119.12$65.51$23.82
    74445SX-ray exam of penis02782.34$119.12$65.51$23.82
    74450SX-ray, urethra/bladder02782.34$119.12$65.51$23.82
    74455SX-ray, urethra/bladder02782.34$119.12$65.51$23.82
    Start Printed Page 60009
    74470XX-ray exam of kidney lesion02643.71$188.85$103.86$37.77
    74475SX-ray control, cath insert02977.07$359.89$172.51$71.98
    74480SX-ray control, cath insert02977.07$359.89$172.51$71.98
    74485SX-ray guide, GU dilation02963.39$172.56$94.90$34.51
    74710XX-ray measurement of pelvis02600.70$35.63$19.59$7.13
    74740XX-ray, female genital tract02643.71$188.85$103.86$37.77
    74742XX-ray, fallopian tube01874.22$214.81$42.96
    74775SX-ray exam of perineum02782.34$119.12$65.51$23.82
    75552SHeart mri for morph w/o dye03366.29$320.19$176.10$64.04
    75553SHeart mri for morph w/dye02847.15$363.96$200.17$72.79
    75554SCardiac MRI/function03355.39$274.37$150.90$54.87
    75555SCardiac MRI/limited study03355.39$274.37$150.90$54.87
    75556ECardiac MRI/flow mapping
    75600SContrast x-ray exam of aorta028013.54$689.24$351.51$137.85
    75605SContrast x-ray exam of aorta028013.54$689.24$351.51$137.85
    75625SContrast x-ray exam of aorta028013.54$689.24$351.51$137.85
    75630SX-ray aorta, leg arteries028013.54$689.24$351.51$137.85
    75635SCt angio abdominal arteries03335.22$265.72$146.14$53.14
    75650SArtery x-rays, head & neck028013.54$689.24$351.51$137.85
    75658SArtery x-rays, arm028013.54$689.24$351.51$137.85
    75660SArtery x-rays, head & neck02797.72$392.98$174.57$78.60
    75662SArtery x-rays, head & neck02797.72$392.98$174.57$78.60
    75665SArtery x-rays, head & neck028013.54$689.24$351.51$137.85
    75671SArtery x-rays, head & neck028013.54$689.24$351.51$137.85
    75676SArtery x-rays, neck028013.54$689.24$351.51$137.85
    75680SArtery x-rays, neck028013.54$689.24$351.51$137.85
    75685SArtery x-rays, spine02797.72$392.98$174.57$78.60
    75705SArtery x-rays, spine02797.72$392.98$174.57$78.60
    75710SArtery x-rays, arm/leg028013.54$689.24$351.51$137.85
    75716SArtery x-rays, arms/legs028013.54$689.24$351.51$137.85
    75722SArtery x-rays, kidney028013.54$689.24$351.51$137.85
    75724SArtery x-rays, kidneys028013.54$689.24$351.51$137.85
    75726SArtery x-rays, abdomen028013.54$689.24$351.51$137.85
    75731SArtery x-rays, adrenal gland028013.54$689.24$351.51$137.85
    75733SArtery x-rays, adrenals028013.54$689.24$351.51$137.85
    75736SArtery x-rays, pelvis028013.54$689.24$351.51$137.85
    75741SArtery x-rays, lung02797.72$392.98$174.57$78.60
    75743SArtery x-rays, lungs028013.54$689.24$351.51$137.85
    75746SArtery x-rays, lung02797.72$392.98$174.57$78.60
    75756SArtery x-rays, chest02797.72$392.98$174.57$78.60
    75774SArtery x-ray, each vessel02797.72$392.98$174.57$78.60
    75790SVisualize A-V shunt02814.32$219.91$114.35$43.98
    75801XLymph vessel x-ray, arm/leg02643.71$188.85$103.86$37.77
    75803XLymph vessel x-ray,arms/legs02643.71$188.85$103.86$37.77
    75805XLymph vessel x-ray, trunk02643.71$188.85$103.86$37.77
    75807XLymph vessel x-ray, trunk02643.71$188.85$103.86$37.77
    75809XNonvascular shunt, x-ray02631.61$81.96$44.26$16.39
    75810SVein x-ray, spleen/liver02797.72$392.98$174.57$78.60
    75820SVein x-ray, arm/leg02814.32$219.91$114.35$43.98
    75822SVein x-ray, arms/legs02814.32$219.91$114.35$43.98
    75825SVein x-ray, trunk02797.72$392.98$174.57$78.60
    75827SVein x-ray, chest02797.72$392.98$174.57$78.60
    75831SVein x-ray, kidney02874.06$206.67$90.93$41.33
    75833SVein x-ray, kidneys02797.72$392.98$174.57$78.60
    75840SVein x-ray, adrenal gland02874.06$206.67$90.93$41.33
    75842SVein x-ray, adrenal glands02874.06$206.67$90.93$41.33
    75860SVein x-ray, neck02874.06$206.67$90.93$41.33
    75870SVein x-ray, skull02874.06$206.67$90.93$41.33
    75872SVein x-ray, skull02874.06$206.67$90.93$41.33
    75880SVein x-ray, eye socket02874.06$206.67$90.93$41.33
    75885SVein x-ray, liver02797.72$392.98$174.57$78.60
    75887SVein x-ray, liver028013.54$689.24$351.51$137.85
    75889SVein x-ray, liver02797.72$392.98$174.57$78.60
    75891SVein x-ray, liver02797.72$392.98$174.57$78.60
    75893NVenous sampling by catheter
    75894SX-rays, transcath therapy02977.07$359.89$172.51$71.98
    75896SX-rays, transcath therapy02977.07$359.89$172.51$71.98
    75898XFollow-up angiogram02643.71$188.85$103.86$37.77
    75900CArterial catheter exchange
    75940XX-ray placement, vein filter01874.22$214.81$42.96
    75945SIntravascular us02672.33$118.61$65.23$23.72
    75946SIntravascular us add-on02672.33$118.61$65.23$23.72
    75952CEndovasc repair abdom aorta
    75953CAbdom aneurysm endovas rpr
    75960STranscatheter intro, stent028013.54$689.24$351.51$137.85
    Start Printed Page 60010
    75961SRetrieval, broken catheter028013.54$689.24$351.51$137.85
    75962SRepair arterial blockage028013.54$689.24$351.51$137.85
    75964SRepair artery blockage, each028013.54$689.24$351.51$137.85
    75966SRepair arterial blockage028013.54$689.24$351.51$137.85
    75968SRepair artery blockage, each028013.54$689.24$351.51$137.85
    75970SVascular biopsy028013.54$689.24$351.51$137.85
    75978SRepair venous blockage028013.54$689.24$351.51$137.85
    75980SContrast xray exam bile duct02977.07$359.89$172.51$71.98
    75982SContrast xray exam bile duct02977.07$359.89$172.51$71.98
    75984SXray control catheter change02963.39$172.56$94.90$34.51
    75989NAbscess drainage under x-ray
    75992SAtherectomy, x-ray exam028013.54$689.24$351.51$137.85
    75993SAtherectomy, x-ray exam028013.54$689.24$351.51$137.85
    75994SAtherectomy, x-ray exam028013.54$689.24$351.51$137.85
    75995SAtherectomy, x-ray exam028013.54$689.24$351.51$137.85
    75996SAtherectomy, x-ray exam028013.54$689.24$351.51$137.85
    76000XFluoroscope examination02721.38$70.25$38.63$14.05
    76001NFluoroscope exam, extensive
    76003NNeedle localization by x-ray
    76005NFluoroguide for spine inject
    76006XX-ray stress view02611.21$61.59$33.87$12.32
    76010XX-ray, nose to rectum02600.70$35.63$19.59$7.13
    76012SPercut vertebroplasty fluor02745.24$266.74$128.12$53.35
    76013SPercut vertebroplasty, ct02745.24$266.74$128.12$53.35
    76020XX-rays for bone age02611.21$61.59$33.87$12.32
    76040XX-rays, bone evaluation02600.70$35.63$19.59$7.13
    76061XX-rays, bone survey02611.21$61.59$33.87$12.32
    76062XX-rays, bone survey02611.21$61.59$33.87$12.32
    76065XX-rays, bone evaluation02611.21$61.59$33.87$12.32
    76066XJoint(s) survey, single film02600.70$35.63$19.59$7.13
    76070ECT scan, bone density study
    76075SDual energy x-ray study0707$75.00$15.00
    76076SDual energy x-ray study0707$75.00$15.00
    76078XPhotodensitometry02611.21$61.59$33.87$12.32
    76080XX-ray exam of fistula02631.61$81.96$44.26$16.39
    *76085AComputer mammogram add-on
    76086XX-ray of mammary duct02631.61$81.96$44.26$16.39
    76088XX-ray of mammary ducts02631.61$81.96$44.26$16.39
    76090SMammogram, one breast02710.60$30.54$16.79$6.11
    76091SMammogram, both breasts02710.60$30.54$16.79$6.11
    76092AMammogram, screening
    76093EMagnetic image, breast
    76094EMagnetic image, both breasts
    76095XStereotactic breast biopsy01874.22$214.81$42.96
    76096XX-ray of needle wire, breast02891.63$82.97$44.80$16.59
    76098XX-ray exam, breast specimen02600.70$35.63$19.59$7.13
    76100XX-ray exam of body section02611.21$61.59$33.87$12.32
    76101XComplex body section x-ray02631.61$81.96$44.26$16.39
    76102XComplex body section x-rays02643.71$188.85$103.86$37.77
    76120XCinematic x-rays02611.21$61.59$33.87$12.32
    76125XCinematic x-rays add-on02611.21$61.59$33.87$12.32
    76140EX-ray consultation
    76150XX-ray exam, dry process02600.70$35.63$19.59$7.13
    76350NSpecial x-ray contrast study
    76355SCAT scan for localization02834.48$228.05$125.42$45.61
    76360SCAT scan for needle biopsy02834.48$228.05$125.42$45.61
    *76362NCat scan for tissue ablation
    76370SCAT scan for therapy guide02821.58$80.43$44.23$16.09
    76375S3d/holograph reconstr add-on02821.58$80.43$44.23$16.09
    76380SCAT scan follow-up study02821.58$80.43$44.23$16.09
    76390EMr spectroscopy
    76393NMr guidance for needle place
    *76394NMri for tissue ablation
    76400SMagnetic image, bone marrow03355.39$274.37$150.90$54.87
    *76490NUs for tissue ablation
    76499XRadiographic procedure02600.70$35.63$19.59$7.13
    76506SEcho exam of head02661.54$78.39$43.11$15.68
    76511SEcho exam of eye02661.54$78.39$43.11$15.68
    76512SEcho exam of eye02661.54$78.39$43.11$15.68
    76513SEcho exam of eye, water bath02650.95$48.36$26.59$9.67
    76516SEcho exam of eye02661.54$78.39$43.11$15.68
    76519SEcho exam of eye02661.54$78.39$43.11$15.68
    76529SEcho exam of eye02650.95$48.36$26.59$9.67
    76536SEcho exam of head and neck02661.54$78.39$43.11$15.68
    76604SEcho exam of chest02661.54$78.39$43.11$15.68
    Start Printed Page 60011
    76645SEcho exam of breast(s)02650.95$48.36$26.59$9.67
    76700SEcho exam of abdomen02661.54$78.39$43.11$15.68
    76705SEcho exam of abdomen02661.54$78.39$43.11$15.68
    76770SEcho exam abdomen back wall02661.54$78.39$43.11$15.68
    76775SEcho exam abdomen back wall02661.54$78.39$43.11$15.68
    76778SEcho exam kidney transplant02661.54$78.39$43.11$15.68
    76800SEcho exam spinal canal02661.54$78.39$43.11$15.68
    76805SEcho exam of pregnant uterus02661.54$78.39$43.11$15.68
    76810SEcho exam of pregnant uterus02650.95$48.36$26.59$9.67
    76815SEcho exam of pregnant uterus02650.95$48.36$26.59$9.67
    76816SEcho exam follow-up/repeat02650.95$48.36$26.59$9.67
    76818SFetl biophys profil w/stress02661.54$78.39$43.11$15.68
    76819SFetl biophys profil w/o strs02661.54$78.39$43.11$15.68
    76825SEcho exam of fetal heart02693.85$195.98$101.91$39.20
    76826SEcho exam of fetal heart06972.08$105.88$55.06$21.18
    76827SEcho exam of fetal heart02693.85$195.98$101.91$39.20
    76828SEcho exam of fetal heart06972.08$105.88$55.06$21.18
    76830SEcho exam, transvaginal02661.54$78.39$43.11$15.68
    76831SEcho exam, uterus02661.54$78.39$43.11$15.68
    76856SEcho exam of pelvis02661.54$78.39$43.11$15.68
    76857SEcho exam of pelvis02650.95$48.36$26.59$9.67
    76870SEcho exam of scrotum02661.54$78.39$43.11$15.68
    76872SEcho exam, transrectal02661.54$78.39$43.11$15.68
    76873NEchograp trans r, pros study
    76880SEcho exam of extremity02661.54$78.39$43.11$15.68
    76885SEcho exam, infant hips02661.54$78.39$43.11$15.68
    76886SEcho exam, infant hips02661.54$78.39$43.11$15.68
    76930NEcho guide, cardiocentesis
    76932NEcho guide for heart biopsy
    76936NEcho guide for artery repair
    76941NEcho guide for transfusion
    76942NEcho guide for biopsy
    76945NEcho guide, villus sampling
    76946NEcho guide for amniocentesis
    76948NEcho guide, ova aspiration
    76950NEcho guidance radiotherapy
    76965NEcho guidance radiotherapy
    76970SUltrasound exam follow-up02650.95$48.36$26.59$9.67
    76975SGI endoscopic ultrasound02661.54$78.39$43.11$15.68
    76977SUs bone density measure02650.95$48.36$26.59$9.67
    76986SUltrasound guide intraoper02661.54$78.39$43.11$15.68
    76999SEcho examination procedure02661.54$78.39$43.11$15.68
    77261ERadiation therapy planning
    77262ERadiation therapy planning
    77263ERadiation therapy planning
    77280XSet radiation therapy field03041.63$82.97$41.52$16.59
    77285XSet radiation therapy field03053.71$188.85$90.65$37.77
    77290XSet radiation therapy field03053.71$188.85$90.65$37.77
    77295XSet radiation therapy field031014.51$738.62$339.05$147.72
    77299ERadiation therapy planning
    77300XRadiation therapy dose plan03041.63$82.97$41.52$16.59
    *77301SRadioltherapy dos plan, imrt0712$875.00$175.00
    77305XRadiation therapy dose plan03041.63$82.97$41.52$16.59
    77310XRadiation therapy dose plan03041.63$82.97$41.52$16.59
    77315XRadiation therapy dose plan03053.71$188.85$90.65$37.77
    77321XRadiation therapy port plan03053.71$188.85$90.65$37.77
    77326XRadiation therapy dose plan03053.71$188.85$90.65$37.77
    77327XRadiation therapy dose plan03053.71$188.85$90.65$37.77
    77328XRadiation therapy dose plan03053.71$188.85$90.65$37.77
    77331XSpecial radiation dosimetry03041.63$82.97$41.52$16.59
    77332XRadiation treatment aid(s)03033.00$152.71$69.28$30.54
    77333XRadiation treatment aid(s)03033.00$152.71$69.28$30.54
    77334XRadiation treatment aid(s)03033.00$152.71$69.28$30.54
    77336XRadiation physics consult03041.63$82.97$41.52$16.59
    77370XRadiation physics consult03053.71$188.85$90.65$37.77
    77399XExternal radiation dosimetry03041.63$82.97$41.52$16.59
    77401SRadiation treatment delivery03002.07$105.37$47.72$21.07
    77402SRadiation treatment delivery03002.07$105.37$47.72$21.07
    77403SRadiation treatment delivery03002.07$105.37$47.72$21.07
    77404SRadiation treatment delivery03002.07$105.37$47.72$21.07
    77406SRadiation treatment delivery03002.07$105.37$47.72$21.07
    77407SRadiation treatment delivery03002.07$105.37$47.72$21.07
    77408SRadiation treatment delivery03002.07$105.37$47.72$21.07
    77409SRadiation treatment delivery03002.07$105.37$47.72$21.07
    77411SRadiation treatment delivery03002.07$105.37$47.72$21.07
    Start Printed Page 60012
    77412SRadiation treatment delivery03002.07$105.37$47.72$21.07
    77413SRadiation treatment delivery03002.07$105.37$47.72$21.07
    77414SRadiation treatment delivery03002.07$105.37$47.72$21.07
    77416SRadiation treatment delivery03002.07$105.37$47.72$21.07
    77417XRadiology port film(s)02600.70$35.63$19.59$7.13
    *77418SRadiation tx delivery, imrt0710$400.00$80.00
    77427ERadiation tx management, x5
    77431ERadiation therapy management
    77432EStereotactic radiation trmt
    77470SSpecial radiation treatment02990.21$10.69$4.06$2.14
    77499ERadiation therapy management
    77520SProton trmt, simple w/o comp0710$400.00$80.00
    77522SProton trmt, simple w/comp0710$400.00$80.00
    77523SProton trmt, intermediate0712$875.00$175.00
    77525SProton treatment, complex0712$875.00$175.00
    77600SHyperthermia treatment03143.90$198.53$101.25$39.71
    77605SHyperthermia treatment03143.90$198.53$101.25$39.71
    77610SHyperthermia treatment03143.90$198.53$101.25$39.71
    77615SHyperthermia treatment03143.90$198.53$101.25$39.71
    77620SHyperthermia treatment03143.90$198.53$101.25$39.71
    77750SInfuse radioactive materials03015.15$262.16$52.53$52.43
    77761SApply intrcav radiat simple031232.40$1,649.29$329.86
    77762SApply intrcav radiat interm031232.40$1,649.29$329.86
    77763SApply intrcav radiat compl031232.40$1,649.29$329.86
    77776SApply interstit radiat simpl031232.40$1,649.29$329.86
    77777SApply interstit radiat inter031232.40$1,649.29$329.86
    77778SApply iterstit radiat compl031232.40$1,649.29$329.86
    77781SHigh intensity brachytherapy031314.84$755.42$164.02$151.08
    77782SHigh intensity brachytherapy031314.84$755.42$164.02$151.08
    77783SHigh intensity brachytherapy031314.84$755.42$164.02$151.08
    77784SHigh intensity brachytherapy031314.84$755.42$164.02$151.08
    77789SApply surface radiation03002.07$105.37$47.72$21.07
    77790NRadiation handling
    77799SRadium/radioisotope therapy031314.84$755.42$164.02$151.08
    78000SThyroid, single uptake02901.75$89.08$48.99$17.82
    78001SThyroid, multiple uptakes02901.75$89.08$48.99$17.82
    78003SThyroid suppress/stimul02901.75$89.08$48.99$17.82
    78006SThyroid imaging with uptake02913.50$178.16$90.20$35.63
    78007SThyroid image, mult uptakes02913.50$178.16$90.20$35.63
    78010SThyroid imaging02901.75$89.08$48.99$17.82
    78011SThyroid imaging with flow02901.75$89.08$48.99$17.82
    78015SThyroid met imaging02913.50$178.16$90.20$35.63
    78016SThyroid met imaging/studies02913.50$178.16$90.20$35.63
    78018SThyroid met imaging, body02924.20$213.80$117.59$42.76
    78020SThyroid met uptake02913.50$178.16$90.20$35.63
    78070SParathyroid nuclear imaging02913.50$178.16$90.20$35.63
    78075SAdrenal nuclear imaging02924.20$213.80$117.59$42.76
    78099SEndocrine nuclear procedure02901.75$89.08$48.99$17.82
    78102SBone marrow imaging, ltd02913.50$178.16$90.20$35.63
    78103SBone marrow imaging, mult02924.20$213.80$117.59$42.76
    78104SBone marrow imaging, body02913.50$178.16$90.20$35.63
    78110SPlasma volume, single02913.50$178.16$90.20$35.63
    78111SPlasma volume, multiple02913.50$178.16$90.20$35.63
    78120SRed cell mass, single02913.50$178.16$90.20$35.63
    78121SRed cell mass, multiple02913.50$178.16$90.20$35.63
    78122SBlood volume02924.20$213.80$117.59$42.76
    78130SRed cell survival study02913.50$178.16$90.20$35.63
    78135SRed cell survival kinetics02924.20$213.80$117.59$42.76
    78140SRed cell sequestration02913.50$178.16$90.20$35.63
    78160SPlasma iron turnover02913.50$178.16$90.20$35.63
    78162SIron absorption exam02913.50$178.16$90.20$35.63
    78170SRed cell iron utilization02913.50$178.16$90.20$35.63
    78172STotal body iron estimation02913.50$178.16$90.20$35.63
    78185SSpleen imaging02913.50$178.16$90.20$35.63
    78190SPlatelet survival, kinetics02913.50$178.16$90.20$35.63
    78191SPlatelet survival02913.50$178.16$90.20$35.63
    78195SLymph system imaging02913.50$178.16$90.20$35.63
    78199SBlood/lymph nuclear exam02901.75$89.08$48.99$17.82
    78201SLiver imaging02913.50$178.16$90.20$35.63
    78202SLiver imaging with flow02913.50$178.16$90.20$35.63
    78205SLiver imaging (3D)02924.20$213.80$117.59$42.76
    78206SLiver image (3d) w/flow02924.20$213.80$117.59$42.76
    78215SLiver and spleen imaging02913.50$178.16$90.20$35.63
    78216SLiver & spleen image/flow02913.50$178.16$90.20$35.63
    78220SLiver function study02913.50$178.16$90.20$35.63
    Start Printed Page 60013
    78223SHepatobiliary imaging02924.20$213.80$117.59$42.76
    78230SSalivary gland imaging02913.50$178.16$90.20$35.63
    78231SSerial salivary imaging02913.50$178.16$90.20$35.63
    78232SSalivary gland function exam02913.50$178.16$90.20$35.63
    78258SEsophageal motility study02913.50$178.16$90.20$35.63
    78261SGastric mucosa imaging02913.50$178.16$90.20$35.63
    78262SGastroesophageal reflux exam02913.50$178.16$90.20$35.63
    78264SGastric emptying study02913.50$178.16$90.20$35.63
    78267ABreath tst attain/anal c-14
    78268ABreath test analysis, c-14
    78270SVit B-12 absorption exam02901.75$89.08$48.99$17.82
    78271SVit B-12 absorp exam, IF02901.75$89.08$48.99$17.82
    78272SVit B-12 absorp, combined02913.50$178.16$90.20$35.63
    78278SAcute GI blood loss imaging02913.50$178.16$90.20$35.63
    78282SGI protein loss exam02901.75$89.08$48.99$17.82
    78290SMeckel's divert exam02913.50$178.16$90.20$35.63
    78291SLeveen/shunt patency exam02913.50$178.16$90.20$35.63
    78299SGI nuclear procedure02901.75$89.08$48.99$17.82
    78300SBone imaging, limited area02913.50$178.16$90.20$35.63
    78305SBone imaging, multiple areas02913.50$178.16$90.20$35.63
    78306SBone imaging, whole body02913.50$178.16$90.20$35.63
    78315SBone imaging, 3 phase02924.20$213.80$117.59$42.76
    78320SBone imaging (3D)02924.20$213.80$117.59$42.76
    78350XBone mineral, single photon02611.21$61.59$33.87$12.32
    78351EBone mineral, dual photon
    78399SMusculoskeletal nuclear exam02901.75$89.08$48.99$17.82
    78414SNon-imaging heart function02924.20$213.80$117.59$42.76
    78428SCardiac shunt imaging02924.20$213.80$117.59$42.76
    78445SVascular flow imaging02913.50$178.16$90.20$35.63
    78455SVenous thrombosis study02913.50$178.16$90.20$35.63
    78456SAcute venous thrombus image02913.50$178.16$90.20$35.63
    78457SVenous thrombosis imaging02913.50$178.16$90.20$35.63
    78458SVen thrombosis images, bilat02913.50$178.16$90.20$35.63
    78459EHeart muscle imaging (PET)
    78460SHeart muscle blood, single02865.41$275.39$151.46$55.08
    78461SHeart muscle blood, multiple02865.41$275.39$151.46$55.08
    78464SHeart image (3d), single02865.41$275.39$151.46$55.08
    78465SHeart image (3d), multiple02865.41$275.39$151.46$55.08
    78466SHeart infarct image02913.50$178.16$90.20$35.63
    78468SHeart infarct image (ef)02924.20$213.80$117.59$42.76
    78469SHeart infarct image (3D)02924.20$213.80$117.59$42.76
    78472SGated heart, planar, single02865.41$275.39$151.46$55.08
    78473SGated heart, multiple02865.41$275.39$151.46$55.08
    78478SHeart wall motion add-on02865.41$275.39$151.46$55.08
    78480SHeart function add-on02865.41$275.39$151.46$55.08
    78481SHeart first pass, single02865.41$275.39$151.46$55.08
    78483SHeart first pass, multiple02865.41$275.39$151.46$55.08
    78491EHeart image (pet), single
    78492EHeart image (pet), multiple
    78494SHeart image, spect02963.39$172.56$94.90$34.51
    78496SHeart first pass add-on02963.39$172.56$94.90$34.51
    78499SCardiovascular nuclear exam02913.50$178.16$90.20$35.63
    78580SLung perfusion imaging02913.50$178.16$90.20$35.63
    78584SLung V/Q image single breath02924.20$213.80$117.59$42.76
    78585SLung V/Q imaging02924.20$213.80$117.59$42.76
    78586SAerosol lung image, single02924.20$213.80$117.59$42.76
    78587SAerosol lung image, multiple02913.50$178.16$90.20$35.63
    78588SPerfusion lung image02924.20$213.80$117.59$42.76
    78591SVent image, 1 breath, 1 proj02913.50$178.16$90.20$35.63
    78593SVent image, 1 proj, gas02924.20$213.80$117.59$42.76
    78594SVent image, mult proj, gas02924.20$213.80$117.59$42.76
    78596SLung differential function02924.20$213.80$117.59$42.76
    78599SRespiratory nuclear exam02913.50$178.16$90.20$35.63
    78600SBrain imaging, ltd static02924.20$213.80$117.59$42.76
    78601SBrain imaging, ltd w/ flow02913.50$178.16$90.20$35.63
    78605SBrain imaging, complete02913.50$178.16$90.20$35.63
    78606SBrain imaging, compl w/flow02924.20$213.80$117.59$42.76
    78607SBrain imaging (3D)02924.20$213.80$117.59$42.76
    78608EBrain imaging (PET)
    78609EBrain imaging (PET)
    78610SBrain flow imaging only02913.50$178.16$90.20$35.63
    78615SCerebral blood flow imaging02913.50$178.16$90.20$35.63
    78630SCerebrospinal fluid scan02924.20$213.80$117.59$42.76
    78635SCSF ventriculography02924.20$213.80$117.59$42.76
    78645SCSF shunt evaluation02913.50$178.16$90.20$35.63
    Start Printed Page 60014
    78647SCerebrospinal fluid scan02924.20$213.80$117.59$42.76
    78650SCSF leakage imaging02924.20$213.80$117.59$42.76
    78660SNuclear exam of tear flow02913.50$178.16$90.20$35.63
    78699SNervous system nuclear exam02913.50$178.16$90.20$35.63
    78700SKidney imaging, static02913.50$178.16$90.20$35.63
    78701SKidney imaging with flow02913.50$178.16$90.20$35.63
    78704SImaging renogram02913.50$178.16$90.20$35.63
    78707SKidney flow/function image02924.20$213.80$117.59$42.76
    78708SKidney flow/function image02924.20$213.80$117.59$42.76
    78709SKidney flow/function image02924.20$213.80$117.59$42.76
    78710SKidney imaging (3D)02913.50$178.16$90.20$35.63
    78715SRenal vascular flow exam02913.50$178.16$90.20$35.63
    78725SKidney function study02913.50$178.16$90.20$35.63
    78730SUrinary bladder retention02913.50$178.16$90.20$35.63
    78740SUreteral reflux study02913.50$178.16$90.20$35.63
    78760STesticular imaging02913.50$178.16$90.20$35.63
    78761STesticular imaging/flow02913.50$178.16$90.20$35.63
    78799SGenitourinary nuclear exam02924.20$213.80$117.59$42.76
    78800STumor imaging, limited area02913.50$178.16$90.20$35.63
    78801STumor imaging, mult areas02924.20$213.80$117.59$42.76
    78802STumor imaging, whole body02924.20$213.80$117.59$42.76
    78803STumor imaging (3D)02924.20$213.80$117.59$42.76
    78805SAbscess imaging, ltd area02924.20$213.80$117.59$42.76
    78806SAbscess imaging, whole body02924.20$213.80$117.59$42.76
    78807SNuclear localization/abscess02924.20$213.80$117.59$42.76
    78810ETumor imaging (PET)
    78890NNuclear medicine data proc
    78891NNuclear med data proc
    78990NProvide diag radionuclide(s)
    78999SNuclear diagnostic exam02913.50$178.16$90.20$35.63
    79000SInit hyperthyroid therapy02945.01$255.03$140.26$51.01
    79001SRepeat hyperthyroid therapy02945.01$255.03$140.26$51.01
    79020SThyroid ablation02945.01$255.03$140.26$51.01
    79030SThyroid ablation, carcinoma02945.01$255.03$140.26$51.01
    79035SThyroid metastatic therapy02945.01$255.03$140.26$51.01
    79100SHematopoetic nuclear therapy02945.01$255.03$140.26$51.01
    79200SIntracavitary nuclear trmt029512.10$615.94$338.76$123.19
    79300SInterstitial nuclear therapy02945.01$255.03$140.26$51.01
    79400SNonhemato nuclear therapy029512.10$615.94$338.76$123.19
    79420SIntravascular nuclear ther029512.10$615.94$338.76$123.19
    79440SNuclear joint therapy02945.01$255.03$140.26$51.01
    79900NProvide ther radiopharm(s)
    79999SNuclear medicine therapy02945.01$255.03$140.26$51.01
    80048ABasic metabolic panel
    80050AGeneral health panel
    80051AElectrolyte panel
    80053AComprehen metabolic panel
    80055AObstetric panel
    80061ALipid panel
    80069ARenal function panel
    80072DArthritis panel
    80074AAcute hepatitis panel
    80076AHepatic function panel
    80090ATorch antibody panel
    80100ADrug screen, qualitate/multi
    80101ADrug screen, single
    80102ADrug confirmation
    80103NDrug analysis, tissue prep
    80150AAssay of amikacin
    80152AAssay of amitriptyline
    80154AAssay of benzodiazepines
    80156AAssay, carbamazepine, total
    80157AAssay, carbamazepine, free
    80158AAssay of cyclosporine
    80160AAssay of desipramine
    80162AAssay of digoxin
    80164AAssay, dipropylacetic acid
    80166AAssay of doxepin
    80168AAssay of ethosuximide
    80170AAssay of gentamicin
    80172AAssay of gold
    80173AAssay of haloperidol
    80174AAssay of imipramine
    80176AAssay of lidocaine
    80178AAssay of lithium
    Start Printed Page 60015
    80182AAssay of nortriptyline
    80184AAssay of phenobarbital
    80185AAssay of phenytoin, total
    80186AAssay of phenytoin, free
    80188AAssay of primidone
    80190AAssay of procainamide
    80192AAssay of procainamide
    80194AAssay of quinidine
    80196AAssay of salicylate
    80197AAssay of tacrolimus
    80198AAssay of theophylline
    80200AAssay of tobramycin
    80201AAssay of topiramate
    80202AAssay of vancomycin
    80299AQuantitative assay, drug
    80400AActh stimulation panel
    80402AActh stimulation panel
    80406AActh stimulation panel
    80408AAldosterone suppression eval
    80410ACalcitonin stimul panel
    80412ACRH stimulation panel
    80414ATestosterone response
    80415AEstradiol response panel
    80416ARenin stimulation panel
    80417ARenin stimulation panel
    80418APituitary evaluation panel
    80420ADexamethasone panel
    80422AGlucagon tolerance panel
    80424AGlucagon tolerance panel
    80426AGonadotropin hormone panel
    80428AGrowth hormone panel
    80430AGrowth hormone panel
    80432AInsulin suppression panel
    80434AInsulin tolerance panel
    80435AInsulin tolerance panel
    80436AMetyrapone panel
    80438ATRH stimulation panel
    80439ATRH stimulation panel
    80440ATRH stimulation panel
    80500XLab pathology consultation03430.39$19.85$10.72$3.97
    80502XLab pathology consultation03420.21$10.69$5.87$2.14
    81000AUrinalysis, nonauto w/scope
    81001AUrinalysis, auto w/scope
    81002AUrinalysis nonauto w/o scope
    81003AUrinalysis, auto, w/o scope
    81005AUrinalysis
    81007AUrine screen for bacteria
    81015AMicroscopic exam of urine
    81020AUrinalysis, glass test
    81025AUrine pregnancy test
    81050AUrinalysis, volume measure
    81099AUrinalysis test procedure
    82000AAssay of blood acetaldehyde
    82003AAssay of acetaminophen
    82009ATest for acetone/ketones
    82010AAcetone assay
    82013AAcetylcholinesterase assay
    82016AAcylcarnitines, qual
    82017AAcylcarnitines, quant
    82024AAssay of acth
    82030AAssay of adp & amp
    82040AAssay of serum albumin
    82042AAssay of urine albumin
    82043AMicroalbumin, quantitative
    82044AMicroalbumin, semiquant
    82055AAssay of ethanol
    82075AAssay of breath ethanol
    82085AAssay of aldolase
    82088AAssay of aldosterone
    82101AAssay of urine alkaloids
    82103AAlpha-1-antitrypsin, total
    82104AAlpha-1-antitrypsin, pheno
    82105AAlpha-fetoprotein, serum
    82106AAlpha-fetoprotein, amniotic
    82108AAssay of aluminum
    Start Printed Page 60016
    82120AAmines, vaginal fluid qual
    82127AAmino acid, single qual
    82128AAmino acids, mult qual
    82131AAmino acids, single quant
    82135AAssay, aminolevulinic acid
    82136AAmino acids, quant, 2-5
    82139AAmino acids, quan, 6 or more
    82140AAssay of ammonia
    82143AAmniotic fluid scan
    82145AAssay of amphetamines
    82150AAssay of amylase
    82154AAndrostanediol glucuronide
    82157AAssay of androstenedione
    82160AAssay of androsterone
    82163AAssay of angiotensin II
    82164AAngiotensin I enzyme test
    82172AAssay of apolipoprotein
    82175AAssay of arsenic
    82180AAssay of ascorbic acid
    82190AAtomic absorption
    82205AAssay of barbiturates
    82232AAssay of beta-2 protein
    82239ABile acids, total
    82240ABile acids, cholylglycine
    82247ABilirubin, total
    82248ABilirubin, direct
    82252AFecal bilirubin test
    82261AAssay of biotinidase
    82270ATest for blood, feces
    82273ATest for blood, other source
    *82274AAssay test for blood, fecal
    82286AAssay of bradykinin
    82300AAssay of cadmium
    82306AAssay of vitamin D
    82307AAssay of vitamin D
    82308AAssay of calcitonin
    82310AAssay of calcium
    82330AAssay of calcium
    82331ACalcium infusion test
    82340AAssay of calcium in urine
    82355ACalculus (stone) analysis
    82360ACalculus (stone) assay
    82365ACalculus (stone) assay
    82370AX-ray assay, calculus
    82373AAssay, c-d transfer measure
    82374AAssay, blood carbon dioxide
    82375AAssay, blood carbon monoxide
    82376ATest for carbon monoxide
    82378ACarcinoembryonic antigen
    82379AAssay of carnitine
    82380AAssay of carotene
    82382AAssay, urine catecholamines
    82383AAssay, blood catecholamines
    82384AAssay, three catecholamines
    82387AAssay of cathepsin-d
    82390AAssay of ceruloplasmin
    82397AChemiluminescent assay
    82415AAssay of chloramphenicol
    82435AAssay of blood chloride
    82436AAssay of urine chloride
    82438AAssay, other fluid chlorides
    82441ATest for chlorohydrocarbons
    82465AAssay, bld/serum cholesterol
    82480AAssay, serum cholinesterase
    82482AAssay, rbc cholinesterase
    82485AAssay, chondroitin sulfate
    82486AGas/liquid chromatography
    82487APaper chromatography
    82488APaper chromatography
    82489AThin layer chromatography
    82491AChromotography, quant, sing
    82492AChromotography, quant, mult
    82495AAssay of chromium
    82507AAssay of citrate
    82520AAssay of cocaine
    Start Printed Page 60017
    82523ACollagen crosslinks
    82525AAssay of copper
    82528AAssay of corticosterone
    82530ACortisol, free
    82533ATotal cortisol
    82540AAssay of creatine
    82541AColumn chromotography, qual
    82542AColumn chromotography, quant
    82543AColumn chromotograph/isotope
    82544AColumn chromotograph/isotope
    82550AAssay of ck (cpk)
    82552AAssay of cpk in blood
    82553ACreatine, MB fraction
    82554ACreatine, isoforms
    82565AAssay of creatinine
    82570AAssay of urine creatinine
    82575ACreatinine clearance test
    82585AAssay of cryofibrinogen
    82595AAssay of cryoglobulin
    82600AAssay of cyanide
    82607AVitamin B-12
    82608AB-12 binding capacity
    82615ATest for urine cystines
    82626ADehydroepiandrosterone
    82627ADehydroepiandrosterone
    82633ADesoxycorticosterone
    82634ADeoxycortisol
    82638AAssay of dibucaine number
    82646AAssay of dihydrocodeinone
    82649AAssay of dihydromorphinone
    82651AAssay of dihydrotestosterone
    82652AAssay of dihydroxyvitamin d
    82654AAssay of dimethadione
    82657AEnzyme cell activity
    82658AEnzyme cell activity, ra
    82664AElectrophoretic test
    82666AAssay of epiandrosterone
    82668AAssay of erythropoietin
    82670AAssay of estradiol
    82671AAssay of estrogens
    82672AAssay of estrogen
    82677AAssay of estriol
    82679AAssay of estrone
    82690AAssay of ethchlorvynol
    82693AAssay of ethylene glycol
    82696AAssay of etiocholanolone
    82705AFats/lipids, feces, qual
    82710AFats/lipids, feces, quant
    82715AAssay of fecal fat
    82725AAssay of blood fatty acids
    82726ALong chain fatty acids
    82728AAssay of ferritin
    82731AAssay of fetal fibronectin
    82735AAssay of fluoride
    82742AAssay of flurazepam
    82746ABlood folic acid serum
    82747AAssay of folic acid, rbc
    82757AAssay of semen fructose
    82759AAssay of rbc galactokinase
    82760AAssay of galactose
    82775AAssay galactose transferase
    82776AGalactose transferase test
    82784AAssay of gammaglobulin igm
    82785AAssay of gammaglobulin ige
    82787AIgg 1, 2, 3 or 4, each
    82800ABlood pH
    82803ABlood gases: pH, pO2 & pCO2
    82805ABlood gases W/02 saturation
    82810ABlood gases, O2 sat only
    82820AHemoglobin-oxygen affinity
    82926AAssay of gastric acid
    82928AAssay of gastric acid
    82938AGastrin test
    82941AAssay of gastrin
    82943AAssay of glucagon
    Start Printed Page 60018
    82945AGlucose other fluid
    82946AGlucagon tolerance test
    82947AAssay, glucose, blood quant
    82948AReagent strip/blood glucose
    82950AGlucose test
    82951AGlucose tolerance test (GTT)
    82952AGTT-added samples
    82953AGlucose-tolbutamide test
    82955AAssay of g6pd enzyme
    82960ATest for G6PD enzyme
    82962AGlucose blood test
    82963AAssay of glucosidase
    82965AAssay of gdh enzyme
    82975AAssay of glutamine
    82977AAssay of GGT
    82978AAssay of glutathione
    82979AAssay, rbc glutathione
    82980AAssay of glutethimide
    82985AGlycated protein
    83001AGonadotropin (FSH)
    83002AGonadotropin (LH)
    83003AAssay, growth hormone (hgh)
    83008AAssay of guanosine
    83010AAssay of haptoglobin, quant
    83012AAssay of haptoglobins
    83013AH pylori analysis
    83014AH pylori drug admin/collect
    83015AHeavy metal screen
    83018AQuantitative screen, metals
    83020AHemoglobin electrophoresis
    83021AHemoglobin chromotography
    83026AHemoglobin, copper sulfate
    83030AFetal hemoglobin, chemical
    83033AFetal hemoglobin assay, qual
    83036AGlycated hemoglobin test
    83045ABlood methemoglobin test
    83050ABlood methemoglobin assay
    83051AAssay of plasma hemoglobin
    83055ABlood sulfhemoglobin test
    83060ABlood sulfhemoglobin assay
    83065AAssay of hemoglobin heat
    83068AHemoglobin stability screen
    83069AAssay of urine hemoglobin
    83070AAssay of hemosiderin, qual
    83071AAssay of hemosiderin, quant
    83080AAssay of b hexosaminidase
    83088AAssay of histamine
    83090AAssay of homocystine
    83150AAssay of for hva
    83491AAssay of corticosteroids
    83497AAssay of 5-hiaa
    83498AAssay of progesterone
    83499AAssay of progesterone
    83500AAssay, free hydroxyproline
    83505AAssay, total hydroxyproline
    83516AImmunoassay, nonantibody
    83518AImmunoassay, dipstick
    83519AImmunoassay, nonantibody
    83520AImmunoassay, RIA
    83525AAssay of insulin
    83527AAssay of insulin
    83528AAssay of intrinsic factor
    83540AAssay of iron
    83550AIron binding test
    83570AAssay of idh enzyme
    83582AAssay of ketogenic steroids
    83586AAssay 17- ketosteroids
    83593AFractionation, ketosteroids
    83605AAssay of lactic acid
    83615ALactate (LD) (LDH) enzyme
    83625AAssay of ldh enzymes
    83632APlacental lactogen
    83633ATest urine for lactose
    83634AAssay of urine for lactose
    83655AAssay of lead
    Start Printed Page 60019
    83661AL/s ratio, fetal lung
    83662AFoam stability, fetal lung
    83663AFluoro polarize, fetal lung
    83664ALamellar bdy, fetal lung
    83670AAssay of lap enzyme
    83690AAssay of lipase
    83715AAssay of blood lipoproteins
    83716AAssay of blood lipoproteins
    83718AAssay of lipoprotein
    83719AAssay of blood lipoprotein
    83721AAssay of blood lipoprotein
    83727AAssay of lrh hormone
    83735AAssay of magnesium
    83775AAssay of md enzyme
    83785AAssay of manganese
    83788AMass spectrometry qual
    83789AMass spectrometry quant
    83805AAssay of meprobamate
    83825AAssay of mercury
    83835AAssay of metanephrines
    83840AAssay of methadone
    83857AAssay of methemalbumin
    83858AAssay of methsuximide
    83864AMucopolysaccharides
    83866AMucopolysaccharides screen
    83872AAssay synovial fluid mucin
    83873AAssay of csf protein
    83874AAssay of myoglobin
    83883AAssay, nephelometry not spec
    83885AAssay of nickel
    83887AAssay of nicotine
    83890AMolecule isolate
    83891AMolecule isolate nucleic
    83892AMolecular diagnostics
    83893AMolecule dot/slot/blot
    83894AMolecule gel electrophor
    83896AMolecular diagnostics
    83897AMolecule nucleic transfer
    83898AMolecule nucleic ampli
    83901AMolecule nucleic ampli
    83902AMolecular diagnostics
    83903AMolecule mutation scan
    83904AMolecule mutation identify
    83905AMolecule mutation identify
    83906AMolecule mutation identify
    83912AGenetic examination
    83915AAssay of nucleotidase
    83916AOligoclonal bands
    83918AOrganic acids, total, quant
    83919AOrganic acids, qual, each
    83921AOrganic acid, single, quant
    83925AAssay of opiates
    83930AAssay of blood osmolality
    83935AAssay of urine osmolality
    83937AAssay of osteocalcin
    83945AAssay of oxalate
    *83950AOncorprotein, her-2/neu
    83970AAssay of parathormone
    83986AAssay of body fluid acidity
    83992AAssay for phencyclidine
    84022AAssay of phenothiazine
    84030AAssay of blood pku
    84035AAssay of phenylketones
    84060AAssay acid phosphatase
    84061APhosphatase, forensic exam
    84066AAssay prostate phosphatase
    84075AAssay alkaline phosphatase
    84078AAssay alkaline phosphatase
    84080AAssay alkaline phosphatases
    84081AAmniotic fluid enzyme test
    84085AAssay of rbc pg6d enzyme
    84087AAssay phosphohexose enzymes
    84100AAssay of phosphorus
    84105AAssay of urine phosphorus
    84106ATest for porphobilinogen
    Start Printed Page 60020
    84110AAssay of porphobilinogen
    84119ATest urine for porphyrins
    84120AAssay of urine porphyrins
    84126AAssay of feces porphyrins
    84127AAssay of feces porphyrins
    84132AAssay of serum potassium
    84133AAssay of urine potassium
    84134AAssay of prealbumin
    84135AAssay of pregnanediol
    84138AAssay of pregnanetriol
    84140AAssay of pregnenolone
    84143AAssay of 17-hydroxypregneno
    84144AAssay of progesterone
    84146AAssay of prolactin
    84150AAssay of prostaglandin
    84152AAssay of psa, complexed
    84153AAssay of psa, total
    84154AAssay of psa, free
    84155AAssay of protein
    84160AAssay of serum protein
    84165AAssay of serum proteins
    84181AWestern blot test
    84182AProtein, western blot test
    84202AAssay RBC protoporphyrin
    84203ATest RBC protoporphyrin
    84206AAssay of proinsulin
    84207AAssay of vitamin b-6
    84210AAssay of pyruvate
    84220AAssay of pyruvate kinase
    84228AAssay of quinine
    84233AAssay of estrogen
    84234AAssay of progesterone
    84235AAssay of endocrine hormone
    84238AAssay, nonendocrine receptor
    84244AAssay of renin
    84252AAssay of vitamin b-2
    84255AAssay of selenium
    84260AAssay of serotonin
    84270AAssay of sex hormone globul
    84275AAssay of sialic acid
    84285AAssay of silica
    84295AAssay of serum sodium
    84300AAssay of urine sodium
    84305AAssay of somatomedin
    84307AAssay of somatostatin
    84311ASpectrophotometry
    84315ABody fluid specific gravity
    84375AChromatogram assay, sugars
    84376ASugars, single, qual
    84377ASugars, multiple, qual
    84378ASugars single quant
    84379ASugars multiple quant
    84392AAssay of urine sulfate
    84402AAssay of testosterone
    84403AAssay of total testosterone
    84425AAssay of vitamin b-1
    84430AAssay of thiocyanate
    84432AAssay of thyroglobulin
    84436AAssay of total thyroxine
    84437AAssay of neonatal thyroxine
    84439AAssay of free thyroxine
    84442AAssay of thyroid activity
    84443AAssay thyroid stim hormone
    84445AAssay of tsi
    84446AAssay of vitamin e
    84449AAssay of transcortin
    84450ATransferase (AST) (SGOT)
    84460AAlanine amino (ALT) (SGPT)
    84466AAssay of transferrin
    84478AAssay of triglycerides
    84479AAssay of thyroid (t3 or t4)
    84480AAssay, triiodothyronine (t3)
    84481AFree assay (FT-3)
    84482AT3 reverse
    84484AAssay of troponin, quant
    Start Printed Page 60021
    84485AAssay duodenal fluid trypsin
    84488ATest feces for trypsin
    84490AAssay of feces for trypsin
    84510AAssay of tyrosine
    84512AAssay of troponin, qual
    84520AAssay of urea nitrogen
    84525AUrea nitrogen semi-quant
    84540AAssay of urine/urea-n
    84545AUrea-N clearance test
    84550AAssay of blood/uric acid
    84560AAssay of urine/uric acid
    84577AAssay of feces/urobilinogen
    84578ATest urine urobilinogen
    84580AAssay of urine urobilinogen
    84583AAssay of urine urobilinogen
    84585AAssay of urine vma
    84586AAssay of vip
    84588AAssay of vasopressin
    84590AAssay of vitamin a
    84591AAssay of nos vitamin
    84597AAssay of vitamin k
    84600AAssay of volatiles
    84620AXylose tolerance test
    84630AAssay of zinc
    84681AAssay of c-peptide
    84702AChorionic gonadotropin test
    84703AChorionic gonadotropin assay
    84830AOvulation tests
    84999AClinical chemistry test
    85002ABleeding time test
    85007ADifferential WBC count
    85008ANondifferential WBC count
    85009ADifferential WBC count
    85013AHematocrit
    85014AHematocrit
    85018AHemoglobin
    85021AAutomated hemogram
    85022AAutomated hemogram
    85023AAutomated hemogram
    85024AAutomated hemogram
    85025AAutomated hemogram
    85027AAutomated hemogram
    85031AManual hemogram, cbc
    85041ARed blood cell (RBC) count
    85044AReticulocyte count
    85045AReticulocyte count
    85046AReticyte/hgb concentrate
    85048AWhite blood cell (WBC) count
    85060XBlood smear interpretation03420.21$10.69$5.87$2.14
    85095DBone marrow aspiration00031.03$52.43$27.99$10.49
    85097XBone marrow interpretation03440.56$28.51$15.68$5.70
    85102DBone marrow biopsy00031.03$52.43$27.99$10.49
    85130AChromogenic substrate assay
    85170ABlood clot retraction
    85175ABlood clot lysis time
    85210ABlood clot factor II test
    85220ABlood clot factor V test
    85230ABlood clot factor VII test
    85240ABlood clot factor VIII test
    85244ABlood clot factor VIII test
    85245ABlood clot factor VIII test
    85246ABlood clot factor VIII test
    85247ABlood clot factor VIII test
    85250ABlood clot factor IX test
    85260ABlood clot factor X test
    85270ABlood clot factor XI test
    85280ABlood clot factor XII test
    85290ABlood clot factor XIII test
    85291ABlood clot factor XIII test
    85292ABlood clot factor assay
    85293ABlood clot factor assay
    85300AAntithrombin III test
    85301AAntithrombin III test
    85302ABlood clot inhibitor antigen
    85303ABlood clot inhibitor test
    Start Printed Page 60022
    85305ABlood clot inhibitor assay
    85306ABlood clot inhibitor test
    85307AAssay activated protein c
    85335AFactor inhibitor test
    85337AThrombomodulin
    85345ACoagulation time
    85347ACoagulation time
    85348ACoagulation time
    85360AEuglobulin lysis
    85362AFibrin degradation products
    85366AFibrinogen test
    85370AFibrinogen test
    85378AFibrin degradation
    85379AFibrin degradation
    85384AFibrinogen
    85385AFibrinogen
    85390AFibrinolysins screen
    85400AFibrinolytic plasmin
    85410AFibrinolytic antiplasmin
    85415AFibrinolytic plasminogen
    85420AFibrinolytic plasminogen
    85421AFibrinolytic plasminogen
    85441AHeinz bodies, direct
    85445AHeinz bodies, induced
    85460AHemoglobin, fetal
    85461AHemoglobin, fetal
    85475AHemolysin
    85520AHeparin assay
    85525AHeparin
    85530AHeparin-protamine tolerance
    85535DIron stain, blood cells
    85536AIron stain peripheral blood
    85540AWbc alkaline phosphatase
    85547ARBC mechanical fragility
    85549AMuramidase
    85555ARBC osmotic fragility
    85557ARBC osmotic fragility
    85576ABlood platelet aggregation
    85585ABlood platelet estimation
    85590APlatelet count, manual
    85595APlatelet count, automated
    85597APlatelet neutralization
    85610AProthrombin time
    85611AProthrombin test
    85612AViper venom prothrombin time
    85613ARussell viper venom, diluted
    85635AReptilase test
    85651ARbc sed rate, nonautomated
    85652ARbc sed rate, automated
    85660ARBC sickle cell test
    85670AThrombin time, plasma
    85675AThrombin time, titer
    85705AThromboplastin inhibition
    85730AThromboplastin time, partial
    85732AThromboplastin time, partial
    85810ABlood viscosity examination
    85999AHematology procedure
    86000AAgglutinins, febrile
    86001AAllergen specific igg
    86003AAllergen specific IgE
    86005AAllergen specific IgE
    86021AWBC antibody identification
    86022APlatelet antibodies
    86023AImmunoglobulin assay
    86038AAntinuclear antibodies
    86039AAntinuclear antibodies (ANA)
    86060AAntistreptolysin o, titer
    86063AAntistreptolysin o, screen
    86077XPhysician blood bank service03430.39$19.85$10.72$3.97
    86078XPhysician blood bank service03440.56$28.51$15.68$5.70
    86079XPhysician blood bank service03440.56$28.51$15.68$5.70
    86140AC-reactive protein
    *86141AC-reactive protein, hs
    86146AGlycoprotein antibody
    86147ACardiolipin antibody
    Start Printed Page 60023
    86148APhospholipid antibody
    86155AChemotaxis assay
    86156ACold agglutinin, screen
    86157ACold agglutinin, titer
    86160AComplement, antigen
    86161AComplement/function activity
    86162AComplement, total (CH50)
    86171AComplement fixation, each
    86185ACounterimmunoelectrophoresis
    86215ADeoxyribonuclease, antibody
    86225ADNA antibody
    86226ADNA antibody, single strand
    86235ANuclear antigen antibody
    86243AFc receptor
    86255AFluorescent antibody, screen
    86256AFluorescent antibody, titer
    86277AGrowth hormone antibody
    86280AHemagglutination inhibition
    86294AImmunoassay, tumor qual
    86300AImmunoassay, tumor ca 15-3
    86301AImmunoassay, tumor, ca 19-9
    86304AImmunoassay, tumor ca 125
    86308AHeterophile antibodies
    86309AHeterophile antibodies
    86310AHeterophile antibodies
    86316AImmunoassay, tumor other
    86317AImmunoassay,infectious agent
    86318AImmunoassay,infectious agent
    86320ASerum immunoelectrophoresis
    86325AOther immunoelectrophoresis
    86327AImmunoelectrophoresis assay
    86329AImmunodiffusion
    86331AImmunodiffusion ouchterlony
    86332AImmune complex assay
    86334AImmunofixation procedure
    *86336AInhibin A
    86337AInsulin antibodies
    86340AIntrinsic factor antibody
    86341AIslet cell antibody
    86343ALeukocyte histamine release
    86344ALeukocyte phagocytosis
    86353ALymphocyte transformation
    86359AT cells, total count
    86360AT cell, absolute count/ratio
    86361AT cell, absolute count
    86376AMicrosomal antibody
    86378AMigration inhibitory factor
    86382ANeutralization test, viral
    86384ANitroblue tetrazolium dye
    86403AParticle agglutination test
    86406AParticle agglutination test
    86430ARheumatoid factor test
    86431ARheumatoid factor, quant
    86485XSkin test, candida03410.10$5.09$2.79$1.02
    86490XCoccidioidomycosis skin test03410.10$5.09$2.79$1.02
    86510XHistoplasmosis skin test03410.10$5.09$2.79$1.02
    86580XTB intradermal test03410.10$5.09$2.79$1.02
    86585XTB tine test03410.10$5.09$2.79$1.02
    86586XSkin test, unlisted03410.10$5.09$2.79$1.02
    86590AStreptokinase, antibody
    86592ABlood serology, qualitative
    86593ABlood serology, quantitative
    86602AAntinomyces antibody
    86603AAdenovirus antibody
    86606AAspergillus antibody
    86609ABacterium antibody
    86611ABartonella antibody
    86612ABlastomyces antibody
    86615ABordetella antibody
    86617ALyme disease antibody
    86618ALyme disease antibody
    86619ABorrelia antibody
    86622ABrucella antibody
    86625ACampylobacter antibody
    86628ACandida antibody
    Start Printed Page 60024
    86631AChlamydia antibody
    86632AChlamydia igm antibody
    86635ACoccidioides antibody
    86638AQ fever antibody
    86641ACryptococcus antibody
    86644ACMV antibody
    86645ACMV antibody, IgM
    86648ADiphtheria antibody
    86651AEncephalitis antibody
    86652AEncephalitis antibody
    86653AEncephalitis antibody
    86654AEncephalitis antibody
    86658AEnterovirus antibody
    86663AEpstein-barr antibody
    86664AEpstein-barr antibody
    86665AEpstein-barr antibody
    86666AEhrlichia antibody
    86668AFrancisella tularensis
    86671AFungus antibody
    86674AGiardia lamblia antibody
    86677AHelicobacter pylori
    86682AHelminth antibody
    86683DHemoglobin, fecal antibody
    86684AHemophilus influenza
    86687AHtlv-i antibody
    86688AHtlv-ii antibody
    86689AHTLV/HIV confirmatory test
    86692AHepatitis, delta agent
    86694AHerpes simplex test
    86695AHerpes simplex test
    86696AHerpes simplex type 2
    86698AHistoplasma
    86701AHIV-1
    86702AHIV-2
    86703AHIV-1/HIV-2, single assay
    86704AHep b core antibody, total
    86705AHep b core antibody, igm
    86706AHep b surface antibody
    86707AHep be antibody
    86708AHep a antibody, total
    86709AHep a antibody, igm
    86710AInfluenza virus antibody
    86713ALegionella antibody
    86717ALeishmania antibody
    86720ALeptospira antibody
    86723AListeria monocytogenes ab
    86727ALymph choriomeningitis ab
    86729ALympho venereum antibody
    86732AMucormycosis antibody
    86735AMumps antibody
    86738AMycoplasma antibody
    86741ANeisseria meningitidis
    86744ANocardia antibody
    86747AParvovirus antibody
    86750AMalaria antibody
    86753AProtozoa antibody nos
    86756ARespiratory virus antibody
    86757ARickettsia antibody
    86759ARotavirus antibody
    86762ARubella antibody
    86765ARubeola antibody
    86768ASalmonella antibody
    86771AShigella antibody
    86774ATetanus antibody
    86777AToxoplasma antibody
    86778AToxoplasma antibody, igm
    86781ATreponema pallidum, confirm
    86784ATrichinella antibody
    86787AVaricella-zoster antibody
    86790AVirus antibody nos
    86793AYersinia antibody
    86800AThyroglobulin antibody
    86803AHepatitis c ab test
    86804AHep c ab test, confirm
    86805ALymphocytotoxicity assay
    Start Printed Page 60025
    86806ALymphocytotoxicity assay
    86807ACytotoxic antibody screening
    86808ACytotoxic antibody screening
    86812AHLA typing, A, B, or C
    86813AHLA typing, A, B, or C
    86816AHLA typing, DR/DQ
    86817AHLA typing, DR/DQ
    86821ALymphocyte culture, mixed
    86822ALymphocyte culture, primed
    86849AImmunology procedure
    86850XRBC antibody screen03450.26$13.24$5.37$2.65
    86860XRBC antibody elution03450.26$13.24$5.37$2.65
    86870XRBC antibody identification03460.77$39.20$12.03$7.84
    86880XCoombs test03410.10$5.09$2.79$1.02
    86885XCoombs test03410.10$5.09$2.79$1.02
    86886XCoombs test03410.10$5.09$2.79$1.02
    86890XAutologous blood process03460.77$39.20$12.03$7.84
    86891XAutologous blood, op salvage03450.26$13.24$5.37$2.65
    86900XBlood typing, ABO03410.10$5.09$2.79$1.02
    86901XBlood typing, Rh (D)03450.26$13.24$5.37$2.65
    86903XBlood typing, antigen screen03450.26$13.24$5.37$2.65
    86904XBlood typing, patient serum03450.26$13.24$5.37$2.65
    86905XBlood typing, RBC antigens03450.26$13.24$5.37$2.65
    86906XBlood typing, Rh phenotype03450.26$13.24$5.37$2.65
    86910EBlood typing, paternity test
    86911EBlood typing, antigen system
    86915XBone marrow/stem cell prep03460.77$39.20$12.03$7.84
    86920XCompatibility test03460.77$39.20$12.03$7.84
    86921XCompatibility test03450.26$13.24$5.37$2.65
    86922XCompatibility test03460.77$39.20$12.03$7.84
    86927XPlasma, fresh frozen03460.77$39.20$12.03$7.84
    86930XFrozen blood prep03471.56$79.41$20.13$15.88
    86931XFrozen blood thaw03471.56$79.41$20.13$15.88
    86932XFrozen blood freeze/thaw03460.77$39.20$12.03$7.84
    86940AHemolysins/agglutinins, auto
    86941AHemolysins/agglutinins
    86945XBlood product/irradiation03450.26$13.24$5.37$2.65
    86950XLeukacyte transfusion03471.56$79.41$20.13$15.88
    86965XPooling blood platelets03471.56$79.41$20.13$15.88
    86970XRBC pretreatment03450.26$13.24$5.37$2.65
    86971XRBC pretreatment03450.26$13.24$5.37$2.65
    86972XRBC pretreatment03450.26$13.24$5.37$2.65
    86975XRBC pretreatment, serum03450.26$13.24$5.37$2.65
    86976XRBC pretreatment, serum03450.26$13.24$5.37$2.65
    86977XRBC pretreatment, serum03450.26$13.24$5.37$2.65
    86978XRBC pretreatment, serum03450.26$13.24$5.37$2.65
    86985XSplit blood or products03471.56$79.41$20.13$15.88
    86999XTransfusion procedure03460.77$39.20$12.03$7.84
    87001ASmall animal inoculation
    87003ASmall animal inoculation
    87015ASpecimen concentration
    87040ABlood culture for bacteria
    87045AStool culture, bacteria
    87046AStool cultr, bacteria, each
    87070ACulture, bacteria, other
    87071ACulture bacteri aerobic othr
    87073ACulture bacteria anaerobic
    87075ACulture bacteria anaerobic
    87076ACulture anaerobe ident, each
    87077ACulture aerobic identify
    87081ACulture screen only
    87084ACulture of specimen by kit
    87086AUrine culture/colony count
    87088AUrine bacteria culture
    87101ASkin fungi culture
    87102AFungus isolation culture
    87103ABlood fungus culture
    87106AFungi identification, yeast
    87107AFungi identification, mold
    87109AMycoplasma
    87110AChlamydia culture
    87116AMycobacteria culture
    87118AMycobacteric identification
    87140ACultur type immunofluoresc
    87143ACulture typing, glc/hplc
    Start Printed Page 60026
    87147ACulture type, immunologic
    87149ACulture type, nucleic acid
    87152ACulture type pulse field gel
    87158ACulture typing, added method
    87164ADark field examination
    87166ADark field examination
    87168AMacroscopic exam arthropod
    87169AMacacroscopic exam parasite
    87172APinworm exam
    87176ATissue homogenization, cultr
    87177AOva and parasites smears
    87181AMicrobe susceptible, diffuse
    87184AMicrobe susceptible, disk
    87185AMicrobe susceptible, enzyme
    87186AMicrobe susceptible, mic
    87187AMicrobe susceptible, mlc
    87188AMicrobe suscept, macrobroth
    87190AMicrobe suscept, mycobacteri
    87197ABactericidal level, serum
    *87198ACytomegalovirus antibody dfa
    *87199AEnterovirus antibody, dfa
    87205ASmear, gram stain
    87206ASmear, fluorescent/acid stai
    87207ASmear, special stain
    87210ASmear, wet mount, saline/ink
    87220ATissue exam for fungi
    87230AAssay, toxin or antitoxin
    87250AVirus inoculate, eggs/animal
    87252AVirus inoculation, tissue
    87253AVirus inoculate tissue, addl
    87254AVirus inoculation, shell via
    87260AAdenovirus ag, if
    87265APertussis ag, if
    87270AChlamydia trachomatis ag, if
    87272ACryptosporidum/gardia ag, if
    87273AHerpes simplex 2, ag, if
    87274AHerpes simplex 1, ag, if
    87275AInfluenza b, ag, if
    87276AInfluenza a, ag, if
    87277ALegionella micdadei, ag, if
    87278ALegion pneumophilia ag, if
    87279AParainfluenza, ag, if
    87280ARespiratory syncytial ag, if
    87281APneumocystis carinii, ag, if
    87283ARubeola, ag, if
    87285ATreponema pallidum, ag, if
    87290AVaricella zoster, ag, if
    87299AAntibody detection, nos, if
    87300AAg detection, polyval, if
    87301AAdenovirus ag, eia
    87320AChylmd trach ag, eia
    87324AClostridium ag, eia
    87327ACryptococcus neoform ag, eia
    87328ACryptospor ag, eia
    87332ACytomegalovirus ag, eia
    87335AE coli 0157 ag, eia
    87336AEntamoeb hist dispr, ag, eia
    87337AEntamoeb hist group, ag, eia
    87338AHpylori, stool, eia
    87339AHpylori ag, eia
    87340AHepatitis b surface ag, eia
    87341AHepatitis b surface, ag, eia
    87350AHepatitis be ag, eia
    87380AHepatitis delta ag, eia
    87385AHistoplasma capsul ag, eia
    87390AHiv-1 ag, eia
    87391AHiv-2 ag, eia
    87400AInfluenza a/b, ag, eia
    87420AResp syncytial ag, eia
    87425ARotavirus ag, eia
    87427AShiga-like toxin ag, eia
    87430AStrep a ag, eia
    87449AAg detect nos, eia, mult
    87450AAg detect nos, eia, single
    87451AAg detect polyval, eia, mult
    Start Printed Page 60027
    87470ABartonella, dna, dir probe
    87471ABartonella, dna, amp probe
    87472ABartonella, dna, quant
    87475ALyme dis, dna, dir probe
    87476ALyme dis, dna, amp probe
    87477ALyme dis, dna, quant
    87480ACandida, dna, dir probe
    87481ACandida, dna, amp probe
    87482ACandida, dna, quant
    87485AChylmd pneum, dna, dir probe
    87486AChylmd pneum, dna, amp probe
    87487AChylmd pneum, dna, quant
    87490AChylmd trach, dna, dir probe
    87491AChylmd trach, dna, amp probe
    87492AChylmd trach, dna, quant
    87495ACytomeg, dna, dir probe
    87496ACytomeg, dna, amp probe
    87497ACytomeg, dna, quant
    87510AGardner vag, dna, dir probe
    87511AGardner vag, dna, amp probe
    87512AGardner vag, dna, quant
    87515AHepatitis b, dna, dir probe
    87516AHepatitis b , dna, amp probe
    87517AHepatitis b , dna, quant
    87520AHepatitis c , rna, dir probe
    87521AHepatitis c , rna, amp probe
    87522AHepatitis c, rna, quant
    87525AHepatitis g , dna, dir probe
    87526AHepatitis g, dna, amp probe
    87527AHepatitis g, dna, quant
    87528AHsv, dna, dir probe
    87529AHsv, dna, amp probe
    87530AHsv, dna, quant
    87531AHhv-6, dna, dir probe
    87532AHhv-6, dna, amp probe
    87533AHhv-6, dna, quant
    87534AHiv-1, dna, dir probe
    87535AHiv-1, dna, amp probe
    87536AHiv-1, dna, quant
    87537AHiv-2, dna, dir probe
    87538AHiv-2, dna, amp probe
    87539AHiv-2, dna, quant
    87540ALegion pneumo, dna, dir prob
    87541ALegion pneumo, dna, amp prob
    87542ALegion pneumo, dna, quant
    87550AMycobacteria, dna, dir probe
    87551AMycobacteria, dna, amp probe
    87552AMycobacteria, dna, quant
    87555AM.tuberculo, dna, dir probe
    87556AM.tuberculo, dna, amp probe
    87557AM.tuberculo, dna, quant
    87560AM.avium-intra, dna, dir prob
    87561AM.avium-intra, dna, amp prob
    87562AM.avium-intra, dna, quant
    87580AM.pneumon, dna, dir probe
    87581AM.pneumon, dna, amp probe
    87582AM.pneumon, dna, quant
    87590AN.gonorrhoeae, dna, dir prob
    87591AN.gonorrhoeae, dna, amp prob
    87592AN.gonorrhoeae, dna, quant
    87620AHpv, dna, dir probe
    87621AHpv, dna, amp probe
    87622AHpv, dna, quant
    87650AStrep a, dna, dir probe
    87651AStrep a, dna, amp probe
    87652AStrep a, dna, quant
    87797ADetect agent nos, dna, dir
    87798ADetect agent nos, dna, amp
    87799ADetect agent nos, dna, quant
    87800ADetect agnt mult, dna, direc
    87801ADetect agnt mult, dna, ampli
    *87802AStrep b assay w/optic
    *87803AClostridium toxin a w/optic
    *87804AInfluenza assay w/optic
    87810AChylmd trach assay w/optic
    Start Printed Page 60028
    87850AN. gonorrhoeae assay w/optic
    87880AStrep a assay w/optic
    87899AAgent nos assay w/optic
    87901AGenotype, dna, hiv reverse t
    *87902AGenotype, dna, hepatitis C
    87903APhenotype, dna hiv w/culture
    87904APhenotype, dna hiv w/clt add
    87999AMicrobiology procedure
    88000EAutopsy (necropsy), gross
    88005EAutopsy (necropsy), gross
    88007EAutopsy (necropsy), gross
    88012EAutopsy (necropsy), gross
    88014EAutopsy (necropsy), gross
    88016EAutopsy (necropsy), gross
    88020EAutopsy (necropsy), complete
    88025EAutopsy (necropsy), complete
    88027EAutopsy (necropsy), complete
    88028EAutopsy (necropsy), complete
    88029EAutopsy (necropsy), complete
    88036ELimited autopsy
    88037ELimited autopsy
    88040EForensic autopsy (necropsy)
    88045ECoroner's autopsy (necropsy)
    88099ENecropsy (autopsy) procedure
    88104XCytopathology, fluids03430.39$19.85$10.72$3.97
    88106XCytopathology, fluids03430.39$19.85$10.72$3.97
    88107XCytopathology, fluids03430.39$19.85$10.72$3.97
    88108XCytopath, concentrate tech03430.39$19.85$10.72$3.97
    88125XForensic cytopathology03420.21$10.69$5.87$2.14
    88130ASex chromatin identification
    88140ASex chromatin identification
    88141NCytopath, c/v, interpret
    88142ACytopath, c/v, thin layer
    88143ACytopath c/v thin layer redo
    88144ACytopath, c/v thin lyr redo
    88145ACytopath, c/v thin lyr sel
    88147ACytopath, c/v, automated
    88148ACytopath, c/v, auto rescreen
    88150ACytopath, c/v, manual
    88152ACytopath, c/v, auto redo
    88153ACytopath, c/v, redo
    88154ACytopath, c/v, select
    88155ACytopath, c/v, index add-on
    88160XCytopath smear, other source03420.21$10.69$5.87$2.14
    88161XCytopath smear, other source03430.39$19.85$10.72$3.97
    88162XCytopath smear, other source03430.39$19.85$10.72$3.97
    88164ACytopath tbs, c/v, manual
    88165ACytopath tbs, c/v, redo
    88166ACytopath tbs, c/v, auto redo
    88167ACytopath tbs, c/v, select
    88170DFine needle aspiration00020.42$21.38$11.75$4.28
    88171DFine needle aspiration00042.47$125.73$32.57$25.15
    88172XCytopathology eval of fna03430.39$19.85$10.72$3.97
    88173XCytopath eval, fna, report03430.39$19.85$10.72$3.97
    88180XCell marker study03440.56$28.51$15.68$5.70
    88182XCell marker study03440.56$28.51$15.68$5.70
    88199ACytopathology procedure
    88230ATissue culture, lymphocyte
    88233ATissue culture, skin/biopsy
    88235ATissue culture, placenta
    88237ATissue culture, bone marrow
    88239ATissue culture, tumor
    88240ACell cryopreserve/storage
    88241AFrozen cell preparation
    88245AChromosome analysis, 20-25
    88248AChromosome analysis, 50-100
    88249AChromosome analysis, 100
    88261AChromosome analysis, 5
    88262AChromosome analysis, 15-20
    88263AChromosome analysis, 45
    88264AChromosome analysis, 20-25
    88267AChromosome analys, placenta
    88269AChromosome analys, amniotic
    88271ACytogenetics, dna probe
    88272ACytogenetics, 3-5
    Start Printed Page 60029
    88273ACytogenetics, 10-30
    88274ACytogenetics, 25-99
    88275ACytogenetics, 100-300
    88280AChromosome karyotype study
    88283AChromosome banding study
    88285AChromosome count, additional
    88289AChromosome study, additional
    88291ACyto/molecular report
    88299XCytogenetic study03420.21$10.69$5.87$2.14
    88300XSurgical path, gross03420.21$10.69$5.87$2.14
    88302XTissue exam by pathologist03420.21$10.69$5.87$2.14
    88304XTissue exam by pathologist03430.39$19.85$10.72$3.97
    88305XTissue exam by pathologist03430.39$19.85$10.72$3.97
    88307XTissue exam by pathologist03440.56$28.51$15.68$5.70
    88309XTissue exam by pathologist03440.56$28.51$15.68$5.70
    88311XDecalcify tissue03420.21$10.69$5.87$2.14
    88312XSpecial stains03420.21$10.69$5.87$2.14
    88313XSpecial stains03420.21$10.69$5.87$2.14
    88314XHistochemical stain03420.21$10.69$5.87$2.14
    88318XChemical histochemistry03420.21$10.69$5.87$2.14
    88319XEnzyme histochemistry03420.21$10.69$5.87$2.14
    88321XMicroslide consultation03420.21$10.69$5.87$2.14
    88323XMicroslide consultation03430.39$19.85$10.72$3.97
    88325XComprehensive review of data03430.39$19.85$10.72$3.97
    88329XPath consult introp03420.21$10.69$5.87$2.14
    88331XPath consult intraop, 1 bloc03430.39$19.85$10.72$3.97
    88332XPath consult intraop, addl03420.21$10.69$5.87$2.14
    88342XImmunocytochemistry03440.56$28.51$15.68$5.70
    88346XImmunofluorescent study03430.39$19.85$10.72$3.97
    88347XImmunofluorescent study03440.56$28.51$15.68$5.70
    88348XElectron microscopy03440.56$28.51$15.68$5.70
    88349XScanning electron microscopy03440.56$28.51$15.68$5.70
    88355XAnalysis, skeletal muscle03440.56$28.51$15.68$5.70
    88356XAnalysis, nerve03440.56$28.51$15.68$5.70
    88358XAnalysis, tumor03440.56$28.51$15.68$5.70
    88362XNerve teasing preparations03430.39$19.85$10.72$3.97
    88365XTissue hybridization03440.56$28.51$15.68$5.70
    88371AProtein, western blot tissue
    88372AProtein analysis w/probe
    *88380AMicrodissection
    88399ASurgical pathology procedure
    88400ABilirubin total transcut
    89050ABody fluid cell count
    89051ABody fluid cell count
    89060AExam,synovial fluid crystals
    89100XSample intestinal contents03601.35$68.72$34.36$13.74
    89105XSample intestinal contents03601.35$68.72$34.36$13.74
    89125ASpecimen fat stain
    89130XSample stomach contents03601.35$68.72$34.36$13.74
    89132XSample stomach contents03601.35$68.72$34.36$13.74
    89135XSample stomach contents03601.35$68.72$34.36$13.74
    89136XSample stomach contents03601.35$68.72$34.36$13.74
    89140XSample stomach contents03601.35$68.72$34.36$13.74
    89141XSample stomach contents03601.35$68.72$34.36$13.74
    89160AExam feces for meat fibers
    89190ANasal smear for eosinophils
    89250XFertilization of oocyte03480.77$39.20$7.84
    89251XCulture oocyte w/embryos03480.77$39.20$7.84
    89252XAssist oocyte fertilization03480.77$39.20$7.84
    89253XEmbryo hatching03480.77$39.20$7.84
    89254XOocyte identification03480.77$39.20$7.84
    89255XPrepare embryo for transfer03480.77$39.20$7.84
    89256XPrepare cryopreserved embryo03480.77$39.20$7.84
    89257XSperm identification03480.77$39.20$7.84
    89258XCryopreservation, embryo03480.77$39.20$7.84
    89259XCryopreservation, sperm03480.77$39.20$7.84
    89260XSperm isolation, simple03480.77$39.20$7.84
    89261XSperm isolation, complex03480.77$39.20$7.84
    89264XIdentify sperm tissue03480.77$39.20$7.84
    89300ASemen analysis
    89310ASemen analysis
    89320ASemen analysis
    89321ASemen analysis
    89325ASperm antibody test
    89329ASperm evaluation test
    Start Printed Page 60030
    89330AEvaluation, cervical mucus
    89350XSputum specimen collection03440.56$28.51$15.68$5.70
    89355AExam feces for starch
    89360XCollect sweat for test03440.56$28.51$15.68$5.70
    89365AWater load test
    89399APathology lab procedure
    90281EHuman ig, im
    90283EHuman ig, iv
    90287EBotulinum antitoxin
    90288EBotulism ig, iv
    90291ECmv ig, iv
    90296KDiphtheria antitoxin03561.11$56.50$11.30
    90371KHep b ig, im03561.11$56.50$11.30
    90375KRabies ig, im/sc03561.11$56.50$11.30
    90376KRabies ig, heat treated03561.11$56.50$11.30
    90378KRsv ig, im, 50 mg03561.11$56.50$11.30
    90379KRsv ig, iv03561.11$56.50$11.30
    90384ERh ig, full-dose, im
    90385KRh ig, minidose, im03561.11$56.50$11.30
    90386ERh ig, iv
    90389KTetanus ig, im03561.11$56.50$11.30
    90393KVaccina ig, im03561.11$56.50$11.30
    90396KVaricella-zoster ig, im03561.11$56.50$11.30
    90399EImmune globulin
    90471NImmunization admin
    90472NImmunization admin, each add
    *90473EImmune admin oral/nasal
    *90474EImmune admin oral/nasal addl
    90476KAdenovirus vaccine, type 403561.11$56.50$11.30
    90477KAdenovirus vaccine, type 703561.11$56.50$11.30
    90581KAnthrax vaccine, sc03561.11$56.50$11.30
    90585KBcg vaccine, percut03561.11$56.50$11.30
    90586KBcg vaccine, intravesical03561.11$56.50$11.30
    90632KHep a vaccine, adult im03561.11$56.50$11.30
    90633KHep a vacc, ped/adol, 2 dose03561.11$56.50$11.30
    90634KHep a vacc, ped/adol, 3 dose03561.11$56.50$11.30
    90636KHep a/hep b vacc, adult im03550.19$9.67$1.93
    90645KHib vaccine, hboc, im03550.19$9.67$1.93
    90646KHib vaccine, prp-d, im03550.19$9.67$1.93
    90647KHib vaccine, prp-omp, im03550.19$9.67$1.93
    90648KHib vaccine, prp-t, im03550.19$9.67$1.93
    90657KFlu vaccine, 6-35 mo, im03540.10$5.09
    90658KFlu vaccine, 3 yrs, im03540.10$5.09
    90659KFlu vaccine, whole, im03540.10$5.09
    90660EFlu vaccine, nasal
    90665KLyme disease vaccine, im03561.11$56.50$11.30
    90669EPneumococcal vacc, ped<5
    90675KRabies vaccine, im03561.11$56.50$11.30
    90676KRabies vaccine, id03561.11$56.50$11.30
    90680KRotovirus vaccine, oral03561.11$56.50$11.30
    90690KTyphoid vaccine, oral03561.11$56.50$11.30
    90691KTyphoid vaccine, im03561.11$56.50$11.30
    90692KTyphoid vaccine, h-p, sc/id03550.19$9.67$1.93
    90693KTyphoid vaccine, akd, sc03561.11$56.50$11.30
    90700KDtap vaccine, im03550.19$9.67$1.93
    90701KDtp vaccine, im03550.19$9.67$1.93
    90702KDt vaccine < 7, im03550.19$9.67$1.93
    90703KTetanus vaccine, im03550.19$9.67$1.93
    90704KMumps vaccine, sc03550.19$9.67$1.93
    90705KMeasles vaccine, sc03561.11$56.50$11.30
    90706KRubella vaccine, sc03550.19$9.67$1.93
    90707KMmr vaccine, sc03561.11$56.50$11.30
    90708KMeasles-rubella vaccine, sc03561.11$56.50$11.30
    90709KRubella & mumps vaccine, sc03561.11$56.50$11.30
    90710KMmrv vaccine, sc03561.11$56.50$11.30
    90712KOral poliovirus vaccine03550.19$9.67$1.93
    90713KPoliovirus, ipv, sc03550.19$9.67$1.93
    90716KChicken pox vaccine, sc03550.19$9.67$1.93
    90717KYellow fever vaccine, sc03561.11$56.50$11.30
    90718KTd vaccine > 7, im03550.19$9.67$1.93
    90719KDiphtheria vaccine, im03561.11$56.50$11.30
    90720KDtp/hib vaccine, im03550.19$9.67$1.93
    90721KDtap/hib vaccine, im03550.19$9.67$1.93
    90723KDtap-hep b-ipv vaccine, im03561.11$56.50$11.30
    90725KCholera vaccine, injectable03550.19$9.67$1.93
    Start Printed Page 60031
    90727KPlague vaccine, im03550.19$9.67$1.93
    90732KPneumococcal vacc, adult/ill03540.10$5.09
    90733KMeningococcal vaccine, sc03561.11$56.50$11.30
    90735KEncephalitis vaccine, sc03561.11$56.50$11.30
    90740KHepb vacc, ill pat 3 dose im03561.11$56.50$11.30
    90743KHep b vacc, adol, 2 dose, im03561.11$56.50$11.30
    90744KHepb vacc ped/adol 3 dose im03561.11$56.50$11.30
    90746KHep b vaccine, adult, im03561.11$56.50$11.30
    90747KHepb vacc, ill pat 4 dose im03561.11$56.50$11.30
    90748KHep b/hib vaccine, im03550.19$9.67$1.93
    90749KVaccine toxoid03550.19$9.67$1.93
    90780EIV infusion therapy, 1 hour
    90781EIV infusion, additional hour
    90782XInjection, sc/im03520.41$20.87$4.17
    90783XInjection, ia03591.79$91.12$18.22
    90784XInjection, iv03591.79$91.12$18.22
    90788XInjection of antibiotic03591.79$91.12$18.22
    90799XTher/prophylactic/dx inject03520.41$20.87$4.17
    90801SPsy dx interview03231.73$88.06$21.13$17.61
    90802SIntac psy dx interview03231.73$88.06$21.13$17.61
    90804SPsytx, office, 20-30 min03221.15$58.54$12.29$11.71
    90805SPsytx, off, 20-30 min w/e&m03221.15$58.54$12.29$11.71
    90806SPsytx, off, 45-50 min03231.73$88.06$21.13$17.61
    90807SPsytx, off, 45-50 min w/e&m03231.73$88.06$21.13$17.61
    90808SPsytx, office, 75-80 min03231.73$88.06$21.13$17.61
    90809SPsytx, off, 75-80, w/e&m03231.73$88.06$21.13$17.61
    90810SIntac psytx, off, 20-30 min03221.15$58.54$12.29$11.71
    90811SIntac psytx, 20-30, w/e&m03221.15$58.54$12.29$11.71
    90812SIntac psytx, off, 45-50 min03231.73$88.06$21.13$17.61
    90813SIntac psytx, 45-50 min w/e&m03231.73$88.06$21.13$17.61
    90814SIntac psytx, off, 75-80 min03231.73$88.06$21.13$17.61
    90815SIntac psytx, 75-80 w/e&m03231.73$88.06$21.13$17.61
    90816SPsytx, hosp, 20-30 min03221.15$58.54$12.29$11.71
    90817SPsytx, hosp, 20-30 min w/e&m03221.15$58.54$12.29$11.71
    90818SPsytx, hosp, 45-50 min03231.73$88.06$21.13$17.61
    90819SPsytx, hosp, 45-50 min w/e&m03231.73$88.06$21.13$17.61
    90821SPsytx, hosp, 75-80 min03231.73$88.06$21.13$17.61
    90822SPsytx, hosp, 75-80 min w/e&m03231.73$88.06$21.13$17.61
    90823SIntac psytx, hosp, 20-30 min03221.15$58.54$12.29$11.71
    90824SIntac psytx, hsp 20-30 w/e&m03221.15$58.54$12.29$11.71
    90826SIntac psytx, hosp, 45-50 min03231.73$88.06$21.13$17.61
    90827SIntac psytx, hsp 45-50 w/e&m03231.73$88.06$21.13$17.61
    90828SIntac psytx, hosp, 75-80 min03231.73$88.06$21.13$17.61
    90829SIntac psytx, hsp 75-80 w/e&m03231.73$88.06$21.13$17.61
    90845SPsychoanalysis03231.73$88.06$21.13$17.61
    90846SFamily psytx w/o patient03242.69$136.93$20.19$27.39
    90847SFamily psytx w/patient03242.69$136.93$20.19$27.39
    90849SMultiple family group psytx03251.38$70.25$18.27$14.05
    90853SGroup psychotherapy03251.38$70.25$18.27$14.05
    90857SIntac group psytx03251.38$70.25$18.27$14.05
    90862XMedication management03740.89$45.30$9.97$9.06
    90865SNarcosynthesis03231.73$88.06$21.13$17.61
    90870SElectroconvulsive therapy03203.88$197.51$80.06$39.50
    90871SElectroconvulsive therapy03203.88$197.51$80.06$39.50
    90875EPsychophysiological therapy
    90876EPsychophysiological therapy
    90880SHypnotherapy03231.73$88.06$21.13$17.61
    90882EEnvironmental manipulation
    90885NPsy evaluation of records
    90887NConsultation with family
    90889NPreparation of report
    90899SPsychiatric service/therapy03221.15$58.54$12.29$11.71
    90901SBiofeedback train, any meth03210.93$47.34$21.78$9.47
    90911SBiofeedback peri/uro/rectal03210.93$47.34$21.78$9.47
    90918AESRD related services, month
    90919AESRD related services, month
    90920AESRD related services, month
    90921AESRD related services, month
    90922AESRD related services, day
    90923AEsrd related services, day
    90924AEsrd related services, day
    90925AEsrd related services, day
    90935SHemodialysis, one evaluation01700.28$14.25$3.14$2.85
    90937EHemodialysis, repeated eval
    *90939NHemodialysis study, transcut
    Start Printed Page 60032
    90940NHemodialysis access study
    90945SDialysis, one evaluation01700.28$14.25$3.14$2.85
    90947EDialysis, repeated eval
    90989EDialysis training, complete
    90993EDialysis training, incompl
    90997EHemoperfusion
    90999EDialysis procedure
    91000XEsophageal intubation03613.25$165.44$82.72$33.09
    91010XEsophagus motility study03613.25$165.44$82.72$33.09
    91011XEsophagus motility study03613.25$165.44$82.72$33.09
    91012XEsophagus motility study03613.25$165.44$82.72$33.09
    91020XGastric motility03613.25$165.44$82.72$33.09
    91030XAcid perfusion of esophagus03613.25$165.44$82.72$33.09
    91032XEsophagus, acid reflux test03613.25$165.44$82.72$33.09
    91033XProlonged acid reflux test03613.25$165.44$82.72$33.09
    91052XGastric analysis test03613.25$165.44$82.72$33.09
    91055XGastric intubation for smear03601.35$68.72$34.36$13.74
    91060XGastric saline load test03601.35$68.72$34.36$13.74
    91065XBreath hydrogen test03601.35$68.72$34.36$13.74
    91100XPass intestine bleeding tube03601.35$68.72$34.36$13.74
    91105XGastric intubation treatment03613.25$165.44$82.72$33.09
    91122TAnal pressure record01562.45$124.71$37.41$24.94
    *91123NIrrigate fecal impaction
    91132XElectrogastrography03601.35$68.72$34.36$13.74
    91133XElectrogastrography w/test03601.35$68.72$34.36$13.74
    91299XGastroenterology procedure03601.35$68.72$34.36$13.74
    92002VEye exam, new patient06010.95$48.36$9.67
    92004VEye exam, new patient06021.38$70.25$14.05
    92012VEye exam established pat06000.86$43.78$8.76
    92014VEye exam & treatment06021.38$70.25$14.05
    92015ERefraction
    92018TNew eye exam & treatment06996.46$328.84$147.98$65.77
    92019SEye exam & treatment06981.03$52.43$19.92$10.49
    92020SSpecial eye evaluation02300.61$31.05$14.28$6.21
    92060SSpecial eye evaluation02300.61$31.05$14.28$6.21
    92065SOrthoptic/pleoptic training02300.61$31.05$14.28$6.21
    92070NFitting of contact lens
    92081SVisual field examination(s)02300.61$31.05$14.28$6.21
    92082SVisual field examination(s)06981.03$52.43$19.92$10.49
    92083SVisual field examination(s)06981.03$52.43$19.92$10.49
    92100NSerial tonometry exam(s)
    92120STonography & eye evaluation02300.61$31.05$14.28$6.21
    92130SWater provocation tonography06981.03$52.43$19.92$10.49
    92135SOpthalmic dx imaging02300.61$31.05$14.28$6.21
    *92136SOphthalmic biometry02300.61$31.05$14.28$6.21
    92140SGlaucoma provocative tests02312.03$103.34$46.50$20.67
    92225SSpecial eye exam, initial06981.03$52.43$19.92$10.49
    92226SSpecial eye exam, subsequent02312.03$103.34$46.50$20.67
    92230TEye exam with photos06996.46$328.84$147.98$65.77
    92235SEye exam with photos02312.03$103.34$46.50$20.67
    92240SIcg angiography02312.03$103.34$46.50$20.67
    92250SEye exam with photos02300.61$31.05$14.28$6.21
    92260SOphthalmoscopy/dynamometry02300.61$31.05$14.28$6.21
    92265SEye muscle evaluation02312.03$103.34$46.50$20.67
    92270SElectro-oculography06981.03$52.43$19.92$10.49
    92275SElectroretinography02162.61$132.86$59.79$26.57
    92283SColor vision examination02300.61$31.05$14.28$6.21
    92284SDark adaptation eye exam02312.03$103.34$46.50$20.67
    92285SEye photography02300.61$31.05$14.28$6.21
    92286SInternal eye photography06981.03$52.43$19.92$10.49
    92287SInternal eye photography02312.03$103.34$46.50$20.67
    92310EContact lens fitting
    92311XContact lens fitting03620.86$43.78$9.63$8.76
    92312XContact lens fitting03620.86$43.78$9.63$8.76
    92313XContact lens fitting03620.86$43.78$9.63$8.76
    92314EPrescription of contact lens
    92315XPrescription of contact lens03620.86$43.78$9.63$8.76
    92316XPrescription of contact lens03620.86$43.78$9.63$8.76
    92317XPrescription of contact lens03620.86$43.78$9.63$8.76
    92325XModification of contact lens03620.86$43.78$9.63$8.76
    92326XReplacement of contact lens03620.86$43.78$9.63$8.76
    92330SFitting of artificial eye02300.61$31.05$14.28$6.21
    92335NFitting of artificial eye
    92340EFitting of spectacles
    92341EFitting of spectacles
    Start Printed Page 60033
    92342EFitting of spectacles
    92352XSpecial spectacles fitting03620.86$43.78$9.63$8.76
    92353XSpecial spectacles fitting03620.86$43.78$9.63$8.76
    92354XSpecial spectacles fitting03620.86$43.78$9.63$8.76
    92355XSpecial spectacles fitting03620.86$43.78$9.63$8.76
    92358XEye prosthesis service03620.86$43.78$9.63$8.76
    92370ERepair & adjust spectacles
    92371XRepair & adjust spectacles03620.86$43.78$9.63$8.76
    92390ESupply of spectacles
    92391ESupply of contact lenses
    92392ESupply of low vision aids
    92393ESupply of artificial eye
    92395ESupply of spectacles
    92396ESupply of contact lenses
    92499SEye service or procedure02300.61$31.05$14.28$6.21
    92502TEar and throat examination02512.43$123.70$27.99$24.74
    92504NEar microscopy examination
    92506ASpeech/hearing evaluation
    92507ASpeech/hearing therapy
    92508ASpeech/hearing therapy
    92510ARehab for ear implant
    92511TNasopharyngoscopy00711.03$52.43$14.22$10.49
    92512XNasal function studies03631.73$88.06$32.58$17.61
    92516XFacial nerve function test03631.73$88.06$32.58$17.61
    92520XLaryngeal function studies03631.73$88.06$32.58$17.61
    92525AOral function evaluation
    92526AOral function therapy
    92531NSpontaneous nystagmus study
    92532NPositional nystagmus study
    92533NCaloric vestibular test
    92534NOptokinetic nystagmus
    92541XSpontaneous nystagmus test03631.73$88.06$32.58$17.61
    92542XPositional nystagmus test03631.73$88.06$32.58$17.61
    92543XCaloric vestibular test03631.73$88.06$32.58$17.61
    92544XOptokinetic nystagmus test03631.73$88.06$32.58$17.61
    92545XOscillating tracking test03631.73$88.06$32.58$17.61
    92546XSinusoidal rotational test03631.73$88.06$32.58$17.61
    92547XSupplemental electrical test03631.73$88.06$32.58$17.61
    92548XPosturography03631.73$88.06$32.58$17.61
    92551EPure tone hearing test, air
    92552XPure tone audiometry, air03640.58$29.52$11.51$5.90
    92553XAudiometry, air & bone03651.31$66.68$20.00$13.34
    92555XSpeech threshold audiometry03640.58$29.52$11.51$5.90
    92556XSpeech audiometry, complete03640.58$29.52$11.51$5.90
    92557XComprehensive hearing test03651.31$66.68$20.00$13.34
    92559EGroup audiometric testing
    92560EBekesy audiometry, screen
    92561XBekesy audiometry, diagnosis03651.31$66.68$20.00$13.34
    92562XLoudness balance test03640.58$29.52$11.51$5.90
    92563XTone decay hearing test03640.58$29.52$11.51$5.90
    92564XSisi hearing test03640.58$29.52$11.51$5.90
    92565XStenger test, pure tone03640.58$29.52$11.51$5.90
    92567XTympanometry03640.58$29.52$11.51$5.90
    92568XAcoustic reflex testing03640.58$29.52$11.51$5.90
    92569XAcoustic reflex decay test03640.58$29.52$11.51$5.90
    92571XFiltered speech hearing test03640.58$29.52$11.51$5.90
    92572XStaggered spondaic word test03640.58$29.52$11.51$5.90
    92573XLombard test03640.58$29.52$11.51$5.90
    92575XSensorineural acuity test03651.31$66.68$20.00$13.34
    92576XSynthetic sentence test03640.58$29.52$11.51$5.90
    92577XStenger test, speech03651.31$66.68$20.00$13.34
    92579XVisual audiometry (vra)03651.31$66.68$20.00$13.34
    92582XConditioning play audiometry03651.31$66.68$20.00$13.34
    92583XSelect picture audiometry03640.58$29.52$11.51$5.90
    92584XElectrocochleography03631.73$88.06$32.58$17.61
    92585SAuditor evoke potent, compre02162.61$132.86$59.79$26.57
    92586SAuditor evoke potent, limit0707$75.00$15.00
    92587XEvoked auditory test03631.73$88.06$32.58$17.61
    92588XEvoked auditory test03631.73$88.06$32.58$17.61
    92589XAuditory function test(s)03640.58$29.52$11.51$5.90
    92590EHearing aid exam, one ear
    92591EHearing aid exam, both ears
    92592EHearing aid check, one ear
    92593EHearing aid check, both ears
    92594EElectro hearng aid test, one
    Start Printed Page 60034
    92595EElectro hearng aid tst, both
    92596XEar protector evaluation03651.31$66.68$20.00$13.34
    92599XENT procedure/service03640.58$29.52$11.51$5.90
    92950SHeart/lung resuscitation cpr00946.08$309.50$105.29$61.90
    92953STemporary external pacing00946.08$309.50$105.29$61.90
    92960SCardioversion electric, ext00946.08$309.50$105.29$61.90
    92961SCardioversion, electric, int00946.08$309.50$105.29$61.90
    92970CCardioassist, internal
    92971CCardioassist, external
    *92973TPercut coronary thrombectomy0973$250.00$50.00
    *92974TCath place, cardio brachytx0981$2,250.00$450.00
    92975CDissolve clot, heart vessel
    92977TDissolve clot, heart vessel01203.08$156.78$42.67$31.36
    92978SIntravasc us, heart add-on02672.33$118.61$65.23$23.72
    92979SIntravasc us, heart add-on02672.33$118.61$65.23$23.72
    92980TInsert intracoronary stent010487.98$4,478.53$895.71
    92981TInsert intracoronary stent010487.98$4,478.53$895.71
    92982TCoronary artery dilation008359.49$3,028.28$794.30$605.66
    92984TCoronary artery dilation008359.49$3,028.28$794.30$605.66
    92986CRevision of aortic valve
    92987CRevision of mitral valve
    92990CRevision of pulmonary valve
    92992CRevision of heart chamber
    92993CRevision of heart chamber
    92995TCoronary atherectomy008292.00$4,683.17$1,351.74$936.63
    92996TCoronary atherectomy add-on008292.00$4,683.17$1,351.74$936.63
    92997CPul art balloon repr, percut
    92998CPul art balloon repr, percut
    93000EElectrocardiogram, complete
    93005SElectrocardiogram, tracing00990.35$17.82$9.80$3.56
    93010AElectrocardiogram report
    93012NTransmission of ecg
    93014EReport on transmitted ecg
    93015ECardiovascular stress test
    93016ECardiovascular stress test
    93017XCardiovascular stress test01001.47$74.83$41.15$14.97
    93018ECardiovascular stress test
    93024XCardiac drug stress test01001.47$74.83$41.15$14.97
    *93025XMicrovolt t-wave assess01001.47$74.83$41.15$14.97
    93040ERhythm ECG with report
    93041SRhythm ECG, tracing00990.35$17.82$9.80$3.56
    93042ERhythm ECG, report
    93224EECG monitor/report, 24 hrs
    93225XECG monitor/record, 24 hrs01001.47$74.83$41.15$14.97
    93226XECG monitor/report, 24 hrs01001.47$74.83$41.15$14.97
    93227EECG monitor/review, 24 hrs
    93230EECG monitor/report, 24 hrs
    93231XEcg monitor/record, 24 hrs01001.47$74.83$41.15$14.97
    93232XECG monitor/report, 24 hrs01001.47$74.83$41.15$14.97
    93233EECG monitor/review, 24 hrs
    93235EECG monitor/report, 24 hrs
    93236XECG monitor/report, 24 hrs01001.47$74.83$41.15$14.97
    93237EECG monitor/review, 24 hrs
    93268EECG record/review
    93270XECG recording00970.84$42.76$23.51$8.55
    93271XEcg/monitoring and analysis00970.84$42.76$23.51$8.55
    93272EEcg/review, interpret only
    93278SECG/signal-averaged00990.35$17.82$9.80$3.56
    93303SEcho transthoracic02693.85$195.98$101.91$39.20
    93304SEcho transthoracic06972.08$105.88$55.06$21.18
    93307SEcho exam of heart02693.85$195.98$101.91$39.20
    93308SEcho exam of heart06972.08$105.88$55.06$21.18
    93312SEcho transesophageal02705.30$269.79$145.69$53.96
    93313SEcho transesophageal02705.30$269.79$145.69$53.96
    93314NEcho transesophageal
    93315SEcho transesophageal02705.30$269.79$145.69$53.96
    93316SEcho transesophageal02705.30$269.79$145.69$53.96
    93317NEcho transesophageal
    93318SEcho transesophageal intraop02705.30$269.79$145.69$53.96
    93320SDoppler echo exam, heart02693.85$195.98$101.91$39.20
    93321SDoppler echo exam, heart06972.08$105.88$55.06$21.18
    93325SDoppler color flow add-on06972.08$105.88$55.06$21.18
    93350SEcho transthoracic02693.85$195.98$101.91$39.20
    93501TRight heart catheterization008034.73$1,767.90$838.92$353.58
    93503TInsert/place heart catheter010315.95$811.92$295.70$162.38
    Start Printed Page 60035
    93505TBiopsy of heart lining010315.95$811.92$295.70$162.38
    93508TCath placement, angiography008034.73$1,767.90$838.92$353.58
    93510TLeft heart catheterization008034.73$1,767.90$838.92$353.58
    93511TLeft heart catheterization008034.73$1,767.90$838.92$353.58
    93514TLeft heart catheterization008034.73$1,767.90$838.92$353.58
    93524TLeft heart catheterization008034.73$1,767.90$838.92$353.58
    93526TRt & Lt heart catheters008034.73$1,767.90$838.92$353.58
    93527TRt & Lt heart catheters008034.73$1,767.90$838.92$353.58
    93528TRt & Lt heart catheters008034.73$1,767.90$838.92$353.58
    93529TRt, Lt heart catheterization008034.73$1,767.90$838.92$353.58
    93530TRt heart cath, congenital008034.73$1,767.90$838.92$353.58
    93531TR & l heart cath, congenital008034.73$1,767.90$838.92$353.58
    93532TR & l heart cath, congenital008034.73$1,767.90$838.92$353.58
    93533TR & l heart cath, congenital008034.73$1,767.90$838.92$353.58
    93536DInsert circulation assi010315.95$811.92$295.70$162.38
    93539NInjection, cardiac cath
    93540NInjection, cardiac cath
    93541NInjection for lung angiogram
    93542NInjection for heart x-rays
    93543NInjection for heart x-rays
    93544NInjection for aortography
    93545NInject for coronary x-rays
    93555NImaging, cardiac cath
    93556NImaging, cardiac cath
    93561NCardiac output measurement
    93562NCardiac output measurement
    93571NHeart flow reserve measure
    93572NHeart flow reserve measure
    93600TBundle of His recording008752.46$2,670.42$534.08
    93602TIntra-atrial recording008752.46$2,670.42$534.08
    93603TRight ventricular recording008752.46$2,670.42$534.08
    93607DLeft ventricular recording008752.46$2,670.42$534.08
    93609TMapping of tachycardia008752.46$2,670.42$534.08
    93610TIntra-atrial pacing008752.46$2,670.42$534.08
    93612TIntraventricular pacing008752.46$2,670.42$534.08
    *93613TElectrophys map, 3d, add-on008752.46$2,670.42$534.08
    93615TEsophageal recording008752.46$2,670.42$534.08
    93616TEsophageal recording008752.46$2,670.42$534.08
    93618THeart rhythm pacing008752.46$2,670.42$534.08
    93619TElectrophysiology evaluation008538.69$1,969.48$654.48$393.90
    93620TElectrophysiology evaluation008538.69$1,969.48$654.48$393.90
    93621TElectrophysiology evaluation008538.69$1,969.48$654.48$393.90
    93622TElectrophysiology evaluation008538.69$1,969.48$654.48$393.90
    93623TStimulation, pacing heart008752.46$2,670.42$534.08
    93624TElectrophysiologic study008752.46$2,670.42$534.08
    93631THeart pacing, mapping008752.46$2,670.42$534.08
    93640SEvaluation heart device0084199.65$10,162.98$2,032.60
    93641SElectrophysiology evaluation0084199.65$10,162.98$2,032.60
    93642SElectrophysiology evaluation0084199.65$10,162.98$2,032.60
    93650TAblate heart dysrhythm focus008672.72$3,701.74$1,265.37$740.35
    93651TAblate heart dysrhythm focus008672.72$3,701.74$1,265.37$740.35
    93652TAblate heart dysrhythm focus008672.72$3,701.74$1,265.37$740.35
    93660STilt table evaluation01013.74$190.38$104.70$38.08
    93662SIntracardiac ecg (ice)02705.30$269.79$145.69$53.96
    93668EPeripheral vascular rehab
    *93701TBioimpedance, thoracic0970$25.00$5.00
    93720ETotal body plethysmography
    93721SPlethysmography tracing00961.71$87.05$47.87$17.41
    93722EPlethysmography report
    93724SAnalyze pacemaker system06900.37$18.83$10.35$3.77
    93727SAnalyze ilr system06900.37$18.83$10.35$3.77
    93731SAnalyze pacemaker system06900.37$18.83$10.35$3.77
    93732SAnalyze pacemaker system06900.37$18.83$10.35$3.77
    93733STelephone analy, pacemaker06900.37$18.83$10.35$3.77
    93734SAnalyze pacemaker system06900.37$18.83$10.35$3.77
    93735SAnalyze pacemaker system06900.37$18.83$10.35$3.77
    93736STelephone analy, pacemaker06900.37$18.83$10.35$3.77
    93737DAnalyze cardio/defibrillator06890.43$21.89$12.03$4.38
    93738DAnalyze cardio/defibrillator06890.43$21.89$12.03$4.38
    93740STemperature gradient studies00961.71$87.05$47.87$17.41
    93741SAnalyze ht pace device sngl06890.43$21.89$12.03$4.38
    93742SAnalyze ht pace device sngl06890.43$21.89$12.03$4.38
    93743SAnalyze ht pace device dual06890.43$21.89$12.03$4.38
    93744SAnalyze ht pace device dual06890.43$21.89$12.03$4.38
    93760ECephalic thermogram
    Start Printed Page 60036
    93762EPeripheral thermogram
    93770NMeasure venous pressure
    93784EAmbulatory BP monitoring
    93786EAmbulatory BP recording
    93788EAmbulatory BP analysis
    93790EReview/report BP recording
    93797SCardiac rehab00950.61$31.05$16.46$6.21
    93798SCardiac rehab/monitor00950.61$31.05$16.46$6.21
    93799SCardiovascular procedure00961.71$87.05$47.87$17.41
    93875SExtracranial study00961.71$87.05$47.87$17.41
    93880SExtracranial study02672.33$118.61$65.23$23.72
    93882SExtracranial study02672.33$118.61$65.23$23.72
    93886SIntracranial study02672.33$118.61$65.23$23.72
    93888SIntracranial study02672.33$118.61$65.23$23.72
    93922SExtremity study00961.71$87.05$47.87$17.41
    93923SExtremity study00961.71$87.05$47.87$17.41
    93924SExtremity study00961.71$87.05$47.87$17.41
    93925SLower extremity study02672.33$118.61$65.23$23.72
    93926SLower extremity study02672.33$118.61$65.23$23.72
    93930SUpper extremity study02672.33$118.61$65.23$23.72
    93931SUpper extremity study02672.33$118.61$65.23$23.72
    93965SExtremity study00961.71$87.05$47.87$17.41
    93970SExtremity study02672.33$118.61$65.23$23.72
    93971SExtremity study02672.33$118.61$65.23$23.72
    93975SVascular study02672.33$118.61$65.23$23.72
    93976SVascular study02672.33$118.61$65.23$23.72
    93978SVascular study02672.33$118.61$65.23$23.72
    93979SVascular study02672.33$118.61$65.23$23.72
    93980SPenile vascular study02672.33$118.61$65.23$23.72
    93981SPenile vascular study02672.33$118.61$65.23$23.72
    93990SDoppler flow testing02672.33$118.61$65.23$23.72
    94010XBreathing capacity test03670.70$35.63$17.82$7.13
    94014XPatient recorded spirometry03670.70$35.63$17.82$7.13
    94015XPatient recorded spirometry03670.70$35.63$17.82$7.13
    94016XReview patient spirometry03693.49$177.65$58.50$35.53
    94060XEvaluation of wheezing03681.47$74.83$38.16$14.97
    94070XEvaluation of wheezing03681.47$74.83$38.16$14.97
    94150NVital capacity test
    94200XLung function test (MBC/MVV)03670.70$35.63$17.82$7.13
    94240XResidual lung capacity03681.47$74.83$38.16$14.97
    94250XExpired gas collection03670.70$35.63$17.82$7.13
    94260XThoracic gas volume03681.47$74.83$38.16$14.97
    94350XLung nitrogen washout curve03681.47$74.83$38.16$14.97
    94360XMeasure airflow resistance03681.47$74.83$38.16$14.97
    94370XBreath airway closing volume03681.47$74.83$38.16$14.97
    94375XRespiratory flow volume loop03670.70$35.63$17.82$7.13
    94400XCO2 breathing response curve03681.47$74.83$38.16$14.97
    94450XHypoxia response curve03670.70$35.63$17.82$7.13
    94620XPulmonary stress test/simple03681.47$74.83$38.16$14.97
    94621XPulm stress test/complex03693.49$177.65$58.50$35.53
    94640SAirway inhalation treatment00770.39$19.85$10.91$3.97
    94642SAerosol inhalation treatment00780.86$43.78$18.83$8.76
    94650SPressure breathing (IPPB)00770.39$19.85$10.91$3.97
    94651SPressure breathing (IPPB)00770.39$19.85$10.91$3.97
    94652CPressure breathing (IPPB)
    94656SInitial ventilator mgmt00790.60$30.54$16.79$6.11
    94657SContinued ventilator mgmt00790.60$30.54$16.79$6.11
    94660SPos airway pressure, CPAP00683.02$153.73$84.55$30.75
    94662SNeg press ventilation, cnp00790.60$30.54$16.79$6.11
    94664SAerosol or vapor inhalations00770.39$19.85$10.91$3.97
    94665SAerosol or vapor inhalations00770.39$19.85$10.91$3.97
    94667SChest wall manipulation00770.39$19.85$10.91$3.97
    94668SChest wall manipulation00770.39$19.85$10.91$3.97
    94680XExhaled air analysis, o203681.47$74.83$38.16$14.97
    94681XExhaled air analysis, o2/co203681.47$74.83$38.16$14.97
    94690XExhaled air analysis03670.70$35.63$17.82$7.13
    94720XMonoxide diffusing capacity03670.70$35.63$17.82$7.13
    94725XMembrane diffusion capacity03681.47$74.83$38.16$14.97
    94750XPulmonary compliance study03681.47$74.83$38.16$14.97
    94760NMeasure blood oxygen level
    94761NMeasure blood oxygen level
    94762NMeasure blood oxygen level
    94770XExhaled carbon dioxide test03670.70$35.63$17.82$7.13
    94772XBreath recording, infant03693.49$177.65$58.50$35.53
    94799XPulmonary service/procedure03670.70$35.63$17.82$7.13
    Start Printed Page 60037
    95004XAllergy skin tests03700.80$40.72$11.81$8.14
    95010XSensitivity skin tests03700.80$40.72$11.81$8.14
    95015XSensitivity skin tests03700.80$40.72$11.81$8.14
    95024XAllergy skin tests03700.80$40.72$11.81$8.14
    95027XSkin end point titration03700.80$40.72$11.81$8.14
    95028XAllergy skin tests03700.80$40.72$11.81$8.14
    95044XAllergy patch tests03700.80$40.72$11.81$8.14
    95052XPhoto patch test03700.80$40.72$11.81$8.14
    95056XPhotosensitivity tests03700.80$40.72$11.81$8.14
    95060XEye allergy tests03700.80$40.72$11.81$8.14
    95065XNose allergy test03700.80$40.72$11.81$8.14
    95070XBronchial allergy tests03693.49$177.65$58.50$35.53
    95071XBronchial allergy tests03693.49$177.65$58.50$35.53
    95075XIngestion challenge test03613.25$165.44$82.72$33.09
    95078XProvocative testing03700.80$40.72$11.81$8.14
    95115XImmunotherapy, one injection03530.25$12.73$2.55
    95117XImmunotherapy injections03530.25$12.73$2.55
    95120EImmunotherapy, one injection
    95125EImmunotherapy, many antigens
    95130EImmunotherapy, insect venom
    95131EImmunotherapy, insect venoms
    95132EImmunotherapy, insect venoms
    95133EImmunotherapy, insect venoms
    95134EImmunotherapy, insect venoms
    95144XAntigen therapy services03710.70$35.63$7.13
    95145XAntigen therapy services03710.70$35.63$7.13
    95146XAntigen therapy services03710.70$35.63$7.13
    95147XAntigen therapy services03710.70$35.63$7.13
    95148XAntigen therapy services03710.70$35.63$7.13
    95149XAntigen therapy services03710.70$35.63$7.13
    95165XAntigen therapy services03710.70$35.63$7.13
    95170XAntigen therapy services03710.70$35.63$7.13
    95180XRapid desensitization03700.80$40.72$11.81$8.14
    95199XAllergy immunology services03700.80$40.72$11.81$8.14
    *95250TGlucose monitoring, cont0972$150.00$30.00
    95805SMultiple sleep latency test020910.54$536.53$279.00$107.31
    95806SSleep study, unattended02132.65$134.90$70.15$26.98
    95807SSleep study, attended020910.54$536.53$279.00$107.31
    95808SPolysomnography, 1-3020910.54$536.53$279.00$107.31
    95810SPolysomnography, 4 or more020910.54$536.53$279.00$107.31
    95811SPolysomnography w/cpap020910.54$536.53$279.00$107.31
    95812SElectroencephalogram (EEG)02132.65$134.90$70.15$26.98
    95813SElectroencephalogram (EEG)02132.65$134.90$70.15$26.98
    95816SElectroencephalogram (EEG)02142.10$106.90$53.45$21.38
    95819SElectroencephalogram (EEG)02142.10$106.90$53.45$21.38
    95822SSleep electroencephalogram02142.10$106.90$53.45$21.38
    95824SElectroencephalography02142.10$106.90$53.45$21.38
    95827SNight electroencephalogram020910.54$536.53$279.00$107.31
    95829SSurgery electrocorticogram02142.10$106.90$53.45$21.38
    95830EInsert electrodes for EEG
    95831NLimb muscle testing, manual
    95832NHand muscle testing, manual
    95833NBody muscle testing, manual
    95834NBody muscle testing, manual
    95851NRange of motion measurements
    95852NRange of motion measurements
    95857STensilon test02181.03$52.43$23.59$10.49
    95858STensilon test & myogram02150.66$33.60$17.47$6.72
    95860SMuscle test, one limb02181.03$52.43$23.59$10.49
    95861SMuscle test, two limbs02181.03$52.43$23.59$10.49
    95863SMuscle test, 3 limbs02181.03$52.43$23.59$10.49
    95864SMuscle test, 4 limbs02181.03$52.43$23.59$10.49
    95867SMuscle test, head or neck02181.03$52.43$23.59$10.49
    95868SMuscle test, head or neck02181.03$52.43$23.59$10.49
    95869SMuscle test, thor paraspinal02150.66$33.60$17.47$6.72
    95870SMuscle test, nonparaspinal02181.03$52.43$23.59$10.49
    95872SMuscle test, one fiber02150.66$33.60$17.47$6.72
    95875SLimb exercise test02150.66$33.60$17.47$6.72
    95900SMotor nerve conduction test02181.03$52.43$23.59$10.49
    95903SMotor nerve conduction test02181.03$52.43$23.59$10.49
    95904SSense/mixed n conduction tst02150.66$33.60$17.47$6.72
    95920SIntraop nerve test add-on02181.03$52.43$23.59$10.49
    95921SAutonomic nerv function test02150.66$33.60$17.47$6.72
    95922SAutonomic nerv function test02150.66$33.60$17.47$6.72
    95923SAutonomic nerv function test02150.66$33.60$17.47$6.72
    Start Printed Page 60038
    95925SSomatosensory testing02162.61$132.86$59.79$26.57
    95926SSomatosensory testing02162.61$132.86$59.79$26.57
    95927SSomatosensory testing02162.61$132.86$59.79$26.57
    95930SVisual evoked potential test02162.61$132.86$59.79$26.57
    95933SBlink reflex test02150.66$33.60$17.47$6.72
    95934SH-reflex test02150.66$33.60$17.47$6.72
    95936SH-reflex test02150.66$33.60$17.47$6.72
    95937SNeuromuscular junction test02181.03$52.43$23.59$10.49
    95950SAmbulatory eeg monitoring02132.65$134.90$70.15$26.98
    95951SEEG monitoring/videorecord020910.54$536.53$279.00$107.31
    95953SEEG monitoring/computer020910.54$536.53$279.00$107.31
    95954SEEG monitoring/giving drugs02132.65$134.90$70.15$26.98
    95955SEEG during surgery02142.10$106.90$53.45$21.38
    95956NEeg monitoring, cable/radio
    95957NEEG digital analysis
    95958SEEG monitoring/function test02132.65$134.90$70.15$26.98
    95961SElectrode stimulation, brain02162.61$132.86$59.79$26.57
    95962SElectrode stim, brain add-on02162.61$132.86$59.79$26.57
    *95965TMeg, spontaneous0972$150.00$30.00
    *95966TMeg, evoked, single0972$150.00$30.00
    *95967TMeg, evoked, each addl0972$150.00$30.00
    95970SAnalyze neurostim, no prog069214.34$729.96$401.47$145.99
    95971SAnalyze neurostim, simple069214.34$729.96$401.47$145.99
    95972SAnalyze neurostim, complex069214.34$729.96$401.47$145.99
    95973SAnalyze neurostim, complex069214.34$729.96$401.47$145.99
    95974SCranial neurostim, complex069214.34$729.96$401.47$145.99
    95975SCranial neurostim, complex069214.34$729.96$401.47$145.99
    95999NNeurological procedure
    *96000TMotion analysis, video/3d0972$150.00$30.00
    *96001TMotion test w/ft press meas0972$150.00$30.00
    *96002TDynamic surface emg0972$150.00$30.00
    *96003TDynamic fine wire emg0972$150.00$30.00
    *96004EPhys review of motion tests
    96100XPsychological testing03731.00$50.90$14.25$10.18
    96105XAssessment of aphasia03731.00$50.90$14.25$10.18
    96110XDevelopmental test, lim03731.00$50.90$14.25$10.18
    96111XDevelopmental test, extend03731.00$50.90$14.25$10.18
    96115XNeurobehavior status exam03731.00$50.90$14.25$10.18
    96117XNeuropsych test battery03731.00$50.90$14.25$10.18
    *96150SAssess hlth/behave, init03221.15$58.54$12.29$11.71
    *96151SAssess hlth/behave, subseq03221.15$58.54$12.29$11.71
    *96152SIntervene hlth/behave, indiv03221.15$58.54$12.29$11.71
    *96153SIntervene hlth/behave, group03221.15$58.54$12.29$11.71
    *96154SInterv hlth/behav, fam w/pt03221.15$58.54$12.29$11.71
    *96155SInterv hlth/behav fam no pt03221.15$58.54$12.29$11.71
    96400EChemotherapy, sc/im
    96405EIntralesional chemo admin
    96406EIntralesional chemo admin
    96408EChemotherapy, push technique
    96410EChemotherapy,infusion method
    96412EChemo, infuse method add-on
    96414EChemo, infuse method add-on
    96420EChemotherapy, push technique
    96422EChemotherapy,infusion method
    96423EChemo, infuse method add-on
    96425EChemotherapy,infusion method
    96440EChemotherapy, intracavitary
    96445EChemotherapy, intracavitary
    96450EChemotherapy, into CNS
    96520TPump refilling, maintenance01253.00$152.71$30.54
    96530TPump refilling, maintenance01253.00$152.71$30.54
    96542EChemotherapy injection
    96545EProvide chemotherapy agent
    96549EChemotherapy, unspecified
    *96567TPhotodynamic tx, skin0972$150.00$30.00
    96570TPhotodynamic tx, 30 min0973$250.00$50.00
    96571TPhotodynamic tx, addl 15 min0973$250.00$50.00
    96900SUltraviolet light therapy00010.43$21.89$7.88$4.38
    96902NTrichogram
    96910SPhotochemotherapy with UV-B00010.43$21.89$7.88$4.38
    96912SPhotochemotherapy with UV-A00010.43$21.89$7.88$4.38
    96913SPhotochemotherapy, UV-A or B00010.43$21.89$7.88$4.38
    96999SDermatological procedure00010.43$21.89$7.88$4.38
    97001APt evaluation
    97002APt re-evaluation
    Start Printed Page 60039
    97003AOt evaluation
    97004AOt re-evaluation
    *97005EAthletic train eval
    *97006EAthletic train reeval
    97010AHot or cold packs therapy
    97012AMechanical traction therapy
    97014AElectric stimulation therapy
    97016AVasopneumatic device therapy
    97018AParaffin bath therapy
    97020AMicrowave therapy
    97022AWhirlpool therapy
    97024ADiathermy treatment
    97026AInfrared therapy
    97028AUltraviolet therapy
    97032AElectrical stimulation
    97033AElectric current therapy
    97034AContrast bath therapy
    97035AUltrasound therapy
    97036AHydrotherapy
    97039APhysical therapy treatment
    97110ATherapeutic exercises
    97112ANeuromuscular reeducation
    97113AAquatic therapy/exercises
    97116AGait training therapy
    97124AMassage therapy
    97139APhysical medicine procedure
    97140AManual therapy
    97150AGroup therapeutic procedures
    97504AOrthotic training
    97520AProsthetic training
    97530ATherapeutic activities
    97532ACognitive skills development
    97533ASensory integration
    97535ASelf care mngment training
    97537ACommunity/work reintegration
    97542AWheelchair mngment training
    97545AWork hardening
    97546AWork hardening add-on
    97601AWound care selective
    97602NWound care non-selective
    97703AProsthetic checkout
    97750APhysical performance test
    97780EAcupuncture w/o stimul
    97781EAcupuncture w/stimul
    97799APhysical medicine procedure
    97802AMedical nutrition, indiv, in
    97803AMed nutrition, indiv, subseq
    97804AMedical nutrition, group
    98925SOsteopathic manipulation00600.23$11.71$2.34
    98926SOsteopathic manipulation00600.23$11.71$2.34
    98927SOsteopathic manipulation00600.23$11.71$2.34
    98928SOsteopathic manipulation00600.23$11.71$2.34
    98929SOsteopathic manipulation00600.23$11.71$2.34
    98940SChiropractic manipulation00600.23$11.71$2.34
    98941SChiropractic manipulation00600.23$11.71$2.34
    98942SChiropractic manipulation00600.23$11.71$2.34
    98943EChiropractic manipulation
    99000ESpecimen handling
    99001ESpecimen handling
    99002EDevice handling
    99024EPostop follow-up visit
    99025EInitial surgical evaluation
    99050EMedical services after hrs
    99052EMedical services at night
    99054EMedical servcs, unusual hrs
    99056ENon-office medical services
    99058EOffice emergency care
    99070ESpecial supplies
    99071EPatient education materials
    99075EMedical testimony
    99078NGroup health education
    99080ESpecial reports or forms
    99082EUnusual physician travel
    99090EComputer data analysis
    *99091ECollect/review data from pt
    Start Printed Page 60040
    99100ESpecial anesthesia service
    99116EAnesthesia with hypothermia
    99135ESpecial anesthesia procedure
    99140EEmergency anesthesia
    99141NSedation, iv/im or inhalant
    99142NSedation, oral/rectal/nasal
    99170TAnogenital exam, child01910.23$11.71$3.40$2.34
    99172EOcular function screen
    99173EVisual acuity screen
    99175NInduction of vomiting
    99183EHyperbaric oxygen therapy
    99185NRegional hypothermia
    99186NTotal body hypothermia
    99190CSpecial pump services
    99191CSpecial pump services
    99192CSpecial pump services
    99195XPhlebotomy03720.53$26.98$10.09$5.40
    99199ESpecial service/proc/report
    99201VOffice/outpatient visit, new06000.86$43.78$8.76
    99202VOffice/outpatient visit, new06000.86$43.78$8.76
    99203VOffice/outpatient visit, new06010.95$48.36$9.67
    99204VOffice/outpatient visit, new06021.38$70.25$14.05
    99205VOffice/outpatient visit, new06021.38$70.25$14.05
    99211VOffice/outpatient visit, est06000.86$43.78$8.76
    99212VOffice/outpatient visit, est06000.86$43.78$8.76
    99213VOffice/outpatient visit, est06010.95$48.36$9.67
    99214VOffice/outpatient visit, est06021.38$70.25$14.05
    99215VOffice/outpatient visit, est06021.38$70.25$14.05
    99217NObservation care discharge
    99218NObservation care
    99219NObservation care
    99220NObservation care
    99221EInitial hospital care
    99222EInitial hospital care
    99223EInitial hospital care
    99231ESubsequent hospital care
    99232ESubsequent hospital care
    99233ESubsequent hospital care
    99234NObserv/hosp same date
    99235NObserv/hosp same date
    99236NObserv/hosp same date
    99238EHospital discharge day
    99239EHospital discharge day
    99241VOffice consultation06000.86$43.78$8.76
    99242VOffice consultation06000.86$43.78$8.76
    99243VOffice consultation06010.95$48.36$9.67
    99244VOffice consultation06021.38$70.25$14.05
    99245VOffice consultation06021.38$70.25$14.05
    99251CInitial inpatient consult
    99252CInitial inpatient consult
    99253CInitial inpatient consult
    99254CInitial inpatient consult
    99255CInitial inpatient consult
    99261CFollow-up inpatient consult
    99262CFollow-up inpatient consult
    99263CFollow-up inpatient consult
    99271VConfirmatory consultation06000.86$43.78$8.76
    99272VConfirmatory consultation06000.86$43.78$8.76
    99273VConfirmatory consultation06010.95$48.36$9.67
    99274VConfirmatory consultation06021.38$70.25$14.05
    99275VConfirmatory consultation06021.38$70.25$14.05
    99281VEmergency dept visit06101.23$62.61$19.41$12.52
    99282VEmergency dept visit06101.23$62.61$19.41$12.52
    99283VEmergency dept visit06112.16$109.95$36.47$21.99
    99284VEmergency dept visit06123.49$177.65$54.14$35.53
    99285VEmergency dept visit06123.49$177.65$54.14$35.53
    99288EDirect advanced life support
    *99289NPt transport, 30-74 min
    *99290NPt transport, addl 30 min
    99291SCritical care, first hour06208.40$427.59$149.66$85.52
    99292NCritical care, addl 30 min
    99295CNeonatal critical care
    99296CNeonatal critical care
    99297CNeonatal critical care
    99298CNeonatal critical care
    Start Printed Page 60041
    99301ENursing facility care
    99302ENursing facility care
    99303ENursing facility care
    99311ENursing fac care, subseq
    99312ENursing fac care, subseq
    99313ENursing fac care, subseq
    99315ENursing fac discharge day
    99316ENursing fac discharge day
    99321ERest home visit, new patient
    99322ERest home visit, new patient
    99323ERest home visit, new patient
    99331ERest home visit, est pat
    99332ERest home visit, est pat
    99333ERest home visit, est pat
    99341EHome visit, new patient
    99342EHome visit, new patient
    99343EHome visit, new patient
    99344EHome visit, new patient
    99345EHome visit, new patient
    99347EHome visit, est patient
    99348EHome visit, est patient
    99349EHome visit, est patient
    99350EHome visit, est patient
    99354NProlonged service, office
    99355NProlonged service, office
    99356CProlonged service, inpatient
    99357CProlonged service, inpatient
    99358NProlonged serv, w/o contact
    99359NProlonged serv, w/o contact
    99360EPhysician standby services
    99361EPhysician/team conference
    99362EPhysician/team conference
    99371EPhysician phone consultation
    99372EPhysician phone consultation
    99373EPhysician phone consultation
    99374EHome health care supervision
    99377EHospice care supervision
    99379ENursing fac care supervision
    99380ENursing fac care supervision
    99381EPrev visit, new, infant
    99382EPrev visit, new, age 1-4
    99383EPrev visit, new, age 5-11
    99384EPrev visit, new, age 12-17
    99385EPrev visit, new, age 18-39
    99386EPrev visit, new, age 40-64
    99387EPrev visit, new, 65 & over
    99391EPrev visit, est, infant
    99392EPrev visit, est, age 1-4
    99393EPrev visit, est, age 5-11
    99394EPrev visit, est, age 12-17
    99395EPrev visit, est, age 18-39
    99396EPrev visit, est, age 40-64
    99397EPrev visit, est, 65 & over
    99401EPreventive counseling, indiv
    99402EPreventive counseling, indiv
    99403EPreventive counseling, indiv
    99404EPreventive counseling, indiv
    99411EPreventive counseling, group
    99412EPreventive counseling, group
    99420EHealth risk assessment test
    99429EUnlisted preventive service
    99431NInitial care, normal newborn
    99432NNewborn care, not in hosp
    99433CNormal newborn care/hospital
    99435ENewborn discharge day hosp
    99436NAttendance, birth
    99440SNewborn resuscitation00946.08$309.50$105.29$61.90
    99450ELife/disability evaluation
    99455EDisability examination
    99456EDisability examination
    99499EUnlisted e&m service
    *99500EHome visit, prenatal
    *99501EHome visit, postnatal
    *99502EHome visit, nb care
    *99503EHome visit, resp therapy
    Start Printed Page 60042
    *99504EHome visit mech ventilator
    *99505EHome visit, stoma care
    *99506EHome visit, im injection
    *99507EHome visit, cath maintain
    *99508EHome visit, sleep studies
    *99509EHome visit day life activity
    *99510EHome visit, sing/m/fam couns
    *99511EHome visit, fecal/enema mgmt
    *99512EHome visit, hemodialysis
    *99539EHome visit, nos
    *99551EHome infus, pain mgmt, iv/sc
    *99552EHm infus pain mgmt, epid/ith
    *99553EHome infuse, tocolytic tx
    *99554EHome infus, hormone/platelet
    *99555EHome infuse, chemotheraphy
    *99556EHome infus, antibio/fung/vir
    *99557EHome infuse, anticoagulant
    *99558EHome infuse, immunotherapy
    *99559EHome infus, periton dialysis
    *99560EHome infus, entero nutrition
    *99561EHome infuse, hydration tx
    *99562EHome infus, parent nutrition
    *99563EHome admin, pentamidine
    *99564EHme infus, antihemophil agnt
    *99565EHome infus, proteinase inhib
    *99566EHome infuse, iv therapy
    *99567EHome infuse, sympath agent
    *99568EHome infus, misc drug, daily
    *99569EHome infuse, each addl tx
    A0021EOutside state ambulance serv
    A0080ENoninterest escort in non er
    A0090EInterest escort in non er
    A0100ENonemergency transport taxi
    A0110ENonemergency transport bus
    A0120ENoner transport mini-bus
    A0130ENoner transport wheelch van
    A0140ENonemergency transport air
    A0160ENoner transport case worker
    A0170ENoner transport parking fees
    A0180ENoner transport lodgng recip
    A0190ENoner transport meals recip
    A0200ENoner transport lodgng escrt
    A0210ENoner transport meals escort
    A0225ANeonatal emergency transport
    A0380ABasic life support mileage
    A0382ABasic support routine suppls
    A0384ABls defibrillation supplies
    A0390AAdvanced life support mileage
    A0392AAls defibrillation supplies
    A0394AAls IV drug therapy supplies
    A0396AAls esophageal intub suppls
    A0398AAls routine disposble suppls
    A0420AAmbulance waiting 1/2 hr
    A0422AAmbulance 02 life sustaining
    A0424AExtra ambulance attendant
    A0425AGround mileage
    A0426AAls 1
    A0427AALS1-emergency
    A0428Abls
    A0429ABLS-emergency
    A0430AFixed wing air transport
    A0431ARotary wing air transport
    A0432API volunteer ambulance co
    A0433Aals 2
    A0434ASpecialty care transport
    A0435AFixed wing air mileage
    A0436ARotary wing air mileage
    A0888ENoncovered ambulance mileage
    A0999AUnlisted ambulance service
    A4206A1 CC sterile syringe&needle
    A4207A2 CC sterile syringe&needle
    A4208A3 CC sterile syringe&needle
    A4209E5+ CC sterile syringe&needle
    A4210ENonneedle injection device
    A4211ESupp for self-adm injections
    Start Printed Page 60043
    A4212ENon coring needle or stylet
    A4213E20+ CC syringe only
    A4214A30 CC sterile water/saline
    A4215ESterile needle
    A4220AInfusion pump refill kit
    A4221AMaint drug infus cath per wk
    A4222ADrug infusion pump supplies
    A4230AInfus insulin pump non needl
    A4231AInfusion insulin pump needle
    A4232ASyringe w/needle insulin 3cc
    A4244EAlcohol or peroxide per pint
    A4245EAlcohol wipes per box
    A4246EBetadine/phisohex solution
    A4247EBetadine/iodine swabs/wipes
    A4250EUrine reagent strips/tablets
    A4253ABlood glucose/reagent strips
    A4254ABattery for glucose monitor
    A4255AGlucose monitor platforms
    A4256ACalibrator solution/chips
    *A4257AReplace Lensshield Cartridge
    A4258ALancet device each
    A4259ALancets per box
    A4260ELevonorgestrel implant
    A4261ECervical cap contraceptive
    A4262NTemporary tear duct plug
    A4263NPermanent tear duct plug
    A4265AParaffin
    A4270ADisposable endoscope sheath
    A4280ABrst prsths adhsv attchmnt
    A4290ESacral nerve stim test lead
    A4300ECath impl vasc access portal
    A4301EImplantable access syst perc
    A4305ADrug delivery system >=50 ML
    A4306ADrug delivery system <=5 ML
    A4310AInsert tray w/o bag/cath
    A4311ACatheter w/o bag 2-way latex
    A4312ACath w/o bag 2-way silicone
    A4313ACatheter w/bag 3-way
    A4314ACath w/drainage 2-way latex
    A4315ACath w/drainage 2-way silcne
    A4316ACath w/drainage 3-way
    A4319ASterile H2O irrigation solut
    A4320AIrrigation tray
    A4321ACath therapeutic irrig agent
    A4322AIrrigation syringe
    A4323ASaline irrigation solution
    A4324AMale ext cath w/adh coating
    A4325AMale ext cath w/adh strip
    A4326AMale external catheter
    A4327AFem urinary collect dev cup
    A4328AFem urinary collect pouch
    A4329DExternal catheter start set
    A4330AStool collection pouch
    A4331AExtension drainage tubing
    A4332ALubricant for cath insertion
    A4333AUrinary cath anchor device
    A4334AUrinary cath leg strap
    A4335AIncontinence supply
    A4338AIndwelling catheter latex
    A4340AIndwelling catheter special
    A4344ACath indw foley 2 way silicn
    A4346ACath indw foley 3 way
    A4347AMale external catheter
    A4348AMale ext cath extended wear
    A4351AStraight tip urine catheter
    A4352ACoude tip urinary catheter
    A4353AIntermittent urinary cath
    A4354ACath insertion tray w/bag
    A4355ABladder irrigation tubing
    A4356AExt ureth clmp or compr dvc
    A4357ABedside drainage bag
    A4358AUrinary leg bag
    A4359AUrinary suspensory w/o leg b
    *A4360AAdult incontinence garment
    A4361AOstomy face plate
    Start Printed Page 60044
    A4362ASolid skin barrier
    A4364AAdhesive, liquid or equal
    A4365AAdhesive remover wipes
    A4367AOstomy belt
    A4368AOstomy filter
    A4369ASkin barrier liquid per oz
    A4370ASkin barrier paste per oz
    A4371ASkin barrier powder per oz
    A4372ASkin barrier solid 4x4 equiv
    A4373ASkin barrier with flange
    A4374ASkin barrier extended wear
    A4375ADrainable plastic pch w fcpl
    A4376ADrainable rubber pch w fcplt
    A4377ADrainable plstic pch w/o fp
    A4378ADrainable rubber pch w/o fp
    A4379AUrinary plastic pouch w fcpl
    A4380AUrinary rubber pouch w fcplt
    A4381AUrinary plastic pouch w/o fp
    A4382AUrinary hvy plstc pch w/o fp
    A4383AUrinary rubber pouch w/o fp
    A4384AOstomy faceplt/silicone ring
    A4385AOst skn barrier sld ext wear
    A4386AOst skn barrier w flng ex wr
    A4387AOst clsd pouch w att st barr
    A4388ADrainable pch w ex wear barr
    A4389ADrainable pch w st wear barr
    A4390ADrainable pch ex wear convex
    A4391AUrinary pouch w ex wear barr
    A4392AUrinary pouch w st wear barr
    A4393AUrine pch w ex wear bar conv
    A4394AOstomy pouch liq deodorant
    A4395AOstomy pouch solid deodorant
    A4396APeristomal hernia supprt blt
    A4397AIrrigation supply sleeve
    A4398AOstomy irrigation bag
    A4399AOstomy irrig cone/cath w brs
    A4400AOstomy irrigation set
    A4402ALubricant per ounce
    A4404AOstomy ring each
    A4421AOstomy supply misc
    A4454ATape all types all sizes
    A4455AAdhesive remover per ounce
    A4460AElastic compression bandage
    A4462AAbdmnl drssng holder/binder
    A4464AJoint support device/garment
    A4465ANon-elastic extremity binder
    A4470AGravlee jet washer
    A4480AVabra aspirator
    A4481ATracheostoma filter
    A4483AMoisture exchanger
    A4490EAbove knee surgical stocking
    A4495EThigh length surg stocking
    A4500EBelow knee surgical stocking
    A4510EFull length surg stocking
    A4550ESurgical trays
    A4554EDisposable underpads
    A4556AElectrodes, pair
    A4557ALead wires, pair
    A4558AConductive paste or gel
    A4561NPessary rubber, any type
    A4562NPessary, non rubber,any type
    A4565ASlings
    A4570NSplint
    A4572ARib belt
    A4575EHyperbaric o2 chamber disps
    A4580NCast supplies (plaster)
    A4590NSpecial casting material
    A4595ATENS suppl 2 lead per month
    A4608ATranstracheal oxygen cath
    A4611AHeavy duty battery
    A4612ABattery cables
    A4613ABattery charger
    A4614AHand-held PEFR meter
    A4615ACannula nasal
    A4616ATubing (oxygen) per foot
    Start Printed Page 60045
    A4617AMouth piece
    A4618ABreathing circuits
    A4619AFace tent
    A4620AVariable concentration mask
    A4621ATracheotomy mask or collar
    A4622ATracheostomy or larngectomy
    A4623ATracheostomy inner cannula
    A4624ATracheal suction tube
    A4625ATrach care kit for new trach
    A4626ATracheostomy cleaning brush
    A4627ESpacer bag/reservoir
    A4628AOropharyngeal suction cath
    A4629ATracheostomy care kit
    A4630ARepl bat t.e.n.s. own by pt
    A4631AWheelchair battery
    A4635AUnderarm crutch pad
    A4636AHandgrip for cane etc
    A4637ARepl tip cane/crutch/walker
    A4640AAlternating pressure pad
    A4641NDiagnostic imaging agent
    A4642GSatumomab pendetide per dose0704$1,591.25$227.80
    A4643NHigh dose contrast MRI
    A4644NContrast 100-199 MGs iodine
    A4645NContrast 200-299 MGs iodine
    A4646NContrast 300-399 MGs iodine
    A4647NSupp- paramagnetic contr mat
    A4649ASurgical supplies
    A4650DSupp esrd centrifuge
    *A4651ACalibrated microcap tube
    *A4652AMicrocapillary tube sealant
    A4655DEsrd syringe/needle
    *A4656ADialysis needle
    *A4657ADialysis syringe w/wo needle
    A4660AEsrd blood pressure device
    A4663AEsrd blood pressure cuff
    A4670EAuto blood pressure monitor
    A4680AActivated carbon filters
    A4690ADialyzers
    A4700DStandard dialysate solution
    A4705DBicarb dialysate solution
    *A4706ABicarbonate conc sol per gal
    *A4707ABicarbonate conc pow per pac
    *A4708AAcetate conc sol per gallon
    *A4709AAcid conc sol per gallon
    A4712ASterile water
    A4714ATreated water for dialysis
    *A4719AoY seto tubing
    *A4720ADialysat sol fld vol > 249cc
    *A4721ADialysat sol fld vol > 999cc
    *A4722ADialys sol fld vol > 1999cc
    *A4723ADialys sol fld vol > 2999cc
    *A4724ADialys sol fld vol > 3999cc
    *A4725ADialys sol fld vol > 4999cc
    *A4726ADialys sol fld vol > 5999cc
    A4730AFistula cannulation set dial
    A4735DLocal/topical anesthetics
    *A4736ATopical anesthetic, per gram
    *A4737AInj anesthetic per 10 ml
    A4740AEsrd shunt accessory
    A4750AArterial or venous tubing
    A4755AArterial and venous tubing
    A4760AStandard testing solution
    A4765ADialysate concentrate
    *A4766ADialysate conc sol add 10 ml
    A4770ABlood testing supplies
    A4771ABlood clotting time tube
    A4772ADextrostick/glucose strips
    A4773AHemostix
    A4774AAmmonia test paper
    A4780DEsrd sterilizing agent
    A4790DEsrd cleansing agents
    A4800DHeparin/antidote dialysis
    *A4801AHeparin per 1000 units
    *A4802AProtamine sulfate per 50 mg
    A4820DSupplies hemodialysis kit
    Start Printed Page 60046
    A4850DRubber tipped hemostats
    A4860ADisposable catheter caps
    A4870APlumbing/electrical work
    A4880DWater storage tanks
    A4890AContracts/repair/maintenance
    A4900DCapd supply kit
    A4901DCcpd supply kit
    A4905DIpd supply kit
    A4910DEsrd nonmedical supplies
    *A4911ADrain bag/bottle
    A4912DGomco drain bottle
    A4913AEsrd supply
    A4914DPreparation kit
    A4918AVenous pressure clamp
    A4919DSupp dialysis dialyzer holde
    A4920DHarvard pressure clamp
    A4921DMeasuring cylinder
    A4927AGloves
    *A4928ASurgical mask
    *A4929ATourniquet for dialysis, ea
    A5051APouch clsd w barr attached
    A5052AClsd ostomy pouch w/o barr
    A5053AClsd ostomy pouch faceplate
    A5054AClsd ostomy pouch w/flange
    A5055AStoma cap
    A5061APouch drainable w barrier at
    A5062ADrnble ostomy pouch w/o barr
    A5063ADrain ostomy pouch w/flange
    A5064DDrain ostomy pouch w/fceplte
    A5071AUrinary pouch w/barrier
    A5072AUrinary pouch w/o barrier
    A5073AUrinary pouch on barr w/flng
    A5074DUrinary pouch w/faceplate
    A5075DUrinary pouch on faceplate
    A5081AContinent stoma plug
    A5082AContinent stoma catheter
    A5093AOstomy accessory convex inse
    A5102ABedside drain btl w/wo tube
    A5105AUrinary suspensory
    A5112AUrinary leg bag
    A5113ALatex leg strap
    A5114AFoam/fabric leg strap
    A5119ASkin barrier wipes box pr 50
    A5121ASolid skin barrier 6x6
    A5122ASolid skin barrier 8x8
    A5123ASkin barrier with flange
    A5126ADisk/foam pad +or- adhesive
    A5131AAppliance cleaner
    A5200APercutaneous catheter anchor
    A5500ADiab shoe for density insert
    A5501ADiabetic custom molded shoe
    A5502DDiabetic shoe density insert
    A5503ADiabetic shoe w/roller/rockr
    A5504ADiabetic shoe with wedge
    A5505ADiab shoe w/metatarsal bar
    A5506ADiabetic shoe w/off set heel
    A5507AModification diabetic shoe
    A5508ADiabetic deluxe shoe
    *A5509ADirect heat form shoe insert
    *A5510ACompression form shoe insert
    *A5511ACustom fab molded shoe inser
    *A6000AWound warming wound cover
    *A6010ACollagen based wound filler
    A6021ACollagen dressing <=16 sq in
    A6022ACollagen drsg>6<=48 sq in
    A6023ACollagen dressing >48 sq in
    A6024ACollagen dsg wound filler
    A6025ESilicone gel sheet, each
    A6154AWound pouch each
    A6196AAlginate dressing <=16 sq in
    A6197AAlginate drsg >16 <=48 sq in
    A6198Aalginate dressing > 48 sq in
    A6199AAlginate drsg wound filler
    A6200ACompos drsg <=16 no border
    A6201ACompos drsg >16<=48 no bdr
    Start Printed Page 60047
    A6202ACompos drsg >48 no border
    A6203AComposite drsg <= 16 sq in
    A6204AComposite drsg >16<=48 sq in
    A6205AComposite drsg > 48 sq in
    A6206AContact layer <= 16 sq in
    A6207AContact layer >16<= 48 sq in
    A6208AContact layer > 48 sq in
    A6209AFoam drsg <=16 sq in w/o bdr
    A6210AFoam drg >16<=48 sq in w/o b
    A6211AFoam drg > 48 sq in w/o brdr
    A6212AFoam drg <=16 sq in w/border
    A6213AFoam drg >16<=48 sq in w/bdr
    A6214AFoam drg > 48 sq in w/border
    A6215AFoam dressing wound filler
    A6216ANon-sterile gauze<=16 sq in
    A6217ANon-sterile gauze>16<=48 sq
    A6218ANon-sterile gauze > 48 sq in
    A6219AGauze <= 16 sq in w/border
    A6220AGauze >16 <=48 sq in w/bordr
    A6221AGauze > 48 sq in w/border
    A6222AGauze <=16 in no w/sal w/o b
    A6223AGauze >16<=48 no w/sal w/o b
    A6224AGauze > 48 in no w/sal w/o b
    A6228AGauze <= 16 sq in water/sal
    A6229AGauze >16<=48 sq in watr/sal
    A6230AGauze > 48 sq in water/salne
    A6231AHydrogel dsg<=16 sq in
    A6232AHydrogel dsg>16<=48 sq in
    A6233AHydrogel dressing >48 sq in
    A6234AHydrocolld drg <=16 w/o bdr
    A6235AHydrocolld drg >16<=48 w/o b
    A6236AHydrocolld drg > 48 in w/o b
    A6237AHydrocolld drg <=16 in w/bdr
    A6238AHydrocolld drg >16<=48 w/bdr
    A6239AHydrocolld drg > 48 in w/bdr
    A6240AHydrocolld drg filler paste
    A6241AHydrocolloid drg filler dry
    A6242AHydrogel drg <=16 in w/o bdr
    A6243AHydrogel drg >16<=48 w/o bdr
    A6244AHydrogel drg >48 in w/o bdr
    A6245AHydrogel drg <= 16 in w/bdr
    A6246AHydrogel drg >16<=48 in w/b
    A6247AHydrogel drg > 48 sq in w/b
    A6248AHydrogel drsg gel filler
    A6250ASkin seal protect moisturizr
    A6251AAbsorpt drg <=16 sq in w/o b
    A6252AAbsorpt drg >16 <=48 w/o bdr
    A6253AAbsorpt drg > 48 sq in w/o b
    A6254AAbsorpt drg <=16 sq in w/bdr
    A6255AAbsorpt drg >16<=48 in w/bdr
    A6256AAbsorpt drg > 48 sq in w/bdr
    A6257ATransparent film <= 16 sq in
    A6258ATransparent film >16<=48 in
    A6259ATransparent film > 48 sq in
    A6260AWound cleanser any type/size
    A6261AWound filler gel/paste /oz
    A6262AWound filler dry form / gram
    A6263ANon-sterile elastic gauze/yd
    A6264ANon-sterile no elastic gauze
    A6265ATape per 18 sq inches
    A6266AImpreg gauze no h20/sal/yard
    A6402ASterile gauze <= 16 sq in
    A6403ASterile gauze>16 <= 48 sq in
    A6404ASterile gauze > 48 sq in
    A6405ASterile elastic gauze /yd
    A6406ASterile non-elastic gauze/yd
    A7000ADisposable canister for pump
    A7001ANondisposable pump canister
    A7002ATubing used w suction pump
    A7003ANebulizer administration set
    A7004ADisposable nebulizer sml vol
    A7005ANondisposable nebulizer set
    A7006AFiltered nebulizer admin set
    A7007ALg vol nebulizer disposable
    A7008ADisposable nebulizer prefill
    Start Printed Page 60048
    A7009ANebulizer reservoir bottle
    A7010ADisposable corrugated tubing
    A7011ANondispos corrugated tubing
    A7012ANebulizer water collec devic
    A7013ADisposable compressor filter
    A7014ACompressor nondispos filter
    A7015AAerosol mask used w nebulize
    A7016ANebulizer dome & mouthpiece
    A7017ANebulizer not used w oxygen
    A7018AWater distilled w/nebulizer
    A7019ASaline solution dispenser
    A7020ASterile H2O or NSS w lgv neb
    A7501ATracheostoma valve w diaphra
    A7502AReplacement diaphragm/fplate
    A7503AHMES filter holder or cap
    A7504ATracheostoma HMES filter
    A7505AHMES or trach valve housing
    A7506AHMES/trachvalve adhesivedisk
    A7507AIntegrated filter & holder
    A7508AHousing & Integrated Adhesiv
    A7509AHeat & moisture exchange sys
    A9150EMisc/exper non-prescript dru
    A9160DPodiatrist non-covered servi
    A9170DChiropractor non-covered ser
    A9190DMisc/expe personal comfort i
    A9270ENon-covered item or service
    A9300EExercise equipment
    A9500GTechnetium TC 99m sestamibi1600$121.70$17.42
    A9502GTechnetium tc99m tetrofosmin, per unit dose0705$114.00$16.32
    A9503GTechnetium TC 99m medronate1601$42.18$5.42
    A9504GTechnetium tc 99m apcitide1602$475.00$68.00
    A9505GThallous chloride TL 201/mci1603$78.16$7.08
    A9507GIndium/111 capromab pendetid, per dose1604$2,192.13$313.82
    A9508GIobenguane sulfate I--31 per 0.5 mCi1045$495.65$70.96
    A9510GTechnetium TC99m Disofenin1205$79.17$11.33
    *A9511GTechnetium TC 99m depreotide1095$38.00$5.44
    A9600GStrontium-89 chloride per mCi0701$963.42$137.92
    A9605GSamarium sm153 lexidronamm 50 mCi0702$1,020.00$146.02
    A9700GEchocardiography contrast per study [per 3 ml]9016$118.75$17.00
    A9900ASupply/accessory/service
    A9901ADelivery/set up/dispensing
    B4034AEnter feed supkit syr by day
    B4035AEnteral feed supp pump per d
    B4036AEnteral feed sup kit grav by
    B4081AEnteral ng tubing w/ stylet
    B4082AEnteral ng tubing w/o stylet
    B4083AEnteral stomach tube levine
    B4084DGastrostomy/jejunostomy tubi
    B4085DGastrostomy tube w/ring each
    *B4086AGastrostomy/jejunostomy tube
    B4150AEnteral formulae category i
    B4151AEnteral formulae cat1natural
    B4152AEnteral formulae category ii
    B4153AEnteral formulae categoryIII
    B4154AEnteral formulae category IV
    B4155AEnteral formulae category v
    B4156AEnteral formulae category vi
    B4164AParenteral 50% dextrose solu
    B4168AParenteral sol amino acid 3.
    B4172AParenteral sol amino acid 5.
    B4176AParenteral sol amino acid 7-
    B4178AParenteral sol amino acid >
    B4180AParenteral sol carb > 50%
    B4184AParenteral sol lipids 10%
    B4186AParenteral sol lipids 20%
    B4189AParenteral sol amino acid &
    B4193AParenteral sol 52-73 gm prot
    B4197AParenteral sol 74-100 gm pro
    B4199AParenteral sol > 100gm prote
    B4216AParenteral nutrition additiv
    B4220AParenteral supply kit premix
    B4222AParenteral supply kit homemi
    B4224AParenteral administration ki
    B5000AParenteral sol renal-amirosy
    B5100AParenteral sol hepatic-fream
    Start Printed Page 60049
    B5200AParenteral sol stres-brnch c
    B9000AEnter infusion pump w/o alrm
    B9002AEnteral infusion pump w/ ala
    B9004AParenteral infus pump portab
    B9006AParenteral infus pump statio
    B9998AEnteral supp not otherwise c
    B9999AParenteral supp not othrws c
    C1010KBlood, L/R, CMV-neg10102.72$138.46$27.69
    C1011KPlatelets, HLA-m, L/R, unit101111.21$570.63$114.13
    C1012KPlatelet conc, L/R, irrad10121.81$92.14$18.43
    C1013KPlatelet conc, L/R, unit10131.11$56.50$11.30
    C1014KPlatelet,aph/pher, L/R, unit10148.45$430.14$86.03
    C1016KBlood,l/r,froz/degly/washed10166.76$344.11$68.82
    C1017KPlt, aph/pher,l/r,cmv-neg10178.82$448.97$89.79
    C1018KBlood, L/R, irradiated10182.96$150.68$30.14
    C1019DPlt, APH,PHER, L/R, IRRAD10199.11$463.74$92.75
    C1050DProsorba Column0976$875.00$175.00
    *C1058GTC 99M oxidronate, per vial1058$36.74$5.26
    *C1064GI-131 cap, each add mCi1064$5.86$.75
    *C1065GI-131 sol, each add mCi1065$15.81$2.03
    *C1066GIN 111 satumomab pendetide1066$1,591.25$227.80
    C1079GCo 57/58 0.5 uCi1079$253.84$36.34
    C1087GI-123 per 100 uCi1087$.65$.06
    C1088TLaser optic tr sys0980$1,875.00$375.00
    C1090DIN 111 chloride, per mCi
    C1091GIN111 oxyquinoline,per0.5mCi1091$427.50$61.20
    C1092GIN 111 pentetate, per 0.5 mCi1092$256.50$23.22
    C1094GTC 99M albumin aggr, 1.0 mCi1094$33.09$4.25
    C1095DTC 99M Depreotide, per vial1095$38.00$5.44
    C1096GTC 99M exametazime, per dose1096$445.31$63.75
    C1097GTC 99M mebrofenin, per vial1097$51.44$7.36
    C1098GTC 99M pentetate, per vial1098$22.43$2.88
    C1099GTC 99M pyrophosphate,per vial1099$39.11$5.60
    C1122GTC 99M arcitumomab per vial1122$1,235.00$176.80
    C1166GCytarabine liposomal, 10 mg1166$371.45$53.18
    C1167GEpirubicin hcl, 2 mg1167$24.94$3.57
    C1178GBusulfan IV, 6 mg1178$26.48$3.79
    C1188GI-131 cap, per 1-5 mCi1188$117.25$15.06
    C1200GTC 99M Sodium Glucoheptonat1200$22.61$3.24
    C1201GTC 99M succimer, per vial1201$135.66$19.42
    C1202GTC 99M sulfur colloid, dose1202$76.00$9.76
    C1207GOctreotide acetate depot 1 mg1207$138.08$19.77
    C1300THyperbaric oxygen0971$75.00$15.00
    C1305GApligraf1305$1,157.81$165.75
    C1348GI-131 sol, per 1-6 mCi1348$146.57$18.82
    C1713HAnchor/screw bn/bn,tis/bn1713
    C1714HCath, trans atherectomy, dir1714
    C1715HBrachytherapy needle1715
    C1716HBrachytx seed, Gold 1981716
    C1717HBrachytx seed, HDR Ir-1921717
    C1718HBrachytx seed, Iodine 1251718
    C1719HBrachytxseed, Non-HDR Ir-1921719
    C1720HBrachytx seed, Palladium 1031720
    C1721HAICD, dual chamber1721
    C1722HAICD, single chamber1722
    C1723DCath, ablation, non-cardiac
    C1724HCath, trans atherec,rotation1724
    C1725HCath, translumin non-laser1725
    C1726HCath, bal dil, non-vascular1726
    C1727HCath, bal tis dis, non-vas1727
    C1728HCath, brachytx seed adm1728
    C1729HCath, drainage1729
    C1730HCath, EP, 19 or fewer elect1730
    C1731HCath, EP, 20 or more elec1731
    C1732HCath, EP, diag/abl, 3D/vect1732
    C1733HCath, EP, othr than cool-tip1733
    C1750HCath, hemodialysis,long-term1750
    C1751HCath, inf, per/cent/midline1751
    C1752HCath, hemodialysis,short-term1752
    C1753HCath, intravas ultrasound1753
    C1754HCatheter, intradiscal1754
    C1755HCatheter, intraspinal1755
    C1756HCath, pacing, transesoph1756
    C1757HCath, thrombectomy/embolect1757
    C1758HCath, ureteral1758
    Start Printed Page 60050
    C1759HCath, intra echocardiography1759
    C1760HClosure dev, vasc, imp/insert1760
    C1762HConn tiss, human (inc fascia)1762
    C1763HConn tiss, non-human1763
    C1764HEvent recorder, cardiac1764
    C1765HAdhesion barrier1765
    C1766HIntro/sheath,strble,non-peel1766
    C1767HGenerator, neurostim, imp1767
    C1768HGraft, vascular1768
    C1769HGuide wire1769
    C1770HImaging coil, MR, insertable1770
    C1771HRep dev, urinary, w/sling1771
    C1772HInfusion pump, programmable1772
    C1773HRetrieval dev, insert1773
    C1776HJoint device (implantable)1776
    C1777HLead, AICD, endo single coil1777
    C1778HLead, neurostimulator1778
    C1779HLead, pmkr, transvenous VDD1779
    C1780HLens, intraocular1780
    C1781HMesh (implantable)1781
    C1782HMorcellator1782
    C1784HOcular dev, intraop, det ret1784
    C1785HPmkr, dual, rate-resp1785
    C1786HPmkr, single, rate-resp1786
    C1787HPatient progr, neurostim1787
    C1788HPort, indwelling, imp1788
    C1789HProsthesis, breast, imp1789
    C1813HProsthesis, penile, inflatab1813
    C1815HPros, urinary sph, imp1815
    C1816HReceiver/transmitter, neuro1816
    C1817HSeptal defect imp sys1817
    C1874HStent, coated/cov w/del sys1874
    C1875HStent, coated/cov w/o del sy1875
    C1876HStent, non-coa/no-cov w/del1876
    C1877HStent, non-coat/cov w/o del1877
    C1878HMatrl for vocal cord1878
    C1879HTissue marker, imp1879
    C1880HVena cava filter1880
    C1881HDialysis access system1881
    C1882HAICD, other than sing/dual1882
    C1883HAdapt/ext, pacing/neuro lead1883
    C1885HCath, translumin angio laser1885
    C1887HCatheter, guiding1887
    C1891HInfusion pump,non-prog,perm1891
    C1892HIntro/sheath,fixed,peel-away1892
    C1893HIntro/sheath,fixed,non-peel1893
    C1894HIntro/sheath, non-laser1894
    C1895HLead, AICD, endo dual coil1895
    C1896HLead, AICD, non sing/dual1896
    C1897HLead, neurostim test kit1897
    C1898HLead, pmkr, other than trans1898
    C1899HLead, pmkr/AICD combination1899
    C2615HSealant, pulmonary, liquid2615
    C2616HBrachytx seed, Yttrium-902616
    C2617HStent, non-cor, tem w/o del2617
    C2618HProbe, cryoablation2618
    C2619HPmkr, dual, non rate-resp2619
    C2620HPmkr, single, non rate-resp2620
    C2621HPmkr, other than sing/dual2621
    C2622HProsthesis, penile, non-inf2622
    C2625HStent, non-cor, tem w/del sys2625
    C2626HInfusion pump, non-prog,temp2626
    C2627HCath, suprapubic/cystoscopic2627
    C2628HCatheter, occlusion2628
    C2629HIntro/sheath, laser2629
    C2630HCath, EP, cool-tip2630
    C2631HRep dev, urinary, w/o sling2631
    C8900SMRA w/cont, abd02847.15$363.96$200.17$72.79
    C8901SMRA w/o cont, abd03366.29$320.19$176.10$64.04
    C8902SMRA w/o fol w/cont, abd03378.54$434.72$239.09$86.94
    C8903SMRI w/cont, breast, uni02847.15$363.96$200.17$72.79
    C8904SMRI w/o cont, breast, uni03366.29$320.19$176.10$64.04
    C8905SMRI w/o fol w/cont, brst, uni03378.54$434.72$239.09$86.94
    C8906SMRI w/cont, breast, bi02847.15$363.96$200.17$72.79
    C8907SMRI w/o cont, breast, bi03366.29$320.19$176.10$64.04
    Start Printed Page 60051
    C8908SMRI w/o fol w/cont, breast, bi03378.54$434.72$239.09$86.94
    C8909SMRA w/cont, chest02847.15$363.96$200.17$72.79
    C8910SMRA w/o cont, chest03366.29$320.19$176.10$64.04
    C8911SMRA w/o fol w/cont, chest03378.54$434.72$239.09$86.94
    C8912SMRA w/cont, lwr ext02847.15$363.96$200.17$72.79
    C8913SMRA w/o cont, lwr ext03366.29$320.19$176.10$64.04
    C8914SMRA w/o fol w/cont, lwr ext03378.54$434.72$239.09$86.94
    C9000GNa chromatecr51, per 0.25mCi9000$.52$.07
    C9001DLinezolid inj, 200 mg9001$24.13$3.45
    C9002DTenecteplase, 50 mg/vial9002$2,612.50$374.00
    C9003GPalivizumab, per 50 mg9003$664.49$95.13
    C9004DGemtuzumab ozogaminicin inj, 5m9004$1,929.69$276.25
    C9006DTacrolimus inj, per 5 mg9006$113.15$16.20
    C9007GBaclofen intrathecal kit-1amp9007$79.80$11.42
    C9008GBaclofen Refill Kit-500 mcg9008$11.69$1.67
    C9009GBaclofen Refill Kit-2000 mcg9009$49.12$7.03
    C9010GBaclofen refill kitu per 4000 mcg9010$43.08$6.17
    C9011DCaffeine Citrate, inj, 1ml9011$3.05$.44
    C9012DInjection, arsenic trioxide9012$23.75$3.40
    C9013GCo 57 cobaltous chloride9013$81.10$10.41
    C9018DBotulinum tox B, per 100 u9018$8.79$1.26
    C9019GCaspofungin acetate, per 5 mg9019$34.20$4.90
    C9020GSirolimus tablet, 1 mg9020$6.51$.93
    C9100GIodinated I-131 Albumin9100$10.34$1.48
    C9102G51 Na Chromate, 50mCi9102$64.84$9.28
    C9103GNa Iothalamate I-125, 10 uCi9103$17.18$2.46
    C9104DAnti-thymocyct globulin, 25 mg9104$325.09$46.54
    C9105GHep B imm glob, per 1 ml9105$133.00$17.08
    C9108GThyrotropin alfa, 1.1 mg9108$531.05$76.02
    C9109GTirofiban hcl, 6.25 mg9109$207.81$29.75
    C9110GAlemtuzumab, per 10 mg/ml9110$486.88$69.70
    *C9111GInj, bivalirudin, 250 mg vial9111$397.81$56.95
    *C9112GPerflutren lipid micro, 2ml9112$148.20$21.22
    *C9113GInj pantoprazole sodium, vial9113$22.80$3.26
    *C9114GNesiritide, per 1.5 mg vial9114$433.20$62.02
    *C9115GInj, zoledronic acid, 2 mg9115$406.78$58.23
    *C9200GOrcel, per 36 cm29200$1,135.25$162.52
    *C9201GDermagraft, per 37.5 sq cm9201$577.60$82.69
    C9503KFresh frozen plasma, ea unit95031.56$79.41$15.88
    C9506DGranulocytes, pheresis950627.75$1,412.59$282.52
    C9700DWater induced thermo0977$1,125.00$225.00
    C9701TStretta procedure0980$1,875.00$375.00
    C9702DChkmate/Novost/Galileo Brach0981$2,250.00$450.00
    *C9703TBard Endoscopic Suturing Sys0979$1,625.00$325.00
    C9708TPreview Tx Planning Software0975$625.00$125.00
    C9711TH.E.L.P. Apheresis System0978$1,375.00$275.00
    D0120EPeriodic oral evaluation
    D0140ELimit oral eval problm focus
    D0150SComprehensve oral evaluation033010.97$558.42$111.68
    D0160EExtensv oral eval prob focus
    D0170ERe-eval,est pt,problem focus
    D0210EIntraor complete film series
    D0220EIntraoral periapical first f
    D0230EIntraoral periapical ea add
    D0240SIntraoral occlusal film033010.97$558.42$111.68
    D0250SExtraoral first film033010.97$558.42$111.68
    D0260SExtraoral ea additional film033010.97$558.42$111.68
    D0270SDental bitewing single film033010.97$558.42$111.68
    D0272SDental bitewings two films033010.97$558.42$111.68
    D0274SDental bitewings four films033010.97$558.42$111.68
    D0277SVert bitewings-sev to eight033010.97$558.42$111.68
    D0290EDental film skull/facial bon
    D0310EDental saliography
    D0320EDental tmj arthrogram incl i
    D0321EDental other tmj films
    D0322EDental tomographic survey
    D0330EDental panoramic film
    D0340EDental cephalometric film
    D0350EOral/facial images
    D0415EBacteriologic study
    D0425ECaries susceptibility test
    D0460SPulp vitality test033010.97$558.42$111.68
    D0470EDiagnostic casts
    D0472SGross exam, prep & report033010.97$558.42$111.68
    D0473SMicro exam, prep & report033010.97$558.42$111.68
    Start Printed Page 60052
    D0474SMicro w exam of surg margins033010.97$558.42$111.68
    D0480SCytopath smear prep & report033010.97$558.42$111.68
    D0501SHistopathologic examinations033010.97$558.42$111.68
    D0502SOther oral pathology procedu033010.97$558.42$111.68
    D0999SUnspecified diagnostic proce033010.97$558.42$111.68
    D1110EDental prophylaxis adult
    D1120EDental prophylaxis child
    D1201ETopical fluor w prophy child
    D1203ETopical fluor w/o prophy chi
    D1204ETopical fluor w/o prophy adu
    D1205ETopical fluoride w/ prophy a
    D1310ENutri counsel-control caries
    D1320ETobacco counseling
    D1330EOral hygiene instruction
    D1351EDental sealant per tooth
    D1510SSpace maintainer fxd unilat033010.97$558.42$111.68
    D1515SFixed bilat space maintainer033010.97$558.42$111.68
    D1520SRemove unilat space maintain033010.97$558.42$111.68
    D1525SRemove bilat space maintain033010.97$558.42$111.68
    D1550SRecement space maintainer033010.97$558.42$111.68
    D2110EAmalgam one surface primary
    D2120EAmalgam two surfaces primary
    D2130EAmalgam three surfaces prima
    D2131EAmalgam four/more surf prima
    D2140EAmalgam one surface permanen
    D2150EAmalgam two surfaces permane
    D2160EAmalgam three surfaces perma
    D2161EAmalgam 4 or > surfaces perm
    D2330EResin one surface-anterior
    D2331EResin two surfaces-anterior
    D2332EResin three surfaces-anterio
    D2335EResin 4/> surf or w incis an
    D2336EComposite resin crown
    D2337ECompo resin crown ant-perm
    D2380EResin one surf poster primar
    D2381EResin two surf poster primar
    D2382EResin three/more surf post p
    D2385EResin one surf poster perman
    D2386EResin two surf poster perman
    D2387EResin three/more surf post p
    D2388EResin four/more, post perm
    D2410EDental gold foil one surface
    D2420EDental gold foil two surface
    D2430EDental gold foil three surfa
    D2510EDental inlay metalic 1 surf
    D2520EDental inlay metallic 2 surf
    D2530EDental inlay metl 3/more sur
    D2542EDental onlay metallic 2 surf
    D2543EDental onlay metallic 3 surf
    D2544EDental onlay metl 4/more sur
    D2610EInlay porcelain/ceramic 1 su
    D2620EInlay porcelain/ceramic 2 su
    D2630EDental onlay porc 3/more sur
    D2642EDental onlay porcelin 2 surf
    D2643EDental onlay porcelin 3 surf
    D2644EDental onlay porc 4/more sur
    D2650EInlay composite/resin one su
    D2651EInlay composite/resin two su
    D2652EDental inlay resin 3/mre sur
    D2662EDental onlay resin 2 surface
    D2663EDental onlay resin 3 surface
    D2664EDental onlay resin 4/mre sur
    D2710ECrown resin laboratory
    D2720ECrown resin w/ high noble me
    D2721ECrown resin w/ base metal
    D2722ECrown resin w/ noble metal
    D2740ECrown porcelain/ceramic subs
    D2750ECrown porcelain w/ h noble m
    D2751ECrown porcelain fused base m
    D2752ECrown porcelain w/ noble met
    D2780ECrown 3/4 cast hi noble met
    D2781ECrown 3/4 cast base metal
    D2782ECrown 3/4 cast noble metal
    D2783ECrown 3/4 porcelain/ceramic
    D2790ECrown full cast high noble m
    Start Printed Page 60053
    D2791ECrown full cast base metal
    D2792ECrown full cast noble metal
    D2799EProvisional crown
    D2910EDental recement inlay
    D2920EDental recement crown
    D2930EPrefab stnlss steel crwn pri
    D2931EPrefab stnlss steel crown pe
    D2932EPrefabricated resin crown
    D2933EPrefab stainless steel crown
    D2940EDental sedative filling
    D2950ECore build-up incl any pins
    D2951ETooth pin retention
    D2952EPost and core cast + crown
    D2953EEach addtnl cast post
    D2954EPrefab post/core + crown
    D2955EPost removal
    D2957EEach addtnl prefab post
    D2960ELaminate labial veneer
    D2961ELab labial veneer resin
    D2962ELab labial veneer porcelain
    D2970STemporary- fractured tooth033010.97$558.42$111.68
    D2980ECrown repair
    D2999SDental unspec restorative pr033010.97$558.42$111.68
    D3110EPulp cap direct
    D3120EPulp cap indirect
    D3220ETherapeutic pulpotomy
    D3221EGross pulpal debridement
    D3230EPulpal therapy anterior prim
    D3240EPulpal therapy posterior pri
    D3310EAnterior
    D3320ERoot canal therapy 2 canals
    D3330ERoot canal therapy 3 canals
    D3331ENon-surg tx root canal obs
    D3332EIncomplete endodontic tx
    D3333EInternal root repair
    D3346ERetreat root canal anterior
    D3347ERetreat root canal bicuspid
    D3348ERetreat root canal molar
    D3351EApexification/recalc initial
    D3352EApexification/recalc interim
    D3353EApexification/recalc final
    D3410EApicoect/perirad surg anter
    D3421ERoot surgery bicuspid
    D3425ERoot surgery molar
    D3426ERoot surgery ea add root
    D3430ERetrograde filling
    D3450ERoot amputation
    D3460SEndodontic endosseous implan033010.97$558.42$111.68
    D3470EIntentional replantation
    D3910EIsolation- tooth w rubb dam
    D3920ETooth splitting
    D3950ECanal prep/fitting of dowel
    D3999SEndodontic procedure033010.97$558.42$111.68
    D4210EGingivectomy/plasty per quad
    D4211EGingivectomy/plasty per toot
    D4220EGingival curettage per quadr
    D4240EGingival flap proc w/ planin
    D4245EApically positioned flap
    D4249ECrown lengthen hard tissue
    D4260SOsseous surgery per quadrant033010.97$558.42$111.68
    D4263SBone replce graft first site033010.97$558.42$111.68
    D4264SBone replce graft each add033010.97$558.42$111.68
    D4266EGuided tiss regen resorble
    D4267EGuided tiss regen nonresorb
    D4268SSurgical revision procedure033010.97$558.42$111.68
    D4270SPedicle soft tissue graft pr033010.97$558.42$111.68
    D4271SFree soft tissue graft proc033010.97$558.42$111.68
    D4273SSubepithelial tissue graft033010.97$558.42$111.68
    D4274EDistal/proximal wedge proc
    D4320EProvision splnt intracoronal
    D4321EProvisional splint extracoro
    D4341EPeriodontal scaling & root
    D4355SFull mouth debridement033010.97$558.42$111.68
    D4381SLocalized chemo delivery033010.97$558.42$111.68
    D4910EPeriodontal maint procedures
    Start Printed Page 60054
    D4920EUnscheduled dressing change
    D4999EUnspecified periodontal proc
    D5110EDentures complete maxillary
    D5120EDentures complete mandible
    D5130EDentures immediat maxillary
    D5140EDentures immediat mandible
    D5211EDentures maxill part resin
    D5212EDentures mand part resin
    D5213EDentures maxill part metal
    D5214EDentures mandibl part metal
    D5281ERemovable partial denture
    D5410EDentures adjust cmplt maxil
    D5411EDentures adjust cmplt mand
    D5421EDentures adjust part maxill
    D5422EDentures adjust part mandbl
    D5510EDentur repr broken compl bas
    D5520EReplace denture teeth complt
    D5610EDentures repair resin base
    D5620ERep part denture cast frame
    D5630ERep partial denture clasp
    D5640EReplace part denture teeth
    D5650EAdd tooth to partial denture
    D5660EAdd clasp to partial denture
    D5710EDentures rebase cmplt maxil
    D5711EDentures rebase cmplt mand
    D5720EDentures rebase part maxill
    D5721EDentures rebase part mandbl
    D5730EDenture reln cmplt maxil ch
    D5731EDenture reln cmplt mand chr
    D5740EDenture reln part maxil chr
    D5741EDenture reln part mand chr
    D5750EDenture reln cmplt max lab
    D5751EDenture reln cmplt mand lab
    D5760EDenture reln part maxil lab
    D5761EDenture reln part mand lab
    D5810EDenture interm cmplt maxill
    D5811EDenture interm cmplt mandbl
    D5820EDenture interm part maxill
    D5821EDenture interm part mandbl
    D5850EDenture tiss conditn maxill
    D5851EDenture tiss condtin mandbl
    D5860EOverdenture complete
    D5861EOverdenture partial
    D5862EPrecision attachment
    D5867EReplacement of precision att
    D5875EProsthesis modification
    D5899ERemovable prosthodontic proc
    D5911SFacial moulage sectional033010.97$558.42$111.68
    D5912SFacial moulage complete033010.97$558.42$111.68
    D5913ENasal prosthesis
    D5914EAuricular prosthesis
    D5915EOrbital prosthesis
    D5916EOcular prosthesis
    D5919EFacial prosthesis
    D5922ENasal septal prosthesis
    D5923EOcular prosthesis interim
    D5924ECranial prosthesis
    D5925EFacial augmentation implant
    D5926EReplacement nasal prosthesis
    D5927EAuricular replacement
    D5928EOrbital replacement
    D5929EFacial replacement
    D5931ESurgical obturator
    D5932EPostsurgical obturator
    D5933ERefitting of obturator
    D5934EMandibular flange prosthesis
    D5935EMandibular denture prosth
    D5936ETemp obturator prosthesis
    D5937ETrismus appliance
    D5951EFeeding aid
    D5952EPediatric speech aid
    D5953EAdult speech aid
    D5954ESuperimposed prosthesis
    D5955EPalatal lift prosthesis
    D5958EIntraoral con def inter plt
    Start Printed Page 60055
    D5959EIntraoral con def mod palat
    D5960EModify speech aid prosthesis
    D5982ESurgical stent
    D5983SRadiation applicator033010.97$558.42$111.68
    D5984SRadiation shield033010.97$558.42$111.68
    D5985SRadiation cone locator033010.97$558.42$111.68
    D5986EFluoride applicator
    D5987SCommissure splint033010.97$558.42$111.68
    D5988ESurgical splint
    D5999EMaxillofacial prosthesis
    D6010EOdontics endosteal implant
    D6020EOdontics abutment placement
    D6040EOdontics eposteal implant
    D6050EOdontics transosteal implnt
    D6055EImplant connecting bar
    D6056EPrefabricated abutment
    D6057ECustom abutment
    D6058EAbutment supported crown
    D6059EAbutment supported mtl crown
    D6060EAbutment supported mtl crown
    D6061EAbutment supported mtl crown
    D6062EAbutment supported mtl crown
    D6063EAbutment supported mtl crown
    D6064EAbutment supported mtl crown
    D6065EImplant supported crown
    D6066EImplant supported mtl crown
    D6067EImplant supported mtl crown
    D6068EAbutment supported retainer
    D6069EAbutment supported retainer
    D6070EAbutment supported retainer
    D6071EAbutment supported retainer
    D6072EAbutment supported retainer
    D6073EAbutment supported retainer
    D6074EAbutment supported retainer
    D6075EImplant supported retainer
    D6076EImplant supported retainer
    D6077EImplant supported retainer
    D6078EImplnt/abut suprtd fixd dent
    D6079EImplnt/abut suprtd fixd dent
    D6080EImplant maintenance
    D6090ERepair implant
    D6095EOdontics repr abutment
    D6100ERemoval of implant
    D6199EImplant procedure
    D6210EProsthodont high noble metal
    D6211EBridge base metal cast
    D6212EBridge noble metal cast
    D6240EBridge porcelain high noble
    D6241EBridge porcelain base metal
    D6242EBridge porcelain nobel metal
    D6245EBridge porcelain/ceramic
    D6250EBridge resin w/high noble
    D6251EBridge resin base metal
    D6252EBridge resin w/noble metal
    D6519EInlay/onlay porce/ceramic
    D6520EDental retainer two surfaces
    D6530ERetainer metallic 3+ surface
    D6543EDental retainr onlay 3 surf
    D6544EDental retainr onlay 4/more
    D6545EDental retainr cast metl
    D6548EPorcelain/ceramic retainer
    D6720ERetain crown resin w hi nble
    D6721ECrown resin w/base metal
    D6722ECrown resin w/noble metal
    D6740ECrown porcelain/ceramic
    D6750ECrown porcelain high noble
    D6751ECrown porcelain base metal
    D6752ECrown porcelain noble metal
    D6780ECrown 3/4 high noble metal
    D6781ECrown 3/4 cast based metal
    D6782ECrown 3/4 cast noble metal
    D6783ECrown 3/4 porcelain/ceramic
    D6790ECrown full high noble metal
    D6791ECrown full base metal cast
    D6792ECrown full noble metal cast
    Start Printed Page 60056
    D6920SDental connector bar033010.97$558.42$111.68
    D6930EDental recement bridge
    D6940EStress breaker
    D6950EPrecision attachment
    D6970EPost & core plus retainer
    D6971ECast post bridge retainer
    D6972EPrefab post & core plus reta
    D6973ECore build up for retainer
    D6975ECoping metal
    D6976EEach addtnl cast post
    D6977EEach addtl prefab post
    D6980EBridge repair
    D6999EFixed prosthodontic proc
    D7110SOral surgery single tooth033010.97$558.42$111.68
    D7120SEach add tooth extraction033010.97$558.42$111.68
    D7130STooth root removal033010.97$558.42$111.68
    D7210SRem imp tooth w mucoper flp033010.97$558.42$111.68
    D7220SImpact tooth remov soft tiss033010.97$558.42$111.68
    D7230SImpact tooth remov part bony033010.97$558.42$111.68
    D7240SImpact tooth remov comp bony033010.97$558.42$111.68
    D7241SImpact tooth rem bony w/comp033010.97$558.42$111.68
    D7250STooth root removal033010.97$558.42$111.68
    D7260SOral antral fistula closure033010.97$558.42$111.68
    D7270ETooth reimplantation
    D7272ETooth transplantation
    D7280EExposure impact tooth orthod
    D7281EExposure tooth aid eruption
    D7285EBiopsy of oral tissue hard
    D7286EBiopsy of oral tissue soft
    D7290ERepositioning of teeth
    D7291STransseptal fiberotomy033010.97$558.42$111.68
    D7310EAlveoplasty w/ extraction
    D7320EAlveoplasty w/o extraction
    D7340EVestibuloplasty ridge extens
    D7350EVestibuloplasty exten graft
    D7410ERad exc lesion up to 1.25 cm
    D7420ELesion > 1.25 cm
    D7430EExc benign tumor to 1.25 cm
    D7431EBenign tumor exc > 1.25 cm
    D7440EMalig tumor exc to 1.25 cm
    D7441EMalig tumor > 1.25 cm
    D7450ERem odontogen cyst to 1.25cm
    D7451ERem odontogen cyst > 1.25 cm
    D7460ERem nonodonto cyst to 1.25cm
    D7461ERem nonodonto cyst > 1.25 cm
    D7465ELesion destruction
    D7471ERem exostosis any site
    D7480EPartial ostectomy
    D7490EMandible resection
    D7510EI&d absc intraoral soft tiss
    D7520EI&d abscess extraoral
    D7530ERemoval fb skin/areolar tiss
    D7540ERemoval of fb reaction
    D7550ERemoval of sloughed off bone
    D7560EMaxillary sinusotomy
    D7610EMaxilla open reduct simple
    D7620EClsd reduct simpl maxilla fx
    D7630EOpen red simpl mandible fx
    D7640EClsd red simpl mandible fx
    D7650EOpen red simp malar/zygom fx
    D7660EClsd red simp malar/zygom fx
    D7670EClosd rductn splint alveolus
    D7680EReduct simple facial bone fx
    D7710EMaxilla open reduct compound
    D7720EClsd reduct compd maxilla fx
    D7730EOpen reduct compd mandble fx
    D7740EClsd reduct compd mandble fx
    D7750EOpen red comp malar/zygma fx
    D7760EClsd red comp malar/zygma fx
    D7770EOpen reduc compd alveolus fx
    D7780EReduct compnd facial bone fx
    D7810ETmj open reduct-dislocation
    D7820EClosed tmp manipulation
    D7830ETmj manipulation under anest
    D7840ERemoval of tmj condyle
    Start Printed Page 60057
    D7850ETmj meniscectomy
    D7852ETmj repair of joint disc
    D7854ETmj excisn of joint membrane
    D7856ETmj cutting of a muscle
    D7858ETmj reconstruction
    D7860ETmj cutting into joint
    D7865ETmj reshaping components
    D7870ETmj aspiration joint fluid
    D7871ELysis + lavage w catheters
    D7872ETmj diagnostic arthroscopy
    D7873ETmj arthroscopy lysis adhesn
    D7874ETmj arthroscopy disc reposit
    D7875ETmj arthroscopy synovectomy
    D7876ETmj arthroscopy discectomy
    D7877ETmj arthroscopy debridement
    D7880EOcclusal orthotic appliance
    D7899ETmj unspecified therapy
    D7910EDent sutur recent wnd to 5cm
    D7911EDental suture wound to 5 cm
    D7912ESuture complicate wnd > 5 cm
    D7920EDental skin graft
    D7940SReshaping bone orthognathic033010.97$558.42$111.68
    D7941EBone cutting ramus closed
    D7943ECutting ramus open w/graft
    D7944EBone cutting segmented
    D7945EBone cutting body mandible
    D7946EReconstruction maxilla total
    D7947EReconstruct maxilla segment
    D7948EReconstruct midface no graft
    D7949EReconstruct midface w/graft
    D7950EMandible graft
    D7955ERepair maxillofacial defects
    D7960EFrenulectomy/frenulotomy
    D7970EExcision hyperplastic tissue
    D7971EExcision pericoronal gingiva
    D7980ESialolithotomy
    D7981EExcision of salivary gland
    D7982ESialodochoplasty
    D7983EClosure of salivary fistula
    D7990EEmergency tracheotomy
    D7991EDental coronoidectomy
    D7995ESynthetic graft facial bones
    D7996EImplant mandible for augment
    D7997EAppliance removal
    D7999EOral surgery procedure
    D8010ELimited dental tx primary
    D8020ELimited dental tx transition
    D8030ELimited dental tx adolescent
    D8040ELimited dental tx adult
    D8050EIntercep dental tx primary
    D8060EIntercep dental tx transitn
    D8070ECompre dental tx transition
    D8080ECompre dental tx adolescent
    D8090ECompre dental tx adult
    D8210EOrthodontic rem appliance tx
    D8220EFixed appliance therapy habt
    D8660EPreorthodontic tx visit
    D8670EPeriodic orthodontc tx visit
    D8680EOrthodontic retention
    D8690EOrthodontic treatment
    D8691ERepair ortho appliance
    D8692EReplacement retainer
    D8999EOrthodontic procedure
    D9110NTx dental pain minor proc
    D9210EDent anesthesia w/o surgery
    D9211ERegional block anesthesia
    D9212ETrigeminal block anesthesia
    D9215ELocal anesthesia
    D9220EGeneral anesthesia
    D9221EGeneral anesthesia ea ad 15m
    D9230NAnalgesia
    D9241EIntravenous sedation
    D9242EIV sedation ea ad 30 m
    D9248NSedation (non-iv)
    D9310EDental consultation
    Start Printed Page 60058
    D9410EDental house call
    D9420EHospital call
    D9430EOffice visit during hours
    D9440EOffice visit after hours
    D9610EDent therapeutic drug inject
    D9630SOther drugs/medicaments033010.97$558.42$111.68
    D9910EDent appl desensitizing med
    D9911EAppl desensitizing resin
    D9920EBehavior management
    D9930STreatment of complications033010.97$558.42$111.68
    D9940SDental occlusal guard033010.97$558.42$111.68
    D9941EFabrication athletic guard
    D9950SOcclusion analysis033010.97$558.42$111.68
    D9951SLimited occlusal adjustment033010.97$558.42$111.68
    D9952SComplete occlusal adjustment033010.97$558.42$111.68
    D9970EEnamel microabrasion
    D9971EOdontoplasty 1-2 teeth
    D9972EExtrnl bleaching per arch
    D9973EExtrnl bleaching per tooth
    D9974EIntrnl bleaching per tooth
    D9999EAdjunctive procedure
    E0100ACane adjust/fixed with tip
    E0105ACane adjust/fixed quad/3 pro
    E0110ACrutch forearm pair
    E0111ACrutch forearm each
    E0112ACrutch underarm pair wood
    E0113ACrutch underarm each wood
    E0114ACrutch underarm pair no wood
    E0116ACrutch underarm each no wood
    E0130AWalker rigid adjust/fixed ht
    E0135AWalker folding adjust/fixed
    E0141ARigid walker wheeled wo seat
    E0142AWalker rigid wheeled with se
    E0143AWalker folding wheeled w/o s
    E0144AEnclosed walker w rear seat
    E0145AWalker whled seat/crutch att
    E0146AFolding walker wheels w seat
    E0147AWalker variable wheel resist
    E0148AHeavyduty walker no wheels
    E0149AHeavy duty wheeled walker
    E0153AForearm crutch platform atta
    E0154AWalker platform attachment
    E0155AWalker wheel attachment,pair
    E0156AWalker seat attachment
    E0157AWalker crutch attachment
    E0158AWalker leg extenders set of4
    E0159ABrake for wheeled walker
    E0160ASitz type bath or equipment
    E0161ASitz bath/equipment w/faucet
    E0162ASitz bath chair
    E0163ACommode chair stationry fxd
    E0164ACommode chair mobile fixed a
    E0165ACommode chair stationry det
    E0166ACommode chair mobile detach
    E0167ACommode chair pail or pan
    E0168AHeavyduty/wide commode chair
    *E0169ASeatlift incorp commodechair
    E0175ACommode chair foot rest
    E0176AAir pressre pad/cushion nonp
    E0177AWater press pad/cushion nonp
    E0178AGel pressre pad/cushion nonp
    E0179ADry pressre pad/cushion nonp
    E0180APress pad alternating w pump
    E0181APress pad alternating w/ pum
    E0182APressure pad alternating pum
    E0184ADry pressure mattress
    E0185AGel pressure mattress pad
    E0186AAir pressure mattress
    E0187AWater pressure mattress
    E0188ESynthetic sheepskin pad
    E0189ELambswool sheepskin pad
    E0191AProtector heel or elbow
    E0192APad wheelchr low press/posit
    E0193APowered air flotation bed
    E0194AAir fluidized bed
    Start Printed Page 60059
    E0196AGel pressure mattress
    E0197AAir pressure pad for mattres
    E0198AWater pressure pad for mattr
    E0199ADry pressure pad for mattres
    E0200AHeat lamp without stand
    E0202APhototherapy light w/ photom
    E0205AHeat lamp with stand
    E0210AElectric heat pad standard
    E0215AElectric heat pad moist
    E0217AWater circ heat pad w pump
    E0218EWater circ cold pad w pump
    E0220AHot water bottle
    *E0221AInfrared heating pad system
    E0225AHydrocollator unit
    E0230AIce cap or collar
    *E0231AWound warming device
    *E0232AWarming card for NWT
    E0235AParaffin bath unit portable
    E0236APump for water circulating p
    E0238AHeat pad non-electric moist
    E0239AHydrocollator unit portable
    E0241EBath tub wall rail
    E0242EBath tub rail floor
    E0243EToilet rail
    E0244EToilet seat raised
    E0245ETub stool or bench
    E0246ETransfer tub rail attachment
    E0249APad water circulating heat u
    E0250AHosp bed fixed ht w/ mattres
    E0251AHosp bed fixd ht w/o mattres
    E0255AHospital bed var ht w/ mattr
    E0256AHospital bed var ht w/o matt
    E0260AHosp bed semi-electr w/ matt
    E0261AHosp bed semi-electr w/o mat
    E0265AHosp bed total electr w/ mat
    E0266AHosp bed total elec w/o matt
    E0270EHospital bed institutional t
    E0271AMattress innerspring
    E0272AMattress foam rubber
    E0273EBed board
    E0274EOver-bed table
    E0275ABed pan standard
    E0276ABed pan fracture
    E0277APowered pres-redu air mattrs
    E0280ABed cradle
    E0290AHosp bed fx ht w/o rails w/m
    E0291AHosp bed fx ht w/o rail w/o
    E0292AHosp bed var ht w/o rail w/o
    E0293AHosp bed var ht w/o rail w/
    E0294AHosp bed semi-elect w/ mattr
    E0295AHosp bed semi-elect w/o matt
    E0296AHosp bed total elect w/ matt
    E0297AHosp bed total elect w/o mat
    E0298DHeavyduty/xtra wide hosp bed
    E0305ARails bed side half length
    E0310ARails bed side full length
    E0315EBed accessory brd/tbl/supprt
    *E0316ABed safety enclosure
    E0325AUrinal male jug-type
    E0326AUrinal female jug-type
    E0350EControl unit bowel system
    E0352EDisposable pack w/bowel syst
    E0370EAir elevator for heel
    E0371ANonpower mattress overlay
    E0372APowered air mattress overlay
    E0373ANonpowered pressure mattress
    E0424AStationary compressed gas 02
    E0425EGas system stationary compre
    E0430EOxygen system gas portable
    E0431APortable gaseous 02
    E0434APortable liquid 02
    E0435EOxygen system liquid portabl
    E0439AStationary liquid 02
    E0440EOxygen system liquid station
    E0441AOxygen contents, gaseous
    Start Printed Page 60060
    E0442AOxygen contents, liquid
    E0443APortable 02 contents, gas
    E0444APortable 02 contents, liquid
    E0450AVolume vent stationary/porta
    E0455AOxygen tent excl croup/ped t
    E0457AChest shell
    E0459AChest wrap
    E0460ANeg press vent portabl/statn
    E0462ARocking bed w/ or w/o side r
    E0480APercussor elect/pneum home m
    *E0481AIntrpulmnry percuss vent sys
    *E0482ACough stimulating device
    E0500AIppb all types
    E0550AHumidif extens supple w ippb
    E0555AHumidifier for use w/ regula
    E0560AHumidifier supplemental w/ i
    E0565ACompressor air power source
    E0570ANebulizer with compression
    E0571AAerosol compressor for svneb
    E0572AAerosol compressor adjust pr
    E0574AUltrasonic generator w svneb
    E0575ANebulizer ultrasonic
    E0580ANebulizer for use w/ regulat
    E0585ANebulizer w/ compressor & he
    E0590ADispensing fee dme neb drug
    E0600ASuction pump portab hom modl
    E0601ACont airway pressure device
    E0602EBreast pump
    *E0603AElectric breast pump
    *E0604AHosp grade elec breast pump
    E0605AVaporizer room type
    E0606ADrainage board postural
    E0607ABlood glucose monitor home
    E0608AApnea monitor
    E0609DBlood gluc mon w/special fea
    E0610APacemaker monitr audible/vis
    E0615APacemaker monitr digital/vis
    E0616NCardiac event recorder
    E0617AAutomatic ext defibrillator
    *E0620ACap bld skin piercing laser
    E0621APatient lift sling or seat
    E0625EPatient lift bathroom or toi
    E0627ASeat lift incorp lift-chair
    E0628ASeat lift for pt furn-electr
    E0629ASeat lift for pt furn-non-el
    E0630APatient lift hydraulic
    E0635APatient lift electric
    E0650APneuma compresor non-segment
    E0651APneum compressor segmental
    E0652APneum compres w/cal pressure
    E0655APneumatic appliance half arm
    E0660APneumatic appliance full leg
    E0665APneumatic appliance full arm
    E0666APneumatic appliance half leg
    E0667ASeg pneumatic appl full leg
    E0668ASeg pneumatic appl full arm
    E0669ASeg pneumatic appli half leg
    E0671APressure pneum appl full leg
    E0672APressure pneum appl full arm
    E0673APressure pneum appl half leg
    E0690AUltraviolet cabinet
    E0700ESafety equipment
    E0710ERestraints any type
    E0720ATens two lead
    E0730ATens four lead
    E0731AConductive garment for tens/
    E0740EIncontinence treatment systm
    E0744ANeuromuscular stim for scoli
    E0745ANeuromuscular stim for shock
    E0746EElectromyograph biofeedback
    E0747AElec osteogen stim not spine
    E0748AElec osteogen stim spinal
    E0749NElec osteogen stim implanted
    *E0752ENeurostimulator electrode
    E0753DNeurostimulator electrodes
    Start Printed Page 60061
    *E0754APulsegenerator pt programmer
    E0755EElectronic salivary reflex s
    E0756EImplantable pulse generator
    E0757EImplantable RF receiver
    E0758AExternal RF transmitter
    *E0759AReplace rdfrquncy transmittr
    E0760EOsteogen ultrasound stimltor
    E0765ENerve stimulator for tx n&v
    E0776AIv pole
    E0779AAmb infusion pump mechanical
    E0780AMech amb infusion pump <8hrs
    E0781AExternal ambulatory infus pu
    E0782ENon-programble infusion pump
    E0783EProgrammable infusion pump
    E0784AExt amb infusn pump insulin
    E0785EReplacement impl pump cathet
    E0786EImplantable pump replacement
    E0791AParenteral infusion pump sta
    E0830NAmbulatory traction device
    E0840ATract frame attach headboard
    E0850ATraction stand free standing
    E0855ACervical traction equipment
    E0860ATract equip cervical tract
    E0870ATract frame attach footboard
    E0880ATrac stand free stand extrem
    E0890ATraction frame attach pelvic
    E0900ATrac stand free stand pelvic
    E0910ATrapeze bar attached to bed
    E0920AFracture frame attached to b
    E0930AFracture frame free standing
    E0935AExercise device passive moti
    E0940ATrapeze bar free standing
    E0941AGravity assisted traction de
    E0942ACervical head harness/halter
    E0943ACervical pillow
    E0944APelvic belt/harness/boot
    E0945ABelt/harness extremity
    E0946AFracture frame dual w cross
    E0947AFracture frame attachmnts pe
    E0948AFracture frame attachmnts ce
    E0950ETray
    E0951ELoop heel
    E0952ELoop tie
    E0953EPneumatic tire
    E0954EWheelchair semi-pneumatic ca
    E0958AWhlchr att- conv 1 arm drive
    E0959EAmputee adapter
    E0961EWheelchair brake extension
    E0962AWheelchair 1 inch cushion
    E0963AWheelchair 2 inch cushion
    E0964AWheelchair 3 inch cushion
    E0965AWheelchair 4 inch cushion
    E0966EWheelchair head rest extensi
    E0967EWheelchair hand rims
    E0968AWheelchair commode seat
    E0969EWheelchair narrowing device
    E0970EWheelchair no. 2 footplates
    E0971EWheelchair anti-tipping devi
    E0972ATransfer board or device
    E0973EWheelchair adjustabl height
    E0974EWheelchair grade-aid
    E0975EWheelchair reinforced seat u
    E0976EWheelchair reinforced back u
    E0977EWheelchair wedge cushion
    E0978EWheelchair belt w/airplane b
    E0979EWheelchair belt with velcro
    E0980EWheelchair safety vest
    E0990EWhellchair elevating leg res
    E0991EWheelchair upholstry seat
    E0992EWheelchair solid seat insert
    E0993EWheelchair back upholstery
    E0994EWheelchair arm rest
    E0995EWheelchair calf rest
    E0996EWheelchair tire solid
    E0997EWheelchair caster w/ a fork
    Start Printed Page 60062
    E0998EWheelchair caster w/o a fork
    E0999EWheelchr pneumatic tire w/wh
    E1000EWheelchair tire pneumatic ca
    E1001EWheelchair wheel
    E1031ARollabout chair with casters
    E1035EPatient transfer system
    E1050AWhelchr fxd full length arms
    E1060AWheelchair detachable arms
    E1065EWheelchair power attachment
    E1066EWheelchair battery charger
    E1069EWheelchair deep cycle batter
    E1070AWheelchair detachable foot r
    E1083AHemi-wheelchair fixed arms
    E1084AHemi-wheelchair detachable a
    E1085AHemi-wheelchair fixed arms
    E1086AHemi-wheelchair detachable a
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    E1088AWheelchair lightweight det a
    E1089AWheelchair lightwt fixed arm
    E1090AWheelchair lightweight det a
    E1091AWheelchair youth
    E1092AWheelchair wide w/ leg rests
    E1093AWheelchair wide w/ foot rest
    E1100AWhchr s-recl fxd arm leg res
    E1110AWheelchair semi-recl detach
    E1130AWhlchr stand fxd arm ft rest
    E1140AWheelchair standard detach a
    E1150AWheelchair standard w/ leg r
    E1160AWheelchair fixed arms
    E1170AWhlchr ampu fxd arm leg rest
    E1171AWheelchair amputee w/o leg r
    E1172AWheelchair amputee detach ar
    E1180AWheelchair amputee w/ foot r
    E1190AWheelchair amputee w/ leg re
    E1195AWheelchair amputee heavy dut
    E1200AWheelchair amputee fixed arm
    E1210AWhlchr moto ful arm leg rest
    E1211AWheelchair motorized w/ det
    E1212AWheelchair motorized w full
    E1213AWheelchair motorized w/ det
    E1220AWhlchr special size/constrc
    E1221AWheelchair spec size w foot
    E1222AWheelchair spec size w/ leg
    E1223AWheelchair spec size w foot
    E1224AWheelchair spec size w/ leg
    E1225AWheelchair spec sz semi-recl
    E1226EWheelchair spec sz full-recl
    E1227EWheelchair spec sz spec ht a
    E1228AWheelchair spec sz spec ht b
    E1230APower operated vehicle
    E1240AWhchr litwt det arm leg rest
    E1250AWheelchair lightwt fixed arm
    E1260AWheelchair lightwt foot rest
    E1270AWheelchair lightweight leg r
    E1280AWhchr h-duty det arm leg res
    E1285AWheelchair heavy duty fixed
    E1290AWheelchair hvy duty detach a
    E1295AWheelchair heavy duty fixed
    E1296AWheelchair special seat heig
    E1297AWheelchair special seat dept
    E1298AWheelchair spec seat depth/w
    E1300EWhirlpool portable
    E1310AWhirlpool non-portable
    E1340ARepair for DME, per 15 min
    E1353AOxygen supplies regulator
    E1355AOxygen supplies stand/rack
    E1372AOxy suppl heater for nebuliz
    E1390AOxygen concentrator
    E1399ADurable medical equipment mi
    E1405AO2/water vapor enrich w/heat
    E1406AO2/water vapor enrich w/o he
    *E1500ACentrifuge
    E1510AKidney dialysate delivry sys
    E1520AHeparin infusion pump for di
    E1530AAir bubble detector for dial
    Start Printed Page 60063
    E1540APressure alarm for dialysis
    E1550ABath conductivity meter
    E1560ABlood leak detector for dial
    E1570AAdjustable chair for esrd pt
    E1575ATransducer protector/fluid b
    E1580AUnipuncture control system
    E1590AHemodialysis machine
    E1592AAuto interm peritoneal dialy
    E1594ACycler dialysis machine
    E1600ADeliv/install equip for dial
    E1610AReverse osmosis water purifi
    E1615ADeionizer water purification
    E1620ABlood pump for dialysis
    E1625AWater softening system
    E1630AReciprocating peritoneal dia
    E1632AWearable artificial kidney
    E1635ACompact travel hemodialyzer
    E1636ASorbent cartridges for dialy
    *E1637AHemostats for dialysis, each
    *E1638APeri dialysis heating pad
    *E1639ADialysis scale
    E1640DReplacement components for d
    E1699ADialysis equipment unspecifi
    E1700AJaw motion rehab system
    E1701ARepl cushions for jaw motion
    E1702ARepl measr scales jaw motion
    E1800AAdjust elbow ext/flex device
    *E1801ASPS elbow device
    E1805AAdjust wrist ext/flex device
    *E1806ASPS wrist device
    E1810AAdjust knee ext/flex device
    *E1811ASPS knee device
    E1815AAdjust ankle ext/flex device
    *E1816ASPS ankle device
    *E1818ASPS forearm device
    E1820ASoft interface material
    *E1821AReplacement interface SPSD
    E1825AAdjust finger ext/flex devc
    E1830AAdjust toe ext/flex device
    *E1840AAdj shoulder ext/flex device
    E1900DSpeech communication device
    *E1902AAAC non-electronic board
    *E2000AGastric suction pump hme mdl
    *E2100ABld glucose monitor w voice
    *E2101ABld glucose monitor w lance
    G0001ADrawing blood for specimen
    G0002NTemporary urinary catheter
    G0004EECG transm phys review & int
    G0005XECG 24 hour recording00970.84$42.76$23.51$8.55
    G0006XECG transmission & analysis00970.84$42.76$23.51$8.55
    G0007NECG phy review & interpret
    G0008KAdmin influenza virus vac03540.10$5.09
    G0009KAdmin pneumococcal vaccine03540.10$5.09
    G0010NAdmin hepatitis b vaccine
    G0015XPost symptom ECG tracing00970.84$42.76$23.51$8.55
    G0016DPost symptom ECG md review
    G0025NCollagen skin test kit
    G0026AFecal leukocyte examination
    G0027ASemen analysis
    G0030SPET imaging prev PET single028518.72$952.92$415.21$190.58
    G0031SPET imaging prev PET multple028518.72$952.92$415.21$190.58
    G0032SPET follow SPECT 78464 singl028518.72$952.92$415.21$190.58
    G0033SPET follow SPECT 78464 mult028518.72$952.92$415.21$190.58
    G0034SPET follow SPECT 76865 singl028518.72$952.92$415.21$190.58
    G0035SPET follow SPECT 78465 mult028518.72$952.92$415.21$190.58
    G0036SPET follow cornry angio sing028518.72$952.92$415.21$190.58
    G0037SPET follow cornry angio mult028518.72$952.92$415.21$190.58
    G0038SPET follow myocard perf sing028518.72$952.92$415.21$190.58
    G0039SPET follow myocard perf mult028518.72$952.92$415.21$190.58
    G0040SPET follow stress echo singl028518.72$952.92$415.21$190.58
    G0041SPET follow stress echo mult028518.72$952.92$415.21$190.58
    G0042SPET follow ventriculogm sing028518.72$952.92$415.21$190.58
    G0043SPET follow ventriculogm mult028518.72$952.92$415.21$190.58
    G0044SPET following rest ECG singl028518.72$952.92$415.21$190.58
    G0045SPET following rest ECG mult028518.72$952.92$415.21$190.58
    Start Printed Page 60064
    G0046SPET follow stress ECG singl028518.72$952.92$415.21$190.58
    G0047SPET follow stress ECG mult028518.72$952.92$415.21$190.58
    G0050SResidual urine by ultrasound02650.95$48.36$26.59$9.67
    G0101VCA screen;pelvic/breast exam06000.86$43.78$8.76
    G0102NProstate ca screening; dre
    G0103APsa, total screening
    G0104SCA screen;flexi sigmoidscope01592.33$118.61$29.65$23.72
    G0105TColorectal scrn; hi risk ind01586.55$333.42$83.36$66.68
    G0106SColon CA screen;barium enema01571.98$100.79$22.19$20.16
    G0107ACA screen; fecal blood test
    G0108ADiab manage trn per indiv
    G0109ADiab manage trn ind/group
    G0110ANett pulm-rehab educ; ind
    G0111ANett pulm-rehab educ; group
    G0112ANett;nutrition guid, initial
    G0113ANett;nutrition guid,subseqnt
    G0114ANett; psychosocial consult
    G0115ANett; psychological testing
    G0116ANett; psychosocial counsel
    *G0117SGlaucoma scrn hgh risk direc02300.61$31.05$14.28$6.21
    *G0118SGlaucoma scrn hgh risk direc02300.61$31.05$14.28$6.21
    G0120SColon ca scrn; barium enema01571.98$100.79$22.19$20.16
    G0121TColon ca scrn not hi rsk ind01586.55$333.42$83.36$66.68
    G0122EColon ca scrn; barium enema
    G0123AScreen cerv/vag thin layer
    G0124AScreen c/v thin layer by MD
    G0125TPET image pulmonary nodule0976$875.00$175.00
    G0126DLung image (PET) staging
    G0127TTrim nail(s)00090.63$32.07$8.34$6.41
    G0128ECORF skilled nursing service
    G0129PPartial hosp prog service00334.17$212.27$48.17$42.45
    G0130XSingle energy x-ray study02611.21$61.59$33.87$12.32
    G0131SCT scan, bone density study02881.17$59.56$32.75$11.91
    G0132SCT scan, bone density study02881.17$59.56$32.75$11.91
    G0141EScr c/v cyto,autosys and md
    G0143AScr c/v cyto,thinlayer,rescr
    G0144AScr c/v cyto,thinlayer,rescr
    G0145AScr c/v cyto,thinlayer,rescr
    G0147AScr c/v cyto, automated sys
    G0148AScr c/v cyto, autosys, rescr
    G0151EHHCP-serv of pt,ea 15 min
    G0152EHHCP-serv of ot,ea 15 min
    G0153EHHCP-svs of s/l path,ea 15mn
    G0154EHHCP-svs of rn,ea 15 min
    G0155EHHCP-svs of csw,ea 15 min
    G0156EHHCP-svs of aide,ea 15 min
    G0163DPet for rec of colorectal ca
    G0164DPet for lymphoma staging
    G0165DPet,rec of melanoma/met ca
    G0166TExtrnl counterpulse, per tx0972$150.00$30.00
    G0167EHyperbaric oz tx;no md reqrd
    G0168TWound closure by adhesive0970$25.00$5.00
    G0173SStereo radoisurgery,complete0721$5,500.00$1,100.00
    G0174DIntensitymodulatedradiation
    G0175VOPPS Service,sched team conf06021.38$70.25$14.05
    G0176POPPS/PHP;activity therapy00334.17$212.27$48.17$42.45
    G0177POPPS/PHP; train & educ serv00334.17$212.27$48.17$42.45
    G0178DIntensitymodulatedradiation
    G0179EMD recertification HHA PT
    G0180EMD certification HHA patient
    G0181EHome health care supervision
    G0182EHospice care supervision
    G0184DOcular photdynamicTx 2nd eye02355.57$283.54$78.91$56.71
    G0185TTranspuppillary thermotx02355.57$283.54$78.91$56.71
    G0186TDstry eye lesn,fdr vssl tech02355.57$283.54$78.91$56.71
    G0187TDstry mclr drusen,photocoag02355.57$283.54$78.91$56.71
    G0188DXray lwr extrmty-full lngth02611.21$61.59$33.87$12.32
    G0190DImmunization administration
    G0191DImmunization admin,each add
    G0192NImmunization oral/intranasal
    G0193AEndoscopicstudyswallowfunctn
    G0194ASensorytestingendoscopicstud
    G0195AClinicalevalswallowingfunct
    G0196AEvalofswallowingwithradioopa
    G0197AEvalofptforprescipspeechdevi
    Start Printed Page 60065
    G0198APatientadapation&trainforspe
    G0199AReevaluationofpatientusespec
    G0200AEvalofpatientprescipofvoicep
    G0201AModifortraininginusevoicepro
    G0202AScreeningmammographydigital
    G0203DScreenmammographyfilmdigital
    G0204SDiagnosticmammographydigital0707$75.00$15.00
    G0205DDiagnosticmammographyfilmpro
    G0206SDiagnosticmammographydigital0707$75.00$15.00
    G0207DDiagnostic mammography film
    G0210SPET img wholebody dxlung ca0712$875.00$175.00
    G0211SPET img wholebody init lung0712$875.00$175.00
    G0212SPET img wholebod restag lung0712$875.00$175.00
    G0213SPET img wholebody dx colorec0712$875.00$175.00
    G0214SPET img wholebod init colore0712$875.00$175.00
    G0215SPETimg wholebod restag colre0712$875.00$175.00
    G0216SPET img wholebod dx melanoma0712$875.00$175.00
    G0217SPET img wholebod init melano0712$875.00$175.00
    G0218SPET img wholebod restag mela0712$875.00$175.00
    G0219SPET img wholbod melano nonco0712$875.00$175.00
    G0220SPET img wholebod dx lymphoma0712$875.00$175.00
    G0221SPET imag wholbod init lympho0712$875.00$175.00
    G0222SPET imag wholbod resta lymph0712$875.00$175.00
    G0223SPET imag wholbod reg dx head0712$875.00$175.00
    G0224SPET imag wholbod reg ini hea0712$875.00$175.00
    G0225SPET whol restag headneck onl0712$875.00$175.00
    G0226SPET img wholbody dx esophagl0712$875.00$175.00
    G0227SPET img wholbod ini esophage0712$875.00$175.00
    G0228SPET img wholbod restg esopha0712$875.00$175.00
    G0229SPET img metabolic brain pres0712$875.00$175.00
    G0230SPET myocard viability post s0712$875.00$175.00
    *G0231SPET WhBD colorec; gamma cam0712$875.00$175.00
    *G0232SPET WhBD lymphoma; gamma cam0712$875.00$175.00
    *G0233SPET WhBD melanoma; gamma cam0712$875.00$175.00
    *G0234SPET WhBD pulm nod; gamma cam0712$875.00$175.00
    *G0236Sdigital film convert diag ma0706$25.00$5.00
    *G0237TTherapeutic procd strg endur0970$25.00$5.00
    *G0238TOth resp proc, indiv0970$25.00$5.00
    *G0239TOth resp proc, group0970$25.00$5.00
    G0240ACritic care by MD transport
    G0241AEach additional 30 minutes
    *G0242SMultisource photon ster plan0714$1,375.00$275.00
    *G0243SMultisour photon stereo treat0721$5,500.00$1,100.00
    *G0244XObserv care by facility topt03396.85$348.69$69.74
    G9001EMCCD, initial rate
    G9002EMCCD, maintenance rate
    G9003EMCCD, risk adj hi, initial
    G9004EMCCD, risk adj lo, initial
    G9005EMCCD, risk adj, maintenance
    G9006EMCCD, Home monitoring
    G9007EMCCD, sch team conf
    G9008EMccd,phys coor-care ovrsght
    G9009EMCCD, risk adj, level 3
    G9010EMCCD, risk adj, level 4
    G9011EMCCD, risk adj, level 5
    G9012EOther Specified Case Mgmt
    G9016ADemo-smoking cessation coun
    H0001EAlcohol and/or drug assess
    H0002EAlcohol and/or drug screenin
    H0003EAlcohol and/or drug screenin
    H0004EAlcohol and/or drug services
    H0005EAlcohol and/or drug services
    H0006EAlcohol and/or drug services
    H0007EAlcohol and/or drug services
    H0008EAlcohol and/or drug services
    H0009EAlcohol and/or drug services
    H0010EAlcohol and/or drug services
    H0011EAlcohol and/or drug services
    H0012EAlcohol and/or drug services
    H0013EAlcohol and/or drug services
    H0014EAlcohol and/or drug services
    H0015EAlcohol and/or drug services
    H0016EAlcohol and/or drug services
    H0017EAlcohol and/or drug services
    H0018EAlcohol and/or drug services
    Start Printed Page 60066
    H0019EAlcohol and/or drug services
    H0020EAlcohol and/or drug services
    H0021EAlcohol and/or drug training
    H0022EAlcohol and/or drug interven
    H0023EAlcohol and/or drug outreach
    H0024EAlcohol and/or drug preventi
    H0025EAlcohol and/or drug preventi
    H0026EAlcohol and/or drug preventi
    H0027EAlcohol and/or drug preventi
    H0028EAlcohol and/or drug preventi
    H0029EAlcohol and/or drug preventi
    H0030EAlcohol and/or drug hotline
    *H1000APrenatal care atrisk assessm
    *H1001AAntepartum management
    *H1002ACarecoordination prenatal
    *H1003APrenatal at risk education
    *H1004AFollow up home visit/prental
    *H1005APrenatalcare enhanced srv pk
    J0120NTetracyclin injection
    J0130GAbciximab injection [10 mg]1605$513.02$73.44
    J0150KAdenosine, 6 mg09170.34$17.31$3.46
    J0151EAdenosine injection
    J0170NAdrenalin epinephrin inject
    J0190NInj biperiden lactate/5 mg
    J0200NAlatrofloxacin mesylate
    J0205GAlglucerase injection per 10 units0900$37.53$5.37
    J0207GAmifostine 500 mg7000$392.06$56.13
    J0210NMethyldopate hcl injection
    J0256GAlpha 1 proteinase inhibitor 10 mg0901$2.09$.30
    J0270EAlprostadil for injection
    J0275EAlprostadil urethral suppos
    J0280NAminophyllin 250 MG inj
    J0282NAmiodarone HCl
    J0285NAmphotericin B
    J0286GAmphotericin b lipid complex 50 mg7001$109.25$15.64
    J0290NAmpicillin 500 MG inj
    J0295NAmpicillin sodium per 1.5 gm
    J0300NAmobarbital 125 MG inj
    J0330NSuccinycholine chloride inj
    J0340DNandrolon phenpropionate inj
    J0350Ganistreplase per 30 u1606$2,693.80$385.64
    J0360NHydralazine hcl injection
    J0380NInj metaraminol bitartrate
    J0390NChloroquine injection
    J0395NArbutamine HCl injection
    J0400DInj trimethaphan camsylate
    J0456NAzithromycin
    J0460NAtropine sulfate injection
    J0470NDimecaprol injection
    J0475NBaclofen 10 MG injection
    J0476EBaclofen intrathecal trial
    J0500NDicyclomine injection
    J0510DBenzquinamide injection
    J0515NInj benztropine mesylate
    J0520NBethanechol chloride inject
    J0530NPenicillin g benzathine inj
    J0540NPenicillin g benzathine inj
    J0550NPenicillin g benzathine inj
    J0560NPenicillin g benzathine inj
    J0570NPenicillin g benzathine inj
    J0580NPenicillin g benzathine inj
    J0585GBotulinum toxin A per unit0902$4.39$.63
    *J0587GBotulinum toxin B, per 100 u9018$8.79$1.26
    J0590DEthylnorepinephrine hcl inj
    J0600NEdetate calcium disodium inj
    J0610NCalcium gluconate injection
    J0620NCalcium glycer & lact/10 ML
    J0630NCalcitonin salmon injection
    J0635NCalcitriol injection
    J0640GLeucovorin calcium injection per 50 mg0725$4.15$.38
    J0670NInj mepivacaine HCL/10 ml
    J0690NCefazolin sodium injection
    *J0692NCefepime HCl for injection
    J0694NCefoxitin sodium injection
    J0695DCefonocid sodium injection
    Start Printed Page 60067
    J0696NCeftriaxone sodium injection
    J0697NSterile cefuroxime injection
    J0698NCefotaxime sodium injection
    J0702NBetamethasone acet&sod phosp
    J0704NBetamethasone sod phosp/4 MG
    *J0706GCaffeine citrate injection9011$3.05$.44
    J0710NCephapirin sodium injection
    J0713NInj ceftazidime per 500 mg
    J0715NCeftizoxime sodium / 500 MG
    J0720NChloramphenicol sodium injec
    J0725NChorionic gonadotropin/1000u
    J0730DChlorpheniramin maleate inj
    J0735NClonidine hydrochloride
    J0740NCidofovir injection
    J0743NCilastatin sodium injection
    *J0744NCiprofloxacin iv
    J0745NInj codeine phosphate /30 MG
    J0760NColchicine injection
    J0770NColistimethate sodium inj
    J0780NProchlorperazine injection
    J0800NCorticotropin injection
    J0810DCortisone injection
    J0835NInj cosyntropin per 0.25 MG
    J0850GCytomegalovirus imm IV /vial0903$370.50$47.58
    J0895NDeferoxamine mesylate inj
    J0900NTestosterone enanthate inj
    J0945NBrompheniramine maleate inj
    J0970NEstradiol valerate injection
    J1000NDepo-estradiol cypionate inj
    J1020NMethylprednisolone 20 MG inj
    J1030NMethylprednisolone 40 MG inj
    J1040NMethylprednisolone 80 MG inj
    J1050NMedroxyprogesterone inj
    J1055EMedrxyprogester acetate inj
    *J1056EMA/EC contraceptiveinjection
    J1060NTestosterone cypionate 1 ML
    J1070NTestosterone cypionat 100 MG
    J1080NTestosterone cypionat 200 MG
    J1090DTestosterone cypionate 50 MG
    J1095NInj dexamethasone acetate
    J1100NDexamethasone sodium phos
    J1110NInj dihydroergotamine mesylt
    J1120NAcetazolamid sodium injectio
    J1160NDigoxin injection
    J1165NPhenytoin sodium injection
    J1170NHydromorphone injection
    J1180NDyphylline injection
    J1190GDexrazoxane HCL injection per 250 mg0726$194.52$24.98
    J1200NDiphenhydramine hcl injectio
    J1205NChlorothiazide sodium inj
    J1212NDimethyl sulfoxide 50% 50 ML
    J1230NMethadone injection
    J1240NDimenhydrinate injection
    J1245KDipyridamole injection, per 10 mg09170.34$17.31$3.46
    J1250NInj dobutamine HCL/250 mg
    J1260GDolasetron mesylate, per 10 mg0750$16.45$2.11
    *J1270NInjection, doxercalciferol
    J1320NAmitriptyline injection
    J1325GEpoprostenol injection 0.5 mg7003$12.04$1.72
    J1327GEptifibatide injection, 5 mg1607$11.31$1.45
    J1330NErgonovine maleate injection
    J1362DErythromycin glucep / 250 MG
    J1364NErythro lactobionate /500 MG
    J1380NEstradiol valerate 10 MG inj
    J1390NEstradiol valerate 20 MG inj
    J1410NInj estrogen conjugate 25 MG
    J1435NInjection estrone per 1 MG
    J1436GEtidronate disodium inj,per 300 mg0727$63.65$9.11
    J1438GEtanercept injection, 25 mg1608$141.01$20.19
    J1440GFilgrastim 300 mcg injection0728$179.08$23.00
    J1441GFilgrastim 480 mcg injection7049$285.38$36.65
    J1450NFluconazole
    J1452NIntraocular Fomivirsen na
    J1455NFoscarnet sodium injection
    J1460NGamma globulin 1 CC inj
    Start Printed Page 60068
    J1470EGamma globulin 2 CC inj
    J1480EGamma globulin 3 CC inj
    J1490EGamma globulin 4 CC inj
    J1500EGamma globulin 5 CC inj
    J1510EGamma globulin 6 CC inj
    J1520EGamma globulin 7 CC inj
    J1530EGamma globulin 8 CC inj
    J1540EGamma globulin 9 CC inj
    J1550EGamma globulin 10 CC inj
    J1560EGamma globulin > 10 CC inj
    J1561GImmune globulin 500 mg0905$35.63$3.23
    J1563EIV immune globulin
    J1565GRSV-IVIG 50 mg0906$15.51$1.99
    J1570KGanciclovir sodium injection 500 mg09070.42$21.38$4.28
    J1580NGaramycin gentamicin inj
    *J1590NGatifloxacin injection
    J1600NGold sodium thiomaleate inj
    J1610NGlucagon hydrochloride/1 MG
    J1620GGonadorelin hydroch/ 100 mcg7005$192.37$27.54
    J1626GGranisetron HCL injection 100 mcg0764$18.54$2.65
    J1630NHaloperidol injection
    J1631NHaloperidol decanoate inj
    J1642NInj heparin sodium per 10 u
    J1644NInj heparin sodium per 1000u
    J1645NDalteparin sodium
    J1650EInj enoxaparin sodium
    *J1655NTinzaparin sodium injection
    J1670GTetanus immune globulin inj up to 250 units0908$102.60$13.18
    J1690DPrednisolone tebutate inj
    J1700NHydrocortisone acetate inj
    J1710NHydrocortisone sodium ph inj
    J1720NHydrocortisone sodium succ i
    J1730NDiazoxide injection
    J1739DHydroxyprogesterone cap 125
    J1741DHydroxyprogesterone cap 250
    J1742NIbutilide fumarate injection
    J1745GInfliximab injection 10 mg7043$63.24$9.05
    J1750NIron dextran
    *J1755NIron sucrose injection
    J1785GInjection imiglucerase /unit0916$3.75$.54
    J1790NDroperidol injection
    J1800NPropranolol injection
    J1810EDroperidol/fentanyl inj, up to 2 ml
    J1820NInsulin injection
    J1825GInterferon beta-1a; 33 mcg0909$225.22$32.24
    J1830GInterferon beta-1b / .25 MG0910$68.40$9.79
    *J1835NIntraconazole injection
    J1840NKanamycin sulfate 500 MG inj
    J1850NKanamycin sulfate 75 MG inj
    J1885NKetorolac tromethamine inj
    J1890NCephalothin sodium injection
    J1910NKutapressin injection
    J1930DPropiomazine injection
    J1940NFurosemide injection
    J1950GLeuprolide acetate /3.75 mg0800$93.47$12.00
    J1955EInj levocarnitine per 1 gm
    J1956NLevofloxacin injection
    J1960NLevorphanol tartrate inj
    J1970DMethotrimeprazine injection
    J1980NHyoscyamine sulfate inj
    J1990NChlordiazepoxide injection
    J2000NLidocaine injection
    J2010NLincomycin injection
    *J2020GLinezolid inj, 200 mg9001$24.13$3.45
    J2060NLorazepam injection
    J2150NMannitol injection
    J2175NMeperidine hydrochl /100 MG
    J2180NMeperidine/promethazine inj
    J2210NMethylergonovin maleate inj
    J2240DMetocurine iodide injection
    J2250NInj midazolam hydrochloride
    J2260KMilrinone lactate / 5 ml70070.44$22.40$4.48
    J2270NMorphine sulfate injection
    J2271NMorphine so4 injection 100 mg
    J2275GMorphine sulfate injection, per 10 mg7010$1.02$.09
    Start Printed Page 60069
    J2300NInj nalbuphine hydrochloride
    J2310NInj naloxone hydrochloride
    J2320NNandrolone decanoate 50 MG
    J2321NNandrolone decanoate 100 MG
    J2322NNandrolone decanoate 200 MG
    J2330DThiothixene injection
    J2350DNiacinamide/niacin injection
    J2352GOctreotide acetate injection7031$138.08$19.77
    J2355GOprelvekin injection, 5 mg7011$245.81$35.19
    J2360NOrphenadrine injection
    J2370NPhenylephrine hcl injection
    J2400NChloroprocaine hcl injection
    J2405GOndansetron HCL injection, per 1 mg0768$6.09$.78
    J2410NOxymorphone hcl injection
    J2430GPamidronate disodium /30 mg0730$265.87$38.06
    J2440NPapaverin hcl injection
    J2460NOxytetracycline injection
    J2480DHydrochlorides of opium inj
    J2500NParicalcitol
    J2510NPenicillin g procaine inj
    J2512DInj pentagastrin per 2 ML
    J2515NPentobarbital sodium inj
    J2540NPenicillin g potassium inj
    J2543NPiperacillin/tazobactam
    J2545APentamidine isethionte/300 mg
    J2550NPromethazine hcl injection
    J2560NPhenobarbital sodium inj
    J2590NOxytocin injection
    J2597NInj desmopressin acetate
    J2640DPrednisolone sodium ph inj
    J2650NPrednisolone acetate inj
    J2670NTotazoline hcl injection
    J2675DInj progesterone per 50 MG
    J2680NFluphenazine decanoate 25 MG
    J2690NProcainamide hcl injection
    J2700NOxacillin sodium injeciton
    J2710NNeostigmine methylslfte inj
    J2720NInj protamine sulfate/10 MG
    J2725NInj protirelin per 250 mcg
    J2730NPralidoxime chloride inj
    J2760NPhentolaine mesylate inj
    J2765GMetoclopramide HCL injection up to 10 mg0754$1.17$.11
    J2770GQuinupristin/dalfopristin1024$102.05$13.11
    J2780NRanitidine hydrochloride inj
    J2790GRho d immune globulin inj [one dose package]0884$34.11$4.38
    J2792GRho(d) immune globulin h, sd, 100 I.U.1609$20.55$2.64
    J2795NRopivacaine HCl injection
    J2800NMethocarbamol injection
    J2810NInj theophylline per 40 MG
    J2820GSargramostim injection, 50 mcg0731$29.06$4.16
    J2860DSecobarbital sodium inj
    J2910NAurothioglucose injeciton
    J2912NSodium chloride injection
    J2915NNA Ferric Gluconate Complex
    J2920NMethylprednisolone injection
    J2930NMethylprednisolone injection
    *J2940GSomatrem injection7033$209.48$29.99
    *J2941GSomatropin injection7034$39.90$5.12
    J2950NPromazine hcl injeciton
    J2970DMethicillin sodium injection
    J2993GReteplase injection9005$1,306.25$187.00
    J2995KInj streptokinase /250000 IU09111.66$84.50$16.90
    J2997KAlteplase recombinant, 1 mg70480.36$18.33$3.67
    J3000NStreptomycin injection
    J3010GFentanyl citrate injeciton7014$1.23$.11
    J3030NSumatriptan succinate / 6 MG
    J3070NPentazocine hcl injeciton
    J3080DChlorprothixene injection
    *J3100GTenecteplase, 50 mg/vial9002$2,612.50$374.00
    J3105NTerbutaline sulfate inj
    J3120NTestosterone enanthate inj
    J3130NTestosterone enanthate inj
    J3140NTestosterone suspension inj
    J3150NTestosteron propionate inj
    J3230NChlorpromazine hcl injection
    Start Printed Page 60070
    J3240EThyrotropin injection
    J3245GTirofiban hydrochloride 12.5 mg7041$436.41$62.48
    J3250NTrimethobenzamide hcl inj
    J3260NTobramycin sulfate injection
    J3265NInjection torsemide 10 mg/ml
    J3270DImipramine hcl injection
    J3280GThiethylperazine maleate inj, up to 10 mg0755$4.60$.66
    J3301NTriamcinolone acetonide inj
    J3302NTriamcinolone diacetate inj
    J3303NTriamcinolone hexacetonl inj
    J3305GInj trimetrexate glucoronate7045$118.75$17.00
    J3310NPerphenazine injeciton
    J3320NSpectinomycn di-hcl inj
    J3350NUrea injection
    J3360NDiazepam injection
    J3364NUrokinase 5000 IU injection
    J3365KUrokinase 250,000 iu inj70366.41$326.29$65.26
    J3370NVancomycin hcl injeciton
    J3390DMethoxamine injection
    *J3395GVerteporfin for injection -15 mg1203$1,458.25$208.76
    J3400NTriflupromazine hcl inj
    J3410NHydroxyzine hcl injeciton
    J3420NVitamin b12 injection
    J3430NVitamin k phytonadione inj
    J3450DMephentermine sulfate inj
    J3470NHyaluronidase injection
    J3475NInj magnesium sulfate
    J3480NInj potassium chloride
    J3485NZidovudine
    J3490NDrugs unclassified injection
    J3520EEdetate disodium per 150 mg
    J3530NNasal vaccine inhalation
    J3535EMetered dose inhaler drug
    J3570ELaetrile amygdalin vit B17
    J7030NNormal saline solution infus
    J7040NNormal saline solution infus
    J7042N5% dextrose/normal saline
    J7050NNormal saline solution infus
    J7051NSterile saline/water
    J7060N5% dextrose/water
    J7070ND5w infusion
    J7100NDextran 40 infusion
    J7110NDextran 75 infusion
    J7120NRingers lactate infusion
    J7130NHypertonic saline solution
    J7190GFactor viii, per I.U.0925$.87$.08
    J7191GFactor VIII (porcine)0926$2.09$.30
    J7192GFactor viii recombinant, per I.U.0927$1.12$.14
    *J7193GFactor IX non-recombinant0931$26.13$3.74
    J7194GFactor IX complex per I.U.0928$.48$.04
    *J7195GFactor IX recombinant0932$1.12$.16
    J7197GAntithrombin iii injection per I.U.0930$1.05$.15
    J7198GAnti-inhibitor, per I.U.0929$1.43$.18
    J7199EHemophilia clot factor noc
    J7300EIntraut copper contraceptive
    *J7302ELevonorgestrel iu contracept
    *J7308NAminolevulinic acid hcl top
    J7310GGanciclovir long act implant, 4.5 mg0913$4,750.00$680.00
    J7315DSodium hyaluronate injection7315$26.13$3.74
    *J7316GSodium hyaluronate injection7315$26.13$3.74
    J7320GHylan g-f 20 injection, 16 mg1611$213.87$27.47
    J7330GCultured chondrocytes implnt, 16 mg1059$14,250.00$2,040.00
    *J7340EMetabolic active D/E tissue
    J7500GAzathioprine oral 50 mg0886$1.25$.11
    J7501GAzathioprine parenteral 100 mg0887$1.06$.10
    J7502GCyclosporine oral 100 mg0888$5.22$.67
    J7504GLymphocyte immune globulin, 250 mg0890$269.06$38.52
    J7505GMuromonab CD3, per 5 mg7038$269.06$38.52
    J7506GPrednisone oral7050$.07$.01
    J7507GTacrolimus oral per 1 mg0891$2.91$.42
    J7508ETacrolimus oral per 5 MG
    J7509NMethylprednisolone oral
    J7510NPrednisolone oral per 5 mg
    *J7511GAntithymocyte globuln rabbit9104$325.09$46.54
    J7513GDaclizumab, parenteral 25 mg1612$397.29$56.88
    Start Printed Page 60071
    J7515NCyclosporine oral 25 mg
    J7516GCyclosporin parenteral 250 mg0889$25.08$3.22
    J7517GMycophenolate mofetil oral 250 mg9015$2.40$.34
    J7520GSirolimus 1 mg/ml9106$6.51$.93
    J7525GTacrolimus injection9006$113.15$16.20
    J7599EImmunosuppressive drug noc
    J7608AAcetylcysteine inh sol u d
    J7618AAlbuterol inh sol con
    J7619AAlbuterol inh sol u d
    *J7622ABeclomethasome inhalatn sol
    *J7624ABetamethasome inhalation sol
    *J7626ABudesonide inhalation sol
    J7628ABitolterol mes inhal sol con
    J7629ABitolterol mes inh sol u d
    J7631ACromolyn sodium inh sol u d
    J7635AAtropine inhal sol con
    J7636AAtropine inhal sol unit dose
    J7637ADexamethasone inhal sol con
    J7638ADexamethasone inhal sol u d
    J7639ADornase alpha inhal sol u d
    *J7641AFlunisolide, inhalation sol
    J7642AGlycopyrrolate inhal sol con
    J7643AGlycopyrrolate inhal sol u d
    J7644AIpratropium brom inh sol u d
    J7648AIsoetharine hcl inh sol con
    J7649AIsoetharine hcl inh sol u d
    J7658AIsoproterenolhcl inh sol con
    J7659AIsoproterenol hcl inh sol ud
    J7668AMetaproterenol inh sol con
    J7669AMetaproterenol inh sol u d
    J7680ATerbutaline so4 inh sol con
    J7681ATerbutaline so4 inh sol u d
    J7682ATobramycin inhalation sol
    J7683ATriamcinolone inh sol con
    J7684ATriamcinolone inh sol u d
    J7699AInhalation solution for DME
    J7799ANon-inhalation drug for DME
    J8499EOral prescrip drug non chemo
    J8510GOral busulfan, 2 mg7015$1.91$.27
    J8520GCapecitabine, oral, 150 mg7042$2.43$.35
    J8521NCapecitabine, oral, 500 mg
    J8530GCyclophosphamide oral 25 mg0801$2.03$.18
    J8560GEtoposide oral 50 mg0802$52.43$6.73
    J8600GMelphalan oral 2 mg0803$2.29$.33
    J8610GMethotrexate oral 2.5 mg0826$3.45$.31
    J8700GTemozolomide, oral 5 mg1086$6.05$.87
    J8999EOral prescription drug chemo
    J9000GDoxorubicin HCL 10 mg0847$37.46$4.81
    J9001GDoxorubicin HCL liposome inj, 10 mg7046$358.95$51.39
    J9015GAldesleukin/single use vial0807$672.60$96.29
    *J9017GArsenic trioxide9012$23.75$3.40
    J9020GAsparaginase injection 10,000 units0814$62.61$8.96
    J9031GBcg live intravesical vac [per installation]0809$166.49$21.38
    J9040GBleomycin sulfate injection, 15 units0857$289.37$37.16
    J9045GCarboplatin injection, 50 mg0811$114.46$16.39
    J9050GCarmustine, 100 mg0812$117.84$16.87
    J9060GCisplatin 10 mg injection0813$42.18$3.82
    J9062ECisplatin 50 MG injeciton
    J9065Gcladribine per 1 mg0858$53.39$4.83
    J9070GCyclophosphamide 100 mg inj0815$5.82$.75
    J9080ECyclophosphamide 200 MG inj
    J9090ECyclophosphamide 500 MG inj
    J9091ECyclophosphamide 1.0 grm inj
    J9092ECyclophosphamide 2.0 grm inj
    J9093GCyclophosphamide lyophilized, 100 mg0816$4.89$.63
    J9094ECyclophosphamide lyophilized
    J9095ECyclophosphamide lyophilized
    J9096ECyclophosphamide lyophilized
    J9097ECyclophosphamide lyophilized
    J9100GCytarabine HCL 100 mg inj0817$6.10$.55
    J9110ECytarabine hcl 500 MG inj
    J9120GDactinomycin actinomycin 0.5 mg0818$13.87$1.99
    J9130GDacarbazine 100 mg inj0819$12.68$1.15
    J9140EDacarbazine 200 MG inj
    J9150GDaunorubicin, 10 mg0820$76.62$6.94
    Start Printed Page 60072
    J9151GDaunorubicin citrate liposom, 10 mg0821$64.60$9.25
    J9160GDenileukin diftitox, 300 MCG1084$999.88$143.14
    J9165GDiethylstilbestrol injection, 250 mg0822$14.41$1.30
    J9170GDocetaxel, 20 mg0823$297.83$42.64
    J9180EEpirubicin HCl injection
    J9181GEtoposide 10 mg inj0824$10.45$.95
    J9182EEtoposide 100 MG inj
    J9185GFludarabine phosphate inj 50 mg0842$271.82$38.91
    J9190GFluorouracil injection, 500 mg0859$2.73$.25
    J9200GFloxuridine injection [500 mg]0827$129.56$16.64
    J9201GGemcitabine hcl 200 mg0828$106.72$15.28
    J9202GGoserelin acetate implant, per 3.6 mg0810$446.49$63.92
    J9206GIrinotecan injection, 20 mg0830$134.25$19.22
    J9208GIfosfamide injection, per 1g0831$156.64$22.42
    J9209GMesna injection, 200 mg0732$36.48$3.30
    J9211GIdarubicin HCL injection, 5 mg0832$412.21$59.01
    J9212GInterferon alfacon-1, 1 mcg0833$4.10$.59
    J9213GInterferon alfa-2a inj, 3 million units0834$34.86$4.99
    J9214GInterferon alfa-2b inj, 1 million units0836$11.28$1.45
    J9215GInterferon alfa-n3 inj, 250, 000 I.U.0865$7.86$1.12
    J9216GInterferon gamma 1-b inj, 3 million units0838$285.65$40.89
    J9217GLeuprolide acetate suspnsion, 7.5 mg9217$592.60$84.84
    J9218GLeuprolide acetate injection, per 1 mg0861$69.79$6.32
    J9219GLeuprolide acetate implant, 65 mg7051$5,399.80$773.02
    J9230GMechlorethamine HCL inj, 10 mg0839$12.01$1.72
    J9245Gmelphalan hydrochl 50 mg0840$400.74$57.37
    J9250GMethotrexate sodium inj, 5 mg0841$.45$.04
    J9260EMethotrexate sodium inj
    J9265GPaclitaxel injection, 30 mg0863$173.50$22.28
    J9266EPegaspargase/singl dose vial
    J9268GPentostatin injection, 10 mg0844$1,654.14$236.80
    J9270GPlicamycin (mithramycin) inj, 2.5 mg0860$93.80$13.43
    J9280GMitomycin 5 mg inj0862$121.65$11.01
    J9290EMitomycin 20 MG inj
    J9291EMitomycin 40 MG inj
    J9293GMitoxantrone hydrochl per 5 mg0864$244.21$34.96
    *J9300GGemtuzumab ozogamicin inj, per 5 mg9004$1,929.69$276.25
    J9310GRituximab cancer treatment, 100 mg0849$454.55$65.07
    J9320GStreptozocin injection, 1 g0850$117.64$16.84
    J9340GThiotepa injection, 15 mg0851$116.97$10.59
    J9350GTopotecan, 4 mg0852$664.19$95.08
    J9355GTrastuzumab, 10 mg1613$52.83$7.56
    J9357GValrubicin, 200 mg1614$423.22$60.59
    J9360GVinblastine sulfate inj, 1 mg0853$4.11$.37
    J9370GVincristine sulfate 1 mg inj0854$30.16$3.87
    J9375EVincristine sulfate 2 MG inj
    J9380EVincristine sulfate 5 MG inj
    J9390GVinorelbine tartrate/10 mg0855$88.83$12.72
    J9600GPorfimer sodium, 75 mg0856$2,603.66$372.74
    J9999EChemotherapy drug
    K0001AStandard wheelchair
    K0002AStnd hemi (low seat) whlchr
    K0003ALightweight wheelchair
    K0004AHigh strength ltwt whlchr
    K0005AUltralightweight wheelchair
    K0006AHeavy duty wheelchair
    K0007AExtra heavy duty wheelchair
    K0008DCstm manual wheelchair/base
    K0009AOther manual wheelchair/base
    K0010AStnd wt frame power whlchr
    K0011AStnd wt pwr whlchr w control
    K0012ALtwt portbl power whlchr
    K0013DCustom power whlchr base
    K0014AOther power whlchr base
    K0015ADetach non-adjus hght armrst
    K0016ADetach adjust armrst cmplete
    K0017ADetach adjust armrest base
    K0018ADetach adjust armrst upper
    K0019AArm pad each
    K0020AFixed adjust armrest pair
    K0021AAnti-tipping device each
    K0022AReinforced back upholstery
    K0023APlanr back insrt foam w/strp
    K0024APlnr back insrt foam w/hrdwr
    K0025AHook-on headrest extension
    Start Printed Page 60073
    K0026ABack upholst lgtwt whlchr
    K0027ABack upholst other whlchr
    K0028AManual fully reclining back
    K0029AReinforced seat upholstery
    K0030ASolid plnr seat sngl dnsfoam
    K0031ASafety belt/pelvic strap
    K0032ASeat uphols lgtwt whlchr
    K0033ASeat upholstery other whlchr
    K0034AHeel loop each
    K0035AHeel loop with ankle strap
    K0036AToe loop each
    K0037AHigh mount flip-up footrest
    K0038ALeg strap each
    K0039ALeg strap h style each
    K0040AAdjustable angle footplate
    K0041ALarge size footplate each
    K0042AStandard size footplate each
    K0043AFtrst lower extension tube
    K0044AFtrst upper hanger bracket
    K0045AFootrest complete assembly
    K0046AElevat legrst low extension
    K0047AElevat legrst up hangr brack
    K0048AElevate legrest complete
    K0049ACalf pad each
    K0050ARatchet assembly
    K0051ACam relese assem ftrst/lgrst
    K0052ASwingaway detach footrest
    K0053AElevate footrest articulate
    K0054ASeat wdth 10-12/15/17/20 wc
    K0055ASeat dpth 15/17/18 ltwt wc
    K0056ASeat ht <17 or >=21 ltwt wc
    K0057ASeat wdth 19/20 hvy dty wc
    K0058ASeat dpth 17/18 power wc
    K0059APlastic coated handrim each
    K0060ASteel handrim each
    K0061AAluminum handrim each
    K0062AHandrim 8-10 vert/obliq proj
    K0063AHndrm 12-16 vert/obliq proj
    K0064AZero pressure tube flat free
    K0065ASpoke protectors
    K0066ASolid tire any size each
    K0067APneumatic tire any size each
    K0068APneumatic tire tube each
    K0069ARear whl complete solid tire
    K0070ARear whl compl pneum tire
    K0071AFront castr compl pneum tire
    K0072AFrnt cstr cmpl sem-pneum tir
    K0073ACaster pin lock each
    K0074APneumatic caster tire each
    K0075ASemi-pneumatic caster tire
    K0076ASolid caster tire each
    K0077AFront caster assem complete
    K0078APneumatic caster tire tube
    K0079AWheel lock extension pair
    K0080AAnti-rollback device pair
    K0081AWheel lock assembly complete
    K0082A22 nf deep cycl acid battery
    K0083A22 nf gel cell battery each
    K0084AGrp 24 deep cycl acid battry
    K0085AGroup 24 gel cell battery
    K0086AU-1 lead acid battery each
    K0087AU-1 gel cell battery each
    K0088ABattry chrgr acid/gel cell
    K0089ABattery charger dual mode
    K0090ARear tire power wheelchair
    K0091ARear tire tube power whlchr
    K0092ARear assem cmplt powr whlchr
    K0093ARear zero pressure tire tube
    K0094AWheel tire for power base
    K0095AWheel tire tube each base
    K0096AWheel assem powr base complt
    K0097AWheel zero presure tire tube
    K0098ADrive belt power wheelchair
    K0099APwr wheelchair front caster
    K0100AAmputee adapter pair
    Start Printed Page 60074
    K0101AOne-arm drive attachment
    K0102ACrutch and cane holder
    K0103ATransfer board < 25≧
    K0104ACylinder tank carrier
    K0105AIv hanger
    K0106AArm trough each
    K0107AWheelchair tray
    K0108AW/c component-accessory NOS
    K0112ATrunk vest supprt innr frame
    K0113ATrunk vest suprt w/o inr frm
    K0114AWhlchr back suprt inr frame
    K0115ABack module orthotic system
    K0116ABack & seat modul orthot sys
    K0183ANasal application device
    K0184ANasal pillows/seals pair
    K0185APos airway pressure headgear
    K0186APos airway prssure chinstrap
    K0187APos airway pressure tubing
    K0188APos airway pressure filter
    K0189AFilter nondisposable w PAP
    K0195AElevating whlchair leg rests
    K0268AHumidifier nonheated w PAP
    K0415ERX antiemetic drg, oral NOS
    K0416ERx antiemetic drg,rectal NOS
    K0452AWheelchair bearings
    K0455APump uninterrupted infusion
    K0460AWC power add-on joystick
    K0461AWC power add-on tiller cntrl
    K0462ATemporary replacement eqpmnt
    K0531AHeated humidifier used w pap
    K0532ANoninvasive assist wo backup
    K0533ANoninvasive assist w backup
    K0534AInvasive assist w backup
    K0538ANeg pressure wnd thrpy pump
    K0539ANeg pres wnd thrpy dsg set
    K0540ANeg pres wnd thrp canister
    K0541ASpeech generating device
    K0542ASpeech generating device
    K0543ASpeech generating device
    K0544ASpeech generating device
    K0545ASpeech generating software
    K0546AAccessory for sgd,mntng syst
    K0547AAccessory for sgd,not clasfd
    K0548AInsulin lispro
    K0549AHosp bed hvy dty xtra wide
    K0550AHosp bed xtra hvy dty x wide
    K0551AResidual limb support system
    L0100ACerv craniosten helmet mold
    L0110ACerv craniostenosis hel non-
    L0120ACerv flexible non-adjustable
    L0130AFlex thermoplastic collar mo
    L0140ACervical semi-rigid adjustab
    L0150ACerv semi-rig adj molded chn
    L0160ACerv semi-rig wire occ/mand
    L0170ACervical collar molded to pt
    L0172ACerv col thermplas foam 2 pi
    L0174ACerv col foam 2 piece w thor
    L0180ACer post col occ/man sup adj
    L0190ACerv collar supp adj cerv ba
    L0200ACerv col supp adj bar & thor
    L0210AThoracic rib belt
    L0220AThor rib belt custom fabrica
    L0300ATLSO flex surgical support
    L0310ATlso flexible custom fabrica
    L0315ATlso flex elas rigid post pa
    L0317ATlso flex hypext elas post p
    L0320ATlso a-p contrl w apron frnt
    *L0321ATlso anti-post-cntrl prefab
    L0330ATlso ant-pos-lateral control
    *L0331ATlso ant-post-lat cntrl prfb
    L0340ATlso a-p-l-rotary with apron
    L0350ATlso flex compress jacket cu
    L0360ATlso flex compress jacket mo
    L0370ATlso a-p-l-rotary hyperexten
    L0380ATlso a-p-l-rot w/ pos extens
    Start Printed Page 60075
    L0390ATlso a-p-l control molded
    *L0391ATlso ant-post-lat-rot cntrl
    L0400ATlso a-p-l w interface mater
    L0410ATlso a-p-l two piece constr
    L0420ATlso a-p-l 2 piece w interfa
    L0430ATlso a-p-l w interface custm
    L0440ATlso a-p-l overlap frnt cust
    L0500ALso flex surgical support
    L0510ALso flexible custom fabricat
    L0515ALso flex elas w/ rig post pa
    L0520ALso a-p-l control with apron
    L0530ALso ant-pos control w apron
    L0540ALso lumbar flexion a-p-l
    L0550ALso a-p-l control molded
    L0560ALso a-p-l w interface
    *L0561APrefab lso
    L0565ALso a-p-l control custom
    L0600ASacroiliac flex surg support
    L0610ASacroiliac flexible custm fa
    L0620ASacroiliac semi-rig w apron
    L0700ACtlso a-p-l control molded
    L0710ACtlso a-p-l control w/ inter
    L0810AHalo cervical into jckt vest
    L0820AHalo cervical into body jack
    L0830AHalo cerv into milwaukee typ
    L0860AMagnetic resonanc image comp
    L0900ATorso/ptosis support
    L0910ATorso & ptosis supp custm fa
    L0920ATorso/pendulous abd support
    L0930APendulous abdomen supp custm
    L0940ATorso/postsurgical support
    L0950APost surg support custom fab
    L0960APost surgical support pads
    L0970ATlso corset front
    L0972ALso corset front
    L0974ATlso full corset
    L0976ALso full corset
    L0978AAxillary crutch extension
    L0980APeroneal straps pair
    L0982AStocking supp grips set of f
    L0984AProtective body sock each
    *L0986ASpinal orth abdm pnl prefab
    L0999AAdd to spinal orthosis NOS
    L1000ACtlso milwauke initial model
    *L1005ATension based scoliosis orth
    L1010ACtlso axilla sling
    L1020AKyphosis pad
    L1025AKyphosis pad floating
    L1030ALumbar bolster pad
    L1040ALumbar or lumbar rib pad
    L1050ASternal pad
    L1060AThoracic pad
    L1070ATrapezius sling
    L1080AOutrigger
    L1085AOutrigger bil w/ vert extens
    L1090ALumbar sling
    L1100ARing flange plastic/leather
    L1110ARing flange plas/leather mol
    L1120ACovers for upright each
    L1200AFurnsh initial orthosis only
    L1210ALateral thoracic extension
    L1220AAnterior thoracic extension
    L1230AMilwaukee type superstructur
    L1240ALumbar derotation pad
    L1250AAnterior asis pad
    L1260AAnterior thoracic derotation
    L1270AAbdominal pad
    L1280ARib gusset (elastic) each
    L1290ALateral trochanteric pad
    L1300ABody jacket mold to patient
    L1310APost-operative body jacket
    L1499ASpinal orthosis NOS
    L1500AThkao mobility frame
    L1510AThkao standing frame
    L1520AThkao swivel walker
    Start Printed Page 60076
    L1600AAbduct hip flex frejka w cvr
    L1610AAbduct hip flex frejka covr
    L1620AAbduct hip flex pavlik harne
    L1630AAbduct control hip semi-flex
    L1640APelv band/spread bar thigh c
    L1650AHO abduction hip adjustable
    L1660AHO abduction static plastic
    L1680APelvic & hip control thigh c
    L1685APost-op hip abduct custom fa
    L1686AHO post-op hip abduction
    L1690ACombination bilateral HO
    L1700ALeg perthes orth toronto typ
    L1710ALegg perthes orth newington
    L1720ALegg perthes orthosis trilat
    L1730ALegg perthes orth scottish r
    L1750ALegg perthes sling
    L1755ALegg perthes patten bottom t
    L1800AKnee orthoses elas w stays
    L1810AKo elastic with joints
    L1815AElastic with condylar pads
    L1820AKo elas w/ condyle pads & jo
    L1825AKo elastic knee cap
    L1830AKo immobilizer canvas longit
    L1832AKO adj jnt pos rigid support
    L1834AKo w/0 joint rigid molded to
    L1840AKo derot ant cruciate custom
    L1843AKO single upright custom fit
    L1844AKo w/adj jt rot cntrl molded
    L1845AKo w/ adj flex/ext rotat cus
    L1846AKo w adj flex/ext rotat mold
    L1847AKO adjustable w air chambers
    L1850AKo swedish type
    L1855AKo plas doub upright jnt mol
    L1858AKo polycentric pneumatic pad
    L1860AKo supracondylar socket mold
    L1870AKo doub upright lacers molde
    L1880AKo doub upright cuffs/lacers
    L1885AKnee upright w/resistance
    L1900AAfo sprng wir drsflx calf bd
    L1902AAfo ankle gauntlet
    L1904AAfo molded ankle gauntlet
    L1906AAfo multiligamentus ankle su
    L1910AAfo sing bar clasp attach sh
    L1920AAfo sing upright w/ adjust s
    L1930AAfo plastic
    L1940AAfo molded to patient plasti
    L1945AAfo molded plas rig ant tib
    L1950AAfo spiral molded to pt plas
    L1960AAfo pos solid ank plastic mo
    L1970AAfo plastic molded w/ankle j
    L1980AAfo sing solid stirrup calf
    L1990AAfo doub solid stirrup calf
    L2000AKafo sing fre stirr thi/calf
    L2010AKafo sng solid stirrup w/o j
    L2020AKafo dbl solid stirrup band/
    L2030AKafo dbl solid stirrup w/o j
    L2035AKAFO plastic pediatric size
    L2036AKafo plas doub free knee mol
    L2037AKafo plas sing free knee mol
    L2038AKafo w/o joint multi-axis an
    L2039AKAFO,plstic,medlat rotat con
    L2040AHkafo torsion bil rot straps
    L2050AHkafo torsion cable hip pelv
    L2060AHkafo torsion ball bearing j
    L2070AHkafo torsion unilat rot str
    L2080AHkafo unilat torsion cable
    L2090AHkafo unilat torsion ball br
    L2102AAfo tibial fx cast plstr mol
    L2104AAfo tib fx cast synthetic mo
    L2106AAfo tib fx cast plaster mold
    L2108AAfo tib fx cast molded to pt
    L2112AAfo tibial fracture soft
    L2114AAfo tib fx semi-rigid
    L2116AAfo tibial fracture rigid
    L2122AKafo fem fx cast plaster mol
    Start Printed Page 60077
    L2124AKafo fem fx cast synthet mol
    L2126AKafo fem fx cast thermoplas
    L2128AKafo fem fx cast molded to p
    L2132AKafo femoral fx cast soft
    L2134AKafo fem fx cast semi-rigid
    L2136AKafo femoral fx cast rigid
    L2180APlas shoe insert w ank joint
    L2182ADrop lock knee
    L2184ALimited motion knee joint
    L2186AAdj motion knee jnt lerman t
    L2188AQuadrilateral brim
    L2190AWaist belt
    L2192APelvic band & belt thigh fla
    L2200ALimited ankle motion ea jnt
    L2210ADorsiflexion assist each joi
    L2220ADorsi & plantar flex ass/res
    L2230ASplit flat caliper stirr & p
    L2240ARound caliper and plate atta
    L2250AFoot plate molded stirrup at
    L2260AReinforced solid stirrup
    L2265ALong tongue stirrup
    L2270AVarus/valgus strap padded/li
    L2275APlastic mod low ext pad/line
    L2280AMolded inner boot
    L2300AAbduction bar jointed adjust
    L2310AAbduction bar-straight
    L2320ANon-molded lacer
    L2330ALacer molded to patient mode
    L2335AAnterior swing band
    L2340APre-tibial shell molded to p
    L2350AProsthetic type socket molde
    L2360AExtended steel shank
    L2370APatten bottom
    L2375ATorsion ank & half solid sti
    L2380ATorsion straight knee joint
    L2385AStraight knee joint heavy du
    L2390AOffset knee joint each
    L2395AOffset knee joint heavy duty
    L2397ASuspension sleeve lower ext
    L2405AKnee joint drop lock ea jnt
    L2415AKnee joint cam lock each joi
    L2425AKnee disc/dial lock/adj flex
    L2430AKnee jnt ratchet lock ea jnt
    L2435AKnee joint polycentric joint
    L2492AKnee lift loop drop lock rin
    L2500AThi/glut/ischia wgt bearing
    L2510ATh/wght bear quad-lat brim m
    L2520ATh/wght bear quad-lat brim c
    L2525ATh/wght bear nar m-l brim mo
    L2526ATh/wght bear nar m-l brim cu
    L2530AThigh/wght bear lacer non-mo
    L2540AThigh/wght bear lacer molded
    L2550AThigh/wght bear high roll cu
    L2570AHip clevis type 2 posit jnt
    L2580APelvic control pelvic sling
    L2600AHip clevis/thrust bearing fr
    L2610AHip clevis/thrust bearing lo
    L2620APelvic control hip heavy dut
    L2622AHip joint adjustable flexion
    L2624AHip adj flex ext abduct cont
    L2627APlastic mold recipro hip & c
    L2628AMetal frame recipro hip & ca
    L2630APelvic control band & belt u
    L2640APelvic control band & belt b
    L2650APelv & thor control gluteal
    L2660AThoracic control thoracic ba
    L2670AThorac cont paraspinal uprig
    L2680AThorac cont lat support upri
    L2750APlating chrome/nickel pr bar
    L2755ACarbon graphite lamination
    L2760AExtension per extension per
    *L2768AOrtho sidebar disconnect
    L2770ALow ext orthosis per bar/jnt
    L2780ANon-corrosive finish
    L2785ADrop lock retainer each
    Start Printed Page 60078
    L2795AKnee control full kneecap
    L2800AKnee cap medial or lateral p
    L2810AKnee control condylar pad
    L2820ASoft interface below knee se
    L2830ASoft interface above knee se
    L2840ATibial length sock fx or equ
    L2850AFemoral lgth sock fx or equa
    L2860ATorsion mechanism knee/ankle
    L2999ALower extremity orthosis NOS
    L3000EFt insert ucb berkeley shell
    L3001EFoot insert remov molded spe
    L3002EFoot insert plastazote or eq
    L3003EFoot insert silicone gel eac
    L3010EFoot longitudinal arch suppo
    L3020EFoot longitud/metatarsal sup
    L3030EFoot arch support remov prem
    L3040EFt arch suprt premold longit
    L3050EFoot arch supp premold metat
    L3060EFoot arch supp longitud/meta
    L3070EArch suprt att to sho longit
    L3080EArch supp att to shoe metata
    L3090EArch supp att to shoe long/m
    L3100EHallus-valgus nght dynamic s
    L3140EAbduction rotation bar shoe
    L3150EAbduct rotation bar w/o shoe
    L3160EShoe styled positioning dev
    L3170EFoot plastic heel stabilizer
    L3201EOxford w supinat/pronat inf
    L3202EOxford w/ supinat/pronator c
    L3203EOxford w/ supinator/pronator
    L3204EHightop w/ supp/pronator inf
    L3206EHightop w/ supp/pronator chi
    L3207EHightop w/ supp/pronator jun
    L3208ESurgical boot each infant
    L3209ESurgical boot each child
    L3211ESurgical boot each junior
    L3212EBenesch boot pair infant
    L3213EBenesch boot pair child
    L3214EBenesch boot pair junior
    L3215EOrthopedic ftwear ladies oxf
    L3216EOrthoped ladies shoes dpth i
    L3217ELadies shoes hightop depth i
    L3218ELadies surgical boot each
    L3219EOrthopedic mens shoes oxford
    L3221EOrthopedic mens shoes dpth i
    L3222EMens shoes hightop depth inl
    L3223EMens surgical boot each
    L3224AWoman's shoe oxford brace
    L3225AMan's shoe oxford brace
    L3230ECustom shoes depth inlay
    L3250ECustom mold shoe remov prost
    L3251EShoe molded to pt silicone s
    L3252EShoe molded plastazote cust
    L3253EShoe molded plastazote cust
    L3254EOrth foot non-stndard size/w
    L3255EOrth foot non-standard size/
    L3257EOrth foot add charge split s
    L3260EAmbulatory surgical boot eac
    L3265EPlastazote sandal each
    L3300ESho lift taper to metatarsal
    L3310EShoe lift elev heel/sole neo
    L3320EShoe lift elev heel/sole cor
    L3330ELifts elevation metal extens
    L3332EShoe lifts tapered to one-ha
    L3334EShoe lifts elevation heel /i
    L3340EShoe wedge sach
    L3350EShoe heel wedge
    L3360EShoe sole wedge outside sole
    L3370EShoe sole wedge between sole
    L3380EShoe clubfoot wedge
    L3390EShoe outflare wedge
    L3400EShoe metatarsal bar wedge ro
    L3410EShoe metatarsal bar between
    L3420EFull sole/heel wedge btween
    L3430ESho heel count plast reinfor
    Start Printed Page 60079
    L3440EHeel leather reinforced
    L3450EShoe heel sach cushion type
    L3455EShoe heel new leather standa
    L3460EShoe heel new rubber standar
    L3465EShoe heel thomas with wedge
    L3470EShoe heel thomas extend to b
    L3480EShoe heel pad & depress for
    L3485EShoe heel pad removable for
    L3500EOrtho shoe add leather insol
    L3510EOrthopedic shoe add rub insl
    L3520EO shoe add felt w leath insl
    L3530EOrtho shoe add half sole
    L3540EOrtho shoe add full sole
    L3550EO shoe add standard toe tap
    L3560EO shoe add horseshoe toe tap
    L3570EO shoe add instep extension
    L3580EO shoe add instep velcro clo
    L3590EO shoe convert to sof counte
    L3595EOrtho shoe add march bar
    L3600ETrans shoe calip plate exist
    L3610ETrans shoe caliper plate new
    L3620ETrans shoe solid stirrup exi
    L3630ETrans shoe solid stirrup new
    L3640EShoe dennis browne splint bo
    L3649EOrthopedic shoe modifica NOS
    L3650AShlder fig 8 abduct restrain
    L3660AAbduct restrainer canvas&web
    L3670AAcromio/clavicular canvas&we
    L3675ACanvas vest SO
    *L3677ASO hard plastic stabilizer
    L3700AElbow orthoses elas w stays
    L3710AElbow elastic with metal joi
    L3720AForearm/arm cuffs free motio
    L3730AForearm/arm cuffs ext/flex a
    L3740ACuffs adj lock w/ active con
    L3760EEO withjoint, Prefabricated
    L3800AWhfo short opponen no attach
    L3805AWhfo long opponens no attach
    L3807AWHFO,no joint, prefabricated
    L3810AWhfo thumb abduction bar
    L3815AWhfo second m.p. abduction a
    L3820AWhfo ip ext asst w/ mp ext s
    L3825AWhfo m.p. extension stop
    L3830AWhfo m.p. extension assist
    L3835AWhfo m.p. spring extension a
    L3840AWhfo spring swivel thumb
    L3845AWhfo thumb ip ext ass w/ mp
    L3850AAction wrist w/ dorsiflex as
    L3855AWhfo adj m.p. flexion contro
    L3860AWhfo adj m.p. flex ctrl & i.
    L3890ETorsion mechanism wrist/elbo
    L3900AHinge extension/flex wrist/f
    L3901AHinge ext/flex wrist finger
    L3902AWhfo ext power compress gas
    L3904AWhfo electric custom fitted
    L3906AWrist gauntlet molded to pt
    L3907AWhfo wrst gauntlt thmb spica
    L3908AWrist cock-up non-molded
    L3910AWhfo swanson design
    L3912AFlex glove w/elastic finger
    L3914AWHO wrist extension cock-up
    L3916AWhfo wrist extens w/ outrigg
    L3918AHFO knuckle bender
    L3920AKnuckle bender with outrigge
    L3922AKnuckle bend 2 seg to flex j
    L3923AHFO, no joint, prefabricated
    L3924AOppenheimer
    L3926AThomas suspension
    L3928AFinger extension w/ clock sp
    L3930AFinger extension with wrist
    L3932ASafety pin spring wire
    L3934ASafety pin modified
    L3936APalmer
    L3938ADorsal wrist
    L3940ADorsal wrist w/ outrigger at
    Start Printed Page 60080
    L3942AReverse knuckle bender
    L3944AReverse knuckle bend w/ outr
    L3946AHFO composite elastic
    L3948AFinger knuckle bender
    L3950AOppenheimer w/ knuckle bend
    L3952AOppenheimer w/ rev knuckle 2
    L3954ASpreading hand
    L3956AAdd joint upper ext orthosis
    L3960ASewho airplan desig abdu pos
    L3962ASewho erbs palsey design abd
    L3963AMolded w/ articulating elbow
    L3964ASeo mobile arm sup att to wc
    L3965AArm supp att to wc rancho ty
    L3966AMobile arm supports reclinin
    L3968AFriction dampening arm supp
    L3969AMonosuspension arm/hand supp
    L3970AElevat proximal arm support
    L3972AOffset/lat rocker arm w/ ela
    L3974AMobile arm support supinator
    L3980AUpp ext fx orthosis humeral
    L3982AUpper ext fx orthosis rad/ul
    L3984AUpper ext fx orthosis wrist
    L3985AForearm hand fx orth w/ wr h
    L3986AHumeral rad/ulna wrist fx or
    L3995ASock fracture or equal each
    L3999AUpper limb orthosis NOS
    L4000ARepl girdle milwaukee orth
    L4010AReplace trilateral socket br
    L4020AReplace quadlat socket brim
    L4030AReplace socket brim cust fit
    L4040AReplace molded thigh lacer
    L4045AReplace non-molded thigh lac
    L4050AReplace molded calf lacer
    L4055AReplace non-molded calf lace
    L4060AReplace high roll cuff
    L4070AReplace prox & dist upright
    L4080ARepl met band kafo-afo prox
    L4090ARepl met band kafo-afo calf/
    L4100ARepl leath cuff kafo prox th
    L4110ARepl leath cuff kafo-afo cal
    L4130AReplace pretibial shell
    L4205AOrtho dvc repair per 15 min
    L4210AOrth dev repair/repl minor p
    L4350APneumatic ankle cntrl splint
    L4360APneumatic walking splint
    L4370APneumatic full leg splint
    L4380APneumatic knee splint
    L4392AReplace AFO soft interface
    L4394AReplace foot drop spint
    L4396AStatic AFO
    L4398AFoot drop splint recumbent
    L5000ASho insert w arch toe filler
    L5010AMold socket ank hgt w/ toe f
    L5020ATibial tubercle hgt w/ toe f
    L5050AAnk symes mold sckt sach ft
    L5060ASymes met fr leath socket ar
    L5100AMolded socket shin sach foot
    L5105APlast socket jts/thgh lacer
    L5150AMold sckt ext knee shin sach
    L5160AMold socket bent knee shin s
    L5200AKne sing axis fric shin sach
    L5210ANo knee/ankle joints w/ ft b
    L5220ANo knee joint with artic ali
    L5230AFem focal defic constant fri
    L5250AHip canad sing axi cons fric
    L5270ATilt table locking hip sing
    L5280AHemipelvect canad sing axis
    L5300DBk sach soft cover & finish
    *L5301ABK mold socket SACH ft endo
    L5310DKnee disart sach soft cv/fin
    *L5311AKnee disart, SACH ft, endo
    L5320DAk open end sach soft cv/fin
    *L5321AAK open end SACH
    L5330DHip canadian sach sft cv/fin
    *L5331AHip disart canadian SACH ft
    Start Printed Page 60081
    L5340DHemipelvectomy canad cv/fin
    *L5341AHemipelvectomy canadian SACH
    L5400APostop dress & 1 cast chg bk
    L5410APostop dsg bk ea add cast ch
    L5420APostop dsg & 1 cast chg ak/d
    L5430APostop dsg ak ea add cast ch
    L5450APostop app non-wgt bear dsg
    L5460APostop app non-wgt bear dsg
    L5500AInit bk ptb plaster direct
    L5505AInit ak ischal plstr direct
    L5510APrep BK ptb plaster molded
    L5520APerp BK ptb thermopls direct
    L5530APrep BK ptb thermopls molded
    L5535APrep BK ptb open end socket
    L5540APrep BK ptb laminated socket
    L5560APrep AK ischial plast molded
    L5570APrep AK ischial direct form
    L5580APrep AK ischial thermo mold
    L5585APrep AK ischial open end
    L5590APrep AK ischial laminated
    L5595AHip disartic sach thermopls
    L5600AHip disart sach laminat mold
    L5610AAbove knee hydracadence
    L5611AAk 4 bar link w/fric swing
    L5613AAk 4 bar ling w/hydraul swig
    L5614A4-bar link above knee w/swng
    L5616AAk univ multiplex sys frict
    L5617AAK/BK self-aligning unit ea
    L5618ATest socket symes
    L5620ATest socket below knee
    L5622ATest socket knee disarticula
    L5624ATest socket above knee
    L5626ATest socket hip disarticulat
    L5628ATest socket hemipelvectomy
    L5629ABelow knee acrylic socket
    L5630ASyme typ expandabl wall sckt
    L5631AAk/knee disartic acrylic soc
    L5632ASymes type ptb brim design s
    L5634ASymes type poster opening so
    L5636ASymes type medial opening so
    L5637ABelow knee total contact
    L5638ABelow knee leather socket
    L5639ABelow knee wood socket
    L5640AKnee disarticulat leather so
    L5642AAbove knee leather socket
    L5643AHip flex inner socket ext fr
    L5644AAbove knee wood socket
    L5645ABk flex inner socket ext fra
    L5646ABelow knee air cushion socke
    L5647ABelow knee suction socket
    L5648AAbove knee air cushion socke
    L5649AIsch containmt/narrow m-l so
    L5650ATot contact ak/knee disart s
    L5651AAk flex inner socket ext fra
    L5652ASuction susp ak/knee disart
    L5653AKnee disart expand wall sock
    L5654ASocket insert symes
    L5655ASocket insert below knee
    L5656ASocket insert knee articulat
    L5658ASocket insert above knee
    L5660ASock insrt syme silicone gel
    L5661AMulti-durometer symes
    L5662ASocket insert bk silicone ge
    L5663ASock knee disartic silicone
    L5664ASocket insert ak silicone ge
    L5665AMulti-durometer below knee
    L5666ABelow knee cuff suspension
    L5667DSocket insert w lock lower
    L5668ASocket insert w/o lock lower
    L5669DBelow knee socket w/o lock
    L5670ABk molded supracondylar susp
    *L5671ABK/AK locking mechanism
    L5672ABk removable medial brim sus
    L5674ABk suspension sleeve
    L5675ABk heavy duty susp sleeve
    Start Printed Page 60082
    L5676ABk knee joints single axis p
    L5677ABk knee joints polycentric p
    L5678ABk joint covers pair
    L5680ABk thigh lacer non-molded
    L5682ABk thigh lacer glut/ischia m
    L5684ABk fork strap
    L5686ABk back check
    L5688ABk waist belt webbing
    L5690ABk waist belt padded and lin
    L5692AAk pelvic control belt light
    L5694AAk pelvic control belt pad/l
    L5695AAk sleeve susp neoprene/equa
    L5696AAk/knee disartic pelvic join
    L5697AAk/knee disartic pelvic band
    L5698AAk/knee disartic silesian ba
    L5699AShoulder harness
    L5700AReplace socket below knee
    L5701AReplace socket above knee
    L5702AReplace socket hip
    L5704ACustom shape covr below knee
    L5705ACustm shape cover above knee
    L5706ACustm shape cvr knee disart
    L5707ACustm shape cover hip disart
    L5710AKne-shin exo sng axi mnl loc
    L5711AKnee-shin exo mnl lock ultra
    L5712AKnee-shin exo frict swg & st
    L5714AKnee-shin exo variable frict
    L5716AKnee-shin exo mech stance ph
    L5718AKnee-shin exo frct swg & sta
    L5722AKnee-shin pneum swg frct exo
    L5724AKnee-shin exo fluid swing ph
    L5726AKnee-shin ext jnts fld swg e
    L5728AKnee-shin fluid swg & stance
    L5780AKnee-shin pneum/hydra pneum
    L5785AExoskeletal bk ultralt mater
    L5790AExoskeletal ak ultra-light m
    L5795AExoskel hip ultra-light mate
    L5810AEndoskel knee-shin mnl lock
    L5811AEndo knee-shin mnl lck ultra
    L5812AEndo knee-shin frct swg & st
    L5814AEndo knee-shin hydral swg ph
    L5816AEndo knee-shin polyc mch sta
    L5818AEndo knee-shin frct swg & st
    L5822AEndo knee-shin pneum swg frc
    L5824AEndo knee-shin fluid swing p
    L5826AMiniature knee joint
    L5828AEndo knee-shin fluid swg/sta
    L5830AEndo knee-shin pneum/swg pha
    L5840AMulti-axial knee/shin system
    L5845AKnee-shin sys stance flexion
    L5846AKnee-shin sys microprocessor
    *L5847AMicroprocessor cntrl feature
    L5850AEndo ak/hip knee extens assi
    L5855AMech hip extension assist
    L5910AEndo below knee alignable sy
    L5920AEndo ak/hip alignable system
    L5925AAbove knee manual lock
    L5930AHigh activity knee frame
    L5940AEndo bk ultra-light material
    L5950AEndo ak ultra-light material
    L5960AEndo hip ultra-light materia
    L5962ABelow knee flex cover system
    L5964AAbove knee flex cover system
    L5966AHip flexible cover system
    L5968AMultiaxial ankle w dorsiflex
    L5970AFoot external keel sach foot
    L5972AFlexible keel foot
    L5974AFoot single axis ankle/foot
    L5975ACombo ankle/foot prosthesis
    L5976AEnergy storing foot
    L5978AFt prosth multiaxial ankl/ft
    L5979AMulti-axial ankle/ft prosth
    L5980AFlex foot system
    L5981AFlex-walk sys low ext prosth
    L5982AExoskeletal axial rotation u
    Start Printed Page 60083
    L5984AEndoskeletal axial rotation
    L5985ALwr ext dynamic prosth pylon
    L5986AMulti-axial rotation unit
    L5987AShank ft w vert load pylon
    L5988AVertical shock reducing pylo
    *L5989APylon w elctrnc force sensor
    *L5990AUser adjustable heel height
    L5999ALowr extremity prosthes NOS
    L6000APar hand robin-aids thum rem
    L6010AHand robin-aids little/ring
    L6020APart hand robin-aids no fing
    L6050AWrst MLd sck flx hng tri pad
    L6055AWrst mold sock w/exp interfa
    L6100AElb mold sock flex hinge pad
    L6110AElbow mold sock suspension t
    L6120AElbow mold doub splt soc ste
    L6130AElbow stump activated lock h
    L6200AElbow mold outsid lock hinge
    L6205AElbow molded w/ expand inter
    L6250AElbow inter loc elbow forarm
    L6300AShlder disart int lock elbow
    L6310AShoulder passive restor comp
    L6320AShoulder passive restor cap
    L6350AThoracic intern lock elbow
    L6360AThoracic passive restor comp
    L6370AThoracic passive restor cap
    L6380APostop dsg cast chg wrst/elb
    L6382APostop dsg cast chg elb dis/
    L6384APostop dsg cast chg shlder/t
    L6386APostop ea cast chg & realign
    L6388APostop applicat rigid dsg on
    L6400ABelow elbow prosth tiss shap
    L6450AElb disart prosth tiss shap
    L6500AAbove elbow prosth tiss shap
    L6550AShldr disar prosth tiss shap
    L6570AScap thorac prosth tiss shap
    L6580AWrist/elbow bowden cable mol
    L6582AWrist/elbow bowden cbl dir f
    L6584AElbow fair lead cable molded
    L6586AElbow fair lead cable dir fo
    L6588AShdr fair lead cable molded
    L6590AShdr fair lead cable direct
    L6600APolycentric hinge pair
    L6605ASingle pivot hinge pair
    L6610AFlexible metal hinge pair
    L6615ADisconnect locking wrist uni
    L6616ADisconnect insert locking wr
    L6620AFlexion-friction wrist unit
    L6623ASpring-ass rot wrst w/ latch
    L6625ARotation wrst w/ cable lock
    L6628AQuick disconn hook adapter o
    L6629ALamination collar w/ couplin
    L6630AStainless steel any wrist
    L6632ALatex suspension sleeve each
    L6635ALift assist for elbow
    L6637ANudge control elbow lock
    L6640AShoulder abduction joint pai
    L6641AExcursion amplifier pulley t
    L6642AExcursion amplifier lever ty
    L6645AShoulder flexion-abduction j
    L6650AShoulder universal joint
    L6655AStandard control cable extra
    L6660AHeavy duty control cable
    L6665ATeflon or equal cable lining
    L6670AHook to hand cable adapter
    L6672AHarness chest/shlder saddle
    L6675AHarness figure of 8 sing con
    L6676AHarness figure of 8 dual con
    L6680ATest sock wrist disart/bel e
    L6682ATest sock elbw disart/above
    L6684ATest socket shldr disart/tho
    L6686ASuction socket
    L6687AFrame typ socket bel elbow/w
    L6688AFrame typ sock above elb/dis
    L6689AFrame typ socket shoulder di
    Start Printed Page 60084
    L6690AFrame typ sock interscap-tho
    L6691ARemovable insert each
    L6692ASilicone gel insert or equal
    L6693ALockingelbow forearm cntrbal
    L6700ATerminal device model #3
    L6705ATerminal device model #5
    L6710ATerminal device model #5x
    L6715ATerminal device model #5xa
    L6720ATerminal device model #6
    L6725ATerminal device model #7
    L6730ATerminal device model #7lo
    L6735ATerminal device model #8
    L6740ATerminal device model #8x
    L6745ATerminal device model #88x
    L6750ATerminal device model #10p
    L6755ATerminal device model #10x
    L6765ATerminal device model #12p
    L6770ATerminal device model #99x
    L6775ATerminal device model#555
    L6780ATerminal device model #ss555
    L6790AHooks-accu hook or equal
    L6795AHooks-2 load or equal
    L6800AHooks-aprl vc or equal
    L6805AModifier wrist flexion unit
    L6806ATrs grip vc or equal
    L6807ATerm device grip1/2 or equal
    L6808ATerm device infant or child
    L6809ATrs super sport passive
    L6810APincher tool otto bock or eq
    L6825AHands dorrance vo
    L6830AHand aprl vc
    L6835AHand sierra vo
    L6840AHand becker imperial
    L6845AHand becker lock grip
    L6850ATerm dvc-hand becker plylite
    L6855AHand robin-aids vo
    L6860AHand robin-aids vo soft
    L6865AHand passive hand
    L6867AHand detroit infant hand
    L6868APassive inf hand steeper/hos
    L6870AHand child mitt
    L6872AHand nyu child hand
    L6873AHand mech inf steeper or equ
    L6875AHand bock vc
    L6880AHand bock vo
    *L6881AAutograsp feature ul term dv
    *L6882AMicroprocessor control uplmb
    L6890AProduction glove
    L6895ACustom glove
    L6900AHand restorat thumb/1 finger
    L6905AHand restoration multiple fi
    L6910AHand restoration no fingers
    L6915AHand restoration replacmnt g
    L6920AWrist disarticul switch ctrl
    L6925AWrist disart myoelectronic c
    L6930ABelow elbow switch control
    L6935ABelow elbow myoelectronic ct
    L6940AElbow disarticulation switch
    L6945AElbow disart myoelectronic c
    L6950AAbove elbow switch control
    L6955AAbove elbow myoelectronic ct
    L6960AShldr disartic switch contro
    L6965AShldr disartic myoelectronic
    L6970AInterscapular-thor switch ct
    L6975AInterscap-thor myoelectronic
    L7010AHand otto back steeper/eq sw
    L7015AHand sys teknik village swit
    L7020AElectronic greifer switch ct
    L7025AElectron hand myoelectronic
    L7030AHand sys teknik vill myoelec
    L7035AElectron greifer myoelectro
    L7040APrehensile actuator hosmer s
    L7045AElectron hook child michigan
    L7170AElectronic elbow hosmer swit
    L7180AElectronic elbow utah myoele
    Start Printed Page 60085
    L7185AElectron elbow adolescent sw
    L7186AElectron elbow child switch
    L7190AElbow adolescent myoelectron
    L7191AElbow child myoelectronic ct
    L7260AElectron wrist rotator otto
    L7261AElectron wrist rotator utah
    L7266AServo control steeper or equ
    L7272AAnalogue control unb or equa
    L7274AProportional ctl 12 volt uta
    L7360ASix volt bat otto bock/eq ea
    L7362ABattery chrgr six volt otto
    L7364ATwelve volt battery utah/equ
    L7366ABattery chrgr 12 volt utah/e
    L7499AUpper extremity prosthes NOS
    L7500AProsthetic dvc repair hourly
    L7510AProsthetic device repair rep
    L7520ARepair prosthesis per 15 min
    L7900AVacuum erection system
    L8000AMastectomy bra
    *L8001ABreast prosthesis bra and form
    *L8002ABrst prsth bra & bilat form
    L8010AMastectomy sleeve
    L8015AExt breastprosthesis garment
    L8020AMastectomy form
    L8030ABreast prosthesis silicone/e
    L8035ACustom breast prosthesis
    L8039ABreast prosthesis NOS
    L8040ANasal prosthesis
    L8041AMidfacial prosthesis
    L8042AOrbital prosthesis
    L8043AUpper facial prosthesis
    L8044AHemi-facial prosthesis
    L8045AAuricular prosthesis
    L8046APartial facial prosthesis
    L8047ANasal septal prosthesis
    L8048AUnspec maxillofacial prosth
    L8049ARepair maxillofacial prosth
    L8100ECompression stocking BK18-30
    L8110ECompression stocking BK30-40
    L8120ECompression stocking BK40-50
    L8130EGc stocking thighlngth 18-30
    L8140EGc stocking thighlngth 30-40
    L8150EGc stocking thighlngth 40-50
    L8160EGc stocking full lngth 18-30
    L8170EGc stocking full lngth 30-40
    L8180EGc stocking full lngth 40-50
    L8190EGc stocking waistlngth 18-30
    L8195EGc stocking waistlngth 30-40
    L8200EGc stocking waistlngth 40-50
    L8210EGc stocking custom made
    L8220EGc stocking lymphedema
    L8230EGc stocking garter belt
    L8239EG compression stocking NOS
    L8300ATruss single w/ standard pad
    L8310ATruss double w/ standard pad
    L8320ATruss addition to std pad wa
    L8330ATruss add to std pad scrotal
    L8400ASheath below knee
    L8410ASheath above knee
    L8415ASheath upper limb
    L8417APros sheath/sock w gel cushn
    L8420AProsthetic sock multi ply BK
    L8430AProsthetic sock multi ply AK
    L8435APros sock multi ply upper lm
    L8440AShrinker below knee
    L8460AShrinker above knee
    L8465AShrinker upper limb
    L8470APros sock single ply BK
    L8480APros sock single ply AK
    L8485APros sock single ply upper l
    L8490AAir seal suction reten systm
    L8499AUnlisted misc prosthetic ser
    L8500AArtificial larynx
    L8501ATracheostomy speaking valve
    *L8505AArtificial larynx, accessory
    Start Printed Page 60086
    *L8507ATrach-esoph voice pros pt in
    *L8509ATrach-esoph voice pros md in
    *L8510AVoice amplifier
    L8600NImplant breast silicone/eq
    L8603NCollagen imp urinary 2.5 ml
    L8606ASynthetic implnt urinary 1ml
    L8610NOcular implant
    L8612NAqueous shunt prosthesis
    L8613NOssicular implant
    L8614ECochlear device/system
    L8619AReplace cochlear processor
    L8630NMetacarpophalangeal implant
    L8641NMetatarsal joint implant
    L8642NHallux implant
    L8658NInterphalangeal joint implnt
    L8670NVascular graft, synthetic
    L8699NProsthetic implant NOS
    L9900AO&P supply/accessory/service
    M0064XVisit for drug monitoring03740.89$45.30$9.97$9.06
    M0075ECellular therapy
    M0076EProlotherapy
    M0100EIntragastric hypothermia
    M0300EIV chelationtherapy
    M0301EFabric wrapping of aneurysm
    M0302DAssessment of cardiac output0970$25.00$5.00
    P2028ACephalin floculation test
    P2029ACongo red blood test
    P2031EHair analysis
    P2033ABlood thymol turbidity
    P2038ABlood mucoprotein
    P3000AScreen pap by tech w md supv
    P3001EScreening pap smear by phys
    P7001ECulture bacterial urine
    P9010KWhole blood for transfusion09501.97$100.28$20.06
    P9011EBlood split unit
    P9012KCryoprecipitate each unit09520.66$33.60$6.72
    P9016KRBC leukocytes reduced09542.67$135.91$27.18
    P9017KOne donor fresh frozn plasma09552.13$108.43$21.69
    P9019KPlatelets, each unit09570.93$47.34$9.47
    P9020KPlaelet rich plasma unit09581.10$55.99$11.20
    P9021KRed blood cells unit09591.93$98.24$19.65
    P9022KWashed red blood cells unit09603.60$183.25$36.65
    P9023KFrozen plasma, pooled, sd09492.78$141.51$28.30
    P9031KPlatelets leukocytes reduced09542.67$135.91$27.18
    P9032KPlatelets, irradiated95001.68$85.52$17.10
    P9033KPlatelets leukoreduced irrad09542.67$135.91$27.18
    P9034KPlatelets, pheresis95019.16$466.28$93.26
    P9035KPlatelet pheres leukoreduced95019.16$466.28$93.26
    P9036KPlatelet pheresis irradiated95029.94$505.99$101.20
    P9037KPlt, aph/pher, L/R, irrad10199.11$463.74$92.75
    P9038KRBC irradiated95052.44$124.21$24.84
    P9039KRBC deglycerolized95044.11$209.22$41.84
    P9040KRBC leukoreduced irradiated95044.11$209.22$41.84
    P9041KAlbumin(human), 5%, 50ml09612.07$105.37$21.07
    P9042DAlbumin (human), 25%, 10ml09621.04$52.94$10.59
    P9043KPlasma protein fraction09561.19$60.58$12.12
    P9044KCryoprecipitatereducedplasma10090.82$41.74$8.35
    *P9045KAlbumin (human), 5%, 250 ml096310.35$526.86$105.37
    *P9046KAlbumin (human), 25%, 20 ml09642.08$105.88$21.18
    *P9047KAlbumin (human), 25%, 50ml09655.20$264.70$52.94
    *P9048KPlasmaprotein fract,5%,250ml09665.95$302.88$60.58
    *P9050KGranulocytes, pheresis unit950627.75$1,412.59$282.52
    P9603AOne-way allow prorated miles
    P9604AOne-way allow prorated trip
    P9612NCatheterize for urine spec
    P9615NUrine specimen collect mult
    Q0035XCardiokymography01001.47$74.83$41.15$14.97
    Q0081DInfusion ther other than che01203.08$156.78$42.67$31.36
    Q0083SChemo by other than infusion01160.91$46.32$9.26
    Q0084SChemotherapy by infusion01174.01$204.13$52.69$40.83
    Q0085SChemo by both infusion and o01184.20$213.80$72.03$42.76
    Q0086DPhysical therapy evaluation/
    Q0091TObtaining screen pap smear01910.23$11.71$3.40$2.34
    Q0092NSet up port xray equipment
    Q0111AWet mounts/ w preparations
    Start Printed Page 60087
    Q0112APotassium hydroxide preps
    Q0113APinworm examinations
    Q0114AFern test
    Q0115APost-coital mucous exam
    Q0136GNon esrd epoetin alpha inj per 1000 units0733$12.26$1.57
    Q0144DAzithromycin dihydrate, oral
    Q0160DFactor IX non-recombinant0931$26.13$3.74
    Q0161DFactor IX recombinant0932$1.12$.14
    Q0163GDiphenhydramine HCL 50 mg1400$.23$.02
    Q0164GProchlorperazine maleate 5 mg1401$.65$.06
    Q0165EProchlorperazine maleate 10 mg
    Q0166GGranisetron HCL 1 mg oral0765$44.69$6.40
    Q0167GDronabinol 2.5 mg oral0762$3.28$.42
    Q0168EDronabinol 5 mg oral
    Q0169GPromethazine HCL 12.5 mg oral1402$.01$.00
    Q0170EPromethazine HCl 25 mg oral
    Q0171GChlorpromazine HCL 10 mg oral1403$.27$.02
    Q0172EChlorpromazine HCl 25 mg oral
    Q0173GTrimethobenzamide HCL 250 mg1404$.38$.03
    Q0174GThiethylperazine maleate 10 mg1405$.56$.08
    Q0175GPerphenazine 4 mg oral1406$.62$.06
    Q0176EPerphenazine 8 mg oral
    Q0177GHydroxyzine pamoate 25 mg1407$.28$.03
    Q0178EHydroxyzine pamoate 50 mg
    Q0179GOndansetron HCL 8 mg oral0769$26.41$3.39
    Q0180GDolasetron mesylate oral, 100 mg0763$69.64$8.94
    Q0181EUnspecified oral anti-emetic
    Q0183NNonmetabolic active tissue
    Q0184NMetabolically active tissue
    Q0185DMetabolic active D/E tissue
    Q0187GFactor VIII recombinant, per 1.2 mg1409$1,596.00$228.48
    Q1001ENtiol category 1
    Q1002ENtiol category 2
    Q1003ENtiol category 3
    Q1004ENtiol category 4
    Q1005ENtiol category 5
    Q2001NOral cabergoline 0.5 mg
    Q2002GElliotts b solution per ml7022$1.43$.20
    Q2003GAprotinin, 10,000 kiu7019$2.16$.31
    Q2004GBladder calculi irrig sol7023$24.70$3.54
    Q2005GCorticorelin ovine triflutat7024$368.03$52.69
    Q2006GDigoxin immune fab (ovine)7025$551.66$78.97
    Q2007GEthanolamine oleate 100 mg7026$39.73$5.69
    Q2008GFomepizole, 15 mg7027$10.93$1.56
    Q2009GFosphenytoin, 50 mg7028$5.73$.82
    Q2010GGlatiramer acetate, per dose7029$30.07$4.30
    Q2011GHemin, per 1 mg7030$.99$.14
    Q2012GPegademase bovine, 25 iu7039$139.33$19.95
    Q2013GPentastarch 10% solution7040$15.11$2.16
    Q2014GSermorelin acetate, 0.5 mg7032$13.60$1.95
    Q2015DSomatrem, 5 mg7033$209.48$29.99
    Q2016DSomatropin, 1 mg7034$39.90$5.12
    Q2017GTeniposide, 50 mg7035$222.80$31.90
    Q2018GUrofollitropin, 75 iu7037$73.29$10.49
    Q2019GBasiliximab 20 mg1615$1,437.78$205.83
    Q2020EHistrelin acetate, 10 mg
    Q2021GLepirudin1617$131.96$18.89
    Q2022GVonWillebrandFactrCmplxperIU1618$.95$.14
    Q3001EBrachytherapy Radioelements
    Q3002GGallium ga 67, per mCi1619$25.62$2.32
    Q3003GTechnetium tc99m bicisate1620$403.99$57.83
    Q3004GXenon xe 1331621$29.93$2.71
    Q3005GTechnetium tc99m mertiatide1622$137.75$19.72
    Q3006GTechnetium tc99m glucepatate1623$22.61$3.24
    Q3007GSodium phosphate p321624$54.34$7.78
    Q3008GIndium 111-in pentetreotide1625$935.75$133.96
    Q3009GTechnetium tc99m oxidronate1626$1.47$.21
    Q3010GTechnetium tc99mlabeledrbcs1627$40.90$5.85
    Q3011GChromic phosphate p321628$150.86$21.60
    Q3012GCo 57, 0.5 Mci1089$81.10$10.41
    Q3013DVerteporfin injection
    Q3014ATelehealth facility fee
    Q3017AAmb srv, ALS assmt, no oth als
    Q4001ACast sup body cast plaster
    Q4002ACast sup body cast fiberglas
    Start Printed Page 60088
    Q4003ACast sup shoulder cast plstr
    Q4004ACast sup shoulder cast fbrgl
    Q4005ACast sup long arm adult plst
    Q4006ACast sup long arm adult fbrg
    Q4007ACast sup long arm ped plster
    Q4008ACast sup long arm ped fbrgls
    Q4009ACast sup sht arm adult plstr
    Q4010ACast sup sht arm adult fbrgl
    Q4011ACast sup sht arm ped plaster
    Q4012ACast sup sht arm ped fbrglas
    Q4013ACast sup gauntlet plaster
    Q4014ACast sup gauntlet fiberglass
    Q4015ACast sup gauntlet ped plster
    Q4016ACast sup gauntlet ped fbrgls
    Q4017ACast sup lng arm splint plst
    Q4018ACast sup lng arm splint fbrg
    Q4019ACast sup lng arm splnt ped p
    Q4020ACast sup lng arm splnt ped f
    Q4021ACast sup sht arm splint plst
    Q4022ACast sup sht arm splint fbrg
    Q4023ACast sup sht arm splnt ped p
    Q4024ACast sup sht arm splnt ped f
    Q4025ACast sup hip spica plaster
    Q4026ACast sup hip spica fiberglas
    Q4027ACast sup hip spica ped plstr
    Q4028ACast sup hip spica ped fbrgl
    Q4029ACast sup long leg plaster
    Q4030ACast sup long leg fiberglass
    Q4031ACast sup lng leg ped plaster
    Q4032ACast sup lng leg ped fbrgls
    Q4033ACast sup lng leg cylinder pl
    Q4034ACast sup lng leg cylinder fb
    Q4035ACast sup lngleg cylndr ped p
    Q4036ACast sup lngleg cylndr ped f
    Q4037ACast sup shrt leg plaster
    Q4038ACast sup shrt leg fiberglass
    Q4039ACast sup shrt leg ped plster
    Q4040ACast sup shrt leg ped fbrgls
    Q4041ACast sup lng leg splnt plstr
    Q4042ACast sup lng leg splnt fbrgl
    Q4043ACast sup lng leg splnt ped p
    Q4044ACast sup lng leg splnt ped f
    Q4045ACast sup sht leg splnt plstr
    Q4046ACast sup sht leg splnt fbrgl
    Q4047ACast sup sht leg splnt ped p
    Q4048ACast sup sht leg splnt ped f
    Q4049AFinger splint, static
    Q4050ACast supplies unlisted
    Q4051ASplint supplies misc
    Q9920AEpoetin with hct <= 20
    Q9921AEpoetin with hct = 21
    Q9922AEpoetin with hct = 22
    Q9923AEpoetin with hct = 23
    Q9924AEpoetin with hct = 24
    Q9925AEpoetin with hct = 25
    Q9926AEpoetin with hct = 26
    Q9927AEpoetin with hct = 27
    Q9928AEpoetin with hct = 28
    Q9929AEpoetin with hct = 29
    Q9930AEpoetin with hct = 30
    Q9931AEpoetin with hct = 31
    Q9932AEpoetin with hct = 32
    Q9933AEpoetin with hct = 33
    Q9934AEpoetin with hct = 34
    Q9935AEpoetin with hct = 35
    Q9936AEpoetin with hct = 36
    Q9937AEpoetin with hct = 37
    Q9938AEpoetin with hct = 38
    Q9939AEpoetin with hct = 39
    Q9940AEpoetin with hct >= 40
    R0070NTransport portable x-ray
    R0075NTransport port x-ray multipl
    R0076NTransport portable EKG
    *T1015EClinic service
    V2020AVision svcs frames purchases
    Start Printed Page 60089
    V2025EEyeglasses delux frames
    V2100ALens spher single plano 4.00
    V2101ASingle visn sphere 4.12-7.00
    V2102ASingl visn sphere 7.12-20.00
    V2103ASpherocylindr 4.00d/12-2.00d
    V2104ASpherocylindr 4.00d/2.12-4d
    V2105ASpherocylinder 4.00d/4.25-6d
    V2106ASpherocylinder 4.00d/>6.00d
    V2107ASpherocylinder 4.25d/12-2d
    V2108ASpherocylinder 4.25d/2.12-4d
    V2109ASpherocylinder 4.25d/4.25-6d
    V2110ASpherocylinder 4.25d/over 6d
    V2111ASpherocylindr 7.25d/.25-2.25
    V2112ASpherocylindr 7.25d/2.25-4d
    V2113ASpherocylindr 7.25d/4.25-6d
    V2114ASpherocylinder over 12.00d
    V2115ALens lenticular bifocal
    V2116ANonaspheric lens bifocal
    V2117AAspheric lens bifocal
    V2118ALens aniseikonic single
    V2199ALens single vision not oth c
    V2200ALens spher bifoc plano 4.00d
    V2201ALens sphere bifocal 4.12-7.0
    V2202ALens sphere bifocal 7.12-20.
    V2203ALens sphcyl bifocal 4.00d/.1
    V2204ALens sphcy bifocal 4.00d/2.1
    V2205ALens sphcy bifocal 4.00d/4.2
    V2206ALens sphcy bifocal 4.00d/ove
    V2207ALens sphcy bifocal 4.25-7d/.
    V2208ALens sphcy bifocal 4.25-7/2.
    V2209ALens sphcy bifocal 4.25-7/4.
    V2210ALens sphcy bifocal 4.25-7/ov
    V2211ALens sphcy bifo 7.25-12/.25-
    V2212ALens sphcyl bifo 7.25-12/2.2
    V2213ALens sphcyl bifo 7.25-12/4.2
    V2214ALens sphcyl bifocal over 12.
    V2215ALens lenticular bifocal
    V2216ALens lenticular nonaspheric
    V2217ALens lenticular aspheric bif
    V2218ALens aniseikonic bifocal
    V2219ALens bifocal seg width over
    V2220ALens bifocal add over 3.25d
    V2299ALens bifocal speciality
    V2300ALens sphere trifocal 4.00d
    V2301ALens sphere trifocal 4.12-7.
    V2302ALens sphere trifocal 7.12-20
    V2303ALens sphcy trifocal 4.0/.12-
    V2304ALens sphcy trifocal 4.0/2.25
    V2305ALens sphcy trifocal 4.0/4.25
    V2306ALens sphcyl trifocal 4.00/>6
    V2307ALens sphcy trifocal 4.25-7/.
    V2308ALens sphc trifocal 4.25-7/2.
    V2309ALens sphc trifocal 4.25-7/4.
    V2310ALens sphc trifocal 4.25-7/>6
    V2311ALens sphc trifo 7.25-12/.25-
    V2312ALens sphc trifo 7.25-12/2.25
    V2313ALens sphc trifo 7.25-12/4.25
    V2314ALens sphcyl trifocal over 12
    V2315ALens lenticular trifocal
    V2316ALens lenticular nonaspheric
    V2317ALens lenticular aspheric tri
    V2318ALens aniseikonic trifocal
    V2319ALens trifocal seg width > 28
    V2320ALens trifocal add over 3.25d
    V2399ALens trifocal speciality
    V2410ALens variab asphericity sing
    V2430ALens variable asphericity bi
    V2499AVariable asphericity lens
    V2500AContact lens pmma spherical
    V2501ACntct lens pmma-toric/prism
    V2502AContact lens pmma bifocal
    V2503ACntct lens pmma color vision
    V2510ACntct gas permeable sphericl
    V2511ACntct toric prism ballast
    V2512ACntct lens gas permbl bifocl
    Start Printed Page 60090
    V2513AContact lens extended wear
    V2520AContact lens hydrophilic
    V2521ACntct lens hydrophilic toric
    V2522ACntct lens hydrophil bifocl
    V2523ACntct lens hydrophil extend
    V2530AContact lens gas impermeable
    V2531AContact lens gas permeable
    V2599AContact lens/es other type
    V2600AHand held low vision aids
    V2610ASingle lens spectacle mount
    V2615ATelescop/othr compound lens
    V2623APlastic eye prosth custom
    V2624APolishing artifical eye
    V2625AEnlargemnt of eye prosthesis
    V2626AReduction of eye prosthesis
    V2627AScleral cover shell
    V2628AFabrication & fitting
    V2629AProsthetic eye other type
    V2630NAnter chamber intraocul lens
    V2631NIris support intraoclr lens
    V2632NPost chmbr intraocular lens
    V2700ABalance lens
    V2710AGlass/plastic slab off prism
    V2715APrism lens/es
    V2718AFresnell prism press-on lens
    V2730ASpecial base curve
    V2740ARose tint plastic
    V2741ANon-rose tint plastic
    V2742ARose tint glass
    V2743ANon-rose tint glass
    V2744ATint photochromatic lens/es
    V2750AAnti-reflective coating
    V2755AUV lens/es
    V2760AScratch resistant coating
    V2770AOccluder lens/es
    V2780AOversize lens/es
    V2781EProgressive lens per lens
    V2785FCorneal tissue processing
    V2790NAmniotic membrane
    V2799AMiscellaneous vision service
    V5008EHearing screening
    V5010EAssessment for hearing aid
    V5011EHearing aid fitting/checking
    V5014EHearing aid repair/modifying
    V5020EConformity evaluation
    V5030EBody-worn hearing aid air
    V5040EBody-worn hearing aid bone
    V5050EHearing aid monaural in ear
    V5060EBehind ear hearing aid
    V5070EGlasses air conduction
    V5080EGlasses bone conduction
    V5090EHearing aid dispensing fee
    V5100EBody-worn bilat hearing aid
    V5110EHearing aid dispensing fee
    V5120EBody-worn binaur hearing aid
    V5130EIn ear binaural hearing aid
    V5140EBehind ear binaur hearing ai
    V5150EGlasses binaural hearing aid
    V5160EDispensing fee binaural
    V5170EWithin ear cros hearing aid
    V5180EBehind ear cros hearing aid
    V5190EGlasses cros hearing aid
    V5200ECros hearing aid dispens fee
    V5210EIn ear bicros hearing aid
    V5220EBehind ear bicros hearing ai
    V5230EGlasses bicros hearing aid
    V5240EDispensing fee bicros
    *V5241EDispensing fee, monaural
    *V5242EHearing aid, monaural, cic
    *V5243EHearing aid, monaural, itc
    *V5244EHearing aid, prog, mon, cic
    *V5245EHearing aid, prog, mon, itc
    *V5246EHearing aid, prog, mon, ite
    *V5247EHearing aid, prog, mon, bte
    *V5248EHearing aid, binaural, cic
    Start Printed Page 60091
    *V5249EHearing aid, binaural, itc
    *V5250EHearing aid, prog, bin, cic
    *V5251EHearing aid, prog, bin, itc
    *V5252EHearing aid, prog, bin, ite
    *V5253EHearing aid, prog, bin, bte
    *V5254EHearing id, digit, mon, cic
    *V5255EHearing aid, digit, mon, itc
    *V5256EHearing aid, digit, mon, ite
    *V5257EHearing aid, digit, mon, bte
    *V5258EHearing aid, digit, bin, cic
    *V5259EHearing aid, digit, bin, itc
    *V5260EHearing aid, digit, bin, ite
    *V5261EHearing aid, digit, bin, bte
    *V5262EHearing aid, disp, monaural
    *V5263EHearing aid, disp, binaural
    *V5264EEar mold/insert
    *V5265EEar mold/insert, disp
    *V5266EBattery for hearing device
    *V5267EHearing aid supply/accessory
    *V5268EALD Telephone Amplifier
    *V5269EAlerting device, any type
    *V5270EALD, TV amplifier, any type
    *V5271EALD, TV caption decoder
    *V5272ETdd
    *V5273EALD for cochlear implant
    *V5274EALD unspecified
    *V5275EEar impression
    V5299EHearing service
    V5336ERepair communication device
    V5362ASpeech screening
    V5363ALanguage screening
    V5364ADysphagia screening
    CPT codes and descriptions only are copyright American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply.
    Copyright American Dental Association. All rights reserved.
    * Code is new in 2002.
            Start Printed Page 60091

    Addendum D.—Payment Status Indicators for the Hospital Outpatient Prospective Payment System

    IndicatorServiceStatus
    APulmonary Rehabilitation Clinical TrialNot Paid Under Outpatient PPS
    ADurable Medical Equipment, Prosthetics and OrthoticsDMEPOS Fee Schedule
    APhysical, Occupational and Speech TherapyPhysician Fee Schedule
    AAmbulanceAmbulance Fee Schedule
    AEPO for ESRD PatientsNational Rate
    AClinical Diagnostic Laboratory ServicesLaboratory Fee Schedule
    APhysician Services for ESRD PatientsPhysician Fee Schedule
    AScreening MammographyLower of Charges or National Rate
    CInpatient ProceduresAdmit Patient
    ENon-Covered Items and ServicesNot Paid Under Outpatient PPS
    FAcquisition of Corneal TissuePaid at Reasonable Cost
    GDrug/Biological Pass-ThroughAdditional Payment
    HDevice Pass-ThroughAdditional Payment
    KNon Pass-Through Drug/BiologicalPaid Under Outpatient PPS
    NIncidental Services, packaged into APC RatePackaged
    PPartial HospitalizationPaid Per Diem APC
    SSignificant Procedure, Not Discounted When MultiplePaid Under Outpatient PPS
    TSignificant Procedure, Multiple Procedure Reduction AppliesPaid Under Outpatient PPS
    VVisit to Clinic or Emergency DepartmentPaid Under Outpatient PPS
    XAncillary ServicePaid Under Outpatient PPS
    —————————— CPT codes and descriptions only are copyright American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply. Copyright American Dental Association. All rights reserved. * Code is new in 2002. Start Printed Page 60091

    Start Printed Page 60092

    Addendum E.—CPT Codes Which Would Be Paid Only As Inpatient Procedures

    [Calender Year 2002]

    CPT/HCPCSStatus IndicatorDescription
    *0001TCEndovas repr abdo ao aneurys
    *0002TCEndovas repr abdo ao aneurys
    *0005TCPerc cath stent/brain cv art
    *0006TCPerc cath stent/brain cv art
    *0007TCPerc cath stent/brain cv art
    00174CAnesth, pharyngeal surgery
    00176CAnesth, pharyngeal surgery
    00192CAnesth, facial bone surgery
    00214CAnesth, skull drainage
    00215CAnesth, skull repair/fract
    *0021TCFetal oximetry, trnsvag/cerv
    *0024TCTranscath cardiac reduction
    00404CAnesth, surgery of breast
    00406CAnesth, surgery of breast
    00452CAnesth, surgery of shoulder
    00474CAnesth, surgery of rib(s)
    00524CAnesth, chest drainage
    00540CAnesth, chest surgery
    00542CAnesth, release of lung
    00544CAnesth, chest lining removal
    00546CAnesth, lung,chest wall surg
    00560CAnesth, open heart surgery
    00562CAnesth, open heart surgery
    00580CAnesth heart/lung transplant
    00604CAnesth, sitting procedure
    00622CAnesth, removal of nerves
    00632CAnesth, removal of nerves
    00634CAnesth for chemonucleolysis
    00670CAnesth, spine, cord surgery
    00792CAnesth, hemorr/excise liver
    00794CAnesth, pancreas removal
    00796CAnesth, for liver transplant
    00802CAnesth, fat layer removal
    00844CAnesth, pelvis surgery
    00846CAnesth, hysterectomy
    00848CAnesth, pelvic organ surg
    00864CAnesth, removal of bladder
    00865CAnesth, removal of prostate
    00866CAnesth, removal of adrenal
    00868CAnesth, kidney transplant
    00882CAnesth, major vein ligation
    00904CAnesth, perineal surgery
    00908CAnesth, removal of prostate
    00928CAnesth, removal of testis
    00932CAnesth, amputation of penis
    00934CAnesth, penis, nodes removal
    00936CAnesth, penis, nodes removal
    00944CAnesth, vaginal hysterectomy
    01140CAnesth, amputation at pelvis
    01150CAnesth, pelvic tumor surgery
    01190CAnesth, pelvis nerve removal
    01212CAnesth, hip disarticulation
    01214CAnesth, replacement of hip
    01232CAnesth, amputation of femur
    01234CAnesth, radical femur surg
    01272CAnesth, femoral artery surg
    01274CAnesth, femoral embolectomy
    01402CAnesth, replacement of knee
    01404CAnesth, amputation at knee
    01442CAnesth, knee artery surg
    01444CAnesth, knee artery repair
    01486CAnesth, ankle replacement
    01502CAnesth, lwr leg embolectomy
    01632CAnesth, surgery of shoulder
    01634CAnesth, shoulder joint amput
    Start Printed Page 60093
    01636CAnesth, forequarter amput
    01638CAnesth, shoulder replacement
    01652CAnesth, shoulder vessel surg
    01654CAnesth, shoulder vessel surg
    01656CAnesth, arm-leg vessel surg
    01756CAnesth, radical humerus surg
    01990CSupport for organ donor
    15756CFree muscle flap, microvasc
    15757CFree skin flap, microvasc
    15758CFree fascial flap, microvasc
    16035CIncision of burn scab, initi
    16036CIncise burn scab, addl incis
    19200CRemoval of breast
    19220CRemoval of breast
    19271CRevision of chest wall
    19272CExtensive chest wall surgery
    19361CBreast reconstruction
    19364CBreast reconstruction
    19367CBreast reconstruction
    19368CBreast reconstruction
    19369CBreast reconstruction
    20660CApply, remove fixation device
    20661CApplication of head brace
    20662CApplication of pelvis brace
    20663CApplication of thigh brace
    20664CHalo brace application
    20802CReplantation, arm, complete
    20805CReplant, forearm, complete
    20808CReplantation hand, complete
    20816CReplantation digit, complete
    20822CReplantation digit, complete
    20824CReplantation thumb, complete
    20827CReplantation thumb, complete
    20838CReplantation foot, complete
    20930CSpinal bone allograft
    20931CSpinal bone allograft
    20936CSpinal bone autograft
    20937CSpinal bone autograft
    20938CSpinal bone autograft
    20955CFibula bone graft, microvasc
    20956CIliac bone graft, microvasc
    20957CMt bone graft, microvasc
    20962COther bone graft, microvasc
    20969CBone/skin graft, microvasc
    20970CBone/skin graft, iliac crest
    20972CBone/skin graft, metatarsal
    20973CBone/skin graft, great toe
    21045CExtensive jaw surgery
    21141CReconstruct midface, lefort
    21142CReconstruct midface, lefort
    21143CReconstruct midface, lefort
    21145CReconstruct midface, lefort
    21146CReconstruct midface, lefort
    21147CReconstruct midface, lefort
    21150CReconstruct midface, lefort
    21151CReconstruct midface, lefort
    21154CReconstruct midface, lefort
    21155CReconstruct midface, lefort
    21159CReconstruct midface, lefort
    21160CReconstruct midface, lefort
    21172CReconstruct orbit/forehead
    21175CReconstruct orbit/forehead
    21179CReconstruct entire forehead
    21180CReconstruct entire forehead
    21182CReconstruct cranial bone
    Start Printed Page 60094
    21183CReconstruct cranial bone
    21184CReconstruct cranial bone
    21188CReconstruction of midface
    21193CReconst lwr jaw w/o graft
    21194CReconst lwr jaw w/graft
    21195CReconst lwr jaw w/o fixation
    21196CReconst lwr jaw w/fixation
    21247CReconstruct lower jaw bone
    21255CReconstruct lower jaw bone
    21256CReconstruction of orbit
    21268CRevise eye sockets
    21343CTreatment of sinus fracture
    21344CTreatment of sinus fracture
    21346CTreat nose/jaw fracture
    21347CTreat nose/jaw fracture
    21348CTreat nose/jaw fracture
    21356CTreat cheek bone fracture
    21360CTreat cheek bone fracture
    21365CTreat cheek bone fracture
    21366CTreat cheek bone fracture
    21385CTreat eye socket fracture
    21386CTreat eye socket fracture
    21387CTreat eye socket fracture
    21390CTreat eye socket fracture
    21395CTreat eye socket fracture
    21408CTreat eye socket fracture
    21422CTreat mouth roof fracture
    21423CTreat mouth roof fracture
    21431CTreat craniofacial fracture
    21432CTreat craniofacial fracture
    21433CTreat craniofacial fracture
    21435CTreat craniofacial fracture
    21436CTreat craniofacial fracture
    21495CTreat hyoid bone fracture
    21510CDrainage of bone lesion
    21557CRemove tumor, neck/chest
    21615CRemoval of rib
    21616CRemoval of rib and nerves
    21620CPartial removal of sternum
    21627CSternal debridement
    21630CExtensive sternum surgery
    21632CExtensive sternum surgery
    21705CRevision of neck muscle/rib
    21740CReconstruction of sternum
    21750CRepair of sternum separation
    21810CTreatment of rib fracture(s)
    21825CTreat sternum fracture
    22100CRemove part of neck vertebra
    22101CRemove part, thorax vertebra
    22102CRemove part, lumbar vertebra
    22103CRemove extra spine segment
    22110CRemove part of neck vertebra
    22112CRemove part, thorax vertebra
    22114CRemove part, lumbar vertebra
    22116CRemove extra spine segment
    22210CRevision of neck spine
    22212CRevision of thorax spine
    22214CRevision of lumbar spine
    22216CRevise, extra spine segment
    22220CRevision of neck spine
    22222CRevision of thorax spine
    22224CRevision of lumbar spine
    22226CRevise, extra spine segment
    22318CTreat odontoid fx w/o graft
    22319CTreat odontoid fx w/graft
    Start Printed Page 60095
    22325CTreat spine fracture
    22326CTreat neck spine fracture
    22327CTreat thorax spine fracture
    22328CTreat each add spine fx
    22548CNeck spine fusion
    22554CNeck spine fusion
    22556CThorax spine fusion
    22558CLumbar spine fusion
    22585CAdditional spinal fusion
    22590CSpine & skull spinal fusion
    22595CNeck spinal fusion
    22600CNeck spine fusion
    22610CThorax spine fusion
    22612CLumbar spine fusion
    22614CSpine fusion, extra segment
    22630CLumbar spine fusion
    22632CSpine fusion, extra segment
    22800CFusion of spine
    22802CFusion of spine
    22804CFusion of spine
    22808CFusion of spine
    22810CFusion of spine
    22812CFusion of spine
    22818CKyphectomy, 1-2 segments
    22819CKyphectomy, 3 or more
    22830CExploration of spinal fusion
    22840CInsert spine fixation device
    22841CInsert spine fixation device
    22842CInsert spine fixation device
    22843CInsert spine fixation device
    22844CInsert spine fixation device
    22845CInsert spine fixation device
    22846CInsert spine fixation device
    22847CInsert spine fixation device
    22848CInsert pelv fixation device
    22849CReinsert spinal fixation
    22850CRemove spine fixation device
    22851CApply spine prosth device
    22852CRemove spine fixation device
    22855CRemove spine fixation device
    23035CDrain shoulder bone lesion
    23125CRemoval of collar bone
    23195CRemoval of head of humerus
    23200CRemoval of collar bone
    23210CRemoval of shoulder blade
    23220CPartial removal of humerus
    23221CPartial removal of humerus
    23222CPartial removal of humerus
    23332CRemove shoulder foreign body
    23395CMuscle transfer, shoulder/arm
    23397CMuscle transfers
    23400CFixation of shoulder blade
    23472CReconstruct shoulder joint
    23900CAmputation of arm & girdle
    23920CAmputation at shoulder joint
    24149CRadical resection of elbow
    24150CExtensive humerus surgery
    24151CExtensive humerus surgery
    24152CExtensive radius surgery
    24153CExtensive radius surgery
    24900CAmputation of upper arm
    24920CAmputation of upper arm
    24930CAmputation follow-up surgery
    24931CAmputate upper arm & implant
    24940CRevision of upper arm
    Start Printed Page 60096
    25170CExtensive forearm surgery
    25390CShorten radius or ulna
    25391CLengthen radius or ulna
    25392CShorten radius & ulna
    25393CLengthen radius & ulna
    25420CRepair/graft radius & ulna
    25900CAmputation of forearm
    25905CAmputation of forearm
    25909CAmputation follow-up surgery
    25915CAmputation of forearm
    25920CAmputate hand at wrist
    25924CAmputation follow-up surgery
    25927CAmputation of hand
    25931CAmputation follow-up surgery
    26551CGreat toe-hand transfer
    26553CSingle transfer, toe-hand
    26554CDouble transfer, toe-hand
    26556CToe joint transfer
    26992CDrainage of bone lesion
    27005CIncision of hip tendon
    27006CIncision of hip tendons
    27025CIncision of hip/thigh fascia
    27030CDrainage of hip joint
    27035CDenervation of hip joint
    27036CExcision of hip joint/muscle
    27054CRemoval of hip joint lining
    27070CPartial removal of hip bone
    27071CPartial removal of hip bone
    27075CExtensive hip surgery
    27076CExtensive hip surgery
    27077CExtensive hip surgery
    27078CExtensive hip surgery
    27079CExtensive hip surgery
    27090CRemoval of hip prosthesis
    27091CRemoval of hip prosthesis
    27120CReconstruction of hip socket
    27122CReconstruction of hip socket
    27125CPartial hip replacement
    27130CTotal hip replacement
    27132CTotal hip replacement
    27134CRevise hip joint replacement
    27137CRevise hip joint replacement
    27138CRevise hip joint replacement
    27140CTransplant femur ridge
    27146CIncision of hip bone
    27147CRevision of hip bone
    27151CIncision of hip bones
    27156CRevision of hip bones
    27158CRevision of pelvis
    27161CIncision of neck of femur
    27165CIncision/fixation of femur
    27170CRepair/graft femur head/neck
    27175CTreat slipped epiphysis
    27176CTreat slipped epiphysis
    27177CTreat slipped epiphysis
    27178CTreat slipped epiphysis
    27179CRevise head/neck of femur
    27181CTreat slipped epiphysis
    27185CRevision of femur epiphysis
    27187CReinforce hip bones
    27215CTreat pelvic fracture(s)
    27216CTreat pelvic ring fracture
    27217CTreat pelvic ring fracture
    27218CTreat pelvic ring fracture
    27222CTreat hip socket fracture
    Start Printed Page 60097
    27226CTreat hip wall fracture
    27227CTreat hip fracture(s)
    27228CTreat hip fracture(s)
    27232CTreat thigh fracture
    27235CTreat thigh fracture
    27236CTreat thigh fracture
    27240CTreat thigh fracture
    27244CTreat thigh fracture
    27245CTreat thigh fracture
    27248CTreat thigh fracture
    27253CTreat hip dislocation
    27254CTreat hip dislocation
    27258CTreat hip dislocation
    27259CTreat hip dislocation
    27280CFusion of sacroiliac joint
    27282CFusion of pubic bones
    27284CFusion of hip joint
    27286CFusion of hip joint
    27290CAmputation of leg at hip
    27295CAmputation of leg at hip
    27303CDrainage of bone lesion
    27365CExtensive leg surgery
    27445CRevision of knee joint
    27447CTotal knee replacement
    27448CIncision of thigh
    27450CIncision of thigh
    27454CRealignment of thigh bone
    27455CRealignment of knee
    27457CRealignment of knee
    27465CShortening of thigh bone
    27466CLengthening of thigh bone
    27468CShorten/lengthen thighs
    27470CRepair of thigh
    27472CRepair/graft of thigh
    27475CSurgery to stop leg growth
    27477CSurgery to stop leg growth
    27479CSurgery to stop leg growth
    27485CSurgery to stop leg growth
    27486CRevise/replace knee joint
    27487CRevise/replace knee joint
    27488CRemoval of knee prosthesis
    27495CReinforce thigh
    27506CTreatment of thigh fracture
    27507CTreatment of thigh fracture
    27511CTreatment of thigh fracture
    27513CTreatment of thigh fracture
    27514CTreatment of thigh fracture
    27519CTreat thigh fx growth plate
    27535CTreat knee fracture
    27536CTreat knee fracture
    27540CTreat knee fracture
    27556CTreat knee dislocation
    27557CTreat knee dislocation
    27558CTreat knee dislocation
    27580CFusion of knee
    27590CAmputate leg at thigh
    27591CAmputate leg at thigh
    27592CAmputate leg at thigh
    27596CAmputation follow-up surgery
    27598CAmputate lower leg at knee
    27645CExtensive lower leg surgery
    27646CExtensive lower leg surgery
    27702CReconstruct ankle joint
    27703CReconstruction, ankle joint
    27712CRealignment of lower leg
    Start Printed Page 60098
    27715CRevision of lower leg
    27720CRepair of tibia
    27722CRepair/graft of tibia
    27724CRepair/graft of tibia
    27725CRepair of lower leg
    27727CRepair of lower leg
    27880CAmputation of lower leg
    27881CAmputation of lower leg
    27882CAmputation of lower leg
    27886CAmputation follow-up surgery
    27888CAmputation of foot at ankle
    28800CAmputation of midfoot
    28805CAmputation thru metatarsal
    31225CRemoval of upper jaw
    31230CRemoval of upper jaw
    31290CNasal/sinus endoscopy, surg
    31291CNasal/sinus endoscopy, surg
    31292CNasal/sinus endoscopy, surg
    31293CNasal/sinus endoscopy, surg
    31294CNasal/sinus endoscopy, surg
    31360CRemoval of larynx
    31365CRemoval of larynx
    31367CPartial removal of larynx
    31368CPartial removal of larynx
    31370CPartial removal of larynx
    31375CPartial removal of larynx
    31380CPartial removal of larynx
    31382CPartial removal of larynx
    31390CRemoval of larynx & pharynx
    31395CReconstruct larynx & pharynx
    31582CRevision of larynx
    31584CTreat larynx fracture
    31587CRevision of larynx
    31725CClearance of airways
    31760CRepair of windpipe
    31766CReconstruction of windpipe
    31770CRepair/graft of bronchus
    31775CReconstruct bronchus
    31780CReconstruct windpipe
    31781CReconstruct windpipe
    31785CRemove windpipe lesion
    31786CRemove windpipe lesion
    31800CRepair of windpipe injury
    31805CRepair of windpipe injury
    32035CExploration of chest
    32036CExploration of chest
    32095CBiopsy through chest wall
    32100CExploration/biopsy of chest
    32110CExplore/repair chest
    32120CRe-exploration of chest
    32124CExplore chest free adhesions
    32140CRemoval of lung lesion(s)
    32141CRemove/treat lung lesions
    32150CRemoval of lung lesion(s)
    32151CRemove lung foreign body
    32160COpen chest heart massage
    32200CDrain, open, lung lesion
    32201CDrain, percut, lung lesion
    32215CTreat chest lining
    32220CRelease of lung
    32225CPartial release of lung
    32310CRemoval of chest lining
    32320CFree/remove chest lining
    32402COpen biopsy chest lining
    32440CRemoval of lung
    Start Printed Page 60099
    32442CSleeve pneumonectomy
    32445CRemoval of lung
    32480CPartial removal of lung
    32482CBilobectomy
    32484CSegmentectomy
    32486CSleeve lobectomy
    32488CCompletion pneumonectomy
    32491CLung volume reduction
    32500CPartial removal of lung
    32501CRepair bronchus add-on
    32520CRemove lung & revise chest
    32522CRemove lung & revise chest
    32525CRemove lung & revise chest
    32540CRemoval of lung lesion
    32650CThoracoscopy, surgical
    32651CThoracoscopy, surgical
    32652CThoracoscopy, surgical
    32653CThoracoscopy, surgical
    32654CThoracoscopy, surgical
    32655CThoracoscopy, surgical
    32656CThoracoscopy, surgical
    32657CThoracoscopy, surgical
    32658CThoracoscopy, surgical
    32659CThoracoscopy, surgical
    32660CThoracoscopy, surgical
    32661CThoracoscopy, surgical
    32662CThoracoscopy, surgical
    32663CThoracoscopy, surgical
    32664CThoracoscopy, surgical
    32665CThoracoscopy, surgical
    32800CRepair lung hernia
    32810CClose chest after drainage
    32815CClose bronchial fistula
    32820CReconstruct injured chest
    32850CDonor pneumonectomy
    32851CLung transplant, single
    32852CLung transplant with bypass
    32853CLung transplant, double
    32854CLung transplant with bypass
    32900CRemoval of rib(s)
    32905CRevise & repair chest wall
    32906CRevise & repair chest wall
    32940CRevision of lung
    32997CTotal lung lavage
    33015CIncision of heart sac
    33020CIncision of heart sac
    33025CIncision of heart sac
    33030CPartial removal of heart sac
    33031CPartial removal of heart sac
    33050CRemoval of heart sac lesion
    33120CRemoval of heart lesion
    33130CRemoval of heart lesion
    33140CHeart revascularize (tmr)
    33141CHeart tmr w/other procedure
    33200CInsertion of heart pacemaker
    33201CInsertion of heart pacemaker
    33236CRemove electrode/thoracotomy
    33237CRemove electrode/thoracotomy
    33238CRemove electrode/thoracotomy
    33243CRemove eltrd/thoracotomy
    33245CInsert epic eltrd pace-defib
    33246CInsert epic eltrd/generator
    33250CAblate heart dysrhythm focus
    33251CAblate heart dysrhythm focus
    33253CReconstruct atria
    Start Printed Page 60100
    33261CAblate heart dysrhythm focus
    33300CRepair of heart wound
    33305CRepair of heart wound
    33310CExploratory heart surgery
    33315CExploratory heart surgery
    33320CRepair major blood vessel(s)
    33321CRepair major vessel
    33322CRepair major blood vessel(s)
    33330CInsert major vessel graft
    33332CInsert major vessel graft
    33335CInsert major vessel graft
    33400CRepair of aortic valve
    33401CValvuloplasty, open
    33403CValvuloplasty, w/cp bypass
    33404CPrepare heart-aorta conduit
    33405CReplacement of aortic valve
    33406CReplacement of aortic valve
    33410CReplacement of aortic valve
    33411CReplacement of aortic valve
    33412CReplacement of aortic valve
    33413CReplacement of aortic valve
    33414CRepair of aortic valve
    33415CRevision, subvalvular tissue
    33416CRevise ventricle muscle
    33417CRepair of aortic valve
    33420CRevision of mitral valve
    33422CRevision of mitral valve
    33425CRepair of mitral valve
    33426CRepair of mitral valve
    33427CRepair of mitral valve
    33430CReplacement of mitral valve
    33460CRevision of tricuspid valve
    33463CValvuloplasty, tricuspid
    33464CValvuloplasty, tricuspid
    33465CReplace tricuspid valve
    33468CRevision of tricuspid valve
    33470CRevision of pulmonary valve
    33471CValvotomy, pulmonary valve
    33472CRevision of pulmonary valve
    33474CRevision of pulmonary valve
    33475CReplacement, pulmonary valve
    33476CRevision of heart chamber
    33478CRevision of heart chamber
    33496CRepair, prosth valve clot
    33500CRepair heart vessel fistula
    33501CRepair heart vessel fistula
    33502CCoronary artery correction
    33503CCoronary artery graft
    33504CCoronary artery graft
    33505CRepair artery w/tunnel
    33506CRepair artery, translocation
    33510CCABG, vein, single
    33511CCABG, vein, two
    33512CCABG, vein, three
    33513CCABG, vein, four
    33514CCABG, vein, five
    33516CCabg, vein, six or more
    33517CCABG, artery-vein, single
    33518CCABG, artery-vein, two
    33519CCABG, artery-vein, three
    33521CCABG, artery-vein, four
    33522CCABG, artery-vein, five
    33523CCabg, art-vein, six or more
    33530CCoronary artery, bypass/reop
    33533CCABG, arterial, single
    Start Printed Page 60101
    33534CCABG, arterial, two
    33535CCABG, arterial, three
    33536CCabg, arterial, four or more
    33542CRemoval of heart lesion
    33545CRepair of heart damage
    33572COpen coronary endarterectomy
    33600CClosure of valve
    33602CClosure of valve
    33606CAnastomosis/artery-aorta
    33608CRepair anomaly w/conduit
    33610CRepair by enlargement
    33611CRepair double ventricle
    33612CRepair double ventricle
    33615CRepair, modified fontan
    33617CRepair single ventricle
    33619CRepair single ventricle
    33641CRepair heart septum defect
    33645CRevision of heart veins
    33647CRepair heart septum defects
    33660CRepair of heart defects
    33665CRepair of heart defects
    33670CRepair of heart chambers
    33681CRepair heart septum defect
    33684CRepair heart septum defect
    33688CRepair heart septum defect
    33690CReinforce pulmonary artery
    33692CRepair of heart defects
    33694CRepair of heart defects
    33697CRepair of heart defects
    33702CRepair of heart defects
    33710CRepair of heart defects
    33720CRepair of heart defect
    33722CRepair of heart defect
    33730CRepair heart-vein defect(s)
    33732CRepair heart-vein defect
    33735CRevision of heart chamber
    33736CRevision of heart chamber
    33737CRevision of heart chamber
    33750CMajor vessel shunt
    33755CMajor vessel shunt
    33762CMajor vessel shunt
    33764CMajor vessel shunt & graft
    33766CMajor vessel shunt
    33767CMajor vessel shunt
    33770CRepair great vessels defect
    33771CRepair great vessels defect
    33774CRepair great vessels defect
    33775CRepair great vessels defect
    33776CRepair great vessels defect
    33777CRepair great vessels defect
    33778CRepair great vessels defect
    33779CRepair great vessels defect
    33780CRepair great vessels defect
    33781CRepair great vessels defect
    33786CRepair arterial trunk
    33788CRevision of pulmonary artery
    33800CAortic suspension
    33802CRepair vessel defect
    33803CRepair vessel defect
    33813CRepair septal defect
    33814CRepair septal defect
    33820CRevise major vessel
    33822CRevise major vessel
    33824CRevise major vessel
    33840CRemove aorta constriction
    Start Printed Page 60102
    33845CRemove aorta constriction
    33851CRemove aorta constriction
    33852CRepair septal defect
    33853CRepair septal defect
    33860CAscending aortic graft
    33861CAscending aortic graft
    33863CAscending aortic graft
    33870CTransverse aortic arch graft
    33875CThoracic aortic graft
    33877CThoracoabdominal graft
    33910CRemove lung artery emboli
    33915CRemove lung artery emboli
    33916CSurgery of great vessel
    33917CRepair pulmonary artery
    33918CRepair pulmonary atresia
    33919CRepair pulmonary atresia
    33920CRepair pulmonary atresia
    33922CTransect pulmonary artery
    33924CRemove pulmonary shunt
    33930CRemoval of donor heart/lung
    33935CTransplantation, heart/lung
    33940CRemoval of donor heart
    33945CTransplantation of heart
    33960CExternal circulation assist
    33961CExternal circulation assist
    *33967CInsert ia percut device
    33968CRemove aortic assist device
    33970CAortic circulation assist
    33971CAortic circulation assist
    33973CInsert balloon device
    33974CRemove intra-aortic balloon
    33975CImplant ventricular device
    33976CImplant ventricular device
    33977CRemove ventricular device
    33978CRemove ventricular device
    *33979CInsert intracorporeal device
    *33980CRemove intracorporeal device
    34001CRemoval of artery clot
    34051CRemoval of artery clot
    34151CRemoval of artery clot
    34401CRemoval of vein clot
    34451CRemoval of vein clot
    34502CReconstruct vena cava
    34800CEndovasc abdo repair w/tube
    34802CEndovasc abdo repr w/device
    34804CEndovasc abdo repr w/device
    34808CEndovasc abdo occlud device
    34812CXpose for endoprosth, aortic
    34813CXpose for endoprosth, femorl
    34820CXpose for endoprosth, iliac
    34825CEndovasc extend prosth, init
    34826CEndovasc exten prosth, addl
    34830COpen aortic tube prosth repr
    34831COpen aortoiliac prosth repr
    34832COpen aortofemor prosth repr
    35001CRepair defect of artery
    35002CRepair artery rupture, neck
    35005CRepair defect of artery
    35013CRepair artery rupture, arm
    35021CRepair defect of artery
    35022CRepair artery rupture, chest
    35045CRepair defect of arm artery
    35081CRepair defect of artery
    35082CRepair artery rupture, aorta
    35091CRepair defect of artery
    Start Printed Page 60103
    35092CRepair artery rupture, aorta
    35102CRepair defect of artery
    35103CRepair artery rupture, groin
    35111CRepair defect of artery
    35112CRepair artery rupture,spleen
    35121CRepair defect of artery
    35122CRepair artery rupture, belly
    35131CRepair defect of artery
    35132CRepair artery rupture, groin
    35141CRepair defect of artery
    35142CRepair artery rupture, thigh
    35151CRepair defect of artery
    35152CRepair artery rupture, knee
    35161CRepair defect of artery
    35162CRepair artery rupture
    35182CRepair blood vessel lesion
    35189CRepair blood vessel lesion
    35211CRepair blood vessel lesion
    35216CRepair blood vessel lesion
    35221CRepair blood vessel lesion
    35241CRepair blood vessel lesion
    35246CRepair blood vessel lesion
    35251CRepair blood vessel lesion
    35271CRepair blood vessel lesion
    35276CRepair blood vessel lesion
    35281CRepair blood vessel lesion
    35301CRechanneling of artery
    35311CRechanneling of artery
    35331CRechanneling of artery
    35341CRechanneling of artery
    35351CRechanneling of artery
    35355CRechanneling of artery
    35361CRechanneling of artery
    35363CRechanneling of artery
    35371CRechanneling of artery
    35372CRechanneling of artery
    35381CRechanneling of artery
    35390CReoperation, carotid add-on
    35400CAngioscopy
    35450CRepair arterial blockage
    35452CRepair arterial blockage
    35454CRepair arterial blockage
    35456CRepair arterial blockage
    35480CAtherectomy, open
    35481CAtherectomy, open
    35482CAtherectomy, open
    35483CAtherectomy, open
    35501CArtery bypass graft
    35506CArtery bypass graft
    35507CArtery bypass graft
    35508CArtery bypass graft
    35509CArtery bypass graft
    35511CArtery bypass graft
    35515CArtery bypass graft
    35516CArtery bypass graft
    35518CArtery bypass graft
    35521CArtery bypass graft
    35526CArtery bypass graft
    35531CArtery bypass graft
    35533CArtery bypass graft
    35536CArtery bypass graft
    35541CArtery bypass graft
    35546CArtery bypass graft
    35548CArtery bypass graft
    35549CArtery bypass graft
    Start Printed Page 60104
    35551CArtery bypass graft
    35556CArtery bypass graft
    35558CArtery bypass graft
    35560CArtery bypass graft
    35563CArtery bypass graft
    35565CArtery bypass graft
    35566CArtery bypass graft
    35571CArtery bypass graft
    35582CVein bypass graft
    35583CVein bypass graft
    35585CVein bypass graft
    35587CVein bypass graft
    35600CHarvest artery for cabg
    35601CArtery bypass graft
    35606CArtery bypass graft
    35612CArtery bypass graft
    35616CArtery bypass graft
    35621CArtery bypass graft
    35623CBypass graft, not vein
    35626CArtery bypass graft
    35631CArtery bypass graft
    35636CArtery bypass graft
    35641CArtery bypass graft
    35642CArtery bypass graft
    35645CArtery bypass graft
    35646CArtery bypass graft
    *35647CArtery bypass graft
    35650CArtery bypass graft
    35651CArtery bypass graft
    35654CArtery bypass graft
    35656CArtery bypass graft
    35661CArtery bypass graft
    35663CArtery bypass graft
    35665CArtery bypass graft
    35666CArtery bypass graft
    35671CArtery bypass graft
    35681CComposite bypass graft
    35682CComposite bypass graft
    35683CComposite bypass graft
    35691CArterial transposition
    35693CArterial transposition
    35694CArterial transposition
    35695CArterial transposition
    35700CReoperation, bypass graft
    35701CExploration, carotid artery
    35721CExploration, femoral artery
    35741CExploration popliteal artery
    35800CExplore neck vessels
    35820CExplore chest vessels
    35840CExplore abdominal vessels
    35870CRepair vessel graft defect
    35901CExcision, graft, neck
    35905CExcision, graft, thorax
    35907CExcision, graft, abdomen
    36510CInsertion of catheter, vein
    36660CInsertion catheter, artery
    36822CInsertion of cannula(s)
    36823CInsertion of cannula(s)
    37140CRevision of circulation
    37145CRevision of circulation
    37160CRevision of circulation
    37180CRevision of circulation
    37181CSplice spleen/kidney veins
    37195CThrombolytic therapy, stroke
    37616CLigation of chest artery
    Start Printed Page 60105
    37617CLigation of abdomen artery
    37618CLigation of extremity artery
    37660CRevision of major vein
    37788CRevascularization, penis
    38100CRemoval of spleen, total
    38101CRemoval of spleen, partial
    38102CRemoval of spleen, total
    38115CRepair of ruptured spleen
    38380CThoracic duct procedure
    38381CThoracic duct procedure
    38382CThoracic duct procedure
    38562CRemoval, pelvic lymph nodes
    38564CRemoval, abdomen lymph nodes
    38700CRemoval of lymph nodes, neck
    38724CRemoval of lymph nodes, neck
    38746CRemove thoracic lymph nodes
    38747CRemove abdominal lymph nodes
    38765CRemove groin lymph nodes
    38770CRemove pelvis lymph nodes
    38780CRemove abdomen lymph nodes
    39000CExploration of chest
    39010CExploration of chest
    39200CRemoval chest lesion
    39220CRemoval chest lesion
    39499CChest procedure
    39501CRepair diaphragm laceration
    39502CRepair paraesophageal hernia
    39503CRepair of diaphragm hernia
    39520CRepair of diaphragm hernia
    39530CRepair of diaphragm hernia
    39531CRepair of diaphragm hernia
    39540CRepair of diaphragm hernia
    39541CRepair of diaphragm hernia
    39545CRevision of diaphragm
    39560CResect diaphragm, simple
    39561CResect diaphragm, complex
    39599CDiaphragm surgery procedure
    41130CPartial removal of tongue
    41135CTongue and neck surgery
    41140CRemoval of tongue
    41145CTongue removal, neck surgery
    41150CTongue, mouth, jaw surgery
    41153CTongue, mouth, neck surgery
    41155CTongue, jaw, & neck surgery
    42426CExcise parotid gland/lesion
    42842CExtensive surgery of throat
    42845CExtensive surgery of throat
    42894CRevision of pharyngeal walls
    42953CRepair throat, esophagus
    42961CControl throat bleeding
    42971CControl nose/throat bleeding
    43030CThroat muscle surgery
    43045CIncision of esophagus
    43100CExcision of esophagus lesion
    43101CExcision of esophagus lesion
    43107CRemoval of esophagus
    43108CRemoval of esophagus
    43112CRemoval of esophagus
    43113CRemoval of esophagus
    43116CPartial removal of esophagus
    43117CPartial removal of esophagus
    43118CPartial removal of esophagus
    43121CPartial removal of esophagus
    43122CParital removal of esophagus
    43123CPartial removal of esophagus
    Start Printed Page 60106
    43124CRemoval of esophagus
    43135CRemoval of esophagus pouch
    43300CRepair of esophagus
    43305CRepair esophagus and fistula
    43310CRepair of esophagus
    43312CRepair esophagus and fistula
    *43313CEsophagoplasty congential
    *43314CTracheo-esophagoplasty cong
    43320CFuse esophagus & stomach
    43324CRevise esophagus & stomach
    43325CRevise esophagus & stomach
    43326CRevise esophagus & stomach
    43330CRepair of esophagus
    43331CRepair of esophagus
    43340CFuse esophagus & intestine
    43341CFuse esophagus & intestine
    43350CSurgical opening, esophagus
    43351CSurgical opening, esophagus
    43352CSurgical opening, esophagus
    43360CGastrointestinal repair
    43361CGastrointestinal repair
    43400CLigate esophagus veins
    43401CEsophagus surgery for veins
    43405CLigate/staple esophagus
    43410CRepair esophagus wound
    43415CRepair esophagus wound
    43420CRepair esophagus opening
    43425CRepair esophagus opening
    43460CPressure treatment esophagus
    43496CFree jejunum flap, microvasc
    43500CSurgical opening of stomach
    43501CSurgical repair of stomach
    43502CSurgical repair of stomach
    43510CSurgical opening of stomach
    43520CIncision of pyloric muscle
    43605CBiopsy of stomach
    43610CExcision of stomach lesion
    43611CExcision of stomach lesion
    43620CRemoval of stomach
    43621CRemoval of stomach
    43622CRemoval of stomach
    43631CRemoval of stomach, partial
    43632CRemoval of stomach, partial
    43633CRemoval of stomach, partial
    43634CRemoval of stomach, partial
    43635CRemoval of stomach, partial
    43638CRemoval of stomach, partial
    43639CRemoval of stomach, partial
    43640CVagotomy & pylorus repair
    43641CVagotomy & pylorus repair
    43800CReconstruction of pylorus
    43810CFusion of stomach and bowel
    43820CFusion of stomach and bowel
    43825CFusion of stomach and bowel
    43832CPlace gastrostomy tube
    43840CRepair of stomach lesion
    43842CGastroplasty for obesity
    43843CGastroplasty for obesity
    43846CGastric bypass for obesity
    43847CGastric bypass for obesity
    43848CRevision gastroplasty
    43850CRevise stomach-bowel fusion
    43855CRevise stomach-bowel fusion
    43860CRevise stomach-bowel fusion
    43865CRevise stomach-bowel fusion
    Start Printed Page 60107
    43880CRepair stomach-bowel fistula
    44005CFreeing of bowel adhesion
    44010CIncision of small bowel
    44015CInsert needle cath bowel
    44020CExploration of small bowel
    44021CDecompress small bowel
    44025CIncision of large bowel
    44050CReduce bowel obstruction
    44055CCorrect malrotation of bowel
    44110CExcision of bowel lesion(s)
    44111CExcision of bowel lesion(s)
    44120CRemoval of small intestine
    44121CRemoval of small intestine
    44125CRemoval of small intestine
    *44126CEnterectomy w/taper, cong
    *44127CEnterectomy w/o taper, cong
    *44128CEnterectomy cong, add-on
    44130CBowel to bowel fusion
    44132CEnterectomy, cadaver donor
    44133CEnterectomy, live donor
    44135CIntestine transplnt, cadaver
    44136CIntestine transplant, live
    44139CMobilization of colon
    44140CPartial removal of colon
    44141CPartial removal of colon
    44143CPartial removal of colon
    44144CPartial removal of colon
    44145CPartial removal of colon
    44146CPartial removal of colon
    44147CPartial removal of colon
    44150CRemoval of colon
    44151CRemoval of colon/ileostomy
    44152CRemoval of colon/ileostomy
    44153CRemoval of colon/ileostomy
    44155CRemoval of colon/ileostomy
    44156CRemoval of colon/ileostomy
    44160CRemoval of colon
    44202CLaparo, resect intestine
    *44203CLap resect s/intestine, addl
    *44204CLaparo partial colectomy
    *44205CLap colectomy part w/ileum
    44300COpen bowel to skin
    44310CIleostomy/jejunostomy
    44314CRevision of ileostomy
    44316CDevise bowel pouch
    44320CColostomy
    44322CColostomy with biopsies
    44345CRevision of colostomy
    44346CRevision of colostomy
    44602CSuture, small intestine
    44603CSuture, small intestine
    44604CSuture, large intestine
    44605CRepair of bowel lesion
    44615CIntestinal stricturoplasty
    44620CRepair bowel opening
    44625CRepair bowel opening
    44626CRepair bowel opening
    44640CRepair bowel-skin fistula
    44650CRepair bowel fistula
    44660CRepair bowel-bladder fistula
    44661CRepair bowel-bladder fistula
    44680CSurgical revision, intestine
    44700CSuspend bowel w/prosthesis
    44800CExcision of bowel pouch
    44820CExcision of mesentery lesion
    Start Printed Page 60108
    44850CRepair of mesentery
    44899CBowel surgery procedure
    44900CDrain app abscess, open
    44901CDrain app abscess, percut
    44950CAppendectomy
    44955CAppendectomy add-on
    44960CAppendectomy
    45110CRemoval of rectum
    45111CPartial removal of rectum
    45112CRemoval of rectum
    45113CPartial proctectomy
    45114CPartial removal of rectum
    45116CPartial removal of rectum
    45119CRemove rectum w/reservoir
    45120CRemoval of rectum
    45121CRemoval of rectum and colon
    45123CPartial proctectomy
    45126CPelvic exenteration
    45130CExcision of rectal prolapse
    45135CExcision of rectal prolapse
    *45136CExcise ileoanal reservoir
    45540CCorrect rectal prolapse
    45541CCorrect rectal prolapse
    45550CRepair rectum/remove sigmoid
    45562CExploration/repair of rectum
    45563CExploration/repair of rectum
    45800CRepair rect/bladder fistula
    45805CRepair fistula w/colostomy
    45820CRepair rectourethral fistula
    45825CRepair fistula w/colostomy
    46705CRepair of anal stricture
    46715CRepair of anovaginal fistula
    46716CRepair of anovaginal fistula
    46730CConstruction of absent anus
    46735CConstruction of absent anus
    46740CConstruction of absent anus
    46742CRepair of imperforated anus
    46744CRepair of cloacal anomaly
    46746CRepair of cloacal anomaly
    46748CRepair of cloacal anomaly
    46751CRepair of anal sphincter
    47001CNeedle biopsy, liver add-on
    47010COpen drainage, liver lesion
    47015CInject/aspirate liver cyst
    47100CWedge biopsy of liver
    47120CPartial removal of liver
    47122CExtensive removal of liver
    47125CPartial removal of liver
    47130CPartial removal of liver
    47133CRemoval of donor liver
    47134CPartial removal, donor liver
    47135CTransplantation of liver
    47136CTransplantation of liver
    47300CSurgery for liver lesion
    47350CRepair liver wound
    47360CRepair liver wound
    47361CRepair liver wound
    47362CRepair liver wound
    *47380COpen ablate liver tumor rf
    *47381COpen ablate liver tumor cryo
    47400CIncision of liver duct
    47420CIncision of bile duct
    47425CIncision of bile duct
    47460CIncise bile duct sphincter
    47480CIncision of gallbladder
    Start Printed Page 60109
    47490CIncision of gallbladder
    47550CBile duct endoscopy add-on
    47570CLaparo cholecystoenterostomy
    47600CRemoval of gallbladder
    47605CRemoval of gallbladder
    47610CRemoval of gallbladder
    47612CRemoval of gallbladder
    47620CRemoval of gallbladder
    47700CExploration of bile ducts
    47701CBile duct revision
    47711CExcision of bile duct tumor
    47712CExcision of bile duct tumor
    47715CExcision of bile duct cyst
    47716CFusion of bile duct cyst
    47720CFuse gallbladder & bowel
    47721CFuse upper gi structures
    47740CFuse gallbladder & bowel
    47741CFuse gallbladder & bowel
    47760CFuse bile ducts and bowel
    47765CFuse liver ducts & bowel
    47780CFuse bile ducts and bowel
    47785CFuse bile ducts and bowel
    47800CReconstruction of bile ducts
    47801CPlacement, bile duct support
    47802CFuse liver duct & intestine
    47900CSuture bile duct injury
    48000CDrainage of abdomen
    48001CPlacement of drain, pancreas
    48005CResect/debride pancreas
    48020CRemoval of pancreatic stone
    48100CBiopsy of pancreas
    48120CRemoval of pancreas lesion
    48140CPartial removal of pancreas
    48145CPartial removal of pancreas
    48146CPancreatectomy
    48148CRemoval of pancreatic duct
    48150CPartial removal of pancreas
    48152CPancreatectomy
    48153CPancreatectomy
    48154CPancreatectomy
    48155CRemoval of pancreas
    48180CFuse pancreas and bowel
    48400CInjection, intraop add-on
    48500CSurgery of pancreas cyst
    48510CDrain pancreatic pseudocyst
    48520CFuse pancreas cyst and bowel
    48540CFuse pancreas cyst and bowel
    48545CPancreatorrhaphy
    48547CDuodenal exclusion
    48556CRemoval, allograft pancreas
    49000CExploration of abdomen
    49002CReopening of abdomen
    49010CExploration behind abdomen
    49020CDrain abdominal abscess
    49021CDrain abdominal abscess
    49040CDrain, open, abdom abscess
    49041CDrain, percut, abdom abscess
    49060CDrain, open, retrop abscess
    49061CDrain, percut, retroper absc
    49062CDrain to peritoneal cavity
    49201CRemoval of abdominal lesion
    49215CExcise sacral spine tumor
    49220CMultiple surgery, abdomen
    49255CRemoval of omentum
    49425CInsert abdomen-venous drain
    Start Printed Page 60110
    49428CLigation of shunt
    49605CRepair umbilical lesion
    49606CRepair umbilical lesion
    49610CRepair umbilical lesion
    49611CRepair umbilical lesion
    49900CRepair of abdominal wall
    49905COmental flap
    49906CFree omental flap, microvasc
    50010CExploration of kidney
    50020CRenal abscess, open drain
    50040CDrainage of kidney
    50045CExploration of kidney
    50060CRemoval of kidney stone
    50065CIncision of kidney
    50070CIncision of kidney
    50075CRemoval of kidney stone
    50100CRevise kidney blood vessels
    50120CExploration of kidney
    50125CExplore and drain kidney
    50130CRemoval of kidney stone
    50135CExploration of kidney
    50205CBiopsy of kidney
    50220CRemoval of kidney
    50225CRemoval of kidney
    50230CRemoval of kidney
    50234CRemoval of kidney & ureter
    50236CRemoval of kidney & ureter
    50240CPartial removal of kidney
    50280CRemoval of kidney lesion
    50290CRemoval of kidney lesion
    50300CRemoval of donor kidney
    50320CRemoval of donor kidney
    50340CRemoval of kidney
    50360CTransplantation of kidney
    50365CTransplantation of kidney
    50370CRemove transplanted kidney
    50380CReimplantation of kidney
    50400CRevision of kidney/ureter
    50405CRevision of kidney/ureter
    50500CRepair of kidney wound
    50520CClose kidney-skin fistula
    50525CRepair renal-abdomen fistula
    50526CRepair renal-abdomen fistula
    50540CRevision of horseshoe kidney
    50545CLaparo radical nephrectomy
    50546CLaparoscopic nephrectomy
    50547CLaparo removal donor kidney
    50548CLaparo remove k/ureter
    50570CKidney endoscopy
    50572CKidney endoscopy
    50574CKidney endoscopy & biopsy
    50575CKidney endoscopy
    50576CKidney endoscopy & treatment
    50578CRenal endoscopy/radiotracer
    50580CKidney endoscopy & treatment
    50600CExploration of ureter
    50605CInsert ureteral support
    50610CRemoval of ureter stone
    50620CRemoval of ureter stone
    50630CRemoval of ureter stone
    50650CRemoval of ureter
    50660CRemoval of ureter
    50700CRevision of ureter
    50715CRelease of ureter
    50722CRelease of ureter
    Start Printed Page 60111
    50725CRelease/revise ureter
    50727CRevise ureter
    50728CRevise ureter
    50740CFusion of ureter & kidney
    50750CFusion of ureter & kidney
    50760CFusion of ureters
    50770CSplicing of ureters
    50780CReimplant ureter in bladder
    50782CReimplant ureter in bladder
    50783CReimplant ureter in bladder
    50785CReimplant ureter in bladder
    50800CImplant ureter in bowel
    50810CFusion of ureter & bowel
    50815CUrine shunt to bowel
    50820CConstruct bowel bladder
    50825CConstruct bowel bladder
    50830CRevise urine flow
    50840CReplace ureter by bowel
    50845CAppendico-vesicostomy
    50860CTransplant ureter to skin
    50900CRepair of ureter
    50920CClosure ureter/skin fistula
    50930CClosure ureter/bowel fistula
    50940CRelease of ureter
    51060CRemoval of ureter stone
    51525CRemoval of bladder lesion
    51530CRemoval of bladder lesion
    51535CRepair of ureter lesion
    51550CPartial removal of bladder
    51555CPartial removal of bladder
    51565CRevise bladder & ureter(s)
    51570CRemoval of bladder
    51575CRemoval of bladder & nodes
    51580CRemove bladder/revise tract
    51585CRemoval of bladder & nodes
    51590CRemove bladder/revise tract
    51595CRemove bladder/revise tract
    51596CRemove bladder/create pouch
    51597CRemoval of pelvic structures
    51800CRevision of bladder/urethra
    51820CRevision of urinary tract
    51840CAttach bladder/urethra
    51841CAttach bladder/urethra
    51845CRepair bladder neck
    51860CRepair of bladder wound
    51865CRepair of bladder wound
    51900CRepair bladder/vagina lesion
    51920CClose bladder-uterus fistula
    51925CHysterectomy/bladder repair
    51940CCorrection of bladder defect
    51960CRevision of bladder & bowel
    51980CConstruct bladder opening
    53085CDrainage of urinary leakage
    53415CReconstruction of urethra
    *53448CRemov/replc ur sphinctr comp
    54125CRemoval of penis
    54130CRemove penis & nodes
    54135CRemove penis & nodes
    54332CRevise penis/urethra
    54336CRevise penis/urethra
    54390CRepair penis and bladder
    *54411CRemv/replc penis pros, comp
    *54417CRemv/replc penis pros, compl
    54430CRevision of penis
    54535CExtensive testis surgery
    Start Printed Page 60112
    54560CExploration for testis
    54650COrchiopexy (Fowler-Stephens)
    55600CIncise sperm duct pouch
    55605CIncise sperm duct pouch
    55650CRemove sperm duct pouch
    55801CRemoval of prostate
    55810CExtensive prostate surgery
    55812CExtensive prostate surgery
    55815CExtensive prostate surgery
    55821CRemoval of prostate
    55831CRemoval of prostate
    55840CExtensive prostate surgery
    55842CExtensive prostate surgery
    55845CExtensive prostate surgery
    55862CExtensive prostate surgery
    55865CExtensive prostate surgery
    56630CExtensive vulva surgery
    56631CExtensive vulva surgery
    56632CExtensive vulva surgery
    56633CExtensive vulva surgery
    56634CExtensive vulva surgery
    56637CExtensive vulva surgery
    56640CExtensive vulva surgery
    57110CRemove vagina wall, complete
    57111CRemove vagina tissue, compl
    57112CVaginectomy w/nodes, compl
    57270CRepair of bowel pouch
    57280CSuspension of vagina
    57282CRepair of vaginal prolapse
    57292CConstruct vagina with graft
    57305CRepair rectum-vagina fistula
    57307CFistula repair & colostomy
    57308CFistula repair, transperine
    57311CRepair urethrovaginal lesion
    57335CRepair vagina
    57531CRemoval of cervix, radical
    57540CRemoval of residual cervix
    57545CRemove cervix/repair pelvis
    58140CRemoval of uterus lesion
    58150CTotal hysterectomy
    58152CTotal hysterectomy
    58180CPartial hysterectomy
    58200CExtensive hysterectomy
    58210CExtensive hysterectomy
    58240CRemoval of pelvis contents
    58260CVaginal hysterectomy
    58262CVaginal hysterectomy
    58263CVaginal hysterectomy
    58267CHysterectomy & vagina repair
    58270CHysterectomy & vagina repair
    58275CHysterectomy/revise vagina
    58280CHysterectomy/revise vagina
    58285CExtensive hysterectomy
    58400CSuspension of uterus
    58410CSuspension of uterus
    58520CRepair of ruptured uterus
    58540CRevision of uterus
    58605CDivision of fallopian tube
    58611CLigate oviduct(s) add-on
    58700CRemoval of fallopian tube
    58720CRemoval of ovary/tube(s)
    58740CRevise fallopian tube(s)
    58750CRepair oviduct
    58752CRevise ovarian tube(s)
    58760CRemove tubal obstruction
    Start Printed Page 60113
    58770CCreate new tubal opening
    58805CDrainage of ovarian cyst(s)
    58822CDrain ovary abscess, percut
    58825CTransposition, ovary(s)
    58940CRemoval of ovary(s)
    58943CRemoval of ovary(s)
    58950CResect ovarian malignancy
    58951CResect ovarian malignancy
    58952CResect ovarian malignancy
    *58953CTah, rad dissect for debulk
    *58954CTah rad debulk/lymph remove
    58960CExploration of abdomen
    59100CRemove uterus lesion
    59120CTreat ectopic pregnancy
    59121CTreat ectopic pregnancy
    59130CTreat ectopic pregnancy
    59135CTreat ectopic pregnancy
    59136CTreat ectopic pregnancy
    59140CTreat ectopic pregnancy
    59325CRevision of cervix
    59350CRepair of uterus
    59514CCesarean delivery only
    59525CRemove uterus after cesarean
    59620CAttempted vbac delivery only
    59830CTreat uterus infection
    59850CAbortion
    59851CAbortion
    59852CAbortion
    59855CAbortion
    59856CAbortion
    59857CAbortion
    60254CExtensive thyroid surgery
    60270CRemoval of thyroid
    60271CRemoval of thyroid
    60502CRe-explore parathyroids
    60505CExplore parathyroid glands
    60520CRemoval of thymus gland
    60521CRemoval of thymus gland
    60522CRemoval of thymus gland
    60540CExplore adrenal gland
    60545CExplore adrenal gland
    60600CRemove carotid body lesion
    60605CRemove carotid body lesion
    60650CLaparoscopy adrenalectomy
    61105CTwist drill hole
    61107CDrill skull for implantation
    61108CDrill skull for drainage
    61120CBurr hole for puncture
    61140CPierce skull for biopsy
    61150CPierce skull for drainage
    61151CPierce skull for drainage
    61154CPierce skull & remove clot
    61156CPierce skull for drainage
    61210CPierce skull, implant device
    61250CPierce skull & explore
    61253CPierce skull & explore
    61304COpen skull for exploration
    61305COpen skull for exploration
    61312COpen skull for drainage
    61313COpen skull for drainage
    61314COpen skull for drainage
    61315COpen skull for drainage
    61320COpen skull for drainage
    61321COpen skull for drainage
    61332CExplore/biopsy eye socket
    Start Printed Page 60114
    61333CExplore orbit/remove lesion
    61334CExplore orbit/remove object
    61340CRelieve cranial pressure
    61343CIncise skull (press relief)
    61345CRelieve cranial pressure
    61440CIncise skull for surgery
    61450CIncise skull for surgery
    61458CIncise skull for brain wound
    61460CIncise skull for surgery
    61470CIncise skull for surgery
    61480CIncise skull for surgery
    61490CIncise skull for surgery
    61500CRemoval of skull lesion
    61501CRemove infected skull bone
    61510CRemoval of brain lesion
    61512CRemove brain lining lesion
    61514CRemoval of brain abscess
    61516CRemoval of brain lesion
    61518CRemoval of brain lesion
    61519CRemove brain lining lesion
    61520CRemoval of brain lesion
    61521CRemoval of brain lesion
    61522CRemoval of brain abscess
    61524CRemoval of brain lesion
    61526CRemoval of brain lesion
    61530CRemoval of brain lesion
    61531CImplant brain electrodes
    61533CImplant brain electrodes
    61534CRemoval of brain lesion
    61535CRemove brain electrodes
    61536CRemoval of brain lesion
    61538CRemoval of brain tissue
    61539CRemoval of brain tissue
    61541CIncision of brain tissue
    61542CRemoval of brain tissue
    61543CRemoval of brain tissue
    61544CRemove & treat brain lesion
    61545CExcision of brain tumor
    61546CRemoval of pituitary gland
    61548CRemoval of pituitary gland
    61550CRelease of skull seams
    61552CRelease of skull seams
    61556CIncise skull/sutures
    61557CIncise skull/sutures
    61558CExcision of skull/sutures
    61559CExcision of skull/sutures
    61563CExcision of skull tumor
    61564CExcision of skull tumor
    61570CRemove foreign body, brain
    61571CIncise skull for brain wound
    61575CSkull base/brainstem surgery
    61576CSkull base/brainstem surgery
    61580CCraniofacial approach, skull
    61581CCraniofacial approach, skull
    61582CCraniofacial approach, skull
    61583CCraniofacial approach, skull
    61584COrbitocranial approach/skull
    61585COrbitocranial approach/skull
    61586CResect nasopharynx, skull
    61590CInfratemporal approach/skull
    61591CInfratemporal approach/skull
    61592COrbitocranial approach/skull
    61595CTranstemporal approach/skull
    61596CTranscochlear approach/skull
    61597CTranscondylar approach/skull
    Start Printed Page 60115
    61598CTranspetrosal approach/skull
    61600CResect/excise cranial lesion
    61601CResect/excise cranial lesion
    61605CResect/excise cranial lesion
    61606CResect/excise cranial lesion
    61607CResect/excise cranial lesion
    61608CResect/excise cranial lesion
    61609CTransect artery, sinus
    61610CTransect artery, sinus
    61611CTransect artery, sinus
    61612CTransect artery, sinus
    61613CRemove aneurysm, sinus
    61615CResect/excise lesion, skull
    61616CResect/excise lesion, skull
    61618CRepair dura
    61619CRepair dura
    61624COcclusion/embolization cath
    61680CIntracranial vessel surgery
    61682CIntracranial vessel surgery
    61684CIntracranial vessel surgery
    61686CIntracranial vessel surgery
    61690CIntracranial vessel surgery
    61692CIntracranial vessel surgery
    61697CBrain aneurysm repr, complx
    61698CBrain aneurysm repr, complx
    61700CBrain aneurysm repr, simple
    61702CInner skull vessel surgery
    61703CClamp neck artery
    61705CRevise circulation to head
    61708CRevise circulation to head
    61710CRevise circulation to head
    61711CFusion of skull arteries
    61720CIncise skull/brain surgery
    61735CIncise skull/brain surgery
    61750CIncise skull/brain biopsy
    61751CBrain biopsy w/ ct/mr guide
    61760CImplant brain electrodes
    61770CIncise skull for treatment
    61850CImplant neuroelectrodes
    61860CImplant neuroelectrodes
    61862CImplant neurostimul, subcort
    61870CImplant neuroelectrodes
    61875CImplant neuroelectrodes
    62000CTreat skull fracture
    62005CTreat skull fracture
    62010CTreatment of head injury
    62100CRepair brain fluid leakage
    62115CReduction of skull defect
    62116CReduction of skull defect
    62117CReduction of skull defect
    62120CRepair skull cavity lesion
    62121CIncise skull repair
    62140CRepair of skull defect
    62141CRepair of skull defect
    62142CRemove skull plate/flap
    62143CReplace skull plate/flap
    62145CRepair of skull & brain
    62146CRepair of skull with graft
    62147CRepair of skull with graft
    62180CEstablish brain cavity shunt
    62190CEstablish brain cavity shunt
    62192CEstablish brain cavity shunt
    62200CEstablish brain cavity shunt
    62201CEstablish brain cavity shunt
    62220CEstablish brain cavity shunt
    Start Printed Page 60116
    62223CEstablish brain cavity shunt
    62256CRemove brain cavity shunt
    62258CReplace brain cavity shunt
    62351CImplant spinal canal cath
    63043CLaminotomy, addl cervical
    63044CLaminotomy, addl lumbar
    63075CNeck spine disk surgery
    63076CNeck spine disk surgery
    63077CSpine disk surgery, thorax
    63078CSpine disk surgery, thorax
    63081CRemoval of vertebral body
    63082CRemove vertebral body add-on
    63085CRemoval of vertebral body
    63086CRemove vertebral body add-on
    63087CRemoval of vertebral body
    63088CRemove vertebral body add-on
    63090CRemoval of vertebral body
    63091CRemove vertebral body add-on
    63170CIncise spinal cord tract(s)
    63172CDrainage of spinal cyst
    63173CDrainage of spinal cyst
    63180CRevise spinal cord ligaments
    63182CRevise spinal cord ligaments
    63185CIncise spinal column/nerves
    63190CIncise spinal column/nerves
    63191CIncise spinal column/nerves
    63194CIncise spinal column & cord
    63195CIncise spinal column & cord
    63196CIncise spinal column & cord
    63197CIncise spinal column & cord
    63198CIncise spinal column & cord
    63199CIncise spinal column & cord
    63200CRelease of spinal cord
    63250CRevise spinal cord vessels
    63251CRevise spinal cord vessels
    63252CRevise spinal cord vessels
    63265CExcise intraspinal lesion
    63266CExcise intraspinal lesion
    63267CExcise intraspinal lesion
    63268CExcise intraspinal lesion
    63270CExcise intraspinal lesion
    63271CExcise intraspinal lesion
    63272CExcise intraspinal lesion
    63273CExcise intraspinal lesion
    63275CBiopsy/excise spinal tumor
    63276CBiopsy/excise spinal tumor
    63277CBiopsy/excise spinal tumor
    63278CBiopsy/excise spinal tumor
    63280CBiopsy/excise spinal tumor
    63281CBiopsy/excise spinal tumor
    63282CBiopsy/excise spinal tumor
    63283CBiopsy/excise spinal tumor
    63285CBiopsy/excise spinal tumor
    63286CBiopsy/excise spinal tumor
    63287CBiopsy/excise spinal tumor
    63290CBiopsy/excise spinal tumor
    63300CRemoval of vertebral body
    63301CRemoval of vertebral body
    63302CRemoval of vertebral body
    63303CRemoval of vertebral body
    63304CRemoval of vertebral body
    63305CRemoval of vertebral body
    63306CRemoval of vertebral body
    63307CRemoval of vertebral body
    63308CRemove vertebral body add-on
    Start Printed Page 60117
    63700CRepair of spinal herniation
    63702CRepair of spinal herniation
    63704CRepair of spinal herniation
    63706CRepair of spinal herniation
    63707CRepair spinal fluid leakage
    63709CRepair spinal fluid leakage
    63710CGraft repair of spine defect
    63740CInstall spinal shunt
    64752CIncision of vagus nerve
    64755CIncision of stomach nerves
    64760CIncision of vagus nerve
    64763CIncise hip/thigh nerve
    64766CIncise hip/thigh nerve
    64802CRemove sympathetic nerves
    64804CRemove sympathetic nerves
    64809CRemove sympathetic nerves
    64818CRemove sympathetic nerves
    64820CRemove sympathetic nerves
    64866CFusion of facial/other nerve
    64868CFusion of facial/other nerve
    65273CRepair of eye wound
    69150CExtensive ear canal surgery
    69155CExtensive ear/neck surgery
    69502CMastoidectomy
    69535CRemove part of temporal bone
    69554CRemove ear lesion
    69950CIncise inner ear nerve
    69970CRemove inner ear lesion
    75900CArterial catheter exchange
    75952CEndovasc repair abdom aorta
    75953CAbdom aneurysm endovas rpr
    92970CCardioassist, internal
    92971CCardioassist, external
    92975CDissolve clot, heart vessel
    92986CRevision of aortic valve
    92987CRevision of mitral valve
    92990CRevision of pulmonary valve
    92992CRevision of heart chamber
    92993CRevision of heart chamber
    92997CPul art balloon repr, percut
    92998CPul art balloon repr, percut
    94652CPressure breathing (IPPB)
    99190CSpecial pump services
    99191CSpecial pump services
    99192CSpecial pump services
    99251CInitial inpatient consult
    99252CInitial inpatient consult
    99253CInitial inpatient consult
    99254CInitial inpatient consult
    99255CInitial inpatient consult
    99261CFollow-up inpatient consult
    99262CFollow-up inpatient consult
    99263CFollow-up inpatient consult
    99295CNeonatal critical care
    99296CNeonatal critical care
    99297CNeonatal critical care
    99298CNeonatal critical care
    99356CProlonged service, inpatient
    99357CProlonged service, inpatient
    99433CNormal newborn care/hospital
    CPT codes and descriptions only are copyright American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply.
    Copyright American Dental Association. All rights reserved.
    *Code is new in 2002.
            Start Printed Page 60118

    Addendum H.—Wage Index for Urban Areas

    Urban Area (Constituent Counties)Wage Index
    0040 Abilene, TX0.7983
    Taylor, TX
    0060 2 Aguadilla, PR0.4832
    Aguada, PR
    Aguadilla, PR
    Moca, PR
    0080 Akron, OH0.9876
    Portage, OH
    Summit, OH
    0120 Albany, GA1.0640
    Dougherty, GA
    Lee, GA
    0160 2 Albany-Schenectady-Troy, NY0.8547
    Albany, NY
    Montgomery, NY
    Rensselaer, NY
    Saratoga, NY
    Schenectady, NY
    Schoharie, NY
    0200 Albuquerque, NM0.9750
    Bernalillo, NM
    Sandoval, NM
    Valencia, NM
    0220 Alexandria, LA0.8059
    Rapides, LA
    0240 Allentown-Bethlehem-Easton, PA1.0077
    Carbon, PA
    Lehigh, PA
    Northampton, PA
    0280 Altoona, PA0.9126
    Blair, PA
    0320 Amarillo, TX
    Potter, TX0.8711
    Randall, TX
    0380 Anchorage, AK1.2696
    Anchorage, AK
    0440 Ann Arbor, MI1.1098
    Lenawee, MI
    Livingston, MI
    Washtenaw, MI
    0450 Anniston, AL0.8276
    Calhoun, AL
    0460 Appleton-Oshkosh-Neenah, WI0.9241
    Calumet, WI
    Outagamie, WI
    Winnebago, WI
    0470 2 Arecibo, PR0.4832
    Arecibo, PR
    Camuy, PR
    Hatillo, PR
    0480 Asheville, NC0.9200
    Buncombe, NC
    Madison, NC
    0500 Athens, GA0.9842
    Clarke, GA
    Madison, GA
    Oconee, GA
    0520 1 Atlanta, GA1.0058
    Barrow, GA
    Bartow, GA
    Carroll, GA
    Cherokee, GA
    Clayton, GA
    Cobb, GA
    Coweta, GA
    DeKalb, GA
    Douglas, GA
    Fayette, GA
    Forsyth, GA
    Fulton, GA
    Gwinnett, GA
    Henry, GA
    Newton, GA
    Paulding, GA
    Pickens, GA
    Rockdale, GA
    Spalding, GA
    Walton, GA
    0560 Atlantic-Cape May, NJ1.1293
    Atlantic, NJ
    Cape May, NJ
    0580 Auburn-Opelika, AL0.8230
    Lee, AL
    0600 Augusta-Aiken, GA-SC0.9970
    Columbia, GA
    McDuffie, GA
    Richmond, GA
    Aiken, SC
    Edgefield, SC
    0640 1 Austin-San Marcos, TX0.9597
    Bastrop, TX
    Caldwell, TX
    Hays, TX
    Travis, TX
    Williamson, TX
    0680 2 Bakersfield, CA0.9659
    Kern, CA
    0720 1 Baltimore, MD0.9856
    Anne Arundel, MD
    Baltimore, MD
    Baltimore City, MD
    Carroll, MD
    Harford, MD
    Howard, MD
    Queen Anne's, MD
    0733 Bangor, ME0.9593
    Penobscot, ME
    0743 Barnstable-Yarmouth, MA1.3626
    Barnstable, MA
    0760 Baton Rouge, LA0.8149
    Ascension, LA
    East Baton Rouge, LA
    Livingston, LA
    West Baton Rouge, LA
    0840 Beaumont-Port Arthur, TX0.8442
    Hardin, TX
    Jefferson, TX
    Orange, TX
    0860 Bellingham, WA1.1826
    Whatcom, WA
    0870 2 Benton Harbor, MI0.9000
    Berrien, MI
    0875 1 Bergen-Passaic, NJ1.1808
    Bergen, NJ
    Passaic, NJ
    0880 Billings, MT0.9352
    Yellowstone, MT
    0920 Biloxi-Gulfport-Pascagoula, MS0.8440
    Hancock, MS
    Harrison, MS
    Jackson, MS
    0960 2 Binghamton, NY0.8547
    Broome, NY
    Tioga, NY
    1000 Birmingham, AL0.8808
    Blount, AL
    Jefferson, AL
    St. Clair, AL
    Shelby, AL
    1010 Bismarck, ND0.7984
    Burleigh, ND
    Morton, ND
    1020 Bloomington, IN0.8842
    Monroe, IN
    1040 Bloomington-Normal, IL0.9038
    McLean, IL
    1080 Boise City, ID0.9050
    Ada, ID
    Canyon, ID
    1123 1,2 Boston-Worcester-Lawrence-Lowell-Brockton, MA-NH (MA Hospitals)1.1454
    Bristol, MA
    Essex, MA
    Middlesex, MA
    Norfolk, MA
    Plymouth, MA
    Suffolk, MA
    Worcester, MA
    Hillsborough, NH
    Merrimack, NH
    Rockingham, NH
    Strafford, NH
    1123 1 Boston-Worcester-Lawrence-Lowell-Brockton, MA-NH (NH Hospitals)1.1293
    Bristol, MA
    Essex, MA
    Middlesex, MA
    Norfolk, MA
    Plymouth, MA
    Suffolk, MA
    Worcester, MA
    Hillsborough, NH
    Merrimack, NH
    Rockingham, NH
    Strafford, NH
    1125 Boulder-Longmont, CO0.9799
    Boulder, CO
    1145  Brazoria, TX0.8209
    Brazoria, TX
    1150 Bremerton, WA1.0758
    Kitsap, WA
    1240 Brownsville-Harlingen-San Benito, TX0.9012
    Cameron, TX
    1260 Bryan-College Station, TX0.9328
    Brazos, TX
    1280 1 Buffalo-Niagara Falls, NY0.9459
    Erie, NY
    Niagara, NY
    1303 Burlington, VT0.9883
    Chittenden, VT
    Franklin, VT
    Grand Isle, VT
    1310 2 Caguas, PR0.4832
    Caguas, PR
    Cayey, PR
    Cidra, PR
    Gurabo, PR
    San Lorenzo, PR
    1320 Canton-Massillon, OH0.8956
    Carroll, OH
    Stark, OH
    Start Printed Page 60119
    1350 Casper, WY0.9496
    Natrona, WY
    1360 Cedar Rapids, IA0.8699
    Linn, IA
    1400 Champaign-Urbana, IL0.9306
    Champaign, IL
    1440 Charleston-North Charleston, SC0.9206
    Berkeley, SC
    Charleston, SC
    Dorchester, SC
    1480 Charleston, WV0.9264
    Kanawha, WV
    Putnam, WV
    1520 1 Charlotte-Gastonia-Rock Hill, NC-SC0.9407
    Cabarrus, NC
    Gaston, NC
    Lincoln, NC
    Mecklenburg, NC
    Rowan, NC
    Stanly, NC
    Union, NC
    York, SC
    1540 Charlottesville, VA1.0566
    Albemarle, VA
    Charlottesville City, VA
    Fluvanna, VA
    Greene, VA
    1560 Chattanooga, TN-GA0.9369
    Catoosa, GA
    Dade, GA
    Walker, GA
    Hamilton, TN
    Marion, TN
    1580 2 Cheyenne, WY0.8747
    Laramie, WY
    1600 1 Chicago, IL1.1046
    Cook, IL
    DeKalb, IL
    DuPage, IL
    Grundy, IL
    Kane, IL
    Kendall, IL
    Lake, IL
    McHenry, IL
    Will, IL
    1620 Chico-Paradise, CA0.9856
    Butte, CA
    1640 1 Cincinnati, OH-KY-IN0.9473
    Dearborn, IN
    Ohio, IN
    Boone, KY
    Campbell, KY
    Gallatin, KY
    Grant, KY
    Kenton, KY
    Pendleton, KY
    Brown, OH
    Clermont, OH
    Hamilton, OH
    Warren, OH
    1660 Clarksville-Hopkinsville, TN-KY0.8393
    Christian, KY
    Montgomery, TN
    1680 1 Cleveland-Lorain-Elyria, OH0.9457
    Ashtabula, OH
    Cuyahoga, OH
    Geauga, OH
    Lake, OH
    Lorain, OH
    Medina, OH
    1720 Colorado Springs, CO0.9744
    El Paso, CO
    1740 Columbia, MO0.8686
    Boone, MO
    1760 Columbia, SC0.9492
    Lexington, SC
    Richland, SC
    1800 Columbus, GA-AL
    Russell, AL0.8440
    Chattahoochee, GA
    Harris, GA
    Muscogee, GA
    1840 1 Columbus, OH0.9565
    Delaware, OH
    Fairfield, OH
    Franklin, OH
    Licking, OH
    Madison, OH
    Pickaway, OH
    1880 Corpus Christi, TX0.8341
    Nueces, TX
    San Patricio, TX
    1890 Corvallis, OR1.1646
    Benton, OR
    1900 2 Cumberland, MD-WV (MD Hospitals)0.8859
    Allegany, MD
    Mineral, WV
    1900 Cumberland, MD-WV (WV Hospital)0.8306
    Allegany, MD
    Mineral, WV
    1920 1 Dallas, TX0.9936
    Collin, TX
    Dallas, TX
    Denton, TX
    Ellis, TX
    Henderson, TX
    Hunt, TX
    Kaufman, TX
    Rockwall, TX
    1950 Danville, VA0.8613
    Danville City, VA
    Pittsylvania, VA
    1960 Davenport-Moline-Rock Island, IA-IL0.8638
    Scott, IA
    Henry, IL
    Rock Island, IL
    2000 Dayton-Springfield, OH0.9225
    Clark, OH
    Greene, OH
    Miami, OH
    Montgomery, OH
    2020 Daytona Beach, FL0.8972
    Flagler, FL
    Volusia, FL
    2030 Decatur, AL0.8775
    Lawrence, AL
    Morgan, AL
    2040 2 Decatur, IL0.8053
    Macon, IL
    2080 1 Denver, CO1.0328
    Adams, CO
    Arapahoe, CO
    Denver, CO
    Douglas, CO
    Jefferson, CO
    2120 Des Moines, IA0.8779
    Dallas, IA
    Polk, IA
    Warren, IA
    2160 1 Detroit, MI1.0487
    Lapeer, MI
    Macomb, MI
    Monroe, MI
    Oakland, MI
    St. Clair, MI
    Wayne, MI
    2180 Dothan, AL0.7988
    Dale, AL
    Houston, AL
    2190 Dover, DE1.0296
    Kent, DE
    2200 Dubuque, IA0.8519
    Dubuque, IA
    2240 Duluth-Superior, MN-WI1.0284
    St. Louis, MN
    Douglas, WI
    2281 Dutchess County, NY1.0532
    Dutchess, NY
    2290 2 Eau Claire, WI0.9068
    Chippewa, WI
    Eau Claire, WI
    2320 El Paso, TX0.9215
    El Paso, TX
    2330 Elkhart-Goshen, IN0.9638
    Elkhart, IN
    2335 2 Elmira, NY0.8547
    Chemung, NY
    2340 Enid, OK0.8357
    Garfield, OK
    2360 Erie, PA0.8716
    Erie, PA
    2400 Eugene-Springfield, OR1.1471
    Lane, OR
    2440 2 Evansville-Henderson, IN-KY (IN Hospitals)0.8721
    Posey, IN
    Vanderburgh, IN
    Warrick, IN
    Henderson, KY
    2440 Evansville-Henderson, IN-KY (KY Hospitals)0.8514
    Posey, IN
    Vanderburgh, IN
    Warrick, IN
    Henderson, KY
    2520 Fargo-Moorhead, ND-MN0.9267
    Clay, MN
    Cass, ND
    2560 Fayetteville, NC0.9027
    Cumberland, NC
    2580 Fayetteville-Springdale-Rogers, AR0.8445
    Benton, AR
    Washington, AR
    2620 Flagstaff, AZ-UT1.0556
    Coconino, AZ
    Kane, UT
    2640 Flint, MI1.0913
    Genesee, MI
    2650 Florence, AL0.7889
    Colbert, AL
    Lauderdale, AL
    2655 Florence, SC0.8722
    Start Printed Page 60120
    Florence, SC
    2670 Fort Collins-Loveland, CO1.0045
    Larimer, CO
    2680 1 Ft. Lauderdale, FL1.0784
    Broward, FL
    2700 Fort Myers-Cape Coral, FL0.9374
    Lee, FL
    2710 Fort Pierce-Port St. Lucie, FL1.0214
    Martin, FL
    St. Lucie, FL
    2720 Fort Smith, AR-OK0.8053
    Crawford, AR
    Sebastian, AR
    Sequoyah, OK
    2750 Fort Walton Beach, FL0.9002
    Okaloosa, FL
    2760 Fort Wayne, IN0.9203
    Adams, IN
    Allen, IN
    De Kalb, IN
    Huntington, IN
    Wells, IN
    Whitley, IN
    2800 1 Forth Worth-Arlington, TX0.9394
    Hood, TX
    Johnson, TX
    Parker, TX
    Tarrant, TX
    2840 Fresno, CA0.9984
    Fresno, CA
    Madera, CA
    2880 Gadsden, AL0.8792
    Etowah, AL
    2900 Gainesville, FL0.9481
    Alachua, FL
    2920 Galveston-Texas City, TX1.0313
    Galveston, TX
    2960 Gary, IN0.9530
    Lake, IN
    Porter, IN
    2975 2 Glens Falls, NY0.8547
    Warren, NY
    Washington, NY
    2980 Goldsboro, NC0.8709
    Wayne, NC
    2985 Grand Forks, ND-MN0.9119
    Polk, MN
    Grand Forks, ND
    2995 Grand Junction, CO0.9774
    Mesa, CO
    3000 1 Grand Rapids-Muskegon-Holland, MI1.0048
    Allegan, MI
    Kent, MI
    Muskegon, MI
    Ottawa, MI
    3040 Great Falls, MT0.9195
    Cascade, MT
    3060 Greeley, CO0.9495
    Weld, CO
    3080 Green Bay, WI0.9357
    Brown, WI
    3120 1 Greensboro-Winston-Salem-High Point, NC0.9539
    Alamance, NC
    Davidson, NC
    Davie, NC
    Forsyth, NC
    Guilford, NC
    Randolph, NC
    Stokes, NC
    Yadkin, NC
    3150 Greenville, NC0.9289
    Pitt, NC
    3160 Greenville-Spartanburg-Anderson, SC0.9217
    Anderson, SC
    Cherokee, SC
    Greenville, SC
    Pickens, SC
    Spartanburg, SC
    3180 2 Hagerstown, MD0.8859
    Washington, MD
    3200 Hamilton-Middletown, OH0.9287
    Butler, OH
    3240 Harrisburg-Lebanon-Carlisle, PA0.9425
    Cumberland, PA
    Dauphin, PA
    Lebanon, PA
    Perry, PA
    3283 1,2 Hartford, CT1.2077
    Hartford, CT
    Litchfield, CT
    Middlesex, CT
    Tolland, CT
    3285 2 Hattiesburg, MS0.7528
    Forrest, MS
    Lamar, MS
    3290 Hickory-Morganton-Lenoir, NC0.9367
    Alexander, NC
    Burke, NC
    Caldwell, NC
    Catawba, NC
    3320 Honolulu, HI1.1544
    Honolulu, HI
    3350 Houma, LA0.7975
    Lafourche, LA
    Terrebonne, LA
    3360 1 Houston, TX0.9631
    Chambers, TX
    Fort Bend, TX
    Harris, TX
    Liberty, TX
    Montgomery, TX
    Waller, TX
    3400 Huntington-Ashland, WV-KY-OH0.9616
    Boyd, KY
    Carter, KY
    Greenup, KY
    Lawrence, OH
    Cabell, WV
    Wayne, WV
    3440 Huntsville, AL0.8883
    Limestone, AL
    Madison, AL
    3480 1 Indianapolis, IN0.9698
    Boone, IN
    Hamilton, IN
    Hancock, IN
    Hendricks, IN
    Johnson, IN
    Madison, IN
    Marion, IN
    Morgan, IN
    Shelby, IN
    3500 Iowa City, IA0.9859
    Johnson, IA
    3520 Jackson, MI0.9257
    Jackson, MI
    3560 Jackson, MS0.8491
    Hinds, MS
    Madison, MS
    Rankin, MS
    3580 Jackson, TN0.9013
    Madison, TN
    Chester, TN
    3600 1 Jacksonville, FL0.9223
    Clay, FL
    Duval, FL
    Nassau, FL
    St. Johns, FL
    3605 2 Jacksonville, NC0.8535
    Onslow, NC
    3610 2 Jamestown, NY0.8547
    Chautauqua, NY
    3620 Janesville-Beloit, WI0.9739
    Rock, WI
    3640 Jersey City, NJ1.1178
    Hudson, NJ
    3660 Johnson City-Kingsport-Bristol, TN-VA0.8617
    Carter, TN
    Hawkins, TN
    Sullivan, TN
    Unicoi, TN
    Washington, TN
    Bristol City, VA
    Scott, VA
    Washington, VA
    3680 Johnstown, PA0.8723
    Cambria, PA
    Somerset, PA
    3700 Jonesboro, AR0.8425
    Craighead, AR
    3710 Joplin, MO0.8727
    Jasper, MO
    Newton, MO
    3720 Kalamazoo-Battlecreek, MI1.0639
    Calhoun, MI
    Kalamazoo, MI
    Van Buren, MI
    3740 Kankakee, IL0.9889
    Kankakee, IL
    3760 1 Kansas City, KS-MO0.9536
    Johnson, KS
    Leavenworth, KS
    Miami, KS
    Wyandotte, KS
    Cass, MO
    Clay, MO
    Clinton, MO
    Jackson, MO
    Lafayette, MO
    Platte, MO
    Ray, MO
    3800 Kenosha, WI0.9568
    Kenosha, WI
    3810 2 Killeen-Temple, TX0.7714
    Bell, TX
    Coryell, TX
    3840 Knoxville, TN0.8890
    Anderson, TN
    Blount, TN
    Knox, TN
    Loudon, TN
    Sevier, TN
    Start Printed Page 60121
    Union, TN
    3850 Kokomo, IN0.9184
    Howard, IN
    Tipton, IN
    3870 La Crosse, WI-MN0.9250
    Houston, MN
    La Crosse, WI
    3880 Lafayette, LA0.8544
    Acadia, LA
    Lafayette, LA
    St. Landry, LA
    St. Martin, LA
    3920 Lafayette, IN0.9121
    Clinton, IN
    Tippecanoe, IN
    3960 Lake Charles, LA0.7765
    Calcasieu, LA
    3980 Lakeland-Winter Haven, FL0.9067
    Polk, FL
    4000 Lancaster, PA0.9296
    Lancaster, PA
    4040 Lansing-East Lansing, MI0.9653
    Clinton, MI
    Eaton, MI
    Ingham, MI
    4080 Laredo, TX0.7849
    Webb, TX
    4100 2 Las Cruces, NM0.8676
    Dona Ana, NM
    4120 1 Las Vegas, NV-AZ1.1182
    Mohave, AZ
    Clark, NV
    Nye, NV
    4150 Lawrence, KS0.7812
    Douglas, KS
    4200 Lawton, OK0.8682
    Comanche, OK
    4243 Lewiston-Auburn, ME0.9287
    Androscoggin, ME
    4280 Lexington, KY0.8791
    Bourbon, KY
    Clark, KY
    Fayette, KY
    Jessamine, KY
    Madison, KY
    Scott, KY
    Woodford, KY
    4320 Lima, OH0.9470
    Allen, OH
    Auglaize, OH
    4360 Lincoln, NE1.0173
    Lancaster, NE
    4400 Little Rock-North Little Rock, AR0.8955
    Faulkner, AR
    Lonoke, AR
    Pulaski, AR
    Saline, AR
    4420 Longview-Marshall, TX0.8571
    Gregg, TX
    Harrison, TX
    Upshur, TX
    4480 1 Los Angeles-Long Beach, CA1.1961
    Los Angeles, CA
    4520 1 Louisville, KY-IN0.9529
    Clark, IN
    Floyd, IN
    Harrison, IN
    Scott, IN
    Bullitt, KY
    Jefferson, KY
    Oldham, KY
    4600 Lubbock, TX0.8463
    Lubbock, TX
    4640 Lynchburg, VA0.9103
    Amherst, VA
    Bedford, VA
    Bedford City, VA
    Campbell, VA
    Lynchburg City, VA
    4680 Macon, GA0.8971
    Bibb, GA
    Houston, GA
    Jones, GA
    Peach, GA
    Twiggs, GA
    4720 Madison, WI1.0367
    Dane, WI
    4800 Mansfield, OH0.8726
    Crawford, OH
    Richland, OH
    4840 Mayaguez, PR0.4860
    Anasco, PR
    Cabo Rojo, PR
    Hormigueros, PR
    Mayaguez, PR
    Sabana Grande, PR
    San German, PR
    4880 McAllen-Edinburg-Mission, TX0.8378
    Hidalgo, TX
    4890  Medford-Ashland, OR1.0314
    Jackson, OR
    4900 Melbourne-Titusville-Palm Bay, FL0.9913
    Brevard, Fl
    4920 1 Memphis, TN-AR-MS0.8978
    Crittenden, AR
    DeSoto, MS
    Fayette, TN
    Shelby, TN
    Tipton, TN
    4940 Merced, CA0.9947
    Merced, CA
    5000 1 Miami, FL0.9950
    Dade, FL
    5015 1 Middlesex-Somerset-Hunterdon, NJ1.1469
    Hunterdon, NJ
    Middlesex, NJ
    Somerset, NJ
    5080 1 Milwaukee-Waukesha, WI0.9971
    Milwaukee, WI
    Ozaukee, WI
    Washington, WI
    Waukesha, WI
    5120 1 Minneapolis-St. Paul, MN-WI1.0930
    Anoka, MN
    Carver, MN
    Chisago, MN
    Dakota, MN
    Hennepin, MN
    Isanti, MN
    Ramsey, MN
    Scott, MN
    Sherburne, MN
    Washington, MN
    Wright, MN
    Pierce, WI
    St. Croix, WI
    5140 Missoula, MT0.9364
    Missoula, MT
    5160 Mobile, AL0.8084
    Baldwin, AL
    Mobile, AL
    5170 Modesto, CA1.0820
    Stanislaus, CA
    5190 1 Monmouth-Ocean, NJ1.1257
    Monmouth, NJ
    Ocean, NJ
    5200 Monroe, LA0.8201
    Ouachita, LA
    5240 2 Montgomery, AL0.7400
    Autauga, AL
    Elmore, AL
    Montgomery, AL
    5280 Muncie, IN0.9939
    Delaware, IN
    5330 Myrtle Beach, SC0.8771
    Horry, SC
    5345 Naples, FL0.9699
    Collier, FL
    5360 1 Nashville, TN0.9754
    Cheatham, TN
    Davidson, TN
    Dickson, TN
    Robertson, TN
    Rutherford TN
    Sumner, TN
    Williamson, TN
    Wilson, TN
    5380 1 Nassau-Suffolk, NY1.3643
    Nassau, NY
    Suffolk, NY
    5483 1 New Haven-Bridgeport-Stamford-Waterbury-1.2294
    Danbury, CT
    Fairfield, CT
    New Haven, CT
    5523 2 New London-Norwich, CT1.2077
    New London, CT
    5560 1 New Orleans, LA0.9036
    Jefferson, LA
    Orleans, LA
    Plaquemines, LA
    St. Bernard, LA
    St. Charles, LA
    St. James, LA
    St. John The Baptist, LA
    St. Tammany, LA
    5600 1 New York, NY1.4427
    Bronx, NY
    Kings, NY
    New York, NY
    Putnam, NY
    Queens, NY
    Richmond, NY
    Rockland, NY
    Westchester, NY
    5640 1 Newark, NJ1.1622
    Essex, NJ
    Morris, NJ
    Sussex, NJ
    Union, NJ
    Warren, NJ
    5660 Newburgh, NY-PA1.1113
    Start Printed Page 60122
    Orange, NY
    Pike, PA
    5720 1 Norfolk-Virginia Beach-Newport News, VA-NC0.8579
    Currituck, NC
    Chesapeake City, VA
    Gloucester, VA
    Hampton City, VA
    Isle of Wight, VA
    James City, VA
    Mathews, VA
    Newport News City, VA
    Norfolk City, VA
    Poquoson City, VA
    Portsmouth City, VA
    Suffolk City, VA
    Virginia Beach City VA
    Williamsburg City, VA
    York, VA
    5775 1 Oakland, CA1.5319
    Alameda, CA
    Contra Costa, CA
    5790 Ocala, FL0.9556
    Marion, FL
    5800 Odessa-Midland, TX1.0104
    Ector, TX
    Midland, TX
    5880 1 Oklahoma City, OK0.8694
    Canadian, OK
    Cleveland, OK
    Logan, OK
    McClain, OK
    Oklahoma, OK
    Pottawatomie, OK
    5910  Olympia, WA1.1350
    Thurston, WA
    5920 Omaha, NE-IA0.9712
    Pottawattamie, IA
    Cass, NE
    Douglas, NE
    Sarpy, NE
    Washington, NE
    5945 1 Orange County, CA1.1246
    Orange, CA
    5960 1 Orlando, FL0.9642
    Lake, FL
    Orange, FL
    Osceola, FL
    Seminole, FL
    5990 Owensboro, KY0.8334
    Daviess, KY
    6015  Panama City, FL0.9061
    Bay, FL
    6020 Parkersburg-Marietta, WV-OH (WV Hospitals)0.8133
    Washington, OH
    Wood, WV
    6020 2 Parkersburg-Marietta, WV-OH (OH Hospitals)0.8668
    Washington, OH
    Wood, WV
    6080 2 Pensacola, FL0.8794
    Escambia, FL
    Santa Rosa, FL
    6120 Peoria-Pekin, IL0.8773
    Peoria, IL
    Tazewell, IL
    Woodford, IL
    6160 1 Philadelphia, PA-NJ1.0947
    Burlington, NJ
    Camden, NJ
    Gloucester, NJ
    Salem, NJ
    Bucks, PA
    Chester, PA
    Delaware, PA
    Montgomery, PA
    Philadelphia, PA
    6200 1 Phoenix-Mesa, AZ0.9638
    Maricopa, AZ
    Pinal, AZ
    6240 Pine Bluff, AR0.7895
    Jefferson, AR
    6280 1 Pittsburgh, PA0.9560
    Allegheny, PA
    Beaver, PA
    Butler, PA
    Fayette, PA
    Washington, PA
    Westmoreland, PA
    6323 2 Pittsfield, MA1.1454
    Berkshire, MA
    6340 Pocatello, ID0.9448
    Bannock, ID
    6360 Ponce, PR0.5218
    Guayanilla, PR
    Juana Diaz, PR
    Penuelas, PR
    Ponce, PR
    Villalba, PR
    Yauco, PR
    6403 Portland, ME0.9427
    Cumberland, ME
    Sagadahoc, ME
    York, ME
    6440 1 Portland-Vancouver, OR-WA1.1150
    Clackamas, OR
    Columbia, OR
    Multnomah, OR
    Washington, OR
    Yamhill, OR
    Clark, WA
    6483 1 Providence-Warwick-Pawtucket, RI1.0805
    Bristol, RI
    Kent, RI
    Newport, RI
    Providence, RI
    Washington, RI
    6520 Provo-Orem, UT0.9843
    Utah, UT
    6560 2 Pueblo, CO0.8811
    Pueblo, CO
    6580 Punta Gorda, FL0.9015
    Charlotte, FL
    6600 Racine, WI0.9333
    Racine, WI
    6640 1 Raleigh-Durham-Chapel Hill, NC0.9818
    Chatham, NC
    Durham, NC
    Franklin, NC
    Johnston, NC
    Orange, NC
    Wake, NC
    6660 Rapid City, SD0.8869
    Pennington, SD
    6680 Reading, PA0.9583
    Berks, PA
    6690 Redding, CA1.1155
    Shasta, CA
    6720 Reno, NV1.0421
    Washoe, NV
    6740 Richland-Kennewick-Pasco, WA1.0960
    Benton, WA
    Franklin, WA
    6760 Richmond-Petersburg, VA0.9678
    Charles City County, VA
    Chesterfield, VA
    Colonial Heights City, VA
    Dinwiddie, VA
    Goochland, VA
    Hanover, VA
    Henrico, VA
    Hopewell City, VA
    New Kent, VA
    Petersburg City, VA
    Powhatan, VA
    Prince George, VA
    Richmond City, VA
    6780 1 Riverside-San Bernardino, CA1.1112
    Riverside, CA
    San Bernardino, CA
    6800 Roanoke, VA0.8371
    Botetourt, VA
    Roanoke, VA
    Roanoke City, VA
    Salem City, VA
    6820 Rochester, MN1.1462
    Olmsted, MN
    6840 1 Rochester, NY0.9347
    Genesee, NY
    Livingston, NY
    Monroe, NY
    Ontario, NY
    Orleans, NY
    Wayne, NY
    6880 Rockford, IL0.9204
    Boone, IL
    Ogle, IL
    Winnebago, IL
    6895 Rocky Mount, NC0.9109
    Edgecombe, NC
    Nash, NC
    6920 1 Sacramento, CA1.1831
    El Dorado, CA
    Placer, CA
    Sacramento, CA
    6960 Saginaw-Bay City-Midland, MI0.9590
    Bay, MI
    Midland, MI
    Saginaw, MI
    6980 St. Cloud, MN0.9919
    Benton, MN
    Stearns, MN
    7000 St. Joseph, MO0.7899
    Andrew, MO
    Buchanan, MO
    7040 1 St. Louis, MO-IL0.8931
    Clinton, IL
    Jersey, IL
    Madison, IL
    Monroe, IL
    St. Clair, IL
    Franklin, MO
    Jefferson, MO
    Start Printed Page 60123
    Lincoln, MO
    St. Charles, MO
    St. Louis, MO
    St. Louis City, MO
    Warren, MO
    7080 2 Salem, OR1.0033
    Marion, OR
    Polk, OR
    7120 Salinas, CA1.4684
    Monterey, CA
    7160 1 Salt Lake City-Ogden, UT0.9863
    Davis, UT
    Salt Lake, UT
    Weber, UT
    7200 San Angelo, TX0.8193
    Tom Green, TX
    7240 1 San Antonio, TX0.8584
    Bexar, TX
    Comal, TX
    Guadalupe, TX
    Wilson, TX
    7320 1 San Diego, CA1.1265
    San Diego, CA
    7360 1 San Francisco, CA1.4140
    Marin, CA
    San Francisco, CA
    San Mateo, CA
    7400 1 San Jose, CA1.4193
    Santa Clara, CA
    7440 1,2 San Juan-Bayamon, PR0.4832
    Aguas Buenas, PR
    Barceloneta, PR
    Bayamon, PR
    Canovanas, PR
    Carolina, PR
    Catano, PR
    Ceiba, PR
    Comerio, PR
    Corozal, PR
    Dorado, PR
    Fajardo, PR
    Florida, PR
    Guaynabo, PR
    Humacao, PR
    Juncos, PR
    Los Piedras, PR
    Loiza, PR
    Luguillo, PR
    Manati, PR
    Morovis, PR
    Naguabo, PR
    Naranjito, PR
    Rio Grande, PR
    San Juan, PR
    Toa Alta, PR
    Toa Baja, PR
    Trujillo Alto, PR
    Vega Alta, PR
    Vega Baja, PR
    Yabucoa, PR
    7460 San Luis Obispo-Atascadero-Paso Robles, CA1.0990
    San Luis Obispo, CA
    7480 Santa Barbara-Santa Maria-Lompoc, CA1.0802
    Santa Barbara, CA
    7485 Santa Cruz-Watsonville, CA1.3970
    Santa Cruz, CA
    7490 Santa Fe, NM1.0194
    Los Alamos, NM
    Santa Fe, NM
    7500  Santa Rosa, CA1.3034
    Sonoma, CA
    7510 Sarasota-Bradenton, FL1.0090
    Manatee, FL
    Sarasota, FL
    7520 Savannah, GA0.9243
    Bryan, GA
    Chatham, GA
    Effingham, GA
    7560 Scranton--Wilkes-Barre--Hazleton, PA0.8683
    Columbia, PA
    Lackawanna, PA
    Luzerne, PA
    Wyoming, PA
    7600 1 Seattle-Bellevue-Everett, WA1.1361
    Island, WA
    King, WA
    Snohomish, WA
    7610 2 Sharon, PA0.8607
    Mercer, PA
    7620 2 Sheboygan, WI0.9068
    Sheboygan, WI
    7640 Sherman-Denison, TX0.9373
    Grayson, TX
    7680  Shreveport-Bossier City, LA0.9050
    Bossier, LA
    Caddo, LA
    Webster, LA
    7720 Sioux City, IA-NE0.8767
    Woodbury, IA
    Dakota, NE
    7760 Sioux Falls, SD0.9139
    Lincoln, SD
    Minnehaha, SD
    7800 South Bend, IN0.9993
    St. Joseph, IN
    7840 Spokane, WA1.0668
    Spokane, WA
    7880 Springfield, IL0.8676
    Menard, IL
    Sangamon, IL
    7920 Springfield, MO0.8567
    Christian, MO
    Greene, MO
    Webster, MO
    8003 2 Springfield, MA1.1454
    Hampden, MA
    Hampshire, MA
    8050 State College, PA0.9133
    Centre, PA
    8080 2 Steubenville-Weirton, OH-WV (OH Hospitals)0.8668
    Jefferson, OH
    Brooke, WV
    Hancock, WV
    8080 Steubenville-Weirton, OH-WV (WV Hospitals)0.8637
    Jefferson, OH
    Brooke, WV
    Hancock, WV
    8120 Stockton-Lodi, CA1.0988
    San Joaquin, CA
    8140 2 Sumter, SC0.8512
    Sumter, SC
    8160 Syracuse, NY0.9621
    Cayuga, NY
    Madison, NY
    Onondaga, NY
    Oswego, NY
    8200 Tacoma, WA1.1616
    Pierce, WA
    8240 2 Tallahassee, FL0.8794
    Gadsden, FL
    Leon, FL
    8280 1 Tampa-St. Petersburg-Clearwater, FL0.8925
    Hernando, FL
    Hillsborough, FL
    Pasco, FL
    Pinellas, FL
    8320 2 Terre Haute, IN0.8721
    Clay, IN
    Vermillion, IN
    Vigo, IN
    8360 Texarkana,AR-Texarkana, TX0.8327
    Miller, AR
    Bowie, TX
    8400 Toledo, OH0.9809
    Fulton, OH
    Lucas, OH
    Wood, OH
    8440 Topeka, KS0.8912
    Shawnee, KS
    8480  Trenton, NJ1.0416
    Mercer, NJ
    8520 Tucson, AZ0.8976
    Pima, AZ
    8560 Tulsa, OK0.8902
    Creek, OK
    Osage, OK
    Rogers, OK
    Tulsa, OK
    Wagoner, OK
    8600 Tuscaloosa, AL0.8171
    Tuscaloosa, AL
    8640 Tyler, TX0.9641
    Smith, TX
    8680 2 Utica-Rome, NY0.8547
    Herkimer, NY
    Oneida, NY
    8720 Vallejo-Fairfield-Napa, CA1.3562
    Napa, CA
    Solano, CA
    8735 Ventura, CA1.0994
    Ventura, CA
    8750 Victoria, TX0.8328
    Victoria, TX
    8760 Vineland-Millville-Bridgeton, NJ1.0441
    Cumberland, NJ
    8780 2 Visalia-Tulare-Porterville, CA0.9659
    Tulare, CA
    8800 Waco, TX0.8150
    McLennan, TX
    8840 1 Washington, DC-MD-VA-WV1.0962
    District of Columbia, DC
    Calvert, MD
    Charles, MD
    Frederick, MD
    Montgomery, MD
    Prince Georges, MD
    Alexandria City, VA
    Start Printed Page 60124
    Arlington, VA
    Clarke, VA
    Culpeper, VA
    Fairfax, VA
    Fairfax City, VA
    Falls Church City, VA
    Fauquier, VA
    Fredericksburg City, VA
    King George, VA
    Loudoun, VA
    Manassas City, VA
    Manassas Park City, VA
    Prince William, VA
    Spotsylvania, VA
    Stafford, VA
    Warren, VA
    Berkeley, WV
    Jefferson, WV
    8920 Waterloo-Cedar Falls, IA0.8677
    Black Hawk, IA
    8940 Wausau, WI0.9696
    Marathon, WI
    8960 1 West Palm Beach-Boca Raton, FL0.9777
    Palm Beach, FL
    9000 2 Wheeling, WV-OH (WV Hospitals)0.8067
    Belmont, OH
    Marshall, WV
    Ohio, WV
    9000 2 Wheeling, WV-OH (OH Hospitals)0.8668
    Belmont, OH
    Marshall, WV
    Ohio, WV
    9040 Wichita, KS0.9606
    Butler, KS
    Harvey, KS
    Sedgwick, KS
    9080 Wichita Falls, TX0.7946
    Archer, TX
    Wichita, TX
    9140 Williamsport, PA0.8628
    Lycoming, PA
    9160 Wilmington-Newark, DE-MD1.0877
    New Castle, DE
    Cecil, MD
    9200 Wilmington, NC0.9409
    New Hanover, NC
    Brunswick, NC
    9260 Yakima, WA1.0567
    Yakima, WA
    9270 Yolo, CA0.9701
    Yolo, CA
    9280 York, PA0.9441
    York, PA
    9320 Youngstown-Warren, OH0.9563
    Columbiana, OH
    Mahoning, OH
    Trumbull, OH
    9340 Yuba City, CA1.0359
    Sutter, CA
    Yuba, CA
    9360 Yuma, AZ0.8989
    Yuma, AZ
    1 Large Urban Area
    2 Hospitals geographically located in the area are assigned the statewide rural wage index for FY 2002.

    Addemdum I.—Wage Index for Rural Areas

    Nonurban AreaWage Index
    Alabama0.7400
    Alaska1.1862
    Arizona0.8681
    Arkansas0.7489
    California0.9659
    Colorado0.8811
    Connecticut1.2077
    Delaware0.9589
    Florida0.8794
    Georgia0.8295
    Hawaii1.1112
    Idaho0.8718
    Illinois0.8053
    Indiana0.8721
    Iowa0.8147
    Kansas0.7812
    Kentucky0.7963
    Louisiana0.7692
    Maine0.8721
    Maryland0.8859
    Massachusetts1.1454
    Michigan0.9000
    Minnesota0.9035
    Mississippi0.7528
    Missouri0.7899
    Montana0.8655
    Nebraska0.8142
    Nevada0.9727
    New Hampshire0.9779
    New Jersey 1
    New Mexico0.8676
    New York0.8547
    North Carolina0.8535
    North Dakota0.7879
    Ohio0.8668
    Oklahoma0.7566
    Oregon1.0038
    Pennsylvania0.8607
    Puerto Rico0.4832
    Rhode Island 1
    South Carolina0.8512
    South Dakota0.7861
    Tennessee0.7928
    Texas0.7714
    Utah0.9051
    Vermont0.9608
    Virginia0.8241
    Washington1.0209
    West Virginia0.8067
    Wisconsin0.9068
    Wyoming0.8747
    1 All counties within the State are classified as urban.

    Addendum J.—Wage Index for Hospitals That are Rreclassified

    AreaWage Index
    Abilene, TX0.7983
    Akron, OH0.9876
    Albany, GA1.0640
    Albuquerque, NM0.9750
    Alexandria, LA0.8059
    Allentown-Bethlehem-Easton, PA1.0077
    Altoona, PA0.9126
    Amarillo, TX0.8502
    Anchorage, AK1.2696
    Ann Arbor, MI1.1098
    Anniston, AL0.7841
    Asheville, NC0.9200
    Athens, GA0.9706
    Atlanta, GA1.0058
    Augusta-Aiken, GA-SC0.9970
    Austin-San Marcos, TX0.9597
    Barnstable-Yarmouth, MA1.3423
    Baton Rouge, LA0.8149
    Bellingham, WA1.1296
    Benton Harbor, MI0.9000
    Bergen-Passaic, NJ1.1808
    Billings, MT0.9352
    Biloxi-Gulfport-Pascagoula, MS0.8105
    Binghamton, NY0.8607
    Birmingham, AL0.8808
    Bismarck, ND0.7984
    Boston-Worcester-Lawrence-Lowell-Brockton, MA-NH1.1293
    Burlington, VT (VT Hospitals)0.9608
    Burlington, VT (NY Hospitals)0.9606
    Caguas, PR0.4832
    Casper, WY0.9346
    Champaign-Urbana, IL0.9140
    Charleston-North Charleston, SC0.9206
    Charleston, WV0.8902
    Charlotte-Gastonia-Rock Hill, NC-SC0.9407
    Chattanooga, TN-GA0.9181
    Chicago, IL1.0917
    Cincinnati, OH-KY-IN0.9473
    Clarksville-Hopkinsville, TN-KY0.8393
    Cleveland-Lorain-Elyria, OH0.9457
    Columbia, MO0.8686
    Columbia, SC0.9168
    Columbus, GA-AL0.8440
    Columbus, OH0.9565
    Corpus Christi, TX0.8238
    Dallas, TX0.9936
    Davenport-Moline-Rock Island, IA-IL0.8538
    Dayton-Springfield, OH0.9225
    Denver, CO1.0328
    Des Moines, IA0.8779
    Dothan, AL0.7988
    Dover, DE1.0003
    Duluth-Superior, MN-WI1.0284
    Eau Claire, WI0.9068
    Elkhart-Goshen, IN0.9517
    Erie, PA0.8716
    Eugene-Springfield, OR1.1006
    Fargo-Moorhead, ND-MN0.9166
    Fayetteville, NC0.8869
    Flagstaff, AZ-UT1.0105
    Flint, MI1.0810
    Florence, AL0.7889
    Florence, SC0.8722
    Fort Collins-Loveland, CO1.0045
    Ft. Lauderdale, FL1.0784
    Fort Pierce-Port St. Lucie, FL1.0114
    Fort Smith, AR-OK0.7857
    Fort Walton Beach, FL0.8828
    Fort Wayne, IN0.9203
    Forth Worth-Arlington, TX0.9394
    Gadsden, AL0.8386
    Gainesville, FL0.9481
    Grand Forks, ND-MN0.9119
    Grand Junction, CO0.9774
    Start Printed Page 60125
    Grand Rapids-Muskegon-Holland, MI0.9939
    Great Falls, MT0.9195
    Greeley, CO0.9495
    Green Bay, WI0.9357
    Greensboro-Winston-Salem-High Point, NC0.9395
    Greenville, NC0.9289
    Greenville-Spartanburg-Anderson, SC0.9217
    Harrisburg-Lebanon-Carlisle, PA0.9425
    Hartford, CT1.1571
    Hattiesburg, MS0.7528
    Hickory-Morganton-Lenoir, NC0.9367
    Honolulu, HI1.1544
    Houston, TX0.9631
    Huntington-Ashland, WV-KY-OH0.9238
    Huntsville, AL0.8696
    Indianapolis, IN0.9698
    Iowa City, IA0.9708
    Jackson, MS0.8491
    Jackson, TN0.8843
    Jacksonville, FL0.9223
    Johnson City-Kingsport-Bristol, TN-VA0.8617
    Jonesboro, AR0.8115
    Joplin, MO0.8528
    Kalamazoo-Battlecreek, MI1.0471
    Kansas City, KS-MO0.9536
    Knoxville, TN0.8890
    Kokomo, IN0.9184
    Lafayette, LA0.8395
    Lansing-East Lansing, MI0.9653
    Las Vegas, NV-AZ1.1182
    Lawton, OK0.8281
    Lexington, KY0.8641
    Lima, OH0.9470
    Lincoln, NE0.9843
    Little Rock-North Little Rock, AR0.8800
    Longview-Marshall, TX0.8571
    Los Angeles-Long Beach, CA1.1961
    Louisville, KY-IN0.9416
    Lubbock, TX0.8463
    Lynchburg, VA0.8795
    Macon, GA0.8971
    Madison, WI1.0367
    Mansfield, OH0.8726
    Medford-Ashland, OR1.0033
    Memphis, TN-AR-MS0.8793
    Miami, FL0.9950
    Milwaukee-Waukesha, WI0.9865
    Minneapolis-St. Paul, MN-WI1.0930
    Missoula, MT0.9177
    Mobile, AL0.8084
    Modesto, CA1.0820
    Monmouth-Ocean, NJ1.1257
    Monroe, LA0.8097
    Montgomery, AL0.7400
    Myrtle Beach, SC0.8577
    Nashville, TN0.9552
    New Haven-Bridgeport-Stamford-Waterbury-Danbury, CT1.2294
    New London-Norwich, CT1.1526
    New Orleans, LA0.9036
    New York, NY1.4287
    Newark, NJ1.1622
    Newburgh, NY-PA1.0797
    Oakland, CA1.5319
    Odessa-Midland, TX0.9495
    Oklahoma City, OK0.8694
    Omaha, NE-IA0.9712
    Orange County, CA1.1246
    Orlando, FL0.9642
    Peoria-Pekin, IL0.8773
    Philadelphia, PA-NJ1.0947
    Pine Bluff, AR0.7895
    Pittsburgh, PA0.9419
    Pittsfield, MA0.9904
    Pocatello, ID0.9159
    Portland, ME0.9427
    Portland-Vancouver, OR-WA1.1150
    Provo-Orem, UT0.9843
    Raleigh-Durham-Chapel Hill, NC0.9818
    Rapid City, SD0.8869
    Reading, PA0.9216
    Redding, CA1.1155
    Reno, NV1.0421
    Richland-Kennewick-Pasco, WA1.0356
    Richmond-Petersburg, VA0.9678
    Roanoke, VA0.8371
    Rochester, MN1.1462
    Rockford, IL0.9042
    Sacramento, CA1.1831
    Saginaw-Bay City-Midland, MI0.9590
    St. Cloud, MN0.9919
    St. Joseph, MO0.8121
    St. Louis, MO-IL0.8931
    Salinas, CA1.4570
    Salt Lake City-Ogden, UT0.9863
    San Diego, CA1.1265
    Santa Fe, NM0.9765
    Santa Rosa, CA1.2631
    Sarasota-Bradenton, FL1.0090
    Savannah, GA0.9243
    Seattle-Bellevue-Everett, WA1.1361
    Sherman-Denison, TX0.9003
    Shreveport-Bossier City, LA0.9050
    Sioux City, IA-NE0.8767
    Sioux Falls, SD0.8939
    South Bend, IN0.9993
    Spokane, WA1.0668
    Springfield, IL0.8571
    Springfield, MO0.8357
    Stockton-Lodi, CA1.0988
    Syracuse, NY0.9621
    Tampa-St. Petersburg-Clearwater, FL0.8925
    Texarkana,AR-Texarkana, TX0.8327
    Toledo, OH0.9809
    Topeka, KS0.8749
    Tucson, AZ0.8976
    Tulsa, OK0.8760
    Tuscaloosa, AL0.8171
    Tyler, TX0.9359
    Victoria, TX0.8328
    Waco, TX0.8150
    Washington, DC-MD-VA-WV1.0854
    Waterloo-Cedar Falls, IA0.8677
    Wausau, WI0.9558
    West Palm Beach-Boca Raton, FL0.9777
    Wichita, KS0.9237
    Wichita Falls, TX0.7946
    Wilmington-Newark, DE-MD1.0877
    Rural Alabama0.7528
    Rural Florida0.8794
    Rural Illinois (IA Hospitals)0.8147
    Rural Illinois (MO Hospitals)0.8053
    Rural Kentucky0.7963
    Rural Louisiana0.7692
    Rural Minnesota0.9035
    Rural Missouri0.7899
    Rural Montana0.8655
    Rural Nebraska0.8142
    Rural Nevada0.9161
    Rural Oregon1.0038
    Rural Texas0.7714
    Rural Washington1.0209
    Rural Wisconsin0.9068
    Rural Wyoming0.8747
    End Supplemental Information

    [FR Doc. 01-29621 Filed 11-29-01; 8:45 am]

    BILLING CODE 4120-01-P

Document Information

Effective Date:
1/1/2002
Published:
11/30/2001
Department:
Centers for Medicare & Medicaid Services
Entry Type:
Rule
Action:
Final rule.
Document Number:
01-29621
Dates:
This final rule is effective January 1, 2002 and is applicable to services furnished on or after January 1, 2002.
Pages:
59855-60125 (271 pages)
Docket Numbers:
CMS-1159-F2
RINs:
0938-AK54
Topics:
Health facilities, Hospitals, Kidney diseases, Medicare, Puerto Rico, Reporting and recordkeeping requirements
PDF File:
01-29621.pdf
CFR: (12)
42 CFR 413.24
42 CFR 413.65
42 CFR 419.2
42 CFR 419.20
42 CFR 419.22
More ...